1/42. The 1998 Pan American Lecture. Intraocular invasion of conjunctival squamous cell carcinoma in five patients.PURPOSE: To report five patients with intraocular invasion of conjunctival squamous cell carcinoma and to make recommendations regarding clinical recognition and treatment of this condition. methods: The authors reviewed the clinical records and pathology slides on five patients who had intraocular invasion of conjunctival squamous cell carcinoma, and they describe the presenting features and histopathology in these cases. RESULTS: Intraocular invasion of conjunctival squamous cell carcinoma occurred in older patients who had one or more recurrences of a previously excised conjunctival epithelial tumor located near the comeoscleral limbus. The intraocular recurrence often was heralded by the onset of low-grade inflammation and secondary glaucoma, simulating a granulomatous iridocyclitis. A white mass generally was observed in the anterior chamber angle. Histopathologic examination revealed an ingrowth of malignant epithelial cells through the limbus with diffuse involvement of the anterior segment of the eye. The reported patients were managed by modified enucleation (standard enucleation with excision of affected conjunctival tissue). Metastatic disease did not develop in any of the patients. CONCLUSIONS: The onset of signs of uveitis and glaucoma and a white mass in the anterior chamber angle in a patient with prior excision of a conjunctival squamous cell neoplasm tumor should raise suspicion of intraocular recurrence of conjunctival squamous cell carcinoma. Most affected patients require enucleation or subtotal orbital exenteration. The prognosis is good.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
2/42. Sympathetic ophthalmia associated with cyclitis: case report.We present a case of sympathetic ophthalmia. A 41-year-old man suffered a penetrating injury to his right eye. Six weeks after the injury he complained of photophobia and redness in his left eye. visual acuity without correction was: right eye (RE), no light perception; and left eye (LE), 1.0. Ocular examination of the left eye revealed a shallow anterior chamber and mildly elevated intraocular pressure (25 mmHg). An initial diagnosis of narrow angle glaucoma was made and antiglaucomatous agents were prescribed. One month after diagnosis the vision in his left eye suddenly dropped to 0.04. Ocular examination showed annular serous retinal detachment and scattered yellow-white lesions (Dalen-Fuchs Nodules). Under the diagnosis of sympathetic ophthalmia, high dose intravenous corticosteroid (methylprednisolone, 200 mg daily) and subtenon dexamethasone (4 mg/0.8 cc) were used. Ten days after beginning treatment the vision improved to 0.1 but the retinal detachment was not sealed completely. Oral prednisolone (100 mg daily) and cyclosporine (125 mg bid) therapy replaced the intravenous corticosteroids. The serum level of cyclosporine was 118 ng/ml. After 3 months the vision improved to 0.6 and the retinal detachment subsided. Renal function and hematocrit status were monitored closely and no abnormal conditions were noted.- - - - - - - - - - ranking = 0.11111111111111keywords = ocular (Clic here for more details about this article) |
3/42. Posner-Schlossman syndrome: a case report.BACKGROUND: Glaucomatocyclitic Crisis (AKA Posner-Schlossman syndrome) is a syndrome that affects patients between the ages of 20 and 50 years. It is characterized by a mild recurrent anterior uveitis associated with an out-of-proportion intraocular pressure spike in the same eye. The cause is unclear, but many theories exist. Some researchers have tried to connect it with primary open-angle glaucoma. CASE REPORT: A review of the record of a 41-year-old Hispanic woman with Posner-Schlossman syndrome is discussed. She sought treatment on multiple occasions with symptoms of mild pain, photophobia, and a blurry left eye. Examination revealed mild anterior chamber reaction and an intraocular pressure (IOP) spike in the same eye. She was treated with topical anti-inflammatory and pressure-lowering agents. Each individual flare-up was treated successfully, but the patient began to show equivocal signs of primary open-angle glaucoma (PDAG). She is currently treated prophylactically for POAG with a beta-blocker. No etiologic factor was identified in this patient. The differential diagnosis is straight-forward and the treatment is general uveitic therapy--minus cycloplegics--combined with an IOP-lowering drop. CONCLUSION: This is an interesting and relatively rare uveitic condition. The list of differential diagnoses is long, as is the theorized etiologies; however, clinically the condition is relatively quickly identifiable by the presence (and absence) of signs and symptoms.- - - - - - - - - - ranking = 0.22222222222222keywords = ocular (Clic here for more details about this article) |
