Romanian journal of ophthalmology最新文献

{"title":"Miscellaneous ophthalmic conditions related to low CD4 cell count in HIV-positive patients.","authors":"Mihaela Cobaschi, Anca Ruxandra Negru, Victor Daniel Dorobăț, Adrian Marinescu, Mioara-Laura Macovei, Cătălin Gabriel Apostolescu, Victoria Aramă","doi":"10.22336/rjo.2024.38","DOIUrl":"10.22336/rjo.2024.38","url":null,"abstract":"<p><p><b>Introduction:</b> Management of patients living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) still represents a challenge for doctors in various medical fields. The presence of co-infections, with different degrees of immune system impairment, raises the need for a multi-disciplinary approach to the PLWHA. <b>Methods:</b> In this paper, we present three cases of PLWHA with various ophthalmological conditions, who were admitted to \"Prof. Dr. Matei Balș\" National Institute for Infectious Diseases (INBIMB). Three of them were late presenters, recently diagnosed with AIDS. All three were in immuno-virological failure. The ophthalmic conditions were either related to the HIV infection, or the result of other complications. <b>Discussion:</b> The diversity and complexity of ocular involvement in PLWHA were deeply linked to the patient's immunological status at the ophthalmological evaluation moment. Thus, antiretroviral therapy (ART) played an important immune status recovery role. Encountered ocular conditions vary, some being directly caused by the presence of the virus, and the others were the result of opportunistic infections (cytomegalovirus, Varicella virus) or other co-infections (Treponema pallidum). Neurological conditions disturbing the natural defense mechanism, prolonged hospital stay, and exposure to multiple antibiotic regimens are risk factors for difficult-to-treat eye infections with multidrug-resistant bacteria. Some ocular conditions can be the reason that leads to HIV infection diagnosis, while others can appear during the time, especially in patients with low ART adherence. The prognostic is conditioned by the early recognition and correct management of the disease and the immunological status recovery under ART. <b>Conclusions:</b> Correct and early diagnosis of HIV-related eye conditions is mandatory to establish the most appropriate medical management to obtain an increase in the quality of life of the patient. <b>Abbreviations:</b> HIV = Human Immunodeficiency Virus, AIDS = Acquired Immunodeficiency Syndrome, ART = Antiretroviral Therapy.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 2","pages":"202-209"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular involvement in highly treatment-experienced patients with HIV.","authors":"Mihaela Cobaschi, Carmen Mihaela Dorobăț, Victor Daniel Dorobăț, Isabela Ioana Loghin, Mioara-Laura Macovei, Adrian Marinescu, Victoria Aramă","doi":"10.22336/rjo.2024.28","DOIUrl":"10.22336/rjo.2024.28","url":null,"abstract":"<p><p><b>Introduction:</b> Ocular involvement in human immunodeficiency virus (HIV) infected and treatment-experienced patients is a significant concern, despite the advancements in antiretroviral therapy (ART) medication. The extended life expectancy of HIV patients has altered the spectrum of HIV-associated ocular diseases, ranging from minor issues to severe vision impairment or blindness. Therefore, understanding these complications becomes crucial in providing comprehensive medical care and quality of life improvement. HIV patients on multiple ARTs can experience various ocular disorders due to the complexity of their treatment regimens, drug toxicities, immune reconstitution, and opportunistic infections. Most worthy to consider are: cytomegalovirus (CMV) retinitis, immune recovery uveitis (IRU), keratoconjunctivitis sicca (dry eye syndrome), and HIV-associated neuroretinal disorders. <b>Materials and methods:</b> A retrospective clinical investigation was conducted on HIV/AIDS-infected patients from January 1, 2013, to December 31, 2023. The study included 62 patients over 18 years, who tested HIV-positive via enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot (WB), with assessments of HIV plasma viral load (VL) and CD4+ T cell counts (CD4). Data collected included demographics, pathological histories, clinical characteristics, blood tests, assessments for opportunistic infections, patient staging, antiretroviral therapy initiation, and disease prognosis. <b>Results:</b> The study found that of most patients, 37 were aged 30-39 (59.7%), with 59.7% males and 40.3% females. Most had been living with HIV for 10-19 years (35.5%). Initial CD4 counts were < 200 cells/mm3 in 46.8% of patients, which improved to 19.3% when the study was