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Sample records for chorioretinitis

  1. Clinical case of toxocariasis chorioretinitis

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    I. G. Pikhovskaia

    2014-07-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  2. Clinical case of toxocariasis chorioretinitis

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    I. G. Pikhovskaia

    2013-01-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  3. Chorioretinitis sclopetaria from BB ex memoria.

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    Otto, C S; Nixon, K L; Mazzoli, R A; Raymond, W R; Ainbinder, D J; Hansen, E A; Krolicki, T J

    2001-01-01

    Chorioretinitis sclopetaria presents a characteristic pattern of choroidal and retinal changes caused by a high velocity projectile passing into the orbit, in close proximity to the globe. While it is unlikely that a patient should completely forget the trauma causing such damage, preserved or compensated visual function may blur the patient's memory of these events over time. Characteristic physical findings help to clarify the antecedent history. Despite the lack of an acknowledged history of ocular trauma or surgery, in our case, the characteristic ocular findings discovered at presentation allowed for recognition of the underlying etiology. Because of good visual function, the patient had completely forgotten about the trauma that occurred 12 years earlier. Strabismus surgery was performed for treatment of the presenting symptomatic diplopia. The pathognomonic findings in chorioretinitis sclopetaria are invaluable in correctly diagnosing this condition, especially when a history of ocular trauma is unavailable.

  4. Relentless placoid chorioretinitis: A case report

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    Obradović Ljiljana

    2016-01-01

    Full Text Available Introduction. Relentless placoid chorioretinitis is an entity which belongs to the group of an atypical intermediate form of primary inflammatory choriocapillaropathies, resembling both acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis, but the retinal distribution and clinical course are not the same. Because of this similarity this entity was termed “AMPPiginous”. This entity was first described by Jones et al. in 2000. The aim of our case report is to present a very specific case where the clinical course was progressive, with loss of vision in the affected eye. Case Outline. A 31-year-old man, with no previous ophthalmic diseases, was hospitalized at the Clinic of Ophthalmology, Clinical Center Kragujevac, because of a reduction of vision in the right eye, and scotoma and metamorphopsia in the left eye. The clinical course of retinal lesions in the left eye resembled the changes observed in acute posterior multifocal placoid pigment epitheliopathy, and the right eye changes were between acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis. The diagnosis of relentless placoid chorioretinitis was confirmed after clinical, laboratory, immunological, virological, and angiography examinations. Conclusion. The progressive clinical course of the disease, complemented by multimodal imaging and extensive laboratory diagnostics, has led us to the diagnosis of relentless placoid chorioretinitis. The combined anti-inflammatory and immunomodulatory therapy led to the stabilization of visual acuity of the left eye as opposed to the right, where there has been no recovery.

  5. Traumatic chorioretinal folds treated with intra-vitreal triamcinolone injection

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    Kook Young Kim

    2013-01-01

    Full Text Available A 34-year-old male visited the hospital due to decreased visual acuity in the left eye following an injury from a car accident. In the left eye, best-corrected visual acuity (BCVA was hand motion and intraocular pressure (IOP was 8 mmHg. Choroidal vasodilation and chorioretinal folds were observed by spectral domain-optical coherence tomography (SD-OCT. Topical and systemic steroid treatments did not improve the chorioretinal folds. Twelve months after the injury, intra-vitreal triamcinolone (4 mg/0.1 ml was injected. Six months after intra-vitreal triamcinolone injection, BCVA in the left eye had improved to 20/100. Fundus examination showed improvement in retinal vascular tortuosity and SD-OCT revealed improvements in choroidal vasodilation and chorioretinal folds. Intra-vitreal triamcinolone injection (IVTI was effective against traumatic chorioretinal folds with no recurrence based on objective observation by fundus photography and SD-OCT.

  6. Ocular syphilis presenting as unilateral chorioretinitis

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    Anand Pai

    2012-01-01

    Full Text Available Syphilis is a multi systemic infection caused by Treponema pallidum. Ocular manifestations of Syphilis have a myriad of presentations and severity. A 31year old male patient was referred from ophthalmology department as a case of chorioretinitis for screening for syphilis. Patient had diminished vision and redness of right eye for 2 months duration. History of premarital exposure and extramarital contact was present. Ocular examination revealed - Rt eye: conjunctival congestion and Argyll Robertson pupil; Lt eye: normal. Fundoscopy of right eye showed yellowish white retinal lesions, macular edema and hyperaemia and left eye was normal .No genital lesion, scars or cutaneous lesion was present.VDRL was reactive in 1 dilution,TPHA was positive ; HIV test was negative ; CSF revealed VDRL - Negative and TPHA -Negative.Patient was treated with Injection procaine penicillin 1.2 Million units intramuscularly daily for 21 days. The patient responded well to treatment and there was improvement in his vision. Ocular Syphilis can occur at any stage of Syphilis and may be the only presenting sign. Syphilis serology was positive confirming the disease.This case highlights the importance of syphilis with ocular manifestation - there by proving that diagnosis of syphilis based on ocular finding is clinically challenging.

  7. Pigmented paravenous chorioretinal atrophy with Coat′s like response

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    Manish Tandon

    2013-01-01

    Full Text Available Pigmented paravenous chorioretinal atrophy (PPCRA is an uncommon retinal disorder of unknown etiology that is neither well understood nor classified. We report an atypical case of PPCRA, associated with Coat′s like response (CLR in a 64-year-old man of Asian origin. Both the eyes were involved, though asymmetrically.

  8. Optical coherence tomography imaging of chorioretinal folds associated with hypotony maculopathy following pars plana vitrectomy

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    Williams Jr BK

    2015-09-01

    Full Text Available Basil K Williams Jr, Jonathan S Chang, Harry W Flynn Jr Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement. In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented. The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds. Keywords: hypotony, chorioretinal folds, ocular coherence tomography

  9. Outcomes of Retinal Detachment Surgery in Eyes with Chorioretinal Coloboma

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    Alireza Ramezani

    2010-01-01

    Full Text Available Purpose: To report the anatomical and functional outcomes of surgery for retinal detachment associated with chorioretinal colobomas. Methods: In this retrospective interventional case series, 28 eyes of 28 patients (including 18 male subjects who had undergone surgery for retinal detachment associated with chorioretinal colobomas were evaluated regarding the type of intervention, final visual acuity and anatomical outcomes, as well as complications. Cases with less than 3 months of follow-up were excluded. Results: Primary surgery included vitrectomy in 25 (89.3% and scleral buckling in 3 (10.7% eyes. The internal tamponade used in eyes undergoing vitrectomy was silicone oil in 23 (92% eyes and 20% sulfur hexafluoride (SF6 in 2 (8% eyes. Silicone oil was removed in 11 eyes (45.8%. The mean number of operations per eye was 1.57±0.74, mean follow-up was 40±36 months, and the retina remained attached in 26 eyes (92.9% at final follow-up. Mean preoperative visual acuity was 2.33±0.55 (range, 1.15-2.9 logMAR which significantly improved to 1.72±0.9 (range, 0.09-3.1 logMAR postoperatively (P < 0.001, however, final median visual acuity was counting fingers at 2 m. The most common complications were cataracts (100% and ocular hypertension (46.4%. Conclusion: The most prevalent surgical procedure for treatment of retinal detachment associated with chorioretinal coloboma was pars plana vitrectomy and the most frequently used tamponade was silicone oil. Although anatomical success was satisfactory, functional outcomes were not encouraging which reflects the complexity of the condition and associated abnormalities.

  10. [Morphological and histochemical effects of subthreshold laser therapy on the chorioretinal complex].

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    Fedoruk, N A; Fedorov, A A; Bol'shunov, A V

    2013-01-01

    A variety of subthreshold laser methods that enable selective and precise treatment of chorioretinal microstructures, thus decreasing the risk of negative changes in retina and choriocapillaries, is used in current ophthalmological practice. This comparative pathomorphological and histochemical study allowed characterizing structural changes and functional activity of chorioretinal cells after application of different subthreshold laser technologies.

  11. Toxocara polymerase chain reaction on ocular fluids in bilateral granulomatous chorioretinitis

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    Tian JX

    2015-05-01

    Full Text Available Jenny Xue Tian,1 Stephen O’Hagan2 1Ophthalmology Department, Cairns Base Hospital, Cairns, QLD, Australia; 2Ophthalmology, James Cook University, Cairns, QLD, Australia Abstract: To report a rare case of bilateral granulomatous chorioretinitis complicated by bilateral peripapillary choroidal neovascular membranes. This is the first reported case in Australia where intravitreal injections of anti-vascular endothelial growth factor ranibizumab were used to successfully treat choroidal neovascular membrane caused by granulomatous chorioretinitis. This is also the first reported case in Australia of Toxocara polymerase chain reaction being performed on intraocular fluids. Keywords: granulomatous chorioretinitis, ocular toxocariasis, neovascular membrane, anti-VEGF

  12. Acute syphilitic chorioretinitis after a missed primary diagnosis: a case report

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    Handtrack Claudia

    2008-02-01

    Full Text Available Abstract Introduction Syphilis is well known as an infectious disease which can present with a large variety of symptoms. Clinical diagnosis can be difficult and may be complicated in modern medicine by immunosuppressive treatment and possible side effects of medication. Case presentation We describe a rare case of placoid chorioretinitis due to Treponema pallidum which developed after the primary symptom of proteinuria was not recognized as a rare manifestation of syphilis. Diagnosis of syphilitic chorioretinitis and/or endophthalmitis was made by broad range amplification of the bacterial 16S ribosomal RNA gene obtained from vitreous after diagnostic vitrectomy. Conclusion This case shows that clinicians should be alert in patients with proteinuria and chorioretinitis as they can represent rare manifestations of syphilis. Syphilis should be in the differential diagnosis of any unknown symptom and in the presumed side effects of medication.

  13. Callosal agenesis, chorioretinal lacunae, absence of infantile spasms, and normal development: Aicardi syndrome without epilepsy?

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    Prats Viñas, Jose Maria; Martinez Gonzalez, María Jesús; Garcia Ribes, Ainhoa; Martinez Gonzalez, Sonia; Martinez Fernandez, Ricardo

    2005-06-01

    Aicardi syndrome is defined by the clinical triad of infantile spasms, agenesis of the corpus callosum, and pathognomonic chorioretinal lacunae. Almost all patients are females with severe cognitive and physical disabilities. All of the cases reported in the literature have had early-onset seizures. Most cases of Aicardi syndrome exhibit very slow development, even when seizures are eventually controlled, and the cases with a relatively favourable outcome are associated with low intelligence quotient levels. A relationship between chorioretinal changes or severity of the agenesis of the corpus callosum and prognosis of Aicardi syndrome has been claimed, but few data are available about the clinical features that can predict clinical outcome. We describe a case of Aicardi syndrome in a female aged 24 months. Magnetic resonance imaging showed complete agenesis of the corpus callosum and ophthalmoscopy revealed chorioretinal lacunae in the left eye. She had never had seizures and her psychomotor and language development were normal for age.

  14. A Focal Chorioretinal Bartonella Lesion Analyzed by Optical Coherence Tomography Angiography.

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    Pichi, Francesco; Srivastava, Sunil K; Levinson, Ashleigh; Baynes, Kimberly M; Traut, Caitlyn; Lowder, Careen Y

    2016-06-01

    Neovascularization may be associated with cat-scratch neuroretinitis in the absence of retinal vascular occlusion. Bartonella organisms establish an intimate relationship with the vascular endothelium, causing angioproliferative lesions, which might represent a dedicated pathogenic strategy for expanding the bacterial host cell habitat. In the eye, pathological angiogenesis caused by Bartonella has been described as peripapillary or macular choroidal neovascularization, but the presence of neovascularization within foci of chorioretinitis has never before been reported. The authors present a case of Bartonella chorioretinitis in which optical coherence tomography angiography, by detecting erythrocyte motion, was able to identify neovessels inside the infectious focus. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:585-588.].

  15. Chorioretinal dysplasia-microcephaly-mental retardation syndrome : Another family with autosomal dominant inheritance

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    Hordijk, R; VandeLogt, F; Houtman, WA; VanEssen, AJ

    1996-01-01

    We describe a boy and his father with the chorioretinal dysplasia-microcephaly-mental retardation syndrome (CDMMS). Our report extends the phenotypic spectrum of autosomal dominant CDMMS by describing microphthalmia for the first time in an autosomal dominant family. The boy was also severely mental

  16. Visualization of chorioretinal vasculature in mice in vivo using a combined OCT/SLO imaging system

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    Goswami, Mayank; Zhang, Pengfei; Pugh, Edward N.; Zawadzki, Robert J.

    2016-03-01

    Chorioretinal blood vessel morphology in mice is of great interest to researchers studying eye disease mechanisms in animal models. Two leading retinal imaging modalities -- Optical Coherence Tomography (OCT) and Scanning Laser Ophthalmoscopy (SLO) -- have offered much insight into vascular morphology and blood flow. OCT "flow-contrast" methods have provided detailed mapping of vascular morphology with micrometer depth resolution, while OCT Doppler methods have enabled the measurement of local flow velocities. SLO remains indispensable in studying blood leakage, microaneurysms, and the clearance time of contrast agents of different sizes. In this manuscript we present results obtained with a custom OCT/SLO system applied to visualize the chorioretinal vascular morphology of pigmented C57Bl/6J and albino nude (Nu/Nu) mice. Blood perfusion maps of choroidal vessels and choricapillaris created by OCT and SLO are presented, along with detailed evaluation of different OCT imaging parameters, including the use of the scattering contrast agent Intralipid. Future applications are discussed.

  17. [Role of immunological factors in peripheral vitreo-chorioretinal dystrophies and macular ruptures of the retina].

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    Balashova, L M; Saksonova, E O; Zaĭtseva, N S; Slepova, O S; Teplinskaia, L E; Il'nitskiĭ, V V; Grishin, V L

    1995-01-01

    The authors analyze the results of clinical and immunological examinations of patients with peripheral vitreo-chorioretinal dystrophies (PVCRD) and macular ruptures of the retina. No antibodies to S-AG were detected in the lacrimal fluid in 87.5% of patients with PVCRD without retinal defects. In patients with PVCRD with retinal defects antibodies to S-AG were detected in 70% of cases. These antibodies were absent in the patients with macular ruptures of the retina. In none of the patients were these antibodies detected in the blood serum. The levels of circulating immune complexes were normal in the patients PVCRD and increased in those with macular ruptures of the retina. These data permit a hypothesis on the development of local autoimmune reactions in PVCRD patients in response to the appearance of AG of the injured tissues.

  18. Severe acute syphilitic posterior placoid chorioretinitis with complete spontaneous resolution: The natural course

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    Franco, Mónica; Nogueira, Vanda

    2016-01-01

    Purpose: We report on a case of unilateral acute syphilitic posterior placoid chorioretinitis (ASPPC) with spontaneous resolution of the lesions, and discuss the role of an altered versus adequate immune response as the major pathogenic factor. Methods: We describe a case of acute loss of visual acuity (VA) in the left eye (LE) in a 55-year-old healthy man. Results: The patient presented with VA of 20/20 in the right eye (RE) and hand movements in the LE. Fundoscopy revealed a large yellowish placoid macular lesion with subretinal fluid in the LE, with no abnormalities detected in the RE. Fluorescein angiography showed early hypofluorescence with late staining in the affected area. The clinical findings progressed fast during the first week, with extension of the initial lesion outside the temporal retinal vascular arcades and the appearance of new lesions in the same eye. The patient abandoned the clinic for two weeks with no treatment. When observed again, VA of the LE had recovered to 20/20 and the lesions had completely resolved. Venereal disease research laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests results were positive and HIV antibody test titers negative. The diagnosis of ASPPC in the left eye was made. The patient accepted treatment with penicillin G only 45 days after the initial presentation. AV remained stable at 20/20 both eyes and no relapses of the lesions were observed during this period without therapy. The patient was followed for 3 months after treatment. He remained asymptomatic and the ophthalmic examination was unremarkable. Conclusions: The pathogenesis of ASPPC is still not understood. Our case showed a sequential pattern of the chorioretinal lesions, with initial aggravation and complete posterior spontaneous resolution, showing the natural course of the disease. These findings suggest the presence of an adequate ocular immune response in patients with ASPPC, not supporting the initially proposed

  19. Toxoplasmosis with chorioretinitis in an HIV-infected child with no visual complaints—importance of fundus examination

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    Pereira, Noella Maria Delia; Shah, Ira; Lala, Mamatha

    2017-01-01

    Central nervous system lesions are common in HIV-infected patients. In the combination anti-retroviral therapy (ART) era, Toxoplasma reactivation has been observed only in patients with unrecognized HIV infection or refusing therapy. We present the case of 10-year-old girl with AIDS who initially presented with pneumonia. She was treated for pneumonia and thereafter started on ART as her CD4 count was low. However, 5 days after starting ART she presented with left ptosis and right-sided monoparesis. She was diagnosed with neurotoxoplasmosis and responded successfully to pyrimethamine–sulfadoxine therapy. Though she had no vision difficulties, her fundus examination revealed chorioretinitis during the hospital stay. We emphasize the importance of routine fundus examination prior to starting ART to rule out chorioretinitis even in an older child with no visual complaints. PMID:28058107

  20. Zika virus infects cells lining the blood-retinal barrier and causes chorioretinal atrophy in mouse eyes

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    Singh, Pawan Kumar; Guest, John-Michael; Kanwar, Mamta; Gao, Nan; Juzych, Mark S.; Abrams, Gary W.; Yu, Fu-Shin

    2017-01-01

    Zika virus (ZIKV) is an important pathogen that causes not only neurologic, but also ocular, abnormalities. Thus, it is imperative that models to study ZIKV pathogenesis in the eye are developed to identify potential targets for interventions. Here, we studied ZIKV interactions with human retinal cells and evaluated ZIKV’s pathobiology in mouse eyes. We showed that cells lining the blood-retinal barrier (BRB), the retinal endothelium, and retinal pigment epithelium (RPE) were highly permissive and susceptible to ZIKV-induced cell death. Direct inoculation of ZIKV in eyes of adult C57BL/6 and IFN-stimulated gene 15 (ISG15) KO mice caused chorioretinal atrophy with RPE mottling, a common ocular manifestation of congenital ZIKV infection in humans. This response was associated with induced expression of multiple inflammatory and antiviral (IFNs) response genes in the infected mouse retina. Interestingly, ISG15 KO eyes exhibited severe chorioretinitis, which coincided with increased retinal cell death and higher ZIKV replication. Collectively, our study provides the first evidence to our knowledge that ZIKV causes retinal lesions and infects the cells lining the BRB and that ISG15 plays a role in retinal innate defense against ZIKV infection. Our mouse model can be used to study mechanisms underlying ZIKV-induced chorioretinitis and to gauge ocular antiviral therapies. PMID:28239662

  1. Progressive subretinal fibrosis and multifocal granulomatous chorioretinitis Fibrose sub-retiniana progressiva e corioretinite granulomatosa multifocal

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    Miguel Hage Amaro

    2006-06-01

    Full Text Available We describe a case of progressive subretinal fibrosis and multifocal chorioretinitis along with its findings on both fluorescein and indocyanine green angiography. The progressive subretinal fibrosis syndrome is a severe subset of multifocal choroiditis. The clustering of lesions around the nerve optic head may mean that the disease is spread through the flow in and out of the eye around the optic nerve.Descrevemos um caso de fibrose sub-retiniana progressiva e corrioretinite multifocal granulomatosa junto com os achados de angiografia fluoresceínica e com indocianina verde e propomos uma nova fisiopatologia para a fibrose em anel justa-papilar. A síndrome de fibrose sub-retiniana progressiva é uma doença grave, rara e constitui um subtipo grave da coroidite multifocal. As múltiplas lesões com fibrose circundando o disco óptico podem significar que a doença é oriunda do fluxo do líquido céfalo-raqueano, ao redor do nervo óptico.

  2. Ultrastructural changes of chorioretinal complex under sub-threshold laser exposure at wavelengths of 0.81 and 0.532 μm (experimental study

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    N. A. Fedoruk

    2014-01-01

    Full Text Available Aim: To reveal ultrastructural changes of chorioretinal complex and their possible reversibility under sub-threshold laser exposure at wavelengths of 0.81 and 0.532 μm in 1, 8 and 30 days. Methods: Experimental study was performed on 16 chinchilla rabbits (32 eyes using laser at wavelengths of 0.532 and 0.81 μm in CW, micropulse, and transpupillary thermotherapy modes. Transmission electron microscope EM-10C (Opton, Oberkochen, Germany was used to perform ultrastructural study of retina following laser exposure. Results: In a day after sub-threshold laser exposure, ultrastructural changes were mainly detected in retinal pigment epithelium (RPE, choriocapillaries, and photoreceptors. In 8 days, intracellular regeneration of RPE and partial restoration of choriocapillary blood flow and RPE macrophages were observed. In 30 days, RPE morphology, the number and the structure of photoreceptor outer segments were re-established. Mitochondria of photoreceptor inner segments regenerated as well. Conclusion: Ultrastructural changes of chorioretinal complex following sub-threshold laser radiation were reversible. Intracellular regeneration provided almost complete recovery of chorioretinal complex structure by day 30.

  3. Ultrastructural changes of chorioretinal complex under sub-threshold laser exposure at wavelengths of 0.81 and 0.532 μm (experimental study

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    N. A. Fedoruk

    2015-01-01

    Full Text Available Aim: To reveal ultrastructural changes of chorioretinal complex and their possible reversibility under sub-threshold laser exposure at wavelengths of 0.81 and 0.532 μm in 1, 8 and 30 days. Methods: Experimental study was performed on 16 chinchilla rabbits (32 eyes using laser at wavelengths of 0.532 and 0.81 μm in CW, micropulse, and transpupillary thermotherapy modes. Transmission electron microscope EM-10C (Opton, Oberkochen, Germany was used to perform ultrastructural study of retina following laser exposure. Results: In a day after sub-threshold laser exposure, ultrastructural changes were mainly detected in retinal pigment epithelium (RPE, choriocapillaries, and photoreceptors. In 8 days, intracellular regeneration of RPE and partial restoration of choriocapillary blood flow and RPE macrophages were observed. In 30 days, RPE morphology, the number and the structure of photoreceptor outer segments were re-established. Mitochondria of photoreceptor inner segments regenerated as well. Conclusion: Ultrastructural changes of chorioretinal complex following sub-threshold laser radiation were reversible. Intracellular regeneration provided almost complete recovery of chorioretinal complex structure by day 30.

  4. Spectral-Domain Optical Coherence Tomography Features of Acute Syphilitic Posterior Placoid Chorioretinitis: The Role of Autoimmune Response in Pathogenesis

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    Pedro Brito

    2011-01-01

    Full Text Available Purpose: Syphilis is an infectious disease that can cause a wide variety of ocular signs. One of the rarest manifestations of ocular syphilis is acute syphilitic posterior placoid chorioretinitis (ASPPC. We report on the spectral-domain optical coherence tomography (SD-OCT features of a case diagnosed with unilateral ASPPC. Methods: A 64-year-old man presented with a sudden loss of visual acuity (VA in the right eye. His only clinical sign was a large, geographic, yellow-white lesion centered on the right fovea. Our patient was studied with SD-OCT on presentation and during follow-up, as well as with fluorescein and indocyanine green angiography, electrophysiological study, and serologic and autoimmune screening. Results: Laboratory workup revealed positive serology for active syphilis and elevated anti-beta2 glycoprotein I antibodies. SD-OCT showed a marked distortion of both the choroidal and outer retinal architecture. After treatment, best-corrected VA improved to 20/25. Pattern electroretinography displayed a severe reduction of P50 amplitude, which improved in late follow-up. Six months after presentation, VA was 20/25 and anti-beta2 glycoprotein I antibodies returned to normal levels. Conclusions: Our findings are compatible with immunologically mediated temporary physiological impairment of the neuroretina, since the changes seen by SD-OCT could not have normalized if they were due to anatomical injury. The results of our study provide clues to understanding the pathogenesis of this disease and allow us to define a characteristic temporal sequence of events in ASPPC.

  5. Molecular response of chorioretinal endothelial cells to complement injury: implications for macular degeneration.

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    Zeng, Shemin; Whitmore, S Scott; Sohn, Elliott H; Riker, Megan J; Wiley, Luke A; Scheetz, Todd E; Stone, Edwin M; Tucker, Budd A; Mullins, Robert F

    2016-02-01

    Age-related macular degeneration (AMD) is a common, blinding disease of the elderly in which macular photoreceptor cells, retinal pigment epithelium and choriocapillaris endothelial cells ultimately degenerate. Recent studies have found that degeneration of the choriocapillaris occurs early in this disease and that endothelial cell drop-out is concomitant with increased deposition of the complement membrane attack complex (MAC) at the choroidal endothelium. However, the impact of MAC injury to choroidal endothelial cells is poorly understood. To model this event in vitro, and to study the downstream consequences of MAC injury, endothelial cells were exposed to complement from human serum, compared to heat-inactivated serum, which lacks complement components. Cells exposed to complement components in human serum showed increased labelling with antibodies directed against the MAC, time- and dose-dependent cell death, as assessed by lactate dehydrogenase assay and increased permeability. RNA-Seq analysis following complement injury revealed increased expression of genes associated with angiogenesis including matrix metalloproteinase (MMP)-3 and -9, and VEGF-A. The MAC-induced increase in MMP9 RNA expression was validated using C5-depleted serum compared to C5-reconstituted serum. Increased levels of MMP9 were also established, using western blot and zymography. These data suggest that, in addition to cell lysis, complement attack on choroidal endothelial cells promotes an angiogenic phenotype in surviving cells.

  6. Toksoplasmose-chorioretinitis: klinisk forløb og behandling af syv patienter

    DEFF Research Database (Denmark)

    Lebech, A M; Lebech, M; Børme, K K

    1996-01-01

    Toxoplasmosis is a major and preventable cause of severe visual loss and blindness in young people. Ocular toxoplasmosis is the leading cause of posterior uveitis and in most cases it represents a late manifestation of a congenital infection. The clinical picture and anti-Toxoplasma therapy...

