RESUMEN
The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.
Asunto(s)
Betacoronavirus , Consenso , Infecciones por Coronavirus/epidemiología , Oftalmopatías/terapia , Pandemias , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/normas , Citas y Horarios , COVID-19 , Humanos , Examen Físico , Consulta Remota , Enfermedades de la Retina/terapia , SARS-CoV-2 , Triaje , Enfermedades de la Úvea/terapia , Cuerpo Vítreo/patologíaRESUMEN
A 58-year-old man, a known diabetic and hypertensive for 5 years was presented to us with a drop in reading vision in both eyes of 2 months duration. His best-corrected visual acuity was 6/24, N36 in both eyes. Fundus findings revealed moderate non-proliferative diabetic retinopathy with bilateral diffuse macular oedema. When conventional therapy with intravitreal ranibizumab did not alter the clinical picture, we looked into the differential diagnosis of bilateral persistent macular detachments and investigated further. Haematological tests revealed severe anaemia with pancytopenia, which prompted further investigations including a bone marrow biopsy confirming a diagnosis of multiple myeloma. Chemotherapy gradually caused resolution of the macular detachments at 8 months follow-up. This report illustrates that a high index of suspicion regarding systemic condition is required in certain cases presenting as diabetic macular oedema, but not responding to the conventional treatment.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclofosfamida/uso terapéutico , Dexametasona/uso terapéutico , Retinopatía Diabética/diagnóstico por imagen , Edema Macular/diagnóstico por imagen , Mieloma Múltiple/diagnóstico por imagen , Talidomida/uso terapéutico , Trastornos de la Visión/diagnóstico por imagen , Anemia/diagnóstico , Biopsia con Aguja Gruesa , Médula Ósea/patología , Retinopatía Diabética/complicaciones , Retinopatía Diabética/fisiopatología , Diagnóstico Diferencial , Angiografía con Fluoresceína , Humanos , Edema Macular/patología , Masculino , Persona de Mediana Edad , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/tratamiento farmacológico , Mieloma Múltiple/patología , Pancitopenia/diagnóstico , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatologíaRESUMEN
Bilateral occurrence of macular hole in X-linked retinoschisis is an extremely rare event. Spectral domain optical coherence tomography (OCT) findings revealed that formation of a macular hole is secondary to the retinoschisis process alone. Bilateral macular holes should be added to the spectrum of X-linked retinoschisis variations and the retinoschisis process alone should be accounted for their formation.
Asunto(s)
Perforaciones de la Retina/genética , Perforaciones de la Retina/patología , Retinosquisis/patología , Tomografía de Coherencia Óptica , Adulto , Humanos , Masculino , Baja Visión/genética , Baja Visión/patologíaRESUMEN
We review 12 consecutive cases of pre-macular fibrosis (PMF) treated by vitreous surgical techniques. The causes of PMF included retinal detachment surgery in four patients, idiopathic in three patients, laser treatment in three patients, pars planitis in one patient and diabetic retinopathy in one patient. The membrane was successfully removed in all the patients. One patient developed a retinal detachment that was repaired successfully. All patients had improved visual acuity (VA) of two Snellen lines or more and six patients achieved VA of 6/12 or better. Patients with PMF following retinal detachment had poorer final VA.
