Congenital Simple Hamartoma of Retinal Pigment Epithelium: Clinical and Imaging Findings

Congenital simple hamartoma of retinal pigment epithelium (CSHRPE) is a rare, asymptomatic, and incidentally detected benign lesion. However, it is very important to do the differential diagnosis from other pigmented retinal lesions. Its clinical presentation and imaging findings are very helpful in doing this differentiation. This paper presents clinical and imaging findings of a 56-year-old woman with incidentally detected CSHRPE. The lesion was small, heavily pigmented, well circumscribed, and slightly elevated. Optical coherence tomography (OCT) scanning was diagnostic and showed an elevated retina at the site of the lesion, increased optical reflectivity on its inner surface, optical shadowing of deeper structures, and clearly cut tumor margins. Ocular ultrasonography, fluorescein angiography, and fundus autofluorescence imaging which is firstly described in this report did not show any characteristic finding

Prevalencija ovčje estroze (Oestrus ovis Linnaeus, 1761, Diptera: Oestridae) i rizični čimbenici njezina širenja u istočnoj Turskoj.

This study was carried out to estimate the prevalence, larval burden and some risk factors of ovine oestrosis in 328 heads of randomly selected sheep slaughtered in one year at Van, eastern Turkey. Of the total heads, 127 (38.71 %) were infested with Oestrus ovis (Linnaeus, 1761, Diptera: Oestridae) larvae. The prevalence of O. ovis was 51.68 % in summer, 40.69 % in spring, 35.80 % in autumn, and 23.61 % in winter. The differences between seasons were statistically significant (P<0.05). Out of a total of 511 larvae collected, 17 % were L1, 29 % L2, and 54 % L3 larvae. All three larval instars were observed in all study months, apart from the fact that no first-stage larvae were seen in December and March. The overall larval intensity for the infested sheep was 4.02, with 3.42 in spring, 3.80 in summer, 4.03 in autumn and 5.82 in winter. The infestation rates were 41.26 % in female and 34.42 % in male sheep. The infestation rate in sheep less than 2-years-old was 23.33 %, in those 2 to 4 years-old 36.42 % and inj those older than 4 years old 48.43 %. Sheep with dark head color had a higher risk than sheep with white and spotted heads (P<0.05).Ovo istraživanje provedeno je radi procjene prevalencije, opterećenja ličinkama i čimbenika rizika estroze u 328 nasumično odabranih ovaca na klaonici u Van-u u istočnoj Turskoj. Od toga broja je 127 ovaca (38,71%) bilo invadirano ličinkama ovčjeg štrka Oestrus ovis (Linnaeus, 1761, Diptera: Oestridae). Prevalencija O. ovis iznosila je 51,68 % ljeti, 40,69 % u proljeće, 35,80 % u jesen i 23,61 % zimi. Sezonske razlike bile su statistički signifikantne (P<0,05). Od ukupno 511 prikupljenih ličinaka 17 % bile su ličinke L1, 29% L2 te 54 % L3. Razvoj svih triju stupnjeva ličinaka bio je promatran svaki mjesec tijekom istraživanja, osim što ličinke prvog stupnja nisu bile ustanovljene u prosincu i ožujku. Prosječna jačina invazije po ovci iznosila je 4,02: na proljeće 3,42, ljeti 3,80, u jesen 4,03 te zimi 5,82. Stupanj invazije iznosio je 41,26% u ovaca i 34,42% u ovnova. Stupanj invazije u životinja mlađih od 2 godine iznosio je 23,33%, u onih u dobi od 2 do 4 godine bio je 36,42 %, a u onih starijih od 4 godine bio je 48,43 %. Ovce s tamnom bojom dlake na glavi imale su veći rizik od oboljevanja u usporedbi s ovcama koje su imale bijelu ili šarenu glavu (P<0,05)

Prevalencija ovčje estroze (Oestrus ovis Linnaeus, 1761, Diptera: Oestridae) i rizični čimbenici njezina širenja u istočnoj Turskoj.

