Subject(s)
Immunosuppressive Agents/adverse effects , Posterior Leukoencephalopathy Syndrome/chemically induced , Posterior Leukoencephalopathy Syndrome/diagnosis , Tacrolimus/adverse effects , Adolescent , Delayed Diagnosis , Female , Humans , Lung Transplantation , Magnetic Resonance Imaging , Posterior Leukoencephalopathy Syndrome/physiopathology , Vision Disorders/chemically induced , Vision Disorders/diagnosis , Vision Disorders/physiopathology , Visual Acuity/physiologyABSTRACT
Choroidal hemorrhages involve bleeding into the potential space between the choroid and sclera and are a serious ocular complication. Common causes of choroidal hemorrhages include intraocular surgeries, such as scleral buckling, cataract extractions, and glaucoma filtering procedures, or trauma. We report a case of choroidal and vitreous hemorrhage after micropulse cyclophotocoagulation. An 82-year-old female presented postoperative day 1 with blurry vision and pain in her right eye. Examination showed that she had a choroidal hemorrhage, 200 degrees of ciliary body swelling, and vitreous hemorrhage. Although the choroidal hemorrhage resolved with steroids, the vitreous hemorrhage required pars plana vitrectomy. To the best of our knowledge, this article discusses the first reported case of choroidal and vitreous hemorrhage due to micropulse cyclophotocoagulation.
Subject(s)
Choroid Hemorrhage/etiology , Ciliary Body/surgery , Laser Coagulation/adverse effects , Sclera/surgery , Vitreous Hemorrhage/etiology , Aged, 80 and over , Choroid Hemorrhage/drug therapy , Female , Glaucoma, Open-Angle/surgery , Glucocorticoids/therapeutic use , Humans , Intraocular Pressure/physiology , Vitrectomy , Vitreous Hemorrhage/surgeryABSTRACT
PURPOSE: To determine whether an association exists between dry eye disease (DED) and statin use and/or dyslipidemia. DESIGN: Retrospective, case-control study. METHODS: Setting: University of North Carolina (UNC)-affiliated healthcare facilities. STUDY POPULATION: 72,931 patients seen at UNC ophthalmology clinics over a 10-year period. MAIN OUTCOME MEASURES: Odds ratios (ORs) calculated between DED and a history of low, moderate, or high-intensity statin use; and ORs calculated between DED and abnormal lipid panel values. RESULTS: Total of 39,336 individuals (53.9% female) were analyzed after exclusion of individuals with confounding risk factors for DED. Of these, 3,399 patients (8.6%) carried a diagnosis of DED. Low-, moderate-, and high-intensity statin regimens were used by 751 subjects (1.9%), 2,655 subjects (6.8%), and 1,036 subjects (2.6%). Lipid abnormalities were identified as total cholesterol >200 mg/dL, 4,558 subjects (11.6%); high-density lipoprotein (HDL) <40 mg/dL, 2,078 subjects (5.3%); low-density lipoprotein (LDL) >130 mg/dL, 2,756 subjects (7.0%); and triglycerides (TGs) >150 mg/dL, 2,881 subjects (7.3%). The odds ratios (OR) of carrying a diagnosis of DED given the presence of low-, moderate-, and high-intensity statin use were 1.39 (95% confidence interval [CI]: 1.13-1.72); OR 1.47 (95% CI: 1.30-1.65), and OR 1.46 (95% CI: 1.21-1.75), respectively. The OR of carrying a diagnosis of DED given the presence of total cholesterol >200 mg/dL, HDL <40 mg/dL, LDL >130 mg/dL, and TGs >150 mg/dL were 1.66 (95% CI: 1.52-1.82), 1.45 (95% CI: 1.26-1.67), 1.55 (95% CI: 1.39-1.74), and 1.43 (95% CI: 1.27-1.61), respectively. CONCLUSIONS: A history of statin use or dyslipidemia is associated with an increased odds of having a DED diagnosis. Further studies are needed to determine whether statin use and/or dyslipidemia increases the risk of DED.
Subject(s)
Dry Eye Syndromes/diagnosis , Dyslipidemias/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Adolescent , Adult , Aged , Case-Control Studies , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Coronary Disease/blood , Coronary Disease/drug therapy , Dry Eye Syndromes/blood , Dry Eye Syndromes/physiopathology , Dyslipidemias/blood , Dyslipidemias/physiopathology , Female , Humans , Male , Middle Aged , Odds Ratio , Retrospective Studies , Risk Assessment , Triglycerides/blood , Young AdultABSTRACT
Orbital lymphoma can result in rapid loss of vision if not diagnosed and treated in a timely manner. This patient presented with rapid visual loss and on examination had a rubeosis iridis with a hyphema as well as neovascular glaucoma with vitreous hemorrhage. His medical history included systemic diffuse large B-cell lymphoma and a workup ultimately revealed an orbital mass in the body of the optic nerve. Optic nerve biopsy demonstrated diffuse large B-cell lymphoma. To the authors' knowledge, neovascular glaucoma as the presentation of an extraocular diffuse large B-cell lymphoma has not been reported previously. Lymphomas of the orbit and its adnexa constitute roughly 1% of all non-Hodgkin lymphoma. Most cases are marginal-zone B-cell lymphomas, with the second most common being diffuse large B-cell lymphomas. Orbital lymphomas can rapidly progress to complete visual loss when not diagnosed early. The authors report a patient who presented with rapid visual loss due to hyphema, rubeosis iridis, neovascular glaucoma and vitreous hemorrhage secondary to orbital diffuse large B-cell lymphoma. Research methods were adherent to the ethical principles outlined in the Declaration of Helsinki as amended in 2013. The collection and evaluation of protected patient health information was Health Insurance Portability and Accountability Act compliant.The authors report a case of lymphoma metastatic to the optic nerve masquerading as neovascular glaucoma with vitreous hemorrhage.
