RESUMO
Unwelcome hair has become a significant issue encountered in our society by young people, particularly young women. Hair removal has been achieved through various methods, both mechanical, with intense pulse light therapy and laser photoablation of hair follicles using various energy delivery systems. There is a relative paucity of clinical trials comparing the safety and efficacy of various hair removal modalities. A comparative study between alexandrite, diode, and intense pulsed light (IPL) was conducted and found similar safety profile across all three modalities. Several adverse effects have been noted as a result of this therapy. Laser-assisted hair removal can lead to ocular anterior segment and/or retinal injury. A laser beam directed toward the eye may easily penetrate both the eyelid or the cornea and cause catastrophic ocular injury. Unfortunately, regulation and licensing of the use of laser-assisted hair removal devices has not yet been well elucidated nor standardized across Australia. There are few cases in the literature reporting retinal burns following inadvertent laser injury, with even fewer directly involving the macula. We report a case of unilateral anterior uveitis and a macular defect following inadvertent laser exposure, leading to photophobia and pain, and reduced visual acuity.
Assuntos
Remoção de Cabelo , Terapia a Laser , Humanos , Feminino , Adolescente , Calibragem , Remoção de Cabelo/métodos , Lasers , FototerapiaAssuntos
Edema/etiologia , Olho/patologia , Doenças Orbitárias/etiologia , Trombose Venosa/diagnóstico , Seio Cavernoso/diagnóstico por imagem , Seio Cavernoso/patologia , Edema/diagnóstico , Olho/irrigação sanguínea , Humanos , Doenças do Aparelho Lacrimal/diagnóstico , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Doenças Orbitárias/diagnóstico , Trombofilia/diagnóstico , Trombofilia/terapia , Tomografia Computadorizada por Raios X/métodos , Veias/diagnóstico por imagem , Veias/patologia , Trombose Venosa/complicaçõesAssuntos
Ceratite por Acanthamoeba/etiologia , Úlcera da Córnea/etiologia , Infecções Oculares Bacterianas/etiologia , Procedimentos Ortoceratológicos/efeitos adversos , Infecções por Pseudomonas/etiologia , Ceratite por Acanthamoeba/diagnóstico , Ceratite por Acanthamoeba/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/uso terapêutico , Antiprotozoários/uso terapêutico , Criança , Úlcera da Córnea/diagnóstico , Úlcera da Córnea/tratamento farmacológico , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/isolamento & purificação , Adulto JovemRESUMO
Ethambutol is utilised in the treatment of Mycobacterium avium and Mycobacterium tuberculosis infection. The authors report two siblings who developed the adverse effect of ethambutol-induced optic chiasmopathy, with recovery following cessation of ethambutol. Discussion explores potential genetic predisposition to development of this condition and its resolution. Ethambutol optic neuropathy (EON), Leber's hereditary optic neuropathy (LHON), and other optic neuropathies of mitochondrial origin share a common pathophysiology. Consequently, the authors postulate treatments utilised in LHON, including vitamin B supplementation and idebenone, may have benefit in EON. This article presents concepts for further research, suggesting a potential genetic susceptibility to EON and its treatment.
Assuntos
Inibidores da Liberação da Acetilcolina/efeitos adversos , Toxinas Botulínicas Tipo A/efeitos adversos , Glaucoma de Ângulo Fechado/induzido quimicamente , Técnicas Cosméticas , Feminino , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/cirurgia , Gonioscopia , Humanos , Injeções Intradérmicas , Pressão Intraocular , Iridectomia , Pessoa de Meia-Idade , Órbita/efeitos dos fármacos , Tonometria Ocular , Testes de Campo Visual , Campos VisuaisRESUMO
Both intracranial hypertension and keratoconus may be associated with visual impairment. The authors present a case of a young female with poor right vision that did not improve despite treatment of her intracranial hypertension. Ophthalmic consultation diagnosed keratoconus as the cause.
