Chorioretinal scar

  • 文章类型: Case Reports
    背景:激光皮肤表面修复术是一种流行的非侵入性皮肤恢复美容程序。由于健康保险计划通常不涵盖这些类型的程序,病人经常自掏腰包。因此,有出国的动机,价格更实惠。然而,目的地国家的从业者可能缺乏严格的激光安全培训,监管监督,或许可,特别是在用于“美容”程序的设备上。在某些情况下,这会导致悲剧性的结果,尤其是当不合格的从业者操作医疗级激光设备时。
    方法:一名29岁的妇女因手持调Q掺钕钇铝石榴石(Nd:YAG)激光脉冲装置在越南一家医疗水疗中心进行皮肤表面修复治疗而遭受视网膜烧伤。患者没有充分了解其视力的潜在风险,也没有提供任何眼睛保护。短暂的,由于黄斑烧伤,患者右眼意外激光照射导致不可逆的视力丧失。这一事件立即引起了痛苦,接着突然出现了漂浮物,还有视网膜和玻璃体出血.尽管使用非标签贝伐单抗治疗脉络膜新生血管膜的发展,由于黄斑瘢痕的存在,视力保持在计数手指的水平。
    结论:使用基于激光的设备时,采取安全措施至关重要,例如佩戴安全护目镜或使用眼罩来保护眼部组织免受潜在损害。美容激光设备的日益普及带来了巨大的公共卫生风险,因为许多操作员缺乏基本安全标准的足够培训,或者他们忽视了跟随他们。此外,在国外寻求服务的患者必须遵守目的地国家的监管规定,这可能并不总是执行必要的安全标准。需要进一步的研究来确定区域和全球激光相关损伤的发生率,以帮助指导教育和监管工作。
    BACKGROUND: Laser skin resurfacing is a popular cosmetic procedure for noninvasive skin rejuvenation. Since health insurance plans often do not cover these types of procedures, patients often pay out of pocket. Consequently, there is an incentive to go abroad, where prices are more affordable. However, practitioners in destination countries may lack rigorous training on laser safety, regulatory oversight, or licensing, especially on devices used for \"cosmetic\" procedures. In certain cases, this can lead to tragic outcomes, especially when underqualified practitioners operate medical-grade laser devices.
    METHODS: A 29-year-old woman suffered a retinal burn from a handheld Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser pulse device used to perform skin resurfacing treatment at a medical spa in Vietnam. The patient was not adequately informed about the potential risk to her vision and was not provided with any eye protection. A momentary, unintended laser exposure to the patient\'s right eye led to irreversible vision loss due to a macular burn. This incident caused immediate pain, followed by the sudden appearance of floaters, along with a retinal and vitreous hemorrhage. Despite treatment with off-label bevacizumab for the development of a choroidal neovascular membrane, vision remained at the level of counting fingers because of the presence of the macular scar.
    CONCLUSIONS: When utilizing laser-based devices, it is crucial to employ safety measures, such as the wearing of safety goggles or the use of eye shields to protect ocular tissues from potential damage. The growing availability of cosmetic laser devices presents a substantial public health risk, because numerous operators lack adequate training in essential safety standards, or they neglect to follow them. Furthermore, patients seeking services abroad are subject to the regulatory practices of the destination country, which may not always enforce the requisite safety standards. Further research is needed to determine regional and global incidence of laser-related injuries to help direct educational and regulatory efforts.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:报道视网膜母细胞瘤(RB)经一线静脉化疗及其他治疗后随访中RetCam荧光素血管造影(FA)的变化及其与临床表现的相关性。
    方法:对2020年2月至2022年2月在全身麻醉下接受治疗后RetCam眼底照相和FA的RB患者进行回顾性分析。
    结果:纳入70例RB患者的78只眼。在55只(70.5%)具有1、2或3型回归模式的眼睛中,主要肿瘤在24只眼(43.6%)的动脉期开始出现强荧光,在24只(43.6%)眼的早期静脉期,7只(12.7%)眼处于静脉晚期。在局灶性治疗(冷冻疗法和经瞳孔热疗)后发展脉络膜视网膜疤痕的36只(46.2%)眼睛中,所有眼睛都有窗口缺陷和可见的脉络膜血管,巩膜染色10例(27.8%),瘢痕组织胶质增生8例(22.2%)。玻璃体种子如果钙化,则显示出高荧光(6眼,7.7%)和低荧光,如果没有钙化(11只眼,14.1%)。后类种子(11眼,14.1%)低/等荧光,而视网膜下种子(6只眼,7.7%)为高荧光。在14只(17.9%)眼中检测到周围视网膜血管的渗漏,在6只(7.7%)眼中检测到无灌注。
    结论:RetCam广角FA可用于评估RB治疗后的肿瘤及相关血管和视网膜变化。恶化的肿瘤在静脉阶段表现出后来的荧光素摄取。脉络膜视网膜瘢痕的荧光血管造影变化包括窗口缺损,脉络膜血管的能见度,巩膜染色,和船只的泄漏。在肿瘤消退稳定的眼中可以看到视网膜血管渗漏和外周非灌注。
    OBJECTIVE: To report RetCam fluorescein angiographic (FA) changes and correlation with clinical findings in the follow-up of retinoblastoma (RB) after frontline intravenous chemotherapy and other treatments.
    METHODS: Patients having RB who underwent post-treatment RetCam fundus photography and FA under general anesthesia between February 2020 and February 2022 were retrospectively analyzed.
    RESULTS: 78 eyes of 70 patients with RB were included. In 55 (70.5%) eyes with type 1, 2 or 3 regression patterns, the main tumor started to show hyperfluorescence in arterial phase in 24 eyes (43.6%), in early venous phase in 24 (43.6%) eyes, and in late venous phase in 7 (12.7%) eyes. Of thirty-six (46.2%) eyes with chorioretinal scars developing after focal treatments (cryotherapy and transpupillary thermotherapy), window defects and visible choroidal vessels were found in all eyes, scleral staining in 10 (27.8%), and gliosis on scar tissue in 8 (22.2%). Vitreous seeds showed hyperfluorescence if they were calcified (6 eyes, 7.7%) and hypofluorescence if non-calcified (11 eyes, 14.1%). Retrohyaloid seeds (11 eyes, 14.1%) were hypo/isofluorescent while subretinal seeds (6 eyes, 7.7%) were hyperfluorescent. Leakage from peripheral retinal vessels was detected in 14 (17.9%) eyes and non-perfusion in 6 (7.7%) eyes.
    CONCLUSIONS: RetCam wide-angle FA is useful to evaluate the tumor and associated vascular and retinal changes after treatment in RB. Regressed tumors demonstrate later fluorescein uptake in venous phases. Fluorescein angiographic changes in chorioretinal scars include window defects, visibility of choroidal vessels, scleral staining, and leakage from vessels. Retinal vascular leakage and peripheral non-perfusion can be seen in eyes with regressed stable tumors.
