Cauchy Modeling as a New Trend in Research of Fullerene- Type Nanomaterials

 

Abstract

In the work, based on the analysis of heat and gas with acoustic phonons by fullerene, the physical criterion Cauchy is the kind of thermal strength before spring strain, which is caused by the nanotube fullerene

Keywords: Thermal Conductivity; Fullerene; Optimization; Numbers Similarity Numbers

Introduction

Studies of the thermal conductivity of structured nano systems draw attention to the fact that in micro- and nanoelectronics the urgent task of heat dissipation released during the operation of electrical elements [1-6]. So, in the process of electrical switching of the element energy is consumed which is on the verge of thermal fluctuations This means that a billion (109) transistor chip uses order energy in a single act 10^-3J. Then, in order of speed 1GHz , the energy consumed can reach values far exceeding the power of a jogging electric kettle

In order to remove Joule-Lenz heat in electric nanoelements, both microchannels with liquid carriers of heat and conductive elements, such as nanocomposite ceramics filled with carbon nanotubes, can be used, which, depending on their chiral characteristics, can alter the physical properties of nano cells. Thus, it was established [9-12] and confirmed by theoretical estimates [13,14] that the thermal conductivity at room temperature of a carbon nanotube can reach values of which significantly exceeds the thermal conductivity of diamon which was considered one of the best heat conductors. Carbon nanotubes are thermally stable, characterized by high electrical conductivity [10], high electron mobility [11], and a large specific surface value [15]. It is believed [16] that the abnormally high thermal conductivity of carbon nanotubes is due to their regular structure and the small number of defects and impurity centers in them. In the elementary cell of graphene there are two carbon atoms, so the dispersion spectrum consists of three optical and three acoustic branches, among which the longitudinal and transverse acoustic modes correspond to the speed of sound 2130 and 1360 M/s

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A Review of Metabolic Sensors in Glaucoma

 

Abstract

Glaucoma is the second leading cause of irreversible blindness worldwide. It is a multifactorial, progressive, chronic optic neuropathy that is characterized by loss of retinal ganglion cells (RGC) and optic nerve head (ONH) cupping including extra cellular matrix (ECM) remodelling and fibrosis at the lamina cribrosa (LC). Clinically this results in chronic, progressive peripheral visual field loss. The pathogenesis of glaucoma is not yet fully understood. Therefore, there is an urgent need to identify and target the underlying mechanisms governing ECM remodelling of the LC, in order to stop the progressive, chronic damage to the LC/ONH and irreversible visual field loss. This review identifies and examines some of the key metabolic processes and cellular sensors involved in the pathogenesis of ECM fibrosis in general but herein specifically in glaucoma, including mitochondrial dysfunction and adenosine monophosphate activated protein kinase (AMPK) upregulation. Furthermore, the development of novel therapeutics such as nicotinamide (NAM) and metformin are discussed as promising potential future therapeutic options for glaucoma.

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A Review of Achromatopsia

 

Abstract

Congenital achromatopsia is a hereditary form of day blindness caused by cone photoreceptor dysfunction, with an incidence of approximately 1 in 30,000. This inherited disorder is characterized by a lack of color discrimination, nystagmus, photophobia, and low visual acuity (< 0.2). The most typical genetic mutations are autosomal recessive changes in CNGA3, CNGB3, GNAT2, PDE6H, PDE6C, or ATF6. It should not be confused with cerebral achromatopsia, which is an acquired form of total color blindness that can result from illness, trauma, or some other cause. Color plays an essential role in our lives. It can change actions, influence thinking, and cause reactions. As a powerful type of communication, color is irreplaceable. Green means “go” and red means “stop”. Traffic lights send this global meaning. Color vision deficiency, creates challenges in the daily lives of those who have an insufficient visual sense.

Purpose: The aim of this review is to examine the literature published on achromatopsia and summarize the diagnosis, management, genetic characteristics, and the recent advances in gene therapy.

Conclusions: Congenital achromatopsia is a complex inherited disease. Management of achromatopsia is multifaceted. There is currently no cure for achromatopsia, although gene therapy is a therapeutic option already being studied in clinical trials. The most recent study in human adults can be classified as safe and positive in terms of efficacy.

