Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25.823
Filtrar
1.
Einstein (Sao Paulo) ; 19: eRC5521, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33656059

RESUMEN

Sophisticated imaging systems have helped to redefine the clinical presentation of acute macular neuroretinopathy and have markedly enhanced diagnostic sensitivity. The proposed mechanism of paracentral acute middle maculopathy is related to ischemia at the level of the superficial and deep retinal capillary plexi. This is a case report of a patient who developed an acute macular neuroretinopathy after an uneventful angioplasty with stents in the coronary artery.


Asunto(s)
Angioplastia/efectos adversos , Aterosclerosis/cirugía , Vasos Coronarios/cirugía , Stents/efectos adversos , Enfermedad Aguda , Femenino , Angiografía con Fluoresceína , Humanos , Degeneración Macular , Persona de Mediana Edad , Tomografía de Coherencia Óptica , Síndromes de Puntos Blancos/diagnóstico por imagen , Síndromes de Puntos Blancos/etiología
2.
Cesk Slov Oftalmol ; 77(1): 36-44, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33740866

RESUMEN

Pachychoroid disease of retina is a spectrum of diseases manifested by thickening and hyperperfusion of the choroid with changes in the sensory part of the retina. The main unit of this group is central serous chorioretinopathy (CSC). In practice, we often encounter other conditions, which are manifested by thickening of the choroid and changes in the retina, but they cannot be classified as pachychoroid diseases. The aim of this study is to point out on a series of 3 case reports the difficulties in the differential diagnosis of retinal diseases in which we find thickening of the choroid. Case report 1: 42-year-old patient treated for central serous chorioretinopathy. After optical coherence tomography (OCT), fluorescence angiography (FAG) and indocyanine green angiography (ICG) the diagnosis was changed to choroidal hemangioma and he was treated with photodynamic therapy (PDT) which led to a reduction of the hemangioma. Case report 2: A 30-year-old patient treated for ankylosing spondylitis comes for visual impairment in the left eye. On OCT the condition resembled chronic CSC. The patient suffered from a febrile exanthema a few days ago. Serological testing for coxsackievirus was positive and the diagnosis was changed to acute chorioretinitis in coxsackievirus infection. Oral treatment with prednisone was successful. Case report 3: A 46-year-old patient was treated conservatively for CSC. After FAG and ICG, a solitary dilated choroidal vessel was found in the area of the papillomacular bundle with leakage under the sensory epithelium which was diagnosed as choroidal macrovessel. We performed PDT with a very good anatomical effect. Conclusion: Precise differentiation of these mentioned diseases from pachychoroid retinal diseases was essential in choosing the appropriate therapy. The use of all modern imaging methods of the retina and choroid plays a key role in determining the diagnosis. Key words: pachychoroid disease, central serous chorioretinopathy, choroidal hemangioma, chorioretinitis, coxsackievirus, choroidal macrovessel.


Asunto(s)
Coriorretinopatía Serosa Central , Mácula Lútea , Adulto , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/tratamiento farmacológico , Coroides , Angiografía con Fluoresceína , Humanos , Masculino , Persona de Mediana Edad , Epitelio Pigmentado de la Retina , Tomografía de Coherencia Óptica
3.
Medicine (Baltimore) ; 100(10): e24991, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725872

