Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.468
Filtrar
2.
Niger Postgrad Med J ; 26(4): 205-210, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621659

RESUMO

Background: Knowledge of the ophthalmic manifestations of leukaemia is important not only because of the frequency with which changes are seen but because the eye often reflects the disease state of the illness, and once identified, prompt referral, early treatment can be instigated, blindness can be averted and a life may be saved. These manifestations are often overlooked because of the underestimation of the magnitude of the ocular sequelae which may be blinding. Aim: This study aims to describe the ophthalmic findings in adult leukaemic patients at two teaching hospitals in Lagos, Nigeria. Patients and Methods: This was a clinic-based, comparison multicentre study conducted at Lagos University Teaching Hospital and Lagos State University Teaching Hospital over a 9-month period of May 2012-January 2013. The cases were newly diagnosed leukaemic patients (acute and chronic) from the haematology clinics. Controls were escorts of apparently normal patients. Detailed ocular examination was carried out after written informed consent was obtained. Analysis was done using SPSS 17. Results: A total of 160 eyes in 80 individuals examined comprised forty cases and forty controls. The results of the cases were compared with the age- and sex-matched controls. Leukaemic-related ophthalmic manifestations were present in 56 eyes (70.0%) of the cases studied. Findings in cases were periorbital oedema in 8 eyes (10%), subconjunctival haemorrhage in four eyes (5%), intraretinal haemorrhage as found in 25 eyes (31.3%), retinal venous tortuosity in 21 eyes (26.3%), Roth spots in 19 eyes (23.8%) and retinal infiltrates in 17 eyes (21.3%). Conclusion: Ophthalmic disorders occur in adult patients living with leukaemia. Prompt initial and periodic ophthalmic evaluation is recommended in all leukaemic patients.


Assuntos
Oftalmopatias/etiologia , Olho/patologia , Leucemia/complicações , Hemorragia Retiniana/etiologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Hospitais de Ensino , Humanos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Hemorragia Retiniana/epidemiologia
3.
Ann Biol Clin (Paris) ; 77(4): 439-445, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418706

RESUMO

A 67 years old woman with a Waldenström disease was admitted in the intensive care unit for dyspnea and fever. During hospitalization, episodes of undetectable glycemia were observed without any hypoglycemia symptoms. Plasma glucose was determined with the hexokinase method (recommended). From this observation, a literature review on PubMed was performed to investigate similar cases. In patients with protides in excess (e.g. immunoproliferative syndrome), absorption measurements could be disrupted by the precipitation of excess protein (IgM in most cases). Other parameters could be affected: bilirubin, phosphate, HDL cholesterol, GGT, CRP and calcemia. In our case, the main difficulty was to identify the cause of the interference and then correct it. Using a series of dilution, we prevented protide precipitation allowing correct glucose determination. Those interferences are rare, but present a real analytical difficulty. Biologists should be aware of those interferences because of dramatics consequences.


Assuntos
Análise Química do Sangue/métodos , Glicemia/análise , Hexoquinase/metabolismo , Hipoglicemia/diagnóstico , Paraproteínas/efeitos adversos , Macroglobulinemia de Waldenstrom/sangue , Idoso , Artefatos , Análise Química do Sangue/normas , Glicemia/metabolismo , Diagnóstico Diferencial , Dispneia/sangue , Dispneia/diagnóstico , Dispneia/etiologia , Reações Falso-Positivas , Feminino , Febre/sangue , Febre/diagnóstico , Febre/etiologia , Hexoquinase/química , Humanos , Hipoglicemia/sangue , Paraproteínas/metabolismo , Hemorragia Retiniana/sangue , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/etiologia , Macroglobulinemia de Waldenstrom/complicações , Macroglobulinemia de Waldenstrom/diagnóstico
4.
Arch. Soc. Esp. Oftalmol ; 94(8): 409-412, ago. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185629

