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https://www.readbyqxmd.com/read/29396063/forgetting-the-fundoscope-a-case-of-fulminant-idiopathic-intracranial-hypertension-causing-rapid-visual-loss
#1
Eoin Mulroy, Thiyaga Krishnan, Stephen Best, Neil E Anderson
Idiopathic intracranial hypertension (IIH) is a syndrome of elevated intracranial pressure without evidence of intracranial mass lesion or venous thrombosis, and bland cerebrospinal fluid examination. It mostly affects overweight women of childbearing age and if left untreated, can lead to permanent visual loss. Visual decline in this condition is generally slow, over months to years. However, a small proportion of patients develop rapidly progressive visual loss within days or weeks of onset of headaches. We describe a 29 year-old patient with fulminant IIH in whom inadequate fundoscopy and assessment of vision contributed to a delay in diagnosis and poor outcome...
January 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29344064/occult-acute-macular-neuroretinopathy
#2
Michael S Vaphiades, Brendan Grondines
A 19-year-old Caucasian woman developed an upper respiratory infection, took a cold formulation containing 5 mg of phenylephrine, and developed a very rare and unusual form of acute macular neuroretinopathy (AMN) that could not be detected on fundoscopic examination, visual fields, nor electrophysiological testing. Spectral-domain optical coherence tomography (SD-OCT) revealed a lesion limited to the fovea. This case illustrates the value of SD-OCT, in light of otherwise normal testing, in a variant of AMN the authors call "occult AMN"...
August 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/29298168/incidence-of-cystoid-macular-edema-after-descemet-membrane-endothelial-keratoplasty
#3
Viridiana Kocaba, Romain Mouchel, Jacques Fleury, Anne-Sophie Marty, Hélène Janin-Manificat, Delphine Maucort-Boulch, Carole Burillon
PURPOSE: The incidence of and risk factors for cystoid macular edema (CME) after Descemet membrane endothelial keratoplasty (DMEK) remain uncertain. This study examines the incidence of and risk factors for CME after DMEK. METHODS: This retrospective, single-center study included patients with no history of CME who had undergone DMEK. Patients were examined weekly for 1 month after surgery and at 3 and 6 months after surgery. Follow-up examinations included visual acuity (VA) assessment, pachymetry, anterior segment optical coherence tomography, biomicroscopy, intraocular pressure measurement, and fundoscopy...
March 2018: Cornea
https://www.readbyqxmd.com/read/29283732/seroprevalence-and-manifestations-of-ocular-toxoplasmosis-in-patients-with-schizophrenia
#4
Fábio Barreto Morais, Tiago Eugênio Faria E Arantes, Cristina Muccioli
PURPOSE: Recent studies have linked infectious agents such as Toxoplasma gondii to schizophrenia. We investigated the seroprevalence of T. gondii and conducted ophthalmologic examinations in schizophrenia patients and controls to identify lesions suggestive of ocular toxoplasmosis. METHODS: During 2015 and 2016, 34 schizophrenia patients and 85 healthy controls underwent ophthalmologic examination and anti-T. gondii IgG and IgM antibody measurements by chemiluminescence...
December 28, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29260122/unusual-straatsma-syndrome-how-dogmatic-is-a-bad-prognosis
#5
Ana Vide-Escada, Helena Prior Filipe
Purpose: To show that Straatsma Syndrome can have a good outcome and to highlight an unusual presentation of this disease. Observations: A four-year-old boy presents with severe right eye amblyopia in association with high myopia, esotropia, heterochromia iridum and extensive myelinated retinal fibers involving both temporal arcades and the optic nerve head. Right eye initial visual acuity was less than 20/400 for distance and less than R6W10 for near. Left eye examination was unremarkable...
December 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29258533/incidental-branch-retinal-artery-occlusion-on-optical-coherence-tomography-angiography-presenting-as-segmental-optic-atrophy-in-a-child-a-case-report
#6
Ji Hyung Choi, Hee Kyung Yang, Ji Eun Lee
BACKGROUND: Retinal artery occlusion is extremely rare in the pediatric population and most patients have risk factors. We report a case of a healthy child with segmental optic atrophy, complicated by incidental branch retinal artery occlusion (BRAO). CASE PRESENTATION: A 10-year-old boy who had a history of his mother's gestational diabetes presented with an inferonasal visual field defect in the left eye. His best-corrected visual acuities were 20/20 in both eyes (OU)...
December 19, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29230338/optical-coherence-tomography-angiography-of-punctate-inner-choroidopathy
#7
Blake M Hampton, Christopher M Aderman, Harry W Flynn, Jayanth Sridhar
Purpose: To report a case of bilateral choroidal neovascularization (CNV) in punctate inner choroidopathy (PIC) visualized utilizing optical coherence tomography angiography (OCT-A). Methods: Case report. Results: A 29-year-old woman presented with new visual symptoms in both eyes. Fundoscopic exam revealed bilateral multifocal, small, well-defined lesions consistent with PIC. Optical coherence tomography demonstrated subretinal fluid and retinal pigment epithelium detachments (RPEDs) in both eyes...
