1/79. Presumed ocular bartonellosis.BACKGROUND: The spectrum of diseases caused by bartonella henselae continues to expand and ocular involvement during this infection is being diagnosed with increasing frequency. methods: The clinical features and visual prognosis for 13 patients with intraocular inflammatory disease and laboratory evidence of bartonellosis were investigated. There were nine patients with neuroretinitis and four with panuveitis with positive antibody titres against B henselae determined by an enzyme immunoassay (IgG exceeding 1:900 and/or IgM exceeding 1:250). RESULTS: Positive IgG levels were found for eight patients and positive IgM levels for five. Despite animal exposure of 10 patients, only two (IgG positive) cases had systemic symptoms consistent with the diagnosis of cat scratch disease. Pathological fluorescein leakage of the optic disc was observed in all affected eyes. At 6 months' follow up, 3/18 (17%) affected eyes had a visual acuity of less than 20/100, owing to optic disc atrophy and cystoid macular oedema. 12 patients (17 eyes) were treated with antibiotics; visual acuity improved two or more Snellen lines for 9/17 (53%) eyes. CONCLUSIONS: The possibility of B henselae infection should be considered in patients with neuroretinitis and panuveitis (especially in cases with associated optic nerve involvement) even in the absence of systemic symptoms typical for cat scratch disease.- - - - - - - - - - ranking = 1keywords = optic, edema (Clic here for more details about this article) |
2/79. Progression of cytomegalovirus retinitis in acquired immunodeficiency syndrome: a case report.We report an AIDS patient with cytomegalovirus (CMV) retinitis that developed from an early minor lesion and progressed to extended involvement of the retina and severe deterioration of vision due to poor compliance with ganciclovir treatment. A 33-year-old man was known to have acquired immunodeficiency syndrome (AIDS) for eight months. The patient had no complaint of visual symptoms. A routine eye examination revealed his visual acuity to be 6/6 in both eyes. The dilated eye fundus examination using indirect ophthalmoscopy disclosed a localized white yellowish granular lesion in the peripheral retina of the right eye and a completely normal left eye. CMV retinitis with initial manifestation in the right eye was diagnosed. Due to incomplete treatment with ganciclovir, the retinal lesion rapidly enlarged and extended to the posterior pole, with eventual destruction of the nerve fiber layer and optic disc. The visual acuity of right eye dropped from 6/6 to 1/60 within six months. This case report indicates the importance of early, dilated eye fundus examination and recognition of early CMV retinitis in order to salvage visual function in AIDS patients. Completion of the anti-CMV treatment course in halting the progression of CMV retinitis is also emphasized.- - - - - - - - - - ranking = 0.33132946268286keywords = optic (Clic here for more details about this article) |
3/79. Diffuse unilateral subacute neuroretinitis.BACKGROUND: Diffuse unilateral subacute neuroretinitis (DUSN) is an inflammatory disorder of the retina thought to be caused by a motile worm. It initially presents with unilateral recurring crops of gray-white retinal lesions and mild to severe inflammation. Over a period of months, diffuse retinal pigment epithelium (RPE) changes, arteriolar attenuation, and optic atrophy will develop. In approximately 25% of cases, a worm is visualized during the eye examination. Laser treatment to kill the worm is the only reliable way to halt progression of this disease. methods: The following case report presents a 9-year-old girl with unilateral vision loss. RESULTS: Clinical observation and several blood tests to rule out systemic diseases resulted in a diagnosis of DUSN. Although a worm was not visualized, laser treatment of its suspected location resulted in recovery of some vision. CONCLUSIONS: DUSN is often diagnosed by clinical presentation alone, because a worm may not be visualized. An appropriate initial work-up and timely initiation of laser treatment are essential to preservation of vision.- - - - - - - - - - ranking = 0.33132946268286keywords = optic (Clic here for more details about this article) |
4/79. Tuberculous neuroretinitis.OBJECTIVES: To describe a patient with tuberculous neuroretinitis. MATERIALS AND methods: Retrospective case report. RESULTS: We describe a 43-year-old otherwise asymptomatic woman with a known exposure to tuberculosis who had unilateral optic disc edema and a partial macular star (neuroretinitis). This was followed approximately 1 year later by the development of an exudative retinal detachment in the setting of bilateral multifocal choroiditis. Laboratory testing revealed a marked positive cutaneous reaction to purified protein derivative (PPD). Treatment with antituberculosis medicine alone resulted in prompt resolution of the choroidal infiltrates and complete flattening of the exudative detachment. CONCLUSIONS: tuberculosis should be considered in the differential diagnosis for patients with neuroretinitis.- - - - - - - - - - ranking = 0.33734107463428keywords = optic, edema (Clic here for more details about this article) |
