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Moreno Benito N, Blasco Palacio PB, Rodríguez García I. Presumed fluoxetine maculopathy. Arch Soc Esp Oftalmol (Engl Ed) 2024:S2173-5794(24)00072-0. [PMID: 38663717 DOI: 10.1016/j.oftale.2024.04.010] [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: 01/19/2024] [Accepted: 03/02/2024] [Indexed: 04/29/2024]
Abstract
To report a unique case of a patient who developed simultaneous bilateral maculopathy presumed from intake of fluoxetine. The optic coherence tomography (OCT) macular showed a subfoveal disruption in the outer retinal layer in both eyes (OU), higher in the left one (OS). Although reported cases of serotonin recapture inhibitors (SSRIs) Maculopathy so far have been caused by sertraline, fluoxetine shares the biological mechanism, and OCT findings and ocular symptoms are the same as published. We should be aware with ocular symptoms in patients that take fluoxetine.
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Niegowski LJ, Cohen SY, Crincoli E, Mehanna CJ, Souied EH. Cognitive bias evaluation on the choice of treatment in common retinal disorders among retina specialists in 2023. J Fr Ophtalmol 2024; 47:104177. [PMID: 38603895 DOI: 10.1016/j.jfo.2024.104177] [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: 07/26/2023] [Revised: 10/01/2023] [Accepted: 10/22/2023] [Indexed: 04/13/2024]
Abstract
PURPOSE The study aimed to discern the intent to treat with the therapeutic agents prescribed first or second line in the following eye conditions: neovascular age-related macular Degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion (RVO), and myopic maculopathy with choroidal neovascularization (MMNV). The study also aimed to distinguish the ophthalmologists' intended treatment for their patients from those that they would prescribe for themselves if they were affected by the above macular conditions. METHODS The study utilized an online survey of 243 French ophthalmologists practicing medical retina, with males accounting for 54.3% of the participants. Data was obtained using a questionnaire that focused on the ophthalmologists' experience with various agents as well as their first and second line choices for nAMD, DME, RVO, and MMNV. RESULTS The vast majority of French ophthalmologists (99%) had experience with the most widely used anti-vascular endothelial growth factors (anti-VEGFs); ranibizumab, bevacizumab, and aflibercept. Fewer than 8% reported experience with anti-VEGF drug reservoirs, biosimilars, or faricimab. The study findings also showed ranibizumab and aflibercept as the commonly prescribed first line choices for the above-mentioned ocular conditions. For the second line choice, the study showed that aflibercept and dexamethasone intravitreal implants were the most common across the four retinal conditions studied. The only difference in intent to treat for "patients" versus "yourself" was for biosimilars (0% to 0.8%, P=0.001). CONCLUSION The findings regarding the first and second line choices for the mentioned ocular disorders were found to agree with the findings of published literature currently used in practice, with a tendency to prefer ranibizumab as first line therapy for neovascular disorders and aflibercept as first line therapy for macular edema. In addition, there were no differences between choices for first and second line therapy for patients vs. ophthalmologists.
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Affiliation(s)
- L-J Niegowski
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - S Y Cohen
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France; Ophthalmology Center for Imaging and Laser, Paris, France
| | - E Crincoli
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - C J Mehanna
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - E H Souied
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France.
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Kim J, Kwon HY, Kim JH, Ahn SJ. Nationwide Usage of Pentosan Polysulfate and Practice Patterns of Pentosan Polysulfate Maculopathy Screening in South Korea. Ophthalmol Retina 2024; 8:246-253. [PMID: 37832716 DOI: 10.1016/j.oret.2023.10.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To investigate the nationwide use of pentosan polysulfate (PPS) and screening practices for PPS maculopathy (PPM), with a focus on the timing and modalities used. DESIGN Population-based cohort study. PARTICIPANTS For evaluation of nationwide usage, 133 762 individuals who received PPS prescriptions between 2012 and 2021 were included. To investigate practice patterns, 55 487 individuals (referred to as overall users) who initiated PPS therapy between 2018 and 2020 were identified using the Health Insurance Review and Assessment database. After excluding patients with ophthalmic diseases before PPS administration, 34 857 PPS users without prior ophthalmic diseases were identified. METHODS Ophthalmic examinations performed after initiating PPS therapy were categorized as baseline and subsequent monitoring examinations. The timing and modalities employed for these examinations were analyzed. The annual trends in PPS utilization and maculopathy screening were evaluated by assessing the number of PPS users and determining the proportion of patients receiving retinal/macular examinations among these users. MAIN OUTCOME MEASURES Performance of baseline and subsequent monitoring examinations and timing and modalities used for screening. RESULTS The number of PPS users dramatically increased annually over the study period from 5494 in 2012 to 40 451 in 2021. However, the majority of PPS users did not undergo baseline or subsequent monitoring examinations for PPM. Only 27.2% and 12.4% of PPS users without prior ophthalmic disease underwent baseline and monitoring examinations, respectively. Funduscopy/fundus photography was the most commonly utilized, whereas OCT and fundus autofluorescence (FAF) were performed in only 45.2% and 5.3% of the PPS users without prior ophthalmic diseases for monitoring, respectively. The performance of the screening examinations differed significantly across the 3 different daily dose and duration groups (all P < 0.05). CONCLUSIONS This study highlights the lack of performance of baseline and monitoring examinations for maculopathy in most patients taking PPS in South Korea. The limited use of OCT and FAF suggests potential insensitivity in detecting PPM. These findings emphasize the need for improvements in screening practices, including increased awareness and referrals to ophthalmologists, utilization of more sensitive modalities, and regular monitoring to enable early detection of PPM. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Jiyeong Kim
- Department of Pre-Medicine, College of Medicine, and Biostatistics Lab, Medical Research Collaborating Center (MRCC), Hanyang University, Seoul, Republic of Korea
| | - Hyeon Yoon Kwon
- Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Ji Hong Kim
- Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Seong Joon Ahn
- Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea.
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Bayraktar Bilen N, Polat Gültekin B, Dagdas S, Kalayci D. Deferoxamine-related bilateral maculopathy with optical coherence tomography findings. Photodiagnosis Photodyn Ther 2024; 45:103961. [PMID: 38163453 DOI: 10.1016/j.pdpdt.2023.103961] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/05/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND We present a case of bilateral maculopathy associated with deferoxamine mesylate (DFO) treatment. METHODS A 53-year-old man with myelodysplastic syndrome (MDS) received DFO therapy due to elevated ferritin levels. He was then referred to ophthalmology clinic due to blurred vision. He was diagnosed as bilateral neurosensory retinal detachment of the macula. During follow up, best corrected visual acuity (BCVA), optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and fundus autofluorescence (FAF) were evaluated. RESULTS At first visit, OCT showed bilateral foveal neurosensory detachment. Hyperfluorescence of the macula and the peripapillary region were found on FFA. After discontinuation of DFO, BCVA improved from 20/120 to 20/60 with resolution of the foveal detachments on OCT scan. Four weeks later, FAF showed bilateral mottled hyperautofluorescence and hypoautofluorescence at the macula and the peripapillary region. CONCLUSION Deferoxamine can cause acute retinal toxicity. Haematologists should be alert to visual complaints associated with DFO therapy, as early diagnosis and discontinuation of the medication allows recovery of visual function with residual fundus findings.
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Affiliation(s)
- Neslihan Bayraktar Bilen
- Department of Ophthalmology, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9, Gayret Mah. Oruc Reis Sk. Parkciftlik Konutlari CK-6/17, Yenimahalle, Çankaya, Ankara, Turkey.
| | - Burcu Polat Gültekin
- Department of Ophthalmology, Veni Vidi Hospital, Ataşehir, Mavişehir Kipa Kavşağı, 8258/3. Sokak No: 4, Çiğli, İzmir 35640, Turkey
| | - Simten Dagdas
- Department of Hematology, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9 Çankaya, Ankara, Turkey
| | - Defne Kalayci
- Department of Ophthalmology, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9, Gayret Mah. Oruc Reis Sk. Parkciftlik Konutlari CK-6/17, Yenimahalle, Çankaya, Ankara, Turkey
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Joseph A, Bullimore M, Drawnel F, Miranda M, Morgan Z, Wang YZ. Remote Monitoring of Visual Function in Patients with Maculopathy: The Aphelion Study. Ophthalmol Ther 2024; 13:409-422. [PMID: 38015309 PMCID: PMC10776523 DOI: 10.1007/s40123-023-00854-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Remote monitoring of vision, using tools such as the shape discrimination hyperacuity (SDH) test, can detect disease activity in patients with maculopathy. We determined the in-clinic accuracy and repeatability of three myVisionTrack expanded version (mVTx) tests for self-testing of visual acuity (VA) and contrast sensitivity. METHODS Aphelion, a single-arm, prospective study conducted at two sites in the USA, included adults with any maculopathy and a baseline VA of 0.7 log of minimum angle of resolution (logMAR) (Snellen 20/100) or better. Participants completed the mVTx tests (tumbling E, Landolt C, contrast sensitivity, and SDH) and standard clinical tests (near and distance Early Treatment Diabetic Retinopathy Study [ETDRS] charts and the Pelli-Robson contrast sensitivity chart). Test-retest repeatability and agreement between the mVTx tests and the corresponding clinical test were assessed by Bland-Altman analyses. Participants also completed a usability survey. RESULTS The mean age of the 122 participants was 67 years. The most common diagnosis was age-related macular degeneration (42% of patients). The tumbling E test had a test-retest 95% limit of agreement (LoA) of ± 0.18 logMAR; the Landolt C test, ± 0.23 logMAR; the SDH test, ± 0.24 logMAR; and the contrast sensitivity test, ± 0.32 log contrast threshold (logCT). Compared with the distance ETDRS chart, the LoA was ± 0.35 logMAR for the tumbling E test (mean difference, - 0.07 logMAR) and ± 0.39 logMAR for the Landolt C test (mean difference, 0.03 logMAR). For the contrast sensitivity test, the LoA compared with the Pelli-Robson chart was ± 0.30 logCT (mean difference, - 0.25 logCT). Most participants (85%) reported that they learned the tests quickly. The tumbling E test scored the highest on ease of use. CONCLUSION The mVTx tests of VA are accurate and repeatable, supporting their potential use alongside the SDH test to detect disease progression remotely between clinic visits.
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Affiliation(s)
| | - Mark Bullimore
- University of Houston College of Optometry, Houston, TX, USA
| | | | - Marco Miranda
- Roche Products, Ltd., Welwyn Garden City, UK
- University College London Institute of Ophthalmology, London, UK
| | - Zoe Morgan
- F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Yi-Zhong Wang
- Retina Foundation of the Southwest, 9600 N. Central Expressway, Suite 200, Dallas, TX, 75321, USA.
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA.
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Liu J, Korban S, Moster MR, Rhéaume MA, Wang Q. Bilateral severe iatrogenic pigmentary glaucoma following laser treatment for cosmetic iris color change. Am J Ophthalmol Case Rep 2023; 32:101927. [PMID: 37771388 PMCID: PMC10522941 DOI: 10.1016/j.ajoc.2023.101927] [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: 04/10/2023] [Revised: 08/11/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023] Open
Abstract
Purpose We report a case of bilateral severe pigmentary glaucoma and paracentral acute middle maculopathy (PAMM) following laser treatment for iris color change. Observations A 32-year-old female presented to our emergency clinic after having undergone 4 sessions of bilateral cosmetic iris laser treatment in Turkey to lighten the color of her dark brown irides. Visual acuity was 20/150 in the right eye (OD) and counting fingers in the left eye (OS) at presentation. Intraocular pressures (IOP) were 50 mmHg in the right eye and 42 mmHg in the left eye, with 4+ free-floating pigmented cells in the anterior chamber. The fundus exam revealed cup-to-disc ratios of 0.5 in the right eye and 0.35 in the left eye and scattered intraretinal hemorrhages in both eyes. The diagnoses of bilateral severe iatrogenic pigmentary glaucoma and PAMM were established. Urgent bilateral fornix-based trabeculectomies with mitomycin C (MMC) 0.05% were performed with an attempt to wash out as much pigment from the anterior chamber as possible. Post-operatively, despite well-controlled IOP and cessation of all glaucoma medications, the patient remains with visual field defects and significant glare. Conclusions and Importance Photoablative iridoplasty is rarely encountered as a cause of iatrogenic pigmentary glaucoma in North American due to strict regulations against this procedure. However, physicians must be aware of its devastating and life-changing visual sequelae and elicit a careful history in patients with a similar presentation. Our patient demonstrated acute, severe glaucomatous damage from pigmentary dispersion along with PAMM, a newly described complication of this procedure. We strongly advise against this medically unnecessary practice.
