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Purpose: To report convergence insufficiency in a patient with Parkinson's' disease stimulated by turning on the deep brain stimulator. Observations: 72-year-old male with Parkinson's disease and hypertension presenting for the evaluation of blurry vision at near and mid distance that started after activation of an implanted Deep brain stimulator.Baseline ophthalmologic evaluation prior to deep brain stimulator implantation surgery and with the deep brain stimulator turned off demonstrated a full motility, centered eyes for distance and near and a best corrected visual acuity of 20/20, normal pupil exam, confrontational visual fields and dilated fundus exam. Following this examination, the Deep brain stimulator was turned on and re-evaluation few minutes later demonstrated the same findings except for a 6-prism diopter exotropia at near consistent with convergence insufficiency.Following our evaluation a set of +3 diopters base-in prisms were added to near glasses with total relief of symptoms. The patient did not require surgical adjustment of the deep brain stimulator leads. Conclusions and importance: Given the therapeutic effects of deep brain stimulation on convergence insufficiency reported in several studies, in addition to the influence of deep brain stimulation as Parkinson's Disease treatment in areas possibly associated with vergence control, convergence insufficiency secondary to deep brain stimulation does not seem very unlikely, although not often reported. Further studies are needed to optimize deep brain stimulation surgery to maximize benefits and limit adverse events, as well as being aware of convergence insufficiency as a possible cause for visual disturbance.
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Aim: To report the efficacy of the revision of failed ab interno canaloplasty with micro-invasive suture trabeculotomy (MIST) over a follow-up period of 24 months. Materials and methods: A retrospective analysis was performed on 23 eyes with open-angle glaucoma (OAG), on whom an ab interno canaloplasty revision with MIST was performed for glaucoma progression. The primary outcome was the proportion of eyes with a significant intraocular pressure (IOP) reduction at 12 months post trabeculotomy, defined as an IOP ≤ 18 mm Hg or ≥20% reduction in IOP without any secondary intervention (SI), and with the same or fewer number of glaucoma medications (NGM). All parameters, including best corrected visual acuity (BCVA), IOP, NGM, and SI, were evaluated at 1, 6, 12, 18, and 24 months. Results: At 12 months, eight out of 23 eyes (36.4%) achieved complete success, maintained in six eyes (27.3%) at 24 months. A significantly lower mean IOP was recorded at all visits [14.3 ± 4.0 mm Hg at 24 months vs 23.1 ± 6.8 mm Hg at baseline (BL)] with a percent IOP change of up to 27.3% at 24 months postoperatively. NGM and BCVA did not significantly decrease from BL. A total of 11 eyes (47.8%) needed an SI throughout the follow-up period. Conclusion: Ab interno trabeculotomy in patients with failed canaloplasty was not shown to be effective in providing a satisfactory control of IOP in OAG patients, possibly due to the small suture gauge used in the initial canaloplasty. Clinical significance: Further research is needed to optimize the surgical outcome. How to cite this article: Seif R, Jalbout NDE, Sadaka A, et al. Size Matters: Ab Interno Canaloplasty Revision with Suture Trabeculotomy. J Curr Glaucoma Pract 2022;16(3):152-157.
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ADN Mitocondrial/genética , Complejo IV de Transporte de Electrones/genética , Mutación , NADH Deshidrogenasa/genética , Atrofia Óptica Hereditaria de Leber/genética , Adolescente , Análisis Mutacional de ADN , Humanos , NADH Deshidrogenasa/metabolismo , Atrofia Óptica Hereditaria de Leber/metabolismo , Adulto JovenRESUMEN
BACKGROUND: An association between idiopathic intracranial hypertension (IIH) and anemia has been speculated from previous case reports and case series. Retrospective studies to date have not used matched case controls to compare standardized complete blood count (CBC) values for the presence of anemia. METHODS: At our tertiary care facility, 50 patients with IIH were matched with 50 case-control patients to compare CBC values from laboratory affiliates with standardized ranges. RESULTS: No significant difference was found for any CBC parameters for IIH vs control patients. For female IIH and control patients as well as male IIH patients, values for red blood cell count, hemoglobin (HGB), and hematocrit (HCT) tended to trend on the lower end of "normal" range, whereas this was not seen in male control patients. CONCLUSIONS: In this retrospective, matched case-control study, no significant association was found between IIH and anemia when comparing standardized CBC values. In accordance with previous studies, the prevalence of anemia may be relatively higher in the IIH population due to a prominent demographic overlap of females of child-bearing age.
