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Zamorano M, Redondo Marcos I, González-López JJ. Bilateral macular edema in sistemic sclerosis. Arch Soc Esp Oftalmol (Engl Ed) 2024:S2173-5794(24)00060-4. [PMID: 38593979 DOI: 10.1016/j.oftale.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/20/2024] [Indexed: 04/11/2024]
Abstract
Systemic sclerosis is a chronic, autoimmune, multisystem disease characterized by vascular dysfunction, chronic inflammation and widespread fibrosis. Although vascular involvement commonly manifests in the skin, it can also affect other organs, including the eyes. The characteristic vascular alteration is an obliterative fibroproliferative vasculopathy leading to hypoxia and tissue ischemia. We present a case of bilateral macular edema in a patient diagnosed with systemic sclerosis, as a consequence of retinal and choroidal vascular changes.
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Affiliation(s)
- M Zamorano
- Departamento de Oftalmología, Hospital Universitario de Guadalajara, Guadalajara, Spain.
| | - I Redondo Marcos
- Departamento de Oftalmología, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J J González-López
- Departamento de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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2
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Parakh S, Maheshwari S, Das S, Kumar V, Agrawal R, Gupta V, Mruthyunjaya P, Luthra S. Presumed bilateral diffuse uveal melanocytic proliferation – A case report and review of literature. Am J Ophthalmol Case Rep 2022; 27:101582. [PMID: 35619994 PMCID: PMC9127154 DOI: 10.1016/j.ajoc.2022.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 10/26/2022] Open
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3
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Gargallo-Benedicto A, Clemente-Tomás R, Pastor-Espuig M, Alías-Alegre EG, Navarro-Casado MN. Bilateral neurosensory retinal detachment secondary to tadalafil treatment. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:234-238. [PMID: 35523471 DOI: 10.1016/j.oftale.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/21/2020] [Indexed: 06/14/2023]
Abstract
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.
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Affiliation(s)
| | - R Clemente-Tomás
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - M Pastor-Espuig
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - E G Alías-Alegre
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - M N Navarro-Casado
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
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4
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Rauchegger T, Osl A, Teuchner B, Haas G. Symptomatic idiopathic bilateral multifocal retinal pigment epithelial detachments. Am J Ophthalmol Case Rep 2022; 25:101336. [PMID: 35146203 PMCID: PMC8819277 DOI: 10.1016/j.ajoc.2022.101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 10/29/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To report a rare case of idiopathic bilateral serous retinal pigment epithelial detachments. Observations We present a case of a 43-year-old female patient with metamorphopsia with the presence of innumerable bilateral serous retinal pigment epithelial detachments. Detailed ocular and systemic clinical work-up revealed no underlying disease. Conclusions /Importance: Idiopathic multiple serous retinal pigment epithelial detachments are an extremely rare condition, that has been observed as an incidental clinical finding in asymptomatic patients. Multimodal imaging and detailed systemic work up are essential to rule out an underlying disease. Initial symptoms, as in our case, are uncommon and usually occur only in patients with complications such as choroidal neovascularization or hemorrhages. Therefore, regular follow ups are recommended to early detect and treat possible complications. Idiopathic multiple serous retinal pigment epithelial detachments (PEDs) are an extremely rare condition. Multimodal imaging is essential to confirm the serous nature of the PEDs and to rule out presence of an underlying disease. Regular follow ups are recommended to early detect and treat possible complications.
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Affiliation(s)
- Teresa Rauchegger
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Antonia Osl
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Barbara Teuchner
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Gertrud Haas
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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Ting HC, Ma SH, Tai YH, Dai YX, Chang YT, Chen TJ, Chen MH. Association between alopecia areata and retinal diseases: A nationwide population-based cohort study. J Am Acad Dermatol 2021; 87:771-778. [PMID: 34794815 DOI: 10.1016/j.jaad.2021.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/18/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Growing evidence has revealed abnormalities in the retinal structures of patients with alopecia areata (AA). However, the relationship between AA and retinopathy remains unclear. OBJECTIVE To investigate the association between AA and retinal diseases. METHODS The study participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9909 patients with AA and 99,090 matched controls to assess the risk of retinal diseases. A Cox regression model was used for all analyses. RESULTS Compared with the controls, patients with AA had an adjusted hazard ratio (aHR) of 3.10 (95% confidence interval [CI] 2.26-4.26) for retinal diseases. With respect to individual retinal diseases, Patients with AA had significantly higher risks of developing retinal detachment (aHR 3.98; 95% CI 2.00-7.95), retinal vascular occlusion (aHR 2.45; 95% CI 1.22-4.92), and retinopathy (aHR 3.24; 95% CI 2.19-4.81) than controls. LIMITATIONS This was a retrospective cohort study. Meanwhile, almost all the participating individuals were residents of Taiwan; therefore, the validity of our findings in other demographics remains unclear. CONCLUSION Patients with AA had a significantly higher risk of retinal disease than controls. Further studies are needed to clarify the pathophysiology of AA and retinal diseases.
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Affiliation(s)
- Hui-Chu Ting
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Sheng-Hsiang Ma
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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Abstract
A 24-year-old pregnant woman applied with 2 days of sudden vision loss. Funduscopy showed serous retinal detachment along in the right eye and tear was not found. In the left eye, there were two small subretinal fluid accumulationsThe patient was diagnosed with serous retinal detachment due to preeclampsia. Serous retinal detachment of the patient regressed spontaneously within 1 month. All pregnant women with gestational hypertension should undergo retinal examination.
