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Dorronsoro M, Bronfen S, Alconcher L, Lucarelli L. Bilateral neuroretinitis and membranous lupus nephritis: 2 infrequent manifestations in juvenile lupus. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:175-179. [PMID: 36738922 DOI: 10.1016/j.oftale.2023.01.002] [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] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/15/2022] [Indexed: 02/05/2023]
Abstract
Fifteen-year-old female patient, previously healthy, referred to our center for presenting abdominal pain, vomiting, diarrhea, malar erythema, palpebral and lower limb edema, arthralgia, morning stiffness and bilateral blurred vision. Laboratory and imaging studies together with the clinic allowed the diagnosis of nephrotic syndrome secondary to systemic lupus erythematosus. Ophthalmology examination revealed a visual acuity of 8/10 in both eyes and bilateral disc edema with partial macular star, findings compatible with bilateral neuroretinitis. Renal biopsy established the diagnosis of membranous lupus nephritis. Immunosuppressive treatment was started, obtaining gradual clinical improvement. Although systemic lupus erythematosus with membranous lupus nephritis and neuroretinitis is a very infrequent association, when faced with a patient with bilateral neuroretinitis, we must consider systemic lupus erythematosus within the differential diagnoses.
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Affiliation(s)
- M Dorronsoro
- Servicio de Oftalmología, Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina.
| | - S Bronfen
- Servicio de Nefrología Infantil, Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
| | - L Alconcher
- Servicio de Nefrología Infantil, Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
| | - L Lucarelli
- Servicio de Nefrología Infantil, Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
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Salicio-Bermejo Y, Cilla-Eguiluz G, Blanco-Esteban A, Martin-Peñaranda T, Grandioso-Vas D, Echeverría-Irigoyen MJ. Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019. ACTA ACUST UNITED AC 2021; 39:451-453. [PMID: 34446396 DOI: 10.1016/j.eimce.2021.08.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/13/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS A retrospective review of serology registries and clinical registries, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA ≥1/256). RESULTS Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.
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Affiliation(s)
- Yolanda Salicio-Bermejo
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain
| | - Gustavo Cilla-Eguiluz
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain; Instituto de Investigación Sanitaria Biodonostia, Área de Enfermedades Infecciosas, San Sebastián, Gipuzkoa, Spain
| | - Ana Blanco-Esteban
- Departamento de Oftalmología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain
| | - Tania Martin-Peñaranda
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain
| | - David Grandioso-Vas
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain
| | - María Julia Echeverría-Irigoyen
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, Spain.
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Salicio-Bermejo Y, Cilla-Eguiluz G, Blanco-Esteban A, Martin-Peñaranda T, Grandioso-Vas D, Echeverría-Irigoyen MJ. Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019. Enferm Infecc Microbiol Clin 2020; 39:S0213-005X(20)30261-5. [PMID: 32950265 DOI: 10.1016/j.eimc.2020.07.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS A retrospective review of serology and clinical records, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA≥1/256). RESULTS Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.
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Affiliation(s)
- Yolanda Salicio-Bermejo
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España
| | - Gustavo Cilla-Eguiluz
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España; Instituto de Investigación Sanitaria Biodonostia, Área de Enfermedades Infecciosas, San Sebastián, Gipuzkoa, España
| | - Ana Blanco-Esteban
- Departamento de Oftalmología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España
| | - Tania Martin-Peñaranda
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España
| | - David Grandioso-Vas
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España
| | - María Julia Echeverría-Irigoyen
- Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España.
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Carrillo-Soto MA, Montoya-Valladares AS. About 3 cases of post-acute retinopathy of chikungunya fever. ACTA ACUST UNITED AC 2020; 95:408-410. [PMID: 32505386 DOI: 10.1016/j.oftal.2020.04.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
A descriptive study is presented on a case series of 3 patients, with IgM an IgG serology diagnosis of Chikungunya in whom other metabolic, autoimmune and infectious diseases were ruled out. They presented with other ocular manifestations with vascular changes and inflammatory characteristics. They were treated at the Retinovascular and Retinal and Vitreous clinics at the "Dr. Rodolfo Robles Valverde Hospital" and "Benemérito Comité Pro-ciegos y Sordos" in Guatemala City during 2019. Guatemala is a country with a high prevalence of vector-borne diseases, including chikungunya. In recent years cases of this disease has increased in recent years, and complications are currently seen more frequently. Within these complications, there have been reports of cases of optic neuritis, iridocyclitis, episcleritis, retinitis, uveitis, and blood dyscrasia that can affect the retina. It is important to consider these as an important differential diagnosis of ocular vascular alterations.
