Rare cause of floaters: A motile live worm in vitreous cavity.
Ontology highlight
ABSTRACT:
SUBMITTER: Rajan RP
PROVIDER: S-EPMC6727692 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Publications
Rare cause of floaters: A motile live worm in vitreous cavity.
Rajan Renu P RP Jena Soumya S Ramachandran N Obuli NO Kohli Piyush P
Indian journal of ophthalmology 20190901 9
Ocular filariasis commonly presents as subconjunctival or eyelid nodules. We report a rare case of a live, motile worm causing floaters. The worm was isolated from the vitreous cavity and revealed to be Dirofilaria repens. Correct recognition of the worm is necessary as human dirofilariasis does not present as microfilaremia and does not require systemic therapy; in contrast to other causes of ocular filariasis, which require systemic therapy. As ophthalmologist may be the first physician to enc ...[more]
Similar Datasets
Project description:Background/objectivesTo evaluate the efficacy and safety of pars plana vitrectomy for symptomatic floaters.Subjects/methodsForty-eight vitreoretinal surgeons from 16 countries provided information on 581 eyes who underwent vitrectomy for floaters in this retrospective survey study conducted by European VitreoRetinal Society. Percentage symptomatic improvement, incidence of retinal tears/detachment and post-vitrectomy cataract surgery, and the factors associated with satisfaction and complications were investigated.ResultsNinety-two percent were satisfied with the results, with 86.3% reporting complete resolution of daily-life symptoms. Overall satisfaction was lower in patients with smaller vitreous opacities at presentation (OR:0.4). Iatrogenic retinal breaks occurred in 29 eyes (5%). Core vitrectomy and cut rates of 1500-4000 or >4000 cuts/min were associated with lower risk of retinal breaks than complete vitrectomy (OR:0.05) and cut rates < 1500 cuts/min (OR: 0.03, 0.12, respectively). Fourteen eyes (2.4%) developed retinal detachment at a median of 3 months; and 84 (48.6%) developed cataract at a median of 16 months post-vitrectomy.ConclusionsPars plana vitrectomy resulted in high patient satisfaction with relatively low rate of severe complications in a large group of patients. The procedure may be safer when core vitrectomy and cut rates > 1500 cuts/min are favoured. Proper patient selection and informed consent are the most important aspects of surgery.
| S-EPMC7182575 | biostudies-literature
Project description:BackgroundThe vitreous is the clear jelly of the eye and contains fine strands of proteins. Throughout life the composition of this vitreous changes, which causes the protein strands in it to bundle together and scatter light before it reaches the retina. Individuals perceive the shadows cast by these protein bundles as 'floaters'. Some people are so bothered by floaters that treatment is required to control their symptoms. Two major interventions for floaters include Nd:YAG laser vitreolysis and vitrectomy. Nd:YAG laser vitreolysis involves using laser energy to fragment the vitreous opacities via a non-invasive approach. Vitrectomy involves the surgical replacement of the patient's vitreous (including the symptomatic vitreous floaters) with an inert and translucent balanced salt solution, through small openings in the pars plana.ObjectivesTo compare the effectiveness and safety of Nd:YAG laser vitreolysis to pars plana vitrectomy for symptomatic vitreous floaters.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 17 January 2017), Embase Ovid (1947 to 17 January 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 17 January 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 17 January 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 17 January 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 17 January 2017. We did not use any date or language restrictions in the electronic searches for trials. We also searched conference proceedings to identify additional studies.Selection criteriaWe included only randomised controlled trials (RCTs) that compared Nd:YAG laser vitreolysis to pars plana vitrectomy for treatment of symptomatic floaters.Data collection and analysisWe planned to use methods recommended by Cochrane. The primary outcome we planned to measure was change in vision-related quality of life from baseline to 12 months, as determined by a vision-related quality of life questionnaire. The secondary outcomes we planned to measure were best corrected logMAR or Snellen visual acuity at 12 months for the treated eye(s) and costs. Adverse outcomes we planned to record were the occurrence of sight-threatening complications by 12 months (asymptomatic retinal tears, symptomatic retinal tears, retinal detachment, cataract formation, and endophthalmitis).Main resultsNo studies met the inclusion criteria of this review.Authors' conclusionsThere are currently no RCTs that compare Nd:YAG laser vitreolysis with pars plana vitrectomy for the treatment of symptomatic floaters. Properly designed RCTs are needed to evaluate the treatment outcomes from the interventions described. We recommend future studies randomise participants to either a Nd:YAG laser vitreolysis group or a vitrectomy group, with participants in each group assigned to either receive treatment or a sham intervention. Future studies should follow participants at six months and 12 months after the intervention. Also they should use best corrected visual acuity (BCVA) using an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart read at 4 metres, vision-related quality of life (VRQOL), and adverse outcomes as the outcome measures of the trial.