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Affiliation(s)
- Utku Limon
- Department of Eye Clinic Retina, Umraniye Education and Research Hospital, Istanbul, Turkey
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7
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Kinast RM, Solomon SD, Cubillan LD, Hovakimyan A, Acharya N, Cunningham ET. Prevalence and causes of clinically detectable uveitic serous retinal detachment. Eur J Ophthalmol 2021; 31:3093-3098. [PMID: 33530714 DOI: 10.1177/1120672121991391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the prevalence and causes of clinically detectable uveitic serous retinal detachment (SRD). METHODS Retrospective chart review of a large clinic-based series. RESULTS Serous retinal detachment was present in 78 of the 2761 (2.8%) patients. Vogt-Koyanagi-Harada (VKH) disease was the most commonly identified cause (38/78, 48.7%). Less common associated etiologies included toxoplasmic retinochoroiditis (8/78, 10.3%), sarcoidosis (5/78, 6.4%), intraocular lymphoma (4/78, 5.1%), presumed tuberculosis (3/78, 3.8%), and posterior scleritis (2/78, 2.6%). Fifteen patients (19.2%) with uveitic SRD at presentation had no identifiable etiology and were labeled idiopathic or indeterminant. Thirty of the 38 patients with VKH disease (78.9%) had positive neurological and/or integumentary findings, and therefore constituted either complete or incomplete subtypes of the disease. The remaining eight (21.1%) had presumed/ocular VKH disease limited to the eye. CONCLUSION While VKH disease by far is the most common cause of clinically detectable uveitic SRD, a number of other non-infectious and infectious inflammatory disorders were also associated with this distinctive clinical finding.
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Affiliation(s)
- Robert M Kinast
- Legacy Devers Eye Institute, Legacy Health System, Portland, OR, USA
| | - Sharon D Solomon
- Retina Division of the Wilmer Eye Institute, Department of Ophthalmology, the John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leo Dp Cubillan
- Institute of Ophthalmology, National Institutes of Health, University of the Phillipines, Manila, Philippines
| | | | - Nisha Acharya
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA
| | - Emmett T Cunningham
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA.,The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA.,The Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
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Gargallo-Benedicto A, Clemente-Tomás R, Pastor-Espuig M, Alías-Alegre EG, Navarro-Casado MN. Bilateral neurosensory retinal detachment secondary to tadalafil treatment. Arch Soc Esp Oftalmol (Engl Ed) 2021; 97:S0365-6691(20)30488-3. [PMID: 33483171 DOI: 10.1016/j.oftal.2020.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/05/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.
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9
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Yamada S, Kitajima T, Marumo S, Fukui M. Legionnaire's disease presenting as bilateral central scotomata: a case report. BMC Infect Dis 2021; 21:32. [PMID: 33413170 PMCID: PMC7791691 DOI: 10.1186/s12879-020-05715-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Legionnaire’s disease is one of the major causes of community-acquired pneumonia and is occasionally complicated by neurological symptoms. However, reports of ocular lesions due to Legionnaire’s disease are limited. Case presentation We report the case of a patient with Legionnaire’s disease presenting as bilateral central scotomata due to retinal lesions. The patient consulted due to fever and bilateral central scotomata, as well as other extrapulmonary symptoms. Optical coherence tomography (OCT) showed bilateral accumulations of fluid under the retina, and the patient was diagnosed with bilateral exudative retinal detachment. Later, Legionnaire’s disease was confirmed by pulmonary infiltrates on chest imaging and positive urinary antigen for Legionella pneumophila. After administration of antibiotics, the bilateral central scotomata and bilateral subretinal fluid accumulations completely resolved, as did the other extrapulmonary symptoms and the pulmonary infiltrates. Thus, the bilateral central scotomata due to exudative retinal detachment were thought to be caused by Legionnaire’s disease. Conclusions This case demonstrates that Legionnaire’s disease can present as bilateral central scotomata. We may consider the possibility of extrapulmonary involvement complicating Legionnaire’s disease when we encounter bilateral ocular lesions in patients with fever and pneumonia.
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Affiliation(s)
- Sho Yamada
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
| | - Takamasa Kitajima
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Satoshi Marumo
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Motonari Fukui
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
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da Cruz NFS, Polizelli MU, Cezar LM, Cardoso EB, Penha F, Farah ME, Rodrigues EB, Novais EA. Effects of phosphodiesterase type 5 inhibitors on choroid and ocular vasculature: a literature review. Int J Retina Vitreous 2020; 6:38. [PMID: 32782824 DOI: 10.1186/s40942-020-00241-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
To provide information on the effects of phosphodiesterase type 5 (PDE5) inhibitors on choroidal vessels and central serous chorioretinopathy (CSC) and possible implications for development of exudative age-related macular degeneration (AMD). Two independent investigators conducted a qualitative review of PubMed to identify studies on the choroidal effect of PDE5 inhibitors in June 2019. The search used key words that included PDE5 inhibitors, sildenafil, tadalafil, vardenafil, choroid, choroidal flow, choroidal vessels, choroidal thickness, CSC, AMD or a combination. Only studies which assessed choroidal findings were included. Many ocular diseases are related to changes in choroidal thickness and perfusion. Patients with AMD, who have decreased choroidal perfusion, may manifest more severely diminished choroidal ability to deliver oxygen and other metabolites to the retina, leading to growth of neovascular tissue. As a result of this engorgement of the choroidal vasculature, some patients may have leakage across the retinal pigment epithelium (RPE) and accumulation of subretinal fluid, resulting in CSC. Transient visual symptoms, i.e., changes in color perception and increased light sensitivity, are well-known adverse effects, but there have been rare reports of vision-threatening ocular complications in users of PDE5 inhibitors, such as nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion. The choroid is a vascular tissue analogous in many respects to the corpus cavernosum, and PDE5 inhibitors may increase the choroidal thickness and perfusion. While it is intuitively obvious that thickness of the choroid alone does not guarantee better choriocapillaris oxygenation, it is a reasonable step towards ameliorating ischemia. These drugs have numerous physiologic effects on the choroid related to blood flow, such as clinical consequences in CSC and AMD.
