Genetic disease / congenital abnormalities < PEDIATRIC OPHTHALMOLOGY

  • 文章类型: Journal Article
    目的:报告一例粘多糖贮积症(MPS)II型B患者的视神经和视网膜受累的临床和影像学特征。
    方法:一名27岁男性,诊断为MPSIIB型,并在过去19年接受酶替代疗法,被转介给视网膜服务。眼科评估,其中包括多模态成像,进行调查潜在的视网膜和视盘受累。
    结果:眼部检查显示色素性视网膜病变,主要是外部视网膜丧失,主要在旁凹和中央凹区域。值得注意的是,多模态成像确定黄斑水肿没有任何渗漏的迹象,意味着黄斑水肿和视网膜神经变性之间的关联。此外,两只眼睛都表现出视盘边缘模糊。
    结论:我们在此描述了MPSIIB型患者的视网膜和视盘受累的多模态影像学表现。该报告首次描述了黄斑水肿的存在,而没有渗漏,同时光感受器损伤和视盘肿胀。
    OBJECTIVE: To report clinical and imaging features of optic nerve and retinal involvement in a patient with mucopolysaccharidosis (MPS) type II B.
    METHODS: A 27-year-old man, diagnosed with MPS type II B and undergoing enzymatic substitution therapy for the past 19 years, was referred to the retina service. An ophthalmological evaluation, which included multimodal imaging, was conducted to investigate potential retinal and optic disc involvement.
    RESULTS: The eye examination revealed a pigmentary retinopathy with a predominant loss of the outer retinal loss, primarily in the parafoveal and perifoveal regions. Notably, multimodal imaging identified macular edema without any signs of leakage, implying an association between macular edema and retinal neurodegeneration. Additionally, both eyes exhibited an optic disc with blurred margins.
    CONCLUSIONS: We herein describe the multimodal imaging findings of retinal and optic disc involvement in a patient with MPS type II B. This report describes for the first-time the presence of macular edema without leakage alongside photoreceptor damage and optic disc swelling.
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  • 文章类型: Journal Article
    目的:在本报告中,我们的目的是在接受1型ROP间接激光光凝治疗的婴儿的随访过程中,表现出异常的玻璃样动脉残留,并具有非典型定位。
    方法:回顾性病例报告。
    结果:我们报告了一例在随访期间在黄斑区再次出现偏心定位的透明茎,1型ROP激光光凝后2周,随后进展至导致中央凹变形,用保留晶状体的玻璃体切除术成功切除。
    结论:据我们所知,文献中没有类似的案例。在纤维血管增生延伸到玻璃体的情况下,尤其是早产儿,应该记住,这可能是PFV的再现,并且可能并不总是位于视盘上。
    OBJECTIVE: In this report, we aim to present an unusual reappearance of hyaloidal artery remnant with atypical localization during the follow-up of an infant who underwent indirect laser photocoagulation for type 1 ROP.
    METHODS: Retrospective case report.
    RESULTS: We report a case of reappearance of an eccentrically located hyaloidal stalk in the macular area during the follow-up period, 2 weeks after laser photocoagulation for type 1 ROP subsequently progressed to cause foveal distortion, which is successfully removed with a lens-sparing vitrectomy.
    CONCLUSIONS: To the best of our knowledge, there is no similar case in the literature. In the presence of fibrovascular proliferation extending into the vitreous, especially in premature infants, it should be kept in mind that this may be a reappearance of PFV and it may not always be located on the optic disc.
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  • 文章类型: Case Reports
    背景:先天性动脉乳头周围环是罕见的实体,文献中描述的病例很少。
    方法:一名25岁的亚裔男性左眼(LE)出现弥漫性玻璃体出血。OCT-A显示视神经乳头存在双侧血管环。荧光素血管造影(FA)证实了双眼的血管异常,早期动脉充盈,无染料渗漏。在二十天的随访中,LE的玻璃体出血完全重新吸收,BCVA从20/63改善到20/20。
    结论:玻璃体出血的鉴别诊断应考虑先天性乳头周围环,特别是在没有眼/头部外伤史的年轻患者中。强烈建议多模态成像以正确管理患者,避免不必要的治疗选择。
    BACKGROUND: Congenital arterial peripapillary loops are rare entities and very few cases are described in literature.
    METHODS: A 25-year-old Asian man presented a diffuse vitreous hemorrhage in his Left Eye (LE). OCT-A revealed the presence of bilateral vascular loops at the optic nerve head. Fluorescein angiography (FA) confirmed the vascular abnormality in both eyes, with arterial filling in early phases and no dye leakage. At twenty days of follow up, the vitreous hemorrhage in the LE completely reabsorbed and BCVA improved from 20/63 to 20/20.
    CONCLUSIONS: Congenital peripapillary loops should be considered in the differential diagnosis of vitreous hemorrhage, especially in young patients with no history of ocular/head trauma. Multimodal imaging is highly recommended to properly manage the patients, avoiding unnecessary therapeutic choices.
