PURPOSE: To report the occurrence of central vein occlusion in an Eales disease patient. CASE SUMMARY: A 23-year-old man presented with decreased left eye visual acuity and was diagnosed with bilateral Eales disease after ophthalmic evaluations. The patient received laser photocoagulation and visual acuity in his left eye improved 1 month after treatment. He was followed up regularly for 3 years and had no specific eye problems. Subsequently, the patient visited our clinic because of visual disturbance in his right eye. The patient's visual acuity was 0.6 in his right eye, and 1.0 in his left eye. On right eye fundus examination, there were multiple flame shape hemorrhages and retinal vascular tortuosity was observed. Arteriovenous transit time was extended on fluorescein angiography. Therefore, the patient was diagnosed with central retinal vein occlusion and underwent an internal medical examination to reveal a possible systemic cause of the central retinal vein occlusion; however, there were no systemic problems. Macular edema was observed on optical coherence tomography and the patient received an intravitreal bevacizumab injection. Six months after treatment, the right eye visual acuity and macular edema improved. CONCLUSIONS: Reports of branched retinal vein occlusion on the peripheral retina are common in Eales disease patients. However, the authors experienced and report a case of central retinal vein occlusion occurring in Eales disease.
Antibodies, Monoclonal, Humanized ; Eye ; Fluorescein Angiography ; Hemorrhage ; Humans ; Light Coagulation ; Macular Edema ; Neovascularization, Pathologic ; Retina ; Retinal Vasculitis ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Tomography, Optical Coherence ; Veins ; Visual Acuity ; Young Adult ; Bevacizumab

PURPOSE: To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment. METHODS: The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 microm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated. RESULTS: In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324). CONCLUSIONS: In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
Adult ; Female ; Humans ; *Lens Implantation, Intraocular/adverse effects ; Male ; Middle Aged ; *Phacoemulsification/adverse effects ; Postoperative Complications/prevention & control ; Retinal Detachment/physiopathology/*surgery ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; *Vitrectomy/adverse effects

PURPOSE: To report a case of central retinal vein occlusion caused by iron deficiency anemia in a healthy young adult. CASE SUMMARY: A 23-year-old female was referred to the department of ophthalmology after 4 days of acute onset of decreased vision in her left eye. The best corrected visual acuity was 20/20 in the right eye and 10/20 in the left eye. There was no ocular pain, afferent pupillary defect or other ocular symptoms. Results of the anterior segment examination were normal. Fundus examination showed mild optic disc swelling, flame-shaped retinal hemorrhages around the optic disc, and vascular tortuosity with dilatation. The fluorescein angiography showed tortuous peripapillary veins, multiple blocked fluorescences due to retinal hemorrhages, and delayed arteriovenous transit time. All medical examinations and laboratory tests for the risk factors of central retinal vein occlusion were within normal limits, except for iron deficiency anemia. The patient was subsequently treated with oral iron. Three months after the first visit, the best corrected visual acuity was 20/20 in the patient's left eye with nearly normal fundus appearances and no iron deficiency anemia detected in laboratory tests. CONCLUSIONS: In cases of CRVO in young adults without other systemic diseases and risk factors, evaluation of the hematologic state may be necessary.
Anemia, Iron-Deficiency ; Dilatation ; Eye ; Female ; Fluorescein Angiography ; Humans ; Iron ; Ophthalmology ; Pupil Disorders ; Retinal Hemorrhage ; Retinal Vein ; Risk Factors ; Veins ; Vision, Ocular ; Visual Acuity ; Young Adult

Hydrogel buckles, which are used in scleral buckling surgery for retinal detachment, have been associated with late complications after successful retinal reattachment surgery, including strabismus, extraocular motility restriction, extrusion through the eyelid or conjunctiva, intraocular erosion, and scleral erosion. Hydrogel buckles sometimes appear as well-marginated, circumferential, lobulating, contoured cystic masses mimicking orbital cysts on orbital CT or MRI. We report the radiologic findings in 5 patients whose hydrogel buckles needed to be differentiated from orbital cysts.
Conjunctiva ; Eyelids ; Foreign Bodies ; Humans ; Hydrogel ; Orbit ; Retinal Detachment ; Retinaldehyde ; Scleral Buckling ; Strabismus ; Tomography, X-Ray Computed

PURPOSE: To report a case of macular hole following intravitreal ranibizumab injection in choroidal neovascularization associated with age-related macular degeneration. CASE SUMMARY: A 73-year-old man was referred for a sudden decline in vision in his right eye. The best corrected visual acuity was 0.15 in the right eye and 0.9 in the left eye. There was a choroidal neovascularization associated with subretinal hemorrhage in the right eye. Optical coherence tomogram (OCT) showed subretinal hemorrhage and pigment retinal epithelium detachment in the right eye. The patient received intravitreal ranibizumab injection. Four weeks after the initial treatment, the best corrected visual acuity of the right eye was improved to 0.3. The patient received a second intravitreal ranibizumab injection. Four weeks after the second injection, the patient presented with further decreased vision in his right eye, with a best corrected visual acuity of 0.02. Although the fundus examination was indistinct, OCT confirmed the presence of a full thickness macular hole. The patient received a third intravitreal ranibizumab injection. Four weeks after receiving the third injection, the patient underwent pars plana vitrectomy with internal limiting membrane peeling and fluid-gas exchange. Four months later, the macula hole was closed completely and visual acuity was 0.1. CONCLUSIONS: Although it is rare, intravitreal ranibizumab injection in the treatment of choroidal neovascularization secondary to age-related macular degeneration may cause complicated by a macular hole.
Aged ; Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Epithelium ; Eye ; Hemorrhage ; Humans ; Macular Degeneration ; Membranes ; Retinal Perforations ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; Ranibizumab