done. CMV retinitis prevalence decreased from 46.8% initially to 35.5% despite ART. Other conditions included ocular toxoplasmosis (3.22%), tuberculosis-related uveitis (1,6%), keratoconjunctivitis sicca (19.3%), and HIV retinopathy (29%). Notably, 62.1% of CMV retinitis patients experienced significant visual acuity reduction. Oral valganciclovir was beneficial for patients with CMV disease affecting multiple sites and effective for both induction and maintenance therapy of CMV retinitis. <b>Conclusions:</b> Managing ocular complications in HIV-experienced patients requires a multidisciplinary approach with regular ophthalmologic evaluations, prompt treatment of infections, and continuous monitoring of ART effectiveness. Early detection and intervention are crucial for preserving vision and improving outcomes. The study highlighted the importance of constant monitoring even after viral suppression. <b>Abbreviations:</b> HIV = Human immunodeficiency virus, ART = antiretroviral therapy, CMV = cytomegalovirus, IRU = immune recovery uveitis, ELISA = enzyme-linked immunosorbent assay, WB = Western Blot, VL = viral load, CD4 = CD4+ T cells.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 2","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal parameters in diabetics versus non-diabetics and correlation with various blood sugar parameters.","authors":"Shailaja Pandey, Archana Singh, Harikrishnan Vannadil, Mohini Agrawal","doi":"10.22336/rjo.2024.24","DOIUrl":"10.22336/rjo.2024.24","url":null,"abstract":"<p><p><b>Aim:</b> To compare corneal parameters in diabetics versus age-group-matched non-diabetics; also, to correlate these parameters with the duration of diabetes, glycated haemoglobin (HbA1c) levels, and severity levels of diabetic retinopathy (DR). <b>Materials and methods:</b> A comparative study was conducted at a tertiary eye-care center from January 2020 to December 2020. Two-hundred patients (400 eyes) with type-2 diabetes (100) and age-sex-matched non-diabetics (100) were included. Corneal morphological parameters like central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variance (CoV), hexagonality (6A), and average cell area were recorded by specular microscopy. These parameters were correlated with the duration of diabetes, severity of disease based upon fasting blood glucose levels, HbA1c, and grade of DR. Mean and standard deviation were calculated, and regular distribution of continuous data was tested using independent sample t-test and ANOVA. <b>Results:</b> Mean ECD (2447.32 ± 269.89/mm2), 6A (45.03 ± 6.71%), and IOP (15.47 ± 2.02 mmHg) changed in diabetic cases and were significantly low in diabetics, whereas, mean average cell area (413 ± 50.19 mm2), standard deviation (167.05 ± 77.91), CCT (525.81 ± 36.69) and CoV (39.84 ± 15.59%), were significantly high in diabetics. Mean CCT had insignificant variation. Subgroup analysis within diabetics showed a statistically significant reduction of ECD, cell count, and 6A with increased duration of diabetes, poor glycaemic control, and raised HbA1c. <b>Discussion:</b> The corneal endothelial analysis is vital in daily clinical practice and provides valuable evidence concerning the viability of corneal endothelium in various intraocular surgeries. Uncontrolled DM harms the cornea with 70% of diabetics resulting in complications like keratopathy. The study highlighted that the increased duration of diabetes raised HbA1c, and poor glycemic control negatively affected corneal morphology. Our study showed a definite reduction in ECD and 6A in diabetics compared to non-diabetics. <b>Conclusion:</b> A definite reduction in the corneal endothelial counts, cell density, and hexagonality was found in type-2 diabetics compared to non-diabetics. <b>Abbreviations:</b> DM = Diabetes Mellitus, CCT = central corneal thickness, ECC = endothelial cell counts, ECD = endothelial cell density, CoV = coefficient of variance, 6A = hexagonality, DR = Diabetic retinopathy, SD = Standard of deviation, IOP = Intraocular pressure.