dorzolamide and Syndrome

Ibrutinib is a tyrosine kinase inhibitor commonly used in patients with chronic lymphocytic leukemia. Based on the published literature, it has a very sound ophthalmologic safety profile. In the following, we describe a case of anterior chamber fibrinoid syndrome in a patient on ibrutinib for B-cell chronic lymphocytic leukemia after uncomplicated cataract extraction.. A 75-year-old white man with B-cell chronic lymphocytic leukemia on ibrutinib therapy and without significant past ocular history presented 1 day after uncomplicated phacoemulsification with in-the-bag intraocular lens implantation with multiple, discrete, pigmented cords in the anterior chamber. His vision was 20/100 and intraocular pressure was 43 mmHg. There was no hypopyon, hyphema, or cellular reaction. The dilated fundus examination was unremarkable. He was diagnosed as having fibrinoid syndrome and started on topical prednisolone, brimonidine, timolol-dorzolamide, and orally administered acetazolamide. Within 2 weeks, the fibrin cords disappeared completely, vision improved to 20/30, and the intraocular pressure normalized off all medications.. The precise etiology of fibrinoid syndrome remains unclear. This is the first case of fibrinoid syndrome in a patient on ibrutinib, which is known to cross the blood-brain barrier and induce intraocular changes. It is important to differentiate this syndrome from toxic anterior segment syndrome and endophthalmitis, and to initiate appropriate treatment. The fibrin bands tend to be exquisitely sensitive to topical steroids and to resolve within a few weeks without sequelae.

Topics: Adenine; Administration, Topical; Aged; Anterior Chamber; Antihypertensive Agents; Antineoplastic Agents; Brimonidine Tartrate; Cataract Extraction; Humans; Intraocular Pressure; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Phacoemulsification; Piperidines; Prednisolone; Pyrazoles; Pyrimidines; Sulfonamides; Syndrome; Thiophenes; Timolol; Treatment Outcome; Visual Acuity

Mutations in the MFRP (membrane-type frizzled-related protein) gene leads to an entity characterized by retinitis pigmentosa, nanophthalmos, optic disk drusen, and macular changes, originally described as foveoschisis. Despite the association of MFRP gene mutation and increase in macular thickness, no treatment modality has been described for cystoid macular edema related to this particular entity so far.. In this case report, a 52-year-old woman presented with nanophthalmos, optic disk drusen, retinitis pigmentosa, and increase in macular thickness. Genetic analysis revealed an MFRP gene mutation. The patient was treated with topical carbonic anhydrase inhibitors.. A progressive decrease in macular thickness and cystic changes was observed during the 2-month course of topical carbonic anhydrase inhibitor treatment, and best-corrected visual acuity improved from 20/100 to 20/50. Macular thickness remained stable after 6 months of follow-up.. Cystoid macular edema is part of the macular changes noted in the MFRP mutation-related nanophthalmos-retinitis pigmentosa-foveoschisis-optic disk drusen, syndrome. Taking into account that resolution of cystoid macular edema in patients with retinitis pigmentosa may delay an irreversible decrease in visual acuity, treatment should be considered when cystic changes are suspected. Topical carbonic anhydrase inhibitor was effective in decreasing macular thickness and cystic changes in the patient reported.

Topics: Administration, Topical; Carbonic Anhydrase Inhibitors; Female; Frameshift Mutation; Humans; Macular Edema; Membrane Proteins; Microphthalmos; Middle Aged; Optic Disk Drusen; Retinitis Pigmentosa; Sulfonamides; Syndrome; Thiophenes; Treatment Outcome

We report a case of Urrets-Zavalia Syndrome after a glaucoma filtration device (g.f.d.) implantation. A 74-year-old woman with bilateral advanced glaucoma has been planned for surgery. The patient underwent to g.f.d. implantation in the right eye. On postoperative day 1, the patient had an edematous cornea with a dilated and non reactive pupil. In this article we describe the clinical history of this patient. To our knowledge, this is the first case of Urrets-Zavalia Syndrome after a g.f.d. implantation.

