RESUMO
An 8-month-old baby girl, who accompanied her sister with an eye problem, was incidentally noticed to have smaller left eye compared to the right. The mother said that it had been present for 2 months. The child showed no detectable focal neurological deficits. Her vision was age appropriate in both eyes. A slight left-sided ptosis was present. Her eye movements were full in both eyes and there was no evidence of strabismus. Bilateral fundus examination was normal. The child had anisocoria (left pupil being smaller than the right one) and left hemifacial anhidrosis, which prompted the diagnosis of Horner's syndrome. Magnetic resonance imaging of her chest showed a mass lesion in the apical region of the left lung which was later excised and found to be a neuroblastoma. This emphasizes the importance of having an eye on the siblings of children who come to the hospital.
Une petite fille de 8 mois, qui accompagnait sa soeur souffrant d'un problème oculaire, a par hasard été remarquée pour avoir un oeil gauche plus petit que le droit. La mère a dit qu'il était présent depuis 2 mois. L'enfant n'a montré aucun déficit neurologique focal détectable. Sa vision était adaptée à l'âge pour les deux yeux. Un léger ptosis gauche était présent. Ses mouvements oculaires étaient normaux pour les deux yeux et il n'y avait aucun signe de strabisme. L'examen bilatéral du fond d'oeil était normal. L'enfant avait une anisocorie (la pupille gauche étant plus petite que la droite) et une anhidrose hémifaciale gauche, ce qui a conduit au diagnostic de syndrome de Horner. Une IRM thoracique réalisée a montré une masse tissulaire de la région apicale du poumon gauche qui a ensuite été réséquée.L'examen anatomopathologique a révélé qu'ils agissait d'un neuroblastome. Cela souligne l'importance de garder un oeil sur la fratrie des enfants qui viennent consulter à l'hôpital.
Assuntos
Acomodação Ocular , Aniridia/complicações , Ataxia Cerebelar/complicações , Deficiência Intelectual/complicações , Iris/anormalidades , Aniridia/diagnóstico , Ataxia Cerebelar/diagnóstico , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Deficiência Intelectual/diagnóstico , SíndromeRESUMO
The purpose of this study was to document the standard full field electroretinographic (ERG) and wide field multifocal electroretinographic (WF-mfERG) findings in eyes with recent onset hemi-retinal vein occlusion (HRVO) and to compare the electro-diagnostic findings in the affected and fellow eyes with reference to normative data. Eight patients with HRVO were assessed using ERG and WF-mfERG. WF-mfERG first order responses from the affected hemi-retinae and the unaffected hemi-retinae in each affected eye were compared. WF-mfERG responses from each affected hemi-retina and from the symmetrical hemi-retina of each fellow eye were compared. ERG responses between affected and unaffected eyes were also compared. All electrodiagnostic tests were compared to normative data (5-95% confidence limits derived from age-related controls). WF-mfERG P1 and N1 implicit times were greater for the affected hemi-retinae than for the unaffected hemi-retinae (p <0.05). WF-mfERG N1 and P1 implicit times were prolonged (p < 0.05) and WF-mfERG P1/N1 amplitude ratios were significantly reduced (p < 0.05) for the affected eyes when compared with the fellow eyes. Maximal b-wave, cone b-wave and flicker implicit times were prolonged (p < 0.05) when comparing affected and fellow eyes. These results indicate that retinal injury due to HRVO culminates in significant delay of both ERG and WF-mfERG implicit times. These results suggest that WF-mfERG in combination with ERG may have a role in the management of HRVO.
