1/13. Recurrent endogenous candidal endophthalmitis in a premature infant.Endogenous candida endophthalmitis resulting from candidemia in low-birth-weight infants usually occurs as a retinochoroiditis, which is effectively treated with systemic antifungal agents. We report a case of candida endophthalmitis that recurred 4 months after completion of systemic antifungal therapy. The recurrent candida infection affected primarily the iris and lens, rather than the retina and choroid. vitrectomy was required for diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
2/13. Surgical removal of subfoveal choroidal neovascularization without removal of posterior hyaloid: a consecutive series in younger patients.PURPOSE: Subfoveal choroidal neovascularization (CNV) remains a common and important cause of visual loss. Previous studies have suggested that submacular surgery may improve or maintain visual acuity, particularly in younger patients. The majority of reported cases included removal of the posterior hyaloid during vitrectomy. The authors present a consecutive series of patients age 55 or younger with subfoveal CNV removal without posterior hyaloid removal. methods: Seventeen patients without age-related macular degeneration (ARMD), with subfoveal CNV from choroiditis, presumed ocular histoplasmosis syndrome, myopia, or idiopathic causes, underwent a small retinotomy technique to extract the membranes after vitrectomy without posterior hyaloid removal. RESULTS: Median improvement in visual acuity was from 20/320 to 20/50. Eleven patients (65%) experienced an improvement of three or more lines of Snellen acuity (average 7.5), 4 (23%) were within two lines of preoperative acuity, and 2 (12%) had decreased acuity, with an average follow-up of 12 months (range 3-31). Choroidal neovascularization recurred in six patients (35%). Postoperative retinal detachment, epiretinal proliferation, or macular hole did not occur. CONCLUSIONS: In this series of younger patients with subfoveal CNV not from ARMD, visual acuity was improved in the majority after submacular membrane removal. Omission of removal of the posterior hyaloid did not adversely affect outcome.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
3/13. Indoor mold spore exposure: a possible factor in the etiology of multifocal choroiditis.PURPOSE: To report on the correlation between indoor mold exposure and a case of multifocal choroiditis (MFC). DESIGN: Observational case report. methods: A 37-year-old woman diagnosed with MFC who had had extensive mold exposure underwent an allergic evaluation, including a comprehensive environmental history, physical examination, radioallergosorbent test, and skin testing. RESULTS: The patient's vision deteriorated after numerous recurrences of MFC triggered by exposure to extremely high mold environments (mold counts recorded between 3,000 and 13,000 mold spores/m(3)). CONCLUSIONS: Exposure to high indoor mold count environments may be a factor in the etiology of MFC. Further studies are indicated.- - - - - - - - - - ranking = 5keywords = choroiditis (Clic here for more details about this article) |
4/13. pneumocystis carinii and mycobacterium avium-intracellulare infection of the choroid.It has been hypothesized that coinfection with mycobacteria occurs in patients with pneumocystis carinii choroiditis, but cases demonstrating ocular infection by both organisms have not been reported. This study reports the case of a patient with P. carinii choroiditis who was treated with intravenous trimethoprim and sulfamethoxazole, followed by intravenous trimethoprim and dapsone. The choroidal lesions failed to resolve despite 6 weeks of treatment, and the patient died from massive pulmonary infection caused by P. carinii, Mycobacterium avium-intracellulare, and cytomegalovirus infections. Ocular histologic and electron microscopic examinations revealed choroidal infection by both P. carinii and M. avium-intracellulare. serum levels of sulfamethoxazole were below the recommended therapeutic range for treating P. carinii infection during the first week of therapy, but adequate drug levels were subsequently obtained. Failure of choroidal lesions of P. carinii to resolve in some cases may suggest insufficient antimicrobial levels in the blood or raise the possibility of coexistent M. avium-intracellulare or other opportunistic infection.- - - - - - - - - - ranking = 2keywords = choroiditis (Clic here for more details about this article) |
5/13. Curvilinear pigmentary lesions in a rod-cone dystrophy.PURPOSE: To report a peculiar curvilinear pigmentary lesion in the peripheral fundus in a rod-cone dystrophy. methods: Observational case report. Fundus examination of a 57-year-old woman who was known to have a generalized rod-cone dystrophy since she was 8 years old. RESULTS: The peripheral fundus examination revealed a curvilinear lesion which resembles a well-known finding associated with a presumed ocular histoplasmosis syndrome or multifocal choroiditis. CONCLUSIONS: The differential diagnosis of a peculiar curvilinear pigmentary lesion in the peripheral fundus may be expanded to include a generalized rod-cone dystrophy.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
6/13. Multifocal choroiditis in disseminated cryptococcus neoformans infection.PURPOSE: To report an uncommon case of multifocal choroiditis as the result of disseminated cryptococcus neoformans infection in a patient who is hiv-positive. DESIGN: Interventional case report. methods: A 27-year-old hiv-positive woman with fever, headache, and vomiting was examined. Lumbar puncture was performed and revealed C neoformans infection. Her condition evolved with sudden bilateral blindness and deafness. Ophthalmologic examination revealed multiple yellowish choroidal lesions in the posterior pole of both eyes. RESULTS: Postmortem examination showed disseminated C neoformans infection. Histologic examination of the eyes confirmed the presence of C neoformans in the choroiditis. CONCLUSION: Multifocal choroiditis in C neoformans infection is a rare ophthalmic manifestation. The recognition of this condition by ophthalmologists can help physicians to diagnose a disseminated and fatal disease.- - - - - - - - - - ranking = 7keywords = choroiditis (Clic here for more details about this article) |
