RESUMO
We studied two cases of bilateral visual loss secondary to an optic neuropathy in patients with cryptococcal meningitis. In both cases a history of visual loss after the onset of an episode of cryptococcal meningitis was elicited. Visual fields were consistent with optic nerve disease. The patients' visual loss appeared to be the result of perineuritic adhesive arachnoiditis. Although no surgical interventions were carried out in our patients, medical or surgical intervention may be useful to prevent or relieve constrictive arachnoiditis and preserve vision in selected patients.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Aracnoidite/complicações , Criptococose/complicações , Infecções Oportunistas/complicações , Atrofia Óptica/etiologia , Adulto , Aracnoidite/etiologia , Infecções por Citomegalovirus/complicações , Humanos , Masculino , Atrofia Óptica/complicações , Atrofia Óptica/diagnóstico , Pneumonia por Pneumocystis/complicações , Retinite/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Campos VisuaisAssuntos
Fluoresceínas/efeitos adversos , Doenças Cardiovasculares/induzido quimicamente , Toxidermias/etiologia , Serviços Médicos de Emergência , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Angiofluoresceinografia , Fluoresceínas/administração & dosagem , Humanos , Injeções Intra-Arteriais/efeitos adversos , Injeções Intravenosas , Náusea/induzido quimicamente , Necrose , Doenças Respiratórias/induzido quimicamente , Pele/efeitos dos fármacos , Pele/patologia , Vômito/induzido quimicamenteRESUMO
Pneumatic retinopexy is a new procedure that is effective in treating many uncomplicated cases of rhegmatogenous retinal detachment (RD). It may be done in the office using a cryoprobe or laser and an expanding gas bubble and for this reason has become popular among RD surgeons. Reports of associated complications are limited. Three patients who had remarkably posterior retinal breaks after pneumatic retinopexy are presented with evidence that these breaks are a direct complication of this procedure. A possible explanation as to the pathogenesis of pneumatic retinopexy-associated posteriorly located retinal tears, as well as suggestions regarding prophylactic measures that may be taken to avoid this complication, are also presented.
Assuntos
Fluoretos/administração & dosagem , Fluorocarbonos/administração & dosagem , Complicações Pós-Operatórias , Descolamento Retiniano/cirurgia , Perfurações Retinianas/etiologia , Hexafluoreto de Enxofre/administração & dosagem , Adulto , Olho , Feminino , Humanos , Injeções , Terapia a Laser , Masculino , Pessoa de Meia-Idade , Reoperação , Perfurações Retinianas/patologia , Perfurações Retinianas/cirurgia , VitrectomiaRESUMO
We reviewed the records of ocular examinations of patients referred or examined for inflammatory retinal disease over a two-year period and found 18 cases in which retinopathy was documented before the diagnosis of acquired immunodeficiency syndrome (AIDS). Seventeen patients were either homosexual men or intravenous drug abusers. Although 13 patients had AIDS-related complex, no patients met the Centers for Disease Control criteria for AIDS before their ophthalmologic examination. In all 18 cases, the diagnosis of severe immunodeficiency suggestive of infection by the human immunodeficiency virus (HIV) was made by the ophthalmologist. These ophthalmologic findings included five patients with asymptomatic retinal cotton-wool patches, two patients with endogenous Staphylococcus epidermidis bacterial endophthalmitis, and 11 cases of isolated cytomegalovirus retinitis. All patients were ambulatory outpatients at the time of ophthalmologic examination. Noninfectious retinopathy and intraocular opportunistic infections suggest the diagnosis of HIV infection and AIDS, and the ophthalmologist may play an important role in early diagnosis of this disease.