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Affiliation(s)
- Jiaru Liu
- Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | - Salim Korban
- Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | - Marlene R. Moster
- Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA
- Sidney Kimmel Medical Collage, Thomas Jefferson University, Philadelphia, PA, USA
| | - Marc-André Rhéaume
- Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada
- Department of Ophthalmology, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Qianqian Wang
- Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada
- Department of Ophthalmology, University of Montreal Hospital Center, Montreal, Quebec, Canada
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Gklavas K, Athanasiou A, Neubauer J, Lilou E, Pohl L, Bartz-Schmidt KU, Dimopoulos S. Long-term outcomes of autologous platelet treatment for optic disc pit maculopathy. Graefes Arch Clin Exp Ophthalmol 2023; 261:3177-3185. [PMID: 37401935 PMCID: PMC10587340 DOI: 10.1007/s00417-023-06159-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE Optic disc pits (ODPs) are rare congenital cavitary abnormalities of the optic nerve head, which can lead to serous macular detachments. The aim of this study was to evaluate the long-term efficacy of pars plana vitrectomy (PPV) combined with autologous platelet concentrate (APC) for the treatment of optic disc pit maculopathy (ODP-M). METHODS A retrospective analysis was performed on eleven eyes of ten patients with ODP-M, who received PPV combined with APC. Nine eyes operated primary, four of which had a repeat surgery also with injection of APC and two eyes underwent a rescue surgery, after they have been operated in another eye center without APC. Morphological and functional results were the main outcome parameters, determined by optical coherence tomography (OCT) and best-corrected visual acuity (BCVA), respectively. RESULTS The mean duration of visual loss before surgery was 4.7 ± 3.89 months (range 0-12 months). The mean BCVA increased significantly from 0.82 ± 0.33 logMAR (range 0.4-1.3) preoperatively to 0.51 ± 0.36 logMAR (range 0-1.2) at the last examination (p = 0.0022). A significant morphological improvement was also noticed with decrease of the mean foveal thickness from 935.82 ± 248.48 µm (range 559-1400 µm) preoperatively to 226.45 ± 76.09 µm (range 110-344 µm) at the final examination (p < 0.0001). The patients were followed-up for a mean 65.36 ± 48.81 months (range 1-144 months). Two eyes developed postoperatively a retinal detachment. Cataract surgery was performed in 5 eyes during the follow-up period. CONCLUSION Our study demonstrated that PPV with APC can improve functional and morphological outcomes, both as a primary and a rescue therapy, without any recurrence over a long follow-up period. To the best of our knowledge, this was the longest observation period regarding the use of APC in treatment of ODP-M.
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Affiliation(s)
| | | | - Jonas Neubauer
- Centre for Ophthalmology, Eberhard-Karls University, Tübingen, Germany
| | - Evangelia Lilou
- Institute for Ophthalmic Research, Eberhard-Karls University, Tübingen, Germany
| | - Lisa Pohl
- Centre for Ophthalmology, Eberhard-Karls University, Tübingen, Germany
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Zeppieri M. Ophthalmologic implications to consider when using hydroxychloroquine to treat COVID-19 and induced arthritis. World J Exp Med 2023; 13:95-98. [PMID: 37767541 PMCID: PMC10520758 DOI: 10.5493/wjem.v13.i4.95] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/16/2023] [Accepted: 06/16/2023] [Indexed: 09/15/2023] Open
Abstract
As the world continues to grapple with the novel coronavirus [coronavirus disease 2019 (COVID-19)], many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate. Hydroxychloroquine (HCQ) is an antimalarial drug that is typically used for several autoimmune, rheumatic, and dermatological conditions. It has also been considered to treat and prevent COVID-19 and subsequent arthritis associated with the infection. This drug is known to cause retinal toxicity, which can lead to vision impairment or loss. While the exact mechanism is not yet fully understood, it is thought to be due to the accumulation of the drug in the retinal pigment epithelium. The risk of toxicity increases with long-term use or with high doses of the drug and is more likely to occur in patients with pre-existing retinal diseases or those who are predisposed to retinal diseases. In this context, several steps can be taken to monitor and minimize the risk of ophthalmological adverse events when using HCQ to treat patients with COVID-19.
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Affiliation(s)
- Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Mbu-Nyamsi D, Vincent M, Perez-Fontana M, Best AL, Mesnard C, Villeroy F, Foucher A, Raffray L, Terrier CSP, Bertolotti A. Ophthalmic complications during the dengue epidemic in Reunion Island in 2020: a case series and review of the literature. BMC Infect Dis 2023; 23:506. [PMID: 37528344 PMCID: PMC10394947 DOI: 10.1186/s12879-023-08432-4] [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: 12/06/2022] [Accepted: 06/28/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Dengue is an arboviral disease transmitted by the dengue virus, whose vectors are Aedes aegypti and Aedes albopictus. The acute phase with its cohort of well-known symptoms is usually spontaneously favorable. Since 2020 in Reunion Island, a new symptom has appeared: the ocular damage of dengue fever, which has already been described in South Asia and South-East Asia. We therefore decided to describe the clinical, biological, ophthalmological, therapeutic, and outcomes of patients with ocular manifestations during dengue fever in Reunion Island in 2020. PATIENTS AND METHODS This was a retrospective observational study. Patients were included from January 2020 to August 2020 and then reassessed by teleconsultation 1 year later. The patients were identified from the French public health surveillance network by all ophthalmologists on the island. Medical data were collected directly from medical records. RESULTS Twenty-eight patients were included. The mean age was 41.9 years. Ocular involvement occurred approximately 9.2 days after the onset of dengue symptoms. The main symptoms were scotoma (71.4%) and sudden decrease of visual acuity (39.2%). Eighteen patients (64.2%) had macular involvement. Fourteen patients were treated with oral or intravenous corticosteroids. Twenty-two (78.5%) patients were evaluated by telephone one year later. Scotoma and decreased visual acuity persisted in 15 patients. Thirteen patients (59%) were bothered by night driving, 32% of patients had reading difficulties and 27% of patients became sensitive to prolonged exposure to screens. CONCLUSION Ocular complications of dengue require early and collegial management to limit the risk of long-term sequelae. Further studies on the characteristics and complications of dengue fever are needed to better understand this disease.
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Affiliation(s)
- Digé Mbu-Nyamsi
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Muriel Vincent
- Santé Publique France, Océan Indien, Saint Denis, La Réunion, France
| | | | - Anne-Laurence Best
- Département d'ophtalmologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Charles Mesnard
- Département d'ophtalmologie, CHOR, Saint Paul, La Réunion, France
| | - Fréderic Villeroy
- Département d'ophtalmologie, CHU de La Réunion, Saint Denis, La Réunion, France
| | - Aurélie Foucher
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Loic Raffray
- Département de médecine interne, CHU de La Réunion, Saint Denis, La Réunion, France
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Université de La Réunion, INSERM UMR 1187, CNRS 9192, IRD 249, Plateforme CYROI, Sainte Clotilde, La Réunion, France
| | - Cécile Saint-Pastou Terrier
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Antoine Bertolotti
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France.
- CHU de La Réunion, CIC-INSERM1410, Saint Pierre, La Réunion, France.
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Jahrig C, Ku CA, Marra M, Pennesi ME, Yang P. Vitelliform maculopathy in MELAS syndrome. Am J Ophthalmol Case Rep 2023; 30:101842. [PMID: 37096132 PMCID: PMC10121376 DOI: 10.1016/j.ajoc.2023.101842] [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: 08/29/2022] [Revised: 03/01/2023] [Accepted: 04/02/2023] [Indexed: 04/26/2023] Open
Abstract
Purpose We present a unique case of foveomacular vitelliform lesions in a patient with metabolic encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). Observations After performing large panel next generation sequencing genetic testing, there was no likely alternative genetic etiology for vitelliform maculopathy in this patient. Conclusions and Importance We present a rare case of a visually asymptomatic pediatric patient with MELAS and vitelliform maculopathy, which may be part of the spectrum of retinal manifestations in MELAS. Pediatric-onset vitelliform maculopathy in MELAS may be under-diagnosed due to its asymptomatic nature. Given the known risk of choroidal neovascularization in vitelliform maculopathy, it is important to identify these patients for proper surveillance.
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Affiliation(s)
- Cody Jahrig
- Department of Medicine, Nassau University Medical Center, East Meadow, NY, United States
| | - Cristy A. Ku
- Department of Ophthalmology, University of California Davis, Sacramento, CA, United States
| | - Molly Marra
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University (OHSU), Portland, OR, United States
| | - Mark E. Pennesi
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University (OHSU), Portland, OR, United States
| | - Paul Yang
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University (OHSU), Portland, OR, United States
- Corresponding author. Casey Eye Institute, 545 SW Campus Drive, Portland, OR, 97239, United States.
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Silva Tavares Neto JED, Cyrino FVR, Lucena MM, Scott IU, Messias AMV, Jorge R. Intravitreal bevacizumab plus propranolol for neovascular age-related macular degeneration (the BEVALOL study): a phase I clinical trial. Int J Retina Vitreous 2023; 9:28. [PMID: 37055868 PMCID: PMC10099020 DOI: 10.1186/s40942-023-00460-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/25/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Given the persistently large public health impact of neovascular age-related macular degeneration (nARMD) despite many years of anti-VEGF therapy as the first-line treatment and the demonstrated ability of b-blockers to reduce neovascularization, a synergistic effect between an anti-VEGF agent and an intravitreal beta-blocker is important to investigate in the quest for therapeutic alternatives that maximize efficacy and/or reduce costs. The main purpose of this study is to investigate the safety of a 0.1 ml intravitreal injection of a combination of bevacizumab (1.25 mg/0.05 ml) and propranolol (50 g/0.05 ml) to treat nARMD. METHODS Prospective phase I clinical trial that included patients with nARMD. Comprehensive ophthalmic evaluation was performed at baseline and included Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), biomicroscopy of the anterior and posterior segments, binocular indirect ophthalmoscopy, color fundus photography, spectral domain optical coherence tomography (OCT), OCT angiography (OCT-A), fluorescein angiography (Spectralis, Heidelberg), and full-field electroretinography (ERG). All eyes were treated with a 0.1 ml intravitreal injection of a combination of bevacizumab (1.25 mg/0.05 ml) and propranolol (50 g/0.05 ml) within 1 week of baseline evaluation. The patients were reexamined at weeks 4, 8 and 12, and clinical evaluation and SD-OCT were performed at all follow-up visits. Additional injections of combination bevacizumab (1.25 mg/0.05 ml) and propranolol (50 g/0.05 ml) were administered at weeks 4 and 8. At the final study evaluation (week 12), color fundus photography, OCT-A, fluorescein angiography, and full-field ERG were repeated. RESULTS Eleven patients (11 eyes) completed all study visits of the 12 week study. Full field ERG b-waves did not show significant (p < 0.05) changes at week 12 compared to baseline. During the 12 week follow-up period, none of the study eyes developed intraocular inflammation, endophthalmitis or intraocular pressure elevation more than 4 mmHg over baseline. Mean ± SE BCVA (logMAR) was 0.79 ± 0.09 at baseline and was significantly (p < 0.05) improved to 0.61 ± 0.10 at week 4; 0.53 ± 0.10 at week 8; and 0.51 ± 0.09 at week 12. Mean ± SE central subfield thickness (CST) (μm) was 462 ± 45 at baseline and was significantly (p < 0.05) lower at 4, 8 and 12 weeks (385 ± 37; 356 ± 29 and 341 ± 24, respectively). CONCLUSIONS In this 12 week trial of a combination of intravitreal bevacizumab and propranolol for treatment of nARMD, no adverse events or signals of ocular toxicity were observed. Further studies using this combination therapy are warranted. Trial Registration Project registered in Plataforma Brasil with CAAE number 28108920.0.0000.5440 and approved in ethics committee of Clinics Hospital of Ribeirao Preto Medicine School of São Paulo University-Ribeirão Preto, São Paulo, Brazil (appreciation number 3.999.989 gave the approval).