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11
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Wieder MS, Fleischman JA, Rashid S. Bilateral serous retinal detachments associated with burkitt lymphoma. Am J Ophthalmol Case Rep 2020; 18:100654. [PMID: 32195444 PMCID: PMC7078497 DOI: 10.1016/j.ajoc.2020.100654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/04/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a case of bilateral serous retinal detachments in a patient found to have burkitt lymphoma. Observations A patient who presented with bilateral serous retinal detachments and “B” symptoms underwent extensive workup and was found to have burkitt lymphoma. Multiagent chemotherapy was initiated with resolution of the serous retinal detachments and visual recovery occurring in parallel to disease remission. Conclusions and Importance Burkitt lymphoma can present with serous retinal detachments and should be included in the differential for a patient with bilateral serous retinal detachments along with Vogt-Koyanagi-Harada syndrome.
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12
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Faber H, Gelisken F. [Acute loss of visual acuity after pregnancy]. Ophthalmologe 2019; 117:147-149. [PMID: 31144012 DOI: 10.1007/s00347-019-0917-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 28-year-old female patient presented with acute loss of visual acuity after pre-eclampsia. Funduscopy revealed minor alterations of the posterior pole of the macula. Optical coherence tomography displayed a bilateral neurosensory detachment. Fluorescence angiography showed filling defects of the choroid in both eyes. These findings were in line with choroidal ischemia following a hypertensive episode. The symptoms disappeared completely after 3 months without additional treatment. To clarify ambiguous pathologies the ophthalmologist should always initiate a comprehensive evaluation in internal medicine to find the right diagnosis and treatment.
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Affiliation(s)
- Hanna Faber
- Department für Augenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland.
| | - Faik Gelisken
- Department für Augenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
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Ghanbari H, Dehghani A, Pourazizi M. Bilateral Diffuse and Cluster Pigment Epithelial Detachment Associated with Diffuse Proliferative Glomerulonephritis. Case Rep Ophthalmol Med 2018; 2018:5474696. [PMID: 29675279 PMCID: PMC5841106 DOI: 10.1155/2018/5474696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/14/2018] [Accepted: 01/28/2018] [Indexed: 11/18/2022] Open
Abstract
Retinal pigment epithelium detachment (PED) is an area of retinal pigment epithelium (RPE) elevation with minimal or no sensory retinal detachment resulting from the accumulation of sub-RPE fluid. There are many etiological factors that lead to the development of PED. PED may be observed as an isolated finding or in association with ocular and systemic conditions. In this case we report a 23-year-old male with bilateral cluster PED associated with diffuse proliferative glomerulonephritis (DPGN). The importance of current report is that development of PED and DPGN is more than a simple incidental event. Patients with DPGN should have regular fundus examinations, and follow-up should be conducted by an ophthalmologist who is aware of the possible presence of these diseases.
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Affiliation(s)
| | - Alireza Dehghani
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Chang YS, Weng SF, Chang C, Wang JJ, Chen HI, Ko SY, Tu IT, Chien CC, Wang JJ, Wang CM, Jan RL. Risk of serous retinal detachment in patients with end-stage renal disease on dialysis. PLoS One 2017; 12:e0180133. [PMID: 28658289 PMCID: PMC5489197 DOI: 10.1371/journal.pone.0180133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/10/2017] [Indexed: 11/18/2022] Open
Abstract
The aim of this retrospective, nationwide, matched cohort study was to investigate the association of serous retinal detachment with having end-stage renal disease (ESRD) while on dialysis. The cohort study included 94,024 patients with ESRD on dialysis registered between January 2000 to December 2009 in the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,024 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. Twenty-seven ESRD patients and 11 controls developed serous retinal detachment (P < 0.001) during follow-up, demonstrating a significantly increased risk of serous retinal detachment in patients with ESRD on dialysis compared with controls (incidence rate ratio = 3.39, 95% confidence interval [CI] = 1.68–6.83). After adjustment for potential confounders, patients were 3.86 times more likely to develop serous retinal detachment than the full cohort (adjusted HR = 3.86, 95% CI = 1.15–12.96). In conclusion, patients with ESRD on dialysis demonstrate an increased risk of serous retinal detachment. Interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with serous retinal detachment in patients with ESRD on dialysis and prevent impairments of visual acuity.
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Affiliation(s)
- Yuh-Shin Chang
- Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun Chang
- Department of Education, University of Taipei, Taipei, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hong-I Chen
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shun-Yao Ko
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - I-Te Tu
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chih-Chiang Chien
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Jian-Jhong Wang
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ching-Min Wang
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ren-Long Jan
- Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
- * E-mail:
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16
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Abstract
Purpose: To describe an unusual retinal manifestation of dengue fever in an endemic region. Case Report: A 35 year old male presenting with acute onset decreased vision in his right eye, was found to have a massive retinal pigment epithelial detachment (PED) extending up to the vascular arcades. He had been diagnosed with acute hypokalemic quadriparesis in dengue fever in the preceding week, which had resolved following treatment. The patient was managed conservatively. At three months follow up, there was spontaneous flattening of the PEDs with improvement in visual acuity. Conclusion: Dengue fever complicated by acute hypokalemic quadriparesis can be associated with PED, which can be large. The condition resolves spontaneously and bears a good prognosis.
