A 54-year-old male with no systemic comorbidities presented with painless vision decline. Examination revealed age-related lens changes, notably a heart-shaped opacification in the right eye. Corrective glasses were prescribed.
{"title":"Love-struck lens: A romantic twist in visual decline","authors":"D. A. Khurana","doi":"10.25259/lajo_5_2024","DOIUrl":"https://doi.org/10.25259/lajo_5_2024","url":null,"abstract":"A 54-year-old male with no systemic comorbidities presented with painless vision decline. Examination revealed age-related lens changes, notably a heart-shaped opacification in the right eye. Corrective glasses were prescribed.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141674939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Filariasis, a predominantly lymphatic disease can rarely have ocular involvement in endemic as well as a few non-endemic zones of the Indian subcontinent. It has also been reported from countries of South East Asia. In India, Wuchereria bancrofti and Brugia malayi are the nematodes causing filariais. Ocular involvement can happen in a wide spectrum, involving lacrimal glands, conjunctiva and fornices, cornea, anterior chamber, and vitreous cavity. We report a case of adult filarial worm (B. malayi) inside a conjunctival granuloma in a lady hailing from a rural, non-endemic part of the country. The lady presented with a short history of ocular irritation and redness. Clinical examination revealed a small granuloma-like lesion with surrounding inflammation over the conjunctiva. The rest of the anterior segment as well as the posterior segment was fairly within normal limits. The history as well as clinical examination was not supportive of a parasitic infestation, leading the doctors to treat the lesion as an allergic disease. However, the lesion remained unresolved, and surgical excision was undertaken. On surgical intervention, a live worm was spotted inside the lesion. Parasitological evaluation of the worm was confirmatory of adult filaria (B. malayi). The patient responded to a combination therapy of oral diethylcarbamazine and albendazole.
{"title":"Ocular filariasis in the form of a conjunctival granuloma – A rare case report from non-endemic part of India","authors":"Annesha Sarkar, Dipankar Das, Saidul Islam, Apurba Deka","doi":"10.25259/lajo_1_2024","DOIUrl":"https://doi.org/10.25259/lajo_1_2024","url":null,"abstract":"Filariasis, a predominantly lymphatic disease can rarely have ocular involvement in endemic as well as a few non-endemic zones of the Indian subcontinent. It has also been reported from countries of South East Asia. In India, Wuchereria bancrofti and Brugia malayi are the nematodes causing filariais. Ocular involvement can happen in a wide spectrum, involving lacrimal glands, conjunctiva and fornices, cornea, anterior chamber, and vitreous cavity. We report a case of adult filarial worm (B. malayi) inside a conjunctival granuloma in a lady hailing from a rural, non-endemic part of the country. The lady presented with a short history of ocular irritation and redness. Clinical examination revealed a small granuloma-like lesion with surrounding inflammation over the conjunctiva. The rest of the anterior segment as well as the posterior segment was fairly within normal limits. The history as well as clinical examination was not supportive of a parasitic infestation, leading the doctors to treat the lesion as an allergic disease. However, the lesion remained unresolved, and surgical excision was undertaken. On surgical intervention, a live worm was spotted inside the lesion. Parasitological evaluation of the worm was confirmatory of adult filaria (B. malayi). The patient responded to a combination therapy of oral diethylcarbamazine and albendazole.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"58 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141269228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scleral lenses (SL) are larger diameter lenses that rest over the scleral, unlike the corneal lenses. These lenses are fitted to not touch the cornea by creating a space that will be filled with sterile isotonic fluid. Indications of SL include corneal ectatic conditions such as keratoconus (KC), pellucid marginal degeneration,and ocular surface disorders such as dry eye (DE), Stevens-Johnson syndrome (SJS), and graft-versus-host disease. Corneal ectasia in SJS has been rarely reported but still exists, which causes severe DE, photophobia, and blurred vision. In such a scenario, SL is an ideal treatment option as they provide constant lubrication to the ocular surface and better visual acuity. This report witnessed the effectiveness of SL in SJS associated with KC – a rare combination.
