Introduction. Susac’s syndrome consists of the clinical triad of cerebral microangiopathy, branch retinal artery occlusions, and hearing loss. The pathogenesis of the disease remains unknown. The severity of retinal ...Introduction. Susac’s syndrome consists of the clinical triad of cerebral microangiopathy, branch retinal artery occlusions, and hearing loss. The pathogenesis of the disease remains unknown. The severity of retinal vasculopathy remains variable. Case report. A 57-year-old Caucasian woman presented in 1999 for the diagnostic and therapeutic management of a severe and complete form of the disease. Fluorescein angiography and cerebral MRI were contributive in this case and confirmed the diagnosis. A severe unilateral visual loss occurred one month after the initiation of systemic corticosteroids. Funduscopy disclosed a temporal retinal artery occlusion with major ischemia. Therefore, cyclophosphamide and anticoagulants were added to corticosteroids and total visual recovery was achieved within 2 weeks without any relapse after a follow-up period of 54 months. Conclusion. Therapeutic management of Susac’s syndrome is still controversial. Major immunosuppressive regimens are mandatory in the face of severe visual loss associated with central or branch retinal artery occlusions. The final prognosis of the disease seems favorable in the absence of prolonged and symptomatic retinal ischemia.展开更多
PURPOSE: To report the association of Fuchs heterochromic cyclitis (FHC) and ocular toxocariasis in a young adult. DESIGN: Observational case report. METHODS: A 26-year old patient was referred for the management of a...PURPOSE: To report the association of Fuchs heterochromic cyclitis (FHC) and ocular toxocariasis in a young adult. DESIGN: Observational case report. METHODS: A 26-year old patient was referred for the management of a unilateral intermediate uveitis associated with a lower peripheral subretinal fibrotic lesion near the pars plana. Diagnosis of FHC was clinically confirmed. Laboratory examination was performed to exclude an infectious condition. RESULTS: LISA assay detected significant levels of IgG directed against Toxocara canis. Toxoplasmic serology was negative, excluding this differential diagnosis. Other examinations, including complete blood cell count, urinalysis, serum angiotensin-converting enzyme, lysosyme, chest CT scan, and syphilis serology were noncontributive. CONCLUSIONS: Previous studies have reported on the association of FHC and other parasitic conditions, such as toxoplasmosis but also on herpetic ocular infections. Serologic analysis for toxocariasismay be proposed in patients with FHC and retinal scars in the absence of toxoplasmosis.展开更多
Purpose: The vast majority of ruptured aneurysms of the anterior communicating artery typically present with subarachnoid haemorrhage. Isolated visual complaints are very uncommon in this setting. We present an unusua...Purpose: The vast majority of ruptured aneurysms of the anterior communicating artery typically present with subarachnoid haemorrhage. Isolated visual complaints are very uncommon in this setting. We present an unusual case of a patient with an acute retrobulbar optic neuropathy, secondary to a ruptured anterior communicating artery aneurysm. Design: Observational case report. Methods: A 29- year-old woman was assessed for an acute, isolated unilateral optic neuropathy of unknown origin. Although an initial encephalic MRI was believed to be normal, an underlying ruptured anterior communicating artery aneurysm was eventually diagnosed when the patient became stuporous because of intracranial bleeding. Conclusions: Occurrence of an acute retrobulbar optic neuropathy may be the initial isolated sign related to a ruptured anterior communicating artery aneurysm, prompting an appropriate neuroradiological assessment.展开更多
文摘Introduction. Susac’s syndrome consists of the clinical triad of cerebral microangiopathy, branch retinal artery occlusions, and hearing loss. The pathogenesis of the disease remains unknown. The severity of retinal vasculopathy remains variable. Case report. A 57-year-old Caucasian woman presented in 1999 for the diagnostic and therapeutic management of a severe and complete form of the disease. Fluorescein angiography and cerebral MRI were contributive in this case and confirmed the diagnosis. A severe unilateral visual loss occurred one month after the initiation of systemic corticosteroids. Funduscopy disclosed a temporal retinal artery occlusion with major ischemia. Therefore, cyclophosphamide and anticoagulants were added to corticosteroids and total visual recovery was achieved within 2 weeks without any relapse after a follow-up period of 54 months. Conclusion. Therapeutic management of Susac’s syndrome is still controversial. Major immunosuppressive regimens are mandatory in the face of severe visual loss associated with central or branch retinal artery occlusions. The final prognosis of the disease seems favorable in the absence of prolonged and symptomatic retinal ischemia.
文摘PURPOSE: To report the association of Fuchs heterochromic cyclitis (FHC) and ocular toxocariasis in a young adult. DESIGN: Observational case report. METHODS: A 26-year old patient was referred for the management of a unilateral intermediate uveitis associated with a lower peripheral subretinal fibrotic lesion near the pars plana. Diagnosis of FHC was clinically confirmed. Laboratory examination was performed to exclude an infectious condition. RESULTS: LISA assay detected significant levels of IgG directed against Toxocara canis. Toxoplasmic serology was negative, excluding this differential diagnosis. Other examinations, including complete blood cell count, urinalysis, serum angiotensin-converting enzyme, lysosyme, chest CT scan, and syphilis serology were noncontributive. CONCLUSIONS: Previous studies have reported on the association of FHC and other parasitic conditions, such as toxoplasmosis but also on herpetic ocular infections. Serologic analysis for toxocariasismay be proposed in patients with FHC and retinal scars in the absence of toxoplasmosis.
文摘Purpose: The vast majority of ruptured aneurysms of the anterior communicating artery typically present with subarachnoid haemorrhage. Isolated visual complaints are very uncommon in this setting. We present an unusual case of a patient with an acute retrobulbar optic neuropathy, secondary to a ruptured anterior communicating artery aneurysm. Design: Observational case report. Methods: A 29- year-old woman was assessed for an acute, isolated unilateral optic neuropathy of unknown origin. Although an initial encephalic MRI was believed to be normal, an underlying ruptured anterior communicating artery aneurysm was eventually diagnosed when the patient became stuporous because of intracranial bleeding. Conclusions: Occurrence of an acute retrobulbar optic neuropathy may be the initial isolated sign related to a ruptured anterior communicating artery aneurysm, prompting an appropriate neuroradiological assessment.
