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Determining factors associated with Psychosocial Stress in Breast cancers Patients in a Safety Net Clinic.
Purpose To describe the corneal findings and management of a 61-year-old female with vortex keratopathy following short term, high dose hydroxychloroquine used in the setting of a clinical trial for recurrent breast cancer. Observations The patient was found to have significant corneal vortex keratopathy without retinal pathology within 3 months of 1200 mg daily hydroxychloroquine treatment as an adjuvant medication for cancer therapy. Cessation of the medication led to the resolution of the corneal verticillata within 1 month yet the vision did not return to baseline. Ultimately, remaining irregular astigmatism and ocular surface disease required a scleral contact lens to achieve a BSCVA of 20/25 OU. Conclusions and Importance Hydroxychloroquine-induced vortex keratopathy is largely considered dose and duration dependent and is uncommon with most standard treatment algorithms. However, with increasing use of high-dose hydroxychloroquine in adjunct cancer therapy, corneal findings are likely to become more frequent. Persistent visual impairment may occur, thus increased understanding of this pathology can aid in counseling patients and guiding treatment recommendations. © 2020 The Authors.Purpose To report a new surgical technique with a Finesse Flex loop during internal limiting membrane (ILM) peeling for a case of macular hole retinal detachment (MHRD). Observations A 55-year-old woman with a history of macular hemorrhage due to high myopia underwent 25-gauge vitrectomy combined with cataract surgery for MHRD. After core vitrectomy, ILM peeling was performed for macular hole (MH) closure with a novel use of a Finesse Flex loop. While holding down the detached retina with the Finesse Flex loop with one hand, ILM peeling was conducted from the temporal to nasal side with the other hand using ILM forceps. Inverted ILM flap technique was combined, and fluid-gas exchange with 12% octafluoropropane tamponade was performed. The MH was closed, and the retina was attached with no postoperative complication. The logMAR best-corrected visual acuity improved post-treatment. Conclusions and Importance The Finesse Flex loop can be used to control the retina when performing ILM peeling on a detached retina in MHRD patients. © 2020 The Authors.Purpose To report a case of transient anisocoria and mydriasis in a 14 year old boy with toxoplasmosis retinochoroiditis. Observation The patient presented with panuveitis and mydriasis which persisted for 18 days and spontaneously resolved. Conclusions and importance Mydriasis is a rare potential neurological manifestation of toxoplasmosis retinochoroiditis. Clinicians should be aware of this rare cause of anisocoria. © 2020 The Authors.Purpose This case report describes a case of Horner syndrome resulting from central nervous system (CNS) toxoplasmosis in an immunocompromised patient. Horner Syndrome is a neurological condition characterized by unilateral miosis, ptosis with apparent enophthalmos, and anhidrosis due to inhibition of the sympathetic pathway. The ocular sympathetic pathway runs from the posterolateral hypothalamus to the ophthalmic branch of the trigeminal nerve (cranial nerve V1). Central nervous system (CNS) toxoplasmosis infection is typically only seen in immunocompromised patients. To our knowledge, toxoplasmosis has never been reported as a cause of Horner syndrome. Observations A forty-four-year-old Caucasian male was admitted to the hospital for left upper extremity paresthesias, gait instability, and painful vesicular skin lesions, and Horner syndrome. Upon review, he had an 18-year history of HIV initially controlled on anti-retrovirals but had been lost to follow-up for several years until he developed severe headavier Inc.Purpose Bee sting injuries to the eye and surrounding tissue are an infrequent occurrence. Here we present an interesting Case of a 64 year old bee keeper who was stung in the left upper eyelid. Observations After the injury, she developed pain and inflammation of the eyelid though a few days after the injury noted increased eye pain. On initial ophthalmic assessment, no retained foreign body was noted. Small molecule library Six days after the incident, her lid edema had improved and a retained foreign body - the bee stinger - had been found on eversion of the eyelid. We propose that as the inflammation resolved, the stinger extruded from the inner eyelid tissue, causing a corneal abrasion, which was the source of her acute increase in pain. Conclusion and Importance In cases of bee injuries, it is paramount to consider the possibility of retained foreign bodies and to perform a thorough ophthalmic examination and assessment. © 2020 The Author(s).Background Overweight and obesity are major risk factors for gestational diabetes among U.S. women. Evidence suggests that longer duration of breastfeeding among women with a history of gestational diabetes is associated with lower incidence of developing type 2 diabetes after pregnancy. Women may potentially benefit from a lifestyle change program that includes breastfeeding education and support. Purpose To describe the design and justification of a combined breastfeeding, national Diabetes Prevention Program (DPP)-based feasibility randomized controlled trial, the electronic Monitoring Of Mom's Schedule (eMOMSTM) study. eMOMSTM compares the feasibility and efficacy of three interventions on six-month postpartum weight loss among women with a BMI ≥25. Methods The intervention is delivered via Facebook and includes three groups DPP and breastfeeding (eMOMS1); DPP only (eMOMS2); and Usual Care (eMOMS3). Recruitment is ongoing at two clinical sites (rural and urban). A total of 72 women, 24 per group, will be randomly assigned to one of the three groups. It is anticipated that women in eMOMS1 will have greater weight loss and increased length of breastfeeding at three and six months postpartum compared to women in eMOMS2 and eMOMS3. Additional data will be collected on metabolic markers, anthropometrics, physical activity, nutrition, breastfeeding, and depression. Program cost will be compared to that of traditionally scheduled group meetings. Expected study completion date October 2021. Conclusions This study has the potential to define a high impact, cost effective intervention that can improve public health by reducing negative health outcomes associated with gestational diabetes among an at-risk population. © 2020 The Authors.
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