| S-EPMC6481890 | biostudies-literature
Project description:PurposeTo report the surgical outcomes of 27-gauge pars plana vitrectomy (PPV) for symptomatic vitreous floaters.Methods47 eyes of 47 patients (39 males, 83.0%) with symptomatic vitreous floaters who underwent 27-gauge PPV and followed up for more than 6 months were included. The mean age was 34.7 ± 13.5 years.ResultsNo operative complication occurred. At first day postoperatively, the intraocular pressure (IOP) was significantly lower than that at other time points (8.6 ± 2.7 mmHg, p < 0.001). 28 (59.6%) eyes had transient hypotony (IOP < 8 mmHg). All were recovered within 1 week postoperatively. The BCVA of 41 eyes (41/47, 87.2%) remained unchanged or improved. Postoperative complications occurred in two eyes: one (2.1%) had endophthalmitis and one (2.1%) had retinal detachment. No clinical significant cataract was observed in the 42 postoperative phakic eyes. 91.5% of the patients were satisfied with the surgery outcome. Besides, 91.3% of the patients felt that the floaters were removed completely or only had an acceptable residual.ConclusionVisual acuity of most patients remained unchanged or improved following 27-gague pars plana vitrectomy for symptomatic vitreous floaters, resulting in high patient satisfaction. However, this treatment should be performed with great caution since severe postoperative complications may still occur. This trial is registered with NCT03049163.
| S-EPMC5727722 | biostudies-literature
Project description:ImportanceVitreous floaters are common and can worsen visual quality. YAG vitreolysis is an untested treatment for floaters.ObjectiveTo evaluate YAG laser vitreolysis vs sham vitreolysis for symptomatic Weiss ring floaters from posterior vitreous detachment.Design, setting, and participantsThis single-center, masked, sham-controlled randomized clinical trial was performed from March 25, 2015, to August 3, 2016, in 52 eyes of 52 patients (36 cases and 16 controls) treated at a private ophthalmology practice.InterventionsPatients were randomly assigned to YAG laser vitreolysis or sham YAG (control).Main outcomes and measuresPrimary 6-month outcomes were subjective change measured from 0% to 100% using a 10-point visual disturbance score, a 5-level qualitative scale, and National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes included objective change assessed by masked grading of color fundus photography and Early Treatment Diabetic Retinopathy Study best-corrected visual acuity.ResultsFifty-two patients (52 eyes; 17 men and 35 women; 51 white and 1 Asian) with symptomatic Weiss rings were enrolled in the study (mean [SD] age, 61.4 [8.0] years for the YAG laser group and 61.1 [6.6] years for the sham group). The YAG laser group reported greater symptomatic improvement (54%) than controls (9%) (difference, 45%; 95% CI, 25%-64%; P < .001). In the YAG laser group, the 10-point visual disturbance score improved by 3.2 vs 0.1 in the sham group (difference, -3.0; 95% CI, -4.3 to -1.7; P < .001). A total of 19 patients (53%) in the YAG laser group reported significantly or completely improved symptoms vs 0 individuals in the sham group (difference, 53%; 95% CI, 36%-69%, P < .001). Compared with sham, NEI VFQ-25 revealed improved general vision (difference, 16.3; 95% CI, 0.9-31.7; P = .04), peripheral vision (difference, 11.6; 95% CI, 0.8-22.4; P = .04), role difficulties (difference, 17.3; 95% CI, 8.0-26.6; P < .001), and dependency (difference, 5.6; 95% CI, 0.5-10.8; P = .03) among the YAG laser group. Best-corrected visual acuity changed by -0.2 letters in the YAG laser group and by -0.6 letters in sham group (difference, 0.4; 95% CI, -6.5 to 5.3; P = .94). No differences in adverse events between groups were identified.Conclusions and relevanceYAG laser vitreolysis subjectively improved Weiss ring-related symptoms and objectively improved Weiss ring appearance. Greater confidence in these outcomes may result from larger confirmatory studies of longer duration.Trial registrationclinicaltrials.gov NCT02897583.