RESUMEN

RATIONALE: Crouzon syndrome is an autosomal dominant genetic disorder caused by mutations in fibroblast growth factor receptor 2 (FGFR2) and one of the most common types of craniosynostosis. Here we report the detection of FGFR2 mutation and its related clinical findings in 2 patients with Crouzon syndrome from a Chinese family. PATIENT CONCERNS: We report a case of a 28-year-old male patient presented with the chief complaint of gradually blurring of his eyes over the last 6 months before visiting our clinics. History revealed low visual acuity in his right eye since childhood. Physical examination showed that both the patient and his mother have the appearance of craniofacial dysostosis, mandibular prognathism, ocular proptosis, short superior lip, scoliosis, and thoracic deformity. DIAGNOSIS: Auxiliary examinations lead to the diagnosis of Crouzon syndrome with binocular optic atrophy, myelinated retina nerve fibers, and ametropia in both eyes, and amblyopia in the right eye of the male patient. The molecular genetic analysis confirmed the diagnosis by detecting a heterozygous pathogenic mutation c.1026C > G (C342W) in exon 10 of FGFR2 in both the patient and his mother, but not in any of the unaffected family members. INTERVENTIONS AND OUTCOMES: None. LESSONS: Our study confirms the presence of optic nerve atrophy in patients with Crouzon syndrome carrying FGFR2 C342W mutations and indicates that MRI and funduscopy should be performed to examine the optic nerve changes for patients with Crouzon syndrome.


Asunto(s)
Disostosis Craneofacial/complicaciones , Atrofias Ópticas Hereditarias/genética , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Adulto , China , Disostosis Craneofacial/genética , Análisis Mutacional de ADN , Exones/genética , Femenino , Angiografía con Fluoresceína , Heterocigoto , Humanos , Imagen por Resonancia Magnética , Masculino , Mutación Missense , Atrofias Ópticas Hereditarias/diagnóstico , Nervio Óptico/diagnóstico por imagen , Linaje , Tomografía Computarizada por Rayos X
5.
Vestn Oftalmol ; 137(1): 60-67, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33610151

RESUMEN

PURPOSE: To assess the influence of the frequency of retinal protective therapy courses on the indicators of regional hemodynamics of the eye. MATERIAL AND METHODS: The study included 17 patients (34 eyes) with a diagnosis of primary open-angle glaucoma (POAG), advanced stage. The patients were divided into 2 groups: the first group received a course of retinal protective therapy with Retinalamin every 3 months, the second group received a course of retinal protective therapy with Retinalamin every 6 months. All patients underwent standard ophthalmological examination including standard automatic perimetry according to the 24-2 program, optical coherence tomography angiography (OCT-A) of the macular area and optic disc. RESULTS: The comparison of hemodynamic parameters of all vascular plexuses of the retina at the beginning and at the end of the study, as well as intergroup comparison did not reveal any statistically significant differences (p>0.05). However, when studying the density and fractal dimension of the vascular bed, multidirectional trends were observed. Specifically, in the peripapillary region, there was a decrease in the length from 19.8 (1/mm) to 19.0 (1/mm) (p=0.37) and the density from 36.6% to 35.7% (p=0.63) of the vascular bed of the peripapillary capillary plexus of the retina in patients of the first group. In the superficial vascular plexus, the trend in the density of the vascular bed in both groups slightly changed (in group 1 - 38.1% and 38.3%, p=0.97; group 2 - 37.8% and 38.7%, p=0.46). The fractal dimension of the vascular bed in the first group tended to increase during treatment from 18.8 (1/mm) to 19.1 (1/mm) (p=0.5), while in the second group, on the contrary, it had tendency to decrease from 18.6 (1/mm) to 17.9 (1/mm) (p=0.63). In the deep vascular plexus, the density of the vascular bed trended to decrease in both groups, but in group 2 (42.5% and 42.4%, p=1.0) it was more pronounced than in the first group (42.5% and 42.6%, p=0.82). However, the fractal dimension of the vascular bed increased in group 1 (21.0 (1/mm) and 21.3 (1/mm), p=0.43) and showed a slight tendency to decrease in group 2 (21.5 (1/mm) and 21.0 (1/mm), p=0.86). CONCLUSION: The general trend of changes in hemodynamic parameters demonstrates a potential positive effect, especially in the data related to the deep vascular plexus.


