RESUMEN
BACKGROUND: We report a rare case of optic neuropathy following dacryocystorhinostomy (DCR) in a 57-year-old female patient with May-Hegglin anomaly. CASE PRESENTATION: The patient was presented with sudden onset of vision loss for the left eye after DCR under general anesthesia. Her best corrected visual acuity was light perception in the left eye. Relative afferent pupillary defect was detected in her left eye. Magnetic resonance imaging of the orbit revealed an hyperintensity at the intra-orbital segment of the left optic nerve on T2-weighted image and Flair image. The patient was diagnosed with acute postoperative optic neuropathy and treated with methylprednisolone. Although her vision partially improved, she was left with a visual field defect in the left eye. CONCLUSIONS: In patients with hematologic diseases, postoperative vision loss can occur following even minor surgery under general anesthesia, such as DCR. Therefore, preoperative counseling regarding the risk of visual loss should be given to high-risk patients.
Asunto(s)
Dacriocistorrinostomía/efectos adversos , Pérdida Auditiva Sensorineural/complicaciones , Enfermedades del Nervio Óptico/etiología , Nervio Óptico/patología , Trombocitopenia/congénito , Agudeza Visual , Campos Visuales/fisiología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/fisiopatología , Trombocitopenia/complicacionesRESUMEN
PURPOSE: This study aimed to evaluate the influence of varying concentrations of sodium hyaluronate (SH) eye drops on corneal aberrations in normal individuals wearing silicone hydrogel contact lenses. METHODS: Normal individuals wearing silicone hydrogel contact lenses were enrolled in this study. Subjects were classified into two groups depending on the concentration of the preservative-free SH used (group 1, 0.1% SH; group 2, 0.3% SH). All subjects were asked to blink five times after instillation of the SH eye drop and before the Galilei measurements. Corneal aberrations were measured over the contact lenses before and after SH eye drop instillation. Visual acuity (VA) over the contact lenses was also measured both before instillation of the SH eye drop and after the subjects completed the five blinks. RESULTS: There was no change in VA after SH instillation in group 1; however, group 2's VA significantly deteriorated after SH instillation. Changes in VA after SH instillation compared to baseline were significantly higher in group 2 than in group 1. Similarly, the increase in corneal aberrations after SH instillation was significant in group 2 but not significant in group 1. Among the significantly increased corneal aberration parameters, defocus was the main type in group 2. Changes in corneal aberrations after SH instillation compared to baseline were significantly higher in group 2 than in group 1. CONCLUSIONS: A 0.3%-concentration of SH increases corneal aberration and decreases VA in soft contact lens wearers. Defocus is the main type of aberration that increased in the 0.3% SH instillation group.
Asunto(s)
Lentes de Contacto Hidrofílicos/estadística & datos numéricos , Aberración de Frente de Onda Corneal/fisiopatología , Aberración de Frente de Onda Corneal/terapia , Ácido Hialurónico/administración & dosificación , Viscosuplementos/administración & dosificación , Agudeza Visual/efectos de los fármacos , Adulto , Paquimetría Corneal , Topografía de la Córnea , Femenino , Humanos , Masculino , Soluciones Oftálmicas , Conservadores Farmacéuticos , Refracción Ocular/efectos de los fármacosRESUMEN
PURPOSE: To compare the quantitative changes of peripheral angle after laser iridotomy (LI) alone (group A) or combined LI and Iridoplasty (group B) using iridotrabecular contact (ITC) index by swept-source anterior segment optical coherence tomography (AS-OCT). METHODS: In this prospective comparative observational study, OCT images were obtained before and after the procedure. In each image frame, scleral spur (SS) and the ITC end point (EP) were marked and ITC index was calculated as a percentage of the angle closure from 360°. Age, gender, diagnosis and initial ITC index in Group B were matched with group A. Changes in ITC index, anterior chamber angle parameters, and intraocular pressure (IOP) were inspected. RESULTS: Thirty-three eyes (20 patients) with shallow anterior chamber were included in each group. Initial ITC index and initial IOP were not significantly different between the two groups (both p > 0.05). However, ITC index and IOP after the procedure were significantly lower in group B than those in group A (ITC index: 31.3 ± 23.2 in group A, 19.0 ± 21.3 in group B, p = 0.011, IOP: p = 0.004). All anterior chamber angle parameters in group B and all parameters in group A except nasal trabecular-iris angles (TIA) were significantly increased after the laser procedure (all p < 0.05). CONCLUSION: In patients with shallow anterior chamber, combined LI and Iridoplasty may open the peripheral angle better than LI alone. Iridoplasty may be able to additionally relieve the peripheral angle closure caused by other mechanisms than pupillary block.
Asunto(s)
Glaucoma de Ángulo Cerrado/cirugía , Presión Intraocular , Iridectomía/métodos , Iris/cirugía , Terapia por Láser/métodos , Procedimientos de Cirugía Plástica/métodos , Malla Trabecular/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Glaucoma de Ángulo Cerrado/diagnóstico , Glaucoma de Ángulo Cerrado/fisiopatología , Gonioscopía , Humanos , Iris/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: To describe the change of lacrimal gland volumes in Korean patients with thyroid-associated ophthalmopathy (TAO) via computed tomography (CT). METHODS: A retrospective review of CT images from 217 TAO patients and 135 control subjects was performed. The TAO patients were diagnosed between May 2005 and May 2014 and had a CT performed on initial presentation (330 orbital CT scans). These images were compared with 270 orbital CT scans from the control group, obtained between May 2013 and May 2014. An open source DICOM viewer was used to calculate the volume of the lacrimal gland. RESULTS: The mean volume of the lacrimal gland in TAO patients was 0.816 cm3 in the right orbit (standard deviation [SD], 0.048) and 0.811 cm3 in the left orbit (SD, 0.051), with no significant difference between right and left (p = 0.192). However, significant differences were observed between TAO patients and healthy individuals (p < 0.001). There was no significant difference between mean lacrimal gland volumes of males (0.812 cm3; SD, 0.037) and females (0.816 cm3; SD, 0.029) (p = 0.513). There was a negative correlation between gland volume and age in TAO patients (Pearson r = -0.479, p = 0.00). The subjective tearing (right: r = 0.244, p = 0.018; left: r = 0.226, p = 0.024), corneal superficial punctate keratopathy (right: r = 0.192, p = 0.040; left: r = 0.206, p = 0.036), and exophthalmometry (right: r = 0.182, p = 0.032; left: r = 0.180, p = 0.046) correlated with lacrimal gland volume. CONCLUSIONS: This study is the first to use CT images to calculate the lacrimal gland volume of Korean TAO patients. In TAO patients, the lacrimal gland volume was notably increased compared to control subjects. The lacrimal gland volume decreased with age, but there was no difference between gender and no difference between left and right. The lacrimal gland volume correlated with subjective tearing, corneal superficial punctate keratopathy and exophthalmometry.