Notes

Throughout sufferers having transjugular intrahepatic portosystemic shunt, rifaximin avoided overt hepatic encephalopathy.
CCF picture can mimic the GO's manifestations. Thus, CCF should be considered in the differential diagnosis of GO, especially in unilateral, asymmetric, and atypical cases. We reported herein a case of CCF in a patient diagnosed with GBD, having a previous history of inactive GO, a diagnostic challenge, since the first presumed diagnosis in patients with GBD is always GO. To the best of our knowledge, there are only three previous reports in the medical literature in which the CCF was diagnosed in a GBD patient with a history of GO. Abbreviations CCF = Carotid Cavernous Fistula, GBD = Graves-Basedow disease, GO = Graves' ophthalmopathy, CS = cavernous sinus, SOV = superior ophthalmic vein, ICA = internal carotid artery, IOP = intraocular pressure.Objective To report a case of choroidal mass secondary to mucinous cystadenocarcinoma of ovary in a young woman. Method A case report. Result A 21-year-old woman presented with insidious painless, progressive, central scotoma of the right eye for 5 weeks. She was disease free for 9 years after she underwent right salpingo-oophorectomy for her mucinous cystadenocarcinoma of right ovary. She completed 6 cycles of chemotherapy regimen. On presentation, her visual acuity was counting finger in the right eye and 6/ 6 in the left eye. Both anterior segments were unremarkable. Fundus examination of the right eye showed multiple choroidal masses with the largest in the temporal to fovea. Generally, she was well. Her tumor markers were raised. Urgent Computed Tomography (CT) Scan of thorax, abdomen and pelvis showed multiple distance metastases. She was referred to the gynecology team. She was scheduled for chemotherapy. However, she defaulted the treatment. 3 months after that, her general condition deteriorated. She developed bilateral internal jugular vein thrombosis and massive right pleural effusion. She passed away due to that complication. Conclusion Choroidal metastasis from primary ovary carcinoma is very rare. Ocular symptoms can be the first presenting features to a life-threatening condition.We presented a case of a 76-year-old male patient with phacolytic glaucoma and a rather atypical clinical presentation. The sudden onset of intense pain forced the patient to seek medical help and by doing so, further damage of the optic nerve was prevented and a good visual acuity was obtained following cataract surgery.Objective Idiopathic intracranial hypertension (IIH) is a neuro-ophthalmological syndrome of unknown cause that can be vision-threatening, so an early diagnosis is crucial. Case report We reported a case of a 68-year-old asymptomatic male referred with a cataract in his right eye (OD). Best-corrected visual acuity (BCVA) was 70 letters (20/ 40) in the OD and 85 letters (20/ 20) in the left eye (OS). Ophthalmological examination revealed a significant nuclear cataract in the OD that explained the visual acuity. Fundus imaging showed a faint nasal margin elevation of the optic disc of both eyes (OU). Optical coherence tomography (OCT) revealed a sectorial retinal nerve fiber layer (RNFL) atrophy in the inferior quadrant in the OS. Nevertheless, visual field (VF) did not demonstrate defects. Neuroimaging was normal and examination of CSF revealed an opening pressure of 500 mmH2O. A diagnosis of IIH was confirmed and acetazolamide 250 mg twice daily was recommended. After 12 months of follow-up, RNFL thickness remained stable and VF did not confirm defects. Conclusion A routine eye examination was the onset of IIH in our case. Thus, the ophthalmologist played a crucial role in the early diagnosis of this syndrome. Papilledema is usually a key criterion for IIH, so after its detection, exclusion diagnosis and treatment should be initiated in order to avoid permanent visual loss.Purpose To illustrate the improvement pattern of bacillary layer detachment (BLD) in a closely monitored patient with Vogt-Koyanagi-Harada (VKH) disease. Methods Imaging with color fundus photography and spectral domain optical coherence tomography (SD-OCT). Results The pattern of BLD was noticed better with each passing day under the treatment of ten days' long pulse methylprednisolone (1 g/ day) therapy. Though a meaningful decrease in size and shape of the BLD occurred on the eight day of pulse treatment, it showed resolution at two weeks follow-up, but the associated subretinal serous fluid persisted until the sixth week of treatment. Conclusion The term BLD has become a widely used description as an OCT finding in some diseases but its evolution with the treatment was less illustrated previously. Thereby, our aim was to share our observation of a patient with VKH disease having BLD, with the ophthalmic community.Purpose To describe a clinical case of toxic optic neuropathy with severe visual loss caused by inhalation abuse of methanol products. Method A 25-year-old male student was admitted to the emergency department with an acute bilateral visual loss and headaches, nausea, and cold sweats. A complete clinical and ophthalmologic examination was performed. Results On ophthalmic examination, visual acuity (VA) was light perception in the right eye (RE) and no light perception in the left eye (LE). Pupillary examinations demonstrated dilated, non-reactive pupils. An arterial blood gas analysis showed systemic metabolic acidosis with a pH of 7.23 and Gap anion elevated. Consequently, these results were enough to provide a substantial suspicion of methanol toxicity and start the treatment. 72 hours after, he confessed that he had been inhaling methanol-based solvent for eight years. Selleckchem TGF-beta inhibitor Conclusions Methanol-induced toxicity can cause a non-reversible toxic optic neuropathy. Blood acidemia with Gap anion elevated and a suspicious fundus ophthalmic examination allows a fast diagnosis. A quick treatment based on dialysis, intravenous ethanol, sodium bicarbonate, vitamin B12, and intravenous methylprednisolone slows the secondary intoxication damages. We presented herein a procedure to identify and manage toxic optic neuropathy caused by methanol inhalation. Abbreviations VA = Visual Acuity, RE = right eye, LE = left eye, OCT = Optical Coherence Tomography, RNFL = Retinal Nerve Fiber Layer, CT = computed tomography, MRI = magnetic resonance imaging, VEPs = visual evoked potentials.
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