RESUMO

Mujer de 20 años de edad con disminución brusca de visión en el ojo izquierdo. En la exploración de fondo de ojo, se observó una hemorragia prerretiniana focal en la arcada temporal superior con hemovítreo acompañante. La evolución espontánea fue favorable. A los 18 meses presentó una nueva pérdida visual en ese ojo, objetivándose una hemorragia premacular subhialoidea que fue drenada satisfactoriamente mediante una hialoidotomía con láser Nd-YAG. La paciente había presentado además, una hemorragia digestiva alta y menorragia. Se le realizó un estudio de la hemostasia que demostró un déficit del factor VII de la coagulación. Se trata de un trastorno muy infrecuente que, con anterioridad, no se había descrito en asociación a la aparición de hemorragias prerretinianas


The case concerns a 20 year-old woman with a sudden visual loss in her left eye. In the fundus examination, a focal pre-retinal haemorrhage was observed in the superior temporal vascular branch with accompanying vitreous haemorrhage. There was a favourable spontaneous outcome. Eighteen months later, she presented with a new visual loss in the same eye, showing a sub-hyaloid pre-macular haemorrhage that was satisfactorily drained by hyaloidotomy using a Nd-YAG laser. The patient had also presented with an upper digestive tract haemorrhage and menorrhagia. A haemostasis study was performed that showed a coagulation factor VII deficiency. This is a very uncommon disorder that has not been previously described in association with the appearance of pre-retinal haemorrhages


Assuntos
Humanos , Feminino , Adulto Jovem , Cegueira/etiologia , Deficiência do Fator VII/complicações , Hemorragia Retiniana/etiologia , Hemorragia Vítrea/etiologia , Deficiência do Fator VII/diagnóstico , Fundo de Olho , Lasers de Estado Sólido/uso terapêutico , Recidiva , Hemorragia Retiniana/diagnóstico por imagem , Hemorragia Retiniana/cirurgia , Hemorragia Vítrea/diagnóstico por imagem
5.
Medicine (Baltimore) ; 98(26): e16215, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261575

RESUMO

RATIONALE: Optic disk hemorrhage has been closely correlated with glaucoma for its development and progression. Phacoemulsification surgery results in large intraocular pressure (IOP) fluctuation. We report a case of optic disk hemorrhage and consequently progressive vitreous hemorrhage after an unsuccessful phacoemulsification surgery in an advanced normal tension glaucoma (NTG) patient. PATIENT CONCERNS: An advanced NTG patient of 82 years old with chronic hypertension underwent an unsuccessful phacoemulsification surgery complicated by posterior capsule rupture. During the postoperative 2 weeks, recurrent episodes of fresh hyphema occurred and B ultrasonography scan revealed the progressive vitreous hemorrhage. The IOP went out of control under the maximum tolerable IOP-lowering medications. DIAGNOSIS: Vitreous hemorrhage after phacoemulsification in an advanced NTG patient. INTERVENTIONS: Vitrectomy was performed to search for the cause of the progressive vitreous hemorrhage. After removal of the thick vitreous hemorrhage, a fresh spot of optic disk hemorrhage was detected at the nasal margin of the significantly-cupping disk. OUTCOMES: Postoperatively, the hemorrhagic vitreous opacity gradually resolved and the IOP remained stable at 10 ∼13 mmHg with topical prostaglandin analogue drops. Fundus examination revealed the dilated disk vessel with localized angiomatous change at the nasal disk margin. LESSONS: Severe optic disk hemorrhage may occur after phacoemulsification in advanced glaucoma patients. Systemic vascular factors, such as chronic hypertension and old age, and surgical complications, such as posterior capsule rupture and postoperative IOP elevation, would further increase the risk. For phacoemulsification in advanced glaucoma cases, extra care should be taken to control intraoperative IOP fluctuations and monitor postoperative IOP.


Assuntos
Glaucoma/complicações , Disco Óptico , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/etiologia , Hemorragia Retiniana/etiologia , Hemorragia Vítrea/etiologia , Idoso de 80 Anos ou mais , Humanos , Masculino
7.
Jpn J Ophthalmol ; 63(5): 382-388, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31243593