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Affiliation(s)
- José Edísio da Silva Tavares Neto
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes av., Ribeirão Preto, 14048-900, Brazil
| | - Francyne Veiga Reis Cyrino
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes av., Ribeirão Preto, 14048-900, Brazil
| | - Moises Moura Lucena
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes av., Ribeirão Preto, 14048-900, Brazil
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - André Márcio Vieira Messias
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes av., Ribeirão Preto, 14048-900, Brazil
| | - Rodrigo Jorge
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes av., Ribeirão Preto, 14048-900, Brazil.
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Huan T, Cheng SY, Tian B, Punzo C, Lin H, Daly M, Seddon JM. Identifying Novel Genes and Variants in Immune and Coagulation Pathways Associated with Macular Degeneration. Ophthalmol Sci 2023; 3:100206. [PMID: 36275200 PMCID: PMC9574715 DOI: 10.1016/j.xops.2022.100206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022]
Abstract
Purpose To select individuals and families with a low genetic burden for age-related macular degeneration (AMD), to inform the clinical diagnosis of macular disorders, and to find novel genetic variants associated with maculopathies. Design Genetic association study based on targeted and whole-exome sequencing. Participants A total of 758 subjects (481 individuals with maculopathy and 277 controls), including 316 individuals in 72 families. Methods We focused on 150 genes involved in the complement, coagulation, and inflammatory pathways. Single-variant tests were performed on 7755 variants shared among ≥ 5 subjects using logistic regression. Gene-based tests were used to evaluate aggregate effects from rare and low-frequency variants (at minor allele frequency [MAF] ≤ 5% or ≤ 1%) in a gene using burden tests. For families whose affected members had a low burden of genetic risk based on known common and rare variants related to AMD, we searched for rare variants (MAF < 0.001) whose risk alleles occurred in ≥ 80% of affected individuals but not in controls. Immunohistochemistry was performed to determine the protein expression of a novel gene (coagulation factor II thrombin receptor-like 2 [F2RL2]) in retinal tissues. Main Outcome Measures Genotypes and phenotypes of macular degeneration. Results We confirmed the association of a synonymous variant in complement factor H (Ala473, rs2274700, proxy to intronic rs1410996, r 2 = 1) with maculopathy (odds ratio, 0.64; P = 4.5 × 10-4). Higher AMD polygenic risk scores (PRSs) were associated with intermediate and advanced AMD. Among families with low PRSs and no known rare variants for maculopathy, we identified 2 novel, highly penetrant missense rare variants in ADAM15, A disintegrin and metalloprotease, metallopeptidase domain 15 (p.Arg288Cys) and F2RL2 (p.Leu289Arg). Immunohistochemistry analyses revealed F2RL2 protein expression in cone photoreceptor outer segments and Müller glia cells of human and pig retinas. Coagulation factor II thrombin receptor-like 2 expression appeared increased in fibrotic areas in advanced AMD samples with neovascularization, suggesting that F2RL2 may play a role in the progression to advanced macular disease. Conclusions New missense rare variants in the genes ADAM15 and F2RL2 were associated with maculopathies. Results suggest that novel genes related to the coagulation and immune pathways may be involved in the pathogenesis of macular diseases.
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Key Words
- AMD, age-related macular degeneration
- ATP, adenosine triphosphate
- C3, complement component 3
- C9, complement component 9
- CADD, Combined Annotation Dependent Depletion
- CFH, complement factor H
- CFI, complement factor I
- Coagulation pathway, Immune pathways
- ENG, endoglin
- F2RL2, coagulation factor II thrombin receptor-like 2
- FANTOM5, functional annotation of the mammalian genome
- GS, glutamine synthetase
- GWAS, genome-wide association studies
- MAF, minor allele frequency
- Macular degeneration
- Maculopathy
- PECAM1, Platelet Endothelial Cell Adhesion Molecule 1
- PRS, polygenic risk score
- SKAT, sequence kernel association testing
- SNP, single nucleotide polymorphism
- TPM, tags per million
- Targeted sequencing
- WES, whole-exome sequencing
- Whole-exome sequencing
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Affiliation(s)
- Tianxiao Huan
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Shun-Yun Cheng
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Bo Tian
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Claudio Punzo
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Haijiang Lin
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Mark Daly
- Massachusetts General Hospital and Broad Institute, Cambridge, Massachusetts
| | - Johanna M. Seddon
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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13
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Taslipinar Uzel AG, Gelisken F, Bartz-Schmidt KU, Neubauer J. Natural Course of Optic Disc Pit Maculopathy: An Optical Coherence Tomography Study. Ophthalmologica 2022; 245:563-569. [PMID: 36103807 DOI: 10.1159/000526023] [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: 03/21/2022] [Accepted: 06/29/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of this study was to analyze the impact of OCT characteristics on the natural course of optic disc pit maculopathy (ODP-M). METHODS This was a single-center, retrospective, observational case series. Patients with ODP-M were included in the study. Baseline demographic characteristics, central macular thickness (CMT), IPP, subretinal fluid (SRF), subretinal precipitations, outer retinal fluid (ORF), and outer retinal layer hole were evaluated. The changes in the OCT characteristics were analyzed with respect to the best-corrected visual acuity (BCVA) from baseline to the last visit. RESULTS Twenty-two eyes of 22 patients were evaluated with a mean follow-up time of 37.6 (median 22) months. The mean BCVA was 0.31 logMAR at baseline and 0.28 logMAR at the final visit (p = 0.521). Baseline BCVA was significantly related to CMT (β coefficient 0.001, p = 0.002). Mean BCVA increased in 7 patients (group 1), remained stable in nine (group 2), and decreased (group 3) in 6 patients. No significant difference was found between the groups regarding the baseline BCVA, CMT, and extent of retinal fluid. In patients with subretinal deposits, BCVA remained stable in 3 patients and worsened in one. ORF was recorded in all patients. In patients with SRF, the mean change of BCVA during follow-up differed significantly, depending on the presence (0.07 logMAR) or absence (-0.125 logMAR) of SRF (p = 0.019). CONCLUSION Among the OCT characteristics, SRF was a negative prognostic factor in ODP-M. Most ODP-M patients showed improved or stable vision over 3 years of follow-up. Therefore, observation may be considered in patients with reasonable vision and without SRF even when they present with remarkable OCT findings.
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Affiliation(s)
- Ayse Guzin Taslipinar Uzel
- Department of Ophthalmology, Balıkesir State Hospital, Balıkesir, Turkey.,Department of Ophthalmology, Eberhard Karls University, Tübingen, Germany
| | - Faik Gelisken
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Germany
| | | | - Jonas Neubauer
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Germany
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Qian T, Xu X, Liu X, Yen M, Zhou H, Mao M, Cai H, Shen H, Xu X, Gong Y, Yu S. Efficacy of MP-3 microperimeter biofeedback fixation training for low vision rehabilitation in patients with maculopathy. BMC Ophthalmol 2022; 22:197. [PMID: 35484529 PMCID: PMC9047472 DOI: 10.1186/s12886-022-02419-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of MP-3 microperimeter biofeedback fixation training (MBFT) in vision rehabilitation of low-vision patients affected by macular disease with central vision loss. METHODS Seventeen eyes (7 age-related macular degeneration, 10 myopic maculopathy) of 17 patients were included in this prospective, interventional study. The preferred retinal locus was determined by comprehensive ophthalmoscopic fundus evaluation including fundus photography, autofluorescence, optical coherence tomography, and microperimetry. The rehabilitation consisted of three 10-min sessions per eye to be performed twice per week for 20 consecutive weeks using the MP-3 microperimeter. Best corrected visual acuity (BCVA), reading speed, mean central sensitivity, the percentages of fixation points within specified regions, bivariate contour ellipse area (BCEA) and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) were recorded pre- and post-training. RESULTS The final BCVA, reading speed and mean central sensitivity all showed significant improvements after rehabilitation (P < 0.0001, P = 0.0013, and P = 0.0002, respectively). The percentages of fixation points located within 2° and 4° diameter circles both significantly increased after training (P = 0.0008 and P = 0.0007, respectively). The BCEA encompassing 68.2, 95.4, 99.6% of fixation points were all significantly decreased after training (P = 0.0038, P = 0.0022, and P = 0.0021, respectively). The NEI-VFQ-25 scores were significantly increased at the end of the rehabilitation training (P < 0.0001). CONCLUSION Rehabilitation with MP-3 MBFT is a user-friendly therapeutic option for improving visual function, fixation stability, and quality of life in advanced macular disease. TRIAL REGISTRATION The prospective study was registered with the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ). TRIAL REGISTRATION NUMBER ChiCTR2000029586 . Date of registration: 05/02/2020.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xian Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xinyi Liu
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Manni Yen
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Manman Mao
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Huiting Cai
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Hangqi Shen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Yuanyuan Gong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China. .,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China. .,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China. .,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China. .,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China.
| | - Suqin Yu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China. .,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China. .,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China. .,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China. .,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China.
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15
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Kang HG, Kim JD, Lee J, Byeon SH, Kim SS, Kim M. Clinical features, treatment factors, and long-term outcomes of optic disc pit maculopathy. Graefes Arch Clin Exp Ophthalmol 2022; 260:2867-2875. [PMID: 35445878 DOI: 10.1007/s00417-022-05661-2] [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: 10/31/2021] [Revised: 03/29/2022] [Accepted: 04/08/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess the clinical features, treatment factors, and long-term visual and anatomical outcomes of optic disc pit maculopathy (ODPM) in Korean patients. METHODS Consecutive patients diagnosed between January 2000 and September 2020 were retrospectively reviewed. The primary outcome was best-corrected visual acuity (BCVA) and anatomical changes (determined by macular thickness reduction and fluid resorption). Secondary outcomes included factors associated with poor visual outcomes (> 3-line decrease or < 20/200 vision). RESULTS Of the 24 eyes (24 patients, mean age, 42.8 years) in this study, two peak incidence groups were noted: children younger than 14 years (six patients; mean age, 9.7 years) and middle-aged adults (18 patients; 53.8 years). There were no significant differences between groups in terms of clinical features, treatment, and outcomes (P > 0.05). The primary treatment involved immediate (7 eyes) or delayed (9) vitrectomy, laser only (2), or observation only (6). Good (50%) or partial (33%) anatomical response was noted in most cases at the final follow-up (P > 0.05). However, regression analyses showed that poor visual outcomes were associated with low preoperative BCVA (OR, 8.73; 95%CI, 1.34-56.85; P = 0.023) and delayed vitrectomy (OR, 13.00; 95%CI, 1.70-99.38; P = 0.013), while presence of intraretinal fluid in the inner and outer layers reduced the risk (OR, 0.086; 95%CI, 0.01-0.88; P = 0.039). CONCLUSION Patients with ODPM may have two peak incidence groups with similar clinical features and treatment outcomes, supporting the idea of heterogeneous mechanisms triggering fluid accumulation. Although the primary treatment choice may not impact long-term anatomical outcomes, delayed vitrectomy may be associated with poorer visual outcomes.
