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1.
Zhonghua Yan Ke Za Zhi ; 56(12): 950-955, 2020 Dec 11.
Artigo em Chinês | MEDLINE | ID: mdl-33342122

RESUMO

Optical coherence tomography angiography (OCTA) is a novel, non-invasive imaging technology, which could acquire volumetric angiographic information. Numerous studies have reported the potential clinical use of OCTA in a variety of common retinal disorders. Polypoidal choroidal vasculopathy (PCV) is characterized by the formation of branching choroidal vascular networks (BVN) with terminal dilatations (polyps). Indocyanine green angiography (ICGA) remains the golden diagnostic standard for PCV. The clinical application of OCTA in PCV is also widely investigated recent years. But the results are controversially interpreted. In addition to various diagnostic accuracy of PCV from different studies, the clinical application of OCTA in PCV is limited. With the constant innovation of fundus imaging techniques, OCTA is reaching greater investigation depth and become more accurate at picking up blood flow signals, which also improves the diagnostic accuracy of PCV. In this paper, we reviewed the clinical application and research progress of OCTA in PCV, in order to provide some assistant for clinical practice and correct interpretation of the reports. (Chin J Ophthalmol, 2020, 56:950-955).


Assuntos
Doenças da Coroide , Neovascularização de Coroide , Corioide/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Neovascularização de Coroide/diagnóstico por imagem , Angiofluoresceinografia , Fundo de Olho , Humanos , Verde de Indocianina , Estudos Retrospectivos , Tomografia de Coerência Óptica
2.
Rev. bras. oftalmol ; 79(5): 336-339, set.-out. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1137986

RESUMO

Abstract Sclerochoroidal calcifications (SC) are a rare and benign ocular condition characterized by yellow-white irregular subretinal lesions usually found in the supero-temporal arcade of the midperipheral fundus in middle-aged elderly men. We present a clinical case of a 79- year-old patient who during a fundus examination presented raised whitish nodules in the supero-temporal arcade in the right eye. After performing optical coherence tomography, ultrasound, ocular computed tomography and laboratory analysis, she was diagnosed with idiopathic sclerochoroidal calcifications The pathogenesis of sclerochoroidal calcifications remains unclear but systemic conditions should be discarded. It is important to distinguish sclerochoroidal calcifications from other conditions such as tumors.


Resumo Calcificações esclerocoroidais (SC) são uma condição ocular rara e benigna caracterizada por lesões sub-retinianas irregulares amarelo-brancas, geralmente encontradas na arcada superotemporal do fundo médio-periférico em homens idosos de meia-idade. Apresentamos um caso clínico de uma paciente de 79 anos que durante exame de fundo apresentou nódulos esbranquiçados elevados na arcada superotemporal do olho direito. Após realizar tomografia de coerência óptica, ultra-sonografia, tomografia computadorizada ocular e análise laboratorial, ela foi diagnosticada com calcificações esclerocoroidais idiopáticas A patogênese das calcificações esclerocoroidais permanece incerta, mas as condições sistêmicas devem ser descartadas. É importante distinguir calcificações esclerocoroidais de outras condições, como tumores.


Assuntos
Calcinose/diagnóstico por imagem , Doenças da Esclera/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Diagnóstico Diferencial , Doenças Metabólicas
3.
Medicine (Baltimore) ; 99(35): e21934, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871935