RESUMO

PURPOSE: To examine the outcomes of vitrectomy with subretinal tissue plasminogen activator (tPA) injection and postoperative intravitreal antivascular endothelial growth factor (VEGF) injection for submacular hemorrhage (SMH) associated with polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Retrospective, consecutive case series. METHODS: Patients who underwent vitrectomy for SMH associated with PCV and who were followed up for at least 12 months were included. Surgery consisted of vitrectomy with subretinal tPA and air tamponade. Postoperative intravitreal anti-VEGF was administered pro re nata. The following were examined: best-corrected visual acuity (BCVA) at baseline, at 1 month, and at the final visit; the percentage of patients requiring anti-VEGF postoperatively; and the number of injections administered. RESULTS: This study included 23 eyes of 23 patients (21 men, 2 women) with a mean age of 72.5 ± 9.0 years. The mean duration from disease onset to surgery was 9.0 ± 6.6 days. The mean maximum SMH size was 5.8 ± 4.8 disc diameters. The mean follow-up period was 33 ± 14 months. The BCVA was significantly improved when compared with baseline 1 month after surgery and at the final visit. Postoperative anti-VEGF was required for 91% of the eyes. In eyes that underwent anti-VEGF therapy until the final visit, the mean injection number was 4.1/year. CONCLUSIONS: Vitrectomy with subretinal tPA and air tamponade improved visual acuity in patients with SMH associated with PCV. Postoperative intravitreal anti-VEGF injection maintained the improved BCVA throughout a mean period of 33 months.


Assuntos
Doenças da Coroide/complicações , Corioide/irrigação sanguínea , Pólipos/complicações , Hemorragia Retiniana/terapia , Ativador de Plasminogênio Tecidual/administração & dosagem , Acuidade Visual , Vitrectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Doenças da Coroide/diagnóstico , Feminino , Fibrinolíticos/administração & dosagem , Seguimentos , Humanos , Injeções Intraoculares , Masculino , Pessoa de Meia-Idade , Pólipos/diagnóstico , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento
8.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1955-1962, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31197448

RESUMO

PURPOSE: To compare the clinical characteristics and outcomes of eyes with unilateral disc hemorrhage (DH) in different locations. METHODS: This was a retrospective cohort study. DHs were classified by locations: the superior, superotemporal, inferotemporal, or inferior sectors of optic disc were classified as the susceptible area, while other sectors were defined as the less susceptible area. Structural and functional outcomes were analyzed by the Humphrey field analyzer and spectral domain optical coherence tomography. RESULTS: Forty-three eyes with DHs in the susceptible area were less myopic and had more peripapillary-type DH, larger cup-to-disc ratio, cup volume, and disc area. Thirty-three eyes with DHs in the less susceptible area had less association with RNFL defects, greater tilted ratio, and less torsion of the disc. Follow-up revealed that the change in sectoral RNFL (µm) thickness was significantly greater for DHs in the susceptible area within one year (- 6.0 ± 14.0 vs. 0.7 ± 13.0, p = 0.035) and two years (- 10.0 ± 17.4 vs. - 1.1 ± 7.6, p = 0.012), while the change in average RNFL thickness was not different. Eyes with DHs in the susceptible area had faster MD deterioration (dB/year) than those in the less susceptible area within four years (- 0.32 ± 0.51 vs. - 0.05 ± 0.45, p = 0.047). A total of 16.9% of eyes, all in the susceptible area, had localized VF progression at DH corresponding area. CONCLUSION: Disc hemorrhage in the superotemporal and inferotemporal regions had more subsequent structural and functional deterioration compared with the eyes with DHs in the temporal quadrant and nasal area.


Assuntos
Glaucoma/complicações , Disco Óptico/irrigação sanguínea , Doenças do Nervo Óptico/diagnóstico , Células Ganglionares da Retina/patologia , Hemorragia Retiniana/diagnóstico , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia , Feminino , Seguimentos , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Doenças do Nervo Óptico/etiologia , Hemorragia Retiniana/etiologia , Estudos Retrospectivos , Acuidade Visual
9.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1963-1970, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31209566