Keywords: Achromatopsia (ACHM); Gene therapy

Introduction

Achromatopsia is a condition characterized by a partial or total absence of color vision [1]. People with complete achromatopsia cannot perceive any colors; they only see white, black, and shades of gray. Incomplete achromatopsia is a milder form of the disease that allows some color discrimination [1]. Oliver Sacks, in The Case of Color-blind Painter [2], transcribe the disturbing story of one of his cerebral achromatopsia patients after a car accident in the following way: Mr. I. could hardly tolerate the changed aspects of people (“like animated grey statues”) any more than he could tolerate his own appearance in the mirror: he shunned social intercourse and found sexual intercourse impossible. He saw people’s fesh, his wife’s fesh, his own fesh, as an abhorrent grey; “fesh-colored” now appeared “rat-colored” to him.

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Intravitreal Injection of Ranibizumab in Macular Edema Secondary to Retinal Vein Occlusion

 

Abstract

Aim: This study aimed to evaluate the safety and efficacy of intravitreal Ranibizumab 0.5mg in the treatment of macular edema secondary to retinal vein occlusion.

Patients & Methods: This was a prospective interventional analytical study included 39 eyes of 39 patients with retinal vein occlusion. Ophthalmic examination included assessment of visual acuity, measurement of intraocular pressure, and fundus examination. All patients were scanned using Swept source optical coherence tomography (3D DRI OCT Triton [plus], Topcon Corporation, Tokyo, Japan) to assess central macular thickness. The changes of visual acuity, IOP, and central macular thickness were assessed. Data were analyzed via Kolmogorov-Smirnov test and Wilcoxon signed rank.

Results: The mean age was 56.56 ± 9.6, 48.7% were male and 51.3% were females. Hypertension was detected in 69.2%, and hyperlipidemia in 2.6%. The mean best corrected visual acuity was 1.5 logMAR, 1.00 logMAR,1.00 logMAR, preoperative, fourth month, six months postoperative, respectively, (p<0.001). The mean central macular thickness was 675 μ, 306 u, 264 u, preoperative, fourth month, six months postoperative, respectively, (p< 0.001). The OP was 16.5 mmHg, 16.9 mmHg, 17.1 mmHg, preoperative, fourth month, six months postoperative, respectively, (p=0.423). There were no observed significant ocular adverse events such as ocular inflammation, sterile and infectious endophthalmitis, or sustained increase in intraocular pressure with the use of intravitreal ranizumab injections.

Conclusion: Intravitreal Ranibizumab injections as monotherapy have shown promising results with BCVA improvement and a decrease of central macular thickness in patients with macular edema secondary to retinal vein occlusion.

Keywords: Ranibizumab; Macular Thickness; OCT; Visual Acuity

Introduction

Retinal vein occlusion (RVO) is the most common retinal vascular disease after diabetic retinopathy [1]. Depending on the area of retinal venous drainage effectively occluded it is broadly classified as either central retinal vein occlusion (CRVO), hemispheric retinal vein occlusion , or branch retinal vein occlusion (BRVO) [2]. Although the exact etiology of RVO remains elusive, it is likely to follow a thrombotic event. In CRVO this may occur in the central retinal vein (CRV) at the lamina cribrosa or at a variable distance in its journey within the optic nerve posterior to the lamina cribrosa [2]. Hypoxia-induced expression of vascular endothelial growth factor (VEGF) is thought to be a trigger for macular edema. High intravitreal levels of VEGF have been found in patients with retinal vein occlusion [3]. Upregulation of VEGF is associated with breakdown of the blood-retina barrier with increased vascular permeability resulting in retinal edema, stimulation of endothelial cell growth, and neovascularization [4,5]. Macular edema leads to vision loss in many patients with either central or branch retinal vein occlusions (CRVO or BRVO). BRVO is the more common of the two presentations, accounting for approximately 80% of RVO [6].
Recently, there has been interest in the use of vascular endothelial growth factor (VEGF) inhibition in the treatment of RVO because of the observation of increased VEGF in the vitreous and aqueous of patients with these conditions [7].

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Visual Impairment and its Rehabilitation: A Review

 

Abstract

Visual impairment (VI) is a condition of reduced visual performance that cannot be remedied by refractive correction (spectacles or contact lenses), surgery or medical methods. Visual Impairment is a broader term that encompasses both Low vision and Blindness. The prevalence of visual impairment is estimated to be around 2.2 billion in the world as per World Health Organization (WHO). Causes of Visual Impairment differs significantly in different regions. Saying that, still cataract and refractive errors are main causes of visual impairment globally. Owing to its negative impact on the individual’s dailies, professional life, productive time, confidence, and self-respect, VI needs to be addressed timely and appropriately. Visual impairments do have profound consequences for the individual, however effective rehabilitation services can restore independence and therefore ameliorate these consequences and restore the individual’s quality of life.