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 2","pages":"128-134"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual evoked potential evaluation following brain injury in school-aged children.","authors":"Victoria Verejan","doi":"10.22336/rjo.2024.05","DOIUrl":"https://doi.org/10.22336/rjo.2024.05","url":null,"abstract":"<p><p><b>Aim:</b> The research aimed to establish reference values of visual evoked potentials among school-aged children after brain injury. <b>Methods:</b> Eighteen patients with persisting visual symptoms after brain injury have been examined. A pattern-VEP test has been used during the examination. <b>Results:</b> The prolongation of the N2 wave in 55,6%-66,6%, P wave in 55,7%-66,7%, and N3 wave in 16,7%-22,2% was determined in the research group. Likewise, the decrease in the amplitude of the P wave was determined in the case of 16,7%-33,3%. According to the topography, we concluded that the prechiasmatic alteration was predominantly determined as bilateral in the optic pathways, with emphasis equally on the right and left. <b>Conclusions:</b> VEP evaluation remains one of the most credible methods of examination. In the case of moderate or severe traumatic optic neuropathy, it allows the detection of damage to the optic pathways before the appearance of organic changes that are often irreversible. The possibility of early detection of such modifications could justify the initiation of a dosed stimulatory treatment, to avoid damage to the optic pathways that would induce secondary optic atrophy. <b>Abbreviations:</b> VEP = visual evoked potentials, MRI = magnetic resonance imaging.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute calcareous corneal degeneration in a patient with chronic graft-versus-host disease.","authors":"Marta Gema Solaz Ruiz, Lorena Azorín Pérez, Carlos Cauto Picazo, Laura Sánchez Sanz, Ana Hervás Ontiveros, Enrique España Gregori","doi":"10.22336/rjo.2024.10","DOIUrl":"https://doi.org/10.22336/rjo.2024.10","url":null,"abstract":"<p><p><b>Objective:</b> To describe acute calcareous corneal degeneration as a complication of chronic graft-versus-host disease. <b>Materials and methods:</b> Clinical case and review of the literature. <b>Results:</b> We presented a case of bilateral acute calcareous corneal degeneration in a patient with chronic graft-versus-host disease. <b>Conclusions:</b> Chronic graft-versus-host disease (cGVHD) occurs in 50-70% of bone marrow transplantation patients, the most frequent ocular complication being keratoconjunctivitis sicca (KCS). Calcareous corneal degeneration is a type of calcium deposition that can be secondary to chronic ocular inflammation or dry eye, but there are few cases reported of acute calcareous corneal degeneration and recurrent perforation in cGVHD. <b>Abbreviations:</b> GVHD = Chronic graft-versus-host disease, aGVHD = Acute graft-versus-host disease, cGVHD = Chronic graft-versus-host disease, KCS = Keratoconjunctivitis sicca, PKP = Penetrating keratoplasty, AMT = Amniotic membrane transplantation, PRGF = Plasma rich in growth factors, OD = Right eye, OS = Left eye.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"53-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging differential diagnosis - Leber's Hereditary Optic Neuropathy.","authors":"Raluca Eugenia Iorga, Răzvana Sorina Munteanu-Dănulescu, Ciprian Danielescu","doi":"10.22336/rjo.2024.13","DOIUrl":"https://doi.org/10.22336/rjo.2024.13","url":null,"abstract":"<p><p>Leber's hereditary optic neuropathy (LHON) is the most common maternally inherited disease linked to mitochondrial DNA (mtDNA). The patients present with subacute asymmetric bilateral vision loss. Approximately 95% of the LHON cases are caused by m.3460G>A (<i>MTND1</i>), m.11778G>A (<i>MTND4</i>), and m.14484T>C (<i>MTND6</i>) mutations. The hallmark of hereditary optic neuropathies determined by mitochondrial dysfunction is the vulnerability and degeneration of retinal ganglion cells (RGC). We present the case of a 28-year-old man who came to our clinic complaining of a subacute decrease in visual acuity of his left eye. From his medical history, we found out that one month before he had the same symptoms in the right eye. From the family history, we noted that an uncle has had vision problems since childhood. We carried out complete blood tests, including specific antibodies for autoimmune and infectious diseases. Laboratory tests and MRI were within normal limits. A blood test of the mtDNA showed the presence of 11778 G>A mutation on the mtND6 gene. The medical history, the fundus appearance, the OCT, and the paraclinical investigations, made us diagnose our patient with Leber's hereditary optic neuropathy. As soon as possible, we began the treatment with systemic idebenone, 900 mg/day. We examined the patient 2, 6, and 10 weeks after initiating the treatment. <b>Abbreviations:</b> LHON = Leber's Hereditary Optic Neuropathy, mtDNA = mitochondrial DNA, VA = visual acuity, RE = right eye, LE = left eye, OCT = Optical coherence tomography, pRNFL = peripapillary retinal nerve fiber layer, GCL = retinal ganglion cells layer, MRI = magnetic resonance imaging, VEP = visual evoked potentials, VEP IT = VEP implicit time, VEP A = VEP amplitude.