RESUMO
The present retrospective study evaluated intraocular pressure (IOP) and medication burden after bimatoprost sustained-release (bimatoprost SR, Durysta, Allergan) implantation in patients with glaucoma. A secondary objective was to examine an effect of bimatoprost SR in a subset of patients with prior minimally invasive and incisional glaucoma surgery. A retrospective chart review of 122 eyes that received bimatoprost SR by 6 glaucoma specialists at Wills Eye Hospital between March 2020 and September 2021 was performed. One hundred and eighteen eyes from 84 patients had a reduction in IOP (18.5±5.7mmHg vs. 16.0±5.4mmHg, P<0.01) and required fewer glaucoma medications (2.1±1.4 vs. 1.2±1.2, P<0.01) after bimatoprost SR implantation. In 41 eyes from 31 patients who previously underwent glaucoma surgery (including iStent, goniotomy, trabeculectomy, Xen Gel Stent, or tube shunt surgery), medication burden was decreased after bimatoprost SR implantation (1.9±1.3 vs. 1.0±1.0, P<0.001). These data suggest that bimatoprost SR is an efficacious treatment modality for glaucoma, even in post-surgical patients.
Assuntos
Glaucoma , Pressão Intraocular , Humanos , Bimatoprost/efeitos adversos , Estudos Retrospectivos , Preparações de Ação Retardada/uso terapêutico , Glaucoma/tratamento farmacológico , Glaucoma/cirurgia , Glaucoma/induzido quimicamente , Resultado do TratamentoRESUMO
PurposeTo determine the differences in the presentation of ophthalmic giant cell arteritis between African-Americans and Caucasians.MethodsThis was a multicenter retrospective case series comparing African-American patients with ophthalmic GCA to a previously published Caucasian cohort. Neuro-ophthalmic centers across the United States were contacted to provide data on African-American patients with biopsy-proven ophthalmic giant cell arteritis. The differences between African-American and Caucasian patients with respect to multiple variables, including age, sex, systemic and ophthalmic signs and symptoms, ocular ischemic lesions, and laboratory results were studied.ResultsThe Caucasian cohort was slightly older (mean=76.1 years) than the African-American cohort (mean=72.6 years, P=0.03), and there was no difference in sex distribution between the two cohorts. Headache, neck pain, and anemia were more frequent, while jaw claudication was less frequent in African-Americans (P<0.01, <0.001, 0.02, and 0.03 respectively). Acute vision loss was the most common presentation of giant cell arteritis in both groups, though it was less common in African-Americans (78 vs 98% of Caucasians, P<0.001). Eye pain was more common in African-Americans (28 vs 8% of Caucasians, P<0.01).ConclusionsThe presenting features of ophthalmic giant cell arteritis in African-Americans and Caucasians are not markedly different, although a few significant differences exist, including higher rates of headache, neck pain, anemia, and eye pain, and lower rates of jaw claudication and acute vision loss in African-Americans. Persons presenting with suspicious signs and symptoms should undergo evaluation for giant cell arteritis regardless of race.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Dor Ocular/epidemiologia , Arterite de Células Gigantes/complicações , Transtornos da Visão/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Dor Ocular/etiologia , Feminino , Arterite de Células Gigantes/epidemiologia , Arterite de Células Gigantes/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Artérias Temporais/patologia , Estados Unidos/epidemiologia , Transtornos da Visão/etiologia , Acuidade Visual/fisiologia , População Branca/estatística & dados numéricosRESUMO
AIMS: To determine the prevalence of intraocular pressure (IOP) alterations following intravitreal injection of triamcinolone acetonide (IVTA) and to assess possible risk factors of IOP elevation in eyes receiving single and/or repeat injections. METHODS: Retrospective, consecutive case series. 570 consecutive eyes of 536 patients who received a single IVTA injection (4 mg/0.1 ml) and a second set of 43 eyes of 40 patients who received a second injection. Retrospective review of all IVTA cases performed by three vitreoretinal surgeons over a 42 month period beginning in 2000. The main outcome measure was change in IOP defined as absolute value of IOP elevation (5 mm Hg or higher, 10 mm Hg or higher), and percentage of baseline (30% or higher increase from baseline IOP). RESULTS: Of the 528 eyes receiving single injections, 281 (53.2%) had an IOP elevation; 267 eyes (50.6%) experienced an elevation of IOP of at least 30%, and 245 (45.8%) and 75 (14.2%) eyes had an increase of 5 mm Hg or 10 mm Hg or more, respectively. Baseline IOP greater than 16 mm Hg is a risk factor for post-injection IOP elevation. Of the 43 eyes which received a second injection, 28 (65.1%) experienced an increase in IOP of at least 30% of baseline. Filtering surgery was required in five (0.094%) of the single and one (2.3%) of repeat injection eyes. CONCLUSIONS: Elevated IOP after IVTA is common and patients should be monitored beyond 6 months post-injection. Patients with a baseline IOP more than 16 mm Hg or receiving a second injection should be carefully monitored for an elevated IOP.
