RESUMEN
PURPOSE: To determine the relationship between the visual result and perfusion of the subfoveal choriocapillaris after surgical excision of subfoveal neovascularization in presumed ocular histoplasmosis syndrome. METHODS: We reviewed the records of 38 eyes of 37 patients with gradable postoperative fluorescein angiograms and color photographs after surgical excision of a subfoveal neovascular membrane in presumed ocular histoplasmosis syndrome. The postoperative photographs and fluorescein angiograms were graded in a masked fashion for the presence of perfusion of the subfoveal choriocapillaris. We used preoperative and postoperative best-corrected visual acuities to determine the correlation between postoperative perfusion of the subfoveal choriocapillaris and both final visual acuity and visual improvement after surgery. RESULTS: After surgery, the subfoveal choriocapillaris was perfused in 24 of the 38 eyes (63%) and nonperfused in 14 (37%). Best-corrected visual acuity improved by at least 2 Snellen lines in 17 of the 24 perfused eyes (71%) and two of the 14 nonperfused eyes (14%) (P = .0089). Best-corrected visual acuity of 20/100 or better was achieved in 18 of the perfused eyes (75%) and four nonperfused eyes (29%) (P = .0076). CONCLUSION: Both final visual acuity and improvement in visual acuity were correlated with postoperative perfusion of the subfoveal choriocapillaris in patients with presumed occular histoplasmosis syndrome. Development of techniques to maintain or reestablish perfusion of the subfoveal choriocapillaris after surgery may improve visual outcome in these eyes.
Asunto(s)
Coroides/irrigación sanguínea , Ojo/microbiología , Histoplasmosis/fisiopatología , Histoplasmosis/cirugía , Mácula Lútea/cirugía , Visión Ocular , Capilares/patología , Capilares/fisiopatología , Angiografía con Fluoresceína , Fóvea Central , Humanos , Neovascularización Patológica/cirugía , Periodo Posoperatorio , Agudeza VisualAsunto(s)
Coroides/irrigación sanguínea , Mácula Lútea/cirugía , Complicaciones Posoperatorias/etiología , Toxoplasmosis Ocular/cirugía , Adulto , Atrofia , Capilares/patología , Coroides/patología , Angiografía con Fluoresceína , Humanos , Masculino , Retina/parasitología , Retina/patología , Retina/cirugía , Neovascularización Retiniana/patología , Neovascularización Retiniana/cirugía , SíndromeRESUMEN
A 10-year-old girl with ocular complications of Stevens-Johnson syndrome developed a large superior orbital cyst above the right eye. When the cyst recurred after needle aspiration, it was removed surgically and the superior conjunctival fornix was replaced with a buccal mucous membrane graft. Histopathologically the lesion proved to be a clear cyst lined by nonkeratinizing epithelium compatible with conjunctival epithelium with rare goblet cells. The patient did well postoperatively. An orbital cyst is a rare ocular complication of the Stevens-Johnson syndrome.