| S-EPMC5710539 | biostudies-literature
Project description:A 46-year-old male presented with best corrected visual acuity (BCVA) of 20/125 in his right eye. Fundus showed disc edema, multiple yellow outer retinal crops, macular edema and a live motile worm in the subretinal space. Diagnosis of diffuse unilateral subacute neuroretinitis (DUSN) was made and pattern scanning laser photocoagulation (PSLP) was performed along with administration of oral albendazole, diethylcarbamazine and corticosteroids. Complete disappearance of the worm was observed at 2 weeks. At last follow up, final BCVA improved to 20/30. Herein, we report role of PSLP in the management of DUSN.
| S-EPMC6727712 | biostudies-literature
Project description:IntroductionTo evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and non-PVD.MethodsIn this prospective cohort study, 51 eyes with symptomatic floaters were treated with YAG laser vitreolysis. Participants were divided into complete PVD and non-PVD groups. Objective visual quality measures including the Strehl ratio (SR), internal spherical aberration (SA), internal comatic aberration (CA), internal high-order aberration (HOA), area ratio of modulation transfer function (MTFa) and Vitreous Floaters Symptom Questionnaire (VFSQ-13) scores were used to compare the efficacy of YAG laser vitreolysis treatment between two groups.ResultsThe mean age of all patients was 56.80 ± 10.82 years old. In total, 36 of 51 (70.59%; 95% CI 58.10-83.10) patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment. Post-treatment MTFa, internal SA and internal HOA were significantly better compared to baseline (26.19 ± 14.73 vs. 29.19 ± 17.98, p = 0.013; 0.05 ± 0.05 vs. 0.04 ± 0.04, p = 0.031 and 0.23 ± 0.22 vs. 0.16 ± 0.07, p = 0.044; respectively) in all eyes. Twenty-nine of 51 (56.86%) eyes had floaters of non-PVD type. Significant or complete subjective improvements in the PVD group and non-PVD group were 72.73% and 68.97% (p = 0.344), respectively.ConclusionsImproved subjective and objective visual quality in participants with symptomatic floaters following YAG laser vitreolysis was found in both groups. The efficacy of YAG laser vitreolysis was comparable in floaters of complete PVD and non-PVD types.
| S-EPMC8770727 | biostudies-literature
Project description:PurposeTo describe the appearance of vitreous opacities using dynamic ultra-widefield infrared confocal scanning laser ophthalmoscopy (IRcSLO).DesignRetrospective case series.MethodsEyes of patients complaining of myodesopsia were analyzed using dynamic ultra-widefield IRcSLO imaging (Nidek Mirante, Nidek Co., Ltd., Gamagori, Japan), and classified according to a vitreous opacity severity scale.ResultsThirty eyes of 21 patients were included in this study. The average age was 56 years. Symptom duration ranged from 1 to more than 365 days. The most common cause of vitreous floaters was posterior vitreous detachment (63.3%), followed by vitreous syneresis (23.3%), asteroid hyalosis (10%) and vitreous hemorrhage (3.3%). Opacities were classified as Grade 1 in three eyes (10%), Grade 2 in 10 eyes (33.3%), Grade 3 in 11 eyes (36.6%), Grade 4 in two eyes (6.6%) and Grade 5 in four eyes (13.3%). Patients with Grade 1 opacities were younger than patients with opacities Grade 2 or greater. A visible Weiss ring could be identified in 0% of eyes with Grade 1 opacities, 40% of eyes with Grade 2 opacities, 100% of eyes with Grade 3 opacities, and 100% of eyes with Grade 4 opacities. In patients with Grade 5 opacities, a Weiss ring could not be identified.ConclusionDynamic ultra-widefield IRcSLO imaging is a useful tool to evaluate patients with vitreous floaters. It allows for accurate visualization of the number, density, and behavior of the shadows that vitreous opacities project over a very wide area of the retina, which has a positive correlation with patient perception of floaters.
