Cases reported "Uveitis"

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1/11. Juvenile xanthogranuloma masquerading as pediatric chronic uveitis: a clinicopathologic study.

    Juvenile xanthogranuloma (JXG) is a rare, pediatric histiocytic skin disorder that may affect the eye. It can present with protean ocular manifestations, including masquerade uveitis, heterochromia, hyphema, or glaucoma. It very rarely involves the retina and posterior segment; indeed, posterior involvement has been documented histopathologically in only one case. We present the case of a 2-year-old child with ocular JXG presenting as chronic, refractive uveitis, without skin or systemic findings. The blind, painful eye was enucleated and found to harbor a diffuse histiocytic process that involved both the anterior and posterior segments, including the retina and subretinal space. Histological, immunohistochemical, and electron microscopic studies confirmed the diagnosis of JXG. The pathologic classification and differential diagnosis of systemic histiocytic disorders are discussed. Since JXG can present as masquerade pediatric uveitis, this entity should be considered in children with atypical uveitis. In rare instances, JXG may involve the posterior segment and the retina, leading to retinal detachment and blindness.
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keywords = hyphema
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2/11. An unusual case of uveitis-glaucoma-hyphema syndrome.

    PURPOSE: To report a case of uveitis-glaucoma-hyphema (UGH) syndrome in which anterior chamber paracentesis led to the diagnosis of sickle cell trait. DESIGN: Observational case report. methods: A 43-year-old Cuban pseudophakic male was seen multiple times over a 3-year period complaining of floaters and blurry vision in his left eye. He was noted to have an inferotemporally displaced posterior chamber intraocular lens and recurrent microhyphemas with elevated intraocular pressure (IOP) readings between 29 and 46 mm Hg with each episode. He was diagnosed with UGH syndrome. Posterior chamber intraocular lens explantation and anterior chamber washout was performed. The aqueous fluid was submitted for cytopathologic examination. RESULTS: Postoperatively, the patient's symptoms resolved and he had no further hemorrhages or elevated IOP readings. Cytopathology of the aspirate revealed sickled red blood cells. CONCLUSIONS: Microscopic examination of aqueous fluid can be a valuable tool in diagnosing ophthalmic manifestations of systemic disease.
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keywords = hyphema
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3/11. Bilateral spontaneous hyphema with uveitis in a young girl.

    A healthy 5-year-old girl presented with bilateral hyphema as an initial symptom of uveitis. The ocular findings and the patient's age suggested that the uveitis was due to juvenile rheumatic arthritis or chronic iridocyclitis.
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ranking = 5
keywords = hyphema
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4/11. Pseudophakic posterior iris chafing syndrome.

    Posterior iris chafing by the loop or the optic portion of sulcusfixated posterior chamber lens implants may cause a spectrum of disorders that include iris-pigment epithelial "window defects," pigment dispersion with or without elevation of intraocular pressure, intermittent microhyphemas with transient visual obscurations, and the UGH syndrome. It appears that secondary pigmentary glaucoma is more likely with planar loop design than with angulated loops. Optic and loop materials may play a role in the development of the disorder. Implantation of both supporting loops of the implant within the capsular bag is suggested to prevent posterior iris chafing.
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ranking = 1
keywords = hyphema
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5/11. Fox shield treatment of the UGH syndrome.

    The uveitis-glaucoma-hyphema (UGH) syndrome has been described with all types of intraocular lenses. The usual forms of therapy include miotics, mydriatics, steroids, antiglaucomatous medications, laser therapy, and surgical explanation. I describe five patients in whom the UGH syndrome resolved after long-term Fox shield treatment to prevent nocturnal hand-eye trauma.
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ranking = 1
keywords = hyphema
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6/11. Complications while removing the IOLAB 91Z lens for the UGH-UGH syndrome.

    Five patients having UGH syndrome (uveitis-glaucoma-hyphema plus vitreous hemorrhage) with the IOLAB 91Z intraocular lens (IOL) requiring removal are reported. Preoperative gonioscopy showed the polypropylene loops to be enmeshed in synechias. In four cases the IOL was difficult to remove and two cases had significant intraoperative complications. In one case we used the Nd:YAG laser to cut the synechias preoperatively and effected an easy removal.
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keywords = hyphema
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7/11. Five cases of severe anterior chamber lens implant complications.

    anterior chamber implant-induced complications resulted in loss of useful vision in five cases--two from uveitis-glaucoma-hyphema syndrome, two from pupillary block glaucoma, and one from neovascular glaucoma.
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keywords = hyphema
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8/11. Late hyphema due to vascularization of the cataract wound.

    Nineteen patients with hyphema due to fibrovascular tissue in the cataract wound were seen. In 3 patients the hyphema occurred after closure of an unitentional filtering bleb. Two patients receiving anticoagulants before and after the hyphema occurred did not have recurrence of the bleeding. In one patient the hyphema was induced by scleral depression. This benign condition is frequently misdiagnosed. When erythrocytes are seen in the anterior chamber of an aphakic patient, vascularization of the cataract wound should be suspected and confirmed by gonioscopy.
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ranking = 8
keywords = hyphema
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9/11. uveitis-glaucoma-hyphema syndrome: a late complication of posterior chamber lenses.

    The uveitis-glaucoma-hyphema (UGH) syndrome is a triad that rarely occurs in the late postoperative period after an extracapsular cataract extraction (ECCE) with implantation of a posterior chamber (PC) intraocular lens (IOL). Surgical techniques as well as IOL design can influence the incidence of the UGH syndrome. We describe two patients who developed an UGH syndrome respectively 5 and 6 years after an ECCE with implantation of a flexible closed-loop one-plane PC IOL of the Anis type. Intraoperatively, an envelope technique had been used. Although no tears had occurred, an asymmetrical bag-sulcus fixation of the IOL had been obtained, with manifest upward decentration of the IOL, probably eroding the ciliary sulcus by its closed loops, acting as a semi-rigid system.
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ranking = 5
keywords = hyphema
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10/11. An unusual case of cryptococcal endophthalmitis.

    BACKGROUND: Cryptococcal endophthalmitis is a rare disorder, almost invariably diagnosed after enucleation or at postmortem examination. There are therefore few guidelines as to its identification or treatment. methods: A case of culture-positive cryptococcal endophthalmitis in a patient with chronic uveitis was diagnosed by vitreous biopsy at the time of retinal detachment repair. The patient was treated with oral fluconazole for 5 months. All reported cases of cryptococcal endophthalmitis were reviewed and compared. RESULTS: After oral fluconazole therapy, the patient was culture negative on repeat tap. Despite conversion to culture-negative status, however, visual acuity declined to hand motions because of hyphema and hypotony. The organism was successfully identified as a non-neoformans species, cryptococcus laurentii, previously unreported as an ocular pathogen. CONCLUSION: This unique case demonstrates that cryptococcal disease can be diagnosed antemortem by vitreous biopsy, and should be added to the differential diagnosis in cases of chronic smoldering uveitis. A non-neoformans organism is also identified for the first time as a cause of ocular cryptococcosis. fluconazole, used here for the only time of which we are aware to treat cryptococcal endophthalmitis, produced successful conversion to culture negativity and resolution of the uveitis.
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ranking = 1
keywords = hyphema
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