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retropupillary Iris-fixated versus Sutured Scleral-fixated Intraocular Lenses.","authors":"Rozaliya Hristova, Denitsa Cholakova, Alexander Oscar, Bogumil Wowra, Dimitar Dzhelebov, Yani Zdravkov","doi":"10.22336/rjo.2024.04","DOIUrl":"https://doi.org/10.22336/rjo.2024.04","url":null,"abstract":"<p><p><b>Aim:</b> To compare the anatomical and functional results and patient satisfaction following retropupillary implantation of Artisan Aphakia iris-fixated intraocular lens (rAAIF) and sutured scleral fixated intraocular lens (SFIOL). <b>Subjects and methods:</b> We presented a prospective double-arm non-blinded study. Forty-one eyes with acquired aphakia, no age-related macular degeneration, no previous keratoplasty, no combined procedures, no AC reaction (cells, fibrin), normal intraocular pressure, no history of endothelial corneal dystrophy in relatives or fellow eye were included. Indications, complications, corrected distance visual acuity (CDVA), endothelial cell density (ECD), and patient satisfaction score were assessed. <b>Results:</b> Retropupillary AAIF was implanted in 21 (51.22%) eyes and SFIOL in 20 (48.78%) eyes. The most common indication was complicated cataract surgery in 18 cases (43.90%), followed by trauma in 16 (39.02%), and spontaneous dislocation in 7 (17.07%). No difference between rAAIF and SFIOL in terms of sex, laterality (χ=0.13, <i>p</i>=0.72), indications (χ=0.78, <i>p</i>=0.68), previous ocular history, and comorbidities was observed. The complications and the visual outcomes at 6 months postoperatively were similar between the two groups (<i>p</i>=0.95 and <i>p</i>=0.321, respectively). The ECD loss in the two groups was also similar (<i>p</i>=0.89). The patient satisfaction score was 58.67±8.80 in the rAAIF and 56.69±11.50 in the SFIOL group, which was statistically similar (<i>p</i>=0.764). <b>Conclusion:</b> Retropupillary AAIF and SFIOL showed similar results concerning visual acuity, endothelial cell loss, and patient satisfaction. Careful preoperative individual assessment is required to have optimal results with either technique. <b>Abbreviations:</b> AAIF = Artisan Aphakia iris-fixated intraocular lens, rAAIF = retropupillary Artisan Aphakia iris-fixated intraocular lens, CDVA = corrected distance visual acuity, ECD = endothelial cell density, IOL = intraocular lens, SD = standard deviation, SFIOL = scleral fixated intraocular lens.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limbal reconstruction in uveitic glaucoma patient with exposed Ahmed valve coincident with corneal melting and iris prolapse using multiple corneoscleral allografts.","authors":"Stylianos Artemios Kandarakis, Leonidas Doumazos, Marios Timpilis, Georgia Karageorgiou, Petros Petrou, Ilias Georgalas","doi":"10.22336/rjo.2024.12","DOIUrl":"https://doi.org/10.22336/rjo.2024.12","url":null,"abstract":"<p><p><b>Aim:</b> To present a complex case of Ahmed tube exposure 6 months after the implantation associated with corneal melting and iris prolapse, and the surgical reposition that required multiple allografts and limbal reconstruction. <b>Methods:</b> A 60-year-old patient arrived at the emergency room with tube exposure combined with corneal melting and iris prolapse from a previously placed Ahmed valve 6 months prior. Our approach was to use one corneoscleral graft to repair the melted cornea and avoid further iris prolapse and a second scleral graft to cover the repositioned tube. Upon completion of conjunctival dissection, cleaning and deepithelization of the melted cornea and the tube by application of alcohol 100% followed. A new entry point was made for the tube and was covered using an alcohol-preserved scleral allograft and the previous entry point was repaired using a corneoscleral allograft with the corneal aspect restoring the limbus and avoiding further iris protrusion. <b>Results:</b> 6 months follow-up of the patient showed excellent recovery, anatomical restoration, and IOP normalization. <b>Conclusion:</b> Surgical repair of these cases can be very demanding, and requires surgical improvisation and prolonged surgical time. The literature remains very limited on how a surgeon should approach similar cases, which are the crucial tips, and which are the missteps that should be avoided. In this case, we used multiple scleral/corneoscleral allografts in a specific orientation and different sutures to reconstruct the damaged limbal area and restore the anatomy. <b>Abbreviations:</b> VA = Visual Acuity, GDD = Glaucoma Drainage Device, IOP = Intra Ocular Pressure.