No abstract available.
Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Lamivudine

Acute pancreatitis rarely occurs in the postpartum period. Furthermore, there are very few reports of it after cesarean section delivery. A 35-year-old woman presented with dyspnea and abdominal distension on the third day after cesarean section delivery. Under a suspicion of acute pancreatitis, she was initially managed with conservative treatment. However, she developed intra-abdominal fluid collections and gastric bleeding, which were managed with percutaneous drainage, endoscopic hemostasis, and angiographic embolization. She was discharged with good clinical recovery. Postpartum pancreatitis, especially after cesarean section, is rare; however, its management is not different from that for usual pancreatitis.
Adult ; Cesarean Section* ; Drainage ; Dyspnea ; Esophageal and Gastric Varices ; Female ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Pancreatitis* ; Postpartum Period ; Pregnancy ; Stomach Ulcer

Background/Aims: Renal toxicity is a concern in patients with chronic hepatitis B taking nucleotide analogues, such as adefovir (ADV) and tenofovir disoproxil fumarate (TDF). We sought to determine the long-term renal effects of nucleotide analogue treatment versus entecavir (ETV) treatment. Methods: In this retrospective single-center study, we selected 87 patients who were treated with ADV and subsequently with TDF from June 2008 to December 2013. ETV-treated patients were matched by treatment duration. We analyzed the creatinine increase over 0.5 mg/dL, glomerular filtration rate (GFR) decrease over 25%, phosphorus decrease under 2.0 mg/dL, and dose reduction of antiviral agents. Results: The median follow-up period was 60.0 months for both groups. The incidence of liver cirrhosis was higher in the ADVTDF group than in the ETV group (32.2% vs 74.7%, p<0.01).Creatinine increased in both groups during follow-up, but the difference was not significant (5.7% and 2.3%, p=0.44). In addition, GFR decreased more often in the ADV-TDF group than in the ETV group (31.0% and 14.9%, p=0.01). After multivariate Cox regression analysis, ADV-TDF treatment was significantly associated with a GFR decrease over 25% (hazard ratio, 2.10; 95% confidence interval, 1.08 to 4.10; p=0.03) after adjusting for the baseline GFR decrease. Conclusions Patients taking nucleotide analogues had a significantly higher number of renal events than did those taking ETV. Clinicians should be aware of the development of renal toxicity in this patient population. Further long-term studies are warranted.

BACKGROUND/AIMS: Guidelines recommend surveillance for hepatocellular carcinoma (HCC) recurrence at 3-month intervals during the first year after curative treatment and 6-month intervals thereafter in all patients. This strategy does not reflect individual risk of recurrence. We aimed to stratify risk of recurrence to optimize surveillance intervals 1 year after treatment. METHODS: We retrospectively analyzed 1,316 HCC patients treated with resection/radiofrequency ablation at Barcelona Clinic Liver Cancer stage 0/ A. In patients without 1-year recurrence under 3-monthly surveillance, a new model for recurrence was developed using backward elimination methods: training (n=582)/ validation cohorts (n=291). Overall survival (OS) according to risk stratified by the new model was compared according to surveillance intervals: 3-monthly versus 6-monthly (n=401) after lead time bias correction and propensity-score matching analyses. RESULTS: Among patients without 1-year recurrence, age and international normalized ratio values were significant factors for recurrence (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.00 to 1.03; p=0.009 and HR, 5.63; 95% CI, 2.24 to 14.18; p < 0.001; respectively). High-risk patients stratified by the new model showed significantly higher recurrence rates than low-risk patients in the validation cohort (HR, 1.73; 95% CI, 1.18 to 2.53; p=0.005). After propensity-score matching between the 3-monthly and 6-monthly surveillance groups, OS in high-risk patients under 3-monthly surveillance was significantly higher than that under 6-monthly surveillance (p=0.04); however, OS in low-risk patients under 3-monthly surveillance was not significantly different from that under 6-monthly surveillance (p=0.17). CONCLUSIONS: In high-risk patients, 3-monthly surveillance can prolong survival compared to 6-monthly surveillance. However, in low-risk patients, 3-monthly surveillance might not be beneficial for survival compared to 6-monthly surveillance.
Bias (Epidemiology) ; Carcinoma, Hepatocellular* ; Cohort Studies ; Humans ; International Normalized Ratio ; Liver Neoplasms ; Recurrence ; Retrospective Studies