R. Khoramnia

Cataract in a young patient

ZusammenfassungDie myotone Dystrophie Curschmann-Steinert ist eine genetische Erkrankung mit autosomal-dominantem Erbgang. Patienten leiden in der Regel an einer Myotonie, Muskelatrophie, Muskelschwäche und Facies myopathica. Zusätzlich können ophthalmologische Symptome auftreten. Insbesondere eine subkapsuläre Linsentrübung und bilaterale Ptosis sind häufig. Daher kann der Augenarzt bei der Diagnosestellung und der Einleitung der weiteren Diagnostik hilfreich sein. Trotz klinisch markanter Befunde wird das Krankheitsbild wegen der Mannigfaltigkeit der Symptome und klinischen Manifestationen oft übersehen.AbstractMyotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.Myotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.

Sehstörungen bei auffälligem Fundusbefund

ZusammenfassungDas choroidale Osteom ist ein meist unilateral auftretender, gutartiger verknöchernder Tumor der Aderhaut. Es ist oft juxtapapillär gelegen und tritt typischerweise bei Frauen im 2.–3.xa0Lebensjahrzehnt ohne Symptome auf. Einige Patienten klagen über verschwommenes Sehen, Metamorphopsien und Gesichtsfelddefekte. Im Ultraschall zeigt sich eine verkalkte choroidale Läsion mit typischem Schallschatten. Sofern der Verdacht auf eine als Komplikation auftretende choroidale Neovaskularisation besteht, sollte diese mittels Fluoreszeinangiographie und optischer Kohärenztomographie ausgeschlossen werden.AbstractThe choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.The choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.

Spontaneous closure of traumatic macular holes. Two cases

ZusammenfassungBezüglich der optimalen Therapie des traumatischen Makulaforamens (TMF) gibt es keine Einigkeit. Wir berichten über den Spontanverschluss von TMF in 2 Fällen. Beim 1. Patienten führte der Verschluss zu einem Visusanstieg von 0,2 auf 0,8. Der 2. Patient zeigte trotz des Verschlusses wenige Tage nach dem Trauma keinen Visusanstieg. Dies ist vermutlich auf eine irreversible Schädigung von Photorezeptoren und retinalem Pigmentepithel zurückzuführen. Wegen der nicht seltenen Möglichkeit eines Spontanverschlusses von TMF hat eine abwartende Haltung bei diesem Krankheitsbild ihre Berechtigung.AbstractThe optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.The optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.

Spontanverschluss traumatischer Makulaforamina

ZusammenfassungBezüglich der optimalen Therapie des traumatischen Makulaforamens (TMF) gibt es keine Einigkeit. Wir berichten über den Spontanverschluss von TMF in 2 Fällen. Beim 1. Patienten führte der Verschluss zu einem Visusanstieg von 0,2 auf 0,8. Der 2. Patient zeigte trotz des Verschlusses wenige Tage nach dem Trauma keinen Visusanstieg. Dies ist vermutlich auf eine irreversible Schädigung von Photorezeptoren und retinalem Pigmentepithel zurückzuführen. Wegen der nicht seltenen Möglichkeit eines Spontanverschlusses von TMF hat eine abwartende Haltung bei diesem Krankheitsbild ihre Berechtigung.AbstractThe optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.The optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.

Nearly an eye-catcher.

In June, 2008, a 15-year-old boy presented to our emergency department with a key penetrating his left orbit (fi gure A, B). He had been playing a game of football while wearing his key on a necklace. When our patient went to head the ball, his key fl ew upwards against gravity, got in the way of the fl ight path of the approaching football, and penetrated his left eye socket. CT showed that the key had lodged deep within the orbit, but fortunately it did not injure the globe (fi gure C). Our patient had surgery to loosen and remove the key (webvideo), which had become lodged in the inferior wall of the orbit (fi gure D). He was also given prophylactic broad-spectrum antibiotics. Our patient recovered well after surgery and had no visual sequelae. He was in violation of Federation Internationale de Football Association (International Federation of Association Football [FIFA]) rules by wearing a necklace with a key during the game.

Linsentrübung bei einem jungen Patienten

ZusammenfassungDie myotone Dystrophie Curschmann-Steinert ist eine genetische Erkrankung mit autosomal-dominantem Erbgang. Patienten leiden in der Regel an einer Myotonie, Muskelatrophie, Muskelschwäche und Facies myopathica. Zusätzlich können ophthalmologische Symptome auftreten. Insbesondere eine subkapsuläre Linsentrübung und bilaterale Ptosis sind häufig. Daher kann der Augenarzt bei der Diagnosestellung und der Einleitung der weiteren Diagnostik hilfreich sein. Trotz klinisch markanter Befunde wird das Krankheitsbild wegen der Mannigfaltigkeit der Symptome und klinischen Manifestationen oft übersehen.AbstractMyotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.Myotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.

