To report a combined cilioretinal artery and partial central retinal vein occlusion shortly after delivery in a twin-pregnant woman.A 25-year-old woman presented to our clinic with the complaint of blurred vision in the right eye 1 week after delivery. She underwent detailed ophthalmic and systemic investigations.The patient had an uncomplicated twin pregnancy. Ocular examination showed combined cilioretinal artery and partial central retinal vein occlusion in the right eye. Systemic diseases were excluded. Laboratory evaluations revealed increased plasma d-dimer level (1.64 mg/mL). Spontaneous recovery occurred without treatment 1 month after delivery.Twin pregnancy may lead to exaggerated hypercoagulability and increased d-dimer level in pregnant women. This situation may be a risk factor for retinochoroidal vascular occlusions.
Aim: To evaluate the urgency of ophthalmology consultations in the emergency department (ED) and the presence of ophthalmic pathology. This study also aimed to determine whether the weekend phenomenon affected emergency ophthalmologic consultation requests. Materials and Methods: Ophthalmology consultations requested by the emergency physician for patients who visited the academic ED of a tertiary care hospital in Turkey from January to December 2019 were retrospectively investigated. Consultation requests were grouped as possible emergent, unlikely to be emergent, and undetermined. Results: A total of 256 eligible patients were included in the study. The top three reasons for emergency ophthalmologic consultations were blunt trauma (29.7%), foreign body (24.2%), and conjunctivitis (13.3%). 70.3% of the patients were categorized as a possible emergent, 18.4% as unlikely to be emergent, and 11.3% undetermined. The frequency of consultation requests with diagnoses that are unlikely to be emergent at weekends and out of working hours was lower than during weekdays and working hours (p = 0.032, p = 0.029, respectively). Most of the possible emergent consultations had ophthalmic pathology (p = 0.001). Conclusion: Traumatic injuries are the most common cause of ophthalmology consultation in the ED. Approximately one-fifth of patients are unlikely to be emergent. Early ophthalmology evaluation is required in possible emergent category patients. The weekend effect does not influence ophthalmology consultations. Establishing eye emergency services or having an available ophthalmologist is crucial in the emergency diagnosis and treatment of patients who require special practice skills.
This report concerns a case of Idiopathic Intracranial Hypertension (IIH) in a man treated with lumbar peritoneal shunting. Despite resolution of papilloedema a central scotoma remained and evaluation in the retinal department revealed peripapillary choroidal neovascularisation (CNV). During 10 months follow up fundus appearance and Optical Coherence Tomographic (OCT) findings improved although his visual acuity did not change. The case is presented as an example of improvement of a neovascular membrane following treatment of raised intracranial pressure.
Purpose: To report the measurements of central corneal thickness (CCT) in uveitic eyes with Behçet disease (BD) and compare it with age- and sex-matched healthy controls. Materials and Methods: This study included 69 eyes with ocular BD with no history of corneal disease, glaucoma, or ocular surgery and 50 eyes of healthy controls. Eyes with ocular BD were subdivided into active and inactive groups. Active group was defined as the presence of anterior uveitis or panuveitis, whereas inactive group was defined as having had at least 1 previous attack and absence of any active inflammation in the eye within the last 3 months. CCT was measured with ultrasonic pachymeter. Statistical analyses were performed, and P < 0.05 was considered statistically significant. Results: Active group had 24 patients and inactive group had 45 patients. Demographic characteristics of patients with ocular BD and control subjects were similar (P > 0.05). There was no significant difference in respect to the disease duration between active and inactive groups (P = 0.160). The mean CCT was significantly greater in active group (584.75 ± 20.94 μm) than in inactive group (540.55 ± 36.16 μm) and control group (543.04 ± 25.35 μm) (P = 0.0001). Conclusions: We found that eyes with active BD had increased CCT because of active inflammation when compared with inactive and control groups, and mean CCT of inactive BD was normal. Therefore, we assume that CCT is in normal range in the inactive phase, and recurrent uveitis does not lead to a permanent change in CCT in BD.
This article reviews the therapeutic approaches in children with Vogt-Koyanagi-Harada (VKH) syndrome, and reports on a 9-year-old girl with progressive visual loss due to VKH syndrome in spite of treatment. In previous reports, corticosteroids were found to be the most effective agents in the treatment of VKH syndrome, while combination therapies with cyclosporine, methotrexate, or azathioprine were used with favorable results in refractory cases. In the current case, none of the treatments sufficiently stabilized the vision, but triple combination of corticosteroids, cyclosporine, and methotrexate suppressed the relapses of intraocular inflammation. Treatment of children with VKH syndrome is challenging. Various treatment modalities have been reported with various responses, but there is still no definite treatment regimen, and the treatment is usually individualized in pediatric VKH cases.
To assess the changes in the conjunctival cytology of patients given a subconjunctival injection of 5-fluorouracil (5-FU) to treat failed filtering blebs.The patients were classified into 3 groups. The first group included 15 eyes in 15 patients who were given subconjunctival injections of 5-FU after unsuccessful glaucoma surgery. The second group consisted of 15 eyes of 15 patients with primary open angle glaucoma treated with antiglaucomatous eyedrops. Twelve healthy age- and sex-matched volunteers formed the third group. Impression cytology specimens were obtained from the bulbar conjunctiva just beside the injection sites using cellulose acetate filter paper. The samples were fixed in 95% ethanol, stained with Papanicolaou stain, and evaluated under light microscopy and graded.In the first group, grade 0-3 cytological changes were seen in 1 eye (6.6%), 9 eyes (60%), 4 eyes (26.6%), and 1 eye (6.6%). Apoptosis was observed in 2 eyes (13%) and nuclear atypia in 7 eyes (47%). In the second group, 9 eyes (60%) were grade 0, 4 eyes (27%) were grade 1, and 2 eyes (13%) were grade 2. Also, nuclear atypia was observed in 1 eye (6.6%). In the third group, 10 eyes (83%) were grade 0 and 2 eyes (17%) were grade 1. There was no significant difference in terms of the impression cytology grades between the groups because of small sample size.The use of subconjunctival 5-FU injections after glaucoma surgery may lead to squamous metaplastic changes and nuclear atypia and apoptotic cell death in the conjunctival epithelium in short-term period.
