Subject(s)
Chorioretinitis/diagnosis , Retinal Pigment Epithelium , Virus Diseases/diagnosis , Vision, Binocular , Vision, Low/etiology , Adult , Chorioretinitis/drug therapy , Cortisone/therapeutic use , Diagnosis, Differential , Fluorescein Angiography , Follow-Up Studies , Humans , Male , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/drug therapy , Retinal Pigment Epithelium/drug effects , Syndrome , Tomography, Optical Coherence , Virus Diseases/drug therapy , Vision, Binocular/drug effects , Vision, Low/drug therapyABSTRACT
In this article, a case of recurrent epithelial defects in neurotrophic keratopathy is described. Multiple abrasions of the corneal epithelium with a therapeutic contact lens, corneal stitches, and amniotic membrane transplantation in combination with artificial tears brought only short-term success. However, a botulinum toxin A induced protective ptosis could finally achieve permanent epithelial closure. As this case shows, protective ptosis can be a promising approach in spite of multiple previous ineffective therapeutic efforts.
Subject(s)
Blepharoptosis/chemically induced , Botulinum Toxins, Type A/administration & dosage , Cornea/innervation , Corneal Diseases/therapy , Diabetic Neuropathies/therapy , Epithelium, Corneal/innervation , Polyneuropathies/therapy , Diabetes Mellitus, Type 1/complications , Eyelids/drug effects , Female , Humans , Injections , Middle Aged , Recurrence , Uveitis, Anterior/therapyABSTRACT
CASE REPORT: A 29-year-old female patient presented with a unilateral deterioration of visual acuity, metamorphopsia and a paracentral scotoma. The patient had suffered from a viral rhinitis 1 week prior to the ophthalmological symptoms. DIAGNOSTICS: Fundoscopy revealed parafoveal changes in the retinal pigment epithelium and spectral-domain optical coherence tomography (SD-OCT) disclosed corresponding hyperreflective, subretinal changes with disruption of Bruch's membrane and the outer limiting membrane. In the course of the disease there was a spontaneous regression of these changes. Visual acuity improved and the central scotoma resolved. The patient showed the typical history and clinical findings of unilateral acute idiopathic maculopathy. CONCLUSION: The most probable explanation for the patient's symptoms is an immunologically triggered adverse reaction due to a previous viral rhinitis, with participation of the retina and retinal pigment epithelium. As a rule the disease has a spontaneous and favorable course.
Subject(s)
Macula Lutea/pathology , Retinitis/diagnosis , Retinitis/etiology , Rhinitis/complications , Virus Diseases/complications , Vision Disorders/etiology , Adult , Diagnosis, Differential , Female , Humans , Prodromal Symptoms , Rhinitis/diagnosis , Virus Diseases/diagnosis , Vision Disorders/diagnosisSubject(s)
Retinal Diseases/diagnosis , Retinal Diseases/therapy , Scotoma/diagnosis , Scotoma/therapy , Tomography, Optical Coherence/methods , Visual Field Tests/methods , Acute Disease , Diagnosis, Differential , Fluorescein Angiography/methods , Humans , Male , Middle Aged , Retinal Diseases/complications , Scotoma/etiology , Treatment OutcomeABSTRACT
BACKGROUND: The healing process of corneal defects requires functioning limbus stem cells. Their loss will lead to secondary wound healing problems. Stem cell research offers new treatment options. MATERIAL AND METHODS: A Medline search of the U. S. National Library of Medicine was carried out. RESULTS: The autologous limbus stem cell transplantation is currently the treatment of choice. Amniotic membrane transplantation, previously settled with limbus stem cells, is a clinically proven method. In animal experiments bone marrow-derived mesenchymal stem cells or epidermal stem cells can be used to improve healing of corneal defects. Adipose-derived stem cells may support the regenerative ability of the cornea as well. Moreover, membrane transplantation of epithelial cells from the buccal mucosa cultivated in vitro was clinically tested. DISCUSSION AND CONCLUSIONS: Limbus stem cell failure of both eye is the limiting factor for autologous limbus stem cell transplantation. Epithelial cells, epidermal stem cells, bone marrow- or adipose-derived mesenchymal stem cells promote the regeneration of the cornea and have become established for the treatment of corneal defects. Additionally, mesenchymal stem cells offer the advantage of immunosuppressive and anti-inflammatory effects.