Topics: Acetazolamide; Aged; Brimonidine Tartrate; Cataract Extraction; Combined Modality Therapy; Drug Resistance; Drug Therapy, Combination; Female; Glaucoma Drainage Implants; Glaucoma, Open-Angle; Humans; Hypertension; Miotics; Mydriasis; Ocular Hypertension; Pilocarpine; Prostaglandins F; Quinoxalines; Sulfonamides; Syndrome; Thiophenes; Timolol

The purpose of this study was to evaluate the efficacy of topical dorzolamide 2% eye drops on macular function and thickness in a case of enhanced S-cone syndrome (ESCS). A 24-year-old Asian man with enhanced S-cone syndrome treated with topical dorzolamide in the left eye participated in the study. Examinations performed before and during treatment were included visual acuity (VA), contrast sensitivity measured with briefly presented grating targets (grating CS) and the Pelli-Robson chart (P-R CS), microperimetry (MP), and spectral-domain optical coherence tomography (SD-OCT). Following 4 months of treatment, the mean thickness of the central 1-mm foveal subfield of the left eye, as measured by SD-OCT, decreased from 551 to 242 μm. Mean MP sensitivity within the central 12 degrees (28 points) increased from 9.4 dB at baseline to 11.2 dB. Although Pelli-Robson contrast sensitivity improved only minimally in the left eye, grating contrast sensitivity improved by more than a factor of two. Mean log MAR VA was 0.22 OD and 1.00 OS (at baseline), which improved to 0.10 OD and 0.66 OS after 4 months of treatment. The results indicate that in our patient with enhanced S-cone syndrome, treatment with topical dorzolamide was effective in improving macular thickness, VA, microperimetry sensitivity, and grating contrast sensitivity. These measures of retinal structure and function are sensitive tools for evaluating the effects of treatment in enhanced S-cone syndrome patients with cystoid macular edema. Further investigation is warranted to assess the relationships among visual performance for daily activities, visual sensitivity, and macular thickness.

Topics: Administration, Topical; Carbonic Anhydrase Inhibitors; Contrast Sensitivity; Humans; Macular Edema; Male; Retinal Cone Photoreceptor Cells; Retinal Diseases; Sulfonamides; Syndrome; Thiophenes; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity; Visual Field Tests; Young Adult

A case of a patient with Weill-Marchesani syndrome who developed a secondary glaucoma due to synechiae in both eyes is described. As intraocular pressure (IOP) could not be controlled with medical treatment in the left eye (LE), the patient underwent glaucoma filtering surgery. IOP was controlled and no complications occurred. However, 15 months later, athalamia stage 1 was diagnosed in the LE, without any alterations in the posterior pole. To solve this complication, a vitrectomy with lens extraction and intraocular lens implantation in the LE was performed. Currently, IOP is 12 mmHg and the anterior chamber remains deep.. The association of vitrectomy and lens surgery in those cases where there is a predisposition to forward movement of the lens, might reduce intra and postoperative complications.

Topics: Abnormalities, Multiple; Adult; Cataract Extraction; Combined Modality Therapy; Drug Resistance; Dwarfism; Female; Fingers; Glaucoma, Angle-Closure; Hand Deformities, Congenital; Humans; Intraocular Pressure; Iridectomy; Lens Implantation, Intraocular; Lens, Crystalline; Mitomycins; Phacoemulsification; Postoperative Complications; Sulfonamides; Syndrome; Thiophenes; Trabeculectomy; Vitrectomy

To report a case of glaucomatocyclitic crisis (Posner-Schlossman syndrome) in a child.. Case report. A 13-year-old boy presented with decreased vision, photophobia, halos, and pain in the right eye.. Findings in this child were consistent with a diagnosis of Posner-Schlossman syndrome.. Glaucomatocyclitic crisis can occur in a child and must be included in the differential diagnosis of uveitis and glaucoma in pediatric patients.

Topics: Adolescent; Clonidine; Corneal Edema; Diagnosis, Differential; Drug Therapy, Combination; Glaucoma; Humans; Intraocular Pressure; Male; Pain; Prednisolone; Sulfonamides; Syndrome; Thiophenes; Timolol; Uveitis, Intermediate; Vision Disorders; Visual Acuity