Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Escleritis/complicaciones , Escleritis/tratamiento farmacológico , Uveítis Anterior/complicaciones , Uveítis Anterior/tratamiento farmacológico , Antiinflamatorios/uso terapéutico , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Escleritis/diagnóstico , Resultado del Tratamiento , Uveítis Anterior/diagnósticoAsunto(s)
Anticuerpos Monoclonales/administración & dosificación , Coriorretinitis/complicaciones , Coriorretinitis/tratamiento farmacológico , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/etiología , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Adulto , Anticuerpos Monoclonales Humanizados , Bevacizumab , Coriorretinitis/diagnóstico , Neovascularización Coroidal/diagnóstico , Humanos , Masculino , Resultado del TratamientoRESUMEN
BACKGROUND: We present the description of a successful outcome of intravitreal triamcinolone injection (IVTA) in a patient with cystoid macular oedema (CME) and severe retinal vasculitis suggestive of ocular Behçet's disease. HISTORY AND SIGNS: A healthy 32 year-old Caucasian man presented initially with right retinal vasculitis with preserved vision. Despite initial systemic treatment with high dose steroids, he developed CME with a reduction in vision. THERAPY AND OUTCOME: IVTA injection was carried out, and resulted in a good anatomic and functional response. The same picture developed in his left eye 2 months later and a similar response occurred following IVTA. Six months after the initial episode and despite treatment with cyclosporine and azathioprine, CME reoccurred in his RE inducing a decrease of his VA from 6/5 to 6/24. IVTA injection was repeated and a week later his VA increased to 6/6. At this stage patient was referred for initiation of therapy with infliximab. CONCLUSION: IVTA injection appears to be very helpful for the resolution of acute CME and for visual recovery, but we would like to emphasise that even though this approach seems to be helpful in an acute situation, the effect is short-lived and proper immunosuppression is needed for long-term control of the disease and its complications.
Asunto(s)
Síndrome de Behçet/tratamiento farmacológico , Edema Macular/tratamiento farmacológico , Triamcinolona/administración & dosificación , Cuerpo Vítreo/efectos de los fármacos , Adulto , Antiinflamatorios/administración & dosificación , Quimioterapia Adyuvante , Humanos , Inyecciones , Masculino , Resultado del TratamientoRESUMEN
BACKGROUND: We present the description of a successful outcome in a case of varicella-zoster virus (VZV) acute retinal necrosis (ARN). HISTORY AND SIGNS: A healthy 40-year-old patient was admitted for a VZV retinitis. THERAPY AND OUTCOME: 10 days after the onset of intravenous (i. v.) acyclovir treatment, new small peripheral retinal necrotic lesions appeared in the right eye. A viral resistance was suspected and the acyclovir therapy was optimised with i. v. foscarnet combined with 2 intravitreal injections of ganciclovir. The outcome was favourable with a final vision of 1.0 after a follow-up of 30 months. No systemic or local complications were observed. CONCLUSIONS: VZV ARN is a severe infection with a poor prognosis. This case demonstrates that combination of antiviral therapies given intravenously (acyclovir + foscarnet) and in the vitreous (ganciclovir) may be safe and efficacious in the management of necrotising herpetic retinopathies affecting immunocompetent patients.