RESUMO

RATIONALE: We report a case of central retinal artery occlusion (CRAO) accompanied by choroidal folds in a patient positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA). PATIENT CONCERNS: The study involved a 67-year-old female patient who presented at the Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan on October 24, 2016 after becoming aware of a sudden decrease of visual acuity (VA) in her right eye. Other than suffering with scleritis 6-months previous, there was no obvious past history. DIAGNOSIS: Upon examination, the VA in her right eye was hand motion, and the anterior segment of that eye showed thinning of the superior sclera. Macular edema in the inner retina and cherry red spots were observed in the ocular fundus, and optical coherence tomography (OCT) findings showed hyperreflectivity of the inner retina and choroidal folds. Fluorescein angiography (FA) examination of the fundus showed scattered areas of no retinal perfusion, and indocyanine green angiography (IA) findings of the fundus indicated a possible choroidal circulatory disturbance in her right eye. Blood test findings revealed the patient to be positive for MPO-ANCA. Based on the above findings, the patient was diagnosed with CRAO and choroidal circulatory disturbance due to ANCA-associated vasculitis. INTERVENTIONS: For treatment, steroid semi-pulse therapy was initiated. OUTCOMES: Post treatment initiation, the fundus features and choroidal folds gradually improved, and her VA slightly improved to 0.08. LESSONS: Based on the FA, IA, and OCT findings, the present case was considered to have CRAO accompanied by choroidal circulatory disturbance due to ANCA-associated vasculitis, a rare disease that may be complicated by choroidal circulatory disturbances.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Doenças da Coroide/etiologia , Oclusão da Artéria Retiniana/etiologia , Idoso , Anti-Inflamatórios/administração & dosagem , Azatioprina/administração & dosagem , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/tratamento farmacológico , Feminino , Angiofluoresceinografia , Glucocorticoides/administração & dosagem , Humanos , Prednisolona/administração & dosagem , Pulsoterapia , Oclusão da Artéria Retiniana/diagnóstico por imagem , Oclusão da Artéria Retiniana/tratamento farmacológico , Tomografia de Coerência Óptica , Baixa Visão/etiologia
5.
Arq. bras. oftalmol ; 83(1): 19-27, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1088958

RESUMO

ABSTRACT Purpose: To assess the reproducibility of retinal and choroidal measurements in the macular and peripapillary areas using swept-source optical coherence tomography in patients with Parkinson's disease. Methods: A total of 63 eyes of 63 patients with idiopathic Parkinson's disease were evaluated using a three-dimensional protocol of swept-source optical coherence tomography. The following layers were analyzed: full retinal thickness, retinal nerve fiber layer, ganglion cell layer, and choroid. The coefficient of variation was calculated for every measurement. Results: In the macular area, the mean coefficients of variation of retinal thickness, ganglion cell layer + thickness, and choroidal thickness were 0.40%, 0.84%, and 2.09%, respectively. Regarding the peripapillary area, the mean coefficient of variation of the retinal nerve fiber layer thickness was 2.78. The inferior quadrant showed the highest reproducibility (coefficient of variation= 1.62%), whereas the superonasal sector showed the lowest reproducibility (coefficient of variation= 8.76%). Conclusions: Swept-source optical coherence tomography provides highly reproducible measurements of retinal and choroidal thickness in both the macular and peripapillary areas. The reproducibility is higher in measurements of retinal thickness versus choroidal thickness.


RESUMO Objetivo: Avaliar a reprodutibilidade das medições da retina e da coroide nas áreas macular e peripapilar utilizando a tomografia de coerência ótica com fonte de varredura pacientes com doença de Parkinson. Métodos: Um total de 63 olhos de 63 pacientes com doença de Parkinson idiopática foram avaliados usando um protocolo 3D de tomografia de coerência ótica de fonte Triton Swept. Foram analisadas as seguintes camadas: espessura retiniana total, camada de fibras nervosas da retina, camada de células ganglionares e coróide. O coeficiente de variação foi calculado para cada medição. Resultados: Na área macular, os coeficientes médios de variação da espessura da retina, da camada de células ganglionares + espessura e da espessura da coróide foram de 0,40%, 0,84% e 2,09%, respectivamente. Em relação à área peripapilar, o coeficiente médio de variação da espessura da camada de fibras nervosas da retina foi de 2,78%. O quadrante inferior apresentou a maior reprodutibilidade (coeficiente de variação= 1,62%), enquanto o setor superonasal apresentou a menor reprodutibilidade (coeficiente de variação= 8,76%). Conclusões: A tomografia de coerência ótica de fonte Triton Swept fornece medições altamente reprodutíveis da espessura da retina e da coroide nas áreas macular e peripapilar. A reprodutibilidade é maior nas medidas da espessura da retina versus a espessura da coróide.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Parkinson/complicações , Retina/diagnóstico por imagem , Doenças da Coroide/etiologia , Doenças da Coroide/diagnóstico por imagem , Corioide/diagnóstico por imagem , Retina/anatomia & histologia , Retina/fisiopatologia , Reprodutibilidade dos Testes , Corioide/anatomia & histologia , Corioide/fisiopatologia , Tomografia de Coerência Óptica/métodos
6.
Arch. Soc. Esp. Oftalmol ; 95(1): 42-44, ene. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-195317