Linsentrübung bei einem jungen Patienten@@@Cataract in a young patient

ZusammenfassungDie myotone Dystrophie Curschmann-Steinert ist eine genetische Erkrankung mit autosomal-dominantem Erbgang. Patienten leiden in der Regel an einer Myotonie, Muskelatrophie, Muskelschwäche und Facies myopathica. Zusätzlich können ophthalmologische Symptome auftreten. Insbesondere eine subkapsuläre Linsentrübung und bilaterale Ptosis sind häufig. Daher kann der Augenarzt bei der Diagnosestellung und der Einleitung der weiteren Diagnostik hilfreich sein. Trotz klinisch markanter Befunde wird das Krankheitsbild wegen der Mannigfaltigkeit der Symptome und klinischen Manifestationen oft übersehen.AbstractMyotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.Myotonic dystrophy Curschmann-Steinert is a genetic disease which is inherited in an autosomal dominant pattern. Patients usually suffer from myotonia, muscular atrophy and weakness and myopathic facies. Furthermore, patients often present with ophthalmological symptoms with subcapsular cataract and bilateral ptosis being the most frequent ones. Therefore the ophthalmologist can help to detect patients suspected of having this disease and initiate further investigations. Despite clinically distinct findings, the disease is often overlooked because of the diversity of symptoms and clinical manifestations.

Sehstörungen bei auffälligem Fundusbefund@@@Worsening of vision with apparent changes of the posterior pole

ZusammenfassungDas choroidale Osteom ist ein meist unilateral auftretender, gutartiger verknöchernder Tumor der Aderhaut. Es ist oft juxtapapillär gelegen und tritt typischerweise bei Frauen im 2.–3.xa0Lebensjahrzehnt ohne Symptome auf. Einige Patienten klagen über verschwommenes Sehen, Metamorphopsien und Gesichtsfelddefekte. Im Ultraschall zeigt sich eine verkalkte choroidale Läsion mit typischem Schallschatten. Sofern der Verdacht auf eine als Komplikation auftretende choroidale Neovaskularisation besteht, sollte diese mittels Fluoreszeinangiographie und optischer Kohärenztomographie ausgeschlossen werden.AbstractThe choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.The choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.

Worsening of vision with apparent changes of the posterior pole

ZusammenfassungDas choroidale Osteom ist ein meist unilateral auftretender, gutartiger verknöchernder Tumor der Aderhaut. Es ist oft juxtapapillär gelegen und tritt typischerweise bei Frauen im 2.–3.xa0Lebensjahrzehnt ohne Symptome auf. Einige Patienten klagen über verschwommenes Sehen, Metamorphopsien und Gesichtsfelddefekte. Im Ultraschall zeigt sich eine verkalkte choroidale Läsion mit typischem Schallschatten. Sofern der Verdacht auf eine als Komplikation auftretende choroidale Neovaskularisation besteht, sollte diese mittels Fluoreszeinangiographie und optischer Kohärenztomographie ausgeschlossen werden.AbstractThe choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.The choroidal osteoma is a typically unilateral, benign ossifying tumor of the choroid. It is mostly located in the juxtapapillary area and usually found in females in the second or third decade of life. Most patients are asymptomatic. However, some can present with blurred vision, metamorphopsia, and visual field defects. Ultrasonography can show a calcified choroidal plaque with a typical shadowing posterior to the lesion. Fluorescein angiography and optical coherence tomography should be used if choroidal neovascularization is suspected as a possible complication of the choroidal osteoma.

Spontanverschluss traumatischer Makulaforamina@@@Spontaneous closure of traumatic macular holes: Zwei Fälle@@@Two cases

ZusammenfassungBezüglich der optimalen Therapie des traumatischen Makulaforamens (TMF) gibt es keine Einigkeit. Wir berichten über den Spontanverschluss von TMF in 2 Fällen. Beim 1. Patienten führte der Verschluss zu einem Visusanstieg von 0,2 auf 0,8. Der 2. Patient zeigte trotz des Verschlusses wenige Tage nach dem Trauma keinen Visusanstieg. Dies ist vermutlich auf eine irreversible Schädigung von Photorezeptoren und retinalem Pigmentepithel zurückzuführen. Wegen der nicht seltenen Möglichkeit eines Spontanverschlusses von TMF hat eine abwartende Haltung bei diesem Krankheitsbild ihre Berechtigung.AbstractThe optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.The optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.