Keywords: Visual Impairment; Blindness; low Vision; Rehabilitation; Optical Devices; Non-Optical Devices

Introduction

Impairment of any kind (sensorial or motor) is a bane for any human being. With visual impairment being one of the leading causes of sensorial impairment, it is necessary to acknowledge its prevalence, causes and methods to avoid them, if possible. Also, at the same time, it is important to understand that the term “visual impairment”, “blindness” and “Low vision” are not synonymous; rather visual impairment includes low vision as well as blindness. Simply, Visual impairment (VI) is a condition of reduced visual performance that cannot be remedied by refractive correction (spectacles or contact lenses), surgery or medical methods [1]. Various definitions of visual impairment have been given by various concerned authorities. International Statistical Classification of Diseases and Related Health Problems (ICD) defines visual impairment categories primarily on the basis of recommendations made by a World Health Organization (WHO) Study Group in 1972 [2] and defines as:

• low vision is defined as visual acuity of less than 6/18, but equal to or better than 3/60, or a corresponding visual field loss to less than 20 degrees in the better eye with best possible correction
• blindness is defined as visual acuity of less than 3/60, or a corresponding visual field loss to less than 10 degrees in the better eye with best possible correction.

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Headache and Eye-A Mutual Relationship

 

Opinion

Headache is probably the commonest neurological complaint worldwide. According to the World Health Organization (WHO), 1.7-4% of the adult population of the world have headaches on 15 or more days every month. Sometimes these symptoms are misunderstood and confused with Migraine Attacks or with normal tension headaches. It is also one of the commonest problems because of which people come for a glass/eye check-up. Very often the belief is that a change of eye power is the reason for headaches. Students who constantly keep reading books or keep doing their academic exercises have more chances to suffer from eye related problems like Eye strain, Fatigue, Eye pain, Headache etc. When a patient comes to you with complaints like headache after some continuous reading it is important to be able to distinguish if it is related to the eyes or not. Headache can be felt in a variety of places on the head, including the temples, sinuses, forehead and back of the head. Eye pain associated with a headache can be caused by a few different types of headaches, as well as other seemingly unrelated conditions. But regardless of the cause, this type of pain can be mild, moderate, or even unbearable.

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Effects of Long Term Use of Prostaglandin Analogues with and Without Preservative on Normal Conjunctival Flora of Glaucoma Patients

 

Abstract

Purpose: The effects of long term use of Benzalkonium chloride-preserved prostaglandin analogue eye drop on conjunctival bacterial flora was investigated and compared with preservative-free prostaglandin analogue eye drop

Methods: Conjunctival swabs were collected from 48 patients of glaucoma who had instilled either BAK-preserved latanoprost or preservative-free travoprost eye drops for 1 year. The bacterial characteristics and sensitivity patterns of the bacterial isolates from the conjunctival swabs of the two groups were compared between each other and also with conjunctival bacterial flora from normal healthy controls.

Results: There was no significant difference in culture positivity among the three groups (p = 0.99). 100% (13/13) isolates from Latanoprost group were Gram positive organisms. In the Travoprost group, 12 out of 14 isolates (85.7%) from 13 eyes were gram positive while the rest 2 bacteria (14.3%) were gram negative. In Controls, 14 out of 16 (87.5%) isolates were gram positive and the rest were gram negative. Methicillin-resistance was seen in 72.7% (8/11) of the CONS isolated from Latanoprost group, while 45.5% (5/11) of the CONS isolated from preservative free travoprost group were Methicillin resistant. While in the controls 45.4% (5/11) of the isolated CONS were Methicillin resistant. The occurrence of Methicillin resistant CONS (MR CONS) was higher in latanoprost group than the other two groups, though not statistically significant. Resistance to commonly used antibiotics was comparatively higher in BAK-preserved latanoprost group. Not a single gram positive bacteria was resistant to Vancomycin

Conclusion: Long-term use of prostaglandin analogues for glaucoma may adversely affect the antibiotic-resistance of indigenous bacterial flora of the eye by increasing the resistance against common antibiotics including Methicillin resistance.