Assuntos
Anti-Inflamatórios/efeitos adversos , Glucocorticoides/efeitos adversos , Hipertensão Ocular/induzido quimicamente , Triancinolona Acetonida/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/administração & dosagem , Anti-Hipertensivos/administração & dosagem , Esquema de Medicação , Feminino , Glaucoma/fisiopatologia , Glucocorticoides/administração & dosagem , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/tratamento farmacológico , Estudos Retrospectivos , Análise de Sobrevida , Triancinolona Acetonida/administração & dosagem , Corpo VítreoRESUMO
PURPOSE: To determine the sensitivity and specificity of various methods of detecting a relative afferent pupillary defect (RAPD) in patients with glaucoma-related diagnoses. PATIENTS AND METHODS: Patients underwent RAPD evaluation using the swinging flashlight method (SFM), the magnifier-assisted SFM, and pupillography using the Konan RAPDx. Main outcome measures were sensitivity and specificity of three methods of RAPD evaluation in detecting visual field mean deviation (MD), cup to disc ratio (CDR), disc damage likelihood scale (DDLS), and retinal nerve fiber layer (RNFL) asymmetry. RESULTS: Eighty-one consecutive patients from the Wills Eye Hospital glaucoma service were enrolled, 60 with glaucoma and 21 with ocular hypertension or glaucoma suspect. Thirty-one percent of subjects had MD asymmetry>5 dB, 19.7% had CDR asymmetry≥0.20, 26.7% had DDLS asymmetry≥2, and 38.2% had RNFL asymmetry>10 microns. Sensitivity values for pupillography were 93.3% (95% CI, 68.1-99.8) for detecting MD asymmetry, 80.0% (95% CI, 51.9-95.7) for CDR asymmetry, 100.0% (95% CI, 73.5-100.0) for DDLS asymmetry, and 69.2% (95% CI, 38.6-90.9) for RNFL asymmetry. Specificity values were 41.2% (95% CI, 24.7-59.3) for detecting MD asymmetry, 32.8% (95% CI, 21.3-46.0) for CDR asymmetry, 33.3% (95% CI, 18.0-51.8) for DDLS asymmetry, and 42.9% (95% CI, 21.8-66.0) for RNFL asymmetry. Pupillography amplitude score was correlated with MD asymmetry (r2=0.41, P<0.001) and area under the curve was 0.84. CONCLUSION: Automated pupillography had higher sensitivity and lower specificity in detecting MD, CDR, DDLS, and RNFL asymmetry. Within the bounds of the cohort tested, this method had limited case-finding ability.
Assuntos
Técnicas de Diagnóstico Oftalmológico , Glaucoma/diagnóstico , Distúrbios Pupilares/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Hipertensão Ocular/diagnóstico , Estudos Prospectivos , Células Ganglionares da Retina/patologia , Sensibilidade e Especificidade , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos Visuais , Adulto JovemRESUMO
BACKGROUND: A case of alcohol-induced depersonalization disorder is presented. The subject had experienced several depersonalization states following the consumption of alcohol rather than from a psychogenic etiology, and the episodes were transient, not chronic. METHODS: Three quantitative EEG (QEEG) studies were performed on the subject, one during the index depersonalization episode and two subsequent studies when the subject was clinically asymptomatic. RESULTS: Slow wave activity (relative theta power) was significantly increased when symptomatic. This slowing was still present over the occiput 3 days after the symptoms had remitted but was absent 17 days after symptoms had ameliorated. CONCLUSIONS: The time course of EEG slowing suggests a metabolic encephalopathy, a condition which likely contributes to the manifestations of depersonalization syndrome.