  7. Optical imaging of the chorioretinal vasculature in the living human eye.

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    Kim, Dae Yu; Fingler, Jeff; Zawadzki, Robert J; Park, Susanna S; Morse, Lawrence S; Schwartz, Daniel M; Fraser, Scott E; Werner, John S

    2013-08-27

    Detailed visualization of microvascular changes in the human retina is clinically limited by the capabilities of angiography imaging, a 2D fundus photograph that requires an intravenous injection of fluorescent dye. Whereas current angiography methods enable visualization of some retinal capillary detail, they do not adequately reveal the choriocapillaris or other microvascular features beneath the retina. We have developed a noninvasive microvascular imaging technique called phase-variance optical coherence tomography (pvOCT), which identifies vasculature three dimensionally through analysis of data acquired with OCT systems. The pvOCT imaging method is not only capable of generating capillary perfusion maps for the retina, but it can also use the 3D capabilities to segment the data in depth to isolate vasculature in different layers of the retina and choroid. This paper demonstrates some of the capabilities of pvOCT imaging of the anterior layers of choroidal vasculature of a healthy normal eye as well as of eyes with geographic atrophy (GA) secondary to age-related macular degeneration. The pvOCT data presented permit digital segmentation to produce 2D depth-resolved images of the retinal vasculature, the choriocapillaris, and the vessels in Sattler's and Haller's layers. Comparisons are presented between en face projections of pvOCT data within the superficial choroid and clinical angiography images for regions of GA. Abnormalities and vascular dropout observed within the choriocapillaris for pvOCT are compared with regional GA progression. The capability of pvOCT imaging of the microvasculature of the choriocapillaris and the anterior choroidal vasculature has the potential to become a unique tool to evaluate therapies and understand the underlying mechanisms of age-related macular degeneration progression.

  8. MFGE8 does not influence chorio-retinal homeostasis or choroidal neovascularization in vivo.

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    William Raoul

    Full Text Available PURPOSE: Milk fat globule-epidermal growth factor-factor VIII (MFGE8 is necessary for diurnal outer segment phagocytosis and promotes VEGF-dependent neovascularization. The prevalence of two single nucleotide polymorphisms (SNP in MFGE8 was studied in two exsudative or "wet" Age-related Macular Degeneration (AMD groups and two corresponding control groups. We studied the effect of MFGE8 deficiency on retinal homeostasis with age and on choroidal neovascularization (CNV in mice. METHODS: The distribution of the SNP (rs4945 and rs1878326 of MFGE8 was analyzed in two groups of patients with "wet" AMD and their age-matched controls from Germany and France. MFGE8-expressing cells were identified in Mfge8(+/- mice expressing ß-galactosidase. Aged Mfge8(+/- and Mfge8(-/- mice were studied by funduscopy, histology, electron microscopy, scanning electron microscopy of vascular corrosion casts of the choroid, and after laser-induced CNV. RESULTS: rs1878326 was associated with AMD in the French and German group. The Mfge8 promoter is highly active in photoreceptors but not in retinal pigment epithelium cells. Mfge8(-/- mice did not differ from controls in terms of fundus appearance, photoreceptor cell layers, choroidal architecture or laser-induced CNV. In contrast, the Bruch's membrane (BM was slightly but significantly thicker in Mfge8(-/- mice as compared to controls. CONCLUSIONS: Despite a reproducible minor increase of rs1878326 in AMD patients and a very modest increase in BM in Mfge8(-/- mice, our data suggests that MFGE8 dysfunction does not play a critical role in the pathogenesis of AMD.

  9. Assessment of the effect of intravitreal triamcinolone acetonide on the chorioretinal and vitreous inflammatory reaction to cryotherapy in rabbits

    Directory of Open Access Journals (Sweden)

    Eugênio Santana de Figueirêdo

    2012-10-01

    Full Text Available PURPOSE: To evaluate the inflammatory response in the choroid, retina and vitreous in rabbit eyes underwent cryotherapy followed by intravitreal triamcinolone acetonide and to compare with those underwent cryotherapy followed by intravitreal injection of saline solution. METHODS: This is a prospective case-control study. Surgical procedures were performed in eleven rabbits. Two animals were excluded because they did not complete the postoperative period or had intraoperative or postoperative complications. All rabbits underwent superior temporal peritomy and transscleralcryotherapy in both eyes. After cryotherapy, animals received intravitreal injection of triamcinolone acetonide in one eye and saline solution in the fellow eye. Animals were sacrificed seven days after the procedure and their eyes were enucleated. Histological sections of eyeballs were prepared and the vitreous humor was aspirated. The count of inflammatory cells was performed by light microscopy. RESULTS: Histological sections of both eyes of nine rabbits were analyzed. Inflammatory cells were found only in the choroid. There was no statistically significant difference in the number of inflammatory cells between the two groups, regardless of cell type analyzed. CONCLUSION: This study showed no statistically significant difference between the use or absence of intravitreal triamcinolone acetonide in the inflammatory response to cryotherapy in rabbit eyes. Studies with larger samples are needed to confirm the trend of this paper.

  10. Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

    Science.gov (United States)

    Itokawa, Takashi; Hori, Yuichi

    2017-01-01

    Purpose. To determine the correlations among the mean blur rate (MBR) in the optic nerve head (ONH) shown by laser speckle flowgraphy (LSFG), retinal arteriosclerosis, and the circulation time obtained by fluorescein angiography (FA). Method. We evaluated 118 patients and assessed their time of choroidal flush, arm-to-retina time, and early and late phases of retinal circulation time (RT: sec) obtained by FA. The severity of retinal arteriosclerosis was classified according to the Scheie classification. The MBR values throughout the ONH (MBR-A), in the tissue (MBR-T), and in the vessels (MBR-V) were analyzed. Results. Patients with retinal vein occlusion (RVO) showed prolonged early and late phases of RT compared to other ocular diseases. Single and multiple regression analyses showed that the MBR-V and Scheie classification were significantly associated with both the choroidal flush and arm-to-retina times. The incidences of RVO and MVR-V were significantly associated with the early phase of RT, and the incidences of RVO, MBR-V, Scheie classification, and gender were revealed to be factors independently contributing to the late phase of RT. Conclusion. MBR-V in the ONH and retinal arteriosclerosis are important contributing factors for the circulation time of each stage obtained by FA.

  11. Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

    Directory of Open Access Journals (Sweden)

    Hironori Osamura

    2017-01-01

    Full Text Available Purpose. To determine the correlations among the mean blur rate (MBR in the optic nerve head (ONH shown by laser speckle flowgraphy (LSFG, retinal arteriosclerosis, and the circulation time obtained by fluorescein angiography (FA. Method. We evaluated 118 patients and assessed their time of choroidal flush, arm-to-retina time, and early and late phases of retinal circulation time (RT: sec obtained by FA. The severity of retinal arteriosclerosis was classified according to the Scheie classification. The MBR values throughout the ONH (MBR-A, in the tissue (MBR-T, and in the vessels (MBR-V were analyzed. Results. Patients with retinal vein occlusion (RVO showed prolonged early and late phases of RT compared to other ocular diseases. Single and multiple regression analyses showed that the MBR-V and Scheie classification were significantly associated with both the choroidal flush and arm-to-retina times. The incidences of RVO and MVR-V were significantly associated with the early phase of RT, and the incidences of RVO, MBR-V, Scheie classification, and gender were revealed to be factors independently contributing to the late phase of RT. Conclusion. MBR-V in the ONH and retinal arteriosclerosis are important contributing factors for the circulation time of each stage obtained by FA.

  12. Uveitis

    Science.gov (United States)

    Iritis; Pars planitis; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis; Iridocyclitis ... Uveitis can be caused by autoimmune disorders . These diseases occur when the body's immune system attacks and ...

  13. Fundus Photographic, Fluorescein Angiographic Signs in Successful Laser Chorioretinal Venous Anastomosis for Retinal Vein Occlusion%建立激光诱导络网膜静脉吻合的视网膜静脉阻塞眼及其眼底血管荧光造影表现

    Institute of Scientific and Technical Information of China (English)

    温晓霞; 张帆; 刘哲丽; 吴景天

    2002-01-01

    目的:描述成功建立脉络膜视网膜静脉吻合的视网膜静脉阻塞(retinal vein oclusion,RVO)眼的眼底改变和眼底血管荧光造影特征.方法:氪红激光诱导脉络膜视网膜静脉吻合术后,患者每1~2周复查一次,每次随诊均拍摄彩色眼底照片,并做荧光素眼底血管造影(fundusfluorescein angiography,FFA)检查,选取成功形成脉络膜视网膜静脉吻合的25例RVO 25眼,分析成功形成吻合的RVO眼的眼底及FFA特征.结果:1吻合成功的眼底征象:治疗部位的视网膜静脉下沉入脉络膜,吻合近端静脉段变细,主干静脉变狭窄,静脉逆向变粗,吻合近端静脉段变粗,吻合部位形成静脉袢.2吻合成功的FFA征象:①吻合局部团状高荧光;②视盘和吻合之间出现的逆向静脉血流;③静脉层流缺损.结论:激光诱导脉络膜视网膜静脉吻合可回流部分静脉血液,缓解阻塞静脉的压力.

  14. Protozoan Infections

    Science.gov (United States)

    1989-01-01

    cooked meat of infected animals, especially sheep and pigs. Toxoplasma infects one-third to one-half of normal humans by age 40, but causes...Toxoplasma in the first trimester, 30-50 per cent deliver an obviously affected infant. Congenital infection is associated with hydrocephalus...chorioretinitis, hepatosplenomegaly, and rash. In survivors, mental retardation, deaf- ness, and cardiac malformations may be noted. Chorioretinitis may also

  15. [Influence of genetic mutations on clinical presentation of subretinal neovascularization. Report 1: The impact of CFH and IL-8 genes polymorphism].

    Science.gov (United States)

    Budzinskaia, M V; Pogoda, T V; Generozov, É V; Chikun, E A; Shchegoleva, I V; Kazarian, É É; Galoian, N S

    2011-01-01

    Genetic analysis was performed in patients with subretinal neovascularization (CNV). The results showed significant association of CFH (compliment factor H) gene polymorphism with increase (rs1061170, rs514943 and rs380390) or decrease (rs529825, rs7524776, rs1831281, rs2274700, rs1576340, rs12144939, rs7540032) of CNV development risk. The incidence of IL-8 gene mutation was significantly (p = 0.008) higher in patients after chorioretinitis. Apparently -125 > A polymorphism in patients with chorioretinitis increases risk of CNV development, thus promoting raise of proangiogenic factors concentration in eyes with inflammatory background. The clinical presentation in patients with AMD and myopic disease associated with (-125) A mutation of promoter region of IL-8 gene was similar to that of patients with chorioretinitis. The features are the following: focal pattern, no drusen and RPE detachment, predominantly classic form of CNV (without occult pattern), formation of well-organized newly developed vessels.

  16. [Congenital toxoplasmosis with ocular involvment--case report].

    Science.gov (United States)

    Constantin, Farah; Denislam, Dogan

    2014-01-01

    Two thirds of the congenital toxoplasmosis cases describe minimal or inapparent symptoms present at birth, being diagnosed from a psychomotor retard. The forms of chorioretinitis may be described by repeated outbursts in the first years of life. Chorioretinitis or focal necrotizing retinitis usually develops in a bilateral way, being progressive and leading to blindness. Usually there is only one focal inflammatory beginning at the edge of a pigmented scar and the local inflammatory process may extend through successive spikes in other regions of the retina. Active chorioretinitis is expressed clinically by a blurred misty eyesight, with the advent of scotomas, photophobia, and if the macula is involved, the loss of the central eyesight may occur. In this paper I present the patient R.A., 6 years old from Constanta who is hospitalized in the Clinic of Infectious Diseases for investigations and treatment continuity because positive IgG Toxoplasma was previously found. The child has spastic quadriplegia and profound mental retardation.

  17. Aicardi syndrome: Neonatal diagnosis by means of transfontanellar ultrasound

    Institute of Scientific and Technical Information of China (English)

    Claudio; Rodrigues; Pires; Edward; Araujo; Júnior; Adriano; Czapkowski; Sebasti?o; Marques; Zanforlin; Filho

    2014-01-01

    Aicardi syndrome is a rare genetic disease characterized by a characteristic classical trio of neurological clinical abnormalities(spasms),agenesis of the corpus callosum and ophthalmological abnormalities(chorioretinal lacunae).The diagnosis can be suspected by prenatal ultrasound with color Doppler identifying the agenesis of the corpus callosum.Usually,the diagnosis is confirmed in the neonate period by transfontanellar ultrasound and ophthalmological examination.We present a case of newborn with Aicardi syndrome,being the transfontanellar identified partial dysgenesis of the corpus callosum and a cyst in the inter-hemispheric fissure.Ophthalmological examination showed bilateral chorioretinal lacunae.

  18. Clinical applications of choroidal imaging technologies

    Directory of Open Access Journals (Sweden)

    Jay Chhablani

    2015-01-01

    Full Text Available Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.

  19. Can chemoprophylaxis against opportunistic infections be discontinued after an increase in CD4 cells induced by highly active antiretroviral therapy?

    DEFF Research Database (Denmark)

    Kirk, O; Lundgren, Jens Dilling; Pedersen, C;

    1999-01-01

    /100 PY follow-up (95% confidence interval, 0.0-3.2). No cases of cerebral toxoplasmosis, cytomegalovirus chorioretinitis, or disseminated Mycobacterium avium infection were observed. Follow-up time for these was, however, limited. CONCLUSION: PCP-chemoprophylaxis can be safely discontinued after HAART...

  20. Primary toxoplasmosis with critical illness and multi-organ failure in an immunocompetent young man.

    Science.gov (United States)

    Undseth, Øystein; Gerlyng, Per; Goplen, Anne K; Holter, Ellen S; von der Lippe, Elisabeth; Dunlop, Oona

    2014-01-01

    An immunocompetent young man became critically ill with multi-organ failure due to primary toxoplasmosis. Although treated successfully, he relapsed after 1 y with bilateral toxoplasmic chorioretinitis. Severe disseminated toxoplasmosis rarely occurs in immunocompetent patients and may reflect an increased risk of relapse. Secondary prophylaxis must be considered.

  1. Refractory seizures with global developmental delay: A rare cause

    Directory of Open Access Journals (Sweden)

    P N Vinoth

    2011-01-01

    Full Text Available Aicardi syndrome is a genetic disorder characterized by the triad of infantile spasm in flexion, callosal agenesis and ocular abnormalities (chorioretinal lacunae, coloboma of optic disc. We report a typical case of Aicardi syndrome with all the classical features.

  2. Ultrawide-field fundus photography of the first reported case of gyrate atrophy from Australia.

    Science.gov (United States)

    Moloney, Thomas P; O'Hagan, Stephen; Lee, Lawrence

    2014-01-01

    Gyrate atrophy of the choroid and retina is a rare chorioretinal dystrophy inherited in an autosomal recessive pattern. We describe the first documented case of gyrate atrophy from Australia in a 56-year-old woman with a history of previous diagnosis of retinitis pigmentosa and worsening night vision in her right eye over several years. She was myopic and bilaterally pseudophakic, and fundus examination revealed pale optic discs and extensive peripheral chorioretinal atrophy exposing bare sclera bilaterally with only small islands of normal-appearing retina at each posterior pole. Visual field testing showed grossly constricted fields, blood testing showed hyperornithinemia, and further questioning revealed consanguinity between the patient's parents. We then used the patient's typical retinal findings of gyrate atrophy to demonstrate the potential use of ultrawide-field fundus photography and angiography in diagnosis and monitoring response in future treatment.

  3. Fibrose sub-retiniana progressiva e corioretinite granulomatosa multifocal

    OpenAIRE

    Miguel Hage Amaro; Cristina Muccioli; Mario Martins dos Santos Motta

    2006-01-01

    We describe a case of progressive subretinal fibrosis and multifocal chorioretinitis along with its findings on both fluorescein and indocyanine green angiography. The progressive subretinal fibrosis syndrome is a severe subset of multifocal choroiditis. The clustering of lesions around the nerve optic head may mean that the disease is spread through the flow in and out of the eye around the optic nerve.Descrevemos um caso de fibrose sub-retiniana progressiva e corrioretinite multifocal granu...

  4. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...... diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion...

  5. Acute Papillitis in Young Female with Toxoplasmosis

    OpenAIRE

    Rakhshandeh Alipanahi; Sima Sayyahmelli

    2011-01-01

    Papillitis and complicating acute toxoplasma retinochoroiditis, are unusual and atypical features of toxoplasmosis. This report presents a female with unusual acute papillitis. This patient had an active toxoplasmic chorioretinitis lesion that appeared to involve the optic nerve head and a major blood vessel as well as central nervous systems (CNS). Papillitis may be secondary to juxtapapillary retinitis (Jensen choroiditis). Very rarely, the optic nerve head may be the primary site of involv...

  6. Advanced drug delivery and targeting technologies for the ocular diseases

    OpenAIRE

    Barar, Jaleh; AGHANEJAD, Ayuob; Fathi, Marziyeh; Omidi, Yadollah

    2016-01-01

    Introduction: Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis...

  7. Solar energy research at Sandia Laboratories and its effects on health and safety

    Energy Technology Data Exchange (ETDEWEB)

    Young, L.L. III

    1977-10-01

    Various solar energy research and development projects at Sandia Laboratories are discussed with emphasis on the primary health and safety hazard associated with solar concentration systems. This limiting hazard is chorioretinal damage. The unique safety and health hazards associated with solar energy collector and receiver systems cannot be measured yet, but progress is being made rapidly. Research is continuing, especially for eye hazards, with more extensive work planned.

  8. Smoking and Age-Related Macular Degeneration: Review and Update

    Science.gov (United States)

    Velilla, Sara; García-Medina, José Javier; García-Layana, Alfredo; Pons-Vázquez, Sheila; Pinazo-Durán, M. Dolores; Gómez-Ulla, Francisco; Arévalo, J. Fernando; Díaz-Llopis, Manuel; Gallego-Pinazo, Roberto

    2013-01-01

    Age-related macular degeneration (AMD) is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health. PMID:24368940

  9. Smoking and Age-Related Macular Degeneration: Review and Update

    Directory of Open Access Journals (Sweden)

    Sara Velilla

    2013-01-01

    Full Text Available Age-related macular degeneration (AMD is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health.

  10. Retinal imaging in the twenty-first century: state of the art and future directions.

    Science.gov (United States)

    Keane, Pearse A; Sadda, Srinivas R

    2014-12-01

    Assessment of chorioretinal disease is dependent on the ability to visualize pathologic changes occurring in the posterior segment of the eye using optical instruments, termed ophthalmoscopy. Ophthalmoscopy, in turn, has been enhanced greatly by the development of techniques that allow recording of these changes, termed retinal imaging. As well as documenting pathologic features, retinal and fundal imaging facilitates the identification of morphologic features not visible to the clinician on biomicroscopy. As such, advances in retinal imaging have proven fundamental to many paradigm shifts in our understanding and treatment of ocular disease. In the 1950s, with the advent of electronic flashes and 35-mm cameras, the field of modern fundus photography was born. Similarly, in the 1960s and 1970s, the introduction of fluorescein and indocyanine green angiography revolutionized our ability to assess the integrity of the chorioretinal vasculature. More recently, in the 1990s, the introduction of a wholly new form of noninvasive cross-sectional imaging, optical coherence tomography, has greatly facilitated use of emerging pharmacotherapies in diagnosing and monitoring chorioretinal disease. In this translational science review, we provide an overview of current, state-of-the-art retinal imaging technologies, as well as highlight many emerging imaging technologies that we believe are likely to transform the provision of eye care in the 21st century.

  11. Pars plana cicatrization of sewn-in posterior chamber intraocular lens haptics.

    Science.gov (United States)

    McDermott, M L; Puklin, J E

    1997-03-01

    The authors describe the unexpected finding of cicatrization of posterior chamber lens haptics to the pars plana. This was found during removal of a secondary, transscleral sewn-in pseudophakos during a retinal reattachment procedure. Ophthalmic history and intraoperative photography revealed pars plana cicatrization of haptics. Despite removal of trans-scleral prolene fixation sutures and application of gentle traction, the posterior chamber lens haptics remained firmly adherent to pars plana retina. The haptics were amputated to prevent significant chorioretinal damage. The conventional belief that all sewn-in posterior chamber intraocular lenses cause little or no scarring response around the haptics may be unfounded.

  12. The advent of Cytomegalovirus infection in HIV infected patients: A review

    Directory of Open Access Journals (Sweden)

    Sundar Isaac Kirubakaran

    2004-03-01

    Full Text Available Cytomegalovirus is considered as one among the long list of latent infections in humans that although normally controlled by the cellular immune response, gets activated after HIV infection takes its role on infecting the T4 lymphocytes. Clinical disease due to Cytomegalovirus has been recognized in up to 40% of patients with advanced HIV disease. The clinical syndromes most commonly associated include chorioretinitis, esophagitis, colitis, pneumonitis, adrenalitis and neurological disorders. Cytomegalovirus infections are usually diagnosed clinically and by serological tests for CMV immunoglobulin. Chemotherapy using systemic agents, including ganciclovir, intravenous foscarnet and intravenous cidofovir is effective. New agents, as for example an anti-sense agent against cytomegalovirus, appear promising.

  13. Aicardi syndrome: a case report and radiologic findings; Sindrome de Aicardi: relato de caso e achados radiologicos

    Energy Technology Data Exchange (ETDEWEB)

    Granzotto, Enrico; Prado, Cecilia Hissae Miyake Almeida; Barros, Andre Della Barba; Botter, Carlos Eduardo [Clinica Radiologica Documenta Ltda., Ribeirao Preto, SP (Brazil)]. E-mail: gram79@gmail.com; Mendes, Rozana de Miranda [Santa Casa de Ribeirao Preto, SP (Brazil); Granzotto, Ticiana [Curso de Especializacao em Oftalmologia Professor Ivo Correa Meyer de Porto Alegre, RS (Brazil)

    2008-07-01

    The authors report the findings of Aicardi syndrome, a disease of unknown etiology composed of multiple spasms, chorioretinal lacunae and agenesis of the corpus callosum. They present a case of Aicardi syndrome with characteristic clinical presentation and magnetic resonance imaging findings. The disease, despite being considered rare, has characteristic imaging findings. Over the past years magnetic resonance imaging has improved its ability in demonstrating other findings besides agenesis of the corpus callosum, making the radiologist's role very important in the diagnostic suspicion of this disease. (author)

  14. Acute Papillitis in Young Female with Toxoplasmosis

    Science.gov (United States)

    Alipanahi, Rakhshandeh; Sayyahmelli, Sima

    2011-01-01

    Papillitis and complicating acute toxoplasma retinochoroiditis, are unusual and atypical features of toxoplasmosis. This report presents a female with unusual acute papillitis. This patient had an active toxoplasmic chorioretinitis lesion that appeared to involve the optic nerve head and a major blood vessel as well as central nervous systems (CNS). Papillitis may be secondary to juxtapapillary retinitis (Jensen choroiditis). Very rarely, the optic nerve head may be the primary site of involvement. This case report illustrates a rare presentation of acute papillitis in a young immunocompetent female. PMID:21887084

  15. Acute papillitis in young female with toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Rakhshandeh Alipanahi

    2011-01-01

    Full Text Available Papillitis and complicating acute toxoplasma retinochoroiditis, are unusual and atypical features of toxoplasmosis. This report presents a female with unusual acute papillitis. This patient had an active toxoplasmic chorioretinitis lesion that appeared to involve the optic nerve head and a major blood vessel as well as central nervous systems (CNS. Papillitis may be secondary to juxtapapillary retinitis (Jensen choroiditis. Very rarely, the optic nerve head may be the primary site of involvement. This case report illustrates a rare presentation of acute papillitis in a young immunocompetent female.

  16. Can chemoprophylaxis against opportunistic infections be discontinued after an increase in CD4 cells induced by highly active antiretroviral therapy?

    DEFF Research Database (Denmark)

    Kirk, O; Lundgren, Jens Dilling; Pedersen, C;

    1999-01-01

    BACKGROUND: In the 'USPHS/IDSA Guidelines for Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus', the indications for chemoprophylaxis are based on nadir CD4 cell count. Many patients have, however, experienced an increase in CD4 cell count after....../100 PY follow-up (95% confidence interval, 0.0-3.2). No cases of cerebral toxoplasmosis, cytomegalovirus chorioretinitis, or disseminated Mycobacterium avium infection were observed. Follow-up time for these was, however, limited. CONCLUSION: PCP-chemoprophylaxis can be safely discontinued after HAART...

  17. Pneumatic retinopexy.

    Science.gov (United States)

    Tornambe, P E

    1988-01-01

    Pneumatic retinopexy, a term introduced by Hilton in 1985, describes a recently revised and modified operation used for primary rhegmatogenous retinal reattachment. A gas bubble is injected into the vitreous cavity and the patient positioned so that the bubble closes the retinal break, permitting resorption of subretinal fluid. A chorioretinal adhesion formed around the break secures the retina in place. The history of pneumatic retinopexy is presented as well as recent studies on the subject. Characteristics of intraocular gases are reviewed. A protocol is described for pneumatic repair of complex retinal detachments. Patient selection and surgical techniques are recommended. Pneumatic retinopexy is compared to other retinal reattachment techniques and controversial issues are discussed.

  18. Isolated posterior uveal effusion: expanding the spectrum of the uveal effusion syndrome

    Directory of Open Access Journals (Sweden)

    Pautler SE

    2014-12-01

    Full Text Available Scott E Pautler,1 David J Browning2 1Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA; 2Charlotte Ear Eye Nose and Throat Associates, Charlotte, NC, USA Abstract: Uveal effusion syndrome usually causes peripheral chorioretinal detachment, but posterior effusion may present as isolated macular edema with serous macular detachment in the setting of hyperopia and a thickened posterior choroid. Carbonic anhydrase inhibitors may be effective to treat this condition. Keywords: uveal effusion, serous, macular detachment, macular edema

  19. Gyrate atrophy of choroid and retina with myopia, cataract and systemic proximal myopathy: A rare case report from rural India

    Directory of Open Access Journals (Sweden)

    Surekha Bangal

    2012-12-01

    Full Text Available AbstractGyrate atrophy is a rare metabolic disease with autosomal recessive inheritance pattern characterised by hyperornithinemia and typical ocular findings. This report presents a 17-year-old intellectually challenged girl consulting for a progressive fall of visual acuity with night blindness. Fundus examination showed patches of chorioretinal atrophy with typical scalloped borders and peri vascular pigmentation in the equatorial region. Fundus fluroscein angiography revealed characteristic staining pattern. Other ocular associations included myopia and posterior sub capsular cataract. Progressive systemic proximal myopathy was one of the associated features. Dietary supplementation of vitamin B6 was advised.

