Objectives:To describe ocular manifestations, diagnosis, and treatment of cat scratch disease.Materials and Methods:Clinical records of patients with ocular cat scratch disease were reviewed.Results:Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9±18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, ≤0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47±14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye.Conclusion:Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations.
A 39-year old male patient presented with severe herpes zoster ophthalmicus (HZO) on the left side of his face and developed orbital apex syndrome (OAS) despite systemic valacyclovir therapy. Persistent low vision, ptosis, limitation of extraocular muscle movements, anisocoria, epiphora, and photophobia led to suspicion of OAS. OAS was confirmed by orbital MRI. Intravenous acyclovir and systemic corticosteroids were initiated. Gradual recovery occurred over six months. The patient was seronegative for HIV and syphilis. He reported alcohol consumption for the last few months. This case increased awareness of a rare, but a sight-threatening complication of HZO in an immunocompetent patient.
* BACKGROUND AND OBJECTIVE: To determine the visual outcome and complications of posterior chamber intraocular lens implantation after capsular tear in patients undergoing phacoemulsification at Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey. * PATIENTS AND METHODS: The medical records of patients who underwent phacoemulsification surgery for senile cataract from January 1, 1996, to December 31, 1998, were reviewed. Patient inclusion criteria were implantation of a posterior chamber intraocular lens after phacoemulsification, being operated on by one of two surgeons, and a follow-up of at least 1 year. There were 58 eyes in the group with capsular tear and 1 59 eyes in the group with intact capsule. * RESULTS: A final visual acuity of 0.8 or more was more common in eyes with uncomplicated phacoemulsification surgery (chi-square = 16.25, P= .03). Refraction stabilized most commonly at 2 to 6 months postoperatively in patients with capsular tear and 1 to 21 days postoperatively in patients with uncomplicated phacoemulsification (chi-square = 22.61, P< .001). Complications such as retinal detachment (odds ratio = 11.70, P< .05), cystoid macular edema (odds ratio = 26.33, P< .01), increased intraocular pressure (odds ratio = 14.54, P < .05), and decentration of the intraocular lens (odds ratio = 32.79, P = .00 1 ) were more frequendy observed in eyes with capsular tear. * CONCLUSIONS: It takes longer for the refraction to stabilize in eyes with posterior chamber intraocular lens implantation after capsular tear during phacoemulsification. Complications such as retinal detachment, cystoid macular edema, increased intraocular pressure, and decentration of the intraocular lens are more common in these patients, and therefore they should be observed for a longer period of time. [Ophthalmic Surg Lasers Imaging 2004;35:219-224.]
<H4>BACKGROUND AND OBJECTIVE</H4> <P>This study was conducted to analyze the efficacy of the adjustable suture technique for correction of strabismus in patients with different types of strabismus.</P><H4>PATIENTS AND METHODS</H4> <P>This was an observational case series of patients who underwent the adjustable suture technique for correction of strabismus. A total of 33 adult patients (16 males and 17 females) with a minimum postoperative follow-up period of 6 months were included in the study. Patients were analyzed in three groups (patients with exotropia, esotropia, and vertical deviations). Success criteria determined were percentage change in the angle of deviation for far and near fixation, need for reoperation, and relief of diplopia.</P> <H4>RESULTS</H4> <P>The median percentage change in the angle of deviation for far and near fixation was 86.60% and 84%, 92.50% and 94.44%, and 100% and 100% in the exotropia, esotropia, and vertical deviation groups, respectively. There was no need for reoperation, and postoperative adjustment performed 24 hours after surgery was needed in 30.3% of patients due to diplopia.</P> <H4>CONCLUSIONS</H4> <P>The adjustable suture technique seems to be an effective method in the correction of various types of strabismus.</P> <P>[<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:196-202.]</P> <H4>AUTHORS</H4> <P>From Marmara University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey.</P> <P>Accepted for publication May 9, 2006.</P> <P>Presented in part as a poster at the 29th Meeting of the European Strabismological Association, Izmir, Turkey, June 1-4, 2004.</P> <P>Address correspondence to Sumru Onal, MD, Altunizade Mah., Okulcikmazi Sok. No: 11/5, 34660 Üsküdar, Istanbul, Turkey.</P>
Candida endophthalmitis is a common cause of fungal endophthalmitis. A case of bilateral endogenous endophthalmitis caused by Candida albicans without candidemia in an otherwise healthy 77-year-old man was reported. The patient underwent bilateral pars plana vitrectomy and intravitreal liposomal amphotericin B injections in addition to systemic fluconazole therapy. Postoperatively, a significant decrease of inflammation and resolution of abscesses were observed in both eyes. Vision improved in the left eye but remained constant in the right eye because of secondary cataract formation. To the best of our knowledge, this is the first report on the use of liposomal amphotericin B intravitreally in a patient with bilateral endogenous candida endophthalmitis. No evidence of clinical ocular toxicity was observed with the liposomal form of amphotericin B injection.
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