Asunto(s)
Glaucoma de Ángulo Abierto , Disco Óptico , Angiografía , Angiografía con Fluoresceína , Glaucoma de Ángulo Abierto/diagnóstico , Humanos , Disco Óptico/diagnóstico por imagen , Proyectos Piloto , Vasos Retinianos/diagnóstico por imagen , Tomografía de Coherencia Óptica
6.
Vestn Oftalmol ; 137(1): 107-114, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33610158

RESUMEN

Chronic kidney disease (CKD) is a significant public health problem with a high risk of developing age-dependent eye diseases. Renal glomeruli and the choroid have similar structures and vascular networks; the internal hematoretinal barrier and the glomerular filtration barrier have similar developmental path; the renin-angiotensin-aldosterone hormonal system is found in both the eye and the kidneys. All this determines the similarity of physiological and pathogenetic features of the development of diseases associated with these organs. The article discusses general risk factors and pathophysiological mechanisms of development of retinal and renal lesions in CKD, the influence of various factors of pathogenesis on their development and progression. The anatomical similarity of vascularization, accompanied by microvascular changes in the retina and kidneys, leads to similar complications in both organs. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) are accurate, well reproducible and non-invasive methods for diagnosing and assessing changes in the retinal microvascular bed, which make it possible to assess microvasculature changes in the kidneys. In CKD, the retina shows signs of impaired capillary perfusion, a decrease in their density, expansion of intercapillary spaces, a rarefaction of the density of the parafoveolar capillary network, which may indicate a decrease in peritubular capillary blood flow, blood circulation of the kidneys in general and their ischemia. Significant thinning of the retina and choroid, along with a decrease in macular volume, even in the initial stages of CKD, is accompanied by impaired renal function (changes in the estimated glomerular filtration rate and urinary albumin excretion), which is a sign of systemic microvascular lesion and pathological process in the kidneys. Therefore, monitoring of retinal vessels using OCT and OCT-A can become a reliable indicator of the progression of renal microvascular changes at any stage of the disease.


Asunto(s)
Insuficiencia Renal Crónica , Vasos Retinianos , Coroides , Angiografía con Fluoresceína , Humanos , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/diagnóstico , Retina/diagnóstico por imagen , Vasos Retinianos/diagnóstico por imagen , Tomografía de Coherencia Óptica
7.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526522

RESUMEN

A 44-year-old woman presented with decreased vision in both eyes. The retina in both eyes had drusen distributed along vascular arcades, central macula and in peripapillary region. Macula had pigmented scarring and exudation. Fundus autofluorescence showed drusen. Optical coherence tomography showed drusen, subretinal and intraretinal fluid. Fundus fluorescein and indocyanine green angiography showed drusen, retinal pigment epithelial atrophy and vascular network. Younger age at presentation, bilateral symmetry, typical distribution of drusen along the arcades in a radiating pattern, peripapillary involvement, scarring and atrophy at macula were suggestive of doyne honeycomb retinal dystrophy. The reduced vision was due to macular atrophy and an active choroidal neovascular membrane. The patient was treated with antivascular endothelial growth factor injections for choroidal neovascular membrane. Our case highlights the importance of pattern recognition and multimodal imaging for diagnosing the type of macular dystrophy as doyne honeycomb retinal dystrophy, while simultaneously managing choroidal neovascular membrane.


Asunto(s)
Neovascularización Coroidal/diagnóstico por imagen , Angiografía con Fluoresceína , Tomografía de Coherencia Óptica , Adulto , Inhibidores de la Angiogénesis/uso terapéutico , Angiografía , Neovascularización Coroidal/complicaciones , Neovascularización Coroidal/tratamiento farmacológico , Colorantes , Femenino , Fondo de Ojo , Humanos , Verde de Indocianina , Inyecciones Intravítreas , Imagen Multimodal , Drusas del Disco Óptico/complicaciones , Drusas del Disco Óptico/congénito , Drusas del Disco Óptico/diagnóstico por imagen , Ranibizumab/uso terapéutico
8.
BMJ Case Rep ; 14(2)2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568408

RESUMEN

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.