Assuntos
Hipertensão Intracraniana/complicações , Ceratocone/complicações , Transtornos da Visão/etiologia , Acuidade Visual , Adulto , Feminino , HumanosAssuntos
Anti-Inflamatórios/uso terapêutico , Celulite Orbitária/diagnóstico por imagem , Prednisolona/uso terapêutico , Esclerite/diagnóstico por imagem , Esclerite/tratamento farmacológico , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Biópsia por Agulha , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Celulite Orbitária/tratamento farmacológico , Esclerite/patologia , Tomografia Computadorizada por Raios XRESUMO
Brimonidine tartarate is a selective alpha2-adrenergic receptor agonist that is indicated for use in the treatment of glaucoma and ocular hypertension. Since its introduction in 1997 there have been a small number of case reports concerning granulomatous anterior uveitis as a late adverse reaction to long-term brimonidine therapy. We report a case of bilateral anterior uveitis and granulomatous papillary conjunctivitis in a 78-year-old gentleman after 2 years of brimonidine therapy. Cessation of brimonidine lead to rapid termination of uveitis. The histologic features of the conjunctiva are described. This has not been previously reported.
Assuntos
Agonistas alfa-Adrenérgicos/efeitos adversos , Conjuntivite/induzido quimicamente , Quinoxalinas/efeitos adversos , Uveíte Anterior/induzido quimicamente , Agonistas de Receptores Adrenérgicos alfa 2 , Idoso , Tartarato de Brimonidina , Túnica Conjuntiva/patologia , Conjuntivite/diagnóstico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Granuloma/induzido quimicamente , Granuloma/diagnóstico , Humanos , Masculino , Uveíte Anterior/diagnósticoRESUMO
PURPOSE: To evaluate the management and outcomes of patients undergoing pars plana vitrectomy (PPV) for retained lens material after cataract surgery; and to evaluate risk factors for poor visual outcome, retinal detachment, raised intraocular pressure (IOP), and cystoid macular edema (CME). DESIGN: Retrospective interventional consecutive case series. METHODS: setting: Institutional and Clinical practice. study population: Patients with retained lens material after cataract surgery who underwent vitrectomy at Sydney Eye Hospital between July 1, 1998 and October 31, 2003. intervention: Standard three-port PPV/lensectomy. main outcome measures: Final best-corrected visual acuity (BCVA), retinal detachment, raised IOP, and CME. RESULTS: A total of 223 eyes of 223 patients were included, with a mean follow-up of 20.5 months after vitrectomy. Final BCVA was 6/12 or better in 159 patients (71.3%). Retinal detachment occurred in 20 patients (9%), with 11 diagnosed before or during vitrectomy, and nine occurring after vitrectomy. Ten patients (5.0%) developed raised IOP and 42 (23.2%) developed CME. Poor final visual acuity was associated with retinal detachment (P = .0026), and with poor visual acuity at presentation (P = .030). There was a significant association between retinal detachment and a long interval (>30 days) between cataract surgery and vitrectomy (P = .00047) and between retinal detachment and younger age (P = .0070). CONCLUSIONS: Visual acuity results in this study compared favorably with previously published reports. Although the overall rate of retinal detachment was low, it was significantly higher in those with a delayed interval between cataract surgery and vitrectomy, and was significantly associated with a poorer visual outcome.
Assuntos
Extração de Catarata/efeitos adversos , Complicações Intraoperatórias , Subluxação do Cristalino/cirurgia , Vitrectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Edema da Córnea/etiologia , Feminino , Seguimentos , Humanos , Pressão Intraocular/fisiologia , Subluxação do Cristalino/etiologia , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To examine the epidemiology of retinoblastoma in New South Wales (NSW), from 1975 to 2001, comparing the incidence with other parts of the developed world. METHODS: Examination of medical files for patients presenting to NSW retinoblastoma treatment centers between 1975 and 2001. Comparisons to international data were made. RESULTS: One hundred twenty-eight patients [63 (49.2%) male and 65 (51.8%) female] presented. The mean annual incidence of retinoblastoma in NSW was 8 per million children aged 0 to 6 years, per year. CONCLUSIONS: The incidence of retinoblastoma in NSW is similar to other parts of the developed world.
Assuntos
Neoplasias da Retina/epidemiologia , Retinoblastoma/epidemiologia , Idade de Início , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , New South Wales/epidemiologia , Prevalência , Distribuição por SexoRESUMO
PURPOSE: The aim of this study was to retrospectively review uveitis cases at The Children's Hospital at Westmead, Sydney, since its inception in 1997 to 2001, including patients presenting at the Camperdown, Sydney, campus between 1989 and 1997 attending Westmead for further care. Comparison is made with international centres. METHODS: Information was obtained from medical records. RESULTS: Forty patients (53 eyes) presented, of whom 23 (57.5%) were female and 17 (42.5%) were male (mean age 6.7 years). Of 53 eyes, 35 (66%) had anterior uveitis, three (5.7%) intermediate uveitis, seven (13.2%) posterior uveitis and eight (15.1%) panuveitis. Twenty-seven (67.5%) patients had disease unilaterally and 13 (32.5%) bilaterally. Twenty-four (60%) cases were idiopathic. Seven (17.5%) cases were associated with juvenile rheumatoid arthritis, three (7.5%) with herpes zoster, two (5%) with herpes simplex, two (5%) with toxocara, one (2.5%) with toxoplasma, and one (2.5%) with ulcerative colitis. Complications included cataract in 14 (26.4%) eyes; band keratopathy in four (7.5%) eyes; macular scarring in three (5.7%) eyes; and glaucoma in four (7.5%) eyes. Last measured acuity was 6/6 for 19 (35.8%) eyes, < or =6/18 for 15 (28.3%) eyes and <6/60 for eight (15.1%) eyes. CONCLUSIONS: Despite small numbers, the comparisons of this study with some international studies, and its contrasts with other studies, are due to similarities and differences amongst these studies with respect to factors of referral bias, and the aetiological basis of disease.
Assuntos
Uveíte/epidemiologia , Criança , Feminino , Humanos , Masculino , New South Wales/epidemiologia , Estudos Retrospectivos , Uveíte/complicações , Uveíte/terapiaRESUMO
This case report demonstrates cervical spinal cord pathology which presented with brainstem and cerebellar signs consequent to the peritumoural oedema that extended rostrally to the pontomedullary junction. A Medline search of the literature back to 1960 failed to produce any previous report of a cervical ependymoma presenting with brainstem and cerebellar signs purely consequent to oedema. This case highlights the need to look further afield when presented with the scenario of clinical features of a brainstem lesion with only oedema apparent on cranial imaging. It indicates the need to include cervical imaging well below the foramen magnum in these circumstances.
Assuntos
Tronco Encefálico/fisiopatologia , Cerebelo/fisiopatologia , Ependimoma/patologia , Ependimoma/cirurgia , Apraxia da Marcha/etiologia , Parestesia/etiologia , Neoplasias da Medula Espinal/patologia , Neoplasias da Medula Espinal/cirurgia , Vértebras Cervicais/patologia , Edema/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
PURPOSE: This study assesses the value of routinely investigating children with retinoblastoma with bone marrow aspiration and lumbar puncture, staging investigations not without risk and trauma to the patient, emotional stress on parents and financial cost to the community. METHODS: Medical files and specimens were obtained and examined for patients with retinoblastoma presenting to the Royal Alexandra Hospital for Children, Camperdown and the Children's Hospital at Westmead, Sydney, from 1975 to 2001. RESULTS: In total, 123 patients presented; 62 (50.4%) were boys and 61 (49.6%) were girls. Of these 123 patients, 74 (60.2%) had unilateral disease, 46 (37.4%) involving the left eye and 28 (22.8%) involving the right eye. There were 47 (38.2%) patients with bilateral disease, and two (1.6%) with trilateral disease. Mean age of presentation was 17.9 months (23.1 months for unilateral subjects; 10.3 months for bi-lateral subjects; 3.5 months for trilateral subjects). There were 13 (10.6%) with a positive family history. Of 74 unilateral subjects, 70 (94.6%) required enucleation and four (5.4%) were salvaged. Of 47 bilateral subjects, 13 (27.7%) did not require enucleation, 27 (57.4%) required unilateral enucleation and seven (14.9%) required bilateral enucleation. Both trilateral subjects died. Of all 123 subjects, 112 (91.1%) had bone marrow aspiration and lumbar puncture performed during initial assessment, and none showed evidence of malignancy. CONCLUSIONS: Given the small but significant risks associated with these procedures, the results of this study cannot support bone marrow aspiration and lumbar puncture as routine investigations in all patients presenting with retinoblastoma, suggesting a more limited usage of these investigations is warranted.