5/79. Cat-scratch neuroretinitis.BACKGROUND: cat-scratch disease is a subacute regional lymphadenitis, usually preceded by a history of a cat scratch or exposure to kittens. The disease is caused by bartonella henselae, and possibly bartonella quintana, pleomorphic gram-negative rods formerly known as Rochalimaea henselae and Rochalimaea quintana. Ocular involvement is rare and typically manifests as either Parinaud's oculoglandular syndrome or neuroretinitis. patients with neuroretinitis resulting from cat-scratch disease may be asymptomatic or experience mild-to-severe vision loss. The clinical features, angiographic appearance, differential diagnosis, and management of cat-scratch neuroretinitis are discussed. CASE REPORT: A 30-year-old white woman reported to the eye clinic with painless, decreased vision in the right eye. A diagnosis of cat scratch neuroretinitis was made on the basis of the history of cat scratch, clinical appearance, and angiographic findings. Treatment with oral ciprofloxacin restored vision to normal in 4 weeks. CONCLUSION: Painless vision loss associated with optic nerve swelling and macular star exudate should alert suspicion of systemic disease. Additional findings--including positive history of a cat scratch, lymphadenopathy, and flu-like symptoms--may indicate bartonella henselae or bartonella quintana infection. While treatment remains controversial, appropriate serology testing may aid in the diagnosis and management of the underlying infection.- - - - - - - - - - ranking = 0.33132946268286keywords = optic (Clic here for more details about this article) |
6/79. Neovascularization of the optic disc after highly active antiretroviral therapy in an AIDS patient with cytomegalovirus retinitis--A new immune recovery-related ocular disorder?A patient with AIDS and cytomegalovirus (CMV) retinitis developed a massive bilateral peripheral occlusive vasculopathy with a bilateral neovascularization of the optic disc five weeks after the introduction of highly active antiretroviral therapy (HAART). No associate cause of occlusive vasculopathy was found. Occlusive vasculopathy and optic disc neovascularization may be an immune recovery-related ocular disorder.- - - - - - - - - - ranking = 1.9879767760972keywords = optic (Clic here for more details about this article) |
7/79. optic disk neovascularization in a patient with cytomegalovirus retinitis associated with renal transplantation.PURPOSE: To report the development of optic nerve head neovascularization during the recovery phase of cytomegalovirus (CMV) retinitis in a renal allograft recipient. CASE REPORT: A 46-year-old male renal allograft recipient developed CMV retinitis seven months after transplantation. At the time of the diagnosis, the patient was being immunosuppressed with prednisone, cyclosporine, and azathioprine, and was treated with repeated intravitreal and intravenous ganciclovir. Six weeks after the initiation of therapy, optic disk neovascularization developed. This was confirmed by fluorescein angiography, which showed no areas of retinal capillary nonperfusion. At this stage, active retinal lesions were partially resolved. Apart from intraocular inflammation, no other cause of neovascularization was detected. Over the following six months, optic disk neovascularization regressed spontaneously without causing vitreous hemorrhage or visual loss. There was no recurrence of CMV retinitis during follow-up. CONCLUSION: optic disk neovascularization may develop in the healing phase of CMV retinitis in renal transplant recipients.- - - - - - - - - - ranking = 2.6736118873685keywords = optic disk, optic, disk (Clic here for more details about this article) |
8/79. Macular star associated with posterior hyaloid detachment.PURPOSE: To report a patient with a Leber's idiopathic stellate neuroretinitis-like lesion that was caused by vitreous traction accompanying a posterior hyaloid detachment. methods: We present a 49-year-old woman who showed segmental optic disc edema, peripapillary retinal detachment, and a macular star. RESULTS: An incomplete posterior hyaloid detachment was present, and the posterior hyaloid membrane was attached to the nasal margin of the optic disc. fluorescein angiography revealed a bent retinal artery on the upper margin of the optic disc, and leakage of fluorescein was observed from this area. CONCLUSION: Vascular damage to the optic disc due to vitreous traction should also be considered as a mechanism for the ophthalmoscopic appearance of the fundus when lesions suggestive of Leber's idiopathic stellate neuroretinitis are present in an adult.- - - - - - - - - - ranking = 1.3313294626829keywords = optic, edema (Clic here for more details about this article) |
9/79. An ocular cat-scratch disease patient positive for cytoplasmic anti-neutrophil cytoplasmic antibody.BACKGROUND: We report a case of ocular cat-scratch disease with permanent vision reduction in a patient who was cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) positive. methods: Case report and review of the literature. RESULTS: While taking steroids and antibiotics, a 52-year-old man with uveitis associated with cat-scratch disease developed retinal vein occlusion and a macular exudate. His final visual acuity was poor because of residual macular degeneration and optic atrophy. serum C-ANCA increased and decreased in parallel with ocular inflammatory activity. CONCLUSION: C-ANCA is an indicator of vasculitis and may be useful as an indicator of severe cat-scratch disease.- - - - - - - - - - ranking = 0.33132946268286keywords = optic (Clic here for more details about this article) |
10/79. Unilateral neuroretinitis and periparillary serous retinal detachment in cat-scratch disease.cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.- - - - - - - - - - ranking = 5.8328390490554keywords = papillitis (Clic here for more details about this article) |
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