ABSTRACT
Purpose: To describe the clinical profile and demographic distribution of band-shaped keratopathy (BSK) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,664,906 new patients presenting between January 2011 and January 2021 (10-year period). Patients with a clinical diagnosis of BSK in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 8801 (0.33%) patients were diagnosed with BSK. The prevalence rates were 0.47% in children (age: <16 years) and 0.31% in adults. The majority of patients were males (62.87%) with unilateral affliction (85.21%). The mean age of the patients was 40.43 ± 23.14 years. The majority (16.93%) of the patients were in the age bracket of 11-20 years. A larger proportion of the patients were from higher socioeconomic status (60.46%) and the urban region (45.9%). Of the 10,103 eyes affected with BSK, the common ocular comorbidities were status post-vitreoretinal surgery (20.55%) and uveitis (12.7%) in children and corneal scar (41.23%) and spheroidal degeneration (13.7%) in adults. Most of the eyes had mild or no visual impairment (24.74%). Among the eyes that needed surgical intervention, chelation with ethylenediaminetetraacetic acid (EDTA) was the most performed surgical procedure (1.68%) along with phototherapeutic keratectomy (0.32%). Conclusion: BSK commonly affects adult males and is unilateral in nature. The majority of the patients in this cohort belonged to higher socioeconomic strata and urban geography. At initial presentation, visual impairment was mild to moderate in a vast majority of the patients, and the most common surgical intervention performed was chelation with EDTA during the study period.
Subject(s)
Corneal Dystrophies, Hereditary , Vision, Low , Adolescent , Adult , Chelating Agents/therapeutic use , Child , Corneal Dystrophies, Hereditary/diagnosis , Cross-Sectional Studies , Demography , Edetic Acid/therapeutic use , Female , Humans , Male , Middle Aged , Retrospective Studies , Vision, Low/drug therapy , Visual Acuity , Young AdultABSTRACT
A 68-year-old man presented with diminution of distance and near vision in the right eye for a duration of 1 month postblunt trauma with a stick. On examination, his visual acuity in the right eye was 20/320 and near vision was Subject(s)
Central Serous Chorioretinopathy/diagnosis
, Eye Injuries/complications
, Iridocyclitis/diagnosis
, Retinal Detachment/diagnosis
, Vision, Low/diagnosis
, Wounds, Nonpenetrating/complications
, Administration, Ophthalmic
, Aged
, Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
, Central Serous Chorioretinopathy/drug therapy
, Central Serous Chorioretinopathy/etiology
, Fluorescein Angiography
, Fovea Centralis/diagnostic imaging
, Fovea Centralis/pathology
, Humans
, Iridocyclitis/drug therapy
, Iridocyclitis/etiology
, Male
, Mydriatics/administration & dosage
, Retinal Detachment/drug therapy
, Retinal Detachment/etiology
, Retinal Pigment Epithelium/diagnostic imaging
, Retinal Pigment Epithelium/pathology
, Subretinal Fluid/diagnostic imaging
, Tomography, Optical Coherence
, Treatment Outcome
, Vision, Low/drug therapy
, Vision, Low/etiology
, Visual Acuity
Subject(s)
Adrenal Gland Neoplasms/complications , Pheochromocytoma/complications , Retinal Artery Occlusion/etiology , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Retinal Artery Occlusion/drug therapy , Tomography, Optical Coherence , Vision, Low/drug therapy , Vision, Low/etiology , Visual AcuitySubject(s)
Diabetes Mellitus, Type 1/genetics , Vision, Low/genetics , Wolfram Syndrome/genetics , Biphasic Insulins/therapeutic use , Child , Diabetes Mellitus, Type 1/drug therapy , Frameshift Mutation/genetics , Homozygote , Humans , Hypoglycemic Agents/therapeutic use , Male , Membrane Proteins/genetics , Treatment Outcome , Vision, Low/drug therapy , Wolfram Syndrome/drug therapyABSTRACT
We reported uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus with pulmonary arterial hypertension. Choroidal retinopathy is rare but extremely destructive to visual function. Therefore, prompt diagnosis and effective treatments will result in complete resolution of the uveal effusion and functional restoration of vision.
Subject(s)
Choroid Diseases/diagnosis , Hypertension, Pulmonary/etiology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Myopia/diagnosis , Myopia/etiology , Uvea/pathology , Adult , Antibodies, Antinuclear/blood , Antirheumatic Agents/therapeutic use , Choroid/diagnostic imaging , Choroid/pathology , Choroid Diseases/drug therapy , Choroid Diseases/etiology , Ciliary Body/diagnostic imaging , Ciliary Body/pathology , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Hypertension, Pulmonary/drug therapy , Hypertrophy, Right Ventricular/diagnostic imaging , Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/drug therapy , Microscopy, Acoustic , Myopia/drug therapy , Prednisone/therapeutic use , Quality of Life , Raynaud Disease/complications , Retina/diagnostic imaging , Retina/pathology , Retinal Detachment/diagnostic imaging , Retinal Detachment/drug therapy , Retinal Detachment/etiology , Tomography, Optical Coherence , Treatment Outcome , Vision, Low/drug therapy , Vision, Low/etiologyABSTRACT
Central retinal artery occlusion (CRAO) is uncommon among children and young adults. Bilateral CRAO before the age of 18 years are extremely rare. We present a case of an idiopathic bilateral CRAO in a young healthy female.