  20. Intraocular nematode with diffuse unilateral subacute neuroretinitis: case report

    Directory of Open Access Journals (Sweden)

    Zakariah Sakinah

    2011-06-01

    Full Text Available Abstract Background Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue. Case presentation A 26-year old man presented with painless reduced vision of the left eye for one week duration. It was associated with floaters. Visual acuity on the left eye was hand movement. Anterior segment examination was normal with normal intra-ocular pressure. Fundus examination showed a live nematode lying subretinally at the macular area with macular oedema and multifocal chorioretinal lesions at peripheral retina. There was no vitritis, vasculitis or any retinal hemorrhage. Systemic examination revealed normal findings and laboratory studies only showed leucocytosis with normal eosinophil count and negative serum toxocara antibody. The diagnosis of introcular nematode with diffuse unilateral subacute neuroretinitis was made. He was treated with oral anti-helminths and a course of oral steroid at a reducing dose. The nematode had died evidenced by its immobility during the treatment and finally disintegrated, leaving macular oedema with mottling appearance and mild hyperpigmentation. Multifocal chorioretinal lesions had also resolved. However despite treatment his visual acuity during follow-up had remained poor. Conclusions Cases of intraocular nematode, though not commonly encountered, continue to present the ophthalmologist with the problem of diagnosis and management and hence poorer prognosis to the patient.

  1. Clinical course of focal choroidal excavation in Vogt–Koyanagi–Harada disease

    Directory of Open Access Journals (Sweden)

    Nishikawa Y

    2014-12-01

    Full Text Available Yuko Nishikawa,1–3,* Kaoru Fujinami,1,2,4,5,* Ken Watanabe,1,2 Toru Noda,1,2 Kazushige Tsunoda,1,2 Kunihiko Akiyama1,2 1Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; 2Laboratory of Visual Physiology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan; 3Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan; 4Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 5UCL Institute of Ophthalmology, London, UK*These authors contributed equally to this workAbstract: We describe focal choroidal excavation (FCE in a case of Vogt–Koyanagi–Harada (VKH disease and compare the findings with different chorioretinal conditions. A 55-year-old man was diagnosed with VKH based on panuveitis and exudative retinal detachments. Spectral-domain optical coherence tomography demonstrated a dome-shaped protrusion with a nonconforming pattern at the fovea, which had been detected as a conforming pattern 1 year before the onset. The FCE pattern returned into a conforming pattern following corticosteroid therapy. These findings suggest that the natively existent FCE could be affected by pathophysiological changes of VKH as well as other chorioretinal conditions.Keywords: choroidal excavation, focal choroidal excavation, Vogt–Koyanagi–Harada disease, optical coherence tomography

  2. Microcephaly-chorioretinopathy syndrome, autosomal recessive form. A case report

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    Full Text Available CONTEXT: The autosomal recessive form of microcephaly-chorioretinopathy syndrome is a rare genetic condition that is considered to be an important differential diagnosis with congenital toxoplasmosis.CASE REPORT: Our patient was a seven-year-old white boy who was initially diagnosed with congenital toxoplasmosis. However, his serological tests for congenital infections, including toxoplasmosis, were negative. He was the first child of young, healthy and consanguineous parents (fourth-degree relatives. The parents had normal head circumferences and intelligence. The patient presented microcephaly and specific abnormalities of the retina, with multiple diffuse oval areas of pigmentation and patches of chorioretinal atrophy associated with diffuse pigmentation of the fundus. Ophthalmological evaluations on the parents were normal. A computed tomography scan of the child's head showed slight dilation of lateral ventricles and basal cisterns without evidence of calcifications. We did not find any lymphedema in his hands and feet. He had postnatal growth retardation, severe mental retardation and cerebral palsy.CONCLUSIONS: The finding of chorioretinal lesions in a child with microcephaly should raise suspicions of the autosomal recessive form of microcephaly-chorioretinopathy syndrome, especially in cases with an atypical pattern of eye fundus and consanguinity. A specific diagnosis is essential for an appropriate clinical evaluation and for genetic counseling for the patients and their families.

  3. TOXOPLASMOSIS DALAM KEHAMILAN

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    Sri Wahyuni

    2013-09-01

    Full Text Available ABSTRACT. Toxoplasmosis is one zoonosis caused by toxoplasmosis gondii that can infected pets and human.Infection in woman pregnant, frequently asymptomatic. While impact at this disease woman pregnant for herpregnancy, specially at third trimester pregnant were hidrocephalus, chorioretinitis, deaf or epilepsi.Toxoplasmosis is a disease caused by toxoplasma gondii, transmitted to human by eating food under cooked,infected meat or handling soil or cat feces that contain the parasite. The route of infection in to human by aquiredor congenital variation impact of congenital toxoplasmosis were chorioretinitis, hydrocephalus, intracranialcalcificatio. Laboratorys tests are very important of clinical sign is asymtomatic. Test that commonly usedmoreanti toxoplasma Ig G, Ig M, Ig A and Aviditas Anti Toxoplasma. Primmary and secondary prevention is important.Treatment to toxoplasmosis with spiramycine is effective. Toxoplasmosis infection prevention could be done byavoid risk factor of toxoplasmosis ie not eating raw specially undercooked meat, not contact with animal'sinfected. Toxoplasmosis treatment in pregnancy is needed include abortion and antibiotic support to infant couldbe done according to discussion from doctor, patients and her husband.Key words: Toxoplasmosis, pregnancy

  4. Ultrawide-field fundus photography of the first reported case of gyrate atrophy from Australia

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    Moloney TP

    2014-08-01

    Full Text Available Thomas P Moloney,1 Stephen O’Hagan,1 Lawrence Lee2,3 1Department of Ophthalmology, Cairns Hospital, Cairns, QLD, Australia; 2City Eye Centre, Brisbane, QLD, Australia; 3Associate Professor of Ophthalmology, School of Medicine, University of Queensland, Brisbane, QLD, Australia Abstract: Gyrate atrophy of the choroid and retina is a rare chorioretinal dystrophy inherited in an autosomal recessive pattern. We describe the first documented case of gyrate atrophy from Australia in a 56-year-old woman with a history of previous diagnosis of retinitis pigmentosa and worsening night vision in her right eye over several years. She was myopic and bilaterally pseudophakic, and fundus examination revealed pale optic discs and extensive peripheral chorioretinal atrophy exposing bare sclera bilaterally with only small islands of normal-appearing retina at each posterior pole. Visual field testing showed grossly constricted fields, blood testing showed hyperornithinemia, and further questioning revealed consanguinity between the patient’s parents. We then used the patient’s typical retinal findings of gyrate atrophy to demonstrate the potential use of ultrawide-field fundus photography and angiography in diagnosis and monitoring response in future treatment. Keywords: gyrate atrophy, ultrawide-field retinal photography, angiography, retinal photography, hyperornithinemia

  5. Transscleral diode laser retinopexy in retinal reattachment surgery Retinopexia com laser de diodo transescleral na cirurgia de descolamento de retina

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    João Carlos de Miranda Gonçalves

    2004-02-01

    Full Text Available PURPOSE: Transscleral diode retinal photocoagulation (diopexy is becoming an accepted technique in the treatment of selected retinal diseases. The objective of this study is to evaluate diopexy technique in the production of adhesive chorioretinal lesions during the surgical treatment of the rhegmatogenous retinal detachment. METHODS: 25 patients with rhegmatogenous retinal detachment were enrolled in a prospective clinical-surgical study to evaluate the technique of transscleral diode laser photocoagulation to obtain adhesive chorioretinal lesions during retinal reattachment surgery. The surgery consisted of the placement of an exoplant silicon to produce a buckle effect combined with a drainage of subretinal fluid in most cases. RESULTS: By a mean follow-up of 10 months, 21 of 25 eyes had their retinas reattached after only one surgery with diopexy used in all cases. CONCLUSION: Transscleral diode laser photocoagulation was a technically easy, controlled, effective, reproducible and safe means of obtaining chorioretinal adhesion in retinal reattachment surgery.OBJETIVO: Fotocoagulação transescleral com laser de diodo (diopexia está se tornando técnica utilizada no tratamento de algumas doenças retinianas. O objetivo deste estudo é avaliar a técnica de diopexia na produção de lesões coriorretinianas aderentes durante o tratamento cirúrgico do descolamento de retina regmatogênico. MÉTODOS: Vinte e cinco pacientes com descolamento de retina regmatogênico participaram deste estudo clínico-cirúrgico prospectivo para avaliar a técnica de fotocoagulação com laser de diodo transescleral para obter lesões coriorretinianas aderentes durante a cirurgia de descolamento de retina. A cirurgia consistiu de colocação de explante de silicone para produzir efeito de introflexão escleral combinado com drenagem do líquido subretiniano na maioria dos casos. RESULTADOS: Após um período médio de seguimento de 10 meses, em 21 dos 25 olhos

  6. Ocular histoplasmosis syndrome.

    Science.gov (United States)

    Diaz, Rocio I; Sigler, Eric J; Rafieetary, Mohammad R; Calzada, Jorge I

    2015-01-01

    Ocular histoplasmosis syndrome (OHS) is a chorioretinal disorder with a distinct fundus appearance that is commonly found in regions endemic for Histoplasma capsulatum. Choroidal neovascularization (CNV) secondary to OHS is considered one of the principal causes of central vision loss among young adults in endemic areas. Although there is no consensus regarding its pathogenesis, evidence points to Histoplasma capsulatum as the most probable etiology. Once considered an intractable hemorrhagic maculopathy, CNVs are now treatable. Extrafoveal CNVs are successfully treated with laser photocoagulation. Subfoveal and juxtafoveal CNVs are managed with anti-vascular endothelial growth factor therapy, photodynamic therapy, or a combination of both. Modern imaging technologies such as spectral-domain optical coherence tomography have improved our diagnostic abilities, making it easier to monitor disease activity and CNV regression. We review the epidemiology, pathogenesis, clinical manifestations, differential diagnosis, and current treatment of this disease.

  7. Choroidal Neovascular Membrane Formation and Retinochoroidopathy in a Patient with Systemic Langerhans Cell Histiocytosis: A Case Report and Review of the Literature

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    Aristomenis Thanos

    2012-04-01

    Full Text Available We report a case of bilateral atrophic retinochoroidopathy with choroidal neovascular membrane (CNVM formation in a patient with systemic Langerhans cell histiocytosis (LCH. A 35-year-old female, diagnosed with LCH at the age of 3, experienced an episode of acute vision loss in her right eye. Visual acuity was counting fingers. Dilated fundus exam and fluorescein angiography revealed the presence of CNVM along with bilateral widespread areas of chorioretinal atrophy. The patient underwent removal of CNVM with excellent postoperative visual acuity (20/25; however, indolent progression of her disease led to gradual deterioration of visual acuity (20/80 in the right eye and 20/320 in the left. This case shows that in contrast to previous reports, intraocular involvement of LCH does not need to be dramatic and clinically evident but it can acquire a chronic degenerative form. This report aims to raise awareness among ophthalmologists concerning the potential intraocular sequelae of LCH.

  8. [Candida infiltrations in the iris and lens during iritis and situation after sepsis].

    Science.gov (United States)

    Kuerten, D; Fuest, M; Mazinani, B; Walter, P; Plange, N

    2017-01-31

    Intraocular Candida infections are overall rather rare; nevertheless they are often found as endogenous infections after Candida sepsis and can be sight-threatening. The most common manifestations are either a sole chorioretinitis or an endophthalmitis. Here we report the case of a 35-year-old man developing Candida infiltrations in the lens capsule and behind the iris after corticosteroid treatment of a presumed HLA-B27-positive iritis. The patient suffered from a life-threatening intensive care stay with positive Candida blood cultures earlier after intestinal perforation. With systemic intracameral and topical voriconazole, the infection was successfully treated. In patients with positive blood samples for Candida, topical and systemic corticosteroids should be given with care even months after the last positive blood cultures.

  9. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

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    Escott S

    2013-02-01

    Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

  10. Seroepidemiology and risk assessment of Toxoplasma gondii infection in captive wild birds and mammals in two zoos in the North of Portugal.

    Science.gov (United States)

    Tidy, Ana; Fangueiro, Sara; Dubey, Jitender P; Cardoso, Luís; Lopes, Ana Patrícia

    2017-02-15

    Toxoplasmosis, caused by the protozoan Toxoplasma gondii, is one of the most widespread zoonoses in the world. It can affect most warm-blooded animals but only felids are its definitive hosts. We determined seroprevalence and associated risk factors in birds and mammals kept in two zoological parks in northern Portugal. Sera from 77 birds and 42 mammals were assayed for the presence of T. gondii antibodies by the modified agglutination test (MAT, cut-off titre 20); 34.5% (41/119) were seropositive. All seropositive animals were apparently healthy except one seropostive mandarin (Aix galericulata) which had chorioretinitis. This is the first report on T. gondii seroprevalence in wild animals in captivity in Portugal. The present findings indicate a widespread exposure of zoo animals in Portugal to T. gondii.

  11. Acetazolamide for cystoid macular oedema in Bietti crystalline retinal dystrophy.

    Science.gov (United States)

    Broadhead, Geoffrey K; Chang, Andrew A

    2014-04-01

    Bietti crystalline retinal dystrophy is a rare, inherited disorder whose hallmark is the presence of retinal crystal deposits associated with later chorioretinal degeneration. This condition may rarely be complicated by the development of cystoid macular oedema leading to rapid visual decline. Currently, treatment options for this complication of Bietti dystrophy are limited and the visual prognosis is poor. Here, we present a case of cystoid macular oedema associated with Bietti dystrophy that was successfully diagnosed using multimodal imaging techniques including optical coherence tomography and fluorescein angiography. These modalities confirmed the diagnosis of macular oedema and excluded other possible causes of oedema such as choroidal neovascularisation. In this patient, cystoid macular oedema was resolved with oral acetazolamide therapy, a treatment that has not been previously reported in this context. Acetazolamide treatment resulted in oedema resolution and improvement in visual function, and can be considered a therapeutic option for other patients with Bietti dystrophy who develop cystoid macular oedema.

  12. Bietti crystalline corneoretinal dystrophy associated with CYP4V2 gene mutations.

    Science.gov (United States)

    Nakamura, Makoto; Lin, Jian; Nishiguchi, Koji; Kondo, Mineo; Sugita, Jiro; Miyake, Yozo

    2006-01-01

    Bietti crystalline corneoretinal dystrophy (BCD) is an autosomal recessive chorioretinal dystrophy characterized by progressive night blindness, tiny, yellowish, glistening retinal crystals, choroidal sclerosis, and crystalline deposits in the peripheral cornea. Recent studies have demonstrated that the CYP4V2 gene which encodes a CYP450 family protein is the causative gene of the disease. We have identified a homozygous mutation in the CYP4V2 gene in 8 separate Japanese patients with BCD and conclude that mutations in the CYP4V2 gene are the major cause of BCD. The IVS6-8_c.810del/insGC mutation is found at a higher frequency in the Asian populations suggesting a founder effect.

  13. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids.

  14. Sex and Reproduction in the Transmission of Infectious Uveitis

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    Janet L. Davis

    2014-01-01

    Full Text Available Current data permit only speculations regarding sex differences in the prevalence of infectious uveitis between women and men because uveitis case surveys do not uniformly report gender data. Differences in prevalence that are reported in the literature could relate to simple differences in the number of women and men at risk for infection or to biological differences between men and women. Compared to other types of uveitis, infectious uveitis may be directly related to occupational exposures or sexual behaviors, which differ between women and men, and may mask actual biological differences in susceptibility to ocular manifestations of the infection and its prognosis. In infectious uveitis for which there is no element of sexual transmission and data is available, prevalence of ocular disease is roughly equal between women and men. Women also have a unique relationship with infectious uveitis in their role as mothers. Vertical transmission of infections such as herpes simplex, toxoplasmosis, and cytomegalovirus can produce severe chorioretinitis in neonates.

  15. Varicella infection and toxoplasmosis in pregnancy.

    Science.gov (United States)

    Grant, A

    1996-09-01

    Varicella occurring in pregnancy can be dangerous for the fetus, the mother, and the newborn. The fetus may experience multiple system damage. The mother and newborn are at increased risk for varicella pneumonia with a 9% and 20% fatality rate, respectively. The recent introduction of the varicella vaccine will affect the occurrence of gestational infection. Toxoplasmosis is rarely dangerous for the pregnant woman, yet the fetus and newborn may be at risk for chorioretinitis, hydrocephalus, intracranial calcifications, and convulsions. The greatest challenge in the management of toxoplasmosis in pregnancy is diagnosis of the asymptomatic newborn before damage occurs. Strategies to prevent toxoplasmosis should be taught to every pregnant woman as part of parental care.

  16. Ocular hemodynamics in patients with rhegmatogenous retinal detachment

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    N. H. Zavgorodnya

    2014-10-01

    Full Text Available Aim. In case of retinal detachment atrophic processes lead to irreversible loss of functions within 4–6 days, it happens on underlying low ocular blood flow. In order to evaluate the degree of violation of regional hemodynamics in patients with retinal detachment two groups of patients were examined: the main group (52 patients with rhegmatogenous retinal detachment and the control group (24 myopic patients with lattice form of peripheral chorioretinal dystrophy. Methods and results. Doppler and reography results had been compared, significant decrease of blood flow in patients with retinal detachment was found. No differences between affected and fellow eye in these patients, close negative correlation between the level of ocular blood flow and the degree of myopia in the control group. Conclusion. This demonstrates the feasibility of actions to improve regional blood flow in patients operated on for retinal detachment.

  17. Severe ocular sequelae of congenital toxoplasmosis: huge macular scar.

    Science.gov (United States)

    Zahir, Fadoua; Abdellaoui, Meriem; Younes, Samar; Benatiya, Idriss A; Tahri, Hicham

    2015-01-01

    Retinochoroiditis is the most common ocular manifestation of congenital toxoplasmosis, but other associated ophthalmological pathologies can also occur. Ophthalmologists are rarely able to distinguish between toxoplasmic retinochoroiditis due to infection acquired before or after birth, unless other clinical or serological indications are present. This article reports a case of a 3-year-old boy with abnormalities suggestive of congenital toxoplasmosis. The clinical and complementary examinations are discussed. The education of pregnant women is crucial for the prevention of congenital toxoplasmosis. Awareness of antenatal and postnatal presenting signs and symptoms is important for clinicians, because early diagnosis and treatment may minimize sequelae. Untreated, the majority of affected infants will develop chorioretinitis, deafness and/or neurological symptoms.

  18. [Ophthalmic manifestations of toxoplasmosis in a human immunodeficiency virus-positive patient. Description of a case].

    Science.gov (United States)

    Hermida Pérez, J A; Bermejo Hernandez, Á; Sobenes Gutierrez, R

    2014-03-01

    Toxoplasmosis is an infection of worldwide distribution caused by Toxoplasma gondii, and infects a large proportion of the world population. Only under certain circumstances of severe immunosuppression can the parasite reactivate and cause disease. The most common form of presentation of this pathology in patients with positive HIV is the brain abscess. One of the extra-cerebral forms is toxoplasmic chorioretinitis, which could lead to a chronic active form of a slowly progressive retinitis. Diagnosis is made by observing the eye fundus and confirmed by the scarring obtained after specific treatment. We report a case of a patient with diabetes and positive HIV, in whom a toxoplasmic scar injury was detected in the annual retinography follow-up. A conservative therapeutic approach was decided, with regular check-ups for possible detection of disease activation.

  19. Síndrome de Aicardi: relato de caso Aicardi syndrome: case report

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    José Alexandre Bastos

    2001-06-01

    Full Text Available Relatamos um caso de síndrome de Aicardi completa em criança do sexo feminino de 2 meses de idade com defeitos lacunares da coróide, espasmos em flexão, agenesia de corpo caloso e alterações eletrencefalográficas do tipo hipsarritmia assimétrica e alterna atendida no Serviço de Neuropediatria e Neurofisiologia clínica do Hospital de Base de São José do Rio Preto, SP .We report a case of Aicardi syndrome in a female child with 2 month old, ocular abnormalities "chorioretinal lacunae", flexion in spasms, hipsarrhythmic "split brain", callosal agenesis refered to Service of Neuropediatric and Neurophysiology of Base Hospital of São José do Rio Preto, SP, Brazil.

  20. Aicardi syndrome: A report of five Indian cases

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    Banerjee T

    2006-01-01

    Full Text Available Five Indian cases of Aicardi syndrome, aged 1-13 years and all with the classic triad of infantile spasm, corpus callosal agenesis and chorioretinal lacunae, were presented. The purpose of this report was to demonstrate the clinical, electroencephalographic (EEG and radiological spectrum and the treatment outcome of this disorder among the Indians. None of the patient had any family history of similar illness. All had profound psychomotor impairment with no meaningful speech development. There were microphthalmia in 2, optic disc coloboma in 1, interhemispheric cyst in 1, periventricular heterotopia in 2 and thoracolumbar kyphoscoliosis in 2 cases. They all had early onset epilepsy and there were multiple types of seizures. Two cases (40% had the characteristic dissociated burst-suppression pattern in EEG. Two cases whose antiepileptic medications included vigabatrin had complete control of seizure.

  1. A Case with Microphthalmia and Multiple Congenital Anomalies

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    Ayça Sarı

    2013-12-01

    Full Text Available We present a 7-month-old girl with bilateral microphthalmia, sclerocornea, iris and chorioretinal coloboma, blepharophimosis and dacryostenosis. Microphthalmia is one of the most common features in many syndromes as Micro syndrome, oculodentodigital dysplasia, oculofaciocardiodental syndrome, and Lenz microphthalmia syndrome. Our patient’s clinical features also involved microcephaly, cleft palate, developmental delay, digital and urogenital anomalies, cardiac septal defects and hearing loss, which diagnosis is mostly consistent with the Lenz microphthalmia syndrome. Lenz microphthalmia syndrome is a very rare conditions and their expressions are more often in countries with high rates of consanguineous marriages. Hence, recognizing such rare syndromes in patients with multiple congenital anomalies is essential. (Turk J Ophthalmol 2013; 43: 468-70

  2. Current and emerging treatment options for myopic choroidal neovascularization

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    El Matri L

    2015-04-01

    Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

  3. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...... diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion...... of patients who developed particular diseases changed with calendar time. Most striking was a three to fourfold decrease in diseases caused by cytomegalovirus. In conclusion, the study showed that disease frequencies in patients with AIDS may vary with the patients risk behaviour and duration of AIDS...

  4. Ophthalmomyiasis interna anterior in a dog: keratotomy and extraction of a Cuterebra sp. larva.

    Science.gov (United States)

    Edelmann, Michele L; Lucio-Forster, Araceli; Kern, Thomas J; Bowman, Dwight D; Ledbetter, Eric C

    2014-11-01

    A 1-year-old female spayed mixed-breed dog was presented for evaluation of acute onset of lethargy and blepharospasm OD. Slit-lamp biomicroscopy revealed a segmented larva embedded in the inferonasal iris. Moderate anterior uveitis was present. After pharmacologic dilation, mild vitreal hemorrhage and chorioretinal migration tracks were identified. The dog was treated empirically for uveitis for 5 days, after which a keratotomy and larval foreign body extraction was performed. The dog recovered uneventfully from intraocular surgery and remained visual and comfortable. Parasite evaluation confirmed the larva to be a Cuterebra sp. To the authors' knowledge, this is the first report of canine ophthalmomyiasis interna anterior, and the first report of successful surgical removal from the anterior segment in a dog with preservation of vision.

  5. Cataract Surgery after Retinal Detachment Surgery with Arruga’s Suture: Case Report

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    Erkan Ünsal

    2016-12-01

    Full Text Available A 56-year old female patient presented to our clinic with a complaint of low vision in her right eye. Twenty-two years earlier she had undergone a scleral buckling operation in her right eye because of retinal detachment. She indicated that vision in her right eye was good after the surgery but had recently been gradually declining. Best-corrected vision acuity was counting fingers at 1 meter in the right eye and 8/10 in the left eye. Anterior segment examination revealed stage 3 nuclear cataract in the right eye. Examination of the right eye was blurred and revealed an area of chorioretinal atrophy posterior to the equator, approximately 3 disc diameters in the peripapillary zone and about 2 disc diameters in the nasal papilla zone. Anteriorly of the equator there was an area of chorioretinal atrophy as well as a narrow, sharply demarcated, shiny 360⁰ suture with high buckling pressure, situated intraretinally but extending into the vitreous in some places. The structure was thought to be made of polyethylene. Around the suture there were retinal atrophic changes. After detailed explanation of the possible surgical complications and after obtaining informed consent, the right eye cataract was removed by phacoemulsification and a foldable intraocular lens was placed into the capsule. During the operation, we worked under low fluid pressure and as atraumatically as possible due to the possibility of intraocular pressure changes and the risk of the suture causing retinal and blood vessel tears or passing completely into the eye and causing intravitreal hemorrhage. A month after an uncomplicated surgery, the posterior segment examination demonstrated a reattached retina and the patient’s best corrected visual acuity was 6/10.

