1/18. Confocal microscopy in the iridocorneal endothelial syndrome.AIMS: To report the appearances of iridocorneal endothelial (ICE) syndrome from real time, white light confocal microscopy. methods: Three consecutive patients, each with ICE syndrome, were examined prospectively. Corneal specular and confocal microscopic examinations were performed in all three patients. In the first patient, a penetrating keratoplasty was performed and the cornea was examined by light and scanning electron microscopy. No surgery was performed in the remaining two patients. RESULTS: In the first patient corneal oedema prevented endothelial specular microscopy. Confocal microscopy performed before penetrating keratoplasty successfully revealed abnormal epithelial-like endothelial cells. Histological examinations of the cornea following penetrating keratoplasty revealed the presence of multilayered endothelial cells with epithelial features (microvilli). In the remaining two patients, specular microscopy showed the presence of ICE cells with typical dark/light reversal. Confocal microscopy demonstrated groups of endothelial cells with epitheloid appearances. In all three patients, the contralateral endothelial appearance was normal by specular and confocal microscopy, except for moderate endothelial polymegathism in one patient. Epithelial-like endothelial cells were characterised by prominent nuclei on confocal microscopy. CONCLUSIONS: The application of confocal microscopy indicates that the ICE syndrome is characterised by epitheloid changes in the endothelium. Confocal microscopy may be used to diagnose the ICE syndrome by demonstrating epithelial-like endothelial cells with hyperreflective nuclei. This technique is especially of value in cases of corneal oedema, since specular microscopy may fail to image the endothelium in such cases.- - - - - - - - - - ranking = 1keywords = edema (Clic here for more details about this article) |
2/18. Production of anterior segment ischemia.Anterior segment ischemia changes can occur without detachment of any muscles. The most common cause of such ischemic changes of the anterior segment is the removal of too many rectus muscles in one operation. Twenty dog eyes and eight monkey eyes were subjected to the disinsertion and detachment of various combinations of extraocular muscles. They were sacrificed at intervals from 30 to 90 days. During the observation period, they were observed for gross and slit lamp changes. The enucleated eyes were studied microscopically for signs of ischemic and necrotic changes. Two patients who were studied, observed, and treated for anterior segment ischemia following muscle surgery are described. The changes which occur after muscle surgery are extensive and include corneal edema, cataract, chemosis, corneal changes, decreases in intraocular pressure, decreases in outflow or glaucoma and frank necrosis. The variables which lead to this reaction is described in detail. Also, some unanswered queries, such as the duration of the reaction and the time interval of the reaction after multiple muscle surgeries, are discussed.- - - - - - - - - - ranking = 0.5keywords = edema (Clic here for more details about this article) |
3/18. Is Posner Schlossman syndrome benign?PURPOSE: To determine the clinical course of patients with Posner Schlossman syndrome (PSS). DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Fifty-three eyes of 50 patients. methods: The case notes of all patients with PSS seen at the uveitis Clinic of singapore National eye Centre were reviewed for evidence of glaucoma damage and risk factors. MAIN OUTCOME MEASURES: Visual field and optic disc changes consistent with glaucoma. RESULTS: There were 28 men and 22 women, and their mean age at onset was 35 years. Fourteen eyes (26.4%) were diagnosed to have developed glaucoma as a result of repeated attacks of PSS. patients with 10 years or more of PSS have a 2.8 times higher risk (95% confidence interval 1.19-6.52) of developing glaucoma compared with patients with less than 10 years duration of the disease. Nine eyes (17%) underwent glaucoma filtering surgery with antimetabolites. Their postoperative follow-up ranged from 15 to 50 months (mean, 37 months). Four eyes continued to have episodes of iritis after surgery, and one of these eyes had elevated intraocular pressure during the event. CONCLUSIONS: A significant number of patients with PSS have glaucoma develop over time, and they need to have their optic disc appearance and visual fields carefully monitored.- - - - - - - - - - ranking = 3.311657706851keywords = optic (Clic here for more details about this article) |
4/18. Traumatic central retinal artery occlusion with sickle cell trait.An 8-year-old black boy with sickle cell trait struck his left brow and globe on the edge of a table and had immediate blurring of vision. Six days later visual acuity was light projection, and traumatic iritis with secondary glaucoma and perimacular edema were present. fluorescein angiography indicated obstructed peripheral and perimacular arterioles and dye leakage from the disk.- - - - - - - - - - ranking = 0.5keywords = edema (Clic here for more details about this article) |