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Affiliation(s)
- Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea.,Translational Genome Informatics Laboratory, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Dong Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, 06273, Seoul, Republic of Korea
| | - Junwon Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, 06273, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, 06273, Seoul, Republic of Korea.
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16
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Nuzzi R, Rossi A, Nuzzi A. Intravitreal dexamethasone: variation of surgical technique and prevention of ocular complications with ASOCT follow-up. Graefes Arch Clin Exp Ophthalmol 2022; 260:2819-28. [PMID: 35471738 DOI: 10.1007/s00417-022-05650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/29/2021] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE To verify the correct decision-making procedure on performing an intravitreal injection by investigating the in vivo wound morphology and evolution of 22-gauge wounds after dexamethasone oblique injection with anterior segment optical coherence tomography (OCT). DESIGN Prospective, observational consecutive case series. METHODS Subjects underwent a dexamethasone injection at University Eye Clinic of Turin. All the injections have been performed in an oblique (aka beveled or angled) fashion. Patients were divided according to the number of injections already performed with dexamethasone. Group 1 consisted of patients at the first injection, group 2 of patients at a second or more injection always in the same quadrant, and group 3 of patients at the second or more injection in a different quadrant. The incisions were imaged with the Heidelberg SPECTRALIS OCT device on postoperative days 1, 8, and 15. The main outcome measure was wound structure/characteristics (e.g., presence of gaping) as evaluated with OCT. Surgical and ocular parameters were also recorded. RESULTS Thirty-three consecutive patients were investigated. OCT demonstrated closed wounds in all eyes on postoperative days 1, 8, and 15. In all patients, the external (entry) side of the incision was seen as a gape; however, the rest of the wound was closed. No complications were recorded in the different patients during the follow-up. In patients of group 1, we identified the scleral pathway in 10 eyes at day 1. At 8 days in 9 of 10 eyes, the sclera had returned to its restitutio ad integrum. In patients of group 2, the scleral pathway was recognizable on the first day of control; in 7 patients, this was accompanied by the presence of intrascleral edema with peri-wound fluid. At the 8-day checkup, 3 eyes still showed signs attributable to the intrascleral pathway accompanied by peri-wound edema. In group 3, it was possible to identify the intrascleral pathway in 8 patients. There were no signs of intrascleral peri-wound edema or other anatomical changes in 9 patients as early as the first day. In the 8-day follow-up, the signs of scleral edema were absent in the single patient who presented them. At 15 days, there were no signs of scleral pathway in all eyes analyzed. CONCLUSIONS Speaking of intravitreal injections of slow-release dexamethasone, the technique that involves moving the conjunctiva and a beveled or angled sclerotomy after a careful choice of the injection site, paying attention to vary the quadrant involved with each puncture, reduces the number of days of closure of the sclera via and the scleral damage, thus protecting the patient from complications. For the future, it is hoped that the operating microscope and intraoperative OCT will be used on every occasion.
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Torres Ledesma B, Bueno García P, Torres Pereda JP. Combined treatment for optic disc pit maculopathy secondary to glaucoma. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:668-672. [PMID: 34844689 DOI: 10.1016/j.oftale.2020.11.013] [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: 04/22/2020] [Accepted: 11/18/2020] [Indexed: 06/13/2023]
Abstract
A 58-year-old man was referred to the retina specialist for evaluation of decreased vision in the left eye (LE). At the first visit, visual acuity was 0.9 in right eye (RE) and hands movement in LE, and the intraocular pressure (IOP) was 34 mmHg and 42 mmHg in right and left eye, respectively. Dilated funduscopic examination revealed papillary pallor, increased cup-to-disc ratio of the optic nerve in both eyes, and retinal posterior pole oedema in the LE. Optical coherence tomography (OCT) and fluorescein angiography assessment confirmed the diagnosis of a macular serous retinal detachment (RD) caused by an optic disc pit secondary to glaucoma. Combined surgical treatment with ExPress drainage device implantation, pars plana vitrectomy (PPV), and juxtapapillar laser endophotocoagulation was performed. The IOP returned to normal, as well as complete anatomical resolution of macular RD.
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Affiliation(s)
- B Torres Ledesma
- Complejo Hospitalario Universitario de Badajoz, Servicio de Oftalmología, Sección Retina, Badajoz, Spain.
| | - P Bueno García
- Complejo Hospitalario Universitario de Badajoz, Servicio de Oftalmología, Sección Retina, Badajoz, Spain
| | - J P Torres Pereda
- Complejo Hospitalario Universitario de Badajoz, Servicio de Oftalmología, Sección Retina, Badajoz, Spain
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Kelkar A, Kelkar JA, Bolisetty M, Kanoriya A. Management of Recurrent Optic Disc Pit-Associated Maculopathy with Human Amniotic Membrane Graft in a Pediatric Case: A Case Report. Case Rep Ophthalmol 2021; 12:734-739. [PMID: 34720971 PMCID: PMC8460937 DOI: 10.1159/000518808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/16/2021] [Accepted: 07/25/2021] [Indexed: 11/19/2022] Open
Abstract
A 13 years old previously operated with 25-G pars plana vitrectomy with double internal limiting membrane peel and juxtapapillary endolaser with SF 6 gas tamponade for optic disc pit-associated maculopathy (ODP-M), presented with recurrence after 9 months of successful primary surgery. Three 25-G sclerotomies were made and Human Amniotic Membrane Graft was tucked into the optic disc pit (ODP), the position of the graft was confirmed with intraoperative ocular coherence tomography. Subretinal fluid rapidly resolved within 48 h and best-corrected visual acuity improved to 0.5 LogMAR after 1 week. During the follow-up period of 12 months, no episodes of recurrence or reduction vision or adverse reactions were noted.
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Affiliation(s)
- Aditya Kelkar
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, India
| | - Jai Aditya Kelkar
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, India
| | - Mounika Bolisetty
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, India
| | - Ashwani Kanoriya
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, India
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González-Martín-Moro J, Almagro EG, Abreu NV, Serrano FN. Poppers maculopathy: A quantitative review of previous literature. Semin Ophthalmol 2021; 37:391-398. [PMID: 34634219 DOI: 10.1080/08820538.2021.1986552] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To review the available literature on poppers maculopathy (PM). MATERIAL AND METHODS Sixty-four patients (60 with bilateral and 4 with unilateral involvement), for a total of 124 eyes were reported in PubMed, Google Scholar and Embase. Patterns were analyzed according to country, age, gender, sexual orientation, HIV status, consumption habits, visual acuity at presentation (VAP), final visual acuity (VAF) and optical coherence tomography (OCT). RESULTS Most cases (110 eyes) of PM were reported in European countries and affected middle-aged men (only 8 eyes from female users). The median age was 38.7 years (SD = 10.5 years). Final visual acuity (Median = 0.8; Interquartile range: 0.67-1) was higher than visual acuity at presentation (Median = 0.67; Interquartile range: 0.4-0.8). Many articles lack data on sexual orientation and HIV status as this is considered very personal information. One third of the eyes (40 eyes) developed PM after a single exposure. No significant differences were found between eyes that developed PM after a single exposure and those which developed the condition after several exposures. The most commonly reported pattern was an interruption of the ellipsoid line (68 eyes). CONCLUSION PM is more prevalent in Europe or European ophthalmologists are more likely to diagnose PM. PM usually affects middle-aged men given that this condition generally appears with chronic exposure to poppers. VAF was higher than VAP, suggesting that this toxicity is in part reversible. Information about HIV status was not provided in most recent articles, thus it is not possible to make inferences about the possible implication of HIV drugs as cofactors for the development of this retinal toxicity.
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Affiliation(s)
- Julio González-Martín-Moro
- Department of Ophthalmology, Hospital Universitario Del Henares, Coslada, Madrid, Spain.,Grado de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Elena Guzmán Almagro
- Department of Ophthalmology, Hospital Universitario Del Henares, Coslada, Madrid, Spain
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Bijan S, Yu SY, Kiri G, Bhaleeya S, Tzekov R. Effect of spatial averaging on the amplitude ring ratio in multifocal electroretinography. Doc Ophthalmol 2021. [PMID: 34505962 DOI: 10.1007/s10633-021-09850-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the effect of spatial averaging on the multifocal electroretinography (mfERG) amplitude ring ratios used in screening for hydroxychloroquine (HCQ) toxicity. METHODS This was a retrospective review of the records of patients screened for HCQ retinopathy at the USF Eye Institute (University of South Florida) during the period of 2015-2020. Patients were tested binocularly with Diagnosys mfERG system (Diagnosys LLC, Lowell, MA). Only the records of patients referred internally were used. The effects of the lowest level (level 1, or 8%) of spatial averaging on the P1 amplitude ring ratios used for screening of HCQ maculopathy: R1/R2, R2/R5, R5/R3 and R5/R4, were evaluated. RESULTS The records of 40 patients (4 males, 36 females) aged 54.4 ± 14.1 years were selected for analysis. The use of spatial averaging had a significant effect on P1 amplitudes, and on the ring ratios and this effect was correlated with the magnitude of the amplitudes and the ratios. Spatial averaging diminished P1 amplitude significantly in ring 1 (p < 0.0001) and increased it slightly in ring 4 (p < 0.05), while it had no effect on the amplitude of the other three rings. Although as a group spatial averaging had a moderate effect on the R1/R2 ratio (~ -15%), on an individual basis the range was wide, from -36 to 43%. The effect on the other ring ratios was similar: The average group effect was ~ -5%, ~ -3.4% and ~ -4% for R2/R5, R5/R3 and R5/R4 ratios, but individual effects ranged from 0.18% to -27.3%, 0.9% to -14.2% and 0.9% to -26.2%, respectively. CONCLUSIONS For all ring ratios used in this analysis, spatial averaging has a substantial effect on the ring ratio, which could affect the interpretation of the results. Therefore, use of spatial averaging should be avoided when analyzing mfERG results for HCQ screening.
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Mazzola M, Premoli L, Metrangolo C, Cattaneo J, Premi E, Donati S, Azzolini C. Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle's Fiber Layer. Case Rep Ophthalmol 2021; 12:446-450. [PMID: 34177540 PMCID: PMC8216004 DOI: 10.1159/000510626] [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: 05/18/2020] [Accepted: 08/01/2020] [Indexed: 11/19/2022] Open
Abstract
This case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle's fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best corrected visual acuity (BCVA) was 20/100 OD. Fundus examination showed a stellate intraretinal hemorrhage in the fovea of the OD. The hemorrhage was organized in a peculiar petaloid pattern with feathery distal edges, suggesting localization within the radially oriented HFL. The presence of both choroidal neovascularization and microvascular abnormalities consistent with macular telangiectasia type 2 (MacTel 2) were excluded. Based on these findings, a diagnosis of myopic SH was made. At 4-month follow-up BCVA OD spontaneously improved to 20/40, without any treatment been ever administered to the patient. Spectral-domain optical coherence tomography OD showed reabsorption of the hemorrhage and almost complete restoration of the foveal architecture. The intraretinal location and spread of the hemorrhage into the HFL in our patient are an unusual presentation of SH, which vividly highlights the anatomy of the fovea. Since fibers in HFL are quite delicate and loosely arranged, this layer is very susceptible to deposition of transudates, exudates, hemorrhage, and other products. Radial hemorrhage in HFL has been originally reported in 4 patients as complication of MacTel 2. It has been previously postulated that it may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus. On the contrary, our data suggest that radial hemorrhage in the HFL does not represent a characteristic finding of MacTel 2, but must rather be considered a non-specific sign with multiple possible etiologies.
