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Surgical treatment complicated by dacryocystitis and retinal detachment of a patient with Wegener granulomatosis
ABSTRACTS
627
Treatment of Age-related Macular Degeneration with Low-dose Radiation Therapy Study Group doi:10.1016/j.jjo.2003.09.013
*Department of Ophthalmology, Hirosaki University School of Medicine; †Department of Ophthalmology, Hatinohe Red Cross Hospital; ‡Department of Ophthalmology, Aomori City Hospital doi:10.1016/j.jjo.2003.09.014
Surgical Treatment Complicated by Dacryocystitis and Retinal Detachment of a Patient with Wegener Granulomatosis Background: We report surgical treatment of a patient with dacryocystitis and retinal detachment (RD), which are rare ophthalmic involvements of Wegener granulomatosis (WG). Case: The patient was a 26-year-old man with WG. He was diagnosed as having WG 4 years previously and he had been treated by maintenance doses of prednisolone and cyclophosphamide. Rheumatoid factor and serum antinuclear antibody were negative. Cytoplasmic pattern-antineutrophil cytoplasmic antibody (C-ANCA) and renal function were normal. He was found to have nasolacrimal duct obstruction and lattice degeneration bilaterally, retinal tear with RD in the left eye and tear without RD in the right eye. No sign of vasculitis was found in fluorescein angiography. Bilateral dacryocystorhinostomy was performed without any sign of postoperative necrosis of the wound. After the surgery, epiphora and eye discharge disappeared and lacrimal passage has been maintained without obstruction. The pathological findings of his nasal mucosa and lacrimal sac showed chronic inflammation and no typical changes of WG. There was no abnormal change in the conjunctiva and sclera after an uncomplicated scleral buckling surgery. Conclusion: We conclude that operations such as dacryocystorhinostomy and scleral buckling surgery may be performed successfully when WG is controlled within the normal limits of C-ANCA. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:331–336, 2003) Tomomi Metoki*, Masabumi Kubo†, Yoshiko Takano*, Hideo Nakamura‡ and Mitsuru Nakazawa*
Three Cases of Hypotonic Maculopathy due to Blunt Trauma, Treated by 360-degree Scleral Buckling Background: In hypotonic maculopathy with a shallow anterior chamber, it is difficult to delineate the extent of cyclodialysis. Reoperations are often reported, and a method of management for hypotonic maculopathy is not yet established. Cases: We treated three patients with hypotonic maculopathy due to blunt trauma. Case 1 did not improve after two cryoablations, two cyclopexies, and a laser photocoagulation treatment. Cases 2 and 3 did not improve after a single laser photocoagulation treatment. All cases exhibited retinal breaks, and underwent 360degree scleral buckling. Results: In all cases, intraocular pressure was normalized soon after the surgery. We found that ultrasound biomicroscopy (UBM) was helpful in clarifying cyclodialysis, and that optical coherence tomography (OCT) was useful to observe morphologic changes of the macula in detail. Conclusion: This procedure is considered to be useful in the treatment of hypotonic maculopathy. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:337–342, 2003) Asae Inukai*, Sumiyoshi Tanaka†, Akira Hirose*, Sakaki Tomimitsu* and Manabu Mochizuki* *Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University; †Department of Ophthalmology, Teikyo University School of Medicine, Ichihara Hospital doi:10.1016/j.jjo.2003.09.015
627
Treatment of Age-related Macular Degeneration with Low-dose Radiation Therapy Study Group doi:10.1016/j.jjo.2003.09.013
*Department of Ophthalmology, Hirosaki University School of Medicine; †Department of Ophthalmology, Hatinohe Red Cross Hospital; ‡Department of Ophthalmology, Aomori City Hospital doi:10.1016/j.jjo.2003.09.014
Surgical Treatment Complicated by Dacryocystitis and Retinal Detachment of a Patient with Wegener Granulomatosis Background: We report surgical treatment of a patient with dacryocystitis and retinal detachment (RD), which are rare ophthalmic involvements of Wegener granulomatosis (WG). Case: The patient was a 26-year-old man with WG. He was diagnosed as having WG 4 years previously and he had been treated by maintenance doses of prednisolone and cyclophosphamide. Rheumatoid factor and serum antinuclear antibody were negative. Cytoplasmic pattern-antineutrophil cytoplasmic antibody (C-ANCA) and renal function were normal. He was found to have nasolacrimal duct obstruction and lattice degeneration bilaterally, retinal tear with RD in the left eye and tear without RD in the right eye. No sign of vasculitis was found in fluorescein angiography. Bilateral dacryocystorhinostomy was performed without any sign of postoperative necrosis of the wound. After the surgery, epiphora and eye discharge disappeared and lacrimal passage has been maintained without obstruction. The pathological findings of his nasal mucosa and lacrimal sac showed chronic inflammation and no typical changes of WG. There was no abnormal change in the conjunctiva and sclera after an uncomplicated scleral buckling surgery. Conclusion: We conclude that operations such as dacryocystorhinostomy and scleral buckling surgery may be performed successfully when WG is controlled within the normal limits of C-ANCA. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:331–336, 2003) Tomomi Metoki*, Masabumi Kubo†, Yoshiko Takano*, Hideo Nakamura‡ and Mitsuru Nakazawa*
Three Cases of Hypotonic Maculopathy due to Blunt Trauma, Treated by 360-degree Scleral Buckling Background: In hypotonic maculopathy with a shallow anterior chamber, it is difficult to delineate the extent of cyclodialysis. Reoperations are often reported, and a method of management for hypotonic maculopathy is not yet established. Cases: We treated three patients with hypotonic maculopathy due to blunt trauma. Case 1 did not improve after two cryoablations, two cyclopexies, and a laser photocoagulation treatment. Cases 2 and 3 did not improve after a single laser photocoagulation treatment. All cases exhibited retinal breaks, and underwent 360degree scleral buckling. Results: In all cases, intraocular pressure was normalized soon after the surgery. We found that ultrasound biomicroscopy (UBM) was helpful in clarifying cyclodialysis, and that optical coherence tomography (OCT) was useful to observe morphologic changes of the macula in detail. Conclusion: This procedure is considered to be useful in the treatment of hypotonic maculopathy. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:337–342, 2003) Asae Inukai*, Sumiyoshi Tanaka†, Akira Hirose*, Sakaki Tomimitsu* and Manabu Mochizuki* *Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University; †Department of Ophthalmology, Teikyo University School of Medicine, Ichihara Hospital doi:10.1016/j.jjo.2003.09.015