Limits...
Exudative detachment as a masquerader in hypoalbuminaemic patients.

Wong MH, Cheung GC, Chee SP, Mathur R - Clin Kidney J (2014)

View Article: PubMed Central - PubMed

Affiliation: Singapore National Eye Centre , Singapore.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Most RDs result from a tear(s) in the retina, through which liquefied vitreous enters the sub-retinal space... Rarely, however, exudative retinal detachment (ERD) occurs due to an underlying ocular or systemic condition that produces excess sub-retinal fluid in the absence of tears and/or tractional pull... A 44-year-old female presented to the ophthalmology service with bilateral severe visual loss of 1-month duration... She had a past history of protein C, protein S and anti-thrombin III deficiency, complicated by superior mesenteric and portal vein thrombosis for which she was on warfarin therapy... Her vision was 6/120 in the right eye and light perception in the left... There was a right inferior quadrant and left total ERD associated with vitreous haemorrhage... Ocular ultrasonography (B scan) did not reveal any underlying posterior scleritis or choroidal tumour... Systemic investigations revealed severe hypoalbuminaemia (albumin 10 G/L), elevated serum alkaline phosphatase 124 U/L (32–103 U/L) and gamma-glutamyl transferase 226 U/L (7–39 U/L) levels and total urine protein 0.20 G/day... The gastroenterologist made a diagnosis of protein-losing enteropathy based on the presence of intestinal oedema, which developed secondary to superior mesenteric and portal vein thrombosis... Clinically, there were no systemic signs of VKH... FA and indocyanine-green angiography did not reveal any underlying choroidal masses but showed multi-focal areas of leakages with exudation as seen in Case 2... ERDs are common and may be seen in ocular as well as systemic conditions... Similarly, direct damage to the ion channels (RPE pump) on the surfaces of the RPE cells in conditions like malignant hypertension and pre-eclampsia also leads to accumulation of sub-retinal fluid and exudative detachment... While most cases of exudative detachments secondary to a systemic illness improve with treatment of the underlying disease with high-dose systemic steroids and immuno-suppressants, primary ocular pathologies like central serous retinopathy (CSR) are worsened by systemic steroids.

No MeSH data available.


Related in: MedlinePlus

(a) Bilateral fundus photographs showing exudative detachment (right more than left). (b) Corresponding auto-fluorescence frames. (c) Auto-fluorescence frames showing resolution of the fluid after initiation of oral steroids. The mottled areas reflect the damaged RPE cells after the resolution of the fluid.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4377793&req=5

SFT161F2: (a) Bilateral fundus photographs showing exudative detachment (right more than left). (b) Corresponding auto-fluorescence frames. (c) Auto-fluorescence frames showing resolution of the fluid after initiation of oral steroids. The mottled areas reflect the damaged RPE cells after the resolution of the fluid.

Mentions: A 60-year-old female with no past medical history, presented to the Accident and Emergency Department for bilateral central blurring of vision for 4 days. She also had bilateral ankle oedema. Her visual acuities were 6/30 in the right eye and 6/21 in the left. Fundus examination showed bilateral neurosensory RDs (Figure 2a and b).Fig. 2.


Exudative detachment as a masquerader in hypoalbuminaemic patients.

Wong MH, Cheung GC, Chee SP, Mathur R - Clin Kidney J (2014)

(a) Bilateral fundus photographs showing exudative detachment (right more than left). (b) Corresponding auto-fluorescence frames. (c) Auto-fluorescence frames showing resolution of the fluid after initiation of oral steroids. The mottled areas reflect the damaged RPE cells after the resolution of the fluid.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4377793&req=5

SFT161F2: (a) Bilateral fundus photographs showing exudative detachment (right more than left). (b) Corresponding auto-fluorescence frames. (c) Auto-fluorescence frames showing resolution of the fluid after initiation of oral steroids. The mottled areas reflect the damaged RPE cells after the resolution of the fluid.
Mentions: A 60-year-old female with no past medical history, presented to the Accident and Emergency Department for bilateral central blurring of vision for 4 days. She also had bilateral ankle oedema. Her visual acuities were 6/30 in the right eye and 6/21 in the left. Fundus examination showed bilateral neurosensory RDs (Figure 2a and b).Fig. 2.

View Article: PubMed Central - PubMed

Affiliation: Singapore National Eye Centre , Singapore.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Most RDs result from a tear(s) in the retina, through which liquefied vitreous enters the sub-retinal space... Rarely, however, exudative retinal detachment (ERD) occurs due to an underlying ocular or systemic condition that produces excess sub-retinal fluid in the absence of tears and/or tractional pull... A 44-year-old female presented to the ophthalmology service with bilateral severe visual loss of 1-month duration... She had a past history of protein C, protein S and anti-thrombin III deficiency, complicated by superior mesenteric and portal vein thrombosis for which she was on warfarin therapy... Her vision was 6/120 in the right eye and light perception in the left... There was a right inferior quadrant and left total ERD associated with vitreous haemorrhage... Ocular ultrasonography (B scan) did not reveal any underlying posterior scleritis or choroidal tumour... Systemic investigations revealed severe hypoalbuminaemia (albumin 10 G/L), elevated serum alkaline phosphatase 124 U/L (32–103 U/L) and gamma-glutamyl transferase 226 U/L (7–39 U/L) levels and total urine protein 0.20 G/day... The gastroenterologist made a diagnosis of protein-losing enteropathy based on the presence of intestinal oedema, which developed secondary to superior mesenteric and portal vein thrombosis... Clinically, there were no systemic signs of VKH... FA and indocyanine-green angiography did not reveal any underlying choroidal masses but showed multi-focal areas of leakages with exudation as seen in Case 2... ERDs are common and may be seen in ocular as well as systemic conditions... Similarly, direct damage to the ion channels (RPE pump) on the surfaces of the RPE cells in conditions like malignant hypertension and pre-eclampsia also leads to accumulation of sub-retinal fluid and exudative detachment... While most cases of exudative detachments secondary to a systemic illness improve with treatment of the underlying disease with high-dose systemic steroids and immuno-suppressants, primary ocular pathologies like central serous retinopathy (CSR) are worsened by systemic steroids.

No MeSH data available.


Related in: MedlinePlus