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Affiliation(s)
- Marco Mazzola
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy.,Ophthalmology Department, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Laura Premoli
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy
| | - Cristian Metrangolo
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy
| | - Jennifer Cattaneo
- Ophthalmology Clinic, Department of Neuroscience, ASST Ovest Milanese, Legnano, Italy
| | - Elias Premi
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy
| | - Simone Donati
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy
| | - Claudio Azzolini
- Ophthalmology Clinic, Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy
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Edwards Mayhew RG, Kahook MY, Seibold LK. Hypotony maculopathy captured with vertical rasters on optical coherence tomography (OCT) imaging. Am J Ophthalmol Case Rep 2021; 22:101076. [PMID: 33869892 DOI: 10.1016/j.ajoc.2021.101076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/25/2021] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To remind eye care providers of the importance of obtaining vertical rasters in OCT evaluation of patients with suspected hypotony maculopathy. Observations OCT with vertical rasters may identify chorioretinal folds that are missed by ophthalmoscopic examination, fundus photography, and traditional OCT with horizontal rasters alone. Conclusions and importance In patients with low IOP and decreased vision, OCT imaging with horizonal and vertical rasters should be obtained to diagnose hypotony maculopathy and monitor response to treatment.
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23
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Mishra AV, Pollmann AS, Choudhry N, Demmings E, Gupta RR. Unilateral benign yellow dot maculopathy. Am J Ophthalmol Case Rep 2021; 22:101068. [PMID: 33796798 PMCID: PMC7995479 DOI: 10.1016/j.ajoc.2021.101068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/05/2020] [Revised: 02/14/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To describe a unique case of unilateral benign yellow dot maculopathy. Observations A 25-year-man was evaluated after incidental finding of yellow dots in the right macula. The findings of examination and multimodal imaging were in keeping with a diagnosis of benign yellow dot maculopathy. Conclusions and importance Benign yellow dot maculopathy is a recently described entity with either a sporadic or dominant inheritance pattern. This is the first known report of the characteristic findings of this phenotype presenting unilaterally.
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Affiliation(s)
- Amit V. Mishra
- Department of Ophthalmology and Visual Sciences, Dalhousie University, 1276 South Park Street, Room 2035D, 2 West Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada
- Corresponding author. Department of Ophthalmology & Visual Sciences, Dalhousie University/Nova Scotia Health Authority, 1276 South Park Street, Room 2035D, 2 West Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada.
| | - André S. Pollmann
- Department of Ophthalmology and Visual Sciences, Dalhousie University, 1276 South Park Street, Room 2035D, 2 West Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, 3280 Bloor St. W. Suite 310, Etobicoke, ON, M8X 3X3, Canada
- Cleveland Clinic Canada, 181 Bay St. 30th Floor, Toronto, ON, M5J 2T3, Canada
| | - Erin Demmings
- Department of Ophthalmology and Visual Sciences, Dalhousie University, 1276 South Park Street, Room 2035D, 2 West Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada
| | - R. Rishi Gupta
- Department of Ophthalmology and Visual Sciences, Dalhousie University, 1276 South Park Street, Room 2035D, 2 West Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada
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Gameiro Filho AR, Sturzeneker G, Rodriguez EEC, Maia A, Morales MC, Belfort RN. Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma. Int J Retina Vitreous 2021; 7:27. [PMID: 33795031 PMCID: PMC8017785 DOI: 10.1186/s40942-021-00300-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/17/2020] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.
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Affiliation(s)
- Aluisio Rosa Gameiro Filho
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil.
| | - Guilherme Sturzeneker
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Ever Ernesto Caso Rodriguez
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - André Maia
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Melina Correia Morales
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Rubens N Belfort
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
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Javidi H, Ah-Moye S, Hennings C, Mehta H, Mahmood S. Presumed Sertraline-Associated Maculopathy: A Case Series. Ophthalmol Ther 2021; 10:359-65. [PMID: 33743165 DOI: 10.1007/s40123-021-00340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/10/2021] [Accepted: 02/27/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To report findings of maculopathy after treatment with sertraline in three patients. Methods This case series includes three patients who presented with reduced visual acuity after treatment with sertraline for various psychiatric indications. All patients had been treated with sertraline for varying periods of time between 4 weeks and 5 years. Results Data were collected from three patients (age range, 27–68 years). All three patients were white females, with both eyes being affected in all cases. The range of presenting visual acuities was between 20/30 and 20/100 after presentation with central visual disturbance. All patients underwent comprehensive ocular examination and imaging with the main ocular findings being outer retinal layer and retinal pigment epithelial disruption. The follow-up period was between 1 and 9 months with final visual acuities between 20/25 and 20/100. Patients showed objective clinical evidence of phenotypically similar maculopathy supported by appropriate imaging Conclusion In this cohort, we report the possible association of sertraline use and associated maculopathy in three patients. This is potentially significant, given the large numbers of patients treated with sertraline currently; however, further evidence is required to both quantify how common this association is and establish a possible causative mechanism.
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Torres Ledesma B, Bueno García P, Torres Pereda JP. Combined Treatment for Optic Disc Pit Maculopathy Secondary to Glaucoma. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(20)30483-4. [PMID: 33495054 DOI: 10.1016/j.oftal.2020.11.013] [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: 04/22/2020] [Revised: 10/14/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
CASE REPORT A 58-year-old man was referred to the retina specialist for evaluation of decreased vision in the left eye (LE). At the first visit, visual acuity was 0.9 in right eye (RE) and hands movement in LE, and the intraocular pressure (IOP) was 34 mmHg and 42 mmHg in right and left eye, respectively. Dilated funduscopic examination revealed papillary pallor, increased cup-to-disc ratio of the optic nerve in both eyes, and retinal posterior pole edema in the LE. Optical coherence tomography (OCT) and fluorescein angiography assessment confirmed the diagnosis of a macular serous retinal detachment (RD) caused by an optic disc pit secondary to glaucoma. Combined surgical treatment with ExPress drainage device implantation, pars plana vitrectomy (PPV), and juxtapapillar laser endophotocoagulation was performed. IOP normalization was achieved as well as complete anatomical resolution of macular RD.
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Affiliation(s)
- B Torres Ledesma
- Complejo Hospitalario Universitario de Badajoz. Servicio de Oftalmología. Sección Retina, Badajoz, España.
| | - P Bueno García
- Complejo Hospitalario Universitario de Badajoz. Servicio de Oftalmología. Sección Retina, Badajoz, España
| | - J P Torres Pereda
- Complejo Hospitalario Universitario de Badajoz. Servicio de Oftalmología. Sección Retina, Badajoz, España
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Torrado-Cobian LA, Fivgas GD. Optic nerve pit maculopathy worsened during pregnancy: a case report. BMC Ophthalmol 2021; 21:21. [PMID: 33413194 PMCID: PMC7791707 DOI: 10.1186/s12886-020-01775-5] [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: 09/02/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report a case of Optic Disc Pit (ODP) maculopathy exacerbated during pregnancy. CASE PRESENTATION A 30-year-old female developed unilateral blurry vision at 10-weeks gestation. Ophthalmic examination revealed left eye reduced visual acuity (VA) with the presence of subretinal fluid temporal to the disc extending to the fovea. On Spectral Domain Optical Coherence Tomography (SD-OCT) subretinal, and intraretinal fluid was confirmed. Laser photocoagulation was tried in an attempt to prevent surgical intervention without success; subsequently, pars plana vitrectomy, internal limiting membrane peel and gas tamponade was performed. Three-weeks later, a full thickness macular hole developed, and repeat surgery was performed. Nine-months after the second surgery the macular hole was closed with near complete resorption of edema. CONCLUSIONS No trigger factors for ODP maculopathy have been reported before. We report a case of worsening ODP maculopathy during pregnancy with good visual outcome after surgical intervention.
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Affiliation(s)
- Laura A Torrado-Cobian
- Department of Ophthalmology, Retina Division, Louisiana State University (LSU) School of Medicine, 533 Bolivar Street, Room 451B, New Orleans, LA, 70112, USA
| | - George D Fivgas
- LSU Department of Ophthalmology, Retina Division, Private Practice: The Retina Center, 7777 Hennessy Blvd, Suite 3000, Baton Rouge, LA, 70808, USA.
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Kremláček J, Nekolová J, Středová M, Langrová J, Szanyi J, Kuba M, Kubová Z, Vít F, Voda P, Veselá M, Jirásková N. Vision before and after scharioth macular lens implantation in patients with AMD: an electrophysiological study. Doc Ophthalmol 2021; 143:17-31. [PMID: 33392893 DOI: 10.1007/s10633-020-09814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/24/2020] [Accepted: 12/11/2020] [Indexed: 11/09/2022]
Abstract
Background For patients with age-related macular degeneration (AMD), a special intraocular lens implantation partially compensates for the loss in the central part of the visual field. For six months, we evaluated changes in neurophysiological parameters in patients implanted with a “Scharioth macula lens” (SML; a center near high add + 10 D and peripheral plano carrier bifocal lens designed to be located between the iris and an artificial lens). Methods Fourteen patients (5 M, 9 F, 63–87 years) with dry AMD were examined prior to and at 3 days after, as well as 1, 2, and 6 months after, implantation using pattern-reversal, motion-onset, and cognitive evoked potentials, psychophysical tests evaluating distant and near visual acuity, and contrast sensitivity. Results Near visual acuity without an external aid was significantly better six months after implantation than before implantation (Jaeger table median (lower; upper quartile): 4 (1; 6) vs. 15 (13; 17)). Distant visual acuity was significantly altered between the pre- (0.7 (0.5; 0.8) logMAR) and last postimplantation visits (0.8 (0.7; 0.8) logMAR), which matched prolongation of the P100 peak time (147 (135; 151) ms vs. 161 (141; 166) ms) of 15 arc min pattern-reversal VEPs and N2 peak time (191.5 (186.5; 214.5) ms vs. 205 (187; 218) ms) of peripheral motion-onset VEPs. Conclusion SML implantation significantly improved near vision. We also observed a slight but significant decrease in distant and peripheral vision. The most efficient electrophysiological approach to test patients with SML was the peripheral motion-onset stimulation, which evoked repeatable and readable VEPs. Supplementary Information The online version
containssupplementary material available at (10.1007/s10633-020-09814-8).
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Gao J, Panse K, Foster CS, Anesi SD. Paraneoplastic acute exudative polymorphous vitelliform maculopathy improved with intravitreal methotrexate. Am J Ophthalmol Case Rep 2020; 20:100930. [PMID: 33005818 PMCID: PMC7509776 DOI: 10.1016/j.ajoc.2020.100930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/09/2019] [Revised: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose To describe a case of acute exudative polymorphous vitelliform maculopathy (AEPVM) treated with intravitreal methotrexate. Observations A 58-year-old man with a history of metastatic melanoma developed paraneoplastic acute exudative polymorphous vitelliform maculopathy, refractory to oral prednisone, intravitreal bevacizumab and intravitreal preservative-free triamcinolone. Improvement in vision and resolution of subfoveal fluid was later seen after intravitreal methotrexate therapy. Conclusions and Importance AEPVM is a rare and poorly understood retinal disorder that may be idiopathic or may manifest in patients with malignancies. The pathogenic process is thought to be an attack directed against the retinal pigment epithelium (RPE) and photoreceptors. Intravitreal methotrexate may provide benefit when treating AEPVM, especially when trials of steroids and anti-VEGF medications have failed.
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Affiliation(s)
- Jie Gao
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
| | - Ketaki Panse
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
| | - C Stephen Foster
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States.,Harvard Medical School, United States
| | - Stephen D Anesi
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
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Padungkiatsagul T, Leung LS, Moss HE. Retinal Diseases that Can Masquerade as Neurological Causes of Vision Loss. Curr Neurol Neurosci Rep 2020; 20:51. [PMID: 32930896 DOI: 10.1007/s11910-020-01071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE OF REVIEW This review aims to discuss retinal diseases that may masquerade as neurological causes of vision loss and highlights modern ophthalmic ancillary testing that can help to establish these diagnoses. RECENT FINDINGS Retinal diseases with signs and symptoms overlapping with neurological causes of vision loss include central serous chorioretinopathy, retinal ischemia, acute macular neuroretinopathy, Acute zonal occult outer retinopathy (AZOOR) complex diseases, paraneoplastic retinopathy, retinal dystrophy, and toxic retinopathy. Diagnosis is facilitated by electrophysiologic studies and multimodal ophthalmic imaging including optical coherence tomography and fundus autofluorescence imaging. Looking into the future, translation of adaptive optics ophthalmoscopy into clinical practice may facilitate early detection of microscopic retinal abnormalities that characterize these conditions. With conventional methods of physical examination, diagnosis of retinal diseases that may masquerade as neurological causes of vision loss can be challenging. Current advance in multimodal ophthalmic imaging along with electrophysiologic studies enhances the provider's ability to make early diagnosis and monitor progression of these conditions.
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Gračner T. SCREENING FOR DIABETIC RETINOPATHY - A TWELVE-MONTH REVIEW. Acta Clin Croat 2020; 59:424-430. [PMID: 34177051 PMCID: PMC8212655 DOI: 10.20471/acc.2020.59.03.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The purpose is to provide a twelve-month database review of screening for diabetic retinopathy (DR). A total of 1428 diabetes mellitus (DM) patients screened in 2017 were analyzed in a retrospective study. Retinal photographs were reviewed by an ophthalmologist for the presence and stage of DR, as well as for additional nondiabetic findings. The following grading categories of DR were used: without DR, mild non-proliferative DR (NPDR), moderate NPDR, severe non-proliferative NPDR, proliferative DR (PDR), clinically significant macular edema (CSME) and ungradable finding. Severe NPDR, PDR and CSME were classified as vision-threatening DR. Out of 1428 DM patients, 27 were diagnosed with type 1 DM and 1401 with type 2 DM, 353 of them had newly diagnosed type 2 DM. Without DR category was recorded in 85.2% of all eyes screened, 2.8% were ungradable, and 12% showed varying stages of DR. Vision-threatening DR was found in 2.8% and additional nondiabetic findings in 5.2% of all screened eyes. In the group of newly diagnosed type 2 DM, 92.5% of screened eyes were without DR, 3.1% were ungradable and 4.3% showed varying stages of DR. In the group of newly diagnosed type 2 DM, vision-threatening DR was recorded in 0.1% and additional nondiabetic finding in 5.7% of the eyes screened. In conclusion, a small proportion of screened DM patients with detected DR had vision-threatening DR.
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Pandey S, Kumar P, Moulick PS, Vats S. Spectral domain optical coherence tomography-based prevalence of hydroxychloroquine maculopathy in Indian patients on hydroxychloroquine therapy: A utopia of underdiagnosis. Med J Armed Forces India 2020; 76:395-401. [PMID: 32836708 PMCID: PMC7240261 DOI: 10.1016/j.mjafi.2020.04.012] [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: 03/23/2020] [Accepted: 04/24/2020] [Indexed: 10/27/2022] Open
Abstract
Background Spectral domain optical coherence tomography (SD-OCT) detects early structural damage to macula in patients on Hydroxychloroquine (HCQ) therapy. The current screening protocols emphasize concurrent use of both SD-OCT and Visual field analysis (VFA) which detects functional damage to detect Hydroxychloroquine maculopathy. However, VFA is a time-consuming and subjective test which is often neglected. This study gives the prevalence of Hydroxychloroquine maculopathy using SD-OCT alone which often fails to detect macular damage in peri-foveal and extra-foveal area of the retina. Methods Three hundred thirty four eyes of 167 patients taking systemic Hydroxychloroquine were studied with SD-OCT macular cube 512 x 128 to diagnose structural macular damage to detect prevalence of Hydroxychloroquine maculopathy. Results Out of 167 patients, only four patients showed features suggestive of Hydroxychloroquine maculopathy. One patient had ELM loss, two had para-foveal and one had peri-foveal IS-OS disruption. The SD-OCT gave prevalence as 2.4%. Conclusion SD-OCT alone can underdiagnose burden of Hydroxychloroquine maculopathy (prevalence = 2.4%) when compared to studies which use both SD-OCT and Visual field analysis (prevalence = 7.5%).
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Affiliation(s)
- Shikha Pandey
- Junior Resident, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Poninder Kumar
- Professor & HoD, Dept of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - P S Moulick
- Senior Consultant (Ophthalmology), Apollo Gleneagles Hospital, Kolkata, India
| | - Sumedha Vats
- Senior Resident, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
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Bunod R, Miere A, Zambrowski O, Girard PM, Surgers L, Souied EH. Ritonavir associated maculopathy- multimodal imaging and electrophysiology findings. Am J Ophthalmol Case Rep 2020; 19:100783. [PMID: 32803017 PMCID: PMC7417746 DOI: 10.1016/j.ajoc.2020.100783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/27/2019] [Revised: 03/22/2020] [Accepted: 06/08/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose To report the case 47-year-old patient presenting with severe maculopathy associated with long-term ritonavir treatment. Methods Observational case report of one patient and literature review. Results A 47 year-old Caucasian man presented with progressive bilateral vision loss for the past 5 years. His medical history included Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) coinfection since 1992. He was treated by highly active antiretroviral therapy for 24 years including 4 years of didanosine treatment and 18 years of ritonavir treatment. Bilateral extensive macular atrophy with foveal sparing on the left eye and absence of midperipheral/peripheral retina involvement was confirmed on multimodal imaging and functional testing including swept-source OCT angiography and electroretinography. Conclusion Ritonavir associated maculopathy is a scarcely described medication-associated retinopathy. In this case, an extensive macular atrophy (with complete loss of photoreceptor, RPE and choriocapillaris layers) and subsequent cone-rod dysfunction appeared after 18 years of ritonavir exposure.
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Affiliation(s)
- Roxane Bunod
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, 40 Avenue de Verdun, 94000, Creteil, France
| | - Alexandra Miere
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, 40 Avenue de Verdun, 94000, Creteil, France
| | - Olivia Zambrowski
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, 40 Avenue de Verdun, 94000, Creteil, France
| | - Pierre-Marie Girard
- Department of Infectious and Tropical Diseases, Hôpital Saint Antoine, AP-HP and UMRS, 1136, Sorbonne Université, F75013, Paris, France
| | - Laure Surgers
- Department of Infectious and Tropical Diseases, Hôpital Saint Antoine, AP-HP and UMRS, 1136, Sorbonne Université, F75013, Paris, France
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, 40 Avenue de Verdun, 94000, Creteil, France
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Fernandez-Ruiz R, Bornkamp N, Kim MY, Askanase A, Zezon A, Tseng CE, Belmont HM, Saxena A, Salmon JE, Lockshin M, Buyon JP, Izmirly PM. Discontinuation of hydroxychloroquine in older patients with systemic lupus erythematosus: a multicenter retrospective study. Arthritis Res Ther 2020; 22:191. [PMID: 32807233 PMCID: PMC7430013 DOI: 10.1186/s13075-020-02282-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/01/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background Although hydroxychloroquine (HCQ) is a mainstay of treatment for patients with systemic lupus erythematosus (SLE), ocular toxicity can result from accumulated exposure. As the longevity of patients with SLE improves, data are needed to balance the risk of ocular toxicity and the risk of disease flare, especially in older patients with quiescent disease. Accordingly, this study was initiated to examine the safety of HCQ withdrawal in older SLE patients. Methods Data were obtained by retrospective chart review at three major lupus centers in New York City. Twenty-six patients who discontinued HCQ and thirty-two patients on HCQ matched for gender, race/ethnicity, and age were included in this study. The primary outcome was the occurrence of a lupus flare classified by the revised version of the Safety of Estrogens in Lupus Erythematosus: National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) Flare composite index, within 1 year of HCQ withdrawal or matched time of continuation. Results Five patients (19.2%) in the HCQ withdrawal group compared to five (15.6%) in the HCQ continuation group experienced a flare of any severity (odds ratio [OR] = 1.28; 95% CI 0.31, 5.30; p = 0.73). There were no severe flares in either group. The results were similar after adjusting for length of SLE, number of American College of Rheumatology criteria, low complement levels, and SELENA-SLEDAI score, and in a propensity score analysis (OR = 1.18; 95% CI 0.23, 6.16; p = 0.84). The analysis of time to any flare revealed a non-significant earlier time to flare in the HCQ withdrawal group (log-rank p = 0.67). Most flares were in the cutaneous and musculoskeletal systems, but one patient in the continuation group developed pericarditis. The most common reason for HCQ withdrawal was retinal toxicity (42.3%), followed by patient’s preference (34.6%), other confirmed or suspected adverse effects (15.4%), ophthalmologist recommendation for macular degeneration (3.8%), and rheumatologist recommendation for quiescent SLE (3.8%). Conclusions In this retrospective study of older stable patients with SLE on long-term HCQ, withdrawal did not significantly increase the risk of flares.
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Affiliation(s)
- Ruth Fernandez-Ruiz
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
| | - Nicole Bornkamp
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Mimi Y Kim
- Division of Biostatistics, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Anca Askanase
- Division of Rheumatology, Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Anna Zezon
- Division of Rheumatology, Englewood Hospital and Medical Center, Englewood, NJ, USA
| | - Chung-E Tseng
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - H Michael Belmont
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Amit Saxena
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Jane E Salmon
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Michael Lockshin
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Jill P Buyon
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Peter M Izmirly
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
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Wagner H, Pielen A, Agostini H, Böhringer D, Lagrèze WA, Biermann J. Surgical outcomes in patients with optic disc pit maculopathy: does peeling the ILM lead to better outcomes? Int Ophthalmol 2020; 40:3363-76. [PMID: 32737732 DOI: 10.1007/s10792-020-01524-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/09/2019] [Accepted: 07/17/2020] [Indexed: 10/26/2022]
Abstract
PURPOSE Optic disc pits (ODPs) are rare congenital anomalies. Several patients develop optic disc pit maculopathy (ODP-M): visual impairment caused by intra- and/or subretinal fluid. Treatment mode remains controversial. This study was designed to investigate the effectiveness of pars plana vitrectomy (PPV) and gas tamponade with or without internal limiting membrane (ILM)-peeling in improving visual acuity and reducing subretinal fluid in ODP-M patients. METHODS We retrospectively reviewed the charts of 16 patients who underwent surgery for ODP-M from 2002-2015. Six patients underwent PPV with gas tamponade (group 1); ten patients additionally received ILM-peeling (group 2). Pre- and postoperative visual acuity and central retinal thickness (CRT) were compared between groups, as well as retinal morphology and the number of secondary vitrectomies and complications. RESULTS Median visual acuity improved by 2 ETDRS lines in both groups (p = 0.713, Mann-Whitney U test). Median CRT decreased by 426.5 µm and 460 µm (p = 0.931). One patient in group 1 underwent repeat vitrectomy for persistent retinoschisis. Three patients in group 2 required repeat vitrectomy: two to treat a macular hole, one for peripheral retinal holes with retinal detachment. CONCLUSION In our cohort, PPV with gas tamponade proved to be an effective first-line treatment for ODP-M. Additional ILM-peeling did not give a significant benefit in this study.