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Affiliation(s)
- Neha Goel
- ICARE Eye Hospital and Postgraduate Institute, Noida, Uttar Pradesh, India
| | | | - Pooja Jain
- Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - Basudeb Ghosh
- Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
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Strauß O. Pharmacology of the retinal pigment epithelium, the interface between retina and body system. Eur J Pharmacol 2016; 787:84-93. [PMID: 27044435 DOI: 10.1016/j.ejphar.2016.03.066] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/14/2016] [Accepted: 03/31/2016] [Indexed: 12/12/2022]
Abstract
The retinal pigment epithelium (RPE) is a close, interactive partner to the photoreceptors as well as an interface with the endothelium of the choroid and thus with the body's circulatory system. To fulfill these roles, the RPE communicates with neighboring tissue by secretion of a large variety of factors and is able to react to secreted factors via a plethora of transmembrane receptors. Clinically relevant local pharmacological effects are caused by anti-VEGF-A treatment in choroidal neovascularization or by carboanhydrase inhibitors reducing fluid accumulation in the macula. Being exposed to the bloodstream, the RPE reacts to systemic disease, such as diabetes or hypertension, but also to systemic pharmacological intervention, for example to hypotensive drugs acting on the renin-angiotensin-system. Sustained pharmacological treatments, in particular, cause side effects at the RPE with consequences for both RPE function and photoreceptor survival. Among these are systemic inhibition of angiotensin-converting enzyme, insulin treatment in diabetes and anti-VEGF-A therapy. Given the special anatomical and functional relationships of the RPE, pharmacological intervention targeting either the eye or the body systemically should take potential alteration of RPE and subsequently photoreceptor function into account.
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Lavezzo MM, Sakata VM, Morita C, Rodriguez EEC, Abdallah SF, da Silva FTG, Hirata CE, Yamamoto JH. Vogt-Koyanagi-Harada disease: review of a rare autoimmune disease targeting antigens of melanocytes. Orphanet J Rare Dis 2016; 11:29. [PMID: 27008848 PMCID: PMC4806431 DOI: 10.1186/s13023-016-0412-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 03/16/2016] [Indexed: 12/18/2022] Open
Abstract
Vogt-Koyanagi-Harada disease (VKHD) is a rare granulomatous inflammatory disease that affects pigmented structures, such as eye, inner ear, meninges, skin and hair. This disease is mainly a Th1 lymphocyte mediated aggression to melanocytes after a viral trigger in the presence of HLA-DRB1*0405 allele. The absence of ocular trauma or previous intraocular surgery sets VKHD appart from sympathetic ophthalmia, its main differential diagnosis. The disease has an acute onset of bilateral blurred vision with hyperemia preceded by flu-like symptoms. The acute uveitic stage is characterized by a diffuse choroiditis with serous retinal detachment and optic disc hyperemia and edema. Fluorescein angiography in this phase demonstrates multiple early hyperfluorescent points. After the acute uveitic stage, ocular and integumentary system pigmentary changes may appear. Ocular findings may be accompanied by lymphocytic meningitis, hearing impairment and/or tinnitus in a variable proportion of patients. Prompt diagnosis followed by early, aggressive and long-term treatment with high-dose corticosteroids is most often ensued by good visual outcomes. However, some patients may experience chronic uveal inflammation with functional eye deterioration. The current review discusses the general features of VKHD, including epidemiology, classification into categories, differential diagnosis and current therapeutic approaches.
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Affiliation(s)
- Marcelo Mendes Lavezzo
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Viviane Mayumi Sakata
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Celso Morita
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Ever Ernesto Caso Rodriguez
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Smairah Frutuoso Abdallah
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Felipe T G da Silva
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Carlos Eduardo Hirata
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil
| | - Joyce Hisae Yamamoto
- Uveitis Service, Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Diana, 863 apto 91J, 05019-000, São Paulo, Brazil.
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Shukla D. Re: Sophie et al.: Predictors of functional and anatomic outcomes in patients with diabetic macular edema treated with ranibizumab (Ophthalmology 2015;122:1395-401). Ophthalmology 2016; 123:e11-e12. [PMID: 26802713 DOI: 10.1016/j.ophtha.2015.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 07/17/2015] [Accepted: 07/17/2015] [Indexed: 10/22/2022] Open
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Dave VP, Pappuru RR. Idiopathic multiple retinal pigment epithelial detachments - A case report. Saudi J Ophthalmol 2015; 29:295-7. [PMID: 26586982 PMCID: PMC4625390 DOI: 10.1016/j.sjopt.2015.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 04/15/2015] [Accepted: 05/11/2015] [Indexed: 11/16/2022] Open
Abstract
Retinal pigment epithelial detachment, often asymptomatic is a common retinal finding. Multiple serous retinal pigment epithelial detachment especially in a female is very uncommon. We describe a case of multiple retinal pigment epithelial detachments throughout the fundus in a 51-year old female otherwise asymptomatic. Indocyanine green angiography and fundus auto fluorescence showed abnormalities with a normal systemic work-up. This is the first report of an asymptomatic patient correlating angiogram with auto fluorescence in multiple serous retinal pigment epithelial detachments.
