1/75. retinitis pigmentosa, nanophthalmos, and optic disc drusen: a case report.OBJECTIVE: Although the associations of retinitis pigmentosa (RP) with nanophthalmos/microphthalmos and RP with optic disc drusen have previously been recognized, the concurrence of all three features, as far as the authors are aware, has not previously been reported. DESIGN: Case report. RESULTS: The authors report a sporadic case of nanophthalmos, RP, and optic nerve drusen with the additional complication of chronic angle closure glaucoma. CONCLUSIONS: Visual loss may be secondary to the complications of nanophthalmos, RP, or optic nerve drusen. Chronic angle closure may be caused by choroidal effusion with serous retinal detachment, which may, in turn, cause a pseudo-RP picture. It is therefore important to recognize the possible association of true RP with nanophthalmos as a cause for visual deterioration.- - - - - - - - - - ranking = 1keywords = detachment, retinal detachment, pigment (Clic here for more details about this article) |
2/75. ciliary body melanocytoma with anterior segment pigment dispersion and elevated intraocular pressure.PURPOSE: To discuss a case in which melanocytoma of the ciliary body presented with widespread pigment dispersion and elevated intraocular pressure (IOP). methods: A 64-year old woman presented with increased IOP and persistent anterior segment inflammation in her right eye. She had undergone a trabeculectomy for uncontrolled IOP before presentation. Slit-lamp examination, gonioscopy, and ultrasound biomicroscopy revealed a ciliary body mass with extension into the subconjunctiva in addition to widespread pigmentary dispersion in the anterior segment. Enucleation of the right eye was performed for histopathologic evaluation, as a diagnosis of ciliary body melanoma was made on clinical examination. RESULTS: Histopathologic findings were diagnostic of a melanocytoma of the ciliary body with necrosis and focal malignant transformation with extension of melanocytoma cells and melanophages into the subconjunctival space, trabecular meshwork, and anterior chamber angle. CONCLUSION: Melanocytoma of the ciliary body is a rare intraocular tumor that may present with pigment dispersion and secondary elevated IOP. Careful examination of the anterior segment is imperative in such cases.- - - - - - - - - - ranking = 0.15123327811857keywords = pigment (Clic here for more details about this article) |
3/75. Unilateral capsular glaucoma after long-standing bilateral pigmentary glaucoma.In 1964 we treated a 42-year-old woman diagnosed to have classical bilateral pigment dispersion syndrome combined with an intraocular pressure (IOP) of up to 28 mmHg in both eyes. The patient now has a daughter, also with pigment dispersion syndrome. Miotic treatment brought the IOPs to normal, and 8 years later when the disease was in the inactive phase all treatment could be discontinued. At the age of 67 years, exfoliation deposits became visible in the right eye only, but the IOPs were still below 21 mmHg. Four years later, the pressure of the right eye rose to 31 mmHg. During the next few years all available IOP-lowering medications and laser trabeculoplasty failed, and finally trabeculectomy had to be performed to keep the pressure of the right eye under control and to halt visual field changes, which had already appeared. This case illustrates that development of exfoliation syndrome may take place irrespective of pigment dispersion, and that their simultaneous occurrence may lead to an IOP rise that is resistant to medical therapy and laser trabeculoplasty. It additionally provides further clues to the pathogenesis of capsular glaucoma.- - - - - - - - - - ranking = 0.15123327811857keywords = pigment (Clic here for more details about this article) |
4/75. Postoperative descemet membrane detachment with maintenance of corneal clarity after trabeculectomy.This case report describes an unusual complication of descemet membrane detachment after anterior chamber reformation to treat a flat anterior chamber and hypotony from a trabeculectomy. This large descemet membrane detachment was unexpectedly associated with a clear cornea. Treatment was conservative, and the descemet membrane detachment spontaneously resolved in 6 months.- - - - - - - - - - ranking = 5.9519215415117keywords = detachment (Clic here for more details about this article) |
