hypotonic maculopathy

  • 文章类型: Case Reports
    溴莫尼定是治疗青光眼的常用药物,与眼自身免疫性疾病如葡萄膜炎和结膜炎有关。溴莫尼定下的角膜病理学通常不太常见。
    这里,我们报道了1例78岁的男性患者,在接受溴莫尼定治疗6周后,出现了低眼压和低张性黄斑病变。系统自身免疫性和感染性疾病的系统性检查为阴性。我们停止了溴莫尼定,并局部使用泼尼松龙,在这种情况下,炎性角膜体征和眼内压恢复正常。脉络膜视网膜皱褶在9个月后持续存在。
    我们的病例报告建议监测患者在溴莫尼定下的无菌角膜浸润。
    UNASSIGNED: Brimonidine is a commonly used drug for glaucoma treatment, which has been linked to ocular autoimmune disorders like uveitis and conjunctivitis. Corneal pathology under brimonidine is generally less common.
    UNASSIGNED: Here, we report a 78 -year-old male patient suffering from immune corneal stromal inflammation with hypotony and resulting hypotonic maculopathy after 6 weeks after introduction of brimonidine treatment. Systemic work-up for system autoimmune and infectious diseases was negative. We discontinued brimonidine and administered topical prednisolone under which inflammatory corneal signs and intraocular pressure normalized. Chorioretinal folds persisted after 9 months.
    UNASSIGNED: Our case report suggests monitoring patients under brimonidine for sterile corneal infiltration.
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  • 文章类型: Journal Article
    BACKGROUND: To describe a \"triple\" surgical procedure, which combined traumatic cataract extraction by phacoemulsification with gas endotamponade and cyclocryotherapy in the successful treatment of a traumatic cyclodialysis cleft.
    METHODS: A 44-year-old man who suffered severe left eye blunt trauma with an elastic band developed a 4-hour extent cyclodialysis cleft with consequent hypotony. After 7 weeks of persistent hypotonic maculopathy unresponsive to medical treatment, and with an evolving traumatic cataract, the patient underwent cataract surgery combined with intravitreal gas endotamponade (20% SF6) and cyclocryotherapy.
    RESULTS: Two weeks after the procedure the intraocular pressure increased to 12 mmHg and remained steady during the next 14 months of follow-up. Hypotonic maculopathy resolved and successful closure of the cyclodialysis cleft was confirmed by gonioscopy and ultrasound biomicroscopy.
    CONCLUSIONS: Gas endotamponade and cyclocryotherapy constitute a promising option in the treatment of cyclodialysis clefts unresponsive to medical therapy. In our case, this minimally invasive technique was innovatively combined with cataract surgery. Despite early postoperative intraocular inflammation, a successful outcome was achieved.
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  • 文章类型: Case Reports
    UNASSIGNED: To report the frequency of post glaucoma filtration surgery hypotonic maculopathy determined by spectral domain optical coherence tomography (SD-OCT).
    UNASSIGNED: A cross-sectional retrospective observational study. Post glaucoma filtration surgery patients whose intraocular pressures (IOP) achieved 30% reduction from baseline or was controlled to IOP <14 mm Hg and had SD-OCT images and fundus photographs were enrolled. Hypotonic maculopathy was diagnosed independently on SD-OCT images and on fundus photographs.
    UNASSIGNED: 112 eyes of 88 patients were included in this study. 17 eyes of 14 patients were diagnosed with hypotonic maculopathy on SD-OCT images (17/112, 15.2%). Among these eyes, only 3 eyes were also diagnosed with hypotony maculopathy on fundus photography. Hypotonic maculopathy on SD-OCT was found only in eyes with IOP ≤10 mm Hg. (17.4% in eyes with IOPs between 7 and 10 mm Hg, and 22.7% in eyes with IOP ≤ 6 mm Hg). Associations with age, sex, central corneal thickness, refractive error, IOP reduction rate and interval between surgery and OCT acquisition were not significant (P > 0.05).
    UNASSIGNED: In most cases, hypotonic maculopathy detected by SD-OCT were not recognizable on fundus photographs. Hypotonic maculopathy was detected not only in eyes with conventional ocular hypotony (IOP < 6 mm Hg) but also in eyes with IOP between 7 and 10 mm Hg.
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  • 文章类型: Case Reports
    UNASSIGNED: Hypotonic maculopathy secondary to cyclodialysis often persists and causes irreversible visual loss despite a variety of treatments proposed. The purpose of this study is to report two cases with persistent hypotonic maculopathy due to a large cyclodialysis cleft treated with a simple, lens-sparing technique of external drainage, diathermy, and suturing under the placement of an infusion cannula.
    UNASSIGNED: Both patients had sustained blunt trauma to one eye, causing persisting hypotonic maculopathy. One eye was phakic. The ciliary body was totally detached with a large cyclodialysis cleft. After half-thickness scleral flaps were made and a 25-gauge infusion cannula was placed at the pars plana, external drainage was performed. Transscleral diathermy and interrupted suturing also were done.
    UNASSIGNED: In both cases, the ciliary detachment promptly improved and the intraocular pressure normalized after transient elevation for a few days. No adverse events were observed.
    UNASSIGNED: We successfully treated two cases with hypotonic maculopathy by a simple technique with an infusion cannula. This procedure is simple, immediately effective, less invasive, and applicable to all cases including phakic eyes.
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  • 文章类型: Journal Article
    OBJECTIVE: To assess the surgical and functional outcome of internal direct cyclopexy as therapy of complicated traumatic cyclodialysis.
    METHODS: The single-centre interventional case-series study included eyes with traumatic cyclodialysis who had consecutively been treated. Internal cyclopexy was performed using double-armed sutures introduced into the eye through the pars plana opposite to the cyclodialysis cleft and which were laid parallel to limbus. Additional procedures included cataract surgery, and pars plana vitrectomy. The cyclodialysis was documented upon ultrasound biomicroscopy and gonioscopy.
    RESULTS: The study included 44 patients (44 eyes). The cyclodialysis extended over 4.8 ± 3.2 clock hours of scleral spur circumference (range 1-12 hr, median 4 hr), involving >180° of the scleral spur circumference in 16 eyes (37%) and 360° in 3 eyes (7%). Besides cyclodialysis, additional trauma-related complications included hyphema, iridodialysis, lens dislocation, cataract, vitreous haemorrhage, retinal detachment, suprachoroidal haemorrhage and endophthalmitis. The surgery performed on average at 64 days after the trauma included a mean number of 4.6 ± 1.9 sutures (range: 2-9), with 1.2 sutures per 30° width of cyclodialysis. Mean follow-up was 32 ± 8 weeks (range: 6-51 weeks). Closure of the cyclodialysis was achieved in all 44 eyes, and intraocular pressure (IOP) increased from 8.0 ± 3.4 mmHg (range: 3 21 mmHg) to 14.4 ± 4.0 mmHg (range: 11-21 mmHg). Mean visual acuity (VA) improved from 2.3 ± 1.1 logMAR (range: 0.22-4.0) to 1.2 ± 0.8 logMAR (range 0.3-4.0 logMAR).
    CONCLUSIONS: In conclusion, internal direct cyclopexy is a novel and relatively little invasive surgery technique for the repair of traumatic cyclodialysis.
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