vitreous / retinal disease < PEDIATRIC OPHTHALMOLOGY

  • 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
    目的:报告Coats病的异常前段和后段特征的临床过程和处理以及它们与患者年龄的关系,以提高对这些目前文献中很少描述的罕见临床特征的认识。
    方法:在意大利锡耶纳大学视网膜母细胞瘤转诊中心和眼科部门对45例Coats病患者的45只眼进行了回顾性描述性回顾,分析了2000年至2022年的数据。修改了医疗记录和图像,以发现某些病例在受Coats疾病影响的患者中表现出异常的前后段特征。因此,我们确定了4种异常的临床状况:视网膜大囊肿,前房胆固醇血症,保留中央凹的Coats疾病和继发性血管增殖性肿瘤。
    结果:2例视网膜大囊肿患者(2/45=4.4%),一个前房胆固醇血症(1/45=2.2%),2例保留中央凹的Coats病(2/45=4.4%),1例与血管增生性肿瘤相关(1/45=2.2%),总共6例(6/45=13.3%)患者在Coats病中表现出异常的前段或后段特征。
    结论:在年龄较小的儿童中,Coats疾病的异常前段和后段特征如视网膜大囊肿和前房胆固醇病的报道更为频繁,而在年龄较大的患者中,中央凹保留和血管增生性肿瘤的报道更为常见。然后,年龄是强有力的预后标记,其允许区分Coats疾病的两种不同表型:年龄小于和大于3岁的患者,分别具有更积极和更温和的表型。
    OBJECTIVE: To report the clinical course and management of unusual anterior and posterior segment features of Coats disease and their relation to the age of the patients to increase the awareness towards these rare clinical features rarely described in the current literature.
    METHODS: A retrospective descriptive review of 45 eyes of 45 patients affected by Coats disease was conducted at the Retinoblastoma Referral Center and Ophthalmology Unit of the University of Siena in Italy analyzing data from 2000 to 2022. Medical records and images were revised to find some cases presenting unusual anterior and posterior segment features in patients affected by Coats disease.We identified therefore 4 unusual clinical conditions: retinal macrocysts, anterior chamber cholesterolosis, fovea-sparing Coats disease and secondary vasoproliferative tumor.
    RESULTS: Two patients presented with retinal macrocyst (2/45  =  4.4%), one with anterior chamber cholesterolosis (1/45  =  2.2%), two with fovea sparing Coats disease (2/45  =  4.4%) and one with vasoproliferative tumor associated (1/45  =  2.2%) for a total of six (6/45  =  13.3%) patients manifesting unusual anterior or posterior segment features in Coats disease.
    CONCLUSIONS: Unusual anterior and posterior segment features of Coats disease such as retinal macrocyst and anterior chamber cholesterolosis have been more frequently reported in younger children while fovea-sparing and vasoproliferative tumors have been more commonly described in older patients. Age is then a strong prognostic marker which allows to distinguish two different phenotypes of Coats disease: patients younger and older than 3 years old with more aggressive and milder phenotype respectively.
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