1/9. Unusual retinal vasculitis in a patient with protein s deficiency and systemic toxoplasmosis: a case report.A 28-year old female patient presented with unilateral dropped visual acuity and a central scotoma. Fundus examination and a fluorescein angiogram were suggestive for central retinal vein prethrombosis. Further tests revealed an isolated protein s deficiency for which oral anticoagulation therapy was initiated. Six months later she presented with new symptoms of a right retrobulbar pain on ocular movements. The retinal vessels had normalized with improved visual acuity. Re-evaluation of the fluorescein angiogram taken six months earlier showed an image compatible with unilateral vasculitis. During this six month period persisting high levels of IgG and IgM antibodies against toxoplasma were observed while no signs of other active infection could be found. This report illustrates that in cases of prethrombosis with vasculitis in a young patient, a full medical examination and a thorough investigation of infectious diseases are warranted.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Temporal arteritis: a spectrum of ophthalmic complications.Seven patients of temporal arteritis with eye involvement have been presented. These cases represent a spectrum of disease from intermittent diplopia with minimal 6th nerve weakness through mild retinal ischemia with recovery to permanent bilateral blindness. Temporal arteritis should be suspected when any form of ocular ischemia is suspected by history or found on examination of an elderly person. An early diagnosis may protect the vision in both eyes if vision is normal at the time of diagnosis. If vision in one eye is decreased because of ischemia, the vision in the other eye can usually be retained if proper therapy is instituted. Furthermore, adequate therapy may even result in improvement in vision in the involved eye. patients with biopsy proven temporal arteritis should be continued on steroid therapy until the active disease is quiescent. Inactivity should be determined by carefully monitoring the ESR while steroids are being tapered. If the ESR rises, it is indicative of continued inflammation and if steroids are not continued, the eyes remain at risk as seen in Case 5. If the ESR remains elevated for a year or more despite continuation of high steroid levels, consideration should be given to repeating the temporal artery biopsy. Temporal arteritis should be considered in the differential diagnosis of any multisystem disease in older patients. Even central nervous system involvement may occur concomitantly, since the intracranial vessels are not immune from the disease process. tuberculosis, systemic syphilis and more recently the collagen vascular diseases have been dubbed the "great imitators" and "the protean diseases." We suggest that the same terminology can be applied to temporal arteritis. Temporal arteritis can affect any organ. Moreover, there is a wide spectrum of variation in the degree of involvement of any particular tissue as illustrated by these 7 cases of ocular involvement.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. Shiny multifocal chorioretinitis with papillitis.We report a case of unilateral inflammation involving the retinal pigment epithelium-choriocapillaris complex and the optic disc, characterized by multiple, small, shiny, yellowish-white subretinal lesions involving the midperiphery of the retina and associated with optic disc edema. These lesions showed hypofluorescence in the early transit phase of the fluorescein angiogram and leakage in the late phase. Perivascular staining of the retinal vessels and diffuse optic disc leakage were also present. A benign course associated with marked visual improvement and resolution of the inflammatory lesions occurred.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Optic neuropathy in systemic lupus erythematosus.We report data from seven cases of optic neuropathy in systemic lupus erythematosus. The visual outcome varied, but improvement occasionally occurred following treatment with corticosteroids. The clinical picture was variable and could present as acute retrobulbar optic neuritis, ischemic optic neuropathy, or slowly progressive visual loss. Visual evoked response testing revealed increased latency in two patients and loss of amplitude in two others; a fifth patient had both findings in the involved eye. Despite the variable presentation, the probable pathogenesis in all cases is vaso-occlusive disease in small vessels of the optic nerves.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. Ischemic optic neuropathy associated with optic disc drusen.Ischemic optic neuropathy developed in five eyes of four patients with optic nerve drusen. Two of the patients were in their 20s, a decade when idiopathic ischemic optic neuropathy is rare. This argues against a chance concurrence of drusen and idiopathic ischemic optic neuropathy. infarction of the distal portion of the optic nerve in patients with drusen may result from mechanical distortion of blood vessels in the laminar and prelaminar regions.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/9. Occlusion of the central retinal artery after retrobulbar corticosteroid injection.Occlusion of the central retinal artery with loss of all vision occurred in a 38-year-old white woman given a retrobulbar injection of betamethasone acetate and betamethasone disodium phosphate (Celestone Soluspan) for the treatment of a retrobulbar neuritis. ophthalmoscopy revealed embolic, whitish material within several of the small retinal arterioles and capillaries. This, together with the absence of any signs of retrobulbar hemorrhage, suggested that the corticosteroid material was accidentally injected into a branch of the central retinal artery and subsequently passed into the main vessel.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/9. CAT scan and immunohistochemical findings in a case of cerebral thromboangiitis obliterans (Buerger's disease).Immunohistochemical examinations were carried out in a case of thromboangiitis obliterans. A 26-year-old man developed 4 brain infarctions which could be demonstrated by CAT scan. He suffered from a left-sided hemiparesis, major epileptic seizures, and an ischemic optic neuritis. Immunologic studies supported a diagnosis of cerebral thromboangiitis obliterans (CTAO). The serum anti-elastin titer as well as IgE were considerably increased and a biopsy of the temporal artery showed immunohistochemical signs of an acute inflammatory vessel disease. After the diagnosis of CTAO had been made, the patient was treated with azathioprine and dexamethasone. In cases of young stroke patients, a temporal biopsy is important in confirming the diagnosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. cerebrospinal fluid and MRI findings in three patients with multiple sclerosis and systemic lupus erythematosus.Three patients fulfilling the diagnostic criteria of both multiple sclerosis (MS) and systemic lupus erythematosus (SLE) were examined clinically, immunologically and by magnetic resonance imaging (MRI). In all three patients MRI showed several high-signal lesions compatible with MS and, additionally, non-specific small white matter lesions suggesting small vessel occlusion were seen. In CSF the cytoimmunological abnormalities were variable and showed only slight to moderate immunoactivation within the CNS at the time of sampling.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. Optic nueritis in hypoparathyroidism.Disk swelling in patients with hypoparathyroidism has often been attributed to papilledema but rarely to optic neuritis. Although we are reporting a patient with hypoparathyroidism in whom optic neuritis developed, a causal relationship is not yet clear. The patient may have had ischemic optic neuropathy concomitant with hypoparathyroidism or caused by tetanic vasospasm or calcification of optic nerve nutrient vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |