1/2. Valsalva retinopathy: diagnostic challenges in a patient with pars-planitis.PURPOSE: To describe a case of Valsalva retinopathy in a patient with pars-planitis and to discuss its management. methods: We present a case of a 19-year-old male with a six-month history of bilateral intermediate uveitis, referred for evaluation of recent-onset spontaneous bilateral vitreous hemorrhages. Clinical evaluation and fluorescein angiography were negative for the presence of neovascularization. On closer questioning the patient revealed that he had his most recent symptoms after heavy weight lifting. RESULTS: The patient was instructed to avoid heavy weight lifting. Over the next two months, vitreal hemorrhages had resolved. However, despite the treatment with systemic prednisone, the patient's intermediate uveitis was still active, and cystoid macular edema had developed. Therefore, we proceeded to systemic immunomodulatory therapy, which controlled the inflammation and preserved vision in each eye. CONCLUSIONS: Although a very rare cause, valsalva maneuver should be included in the differential diagnosis of bilateral vitreous hemorrhages. Ophthalmologists should advise patients with known eye problems that can predispose to vitreal hemorrhages to refrain from it.- - - - - - - - - - ranking = 1keywords = intermediate (Clic here for more details about this article) |
2/2. Chronic propionibacterium acnes endophthalmitis as a cause of intermediate uveitis.Although the pathogenesis in most cases of intermediate uveitis is unknown, a small minority of cases is associated with a variety of specific inflammatory etiologies: sarcoidosis; multiple sclerosis; lyme disease; syphilis; ocular lymphoma; and as a rare manifestation of Behcet's disease and AIDS. A 61-year-old woman developed pars planitis after cataract surgery. A vitrectomy was performed after ten months when a white capsular plaque and an hypopyon developed. propionibacterium acnes was isolated. The intermediate uveitis was not controlled until later removal of the intraocular lens and capsular remnants. Chronic propionibacterial endophthalmitis may be a cause of intermediate uveitis.- - - - - - - - - - ranking = 3.5keywords = intermediate (Clic here for more details about this article) |