Asunto(s)
Coroides/fisiopatología , Angiografía con Fluoresceína/métodos , Inflamación/diagnóstico , Enfermedades de la Retina/diagnóstico , Tomografía de Coherencia Óptica/métodos , Síndrome Uveomeningoencefálico/diagnóstico , Adulto , Femenino , Humanos
9.
Medicine (Baltimore) ; 100(7): e24789, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607834

RESUMEN

RATIONALE: Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease of unknown etiology. GPA affects multiple ocular tissues, most commonly the orbit, conjunctiva, cornea, and sclera. Retinal and choroidal manifestations are rare in GPA, but they often include choroidal neovascularization (CNV). PATIENT CONCERNS: A 36-year-old man was diagnosed with GPA. He had been taking oral steroid treatment for 8 years. He experienced disease recurrence and the dose of oral prednisolone was increased after steroid pulse therapy. Fundus examination showed small retinal pigment epithelial detachment and serous retinal detachment (SRD). Optical coherence tomography (OCT) revealed a protruded lesion inside the SRD. Fluorescein angiography (FA) showed a small, dot-shaped fluorescein leakage in the SRD, and indocyanine green fluorescein fundus angiography showed choroidal vascular hyperpermeability that was consistent with the hyperfluorescence seen with FA. We had to determine whether the protruded lesion inside the SRD was CNV secondary to the inflammation due to GPA or whether it was central serous chorioretinopathy (CSC)-like condition caused by high-dose steroid treatment. DIAGNOSES: We confirmed that the SRD was due to CSC but not CNV because the protruded lesion examined by B-scan OCT angiography (OCTA) showed no blood flow. INTERVENTIONS: We decided to reduce the dose of steroid. OUTCOMES: Since the reduction of steroids, no sign of worsening in the protruded lesions with SRD has been observed. LESSONS: We therefore propose the effectiveness of this advanced function of OCTA for the examination of blood flow signal images to detect CNV.


Asunto(s)
Coriorretinopatía Serosa Central/etiología , Glucocorticoides/efectos adversos , Granulomatosis con Poliangitis/tratamiento farmacológico , Prednisolona/efectos adversos , Desprendimiento de Retina/etiología , Administración Oral , Adulto , Progresión de la Enfermedad , Angiografía con Fluoresceína , Granulomatosis con Poliangitis/complicaciones , Humanos , Masculino , Prednisolona/administración & dosificación , Tomografía de Coherencia Óptica
10.
Medicine (Baltimore) ; 100(7): e24790, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607835

RESUMEN

RATIONALE: Half-dose or reduced-fluence photodynamic therapy (PDT) with verteporfin has been well acknowledged to be the most effective and permanent treatment with very low rates of complications. However, we report a case of chronic central serous chorioretinopathy (CSC) who developed choroidal neovascularization (CNV) secondary to half-dose PDT within only 3 weeks. Such an occurrence following this short a course of treatment has not been reported previously. PATIENT CONCERNS: A 46-year-old Chinese man who had been diagnosed as acute more than 1 year ago revisited our department recently and complained of blurred vision again in his left eye. DIAGNOSES: Fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) revealed patchy hyperfluorescent dots and optical coherence tomography (OCT) indicated irregular flat pigment epithelium detachment (PED) in the central macula. The patient was diagnosed with chronic CSC. INTERVENTIONS: The patient was treated by half-dose PDT with verteporfin. Three weeks later, the patient complained of sudden blurred vision and fundus examination showed macular hemorrhages with a best-corrected visual acuity (BCVA) of 20/250. OCT angiography (OCTA) showed a distinct area of flower-like CNV located within the deep retinal slab. Secondary CNV had developed after a quite short course of half-dose PDT treatment. Subsequently, the patient was administered by 2 intravitreal injections of aflibercept (2 mg). OUTCOMES: Two months after the second intravitreal injection, macular hemorrhages and secondary CNV were completely resolved, and the BCVA improved to 20/25. LESSONS: Patients of chronic CSC with irregular PED who undergo PDT should be warned of secondary CNV within a short course after treatment. If happened, it should be treated by intravitreal injections of anti-vascular endothelial growth factor agents as soon as possible.