5/18. Serious complications of topical mitomycin-C after pterygium surgery.BACKGROUND: The use of topical mitomycin (mitomycin-C) as a medical adjunct to pterygium and glaucoma surgery is increasing. methods: The authors report on a series of 10 patients who experienced serious, vision-threatening complications associated with the use of this drug after pterygium surgery. RESULTS: Complications included severe secondary glaucoma (4 patients), corneal edema (3 patients), corneal perforation (1 patient), corectopia (2 patients), iritis (8 patients), sudden onset mature cataract (2 patients), scleral calcification (1 patient) and incapacitating photophobia and pain (8 patients). Two patients required penetrating keratoplasties and a third required three lamellar keratoplasties. Another patient underwent four additional surgeries including a conjunctival Z-plasty, scleral patch grafting, and conjunctival autografting before his intractable pain and photophobia resolved 15 months after the original surgery. Because of these complications, 6 patients required a total of 20 return visits to the operating room after their original pterygium surgery. In 5 eyes, visual acuity remained at 20/200 or less. Three of the six patients with the most severe complications had concomitant chronic external diseases (rosacea [3 patients], ichthyosis [1 patient], keratitis sicca [1 patient]). CONCLUSION: The authors urge extreme caution in the use of mitomycin. If mitomycin is used, the lowest possible concentration should be applied for the shortest time period in an effort to avoid these complications. A prospective multicenter study of the ophthalmic use of this medication is needed.- - - - - - - - - - ranking = 0.5keywords = edema (Clic here for more details about this article) |
6/18. A case of frosted-branch retinal angiitis in a child.We report the case of a patient with frosted-branch angiitis of the retina in a 3-year-old girl. She had acute visual disturbances OU, and we observed iritis, retinal edema, and retinal angiitis. Retinal angiitis showed the same condition as previously described, the so-called acute frosted retinal periphlebitis accompanied with vascular sheathing. Her eyes improved rapidly after administration of an oral corticosteroid, and during the ensuing four months, she had no recurrences.- - - - - - - - - - ranking = 0.5keywords = edema (Clic here for more details about this article) |
7/18. Ocular manifestations of mycoplasma pneumoniae infection.Ocular manifestations of mycoplasma pneumoniae infection, other than conjunctivitis, are uncommon. optic disk swelling, optic nerve atrophy, retinal exudates and hemorrhages, and cranial nerve palsies have been infrequently reported. We describe a 15-year-old patient who developed bilateral optic disk edema and iritis during an acute infection with M. pneumoniae and review the world literature on findings associated with ocular manifestations of infection with this pathogen. Although our patient experienced complete resolution of iritis and optic disk edema after 6 weeks, several patients described in the literature have experienced permanent sequelae as a result of optic neuropathy.- - - - - - - - - - ranking = 7.6233154137019keywords = optic, edema (Clic here for more details about this article) |
8/18. Tubulointerstitial nephritis and uveitis syndrome associated with hyperthyroidism.We report a 17-year-old male patient with tubulointerstitial nephritis and uveitis (TINU) associated with hyperthyroidism. He presented with a 2-month history of fatigue, loss of appetite, low-grade fever, and a 12-kg weight loss when he was admitted to our hospital. He had iritis, which was complicated by fibrin in the anterior chamber, diagnosed by slit-lamp examination. On laboratory examinations, deteriorated renal function (blood urea nitrogen level was 25.9 mg/dl and creatinine level was 2.82 mg/dl) and elevated urinary levels of N-acetyl-beta-D-glucosaminidase (33.1 U/l) and beta2-microglobulin (78,600 microg/l) were observed. serum thyroid-stimulating hormone (TSH) was undetectable, at less than 0.01 microIU/ml, and free triiodothyronine and free thyroxine were elevated, up to 5.23 pg/ml and 2.85 ng/dl, respectively. The titers of antithyroglobulin and antithyroid microsomal and TSH-receptor antibodies were not elevated. Abdominal and thyroidal ultrasonography showed evident bilateral enlargement of the kidneys and diffuse enlargement of the thyroid gland. iodine-123 scintigraphy showed low uptake in the thyroid gland. The biopsied renal specimen showed mild edema and severe diffuse infiltration of mononuclear cells and few eosinophils in the interstitium, without any glomerular or vascular abnormalities. Based on the clinical features and pathological findings, a diagnosis of TINU syndrome with associated hyperthyroidism was made. Treatment was started with 30 mg/day of prednisolone. The iritis disappeared, and the patient's clinical status improved remarkably. This case suggests the possibility of thyroid dysfunction in some patients with TINU syndrome, and we believe thyroid function should be measured in all TINU patients. Moreover, histopathological diagnosis of the thyroid glands before treatment is necessary for TINU patients with thyroid dysfunction.- - - - - - - - - - ranking = 0.5keywords = edema (Clic here for more details about this article) |
9/18. Identification of toxoplasma gondii in paraffin-embedded sections by the polymerase chain reaction.We used the polymerase chain reaction to amplify dna fragments specific to toxoplasma gondii. The sensitivity of the technique allowed for the detection of as few as ten cultured T. gondii tachyzoites. We applied the same amplification technique to deparaffinized ocular sections from two cases of ocular toxoplasmosis. Although toxoplasmic cysts could only be seen in one eye by optical microscopy, polymerase chain reaction allowed the identification of the parasite in both cases. Our study indicates the feasibility of a sensitive dna-based assay to complement pathologic studies of an ocular parasitic disease.- - - - - - - - - - ranking = 1.6558288534255keywords = optic (Clic here for more details about this article) |
10/18. iritis and papillitis as a primary presentation of lyme disease.A 9-year-old boy had iridocyclitis and papillitis. Laboratory evaluation revealed a positive Lyme titer. Institution of therapy with intravenous ceftriaxone resulted in regression of the ocular inflammation. Ophthalmologists should consider lyme disease in the differential diagnosis of iridocyclitis in conjunction with papillitis.- - - - - - - - - - ranking = 3078.3154788265keywords = papillitis (Clic here for more details about this article) |
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