Publications by authors named "Fernando A Arevalo"

8 Publications

  • Page 1 of 1

Unilateral Ischemic Maculopathy Associated with Cytomegalovirus Retinitis in Patients with AIDS: Optical Coherence Tomography Findings.

J Ophthalmic Vis Res 2015 Oct-Dec;10(4):487-90

Department of Retina and Vitreous, Ophthalmology Clinic Oftalmolaser, Lima, Peru.

To describe the clinical and optical coherence tomography (OCT) characteristics of ischemic maculopathy in two patients with acquired immunodeficiency syndrome (AIDS). Two patients with AIDS and cytomegalovirus (CMV) retinitis developed ischemic maculopathy. Both patients presented with central visual loss and active granular CMV retinitis. The presence of opacification of the superficial retina in the macular area and intraretinal edema suggested the diagnosis. Fluorescein angiography changes were similar in the two cases with enlargement of the foveal avascular zone and late staining of juxtafoveal vessels. OCT changes were suggestive of retinal ischemia: Increased reflectivity from the inner retinal layer and decreased backscattering from the retinal photoreceptors due to fluid and retinal edema. Ischemic maculopathy may cause a severe and permanent decrease in vision in AIDS patients. Fluorescein angiography and OCT should be considered in any patient with AIDS and unexplained visual loss. The mechanism of ischemic maculopathy may be multifactorial.
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http://dx.doi.org/10.4103/2008-322X.176903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795401PMC
April 2016

Pneumatic displacement with perfluoropropane gas and intravitreal tissue plasminogen activator for subretinal subfoveal hemorrhage after focal laser photocoagulation in central serous chorioretinopathy.

Case Rep Ophthalmol Med 2014 17;2014:592746. Epub 2014 Nov 17.

King Khaled Eye Specialist Hospital, Al-Oruba Street, P.O. Box 7191, Riyadh 11462, Saudi Arabia ; The Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 1300 Thames Street, Baltimore, MD 21231, USA.

Objective. To report the visual and anatomic outcomes of pneumatic displacement with perfluoropropane (C3F8) gas and intravitreal tissue plasminogen activator (IVTPA) for subretinal subfoveal hemorrhage after focal laser photocoagulation in central serous chorioretinopathy (CSCR). Method. Interventional, retrospective case report of one eye (one patient). Outcome measures included visual acuity (VA), central macular thickness (CMT), and size of the lesion at two weeks of followup. Fluorescein angiography (FA) and optical coherent tomography (OCT) were used to measure anatomic outcomes. Results. A 35-year-old man with history of chronic CSCR received focal laser photocoagulation in the right eye two days before presentation. At initial examination, VA was 20/200 (ETDRS chart), CMT was 398 μ, and a subretinal subfoveal hemorrhage was seen. Tissue plasminogen activator (tPA) at a dose of 25 µg/0.1 mL was injected intravitreally before intravitreal C3F8 injection, and prone positioning was indicated postoperatively. At 24 hours, the hemorrhage had been displaced inferiorly and VA improved to 20/100. Two weeks later, VA improved to 20/80, CMT decreased to 225 μ, and the hemorrhage decreased without foveal involvement. Conclusions. The technique seems safe and effective in treating visually significant subretinal subfoveal hemorrhage.
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http://dx.doi.org/10.1155/2014/592746DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251634PMC
December 2014

Disseminated histoplasmic multifocal choroiditis in AIDS.

Ophthalmic Surg Lasers Imaging Retina 2014 Mar-Apr;45(2):179-80. Epub 2014 Feb 7.

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http://dx.doi.org/10.3928/23258160-20140131-02DOI Listing
September 2014

Clinical applications of optical coherence tomography in the posterior pole: the 2011 José Manuel Espino Lecture - Part II.

Clin Ophthalmol 2013 8;7:2181-206. Epub 2013 Nov 8.

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

Optical coherence tomography (OCT) is a high-resolution, cross-sectional imaging technique that allows detailed assessment of retinal thickness and morphologic evaluation of the retinal layers. This technology has developed quickly over the past two decades. OCT imaging has rapidly been integrated into routine ophthalmic clinical practice and trials. It has complemented fluorescein angiography in many instances, especially in the diagnosis and management of retinal disorders, including diabetic macular edema and age-related macular degeneration. With OCT, the exact localization of pathologic features can be visualized in segmentation maps of the retina, and this has allowed OCT to be used to evaluate specific features that may serve as predictive factors in the prognosis and follow up of these pathologies. Therefore, it has become an important clinical and research tool for the diagnosis, follow up, treatment, and assessment of new treatment modalities for all diseases that affect the posterior pole of the eye.
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http://dx.doi.org/10.2147/OPTH.S51158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825852PMC
June 2014

Clinical applications of optical coherence tomography in the posterior pole: the 2011 José Manuel Espino Lecture - Part I.

Clin Ophthalmol 2013 8;7:2165-79. Epub 2013 Nov 8.

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

Optical coherence tomography (OCT) is now a standard of care in ophthalmology and is considered essential for the diagnosis and monitoring of many retinal diseases. One of the major advances obtained with OCT was the understanding of the pathophysiology of macular holes. Non-full-thickness macular holes have been revisited because high-resolution OCT images can detect a lamellar macular defect that is not always visible clinically, and surgery has been advocated by some authors. OCT can be valuable in determining the need for and/or timing of surgical intervention on epiretinal membranes or vitreomacular traction syndrome. In addition, we can use this technology as a predictive factor in the prognosis and follow-up of the most common posterior pole pathologies.
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http://dx.doi.org/10.2147/OPTH.S51098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825704PMC
June 2014

Diffuse unilateral subacute neuroretinitis.

J Pediatr Ophthalmol Strabismus 2013 Jul-Aug;50(4):204-12. Epub 2012 Dec 18.

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Diffuse unilateral subacute neuroretinitis (DUSN) is a usually unilateral inflammatory disease characterized by an insidious, usually severe loss of peripheral and central vision. Clinical characteristics are manifested in early and late stages. Parasites of different sizes and several species of nematodes have been reported as the etiology of DUSN without conclusive evidence about the specific agent. Because serologic testing has been variable, the definitive diagnosis is made when the clinical characteristics of DUSN are found in conjunction with an intraocular worm. Laser photocoagulation, pars plana vitrectomy, thiabendazole, and albendazole have been used to treat DUSN with variable success.
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http://dx.doi.org/10.3928/01913913-20121211-03DOI Listing
March 2014

Ocular toxocariasis.

J Pediatr Ophthalmol Strabismus 2013 Mar-Apr;50(2):76-86. Epub 2012 Aug 28.

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Ocular toxocariasis is an uncommon worldwide parasitic infection that affects mostly children and is found in both rural and metropolitan areas. In many parts of the world, parasitic infections of the eye are a major cause of blindness. The diagnosis of toxocariasis is essentially clinical, based on the lesion morphology and supportive laboratory data such as serum enzyme-linked immunosorbent assay (ELISA) titers and ELISA Toxocara titers on aqueous humor; other diagnostic methods are imaging studies including optical coherence tomography, fluorescein angiography, computed tomography, and ocular ultrasound. Treatment is directed at complications arising from intraocular inflammation and vitreous membrane traction. Early vitrectomy may be of value both diagnostically and therapeutically.
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http://dx.doi.org/10.3928/01913913-20120821-01DOI Listing
December 2013