The primary goal of management is obliteration of the fistula to prevent further venous hypertension and intracranial hemorrhage.20 Additionally, symptomatic management, particularly medical and surgical control of IOP, is used to reduce the rate of associated complications.14 In the literature, resolution of CCF GSI-IX and its ocular manifestations is almost exclusively achieved with one more interventions.2�C3,14,17�C21 However, Inhibitors,Modulators,Libraries Yong and Heran5 describe a case of post-traumatic carotid and vertebral artery dissection with CCF that resolved without neurosurgical intervention. They do not describe any ophthalmologic findings or sequelae. In contrast, our patient had venous stasis with ophthalmic signs that waned over time, resolving without neurosurgical or vascular intervention.
The patient��s only lingering sequela was minimal pupillary dilation, Inhibitors,Modulators,Libraries and she retained 20/20 visual acuity in both eyes, though her vascular abnormalities persisted at last follow-up. Intervention is not without risk, and in cases similar to ours, in which the potential complications associated with intervention are great, the knowledge that spontaneous and thorough resolution is possible, Inhibitors,Modulators,Libraries if rare, may help guide clinicians in making the decisions for patient management. Physicians may choose to monitor patients that are stable and experiencing few and non-life-threatening symptoms.
Acute retinal necrosis (ARN) is a potentially blinding condition, predominantly caused by varicella zoster (VZV), herpes simplex virus type 1 and 2 (HSV), and, infrequently, by cytomegalovirus (CMV).
1 Clinical diagnosis is based on criteria published by the Inhibitors,Modulators,Libraries American Uveitis Society, independent of causative agent or patient immune status.2 ARN causes devastation, due not only to the fulminant vaso-occlusive retinitis but also to the high incidence of tractional and nectrotic retinal tears leading to retinal detachment. Despite advancements in surgical, laser, Inhibitors,Modulators,Libraries and antiviral therapy, the visual prognosis of ARN is poor, with a retinal detachment rate of up to 80%.3�C4 The majority of cases of ARN, particularly HSV related, are caused by reactivation of a previous Anacetrapib infection in immunocompetent or compromised individuals.5 In particular, ARN caused by HSV most often occurs in association with, or many years after, HSV encephalitis, meningitis, or following neurosurgery or trauma.6 We describe a case of an immunocompetent man with a history of neonatal herpes simplex virus exposure with HSV-2 ARN, the course of which was complicated by subconjunctival steroid injection. Case Report A previously well 30-year-old white man presented to the Ophthalmology Clinic at the Royal Brisbane and Women��s Hospital with a red, painful left eye and decreased visual acuity of 10 days�� duration.
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