Purpose:The purpose of this study was to assess the role of combined surgical treatment of therapeutic penetrating keratoplasty and pars plana vitrectomy in the anatomical and functional outcome of infectious keratitis endophthalmitis.Methods: This study reviewed the medical records of 4 participating centers in the United States and Mexico. This study included patients with a clinical diagnosis of infectious keratitis endophthalmitis who had been treated with an early therapeutic penetrating keratoplasty and pars plana vitrectomy as the main treatment for endophthalmitis. From each medical record, the study retrieved demographic data, relevant medical and drug history, baseline clinical manifestation of endophthalmitis, best-corrected visual acuity, and the need for enucleation/evisceration for the control of the infection or any other reason through the follow-up. Results:The study included 48 patients (50.15 6 20.6 years). The mean follow-up time was 13 6 0.5 months. The mean best-corrected visual acuity at baseline was 2.1 6 0.25 logarithm of the minimum angle of resolution. At month 12 was 2.09 6 0.61 logarithm of the minimum angle of resolution (P = 0.9). The overall prevalence of enucleation/evisceration was 8.3% (95% confidence interval: 2.32%-19.98%). The prevalence of a vision of no-light perception was 20.8% (95% confidence interval: 2.32%-19.98%). Conclusions:Combined surgery for severe cases of infectious keratitis endophthalmitis eradicates the infection in most cases, while significantly improving the overall outcomes.
Background The objective of this publication is to report a case of an atypical partial central retinal artery occlusion (CRAO) with substantial visual recovery without treatment. Case Presentation An 83-year-old woman without significant medical history with sudden unilateral visual loss presented with no known significant ophthalmological or medical history besides systemic arterial hypertension. Examination showed multiple cotton-wool spots in a peripapillary distribution, as well as a heterogenous pattern of grey translucency in the macula resulting in an indistinct cherry-red spot. Fluorescein angiography showed normal choroidal filling and an important delay of dye transit through the retinal circulation. Carotid Doppler echography showed a small endothelial atherosclerotic plaque without hemodynamic repercussion. A detailed history and further examination revealed no other systemic diseases except for moderate hypercholesterolemia. The patient was referred for management of her hypertension but otherwise did not undergo specific therapy for CRAO because of the delayed presentation. Four weeks after the initial visual loss, the patient showed resolution of the retinal findings and a surprising improvement to 20/50 visual acuity. Conclusion This case highlights a rare subtype of central retinal artery occlusion. In this disease, partial occlusion reveals atypical signs including large cotton-wool spots as the predominant finding, making the initial diagnosis difficult. Visual recovery may be significant in partial CRAO, even without treatment.
Purpose To report clinical findings and final visual acuity outcomes in patients with Coats disease (CD) treated in central Mexico. Methods Retrospective case series analysis of CD patients recruited from five referral hospitals. Clinical characteristics that included age and symptoms at diagnosis, the area of retinal affected, treatment modalities and visual outcomes were recorded. Age of presentation and retinal zones involved were evaluated based on final visual outcomes. Results 67 eyes (66 patients) with diagnosis of CD were identified. Male gender occurred in 81% and the right eye was affected in 55% of the cases. Mean age at diagnosis was 11 years (median 9.8, range 6 months to 65 years). Only 9 patients (13%) had initial visual acuity (VA) better than 1.3 logMAR. Twenty patients received more than one treatment modality and laser photocoagulation was the most widely used. Final VA was classified as blindness in 57 (85%) patients, and it was correlated with worse initial visual acuity (p = 0.005). Number and extension of affected retinal zones were not correlated with age of presentation or gender (p > 0.05). During a mean follow-up of 42 months (SD +/- 37.8), there was slight improvement in visual acuity after treatment in only three cases (4.5%). Conclusion Final visual acuity in almost all CD patients was severe visual impairment. Visual prognosis is poor and depends on stage, location of disease and age of presentation. New strategies for early CD diagnosis by novel methods are needed to improve visual outcomes in these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.