1/21. Systemic lupus erythematosus with optical neuromyelitis (Devic's syndrome). A case with a 35-year follow-up.Optical neuromyelitis or Devic's syndrome is a very uncommon neurological manifestation of systemic lupus erythematosus. It is also associated with antiphospholipid antibodies, limited responsiveness to glucocorticoid treatment and a poor prognosis. We report the case of a female systemic lupus erythematosus patient who developed recurrent flares of optical neuritis and transverse myelitis. These flares consistently responded to glucocorticoid therapy. Despite the absence of overt anticardiolipin antibodies in the course of the disease, long-term anticoagulant therapy has been introduced with positive results. Treatments are usually of limited efficacy in Devic's syndrome. In our patient, however, aggressive glucocorticoid treatment resulted in prolonged survival.- - - - - - - - - - ranking = 1keywords = neuromyelitis, optica (Clic here for more details about this article) |
2/21. Birdshot retinochoroidopathy: measurement of the posterior fundus spots and macular edema using a retinal thickness analyzer, before and after treatment.PURPOSE: To measure the retinal thickness in the macular area and at the typical fundus spots in a patient with birdshot retinochoroidopathy, using the retinal thickness analyzer (RTA), a new image analyzer involving laser-slit biomicroscopy, and to quantify the changes after systemic corticosteroid therapy. CASE REPORT: A 54-year-old man with posterior uveitis underwent visual acuity measurement, fluorescein and indocyanine green (ICG) angiographies, optical coherence tomography (OCT) and RTA measurements before and after steroid treatment. RESULTS: The thickness at the birdshot spots measured with RTA remained unchanged after treatment, but the thickness at the fovea decreased in both eyes. Fluorescein and ICG angiographies and OCT showed no change with treatment. CONCLUSIONS: RTA seems a more sensitive method for assessing changes in macula thickness in the course of birdshot retinochoroidopathy and can help document the effect of treatment.- - - - - - - - - - ranking = 0.030609449352049keywords = optica (Clic here for more details about this article) |
3/21. Demyelinating disorder of the central nervous system occurring in black South Africans.OBJECTIVES: To investigate the nature and cause in eight black South African patients of a recurrent (multiphasic), remitting, and relapsing demyelinating disease of the CNS. methods: The clinical and laboratory investigations and radiological manifestations of these patients were documented. RESULTS: Each patient had two or more acute attacks of demyelinating disease affecting the CNS. The clinical presentations of the patients were predominantly those of multiphasic neuromyelitis optica (NMO). brain MRI in these patients showed features consistent with those described for acute disseminated encephalomyelitis (ADEM), as well as lesions that are described in multiple sclerosis. There was involvement of the corpus callosum in addition to typical ADEM lesions. Laboratory investigations excluded all other known causes of multiphasic CNS demyelination. Oligoclonal antibodies were not detected in these patients at any time. The patients were all from a population with a low risk for MS (black South Africans). CONCLUSION: The patients described here represent a new phenotypic expression of a recurrent (multiphasic), steroid sensitive, inflammatory demyelinating disorder of the CNS occurring in black South Africans. The disorder is either a distinct inflammatory demyelinating disorder of the CNS of as yet unknown aetiology, or a varied form of MS (ADEM/NMO) occurring in a population with a low risk (where the genetic trait and environmental risk factors for MS do not exist) for MS.- - - - - - - - - - ranking = 0.54010261001163keywords = neuromyelitis optica, neuromyelitis, optica (Clic here for more details about this article) |
