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Yepez JB, Murati FA, Petitto M, De Yepez J, Galue JM, Revilla J, Petitto A, Vinardell S, Arevalo JF. Vogt-Koyanagi-Harada Disease Following COVID-19 Infection. Case Rep Ophthalmol 2021; 12:804-808. [PMID: 34720981 PMCID: PMC8525290 DOI: 10.1159/000518834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/01/2021] [Indexed: 11/19/2022] Open
Abstract
A 29-year-old female presented to the emergency clinic with gradual visual disturbance in both eyes for 15 days duration, accompanied by bilateral tinnitus, and ocular pain that increased with ocular movements. One month prior to presentation, the patient had tested positive for severe acute respiratory syndrome coronavirus-2 but without complications. Visual acuity was 20/100 in the right eye and 20/300 in the left eye. Funduscopy demonstrated optic nerve swelling, radial nerve fiber striation disruption, and bilateral retinal folds. Optical coherence tomography showed serous (bacillary) retinal detachment and multifocal areas of hyper-reflective changes in the inner and outer plexiform layer with inner nuclear layer thickening and disruption of the interdigitation zone bilaterally. We present a case of incomplete Vogt-Koyanagi-Harada disease following COVID-19 infection.
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Affiliation(s)
- Juan B Yepez
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Felipe A Murati
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | | | - Jazmin De Yepez
- Pediatric and Strabismus Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Jose M Galue
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Julio Revilla
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | | | - Susana Vinardell
- Retina Department, Sotero del Rio Hospital, Santiago de Chile, Chile
| | - J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Yepez JB, Murati FA, Petitto M, De Yepez J, Galue JM, Vinardell S, Mura M, Arevalo JF. Apolipoprotein AI-Derived Vitreous Amyloidosis: An Elusive Diagnosis. Case Rep Ophthalmol 2020; 11:287-292. [PMID: 32774294 PMCID: PMC7383199 DOI: 10.1159/000508065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/22/2020] [Indexed: 11/24/2022] Open
Abstract
A 56-year-old female presented with vitreous opacity with gradual visual disturbance in her right eye of 1-year duration. A Non-Hodgkin's lymphoma had been treated 15 years before. Presenting best-corrected visual acuity (BCVA) was 20/200 in her right eye and 20/25 in her left eye. Intraocular pressure was 18 mm Hg bilaterally. Slit-lamp examination revealed no abnormal findings in the anterior segment of both eyes, including the absence of cells and flare. Fundoscopic examination indicated hazy media with the typical glass-wool-like appearance in her right eye. B-scan ultrasound demonstrated that the vitreous was full of middle-echo spots, vitreous opacities, and posterior vitreous detachment occurred. The patient underwent vitreous biopsy and a standard 25-gauge pars plana vitrectomy (diagnostic and therapeutic). Intraoperatively, the eye was noted to have severe diffuse debris and very strong vitreoretinal adhesions. Cytospin smears prepared from the vitreous aspirate indicated amorphous acellular material that stained positively with Congo Red and showed apple green birefringence on polarized microscopy, consistent with the diagnosis of amyloidosis. A genetic evaluation of tongue tissue demonstrated apolipoprotein AI-derived amyloidosis. The BCVA was 20/25 OU at 3 months postoperatively.
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Affiliation(s)
- Juan B Yepez
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Felipe A Murati
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | | | - Jazmin De Yepez
- Pediatric and Strabismus Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Jose M Galue
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | - Susana Vinardell
- Retina Department, Sotero del Rio Hospital, Santiago de Chile, Chile
| | - Marco Mura
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Yepez JB, Murati FA, Petitto M, De Yepez J, Mura M, Kozak I. Peritomy-sparing scleral buckle. Am J Ophthalmol Case Rep 2019; 15:100474. [PMID: 31193999 PMCID: PMC6545391 DOI: 10.1016/j.ajoc.2019.100474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 05/27/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To introduce a modified technique for encircling circumferential scleral buckling without peritomy thorough a small conjunctival opening for the repair of uncomplicated rhegmatogenous retinal detachment (RD). Methods This technique was performed in 10 eyes of 10 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling without peritomy. Transconjunctival traction sutures were placed in four rectus muscles. After transconjunctival location of the retinal break, a 5- to 6-mm radial conjunctival incision was performed in 4 quadrants without cutting the limbal conjunctiva–Tenon's capsule. A 240-silicone band in scleral belt loops was used for an encircling circumferential buckle. After drainage and cryopexy, SF6 was used for tamponade. The incision was closed via layered closure only ocassionally. Results Primary attachment success of 100% was achieved by single procedure. The intraoperative and postoperative complications observed included subconjunctival hemorrhage observed in 5 (50%) of eyes. These disappeared in the postoperative period. Conclusions Minimal conjunctival incision in scleral buckle without peritomy can achieve excellent anatomical success in patients with rhegmatogenous RD without distorting ocular surface anatomy. This is the first description of technique preserving corneal limbus anatomy that could convert buckling surgery to more attractive option for retina surgeons.