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Kortuem C, Marx T, Altpeter EK, Trauzettel-Klosinski S, Kuester-Gruber S. Comparing Reading Speeds for Reading Standardized Single Sentences and Paragraphs in Patients with Maculopathy. Ophthalmic Res 2020; 64:512-522. [PMID: 32585666 DOI: 10.1159/000509687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/04/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to compare reading speeds (RS) of either paragraphs of text or single sentences in patients with maculopathy by investigating the repeatability of RS to decide which text type to use in studies on patients with maculopathy. METHODS RS was measured for standardized texts in 25 participants with a central scotoma due to maculopathy (mean age 77.8 years ± 9.9 SD, mean binocular visual acuity 0.65 logMAR (±0.85 SD), median magnification requirement 3-fold). Reading 3 single sentences taken from the Radner reading charts (sample #1, #2, and #3) of 14 words and reading 3 paragraphs of International Reading Speed Texts (IReST, sample # 3, #6, and #10) with a mean of 132 (±3.2 SD) words, each in German, were compared. The 6 texts were read aloud in random order from a closed-circuit TV system, with size adjusted according to the individual magnification requirement. Reading time was measured by stopwatch, and speed was calculated in correctly read words per minute (wpm). Differences in RS depending on text length (single sentence vs. paragraph) and text sample were calculated by the Bland-Altman analysis. RESULTS The mean RS showed no significant difference between 2 charts of the same kind (sentences: 93 wpm ± 37 SD; paragraphs: 95 wpm ± 38 SD). RS differences between 2 charts were lower in paragraphs than in single sentences. Highest correlations of RS between all 6 texts existed between the 3 IReST text samples (r = 0.98, 0.98, and 0.98) compared with the 3 Radner sentences (r = 0.89, 0.81, and 0.90). The inter-chart reliability (coefficient of repeatability) was smaller for the paragraphs (12.9 wpm) than for the single sentences (36.4 wpm). CONCLUSION In patients with maculopathy, single sentences are well suited for single measurement of RS. For repeated measurements (e.g., monitoring the course of a reading disorder or assessing effects of interventions), paragraphs are preferable because of their lower variability of RS between the paragraphs.
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Affiliation(s)
- Constanze Kortuem
- Center for Ophthalmology, Department for Strabology, Lids and Orbit, University of Tuebingen, Tuebingen, Germany
| | - Tobias Marx
- Center for Ophthalmology, Low Vision Clinic, University of Tuebingen, Tuebingen, Germany
| | - Elke Karin Altpeter
- Center for Ophthalmology, Low Vision Clinic, University of Tuebingen, Tuebingen, Germany
| | | | - Stephan Kuester-Gruber
- Center for Ophthalmology, Vision Rehabilitation Research Unit, University of Tuebingen, Tuebingen, Germany,
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Holt CB, Hoffmann-Petersen IT, Hansen TK, Parving HH, Thiel S, Hovind P, Tarnow L, Rossing P, Østergaard JA. Association between severe diabetic retinopathy and lectin pathway proteins - an 18-year follow-up study with newly diagnosed type 1 diabetes patients. Immunobiology 2020; 225:151939. [PMID: 32381273 DOI: 10.1016/j.imbio.2020.151939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 11/18/2022]
Affiliation(s)
- C B Holt
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; Aarhus University, Aarhus, Denmark.
| | | | - T K Hansen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - H-H Parving
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - S Thiel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - P Hovind
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - L Tarnow
- Steno Diabetes Center, Sjaelland, Denmark
| | - P Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; University of Copenhagen, Copenhagen, Denmark
| | - J A Østergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Diaz Aljaro P, Loscos Arenas J, Broc Iturralde L, Carbonell Puig M, Romera Romero P. Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation. Case Rep Ophthalmol 2020; 11:151-155. [PMID: 32355500 PMCID: PMC7184795 DOI: 10.1159/000507109] [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: 03/28/2019] [Accepted: 03/08/2020] [Indexed: 11/28/2022] Open
Abstract
We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.
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Affiliation(s)
- Pablo Diaz Aljaro
- Ophthalmology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jordi Loscos Arenas
- Ophthalmology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Laura Broc Iturralde
- Ophthalmology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marc Carbonell Puig
- Ophthalmology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Pau Romera Romero
- Ophthalmology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Abstract
Purpose Torpedo lesions in the retina are rare. This study aimed to investigate torpedo-shaped lesions in the retina in an adult population and to determine the spectrum and features of the disease. Methods The review of a database for clinical diagnosis identified nine patients who were diagnosed with torpedo-shaped lesions in the retina between June 2017 and February 2019. Fundus photography and optical coherence tomography (OCT) imaging were used to analyze the cases. Multicolor imaging was also performed. Results Nine patients with torpedo-shaped lesions in the fundus were identified. Fundus images revealed that the lesion involved the macula in six eyes; in the remaining three eyes, the lesion was present outside the macula. OCT identified six patients with type 1 torpedo lesions, one with type 2, and two with type 3. On multicolor imaging, the lesion was visualized as a region of increased reflectance in blue, green, and infrared light in all eyes, with notably increased infrared reflectance in eyes with focal choroidal excavation. Choroidal neovascular membrane was evident in one patient on OCT angiography. Conclusion Torpedo lesions in the retina can occur away from the macula and exhibit features similar to those of torpedo maculopathy. As such, the authors propose a change in the nomenclature for torpedo lesions in the retina from "torpedo maculopathy" to "torpedo retinopathy."
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Kushagra Jain
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Arpitha Pereira
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Thirumalesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
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Astakhov YS, Astakhov SY, Lisochkina AB, Nechiporenko PA. Eight-year multimodal follow-up of recurrent idiopathic acute exudative polymorphous vitelliform maculopathy. J Fr Ophtalmol 2020; 43:500-516. [PMID: 32147214 DOI: 10.1016/j.jfo.2020.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/31/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe and analyze clinical findings in a patient with recurrent idiopathic acute exudative polymorphous vitelliform maculopathy (AEPVM), followed in detail, and to propose the diagnostic and follow-up algorithm. DESIGN Retrospective observational analysis. PATIENT A young adult male patient diagnosed with idiopathic AEPVM who developed two relapses in a 12-month period eight years after the initial onset. METHODS Review of clinical charts, multimodal imaging, and electrophysiology findings. The patient repeatedly underwent complete ophthalmic examinations, including best-corrected visual acuity testing (BCVA), slit-lamp and fundus examinations; digital fundus photography, time-domain optical coherence tomography (OCT) in 2009 (Stratus OCT, Carl Zeiss Meditec, USA) and spectral-domain OCT in 2017-2018 (Spectralis-OCT, Heidelberg Engineering, Germany), together with fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICGA), all with HRA2 (Heidelberg Engineering, Germany); microperimetry (MP-1 microperimeter, Nidek, Japan). Laser flare photometry (Kowa FM-600, Japan) and electrophysiology testing were also performed. MAIN OUTCOME MEASURES Clinical features of long-lasting recurrent idiopathic AEPVM, and diagnostic and follow-up algorithm in such rare cases. RESULTS Case report of a 25-year-old male Caucasian patient with typical features of AEPVM, including serous neuroepithelial detachment with irregular retinal elevations, ophthalmoscopically resembling retinal folds, with subsequent subretinal accumulation of characteristic yellow-white vitelliform deposits. Features in this case rarely described, or even not yet reported, include indocyanine- and fluorescein-negative intraretinal cystic changes, optic disc hyperfluorescence on FA, serous retinal elevations mimicking retinal folds, increased choroidal thickness, lack of rapid visual recovery, and very slow anatomical improvement of the relapses. Bimonthly fundus autofluorescence evaluation together with SD-OCT were the most informative diagnostic methods, demonstrating the evolution of pathological signs. CONCLUSION AEPVM may be a recurrent or even chronic condition with uncertain long-term visual outcomes. It may have variable clinical presentations depending on the stage of the disease, and both clinical manifestations and imaging features of different stages of the pathologic process may overlap. Patients should be made aware that visual improvement occurs very slowly, if at all. Bimonthly fundus autofluorescence evaluation together with SD-OCT should be recommended in such cases.
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Affiliation(s)
- Y S Astakhov
- Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - S Y Astakhov
- Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - A B Lisochkina
- Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - P A Nechiporenko
- Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia.
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Bertoli F, Šuštar M, Jarc Vidmar M, Perovšek D, Brecelj J, Markelj Š, Jaki Mekjavić P, Šuput D, Tomšič M, Isola M, Battistella C, Lanzetta P, Hawlina M. Electrophysiological and SD-OCT findings in patients receiving chloroquine therapy in relation to cumulative dosage and duration of treatment. Doc Ophthalmol 2020; 141:1-14. [PMID: 31927702 DOI: 10.1007/s10633-019-09744-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/30/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Assessment of multifocal ERG (mfERG) changes in patients treated with chloroquine and their correlation with morphological abnormalities, detected by spectral-domain optical coherence tomography in relation to cumulative dosage. METHODS Data from 37 eyes of 20 patients were retrospectively collected, and one randomly selected eye per patient was considered for statistical analysis. Eyes were divided into three groups according to mfERG and visual acuity findings: normal, early and advanced maculopathy. Functional measures of the first three mfERG rings were compared with retinal thickness measures of the corresponding OCT ETDRS circles. Data on cumulative dose and duration of therapy were also evaluated. RESULTS The mean mfERG values progressively decreased according to the stage of the disease. In particular in the early maculopathy group, amplitudes were significantly reduced in all the three central rings. The mean ring ratio R1/R2 was abnormal only in the early maculopathy group. OCT thickness measures were significantly lower in all the three ETDRS circles in the advanced maculopathy group, and in the paracentral circle in the early maculopathy group. Considering all the eyes, there was a statistically significant correlation between functional and morphological values (p < 0.001). High chloroquine cumulative dosages were always associated with retinal toxic effects, whereas lower cumulative dosages generated different levels of toxicity. CONCLUSIONS This study shows a strong association between mfERG ring values and the corresponding OCT thickness measures; however, mfERG may enhance early detection of functional changes in patients treated with chloroquine, especially in ambiguous cases. At low chloroquine cumulative dosages, different subjects might have different susceptibilities to the drug.
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Affiliation(s)
- Federica Bertoli
- Department of Medicine - Ophthalmology, University of Udine, Piazzale Santa Maria della Misericordia, 33100, Udine, Italy.
- Scientific Institute I.R.C.C.S. "Eugenio Medea" - "La Nostra Famiglia", Udine, Italy.
| | - Maja Šuštar
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Martina Jarc Vidmar
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Darko Perovšek
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Jelka Brecelj
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Špela Markelj
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Polona Jaki Mekjavić
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Daša Šuput
- Department of Rheumatology, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia
| | - Matija Tomšič
- Department of Rheumatology, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | | | - Paolo Lanzetta
- Department of Medicine - Ophthalmology, University of Udine, Piazzale Santa Maria della Misericordia, 33100, Udine, Italy
- Istituto Europeo di Microchirurgia Oculare (IEMO), Udine, Italy
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia.
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Abstract
Background To report and describe an unusual case of a patient with optic disc pit in one eye and optic disc coloboma with a focal pit associated with macular retinoschisis in the other eye. Case presentation A 21-year-old woman presented with optic disc pit in the right eye and optic disc coloboma with a focal pit like excavation in the left eye. Macular spectral domain optical coherence tomography (SD-OCT) of the left eye revealed macular retinoschisis, without serous detachment. Conclusions Proper monitoring of patients with disc anomalies associated with maculopathy is mandatory. The use of OCT imaging during follow-up can help to identify involvement of the fovea or enlargement of the retinoschisis area.