RESUMO

PURPOSE: In order to clarify the association between peripapillary vascular changes and disc hemorrhage (DH) occurrences over time, we analyzed the density of radial peripapillary capillary (RPC) and clinical parameters during follow-up periods in patients with normal-tension glaucoma (NTG). METHODS: Seventy-seven eyes of 77 NTG patients were subjected to analysis. We selected patients who had an initial optical coherence tomography angiography (OCTA) scan in 2015 and who had another OCTA scan in 2018 with both OCTA scans showing good-quality images. We investigated the relationships between DH occurrence and each of the following parameters: RPC density, circumpapillary retinal nerve fiber layer (cpRNFL) thickness slope and total deviation (TD) slope. RESULTS: In the period between the initial and final OCTA, we categorized the patients into 53 sides with DH (DH group) and 101 sides without DH (non-DH group). The ΔRPC density of sides with DH was significantly greater than that of sides without DH (DH, - 4.42 ± 6.43%; without DH, - 2.48 ± 5.29%; p = 0.0469). The cpRNFL thickness slope of sides with DH was significantly faster than that of sides without DH (DH, - 2.85 ± 3.17; without DH, - 0.74 ± 2.46 µm/y; p < 0.0001). The TD slope of sides with DH was significantly faster than that of sides without DH (DH, - 0.50 ± 0.77; without DH, - 0.22 ± 0.53 dB/y; p = 0.0163). As DH occurrence increased, the RPC density significantly decreased (r = -0.255, p = 0.0014). Stepwise multiple regression analysis to identify factors influencing RPC changes showed that frequency of DH (ß = - 0.224, p = 0.008) and central corneal thickness (ß = - 0.220, p = 0.009) were significantly associated with RPC changes. CONCLUSIONS: DH occurrence may prompt the structural and vascular deterioration of NTG.


Assuntos
Angiofluoresceinografia/métodos , Pressão Intraocular , Glaucoma de Baixa Tensão/diagnóstico , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina/patologia , Hemorragia Retiniana/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Capilares/patologia , Feminino , Seguimentos , Fundo de Olho , Humanos , Glaucoma de Baixa Tensão/complicações , Glaucoma de Baixa Tensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/fisiopatologia , Vasos Retinianos/patologia , Estudos Retrospectivos , Campos Visuais
10.
Invest Ophthalmol Vis Sci ; 60(6): 1824-1832, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31042788

RESUMO

Purpose: To establish the existence of minute-sized optic disc hemorrhage (DH; i.e., optic disc microhemorrhage [micro-DH]) in primary open-angle glaucoma (POAG) and to evaluate its clinical implications for glaucoma progression. Design: Retrospective analysis of prospectively collected data. Methods: POAG patients with macro-DH who had met the following conditions were included: follow-up period 7 years or longer (at least 3 years before and at least 4 years after the date of first macro-DH), and more than nine reliable VF results. Micro-DH was defined as a less than 0.01-mm2 area DH that is undetectable on conventional stereo disc photography (SDP) but can be discriminated by enhanced SDP. SDPs were enhanced by customized image-compensation software. Each enhanced image was evaluated to determine the presence of micro-DH. VF progression was confirmed by standard automated perimetry's guided progression analysis. Results: Among the 107 POAG eyes with macro-DH, micro-DH was detected prior to macro-DH in 39 (36.4%), the median time lag being 13.6 months. Over the course of the mean 7.1 ± 0.8-year follow-up period, 40 of 107 eyes showed VF progression: 21 (53.8%) of the 39 eyes of the micro-DH positive group and 19 (27.9%) of the 68 eyes of the micro-DH-negative group (P = 0.008). In the micro-DH-positive group, the cumulative VF-progression probability was significantly greater (P = 0.001), and the overall VF-deterioration rate was much faster (-1.01 ± 0.58 vs. -0.78 ± 0.49 dB/year, P = 0.029). Conclusions: Micro-DH was found prior to macro-DH detection in a significant proportion of POAG patients; micro-DH, moreover, was associated with earlier and faster VF progression.


Assuntos
Glaucoma de Ângulo Aberto/complicações , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Hemorragia Retiniana/etiologia , Progressão da Doença , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Prognóstico , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais/fisiologia
14.
Eur J Pediatr ; 178(6): 957-960, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30937605

