RESUMO
PURPOSE: To report a case of bilateral angle-closure associated with systemic hantavirus infection. MATERIALS AND METHODS: A 32-year-old Caucasian man was referred with blurred vision, fever, cough, dyspnea and thrombocytopenia. Ophthalmologic examination revealed myopic shift, elevated intraocular pressure (30 mmHg right eye and 24 mmHg left eye), corneal edema, iridocorneal angle closure and shallow anterior chamber. Ciliochoroidal effusion was detected on anterior segment optical coherence tomography and ultrasound biomicroscopy. Serologic test and polymerase chain reaction confirmed the diagnosis of hantavirus infection and the serotype Puumala. On the sixth day after he started topical anti-glaucoma and cycloplegic medications, the anterior chamber and iridocorneal angles were normalized with disappearance of ciliochoroidal effusion. CONCLUSION: Puumala hantavirus infection is an exceptional cause of acute bilateral angle-closure combined with ciliochoroidal effusion.
Assuntos
Efusões Coroides/virologia , Infecções Oculares Virais/virologia , Glaucoma de Ângulo Fechado/virologia , Infecções por Hantavirus/virologia , Orthohantavírus/isolamento & purificação , Doença Aguda , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Adulto , Anticorpos Antivirais/sangue , Tartarato de Brimonidina/uso terapêutico , Inibidores da Anidrase Carbônica/uso terapêutico , Efusões Coroides/diagnóstico , Efusões Coroides/tratamento farmacológico , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/tratamento farmacológico , Orthohantavírus/genética , Infecções por Hantavirus/diagnóstico , Infecções por Hantavirus/tratamento farmacológico , Humanos , Pressão Intraocular , Masculino , Microscopia Acústica , Miopia/diagnóstico , Miopia/tratamento farmacológico , Miopia/virologia , RNA Viral/sangue , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real , Tomografia de Coerência Óptica , Tonometria OcularRESUMO
Epidemic nephropathy, i.e. nephropatia epidemica is a febrile illness caused by the Puumala virus and involving a transient impairment in kidney function. Additional commonly experienced symptoms include headache, backache and limb pain, as well as drowsiness or restlessness and nausea. Visual disturbances appear in approx. one third of those affected with the disease. Blurring of vision is the most common problem. We describe a patient case in which a previously healthy woman contracted epidemic nephropathy causing ocular symptoms that were strong.
Assuntos
Glaucoma de Ângulo Fechado/virologia , Febre Hemorrágica com Síndrome Renal/complicações , Doença Aguda , Feminino , Finlândia , Febre Hemorrágica com Síndrome Renal/virologia , Humanos , Virus PuumalaRESUMO
PURPOSE: To report a case of bilateral simultaneous angle-closure glaucoma caused by septic condition of Korean hemorrhagic fever. METHODS: A 62-year-old man visited our emergency center with signs of sepsis (fever, leukocytosis, and oliguria). After 4 days of hospitalization, the patient reported blurred vision. Upon ophthalmologic examination, elevated intraocular pressure, edematous cornea, closed anterior chamber angle, and shallow anterior chamber without iris bowing were found in both eyes in slit-lamp examination and in Pentacam (Oculus, Wetzlar, Germany) Scheimpflug images. Bilateral choroidal effusion was observed on an ultrasound B scan as well. The serologic test for anti-hantaan virus immunoglobulin G (IgG) was positive. RESULTS: Along with the sepsis treatment, intravenous hyperosmotic agent, antiglaucoma eye drops, and 1% atropine eye drop were administered immediately. To control the choroidal effusion, systemic steroid was also administered. After 4 months, anterior chamber depth and choroidal effusion were normalized. CONCLUSIONS: Systemic causes should be considered in patients with bilateral angle-closure glaucoma, and Korean hemorrhagic fever can be one of the causes in endemic areas.
