1/21. 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) |
2/21. Intravitreal clindamycin and dexamethasone for toxoplasmic retinochoroiditis.BACKGROUND AND OBJECTIVE: To present a new method for the management of toxoplasmic retinochoroiditis (TRC). methods: The patients were females ranging in age from 10 to 61 years (average 26.5). Four eyes of 4 patients were treated with intravitreal injections of 1.0 mg clindamycin in 0.1 mL and 1.0 mg of dexamethasone in 0.1 mL. The injections were given under general or peribulbar anesthesia. Three patients continued one systemic drug. Follow-up ranged from 11 to 26 months (mean 17.5). RESULTS: A favorable response was noted in each eye within two weeks after the intravitreal injections. All patients required 2 to 4 intravitreal injections in the affected eye for the control of TRC. visual acuity improved in each eye. The disc and macula were preserved in all eyes. recurrence was noted in one case, which responded to a repeated intravitreal injection of clindamycin and dexamethasone. CONCLUSIONS: intravitreal injections of clindamycin and dexamethasone are well tolerated and may offer an additional strategy to treat TRC in patients who are unable to afford or tolerate systemic therapy, or whose disease progresses despite systemic therapy.- - - - - - - - - - ranking = 5keywords = choroiditis (Clic here for more details about this article) |
3/21. 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) |
4/21. Long-term immunosuppressive treatment of serpiginous choroiditis.OBJECTIVE: To determine the efficacy of immunosuppressive treatment in serpiginous choroiditis. DESIGN: The clinical courses were reviewed of six consecutive patients (12 eyes) with vision-threatening, steroid-dependent/resistant serpiginous choroiditis treated with a combination of immunosuppressive agents including azathioprine, cyclosporine, and cyclophosphamide. All patients underwent treatment for at least 12 months. RESULTS: The follow-up period ranged from 17 to 105 months (mean 57, median 43). All patients were able to taper oral steroids. Five patients discontinued all immunosuppressive medications after a treatment period of 12 to 69 months (mean 39 months). Immunosuppressive treatment was continued in one patient at a "low" maintenance dose. Ten eyes had improved visual acuities, while vision remained impaired in two due to macular scars. recurrence was noted in two patients when an attempt was made to decrease the dose of immunosuppressive medication. Two patients experienced side effects which were reversed by decreasing the dose of the medications. CONCLUSION: Long-term immunosuppressive treatment appears to prolong remission and preserve vision in patients with serpiginous choroiditis.- - - - - - - - - - ranking = 7keywords = choroiditis (Clic here for more details about this article) |
5/21. 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) |
6/21. Fuchs' heterochromic iridocyclitis following bilateral ocular toxoplasmosis.PURPOSE: To describe the development of Fuchs' heterochromic iridocyclitis (FHI) following bilateral ocular toxoplasmosis in an Asian Indian female. methods: Case report of a patient with bilateral ocular toxoplasmosis who developed bilateral Fuchs' heterochromic iridocyclitis. RESULTS: Features characteristic of bilateral Fuchs' heterochromic iridocyclitis developed following several attacks of bilateral toxoplasmic retinochoroiditis in a 26-year-old Indian female patient. CONCLUSION: Fuchs' heterochromic iridocyclitis can develop over a period of time in patients with ocular toxoplasmosis.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
7/21. Recurrent secondary frosted branch angiitis after toxoplasmosis vasculitis.PURPOSE: To describe a case of recurrent frosted branch angiitis after treatment of ocular toxoplasmosis. methods: In a 6-year-old boy, we found perivascular, creamy, patchy, retinal sheathing in both eyes without any focal necrotizing retinochoroiditis or scarring. IgM antibodies for toxoplasma gondii were also found. The patient was treated with antitoxoplasmosis medication and a systemic steroid. RESULTS: Several years after treatment of the toxoplasmosis, frosted branch angiitis occurred twice without any retinal scarring or serological evidence of toxoplasmosis. After systemic steroid therapy, the angiitis improved without further complications. CONCLUSIONS: Toxoplasmic retinal vasculitis should be considered as a cause of frosted branch angiitis.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