Subject(s)
Blindness/diagnosis , Retinal Artery Occlusion/diagnosis , Vision, Low/diagnosis , Adolescent , Blindness/drug therapy , Blindness/physiopathology , Enzyme Inhibitors/therapeutic use , Female , Fibrinolytic Agents/therapeutic use , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Magnetic Resonance Imaging , Methylprednisolone/therapeutic use , Mycophenolic Acid/therapeutic use , Retinal Artery Occlusion/drug therapy , Retinal Artery Occlusion/physiopathology , Tissue Plasminogen Activator/therapeutic use , Tomography, Optical Coherence , Vision, Low/drug therapy , Vision, Low/physiopathology , Visual Acuity/physiologySubject(s)
Optic Atrophy, Hereditary, Leber/diagnostic imaging , Optic Atrophy, Hereditary, Leber/genetics , Vision, Low/diagnostic imaging , Vision, Low/genetics , Antioxidants/therapeutic use , Child , Humans , Male , Optic Atrophy, Hereditary, Leber/drug therapy , Ubiquinone/analogs & derivatives , Ubiquinone/therapeutic use , Vision, Low/drug therapySubject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis , Retinal Hemorrhage/etiology , Tomography, Optical Coherence , Vision Disorders/etiology , Vision, Binocular , Vision, Low/etiology , Adolescent , Emergency Service, Hospital , Fundus Oculi , Humans , Imatinib Mesylate/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Male , Retinal Hemorrhage/diagnostic imaging , Retinal Hemorrhage/drug therapy , Vision Disorders/drug therapy , Vision, Binocular/drug effects , Vision, Low/drug therapySubject(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
Susac syndrome (SS) is a rare retinal-cochlear-cerebral disease with an unclear etiology. A 35-year-old man presented with sudden painless vision loss in the right eye and 2 months later in the left eye with hemiparesis, behavioral changes, and hearing loss. Ophthalmic examinations revealed multiple branch retinal artery occlusions (BRAOs) in both eyes. Brain magnetic resonance imaging showed inflammatory changes with multiple "punched-out" lesions in the corpus callosum which confirmed the diagnosis of SS. Despite intravenous and oral corticosteroid therapy, the disease progressed with the development of new BRAOs, low vision in both eyes, and disability. Prompt diagnosis and early treatment may save the vision and even patient's life.
Subject(s)
Susac Syndrome/diagnosis , Vision, Low/diagnosis , Visually Impaired Persons , Administration, Oral , Adult , Disability Evaluation , Disease Progression , Drug Combinations , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Injections, Intravenous , Magnetic Resonance Imaging , Male , Methylprednisolone/therapeutic use , Prednisolone/therapeutic use , Retinal Artery Occlusion/diagnosis , Retinal Artery Occlusion/drug therapy , Susac Syndrome/drug therapy , Vision, Low/drug therapyABSTRACT
BACKGROUND: Patients with initially low visual acuity were excluded from the therapy approval studies for retinal vein occlusion. But up to 28 % of patients presenting with central retinal vein occlusion have a baseline BCVA of less than 34 ETDRS letters (0.1). The purpose of our study was to assess visual acuity and central retinal thickness in patients suffering from central retinal vein occlusion and low visual acuity (<0.1) in comparison to patients with visual acuity (≥0.1) treated with Dexamethasone implant 0.7 mg for macular edema. METHODS: Retrospective, controlled observational case study of 30 eyes with macular edema secondary to central retinal vein occlusion, which were treated with a dexamethasone implantation. Visual acuity, central retinal thickness and intraocular pressure were measured monthly. Analyses were performed separately for eyes with visual acuity <0.1 and ≥0.1. RESULTS: Two months post intervention, visual acuity improved only marginally from 0.05 to 0.07 (1 month; p = 0,065) and to 0.08 (2 months; p = 0,2) in patients with low visual acuity as compared to patients with visual acuity ≥0.1 with an improvement from 0.33 to 0.47 (1 month; p = 0,005) and to 0.49 (2 months; p = 0,003). The central retinal thickness, however, was reduced in both groups, falling from 694 to 344 µm (1 month; p = 0.003,) to 361 µm (2 months; p = 0,002) and to 415 µm (3 months; p = 0,004) in the low visual acuity group and from 634 to 315 µm (1 month; p < 0,001) and to 343 µm (2 months; p = 0,001) in the visual acuity group ≥0.1. Absence of visual acuity improvement was related to macular ischemia. CONCLUSIONS: In patients with central retinal vein occlusion and initially low visual acuity, a dexamethasone implantation can lead to an important reduction of central retinal thickness but may be of limited use to increase visual acuity.
Subject(s)
Dexamethasone/administration & dosage , Glucocorticoids/administration & dosage , Retinal Vein Occlusion/drug therapy , Vision, Low/drug therapy , Aged , Aged, 80 and over , Case-Control Studies , Drug Implants , Female , Humans , Intravitreal Injections , Male , Middle Aged , Retina/pathology , Retinal Vein Occlusion/complications , Retinal Vein Occlusion/physiopathology , Retrospective Studies , Vision, Low/etiology , Visual Acuity/physiologySubject(s)
Cognitive Dysfunction/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Retinal Vasculitis/diagnosis , Vision, Low/diagnosis , Adult , Antibiotics, Antineoplastic/therapeutic use , Cognitive Dysfunction/drug therapy , Cyclosporine/therapeutic use , Drug Therapy, Combination , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Infusions, Intravenous , Lupus Erythematosus, Systemic/drug therapy , Male , Methylprednisolone/therapeutic use , Mycophenolic Acid/therapeutic use , Retinal Vasculitis/drug therapy , Vision, Low/drug therapy , Visual AcuityABSTRACT
BACKGROUND: Visual loss can be encountered in the immediate, early, or even delayed postoperative period after resection of skull base meningiomas involving the optic apparatus. Various mechanisms for visual loss can include mechanical injury, vascular insult, optic nerve and chiasm edema, and vasospasm of the blood supply to the visual apparatus. CASE DESCRIPTION: In this article, we describe a patient who developed unilateral visual worsening in the early postoperative period after skull base resection of a sphenoclinoidocavernous meningioma that was compressing the ipsilateral optic nerve. After implementing hyperdynamic therapy and high-dose corticosteroids, catheter angiography showed severe vasospasm of the ipsilateral ophthalmic artery with delayed filling of the choroidal blush. Intra-arterial chemical angioplasty with verapamil was administered that resulted in angiographic improvement and clinical restoration of vision back to preoperative baseline. Vision remained stable in the postoperative course and continued to improve after discharge from the hospital. CONCLUSIONS: To our knowledge, this is the first report of successful reversal of postoperative unilateral visual loss related to vasospasm after resection of a skull base sphenoclinoidocavernous meningioma. This may be a useful strategy to diagnose and treat possible vasospasm-induced visual loss after resection of skull base meningiomas involving the optic apparatus.
Subject(s)
Neurosurgical Procedures/adverse effects , Postoperative Complications/drug therapy , Vasodilator Agents/therapeutic use , Vasospasm, Intracranial/drug therapy , Verapamil/therapeutic use , Vision, Low/drug therapy , Adrenal Cortex Hormones/therapeutic use , Female , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Meningeal Neoplasms/diagnostic imaging , Meningeal Neoplasms/therapy , Meningioma/diagnostic imaging , Meningioma/therapy , Middle Aged , Postoperative Complications/etiology , Skull Base/surgery , Sphenoid Bone/surgery , Treatment Outcome , Vasospasm, Intracranial/etiology , Vision, Low/etiologyABSTRACT
UNLABELLED: Punctate Inner Choroidopathy (PIC) is a rare idiopathic ocular inflammatory disease. It occurs mostly in young, myopic, otherwise healthy women. Symptoms of the disease include acute vision decrease associated with central and paracentral scotoma. In 80% of cases PIC occur bilaterally. We report the case of a woman at the age of twenty-five, who was treated for PIC. Due to the finding of active inflammatory deposit in the retina of the left eye and low visual acuity was recommended corticosteroid therapy with a good therapeutic effect. KEY WORDS: Punctate Inner Choroidopathy (PIC), white dot syndromes.
Subject(s)
Chorioretinitis/complications , Adult , Chorioretinitis/diagnosis , Chorioretinitis/drug therapy , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Scotoma/diagnosis , Scotoma/drug therapy , Vision, Low/diagnosis , Vision, Low/drug therapy , Visual AcuitySubject(s)
Posterior Eye Segment/pathology , Scleritis/diagnosis , Vision, Low/diagnosis , Administration, Oral , Female , Glucocorticoids/therapeutic use , Humans , Immunoglobulin M/blood , Posterior Eye Segment/drug effects , Prednisolone/therapeutic use , Rheumatoid Factor/immunology , Scleritis/drug therapy , Vision, Low/drug therapy , Young AdultSubject(s)
Angiogenesis Inhibitors/therapeutic use , Diabetic Retinopathy/drug therapy , Macular Edema/drug therapy , Quality of Life , Ranibizumab/therapeutic use , Vision, Low/drug therapy , Health Status Indicators , Humans , Longitudinal Studies , Macular Edema/etiology , Prospective Studies , Treatment Outcome , Vision, Low/etiologyABSTRACT
Overall, VEGF inhibitors administered by intravitreal injection have a similar harm-benefit balance. However, a publicly funded trial has shown that aflibercept is more effective than ranibizumab and bevacizumab in patients with marked loss of visual acuity.
Subject(s)
Diabetic Retinopathy/drug therapy , Macular Edema/drug therapy , Receptors, Vascular Endothelial Growth Factor/adverse effects , Recombinant Fusion Proteins/adverse effects , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vision, Low/drug therapy , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/adverse effects , Antibodies, Monoclonal, Humanized/therapeutic use , Bevacizumab , Diabetic Retinopathy/complications , Humans , Macular Edema/etiology , Randomized Controlled Trials as Topic , Ranibizumab , Receptors, Vascular Endothelial Growth Factor/administration & dosage , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Recombinant Fusion Proteins/administration & dosage , Recombinant Fusion Proteins/therapeutic use , Vision, Low/etiology , Visual Acuity/drug effectsABSTRACT
Background Various pathophysiological mechanisms such as microvascular and endothelial dysfunction, small vessel disease, diffuse atherosclerosis, and inflammation have been held responsible in the etiology of coronary slow flow. It is also thought to be a reflection of a systemic slow-flow phenomenon in the coronary arterial tree. Case Report A 44-year-old man presented with chest pain causing fatigue, together with blurred vision for the last 2 years, which disappeared after resting. He had used corticosteroid therapy for facial paralysis 1 month ago. Coronary slow flow was detected in all 3 major coronary arteries on coronary angiography. TIMI measurements for the left anterior descending artery, circumflex, and right coronary artery were 64, 72, and 55, respectively. In fundus fluorescein angiography, retinal vascularity was normal, the arm-to-retina circulation time was 21.8 s, and the arteriovenous transit time was 4.3 s. In the early arteriovenous phase, choroidal filling was long, with physiological patchy type. Diltiazem 90 mg/day and acetylsalicylic acid 100 mg/day were given. His chest pain and visual symptoms disappeared after medical treatment. Conclusions Physicians should be aware that glucocorticoids might cause an increase in the symptoms of coronary slow flow and some circulation problems, which might lead to systematic symptoms.
Subject(s)
Atherosclerosis/complications , Blood Flow Velocity/physiology , Coronary Circulation/physiology , Coronary Vessels/physiopathology , Desoxycorticosterone/therapeutic use , Microvascular Angina/physiopathology , Vision, Low/physiopathology , Adult , Atherosclerosis/diagnosis , Atherosclerosis/drug therapy , Blood Flow Velocity/drug effects , Coronary Angiography , Coronary Circulation/drug effects , Coronary Vessels/drug effects , Glucocorticoids/therapeutic use , Humans , Male , Microvascular Angina/drug therapy , Microvascular Angina/etiology , Vision, Low/drug therapy , Vision, Low/etiologyABSTRACT
PURPOSE: To assess the effect of anti-vascular endothelial growth factor treatment on visual acuity outcome in patients with neovascular age-related macular degeneration presenting with very low vision. METHODS: Retrospective analysis of electronic patient care record of 420 eyes treated with ranibizumab between March 2010 and June 2013. The authors classified the extracted sample into 3 categories based on the initial best-corrected visual acuity (BCVA) as measured on the Early Treatment Diabetic Retinopathy Study charts: 0 to 35 letters, 36 to 69 letters, and ≥ 70 letters. Best BCVA achieved in Year 1, and average BCVA over 36 months was computed. The neovascular lesion type, area of lesion, the presence or absence of hemorrhage, retinal pigment epithelium tear, and atrophy were systematically graded as was extent of fibrosis on a categorical scale of 0 to 4. Regression analysis was performed with the best BCVA achieved in Year 1 as the outcome variable and initial BCVA, person, and lesion characteristics as explanatory variables. RESULTS: The mean change in BCVA from the initial visit to the best-attained BCVA during Year 1 was highly statistically significant with an improvement of 9.95 letters. The improvement from initial BCVA to average BCVA over 36 months was 4.01 letters. Regression analysis identified atrophy and fibrosis as predictors of best BCVA, with the model having an r of 0.71. CONCLUSION: Our study supports the use of anti-vascular endothelial growth factor agents even in eyes with low visual acuity particularly when fibrosis and atrophy are absent and suggests algorithms to predict outcome for combinations of visual acuity and lesion characteristics across the full visual acuity range.