7/13. Discontinuation of highly active antiretroviral therapy leads to cryptococcal meningitis/choroiditis in an AIDS patient.BACKGROUND: cryptococcus neoformans is an opportunistic pathogen that can manifest in immunocompromised patients with acquired immune deficiency syndrome. Prevention of cryptococcosis and other opportunistic diseases is an objective in the management of human immunodeficiency virus (hiv)-infected patients. The goal of highly active antiretroviral therapy (HAART) is to reduce the viral loads and enhance CD4 counts in hiv-infected patients. These 2 mechanisms keep hiv-infected patients healthier and enhance their immune systems, thus reducing and often preventing opportunistic infections such as ocular cryptococcal infections. Discontinuation of HAART can lead to ocular opportunistic infections such as cryptococcal choroiditis. CASE REPORT: Presented here is a case of a patient who was treated successfully with HAART of stavudine (D4T), abacavir (Ziagen), ritonavir (Norvir), and saquinavir (Invirase). His last CD4 count before HAART was discontinued was 131 cells/mm(3), and viral load was less than 50 copies/mL. He discontinued his HAART regimen for 2 years and presented to the emergency room with complaints of a severe headache with neck pain, lightheadedness, nausea, disorientation, and unsteady gait. Lumbar puncture results showed cryptococcal infection, and the patient was admitted for the treatment of cryptococcal meningitis with amphotericin b and 5-flucytosine. Cryptococcal choroiditis was diagnosed after treatment of the meningitis. After resolution, his resultant visual acuities were 10/350 in the right eye and 10/600 in the left eye. He is on a maintenance dose of antifungal therapy and has been reinitiated on HAART of abacavir/zidovudine/lamivudine (Trizivir) and lopinavir/ritonavir (Kaletra). CONCLUSION: This case exemplifies the importance of HAART in the prevention of opportunistic infections, cryptococcal meningitis/choroiditis in particular. eye care professionals can play a role in encouraging patients to comply with their HAART regimens.- - - - - - - - - - ranking = 7keywords = choroiditis (Clic here for more details about this article) |
8/13. Presumed pneumocystis carinii choroiditis. Unifocal presentation, regression with intravenous pentamidine, and choroiditis recurrence.pneumocystis carinii choroiditis is a well-documented but rare infection that has been described as a bilateral, multifocal process. Treatment efficacy has not been well established. In this report, three cases of presumed P. carinii choroiditis that developed during aerosolized pentamidine therapy for the prophylaxis of P. carinii pneumonia are described. All patients had unilateral choroiditis, and two patients were first observed to have unifocal choroiditis. In all patients, choroidal lesions decreased in size with intravenous pentamidine treatment. choroiditis exacerbated in the two unifocal cases after the frequency of maintenance intravenous pentamidine therapy was decreased. P. carinii choroiditis may appear as a unifocal, unilateral lesion that may represent an earlier stage of infection than previously described. Intravenous pentamidine therapy appears to control P. carinii choroiditis but may need to be continued to prevent exacerbation. patients receiving prophylactic aerosolized pentamidine therapy are not protected against extrapulmonary disease, and presumed P. carinii choroiditis may serve as a marker for disseminated infection.- - - - - - - - - - ranking = 15keywords = choroiditis (Clic here for more details about this article) |
9/13. Cryptococcal choroiditis.Two patients with acquired immune deficiency syndrome presented with headaches and fevers. A diagnosis of cryptococcal meningitis was made by lumbar puncture and elevated cryptococcal antigens. Complaints of decreased vision in both patients led to the diagnosis of optic disc edema and cryptococcal choroiditis with yellow-white choroidal infiltrates noted in both eyes of the two patients. Systemic treatment with amphotericin b and 5' flucytosine led to resolution of the choroidal infiltrates. Late visual acuity loss was believed to be secondary to optic atrophy.- - - - - - - - - - ranking = 5keywords = choroiditis (Clic here for more details about this article) |
10/13. Endogenous Aspergillus endophthalmitis in an immunocompetent individual.We present an unusual case of aspergillus fumigatus endogenous endophthalmitis in a 27 year old Hispanic male with no history of ocular trauma, surgery, hematologic malignancy, compromised immune system, or intravenous drug use. The patient presented with a two-day history of pain, redness, and visual acuity of bare count fingers in his right eye. He was originally suspected of having toxoplasmic retinochoroiditis, but clinically worsened on systemic anti-toxoplasma medication and corticosteroids. He subsequently underwent pars plana vitrectomy and treatment with intravenous and intravitreal amphotericin b. aspergillus fumigatus was isolated and identified in the vitreous aspirate. With aggressive medical and surgical management, he eventually regained visual acuity of 20/30 in his right eye. This case illustrates the occurrence of endogenous Aspergillus endophthalmitis in a patient with no history of intravenous drug use, ocular trauma, or compromised immune system, and successful outcome with combined medical and surgical management.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
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