Asunto(s)
Coriorretinopatía Serosa Central/tratamiento farmacológico , Neovascularización Coroidal/inducido químicamente , Fármacos Fotosensibilizantes/efectos adversos , Verteporfina/efectos adversos , Inhibidores de la Angiogénesis/administración & dosificación , Neovascularización Coroidal/tratamiento farmacológico , Angiografía con Fluoresceína , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Fármacos Fotosensibilizantes/administración & dosificación , Receptores de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Proteínas Recombinantes de Fusión/administración & dosificación , Tomografía de Coherencia Óptica , Verteporfina/administración & dosificación
11.
N Z Med J ; 134(1528): 96-98, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444310

RESUMEN

Cat-scratch disease (CSD) is a systemic illness caused by the gram-negative bacteria Bartonella henselae (B. henselae). Cats serve as the primary host reservoir for B. henselae, with cat fleas as the horizontal vector of transmission. It is transmitted to humans through close contact with cats and cat scratches and bites. We describe two cases of bilateral Bartonella neuroretinitis that were presented to Palmerston North Hospital Eye Clinic.


Asunto(s)
Anticuerpos Antibacterianos/análisis , Bartonella henselae/inmunología , Ceguera/etiología , Enfermedad por Rasguño de Gato/complicaciones , Infecciones Bacterianas del Ojo/complicaciones , Agudeza Visual , Ceguera/diagnóstico , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/microbiología , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/microbiología , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Masculino , Adulto Joven
12.
BMJ Case Rep ; 14(1)2021 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-33509863

RESUMEN

We describe an atypical form of avascular island demarcated by a ridge in the vascularised retina of retinopathy of prematurity. Fundus fluorescein angiography showed an unusual finding of an avascular island demarcated by shunt vessels in vascularised retina posterior to the ridge. There is a need to document this finding as this could throw some light on the aetiopathogenesis of the disease.


Asunto(s)
Vasos Retinianos/diagnóstico por imagen , Retinopatía de la Prematuridad/diagnóstico por imagen , Angiografía con Fluoresceína , Humanos , Recién Nacido , Coagulación con Láser , Masculino , Retinopatía de la Prematuridad/cirugía
13.
BMJ Case Rep ; 14(1)2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33408104

RESUMEN

Dome-shaped macula (DSM) is characterised by a convex anterior bulging of the macular area. It can further get complicated by accumulation of subretinal fluid (SRF). Foveal cysts that are bilateral, in a setting of DSM, are an entity not yet reported. Management options for DSM with SRF showed variable success. Topical carbonic anhydrase inhibitors (CAIs) have been successful in treating certain macular pathologies. The authors report a rare case of bilateral intraretinal foveal cyst in a myopic child with DSM with favourable response to topical dorzolamide. Topical CAIs may be considered a safe and effective option in such cases.


Asunto(s)
Inhibidores de Anhidrasa Carbónica/administración & dosificación , Quistes/tratamiento farmacológico , Fóvea Central/patología , Enfermedades de la Retina/tratamiento farmacológico , Sulfonamidas/administración & dosificación , Tiofenos/administración & dosificación , Administración Oftálmica , Preescolar , Quistes/diagnóstico , Quistes/etiología , Angiografía con Fluoresceína , Fóvea Central/diagnóstico por imagen , Fóvea Central/efectos de los fármacos , Humanos , Masculino , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Líquido Subretiniano/diagnóstico por imagen , Líquido Subretiniano/efectos de los fármacos , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Agudeza Visual
14.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(1): 135-140, 2021 Jan 30.
Artículo en Chino | MEDLINE | ID: mdl-33509766

