Giant cell arteritis, a large vessel vasculitis is characterized by headache, visual impairment, constitutional symptoms, and increased inflammatory markers. Visual involvement in giant cell arteritis ranges from amaurosis fugax to permanent visual loss, and extensive bilateral visual impairment is a rare presentation. We hereby report a case of combined left central retinal artery occlusion and bilateral anterior ischemic optic neuritis in a patient who poorly responded to standard corticosteroid therapy.
Bisphosphonates are widely used to treat several clinical conditions. Zoledronic acid is one of this class, commonly used for the treatment and prevention of osteoporosis, hypercalcemia of malignancy, Paget’s disease, and multiple myeloma. A variety of ocular side effects associated with bisphosphonates therapy has been reported but are uncommon and readily treatable. Most of these ocular inflammatory conditions are associated with other bisphosphonates such as pamidronate but rarely reported with zoledronic acid. Acute anterior uveitis associated with zoledronic acid is rare. We describe a 75-year-old female who presented with features of acute unilateral non-granulomatous anterior uveitis which developed within 24 h following the first dose of intravenous infusion of zoledronic acid administered to treat post-menopausal osteoporosis. She was treated with topical steroids and made an uneventful recovery in 2 weeks.
Posterior reversible encephalopathy is a rare neurological disease. The association between Posterior reversible encephalopathy syndrome and severe pneumonia is not well described in the available medical literature. We describe a case of a 51 year old female presented to our hospital with sudden loss of vision in both eyes in the background history of pneumonia who recovered completely with treatment. This case report elaborates the very rare entity of posterior reversible encephalopathy syndrome secondary to severe pneumonia.
Background: Kearns Sayre Syndrome (KSS) is a rare mitochondrial disorder with systemic involvement characterised by skeletal, smooth and cardiac muscle dysfunction; pigmentary retinal changes; neurological and endocrine dysfunction. KSS arise from a large-scale deletion of mitochondrial DNA which typically occurs as a sporadic event. Recurrent cardiac syncope is one way of the initial presentation of this syndrome due to involvement of cardiac conduction system.
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