  6. [Congenital toxoplasmosis: clinical manifestation, treatment and follow-up] [Article in Italian] • Il neonato con toxoplasmosi congenita: clinica, terapia e follow-up

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    Lina Bollani

    2014-01-01

    Full Text Available Toxoplamosis is a parasitic zoonosis which occurs worldwide, but is prevalent in Europe, South America and Africa. When infection occurs for the first time during pregnancy, mother to child transmission of the parasite can cause congenital toxoplasmosis. Rate of congenital infection ranges from less than 0.1 to approximately 1 per 1,000 live births. The risk of transmission depends on the gestational age at the time of maternal infection. A diagnosis of congenital toxoplasmosis is usually considered in infants who present: hydrocephalus, chorioretinitis, and intracranial calcifications, but this triade is very rare. Approximately 85% of the infants with congenital toxoplasmosis are clinically normal at birth; however, sequelae of infection may become apparent only months or even years later. Chorioretinitis is the main complication of congenital toxoplasmosis, late onset retinal lesions and relapse can appear many years after birth, but the overall ocular prognosis is satisfactory when infection is identified and treated accordingly. Fortunately, serious neonatal forms and severe neurological impairment have become rare, but prompt treatment of children with convulsions, abnormal muscle tone, hydrocephalus, may improve the prognosis and result in almost normal outcome. For infants who have congenital toxoplasmosis, treatment soon after birth for 1 year with pyrimetamine, sulfadiazine and leukoverin led to remarkable resolution of serious, active disease. A long follow-up is necessary to assess the long-term outcome of children and young adults with congenital toxoplasmosis, that is favourable for the majority of cases. Epidemiological surveillance needs to be improved in order to determine the effectiveness of prevention programs.Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013Guest Editor: Roberto Antonucci

  7. Roturas retinianas em retinocoroidite por toxoplasmose: série de casos Retinal tears in toxoplasmic retinochoroiditis: case series

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    Daniel da Rocha Lucena

    2009-12-01

    Full Text Available Trata-se de série retrospectiva de 10 pacientes com rotura retiniana e retinocoroidite por toxoplasmose atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, de janeiro de 2007 a abril de 2008, com objetivo de avaliar a relação entre lesões de retinocoroidite e a ocorrência de rotura retiniana. Foram utilizados teste de Fisher e qui-quadrado com nível de significância pThis study is a retrospective case series aiming to evaluate the relation between toxoplasmic retinochoroiditis scars and the occurrence of retinal tears. Ten patients with retinal tear and toxoplasmic retinochoroiditis examined at the School of Medicine of Ribeirão Preto Clinics Hospital, between January 2007 and April 2008, were included. Fisher test and qui-square test with significance level of p<0.05 were used. Eight cases (80% had retinal detachment. Twelve tears were found and localized mostly in the temporal superior periphery (6 cases, 50%. No statistically significant association between retinal tear and chorioretinal scar localization was observed considering five retinal quadrants (p=0.0828 or three zones (p=0.2507. The occurrence of retinal tears in patients with uveitis may be related to early posterior vitreous detachment caused by the intraocular inflammatory process. No correlation was observed between the localization of retinal tears and chorioretinal scars in this study, which suggests a causative factor not directly related to the presence of a scar.

  8. Cyr61 induces the expression of monocyte chemoattractant protein-1 via the integrin ανβ3, FAK, PI3K/Akt, and NF-κB pathways in retinal vascular endothelial cells.

    Science.gov (United States)

    You, Jian-Jang; Yang, Chang-Hao; Yang, Chung-May; Chen, Muh-Shy

    2014-01-01

    Diabetes causes a number of metabolic and physiological abnormalities in the retina. Many of the molecular and physiological abnormalities that develop during diabetic retinopathy are due to inflammation. Monocyte chemoattractant protein-1 (MCP-1) is an important factor involved in diabetic retinopathy. In a previous study, we found that cysteine-rich 61 (Cyr61), an important angiogenic factor, also plays an important role in diabetic retinopathy. In addition to the direct effects of Cyr61, we observed that Cyr61 can induce the expression of MCP-1. However, the mechanism through which this occurs is not completely understood in chorioretinal vascular endothelial cells. We therefore investigated the effects of Cyr61 on MCP-1 expression in this cell type. Cyr61 stimulated the expression of MCP-1 at the mRNA, protein, and secreted protein levels in a dose-dependent and time-dependent manner. Both total MCP-1 levels and secreted MCP-1 levels were attenuated during the response to Cyr61 stimulation by pretreatment with integrin ανβ3-blocking antibodies, a FAK inhibitor (PF573228), a PI3K inhibitor (LY294002), and an Akt inhibitor (A6730). Electrophoretic mobility shift assays revealed that the above inhibitors suppressed the activation of NF-κB. Additionally, deletion of the NF-κB-binding element in the MCP-1 gene promoter led to a decrease in expression in luciferase reporter assays. These results show that the induction of MCP-1 by Cyr61 is mediated through the activation of the integrin ανβ3, FAK, PI3K/Akt, and IKK/NF-κB pathways in chorioretinal vascular endothelial cells.

  9. Homozygosity mapping and whole exome sequencing reveal a novel homozygous COL18A1 mutation causing Knobloch syndrome.

    Directory of Open Access Journals (Sweden)

    Alireza Haghighi

    Full Text Available The aim of this study was to identify the genetic basis of a chorioretinal dystrophy with high myopia of unknown origin in a child of a consanguineous marriage. The proband and ten family members of Iranian ancestry participated in this study. Linkage analysis was carried out with DNA samples of the proband and her parents by using the Human SNP Array 6.0. Whole exome sequencing (WES was performed with the patients' DNA. Specific sequence alterations within the homozygous regions identified by whole exome sequencing were verified by Sanger sequencing. Upon genetic analysis, a novel homozygous frameshift mutation was found in exon 42 of the COL18A1 gene in the patient. Both parents were heterozygous for this sequence variation. Mutations in COL18A1 are known to cause Knobloch syndrome (KS. Retrospective analysis of clinical records of the patient revealed surgical removal of a meningocele present at birth. The clinical features shown by our patient were typical of KS with the exception of chorioretinal degeneration which is a rare manifestation. This is the first case of KS reported in a family of Iranian ancestry. We identified a novel disease-causing (deletion mutation in the COL18A1 gene leading to a frameshift and premature stop codon in the last exon. The mutation was not present in SNP databases and was also not found in 192 control individuals. Its localization within the endostatin domain implicates a functional relevance of endostatin in KS. A combined approach of linkage analysis and WES led to a rapid identification of the disease-causing mutation even though the clinical description was not completely clear at the beginning.

  10. Serological IgG avidity test for ocular toxoplasmosis

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    Suresh S

    2012-01-01

    Full Text Available Subramaniam Suresh1, Saidin Nor-Masniwati1, Muhd Nor Nor-Idahriani1, Wan-Hitam Wan-Hazabbah1, Mohamed Zeehaida2, Embong Zunaina11Department of Ophthalmology, 2Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaBackground: The purpose of this study was to evaluate the immunoglobulin (Ig G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis.Methods: A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed.Results: A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6–83 years. Seventy-one patients (54.6% were found to be seropositive, of whom five (3.8% were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis while one (0.8% showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis and 65 patients (50.0% showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection. Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036. Eighteen patients (13.8% were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing.Conclusion: Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.Keywords: ocular toxoplasmosis, chorioretinal scar, toxoplasmosis antibody, IgG avidity test

  11. Intermediate uveitis, posterior uveitis, and panuveitis in the Mid-Atlantic USA

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    Engelhard SB

    2015-08-01

    Full Text Available Stephanie B Engelhard, Vandan Patel, Ashvini K Reddy Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA Background: The purpose of this study was to identify the causes, clinical features, and outcomes of intermediate uveitis, posterior uveitis, and panuveitis in patients managed in a mid-Atlantic tertiary care center.Methods: This was a retrospective observational study of intermediate uveitis, posterior uveitis, and panuveitis patients seen at the University of Virginia from 1984 to 2014. Results: One hundred and fifty-nine intermediate uveitis, posterior uveitis, and panuveitis patients (237 eyes were identified. The patient population was 54.72% female; 67.30% of patients were Caucasian, and 22.01% were African–American. Mean age at diagnosis was 45.5 years. Mean duration of follow-up was 3.95 years. Mean number of visits to the clinic was 10.35. Of 491 uveitis patients, 26 (5.30% had intermediate uveitis, 62 (12.60% had posterior uveitis, and 71 (14.50% had panuveitis. The leading diagnoses in the intermediate uveitis group were pars planitis (73.08% and sarcoidosis (11.54%; toxoplasma uveitis (17.74%, multifocal choroiditis (14.52%, undifferentiated posterior uveitis (14.52%, and birdshot chorioretinitis (11.29% in the posterior uveitis group; and undifferentiated panuveitis (29.58%, post-surgical panuveitis (18.31%, sarcoidosis (12.68%, acute retinal necrosis (12.68%, and toxoplasma uveitis (4.23% in the panuveitis group. The most common treatment modalities included local steroids (57.23% and systemic steroids (42.14%. Ocular hypertension was found in 38 patients (23.90%. Glaucoma surgery was performed in 18.24% of patients and cataract surgery in 21.38%. Mean best-corrected visual acuity was 0.66 logMAR at baseline across all anatomical locations and 0.57 logMAR at final follow-up. Best-corrected visual acuity improved or remained stable during follow-up in all groups. Conclusion: The most common diagnoses

  12. Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment.

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    Kuhn, Ferenc; Aylward, Bill

    2014-01-01

    chorioretinal scar around the tear and aided by some form of intraocular tamponade. The main function of the tamponade is not to temporarily cover the break but to significantly reduce the intraocular currents and thus prevent fluid entry through the break until the chorioretinal adhesion will have become sufficiently strong to seal the retinal edge around the tear; postoperative positioning is therefore not as important as currently assumed.

  13. Current possibilities of chorioretinites diagnostics

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    O. V. Chudinova

    2014-07-01

    Full Text Available Purpose: to study the morphometric changes in retina and the state of regional hemodynamics for chorioretinites of different etiology, to draw parallels between these methods of study with evaluation of their diagnostical significance.Methods: Clinical and instrumental examination was performed in 15 patients (15 eyes — group 1 — with the verified diagnosis of toxoplasmous chorioretinitis and in 13 patients (13 eyes — group 2 — with the diagnosis of tuberculous chorioretinitis. Control (group 3 consisted of 20 subjects (40 eyes, 9 males, 11 females, without any pathology of organ of vision. Complex ophthalmologic examination was performed in all the patients; the examination included the following procedures: determination of visual acuity with correction, computer perimetry, biomicroscopy of eye fundus, inspection of eye fundus using Goldman lens, optic coherent tomogra- phy (OCt, ultrasound Dopplerography (USDG of eye vessels.Results: the following was determined by OCt data: subclinical serous retinal detachment, isolated cells of cyst-like edema, cyst- like edema in macular zone, unevenness of hyperreflective band of pigment epithelium, thinning of neurosensory retina in the area of scarry focus, hyperreflectivity of the zone of the fibrosis being formed, architectonics disorder of NE layers in foveolar zone and para- foveally at the expense of the presence of small hyperreflective parts. In the presence of proliferative process in the vascular coat the reliable decrease of blood flow maximal and minimal velocities in the posterior short ciliary arteries, maximal and minimal velocities of blood flow in the posterior long ciliary arteries in comparison with the values of patients from control group. the data obtained are supposed that proliferative processes in the vascular coat are accompanied by marked local hemodynamic disorders, which should be taken into consideration when complex therapy is prescribed.Conclusion: Dynamic

  14. Mucous membrane grafting for the post-Steven-Johnson syndrome symblepharon: A case report

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    Jayanta Kumar Das

    2011-01-01

    Full Text Available An 18-year-old woman was referred with late sequelae of chloroquine-induced Steven-Johnson syndrome. At the time of presentation, the symblepharon was involving the upper lids to almost the whole of the cornea, and part of the lower bulbar conjunctiva with the lower lid bilaterally. Other ocular examinations were not possible due to the symblepharon. B-scan ultrasonography revealed acoustically clear vitreous, normal chorioretinal thickness, and normal optic nerve head, with an attached retina. Conjunctivo-corneal adhesion released by superficial lamellar dissection of the cornea. Ocular surface reconstruction was carried out with a buccal mucous membrane. A bandage contact lens was placed over the cornea followed by the symblepharon ring to prevent further adhesion. The mucosal graft was well taken up along with corneal re-epithelization. Best corrected visual acuity of 20/120 in both sides after 1 month and 20/80 after 3 months was achieved and maintained till the 2.5-year follow-up.

  15. Don’t Forget What You Can’t See: A Case of Ocular Syphilis

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    Lee, Monica I.; Lee, Annie W.C.; Sumsion, Sean M.; Gorchynski, Julie A.

    2016-01-01

    This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss. PMID:27429702

  16. Don’t Forget What You Can’t See: A Case of Ocular Syphilis

    Directory of Open Access Journals (Sweden)

    Monica I. Lee

    2016-06-01

    Full Text Available This case describes an emergency department (ED presentation of ocular syphilis in a human immunodeficiency virus (HIV infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM. This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss.[West J Emerg Med. 2016;17(4:473-476.

  17. Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection

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    Camila V. Ventura

    2016-02-01

    Full Text Available ABSTRACT Purpose: In 2015, a twenty-fold increase in the prevalence of microcephaly in Brazil was reported, and the Ministry of Health associated this abnormal prevalence with the maternal-fetal Zika virus (ZIKV transmission. Methods: We assessed the ophthalmological findings of ten mothers and their infants that had been clinically diagnosed with ZIKV-related microcephaly and presented ocular abnormalities, born from May to December 2015. Results: Seven mothers (70.0% referred symptoms during pregnancy (malaise, rash and arthralgia, of which six (85.7% were in the first trimester. At the time of exam, no ophthalmological abnormalities were identified in the mothers and they did not report ocular symptoms during pregnancy. Serology was negative in all infants for Toxoplasmosis, Rubella, Cytomegalovirus, Syphilis and Human Immunodeficiency Viruses. Ocular findings included macular alterations (gross pigment mottling and/or chorioretinal atrophy in fifteen eyes (75.0%, and optic nerve abnormalities (hypoplasia with double-ring sign, pallor, and/or increased cup-to-disk ratio in nine eyes (45.0%. Conclusions: Patients presented normal anterior segment and important macular and optic nerve abnormalities. Further studies will assess the visual significance of these alterations.

  18. Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction

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    Moschos, Marilita M; Nitoda, Eirini

    2016-01-01

    Aim The aim of this review was to summarize the ocular action of the most common phosphodiesterase (PDE) inhibitors used for the treatment of erectile dysfunction and the subsequent visual disorders. Method This is a literature review of several important articles focusing on the pathophysiology of visual disorders induced by PDE inhibitors. Results PDE inhibitors have been associated with ocular side effects, including changes in color vision and light perception, blurred vision, transient alterations in electroretinogram (ERG), conjunctival hyperemia, ocular pain, and photophobia. Sildenafil and tadalafil may induce reversible increase in intraocular pressure and be involved in the development of non-arteritic ischemic optic neuropathy. Reversible idiopathic serous macular detachment, central serous chorioretinopathy, and ERG disturbances have been related to the significant impact of sildenafil and tadalafil on retinal perfusion. Discussion So far, PDE inhibitors do not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors. However, physicians should write down any visual symptom observed during PDE treatment and refer the patients to ophthalmologists. PMID:27799745

  19. Bilateral vision loss in a captive cheetah (Acinonyx jubatus).

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    Walser-Reinhardt, Ladina; Wernick, Morena B; Hatt, Jean-Michel; Spiess, Bernhard M

    2010-09-01

    The following case report describes a 1-year-old female cheetah (Acinonyx jubatus) with bilateral blindness and unresponsive pupils. For comparison, a second healthy 2.5-year-old male cheetah without visual deficits was also examined. Clinical examination of both animals included biomicroscopy, indirect ophthalmoscopy, tonometry, and electroretinography. The young female cheetah showed no menace response, no direct or indirect pupillary light reflex, and no dazzle reflex in either eye. Fundus lesions, as detected by indirect ophthalmoscopy, are described for the female animal. In both eyes, the fundus color was green/turquoise/yellow with multiple hyperpigmented linear lesions in the tapetal area around the optic nerve. The optic nerve head was dark gray and about half the normal size suggesting bilateral optic nerve hypoplasia and retinal dysplasia or differentially optic nerve atrophy and chorioretinal scarring. The ERG had low amplitudes in the right eye but appeared normal in the left eye compared with the male cheetah. Blood levels did not suggest current taurine deficiency. This is addressed to some degree in the discussion. Bilateral optic nerve hypoplasia or optic nerve atrophy is a rare anomaly in cats and has not yet been described in a cheetah.

  20. Compound heterozygous PNPLA6 mutations cause Boucher-Neuhäuser syndrome with late-onset ataxia.

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    Deik, A; Johannes, B; Rucker, J C; Sánchez, E; Brodie, S E; Deegan, E; Landy, K; Kajiwara, Y; Scelsa, S; Saunders-Pullman, R; Paisán-Ruiz, C

    2014-12-01

    PNPLA6 mutations, known to be associated with the development of motor neuron phenotypes, have recently been identified in families with Boucher-Neuhäuser syndrome. Boucher-Neuhäuser is a rare autosomal recessive syndrome characterized by the co-occurrence of cerebellar ataxia, hypogonadotropic hypogonadism, and chorioretinal dystrophy. Gait ataxia in Boucher-Neuhäuser usually manifests before early adulthood, although onset in the third or fourth decade has also been reported. However, given the recent identification of PNPLA6 mutations as the cause of this condition, the determining factors of age of symptom onset still need to be established. Here, we have identified a sporadic Boucher-Neuhäuser case with late-onset gait ataxia and relatively milder retinal changes due to compound heterozygous PNPLA6 mutations. Compound heterozygosity was confirmed by cloning and sequencing the patient's genomic DNA from coding exons 26-29. Furthermore, both mutations (one novel and one known) fell in the phospholipase esterase domain, where most pathogenic mutations seem to cluster. Taken together, we herein confirm PNPLA6 mutations as the leading cause of Boucher-Neuhäuser syndrome and suggest inquiring about a history of hypogonadism or visual changes in patients presenting with late-onset gait ataxia. We also advocate for neuroophthalmologic evaluation in suspected cases.

  1. [The efficacy of treating patients with intraocular hemorrhages with emoxypin].

    Science.gov (United States)

    Mokhammad, I; Cherkasov, I S

    1990-01-01

    Emoxipin, a home-made preparation approved by the Pharmacological Committee for clinical usage in 1986, is a retinal protector. Its usage is indicated for treatment of chorioretinitis, diabetic retinopathy, thrombosis of retinal vessels as well as to protects the retina from a damaging action of light of high intensity. In order to study therapeutic effectiveness of emoxipin in intraocular hemorrhages of different genesis, the preparation was used subconjunctivally, 0.5 ml of a 1% solution daily for 10-15 days. Emoxipin was used in 29 patients (29 eyes) with intraocular hemorrhages, of them, due to contusion of the eye--in 19, hypertonic disease--in 6, thrombosis of the central retinal vein--in 2, after intraocular operations--in 2 patients. As a result of the treatment, partial or almost total resolution of hemorrhages and a rise of visual acuity of different degree were recorded in all patients. Before treatment, visual acuity was from light perception to 0.04 in 26 eyes, from 0.09 to 0.3 in 3 eyes. After treatment, it rose to 0.1-0.2 in 12 eyes, to 0.3-1.0--in 17 eyes.

  2. Visual evoked potential (VEP) and multifocal electroretinogram (mfERG) in ocular syphilitic posterior segment inflammation.

    Science.gov (United States)

    Alexander, Philip; Wen, Yaqin; Baxter, Julia M; Tint, Naing L; Browning, Andrew C; Amoaku, Winfried M

    2012-10-01

    The aim of this study is to correlate multifocal electroretinogram (mfERG) and visual evoked potential (VEP) changes with visual acuity and clinical features in patients with posterior segment inflammation secondary to syphilis. A retrospective interventional case series of 4 patients with visual loss secondary to syphilitic uveitis is reported. The mfERG (P1) showed diminished amplitudes and prolonged latency in 7 affected eyes. Visual acuity rapidly improved 2 weeks after initiation of therapy. OCT demonstrated anatomical recovery at 1 month. In three patients, visual acuity was restored to 6/6 at 6-9 months but mfERG responses remained significantly reduced and delayed for 12-15 months before recovery to normal levels. One patient developed a retinal detachment, but achieved 6/9 vision at 30 months. VEP changes, interpreted in combination with mfERG responses, showed evidence of optic nerve involvement in 6 eyes. Ocular findings, including posterior placoid chorioretinitis, are important diagnostic features of secondary and tertiary syphilis. Visual acuity and clinical recovery occur early with appropriate diagnosis and treatment, and precede full electrophysiological recovery of the outer retina-RPE complex. Ophthalmologists have the opportunity to play a key role in undetected or missed diagnoses of syphilis, and with appropriate treatment the visual prognosis is excellent.

  3. Gender Differences in Vogt-Koyanagi-Harada Disease and Sympathetic Ophthalmia

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    Yujuan Wang

    2014-01-01

    Full Text Available Vogt-Koyanagi-Harada disease (VKH and sympathetic ophthalmia (SO are types of T-cell mediated autoimmune granulomatous uveitis. Although the two diseases share common clinical features, they have certain differences in gender predilections. VKH classically has been reported as more prevalent in females than males, yet some studies in Japan and China have not found differences in gender prevalence. Male patients have a higher risk of chorioretinal degeneration, vitiligo, and worse prognosis. Conversely, the changing levels of estrogen/progesterone during pregnancy and the menstrual cycle as well as higher levels of TGF-β show a protective role in females. Potential causes of female predilection for VKH are associated with HLA-DR and HLA-DQ alleles. SO, a bilateral granulomatous uveitis, occurs in the context of one eye after a penetrating injury due to trauma or surgery. In contrast to the female dominance in VKH, males are more frequently affected by SO due to a higher incidence of ocular injury, especially during wartime. However, no gender predilection of SO has been reported in postsurgical cases. No clinically different manifestations are revealed between males and females in SO secondary to either ocular trauma or surgery. The potential causes of the gender difference may provide hints on future treatment and disease evaluation.

  4. Pathways of cholesterol homeostasis in mouse retina responsive to dietary and pharmacologic treatments.

    Science.gov (United States)

    Zheng, Wenchao; Mast, Natalia; Saadane, Aicha; Pikuleva, Irina A

    2015-01-01

    Effects of serum cholesterol on cholesterol content in the retina are currently unknown. It is also unclear how cholesterol levels are controlled in the retina. High-cholesterol diet and oral administrations of simvastatin were used to modulate serum cholesterol in mice. These treatments only modestly affected cholesterol content in the retina and had no significant effect on retinal expression of the major cholesterol- and vision-related genes; the sterol-regulatory element binding protein pathway of transcriptional regulation does not seem to be operative in the retina under the experimental conditions used. Evidence is obtained that posttranslational mechanisms play a role in the control of retinal cholesterol. Retinal genes were only upregulated by oral administrations of TO901317 activating liver X receptors. Three of the upregulated genes could be of particular importance (apoD, Idol, and Rpe65) and have not yet been considered in the context of cholesterol homeostasis in the retina. Collectively, the data obtained identify specific features of retinal cholesterol maintenance and suggest additional therapies for age-related macular degeneration, a blinding disease characterized by cholesterol and lipid accumulations in chorioretinal tissues.

  5. Successful medical treatment for globe penetration following tooth extraction in a dog.

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    Guerreiro, Cleo E; Appelboam, Helen; Lowe, Robert C

    2014-03-01

    A five-year-old entire male Tibetan Terrier was referred for left-sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re-examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures.

  6. Progressive outer retinal necrosis syndrome in the course of systemic lupus erythematosus.

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    Turno-Kręcicka, A; Tomczyk-Socha, M; Zimny, A

    2016-12-01

    Progressive outer retinal necrosis syndrome (PORN) is a severe clinical variant of necrotizing herpetic chorioretinitis, which occurs almost exclusively in patients with advanced acquired immunodeficiency syndrome (AIDS). To date, only a few cases of PORN have been reported in patients, mostly among those who were immunocompromised. To our knowledge, only one case of PORN in a patient with systemic lupus erythematosus (SLE) has been described. We report the case of a 44-year old HIV-negative patient with lupus nephritis, whom was being treated by mycophenolate mophetil (MMF), arechin and prednisone. After 14 months of MMF therapy, the patient revealed PORN symptoms; and several months later, the patient developed Type B primary central nervous system lymphoma (PCNSL). PORN is usually compared to acute retinal necrosis (ARN) syndrome, because of having the same causative agent: varicella zoster virus (VZV). There are also some similarities in clinical findings. Our observation supports the hypothesis that PORN symptoms in HIV-negative patients can be an intermediate form between ARN and PORN, and can vary according to the patient's immune status.

  7. Foxg1-Cre Mediated Lrp2 Inactivation in the Developing Mouse Neural Retina, Ciliary and Retinal Pigment Epithelia Models Congenital High Myopia

    Science.gov (United States)

    Obry, Antoine; Santin, Mathieu D.; Ben-Yacoub, Sirine; Pâques, Michel; Amsellem-Levera, Sabine; Bribian, Ana; Simonutti, Manuel; Augustin, Sébastien; Debeir, Thomas; Sahel, José Alain; Christ, Annabel; de Castro, Fernando; Lehéricy, Stéphane; Cosette, Pascal; Kozyraki, Renata

    2015-01-01

    Myopia is a common ocular disorder generally due to increased axial length of the eye-globe. Its extreme form high myopia (HM) is a multifactorial disease leading to retinal and scleral damage, visual impairment or loss and is an important health issue. Mutations in the endocytic receptor LRP2 gene result in Donnai-Barrow (DBS) and Stickler syndromes, both characterized by HM. To clearly establish the link between Lrp2 and congenital HM we inactivated Lrp2 in the mouse forebrain including the neural retina and the retinal and ciliary pigment epithelia. High resolution in vivo MRI imaging and ophthalmological analyses showed that the adult Lrp2-deficient eyes were 40% longer than the control ones mainly due to an excessive elongation of the vitreal chamber. They had an apparently normal intraocular pressure and developed chorioretinal atrophy and posterior scleral staphyloma features reminiscent of human myopic retinopathy. Immunomorphological and ultrastructural analyses showed that increased eye lengthening was first observed by post-natal day 5 (P5) and that it was accompanied by a rapid decrease of the bipolar, photoreceptor and retinal ganglion cells, and eventually the optic nerve axons. It was followed by scleral thinning and collagen fiber disorganization, essentially in the posterior pole. We conclude that the function of LRP2 in the ocular tissues is necessary for normal eye growth and that the Lrp2-deficient eyes provide a unique tool to further study human HM. PMID:26107939

  8. Emergent infectious uveitis

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    Khairallah Moncef

    2009-01-01

    Full Text Available Infectious causes should always be considered in all patients with uveitis and it should be ruled out first. The differential diagnosis includes multiple well-known diseases including herpes, syphilis, toxoplasmosis, tuberculosis, bartonellosis, Lyme disease, and others. However, clinicians should be aware of emerging infectious agents as potential causes of systemic illness and also intraocular inflammation. Air travel, immigration, and globalization of business have overturned traditional pattern of geographic distribution of infectious diseases, and therefore one should work locally but think globally, though it is not possible always. This review recapitulates the systemic and ocular mainfestations of several emergent infectious diseases relevant to the ophthalmologist including Rickettsioses, West Nile virus infection, Rift valley fever, dengue fever, and chikungunya. Retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement have been associated with these emergent infectious diseases. The diagnosis of any of these infections is usually based on pattern of uveitis, systemic symptoms and signs, and specific epidemiological data and confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical fundus findings, may help in establishing an early clinical diagnosis, which allows prompt, appropriate management.