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Affiliation(s)
- Juan B. Yepez
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Felipe A. Murati
- Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela
| | | | - Jazmin De Yepez
- Pediatric Ophthalmology Department, Clinica de Ojos Maracaibo, Venezuela
| | - Marco Mura
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Igor Kozak
- Moorfields Eye Hospital Centre, Abu Dhabi, United Arab Emirates
- Corresponding author. Vitreoretinal Surgeon/Clinical Lead, Moorfields Eye Hospital Centre, Abu Dhabi, United Arab Emirates.
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Abstract
PURPOSE To report the use of anterior lens capsule flap transplantation in two cases with chronic full-thickness macular hole (MH). METHODS Case series. RESULTS Two cases of chronic MH with a new treatment approach were reported. In the first case, a 66-year-old man presented with a chronic idiopathic MH in the left eye for 2 years. Presenting visual acuity was hand motion. The patient underwent phacoemulsification and vitrectomy with anterior lens capsule flap transplantation in the MH. At 5 months postoperatively, the visual acuity was 20/200 with MH closure. In the second case, a 68-year-old woman presented with decreased visual acuity for 2 years. Her visual acuity was hand motion in the right eye. The patient underwent phacoemulsification and vitrectomy with anterior lens capsule flap transplantation in the MH. Visual acuity improved to 20/400 with reduction in the MH diameter. Vision and MH diameter remained stable over 5 months postoperatively. CONCLUSION Lens capsular flap transplantation is useful in closing chronic MH in the short term.
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Affiliation(s)
- Juan B Yepez
- Department of Vitreoretinal Surgery, Clinica de Ojos, Maracaibo, Venezuela
| | - Felipe A Murati
- Department of Vitreoretinal Surgery, Clinica de Ojos, Maracaibo, Venezuela
| | - Jazmin De Yepez
- Department of Pediatric Ophthalmology and Strabismus, Clinica de Ojos, Maracaibo, Venezuela
| | - Michele Petitto
- Department of Glaucoma, Clinica de Ojos, Maracaibo, Venezuela
| | - J Fernando Arevalo
- Division of Retina, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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De Moraes CG, Pettito M, Yepez JB, Sakuntabhai A, Simon-Loriere E, Zaidi MB, Prot M, Ruffie C, Kim SS, Allikmets R, Terwilliger JD, Lee JH, Maestre GE. Corrigendum: Optic neuropathy and congenital glaucoma associated with probable Zika virus infection in Venezuelan patients. JMM Case Rep 2018; 5:e005161. [PMID: 30323937 PMCID: PMC6152399 DOI: 10.1099/jmmcr.0.005161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- C Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | | | | | - Anavaj Sakuntabhai
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Etienne Simon-Loriere
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Mussaret B Zaidi
- Infectious Diseases Research Laboratory, Hospital General O'Horan, Merida, Mexico.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Matthieu Prot
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Claude Ruffie
- Pasteur Institute, Viral Genomics and Vaccination Unit, Paris, France.,CNRS, URA3015, Paris, France
| | - Susan S Kim
- In-patient Diabetes Unit, St. Peter's Hospital, Albany, NY, USA
| | - Rando Allikmets
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | - Joseph D Terwilliger
- Departments of Psychiatry and Genetics and Development, Columbia University Medical Center, New York, NY, USA.,Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Division of Medical Genetics, New York State Psychiatric Institute, New York, NY, USA.,Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Joseph H Lee