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  • 文章类型: Case Reports
    一名39岁的尼日利亚妇女因头痛和双侧眼痛的两周病史而向眼科诊所赠送了一副新眼镜。在过去的九年中,她是著名的眼镜佩戴者。视力分别为6/6和6/36,在右眼和左眼。双侧前节检查基本正常。右眼双眼间接检眼镜检查后段显示出穿孔的色素沉着过度,6点和左眼周围的脉络膜视网膜瘢痕,沿着下颞部拱廊,在色素沉着过多的脉络膜视网膜瘢痕附近存在一个大的黄斑孔。两只眼睛都没有活动性炎症。光学相干断层扫描证实了左,4级全厚度黄斑孔。
    A 39-year-old Nigerian woman presented to the eye clinic for a new pair of spectacles on account of a two-week history of headaches and bilateral eye ache. She was a known spectacle wearer for the past nine years. The presenting visual acuity was 6/6 and 6/36, respectively, in the right and left eye. Anterior segment examination was essentially normal bilaterally. Posterior segment examination with binocular indirect ophthalmoscopy of the right eye revealed a punched out hyperpigmented, chorioretinal scar in the periphery at 6 o\'clock and in the left eye, a large macula hole adjacent to a hyperpigmented chorioretinal scar along the inferotemporal arcade was present. Active inflammation was absent in both eyes. Optical coherence tomography confirmed a left, grade-4 full-thickness macula hole.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    斑点外视网膜弓形虫病是这种常见眼寄生虫的公认表型。我们提出了一个视力不佳的病例,但及时治疗在最后时间点恢复了良好的视力。彩色摄影显示邻近非活动性视网膜瘢痕的活动性病变进展。荧光素血管造影,和谱域光学相干断层扫描(SD-OCT)。脉络膜视网膜瘢痕的SD-OCT成像显示,视网膜色素上皮肥大和萎缩交替,布鲁赫膜有离散断裂。在基线,活动性病变显示,在活动性视网膜炎区域附近有大量炎性视网膜下液。随着时间的推移,发现视网膜下物质消退,中央凹的解剖结构得到了恢复,视网膜炎区域进展为脉络膜视网膜瘢痕。
    Punctate outer retinal toxoplasmosis is a recognized phenotype of this common ocular parasite. We present a case presenting with poor visual acuity, but with prompt treatment regaining excellent vision by the final time point. Imaging demonstrates progression of an active lesion adjacent to an inactive retinal scar with color photography, fluorescein angiography, and Spectral Domain Optical Coherence Tomography (SD-OCT). SD-OCT imaging of the chorioretinal scar demonstrated alternating hypertrophy and atrophy of the retinal pigment epithelium along with a discrete break in Bruch\'s membrane. At baseline, the active lesion demonstrated a large collection of inflammatory subretinal fluid adjacent to an area of active retinitis. Over time, the subretinal material was found to resolve, there was restoration of the foveal anatomy, and the area of retinitis progressed into a chorioretinal scar.
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  • 文章类型: Case Reports
    OBJECTIVE: To report a case series of patients with chorioretinal lesions secondary to tubulointerstitial nephritis and uveitis (TINU).
    METHODS: Retrospective chart review of patients with TINU.
    RESULTS: We found 4 patients (3 with a possible or probable diagnosis of TINU and 1 with a definite diagnosis of TINU) and multiple chorioretinal lesions.
    CONCLUSIONS: Tubulointerstitial nephritis and uveitis usually presents with anterior uveitis, but chorioretinal lesions do occur and may facilitate the diagnosis.
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  • 文章类型: Case Reports
    背景:本研究的目的是评估眼部炎症患者血清弓形虫病检测的免疫球蛋白(Ig)G亲和力,并确定眼部弓形虫病的临床表现。
    方法:对马来西亚医院的所有眼部炎症患者进行回顾性分析,吉兰丹,马来西亚在2005年至2009年之间进行了。视敏度,临床表现,弓形虫病抗体检测,并对治疗记录进行分析。
    结果:对130例眼部炎症患者进行回顾性分析。患者的平均年龄为38.41(标准偏差19.24,范围6-83)岁。71例患者(54.6%)被发现是血清反应阳性,其中5例(3.8%)IgG和IgM阳性(考虑最近获得性眼部弓形虫病),1例(0.8%)IgG亲和力≤40%(考虑最近获得性眼部弓形虫病),65例(50.0%)IgG亲和力>40%(考虑弓形虫病感染再激活).脉络膜视网膜瘢痕作为眼部表现在血清阳性弓形虫病患者中更为常见(P=0.036)。根据临床表现和血清学检查,有18例患者(13.8%)被诊断为近期和/或活动性眼弓形虫病。
    结论:眼部弓形虫病是一种临床诊断,但特异性弓形虫病抗体检测有助于诊断和区分感染的再激活和最近获得的眼弓形虫病。
    BACKGROUND: 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.
    CONCLUSIONS: 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.
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