Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.
Retinoschisis is an abnormal separation of the retinal layers and is asymptomatic in most cases. Enlargement of the area of retinoschisis and retinal tear and detachment are possible complications of the disease, and the treatment of retinoschisis is controversial. In this case report, we present a case of retinal detachment associated with senile retinoschisis in which pneumatic retinopexy was chosen as the treatment of choice and was performed successfully in one of the eyes. After a literature review on retinoschisis and pneumatic retinopexy for the treatment of associated retinal detachment, we found only one case that was successfully treated without drainage of subretinal fluid, using air as the filler. However, no previous reports have been found in the literature on the effectiveness of pneumatic retinopexy using C3F8 as the sole treatment for progressive retinal detachment in senile retinoschisis.
The spontaneous closure of a full-thickness macular hole (MH) developed after vitrectomy is very uncommon. We report a small series of cases (two patients) with this presentation. The first patient developed a MH 1 month after vitrectomy for an epirrretinal membrane and, the second one, 3 weeks after vitrectomy for rhegmatogenous retinal detachment. The MHs resolved spontaneously 2 months and 1 month after their documentation by optical coherence tomography(OCT), respectively. In this case report, we review the literature on spontaneous closure of MHs and discuss possible mechanisms for this rare event.Keywords: Retinal perforations, Vitrectomy/methods, Optical coherence tomography, Epiretinal membrane, Retinal detachment, Case reports RESUMO O fechamento espontâneo de buraco de mácula de espessura total é um fenômeno raro, especialmente em olhos vitrectomizados. Descrevemos nesse relato dois casos com essa apresentação. No primeiro caso, notou-se o buraco de mácula 1 mês após vitrectomia por membrana epirretiniana e, no segundo, 3 semanas após vitrectomia por descolamento de retina regmatogênico. O fechamento desses buracos ocorreu espontaneamente 2 meses e 1 mês após sua documentação, respectivamente. Feita a revisão bibliográfica e propostas teorias para explicar esta evolução atípica, o entendimento deste fenômeno pôde nos ajudar a refinar a indicação cirúrgi-ca desta patologia.Descritores: Perfurações retinianas, Vitrectomia/métodos, Tomografia de coerência óptica, Membrana epirretiniana, Descolamento retiniano, Relatos de casos CASE REPORTRev Bras Oftalmol. 2014; 73 (6): 389-91
Purpose: To compare the circumpapillary and superficial macular vessel density (cpVD and mVDsup) of eyes with temporal visual field (VF) defect and band atrophy (BA) of the optic nerve and normal controls using optical coherence tomography angiography (OCTA) and to verify the association of vessel density parameters with retinal neural loss assessed by conventional optical coherence tomography (OCT) and VF loss. Methods: Thirty-three eyes of 26 patients with BA and 42 eyes of 22 age-matched normal controls underwent OCT + OCTA scanning. cpVD and circumpapillary retinal nerve fiber layer (cpRNFL) thickness were expressed as average and sector measurements. mVDsup and macular ganglion cell complex (mGCC) thickness were calculated as averages and in quadrants and hemiretinas. VF loss was estimated using the 24-2 and the 10-2 protocols. Results: Compared with controls, BA eyes displayed smaller average cpVD and mVDsup values (p < 0.001 and AROC = 0.91 for both). Sectorial measurements were also reduced, especially the nasotemporal sector average cpVD (p < 0.001 and AROC = 0.96) and the nasal inferior retina mVDsup measurements (p < 0.001 and AROC = 0.93). cpVD and mVDsup correlated strongly (p<0,001) with corresponding cpRNFL and mGCC thickness measurements in affected regions (r range: 0.67-0.78 and 0.56-0.76, respectively). Similarly, cpVD and mVDsup parameters correlated significantly with corresponding VF loss (r range: 0.45-0.68). Conclusion: cpVD and mVDsup are significantly reduced in BA eyes compared with controls and are strongly correlated with retinal neural and VF loss. cpVD and mVDsup reduction on OCTA could serve as a surrogate for retinal neural loss in compressive optic neuropathy and might be useful in its management.
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