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Anemia/complicaciones , Presión Intracraneal/fisiología , Seudotumor Cerebral/etiología , Adulto , Anemia/sangre , Anemia/epidemiología , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Hematócrito , Humanos , Masculino , Prevalencia , Seudotumor Cerebral/epidemiología , Seudotumor Cerebral/fisiopatología , Estudios Retrospectivos , Estados Unidos/epidemiologíaRESUMEN
There is growing evidence of thyroid eye disease association with nutritional deficiencies including selenium and vitamin D. We conducted a retrospective chart review of all patients with clinical diagnosis of TED seen at our clinic from 2016 to 2017. Thirty-five patients met inclusion criteria and had serum 25-hydroxyvitamin D levels available, and 19 had selenium levels available. 7/35 (20%) patients had vitamin D deficiency, and 11 (31%) had vitamin D insufficiency, but none had selenium deficiency. Although both selenium and vitamin D supplementation have been recommended for TED, further investigation is necessary to justify supplementation for patients with TED.
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Trombosis del Seno Cavernoso/diagnóstico , Celulitis (Flemón)/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Cuero Cabelludo , Adulto , Trombosis del Seno Cavernoso/etiología , Celulitis (Flemón)/etiología , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Leucemia-Linfoma Linfoblástico de Células T Precursoras/complicaciones , Rotura Espontánea , Tomografía Computarizada por Rayos X/métodosAsunto(s)
Exoftalmia/etiología , Hidrogeles/efectos adversos , Oftalmoplejía/etiología , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica/efectos adversos , Anciano de 80 o más Años , Exoftalmia/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Oftalmoplejía/diagnóstico , Curvatura de la Esclerótica/métodos , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
A 50-year-old man presented with a 4-month history of right-sided trigeminal neuropathy in the V1 and V2 distribution, right sixth nerve palsy and Horner syndrome. Magnetic resonance imaging (MRI) showed enhancement and thickening along the right ophthalmic nerve and supraorbital nerve and fullness at the right cavernous sinus extending to Meckel's cave. Evaluation for a primary tumour was negative. Cavernous sinus biopsy showed infiltrating poorly differentiated carcinoma; the patient underwent radiation therapy. To our knowledge this is the only case of poorly differentiated carcinoma involving the supraorbital nerve presenting with trigeminal neuropathy and Horner syndrome in the English ophthalmic literature.
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Acute idiopathic blind spot enlargement (AIBSE) is often caused by Acute Zonal Occult Outer Retinopathy (AZOOR), an outer retinal disease. We report two illustrative cases of AZOOR. The first one was a 21-year-old white female who presented with a scotoma and "shimmering lights" in her left eye. In the second case, a 73-year-old white female was referred for evaluation of a "bitemporal hemianopsia" that started years prior, with no clinical significant photopsias. To our knowledge, case two is the longest documented duration of bilateral, progressive, and chronic, idiopathic, enlargement of the blind spot (CIBSE) documented in the English language ophthalmic literature.
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Presión Sanguínea/fisiología , Hipertensión/complicaciones , Disco Óptico/patología , Papiledema/etiología , Agudeza Visual , Adulto , Encéfalo/diagnóstico por imagen , Resultado Fatal , Humanos , Hipertensión/fisiopatología , Imagen por Resonancia Magnética , Masculino , Papiledema/diagnósticoAsunto(s)
Isquemia Encefálica/diagnóstico , Encéfalo/patología , Movimientos Oculares/fisiología , Lupus Eritematoso Sistémico/complicaciones , Imagen por Resonancia Magnética/métodos , Trastornos de la Motilidad Ocular/etiología , Adulto , Isquemia Encefálica/complicaciones , Diagnóstico Diferencial , Humanos , Lupus Eritematoso Sistémico/diagnóstico , Masculino , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/fisiopatología , SíndromeAsunto(s)
Hemianopsia/etiología , Neoplasias Hipofisarias/complicaciones , Campos Visuales , Adulto , Biopsia , Terapia Combinada , Femenino , Hemianopsia/diagnóstico , Hemianopsia/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/terapia , Tomografía de Emisión de PositronesAsunto(s)
Neoplasias del Sistema Nervioso Central/complicaciones , Cadenas kappa de Inmunoglobulina/líquido cefalorraquídeo , Linfoma de Células B/complicaciones , Paraproteinemias/complicaciones , Neoplasias del Sistema Nervioso Central/líquido cefalorraquídeo , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Neoplasias del Sistema Nervioso Central/radioterapia , Humanos , Inmunofenotipificación , Linfoma de Células B/líquido cefalorraquídeo , Linfoma de Células B/diagnóstico por imagen , Linfoma de Células B/radioterapia , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Paraproteinemias/líquido cefalorraquídeo , Paraproteinemias/diagnóstico por imagen , Paraproteinemias/radioterapia , Radioterapia , Tomografía Computarizada por Rayos X , Agudeza Visual/fisiologíaRESUMEN
A 62-year-old female who was legally blind secondary to retinitis pigmentosa (RP) developed new positive visual phenomena (PVP) ("visual storms") following implantation of the Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, CA). The potential mechanisms for the exacerbating PVP or hallucinatory release phenomena are proposed. Clinicians should be aware of these visual phenomena in patients with RP and the potential for worsening of or de novo development of PVP in patients considering the Argus II implant. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:1022-1025.].