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Gladys E Maestre
- Laboratory of Neuroscience, University of Zulia, Maracaibo, Venezuela.,Department of Biomedical Sciences, Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA.,Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
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Zaidi MB, De Moraes CG, Petitto M, Yepez JB, Sakuntabhai A, Simon-Loriere E, Prot M, Ruffie C, Kim SS, Allikmets R, Terwilliger JD, Lee JH, Maestre GE. Non-congenital severe ocular complications of Zika virus infection. JMM Case Rep 2018; 5:e005152. [PMID: 30128159 PMCID: PMC6096927 DOI: 10.1099/jmmcr.0.005152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 04/23/2018] [Indexed: 01/03/2023] Open
Affiliation(s)
- Mussaret B. Zaidi
- Infectious Diseases Research Laboratory, Hospital General O'Horan, Merida, Mexico
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - C. Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | | | - Juan B. Yepez
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Anavaj Sakuntabhai
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Etienne Simon-Loriere
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Matthieu Prot
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Claude Ruffie
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Susan S. Kim
- In-patient Diabetes Unit, St Peter’s Hospital, Albany, NY, USA
| | - Rando Allikmets
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | - Joseph D. Terwilliger
- Departments of Psychiatry and Genetics and Development, Columbia University Medical Center, New York, NY, USA
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Division of Medical Genetics, New York State Psychiatric Institute, New York, NY, USA
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Joseph H. Lee
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Gladys E. Maestre
- Laboratory of Neuroscience, University of Zulia, Maracaibo, Venezuela
- Department of Biomedical Sciences, Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
- Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
- *Correspondence: Gladys E. Maestre, or
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De Moraes CG, Pettito M, Yepez JB, Sakuntabhai A, Simon-Loriere E, Zaidi MB, Prot M, Ruffie C, Kim SS, Allikmets R, Terwilliger JD, Lee JH, Maestre GE. Optic neuropathy and congenital glaucoma associated with probable Zika virus infection in Venezuelan patients. JMM Case Rep 2018; 5:e005145. [PMID: 29896405 PMCID: PMC5994708 DOI: 10.1099/jmmcr.0.005145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Although the current Zika virus (ZIKV) epidemic is a major public health concern, most reports have focused on congenital ZIKV syndrome, its most devastating manifestation. Severe ocular complications associated with ZIKV infections and possible pathogenetic factors are rarely described. Here, we describe three Venezuelan patients who developed severe ocular manifestations following ZIKV infections. We also analyse their serological response to ZIKV and dengue virus (DENV). Case presentation One adult with bilateral optic neuritis, a child of 4 years of age with retrobulbar neuritis [corrected]. and a newborn with bilateral congenital glaucoma had a recent history of an acute exanthematous infection consistent with ZIKV infection. The results of ELISA tests indicated that all patients were seropositive for ZIKV and four DENV serotypes. Conclusion Patients with ZIKV infection can develop severe ocular complications. Anti-DENV antibodies from previous infections could play a role in the pathogenesis of these complications. Well-designed epidemiological studies are urgently needed to measure the risk of ZIKV ocular complications and confirm whether they are associated with the presence of anti-flaviviral antibodies.
