14 research outputs found
Vertebral artery variations revised: origin, course, branches and embryonic development
Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via PubMed database, using the terms: “variations of vertebral artery AND cadaveric study”, “variations of vertebral artery AND cadavers” and “anomalies of vertebral artery AND cadavers”. Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different populations, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area
Macular hole closure after peribulbar steroid injection
PURPOSE: To report the closure of a macular hole after a peribulbar
corticosteroid injection in a patient with anterior uveitis associated
with human leukocyte antigen B*27.
DESIGN: Interventional case report.
METHODS: The patient was evaluated by comprehensive ophthalmic check-up
and optical coherence tomography.
RESULTS: A healthy 50-year-old woman presented to our service with
active human leukocyte antigen B*27, associated anterior uveitis,
macular hole in the right eye and macular edema in the left eye. Visual
acuity was 20/200 in both eyes. Peribulbar injections of triamcinolone
acetonide were administered in both eyes. Three months later, visual
acuity improved to 20/50 in both eyes, and the uveitis was in complete
remission. Optical coherence tomography verified that the macular hole
in the right eye was closed.
CONCLUSIONS: Inflammation and macular edema might be contributing
factors in macular hole formation in patients with uveitis. This case
indicates that treatment of inflammation and macular edema might lead to
macular hole closure in similar cases. (C) 2003 by Elsevier Inc. All
rights reserved
Infliximab for chronic cystoid macular edema associated with uveitis
PURPOSE: To assess the efficacy of the anti-TNF monoclonal antibody
infliximab in uveitis patients without clinically evident ocular
inflammation and impaired visual acuity because of chronic cystoid
macular edema (CME).
DESIGN: Prospective, noncomparative, interventional case series.
METHODS: Patients with refractory CME (14 eyes, mean duration of 14
months), associated with intermediate uveitis (n = 6),
Adamantiades-Behcet disease (n = 2), adult-type vascular pseudotumor (n
= 1), and HLAB27+-related uveitis (n = 1) received an intravenous
infliximab infusion (5 mg/kg); five patients were retreated after 1
month.
RESULTS: Macular thickness, measured by ocular coherence tomography, was
reduced from 428 +/- 138 mum to 219 +/- 51 mum at 2 months postbaseline
(P = .0001), while visual acuity increased from 0.41 +/- 0.18 to 0.83
+/- 0.17 (P < .00001). Anatomic and functional improvement was sustained
at 6 months in all. No ocular or extra-ocular side effects were noted.
CONCLUSION: These promising results suggest that TNF may play an
important pathogenetic role in chronic CME, thus, a controlled trial is
warranted. (C) 2004 by Elsevier Inc. All rights reserved
Patterns of macular edema in patients with uveitis - Qualitative and quantitative assessment using optical coherence tomography
Purpose: To describe the morphologic characteristics of uveitic macular
edema by the use of optical coherence tomography (OCT) and to
investigate the correlation between tomographic features and visual
acuity (VA).
Design: Cross-sectional study.
Participants: Seventy consecutive patients with uveitis in a
university-based practice with a clinical diagnosis of macular edema in
at least one eye. Inclusion criteria were: (1) verification of macular
edema by OCT, (2) adequate media clarity for fundus visualization, and
(3) absence of coexisting ocular disease limiting visual potential.
Methods: Complete ophthalmic examination: best-corrected Snellen VA,
slit-lamp examination, fundus biomicroscopy, indirect ophthalmoscopy,
and OCT. Fluorescein angiography was performed in selected cases.
Main Outcome Measures: Best-corrected Snellen VA and tomographic
features of the macula, including macular thickness measurement and
correlation of macular thickness with VA.
Results: Eighty-four eyes of 60 patients met the inclusion criteria. The
mean VA (Snellen test) was 20/36. There were 3 patterns of macular
edema: diffuse macular edema (DME), cystoid macular edema (CME), and
serous retinal detachment (RD). Serous retinal detachment was detected
in 17 eyes (20.2%). Patients were classified into the following groups:
DME (46 eyes, 54.8%), CME (21 eyes, 25%), DME and RD (5 eyes, 5.9%),
CME and RD (12 eyes, 14.3%). Epiretinal membrane was detected by OCT in
34 eyes (40.5%). Eight eyes (9.5%) demonstrated vitreomacular
traction. The mean retinal thickness at the central fovea was 333 +/-
171 mum (mean +/- standard deviation). Macular edema was located mainly
in the outer retinal layers. Eyes with CME had significantly greater
retinal thickness measurements than eyes with DME (P<0.001).