RESUMO

Se presenta a una niña de 3 meses de edad con un cuadro febril sin foco y con empeoramiento. La exploración fundoscópica mostró una lesión coroidea en el ojo izquierdo junto con lesiones en otros órganos sugestivas de tuberculosis diseminada. La evolución fue favorable tras tratamiento con cuádruple terapia antibiótica asociada a corticoterapia. La tuberculosis diseminada debe tenerse en cuenta ante un cuadro febril de tórpida evolución. La exploración oftalmológica de estos pacientes es fundamental, ya que, aunque es poco frecuente, los signos característicos de las uveítis posteriores nos orientarán hacia el diagnóstico y tratamiento precoz de esta enfermedad


A three-month old baby girl presented with fever of unknown origin and with signs of worsening of this episode. Funduscopy showed a solitary choroidal lesion in her left eye, as well as extraocular lesions suggesting disseminated tuberculosis. A favourable outcome was achieved after quadruple antibiotic course and cortisone therapy. Disseminated tuberculosis should be considered in cases of fever of unknown origin in children with an unsatisfactory evolution. Ocular examination is mandatory, due to the possible posterior uveitis signs that can help with early diagnosis and treatment of some diseases


Assuntos
Humanos , Feminino , Lactente , Doenças da Coroide/diagnóstico , Tuberculoma/diagnóstico , Tuberculose Miliar/diagnóstico , Tuberculose Ocular/diagnóstico , Corticosteroides/uso terapêutico , Amicacina/uso terapêutico , Antituberculosos/uso terapêutico , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/tratamento farmacológico , Quimioterapia Combinada , Etambutol/uso terapêutico , Isoniazida/uso terapêutico , Oftalmoscopia , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Tuberculoma/diagnóstico por imagem , Tuberculose Miliar/tratamento farmacológico , Tuberculose Ocular/diagnóstico por imagem , Tuberculose Ocular/tratamento farmacológico , Uveíte Posterior/diagnóstico , Uveíte Posterior/tratamento farmacológico
7.
Arq Bras Oftalmol ; 83(1): 19-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31664335

RESUMO

PURPOSE: To assess the reproducibility of retinal and choroidal measurements in the macular and peripapillary areas using swept-source optical coherence tomography in patients with Parkinson's disease. METHODS: A total of 63 eyes of 63 patients with idiopathic Parkinson's disease were evaluated using a three-dimensional protocol of swept-source optical coherence tomography. The following layers were analyzed: full retinal thickness, retinal nerve fiber layer, ganglion cell layer, and choroid. The coefficient of variation was calculated for every measurement. RESULTS: In the macular area, the mean coefficients of variation of retinal thickness, ganglion cell layer + thickness, and choroidal thickness were 0.40%, 0.84%, and 2.09%, respectively. Regarding the peripapillary area, the mean coefficient of variation of the retinal nerve fiber layer thickness was 2.78. The inferior quadrant showed the highest reproducibility (coefficient of variation= 1.62%), whereas the superonasal sector showed the lowest reproducibility (coefficient of variation= 8.76%). CONCLUSIONS: Swept-source optical coherence tomography provides highly reproducible measurements of retinal and choroidal thickness in both the macular and peripapillary areas. The reproducibility is higher in measurements of retinal thickness versus choroidal thickness.


