Search

We reported the observation of a 31-year-old female followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 75 Gray. The patient presented with a progressive decline in bilateral vision. Ophthalmologic examination revealed bilateral dry eye, posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The patient presented all ocular complications of radiotherapy. The most severe was radiation retinopathy. Performing optic coherence tomography angiography (OCT-A) earlier could have speeded up the diagnosis and led to a better prognosis. The OCT-A showed more pronounced macular edema in the right eye, and revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor. Yet, we noted a non-improved visual acuity. The aim of this case report was to present the contribution of OCT-A in the diagnosis of radiation maculopathy and attribute these changes to ischemia at the level of the retinal vascular network.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the revealing manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.

L'occlusion de la veine centrale de la rétine (OVCR) du sujet jeune est une entité clinique différente de celle du sujet âgé. Elle est moins associée aux facteurs de risque cardiovasculaires et l'étiologie spécifique reste souvent inconnue. L'hyperhomocystéinémie est connue pour être un facteur de risque rare Nous rapportons le cas d'un patient âgé de 25 ans ayant une baisse brutale et indolore de l'acuité visuelle de l'oeil gauche. L'examen ophtalmologique a retrouvé une acuité visuelle à 10/10e, P2 à droite et à compte les doigts à 1m à gauche non améliorable. L'examen des segments antérieurs était normal aux deux yeux. Le fond d'oeil gauche retrouvait un oedème papillo-rétinien; des veines dilatées et tortueuses; et des hémorragies superficielles en flammèche et profondes en nappe. L'angiographie rétinienne à la fluorescéine confirma le diagnostic d'une (OVCR) gauche, forme mixte à prédominance oedémateuse. La tomographie en cohérence optique (OCT) montre un oedème maculaire cystoïde (OMC) responsable de l'acuité visuelle effondrée. Un bilan étiologique demandé (bilan lipidique complet, bilan inflammatoire, bilan immunologique, bilan de thrombophilie) était normal. Par ailleurs, le taux plasmatique de l'homocystéine était élevé à 19,2 ,mol/L. Un traitement à base de vitaminothérapie a été commencé. L'évolution était marquée par une amélioration de l'acuité visuelle à 2/10, P8 avec régression partielle de l'OMC.

Le lymphangiome orbitaire est une tumeur bénigne à développement progressif, qui se présente sous forme de vaisseaux à parois fines et à lumières dilatées complètement isolées de la circulation artérioveineuse. Le lymphangiome peut se localiser au niveau de la conjonctive, des paupières ou de l'orbite. A ce propos, nous rapportons un cas de lymphangiome orbitaire envahissant le globe oculaire et dont la présentation initiale mimait celle d'un rétinoblastome. Patiente âgée de 19 ans, se plaignant d'une exophtalmie droite et d'une baisse de la vision de l'éil droit évoluant depuis 4 ans. L'examen des annexes objectivait une exophtalmie majeure compliquée d'une ankylose du globe oculaire droit. La photographie du fond d'éil droit montrait la présence d'une masse rétinienne blanchâtre, associée à un essaimage vitréen fait de formations floconneuses. L'échographie oculaire en mode brillance montrait un épaississement hyperéchogène de la rétine. L'IRM orbito-cérébrale montrait une lésion kystique intra orbitaire en rapport avec un lymphangiome. Devant l'évolution longue de la maladie et l'aspect de la masse à l'imagerie, le diagnostic de rétinoblastome a été écarté. La patiente a subit une énucléation et une tumorectomie. L'étude histopathologique de la pièce opératoire a révélé un lymphangiome.

La neuropathie optique regroupe l'ensemble des lésions du nerf optique. Le diagnostic est habituellement clinique: diminution de l'acuité visuelle, altération de la vision des couleurs, déficit du champ visuel. Les étiologies sont multiples, l'origine compressive est rarement rapportée. La souffrance du nerf optique peut être dû dans ce cas soit à l'augmentation de la pression du liquide céphalo rachidien, soit à une compression par un processus intraorbitaire, intracanalaire ou intracrânien. Nous rapportons un cas rare de neuropathie optique d'origine compressive. Il s'agit d'un patient âgé de 43 ans ayant consulté pour une baisse de vision de l'èil droit. L'examen a retrouvé une acuité visuelle limitée à 50 cm, un èdème palpébral sans exophtalmie, un réflexe photomoteur afférent altéré et un èdème papillaire au fond d'èil. L'IRM orbitaire a mis en évidence des lésions en faveur de pseudotumeur inflammatoire engainant le nerf optique avec extension au niveau des fissures orbitaires. Le patient a été mis sous corticothérapie par voie générale avec bonne évolution.