4/42. herpes simplex virus dna identification from aqueous fluid in Fuchs heterochromic iridocyclitis.PURPOSE: To report the presence of herpes simplex virus dna in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis. methods: In an eye with a clinical diagnosis of Fuchs heterochromic iridocyclitis, samples of aqueous humor and anterior capsule of the lens were obtained during cataract surgery. polymerase chain reaction was performed on the samples to detect the presence of viral dna including herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Serologic analysis was also performed for antiviral immunoglobulins. RESULTS: herpes simplex virus dna was identified in the aqueous humor but not in the anterior capsule. serum immunoglobulin g was positive for herpes simplex virus, varicella-zoster virus, and cytomegalovirus. CONCLUSIONS: The presence of herpes simplex virus dna in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis suggests that herpes simplex virus infection may play a role in the pathogenesis of Fuchs heterochromic iridocyclitis.- - - - - - - - - - ranking = 6.2088209272956keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
5/42. zoster sine herpete with bilateral ocular involvement.PURPOSE: To report a case of zoster sine herpete with bilateral ocular involvement. METHOD: Case report. RESULTS: A 65-year-old man showed bilateral iridocyclitis with sectoral iris atrophy and elevated intraocular pressure unresponsive to steroid treatment. No cutaneous eruption was manifest on the forehead. A target region of varicella-zoster virus dna sequence was amplified from the aqueous sample from the left eye by polymerase chain reaction. Bilateral iridocyclitis resolved promptly after initiation of systemic and topical acyclovir treatment. Secondary glaucoma was well controlled by bilateral trabeculectomy. CONCLUSIONS: zoster sine herpete should be considered and polymerase chain reaction performed on an aqueous sample to detect varicella-zoster virus dna for rapid diagnosis whenever anterior uveitis accompanies the characteristic iris atrophy, even in the case of bilateral involvement.- - - - - - - - - - ranking = 0.66666666666667keywords = ocular (Clic here for more details about this article) |
6/42. Hypopyon in a patient with presumptive diffuse unilateral subacute neuroretinitis.PURPOSE: To report a case of diffuse unilateral subacute neuroretinitis (DUSN) that developed an acute iridocyclitis with hypopyon. methods: Case report. We describe a 21-year-old male with clinical diagnosis of DUSN who developed a sudden and severe acute iridocyclitis with hypopyon after one year of follow-up that resolved after treatment with systemic corticosteroids. RESULTS: anterior chamber paracentesis was performed and cultures were negative. Cytologic studies disclosed the presence of eosinophils. CONCLUSIONS: This unusual ocular finding may be related to the death of the nematode in the course of the disease.- - - - - - - - - - ranking = 0.11111111111111keywords = ocular (Clic here for more details about this article) |
7/42. Systemic toxicity of topical and periocular corticosteroid therapy in an 11-year-old male with posterior uveitis.PURPOSE: To report a case of systemic corticosteroid toxicity resulting from topical and periocular therapy. methods: Treatment and follow-up of an 11-year-old male with uveitis are illustrated. Initial presentation of the patient was bilateral iridocyclitis, for which he was treated with prednisolone acetate 1% every 2 hours for 6 months. Subsequently, posterior uveitis developed, necessitating posterior subtenon injections. RESULTS: After initial topical corticosteroid therapy, the patient developed a cushingoid habitus accompanied by increased lanugo hair, acanthosis nigricans, posterior subcapsular lens opacities, and increased intraocular pressure. Cushingoid stigmata worsened after administration of posterior subtenon injection of corticosteroids. The patient's truncal obesity worsened, and his linear growth stopped. CONCLUSIONS: Systemic toxic effects may develop as a result of topical and local use of ophthalmic corticosteroid preparations in susceptible patients.- - - - - - - - - - ranking = 0.66666666666667keywords = ocular (Clic here for more details about this article) |