Assuntos
Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/etiologia , Corioide/diagnóstico por imagem , Doença de Parkinson/complicações , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Idoso de 80 Anos ou mais , Corioide/anatomia & histologia , Corioide/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Retina/anatomia & histologia , Retina/fisiopatologia
8.
Arch Soc Esp Oftalmol ; 95(1): 42-44, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31771808

RESUMO

A three-month old baby girl presented with fever of unknown origin and with signs of worsening of this episode. Funduscopy showed a solitary choroidal lesion in her left eye, as well as extraocular lesions suggesting disseminated tuberculosis. A favourable outcome was achieved after quadruple antibiotic course and cortisone therapy. Disseminated tuberculosis should be considered in cases of fever of unknown origin in children with an unsatisfactory evolution. Ocular examination is mandatory, due to the possible posterior uveitis signs that can help with early diagnosis and treatment of some diseases.


Assuntos
Doenças da Coroide/diagnóstico , Tuberculoma/diagnóstico , Tuberculose Miliar/diagnóstico , Tuberculose Ocular/diagnóstico , Corticosteroides/uso terapêutico , Amicacina/uso terapêutico , Antituberculosos/uso terapêutico , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/tratamento farmacológico , Quimioterapia Combinada , Etambutol/uso terapêutico , Feminino , Humanos , Lactente , Isoniazida/uso terapêutico , Oftalmoscopia , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Tuberculoma/diagnóstico por imagem , Tuberculose Miliar/tratamento farmacológico , Tuberculose Ocular/diagnóstico por imagem , Tuberculose Ocular/tratamento farmacológico , Uveíte Posterior/diagnóstico , Uveíte Posterior/tratamento farmacológico
9.
Indian J Ophthalmol ; 68(1): 130-133, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31856490

RESUMO

Purpose: To investigate choroidal hyper-reflective foci (HRF) in subjects with retinal dystrophy [Stargardt's disease (SGD) and retinitis pigmentosa (RP)] and their association with demographics, visual acuity, choroidal thickness (CT), and choroidal vascularity index (CVI). Methods: Single center retrospective study of subjects with previously diagnosed SGD or RP. Swept-source optical coherence tomography images were analyzed for the presence of choroidal HRFs and CVI using previously validated automated algorithm. A Spearman's rank correlation coefficient was used to evaluate the correlation between the number of HRF and various baseline parameters including age, visual acuity, intraocular pressure, and other optical coherence tomography (OCT) parameters (CT, choroidal area, and CVI) were evaluated in these subjects. Results: This study included 46 eyes (23 subjects) and 55 eyes (28 subjects) with previously diagnosed RP and SGD, respectively. In the RP group, the mean number of HRFs was 247.9 ± 57.1 and mean CVI was 0.56 ± 0.04. In SGD group, mean HRF was 192.5 ± 44.3 and mean CVI was 0.41 ± 0.04. Mean HRF was significantly greater in the RP group (0.02), however, the mean CVI was not statistically different. In RP, mean HRF were correlated only with CVI (r = 0.49; P = 0.001), however, in SGD, it correlated with only choroidal area (r = 0.27; P = 0.04). Conclusion: Choroidal HRF were present in both RP and SGD subjects with more HRFs in those with RP. These HRFs were associated with alteration in choroidal vascularity, which further adds into the pathogenesis of these diseases.


Assuntos
Doenças da Coroide/fisiopatologia , Corioide/irrigação sanguínea , Retinite Pigmentosa/fisiopatologia , Doença de Stargardt/fisiopatologia , Adolescente , Adulto , Corioide/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Vasos Retinianos/fisiopatologia , Retinite Pigmentosa/diagnóstico por imagem , Estudos Retrospectivos , Doença de Stargardt/diagnóstico por imagem , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Adulto Jovem
10.
Eur J Ophthalmol ; 30(5): 886-890, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31394930

RESUMO

PURPOSE: In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography. MATERIALS AND METHODS: A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet). RESULTS: Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(-) or anti-TG2 (-) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = -0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months. CONCLUSION: In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement.