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An Ophthalmologist look at Art

Introduction

In the 1990s Dr. María Dolores Cortés lent me a very interesting book called “An Ophthalmologist look at art” written by Arthur Linksz M.D. The author makes several analyses, observations and conjectures about the portraits of people who accepted the indications of the painter, although there were some important persons who wanted to impose his desires and that created problems for the painter; then it’s about self-portraits, some made in front of a mirror and others taken from a photograph; later it deals with the direction of reading and writing, from left to right in the western and right to left in the East, and ends with uncapítulo on the commented astigmatism of the Greco. I think an ophthalmologist who likes art, especially painting should have read it. In short, when referring to portraits, he points out that people receive the light on the left side so as not to cover it if the painter is right-handed, except when an important person did not meet the painter’s demands.

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Thymoquinone, Lipids and Herbal Medication

 

Opinion

Georges Lemaitre’s first-time atom, or the big bang in English, was the beginning of the universe. From a very small thing began to appear the elements, matter, gases, liquids, like water, then the nebulae, within them the solar systems with their planets, satellites and comets. A small solar system in a corner of a small galaxy called the Milky Way had several planets, some large and other boys; among the little ones one had water where over time surfaces appeared with chlorine arrow that needed the sun’s rays to live and develop, then began to form beings that could move, the animals of which there were microscopic and later reached gigantic. Many millennia later Eve and Adam appeared, who were very good animals but one day they came up with sin and they stopped being animals. The animals did not sin, and first time felt naked. If Eve had not sinned today, we would all walk naked, we would be very good little animals and Jesus of Nazareth would not have had to come, because He came for sinners, not for the saints or the virtuous. A good ateor, sincerely, you can say that you do not believe in God, you must believe in the primal atom, which by analyzing its existence can be considered to be God.

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Pattern of Congenital Ocular Anomalies among Children Seen at a West African Tertiary Eye Care Centre

 

Abstract

Purpose: To describe the pattern of presentation of congenital ocular anomalies among children seen at Department of Ophthalmology (Guinness Eye Centre), Lagos University Teaching Hospital, Lagos, Nigeria.

Methods: A retrospective chart review of children below the age of 16 years who were diagnosed of any type of congenital ocular anomaly at the Pediatric Ophthalmology Clinic of Lagos University Teaching Hospital (LUTH) between January, 2012 and December, 2018 was done. Information concerning age at presentation, gender, affected eye(s), visual acuity and type of congenital anomaly were retrieved from the case files.

Results: Seven hundred and forty-five eyes of 470 patients with congenital anomalies which constituted 13.6% of all the new pediatric ophthalmic consultations were studied. Two hundred and seventy-five (58.5%) children had bilateral ocular involvement while 262 (55.7%) presented within the first year of life. The median age was 0.92 years with an interquartile range of 2.67 years. There were 255 (54.5%) males with a male to female ratio of 1.2:1. Congenital cataract was the most common congenital ocular anomaly documented in 224 (30.1%) eyes of 133 patients. This was followed by congenital squint (131 eyes, 17.6%), congenital glaucoma (91 eyes, 12.2%) and corneal opacity (52 eyes, 7.0%). Overall, cataract, squint, glaucoma, corneal opacity, nasolacrimal duct obstruction and ptosis accounted for 79.0% of the congenital ocular anomalies documented in this study.

Conclusion: Congenital ocular anomalies accounted for 13.6% of Paediatric ophthalmic consultations in this study. Congenital cataract, squint, glaucoma, corneal opacity, nasolacrimal duct obstruction and ptosis were the most common congenital ocular anomalies observed.

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Lupine Publishers | The Mystery of Ectopia Lentis -A Rare Case Report

Lupine Publishers | Trends in Ophthalmology Open Access Journal 

Abstract

We report a case of a 12-year-old male with hematological, ocular, dermatological, dental and gastrointestinal involvement. To the best of our knowledge and after an extensive internet search, this probably is the first case of subluxation of the natural crystalline lens (NCL) with so many systemic associations described plus the pattern of subluxation itself.