2017: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/29227350/tamoxifen-retinopathy-during-treatment-of-an-inoperable-desmoid-tumor
#8
Meredith Furst, Marie B Somogyi, Robert W Wong, Dejka Araujo, Clio A Harper
PURPOSE: To evaluate the clinical significance and rarity of tamoxifen retinopathy after a long-term tamoxifen treatment for an inoperable desmoid tumor. METHODS: Case report. RESULTS: Tamoxifen retinopathy is a condition rarely observed in clinical practice. Although tamoxifen is typically a treatment for breast cancer patients, we present a 68-year-old woman taking tamoxifen for an inoperable desmoid tumor, an equally rare condition. She presented with bilaterally deteriorating vision over the course of a year...
December 8, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29132486/opticard-an-inexpensive-and-portable-method-of-bedside-direct-fundoscopy
#9
Muhammad Tauseef Omer, Efra Abbas
The use of fundoscopy to observe and grade retinal changes in diabetes and hypertension is well known. Fundus screening is recommended prior to discharge of every neonate from the neonatal unit to rule out congenital cataract. However, the traditional direct fundoscopes are expensive and, therefore, not available in majority of the hospitals in developing countries. Also, fundoscopy needs special expertise to use the device. OptiCard is an inexpensive new method of direct fundoscopy that allows visualization of retina and optic disc with or without the use of cell phone...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29109901/posterior-polar-central-choroidal-dystrophy-a-case-report
#10
Funda Dikkaya, Mustafa Özsütçü, Merve Özbek, Sevil Karaman Erdur, Fevzi Şentürk
A 52-year-old male presented with a 25-year history of decreasing vision. Best corrected visual acuity was 0.3 in his right and 0.2 in his left eye. Fundoscopic examination showed bilateral symmetric atrophy of the retinal pigment epithelium and choriocapillaris in the posterior polar areas between vascular arcades and surrounding the optic disc. On fluorescein angiography, the large choroidal vessels beneath these affected regions were easily seen. Fundus autofluorescence imaging showed clearly defined hypoautofluorescent areas that corresponded to the aforementioned lesions...
October 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28980066/blood-pressure-profile-is-associated-with-microalbuminuria-and-retinopathy-in-hypertensive-nondiabetic-patients
#11
Berrin Karadag, Tolga Ozyigit, Zeliha Serindag, Aysegul Ilhan, Beste Ozben
BACKGROUND: Target organ damage is important for global cardiovascular risk assessment. The aim of this study was to explore the association between the blood pressure profile and end-organ damage in a hypertensive non-diabetic cohort. METHODS: A total of 560 consecutive hypertensive nondiabetic patients (mean age: 58.2 ± 13.3 years, 221 men) were included in the study. All patients underwent thorough physical examination including fundoscopic examination. First morning urine samples were obtained from each patient and measurement of the albumin-to-creatinine ratio in first morning urine collection samples was used for diagnosis of microalbuminuria...
October 4, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28971251/rabbit-model-of-ocular-indirect-photodynamic-therapy-using-a-retinoblastoma-xenograft
#12
Jonathan W Kim, Bradley Jacobsen, Emily Zolfaghari, Angela Ferrario, Patricia Chevez-Barrios, Jesse L Berry, Diana K Lee, Grecia Rico, Ingy Madi, Narsing Rao, Kevin Stachelek, Lei-Chi Wang, Charles Gomer
PURPOSE: The goal of this project was to demonstrate the feasibility of coupling the indirect ophthalmoscope laser delivery system with the 690 nm wavelength diode laser used to perform photodynamic therapy (PDT) in the treatment of retinoblastoma. METHODS: For phase 1, a total of six pigmented rabbits were treated with the indirect laser delivery system. The laser source was provided by the Lumenis Opal 690 nm laser unit, delivered through a 810 nm Indirect ophthalmoscope headpiece and a hand-held 28-diopter indirect lens (1...
October 2, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28928940/comparison-of-color-discrimination-in-chronic-heavy-smokers-and-healthy-subjects
#13
Thiago Monteiro de Paiva Fernandes, Natalia Leandro Almeida, Natanael Antonio Dos Santos
Background: Cigarette smoke is probably the most significant source of exposure to toxic chemicals for humans, involving health-damaging components, such as nicotine, hydrogen cyanide and formaldehyde. The aim of the present study was to assess the influence of chronic heavy smoking on color discrimination (CD). Methods: All subjects were free of any neuropsychiatric disorder, identifiable ocular disease and had normal acuity. No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography exam...