Assuntos
Doença Celíaca/complicações , Doenças da Coroide/etiologia , Corioide/patologia , Adolescente , Estudos de Casos e Controles , Doença Celíaca/dietoterapia , Criança , Pré-Escolar , Corioide/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Dieta Livre de Glúten , Feminino , Humanos , Masculino , Cooperação do Paciente , Tomografia de Coerência Óptica
11.
Eur J Ophthalmol ; 30(5): NP66-NP68, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31801355

RESUMO

PURPOSE: To report the morphological and clinical features of a case of retinitis pigmentosa with large choroidal excavation. METHODS: The patient underwent a complete ophthalmologic examination including best-corrected visual acuity assessment, anterior segment and dilated fundus examination and spectral-domain optical coherence tomography. RESULTS: A 41-year-old woman affected by retinitis pigmentosa with genetic confirmation with mutation in RDH12 gene had a best-corrected visual acuity of 20/50 in both eyes. Dilated fundus examination revealed waxy pallor of the optic disc, diffuse narrowing of the retinal arterioles and a generalized retinal pigment epithelium mottling with bony spicule associated with diffuse retinal atrophy. At the posterior pole, an extended bilateral chorioretinal atrophy was evident with a partial sparing of the macular area. On spectral-domain optical coherence tomography, a bilateral large choroidal excavation could be clearly detected and it was associated with a diffuse retinal thinning at the posterior pole and a partial sparing of the fovea. CONCLUSION: Large choroidal excavation has been rarely reported. Although the pathogenetic mechanisms leading to the formation of large choroidal excavation are still a matter of debate, a combination of primary degenerative-inflammatory factors could be retained responsible for the large choroidal excavation development.


Assuntos
Doenças da Coroide/complicações , Retinite Pigmentosa/complicações , Adulto , Oxirredutases do Álcool/genética , Doenças da Coroide/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Humanos , Implante de Lente Intraocular , Facoemulsificação , Retinite Pigmentosa/diagnóstico por imagem , Retinite Pigmentosa/genética , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia
13.
Arq. bras. oftalmol ; 82(6): 522-527, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1038687

RESUMO

ABSTRACT A 26-year-old woman presented at 28 weeks gestation with hypertensive choroidopathy associated with pre-eclampsia. Fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography were performed in both eyes in the immediate postoperative period. SD-OCT images were obtained before delivery and during a 3-month follow-up. Fundus autofluorescence exhibited patchy hyper- and hypoautofluorescent lesions; fluorescein and indocyanine green angiography revealed areas of choroidal ischemia; and SD-OCT showed disorganization of the outer retinal layers and disruption of the ellipsoid zone. After her blood pressure was stabilized, progressive recovery of the outer retinal layer was monitored on SD-OCT.


RESUMO Uma mulher de 26 anos de idade, com 28 semanas de gestação apresentando coroidopatia hipertensiva associada à pré-eclâmpsia. Retinografia, autofluorescência, tomografia de coerência óptica de domínio espectral, angiofluoresceínografia e angiografia com indocianina verde foram realizadas em ambos os olhos no período pós-operatório imediato do parto. Imagens da tomografia de coerência óptica de domínio espectral foram obtidas antes do parto e durante o seguimento de 3 meses. A autofluorescência apresentou lesões heterogêneas hiper e hipoautofluorescentes, a angiofluoresceínografia e angiografia com indocianina verde revelaram áreas de isquemia de coroide, e a tomografia de coerência óptica de domínio espectral apresentou desorganização das camadas externas da retina e interrupção da zona elipsóide. Após a estabilização da pressão sanguínea, a recuperação progressiva da camada externa da retina foi monitorada pela tomografia de coerência óptica de domínio espectral.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Pré-Eclâmpsia , Doenças da Coroide/etiologia , Doenças da Coroide/diagnóstico por imagem , Hipertensão/etiologia , Hipertensão/diagnóstico por imagem , Remissão Espontânea , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , Epitélio Pigmentado da Retina/patologia , Epitélio Pigmentado da Retina/diagnóstico por imagem
14.
Arq Bras Oftalmol ; 82(6): 522-527, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576924