Keywords: Ocular; Systemic; Associations

Case Report

A 12-year-old male (Figure 1) receiving treatment for gastroenteritis from the department of pediatrics (at our institute) presented to us with a history of itching bilateral eyes since his admission to the hospital. Secondly, the department of pediatrics diagnosed the child to be suffering from aplastic anemia and was referring him to a higher center for further management. On the contrary, old records bought by the patient’s father and mother showed that the patient was diagnosed as a case of thalassemia from some other institute and was receiving treatment in the form of regular blood transfusion from that institute. Further, the patient had multiple attacks of diarrhoea in the past few years for which he was admitted in hospital many times. The diarrhoea was not related to any particular meal. He was also receiving treatment from dental department for grade 3 mobility of lower anterior teeth. The positive findings on his general physical and systemic examination were thin sparse hairs on the scalp (Figure 2), facial freckles (Figure 3), and barrel shaped chest (Figure 4). His blood sugar, renal function tests, liver function tests, X ray chest, electrocardiography, vitamin B12 plus folate and zinc levels, C reactive proteins and serum electrolytes which were already carried out were within normal limits. The patient’s parents were farmers by occupation and did not give a history of themselves suffering from any major illness in the past. The patient’s family history revealed that one of the siblings had died at a younger age because of some illness, though no detail or hospital records of the disease were available with the parents. There was no other significant medical, surgical, traumatic or drug usage history.

Ocular examination was carried out. His visual acquity was finger counting at 2 meters bilaterally with no improvement on pinhole and refraction. Slit lamp examination of the right eye (Figure 5) revealed inferonasal subluxation of the NCL with a shallow anterior chamber while the left eye (Figure 6) had subluxation of the NCL into the anterior chamber with a shallow anterior chamber. The intraocular pressure and axial lengths of both the eyes were within normal limits. The patient did allow us to do gonioscopy. Bilateral fundus could not be seen because of media haze, though the NCL bilaterally were not cataractous nor was there any intraocular inflammation. Bilaterally, the ocular movements and pupillary reaction were normal. The itching in his eyes was as a result of allergic conjunctivitis for which we prescribed him antihistaminic eye drops. Clinical features and investigations for diagnosis of homocysteinuria, marfans syndrome and ehler danlos syndrome did not reveal any abnormality. Facility for ultrasound biomicroscopy (UBM), Optical coherence tomography (OCT), B scan ultrasonography and genetic studies were not available at our institute. We could have planned for his NCL removal and a probable intraocular lens implantation under guarded visual prognosis, but the patient wanted all his treatment modalities to be done in single institution, and his referral center had all the facilities.

Discussion

Ectopia lentis is displacement of the lens from its normal position. Ocular causes of lens subluxation include trauma, high myopia, buphthalmos, anterior uveal tumors, pseudoexfoliation syndrome, and hypermature cataracts [1]. Systemic disorders associated with ectopia lentis include Marfan syndrome, homocystinuria, Weill-Marchesani syndrome, and Ehlers-Danlos syndrome [2].

Spontaneous dislocation of the NCL is an extremely rare entity, especially its dislocation to the anterior chamber. This dislocation to the anterior chamber can lead to various complications like corneal edema, pupillary block glaucoma and anterior uveitis which requires urgent removal of the NCL [3]. Surgical procedures such as intracapsular cataract extraction, limbal or pars plana lensectomy and anterior vitrectomy and suturing of the haptics to the sclera have been the surgical modalities in use. Femtosecond laser assisted cataract surgery, glued intraocular lenses, instead of conventional scleral fixation of IOLs with sutures for fixation are another useful advancement in treatment [4].

Conclusion

The presence of ectopia lentis with multisystem involvement in our patient could be a part of a syndrome complex or may be an isolated entity it still remains a mystery for us. Ectopia lentis with hematological involvement has probably not been reported before (to the best of our knowledge)

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Lupine Publishers | Atypical Presentation of Ocular Toxoplasmosis with Exudative Retinal Detachment

 Lupine Publishers | Trends in Ophthalmology Open Access Journal

Abstract

Subretinal fluid, a common clinical pathological entity, is seen in a variety of ocular disorders. Though inflammation is associated with the development of subretinal fluid, toxoplasmosis is an unusual causative agent. A 54 year old lady presented with atypical ocular findings of exudative retinal detachment due to toxoplasmosis. The diagnosis was misinterpreted first as sarcoidosis based on HRCT chest picture, later on diagnosed as ocular toxoplasmosis on correlating clinical presentation, fundus fluorescein angiography (FFA), optical coherence tomography (OCT) findings and serology. Patient was managed with a combination of oral anti Toxoplasma drugs, and oral corticosteroids.