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Affiliation(s)
- Ricardo Yuji Abe
- Hospital Oftalmológico de Brasília, SGAS 607 Avenida L2 Sul, Brasília, Distrito Federal, Brazil.
| | - Camila Ishii Iguma
- Hospital Oftalmológico de Brasília, SGAS 607 Avenida L2 Sul, Brasília, Distrito Federal, Brazil
| | - Lorena Campos Wen
- Hospital Oftalmológico de Brasília, SGAS 607 Avenida L2 Sul, Brasília, Distrito Federal, Brazil
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Wachtlin J, Schumann RG, Maier M, Haritoglou C. [Macular changes in optic disc pits-Optic disc pit maculopathy (ODP-M) : Pathophysiology and possibilities of surgical treatment]. Ophthalmologe 2019; 116:1026-1032. [PMID: 31338589 DOI: 10.1007/s00347-019-0933-z] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An optic disc pit is a rare congenital abnormality of the optic nerve, which in most cases presents as a unilateral finding. Clinically, a greyish oval excavation is seen, most commonly on the temporal side of the optic nerve disc. The optic disc pit alone normally does not lead to substantial symptoms or functional limitations; however, when a maculopathy with intraretinal and/or subretinal fluid and additional other morphological changes in the macula occur, this leads to a decrease in visual acuity. With spectral domain optical coherence tomography (SDOCT) it is possible to identify the various forms of expression, which show different natural courses. Especially the presence of subretinal fluid and defects in the outer retinal layers have a poor prognosis and have the highest risk for further deterioration. Spontaneous resolution can occur but is rare. Observation is recommended in the first step. In cases of progression or pronounced deterioration, surgical intervention is indicated. Many different techniques have been proposed but there is no gold standard at the moment. Most of the surgical approaches comprise pars plana vitrectomy with peeling of the internal limiting membrane (ILM) and gas endotamponade. Newer methods, such as the ILM flap technique also show good results. Generally, it is important to know that postoperative healing and resorption of the fluid often take a long time period of up to 1 year or even longer.
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Affiliation(s)
- J Wachtlin
- Augenabteilung, Sankt Gertrauden Krankenhaus, Paretzer Str. 12, 10713, Berlin, Deutschland. .,MHB, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland.
| | - R G Schumann
- Augenabteilung, Ludwig-Maximilians-Universität, München, Deutschland
| | - M Maier
- Augenklinik, Klinikum rechts der Isar, Technische Universität, München, Deutschland
| | - C Haritoglou
- Augenklinik, Herzog Karl Theodor, München, Deutschland
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Choe HR, Park UC. Different Types of Maculopathy in Eyes after a High-Voltage Electrical Shock Injury. Case Rep Ophthalmol 2019; 10:19-23. [PMID: 31097941 PMCID: PMC6489032 DOI: 10.1159/000496196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/25/2018] [Accepted: 12/09/2018] [Indexed: 11/19/2022] Open
Abstract
Background We report a case of different types of maculopathy in eyes after a high-voltage electrical shock injury. Case Report A 43-year-old male suffered high-voltage electrical injury through his left arm. He underwent cataract surgery in both eyes 3 months after the injury, but there was no vision improvement. Ocular examination, including spectral domain optical coherence tomography, revealed diffuse retinal atrophy in the left eye which did not change until the final visit. In the right eye, an impending macular hole was observed but regressed spontaneously 9 months after the injury, and the visual acuity improved to 20/32 at the final visit. Conclusion Two different types of maculopathy can occur in each eye after high-voltage electrical shock injury, and this might be due to asymmetric pathogenesis of the eyes according to the proximity to the route of electrical current.
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Affiliation(s)
- Hye Rim Choe
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
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45
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Balyen L. Inadvertent macular burns and consecutive psychological depression secondary to Alexandrite laser epilation: A case report. Saudi J Ophthalmol 2019; 33:105-108. [PMID: 30930674 PMCID: PMC6424673 DOI: 10.1016/j.sjopt.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 05/08/2017] [Revised: 03/08/2018] [Accepted: 03/27/2018] [Indexed: 12/28/2022] Open
Abstract
Unwanted hair is an important aesthetic problem in many cultures. Laser epilation devices have become commonly available at the present time. Nowadays, laser hair removal is widely practiced as a cosmetic procedure, however, some ocular complications may occur. The retina is the most vulnerable to laser-related injury which can lead to serious visual impairment. Laser epilation can cause serious complications and medical costs if not performed carefully and appropriately. The use of laser hair removal devices by unskilled aestheticians who is untrained and do not have the proper protective equipment at the beauty centers, can cause serious ophthalmological and psychological disorders and thus substantial labour productivity loss and economic loss. Therefore, the protective eyewear must be used by both the aesthetician and the patient during the procedure of laser epilation. In this way, we can improve the safety of both patients and aestheticians and at the same time ensure their healths. I reported the case of a 49-year-old female with a unilateral maculopathy responsible for an acute visual field defect and consecutive psychological depression secondary to Alexandrite laser epilation. This report is important to raise the awareness of ophthalmology and dermatology society and public about risks of their misuse.
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Affiliation(s)
- Lokman Balyen
- Kafkas University, Faculty of Medicine, Department of Ophthalmology, Kars, Turkey
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46
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Chatziralli I, Theodossiadis G, Brouzas D, Theodossiadis P. Incidence and Evolution of Subretinal Precipitates in Optic Disc Pit Maculopathy. Eur J Ophthalmol 2017; 27:769-73. [PMID: 28665476 DOI: 10.5301/ejo.5000999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the evolution of subretinal precipitates coexistent with optic disc pit (ODP) maculopathy from their appearance at baseline examination until their absorption after successful treatment. METHODS Participants in this retrospective, multicenter study were 42 patients with ODP maculopathy, in whom complete ocular examination was performed, including visual acuity (VA) measurement, slit-lamp examination, color or red-free fundus photography, and optical coherence tomography at baseline after surgical treatment. RESULTS Out of 42 cases, 17 (40.5%) cases of ODP maculopathy, which were examined between 2002 and 2015, were found to have subretinal precipitates associated with multilayer fluid accumulation at baseline. Precipitates were located at the outer part of the photoreceptor layer and remained for 3-6 months after successful treatment and absorption of subretinal fluid. The mean VA was 0.99 ± 0.21 logMAR at baseline and improved to 0.54 ± 0.25 logMAR at the final examination. CONCLUSIONS Macular precipitates in association with signs of disease chronicity, such as multilayer fluid accumulation, became evident at baseline examination. Precipitates' disappearance in 15 out of 17 cases coincided with the absorption of subretinal fluid. The relative low VA at baseline probably could be attributed to the chronicity of the disease.
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47
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. [Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever (French translation of the article)]. J Fr Ophtalmol 2018; 41:659-668. [PMID: 30173871 DOI: 10.1016/j.jfo.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/01/2017] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 01/12/2023]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tics bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France.
| | - A Donnio
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - A Jean-Charles
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - J Guyomarch
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - R Hage
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - F Najioullah
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - R Césaire
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - A Cabié
- EA4537, Inserm CIC 1424, service des maladies infectieuses et tropicales, université des Antilles, France
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48
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Agarwal A, Aggarwal K, Kumar A, Gupta V. Bilateral cystoid macular edema misdiagnosed as pars planitis in a patient on sertraline therapy. Am J Ophthalmol Case Rep 2018; 11:135-138. [PMID: 29984334 PMCID: PMC6031226 DOI: 10.1016/j.ajoc.2018.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/07/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Purpose To describe the presentation, clinical course and management of a patient with bilateral maculopathy associated with sertraline. Observations We report a rare case of bilateral cystoid macular edema and subretinal fluid in a 78-year-old Asian Indian female who was on chronic sertraline therapy. The patient was initially misdiagnosed as intermediate uveitis and started on oral corticosteroids. However, multimodal imaging with fluorescein angiography and optical coherence tomography ruled out ocular inflammation. There was symmetrical bilateral macular involvement and changes on macular electroretinography, which provided clues to the diagnosis of toxic maculopathy. After cessation of sertraline therapy, the retinal pathology reversed with improvement in visual acuity. Conclusions and Importance Development of cystoid macular edema due to sertraline is a very rare adverse event and must be considered by psychiatrists and ophthalmologists. Our case demonstrates this rare toxicity along with its imaging features, and reversal on cessation of sertraline therapy.
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Affiliation(s)
- Aniruddha Agarwal
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kanika Aggarwal
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Aman Kumar
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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49
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever. J Fr Ophtalmol 2018; 41:e235-e243. [PMID: 29929827 DOI: 10.1016/j.jfo.2018.05.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 11/01/2017] [Revised: 04/30/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France.
| | - A Donnio
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Jean-Charles
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - J Guyomarch
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Hage
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - F Najioullah
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Césaire
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Cabié
- EA4537, INSERM CIC 1424, Tropical and Infectious Disease Service, University of the Antilles, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
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Bruender MC, Benjamin N, Agostini HT, Stahl A, Ehlken C. Subjective evaluation of visual acuity is not reliable to detect disease activity in different exudative maculopathies. Graefes Arch Clin Exp Ophthalmol 2018; 256:1565-1571. [PMID: 29858676 DOI: 10.1007/s00417-018-4021-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 05/03/2018] [Accepted: 05/23/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with exudative maculopathies (neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO)) are faced with a high burden of examinations and treatments. This study was conceived to analyze the accuracy of a subjective evaluation of visual acuity (VA) and metamorphopsia to detect disease reactivation, compared to morphological signs of reactivation assessed by means of SD-OCT. METHODS Retrospective study of 888 patients treated for nAMD (n = 638), DME (84), BRVO (110), and CRVO (56) was conducted. Subjective evaluation of the patient at an examination (i.e., change of VA and/or metamorphopsia) was compared to clinical evaluation of disease activity as assessed by SD-OCT. Sensitivity and specificity, negative and positive predictive values (PPV/NPV) for detection of active disease were calculated. Factors associated with false-negative subjective evaluation were analyzed by regression analysis. RESULTS The sensitivity of the subjective evaluation to detect disease reactivation was < 0.50 in all exudative maculopathies. Sensitivity was increased to ≥ 0.60 by combining subjective worsening with loss of 1 line in the VA test in RVO, but not in DME and nAMD. The specificity was > 0.85 in all patients. PPV was > 0.85 in patients with RVO. Regression analysis did not reveal any factors that could reliably identify patient subgroups in which OCT could be omitted, though CRVO patients with a visual acuity of < 0.3 logMAR had an odds ratio of 0.20 for false-negative subjective evaluation (p = 0.009). CONCLUSION The accuracy of subjective evaluation to discriminate disease activity in patients with different exudative maculopathies was low and cannot substitute for frequent SD-OCT exams. Routinely assessed clinical parameters such as age, visual acuity, or treatment experience were of no use to predict the validity of subjective evaluation of disease activity. TRIAL REGISTRATION This trial was registered at the DRKS (Deutsches Register Klinischer Studien, drks.de; No 00006851) prior to the inclusion of the first patient.
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Affiliation(s)
- Marie-Christine Bruender
- Eye Center, Medical Center, Faculty of Medicine, Albert-Ludwigs-University, Killianstraße 5, 79106, Freiburg im Breisgau, Germany
| | - Nicola Benjamin
- Center for Pulmonary Hypertension, Thoraxclinic at the University Hospital Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Hansjuergen Thomas Agostini
- Eye Center, Medical Center, Faculty of Medicine, Albert-Ludwigs-University, Killianstraße 5, 79106, Freiburg im Breisgau, Germany
| | - Andreas Stahl
- Eye Center, Medical Center, Faculty of Medicine, Albert-Ludwigs-University, Killianstraße 5, 79106, Freiburg im Breisgau, Germany
| | - Christoph Ehlken
- Eye Center, Medical Center, Faculty of Medicine, Albert-Ludwigs-University, Killianstraße 5, 79106, Freiburg im Breisgau, Germany.
- Department of Ophthalmology, Faculty of Medicine, Christian-Albrechts-University, Arnold-Heller-Strasse 3, 24105, Kiel, Germany.
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