8/21. Ocular conditions associated with peripapillary subretinal neovascularization, their relative frequencies, and associated outcomes.OBJECTIVE: To determine frequency and outcomes of conditions with peripapillary subretinal neovascular membranes (PSRNVMs). DESIGN: Retrospective observational case series. PARTICIPANTS: All patients from a private community-based retina practice diagnosed with a PSRNVM. methods: review of clinical charts, photographs, and fluorescein angiograms of 115 eyes of 96 patients, accrued over 18 years. MAIN OUTCOME MEASURES: Demographics, visual acuity (VA), laterality, neovascular membrane type and recurrence status over treatment course, and associated ocular conditions. RESULTS: Prevalences of reported associations were 52 (45.2%), age-related maculopathy (arm); 45 (39.1%), idiopathic; 5 (4.3%), multifocal choroiditis; 3 (2.6%), angioid streaks; 2 (1.7%), histoplasmosis; 2 (1.7%), choroidal osteoma; 1 (0.9%), optic disc drusen; and 1 (0.9%), congenital disc anomaly. Newly recognized associations include pattern dystrophy (3 [2.6%]) and peripapillary pseudopodal pigment epithelial and choroidal atrophy (1 [0.9%]). Second-eye involvement was observed in 19.8% of patients over a median follow-up of 2 years. Median initial VAs were 20/40 for arm-associated eyes and 20/30 for idiopathic eyes (P = 0.0230). Median final VAs were 20/70 for arm-associated eyes and 20/32 for idiopathic eyes (P = 0.0261). The VA changes in the arm-associated and idiopathic groups did not differ significantly (P = 0.1453). recurrence of PSRNVMs after laser ablation was seen in 14 of 73 eyes (19.2%). A case of a PSRNVM as a cause of pseudopapilledema leading to unnecessary neurological imaging is reported. CONCLUSIONS: Close inspection of fellow eyes at the time of first eye diagnosis and regular follow-up afterward are indicated, given the high rate of eventual bilateral involvement regardless of associated condition. Laser ablation of PSRNVMs with broad treatment margins reduces recurrence rates relative to earlier series. The differential diagnosis of disc edema should include PSRNVMs. Pattern dystrophy can be associated with PSRNVMs.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
9/21. Ocular toxoplasmosis in pregnancy.PURPOSE: To describe the course of ocular toxoplasmosis during pregnancy. methods: This study was a retrospective, non-comparative case series of four pregnant women who were treated for ocular toxoplasmosis during pregnancy. RESULTS: All of the participants had severe and treatment-resistant toxoplasmic retinochoroiditis during pregnancy, leaving three of them with decreased visual acuity in spite of aggressive therapy. Delivery of the infant appeared to help the recovery in two patients. CONCLUSIONS: Pregnant state may provoke the recurrence of ocular toxoplasmosis.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
10/21. Intravenous pulse methylprednisolone therapy for acute treatment of serpiginous choroiditis.PURPOSE: To evaluate the safety and efficacy of high-dose intravenous steroid therapy (HDIST) for the acute treatment of vision-threatening serpiginous choroiditis. methods: Retrospective review of the records of five patients with serpiginous choroiditis who were treated with HDIST (1 g methylprednisolone for three days) in addition to their standard immunosuppressive treatment. The visual acuities and improvement of ocular signs after HDIST were evaluated. RESULTS: Twelve episodes of macula-threatening choroiditis in five patients with serpiginous choroiditis were treated during a seven-year period. All patients responded to HDIST with evidence of a decrease in intraocular inflammation immediately after and complete restoration of visual acuity within 10 days of commencing treatment. In one patient, medical intervention was required because of gastric distress. During the follow-up, three out of five patients experienced new attacks and two patients developed subretinal neovascularization. CONCLUSION: HDIST is effective in controlling severe vision-threatening serpiginous choroiditis and in improving visual function in a short period of time. However, the effect of this treatment in long-term disease control is uncertain.- - - - - - - - - - ranking = 9keywords = choroiditis (Clic here for more details about this article) |
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