Assuntos
Depressores do Sistema Nervoso Central/efeitos adversos , Córtex Cerebral/efeitos dos fármacos , Despersonalização/induzido quimicamente , Etanol/efeitos adversos , Adulto , Córtex Cerebral/fisiopatologia , Despersonalização/fisiopatologia , Eletroencefalografia/métodos , Análise de Fourier , Humanos , MasculinoRESUMO
OBJECTIVE: To determine if moderate-or low-dose corticosteroid therapy can reduce the diplopia and frequency of deterioration to generalized disease in ocular myasthenia gravis. DESIGN: Retrospective record review. SETTING: Two university-based neuro-ophthalmology services. PATIENTS: All 32 patients with ocular myasthenia gravis, treated with prednisone, followed up for a minimum of 2 years were included. Patients were treated with 1 or more courses of daily prednisone (highest initial dose, 40-80 mg) gradually withdrawn over 4 to 6 weeks. Subsequently, in 6 patients, 2.5 to 20 mg of prednisone was given on alternate day. OUTCOME MEASURES: Diplopia in the primary position or downgaze diplopia and generalized myasthenia gravis after 2 years of follow-up. RESULTS: Diplopia, which was initially found in the primary position in 29 patients and in the downgaze position in 26 patients, was absent in 21 patients at 2 years. Generalized myasthenia gravis occurred in 3 patients at 2 years. Elevated serum acetylcholine receptor antibody levels and abnormal electromyography findings were not predictive of worsening. No patient experienced a major steroid complication. CONCLUSIONS: Moderate-dose daily prednisone for 4 to 6 weeks, followed by low-dose alternate-day therapy as needed, can control the diplopia in patients with ocular myasthenia gravis. The frequency of deterioration to generalized myasthenia gravis at 2 years may be reduced; 9.4% in this study compared with more than 40% previously reported frequency. Corticosteroids may be useful even when ocular motor dysfunction is not normalized.
Assuntos
Corticosteroides/uso terapêutico , Miastenia Gravis/tratamento farmacológico , Feminino , Humanos , MasculinoRESUMO
The group of six patients in this study experienced delayed visual loss following head trauma. Visual loss occurred from 1 day to 13 years after the initial injury. All patients suffered indirect trauma to the internal carotid artery resulting in formation of either an aneurysm or pseudoaneurysm or a carotid-cavernous fistula. Review of the radiologic and clinical findings was performed in six patients. The diagnosis was established by computed tomography, magnetic resonance imaging, and angiography. All patients had follow-up clinical evaluation and imaging studies. Treatment by neurosurgical or interventional neuroradiologic procedures resulted in significant visual improvement in five patients. Different pathophysiologic mechanisms could be correlated with the delayed visual loss produced by the two types of lesions. The pathologic changes associated with the aneurysms/pseudoaneurysms included direct compression of optic nerves and/or chiasm and intracranial hematoma. A carotid-cavernous fistula caused delayed visual loss by either hematoma at the orbital apex or compression of the chiasm and/or optic nerves by saccular dilatation of the cavernous sinus. The delayed onset of decreased vision following head trauma should alert the physician to the possibility of a traumatic aneurysm/pseudoaneurysm or a carotid-cavernous fistula. Different neuro-ophthalmologic symptoms can usually be correlated with the pathologic changes demonstrated by neuroimaging procedures.
Assuntos
Doenças das Artérias Carótidas/complicações , Traumatismos Craniocerebrais/complicações , Aneurisma Intracraniano/complicações , Transtornos da Visão/etiologia , Adolescente , Adulto , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/etiologia , Artéria Carótida Interna , Angiografia Cerebral , Feminino , Seguimentos , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/etiologia , Imageamento por Ressonância Magnética , Masculino , Fatores de Tempo , Tomografia Computadorizada por Raios X , Transtornos da Visão/fisiopatologia , Campos VisuaisRESUMO
We studied 3 scalp potentials recorded prior to saccades in relation to visual targets (the presaccadic negativity [PSN], presaccadic positivity [PSP], and spike potential [SP]) in normal subjects performing self-initiated saccades in darkness. There was a prominent PSN beginning at -800 msec, maximal at the vertex. This finding is consistent with activation of the supplementary eye field in the anterior mesial frontal cortex, a concept which correlates with cortical neuron recordings in monkeys and cerebral blood flow studies in humans. A widespread PSP, with greatest amplitude over the posterior scalp, suggests parieto-occipital participation even in the absence of visual targets. The sharp character of SP with focal lateralized frontal negativity, its "mirror image" scalp distribution when comparing leftward to rightward saccades, and its timing near the onset of saccades support an origin near the orbit, in either ocular motor nerves or muscles.
Assuntos
Movimentos Oculares , Movimentos Sacádicos , Couro Cabeludo/inervação , Adulto , Eletroencefalografia , Eletroculografia , Potenciais Evocados , Feminino , Humanos , Masculino , Neurônios/fisiologia , Valores de ReferênciaRESUMO
The authors describe five patients with trochlear nerve palsy and MS to characterize this rare association. In two patients, trochlear nerve palsy was the initial clinical manifestation of MS. In the other three patients, this sign occurred after previous neurologic events. MRI did not identify a lesion of the fourth nerve nucleus or fascicle. Ophthalmoplegia resolved within 2 months in four of the five patients. A reason this association is rare is that the fascicular course of the trochlear nerve is exposed to little myelin.
Assuntos
Esclerose Múltipla/complicações , Paralisia/patologia , Nervo Troclear/patologia , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paralisia/complicaçõesRESUMO
Single-photon emission computed tomography (SPECT) with 99mTc-hexamethylpropyleneamine oxime (HMPAO) was used to investigate changes in cerebral blood flow in seven patients with cortical visual impairment. Traumatic brain injury (TBI) was the cause of cortical damage in two patients, cerebral ischemia in two patients and carbon monoxide (CO) poisoning, status epilepticus and Alzheimer's Disease (AD) each in three separate patients. The SPECT scans of the seven patients were compared to T2-weighted magnetic resonance image (MRI) scans of the brain to determine the correlation between functional and anatomical findings. In six of the seven patients, the qualitative interpretation of the SPECT studies supported the clinical findings (i.e., the visual field defect) by revealing altered regional cerebral blood flow (rCBF) in the appropriate regions of the visual pathway. MR scans in all of the patients, on the other hand, were either normal or disclosed smaller lesions than those detected by SPECT. We conclude that SPECT may reveal altered rCBF in patients with cortical visual impairment of various etiologies, even when MRI studies are normal or nondiagnostic.
Assuntos
Compostos de Organotecnécio , Oximas , Tomografia Computadorizada de Emissão de Fóton Único , Transtornos da Visão/diagnóstico por imagem , Córtex Visual/diagnóstico por imagem , Adulto , Idoso , Lesões Encefálicas/complicações , Isquemia Encefálica/complicações , Circulação Cerebrovascular/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tecnécio Tc 99m Exametazima , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Córtex Visual/patologiaRESUMO
Using a rabbit model we investigated the role of pigmentation of the ciliary body in obtaining ciliodestruction by neodymium-YAG transscleral cyclophotocoagulation. There was marked destruction of the ciliary body in pigmented rabbit eyes, but no histologic effect was observed in albino rabbit eyes. These findings suggest that pigmentation of the ciliary body is important for obtaining the desired response from neodymium-YAG transscleral cyclophotocoagulation in rabbit eyes by our technique. Further study is necessary to define the role of pigmentation in human eyes in this treatment modality.
Assuntos
Corpo Ciliar/lesões , Terapia a Laser , Fotocoagulação , Pigmentação/efeitos da radiação , Animais , Corpo Ciliar/patologia , Pressão Intraocular , Coelhos , Esclera , Fatores de TempoRESUMO
Acquired sixth-nerve palsies are relatively rare in younger adults. We reexamined 49 patients, aged from 15 to 50 years, with isolated sixth-nerve palsies who were seen between 1972 and 1982 at the Wills Eye Hospital in Philadelphia. In this group, the following etiologies were encountered: vasculopathy (14 patients [29%]), tumors (eight patients [16%]), multiple sclerosis (six patients [12%]), presumed inflammation (four patients [8%]), trauma (three patients [6%]), postlumbar puncture (two patients [4%]), and orbital amyloidosis (one patient [2%]). Eleven patients (22%) had no determined cause of their sixth-nerve palsy. The implications for the clinical management of isolated sixth-nerve palsies in younger adults are discussed.