| S-EPMC9571201 | biostudies-literature
Project description:To describe the eyes with vitreous floaters and to analyze the development of acute symptomatic posterior vitreous detachment (PVD). A retrospective review of medical records was performed on patients with the vitreous floater developed for the first time of their life. Peripapillary vitreous opacity (pVO) was searched in Ultra-wide field (UWF) scanning laser ophthalmoscopy and PVD stage was assessed through spectral-domain optical coherence tomography (SD-OCT). 196 patients (55 males and 141 females), who were 58.4 (± 9.1) years old, visited a retinal clinic 9.4 (± 9.1) days after they experienced vitreous floaters. In 196 eyes, pVO was noticed in 122 eyes (62.2%) at UWF. In 106 eyes where SD-OCT data were available, PVD was noticed in 100 eyes (94.3%). Symptomatic eyes showed more advanced stage of PVD (p < 0.001) than symptom free eyes. Eyes with floaters were more myopic (- 0.7 ± 2.2D vs - 0.5 ± 1.9D, p = 0.02), and had lower intraocular pressure (IOP) (14.7 ± 3.2 mmHg vs 15.2 ± 3.0 mmHg, p = 0.02) than the other symptom free eyes. In patients with first floater symptoms, PVD was in progress in most of the eyes not only the symptomatic eyes but also on the contralateral symptom free eyes. Eyes with vitreous floaters were more myopic and had lower IOP than the opposite symptom free eyes.
| S-EPMC8076170 | biostudies-literature
Project description:BackgroundTo compare the safety and efficacy of topical anesthesia versus retrobulbar anesthesia in 27-gauge pars plana vitrectomy (PPV) for vitreous floaters.Methods30 patients with vitreous floaters were randomized into Group T (topical anesthesia, proparacaine eye drop) and Group R (retrobulbar anesthesia), and underwent 27-gauge PPV. A 5-point visual analogue pain scale (VAPS) was used to assess patients' pain experience of anesthesia and surgery procedure (during surgery, 2 h and 1 day after surgery).ResultsThe VAPS of anesthesia procedure was 1.27 ± 0.59 for patients in Group R, while it was all 0 for patients in Group T (p < 0.001). There was no significant difference for VAPS during surgery (Group T: 1.13 ± 0.74, Group R: 0.67 ± 0.62, p = 0.67), 2 h (Group T: 0.80 ± 1.01, Group R: 0.67 ± 0.62, p = 0.67) and 1 day (Group T: 0.20 ± 0.41, Group R: 0.27 ± 0.46, p = 0.68) after surgery between these two groups. Only one patient (6.7%) in Group T required additional topical anesthesia during the surgery. Most of the patients reported the pain experience came from initial trocar insertion in both groups. None of the patients required post operative analgesia in both groups. No intraoperative or postoperative complications were noted in both groups.ConclusionThis study suggested that topical anesthesia is a safe and effective anesthetic approach for patients with floaters who underwent 27-gauge PPV.Trial registrationClinicalTrials.gov NCT03049163 . Registered 8 February 2017.
| S-EPMC6035792 | biostudies-literature
Project description:BackgroundVitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters.MethodsThe present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health.DiscussionThis clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis.Trial registrationClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
| S-EPMC10787457 | biostudies-literature