RESUMEN

OBJECTIVE: To evaluate the value of fundus autofluorescence (FAF) imaging combined with spectral domain optical coherence tomography (SD-OCT) in diagnosis, prognostic assessment and follow-up observation of acute Vogt-KoyanagiHarada (VKH) disease. METHODS: Clinical data were collected from 12 patients (23 eyes) with acute VKH disease treated in our hospital from May, 2018 to November, 2019, including detailed medical history, best corrected visual acuity (BCVA), and results of slit lamp biomicroscopy, fundus photography, SD-OCT, fundus fluorescein angiography (FFA) and FAF imaging.SDOCT and FAF imaging were repeated after a course of treatment and in follow-up examination, and the results were compared with those at the time of admission. RESULTS: VKH disease involved both eyes in 11 patients (91.7%).Fundus photography showed optic disc edema in 16 eyes (69.6%), and multiple retinal neuroepithelial detachment was detected by SD-OCT in all the involved eyes (100%).IN all the eyes, FFA revealed small and dense fluorescein leakage in the early stage and fluorescein accumulation in advanced stages of VHK disease to form multiple dye pooling in the areas of serous detachment.Hyperauto fluorescence was a common finding in FAF imaging (100%), and the area involved was consistent with that of fluorescein accumulation shown by FAF imaging.Ten eyes (43.5%) showed patches of relative hypoautofluorescence in the hyperauto fl uorescence areas, and granular hyperauto fl uorescence was found in the lesions in 4 eyes (17.4%).During the remission period of VKH disease, FAF imaging showed normal finding in 8 eyes (34.8%) and reduced areas (by 55.2%) and intensity (by 46.5%) of hyperautofluorescence in 9 eyes (39.1%).In 6 eyes (26.1%), only a few hyperautofluorescent spots scattered in the macula were observed.SD-OCT demonstrated significantly reduced (by 69.5% on average) or even disappearance of subretinal fluid in the eyes.The fluorescence intensity in FAF imaging showed a significant positive correlation with the volume of subretinal fluid detected by SD-OCT (r=0.626, P < 0.05). CONCLUSIONS: The combination of fluorescein angiography, FAF imaging and SD-OCT can significantly improve the diagnostic accuracy of VKH disease.FAF imaging combined with SD-OCT provides an effective and noninvasive modality for evaluation of remission and monitoring the changes in VKH disease.


Asunto(s)
Desprendimiento de Retina , Síndrome Uveomeningoencefálico , Enfermedad Aguda , Angiografía con Fluoresceína , Estudios de Seguimiento , Humanos , Desprendimiento de Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica , Síndrome Uveomeningoencefálico/diagnóstico por imagen
15.
Zhonghua Yi Xue Za Zhi ; 101(4): 254-258, 2021 Jan 26.
Artículo en Chino | MEDLINE | ID: mdl-33486933

RESUMEN

Objective: To explore the value of neuroendoscopy combined with fluorescence angiography in anterior circulation aneurysm clipping. Methods: A total of 15 patients with anterior circulation aneurysm from Department of Neurosurgery, Zhongnan Hospital of Wuhan University between October 2018 and January 2019 were enrolled. Neuroendoscopy combined with indocyanine green fluorescence angiography (ICGA) was used to determine the shape of the aneurysm, the specific location of the aneurysm neck and its relationship with the aneurysm-bearing artery during anterior circulation aneurysm clipping. Meanwhile, Neuroendoscopy combined with ICGA can be employed to observe whether there was stenosis and incomplete clamping of the aneurysm-bearing artery after clipping the aneurysm, and whether there was misclamping of the perforating branches hidden under the posterior wall of the aneurysm. Results: The success rate of aneurysm clipping in 15 cases was 15/15. After aneurysm clipping, ICGA and neuroendoscopy were performed. The residual aneurysm neck was detected in 3 cases, and the position of aneurysm clip was adjusted or aneurysm clips were added. In one case, the anterior choroidal aneurysm was found to be mistakenly clipped. After adjusting the aneurysm clip, ICGA and neuroendoscopy showed that the anterior choroidal artery was normal. In another case, the A1 segment aneurysm was clipped. ICGA and neuroendoscopy found that the perforating branch blood vessels were mistakenly clipped. After the adjustment of the aneurysm clip, the blood vessels recovered their patency. There were no surgical-related deaths, disability and coma cases in the study. Conclusions: During aneurysm clipping, neuroendoscopy combined with ICGA can reduce cerebral vasospasm, decrease the misclipping rate of perforation of blood vessels, and avoid residual neck of aneurysm, stenosis or occlusion of aneurysm-bearing artery by using neuroendoscopy to observe whether misclipping of the perforating branch vessels exist and whether the aneurysm is clipped. Therefore, it can reduce postoperative complications.