Au cours des maladies inflammatoires chroniques de l'intestin (MICI), la fréquence de l'infection par le cytomégalovirus (CMV) est rare, variant entre 0,53% et 3,4%. Il s'agit le plus souvent d'une réactivation virale, plutôt que d'une primo-infection. La rétinite à CMV au cours d'une rectocolite hémorragique (RCH)est déjà rapportée, mais les liens de causalité ne sont pas clairement établis. Les capacités immuno-modulatrices du CMV et l'immunosuppression nécessaire au traitement de la maladie pourraient entretenir la réplication virale. Nous rapportons l'observation d'un patient âgé de 56 ans suivi pour RCH résistante, il était traité par azathioprine, quelques mois plus tard il se plaignait d'une asthénie avec une baisse de l'acuité visuelle, elle était évaluée de loin à 7/1O pour l'éil droit et 4/10 pour l'éil gauche. Le fond d'éil montrait la présence d'hémorragies et de nodules cotonneux à droite et un foyer de rétinite nasal actif, extensif à gauche. L'Angiographie à la fluorescéine objectivait une hypofluorescence rétinienne en faveur d'un foyer de rétinite profond gauche. Dans ce contexte d'immunodépression et devant l'aspect clinique évocateur, le diagnostic retenu était celui d'une rétinite à CMV dont le développement a probablement été favorisé par l'azathioprine. Le patient était mis sous Ganciclovir avec une évolution favorable.

La granulomatose avec polyangéite (GPA) est une vascularite nécrosante systémique, caractérisée par une inflammation granulomateuse, une nécrose tissulaire et une vascularite touchant les vaisseaux de moyen et, surtout, de petit calibre, elle touche rarement l'enfant.

We reported the observation of a 31-year-old female followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 75 Gray. The patient presented with a progressive decline in bilateral vision. Ophthalmologic examination revealed bilateral dry eye, posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The patient presented all ocular complications of radiotherapy. The most severe was radiation retinopathy. Performing optic coherence tomography angiography (OCT-A) earlier could have speeded up the diagnosis and led to a better prognosis. The OCT-A showed more pronounced macular edema in the right eye, and revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor. Yet, we noted a non-improved visual acuity. The aim of this case report was to present the contribution of OCT-A in the diagnosis of radiation maculopathy and attribute these changes to ischemia at the level of the retinal vascular network.

We report the observation of a 31-year-old patient followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 70 Gray. This case presented all ocular complications of radiotherapy; radiation retinopathy (RR), which is the most severe complication, could be diagnosed earlier and have a better prognosis if optic coherence tomography angiography (OCTA) was performed. She presented with a progressive decline in bilateral visual acuity. Ophthalmologic examination revealed bilateral posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The OCT B-scan showed more pronounced macular edema in the right eye. The OCTA revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor (VEGF), without improvement in visual acuity. The aim of this case report is to present the contribution of OCT-A in the diagnosis of radiation maculopathy, and attribute these changes to ischemia at the level of the retinal vascular network.

We report the observation of a 31-year-old patient followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 70 Gray. This case presented all ocular complications of radiotherapy; radiation retinopathy (RR), which is the most severe complication, could be diagnosed earlier and have a better prognosis if optic coherence tomography angiography (OCTA) was performed. She presented with a progressive decline in bilateral visual acuity. Ophthalmologic examination revealed bilateral posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The OCT B-scan showed more pronounced macular edema in the right eye. The OCTA revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor (VEGF), without improvement in visual acuity. The aim of this case report is to present the contribution of OCT-A in the diagnosis of radiation maculopathy, and attribute these changes to ischemia at the level of the retinal vascular network.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the revealing manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the revealing manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the revealing manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by widespread clinical manifestations and immunological disorders. A myriad of ocular manifestations can be seen in patients with SLE. The most vision-threatening complication is vaso-occlusive retinopathy including retinal vein occlusion (RVO). RVO associated with SLE is well described in the literature and its association with antiphospholipid antibodies is recognized. However, RVO as the initial manifestation of SLE is scarcely reported. Herein, we report the first case of recurrent RVO as the primary manifestation of SLE in a 40-year-old male patient. He had two consecutive episodes of decreased vision. Ophthalmologic examination disclosed a branch retinal vein occlusion the first time and a central retinal vein occlusion the second time. The diagnosis of SLE was established based on clinical and immunological criteria. He was prescribed antiplatelet therapy, hydroxychloroquine at 5.5 mg/kg/day, and intravitreal anti-vascular endothelial growth factor (VEGF) antibodies regimen. He slowly improved under treatment.