RESUMO
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3 logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1â¯g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2â¯g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1â¯g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100â¯mg per day), subtenon triamcinolone (40â¯mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs.
Assuntos
Ácido Micofenólico , Síndrome Uveomeningoencefálica , Corticosteroides/uso terapêutico , Feminino , Angiofluoresceinografia , Humanos , Ácido Micofenólico/uso terapêutico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Acuidade VisualRESUMO
Presentamos el caso de una mujer hondureña de 27 años sin antecedentes médicos de interés que presentó múltiples áreas de desprendimientos de retina (DR) exudativos y una mejor agudeza visual corregida de 1,3logMAR en ambos ojos. Fue diagnosticada de síndrome de Vogt-Koyanagi-Harada incompleto y tratada con prednisolona intravenosa (1g/24h) durante 3 días, tal y como recomienda la evidencia publicada, junto con micofenolato de mofetilo (2g/24h). Durante el descenso paulatino de corticoesteroides, los DR recidivaron, por lo que se reintrodujeron las megadosis de 1g/24h de corticoesteroides intravenosos durante 6 días hasta la resolución completa de los DR y se añadieron ciclosporina (100mg/24h), triamcinolona subtenoniana (40mg/mL) e inyecciones intravítreas mensuales de ranibizumab en ambos ojos, con un adecuado control de la inflamación coroidea que se tradujo en la remisión de los síntomas y signos (AU)
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100mg per day), subtenon triamcinolone (40mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs (AU)
Assuntos
Humanos , Feminino , Adulto , Síndrome Uveomeningoencefálica/tratamento farmacológico , Ácido Micofenólico/uso terapêutico , Corticosteroides/administração & dosagem , Ácido Micofenólico/administração & dosagem , Resultado do Tratamento , Angiofluoresceinografia , Acuidade VisualRESUMO
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100mg per day), subtenon triamcinolone (40mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs.
Assuntos
Mitologia , Escultura , Anoftalmia , Grécia Antiga , História Antiga , Fotografação , Escultura/históriaRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/etiologia , Corioide/lesões , Ruptura/diagnóstico por imagem , Ruptura/etiologia , Tomografia de Coerência Óptica , Angiografia por Tomografia ComputadorizadaRESUMO
A retinal pigment epithelial (RPE) tear is a well-known complication of retinal pigment epithelial detachments (PED) and may cause a significant visual impairment. The most common cause is a vascularized PED in patients with exudative age-related macular degeneration (AMD). The development of diagnostic imaging techniques brings us closer to the etiology and pathophysiological mechanisms of this entity, offering us new strategies for treatment and follow-up. The advent of intravitreal antiangiogenic treatment (anti-VEGF) has led to an increase in the number of reported cases of RPE tears, which are an important vision-limiting factor during treatment. However, RPE tears may occur spontaneously or as a consequence of thermal laser treatment, photodynamic therapy or anti-VEGF therapy. It is accepted that the mechanism of RPE tears is multifactorial. The optimization of the functional outcome of this complication has been described with continuous treatment with antiangiogenic drugs. The goal of the present review is to evaluate the incidence, risk factors and treatment of RPE tears.
Assuntos
Perfurações Retinianas , Epitélio Pigmentado da Retina/lesões , Diagnóstico por Imagem/métodos , Humanos , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/terapia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/epidemiologia , Perfurações Retinianas/etiologia , Perfurações Retinianas/terapia , Epitélio Pigmentado da Retina/diagnóstico por imagem , Epitélio Pigmentado da Retina/cirurgia , Fatores de Risco , Ruptura Espontânea/diagnóstico , Ruptura Espontânea/epidemiologia , Ruptura Espontânea/etiologia , Ruptura Espontânea/terapiaRESUMO
No disponible