Asunto(s)
Aneurisma Intracraneal , Neuroendoscopía , Angiografía Cerebral , Angiografía con Fluoresceína , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos , Instrumentos Quirúrgicos
16.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33472799

RESUMEN

We report the case of a 19-year-old patient with symptomatic unilateral serous maculopathy associated with an optic nerve coloboma. Fluorescein angiography detected a focal late leak at the temporal edge of the coloboma which was later found to correspond with an area of choroidal neovascularisation on optical coherence tomography angiography. A course of intravitreal ranibizumab achieved good clinical and structural response. This report contributes to the evidence that maculopathies associated with cavitary optic nerve anomalies may in some instances result from choroidal neovascularisation. It also highlights the importance of angiography to identify potential choroidal neovascular membranes, particularly in the absence of haemorrhages and neovascular membranes on fundus examination and conventional optical coherence tomography.


Asunto(s)
Coriorretinopatía Serosa Central/diagnóstico por imagen , Neovascularización Coroidal/diagnóstico por imagen , Coloboma/diagnóstico por imagen , Nervio Óptico/anomalías , Inhibidores de la Angiogénesis , Coriorretinopatía Serosa Central/complicaciones , Coriorretinopatía Serosa Central/tratamiento farmacológico , Coriorretinopatía Serosa Central/patología , Neovascularización Coroidal/complicaciones , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/patología , Coloboma/complicaciones , Coloboma/patología , Femenino , Angiografía con Fluoresceína , Humanos , Inyecciones Intravítreas , Nervio Óptico/diagnóstico por imagen , Nervio Óptico/patología , Ranibizumab/uso terapéutico , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Adulto Joven
17.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-33504523

RESUMEN

Bilateral optic disc swelling is an important clinical sign for potentially life-threatening and sight-threatening conditions, with the most common being raised intracranial pressure and pseudopapillitis. Perhexiline-related and amiodarone-related optic disc swellings are diagnoses of exclusion. This report describes the diagnosis of a man with perhexiline-induced and amiodarone-induced optic neuropathy after extensive investigation consisting of full ophthalmic examination, biochemical screen, temporal artery biopsy, CT, MRI, positron emission tomography and lumbar puncture. There was partial to complete resolution of optic neuropathy following cessation of the causative medication. We postulate that the underlying mechanism of perhexiline toxicity could be mitochondrial dysfunction related. Our case demonstrates that patients treated with perhexiline and amiodarone should be monitored closely for ocular side effects.


Asunto(s)
Amiodarona/efectos adversos , Enfermedades del Nervio Óptico/inducido químicamente , Perhexilina/efectos adversos , Vasodilatadores/efectos adversos , Anciano , Angiografía con Fluoresceína , Humanos , Masculino , Enfermedades del Nervio Óptico/diagnóstico por imagen , Recurrencia , Tomografía de Coherencia Óptica
18.
Arq Bras Oftalmol ; 84(1): 2-10, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33470334