8/42. Effective treatment with topical cyclosporin A of a patient with cogan syndrome.The purpose of this report is to describe the effective treatment of severe anterior segment inflammation due to cogan syndrome through the use of topical administration of cyclosporin A. A 47-year-old female patient had been experiencing headaches and difficulties with her vision. Subsequent examination revealed the sudden onset of bilateral conjunctival injection and swelling of bilateral auricles. Despite the multiple treatment (systemic and topical corticosteroid and antibiotic therapy), necrotizing scleritis had appeared bilaterally and the scleral wall was thinning. Topical administration of 1% cyclosporin A was applied to both eyes 4 times a day. After 2 months of this therapy, the epithelial tissue covered the necrotizing tissue and her symptom of ocular pain was relieved and her corrected visual acuity was improved. This is the first case exhibiting that topical cyclosporin A is an effective treatment for severe anterior segment inflammation associated with cogan syndrome.- - - - - - - - - - ranking = 0.11111111111111keywords = ocular (Clic here for more details about this article) |
9/42. Varicella-zoster viral antigen identified in iridocyclitis patient.BACKGROUND: The varicella-zoster virus (VZV) antigen has not been identified immunohistologically in iridocyclitis due to VZV. CASE: A 65-year-old woman diagnosed with iridocyclitis and secondary glaucoma underwent trabeculectomy. Samples of aqueous humor and juxtacanalicular and iris tissue were obtained for immunohistological and polymerase chain reaction (PCR) study. OBSERVATIONS: Slit-lamp microscopy revealed ciliary injection, corneal epithelial edema, mutton fat precipitates, flare, cells, and progressive iris atrophy in the right eye. Subsequently, scant eruptions on her right upper eyelid appeared and disappeared within a week. Although a diagnostic increase in the complement fixation antibody titer to VZV was not observed, we started medical treatment for VZV, on suspicion of iridocyclitis due to VZV. Despite medical treatment, the ratio of peripheral anterior synechia was greater than 60% and iris atrophy progressed in parallel. The intraocular pressure in the right eye remained above 30 mm Hg at 6 months after the first visit, so trabeculectomy was performed. VZV-specific dna was detected in the aqueous humor by the PCR study. Immunohistological examination demonstrated numerous VZV antigen-positive cells in the iris stroma, in particular, vascular endothelial cells. CONCLUSION: To our knowledge, this is the first report of the detection of VZV antigen in the iris of an iridocyclitis patient.- - - - - - - - - - ranking = 0.11111111111111keywords = ocular (Clic here for more details about this article) |
10/42. cogan syndrome.PURPOSE: To lead ophthalmologists to consider cogan syndrome when managing a patient presenting with keratitis or other ocular inflammation accompanied by sensorineural hearing loss. methods: Seven patients affected by cogan syndrome were studied: two males and five females, ranging from 27 to 65 years of age (mean age: 41 years). Subjects were evaluated for a period ranging from 22 to 46 months (mean follow up time: 29.2 months). All patients were treated with immunosuppressive drug combination therapy (IDCT). RESULTS: Three patients were affected by classic cogan syndrome (i.e., vestibuloauditory symptoms and later sensorineural hearing loss and interstitial keratitis). Four patients presented atypical cogan syndrome (i.e., sensorineural hearing loss and chronic ocular inflammation such as uveitis, scleritis, conjunctivitis, retinal vasculitis, etc.). Four of these patients had a late diagnosis. Two of them were diagnosed when they already had a cochlear implant, one with bilateral deafness underwent cochlear implantation 1 year after the beginning of IDCT, one had severe bilateral hearing loss that improved during the first year of IDCT, and then rapidly worsened to total deafness in 1 month following an episode of severe systemic hypotension. Three patients who had an early diagnosis of cogan syndrome had no worsening of vestibuloauditory dysfunction during the follow up period. CONCLUSION: Diagnosis of cogan syndrome should not be overlooked by ophthalmologists in all patients with recurrent ocular inflammatory disease associated with vestibuloauditory symptoms. early diagnosis is essential to commence the appropriate immunosuppressive therapy that may prevent permanent hearing loss and ocular dysfunction.- - - - - - - - - - ranking = 1.9799980667785keywords = keratitis, ocular (Clic here for more details about this article) |
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