Assuntos
Nervo Abducente , Paralisia/etiologia , Adolescente , Adulto , Amiloidose/complicações , Angiopatias Diabéticas/complicações , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Neoplasias/complicações , Oftalmoplegia/complicações , Doenças Orbitárias/complicações , Gravidez , Fraturas Cranianas/complicações , Punção Espinal/efeitos adversosRESUMO
We describe our experience with intrableb autologous blood injection to manage over-filtering and leaking blebs. Autologous blood was injected into 12 thin cystic filtration blebs of 12 eyes. Indications for blood injection included symptomatic hypotony in five eyes, hypotony associated with bleb leakage in five eyes, and bleb leakage without hypotony in two eyes. Seven eyes (58.3%) were classified as successes and five eyes (41.7%) were classified as failures. The mean (+/- SD) follow-up was 6.8 +/- 2.6 months. Among the eyes classified as successes, a significant increase was noted in intraocular pressure and visual acuity by a mean (+/- SD) of 5.1 +/- 2.9 mm Hg and 5.3 +/- 2.1 lines, respectively. Bleb leakage resolved in four of seven eyes. The most common complication was hyphema formation. Injection of autologous blood into a filtration bleb is an alternative procedure for management of excessive filtration or bleb leakage in selected patients.
Assuntos
Sangue , Cirurgia Filtrante , Glaucoma de Ângulo Aberto/cirurgia , Hipotensão Ocular/terapia , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/patologia , Feminino , Humanos , Injeções , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Trabeculectomia , Acuidade VisualRESUMO
A 70-year-old man underwent coronary artery bypass graft complicated postoperatively by visual loss. The diagnosis was nonarteritic anterior ischemic optic neuropathy. Possible predisposing factors in this patient were hypotension, anemia, a "disk at risk," and internal carotid artery stenosis. In the postoperative setting, the erythrocyte sedimentation rate may be elevated, as it was in this case and does not by itself suggest a diagnosis of giant cell arteritis.
Assuntos
Cegueira/etiologia , Ponte de Artéria Coronária/efeitos adversos , Neuropatia Óptica Isquêmica/etiologia , Complicações Pós-Operatórias , Idoso , Cegueira/diagnóstico , Sedimentação Sanguínea , Doença das Coronárias/cirurgia , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Disco Óptico/patologia , Neuropatia Óptica Isquêmica/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Acuidade Visual , Campos VisuaisRESUMO
A patient with elevated intracranial pressure from aqueductal stenosis presented with unilateral disk edema, enlarged blind spot and a vague visual disturbance. The importance of considering elevated intracranial pressure in some cases without bilateral papilledema is emphasized.
Assuntos
Aqueduto do Mesencéfalo/patologia , Disco Óptico/patologia , Papiledema/etiologia , Pseudotumor Cerebral/diagnóstico , Adulto , Constrição Patológica/complicações , Constrição Patológica/diagnóstico , Diagnóstico Diferencial , Feminino , Fundo de Olho , Humanos , Hidrocefalia/complicações , Hidrocefalia/diagnóstico , Pressão Intracraniana , Imageamento por Ressonância Magnética , Papiledema/diagnóstico , Pseudotumor Cerebral/complicações , Campos VisuaisRESUMO
Neuroimaging with nuclear medicine techniques permits assessment of brain function by measurement of metabolism or blood flow. Such studies complement the anatomic information derived from computed tomography (CT) or magnetic resonance imaging (MRI). We describe two patients with occipital lesions who were initially diagnosed with functional visual loss. Neither CT scan nor MRI adequately demonstrated the source of visual dysfunction; however, single proton emission tomography (SPECT) scanning in a patient with carbon monoxide poisoning and positron emission tomography (PET) scanning in a patient with post-hypoxic delayed encephalopathy were helpful in confirming the organic substrate of their visual impairment. Functional imaging techniques such as SPECT and PET should be considered in patients with suspected cortical visual loss and normal CT or MR scans.