{"title":"Dual benefits of scleral lenses in collateral cases of Stevens-Johnson syndrome and Keratoconus-A case series","authors":"Karpagavalli Subramanian","doi":"10.25259/lajo_23_2023","DOIUrl":"https://doi.org/10.25259/lajo_23_2023","url":null,"abstract":"Scleral lenses (SL) are larger diameter lenses that rest over the scleral, unlike the corneal lenses. These lenses are fitted to not touch the cornea by creating a space that will be filled with sterile isotonic fluid. Indications of SL include corneal ectatic conditions such as keratoconus (KC), pellucid marginal degeneration,and ocular surface disorders such as dry eye (DE), Stevens-Johnson syndrome (SJS), and graft-versus-host disease. Corneal ectasia in SJS has been rarely reported but still exists, which causes severe DE, photophobia, and blurred vision. In such a scenario, SL is an ideal treatment option as they provide constant lubrication to the ocular surface and better visual acuity. This report witnessed the effectiveness of SL in SJS associated with KC – a rare combination.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"44 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140657252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to study the efficacy of intense pulsed light (IPL) therapy and a combination of intense pulse light therapy and low-level light therapy (LLLT) in treating meibomian gland dysfunction (MGD). In this prospective and hospital-based interventional study, 32 patients were enrolled between April 2023 and January 2024 in the Department of Cornea, Sri Sankaradeva Nethralaya, Guwahati. The clinical evaluation was done included the ocular surface disease index (OSDI-6) questionnaire score, tear film break-up time (TBUT), Schirmer test I, slit-lamp examination for lid evaluation to see signs of pitting, telangiectasia, meibomian gland expressibility, meibography (to see gland dropout assessment), and meibomian gland loss percentage (MGL%). The enrolled participants were randomly allocated to receive IPL and combination light therapy (IPL+LLLT) in a 1:1 ratio. Sixty-two eyes of 31 patients were included in this study. In the IPL group, the level of dryness (LOD) improved in nine (56.25%) cases and remained the same in seven cases (73.75%). In the IPL+ LLLT group, the LOD improved in eight cases (53.3%) and remained the same in six (40%) cases. For the right eye (OD), the MGL% was 0.46 ± 0.08 at baseline, which decreased to 0.32 ± 0.07 at six months. For the left eye (OS), MGL% was 0.52 ± 0.09 at baseline, and at six months, it reduced to 0.34 ± 0.08. In OD, MGL% was 0.46 ± 0.06 at baseline, reduced to 0.35 ± 0.12 at six months. In OS, MGL% was 0.49 ± 0.09 at baseline, and at six months, it reduced to 0.35 ± 0.12. In the IPL group, the mean TBUT in OD improved from 3.25 to 5.25 in 1 month. The mean TBUT for OS improved from 4.19 to 6.44 in OS. In the IPL+LLLT group, the mean TBUT in OD improved from 3.2 to 5.2 at one month in OS. The mean TBUT in OS improved from 4.27 to 6 in one month. IPL alone or in combination with LLLT has similar efficacy in treating MGD. There was a reduction in the OSDI score LOD with improved TBUT and decreased MGL% at the end of 1, and six months.
{"title":"Outcome of intense-pulsed light therapy versus combination of intense-pulsed light and low-level light therapy for the treatment of meibomian gland dysfunction","authors":"Balmukund Agarwal, Parmita Dutta, Sangeeta Kalita, Daisy Rani Das, Ankita Singh","doi":"10.25259/lajo_4_2024","DOIUrl":"https://doi.org/10.25259/lajo_4_2024","url":null,"abstract":"\u0000\u0000The objective of this study was to study the efficacy of intense pulsed light (IPL) therapy and a combination of intense pulse light therapy and low-level light therapy (LLLT) in treating meibomian gland dysfunction (MGD).\u0000\u0000\u0000\u0000In this prospective and hospital-based interventional study, 32 patients were enrolled between April 2023 and January 2024 in the Department of Cornea, Sri Sankaradeva Nethralaya, Guwahati. The clinical evaluation was done included the ocular surface disease index (OSDI-6) questionnaire score, tear film break-up time (TBUT), Schirmer test I, slit-lamp examination for lid evaluation to see signs of pitting, telangiectasia, meibomian gland expressibility, meibography (to see gland dropout assessment), and meibomian gland loss percentage (MGL%). The enrolled participants were randomly allocated to receive IPL and combination light therapy (IPL+LLLT) in a 1:1 ratio.\u0000\u0000\u0000\u0000Sixty-two eyes of 31 patients were included in this study. In the IPL group, the level of dryness (LOD) improved in nine (56.25%) cases and remained the same in seven cases (73.75%). In the IPL+ LLLT group, the LOD improved in eight cases (53.3%) and remained the same in six (40%) cases. For the right eye (OD), the MGL% was 0.46 ± 0.08 at baseline, which decreased to 0.32 ± 0.07 at six months. For the left eye (OS), MGL% was 0.52 ± 0.09 at baseline, and at six months, it reduced to 0.34 ± 0.08. In OD, MGL% was 0.46 ± 0.06 at baseline, reduced to 0.35 ± 0.12 at six months. In OS, MGL% was 0.49 ± 0.09 at baseline, and at six months, it reduced to 0.35 ± 0.12. In the IPL group, the mean TBUT in OD improved from 3.25 to 5.25 in 1 month. The mean TBUT for OS improved from 4.19 to 6.44 in OS. In the IPL+LLLT group, the mean TBUT in OD improved from 3.2 to 5.2 at one month in OS. The mean TBUT in OS improved from 4.27 to 6 in one month.\u0000\u0000\u0000\u0000IPL alone or in combination with LLLT has similar efficacy in treating MGD. There was a reduction in the OSDI score LOD with improved TBUT and decreased MGL% at the end of 1, and six months.\u0000","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"139 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Divya Kochhar, J. Kaushik, Ankita Singh, Aatish Saraswat, J. K. Parihar