2017: F1000Research
https://www.readbyqxmd.com/read/28928087/complement-factor-h-in-amd-bridging-genetic-associations-and-pathobiology
#14
REVIEW
Christopher B Toomey, Lincoln V Johnson, Catherine Bowes Rickman
Age-Related Macular Degeneration (AMD) is a complex multifactorial disease characterized in its early stages by lipoprotein accumulations in Bruch's Membrane (BrM), seen on fundoscopic exam as drusen, and in its late forms by neovascularization ("wet") or geographic atrophy of the Retinal Pigmented Epithelial (RPE) cell layer ("dry"). Genetic studies have strongly supported a relationship between the alternative complement cascade, in particular the common H402 variant in Complement Factor H (CFH) and development of AMD...
September 18, 2017: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/28924482/atypical-presentation-of-central-pontine-myelinolysis-in-hyperglycemia
#15
Swapna Talluri, Raghu Charumathi, Muhammad Khan, Kerri Kissell
Central pontine myelinolysis (CPM) usually occurs with rapid correction of severe chronic hyponatremia. Despite the pronounced fluctuations in serum osmolality, CPM is rarely seen in diabetics. This is a case report of CPM associated with hyperglycemia. A 45-year-old non-smoking and non-alcoholic African American male with past medical history of type 2 diabetes, hypertension, stage V chronic kidney disease and hypothyroidism presented with a two-week history of intermittent episodes of gait imbalance, slurred speech and inappropriate laughter...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28892534/utility-of-combining-a-simulation-based-method-with-a-lecture-based-method-for-fundoscopy-training-in-neurology-residency
#16
Deepak K Gupta, Namir Khandker, Kristin Stacy, Curtis M Tatsuoka, David C Preston
Importance: Fundoscopic examination is an essential component of the neurologic examination. Competence in its performance is mandated as a required clinical skill for neurology residents by the American Council of Graduate Medical Education. Government and private insurance agencies require its performance and documentation for moderate- and high-level neurologic evaluations. Traditionally, assessment and teaching of this key clinical examination technique have been difficult in neurology residency training...
October 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28838819/pediatric-idiopathic-intracranial-hypertension-is-the-fixed-threshold-value-of-elevated-lp-opening-pressure-set-too-high
#17
Lucia Gerstl, Nikola Schoppe, Lucia Albers, Birgit Ertl-Wagner, Noam Alperin, Oliver Ehrt, Andreas Pomschar, Mirjam N Landgraf, Florian Heinen
BACKGROUND: Idiopathic intracranial hypertension (IIH) in children is a rare condition of unknown etiology and various clinical presentations. The primary aim of this study was to evaluate if our pediatric IIH study group fulfilled the revised diagnostic criteria for IIH published in 2013, particularly with regard to clinical presentation and threshold value of an elevated lumbar puncture opening pressure. Additionally we investigated the potential utilization of MR-based and fundoscopic methods of estimating intracranial pressure for improved diagnosis...
November 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28808190/cholesterol-crystal-embolization-following-plaque-rupture-a-systemic-disease-with-unusual-features
#18
Firas Ghanem, Deepthi Vodnala, Jagadeesh K Kalavakunta, Sridevi Durga, Noah Thormeier, Prem Subramaniyam, Scott Abela, George S Abela
Cholesterol crystal embolic (CCE) syndrome is often a clinically challenging condition that has a poor prognostic implication. It is a result of plaque rupture with release of cholesterol crystals into the circulation that embolize into various tissue organs. Plaque rupture seems to be triggered by an expanding necrotic core during cholesterol crystallization forming sharp tipped crystals that perforate and tear the fibrous cap. Embolizing cholesterol crystals then initiate both local and systemic inflammation that eventually lead to vascular fibrosis and obstruction causing symptoms that can mimic other vasculitic conditions...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#19
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28775088/bilateral-choroidal-neovascular-membrane-in-a-young-patient-with-sorsby-fundus-dystrophy-the-value-of-prompt-treatment
#20
Nardine Menassa, Sreekala Burgula, Theodoros Empeslidis, Konstantinos T Tsaousis
A 45-year-old man had developed a choroidal neovascular membrane (CNVM) in his left eye at the age of 38 years and had received six intravitreal ranibizumab injections with resulting visual acuities of 6/60 in the affected eye and 6/4 in the unaffected right eye (Snellen charts). Family history and genetic testing revealed tissue inhibitor of metalloproteinase-3 (TIMP3) gene positive Sorsby fundus dystrophy (SFD). The patient has been under regular follow-up since. At the age of 45 years, he presented with subretinal fluid accumulation in his right eye suggestive of CNVM and received six intravitreal ranibizumab injections, which maintained visual acuity of 6/7...
August 3, 2017: BMJ Case Reports
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