Purpose We present a case report with an ocular vascular event and multiple organ thrombosis and dysfunction in the presence of antiphospholipid antibodies. Methods We report a case of a 79 years old female related visual loss in left eye. She had a venous occlusion and vitreous haemorrhage. In two weeks presented a maculopapular, bullous skin lesions on the legs, rapidly followed by widespread cutaneous necrosis and skin ulceration on all the limbs showing the tendons tissues of the heels. Later, she had an extension of thrombotic events to other vessels in the body. With medical treatment, there was initially a small functional improvement and then a general degradation in 10 weeks, followed by the death of the patient secondary to sever pulmonary emboli in the intensive care unit. Results It was found histopathologic evidence of multiple small‐vessel occlusions, and laboratory confirmation of the presence of antiphospholipid and anticardiolipin antibodies, in high title. It was refractory to anticoagulation, steroids and immunomodulation treatment Conclusion Catastrophic antiphospholipid syndrome is an autoimmune disorder characterized by a rapidly progressive life‐threating disease. Catastrophic occurs when three or more organ systems are affected by thromboses in a very short time less than a week. Roughly 50% of these patients have systemic lupus erythematosus. The overall mortality of this desvasting syndrome is about one‐half.
Purpose The aim of this study was to compared the effect of cataract extraction by phacoemulsification and posterior chamber lens implantation on measured intraocular pressure (IOP) using the Goldmann applanation tonometer, the Pascal dynamic contour tonometer (DCT), the Goldmann applanation tonometer (GT) and pneumotonometer (PT) Methods 97 eyes were measured in the operated eye one day before and one day, one week and one month after cataract surgery with the three tonometers, the IOP, ocular pulse amplitude (OPA),and central corneal thickness (CCT) Results Corneal edema induced by phacoemulsification cataract surgery resulted in statistically significant increases in CCT (87,8 μm SD 56,8 ;p< 0,001), Pascal DCT IOP (4,8 mmHg, SD 8,0; p< 0,001),Goldmann IOP (1,4 mmHg, SD 5,1;p<0,015) and OPA (0,9 mmHg, SD 3,5; p< 0,025) but not in pneumotonometry IOP (1,1mmHg, SD 5,3; p=0,065). Changes in IOP measured by GT and PT were less than those measured by the Pascal DCT. The variation between the Pascal DCT (Rho 0,247; p=0,038), and Pneumotonometer (Rho 0,358; p=0,002) was strongly correlated to the change in CCT Conclusion Corneal edema after phacoemulsification cataract surgery increased IOP readings in the three tonometer compared, this increment is bigger in Pascal DCT readings. Changes in CCT are statistically significant associated with increased Pascal DCT IOP readings. Change in corneal biomechanics may in part be responsible for increased in the measured of IOP with Pascal DCT and GT
Purpose The authors report a patient with a multiple optic nerve head pit Methods A bilateral optic nerve head pit was found in a woman patient of 55 years old without macular retinal detachment. An 8‐microm axial resolution prototype spectral domain optical coherence tomography (OCT) and stereo fundus photography were used to observe the patient. The visual acuity remained stable at 20/20. Results The pits of the optic nerve head is a congenital anomaly of the eye and it is attributed to incomplete closure of the foetal fissure.The prevalence is 1: 10000 eyes. This depression is frequently situated in the temporal or infra‐temporal region of the optic disc. There is usually only one pit per optic disc, although two or three occasionally occur. Optic pits are unilateral in 85‐90% of cases. Visual acuity usually remains unaffected unless the patient develops a serous non‐rhegmatogenous retinal detachment of the macula (over 60% of eyes). Visual fields characteristics of pits were found in our patient. Conclusion High resolution OCT technology and appropriate imaging software is able to observe changes of the micro architecture of the optic nerve as this unusual pits bilateral.
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