4/21. Features of age-related macular degeneration on optical coherence tomography.PURPOSE: To describe Optical Coherence Tomographic (OCT) findings in age-related macular lesions. patients AND methods: We selected 6 patients with characteristic features of age-related macular disease on OCT, 4 of whom presented with Choroidal New Vessels (CNV). OCT is analogous to ultrasound, except that light is used instead of sound. The reflected light is analysed with the technique of low-coherence interferometry. RESULTS: Classic CNV present with well-defined boundaries on OCT, whereas occult CNV can present with well- or poorly defined boundaries. Findings in Chronic central serous chorioretinopathy (CSCR) and adult Onset Vitelliform Dystrophy (AOVD) need angiographic correlation when compared to findings in CNV. CONCLUSION: OCT cannot replace conventional diagnostic techniques in exsudative Age-related macular degeneration. Although it accurately depicts associated changes and especially the associated serous detachment in macular disease, the imaging of neovascular membranes faces limited penetration and resolution. The interpretation of the tomograms requires further clinico-histological correlation.- - - - - - - - - - ranking = 0.1224377974082keywords = optica (Clic here for more details about this article) |
5/21. A long-term follow-up study of severe variant of central serous chorioretinopathy.PURPOSE: To facilitate understanding of the long-term course and visual outcome of a severe variant of central serous chorioretinopathy. DESIGN: Consecutive observational case series. patients AND methods: The authors reviewed 25 patients with multifocal posterior pigment epitheliopathy and bullous retinal detachment, who had a mean follow-up time of 10.6 years (range, 6-22 years), with reference to the demographic feature, fundus changes, recurrence, and final anatomic and visual outcome. Two patients underwent optical coherence tomography. RESULTS: The patients were 21 men and 4 women, with a mean age at disease onset of 43.1 years (range, 30-63 years). Twenty-one patients were otherwise healthy, and four developed ocular disease during systemic corticosteroid therapy for metabolic or autoimmune diseases including systemic lupus erythematosus. The disease was bilateral in 21 patients (84%). Nine patients (36%) presented initially with classic central serous chorioretinopathy, followed by its severe variant 7 months to 9 years later. Active disease was characterized by multifocal exudative lesions in the posterior pole and bullous retinal detachment with shifting subretinal fluid in the inferior periphery. Optical coherence tomography of exudative lesions disclosed cloudy and fibrinous subretinal fluid. The exudative lesions were self-limited or responded to photocoagulation. During the follow-up period, 13 patients (52%) showed 1 to 5 recurrent disease, but the disease eventually became quiescent with multifocal atrophic scars in the posterior pole with or without atrophic tracts in the inferior periphery. Final best-corrected visual acuity was 2020 or better in 24 of 46 affected eyes (52%) of 25 patients and 2040 or better in 37 eyes (80.4%). CONCLUSIONS: A severe variant of central serous chorioretinopathy characterized by multifocal posterior exudations and bullous inferior retinal detachment with shifting subretinal fluid may affect otherwise healthy, middle-aged males or individuals receiving systemic corticosteroid therapy for metabolic or autoimmune diseases. Exudative chorioretinal lesions are self-limited or respond to photocoagulation. recurrence is common, but the disease eventually becomes quiescent with favorable visual acuity unless the macula is damaged.- - - - - - - - - - ranking = 0.030609449352049keywords = optica (Clic here for more details about this article) |
6/21. Recurrent keratoconus 40 years after keratoplasty.Recurrent keratoconus is a corneal dystrophy that degrades the optical function of the corneal graft. recurrence of keratoconus after keratoplasty has been reported previously in some scattered case reports, but the aetiology is still unclear. This report describes the case of a 74-year-old white woman, who presented recurrent keratoconus 40 years after keratoplasty. Ophthalmological and videokeratographic data are presented. The patient obtained satisfactory vision with soft contact lenses, and recurrent keratoconus remained stable during a 2-year period. Recurrent keratoconus generally has a moderate to severe effect on visual performance, but contact lenses usually optimise visual acuity. In cases in which the visual defect is severe, a second penetrating keratoplasty should be considered.- - - - - - - - - - ranking = 0.030609449352049keywords = optica (Clic here for more details about this article) |