  9. Fundus autofluorescence and colour fundus imaging compared during telemedicine screening in patients with diabetes.

    Science.gov (United States)

    Kolomeyer, Anton M; Baumrind, Benjamin R; Szirth, Bernard C; Shahid, Khadija; Khouri, Albert S

    2013-06-01

    We investigated the use of fundus autofluorescence (FAF) imaging in screening the eyes of patients with diabetes. Images were obtained from 50 patients with type 2 diabetes undergoing telemedicine screening with colour fundus imaging. The colour and FAF images were obtained with a 15.1 megapixel non-mydriatic retinal camera. Colour and FAF images were compared for pathology seen in nonproliferative and proliferative diabetic retinopathy (NPDR and PDR, respectively). A qualitative assessment was made of the ease of detecting early retinopathy changes and the extent of existing retinopathy. The mean age of the patients was 47 years, most were male (82%) and most were African American (68%). Their mean visual acuity was 20/45 and their mean intraocular pressure was 14.3 mm Hg. Thirty-eight eyes (76%) did not show any diabetic retinopathy changes on colour or FAF imaging. Seven patients (14%) met the criteria for NPDR and five (10%) for severe NPDR or PDR. The most common findings were microaneurysms, hard exudates and intra-retinal haemorrhages (IRH) (n = 6 for each). IRH, microaneurysms and chorioretinal scars were more easily visible on FAF images. Hard exudates, pre-retinal haemorrhage and fibrosis, macular oedema and Hollenhorst plaque were easier to identify on colour photographs. The value of FAF imaging as a complementary technique to colour fundus imaging in detecting diabetic retinopathy during ocular screening warrants further investigation.

  10. Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

    Science.gov (United States)

    Vishnevskia-Dai, Vicktoria; Zur, Dinah; Yaacobi, Shiran; Moroz, Iris; Newman, Hadas; Neudorfer, Meira

    2016-01-01

    Purpose. To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface. Methods. This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well. Results. OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p = 0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p < 0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors. Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface. PMID:26998354

  11. Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model.

    Science.gov (United States)

    Dotan, Assaf; Kremer, Israel; Gal-Or, Orly; Livnat, Tami; Zigler, Arie; Bourla, Dan; Weinberger, Dov

    2016-04-03

    Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal abnormalities. In addition, pathological myopia is a common irreversible cause of visual impairment and blindness. Our study demonstrates the effect of scleral crosslinking using riboflavin and ultraviolet-A radiation on the development of axial myopia in a rabbit model. The axial length of the eyeball was measured by A-scan ultrasound in New Zealand white rabbits aged 13 days (male and female). The eye then underwent 360° conjunctival peritomy with scleral crosslinking, followed by tarsorrhaphy. Axial elongation was induced in 13 day-old New Zealand rabbits by suturing their right eye eyelids (tarsorrhaphy). The eyes were divided into quadrants, and every quadrant had two scleral irradiation zones, each with an area of 0.2 cm² and a radius of 4 mm. Crosslinking was performed by dropping 0.1% dextran-free riboflavin-5-phosphate onto the irradiation zones 20 sec before ultraviolet-A irradiation and every 20 sec during the 200 sec irradiation time. UVA radiation (370 nm) was applied perpendicular to the sclera at 57 mW/cm² (total UVA light dose, 57 J/cm²). Tarsorrhaphies were removed on day 55, followed by repeated axial length measurements. This study demonstrates that scleral crosslinking with riboflavin and ultraviolet-A radiation effectively prevents occlusion-induced axial elongation in a rabbit model.

  12. [Prevention of congenital toxoplasmosis in a Buenos Aires hospital].

    Science.gov (United States)

    Carral, Liliana; Kaufer, Federico; Olejnik, Patricia; Freuler, Cristina; Durlach, Ricardo

    2013-01-01

    The prevention of congenital toxoplasmosis is based on providing information to women, serologic diagnosis and treatment of the infected mother and child. In this article we present the results of 12 years of implementation of a congenital toxoplasmosis prevention program in which we measured the mother's infection incidence rate, the transmission rate and the number and severity of infection in newborns. The study was performed on 12035 pregnant women in the period 2000-2011. The prevalence rate of antibodies against Toxoplasma gondii was 18.33% (2206/12035). Thirty-seven out of 9792 susceptible women presented acute infection and the mother's infection incidence rate was 3.78 per 1000 births. The transplacental transmission rate was 5.4% (2/37). Two newborns presented congenital toxoplasmosis infection, one had no clinical signs while the other presented strabismus and chorioretinitis. Thirty-five infected mothers and the two children with congenital infection were treated. The transmission rates obtained allow consider this prevention program as a valid resource to minimize the impact of congenital toxoplasmosis.

  13. IgE antibodies in toxoplasmosis.

    Science.gov (United States)

    Matowicka-Karna, Joanna; Kemona, Halina

    2014-05-15

    Toxoplasmosis is a worldwide infection caused by the intracellular parasite Toxoplasma gondii. At least a third of the world human population is infected with the parasite, making it one of the most successful parasitic infections. Primary maternal infection may cause health-threatening sequelae for the fetus, or even cause death of the uterus. Reactivation of a latent infection in immune deficiency conditions such as AIDS and organ transplantation can cause fatal toxoplasmic encephalitis. Toxoplasmosis is a major cause of chorioretinitis, especially in individuals with impaired immune systems. In the acute phase, directly after invading the body, T. gondii begins to multiply rapidly. In the majority of cases acquired toxoplasmosis is asymptomatic. In the second week of infection, specific IgM antibodies are present in the blood. IgE antibodies appear at the same time, slightly preceding specific IgA antibodies. The concentration of IgE can be one of the parameters used for diagnosing an infection with T. gondii. Laboratory diagnosis, i.e. IgE and serologic assays, plays the main role in the diagnosis of congenital infection and assists in the confirmatory diagnosis of toxoplasmic encephalitis and ocular toxoplasmosis. This article is a review of IgE in toxoplasmosis.

  14. Multilevel Precision-Based Rational Design of Chemical Inhibitors Targeting the Hydrophobic Cleft of Toxoplasma gondii Apical Membrane Antigen 1 (AMA1).

    Science.gov (United States)

    Vetrivel, Umashankar; Muralikumar, Shalini; Mahalakshmi, B; Lily Therese, K; Madhavan, H N; Alameen, Mohamed; Thirumudi, Indhuja

    2016-06-01

    Toxoplasma gondii is an intracellular Apicomplexan parasite and a causative agent of toxoplasmosis in human. It causes encephalitis, uveitis, chorioretinitis, and congenital infection. T. gondii invades the host cell by forming a moving junction (MJ) complex. This complex formation is initiated by intermolecular interactions between the two secretory parasitic proteins-namely, apical membrane antigen 1 (AMA1) and rhoptry neck protein 2 (RON2) and is critically essential for the host invasion process. By this study, we propose two potential leads, NSC95522 and NSC179676 that can efficiently target the AMA1 hydrophobic cleft, which is a hotspot for targeting MJ complex formation. The proposed leads are the result of an exhaustive conformational search-based virtual screen with multilevel precision scoring of the docking affinities. These two compounds surpassed all the precision levels of docking and also the stringent post docking and cumulative molecular dynamics evaluations. Moreover, the backbone flexibility of hotspot residues in the hydrophobic cleft, which has been previously reported to be essential for accommodative binding of RON2 to AMA1, was also highly perturbed by these compounds. Furthermore, binding free energy calculations of these two compounds also revealed a significant affinity to AMA1. Machine learning approaches also predicted these two compounds to possess more relevant activities. Hence, these two leads, NSC95522 and NSC179676, may prove to be potential inhibitors targeting AMA1-RON2 complex formation towards combating toxoplasmosis.

  15. Progressive outer retinal necrosis syndrome: a comprehensive review of its clinical presentation, relationship to immune system status, and management.

    Science.gov (United States)

    Austin

    2000-12-01

    Progressive outer retinal necrosis (PORN) syndrome is a form of the Varicella zoster virus (VZV) chorioretinitis found almost exclusively in people with the acquired immunodeficiency syndrome (AIDS). This destructive infection has an extremely rapid course that may lead to no light perception in affected eyes within days or weeks. Attempts at its treatment have had limited success. Rhegmatogenous retinal detachments often occur after the development of atrophic retinal holes, and silicone oil temponade has been found to be the most successful reattachment procedure. Unfortunately, cataract formation is common after such surgery. PORN needs to be differentiated from acute retinal necrosis (ARN) syndrome, a necrotizing retinitis that can also be caused by VZV. PORN and ARN are found at opposite ends of the spectrum of necrotizing herpetic retinopathies (NHR), where its clinical presentation depends upon immune system status. After a brief case presentation, the distinguishing clinical characteristics of PORN, its differentiation from ARN, attempts at its treatment, the role of the immune system status on its clinical appearance and treatment, and management of complications such as retinal detachment and subsequent cataracts are discussed.

  16. A Suprachoroidal Electrical Retinal Stimulator Design for Long-Term Animal Experiments and In Vivo Assessment of Its Feasibility and Biocompatibility in Rabbits

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    J. A. Zhou

    2008-01-01

    Full Text Available This article reports on a retinal stimulation system for long-term use in animal electrical stimulation experiments. The presented system consisted of an implantable stimulator which provided continuous electrical stimulation, and an external component which provided preset stimulation patterns and power to the implanted stimulator via a paired radio frequency (RF coil. A rechargeable internal battery and a parameter memory component were introduced to the implanted retinal stimulator. As a result, the external component was not necessary during the stimulation mode. The inductive coil pair was used to pass the parameter data and to recharge the battery. A switch circuit was used to separate the stimulation mode from the battery recharging mode. The implantable stimulator was implemented with IC chips and the electronics, except for the stimulation electrodes, were hermetically packaged in a biocompatible metal case. A polyimide-based gold electrode array was used. Surgical implantation into rabbits was performed to verify the functionality and safety of this newly designed system. The electrodes were implanted in the suprachoroidal space. Evoked cortical potentials were recorded during electrical stimulation of the retina. Long-term follow-up using OCT showed no chorioretinal abnormality after implantation of the electrodes.

  17. Translation of a laboratory-validated equine herpesvirus-1 specific real-time PCR assay into an insulated isothermal polymerase chain reaction (iiPCR) assay for point-of-need diagnosis using POCKIT™ nucleic acid analyzer.

    Science.gov (United States)

    Balasuriya, Udeni B R; Lee, Pei-Yu Alison; Tsai, Yun-Long; Tsai, Chuan-Fu; Shen, Yu-Han; Chang, Hsiao-Fen Grace; Skillman, Ashley; Wang, Hwa-Tang Thomas; Pronost, Stéphane; Zhang, Yan

    2017-03-01

    Equine herpesvirus myeloencephalopathy (EHM), a major problem for the equine industry in the United States, is caused by equine herpesvirus-1 (EHV-1). In addition, EHV-1 is associated with upper respiratory disease, abortion, and chorioretinal lesions in horses. Here we describe the development and evaluation of an inexpensive, user-friendly insulated isothermal PCR (iiPCR) method targeting open reading 30 (ORF30) to detect both neuropathogenic and non-neuropathogenic strains on the field-deployable POCKIT™ device for point-of-need detection of EHV-1. The analytical sensitivity of the EHV-1 iiPCR assay was 13 genome equivalents per reaction. The assay did not cross react with ten non-target equine viral pathogens. Performance of the EHV-1 iiPCR assay was compared to two previously described real-time PCR (qPCR) assays in two laboratories by using 104 archived clinical samples. All 53 qPCR-positive and 46 of the 51 qPCR-negative samples tested positive and negative, respectively, by the iiPCR. The agreement between the two assays was 95.19% (confidence interval 90.48-99.90%) with a kappa value of 0.90. In conclusion, the newly developed EHV-1 iiPCR assay is robust to provide specificity and sensitivity comparable to qPCR assays for the detection of EHV-1 nucleic acid in clinical specimens.

  18. Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction

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    Moschos MM

    2016-10-01

    Full Text Available Marilita M Moschos, Eirini Nitoda 1st Department of Ophthalmology, Medical School, National & Kapodistrian University of Athens, Athens, Greece Aim: The aim of this review was to summarize the ocular action of the most common phosphodiesterase (PDE inhibitors used for the treatment of erectile dysfunction and the subsequent visual disorders.Method: This is a literature review of several important articles focusing on the pathophysiology of visual disorders induced by PDE inhibitors.Results: PDE inhibitors have been associated with ocular side effects, including changes in color vision and light perception, blurred vision, transient alterations in electroretinogram (ERG, conjunctival hyperemia, ocular pain, and photophobia. Sildenafil and tadalafil may induce reversible increase in intraocular pressure and be involved in the development of nonarteritic ischemic optic neuropathy. Reversible idiopathic serous macular detachment, central serous chorioretinopathy, and ERG disturbances have been related to the significant impact of sildenafil and tadalafil on retinal perfusion.Discussion: So far, PDE inhibitors do not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors. However, physicians should write down any visual symptom observed during PDE treatment and refer the patients to ophthalmologists. Keywords: erectile dysfunction, pathophysiological mechanisms, phosphodiesterase inhibitors, PDE5, visual disorders

  19. Zika Virus Infection in Mice Causes Panuveitis with Shedding of Virus in Tears

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    Jonathan J. Miner

    2016-09-01

    Full Text Available Zika virus (ZIKV is an emerging flavivirus that causes congenital abnormalities and Guillain-Barré syndrome. ZIKV infection also results in severe eye disease characterized by optic neuritis, chorioretinal atrophy, and blindness in newborns and conjunctivitis and uveitis in adults. We evaluated ZIKV infection of the eye by using recently developed mouse models of pathogenesis. ZIKV-inoculated mice developed conjunctivitis, panuveitis, and infection of the cornea, iris, optic nerve, and ganglion and bipolar cells in the retina. This phenotype was independent of the entry receptors Axl or Mertk, given that Axl−/−, Mertk−/−, and Axl−/−Mertk−/− double knockout mice sustained levels of infection similar to those of control animals. We also detected abundant viral RNA in tears, suggesting that virus might be secreted from lacrimal glands or shed from the cornea. This model provides a foundation for studying ZIKV-induced ocular disease, defining mechanisms of viral persistence, and developing therapeutic approaches for viral infections of the eye.

  20. Echographic findings in the late stages of Vogt-Koyanagi-Harada disease in mexican population

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    Mariana Mayorquín-Ruiz

    2014-12-01

    Full Text Available Purpose: To correlate clinical findings of Vogt-Koyanagi-Harada disease with standardized echography findings in a cross-sectional, descriptive and observational study. Methods: Patients with Vogt-Koyanagi-Harada disease in the convalescent and recurrence phases were evaluated with standardized ocular echography. Eyes with opaque media were excluded. Clinical findings were correlated with echographic data. Results: Thirty-seven eyes of 25 patients were included. Best corrected visual acuity was in average 20/100 (0.70 logMAR. Clinical findings included: sunset glow fundus (92%, pigment migration (92%, nummular chorioretinal depigmented scars (68% and subretinal fibrosis (64.8%. Standardized echography was able to recognize all the cases with subretinal fibrosis (n=24 described clinically. Standardized echography showed a 100% sensitivity and specificity of finding subretinal fibrosis. Subretinal fibrosis in patients with Vogt-Koyanagi-Harada represents a risk factor for low vision. In our patients’ eyes, presence of subretinal fibrosis had a 2.5 time relative risk of having a visual acuity equal or worst to 20/70. Conclusions: Standardized echography represents a useful tool in patients with VKH in the chronic (convalescence and recurrence phase of the disease. Subretinal fibrosis, a sight threatening complication in the convalescence and recurrent phases of Vogt-Koyanagi-Harada, can be diagnosed with ocular echography, with characteristic images. Knowledge of these images can be useful in cases with opaque media and bilateral anterior segment granulomatous inflammatory disease.

  1. Automated segmentation of serous pigment epithelium detachment in SD-OCT images

    Science.gov (United States)

    Sun, Zhuli; Shi, Fei; Xiang, Dehui; Chen, Haoyu; Chen, Xinjian

    2015-03-01

    Pigment epithelium detachment (PED) is an important clinical manifestation of multiple chorio-retinal disease processes, which can cause the loss of central vision. A 3-D method is proposed to automatically segment serous PED in SD-OCT images. The proposed method consists of five steps: first, a curvature anisotropic diffusion filter is applied to remove speckle noise. Second, the graph search method is applied for abnormal retinal layer segmentation associated with retinal pigment epithelium (RPE) deformation. During this process, Bruch's membrane, which doesn't show in the SD-OCT images, is estimated with the convex hull algorithm. Third, the foreground and background seeds are automatically obtained from retinal layer segmentation result. Fourth, the serous PED is segmented based on the graph cut method. Finally, a post-processing step is applied to remove false positive regions based on mathematical morphology. The proposed method was tested on 20 SD-OCT volumes from 20 patients diagnosed with serous PED. The average true positive volume fraction (TPVF), false positive volume fraction (FPVF), dice similarity coefficient (DSC) and positive predictive value (PPV) are 97.19%, 0.03%, 96.34% and 95.59%, respectively. Linear regression analysis shows a strong correlation (r = 0.975) comparing the segmented PED volumes with the ground truth labeled by an ophthalmology expert. The proposed method can provide clinicians with accurate quantitative information, including shape, size and position of the PED regions, which can assist diagnose and treatment.

  2. Multilevel Precision-Based Rational Design of Chemical Inhibitors Targeting the Hydrophobic Cleft of Toxoplasma gondii Apical Membrane Antigen 1 (AMA1)

    Science.gov (United States)

    Muralikumar, Shalini; Mahalakshmi, B; Lily Therese, K; Madhavan, HN; Alameen, Mohamed; Thirumudi, Indhuja

    2016-01-01

    Toxoplasma gondii is an intracellular Apicomplexan parasite and a causative agent of toxoplasmosis in human. It causes encephalitis, uveitis, chorioretinitis, and congenital infection. T. gondii invades the host cell by forming a moving junction (MJ) complex. This complex formation is initiated by intermolecular interactions between the two secretory parasitic proteins—namely, apical membrane antigen 1 (AMA1) and rhoptry neck protein 2 (RON2) and is critically essential for the host invasion process. By this study, we propose two potential leads, NSC95522 and NSC179676 that can efficiently target the AMA1 hydrophobic cleft, which is a hotspot for targeting MJ complex formation. The proposed leads are the result of an exhaustive conformational search-based virtual screen with multilevel precision scoring of the docking affinities. These two compounds surpassed all the precision levels of docking and also the stringent post docking and cumulative molecular dynamics evaluations. Moreover, the backbone flexibility of hotspot residues in the hydrophobic cleft, which has been previously reported to be essential for accommodative binding of RON2 to AMA1, was also highly perturbed by these compounds. Furthermore, binding free energy calculations of these two compounds also revealed a significant affinity to AMA1. Machine learning approaches also predicted these two compounds to possess more relevant activities. Hence, these two leads, NSC95522 and NSC179676, may prove to be potential inhibitors targeting AMA1-RON2 complex formation towards combating toxoplasmosis. PMID:27445648

  3. APOC impact assessment studies: baseline ophthalmological findings in Morogoro, Tanzania.

    Science.gov (United States)

    Babalola, O E; Maegga, B; Katenga, S; Ogbuagu, F K; Umeh, R E; Seketeli, E; Braide, E

    2008-12-01

    The goal of the African Programme for Onchocerciasis Control (APOC) is to eliminate Onchocerciasis as a disease of public Health significance and an important constraint to socio-economic development in the 19 none OCP (Onchocerciasis Control Project) countries covered through Community-Directed Treatment with Ivermectin, CDTI. In 1998, impact assessment studies were carried out in Morogoro, Tanzania during which baseline ophthalmological parameters were established. The hypothesis being tested is that CDTI will prevent or delay progression of onchocercal eye lesions and blindness. A total of 425 subjects aged 10 years or more from 14 villages within Bwakira district ofMorogoro region in Tanzania were examined for Snellen visual acuity, ocular microfilaria, lens opacities, uveitis and posterior segment disease especially chorioretinitis and optic nerve disease. Motion Sensitivity Screening Test (MSST) was carried out as well. Microfilaria was present in the anterior chamber of nearly half (49.2%) of all subjects examined. Prevalence of blindness was extremely high at 15.2%. Onchocercal lesions were responsible for blindness in 41.5% of these, followed by cataracts (27.7%), glaucoma (10.8%) and trachoma (6.2%). The main pathway to onchocercal blindness in this population was anterior uveitis with or without secondary cataracts. There is an urgent need to get CDTI underway and institute other horizontal primary eye care measures, especially cataract backlog reduction, in order to reduce the excessive burden of avoidable blindness in this community.

  4. High-speed adaptive optics line scan confocal retinal imaging for human eye

    Science.gov (United States)

    Wang, Xiaolin; Zhang, Yuhua

    2017-01-01

    Purpose Continuous and rapid eye movement causes significant intraframe distortion in adaptive optics high resolution retinal imaging. To minimize this artifact, we developed a high speed adaptive optics line scan confocal retinal imaging system. Methods A high speed line camera was employed to acquire retinal image and custom adaptive optics was developed to compensate the wave aberration of the human eye’s optics. The spatial resolution and signal to noise ratio were assessed in model eye and in living human eye. The improvement of imaging fidelity was estimated by reduction of intra-frame distortion of retinal images acquired in the living human eyes with frame rates at 30 frames/second (FPS), 100 FPS, and 200 FPS. Results The device produced retinal image with cellular level resolution at 200 FPS with a digitization of 512×512 pixels/frame in the living human eye. Cone photoreceptors in the central fovea and rod photoreceptors near the fovea were resolved in three human subjects in normal chorioretinal health. Compared with retinal images acquired at 30 FPS, the intra-frame distortion in images taken at 200 FPS was reduced by 50.9% to 79.7%. Conclusions We demonstrated the feasibility of acquiring high resolution retinal images in the living human eye at a speed that minimizes retinal motion artifact. This device may facilitate research involving subjects with nystagmus or unsteady fixation due to central vision loss. PMID:28257458

  5. ALGORITHM OF DIAGNOSTICS AND TREATMENT OF AN AGE-RELATED MACULAR DEGENERATION AT PATIENTS WITH CHRONIC PERIPHERAL UVEITIS

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    Yu. I. Khoroshikh

    2014-01-01

    Full Text Available The results of clinical trial of various approaches in treatment the exudative forms of macular degenerations, including age-related, against chronic slow intensity inflammatory process on the extreme retinal periphery of an eye are described in represented material. There were 91 patients (105 eyes in the research with different types of an exudative macular degeneration. The general criteria of inclusion were: age of 18–80 years old, complaints to discomfort in eyes, a spot before an eye, distortions and decrease in the central sight, ophthalmoscopic symptoms of hypostasis in the central and peripheral areas of a retina. It is analyzed the general criteria of diagnostics and treatment of the disease in the article. Considering defeat of the chorioretinal structures located near the ora serrata at persons of young and advanced age. Practical recommendations to a choice of methods of diagnostics and treatment of various clinical and morphological forms of the disease are made. Screening methods of identification of patients with the peripheral uveitis are offered. The scheme of risk calculation of development the macular pathology at persons with changes on the extreme periphery of a retina, that can be used as a method of prevention of development predictively adverse of “wet" forms of an age-related macular degeneration, by means of timely sparing treatment at patients with chronic inflammatory diseases of eyes is given.