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Affiliation(s)
- Vivek Pravin Dave
- Smt. Kanuri Santhamma Center for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India
| | - Rajeev R Pappuru
- Smt. Kanuri Santhamma Center for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India
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Farioli A, Hemmingsson T, Kriebel D. Vascular risk factors and rhegmatogenous retinal detachment: a follow-up of a national cohort of Swedish men. Br J Ophthalmol 2015; 100:907-913. [DOI: 10.1136/bjophthalmol-2015-307560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/28/2015] [Accepted: 10/01/2015] [Indexed: 12/31/2022]
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Gupta A, Raman R, Kulothungan V, Sharma T. Association of systemic and ocular risk factors with neurosensory retinal detachment in diabetic macular edema: a case-control study. BMC Ophthalmol 2014; 14:47. [PMID: 24716846 PMCID: PMC3984633 DOI: 10.1186/1471-2415-14-47] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 04/04/2014] [Indexed: 11/22/2022] Open
Abstract
Background Diabetic macular edema (DME) with neurosensory retinal detachment (NSD) remains an important cause of visual loss in patients with diabetes. The aim of the study was to elucidate the association of systemic and ocular risk factors with NSD in DME. Methods In a retrospective case–control study, we reviewed clinical records of all the subjects with DME seen between January 2010 and December 2010. Cases and controls were selected based on optical coherence tomography and stereoscopic biomicroscopy review. NSD was defined as subfoveal fluid accumulation under detached retina with or without overlying foveal thickening. The association between the presence of NSD, blood pressure, lipid status and various other biochemical parameters was evaluated. Results Group I (cases) included 37 eyes of 33 patients having DME with NSD and Group II (controls) included 30 eyes of 21 patients having DME without NSD. Patients ranged in age (mean ± SD) from 50 to 62 years (56.6 +/-6.78) for cases and from 51 to 65 years (58.4+/-7.84) for controls. The duration of diabetes ranged from 4 to 15 year (mean 9.45+/-6.08) among cases and 4 to 14 years (9.7+/-5.12) among controls. Significant risk factors for NSD were high values of systolic and diastolic blood pressure (p = 0.039 and 0.043 respectively). Conclusion High systolic and diastolic blood pressures are independent and significant risk factors for NSD in DME.
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Affiliation(s)
| | | | | | - Tarun Sharma
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai 600 006, Tamil Nadu, India.
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Sakata VM, da Silva FT, Hirata CE, de Carvalho JF, Yamamoto JH. Diagnosis and classification of Vogt-Koyanagi-Harada disease. Autoimmun Rev 2014; 13:550-5. [PMID: 24440284 DOI: 10.1016/j.autrev.2014.01.023] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2013] [Indexed: 11/16/2022]
Abstract
Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune disorder that affects pigmented tissues of the body, with its most dire manifestations affecting the eyes. This review focuses on the diagnostic criteria of VKH disease, including some information on history, epidemiology, appropriate clinical and classification criteria, etiopathogenesis, treatment and outcomes. Expert review of most relevant literature from the disease's first description to 2013 and correlation with the experience in the care of VKH disease patients at a tertiary Uveitis Service in Brazil gathered over the past 40 years. The clinical manifestations and ancillary assessment of VKH disease have been summarized in the Revised Diagnostic Criteria proposed in 2001 in a manner that allows systematic diagnosis of both acute and chronic patients. It includes the early acute uveitic manifestations (bilateral diffuse choroiditis with bullous serous retinal detachment and optic disk hyperemia), the late ocular manifestations (diffuse fundus depigmentation, nummular depigmented scars, retinal pigment epithelium clumping and/or migration, recurrent or chronic anterior uveitis), besides the extraocular manifestations (neurological/auditory and integumentary). There are two exclusion criteria, i.e. absence of previous ocular penetrating trauma or surgery and any other ocular disease that could be confounded with VKH disease. HLA-DRB1*0405 plays an important role in pathogenesis, rendering carriers more susceptible to disease. The primary ocular pathological feature is a diffuse thickening of the uveal tract in the acute phase. Later on, there may be a compromise of choriocapillaris, retinal pigment epithelium and outer retina, mostly due to an "upstream" effect, with clinical correlates as fundus derangements. Functional tests (electroretinogram and visual field testing) as well as imaging modalities (retinography, fluorescein/indocyanine green angiography, optical coherence tomography and ultrasound) play an important role in diagnosis, severity grading as well as disease monitorization. Though high-dose systemic corticosteroids remain gold-standard therapy, refractory cases may need other agents (cyclosporine A, anti-metabolites and biological agents). In spite of good visual outcomes in the majority of patients, knowledge about disease progression even after the acute phase and its impact on visual function warrant further investigation.
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Affiliation(s)
- Viviane Mayumi Sakata
- Department of Ophthalmology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Felipe Theodoro da Silva
- Department of Ophthalmology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Joyce Hisae Yamamoto
- Department of Ophthalmology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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González-Escobar AB, González de Gor-Crooke JL, López-Egea-Bueno MA, García-Campos JM. [Multiple retinal pigment epithelial detachments: a case report]. ACTA ACUST UNITED AC 2013; 89:194-8. [PMID: 24269392 DOI: 10.1016/j.oftal.2012.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 10/20/2012] [Accepted: 11/07/2012] [Indexed: 11/28/2022]
Abstract
CASE REPORT A 47 year-old female who presented with a bilateral idiopathic multiple pigment epithelial detachment (PED) in a routine visit. This pathology is shown as a rare clinical manifestation, where the outcome is resolution of localized atrophy of the pigment epithelium, with a good functional prognosis. DISCUSSION PED is a common clinical manifestation in several chorioretinal diseases, particularly in macular degeneration associated with age. Idiopathic PED can be considered as a kind of central type II serous chorioretinopathy. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are complementary tests to study the number, extension, and nature of these PED.