RESUMO

A 26-year-old woman presented at 28 weeks gestation with hypertensive choroidopathy associated with pre-eclampsia. Fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography were performed in both eyes in the immediate postoperative period. SD-OCT images were obtained before delivery and during a 3-month follow-up. Fundus autofluorescence exhibited patchy hyper- and hypoautofluorescent lesions; fluorescein and indocyanine green angiography revealed areas of choroidal ischemia; and SD-OCT showed disorganization of the outer retinal layers and disruption of the ellipsoid zone. After her blood pressure was stabilized, progressive recovery of the outer retinal layer was monitored on SD-OCT.


Assuntos
Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/etiologia , Hipertensão/diagnóstico por imagem , Hipertensão/etiologia , Pré-Eclâmpsia , Adulto , Feminino , Angiofluoresceinografia/métodos , Humanos , Gravidez , Remissão Espontânea , Epitélio Pigmentado da Retina/diagnóstico por imagem , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos
16.
Cesk Slov Oftalmol ; 75(2): 80-84, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31537076

RESUMO

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is relatively rare and especially less known and therefore less often diagnosed condition of the retina periphery predominantly in patients of higher age. Usually temporal periphery is affected. The finding is bilateral in approximately  30 %. Clinically it manifests by multibulbar prominences in periphery, which can sometimes resemble choroidal melanoma. It concerns exudations and hemorrhages under retina (sub-retinal) or under retinal pigment epithelium (sub-RPE). Within weeks or months hemorrhagy is resorbed and flattened and chorioretinal atrophy of various grade remains in affected area, sometimes combined with retinal fibrosis. If the affected area remains limited to the periphery, the central visual acuity does not have to be reduced. Affection is considered to be peripheral form of wet age-related macular degeneration or peripheral form of idiopathic polypoidal choroidal vasculopathy. By differential diagnosis is necessary to exclude especially malignant choroidal melanoma and choroidal detachment. Case report: Own case of 83 years old patient with bilateral PEHCR is described and photo documented. Creation of new prominence - fresh bleeding under retina and RPE in superior periphery - had been captured. Photo documentation of lesion in early stage and in stage of resorbtion after several weeks. Affected areas remained limited to periphery and did not have influence on central vision. That was influenced by degeneration of macula and vitreomacular traction syndrome with distinct epiretinal membrane. Conclusion: PEHCR is less frequent or less diagnosed condition of the retina periphery in old patients. Ongoing exudation and sub-retinal or sub-RPE bleeding. Within weeks heals with chorioretinal scars and subretinal fibrosis. Central vision does not have to be damaged, if lesions do not spread to macula.


Assuntos
Doenças da Coroide , Macula Lutea , Idoso de 80 Anos ou mais , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/patologia , Angiofluoresceinografia , Humanos , Hemorragia Retiniana , Epitélio Pigmentado da Retina
17.
BMC Ophthalmol ; 19(1): 199, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488090

RESUMO

BACKGROUND: To report the successful treatment of ocular toxoplasmosis and present the use of multimodal imaging to describe the changes in ocular toxoplasmic lesions subsequent to treatment. CASE PRESENTATION: A 73-year-old female visited the clinic with decreased visual acuity in the left eye. Fundus examination showed severe vitreous haze with yellow-white infiltrates near the foveal center. Spectral-domain optical coherence tomography (SD-OCT) revealed disorganization of the retinal structure with markedly thickened choroid beneath the active lesion. Highly elevated serum titers of IgG antibodies against Toxoplasma gondii were observed. Topical and systemic steroids with oral Bactrim were administered after a diagnosis of ocular toxoplasmosis was made. After improvement in the severity of vitritis, structural en face swept-source optical coherence tomography (SS-OCT) imaging demonstrated diffuse choroidal dilation with many collateral vascular branches surrounding the active lesion. Eight intravitreal injections of clindamycin (1 mg/0.1 ml) were administered at 1- to 2-week intervals along with systemic antibiotics and steroids. After the treatment, the toxoplasmic lesion resolved to an atrophic chorioretinal scar. Dilated choroidal vessel size was normalized and collateral vascular branches were markedly constricted on structural en face SS-OCT images. CONCLUSIONS: This is the first detailed report on the morphological changes in the choroidal vasculature surrounding ocular toxoplasmic lesions that were characterized using SS-OCT-A imaging. Multimodal imaging with SS-OCT-A can be valuable in clinical diagnosis as well as in clarifying the mechanism of choroidal structural changes in ocular toxoplasmosis.