7/21. Spontaneous closure of a recurrent macular hole following vitrecomy corroborated by optical coherence tomography.Although previously reported with primary macular holes, spontaneous closure of a recurrent macular hole after previous vitrectomy has not been described. In a 71-year-old man, a recurrent macular hole diagnosed by dinical examination and optical coherence tomography was associated with cystoid macular edema on fluorescein angiography and decreased vision 9 months after macular hole surgery and 6 weeks after cataract extraction. Spontaneous dosure of the macular hole and improved visual acuity were noted while awaiting repeat vitrectomy. Findings were corroborated by optical coherence tomography. To date, this represents the first such case in the literature.- - - - - - - - - - ranking = 0.1836566961123keywords = optica (Clic here for more details about this article) |
8/21. Intraretinal silicone oil vacuoles after macular hole surgery with internal limiting membrane peeling.PURPOSE: To report the detection of intraretinal silicone oil vacuoles after the use of a silicone oil tamponade for macular hole surgery with internal limiting membrane (ILM) peeling. DESIGN: Observational case report. methods: A 57-year-old woman with a recurrent macular hole in the left eye underwent macular hole surgery with ILM peeling and silicone oil tamponade. After early silicone oil emulsification was detected, the silicone oil was removed. RESULTS: Follow-up ophthalmoscopic examination and optical coherence tomography imaging revealed intraretinal silicone oil vacuoles in the area of ILM peeling. CONCLUSIONS: Internal limiting membrane defects may facilitate the entry of silicone oil into the retina, leading to accumulation of oil vacuoles. The use of silicone oil in macular hole surgery with ILM peeling may complicate the postoperative outcome.- - - - - - - - - - ranking = 0.030609449352049keywords = optica (Clic here for more details about this article) |
9/21. neuromyelitis optica: importance of cerebrospinal fluid examination during relapse.Devic's neuromyelitis optica (NMO) is a clinical entity characterised by severe transverse myelitis, optic neuropathy and monophasic or recurrent course. We report the case of a woman affected by myelitis and optic neuritis suggesting Devic's disease. diagnosis was supported by clinical, neuroradiological and biochemical findings. In 14 months, the patient developed 5 clinical exacerbations. Six cerebrospinal fluid (CSF) examinations were performed, 3 during relapses and 3 during remitting phases: all the CSF specimens obtained during relapses showed granulocyte pleocytosis and increased protein level, whereas CSF was normal during stationary phases. Oligoclonal banding was always absent. spinal cord MRI showed altered signal at cervical and thoracic levels. We did not find any concomitant systemic disease. The case we report underlines the importance of CSF examination during clinical relapse in NMO diagnosis.- - - - - - - - - - ranking = 0.66254040741983keywords = neuromyelitis optica, neuromyelitis, optica (Clic here for more details about this article) |
10/21. retinal vasculitis and cystoid macular edema after body tattooing: a case report.BACKGROUND: To report a case of retinal vasculitis occurring after the placement of permanent tattoos. history AND SIGNS: A 21-year-old male was referred to our department with impairment of visual acuity. Permanent tattoos covered the head, body, arms and legs. The patient was examined with ophthalmoscopy, fluorescein angiography, indocyanine green angiography and optical coherence tomography. Systemic medical and laboratory work-up were performed in order to exclude an infectious agent or an inflammatory disease. He had no history of intravenous drug abuse. THERAPY AND OUTCOME: Our patient presented severe posterior uveitis associated with retinal vasculitis and cystoid macular edema. Laboratory tests ruled out all diseases causing vasculitis. hiv and B, C hepatitis tests were negative. Cystoid macular edema and vasculitis were resolved after immunosuppressive therapy. CONCLUSIONS: This is the first description of a retinal vasculitis associated with cystoid macular edema in a completely healthy individual after the placement of permanent tattoos. A phagocytosis of tattoo pigments leading to their lysis is described in the literature as a mechanism causing vasculitis.- - - - - - - - - - ranking = 0.030609449352049keywords = optica (Clic here for more details about this article) |
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