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  • 文章类型: Journal Article
    背景:文献中已经提到自闭症谱系障碍(ASD)与视力障碍之间的关联。我们研究的目的是调查白化病儿童中自闭症的患病率与其他原因继发视力障碍儿童中ASD的患病率。
    方法:2015年1月至2020年12月对白化病儿童进行回顾性研究。对照组是由视力范围和年龄相似的早发性视力障碍儿童创建的,继发于白化病以外的诊断。在两组中都确定了相关自闭症患者。
    结果:7108名1-18岁视力障碍儿童被纳入研究。401名儿童被诊断为白化病,其中14人也被诊断为ASD。在对照组中,由307名患者组成,只有3人患有ASD(p:0·03)。
    结论:白化病患者中ASD的患病率为1/28,而其他原因导致视力障碍的儿童中ASD的患病率为1/102。我们旨在提高对被诊断为白化病的儿童自闭症患病率较高的认识,以便早期诊断和支持。
    BACKGROUND: The association between Autism spectrum disorders (ASD) and visual impairment has been mentioned in the literature. The aim of our study was to investigate the prevalence of autism among children with albinism compared to the prevalence of ASD in children with visual impairment secondary to other causes.
    METHODS: Retrospective study of children with albinism from January 2015 to December 2020. A control group was created with children with early onset visual impairment of similar visual range and age, secondary to diagnosis other than albinism. Patients with associated Autism were identified in both groups.
    RESULTS: Seven hundred and eight children aged 1-18 years with visual impairment were included in the study. 401 children had a diagnosis of albinism, of whom 14 were also diagnosed with ASD. In the control group, composed of 307 patients, only 3 had ASD (p: 0·03).
    CONCLUSIONS: The prevalence of ASD in patients with albinism was 1 in 28, while in children with visual impairment from other causes was 1 in 102. We aim to raise awareness of the higher prevalence of autism in children diagnosed with albinism in order to reach earlier diagnosis and support.
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  • 文章类型: Journal Article
    目的:报告以人口为基础的儿童队列中先天性角膜混浊的出生患病率和自然史。
    方法:居住在奥姆斯特德县时诊断为先天性角膜混浊的<5岁患者的医疗记录,明尼苏达,从1977年1月1日至2016年12月31日,我们进行了回顾性回顾.
    结果:在40年的研究期间,有14例患者被诊断为先天性角膜混浊,出生患病率为5188例活产婴儿中的1例。诊断时的平均年龄为7.5个月(范围0-48个月),男性为9岁(64.3%)。四名患者患有先天性青光眼,4人患有角膜缘皮肤样病变,2有巩膜角膜,每个患者都有一个因出生创伤而撕裂的Descemet\'s,单纯疱疹病毒1型角膜炎,角膜白瘤,还有一个未确诊的伤疤.六名(42.8%)患者需要治疗其潜在的角膜混浊,其中包括四名先天性青光眼患者。其他8例(57.1%)患者的中轴清晰。14例患者中有4例(28.6%)需要弱视治疗,4例(28.6%)出现斜视。四名(28.6%)患者有相关的全身状况。在平均5.4年的随访期间(范围1.3-27.0年),中位最佳矫正视力(BCVA)为logmar0.16(20/25)(20/20-手部活动范围),其中1例单侧BCVA小于20/60,1例双侧BCVA小于20/60.
    结论:在这个40年的队列中,先天性角膜混浊相对罕见,是多种疾病的结果。虽然弱视和斜视通常发生,大多数患者的视力预后良好.
    OBJECTIVE: To report the birth prevalence and natural history of congenital corneal opacities among a population-based cohort of children.
    METHODS: The medical records of patients <5 years diagnosed with a congenital onset corneal opacity while residing in Olmsted County, Minnesota, from January 1, 1977, through December 31, 2016, were retrospectively reviewed.
    RESULTS: Fourteen patients were diagnosed with a congenital corneal opacity during the 40-year study period for a birth prevalence of 1 in 5188 live births. The mean age at diagnosis was 7.5 months (range 0-48 months) and 9 (64.3%) were males. Four patients had congenital glaucoma, 4 had limbal dermoids, 2 had sclerocornea, and 1 patient each had Descemet\'s tear from birth trauma, herpes simplex virus type 1 keratitis, corneal leukoma, and an undiagnosed scar. Six (42.8%) patients required treatment for their underlying corneal opacity including the four patients with congenital glaucoma. The other 8 (57.1%) patients had a clear central axis. Four (28.6%) of 14 patients required amblyopia therapy, and 4 (28.6%) developed strabismus. Four (28.6%) patients had associated systemic conditions. During a mean follow up of 5.4 years (range 1.3-27.0 years), the median best corrected visual acuity (BCVA) was logmar 0.16 (20/25) (range 20/20-hand motion) with one patient with unilateral BCVA less than 20/60 and one patient with bilateral BCVA less than 20/60.
    CONCLUSIONS: In this 40-year cohort, congenital corneal opacities were relatively rare and the result of a variety of disorders. Although amblyopia and strabismus occurred commonly, most patients had good visual outcomes.
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