The aim of this series is to report diverse ocular features noted in patients during the induction phase in acute myeloid leukemia (AML). Three female patients undergoing induction therapy for AML reporting for various ocular complaints were examined. Detailed history, including the onset of AML and chemotherapy and any past ocular or systemic ailment, was taken. Best-corrected visual acuity, anterior segment, and posterior segment examinations were performed. Intraocular pressure was measured, and color vision was tested. Routine hematological, and biochemical investigations and imaging were done when required. Patients with abnormal parameters were referred to an oncologist for management. A varied spectrum of ocular manifestations was noted in these three female patients, including preseptal cellulitis, orbital cellulitis, and subhyaloid hemorrhages. Immediate treatment was given to patients with vision-threatening conditions in consultation with an oncologist and otorhinolaryngologist, and patients responded well to the treatment. Owing to its cytoreductive action, AML induction therapy exposes the patient to various adverse events, causing significant ocular and systemic morbidity. All the diagnosed patients of AML are recommended to undergo a baseline ocular assessment.
{"title":"Ocular manifestations of acute myeloid leukemia during induction phase of chemotherapy: A case series","authors":"Divya Kochhar, J. Kaushik, Ankita Singh, Aatish Saraswat, J. K. Parihar","doi":"10.25259/lajo_20_2023","DOIUrl":"https://doi.org/10.25259/lajo_20_2023","url":null,"abstract":"The aim of this series is to report diverse ocular features noted in patients during the induction phase in acute myeloid leukemia (AML). Three female patients undergoing induction therapy for AML reporting for various ocular complaints were examined. Detailed history, including the onset of AML and chemotherapy and any past ocular or systemic ailment, was taken. Best-corrected visual acuity, anterior segment, and posterior segment examinations were performed. Intraocular pressure was measured, and color vision was tested. Routine hematological, and biochemical investigations and imaging were done when required. Patients with abnormal parameters were referred to an oncologist for management. A varied spectrum of ocular manifestations was noted in these three female patients, including preseptal cellulitis, orbital cellulitis, and subhyaloid hemorrhages. Immediate treatment was given to patients with vision-threatening conditions in consultation with an oncologist and otorhinolaryngologist, and patients responded well to the treatment. Owing to its cytoreductive action, AML induction therapy exposes the patient to various adverse events, causing significant ocular and systemic morbidity. All the diagnosed patients of AML are recommended to undergo a baseline ocular assessment.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"45 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139847192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Divya Kochhar, J. Kaushik, Ankita Singh, Aatish Saraswat, J. K. Parihar
The aim of this series is to report diverse ocular features noted in patients during the induction phase in acute myeloid leukemia (AML). Three female patients undergoing induction therapy for AML reporting for various ocular complaints were examined. Detailed history, including the onset of AML and chemotherapy and any past ocular or systemic ailment, was taken. Best-corrected visual acuity, anterior segment, and posterior segment examinations were performed. Intraocular pressure was measured, and color vision was tested. Routine hematological, and biochemical investigations and imaging were done when required. Patients with abnormal parameters were referred to an oncologist for management. A varied spectrum of ocular manifestations was noted in these three female patients, including preseptal cellulitis, orbital cellulitis, and subhyaloid hemorrhages. Immediate treatment was given to patients with vision-threatening conditions in consultation with an oncologist and otorhinolaryngologist, and patients responded well to the treatment. Owing to its cytoreductive action, AML induction therapy exposes the patient to various adverse events, causing significant ocular and systemic morbidity. All the diagnosed patients of AML are recommended to undergo a baseline ocular assessment.