This study was carried out to estimate the prevalence, larval burden and some risk factors of ovine oestrosis in 328 heads of randomly selected sheep slaughtered in one year at Van, eastern Turkey. Of the total heads, 127 (38.71 %) were infested with Oestrus ovis (Linnaeus, 1761, Diptera: Oestridae) larvae. The prevalence of O. ovis was 51.68 % in summer, 40.69 % in spring, 35.80 % in autumn, and 23.61 % in winter. The differences between seasons were statistically significant (P<0.05). Out of a total of 511 larvae collected, 17 % were L1, 29 % L2, and 54 % L3 larvae. All three larval instars were observed in all study months, apart from the fact that no first-stage larvae were seen in December and March. The overall larval intensity for the infested sheep was 4.02, with 3.42 in spring, 3.80 in summer, 4.03 in autumn and 5.82 in winter. The infestation rates were 41.26 % in female and 34.42 % in male sheep. The infestation rate in sheep less than 2-years-old was 23.33 %, in those 2 to 4 years-old 36.42 % and inj those older than 4 years old 48.43 %. Sheep with dark head color had a higher risk than sheep with white and spotted heads (P<0.05).Ovo istraživanje provedeno je radi procjene prevalencije, opterećenja ličinkama i čimbenika rizika estroze u 328 nasumično odabranih ovaca na klaonici u Van-u u istočnoj Turskoj. Od toga broja je 127 ovaca (38,71%) bilo invadirano ličinkama ovčjeg štrka Oestrus ovis (Linnaeus, 1761, Diptera: Oestridae). Prevalencija O. ovis iznosila je 51,68 % ljeti, 40,69 % u proljeće, 35,80 % u jesen i 23,61 % zimi. Sezonske razlike bile su statistički signifikantne (P<0,05). Od ukupno 511 prikupljenih ličinaka 17 % bile su ličinke L1, 29% L2 te 54 % L3. Razvoj svih triju stupnjeva ličinaka bio je promatran svaki mjesec tijekom istraživanja, osim što ličinke prvog stupnja nisu bile ustanovljene u prosincu i ožujku. Prosječna jačina invazije po ovci iznosila je 4,02: na proljeće 3,42, ljeti 3,80, u jesen 4,03 te zimi 5,82. Stupanj invazije iznosio je 41,26% u ovaca i 34,42% u ovnova. Stupanj invazije u životinja mlađih od 2 godine iznosio je 23,33%, u onih u dobi od 2 do 4 godine bio je 36,42 %, a u onih starijih od 4 godine bio je 48,43 %. Ovce s tamnom bojom dlake na glavi imale su veći rizik od oboljevanja u usporedbi s ovcama koje su imale bijelu ili šarenu glavu (P<0,05)

Choroidal neovascularization associated with sympathetic ophthalmia: case report Neovascularização coroidiana associada à oftalmia simpática: relato de caso

A 7-year-old boy with sympathetic ophthalmia secondary to penetrating ocular trauma developed choroidal neovascularization in the macular region of the sympathizing eye. Posterior segment biomicroscopy disclosed a single, round, small, slightly elevated yellow-white lesion temporal to the fovea, linked to the temporal edge of the optic disc by a fibrotic band. On fluorescein angiography the round lesion showed a gradual hyperfluorescence, with late staining and leakage, and was interpreted as a fibrovascular scar from previous choroidal neovascularization. Despite intense immunosuppressive therapy, the patient's final visual acuity was 20/400. Although rarely associated with sympathetic ophthalmia, choroidal neovascularization and its cicatricial stages can occur and compromise the visual prognosis of an already debilitated eye. The best course of treatment for choroidal neovascularization in these types of cases has not yet been determined.<br>Paciente com oftalmia simpática (OS) desenvolveu neovascularização coroidiana (NVC) na região macular do olho simpatizado. A biomicroscopia do segmento posterior do olho afetado revelou uma pequena lesão branco-amarelada, discretamente elevada, localizada na região temporal à fóvea. Uma banda fibrosa ligava o disco óptico à lesão foveal. À angiografia fluoresceínica, a lesão revelou hiperfluorescência progressiva, com impregnação e extravazamento tardio do corante, achados esses característicos de uma cicatriz fibrovascular. Apesar de intenso tratamento com medicação imunossupressora, a acuidade visual final do paciente foi de 20/400. Embora raramente associada à oftalmia simpática a neovascularização coroidiana pode ocorrer e comprometer o prognóstico visual de um olho já debilitado. A melhor opção para o tratamento da neovascularização coroidiana em casos de oftalmia simpática ainda não está determinada

An Algorithm for the Diagnosis of Behçet Disease Uveitis in Adults

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings.Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion.Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis.Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies

Current practice in the management of ocular toxoplasmosis

Background Ocular toxoplasmosis is common across all regions of the world. Understanding of the epidemiology and approach to diagnosis and treatment have evolved recently. In November 2020, an international group of uveitis-specialised ophthalmologists formed the International Ocular Toxoplasmosis Study Group to define current practice. Methods 192 Study Group members from 48 countries completed a 36-item survey on clinical features, use of investigations, indications for treatment, systemic and intravitreal treatment with antiparasitic drugs and corticosteroids, and approach to follow-up and preventive therapy. Results For 77.1% of members, unilateral retinochoroiditis adjacent to a pigmented scar accounted for over 60% of presentations, but diverse atypical presentations were also reported. Common complications included persistent vitreous opacities, epiretinal membrane, cataract, and ocular hypertension or glaucoma. Most members used clinical examination with (56.8%) or without (35.9%) serology to diagnose typical disease but relied on intraocular fluid testing-usually PCR-in atypical cases (68.8%). 66.1% of members treated all non-pregnant patients, while 33.9% treated selected patients. Oral trimethoprim-sulfamethoxazole was first-line therapy for 66.7% of members, and 60.9% had experience using intravitreal clindamycin. Corticosteroid drugs were administered systemically by 97.4%; 24.7% also injected corticosteroid intravitreally, almost always in combination with an antimicrobial drug (72.3%). The majority of members followed up all (60.4%) or selected (35.9%) patients after resolution of acute disease, and prophylaxis against recurrence with trimethoprim-sulfamethoxazole was prescribed to selected patients by 69.8%. Conclusion Our report presents a current management approach for ocular toxoplasmosis, as practised by a large international group of uveitis-specialised ophthalmologists