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Affiliation(s)
- C Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | | | | | - Anavaj Sakuntabhai
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Etienne Simon-Loriere
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Mussaret B Zaidi
- Infectious Diseases Research Laboratory, Hospital General O'Horan, Merida, Mexico.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Matthieu Prot
- Pasteur Institute, Functional Genetics of Infectious Diseases Unit, Paris, France.,CNRS, URA 3012, Paris, France
| | - Claude Ruffie
- Pasteur Institute, Viral Genomics and Vaccination Unit, Paris, France.,CNRS, URA3015, Paris, France
| | - Susan S Kim
- In-patient Diabetes Unit, St. Peter's Hospital, Albany, NY, USA
| | - Rando Allikmets
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | - Joseph D Terwilliger
- Departments of Psychiatry and Genetics and Development, Columbia University Medical Center, New York, NY, USA.,Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Division of Medical Genetics, New York State Psychiatric Institute, New York, NY, USA.,Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Joseph H Lee
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Gladys E Maestre
- Laboratory of Neuroscience, University of Zulia, Maracaibo, Venezuela.,Department of Biomedical Sciences, Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA.,Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
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Abstract
PURPOSE To report the use of intravitreal triamcinolone for Susac Syndrome in one patient. METHODS Case report. RESULTS A 23-year-old woman presented with presented with sudden visual loss in the left eye with associated neurologic symptoms. Ophthalmic examination and fluorescein angiography showed multiple areas of branch retinal artery occlusion, bilaterally. Magnetic resonance imaging showed dot-like, diffusion-restricted lesions in the corpus callosum, and audiometry showed low-frequency sensory hearing loss, compatible with Susac Syndrome. The patient received a single intravitreal injection of triamcinolone (4 mg) in the left eye. One week later, before beginning systemic corticosteroids, all signs and symptoms resolved in the left eye only. CONCLUSION In cases of delayed systemic corticosteroid therapy, intravitreal triamcinolone resolves the ocular manifestations of Susac Syndrome.
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Affiliation(s)
- Juan B Yepez
- *Vitreoretinal Surgery Department, Clinica de Ojos, Maracaibo, Venezuela; and †Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Yepez JB, Murati FA, Pettito M, Peñaranda CF, de Yepez J, Maestre G, Arevalo JF. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela. JAMA Ophthalmol 2017; 135:440-445. [PMID: 28418539 DOI: 10.1001/jamaophthalmol.2017.0561] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. Objective To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. Design, Setting, and Participants This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Interventions Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Main Outcomes and Measures Ophthalmic manifestations of congenital Zika syndrome. Results Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were diagnosed with congenital glaucoma, characterized by the clinical triad of epiphora, photophobia, and blepharospasm; increased intraocular pressure; corneal clouding at birth; and buphthalmos. These data reveal that 12% (95% CI, 5%-24%) of cases of congenital Zika with microcephaly had anterior segment abnormalities and 88% (95% CI, 76%-94%) had important macular and optic nerve abnormalities. The visual sequelae of these ophthalmic manifestations remain unknown. Conclusions and Relevance Congenital Zika syndrome in the current study had severe ocular abnormalities, and all patients had bilateral involvement. Ocular findings were focal macular pigment mottling, chorioretinal atrophy with a predilection for the macular area, congenital glaucoma and optical nerve hypoplasia, and optic disc abnormalities. Ophthalmic examination is recommended in patients with congenital Zika syndrome.
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Affiliation(s)
- Juan B Yepez
- Department of Vitreoretinal Surgery, Clínica de Ojos, Maracaibo, Venezuela2Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Felipe A Murati
- Department of Vitreoretinal Surgery, Clínica de Ojos, Maracaibo, Venezuela
| | - Michele Pettito
- Department of Glaucoma, Clínica de Ojos, Maracaibo, Venezuela
| | | | - Jazmin de Yepez
- Department of Pediatric Ophthalmology, Clínica de Ojos, Maracaibo, Venezuela
| | - Gladys Maestre
- Division of Neurosciences, Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland8Johns Hopkins Zika Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Affiliation(s)
- Juan B Yepez
- Department of Vitreoretinal Surgery, Clinica de Ojos, Maracaibo, Venezuela
| | - J Fernando Arevalo
- Division of Retina, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland3Division of Vitreoretinal, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
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Yepez JB, de Yepez JC, Valero A, Arevalo JF. Surgical Technique for Transscleral Fixation of a Foldable Posterior Chamber Intraocular Lens. Ophthalmic Surg Lasers Imaging Retina 2006; 37:247-50. [PMID: 16749265 DOI: 10.3928/15428877-20060501-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens (IOL) for intracapsular aphakia (secondary IOL) or after complicated phacoemulsification was evaluated. All eyes had inadequate or no posterior capsular support. Follow-up was between 4 and 26 months (mean, 12 months). Uncorrected visual acuity improved (> 2 lines) in all patients. During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions. This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.