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple ocular manifestations in a patient diagnosed with herpes zoster ophthalmicus: case report.","authors":"David-Ionuț Beuran, Mioara-Laura Macovei, Ioana Ruxandra Boca","doi":"10.22336/rjo.2024.16","DOIUrl":"https://doi.org/10.22336/rjo.2024.16","url":null,"abstract":"<p><p><b>Objective:</b> Our purpose was to present a case of a patient diagnosed with herpes zoster ophthalmicus with multiple ocular manifestations. <b>Case presentation:</b> A 70-year-old Caucasian male presented to the hospital for headache and skin hyperesthesia on the scalp and forehead on the left side. The diagnoses of herpes zoster ophthalmicus and acute conjunctivitis were made for the left eye. The patient was followed up for 6 months and during that period the following diagnoses were made for the same eye: peripheral sterile corneal infiltrates, episcleritis, and hypertensive anterior uveitis. <b>Discussions:</b> Herpes zoster ophthalmicus occurs when the reactivation of the dormant virus involves the ophthalmic division of the trigeminal nerve. The most frequent ocular presentations are conjunctivitis, keratitis, uveitis, episcleritis, and scleritis. The standard therapy consists of antivirals, such as acyclovir, valacyclovir, and famciclovir to limit the replication of the virus. The patient's risk factors, the course of treatment, and the severity of the disease, all affect the prognosis, which is highly variable. Prevention of the disease consists of vaccination with one of the following two vaccines, Zostavax and Shingrix. <b>Conclusions:</b> Final visual acuity for the left eye remained 1 despite numerous manifestations of the disease. <b>Abbreviations:</b> VZV = Varicella-zoster virus, BCVA = best-corrected visual acuity, OU = both eyes, OD = right eye, OS = left eye, IOP = intraocular pressure, NCT = non-contact tonometer, ZVX = Zostavax vaccine.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of oculo-orbital complications of odontogenic sinusitis in adults.","authors":"Mihai Alexandru Preda, Codruț Sarafoleanu, Gabriela Mușat, Andreea-Alexandra Preda, Daniel Lupoi, Ramona Barac, Monica Pop","doi":"10.22336/rjo.2024.09","DOIUrl":"https://doi.org/10.22336/rjo.2024.09","url":null,"abstract":"<p><p><b>Introduction:</b> Odontogenic maxillary sinusitis (OMS) is an infectious inflammatory pathology caused by a dental condition. Considering the anatomical relations with the orbit, maxillary sinus infection can easily spread, evolving into severe oculo-orbital complications that can sometimes be life-threatening. <b>Material and methods:</b> We performed a retrospective study of over 2 years, examining the data of 18 patients diagnosed with OMS with oculo-orbital complications. The patients were evaluated regarding their dental history, symptoms, clinical and endoscopic findings, ophthalmologic evaluation, bacteriologic tests, computed tomography (CT) imaging, medical and surgical treatment, and outcomes. <b>Results:</b> The age of the patients was between 24 and 65 years old with an almost equal gender distribution: 10 female and 8 male patients. From the total, 7 patients had type II diabetes, 2 of whom were insulin-dependent, 1 patient had thrombophilia and 2 patients had renal failure with peritoneal dialysis. Regarding the type of oculo-orbital complications, 10 patients were diagnosed with preseptal cellulitis and 8 with orbital cellulitis. Just 5 patients with orbital cellulitis required surgical treatment and orbitotomy was performed, followed by endonasal endoscopic drainage. The evolution after surgical treatment was favorable for all operated patients. <b>Discussions:</b> Oculo-orbital complications of OMS are typically more severe than those of rhinogenic sinusitis because anaerobic bacteria are involved. Immunosuppression represents a favorable environment for the development of OMS and its complications, diabetes being the most common risk factor. A negative prognostic feature is the appearance of ophthalmological symptoms in both eyes, so visual function may be reduced. The treatment of oculo-orbital complications of OMS is urgent and depends on a broad-spectrum antibiotic therapy associated or not with surgical intervention. <b>Conclusions:</b> The diagnosis of oculo-orbital complications of OMS is complex and requires clinical experience as well as extensive medical knowledge to treat both the cause and the consequences of the conditions quickly and effectively. The proper management of oculo-orbital complications is based on a multidisciplinary team: ophthalmology, ENT, dentistry, imaging, and laboratory. <b>Abbreviations:</b> OMS = odontogenic maxillary sinusitis, CT = computed tomography, ENT = ear-nose-throat, MRI = magnetic resonance imaging, HNS = head and neck surgery.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}