{"title":"Ocular manifestations of acute myeloid leukemia during induction phase of chemotherapy: A case series","authors":"Divya Kochhar, J. Kaushik, Ankita Singh, Aatish Saraswat, J. K. Parihar","doi":"10.25259/lajo_20_2023","DOIUrl":"https://doi.org/10.25259/lajo_20_2023","url":null,"abstract":"The aim of this series is to report diverse ocular features noted in patients during the induction phase in acute myeloid leukemia (AML). Three female patients undergoing induction therapy for AML reporting for various ocular complaints were examined. Detailed history, including the onset of AML and chemotherapy and any past ocular or systemic ailment, was taken. Best-corrected visual acuity, anterior segment, and posterior segment examinations were performed. Intraocular pressure was measured, and color vision was tested. Routine hematological, and biochemical investigations and imaging were done when required. Patients with abnormal parameters were referred to an oncologist for management. A varied spectrum of ocular manifestations was noted in these three female patients, including preseptal cellulitis, orbital cellulitis, and subhyaloid hemorrhages. Immediate treatment was given to patients with vision-threatening conditions in consultation with an oncologist and otorhinolaryngologist, and patients responded well to the treatment. Owing to its cytoreductive action, AML induction therapy exposes the patient to various adverse events, causing significant ocular and systemic morbidity. All the diagnosed patients of AML are recommended to undergo a baseline ocular assessment.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":" 366","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139787219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatemeh Abdi, Sara Hemmati, Masoume Sharafinejad, Arzhang Gordiz, S. Aghili, Vahid Zare Hosseinabadi
Multiple evanescent white dot syndrome (MEWDS) is typically a unilateral and transient condition without an exact known underlying cause. Its pathogenesis may involve an immune response to viral antigens that have gained access to the retinal receptor cells. It has been hypothesized that the COVID-19 virus can activate some autoimmune responses. Here, we report a case of MEWDS in a 16-year-old girl with a history of COVID-19 infection two weeks before the visual symptoms. The symptoms and signs improved without any treatment after a three-month follow-up period. In our case, MEWDS occurred shortly after COVID-19 infection and resolved without treatment in three months. Considering ophthalmologic and immunologic associations of COVID-19 can help ophthalmologists in the diagnosis and treatment of similar disorders in the COVID-19 era.
