RESUMO
The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.
Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Oftalmopatias/terapia , Pandemias , Pneumonia Viral/epidemiologia , Padrões de Prática Médica/normas , Agendamento de Consultas , COVID-19 , Humanos , Exame Físico , Consulta Remota , Doenças Retinianas/terapia , SARS-CoV-2 , Triagem , Doenças da Úvea/terapia , Corpo Vítreo/patologiaRESUMO
A 58-year-old man, a known diabetic and hypertensive for 5 years was presented to us with a drop in reading vision in both eyes of 2 months duration. His best-corrected visual acuity was 6/24, N36 in both eyes. Fundus findings revealed moderate non-proliferative diabetic retinopathy with bilateral diffuse macular oedema. When conventional therapy with intravitreal ranibizumab did not alter the clinical picture, we looked into the differential diagnosis of bilateral persistent macular detachments and investigated further. Haematological tests revealed severe anaemia with pancytopenia, which prompted further investigations including a bone marrow biopsy confirming a diagnosis of multiple myeloma. Chemotherapy gradually caused resolution of the macular detachments at 8 months follow-up. This report illustrates that a high index of suspicion regarding systemic condition is required in certain cases presenting as diabetic macular oedema, but not responding to the conventional treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Dexametasona/uso terapêutico , Retinopatia Diabética/diagnóstico por imagem , Edema Macular/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico por imagem , Talidomida/uso terapêutico , Transtornos da Visão/diagnóstico por imagem , Anemia/diagnóstico , Biópsia com Agulha de Grande Calibre , Medula Óssea/patologia , Retinopatia Diabética/complicações , Retinopatia Diabética/fisiopatologia , Diagnóstico Diferencial , Angiofluoresceinografia , Humanos , Edema Macular/patologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/patologia , Pancitopenia/diagnóstico , Tomografia de Coerência Óptica , Resultado do Tratamento , Transtornos da Visão/etiologia , Transtornos da Visão/fisiopatologiaRESUMO
Bilateral occurrence of macular hole in X-linked retinoschisis is an extremely rare event. Spectral domain optical coherence tomography (OCT) findings revealed that formation of a macular hole is secondary to the retinoschisis process alone. Bilateral macular holes should be added to the spectrum of X-linked retinoschisis variations and the retinoschisis process alone should be accounted for their formation.
Assuntos
Perfurações Retinianas/genética , Perfurações Retinianas/patologia , Retinosquise/patologia , Tomografia de Coerência Óptica , Adulto , Humanos , Masculino , Baixa Visão/genética , Baixa Visão/patologiaRESUMO
We review 12 consecutive cases of pre-macular fibrosis (PMF) treated by vitreous surgical techniques. The causes of PMF included retinal detachment surgery in four patients, idiopathic in three patients, laser treatment in three patients, pars planitis in one patient and diabetic retinopathy in one patient. The membrane was successfully removed in all the patients. One patient developed a retinal detachment that was repaired successfully. All patients had improved visual acuity (VA) of two Snellen lines or more and six patients achieved VA of 6/12 or better. Patients with PMF following retinal detachment had poorer final VA.