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Affiliation(s)
- Juan B Yepez
- Retina and Vitreous Service, Clinica de Ojos de Maracaibo, Maracaibo
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Arevalo JF, Mendoza AJ, Velez-Vazquez W, Rodriguez FJ, Rodriguez A, Rosales-Meneses JL, Yepez JB, Ramirez E, Dessouki A, Chan CK, Mittra RA, Ramsay RC, Garcia RA, Ruiz-Moreno JM. Full-Thickness Macular Hole after LASIK for the Correction of Myopia. Ophthalmology 2005; 112:1207-12. [PMID: 15921746 DOI: 10.1016/j.ophtha.2005.01.046] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 01/20/2005] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To describe 19 patients (20 eyes) who developed a macular hole (MH) after undergoing bilateral LASIK for the correction of myopia. DESIGN Noncomparative, interventional, retrospective, multicenter case series. PARTICIPANTS Nineteen patients (20 eyes) who developed an MH after bilateral LASIK for the correction of myopia at 10 institutions in Venezuela, Colombia, Puerto Rico, Spain, and the United States. METHODS Chart review. MAIN OUTCOME MEASURE Macular hole development. RESULTS The MH formed between 1 to 83 months after LASIK (mean, 12.1). In 60% of cases, the MH developed < or =6 months after LASIK, and in 30% of cases it developed > or =1 year after LASIK. Eighteen of 19 (94.7%) patients were female. Mean age was 46 years (range, 25-65). All eyes were myopic (range, -0.50 to -19.75 diopters [mean, -8.9]). Posterior vitreous detachment was not present before and was documented after LASIK in 55% of eyes. A vitrectomy closed the MH on the 14 eyes that underwent surgical management, with an improvement of final best-corrected visual acuity in 13 of 14 (92.8%) patients. Our 20 eyes with a full-thickness MH after LASIK reflect an incidence of approximately 0.02% (20/83938). CONCLUSION An MH may infrequently develop after LASIK for the correction of myopia. Our study shows that vitreoretinal surgery can be successful in restoring vision for most myopic eyes with an MH after LASIK. Vitreoretinal interface changes may play a role in MH formation after LASIK for the correction of myopia.
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Affiliation(s)
- J Fernando Arevalo
- Retina and Vitreous Service, Clinica Oftalmologica Centro Caracas, Caracas, Venezuela.
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Yepez JB, de Yepez JC, Arevalo JF. Intraoperative peripheral anterior capsulotomy to prevent early postoperative capsular block syndrome. J Cataract Refract Surg 2004; 30:1840-2. [PMID: 15342044 DOI: 10.1016/j.jcrs.2004.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2004] [Indexed: 10/26/2022]
Abstract
We describe a new surgical technique, intraoperative peripheral anterior capsulotomy (IPAC), to prevent early postoperative capsular block syndrome (CBS). Eighty consecutive patients (80 eyes) had phacoemulsification and intraocular lens implantation with IPAC in the presence of a small (4.5 to 5.0 mm) anterior continuous curvilinear capsulorhexis (CCC). Patients were followed for a mean of 16 months (range 6 to 24 months), and none developed CBS or other complications. Our series suggests that IPAC may be an alternative to prevent CBS in high-risk eyes, including those with a small anterior CCC or ophthalmic viscosurgical device material trapped in the capsular bag. This surgical technique is safe, effective, inexpensive, and easy to perform.
