Clinical Features, Histopathological Analysis And Surgical Treatment Of A Free Floating Vitreous Cyst: A Case Report

The authors present a report of a 44-year-old female patient, with complaints of visual disturbances in the left eye. The symptoms were present for at least 5 years and worsenedin the last 2 years, impairing her activities. The patient reported perception of a floating circle, which blurred her vision. There was no previous history of trauma, infectious or inflammatory disease. Clinical evaluation included physical examination, laboratory testing, abdominal ultrasonography, thorax X-ray and head tomography. Ophthalmologic examination consisted of visual acuity, motility tests, biomicroscopy, tonometry and indirect ophthalmoscopy. Complementary investigation was done with α and β scan ocular ultrasonography. The chosen therapeutic approach to excise the cyst was pars plana vitrectomy, successfully performed. Anatomopathologic analysis revealed a pigmented vitreous cyst, of possible congenital origin, described as a cystic choristoma from the primitive hyaloid system. Benign evolution, clinical findings and histopathological analysis corroborated the diagnostic hypothesis of a cystic choristoma of the primitive hyaloid system. Surgery (pars plana vitrectomy) was successful and the patient returned with visual acuity of 20/20 in both eyes, and with no further complaints.695753755Tansley, J.O., Cyst of the vitreous (1899) Trans Am Ophthamol Soc, 8, pp. 507-509Cruciani, F., Santino, G., Salandri, A.G., Monolateral idiopathic cyst of the vitreous (1999) Acta Ophthalmol Scand, 77 (5), pp. 601-603. , ReviewJones, W.L., Free-floating vitreous cyst (1998) Optom Vis Sci, 75 (3), pp. 171-173Orellana, J., O'Malley, R.E., McPherson, A.R., Font, R.L., Pigmented free-floating vitreous cysts in two young adults. Electron microscopic observations (1985) Ophthalmology, 92 (2), pp. 297-302Nork, T.M., Millecchia, L.L., Treatment and histopathology of a congenital vitreous cyst (1998) Ophthalmology, 105 (5), pp. 825-830Awan, K.J., Biomicroscopy and argon laser photocystotomy of free-floating vitreous cysts (1985) Ophthalmology, 92 (12), pp. 1710-1711Ruby, A.J., Jampol, L.M., Nd: YAG treatment of a posterior vitreous cyst (1990) Am J Ophthalmol, 110 (4), pp. 428-429Asiyo-Vogel, M.N., El-Hifnawi, El.-S., Laqua, H., Ultrastructural features of a solitary vitreous cyst (1996) Retina, 16 (3), pp. 250-254Hasegawa, N., Kimura, T., Mizota, A., Sano, N., Adachi-Usami, E., Floating vitreous cyst (1996) Retina, 16 (6), pp. 540-542Steinmetz, R.L., Straatsma, B.R., Rubin, M.L., Posterior vitreous cyst (1990) Am J Ophthalmol, 109 (3), pp. 295-29

Risk factors for ovarian failure in patients with systemic lupus erythematosus

The aim of the present study was to identify the risk factors for ovarian failure in patients with systemic lupus erythematosus. Seventy-one women aged 17 to 45 years with systemic lupus erythematosus were studied. Patients were interviewed and their medical records reviewed. Demographic characteristics, clinical and serologic profiles, and menstrual and obstetric histories were recorded. Disease activity was measured by the systemic lupus erythematosus disease activity index. Serum FSH, LH, estradiol, progesterone, TSH, prolactin, and antimicrosomal and antithyroglobulin antibodies were measured. Patients who developed ovarian failure were compared to those who did not. Ovarian failure occurred in 11 patients (15.5%) and nine had premature menopause (11.3%). Cyclophosphamide administration and older patient age were found to be associated with ovarian failure. The cumulative cyclophosphamide dose was significantly higher in patients with ovarian failure than in those without this condition (18.9 vs 9.1 g; P = 0.04). The relative risk for ovarian failure in patients with cumulative cyclophosphamide dose higher than 10 g was 3.2. TSH levels were high in 100% of patients with ovarian failure who had received pulse cyclophosphamide. Ovarian failure, and premature menopause in particular, is common in patients with systemic lupus erythematosus, with the most important risk factors being cyclophosphamide dose and age. Thyroid problems may be another risk factor for ovarian failure in patients with lupus