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Affiliation(s)
- M A Carrillo-Soto
- Clínica de retinovascular, Instituto de Ciencias de la Visión del Comité pro-Ciegos y Sordos de Guatemala, Hospital de ojos y oídos Dr. Rodolfo Robles Valverde, Guatemala, Guatemala.
| | - A S Montoya-Valladares
- Clínica de retinovascular, Instituto de Ciencias de la Visión del Comité pro-Ciegos y Sordos de Guatemala, Hospital de ojos y oídos Dr. Rodolfo Robles Valverde, Guatemala, Guatemala
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Rodríguez-Castelblanco Á, Cordero-Coma M. Leber's idiopathic stellate neuroretinitis: diagnostic and therapeutic conflicts. ACTA ACUST UNITED AC 2019; 94:413-416. [PMID: 31053369 DOI: 10.1016/j.oftal.2019.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 11/17/2022]
Abstract
Three cases of patients with decreased visual acuity and papillitis at onset with subsequent macular star development after a few weeks are presented. Complementary tests were unremarkable in all included patients. Based on this clinical context, they were diagnosed with Leber's idiopathic stellate neuroretinitis, were treated with corticosteroids, as well as with antibiotics in 2cases. All patients showed favourable outcomes, although signs of papillary atrophy were observed in the affected eyes. Leber's idiopathic stellate neuroretinitis diagnosis can be challenging due to the wide spectrum of conditions that have to be ruled out. In addition, macular star may appear later on, which should not exclude its diagnosis. Use of antibiotics and/or corticosteroids is controversial considering its benign nature, but should be considered in selected severe cases. Moreover, the routine use of complementary tests should be carefully evaluated, mainly those that can be aggressive and/or expensive, which should be rationally used.
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Affiliation(s)
| | - M Cordero-Coma
- Unidad de Uveítis, Complejo Asistencial Universitario de León, León, España; IBIOMED, Universidad de León, León, España.
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Reche-Sainz JA, Gracia García-Miguel MT, Pérez-Jacoiste MA. Papillitis and neuroretinitis of tuberculous etiology. ACTA ACUST UNITED AC 2019; 94:359-362. [PMID: 30718012 DOI: 10.1016/j.oftal.2018.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/01/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
A 57-year-old man with miliary tuberculosis reported visual loss in his right eye, a month after starting a four-drug antituberculous treatment regimen. On exploration, an inferior segmental optic disc edema was objectived and it was attributed to ischemic aetiology. Ethambutol was withdrawn and 60mg of oral prednisone daily were given with a tapering dosage. One and a half months later, he presented a sudden loss of vision in his left eye. In fundoscopy, a papillary edema accompanied by a foveal neurosensory detachment was observed but with no more accompanying uveitic signs. Treatment was intensified with moxifloxacin and corticosteroids were reduced, showing a resolution of the macular detachment but with optic atrophy. Isolated tuberculous involvement of the optic nerve may possible in the context of miliary tuberculosis. In this case, the adopted therapeutic approach to the initial papillitis, which was interpreted as ischemic, could favour the appearance of a neuroretinitis in the fellow eye.
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Affiliation(s)
- J A Reche-Sainz
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España.
| | | | - M A Pérez-Jacoiste
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
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Carrillo-Soto MA. Case series of ocular involvement due to dengue. First reported cases in Guatemala. ACTA ACUST UNITED AC 2018; 93:329-35. [PMID: 29580756 DOI: 10.1016/j.oftal.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/24/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Describe the ocular findings of a case series of 8 patients with a diagnosis of dengue. MATERIALS AND METHODS Review of clinical records and interviews with patients during outpatient visits, after informed consent was obtained and following the ethical standards of the Helsinki declaration. The patients were diagnosed with diagnosis by IgM / IgG dengue serology in whom ocular involvement was identified, between January and October 2017 in Retinal-vascular clinic of the "Dr. Rodolfo Robles Valverde Hospital", Guatemala. RESULTS The 8 patients, 5 men and 3 women from rural areas in Guatemala, were diagnosed with dengue by IgM / IgG serology with associated ocular involvement. The mean age was 32.3 years, with the oldest being 45 years old and the youngest being 20 years old. The ocular manifestations identified were, 4 neuroretinitis, 3 venous obstructions, 3 maculopathies, 2 serous detachments, 1 episcleritis, and 1 vasculitis. Two patients developed optic atrophy after resolving the neuroretinitis, and 1 developed peri-foveal scarring after the maculopathy. The ocular involvement was resolved in all patients after treatment, with an improvement in visual acuity, although in some cases damage to the visual field developed as a sequela of neuroretinitis. CONCLUSION It is necessary to consider dengue as an important differential diagnosis in an endemic country such as Guatemala. There are a large number of ocular manifestations due to direct involvement, as well as by an immune system reaction, and thus avoid considering the different ocular manifestations as idiopathic, or due to a different condition.
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Garcia Vilaro M, Bassaganyas Vilarrassa F, Vela Segarra JI, Buil Calvo JA. [Early treatment of idiopathic vasculitis, aneurysms and neuroretinitis (IRVAN). A case report]. ACTA ACUST UNITED AC 2014; 89:117-20. [PMID: 24269400 DOI: 10.1016/j.oftal.2012.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 07/09/2012] [Accepted: 07/12/2012] [Indexed: 11/23/2022]
Abstract
CASE REPORT A 55 year old woman presented with retinal vasculitis, multiple aneurysms, macular exudation and widespread retinal nonperfusion and was diagnosed with IRVAN. She was treated with panretinal laser photocoagulation. After 3 years of follow up visual acuity remains stable and there are no complications due to ischaemic sequelae. DISCUSSION IRVAN syndrome with neovascularisation can progress rapidly despite laser treatment. Panretinal laser photocoagulation has to be considered in the early stages as it is effective in stopping the progression of ischaemia.
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