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Affiliation(s)
- A B González-Escobar
- Servicio de Oftalmología, Hospital Universitario Virgen de la Victoria, Málaga, España.
| | | | - M A López-Egea-Bueno
- Servicio de Oftalmología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J M García-Campos
- Servicio de Oftalmología, Hospital Universitario Virgen de la Victoria, Málaga, España
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Yoon A, Verma S, Birnbaum A. Exudative Retinal Detachment Caused by Metastatic Choriocarcinoma to the Choroid. J Emerg Med 2013; 44:617-9. [DOI: 10.1016/j.jemermed.2012.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 06/27/2011] [Accepted: 05/06/2012] [Indexed: 11/20/2022]
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Grinager HS, Krason DA, Olsen TW. Lyme disease: resolution of a serous retinal detachment and chorioretinal folds after antibiotic therapy. Retin Cases Brief Rep 2012; 6:232-234. [PMID: 25389719 DOI: 10.1097/icb.0b013e3182247783] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Ocular manifestations of Lyme disease are uncommon. There has not been a documented case of serous retinal detachment and chorioretinal folds because of Lyme disease that have resolved after only antibiotic treatment. METHODS (CASE REPORT) A 69-year-old white man with a history of recent tick bites presented with a gradual decrease in visual acuity in the left eye. Initial visual acuity was 3/200 in the left eye. Examination revealed an inferior, serous, macula-off retinal detachment. Chorioretinal folds were also noted. Lyme screening antibody test (enzyme-linked immunosorbent assay) was positive and a confirmatory Western blot was immunoglobulin M negative and immunoglobulin G positive. RESULTS Oral amoxicillin (500 mg 3 times daily for 2 weeks) was given followed by intravenous ceftriaxone (2 g daily for 4 weeks). After two weeks of ceftriaxone, fundus examination and ultrasonography showed complete reattachment of the macula and periphery, and only mild residual chorioretinal folds remained on fluorescein angiogram. CONCLUSION We suggest that Borrelia burgdorferi infection led to choroidal inflammation with secondary chorioretinal folds and a serous retinal detachment, which resolved with antibiotic therapy alone. This supports the suspicion of an intraocular infection, perhaps involving the choroid, as opposed to a secondary autoimmune reaction.
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Affiliation(s)
- Hans S Grinager
- *Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota †St. Paul Infectious Disease Associates, St. Paul, Minnesota ‡Emory Eye Center, Atlanta, Georgia
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Osman Saatci A, Ozbek Soylemezoglu Z, Barut Selver O, Cenk Ecevit M, Ada E. Unilateral, recurrent exudative retinal detachment in association with pansinusitis. GMS Ophthalmol Cases 2012; 2:Doc03. [PMID: 27625932 PMCID: PMC5015599 DOI: 10.3205/oc000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To report a patient with unilateral exudative retinal detachment due to pansinusitis. METHODS Case report. RESULTS A 65-year-old woman with a two-month history of blurred vision, red eye and lid swelling in her left eye was referred to us. Her best-corrected visual acuity was 20/20 in the right eye and 20/200 in the left. Conjunctival vessels were engorged in the OS. Funduscopy revealed a 360° exudative detachment in OS and computerized tomography (CT) imaging revealed pansinusitis. Systemic antibiotic treatment was employed and exudative detachment regressed. However, exudative detachment remitted as soon as antibiotic treatment ceased. Finally she underwent sinus surgery and decompression of the orbita. Her visual acuity improved to 20/100 just two days after the surgery, stabilized at 20/30 and no further recurrences occured during the follow-up of 10 months. CONCLUSION Since exudative retinal detachment usually accompanies systemic inflammatory or neoplastic diseases, systemic screening and collaboration with other disciplines are mandatory. To the best of our knowledge, this is the first report of a case that developed exudative retinal detachment due to pansinusitis and only recovered after decompression surgery.
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Affiliation(s)
- Ali Osman Saatci
- Dokuz Eylul University, Department of Ophthalmology, Izmir, Turkey
| | | | - Ozlem Barut Selver
- Buca Seyfi Demirsoy State Hospital, Department of Ophthalmology, Izmir, Turkey
| | - M Cenk Ecevit
- Dokuz Eylul University, Department of Otorhinolaryngology, Izmir, Turkey
| | - Emel Ada
- Dokuz Eylul University, Department of Radiology, Izmir, Turkey
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Göncü T, Özdek Ş. Idiopathic multiple tiny serous retinal pigment epithelial detachments: Report of 2 cases and review of the literature. ACTA ACUST UNITED AC 2011; 82:556-62. [DOI: 10.1016/j.optm.2011.04.103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 10/30/2010] [Accepted: 04/20/2011] [Indexed: 11/25/2022]
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Wang NK, Chou CL, Tsang SH. Comparing different imaging modalities in harada disease: a case report. Retin Cases Brief Rep 2010; 4:352-5. [PMID: 25390915 DOI: 10.1097/ICB.0b013e3181b5ee42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to compare fluorescein angiography, infrared imaging, fundus autofluorescence, and optical coherent tomography for the diagnosing and monitoring of Harada disease. METHODS This was an interventional case report. RESULTS A 46-year-old Chinese woman presented with headache, tinnitus, and diminished vision in both eyes. Examination revealed bilateral exudative retinal detachment. Optical coherence tomography showed fluid accumulation in three different layers (intraretinal, subretinal, and subretinal pigment epithelium). Fundus autofluorescence revealed regions of hypoautofluorescence as a result of the thick fluid accumulation. Infrared imaging revealed more clinically relevant information than did fundus autofluorescence in this case. CONCLUSION In Harada disease, excessive fluid accumulates in three different layers. Optical coherence tomography is the most effective modality in measuring the axial distribution of the fluid in the z-plane, whereas infrared imaging is better at providing the information in the x-y plane, compared with fundus autofluorescence.