  6. Sulfadiazine resistance in Toxoplasma gondii: no involvement of overexpression or polymorphisms in genes of therapeutic targets and ABC transporters

    Science.gov (United States)

    Doliwa, Christelle; Escotte-Binet, Sandie; Aubert, Dominique; Sauvage, Virginie; Velard, Frédéric; Schmid, Aline; Villena, Isabelle

    2013-01-01

    Several treatment failures have been reported for the treatment of toxoplasmic encephalitis, chorioretinitis, and congenital toxoplasmosis. Recently we found three Toxoplasma gondii strains naturally resistant to sulfadiazine and we developed in vitro two sulfadiazine resistant strains, RH-RSDZ and ME-49-RSDZ, by gradual pressure. In Plasmodium, common mechanisms of drug resistance involve, among others, mutations and/or amplification within genes encoding the therapeutic targets dhps and dhfr and/or the ABC transporter genes family. To identify genotypic and/or phenotypic markers of resistance in T. gondii, we sequenced and analyzed the expression levels of therapeutic targets dhps and dhfr, three ABC genes, two Pgp, TgABC.B1 and TgABC.B2, and one MRP, TgABC.C1, on sensitive strains compared to sulfadiazine resistant strains. Neither polymorphism nor overexpression was identified. Contrary to Plasmodium, in which mutations and/or overexpression within gene targets and ABC transporters are involved in antimalarial resistance, T. gondii sulfadiazine resistance is not related to these toxoplasmic genes studied. PMID:23707894

  7. Diagnosis of Toxoplasmosis in Pregnancy

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    Umit Savasci

    2012-12-01

    Full Text Available Toxoplasmosis is a common worldwide parasitic infection that caused by Toxoplasma gondii. The clinical progress is generally asymptomatic in patient with normal immune system, on the other hand severe clinical presentations seen in patients with immune deficiency or pregnancy. Congenital toxoplasmosis can emerge due to contamination during pregnancy but 6-8 weeks prior to pregnancy are also at risk. Infants with toxoplasmosis have some clinical semptoms such as chorioretinitis, epilepsia, hypotonia, psychomotor disorders, mental retardation, encephalitis, microcephaly, hydrocephalus, intracranial calcifications, hepatosplenomegaly. Early diagnosis during pregnancy and subsequent treatment. may prevent malformations. Toxoplasmosis diagnosis during pregnancy is mostly based on IgM and IgG antibody screening tests. While IgM indicates the acute infection, it disappears in early period and can be detected in low consantrations through long ages. Therefore IgG avidity test takes more place in the diagnosis of toxoplasmosis during pregnancy. High avidity levels indicate acquired infection prior than 16 weeks, so that it is recommended to perform the test in the first trimester. Low IgG avidity level may indicate a newly onset infection. Amniotic fluid T.gondii PCR, anomaly screening with ultrasonography, Toxoplasma gondii cyst dying with Wright-Giemsa dye in plasental and fetal tissue are the other diagnostic tools can be performed during pregnancy. Avidity test methods during the 16 weeks of pregnancy reduce repeating serum analysis, amniotic fluid PCR reguirement, unnecessary antibiotic treatments and noncompulsory abortus. [TAF Prev Med Bull 2012; 11(6.000: 767-772

  8. Systemic and Ophthalmologic Findings in Patients with Iris Coloboma

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    Sevda Ertekin

    2013-01-01

    Full Text Available Pur po se: Ocular coloboma is a rare malformation resulting from defective closure of the embryonic optic fissure. It can affect iris, retina, choroid, optic disc or ciliary body. This study reviews the clinical diagnosis and the accompanying ocular and systemic abnormalities in cases of iris coloboma. Ma te ri al and Met hod: Sixteen eyes of ten patients referred to our clinic and diagnosed as iris coloboma were included in the study and were reviewed retrospectively. Re sults: Seven cases were sporadic, and three cases were familial. Isolated iris coloboma was present in only one case, and chorioretinal involvement was present in all the others. Seven cases had involvement of the optic disc. Other ocular anomalies were unilateral microphthalmia in 3 cases, unilateral anophthalmia in 1 case, and unilateral microcornea in one case. Strabismus was present in the familial cases. Dis cus si on: In patients, diagnosed with iris coloboma, routine eye examination should be completed, refractive errors should be corrected, and these patients must be follewed for amblyopia. If strabismus is concominant, surgery can be performed. For potential complications, patients should be checked at regular intervals. (Turk J Ophthalmol 2013; 43: 19-22

  9. Toxoplasmosis and its Ocular Manifestations

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    Koev Kr.

    2014-06-01

    Full Text Available The present review provides general information about the parasitic infection of toxoplasmosis and describes the ways of its transmission. It outlines the importance of the consequences of toxoplasmosis infection and the methods of its prevention. The review traces the harmful effects of the disease on human and animal organisms, the causes and stages of development of the disease. The review specifically focuses on the ocular manifestations of toxoplasmosis which can cause ocular lesions, inflammation and scarring. Herein are described the ways toxoplasmosis can damage the eyes causing chorioretinitis, nystagmus, microphthalmia, etc. Furthermore, the review addresses the problem of how congenital and acquired toxoplasmosis affects eyes. The ocular symptoms of toxoplasmosis include weakened or blurred vision, eyeballs pain, ocular sensitivity to light, etc. The harmful effects of toxoplasmosis to pregnant women and immunocompromised patients have been delineated. Some of the disease manifestations include jaundice, rash, asphyxia, etc. The review traces the diagnostic work-up and comments on common tests for toxoplasmosis, such as taking of blood serum samples. The review ends with the treatment of the disease and of its ocular manifestations in particular, for example application of intravitreous injection. The prevention of the infection is extremely important for pregnant women, immunocompromised patients and patients with AIDS.

  10. Exome sequencing in 32 patients with anophthalmia/microphthalmia and developmental eye defects.

    Science.gov (United States)

    Slavotinek, A M; Garcia, S T; Chandratillake, G; Bardakjian, T; Ullah, E; Wu, D; Umeda, K; Lao, R; Tang, P L-F; Wan, E; Madireddy, L; Lyalina, S; Mendelsohn, B A; Dugan, S; Tirch, J; Tischler, R; Harris, J; Clark, M J; Chervitz, S; Patwardhan, A; West, J M; Ursell, P; de Alba Campomanes, A; Schneider, A; Kwok, P-Y; Baranzini, S; Chen, R O

    2015-11-01

    Anophthalmia/microphthalmia (A/M) is a genetically heterogeneous birth defect for which the etiology is unknown in more than 50% of patients. We used exome sequencing with the ACE Exome(TM) (Personalis, Inc; 18 cases) and UCSF Genomics Core (21 cases) to sequence 28 patients with A/M and four patients with varied developmental eye defects. In the 28 patients with A/M, we identified de novo mutations in three patients (OTX2, p.(Gln91His), RARB, p.Arg387Cys and GDF6, p.Ala249Glu) and inherited mutations in STRA6 in two patients. In patients with developmental eye defects, a female with cataracts and cardiomyopathy had a de novo COL4A1 mutation, p.(Gly773Arg), expanding the phenotype associated with COL4A1 to include cardiomyopathy. A male with a chorioretinal defect, microcephaly, seizures and sensorineural deafness had two PNPT1 mutations, p.(Ala507Ser) and c.401-1G>A, and we describe eye defects associated with this gene for the first time. Exome sequencing was efficient for identifying mutations in pathogenic genes for which there is no clinical testing available and for identifying cases that expand phenotypic spectra, such as the PNPT1 and COL4A1-associated disorders described here.

  11. An update on the ocular phenotype in patients with pseudoxanthoma elasticum

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    Martin eGliem

    2013-04-01

    Full Text Available Pseudoxanthoma elasticum (PXE is an inherited multi-system disorder characterized by ectopic mineralization and fragmentation of elastic fibres in the skin, the elastic laminae of blood vessels and Bruch membrane in the eye. Biallelic mutations in the ABC transporter gene ABCC6 on chromosome 16 are responsible for the disease.The pathophysiology is incompletely understood. However, there is consent that a metabolic alteration leads to dysfunction in extracellular calcium homeostasis and subsequent calcification of connective tissues rich in elastic fibres. This review summarizes and aims at explaining the variety of phenotypic ocular findings in patients with PXE. Specialised imaging techniques including white light fundus photography, blue light autofluorescence, near-infrared confocal reflectance imaging, high resolution optical coherence tomography, fluorescein and indocyanin green angiography have revealed characteristic lesions at the ocular fundus of PXE patients. These include the classic signs of angioid streaks, peau d’orange, comet lesions and choroidal neovascularisations (CNV, but also the more recently recognised features such as chorioretinal atrophy, subretinal fluid independent from CNV, pattern dystrophy-like changes, debris accumulation under the retinal pigment epithelium, and a decreased fluorescence on late phase indocyanine green angiography.

  12. Electroretinographic findings in transplant chorioretinopathy

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    Brian T Chan-Kai

    2010-07-01

    Full Text Available Brian T Chan-Kai1, Steven Yeh2, Richard G Weleber2, Peter J Francis2, Grazyna Adamus2, S Robert Witherspoon3, Andreas K Lauer11Cullen Eye Institute, Baylor College of Medicine, Houston, Texas; 2Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; 3Retina Institute of Texas, Dallas, Texas, USAAim: Transplant chorioretinopathy is a rare complication following solid organ or bone ­marrow transplantation and can result in severe vision loss. This series presents electroretinogram (ERG results in patients with this condition.Methods: Patients who presented with bilateral vision loss following bone marrow or solid organ transplantation were identified. A complete ophthalmologic examination, fundus ­photography, and fluorescein angiography (FA were performed. Full-field ERG was obtained in all patients and a multifocal ERG (mfERG was obtained in two patients.Results: Four patients were identified. All patients had bilateral vision loss and displayed a characteristic pattern of mottled hyperfluorescence on FA. Three patients developed ­progressive vision loss ranging from 20/60 to hand motions whereas one retained 20/40 vision. All patients exhibited moderate to severe cone dysfunction, while the degree of rod abnormalities was varied. Two patients with severe cone dysfunction showed mild clinical changes initially, but later developed progressive vision loss and chorioretinal atrophy.Conclusion: Transplant chorioretinopathy patients undergoing ERG testing show cone ­dysfunction with a variable degree of rod dysfunction. ERG abnormalities preceded the visual acuity and clinical changes in two patients, suggesting that ERG may be a helpful predictor of the clinical course in this rare disease.Keywords: transplant, chorioretinopathy, electroretinogram, ERG, mfERG

  13. Congenital viral infections of the brain: lessons learned from lymphocytic choriomeningitis virus in the neonatal rat.

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    Daniel J Bonthius

    2007-11-01

    Full Text Available The fetal brain is highly vulnerable to teratogens, including many infectious agents. As a consequence of prenatal infection, many children suffer severe and permanent brain injury and dysfunction. Because most animal models of congenital brain infection do not strongly mirror human disease, the models are highly limited in their abilities to shed light on the pathogenesis of these diseases. The animal model for congenital lymphocytic choriomeningitis virus (LCMV infection, however, does not suffer from this limitation. LCMV is a well-known human pathogen. When the infection occurs during pregnancy, the virus can infect the fetus, and the developing brain is particularly vulnerable. Children with congenital LCMV infection often have substantial neurological deficits. The neonatal rat inoculated with LCMV is a superb model system of human congenital LCMV infection. Virtually all of the neuropathologic changes observed in humans congenitally infected with LCMV, including microencephaly, encephalomalacia, chorioretinitis, porencephalic cysts, neuronal migration disturbances, periventricular infection, and cerebellar hypoplasia, are reproduced in the rat model. Within the developing rat brain, LCMV selectively targets mitotically active neuronal precursors. Thus, the targets of infection and sites of pathology depend on host age at the time of infection. The rat model has further shown that the pathogenic changes induced by LCMV infection are both virus-mediated and immune-mediated. Furthermore, different brain regions simultaneously infected with LCMV can undergo widely different pathologic changes, reflecting different brain region-virus-immune system interactions. Because the neonatal rat inoculated with LCMV so faithfully reproduces the diverse neuropathology observed in the human counterpart, the rat model system is a highly valuable tool for the study of congenital LCMV infection and of all prenatal brain infections In addition, because LCMV

  14. The changes of choroidal thickness of patients with retinal detachment after scleral buckling using enhanced depth imaging (EDI-OCT in Isfahan Feiz Hospital in 2015

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    Heshmatollah Ghanbari

    2016-09-01

    Full Text Available Background: There is a growing interest in the role of the choroid in various chorioretinal diseases. The aim of this study is to investigate the changes in different area of choroidal thickness (CT following scleral buckling surgery using Enhanced-depth imaging optical coherence tomography (EDI-OCT. Methods: This prospective clinical study compared 24 patients with Retinal detachment (RD and 24 control eyes. The macular CT in the sub fovea and in four different regions, superior, inferior, temporal and nasal areas were measured using EDI-OCT at 1000 microns (S1000, I1000, T1000, and N1000. Results: The average age was 52.33±12.72 years (range 30–80 years. There was significant difference between mean subfoveal CT of operated eye in three exams (P<0.05 .This value was significantly larger at before surgery, 1st week and 1st month exams when compared with control eye (P<0.05 for all comparison. All of these thickness significantly decreased at the 1st week and 1st month follow-up exams. Mean CT of operated eye at S1000,T1000, I1000,N1000 locations was 301.68±112.39, 289.89±114.7, 219±57, 276.05±120.76, and 263±111.74µm, respectively before surgery . These macular choroidal thickness in the study eye was larger when compared with the control eye. The differences were statistically significant for the nasal (p=0.009 and superior (p=0.012 locations. Conclusions: Patients with RD had a significantly larger CT that All of these thickness significantly decreased at the 1st week and 1st month follow-up exams.

  15. A Novel Compound Heterozygous Mutation in the CYP4V2 Gene in a Japanese Patient with Bietti’s Crystalline Corneoretinal Dystrophy

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    Yumiko Yokoi

    2011-09-01

    Full Text Available Purpose: To describe the clinical and genetic characteristics of a Japanese family in which one member exhibited Bietti’s crystalline corneoretinal dystrophy (BCD. Methods: Using direct sequencing, mutation screening was performed in the CYP4V2 gene of both the patient with BCD and her daughter. Ophthalmic examinations were performed to determine the clinical features of both subjects. Results: The 64-year-old female patient had a bilateral visual acuity of 0.4. Slit lamp examination revealed bilateral crystalline-like deposits at the superior limbus of the cornea. Fundus examination revealed there was chorioretinal atrophy along with numerous glistening yellowish-white crystalline deposits that were scattered throughout the posterior pole and the mid-peripheral retina. Standard flash electroretinography showed an extinguished electroretinogram and Goldmann kinetic perimetry detected a relative scotoma. Genetic analysis revealed that the patient had a heterozygous mutation in the CYP4V2 gene (IVS6–8delTCATACAGGTCATCGCG/GC, which is the most commonly found mutation in Japanese patients with BCD. Furthermore, the patient was also shown to have a novel heterozygous point mutation in exon 9 of the CYP4V2 gene (c.1168C>T. In contrast, her daughter exhibited no clinical findings for BCD even though she carried the same heterozygous mutation in the CYP4V2 gene (c.1168C>T. Conclusion: A novel compound heterozygous mutation was found in the CYP4V2 gene of a patient with BCD. This previously unreported c.1168C>T mutation causes a missense mutation (p.R390C in the CYP4V2 protein.

  16. The use of SD-OCT in the differential diagnosis of dots, spots and other white retinal lesions

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    Zaharova E

    2011-10-01

    Full Text Available Elena Zaharova1, Jerome Sherman1-31State University of New York's State College of Optometry, University Eye Center, New York, NY, USA; 2SUNY Eye Institute, New York, NY, USA; 3New York Eye Institute and Laser Center, New York, NY, USAPurpose: To demonstrate the utility of a retinal imaging technique using spectral domain optical coherence tomography (SD-OCT for creating a B-scan layer-by-layer analysis to aid in the differential diagnosis of various retinal dots, spots, and other white lesions.Design: Review.Methods: A retrospective review of imaging studies performed with SD-OCT (Topcon, 3DOCT-2000, Oakland, NJ at SUNY State College of Optometry.Results: B-scan layer-by-layer analysis and unique SD-OCT reflectivity patterns of the following retinal white lesions are reviewed in the order of their retinal layer localization: myelinated nerve fiber layer, cotton wool spot, exudates, edema residues, drusen, fundus albipunctatus, Stargardt disease, Bietti crystalline dystrophy, punctate inner choroidopathy (PIC, presumed ocular histoplasmosis syndrome (POHS, post-photocoagulation chorioretinal scarring, and osseous choristoma.Conclusion: The reviewed images demonstrate the utility of SD-OCT in the identification of the unique characteristics of the presented retinal pathologies. SD-OCT is ideal for retinal layer localization of lesions, thus enhancing the differential diagnosis of retinal dots, spots, and other white lesions. Even though true pathognomonic patterns are rare, highly suggestive findings of certain retinal abnormalities often facilitate immediate recognition and diagnosis.Keywords: SD-OCT, photoreceptor integrity line, retinal pigment epithelium, white dot syndrome, retinal pathology, imaging

  17. Clinical features and linkage analysis for a Chinese family with autosomal dominant central areolar choroidal dystrophy

    Institute of Scientific and Technical Information of China (English)

    MA Kai; LIU Ning-pu; YANG Xiu-fen; HAN Cui; ZHANG Ning; XU Jun; LIU Shou-bin; LU Hal; Torkel Snellingen; WANG Ning-li

    2009-01-01

    Background A Chinese family with autosomal dominant central areolar choroidal dystrophy (CACD) was identified.The purpose of this study was to collect the clinical findings from the family and to identify the genetic entity by linkage nalysis.Methods Forty-three individuals from 3 generations of the family underwent ophthalmologic examinations, including best-corrected visual acuity, examination of the anterior segments, and inspection of the ocular fundus after pharmacologic mydriasis. Affected family members further underwent color vision test, color fundus photography,fluorescein angiography, automated perimetry, and electroretinography. The family was followed up for 30 months.Peripheral venous blood or buccal swabs were collected from each family member and genomic DNA was extracted.Linkage analysis was performed for candidate genes or loci using microsatellite markers.Results Seven family members in 3 continuous generations were diagnosed as having autosomal dominant CACD.The family showed progressive development of the disease, affecting both male and female. Age of onset of visual disturbances varied between 11 and 50 years. Phenotypic variability among affected individuals was apparent and ranged from relatively normal-appearing fundus with mild parafoveal pigment mottling to geographic atrophy of the macula. Fluorescein angiography showed hyperfluorescent parafoveal changes in early stage or well-demarcated area of chorioretinal atrophy with enhanced visibility of the residual underlying choroidal vessels in the late stage. Peripheral retina and visual fields were normal in affected individuals. Electroretinogram showed normal or mild reduction in the photopic amplitude. Eight candidate genes (STGD4, RCD1, peripherin/RDS, GUCA1A, RIMS1, UNC119, GUC Y2D, and AIPL1) and two genetic loci (4p15.2-16.3, and 17p13) were excluded to be responsible for the disease by linkage analysis.Conclusions The clinical findings of this Chinese family with CACD shared

  18. Ophthalmologic manifestations of focal dermal hypoplasia (Goltz syndrome): A case series of 18 patients.

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    Gisseman, Jordan D; Herce, Honey H

    2016-03-01

    Focal Dermal Hypoplasia (FDH) or Goltz syndrome is a rare multi-system disorder with cutaneous, ocular, dental, and skeletal anomalies due to dysplasia of mesoectodermal derived tissues. It is an X-linked inheritance syndrome caused by mutations in the PORCN gene. This study is aimed to investigate the ocular findings in patients with Goltz syndrome. To date, there have been a limited number of case reports on the ocular manifestations of FDH. This is a prospective, non-consecutive, observational case series. Prospective ophthalmologic evaluation was performed on 18 patients with confirmed genetic testing for FDH, Goltz Syndrome, as a component of a larger multi-subspecialty study to better characterize the findings of this condition. Special attention was placed on evaluating the incidence of anophthalmia, microphthalmia, colobomas (iris, optic nerve, and/or retinal), cataracts, nystagmus, and strabismus. A complete ophthalmologic exam was done on all the patients. The mean patient age was 12.8 years (1-55 years). Eighty-nine percent were female and 77% (14/18) of patients had some form of an ophthalmologic manifestation of the condition. Ophthalmological findings included chorioretinal colobomas (61%), iris colobomas (50%), microphthalmia (44%), anophthalmia (11%), cataracts (11%), and conjunctival and eyelid papillomas (5%). Nystagmus was present in 33% and strabismus in 22% of the patients. Visual acuity ranged from 20/20 to no light perception. This study demonstrates a higher incidence of ophthalmologic manifestations as previously reported (77% vs. 40%). To our knowledge, this is the largest case series reported in the literature with 18 patients.

  19. OUTCOME OF PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION IN PATIENTS WITH HIGH MYOPIA

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    Sunil

    2015-11-01

    Full Text Available : OBJECTIVE: To evaluate the visual and refractive outcomes of phacoemulsification with intraocular lens (IOL implantation in highly myopic eyes and to assess the intraoperative and postoperative complications. SETTINGS: Tertiary care Centre Ranchi, India. METHODS: Consecutive patients with high myopia were retrospectively studied for outcomes and complications after phacoemulsification and IOL implantation. RESULTS: The study included 125 eyes of 89 patients (53 females and 36 males with a mean age of 56.01±9.51 years and mean follow-up of 19.45±4.07 months. The mean axial length was 29.58±2.57mm and power of the IOL ranged from −4.00 D to + 17.00 D. The mean preoperative logMAR Best corrected visual acuity (BCVA was 0.82±0.26 which improved to 0.38±0.29 at one month and to 0.43±0.33 at last follow-up, the improvement in vision was statistically significant (P<0.0001, paired t test. Postoperatively, 80 eyes (64% had a BCVA between 0.00 logMAR (20/20 and 0.30 logMAR (20/40. Pre-existing myopic chorioretinal degeneration (13.6% was most common factor causing decreased visual acuity. The mean spherical equivalent at one month postoperative was -0.06±1.28 D. The complications included posterior capsule rupture (5.6%, zonular dehiscence (1.6%, retinal detachment (1.6%, cystoid macular edema (8.8% and posterior capsule opacifications (10.4%. CONCLUSIONS: Phacoemulsification with intraocular lens implantation is a safe and effective procedure to improve patients visual acuity in those with high myopia.

  20. [Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey-comment].

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    Atalay, Mustafa Altay; Koc, Ayşe Nedret

    2014-04-01

    Scedosporium apiospermum is a saprophytic fungus which is isolated worldwide in soil, fertilizers, polluted water, rotten vegetables, and other natural environments. It is the cause of mycetoma, a subcutaneous infection, characterized by granule formation. It may also cause severe local or diffuse infections in immunosuppressive patients. S.apiospermum-induced arthritis, endocarditis, keratitis, scleritis, endophthalmitis, meningitis, osteomyelitis, otomycosis, onychomycosis, chronic prostatitis, peritonitis, esophagitis, renal infection, and hepatosplenic abscess have been previously reported in the literature. Possible risk factors of fungal keratitis, one of the major causes of fungal ocular infection, include ocular injury, long-term therapy with topical or systemic steroids, immunosuppressive agents, and underlying diseases such as pre-existing corneal surface abnormality and diabetes mellitus, and wearing contact lenses. We paid great attention to the case report presented by Kalkan Akçay E et al. titled "Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey", which was published in the October 2013 issue of Bulletin of Microbiology [Mikrobiyol Bul 2013; 47(4): 727-33]. Although it is deemed as the first case report of S.apiospermum-related fungal keratitis in Turkey, there were several previous case reports of ocular infections associated with this type of fungus in Turkey, including those of Yucel A titled "An eye mycosis caused by Scedosporium apiospermum (Monosporium apiospermum)" published in 1989, Kiratli et al. titled "Scedosporium apiospermum chorioretinitis" in 2001, Saracli et al. titled "Scedosporium apiospermum keratitis treated with itraconazole" in 2003 and Erdem et al. titled "Clinical follow up of a keratomycosis case with total corneal melting" in 2005. In conclusion, it should be highlighted that the report of Kalkan Akcay et al. is not the first case report of Scedosporium apiospermum-related fungal keratitis in

  1. Progressive retinal detachment secondary to juxtapapillary microholes in association with type 3 posterior staphylomas

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    Dinah CB

    2014-06-01

    Full Text Available Christiana B Dinah,1 Daniela Vaideanu-Collins,2 David HW Steel1,31Ophthalmology Department, Sunderland Eye Infirmary, Sunderland, 2Ophthalmology Department, James Cook University Hospital, Middlesbrough, UK, 3Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UKPurpose: This study describes a novel subtype of retinal detachment occurring in eyes with pathological myopia associated with type 3 posterior staphyloma and discusses the management options.Methods: We retrospectively reviewed the case notes of seven patients who presented with unilateral symptomatic rhegmatogenous retinal detachment secondary to nasal juxtapapillary microholes.Results: All seven patients had pathological myopia and an associated peripapillary type 3 posterior staphyloma. They all presented with symptoms of acute posterior vitreous detachment and had progressive retinal detachment. All cases were discovered to have a single juxtapapillary hole less than 1 disc diameter from the optic-nerve head, within areas of nasal chorioretinal atrophy. The microholes were identified intraoperatively in six of seven cases, with one case identified preoperatively on optical coherence tomography. In the four most recent cases, successful retinal reattachment was achieved with vitrectomy and C2F6 gas tamponade. The remaining three cases were managed with vitrectomy and silicone oil.Conclusion: Seven patients with pathological myopia, type 3 posterior staphyloma, and progressive retinal detachment secondary to juxtapapillary microholes are presented in this paper. High clinical suspicion is required to identify these breaks. Successful retinal reattachment with pars plana vitrectomy and long-acting gas is possible.Keywords: pathological myopia, pars plana vitrectomy, long-acting gas, pathological myopia

  2. Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil

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    Jaqueline Dario Capobiango

    2014-08-01

    Full Text Available This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2% of the mothers received prenatal care but only four (13.0% were treated for toxoplasmosis. Birth weight was <2500 g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%, jaundice (13.8%, and microcephaly (6.9%. During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein ≥ 200 mg/dL presented more brain calcifications (p = 0.0325. Other sequelae were visual impairment (55.2% of the cases, developmental delay (31.0%, motor deficit (13.8%, convulsion (27.5%, and attention deficit (10.3%. All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences.

  3. Analysis of fundus shape in highly myopic eyes by using curvature maps constructed from optical coherence tomography.

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    Masahiro Miyake

    Full Text Available PURPOSE: To evaluate fundus shape in highly myopic eyes using color maps created through optical coherence tomography (OCT image analysis. METHODS: We retrospectively evaluated 182 highly myopic eyes from 113 patients. After obtaining 12 lines of 9-mm radial OCT scans with the fovea at the center, the Bruch's membrane line was plotted and its curvature was measured at 1-µm intervals in each image, which was reflected as a color topography map. For the quantitative analysis of the eye shape, mean absolute curvature and variance of curvature were calculated. RESULTS: The color maps allowed staphyloma visualization as a ring of green color at the edge and as that of orange-red color at the bottom. Analyses of mean and variance of curvature revealed that eyes with myopic choroidal neovascularization tended to have relatively flat posterior poles with smooth surfaces, while eyes with chorioretinal atrophy exhibited a steep, curved shape with an undulated surface (P<0.001. Furthermore, eyes with staphylomas and those without clearly differed in terms of mean curvature and the variance of curvature: 98.4% of eyes with staphylomas had mean curvature ≥7.8×10-5 [1/µm] and variance of curvature ≥0.26×10-8 [1/µm]. CONCLUSIONS: We established a novel method to analyze posterior pole shape by using OCT images to construct curvature maps. Our quantitative analysis revealed that fundus shape is associated with myopic complications. These values were also effective in distinguishing eyes with staphylomas from those without. This tool for the quantitative evaluation of eye shape should facilitate future research of myopic complications.

