Purpose: To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed. Methods: Clinical charts review of forty-five patients treated for endophthalmi tis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients. Results: Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomo nas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period. Conclusion:Even with all the safety that cataract surgery has achieved, today, en dophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.
Purpose: to report a case of branch retinal artery occlusion in the acute phase, using optical coherence tomography to evaluate the morphologic changes. A 27 year-old man had a sudden superior scotoma in the right eye, with fundus examination compatible with inferior temporal branch retinal artery obstruction. The optical coherence tomography revealed increase in thickness and hyper-reflectivity of the inner retinal layers in affected area, with decreased reflectivity of photoreceptor and retinal pigment epithelial layers. The optical coherence tomography findings are consistent with intracellular edema, and not with secondary vascular leakage of extracellular fluid, according to histopathological theories of retinal ischemia and necrosis that occurs after retinal artery occlusion. ABSTRACT RELATOS DE CASOS
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