The optic nerve head and choroidal circulation was delayed in both patients with POAG and those with CPACG, which correlates with loss of neuroretinal rim and retinal nerve fiber layer on the Heidelberg Retina Tomograph II (HRT). Patients with POAG showed diffuse damage with significant rim loss, whereas patients with CPACG showed marked sectorial abnormalities (superotemporal and the inferior-temporal) on fluorescein angiography and HRT. One possible reason for this discrepancy could be sectorial ischemia occurring in cases of CPACG as a result of a sudden rise of intraocular pressure causing disc and visual field damage.
Thyroid associated ophthalmopathy is an autoimmune disorder which involves orbital and periorbital tissue. The immune-mediated inflammation of the orbital tissues can involve extraocular muscles, orbital connective tissue or orbital fat and periocular soft tissues. Bilateral involvement of thyroid associated orbitopathy is usually asymmetric, but unilateral thyroid associated orbitopathy has been less reported. Periorbital oedema as the only sign with hypothyroidism is uncommon and if present, it is more frequent bilaterally present and no cases are evidenced as unilateral. Pitting oedema in hypothyroidism is rare and can be due to increased capillary permeability, decreased adrenergic tone and increase in serotonin metabolism. Unilateral periorbital and eyelid oedema can associate with various clinical entities, multidisciplinary team is necessary to exclude the concomitant disease, so the patient can immediately be treated with proper therapy. We represent the case of unusually unilateral recurrent periorbital oedema in the period of time for 3 years with stabilized primary hypothyroidism and multinodular goitre.
Gilles de la Tourette's syndrome, is a condition characterized by multiple motor and vocal tics, which appear in childhood and are often accompanied by behavioral symptoms. There are isolated reports which associate this syndrome with color vision deficiencies, self-induced haemophthalmous and dislocation of crystalline lens, retinal detachment and keratoconus. This is a case report of a known case of Gilles de la Tourette's Syndrome patient who presented with bilateral visual loss. The visual loss was as consequence of repeated attacks during which he punched his periorbital region with his hand. There was total rhegmatogenous retinal detachment with advanced proliferative vitreoretinopathy in both eyes. The left eye was treated with phacoemulsification vitrectomy. Retina was successfully attached and remained attached at 1 year follow up after silicone oil removal in the left eye.
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