Case Report of Bullous Pemphigoid following Fundus Fluorescein Angiography

Purpose: To report a first case of bullous pemphigoid (BP) following intravenous fluorescein for fundus angiography. Clinical Features: A 70-year-old male patient was admitted to the intensive care unit with BP and sepsis. He reported a history of fundus fluorescein angiography with a pre-diagnosis of senile macular degeneration 2 months prior to presentation. At that time, fluorescein extravasated at the antecubital region. Following the procedure, pruritus and erythema began at the wrists bilaterally, and quickly spread to the entire body. The patient also reported a history of allergy to human albumin solution (Plamasteril®; Abbott) 15 years before, during bypass surgery. On dermatologic examination, erythematous patches were present on the scalp, chest and anogenital region. Vesicles and bullous lesions were present on upper and lower extremities. On day 2 of hospitalization, tense bullae appeared on the upper and lower extremities. The patient was treated with oral methylprednisolone 48 mg (Prednol®; Mustafa Nevzat), topical clobetasol dipropionate 0.05% cream (Dermovate®; Glaxo SmithKline), and topical 4% urea lotion (Excipial Lipo®; Orva) for presumptive bullous pemphigoid. Skin punch biopsy provided tissue for histopathology, direct immunofluorescence examination, and salt extraction, which were all consistent with BP. After 1 month, the patient was transferred to the intensive care unit with sepsis secondary to urinary tract infection; he died 2 weeks later from sepsis and cardiac failure. Conclusions: To our knowledge, this is the first reported case of BP following fundus fluorescein angiography in a patient with known human albumin solution allergy. Consideration should be made to avoid fluorescein angiography, change administration route, or premedicate with antihistamines in patients with known human albumin solution allergy. The association between fundus fluorescein angiography and BP should be further investigated

Pars Plana Vitrectomy in Advanced Coats’ Disease

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Development of ocular hypertension and persistent glaucoma after intravitreal injection of triamcinolone

M Selim Kocabora, Cemil Yilmazli, Muhittin Taskapili, Gokhan Gulkilik, Sahan DurmazVakif Gureba Education and Research Hospital, Istanbul, TurkeyPurpose: This study evaluates intraocular pressure (IOP) elevation secondary to intravitreal injection of triamcinolone acetonide (IVTA) and discusses its management.Methods: The records of 175 patients who underwent IVTA treatment and regular eye examinations in the period 2003–2006 were reviewed. One hundred and twenty-two of these patients were included in the study, of which 147 eyes that received IVTA (4 mg/0.1 ml) were followed for at least 9 months. Mean IOPs observed after IVTA injection as well as IOP elevations defined as moderate (≥5 mm Hg), important (≥10 mm Hg) and severe (>25 mm Hg) during the follow-up period were evaluated and compared statistically.Results: Overall, the mean IOPs following IVTA injection were statistically significantly higher than the preinjection IOP (15.8 ± 2.6), after the first hour (17.7 ± 2.9), the first week (18.7 ± 4.1), the first month (19.6 ± 6.2), the second month (19.1 ± 6.1), the third month (18.0 ± 4.1), the sixth month (17.3 ± 4.0), and the ninth month (17.0 ± 2.7), but not after the first day (16.3 ± 7.6). Important IOP elevations were observed mostly in the first (17.7%) and second months (10.2%). In 40 (27.7%) eyes, topical antiglaucomatous therapy was needed and 7 later required surgical intervention to lower the IOP. Of the remaining 33 eyes, topical treatment was continued in 14 (9.5%) because of IOPs ≥20 mm Hg.Conclusion: The persistence of IOP elevation beyond the IVTA clearance period and the development of intractable secondary glaucoma requiring surgical intervention substantiate the need for careful consideration of IVTA indication and follow-up.Keywords: intravitreal triamcinolone, intraocular pressure, steroid-induced glaucom

Comparison of optical coherence biometry and applanation ultrasound biometry in high-myopic eyes with posterior pole staphyloma

We compared the refractive outcomes of optical coherence biometry and applanation ultrasound biometry in 17 high-myopic eyes with posterior pole staphylorna. The optical coherence biometry provided more accurate IOL power calculations than applanation ultrasound biometry in patients with high myopia and posterior pole staphylorna.We compared the refractive outcomes of optical coherence biometry and applanation ultrasound biometry in 17 high-myopic eyes with posterior pole staphyloma. The optical coherence biometry provided more accurate IOL power calculations than applanation ultrasound biometry in patients with high myopia and posterior pole staphylorna

Comparison of rebound tonometry and non-contact airpuff tonometry to Goldmann applanation tonometry

Purpose: The aim of this study was to compare the intraocular pressure measurements obtained from healthy subjects with the rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry in different age groups. Methods: A total of 180 eyes of 90 healthy subjects were included in the study. According to the subjects’ ages, the eyes were categorized into three groups: group 1 (age: 7–17 years), group 2 (age: 18–40 years), and group 3 (age: 41–75 years). Intraocular pressure was measured on each subject always in the same order: rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry. Central corneal thickness values were obtained using ultrasonic pachymetry. One-way repeated-measures analysis of variance, Pearson’s correlation coefficient, and Bland–Altman analysis were used for the statistical assessment. Results: The mean corneal thickness was found to be 604 ± 13 µm, 546 ± 15 µm, and 547 ± 15 µm in group 1, group 2, and group 3, respectively. Non-contact airpuff tonometry was significantly higher than both Goldmann applanation tonometry and rebound tonometry measurements in all groups ( p  < 0.001, for all). No statistical difference between Goldmann applanation tonometry and rebound tonometry measurements was found in group 1 ( p  = 0.248), group 2 ( p  = 0.63), and group 3 ( p  = 0.126). There was a significant positive correlation in the meaning of intraocular pressure measurements between rebound tonometry and non-contact airpuff tonometry; non-contact airpuff tonometry and Goldmann applanation tonometry; and Goldmann applanation tonometry and rebound tonometry in all groups. Conclusion: As a result, without need for topical anesthesia, fast measurement and ease-of-use rebound tonometry is a reliable alternative to Goldmann applanation tonometry in different age groups

A case of herpetic keratitis after intravitreal triamcinolone injection

Purpose: We report a case of herpetic epithelial keratitis that developed after intravitreal triamcinolone acetonide injection

ASSOCIATION BETWEEN VISUAL ACUITY LOSS AND OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN PATIENTS WITH LATE SOLAR RETINOPATHY

Purpose: To describe optical coherence tomography findings in patients with late solar retinopathy and their association with visual loss