{"title":"Multiple evanescent white dot syndrome following COVID-19 infection: A case report","authors":"Fatemeh Abdi, Sara Hemmati, Masoume Sharafinejad, Arzhang Gordiz, S. Aghili, Vahid Zare Hosseinabadi","doi":"10.25259/lajo_13_2023","DOIUrl":"https://doi.org/10.25259/lajo_13_2023","url":null,"abstract":"Multiple evanescent white dot syndrome (MEWDS) is typically a unilateral and transient condition without an exact known underlying cause. Its pathogenesis may involve an immune response to viral antigens that have gained access to the retinal receptor cells. It has been hypothesized that the COVID-19 virus can activate some autoimmune responses. Here, we report a case of MEWDS in a 16-year-old girl with a history of COVID-19 infection two weeks before the visual symptoms. The symptoms and signs improved without any treatment after a three-month follow-up period. In our case, MEWDS occurred shortly after COVID-19 infection and resolved without treatment in three months. Considering ophthalmologic and immunologic associations of COVID-19 can help ophthalmologists in the diagnosis and treatment of similar disorders in the COVID-19 era.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amber Dubey, Vatsalya Venkatraman, M. Barman, K. Bhattacharjee
This is a descriptive case report of a 25-year-old male who presented with right eye diminution of vision associated with ophthalmoplegia and strabismus following functional endoscopic sinus surgery (FESS) for deviated nasal septum. On examination, he had a large angle right exotropia with enophthalmos and restricted extra ocular movements. Pupils were dilated and fixed suggestive of optic neuropathy and fundus revealed a central retinal artery occlusion. Multimodal radiological imaging revealed optic nerve sheath hematoma, fracture of medial orbital wall and orbital floor along with medial rectus disinsertion with posterior discontinuation. Due to delayed presentation at our clinic, he was managed conservatively with intravenous and oral corticosteroids. The patient displayed mild improvement in ocular movement and vision. He was advised orbital reconstruction of the medial wall and floor for enophthalmos correction and cosmesis. Although a relatively safe procedure, FESS can result into varied orbital complications, including damage to the extraocular muscles, optic nerve and its vascular supply. This case report, to the best of our knowledge is the first of its kind to document ophthalmoplegia due to medial rectus disinsertion along with central retinal artery occlusion. It also highlights the perioperative risk factors and provides insight into the intraoperative signs to be cautious of during sinus surgeries
{"title":"Eyeing risks: Navigating ophthalmic challenges in sinus surgery","authors":"Amber Dubey, Vatsalya Venkatraman, M. Barman, K. Bhattacharjee","doi":"10.25259/lajo_22_2023","DOIUrl":"https://doi.org/10.25259/lajo_22_2023","url":null,"abstract":"This is a descriptive case report of a 25-year-old male who presented with right eye diminution of vision associated with ophthalmoplegia and strabismus following functional endoscopic sinus surgery (FESS) for deviated nasal septum. On examination, he had a large angle right exotropia with enophthalmos and restricted extra ocular movements. Pupils were dilated and fixed suggestive of optic neuropathy and fundus revealed a central retinal artery occlusion. Multimodal radiological imaging revealed optic nerve sheath hematoma, fracture of medial orbital wall and orbital floor along with medial rectus disinsertion with posterior discontinuation. Due to delayed presentation at our clinic, he was managed conservatively with intravenous and oral corticosteroids. The patient displayed mild improvement in ocular movement and vision. He was advised orbital reconstruction of the medial wall and floor for enophthalmos correction and cosmesis. Although a relatively safe procedure, FESS can result into varied orbital complications, including damage to the extraocular muscles, optic nerve and its vascular supply. This case report, to the best of our knowledge is the first of its kind to document ophthalmoplegia due to medial rectus disinsertion along with central retinal artery occlusion. It also highlights the perioperative risk factors and provides insight into the intraoperative signs to be cautious of during sinus surgeries","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"173 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Most cases of refractory glaucoma not amenable to filtration surgery or glaucoma drainage device are managed by cyclodestructive procedures. An 84-year-old female had undergone oculus sinister (OS) transscleral cyclophotocoagulation (TSCPC) after a diagnosis of OS closed angle stage of neovascular glaucoma was made. On the 1st week post-TSCPC, discharge on the conjunctival surface was noted along with a 6 mm hypopyon in the anterior chamber and associated vitritis. Treatment on the lines of fungal endophthalmitis was initiated. At 1 month review, the reaction had reduced significantly. Cases with significant reaction and vitritis post-TSCPC must be treated aggressively on the lines of endophthalmitis to salvage the globe. A rather safe approach to the management of such cases, TSCPC does have rare complications such as inadvertent sclerostomy or panophthalmitis, being reported as isolated case reports. To the best of our knowledge, this is the first case of fungal endophthalmitis being reported post-TSCPC.