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Affiliation(s)
- Juan B Yepez
- Clinica de Ojos de Maracaibo, Caracas 1010, Venezuela
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Yepez JB, Cedeño de Yepez J, Valero A, Arevalo JF. Modified self sealing sclerotomy for drainage of subretinal fluid during scleral buckling surgery. Br J Ophthalmol 2004; 88:589-90. [PMID: 15031190 PMCID: PMC1772082 DOI: 10.1136/bjo.2003.029272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
PURPOSE To report the characteristics and surgical outcomes of rhegmatogenous retinal detachments in myopic eyes after laser in situ keratomileusis (LASIK). METHODS Clinical charts of patients that developed rhegmatogenous retinal detachment after LASIK were reviewed. Surgery to repair rhegmatogenous retinal detachment was performed in 31 eyes (mean follow-up of 14 months after vitreoretinal surgery). RESULTS A total of 38,823 eyes underwent surgical correction of myopia from -0.75 to -29.00 D (mean -6.00 D). Thirty-three eyes (27 patients; frequency .08%) developed rhegmatogenous retinal detachment after LASIK; detachments occurred between 12 days and 60 months (mean 16.3 mo) after LASIK. Eyes that developed a rhegmatogenous retinal detachment had a mean -8.75 D before LASIK. Most rhegmatogenous retinal detachment and retinal breaks occurred in the temporal quadrants (71.1%). Final best spectacle-corrected visual acuity (BSCVA) of 20/40 or better was obtained in 38.7% of the 31 eyes (two patients refused surgery). Poor final visual acuity (20/200 or worse) occurred in 22.6% of eyes. Information regarding visual acuity after LASIK and before the development of rhegmatogenous retinal detachment was available in 24 eyes; 45.8% (11/24 eyes) lost two or more lines of visual acuity after vitreo-retinal surgery. Reasons for poor visual acuity included the development of proliferative vitreo-retinopathy (n=5), epiretinal membrane (n=1), chronicity of rhegmatogenous retinal detachment (n=1), new breaks (n=1), displaced corneal flap (n=1), and cataract. CONCLUSIONS Rhegmatogenous retinal detachment after LASIK for myopia is a serious complication. Final visual acuity may be limited by myopic degeneration, amblyopia, or delayed surgical repair.
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Affiliation(s)
- J Fernando Arevalo
- Retina and Vitreous Service, Clinica Oftalmologica Centro Caracas, San Bernardino, Caracas, Venezuela.
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Yepez JB, de Yepez JC, Azar-Arevalo O, Arevalo JF. Topical Anesthesia With Sedation in Phacoemulsification and Intraocular Lens Implantation Combined With 2-Port Pars Plana Vitrectomy in 105 Consecutive Cases. Ophthalmic Surg Lasers Imaging Retina 2002. [DOI: 10.3928/1542-8877-20020701-07] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Yepez JB, de Yepez JC, Azar-Arevalo O, Arevalo JF. Topical anesthesia with sedation in phacoemulsification and intraocular lens implantation combined with 2-port pars plana vitrectomy in 105 consecutive cases. Ophthalmic Surg Lasers 2002; 33:293-7. [PMID: 12134988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the efficacy of topical anesthesia as an alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and intraocular lens implantation combined with our modified 2-port pars plana vitrectomy technique (phacovitrectomy). PATIENTS AND METHODS Phacovitrectomy using topical anesthesia (4% lidocaine drops) was prospectively performed in 105 eyes with cataract and varied vitreoretinal pathology. In 75 eyes (71.4%), phacovitrectomy was combined with argon laser photocoagulation (endolaser). Preoperative and intraoperative sedation of varying degrees was necessary. Subjective pain and discomfort were graded from 1 (no pain or discomfort) to 4 (severe pain and discomfort). RESULTS All patients had grade 1 pain and discomfort during most of the procedure. All patients had grade 2 (mild) pain and discomfort during pars plana sclerotomies, external bipolar cautery, and conjunctival closure. No patient required additional retrobulbar, peribulbar, or sub-Tenon's anesthesia. CONCLUSION This technique avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. With appropriate case selection, topical anesthesia is a safe and effective alternative to peribulbar or retrobulbar anesthesia in phacovitrectomy.
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Arevalo JF, Yepez JB. Temporary retrobulbar catheter for local anesthesia in vitreoretinal surgery. Arch Ophthalmol 2001; 119:924-5. [PMID: 11405854 DOI: 10.1001/archopht.119.6.924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Yepez JB, de Yepez JC, Arevalo JF. Intraoperative peripheral anterior capsulotomy to prevent early postoperative capsular block syndrome. J Cataract Refract Surg 2001; 27:177-8. [PMID: 11226769 DOI: 10.1016/s0886-3350(01)00740-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arevalo FJ, Yepez JB. Analgesia with Topical Anesthesia or with Opiods? J Cataract Refract Surg 2000. [DOI: 10.1016/s0886-3350(00)00508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Arevalo FJ, Yepez JB. Topical Anesthesia for Combined Phacoemulsification and Posterior Vitrectomy. J Cataract Refract Surg 2000. [DOI: 10.1016/s0886-3350(00)00389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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