Keywords: Subretinal fluid; Toxoplasma; optical coherence tomography

Abbreviation: OCT: Optical Coherence Tomography; FFA: Fluorescein Angiography; SRF: Sub Retinal Fluid; IVMP: Intravenous Methyl Prednisolone

Introduction

Toxoplasmosis is a common ophthalmic disorder and is said to cause a considerable number of cases of posterior ocular inflammation. Different investigators have considered toxoplasmosis to be the cause of 16-70% of cases of posterior uveitis [1,2]. Subretinal fluid (SRF) is a clinical finding. It is seen in a variety of eye diseases, with the list of associated ocular disorders growing as fluorescein angiography (FFA) has become more of a routine procedure for examining the posterior pole. The diagnosis of ocular toxoplasmosis can be made on the basis of clinical findings alone [3]. In the year 1969, Freidman and Knox [4] described the following three clinical presentations of active toxoplasmic retinochoroiditis (which occurs due to inflammatory response to activation of congenital toxoplasmosis [5]:

a) Large destructive active retinitis with associated vitritis (most common).

b) Punctate inner areas of retinitis with minimal associated edema and vitreous reaction.

c) Deep retinal punctate lesions with subretinal exudate (most unusual) associated with a minimal amount of vitreous reaction and with turbid subretinal fluid or blood

When these lesions heal, they lead to scars with an atrophic, “punched out” appearance and variable pigmentary changes. In 1969 Friedmann and Knox described an uncommon form of toxoplasmosis associated with macular subretinal fluid or blood [3]. Very few cases of toxoplasmosis have been reported with associated subretinal fluid, especially from India. We wish to add this case to the relatively small number of well documented instances of ocular toxoplasmosis presented with subretinal fluid.

Case report

A 54 year old female presented with complains of gradual and progressive diminution of vision in left eye for last 5 days. She had no history of uveitis or tuberculosis or contact with pets. She was hypertensive for last 4 year controlled on regular medications. On examination her best corrected visual acuity was 6/9 in right eye and 1/60 in left eye. Intraocular pressures were normal in both eyes. Anterior segment examination of both eyes and fundus in the right eye was unremarkable. Fundus of the left eye revealed disc edema, vitritis with massive subretinal fluid (SRF). Left eye OCT showed subfoveal fibrin with retinal thickening. SRF noted inferior and nasal to fovea and inferior to disc. Foveal thickness of left eye revealed 756 micron and of right eye 165 micron. FFA revealed disc leakage and pooling of dye temporal to disc of left eye in late phase. HRCT chest revealed few nodular lesion and fibrobronchiectatic changes with calcific foci in both lung fields with negative mantoux test and negative sputum for acid fast bacilli. This case was misinterpreted first as sarcoidosis although ACE level was normal and was prescribed intravenous methyl prednisolone (IVMP) for 3 consecutive days followed by oral steroid. There was no improvement in vision and OCT showed same degree of disc edema and subretinal fluid even after 3 days of IVMP (Figures 1 & 2).

Patient was further revaluated for other causes. IgM antitoxoplasma was positive and IgG was negative, suggestive of recent infection. Based on the clinical presentation, fundus fluorescein angiography, OCT, and positive serology, the patient was diagnosed as atypical ocular toxoplasmosis with exudative retinal detachment. The patient was managed with sulfamethoxazole (800 mg) & trimethoprim (160 mg) tablet twice daily and tab clindamycin tablet 300 mg 4 times daily for 6 weeks along with tapering of oral prednisolone. At 4 week follow up she showed improvement in OCT and FFA findings with restoration of visual acuity to 6/24 in left eye. OCT showed decrease in subretinal fibrin, SRF and retinal thickening. Foveal thickness of left eye decreased to 314 micron. On regular follow up for next 2 year no residual or recurrence of retinochoroiditis was noted.

Discussion

Exudative retinal detachment is often under diagnosed in ocular toxoplasmosis. This case was an atypical presentation of ocular toxoplasmosis with exudative retinal detachment based on the presence of subretinal fluid and misinterpreted as sarcoidosis. HRCT chest findings of few nodular lesion and fibrobronchiectatic changes with calcific foci in both lung fields were old healed lesion, but patient had no flare up of lung infection on follow up. In this case positive serology for toxoplasma and response to treatment confirmed the diagnosis.

 https://lupinepublishers.com/ophthalmology-journal/pdf/TOOAJ.MS.ID.000112.pdf

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