5/75. Intracorneal inclusion of high-molecular-weight sodium hyaluronate following detachment of Descemet's membrane during viscocanalostomy.PURPOSE: Viscocanalostomy in accordance with Stegmann's technique is a new surgical option in the treatment of glaucoma. There are few reports available describing the specific complications of viscocanalostomy. We report a case of intracorneal inclusion of high-molecular-weight sodium hyaluronate following viscocanalostomy. CASE REPORT: A 66-year-old man with uncontrolled primary open angle glaucoma of his right eye and a history of argon laser trabeculoplasty underwent viscocanalostomy in accordance with Stegmann's technique. During the filling of Schlemm's canal, a limited lysis of Descemet's membrane advanced centrally in the clear cornea adjacent to the site of canalostomy forming an intracorneal bubble of high-molecular-weight sodium hyaluronate. Postsurgical slit-lamp biomicroscopy showed an intracorneal clear bubble within the corneal periphery without evidence of adjacent corneal edema and with no contact between the corneal endothelium and the iris. Follow-up examinations determined that the appearance of the corneal inclusion, essentially, was unchanged, with only a slight tendency of resorption. No signs of corneal scarring or endothelial decompensation could be noted. CONCLUSION: To date, we could not determine a significant corneal damage in conjunction with the described complication. However, it is difficult to predict the long-term clinical course of our patient. Corneal decompensation as a result of possible endothelial toxicity of high-molecular weight sodium hyaluronate as well as spontaneous absorption seem possible.- - - - - - - - - - ranking = 3.4010980237209keywords = detachment (Clic here for more details about this article) |
6/75. serum methanol levels in subjects with or without optic nerve head disease.We evaluated serum methanol levels in subjects with or without optic nerve head disease. serum methanol levels were determined using gas chromatography in 71 patients with optic nerve head disease and in 127 subjects without optic nerve head disease. Their ages ranged from 17 to 89 years. serum methanol levels in 127 subjects without optic nerve head disease ranged from 0.12 to 3.86 microg/ml (mean /- standard deviation, 1.72 /- 0.86 microg/ml). In the subjects without optic nerve head disease, the differences in the levels between those with cataract versus retinal detachment, men versus women, and between each age-group (50-80 years) were not significant. The methanol levels in patients with optic neuritis (n = 2), wolfram syndrome (n = 1), Leber hereditary optic neuropathy at the late stage (n = 2), retinitis pigmentosa (n = 23), and primary open-angle glaucoma (n = 16) were less than 3.86 microg/ml. methanol levels in 1 patient with Leber hereditary optic neuropathy at the acute stage was 5.28 microg/ml. Of 10 patients with primary angle-closure glaucoma, 1 had a slightly elevated level and 9 had levels less than 3.86 microg/ml. Of 17 patients with normal tension glaucoma, 5 had methanol levels higher than 3.86 microg/ml, and 12 patients had levels less than 3.86 microg/ml. The present study shows that serum methanol levels in subjects without optic nerve head disease ranged from 0.12 to 3.86 microg/ml and were much lower than the levels that produce acute ocular symptoms of methanol intoxication. It is possible that high serum methanol levels may play a part in the acute stage of Leber hereditary optic neuropathy and normal tension glaucoma in certain patients. It is unlikely that increased serum methanol levels participate in primary angle-closure glaucoma.- - - - - - - - - - ranking = 0.91358098393225keywords = detachment, retinal detachment, pigment (Clic here for more details about this article) |
7/75. descemet membrane detachment after viscocanalostomy.PURPOSE: To report a case that developed a large descemet membrane detachment after viscocanalostomy. methods: Case report. A 60-year-old man with primary open-angle glaucoma underwent viscocanalostomy RE. One day after surgery, a small, localized detachment of descemet membrane was present at the operation site. Six months after surgery, he had a large superior descemet membrane detachment involving his visual axis. RESULTS: The descemet membrane remained attached after descemetopexy with sodium hyaluronate and air. Final visual acuity was 20/80, and intraocular pressure was 17 mm Hg without medication. CONCLUSION: Detachment of the descemet membrane should be recognized as a potential complication of viscocanalostomy.- - - - - - - - - - ranking = 5.9519215415117keywords = detachment (Clic here for more details about this article) |