RESUMO

Immune thrombocytopenic purpura (ITP) is a common cause of symptomatic thrombocytopenia in children, most of whom present with cutaneous and mucosal bleeding. Complications, such as intracranial hemorrhage and occult hemorrhage from various sites, are rare, and retinal hemorrhage is exceptionally rare. Our institutional clinical practice guidelines for managing ITP in the pediatric emergency department (PED) include routine funduscopy. The aim of this retrospective case series is to provide evidence-based recommendations for a tertiary care PED work-up of ITP, with special emphasis on the guidelines for funduscopy. The medical records of all pediatric patients diagnosed with ITP over a 4-year period (2013-2016) who had a platelet count < 50,000/mm3 were retrieved and reviewed. Seventy-five patients with thrombocytopenia (platelet count < 50,000/mm3) were diagnosed as having ITP in the PED. Sixty-one (79%) of these patients underwent funduscopy and retinal hemorrhage was ruled out in all of them, indicating that retinal hemorrhage as a complication of ITP is very rare.Conclusion: Our data suggest that funduscopy should not be performed routinely on pediatric ITP patients, but rather be reserved for those who present with concurrent anemia or visual complaints. What is Known: • Many internal institutional protocols in Israel call for retinal hemorrhage bleeding surveillance in work up of ITP. Our study found no case of ITP with retinal bleeding. What is New: • Many internal institutional protocols in Israel call for retinal hemorrhage bleeding surveillance in work up of ITP. Our study found no case of ITP with retinal bleeding.


Assuntos
Oftalmoscopia/normas , Púrpura Trombocitopênica Idiopática/complicações , Hemorragia Retiniana/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Hemorragia Retiniana/etiologia , Estudos Retrospectivos
15.
Ophthalmic Surg Lasers Imaging Retina ; 50(4): 257-259, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30998250

RESUMO

Myopic submacular hemorrhage (SMH) usually arises from either a break in Bruch's membrane (lacquer cracks) that damages the underlying choriocapillaris or the development of a choroidal neovascular membrane (CNVM) at the sites of prior lacquer cracks.1,2 In pathologic myopia (PM), axial elongation leads to thinning of the choroid and retinal pigment epithelium, predisposing to rupture of Bruch's membrane.3 If large hemorrhages involving the fovea are left untreated, subretinal hemorrhage and CNVM can cause devastating long-term vision loss due to irreversible retinal atrophy.4 In this video, the authors describe their technique of using a subretinal injection of recombinant tissue plasminogen activator with a concurrent gas tamponade to displace SMH.


Assuntos
Tamponamento Interno/métodos , Miopia Degenerativa/complicações , Hemorragia Retiniana/terapia , Hexafluoreto de Enxofre/administração & dosagem , Ativador de Plasminogênio Tecidual/administração & dosagem , Acuidade Visual , Vitrectomia/métodos , Adolescente , Lâmina Basilar da Corioide/patologia , Fibrinolíticos/administração & dosagem , Angiofluoresceinografia , Fundo de Olho , Humanos , Injeções Intraoculares , Masculino , Refração Ocular/fisiologia , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/etiologia , Epitélio Pigmentado da Retina/patologia
16.
Zhonghua Yan Ke Za Zhi ; 55(4): 294-301, 2019 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-30982292

RESUMO

Objective: To investigate the treatment of retinopathy of incontinentia pigmenti by anti-vascular endothelial growth factor. Methods: Retrospective study of 5 patients(8 eyes) diagnosed retinopathy of incontinentia pigmenti from 2005 to 2017, including 0 males and 5 females (8 eyes involved) with an average age of 2.4 months(range, 1-5 months). Medical history and family history were recorded in detail for all children. We did the examination of anterior segment of the eyeball, vitreous body,fundus and intraocular pressure for the 5 patients(8eyes).What's more,wo also took pictures for fundus with the machine of Retcam. Fundus fluorescence angiography (FFA) was performed in 2 patients(4 eyes). Different surgical methods were selected according to the specific conditions of the eye and postoperative were observed. Results: At the time of initial diagnosis, preretinal hemorrhage did not affect the macular region in 3 cases (5 eyes), pre retinal hemorrhage affected the macular region in 1 case(1 eye), the retinal neovascularization in 3 cases(5 eyes), the retinal detachment in 2 cases(2 eyes), and nonvascular zone of peripheral retinal in 5cases(8 eyes). Treatment and drug selection: 3 cases(5 eyes) were treated with injection anti-VEGF drug into vitreous body cavity, 1 case(1 eye) was treated with injection anti-VEGF drug into vitreous body cavity plus laser photocoagulation, 1 case(1 eye) was treated with anti-VEGF drugs plus vitrectomy. 1 case(1 eye) was treated with anti-VEGF drugs plus retinal cryotherapy and sclera bucking. In patients of injection anti-VEGF drug into vitreous body cavity, 2 cases(3 eyes) were given a single dose and 1 case (2 eyes) was given a repeated dose. Drug selection: 4 cases(6 eyes) ranibizumab injection (injection dose 0.025 ml), 1 case (2 eyes)conbercept injection (injection dose 0.025 ml). To follow-up date, etina was flat in 4 patients (7 eyes), epiretinal membrane in 2 patients(2 eyes), retinal detachment in 1 patient(1 eye). Conclusions: The efficacy of anti-vascular endothelial growth factor in the treatment of retinopathy of incontinentia pigmenti was prelininarily confimed.However,the optimal use timing,dosage,local and systemic safety issues were needed to be further studied. (Chin J Ophthalmol, 2019, 55:294-301).


