Blunt cranial trauma can have serious effects on eyesight. Purtscher chorioretinopathy (traumatic retinal angiopathy) was first described at the beginning of the 20th century with anormal funduscopic findings after head injuries without any direct ocular trauma. The pathophysiological mechanisms have been debated over decades with various theories. The currently most accepted approach has its origins in microembolization of retinal vessels with subsequent occlusion.
Abstract Purpose Spontaneous corneal perforation is a rare complication of systemic diseases with ocular involvement such as Sjögren's syndrome, rheumatoid arthritis, graft‐versus‐host disease or ocular rosacea. There are few cases of spontaneous perforations in adult patients described in the literature associated with keratoconus (KC) or pellucid marginal degeneration (PMD). This case describes a spontaneous corneal perforation in a young patient with vernal keratoconjunctivitis. Methods Case report. Results A 14‐year‐old male patient presented at the Department of Ophthalmology accompanied by his parents due to one day existing redness and hazy vision of the left eye (OS). Additionally, he noticed a sudden “water outflow from the left eye.” The patient's medical history includes vernal keratoconjunctivitis, systemic prediabetes, obesity and steatohepatitis. Slit‐lamp examination of the left eye revealed a spontaneous corneal perforation of 1.4 × 1.8 mm inferonasal with iris tamponade and a surrounding corneal melting of 4 mm. The anterior chamber had been totally flattened. The right eye was diagnosed by slit‐lamp examination with central corneal thinning and inferior peripheral vascularization. The corneal perforation was primarily treated with histoacrylic tissue glue. Antibiotic treatment with Ceftazidime and Moxifloxacin eye drops alternating every hour has been established. After one week, a progressive corneal melting in the area of the primary corneal perforation was observed. Therefore, a patch “keratoplasty à chaud” had to be performed. The postoperative course was devoid of complications. The patient was initially treated with Pred forte eye drops 4 times daily. An optical penetrating keratoplasty is planned. Conclusions Spontaneous corneal perforation is an extremely rare but severe complication of vernal keratoconjunctivitis, which can also occur in young patients. Ophthalmologists should be aware of this rare complication and inform and treat their patients accordingly.
Purpose To evaluate clinical outcome after surgery of idiopathic epiretinal membranes (ERM) with internal limiting membrane (ILM) peeling using a commercial combination of Brilliant blue G (BBG, 0.25 mg/ml) with 4% polyethylene glycol (PEG). Methods It was a prospective, single-center study. Macular surgery was performed due to ERM (n = 18) by two experienced surgeons. Exclusion criteria were secondary ERM, previous retinal surgery and pharmacological treatment. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and multifocal ERG (RETIscan) were assessed at baseline and three months after surgery. Results The BCVA improved from baseline 0.4 ± 0.13 logMAR to 0.3 ± 0.2 logMAR after three months (p > 0.05). The mean central foveal thickness was reduced from 407 ± 85 μm to 366 ± 56 μm after three months (p > 0.05). At baseline, the mean P1 amplitude (nV/deg2) was 53.5 ± 32.1 in ring 1 and 35.9 ± 20.1 in ring 2. Three months after surgery the mean P1 amplitude was comparable with 57.2 ± 16.3 in ring 1 and 38.0 ± 11.7 in ring 2 compared with the initial situation (p = 0.22 and p = 0.3, respectively). Conclusion BBG with 4% PEG can be used for ILM peeling in patients with idiopathic epiretinal membranes without any sign of short-term toxicity.
Es stellte sich ein 83-jähriger Patient in unserer Notfallambulanz vor mit akuter Visusminderung, Kopfschmerzen und verklebtem Auge rechts seit dem Aufstehen. Am Vortag habe er anamnestisch noch einwandfrei gesehen. Es lag kein Trauma oder Entzündung zugrunde und sein letzter Augenarztbesuch, aufgrund einer Kataraktoperation, sei 40 Jahre her. Eine Therapie mit Augentropfen oder erinnerbaren Augenerkrankungen verneinte der Patient. Allgemein war ein Vorhofflimmern (Versorgung mit einem Herzschrittmacher), Schlaganfall (seitdem Eliquis), chronisches Nierenversagen, Korsakow-Syndrom und Zustand nach Stürzen bei Alkoholabusus bekannt.
Abstract Purpose: The aim of our study was to evaluate retinal function with white light dark‐adapted full‐field sensitivity threshold (FST) and find possible correlations with metabolic function measured with retinal oximetry (RO) in patients with retinitis pigmentosa (RP). Methods: In this prospective observational study (BASEC 2020–00122), FST and RO measurements were performed on 66 RP eyes (33 subjects, 12♀ 21♂) aged between 18 and 80 years (mean 43.2 years); all eyes were graded for disease severity. Main outcome parameters were white FST thresholds using the Diagnosys Espion system with the ColorDomeTM LED full‐field stimulator (Diagnosys LLC, Lowell, MA) as well as the main RO parameters: the mean arterial (A‐SO 2 ; %), venular (V‐SO 2 ; %) oxygen saturation, their difference (A‐V SO 2 ; %), and the corresponding mean diameters of the peripapillary retinal arterioles (D‐A; μm) and venules (D‐V; μm) recorded with the oxygen saturation tool of the Retinal Vessel Analyser (RVA; IMEDOS Systems UG, Jena, Germany). In addition, semi‐automated kinetic perimetry (V4e, III4e, I4e, III3e isopters, Octopus 900®, Haag‐Streit AG Bern, Switzerland) was performed and included in the linear mixed‐effects models analysis calculated with SPSS®. Results: Neither the oxygen saturation parameters ( p > 0.21) nor the D‐A and D‐V ( p > 0.13) showed significant correlations with the FST. However, when compared systematically with the visual field (VF) areas of the different isopters, RO parameters V‐SO 2 ( p = 0.024) and A‐V SO 2 ( p < 0.02) showed significant correlations. Furthermore, both V‐SO 2 and A‐V SO 2 showed gradual changes with more pronounced impairment in oxygen metabolic function in advanced stages of RP when analysed in subgroups of disease severity grades. Conclusions: In advanced stages of RP, RO showed a significant association with standardized VF testing parameters and presented with gradual changes of more pronounced impairment in retinal oxygen metabolic function. Unlike standardized VF parameters, white dark‐adapted FST does not appear to correlate with retinal oxygen metabolic function in RP patients, implying that the two examinations may capture unrelated aspects of the retinal pathological process.
