Aarupepstein7158
0 [1.8-44.0]; P=0.007), and presence of subretinal fibrovascular material (3.1 [1.1 - 8.5]; P=< 0.03), are associated with higher odds of ORT formation. Once the ORT is formed, fibrosis was observed directly underlying the ORT on SD-OCT in 70.9% of cases.
Type-2 membranes at presentation predicts ORT formation. Fibrosis often underlies ORT. This suggests contraction of type-2 MNV derived fibrosis may be important in ORT formation.
Type-2 membranes at presentation predicts ORT formation. Fibrosis often underlies ORT. This suggests contraction of type-2 MNV derived fibrosis may be important in ORT formation.
To discuss a case of a macular hole formation after vitrectomy for myopic retinoschisis with foveal detachment and spontaneous closure, during long term follow-up.
Case report.
A 71-year-old man with myopic retinoschisis with foveal detachment had a vitrectomy with internal limiting membrane (ILM) peeling combined with cataract surgery in the left eye. The preoperative best-corrected visual acuity (BCVA) was 8/20, and the axial length was 27.11 mm. A macular hole with foveal detachment was observed 1 month after surgery. However, the macular hole closed spontaneously with foveal detachment at 4 months of follow-up. Foveal detachment resolved and BCVA improved to 20/20 at nine months of follow-up.
This case suggests that the macular hole formed after vitrectomy for myopic retinoschisis with foveal detachment with ILM peeling can close spontaneously.
This case suggests that the macular hole formed after vitrectomy for myopic retinoschisis with foveal detachment with ILM peeling can close spontaneously.
To report the case of a patient presenting with newly diagnosed atypical hemolytic uremic syndrome (aHUS) and Purtscher-like retinopathy.
Observational case report and review of literature.
A 38-year-old female presented with 3 months of rashes, fevers, arthralgias, and abdominal pain. Initial workup was suggestive of hypereosinophilic syndrome or adult-onset Still's disease. The patient developed acute renal failure and progressively blurry vision bilaterally over the course of 5 days. Funduscopic exam was notable for numerous Purtscher flecken and cotton-wool spots, with rare intraretinal hemorrhages at the posterior pole. The constellation of renal failure, hemolytic anemia, and thrombocytopenia prompted a work-up for thrombotic microangiopathy that was remarkable for a mutation in the gene coding for complement protein C9.
The patient was diagnosed with aHUS. The patient was treated with intravenous pulse dose steroids for 3 days and an extended course of eculizumab. The patient's renal failure resolved, and her visual acuity improved, though she had residual visual field constriction and developed bilateral optic atrophy. Outcomes of other cases of Purtscher-like retinopathy related to aHUS are reviewed.
Purtscher-like retinopathy is a rare, but severe ophthalmic complication of aHUS. Eculizumab is an effective treatment for the systemic illness caused by aHUS, and anatomic resolution of Purtscher-like retinopathy may follow, although visual prognosis remains guarded. Recovery of visual acuity may lag behind resolution of macular edema in these patients.
Purtscher-like retinopathy is a rare, but severe ophthalmic complication of aHUS. Eculizumab is an effective treatment for the systemic illness caused by aHUS, and anatomic resolution of Purtscher-like retinopathy may follow, although visual prognosis remains guarded. Recovery of visual acuity may lag behind resolution of macular edema in these patients.
To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) over 30 months follow-up.
Multimodal imaging including ultrawidefield color fundus photography, blue light fundus autofluorescence, swept-source optical coherence tomography, fluorescein and ICG angiography.
A 49-year old female presented with decreased vision two months after bladder cancer surgery. Exudative retinal detachment as well as leopard spot pattern chorioretinopathy was observed in the right eye. Chemotherapy and cystectomy were initiated. Progressive bilateral vision loss occurred with melanocytic proliferation, choroidal thickening, subretinal fibrosis, fluid extravasation, rapid development of mature cataract, multiple iris cysts and rubeosis despite plasmapheresis and intravenous immunoglobulins (IVIG). Following cataract surgery, massive fibrin reaction resulted in a ciliolenticular block. One year later, positron emission tomography-computed tomography (PET-CT) revealed absence of metastases. At month 23, choto prevent massive fibrin reaction. Intravitreal anti-VEGF injections may be indicated if secondary MNV develops.
To describe intraocular clouding of silicone oil in the absence of emulsification.
Retrospective observational case series of patients who received silicone oil injections and developed silicone oil discoloration without emulsification after pars plana vitrectomy. Clinical examinations and physicochemical analyses were performed to find out the common cause for the opaque oil.
Thirteen patients developed silicone oil discoloration after pars plana vitrectomy. It could be traced down that all patients had received silicone oil from one respective production batch. The silicone oil was removed as soon as possible after the changes were detected (range, 8-16 weeks). Gas chromatography flame ionization detector (GC-FIC), size exclusion chromatography (SEC) and high performance liquid chromatography (HPLC) analysis showed the absence of small molecular weight compounds in the opaque lot. Thermogravimetric analysis (TGA) revealed the opaque lot was more temperature stable. During the follow-ups, no obvious retinal toxicity could be observed and best recorded visual acuity improved considerably in twelve patients and was only limited by the underlying retinal pathology.