{"title":"Fungal endophthalmitis following transscleral cyclophotocoagulation","authors":"Aashish Kant Shah, B. Takkar, G. Warjri","doi":"10.25259/lajo_12_2023","DOIUrl":"https://doi.org/10.25259/lajo_12_2023","url":null,"abstract":"Most cases of refractory glaucoma not amenable to filtration surgery or glaucoma drainage device are managed by cyclodestructive procedures. An 84-year-old female had undergone oculus sinister (OS) transscleral cyclophotocoagulation (TSCPC) after a diagnosis of OS closed angle stage of neovascular glaucoma was made. On the 1st week post-TSCPC, discharge on the conjunctival surface was noted along with a 6 mm hypopyon in the anterior chamber and associated vitritis. Treatment on the lines of fungal endophthalmitis was initiated. At 1 month review, the reaction had reduced significantly. Cases with significant reaction and vitritis post-TSCPC must be treated aggressively on the lines of endophthalmitis to salvage the globe. A rather safe approach to the management of such cases, TSCPC does have rare complications such as inadvertent sclerostomy or panophthalmitis, being reported as isolated case reports. To the best of our knowledge, this is the first case of fungal endophthalmitis being reported post-TSCPC.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129374108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel A. Quiroz-Reyes, E. Quiroz-Gonzalez, M. Quiroz-Gonzalez, V. Lima-Gómez
This study aimed to evaluate the role and efficacy of vitrectomy in the management of chronic diabetic macular edema (DME) refractory to intravitreal anti-vascular endothelial growth factor (anti-VEGF) and corticosteroid treatments. A systematic review and meta-analysis were performed by searching the Embase, Medline, and gray literature. Eight hundred and thirty-nine studies were retrieved and eight were selected (three for quantitative synthesis and five for qualitative synthesis). Visual acuity (VA) and central macular thickness (CMT) were compared between the vitrectomy-treated and control groups (treated with anti-VEGF and intravitreal corticosteroid injection) using the standardized mean difference (SMD) with 95% confidence intervals (CIs) and P-values. There was no significant difference in post-operative VA between the vitrectomy-treated and control groups (SMD = −0.31, 95% CI: −0.76, 0.14, P = 0.18). However, CMT was significantly lower in the vitrectomy group than in the control group (SMD = −0.31, 95% CI: −0.76, 0.14, P = 0.18). In addition, the incidence of postoperative complications was higher in the control groups than that in the vitrectomy group.This systematic review and meta-analysis suggest that vitrectomy may be viable for the management of chronic DME refractory to anti-VEGF and corticosteroid agents. Although there was no significant difference in VA, the CMT was significantly reduced in the vitrectomy group. Moreover, the incidence of post-operative complications was lower in the vitrectomy group than that in the control group. Further studies are needed to confirm these findings and identify patient subgroups that may benefit from vitrectomy.
{"title":"The role and efficacy of vitrectomy for the management of refractory diabetic macular edema: Systematic review and meta-analysis","authors":"Miguel A. Quiroz-Reyes, E. Quiroz-Gonzalez, M. Quiroz-Gonzalez, V. Lima-Gómez","doi":"10.25259/lajo_11_2023","DOIUrl":"https://doi.org/10.25259/lajo_11_2023","url":null,"abstract":"This study aimed to evaluate the role and efficacy of vitrectomy in the management of chronic diabetic macular edema (DME) refractory to intravitreal anti-vascular endothelial growth factor (anti-VEGF) and corticosteroid treatments. A systematic review and meta-analysis were performed by searching the Embase, Medline, and gray literature. Eight hundred and thirty-nine studies were retrieved and eight were selected (three for quantitative synthesis and five for qualitative synthesis). Visual acuity (VA) and central macular thickness (CMT) were compared between the vitrectomy-treated and control groups (treated with anti-VEGF and intravitreal corticosteroid injection) using the standardized mean difference (SMD) with 95% confidence intervals (CIs) and P-values. There was no significant difference in post-operative VA between the vitrectomy-treated and control groups (SMD = −0.31, 95% CI: −0.76, 0.14, P = 0.18). However, CMT was significantly lower in the vitrectomy group than in the control group (SMD = −0.31, 95% CI: −0.76, 0.14, P = 0.18). In addition, the incidence of postoperative complications was higher in the control groups than that in the vitrectomy group.This systematic review and meta-analysis suggest that vitrectomy may be viable for the management of chronic DME refractory to anti-VEGF and corticosteroid agents. Although there was no significant difference in VA, the CMT was significantly reduced in the vitrectomy group. Moreover, the incidence of post-operative complications was lower in the vitrectomy group than that in the control group. Further studies are needed to confirm these findings and identify patient subgroups that may benefit from vitrectomy.","PeriodicalId":437914,"journal":{"name":"Latin American Journal of Ophthalmology","volume":"31 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114028195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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