  4. Criptococose canina: relato de caso Canine ocular cryptococcosis: a case report

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    C.E. Larsson

    2003-10-01

    Full Text Available Descreve-se, pela primeira vez no Brasil, um caso de criptococose canina com acometimento oftalmo e dermatopático, com diagnóstico intra-vitam, em animal da raça Pastor Alemão, fêmea, com 24 meses de vida, criado em São Paulo, em contacto com outros cinco cães assintomáticos, que havia se infectado pelo contato com dejetos de pombos (Columba livia. Evoluia há 90 dias, com quadro tegumentar e ósseo, sintomas e lesões características, sendo, ainda, detectada forma assintomática de coriorretinite, de início unilateral. O diagnóstico foi estabelecido pelos dados da anamnese, dos exames físico, dermatológico e complementares (radiográfico, cultivo micológico, histopatologia de pele tendo-se evidenciado e isolado cepa de Criptococcus neoformans var. neoformans. Após nove meses de terapia com itraconazol (9mg/kg/SID/VO houve involução total do quadro, sem qualquer efeito adverso à droga.A case of cryptococcosis with ocular and cutaneous involvement is reported by the first time in Brazil in a dog. A two-year-old female German Shepherd living in a hold house with other five healthy dogs was infected through the contact with pigeon (Columba livia feces. The illness started 90 days previously with cutaneous and bone involvement resulting in characteristic clinical signs and lesions, in addition to a initially unilateral asymptomatic chorioretinitis. The diagnosis was established based on anamnesis, physical and dermatologic examinations and complementary exams (radiographs, skin biopsy and histopathology and the isolation of a Cryptococcus neoformans var. neoformans strain was accomplished. There was a complete resolution of the disease after nine months of therapy using itraconazole (9mg/kg, q24h, PO and no side effect was observed.

  5. The retarded hair growth (rhg mutation in mice is an allele of ornithine aminotransferase (Oat

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    Jason J. Bisaillon

    2014-01-01

    Full Text Available Because of the similar phenotypes they generate and their proximate reported locations on Chromosome 7, we tested the recessive retarded hair growth (rhg and frizzy (fr mouse mutations for allelism, but found instead that these defects complement. To discover the molecular basis of rhg, we analyzed a large intraspecific backcross panel that segregated for rhg and restricted this locus to a 0.9 Mb region that includes fewer than ten genes, only five of which have been reported to be expressed in skin. Complementation testing between rhg and a recessive null allele of fibroblast growth factor receptor 2 eliminated Fgfr2 as the possible basis of the retarded hair growth phenotype, but DNA sequencing of another of these candidates, ornithine aminotransferase (Oat, revealed a G to C transversion specifically associated with the rhg allele that would result in a glycine to alanine substitution at residue 353 of the gene product. To test whether this missense mutation might cause the mutant phenotype, we crossed rhg/rhg mice with mice that carried a recessive, perinatal-lethal, null mutation in Oat (designated OatΔ herein. Hybrid offspring that inherited both rhg and OatΔ displayed markedly delayed postnatal growth and hair development, indicating that these two mutations are allelic, and suggesting strongly that the G to C mutation in Oat is responsible for the retarded hair growth phenotype. Comparisons among +/+, +/rhg, rhg/rhg and rhg/OatΔ mice showed plasma ornithine levels and ornithine aminotransferase activities (in liver lysates consistent with this assignment. Because histology of 7- and 12-month-old rhg/rhg and rhg/OatΔ retinas revealed chorioretinal degeneration similar to that described previously for OatΔ/OatΔ mice, we suggest that the rhg mutant may offer an ideal model for gyrate atrophy of the choroid and retina (GACR in humans, which is also caused by the substitution of glycine 353 in some families.

  6. A Mouse Model for Laser-induced Choroidal Neovascularization.

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    Shah, Ronil S; Soetikno, Brian T; Lajko, Michelle; Fawzi, Amani A

    2015-12-27

    The mouse laser-induced choroidal neovascularization (CNV) model has been a crucial mainstay model for neovascular age-related macular degeneration (AMD) research. By administering targeted laser injury to the RPE and Bruch's membrane, the procedure induces angiogenesis, modeling the hallmark pathology observed in neovascular AMD. First developed in non-human primates, the laser-induced CNV model has come to be implemented into many other species, the most recent of which being the mouse. Mouse experiments are advantageously more cost-effective, experiments can be executed on a much faster timeline, and they allow the use of various transgenic models. The miniature size of the mouse eye, however, poses a particular challenge when performing the procedure. Manipulation of the eye to visualize the retina requires practice of fine dexterity skills as well as simultaneous hand-eye-foot coordination to operate the laser. However, once mastered, the model can be applied to study many aspects of neovascular AMD such as molecular mechanisms, the effect of genetic manipulations, and drug treatment effects. The laser-induced CNV model, though useful, is not a perfect model of the disease. The wild-type mouse eye is otherwise healthy, and the chorio-retinal environment does not mimic the pathologic changes in human AMD. Furthermore, injury-induced angiogenesis does not reflect the same pathways as angiogenesis occurring in an age-related and chronic disease state as in AMD. Despite its shortcomings, the laser-induced CNV model is one of the best methods currently available to study the debilitating pathology of neovascular AMD. Its implementation has led to a deeper understanding of the pathogenesis of AMD, as well as contributing to the development of many of the AMD therapies currently available.

  7. Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis,

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    Jaqueline Dario Capobiango

    Full Text Available Abstract Objective: To evaluate the Western blotting method for the detection of IgG anti-Toxoplasma gondii (T. gondii (IgG-WB in the serum of children with suspected congenital toxoplasmosis. Methods: We accompanied 47 mothers with acquired toxoplasmosis in pregnancy and their children, between June of 2011 and June of 2014. The IgG-WB was done in house and the test was considered positive if the child had antibodies that recognized at least one band on IgG blots different from the mother's or with greater intensity than the corresponding maternal band, during the first three months of life. Results: 15 children (15.1% met the criteria for congenital toxoplasmosis and 32 (32.3% had the diagnosis excluded. The symptoms were observed in 12 (80.0% children and the most frequent were cerebral calcification in 9 (60.0%, chorioretinitis in 8 (53.3%, and hydrocephalus in 4 (26.6%. IgM antibodies anti-T. gondii detected by chemiluminescence (CL were found in 6 (40.0% children and the polymerase chain reaction (PCR for detection of T. gondii DNA was positive in 5 of 7 performed (71.4%. The sensitivity of IgG-WB was of 60.0% [95% confidence interval (CI 32.3-83.7%] and specificity 43.7% (95% CI 26.7-62.3%. The sensitivity of IgG-WB increased to 76.0 and 89.1% when associated to the research of IgM anti-T. gondii or PCR, respectively. Conclusions: The IgG-WB showed greater sensitivity than the detection of IgM anti-T. gondii; therefore, it can be used for the diagnosis of congenital toxoplasmosis in association with other congenital infection markers.

  8. Advanced drug delivery and targeting technologies for the ocular diseases

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    Barar, Jaleh; Aghanejad, Ayuob; Fathi, Marziyeh; Omidi, Yadollah

    2016-01-01

    Introduction: Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis, retinochoroiditis), ocular hypertension and neuropathy, age-related macular degeneration and mucopolysaccharidosis (MPS) due to accumulation of glycosaminoglycans (GAGs). Such therapies appear to provide ultimate treatments, even though much more effective, yet biocompatible, noninvasive therapies are needed to control some disabling ocular diseases/disorders. Methods: In the current study, we have reviewed and discussed recent advancements on ocular targeted therapies. Results: On the ground that the pharmacokinetic and pharmacodynamic analyses of ophthalmic drugs need special techniques, most of ocular DDSs/devices developments have been designed to localized therapy within the eye. Application of advanced DDSs such as Subconjunctival insert/implants (e.g., latanoprost implant, Gamunex-C), episcleral implant (e.g., LX201), cationic emulsions (e.g., Cationorm™, Vekacia™, Cyclokat™), intac/punctal plug DDSs (latanoprost punctal plug delivery system, L-PPDS), and intravitreal implants (I-vitaion™, NT-501, NT- 503, MicroPump, Thethadur, IB-20089 Verisome™, Cortiject, DE-102, Retisert™, Iluvein™ and Ozurdex™) have significantly improved the treatment of ocular diseases. However, most of these DDSs/devices are applied invasively and even need surgical procedures. Of these, use of de novo technologies such as advanced stimuli-responsive nanomaterials, multimodal nanosystems (NSs)/nanoconjugates (NCs), biomacromolecualr scaffolds, and bioengineered cell therapies

  9. A Quantitative and Standardized Method for the Evaluation of Choroidal Neovascularization Using MICRON III Fluorescein Angiograms in Rats.

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    Jonathan P Wigg

    Full Text Available In-vivo imaging of choroidal neovascularization (CNV has been increasingly recognized as a valuable tool in the investigation of age-related macular degeneration (AMD in both clinical and basic research applications. Arguably the most widely utilised model replicating AMD is laser generated CNV by rupture of Bruch's membrane in rodents. Heretofore CNV evaluation via in-vivo imaging techniques has been hamstrung by a lack of appropriate rodent fundus camera and a non-standardised analysis method. The aim of this study was to establish a simple, quantifiable method of fluorescein fundus angiogram (FFA image analysis for CNV lesions.Laser was applied to 32 Brown Norway Rats; FFA images were taken using a rodent specific fundus camera (Micron III, Phoenix Laboratories over 3 weeks and compared to conventional ex-vivo CNV assessment. FFA images acquired with fluorescein administered by intraperitoneal injection and intravenous injection were compared and shown to greatly influence lesion properties. Utilising commonly used software packages, FFA images were assessed for CNV and chorioretinal burns lesion area by manually outlining the maximum border of each lesion and normalising against the optic nerve head. Net fluorescence above background and derived value of area corrected lesion intensity were calculated.CNV lesions of rats treated with anti-VEGF antibody were significantly smaller in normalised lesion area (p < 0.001 and fluorescent intensity (p < 0.001 than the PBS treated control two weeks post laser. The calculated area corrected lesion intensity was significantly smaller (p < 0.001 in anti-VEGF treated animals at 2 and 3 weeks post laser. The results obtained using FFA correlated with, and were confirmed by conventional lesion area measurements from isolectin stained choroidal flatmounts, where lesions of anti-VEGF treated rats were significantly smaller at 2 weeks (p = 0.049 and 3 weeks (p < 0.001 post laser.The presented method of in

  10. Estrabismo sensorial: estudo de 191 casos Sensorial strabismus: a study of 191 cases

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    Bráulio Folco Telles de Oliveira

    2006-02-01

    Full Text Available OBJETIVO: Avaliar os prontuários dos pacientes com estrabismo sensorial em aspectos variados, como etiologia, tipo e medida do desvio, correlação do tipo do desvio com a idade de aparecimento da doença de base, e resultado cirúrgico dos casos operados. MÉTODOS: Avaliação dos prontuários médicos dos pacientes com estrabismo sensorial atendidos no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - USP - no setor de Motilidade Ocular Extrínseca, no período de setembro de 1990 a julho de 2002. RESULTADOS: Foram avaliados 84 pacientes masculinos e 107 femininos; o diagnóstico mais freqüente para baixa visual foi coriorretinite atrófica em 49 casos. Oitenta e sete pacientes tinham exotropia e 97 tinham esotropia. Oitenta e dois pacientes tiveram cirurgia indicada, e 50 foram operados. Em 42 deles, foi constatado sucesso cirúrgico de 90,5% (desvio longe e perto menor ou igual a 15 dioptrias prismáticas. CONCLUSÕES: O bom resultado cirúrgico observado neste e em outros estudos reforça a necessidade da correção cirúrgica nesses casos.PURPOSE: To evaluate the charts of patients with sensorial strabismus regarding range of different aspects, such as etiology, the type and the amount of deviation, relationship between the type of deviation and the patient's age when the disease occurred and the surgical outcome. METHODS: A retrospective analysis of data charts of 191 patients seen at the section of Ophthalmology at the University of São Paulo, from September 1990 to July 2002. RESULTS: There were 84 male and 107 female patients. The most frequent diagnosis responsible for low vision in the squinted eye was atrophic chorioretinitis in 49 patients. Eighty-seven were exotropes and 97 were esotropes. Fifty patients were operated on, but 8 of them were lost to follow-up. In 90.5% the surgical outcome was successful: less than 15 prismatic diopters of hyper or undercorrection after surgery. CONCLUSIONS: The

  11. Gestational and congenital toxoplasmosis in two hospitals in Bogota, Colombia

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    Edith Angel-Müller

    2014-04-01

    Full Text Available Background. Gestational toxoplasmosis is acquired during pregnancy and involves a risk of the parasite crossing the placenta, thereby leading to foetal infection, which can lead to serious sequelae in children, mainly chorioretinitis, cerebral calcification, hydrocephalus and intellectual disability. Objective. Determining the prevalence of maternal and neonatal toxoplasmosis in women attending the Engativa and La Victoria hospitals in Bogota, Colombia, for delivery. Correlating the results with those of a national multicentre study. Determining IgM and IgA anti-toxoplasma prevalence in newborn (NB umbilical cord blood. Materials and methods. This was a cohort study, which was approved by the participating institutions' ethics committees. The patients signed informed consent forms and filled out a survey requesting demographic and prenatal care data. A blood sample was taken from the umbilical cord on delivery for determining anti-toxoplasma IgM. Anti-toxoplasma IgA was also measured in a subset of patients. Children suspected of having either clinical or serological congenital toxoplasmosis were followed-up for 12 months. Results. The study involved taking 3,224 NB umbilical cord blood samples between April 1st 2009 and July 16th 2010. Positive anti-toxoplasma IgG was found in 28.2% of pregnant women (26.1-29.8 95%CI. Anti-toxoplasma IgM was determined in 558 pregnant women and found positive in 34 patients (i.e. 1.1 per 100 NB gestational toxoplasmosis incidence. Nine blood samples were positive (7 for IgM and 2 for IgA. Five of the NB studied (0.15% were positive for IgG after 12 months' follow-up, thereby confirming a diagnosis of congenital toxoplasmosis accounting for 1 in every 645 live births. Conclusion. This study showed that 70% of the pregnant women were not infected with T. gondii in the chosen hospitals in Bogotá. Gestational toxoplasmosis frequency was around 1% and 0.6% for congenital toxoplasmosis.

  12. Influence of Dll4 via HIF-1α-VEGF signaling on the angiogenesis of choroidal neovascularization under hypoxic conditions.

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    Xiao Dong

    Full Text Available Choroidal neovascularization (CNV is the common pathological basis of irreversible visual impairment encountered in a variety of chorioretinal diseases; the pathogenesis of its development is complicated and still imperfectly understood. Recent studies indicated that delta-like ligand 4 (Dll4, one of the Notch family ligands might participate in the HIF-1α-VEGF pathway to regulate CNV angiogenesis. But little is known about the influence and potential mechanism of Dll4/Notch signals on CNV angiogenesis. Real-time RT-PCR, Western blotting were used to analyze the expression alteration of Dll4, VEGF and HIF-1α in hypoxic RF/6A cells. Immunofluorescence staining, a laser-induced rat CNV model and intravitreal injection techniques were used to confirm the relationships among these molecules in vitro and in vivo. RPE-RF/6A cell co-culture systems were used to investigate the effects of Dll4/Notch signals on CNV angiogenesis. We found that the Dll4 was involved in hypoxia signaling in CNV angiogenesis. Results from the co-culture system showed that the enhancement of Dll4 expression in RF/6A cells led to the significantly faster proliferation and stronger tube forming ability, but inhibited cells migration and invasion across a monolayer of RPE cells in hypoxic environment, while siRNA-mediated Dll4 silencing caused the opposite effects. Pharmacological disruption of Notch signaling using gamma-secretase inhibitor (GSI produced similar, but not identical effects, to that caused by the Dll4 siRNA. In addition, the expression of several key molecules involved in the angiogenesis of CNV was altered in RF/6A cells showing constitutively active Dll4 expression. These results suggest that Dll4 play an important role in CNV angiogenesis, which appears to be regulated by HIF-1α and VEGF during the progression of CNV under hypoxic conditions. Targeting Dll4/Notch signaling may facilitate further understanding of the mechanisms that underlie CNV angiogenesis.

  13. Infectious uveitis in Virginia

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    Engelhard SB

    2015-08-01

    over 60 years of age. This finding is comparable to other American epidemiologic studies. Ocular toxoplasmosis and ARN were also common causes of infectious uveitis. In all, 50.6% of patients had a VA better than 20/40 at the final follow-up visit, indicating the importance of prompt referral and appropriate treatment. Keywords: uveitis, infectious, chorioretinitis, endophthalmitis, toxoplasma

  14. Ocular Health Status and Causes of Enrolment into Special Schools in Osun State, Nigeria

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    Michaeline Isawumi

    2016-12-01

    Full Text Available Background Knowledge of the status of eye diseases among students’ enrolled in the special schools would assist in planning preventive and treatment strategies. Objectives To determine the types and causes of ocular morbidity leading to enrolment of students in special schools of Osun state. Methods We conducted a cross-sectional study by utilizing a total-sampling-technique on students attending all 8 special primary and integrated secondary schools to find out the common ophthalmic diseases between July and September 2013. Teachers’ registers, oral interview and clinical examination were used to obtain data. The data were analyzed by descriptive statistics through SPSS 17 software. Results Four hundred and seventy-two (472 students between the ages of 4 and 36 years with mean of 13.7 ± 4.7 were examined. Two hundred and seventy-six (58.5% were males and one hundred-ninety- six were females. Fathers’ occupation were mostly farmers 142 (30.1% and Artisans 133 (28.2%. Abnormal ocular findings were seen in 9.9% of students. The prevalence of blindness was 4.7% [95% Confidence Interval (CI 2.7 - 6.6]. Anatomical causes of blindness were corneal scarring (2.1% especially post measles keratopathy, whole globe disorders (1.1%, toxoplasma chorioretinal scars and maculopathies (0.6%, amblyopia/uncorrected refractive errors (0.4% and cortical visual impairment (0.2% . The prevalence of visual impairment was 1.4% [CI 0.0 -1.7], with cataracts and refractive error being the most common causes. Other findings included nystagmus (0.2%, vernal conjunctivitis (0.4%, and pigmentary retinopathy (4.2%. Ocular pathologies occurred most frequently among the lower socio-economic group (χ2 169.69, P < 0.001. Conclusions The common causes of ocular diseases leading to enrolment are avoidable. Mandatory eye examination at birth, preschool years and school age is needed for early detection and intervention. Health education, adequate nutrition, and immunization

  15. Observações clínicas e laboratoriais em cães com cinomose nervosa Clinical and laboratory findings in dogs with distemper encephalomyelitis

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    Eduardo Alberto Tudury

    1997-06-01

    Full Text Available Em 81 cães com sinais clínicos, lesões histológicas e corpúsculos de inclusão no sistema nervoso central característicos de cinomose nervosa foi constatada ocorrência freqüente de: alteração das reações posturais (87,65%, diminuição da secreção lacrimal (83,95%, presença de mioclonias (75,30%, paresias (69,12%, conjuntivite (56,79%, corioretinite/ hiperqueratose naso-digital (51,85%, linfopenia (51,85%, anemia (48,05%, principalmente microcítica hipocrômica, e discretas alterações liquóricas caracterizadas por aumento de proteínas totais (77,33% e pleocitose linfocítica (50,72%. A presença de corpúsculos de Lenz em tecidos extraneurais oscilou entre 30 e 45 %, com maior freqüência em linfonodos. Enquanto outras anormalidades clínicas, neurológicas e laboratoriais não tiveram freqüência expressiva para dar apoio ao diagnóstico, o incorreto programa de vacina��ão foi uma constante.Eighty-one dogs with clinical signs and histological lesions characteristic of distemper encephalomyelitis were evaluated. Only dogs with Lenz inclusion bodies in the central nervous system were included in the study. High prevalent findings included: changes in postural reactions (87.65%, decreased tear production (83.95%, myoclonus (75.30%, paresis (69.12%, conjunctivitis (56.79%, chorioretinitis/digital and nasal hyperkeratosis (51.85%. Anemia (48.05%, lymphopenia (51.95%, and mild changes in the cerebrospinal fluid characterized by increase in total protein (77.33% and lymphocytic pleocytosis (50.72% were common laboratorial findings. Presence of Lenz inclusions bodies in tissues other than nervous system varied from 30 to 45%, with a higher frequence in the limph nodes. Other abnormalities in physical, neurological and laboratorial examinations were not helpful in establishing the diagnosis. Most animals examined were not properly vaccinated.

  16. Primary transpupillary thermotherapy of choroidal melanocytic lesions

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    Kaan Gündüz

    2011-01-01

    Full Text Available Purpose : To evaluate the role of primary transpupillary thermotherapy (TTT in the treatment of choroidal melanocytic lesions. Materials and Methods : Retrospective chart review of 24 patients (24 eyes with choroidal melanocytic lesions, including 20 choroidal melanoma and four choroidal nevus treated with primary TTT. Choroidal nevus cases treated with primary TTT either demonstrated risk factors for growth into an early melanoma or had overlying choroidal neovascularization. Results : The mean initial tumor basal diameter was 6.6 (3.0-10.0 mm and the mean initial tumor thickness was 3.0 (1.0-5.0 mm. The mean number of TTT sessions was 2.5 (1-6. The mean decrease in tumor thickness was 1.2 mm (from 3.0 to 1.8 mm at a mean follow-up of 22.7 (range 3-90 months. On the LogMar scale, visual acuity was stable at 1.0. Complications occurred in 50% of eyes. The most frequent complications were vitreous hemorrhage [5 patients (20.8%], focal cataract [5 patients (20.8%], iris atrophy [4 patients (16.6%] and posterior synechia [4 patients (16.6%]. There was no significant difference in the complication rate with respect to tumor thickness >3 mm versus tumor thickness ≤3 mm and juxtapapillary versus nonjuxtapapillary location (Fisher′s exact test, P>0.05. Kaplan-Meier curves showed that 9% of eyes develop recurrence by 1 year and 27% develop recurrence by 5 years after primary TTT. Two eyes (8.3% were enucleated because of neovascular glaucoma and one eye (4.1% was exenterated because of extraocular tumor recurrence. Globe salvage was achieved in 21 patients (87.5%. One patient (4.1% with extraocular tumor recurrence developed liver metastasis and expired. Conclusions : Although TTT may be useful in the treatment of small choroidal melanocytic lesions, the high complication and recurrence rates warrant close monitoring of patients after primary TTT even when a flat chorioretinal scar has been achieved.

  17. Frequência de lesões sugestivas de toxoplasmose ocular em uma população rural do Estado do Rio de Janeiro Frequency of lesions suggestive of ocular toxoplasmosis among a rural population in the State of Rio de Janeiro

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    Ana Luisa Quintella do Couto Aleixo

    2009-04-01

    Full Text Available Para determinar a prevalência da toxoplasmose ocular na população em geral do bairro de Santa Rita de Cássia, Barra Mansa, RJ, foi realizado um estudo seccional no qual 1.071 indivíduos foram submetidos a testes sorológicos (IgG e IgM anti-Toxoplasma e a exame físico e oftalmológico. O diagnóstico da toxoplasmose ocular presumida foi baseado em critérios clínicos, sorológicos e aspecto da lesão retinocoroidiana. As lesões foram classificadas em três tipos morfológicos: 1. Limites marcados com halo de hiperpigmentação e área de atrofia coriorretiniana central. 2. Halo hipopigmentado e área central hiperpigmentada e 3. Hiperpigmentadas ou hipopigmentadas. A prevalência de lesões cicatrizadas compatíveis com toxoplasmose ocular foi de 3,8% na população em geral e 5,8% entre os indivíduos com sorologia positiva para Toxoplasma gondii (65,9% dos indivíduos analisados, com predominância de: lesões do tipo 1 (41,5%, sexo feminino (68,3%, periféricas (58,5% e menores que 3 diâmetros de disco (87,8%.To determine the prevalence of ocular toxoplasmosis among the general population of the district of Santa Rita de Cassia, Barra Mansa, State of Rio de Janeiro, a cross-sectional study on 1,071 individuals was performed. These subjects underwent serological tests (anti-Toxoplasma IgG and IgM and physical and ophthalmological examinations. The diagnosis of presumed ocular toxoplasmosis was based on clinical and serological criteria and the appearance of the retinochoroidal lesion. The lesions were classified into three morphological types: 1. Limits marked with a halo of hyperpigmentation and an area of central chorioretinal atrophy; 2. Hypopigmented halo and hyperpigmented central area; and 3. Hyperpigmented or hypopigmented. The prevalence of healed lesions compatible with ocular toxoplasmosis was 3.8% among the general population and 5.8% among individuals who were seropositive for Toxoplasma gondii (65.9% of the individuals

  18. Features of YAG-laser treatment of posterior capsule opacification in eyes with intraocular comorbidities ext

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    O. I. Borzunov

    2015-01-01

    Full Text Available Purpose: is to evaluate the effectiveness of YAG laser posterior lens capsule dissection in patients with secondary cataract with concurrent intraocular pathology. Patients and methods: retro- and prospective analysis of the results of the YAG — laser treatment of secondary cataract in the 196 eyes, including the intraocular concomitant pathology (myopia, glaucoma, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa operated retinal detachment, chronic uveitis in remission, peripheral chorioretinal degeneration. Effectiveness of treatment was evaluated by checking visual acuity and dynamics of complaints as aberration, glare, distortion in the central field of view without proper disease of the macula. Complex preoperative studies included: refractometry, visometry with correction, perimetry, tonometry, biomicroscopy, ophthalmoscopy, ultrasound examination of the eyeball (if necessary. The examination results should demonstrate convincing evidence that posterior capsular opacification is the main reason for the decrease of visual acuity. Results:, Visual acuity, at average increased from 0.4‑0.6 to 0.8‑1.0 in 50 cases after dissection, Visual acuity improved to 2‑3 lines in 66‑4–5, 24‑6‑7 lines in 74 cases. Visual acuity remains the same, but contrast sensitivity was increased in 6 cases. The IOL location after disruption was evaluated by β-scanning and biomicroscopy. In case of the initial correct IOL position in all 195 (100 % cases, there were no dislocation in the postoperative period. Complications that can be identified were single microcraters on the IOL surface in cases of its full contact with the posterior capsule. These injuries did not affect the visual functions.Conclusion: YAG -Laser dissection of secondary cataract is effective, less traumatic, and the optimal treatment of secondary cataract, including patients with concomitant intraocular pathology, and helps to avoid over

  19. Toxoplasmose humana: meningoencefalomielite toxoplasmica: ocorrência em adulto e recemnascido

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    F. Nery Guimarães

    1943-06-01

    & Henderson (2 cases, Saint Louis, 1941; Paige, Cowen & Wolf (3 cases, New York, 1942; and De Lange (Amsterdam, 1929: diagnosed by Paige, Cowen & Wolf in 1942 .Of these reports considered as undoubtful cases of human toxoplasmosis, 10 represent congenital disease (Torres and Paige, Wolf & Cowen, having occurred in either new born or a-few-month-old children. As in the cases, in which it was possible to examine the mothers of those children, these women were of a healthy appearance, the conclusion was drawn that the disease, although extremely severe and fatal, can present an unapparent form. In 2 cases, serum protection tests proved such an unapparent infection of the mothers, in whom neutralizing antibodies against Toxoplasma were met with (Paige, Cowen & Wolf. Although no detailed microscopical study has been made in all cases, the disease is characterized by granulomatous meningoencephalomyelitis (Wolf & Cowen, often associated with myocarditis and chorioretinitis. The symptoms presented by the patients were: fever, convulsions, respiratory disturbances, hydrocephalus, cyanosis, vomiting, temperature lability, etc., the diagnostic sign of the greatest importance being the presence of foci of profound cerebral calcification and chorioretinitis in new born (Wolf, Cowen & Paige. In 2 cases of toxoplasmosis verified in one 6 and the other 8 years old, patients, an encephalitis, clinically atypical, was met with, one of them having recovered his health (Sabin. The remaining three cases were described in adults; in one of them the changes were not typical (these was a concomittant infection by Bartonella bacilliformis and in the two others the disease assumed an "exanthematous form", simulating a macular fever (Pinkerton & Henderson, the most important microscopical evidence being an interstitial pneumonia. Apart from the clinical similarity, also the encephalitis foci met with in this "exanthematous form" of toxoplasmosis resemble those described in "macular fevers"…

  20. Avaliação das alterações fundoscópicas na miopia degenerativa Fundus changes evaluation in degenerative myopia

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    Oswaldo Ferreira Moura Brasil

    2006-04-01

    Full Text Available OBJETIVO: Avaliar a presença de alterações fundoscópicas em pacientes portadores de miopia degenerativa. MÉTODOS: Quarenta pacientes com erro refrativo de pelo menos -6,00 dioptrias foram selecionados para exame oftalmológico, complementado por retinografia do pólo posterior e ecobiometria. RESULTADOS: Foram estudados 57 olhos de 37 pacientes com erro refrativo de -6,25 a -28,50 dioptrias, com média de -14,05, e comprimento axial de 26,06 a 32,86 mm, com média de 28,01. Encontramos crescente temporal em 36,5% e circunferencial em 21% dos olhos. Vasos da coróide foram visualizados em 35% dos olhos. As alterações do pólo posterior foram as seguintes: estafiloma posterior em 10,5%, mancha de Fuchs em 3,5% e "lacquer cracks" em 1,5%. O exame da periferia retiniana evidenciou atrofia corio-retiniana tipo pavimentosa em 17,5%, branco sem pressão em 10,5%, degeneração "lattice" em 5%, ruptura retiniana em 3,5% e retinosquise em 1,5% dos olhos examinados. CONCLUSÕES: Alterações fundoscópicas que levam à baixa visual são freqüentes em pacientes com miopia degenerativa. O exame da periferia retiniana é muito importante nestes pacientes devido ao risco aumentado de descolamento de retina.PURPOSE: To evaluate the presence of fundus changes in degenerative myopia. METHODS: Forty patients with refractive error of at least -6.00 diopters were selected for ophthalmologic examination followed by posterior pole photograph and echobiometry. RESULTS: We studied 57 eyes of 37 patients with refractive error ranging from -6.25 to -28.50 diopters, with mean -14.05, and axial length ranging from 26.06 to 32.86 mm, with mean 28.01. We found a temporal crescent in 36.5% and a peripapillary one in 20% of the eyes. Choroidal vessels were seen in 35% of the eyes. Posterior pole changes were as follow: posterior staphyloma in 10.5%, Fuchs' spots in 3.5% and lacquer cracks in 1.5%. Peripheral retinal examination revealed paving stone chorioretinal

  1. Condição ocular dos indivíduos facectomizados na região centro-oeste do estado de São Paulo: estudo populacional Cataract-operated individuals at the Center-Western zone of São Paulo state: populational survey

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    Olívia Matai

    2008-02-01

    % of the patients had visual acuity improved with refractive error correction. The main causes of poor vision were refractive error, posterior capsule opacification (19.4%, bullous keratophaty (8.3%, cicatricial chorioretinitis (8.3%, aphakic eyes (8.3%, age-related macular degeneration (5.5%, leukoma (5.5%, glaucoma (5.5%, optic atrophy (5.5%, retinal detachment (2.8%, retinal pigment epithelium atrophy (2.8% and high myopia (2.8%. CONCLUSION: Cataract projects are effective in reducing preventable blindness caused by lens opacity. However, long-term scheduled evaluation of operated patients is necessary avoiding consequent blindness resulting from neglected follow-up.

  2. Panuveitis with oral and genital ulcer misdiagnosed as Behcet’s disease:two cases report and literature review%全葡萄膜炎合并口腔、外阴溃疡误诊为白塞病2例分析及文献复习

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    王昱; 杨柳; 张卓莉

    2016-01-01

    SUMMARY Here we reported two patients who presented with panuveitis and were transferred from oph-thalmologists to rheumatologists,for both the patients had oral and genital ulcers.They were misdiag-nosed with Behcet’s disease at first glance.Two young males presented with acute uveitis with history of recurrent oral and genital ulcers.They initially presented with symptoms and signs resembling Behcet’s disease and were treated with systemic steroids with suboptimal responses.Routine laboratory test re-vealed syphilis and human immunodeficiency virus (HIV)infection.After treatment of penicillin and anti HIV virus therapy,the panuveitis was relived.The other patient was lost in the follow up.Recently epi-demiological data indicate that syphilis and HIV infection increase,which can mimic the manifestation of Behcet’s disease.Diagnosis of sexual transmitted diseases,such as HIV or syphilis needs to be ruled out in all cases that mimic the clinical feature of Behcet’s disease,especially for those who had a history of high risk behaviors.Every patient should have history analysis in detail.Screening of sexual transmitted diseases,such as HIV or syphilis is important especially in those rapid progressive panuveitis.Also, other virus infections,such as cytomegalovirus,epstein-barr virus or Herpes simplex virus can cause mucosa ulcers and uveitis.CD4 T cell count is a very important marker to indicate that the patient has immunodeficiency.Erythema nodosa and pseudofolliculitis are the third common clinical manifestation in Chinese Behcet’s disease patients.Rheumatologist should watch out for patients without skin involvement when making the diagnosis of Behcet’s disease.Syphilis-associated uveitis usually has a good prognosis. Treatment of antibiotics can get good response,92% uveitis can be relieved,with 67% improved vision. Acute syphilitic posterior placoid chorioretinitis (ASPPC)is a clinically and angiographically distinct manifestation of ocular syphilis

  3. Metástasis coroideas Choroidal metastases

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    C. Camarillo

    2008-01-01

    . Etiology varies according to the sex of the patient: lung carcinoma metastasises most frequently in men and breast carcinoma in women. These tend to multifocality and are generally localized in the posterior pole. Fifty percent of cases follow an asymptomatic development, but they can cause loss of vision, scotomas, metamorphopsias and photopsias. Charactersitic ophthamoscopic examination shows a placoid, homogenous choroidal lesion with a creamy appearance. The differential diagnosis must consider the amelanotic nevus, choroidal amelanotic melanoma, choroidal haemangioma, rear scleritis, choroidal osteoma, chorioretinitis, Harada’s disease, rhegmatogenous retina detachment, uveal effusion syndrome, and serous central chorioretinopathy. An exhaustive history and complete ophthalmological examination are essential to the diagnosis, to which fluorescein angiography, ocular echography, fine needle puncture aspiration (FNPA, computerized tomography and magnetic resonance can be added as complementary tests. Treatment of these tumours is usually the systemic treatment of the primary tumour; the possibilities of local treatment are observation, external radiotherapy, transpupillary thermotherapy and enucleation.

  4. 高度近视相关胶原基因的研究进展%The association between collagen genes and high myopia

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    李玲; 郭洪; 白云

    2012-01-01

    高度近视(high myopia)又称病理性近视,其屈光度≤-6.00 D,伴有眼轴的延长和眼基质的改变,是一种致盲的重要器质性眼病.家族性高度近视具有明显的遗传性,符合孟德尔遗传规律,但其致病基因尚未确定.巩膜胶原表达和积聚异常导致眼球过度扩张被认为是高度近视形成的重要机制,因此胶原基因与高度近视的关系已经引起关注.已有研究表明COLA1基因与高度近视相关,同时多种伴有高度近视症状的综合征的致病基因均为胶原基因,以上证据表明胶原基因可能是高度近视的致病基因并应成为高度近视相关基因的重要研究方向.该文就高度近视相关胶原基因的研究进展进行综述.%High myopia (HM;≤-6.0 diopters [D]) affects approximately 2 % of general population,and is a major cause of legal blindness in many countries.The development of HM is a significant risk factor for other ocular diseases,including chorioretinal degeneration,glaucoma,retinal detachment,and premature cataracts.Identifying causative genes will lead to enhanced understanding of the disease process and may aid in prevention.Genetic predisposition seems to be a dominant factor of its development and progression.Each type of Mendelian inheritance for familial HM has been described and several genetic loci have been mapped,but no causative gene has been identified until now.HM is associated with molecular changes in the sclera that result in significant scleral thinning,altered scleral architecture,and ocular axial elongation.Recently,COL1A1 gene polymorphisms were reported to be associated with HM,respectively.Moreover,collagen genes have been identified to be responsible for some syndromes with high myopia as the main symptom of the disease,such as Stickler syndrome,Marshall syndrome and Knobloch syndrome.Above evidences could support the potential association between collagen genes and HM. Aiming to demonstrate that collagen genes

  5. Manifestaciones retinianas de las enfermedades infecciosas Retinal manifestations of infectious diseases

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    M. Pérez de Arcelus

    2008-01-01

    important cause of choroidal neovascularisation. The viruses that most frequently affect the retina are of the herpes type and can produce devastating symptoms in immunoincompetent patients, named acute retinal necrosis syndrome. Retinitis due to cytomegalovirus is more frequent in immunodepressed patients, as in the case of AIDS, but it must also be contemplated in patients with lymphoma and immunomodulatory treatment. The most frequent bacterial diseases that affect the retina are syphilis and tuberculosis. Disease due to cat scratches, caused by a borrelia, can produce a neuroretinitis. Toxoplasmosis is the most common of the infectious diseases caused by a parasite and gives rise to chorioretinitis. Toxocariasis, also caused by a parasite, is second in importance, giving rise to choroidal granulomas and retinal tractions.

  6. Toxoplasmose ocular em cães jovens inoculados com Toxoplasma gondii Ocular toxoplasmosis in young dogs inoculated with Toxoplasma gondii

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    Cláudia Bonini de Abreu

    2002-10-01

    papilledema, peripapillary exsudate and tapetum pigmentation were noted in three dogs submitted to retinograph. The histopathology showed focal mononuclear infiltrate of choroid, congestion of chorioretinal vessels an subretinal edema in eight dogs. Our results allow to conclude that acquired ocular toxoplasmosis in the dogs is as significant as in man and in doing so other studies must be undertaken.

  7. Cerebral mass lesion due to cytomegalovirus in a patient with AIDS: case report and literature review Lesão expansiva cerebral devida a citomegalovírus: relato de caso e revisão da literatura

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    José E. Vidal

    2003-12-01

    Full Text Available Cytomegalovirus (CMV disease in acquired immunodeficiency syndrome (AIDS patients most commonly presents as chorioretinitis and gastro-intestinal infection. Neurological involvement due to CMV may cause several clinical presentations: polyradiculitis, myelitis, encephalitis, ventriculo-encephalitis, and mononeuritis multiplex. Rarely, cerebral mass lesion is described. We report a 39 year-old woman with AIDS and previous cerebral toxoplasmosis. She presented with fever, seizures, and vulval ulcers. Her chest X-ray showed multiple lung nodules, and a large frontal lobe lesion was seen in a brain computed tomography scan. She underwent a brain biopsy through a frontal craniotomy, but her condition deteriorated and she died in the first postoperative day. Histopathological studies and immunohistochemistry disclosed CMV disease, and there was no evidence of cerebral toxoplasmosis, bacterial, mycobacterial or fungal infection. CMV disease should be considered in the differential diagnosis of cerebral mass lesion in AIDS patients. High suspicion index, timely diagnostic procedures (surgical or minimally invasive, and proper utilization of prophylactic and therapeutic medication could improve outcome of these patients.As doenças causadas pelo citomegalovírus (CMV em pacientes com a síndrome da imunodeficiência adquirida apresentam-se principalmente como corioretinite ou comprometimento gastrointestinal. No sistema nervoso central, o CMV pode causar diversas síndromes clínicas: poliradiculite, mielite, encefalite, ventrículo-encefalite e mononeurite múltipla. Raramente, lesões expansivas cerebrais são descritas. Os autores relatam o caso de uma paciente de 39 anos com antecedentes de infecção pelo HIV e toxoplasmose cerebral, que apresentou-se com febre, convulsões e úlceras vulvares. O raios-X de tórax demonstrou múltiplos nódulos pulmonares e a tomografia computadorizada de crânio evidenciou extensa lesão no lobo frontal esquerdo

  8. Fundus characteristics in teenagers with high myopia%青少年高度近视患眼眼底特征及其与屈光状态的相关性

    Institute of Scientific and Technical Information of China (English)

    郭寅; 唐萍; 吴敏; 吕燕云; 冯祎; 刘丽娟; 徐亮

    2016-01-01

    萎缩弧面积更大,豹纹状眼底分级、视盘倾斜发生率及视盘倾斜指数更高,BCVA更差.结论 青少年高度近视患眼主要眼底特征是视盘旁β区萎缩弧;出现后极部眼底病变严重影响视功能.%Objective To assess the fundus characteristics and their associations with refractive error,best corrected visual acuity (BCVA) of highly myopic eyes in Chinese teenagers.Methods This is a crosssectional and retrospective study.544 teenagers (1050 eyes) with refraction more than-6.00 D were recruited from Tongren Eye Care Center.All participants underwent examinations including cycloplegic auto-refractometry and retinoscopy,BCVA,slit lamp and 45°color funds photography centered in macular.BCVA was recorded with logarithm of the minimum angle of resolution (logMAR) acuity.988/1050 (94.1%) fundus photographs with clearly visible optic disc and fovea were selected for analysis.Degree of tessellation in optic disc and macular was defined by the exposure of choroidal vessel.Area of beta parapapillary atrophy (PPA),maximal and minimal diameter of optic disc,degree of fundus tessellation were measured by Image J software.Optic disc ovality was calculated by maximal diameter/minimal diameter.Associations between degree of tessellation,beta PPA area,optic disc ovality and refractive error,BCVA were analyzed.Presence of high myopic retinopathy,including chorioretinal atrophy,lacquer crack and Fuchs spot were also observed.Results Mean spherical equivalent was (10.66 ± 2.63) D.Mean logMAR BCVA was 0.11 ± 0.22.Tessellation was in 66.9% eyes.Mean degree in macular and peripapillary region was 0.83±0.96 and 1.04±1.00(r=0.875,P 0.000).Beta PPA was in 97.3% eyes and mean area was (0.45±0.57) mm2.Mean ovality factor was 1.25±0.18 and Tilted optic disc was in 28.5% eyes.Refractive error,logMAR BCVA,beta PPA area,tilted optic disc and ovality factor were related with the degree of optic disc and macular tessellation (P<0.05).Highly

  9. Retinal peripheral changes after LASIK Alterações da retina periférica após LASIK

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    João Jorge Nassaralla Junior

    2008-06-01

    Full Text Available PURPOSE: To better define the effect of laser in situ keratomileusis (LASIK on myopic eyes and the risk and incidence of retinal complications after surgery. METHODS: In a prospective study, 200 eyes of 100 patients, 49 male and 51 female, with a mean age of 29.7 years, had a complete posterior pole examination before and at 1 week, 1, 3 and 12 months after bilateral simultaneous LASIK for the correction of myopia. Mean spherical equivalent was 7.75D (range 1.00 to -17.25D. Before LASIK, preventive treatment was carried out on predisposing lesions to retinal complications, with laser photocoagulation. RE: Before surgery, the ophthalmic features were: 86 eyes (43% presented no peripheral abnormalities; 49 eyes (24.5% had lattice degeneration; 18 eyes (9%, white without pressure; 5 eyes (2.5%, white with pressure; 33 (16.5%, oral chorioretinal degenerations; 6 (3%, paving stone; 45 (22.5%, posterior vitreous detachment; 20 (10%, retinal vitreous traction; and 12 (6%, round holes. Comparing the incidence of ophthalmic features before and at one year after surgery, there was not a statistical significant difference (P>0.05. CONCLUSION: Although retinal pathologic conditions have been described as complications after LASIK, our data did not reveal a cause-effect relationship between the refractive error corrective procedure and retinal complications. The retinal changes found after LASIK in this series of patients, appear to reflect the predisposition of myopes. Both patient and doctor should be aware that, even after the refractive error correction, the risk of complications related to the myopic eye would persist.OBJETIVO: Definir melhor o efeito da técnica laser in situ keratomileusis (LASIK em olhos míopes, o risco e a incidência de complicações retinianas após a cirurgia. Este estudo foi realizado no Instituto de Olhos de Goiânia. MÉTODOS: Em um estudo prospectivo, 200 olhos de 100 pacientes, 50 homens e 50 mulheres, com idade média de

  10. N-Acetylcarnosine sustained drug delivery eye drops to control the signs of ageless vision: Glare sensitivity, cataract amelioration and quality of vision currently available treatment for the challenging 50,000-patient population

    Directory of Open Access Journals (Sweden)

    Mark A Babizhayev

    2008-10-01

    with advancing age, such as cataract and glaucoma, which are by far the commonest causes of blindness in our sample and in all age groups, glaucomatous neurodegeneration can be treated with developed NAC autoinduction prodrug eye drops equipped with corneal absorption promoters. The common blinding affections presenting in developed countries such as, senile macular degeneration, hereditary chorioretinal dystrophies, diabetic retinopathy are poorly represented in our current summary of vital-statistics and will be reported inherent in next N-acetylcarnosine ophthalmic drug studies.Conclusion: The authors present evidence, about why only a certain kind of NAC is safe, and why only certain formulas designed by IVP for drug discovery are efficacious in the prevention and treatment of senile cataract for long-term use. Overall cumulated studies demonstrate that the designed by IVP new vision-saving drug NAC eye drops help the aging eye to recover by improving its clarity, glare sensitivity, color perception and overall vision.Keywords: age-related ophthalmic diseases, cataract, disability-glare, halos, Halometer, visual-acuity, N-acetylcarnosine lubricant eye drops, repurchase behavior analysis, 50,000-patients’ compliance to self-administer eye drops

  11. Sinais ultra-sonográficos em fetos portadores de toxoplasmose congênita Ultrasonographic markers for fetal congenital toxoplasmosis

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    Júlio César de Faria Couto

    2004-06-01

    ultrasonographic alterations in fetuses infected with Toxoplasma gondii, correlating them with neonatal prognosis. METHODS: between June 1997 and May 2003, 150 pregnant women with suspected toxiplasmosis were examined. Acute infection was confirmed in 72 (48% of these pregnant women and congenital toxoplasmosis was diagnosed in 12 (16% fetuses. Prenatal diagnosis was established by polymerase chain reaction in the amniotic fluid. All the patients received antiparasitic therapy. Ultrasound examination was performed every fortnight and all the infants were evaluated during their first year of life. RESULTS: ultrasonographic changes were observed in eight fetuses. All of them showed symmetric bilateral ventricular enlargement that was associated with periventricular calcifications in five cases. Other changes as hepatic calcification, hepatomegaly, polyhydramnium, and pericardial effusion were less frequent. Among these fetuses, four were stillborn and three showed sequelae (chorioretinitis and neuro-psychomotor retardation. The four fetuses that showed normal ultrasonography had a satisfactory development. CONCLUSION: There was a high incidence of ultrasonographic changes in fetuses with congenital toxoplasmosis, mainly brain damage. Other changes as hepatomegaly and pericardial effusion were less frequent and were related to a systemic infection. The prognosis of these fetuses seems to be correlated with the presence of these lesions mainly because they had high mortality ratio and among the survivors the incidence of sequelae was high. The non-symptomatic fetuses evolved in a favorable way without developing sequelae. These results highlight the value of ultrasonographic examination of these fetuses in order to establish a prognosis and allow the elaboration of a suitable post-natal procedure.

  12. 伴眼部受累的结节病临床特征分析%Clinical analyses of sarcoidosis with ocular involvement

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    刘晓芳; 孙永昌; 戴红蕾; 金建敏; 刘涌

    2014-01-01

    Objective To explore the clinical characteristics and systemic manifestations of sarcoidosis with ocular involvement.Methods The clinical data of 19 cases of sarcoidosis with ocular involvement confirmed by pathology at Beijing Tongren Hospital from March 2004 to February 2014 were analyzed retrospectively.The ocular manifestations, chest imaging findings, laboratory tests and pathological diagnosis were reviewed. And the clinical features of sarcoidosis with ocular involvement were summarized.Results Among them, there were 6 males and 13 females with an average age of (47 ±14) (16-76) years.The ocular symptoms were the initial presenting manifestations of sarcoidosis in 12 cases while 2 cases presented ocular symptoms during the course of disease.And aother 5 cases without ocular symptoms were confirmed to have ocular involvement by eye examination.The main manifestations of ocular sarcoidosis were uveitis (n=16), chorioretinitis (n=3), retinal vasculitis (n=2), optic neuritis (n=1) and orbital mass (n=3).The key feature of sarcoidosis was bilateral hilar lymphadenopathy (BHL) (14/16) on chest film.The diagnosis in 17 cases was confirmed by biopsy of extra-ocular organs.The positive diagnostic rate of bronchial biopsy was 8/9.Conclusions Ocular involvement in sarcoidosis is relatively common due to a variety of ocular manifestations and serious vision impairment in some patients. Ophthalmologic examination is essential in the clinical management of sarcoidosis. Chest imaging and bronchial biopsy are important for the diagnosis of sarcoidosis with initial ocular manifestations.%目的:了解伴眼部受累的结节病的临床特征。方法回顾性分析2004年3月至2014年2月北京同仁医院经组织病理学确诊的19例伴眼部受累的结节病患者的临床资料,分析其眼部表现、胸部影像学特征、实验室检查结果和病理学诊断情况,总结伴眼部受累的结节病的临床特征。结果在其间诊断的39

  13. 合并人免疫缺陷病毒感染的梅毒性葡萄膜视网膜炎的临床表现%Ocular manifestations of syphilitic uveoretinitis in patients co-infected with human immunodeficiency virus

    Institute of Scientific and Technical Information of China (English)

    张锐; 钱江; 王朱健; 袁一飞

    2015-01-01

    uveoretinitis in patients co-infected with human immunodeficiency virus (HIV).Methods Uveoretinitis patients presenting between January 2008 and December 2014 at Eye and ENT Hospital of Fudan University were collected.Patients were selected with positive serologic tests, including rapid plasma regain titer (RPR) > 1 : 8, treponema pallidum particle agglutination assay (TPPA) and human immunodeficiency virus (HIV).Other causes of uveoretinitis were excluded.Each patient underwent complete ophthalmologic examination including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, ophthalmoscopy, applanation tonometry and B-scan ultrasonography.Fundus fluorescein angiography were obtained in each case except for patients whose fundus was blurred with dense vitritis.Optical coherence tomography (OCT) was performed in selected patients.Thorough physical examination was performed simultaneously.Results Twenty six patients were included in this study including 24 male (92.3%) and 2 female (7.7%).The mean age at presentation was 39.3±13.2 (range 20 to 63 years).RPR titres ranged from 1:32 to 1:512.There were 49 eyes altogether and ocular involvement was bilateral in 23 patients (88.5%) and unilateral in 3 patients (11.5%).Panuveitis was the most common ophthalmic presentation (n=39, 79.6%).Only two eyes were anterior uveitis (4.1%) and 8 eyes were posterior uveitis (16.3%).Anterior chamber cells+++ and mild to severe vitreous opacities were observed.Sixteen eyes presented with neuroretinitis (32.7%), 27 eyes had vitritis (55.1%), 5 eyes had retinochoroiditis (10.2%), 5 eyes had optic neuritis (10.2%), 5 eyes had retinitis (10.2%) including 2 eyes with necrotizing retinitis (4.1%), 4 eyes had retinal vasculitis (8.2%).Two eyes (11.5%) presented with posterior placoid chorioretinitis (4.1%) and multifocal choroiditis (4.1%).Systemic manifestations were detected.Five patients had a history of skin rash (19.2%), five (19.2%) had genital