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Hendrickson DJ, Knisely AS, Coulter K, Telander DG, Quan R, Ruebner BH, Leigh MJ. An inborn error of bile salt transport with features mimicking abusive head trauma. Child Abuse Negl 2010; 34:472-476. [PMID: 20627390 DOI: 10.1016/j.chiabu.2009.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Revised: 11/12/2009] [Accepted: 11/12/2009] [Indexed: 05/29/2023]
Affiliation(s)
- Debra J Hendrickson
- University of California Davis Medical Center, Department of Pediatrics, Sacramento, CA, USA
| | - A S Knisely
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Kevin Coulter
- University of California Davis Medical Center, Department of Pediatrics, Sacramento, CA, USA
| | - David G Telander
- University of California Davis Medical Center, Department of Ophthalmology and Vision Science, Sacramento, CA, USA
| | - Richard Quan
- University of California Davis Medical Center, Department of Pediatrics, Sacramento, CA, USA
| | - Boris H Ruebner
- University of California Davis Medical Center, Department of Pathology, Sacramento, CA, USA
| | - Mary Jacena Leigh
- University of California Davis Medical Center, Department of Pediatrics, Sacramento, CA, USA
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Paulus YM, Jain A, Moshfeghi DM. Resolution of persistent exudative retinal detachment in a case of Sturge-Weber syndrome with anti-VEGF administration. Ocul Immunol Inflamm 2009; 17:292-4. [PMID: 19657986 DOI: 10.1080/09273940902989357] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Report the resolution of a persistent exudative retinal detachment in a patient with Sturge-Weber syndrome following intravitreal pegaptanib injection. DESIGN Case report. METHODS A 13-year-old male with Sturge-Weber syndrome presented with a choroidal hemangioma associated with an exudative retinal detachment that failed to resolve 6 months after external beam radiation therapy. RESULTS A single intravitreal pegaptanib injection resulted in 50% resolution of the detachment within 1 week and complete resolution within a month. Despite anatomic success, vision remained poor. CONCLUSIONS VEGF likely plays a role in the pathogenesis of Sturge-Weber choroidal hemangioma-associated exudative retinal detachment and offers potential treatment.
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Affiliation(s)
- Yannis M Paulus
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California 94305, USA
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Abstract
PURPOSE To report primary retinal pigment epithelial (RPE) detachments in sarcoidosis. DESIGN Case report. METHODS Clinical findings, fluorescence angiography and optical coherence tomography (OCT) results are presented and discussed. RESULTS A 54-year-old Hispanic male with biopsy proved sarcoidosis presented with multiple RPE detachment in both eyes. Except for acute iritis, there were no other ocular manifestations of sarcoidosis. CONCLUSIONS Detachments of the RPE may be a rare manifestation of ocular sarcoidosis.
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Affiliation(s)
- Daniel J Salchow
- Harkness Eye Institute, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Abstract
To report the association of a unilateral serous macular detachment with severe postoperative pain. A 71-year-old woman presented with a sudden decrease in vision in the right eye, seven days after a total knee replacement arthroplasty. The patient's history was unremarkable except for a severe pain greater than the visual analog scale of 8 points for about 2 days after surgery. Retinal examination showed a well differentiated serous detachment that was about 3.5 disc diameter in size and located in the macular area. Fluorecein angiography and indocyanine green angiography showed delayed perfusion of the choriocapillaris without leakage points in the early phase and persistent hypofluorescence with pooling of dye in the subretinal space in the late phase. There was a spontaneous resolution of the serous detachment and the choroidal changes with residual pigment epithelial changes. Severe postoperative pain may influence the sympathetic activity and introduce an ischemic injury with a focal, choroidal vascular compromise and secondary dysfunction of overlying RPE cells in select patients.
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Affiliation(s)
- Jee Woong Jung
- Department of Ophthalmology, Gachon University, Gil Medical Center, Incheon, Korea
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Affiliation(s)
- M T S Younis
- Department of Obstetrics and Gynaecology, York Hospital, York, UK.
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Hager A, Wiegand W. [Bilateral serous detachment of the neurosensory retina and retinal pigment epithelium with rip of the peripheral pigment epithelium]. Ophthalmologe 2007; 103:966-70. [PMID: 17043772 DOI: 10.1007/s00347-006-1437-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HISTORY A 52-year-old patient with atypical plasmocytoma presented with a bilateral serous detachment of the retina as well as a huge detachment of the pigment epithelium (PE) in the periphery. Shortly thereafter the PE ruptured. In the left eye this led to substantial central macular fibrosis. DIAGNOSIS The clinically healthy patient showed a nephrotic syndrome; neither typical monoclonality was detectable nor was erythropoiesis or myelopoiesis reduced. THERAPY To avoid further reduction of VA pars plana vitrectomy (ppV) with silicone oil tamponade and laser coagulation was performed. Clinical findings were reduced significantly and VA was stabilized for 2.5 years. DISCUSSION PE detachments and serous retinal detachments in patients with nephrotic syndrome are only mentioned in a few cases. However, a peripheral rupture of the PE to this extent seems to be very rare. Early ppV with silicone oil and laser coagulation may prevent further macular fibrosis.