Multivariate analysis revealed that VA was negatively correlated with
increased macular thickness, presence of CME, and RD (P<0.05).
Conclusions: Optical coherence tomography demonstrated 3 patterns of
macular edema in patients with uveitis: DME, CME, and RD. Epiretinal
membrane coexisted in a significant percentage of patients. In patients
with uveitis with clear media, the morphologic features of macular edema
and macular thickness correlated with VA. Ophthalmology 2004;111:946-953
(C) 2004 by the American Academy of Ophthalmology
Vertebral artery variations revised: Origin, course, branches and embryonic development
Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via PubMed database, using the terms: "variations of vertebral artery AND cadaveric study", "variations of vertebral artery AND cadavers"and "anomalies of vertebral artery AND cadavers". Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different populations, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area. © 2021 Via Medica
Optical coherence tomography findings in the macula after treatment of rhegmatogenous retinal detachments with spared macula preoperatively
Purpose: To present the postoperative optical coherence tomography (OCT)
findings of the macula in rhegmatogenous retinal detachment with spared
macula preoperatively.
Methods: Eleven of 46 patients who underwent surgery for rhegmatogenous
retinal detachment had an uninvolved macula preoperatively. Scleral
buckling without intravitreous gas injection was the operation used in
all eyes. All 11 patients were examined before and after treatment with
slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography,
fluorescein angiography, and OCT.
Results: In 3 of the 11 patients with rhegmatogenous retinal detachment
and uninvolved macula preoperatively, fluid was identified with OCT in
the macula after successful treatment. OCT showed that the fluid
gradually diminished and finally disappeared 5 to 7 months after the
scleral buckling procedure. The fluid in the macula became visible with
slit-lamp biomicroscopy in only one of the three patients.
Conclusion: Subretinal fluid in a preoperatively uninvolved macula can
be found after successful treatment of rhegmatogenous retinal
detachment. If the fluid is located in the fovea, the visual acuity
decreases and does not reach the preoperative levels. OCT identifies the
presence of fluid and contributes to the study of the fluid’s evolution
PB1914: CYTOGENETIC FINDINGS IN 18 CHILDREN WITH MYELODYSPLASTIC SYNDROMES BY KARYOTYPIC AND FISH ANALYSIS
Double adenomas of the pituitary: an imaging, pathological, and clinical diagnostic challenge
Double pituitary adenomas
Double pituitary adenomas represent up to 2.6\ua0% of pituitary adenomas in large surgical series and up to 3.3\ua0% of patients with Cushing's disease have been found to have double or multiple pituitary adenomas. We report the case of a 60-year-old male patient whose medical history began in 2002 with erectile dysfunction; hyperprolactinemia was found and MRI showed a 6-mm area of delayed enhancement in the lateral portion of the right pituitary lobe. Treatment with cabergoline was started with normalization of prolactin levels; the following MRI, performed in 2005 and 2008, showed shrinkage of the pituitary lesion. In 2005, the patient began to manifest weight gain, hypertension, and facial plethora, but no further evaluations were done. In January 2010, the patient came to our attention and underwent multiple tests that suggested Cushing's disease. A new MRI was negative. Bilateral inferior petrosal sinus sampling showed significant pituitary-to-peripheral ratio and, in May 2010, the patient underwent exploratory pituitary surgery with evidence of a 1-2-mm white-coloured midline area compatible with pituitary adenoma that was surgically removed. Post-operatively, the patient's clinical conditions improved with onset of secondary hypoadrenalism. The histologic examination confirmed a pituitary adenoma (immunostaining was found to be positive for ACTH and negative for prolactin). We report the case of an ACTH-producing microadenoma metachronous to a prolactin secreting microadenoma although not confirmed histologically, shrunk by medical treatment. A review of data in the literature regarding double or multiple pituitary adenomas has also been done