8/75. Management of the Pulfrich phenomenon secondary to pigmentary glaucoma.BACKGROUND: The Pulfrich phenomenon can cause annoying symptoms for a patient due to a difference in interocular optic nerve conduction. There are very few reports that describe the successful use of tinted lenses as a treatment modality, while the majority of cases in the literature describe the condition without any reference to treatment. Although there are two previous reported cases of the Pulfrich phenomenon secondary to glaucoma, this article relates the first case of a patient with this phenomenon with glaucoma treated by tinted lenses. CASE REPORT: A 42-year-old woman, who was previously diagnosed with asymmetric pigmentary glaucoma, reported dramatic changes in visual perception-especially with driving and motion-related tasks. The evaluation showed asymmetric optic nerve function and a spontaneous Pulfrich phenomenon. The effects of different grades of neutral-density filters over the better eye were quantified by means of the Pulfrich phenomenon, subjective brightness comparison, and the visual-evoked potential. Relief of some of the symptoms from the Pulfrich phenomenon was achieved using an ophthalmic tint. CONCLUSION: The majority of patients (89%) reported in the literature who are symptomatic of the Pulfrich phenomenon received no treatment. This report illustrates that the traditional optometric tool of tinted lenses can be dramatically effective in relief of the motion-related symptoms secondary to the Pulfrich phenomenon in a patient with pigmentary glaucoma.- - - - - - - - - - ranking = 0.12962852410163keywords = pigment (Clic here for more details about this article) |
9/75. herpes simplex virus dermatitis in patients using latanoprost.PURPOSE: To describe the possible association of latanoprost with herpetic dermatitis of the periocular skin. METHOD: Interventional case reports. A 79-year-old woman with open-angle glaucoma developed a vesicular dermatitis of the left lower eyelid 14 months after starting latanoprost therapy. An 84-year-old man with pigmentary glaucoma developed a vesicular dermatitis of the right upper lid after 2 months of treatment with latanoprost and 8 days of treatment with tobramycin/dexamethasone for presumed bacterial conjunctivitis. In both cases, the dermatitis was characteristic of a herpetic infection. RESULTS: Latanoprost was discontinued in both cases. The woman was treated with vidarabine 3% ointment, and the man was not treated with antiviral agents. In both patients, the dermatitis healed uneventfully. The lesions of the man were cultured, and a biopsy was performed; herpes simplex virus type 1 was recovered from the culture and confirmed by immunofluorescence testing. CONCLUSION: Latanoprost, which has been associated with reactivation of herpetic keratitis, may also cause reactivation of herpetic dermatitis of the periocular skin.- - - - - - - - - - ranking = 0.021604754016938keywords = pigment (Clic here for more details about this article) |
10/75. Asymmetric pigment dispersion in a patient with the unilateral Adie pupil.PURPOSE: Pigmentary glaucoma is a bilateral disorder. When it occurs asymmetrically or unilaterally, a cause should be sought because it may help us to understand the pathophysiology of this condition better. We describe a patient with unilateral pigmentary glaucoma and the Adie pupil in the same eye and discuss the possible role of the Adie pupil in the development of the pigmentary glaucoma. methods: A case report. A 37-year-old woman presented with asymmetric pigment dispersion resulting in pigmentary glaucoma in the right eye and an unilateral Adie pupil in the same eye. RESULTS: We believe that the dilated Adie pupil in the right eye might have resulted in a decreased amount of relative pupillary block. This, then, might have led to an increased contact between the posterior iris and the zonules, resulting in greater pigment dispersion and trabecular obstruction in the right eye. CONCLUSION: It has been proposed that the pigment is liberated from the iris pigment epithelium because of the mechanical rubbing of the posterior iris against the anterior zonular packets. Our case supports this proposed mechanism of pigment release.- - - - - - - - - - ranking = 0.25925704820326keywords = pigment (Clic here for more details about this article) |
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