Assuntos
Doenças da Coroide/patologia , Infecções Oculares Parasitárias/patologia , Epitélio Pigmentado da Retina/patologia , Toxoplasmose Ocular/patologia , Idoso , Antibacterianos/uso terapêutico , Anticorpos Antiprotozoários/sangue , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/tratamento farmacológico , Clindamicina/uso terapêutico , Infecções Oculares Parasitárias/diagnóstico por imagem , Infecções Oculares Parasitárias/tratamento farmacológico , Feminino , Angiofluoresceinografia/métodos , Humanos , Imunoglobulina G/sangue , Imagem Multimodal , Epitélio Pigmentado da Retina/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Toxoplasmose Ocular/diagnóstico por imagem , Toxoplasmose Ocular/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Acuidade Visual/fisiologia
18.
PLoS One ; 14(6): e0218107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181108

RESUMO

PURPOSE: To determine the early signs of posterior staphylomas in highly myopic eyes of younger subjects by swept-source ultra-widefield optical coherence tomography (WF-OCT). METHODS: This was an observational case series study. Highly myopic subjects younger than 20 years old who were examined consecutively by prototype WF-OCT were studied. High myopia was defined according to the Ministry of Health and Welfare, Japan classification. A posterior displacement of the sclera and two OCT features indicating the staphyloma edges were used as markers of a staphyloma. RESULTS: Fifty-five eyes of 30 patients with the mean age of 12.3 years, and the mean axial length of 27.9 mm were studied. Seven of the 55 eyes (12.7%) had a posterior displacement of the sclera and were diagnosed as having a staphyloma. Among the two OCT features of the staphyloma edges, a gradual thinning of the choroid toward the staphyloma edge and gradual re-thickening of choroid from the staphyloma edge toward the posterior pole were found in these 7 eyes. However, the other feature of an inward protrusion of the sclera at the staphyloma edge, was obvious in only 2 eyes. The subfoveal choroid and choroid nasal to the optic disc were significantly thinner in eyes with a staphyloma than those without it. CONCLUSIONS: The changes of the choroidal thickness toward the staphyloma edge with the posterior displacement of the sclera were considered an early sign which precedes an inward protrusion of sclera at the staphyloma edge.


Assuntos
Miopia Degenerativa/complicações , Doenças da Esclera/patologia , Tomografia de Coerência Óptica/métodos , Adolescente , Criança , Corioide/diagnóstico por imagem , Corioide/patologia , Doenças da Coroide/diagnóstico por imagem , Diagnóstico Precoce , Humanos , Japão , Miopia Degenerativa/diagnóstico por imagem , Miopia Degenerativa/patologia , Doenças da Esclera/diagnóstico , Doenças da Esclera/diagnóstico por imagem
20.
Semin Ophthalmol ; 34(4): 211-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31131663

RESUMO

Optical coherence tomography angiography (OCT-A) has enabled fast, non-invasive, high-resolution visualization of vasculature within the eye. In the past few years, it has become increasingly utilized for a range of disorders including age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and uveitis among others. This article reviews technical aspects of OCT-A, its applications in chorioretinal disease, and known limitations of the technology.


Assuntos
Doenças da Coroide/diagnóstico por imagem , Técnicas de Diagnóstico Oftalmológico , Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Humanos , Vasos Retinianos/diagnóstico por imagem
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