This is the first report on opacification of intraocular silicone oil without emulsification. https://www.selleckchem.com/products/nhwd-870.html This discoloration of silicone oil may disturb vision and prevent proper fundus examination, however, seems to be a non-toxic phenomenon without serious long-term consequences.
This is the first report on opacification of intraocular silicone oil without emulsification. This discoloration of silicone oil may disturb vision and prevent proper fundus examination, however, seems to be a non-toxic phenomenon without serious long-term consequences.
To report a case of refractory macular hole (MH) in pseudophakic eye treated with autologous posterior capsule flaps (PCFs) transplantation.
A 48-year-old man visited our hospital with visual loss in the right eye due to unclosed MH. The patient had undergone two prior surgeries in another hospital, i.e. the first included a cataract surgery, vitrectomy, and internal limiting membrane peeling with sulfur hexafluoride (SF6) gas tamponade, and the second included massaging the edges of the MH with a soft-tipped flute needle followed by the same gas, but the MH remained open. In our hospital, PCFs were acquired from the same eye, inserted into the MH, and the same gas tamponade was performed, which was about four months after the disease onset (3 months after the prior second surgery). The patient kept face-down position for a week after the surgery and the MH was closed, which remained for over 12 months. The visual acuity improved from 20/250 to 20/60 and the retinal sensitivities around the MH gradually improved.
An autologous PCFs transplantation was effective in the management of refractory MH to not only close the MH but also improve the visual outcomes.
An autologous PCFs transplantation was effective in the management of refractory MH to not only close the MH but also improve the visual outcomes.
To describe an unusual case of unilateral, endogenous endophthalmitis in an otherwise healthy, term neonate.
A 3-week-old otherwise healthy, term male infant was referred to St. Louis Children's Hospital for a second opinion of presumed panuveitis of the right eye.
Single male infant.
Diffusion weighted magnetic resonance imaging (MRI) demonstrating purulent intraocular contents facilitated the diagnosis of endophthalmitis. Examination of surgical vitreous samples by staining and cytology demonstrated Gram-positive bacterial cocci in short chains, thereby confirming endophthalmitis. Polymerase chain reaction testing of vitreous fluid identified Streptococcus agalactiae, despite an unremarkable systemic workup and a negative pre-partum maternal Group B streptococcal screen.
Endogenous endophthalmitis is a rare but devastating cause of vision loss in otherwise healthy, term neonates. Prompt diagnosis may be facilitated by MRI imaging and diagnostic vitreous biopsy.
Endogenous endophthalmitis is a rare but devastating cause of vision loss in otherwise healthy, term neonates. Prompt diagnosis may be facilitated by MRI imaging and diagnostic vitreous biopsy.
To report a unique case of live intraocular filarial worm leading to development of a full-thickness macular hole (FTMH).
A 18 year-old female presented with decreased vision in right eye (OD) of one week duration. Her best corrected visual acuity (BCVA) in OD was 6/24 while it was 6/6 in the left eye (OS). Clinically, there was presence of a live intravitreal worm with full-thickness macular hole (FTMH) and inferior retinal track marks in OD while OS was normal. Spectral-domain optical coherence tomography (SD-OCT) of OD established the FTMH with hyperreflective debris at its base. The patient underwent OD vitrectomy with worm retrieval in-toto followed by an internal limiting membrane (ILM) peel and 15% Sulphur hexafluoride (SF6) gas injection. The worm sample was sent for histopathological analysis.
At one month, the patient had successive closure of FTMH with improvement in visual acuity upto 6/6 in OD. Histopathology confirmed the worm as Wuchereria bancrofti.
Presence of a live worm in posterior segment can precipitate formation of a FTMH. Possible reasons for development of MH could be secondary to subclinical trauma induced by excessive whipping movements of the worm in subretinal space or by triggering an acute posterior vitreous detachment (PVD).
Presence of a live worm in posterior segment can precipitate formation of a FTMH. Possible reasons for development of MH could be secondary to subclinical trauma induced by excessive whipping movements of the worm in subretinal space or by triggering an acute posterior vitreous detachment (PVD).
The aim of this study was to develop a valid educational intervention to improve knowledge and confidence using communication strategies when interacting with a person with aphasia.
A quantitative, nonrandomized pretest/posttest research study was performed.
Pre- and postcourse assessments were completed with learning participants. This educational intervention was developed using the underlying theoretical concepts of the integrated behavioral model.
Forty-nine new employees from the nursing department participated in this study, with 61% reporting less than 1 year of experience. Pre- to posttraining assessments on the Test of Knowledge of Aphasia improved from 3.7 to 5.8 (p ≤ .0001) for direct knowledge, from 5.5 to 8.2 (p ≤ .0001) for confidence self-efficacy, and from 5.3 to 7.6 (p ≤ .0001) for knowledge self-efficacy.
Results indicated this theory-driven educational training was effective in training employees from the nursing department working in an inpatient rehabilitation environment.
Improving communication effectiveness is critical for overall quality of care and patient safety.