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Affiliation(s)
- A Hager
- Augenabteilung, Asklepios Klinik Nord, Campus Heidberg, Tangstedter Landstrasse 400, 22417 Hamburg.
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Olson JL, Prall FR, Ciardella AP. Bilateral foveal neurosensory detachment in hypertensive retinopathy demonstrated by optical coherence tomography. Eye (Lond) 2006; 20:1370-1. [PMID: 16575418 DOI: 10.1038/sj.eye.6702201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Oh KT, Hartnett ME, Landers MB. Pathogenetic Mechanisms of Retinal Detachment. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50122-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McGehee BE, Chaljub G, Shah RK, Oto A, Camacho AC, Tang RA. Bilateral retinal detachment in a patient with Vogt–Koyanagi–Harada syndrome. Emerg Radiol 2005; 11:366-71. [PMID: 16237574 DOI: 10.1007/s10140-005-0430-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Accepted: 05/18/2005] [Indexed: 11/26/2022]
Abstract
We present a 38-year-old woman with bilateral serous retinal detachments and bilateral panuveitis on fundoscopic exam. CT of the orbits and MRI scans revealed bilateral ocular choroidal thickening and bilateral retinal detachments; however, no other CNS or meningeal lesion was detected. This patient met the clinical criteria for Vogt-Koyanagi-Harada (VKH) Syndrome. Review of VKH syndrome as well as the radiographic findings will be discussed.
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Affiliation(s)
- Blake E McGehee
- Department of Radiology, The University of Texas Medical Branch, Galveston, TX, USA.
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Kitamura M, Takami K, Kitaichi N, Kitachi N, Namba K, Kitamei H, Kotake S, Ohno S. Comparative study of two sets of criteria for the diagnosis of Vogt-Koyanagi-Harada's disease. Am J Ophthalmol 2005; 139:1080-5. [PMID: 15953440 DOI: 10.1016/j.ajo.2005.01.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Revised: 01/27/2005] [Accepted: 01/29/2005] [Indexed: 11/28/2022]
Abstract
PURPOSE The Vogt-Koyanagi-Harada's (VKH) Disease Committee established the "Revised diagnostic criteria for VKH disease" in 2001. The purpose of the present study was to assess the concordance between these criteria and the traditional Sugiura's diagnosis system. DESIGN Observational case series. METHODS The medical records of patients previously diagnosed with VKH disease based upon Sugiura's criteria at the Uveitis Survey Clinic of the Hokkaido University Hospital between 1991 and 2003 were retrospectively reevaluated using the VKH Committee's revised diagnostic criteria for VKH disease. RESULTS Sugiura's criteria were used to identify 169 patients with VKH disease. All patients were Japanese, and 95 cases (56%) were women. Mean age at the time of their first visit to our clinic was 44.7 +/- 13.9 years (range, 9 to 74 years). Using the VKH Committee's new criteria, 91.7% of the previously diagnosed VKH patients were classified as having the disease. Of this group, 11.8% were classified as complete, 71% incomplete, and 8.9% as probable VKH disease. CONCLUSIONS The VKH Committee's revised diagnostic criteria proved useful for VKH disease diagnosis, as the concordance rate for the two criteria was more than 90%. However, patients who had prior cataract surgery or who lacked signs of serous retinal detachment were not classified as having VKH disease because of exclusion by the VKH Committee's new criteria.
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Affiliation(s)
- Mizuki Kitamura
- Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo 060-8638, Japan
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Quiram P, Dumars S, Parwar B, Sarraf D. Viagra-associated serous macular detachment. Graefes Arch Clin Exp Ophthalmol 2005; 243:339-44. [PMID: 15756578 DOI: 10.1007/s00417-004-1099-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Revised: 11/15/2004] [Accepted: 11/24/2004] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To describe the OCT findings in two cases of idiopathic serous macular detachments associated with Sildenafil (Viagra) use. METHODS Two patients were identified with idiopathic serous macular detachments associated with Viagra use. Each patient underwent rigorous historical questioning to rule out known causes of serous macular detachments and to determine contributing factors. A comprehensive ocular examination was performed including dilated biomicroscopic examination of the macula and indirect ophthalmoscopic evaluation of the retinal periphery. Additional evaluation included color fundus photography with FA and ICG, OCT analysis of the macula and B-scan ultrasonography. Systemic workup included MRI of the brain and orbits, CT of the brain, orbits, chest and abdomen, blood chemistries and electrophoresis, lumbar puncture with CSF analysis and chest radiographs. RESULTS Both patients demonstrated idiopathic serous macular detachment associated with peri-macular vitelliform deposits. Although notable peripapillary atrophy and RPE mottling were present, there was no evidence of heme, exudate, or fibrosis to suggest a CNVM. FA showed no focal areas of leakage. Early and late frames of the ICG demonstrated engorged choroidal vessels without frank leakage. Extensive medical evaluation failed to reveal a systemic etiology. OCT findings demonstrated large serous macular detachments that corresponded to the use or discontinuation of Viagra. Discontinuation of Viagra coincided with complete resolution of the serous macular detachment in one patient and improvement of the serous macular detachment in the other. When one patient resumed Viagra use, he experienced a recurrent serous macular detachment. CONCLUSIONS We report the OCT findings of two cases of idiopathic serous macular detachment associated with use of the potent vasodilator Sildenafil (Viagra).
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Affiliation(s)
- Polly Quiram
- Jules Stein Eye Institute, UCLA, 100 Stein Plaza, Los Angeles, CA 90095, USA.
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