Assuntos
Intoxicação por Monóxido de Carbono/diagnóstico por imagem , Hipóxia Encefálica/diagnóstico por imagem , Lobo Occipital/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada de Emissão/métodos , Transtornos da Visão/diagnóstico por imagem , Adulto , Intoxicação por Monóxido de Carbono/etiologia , Intoxicação por Monóxido de Carbono/fisiopatologia , Circulação Cerebrovascular , Feminino , Humanos , Hipóxia Encefálica/etiologia , Hipóxia Encefálica/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Lobo Occipital/fisiopatologia , Tomografia Computadorizada por Raios X , Transtornos da Visão/etiologia , Transtornos da Visão/fisiopatologia , Córtex Visual/fisiopatologia , Campos VisuaisRESUMO
Oculomotor nerve paresis, ocular hypotony, anterior segment ischemia, and the ocular ischemic syndrome are uncommon manifestations of giant cell arteritis. Four patients with these findings had giant cell arteritis documented by temporal artery biopsy. Cerebral angiography or ultrasonography, or both, performed in three patients, excluded hemodynamically significant stenosis of the internal carotid artery as the cause of ocular ischemia and cerebral aneurysms as the cause of oculomotor nerve paresis. Corticosteroid treatment, administered to three patients, resulted in resolution of the oculomotor deficits and the clinical signs of ocular ischemia, although the visual acuity in one patient improved from 20/400 to 20/60. Giant cell arteritis should be considered in the differential diagnosis of the ocular ischemic syndrome.
Assuntos
Olho/irrigação sanguínea , Arterite de Células Gigantes/complicações , Isquemia/complicações , Uveíte/complicações , Idoso , Estenose das Carótidas/complicações , Estenose das Carótidas/tratamento farmacológico , Feminino , Arterite de Células Gigantes/tratamento farmacológico , Humanos , Isquemia/tratamento farmacológico , Masculino , Metilprednisolona/uso terapêutico , Síndrome , Uveíte/tratamento farmacológico , Acuidade VisualRESUMO
PURPOSE: To report a Serratia marcescens infection that clinically simulated a conjunctival neoplasm. METHOD: Case report. RESULTS: A healthy 80-year-old man without contact lenses presented with a pink-yellow conjunctival mass that resembled a solid neoplasm. Stains and cultures of material that exuded from the mass during surgery revealed S. marcescens. Histopathology disclosed an epithelial-lined cyst with macrophages containing S. marcescens. CONCLUSION: Although S. marcescens usually affects the eye as a keratoconjunctivitis in patients with contact lenses, it can also present as a mass simulating a neoplasm in a patient who does not wear contact lenses.
Assuntos
Doenças da Túnica Conjuntiva/diagnóstico , Cistos/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Infecções por Serratia/diagnóstico , Serratia marcescens/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Doenças da Túnica Conjuntiva/tratamento farmacológico , Doenças da Túnica Conjuntiva/microbiologia , Neoplasias da Túnica Conjuntiva/diagnóstico , Cistos/tratamento farmacológico , Cistos/microbiologia , Diagnóstico Diferencial , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Humanos , Masculino , Infecções por Serratia/tratamento farmacológico , Infecções por Serratia/microbiologiaRESUMO
A review of our first 200 neodymium-YAG laser iridectomies performed over a two-year period in various forms of glaucoma showed patent iridectomies in 180 of 182 eyes (99% success) at the last examination (one to 26 months postoperatively). Both failures had preexisting chronic uveitis. Eighteen eyes were lost to follow-up. Complications included intraocular pressure increased more than 10 mm Hg in 54 eyes (30%), hemorrhage in 36 eyes (20%), iritis in 21 eyes (11.5%), posterior synechiae in 13 eyes (7%), corneal changes in seven eyes (4%), and pupillary distortion in six eyes (3%). With experience, fewer applications are required to penetrate the iris, and retreatment to obtain patency is less likely to be needed.
Assuntos
Glaucoma/cirurgia , Terapia a Laser , Humanos , Iris/cirurgiaRESUMO
PURPOSE: To describe the findings in a patient with a nongranulomatous anterior uveitis, presumed to be induced by metipranolol. METHOD: A 69-year-old woman developed bilateral, nongranulomatous, anterior uveitis while undergoing treatment with metipranolol 0.3% for primary open-angle glaucoma. Four months after resolution of the initial episode, the patient was challenged with metipranolol 0.3% in the right eye. RESULT: On reinstituting metipranolol 0.3%, the patient once again developed a unilateral, nongranulomatous, anterior uveitis in the challenged eye. CONCLUSION: Metipranolol 0.3% eyedrops, used to treat primary open-angle glaucoma, appear to cause a nongranulomatous anterior uveitis.