Assuntos
Incontinência Pigmentar/complicações , Descolamento Retiniano/terapia , Hemorragia Retiniana/terapia , Neovascularização Retiniana/terapia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Inibidores da Angiogênese/uso terapêutico , Crioterapia , Feminino , Humanos , Lactente , Fotocoagulação a Laser/métodos , Ranibizumab/uso terapêutico , Descolamento Retiniano/etiologia , Hemorragia Retiniana/etiologia , Neovascularização Retiniana/etiologia , Estudos Retrospectivos , Recurvamento da Esclera , Vitrectomia
17.
Ophthalmol Retina ; 3(1): 53-60, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30935658

RESUMO

PURPOSE: To investigate the visual outcomes of patients with traumatic maculopathy and massive subretinal hemorrhage (SRH) after closed-globe injury. DESIGN: Retrospective, noncomparative, and interventional case series. PARTICIPANTS: Twenty-four patients with traumatic maculopathy and massive SRH after closed-globe injury. METHODS: In this retrospective observational case series, we included 25 eyes of 24 patients who had experienced closed-globe injury with massive SRH. MAIN OUTCOME MEASURES: The demographics, clinical characteristics, and final visual acuity (VA) of the patients. RESULTS: Twenty-five eyes with massive SRHs involving the macula were studied with initial VAs from light perception to 4/200. At initial presentation, vitreous hemorrhages were present in 22 eyes, hyphema in 13 eyes, lid lacerations in 11 eyes, glaucoma in 8 eyes, iridodialysis in 7 eyes, afferent pupillary defect in 6 eyes, lens dislocation or subluxation in 5 eyes, and cyclodialysis clefts and hypotony in 2 eyes. Retinal detachment developed in 7 eyes during the follow-up period. Pars plana vitrectomy usually was performed in patients with persistent vitreous hemorrhage, retinal detachment, lens dislocation, and cyclodialysis cleft with hypotony. In final visual outcomes, 7 eyes achieved favorable visual outcomes with VA of 20/200 or more. Thirteen eyes showed VA of 2/200 or less with dense macular scars or foveal atrophy. Foveal atrophy showed encompassed foveal thinning, retinal pigment epithelial clumping, and the loss of external limiting membrane (ELM), ellipsoidal zone (EZ), and interdigital zone (IZ) on spectral-domain OCT. Fundus autofluorescence demonstrated interposed, reduced, and increased autofluorescence in traumatic pigment epitheliopathy. CONCLUSIONS: Traumatic maculopathy and massive SRH after closed-globe injury often cause poor visual outcomes, especially in eyes with dense macular scars or foveal atrophy. Spectral-domain OCT findings in patients with good visual outcomes revealed partial to complete preservation of the foveal ELM, EZ, and IZ.


Assuntos
Gerenciamento Clínico , Traumatismos Oculares/complicações , Degeneração Macular/diagnóstico , Hemorragia Retiniana/diagnóstico , Acuidade Visual , Vitrectomia/métodos , Ferimentos não Penetrantes/complicações , Adolescente , Adulto , Idoso , Criança , Traumatismos Oculares/diagnóstico , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Degeneração Macular/etiologia , Degeneração Macular/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/terapia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Ferimentos não Penetrantes/diagnóstico , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA