RESUMEN
PURPOSE: To report a case of strabismus in a five-week-old infant, likely secondary to a rare occurrence of congenitally acquired ocular toxocariasis. METHODS: Retrospective case report. RESULTS: A five-week-old male infant with left exotropia was referred to pediatric ophthalmology and to a vitreoretinal specialist. Fundoscopic examination revealed a granuloma with associated retinal folds and tractional retinal detachment typical for ocular toxocariasis. Serology revealed positivity for Toxocara antibodies, consistent with the clinical diagnosis of ocular toxocariasis. CONCLUSION: Ocular toxocariasis is typically thought to be secondary to acquired Toxocara infection secondary to fecal-oral transmission. In this case of early-onset strabismus secondary to ocular toxocariasis, it is hypothesized that this is a presentation of congenitally acquired toxocariasis.
Asunto(s)
Infecciones Parasitarias del Ojo/congénito , Transmisión Vertical de Enfermedad Infecciosa , Enfermedades de la Retina/congénito , Toxocariasis/congénito , Animales , Anticuerpos Antihelmínticos/sangre , Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/transmisión , Humanos , Lactante , Masculino , Enfermedades de la Retina/diagnóstico , Estudios Retrospectivos , Estrabismo/congénito , Estrabismo/diagnóstico , Toxocara/inmunología , Toxocariasis/diagnóstico , Toxocariasis/transmisiónRESUMEN
PURPOSE: To report a novel presentation of dyskeratosis congenita masquerading as familial exudative vitreoretinopathy. METHODS: Observational case series involving single family and literature review. RESULTS: A brother and sister were diagnosed with familial exudative vitreoretinopathy at ages 4 and 2, respectively. Both patients were managed with laser photocoagulation. Eight years after the initial presentation, both siblings developed pancytopenia secondary to bone marrow failure. Laboratory work-up revealed severely shortened telomere length in both patients, and genetic testing revealed a missense mutation in the gene that encodes the reverse transcriptase component of telomerase, confirming the diagnosis of dyskeratosis congenita. The father of both children was a carrier of the same mutation, who exhibited marked retinal vascular tortuosity of the second-order vessels. CONCLUSION: Dyskeratosis congenita is a severe multisystem disorder, which should be considered in cases of pediatric exudative retinopathies with concurrent signs and/or symptoms of bone marrow failure.
Asunto(s)
Enfermedades Óseas Metabólicas/diagnóstico , Médula Ósea/anomalías , Disqueratosis Congénita/complicaciones , Enfermedades de la Retina/diagnóstico , Telangiectasia Retiniana/diagnóstico , Preescolar , Diagnóstico Diferencial , Enfermedades Hereditarias del Ojo , Vitreorretinopatías Exudativas Familiares , Femenino , Humanos , Masculino , RetinaRESUMEN
We report the vitreous concentration of bevacizumab after injection for the treatment of retinopathy of prematurity (ROP). A premature neonate diagnosed with type 1 ROP was treated in both eyes with 0.625 mg intravitreal bevacizumab injection at 32 weeks' postconceptual age. Eleven weeks later there was complete regression clinically, but the patient died. Vitreous samples taken at autopsy revealed a bevacizumab vitreous concentration of 41.57 ng/ml. Histopathology of the retina showed residual preretinal neovascularization. Bevacizumab elimination from the infant vitreous is similar to that of adults, and, although complete regression was clinically apparent, it was not confirmed histopathologically.
Asunto(s)
Bevacizumab/análisis , Retinopatía de la Prematuridad , Cuerpo Vítreo/química , Inhibidores de la Angiogénesis , Anticuerpos Monoclonales Humanizados , Edad Gestacional , Humanos , Lactante , Recién Nacido , Inyecciones Intravítreas , Factor A de Crecimiento Endotelial VascularAsunto(s)
Oxigenoterapia Hiperbárica/efectos adversos , Edema Macular/etiología , Anciano , Aneurisma Roto/complicaciones , Aneurisma Roto/terapia , Inhibidores de la Angiogénesis/uso terapéutico , Femenino , Angiografía con Fluoresceína , Humanos , Edema Macular/diagnóstico por imagen , Edema Macular/tratamiento farmacológico , Ranibizumab/uso terapéutico , Arteria Retiniana/patología , Enfermedades de la Retina/complicaciones , Enfermedades de la Retina/terapia , Tomografía de Coherencia Óptica , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidoresRESUMEN
Purpose. To evaluate potential risk factors for developing tube shunt exposure in glaucoma patients. Patients and Methods. Forty-one cases from 41 patients that had tube shunt exposure from 1996 to 2005 were identified from the Robert Cizik Eye Clinic and Bascom Palmer Eye Institute. Each case was matched with 2 controls of the same gender and with tube shunts implanted within 6 months of the index case. Conditional logistic regression was used to determine risk factors. Results. The study cohort includes a total of 121 eyes from 121 patients. The mean age was 63.6 ± 19.7 years, ranging from 1 to 96 years. The average time to exposure was 19.29 ± 23.75 months (range 0.36-85.74 months). Risk factors associated with tube exposure were Hispanic ethnicity (P = 0.0115; OR = 3.6; 95% CI, 1.3-9.7), neovascular glaucoma (P = 0.0064; OR = 28.5; 95% CI, 2.6-316.9), previous trabeculectomy (P = 0.0070; OR = 5.3; 95% CI, 1.6-17.7), and combined surgery (P = 0.0381; OR = 3.7; 95% CI, 1.1-12.7). Conclusions. Hispanic ethnicity, neovascular glaucoma, previous trabeculectomy, and combined surgery were identified as potential risk factors for tube shunt exposure. These potential risk factors should be considered when determining the indication for performing tube shunt implantation and the frequency of long-term followup.