RESUMEN

PURPOSE: The aim of the study is to evaluate the retinal and choroidal microvascular changes via optical coherence tomography angiography in patients who received hydroxy-chloroquine. METHODS: In total, 28 eyes of 28 patients (24 females, and 4 males) receiving treatment with hydroxy-chloroquine were assessed in this cross-sectional cohort study (hydroxychloroquine group). The high-and low-risk groups consisted of patients receiving hydroxychloroquine for ≥5 years (14 eyes of 28 patients) and <5 years (14 eyes of 28 patients), respectively. A total of 28 age- and gender-matched volunteers were enrolled as the control group. The macular flow area (superficial, deep, and choriocapillaris), superficial and deep vessel density, foveal avascular zone area, central foveal thickness, and subfoveal choroidal thickness parameters were measured by optical coherence tomography angiography. RESULTS: The mean age of the 28 patients who received hydroxychloroquine and the 28 age-matched controls was 45.5 ± 11.1 years (range: 29-70 years) and 44.5 ± 13.9 years (range: 28-70 years), respectively. In patients who received hydroxychloroquine, the values for the superficial, deep, and choriocapillaris macular flow areas were 13.578 ± 0.30, 13.196 ± 0.31, and 17.617 ± 0.42, respectively. In controls, these values were 16.407 ± 0.95, 13.857 ± 0.31, and 18.975 ± 0.76, respectively (p<0.05 for all). The superficial, deep, and cho-riocapillaris flow areas were significantly smaller in patients who received hydroxychloroquine than those in controls (p<0.05 for all). Superficial and deep vessel densities were significantly reduced in patients who received hydroxychlo-roquine in all regions (i.e., foveal, parafoveal, temporal, superior, nasal, and inferior) (p<0.05 for all). Moreover, significant difference was observed between the groups in the foveal avascular zone area (superficial and deep), central foveal thickness, and subfoveal choroidal thickness (p<0.05 for all). CONCLUSIONS: Retinochoroidal microvascular flow and vessel density of the macular area were significantly decreased in patients who received hydroxychloroquine. Hy-droxychloroquine may damage the retinochoroidal mi-cro-vascular architecture. Optical coherence tomography angiography may contribute to the early detection of hy-dro-xychloroquine-induced retinal toxicity.


Asunto(s)
Hidroxicloroquina , Tomografía de Coherencia Óptica , Adulto , Anciano , Coroides/diagnóstico por imagen , Estudios Transversales , Femenino , Angiografía con Fluoresceína , Humanos , Hidroxicloroquina/efectos adversos , Masculino , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Agudeza Visual
19.
Can J Ophthalmol ; 56(2): 83-87, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33497612

RESUMEN

OBJECTIVE: To examine the changes in choriocapillaris and retina caused by coronavirus disease 2019 (COVID-19) by comparing optical coherence tomography angiography (OCTA) findings of COVID-19 patients and healthy controls. METHODS: The study and control groups consisted of 54 eyes of 27 participants, each. Patients and controls underwent OCTA examination. Foveal zone vessel density and parafoveal zone vessel density (for 4 quadrants: nasal, temporal, superior, inferior) were calculated for both superficial and deep capillary plexuses. Additionally, choriocapillaris flow and foveal avascular zone areas were calculated. RESULTS: For the parafoveal area in the study group, vessel density was significantly lower in the superior and nasal quadrants of the superficial capillary plexus and in all quadrants of the deep capillary plexus compared with controls (p < 0.05 for all). The study group had significantly higher choriocapillaris flow area values compared with controls (p = 0.042). CONCLUSION: Reduced vessel density of the retinal capillary plexus was detected in COVID-19 patients who may be at risk for retinal vascular complications.


Asunto(s)
/diagnóstico , Enfermedades de la Coroides/diagnóstico , Coroides/irrigación sanguínea , Infecciones Virales del Ojo/diagnóstico , Enfermedades de la Retina/diagnóstico , Vasos Retinianos/patología , Adulto , Enfermedades de la Coroides/virología , Infecciones Virales del Ojo/virología , Femenino , Angiografía con Fluoresceína , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Retina/virología , Tomografía de Coherencia Óptica , Agudeza Visual , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...