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Other Asphyxial Deaths
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Bilateral eyes were congested, and subconjunctival hemorrhage was present over the right eye. Bluish discoloration of fingernail beds and palms (Figure 6.30) was noted. Bluish discoloration of lips with laceration and multiple reddish blue contusions were present over inner aspect of both upper and lower lips (Figure 6.31).
Survived Neck Compression
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Stefan Pollak, Annette Thierauf-Emberger
Blood extravasations due to congestion provide important diagnostic clues not only in cases of fatal strangulation, but also in survived assaults to the neck. It has to be emphasized, however, that this finding is not a specific sign of asphyxia. Petechial haemorrhages in the conjunctivae have been repeatedly reported in physiological processes involving a pressing effect (labour, fits of coughing, massive vomiting) [10]. In surviving strangulation victims, the presence of petechial bleedings depends on several factors, i.e. duration, intensity and kind of neck compression as well as the relative strength of the persons involved. Isolated petechiae in the eyelids and conjunctivae may escape detection after only a relatively short period of time. On the other hand, there are examples in which it took several weeks until a confluent subconjunctival haemorrhage (hyposphagma) disappeared completely.
The Red Eye: Basic Algorithm on How to Differentiate Main Conditions from Each Other
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
This is the commonest and least useful presentation of any ophthalmic condition. It can range from the trivial to the potentially blinding and even life-threatening. As such patients may present with a red eye for different reasons and at different time periods depending on a thousand factors ranging from a worry at how they look to a deep seated fear of going blind, with factors such as work, booked holidays or childcare arrangements resulting in great variations as to when a patient with the same condition may present to your department. There may be associated pain, tenderness, photophobia or foreign body sensation – depending on the cause. A red eye might be associated with blurred vision or indeed there may be no visual disability whatsoever. There may be no true emergency, but the eye may just look alarming to friends and family, such as classically with a subconjunctival haemorrhage. Either way, a patient has presented to you with a red eye but you should, through triage, see the true emergencies first: penetrating trauma, acute angle closure glaucoma (AACG) or endophthalmitis for example. Triage is fundamental here more than anywhere.
Medical Therapy of Uveitic Macular Edema: Biologic Agents
Published in Ocular Immunology and Inflammation, 2020
Aleksandra Radosavljevic, Mamta Agarwal, Bahram Bodaghi, Justine R. Smith, Manfred Zierhut
In a large randomized controlled clinical trial, Staurenghi et al. analyzed the efficacy and safety of ranibizumab versus placebo, for the treatment of macular edema of diverse causes. The study included 178 patients (118 in the ranibizumab arm and 60 in the placebo arm) and out of them, 21 had inflammatory/post-uveitis conditions (14 in the ranibizumab arm and 7 in the placebo arm). After 2 months of treatment, since more improvement in visual acuity and macular thickness was observed in the ranibizumab arm for all patient groups (no p-values provided), all patients started receiving ranibizumab open-label, according to disease activity. After a 12-month follow-up, in the treatment subgroup of 14 patients with post-uveitis conditions who received on average of 7.1 injections of ranibizumab, the authors report an improvement of 5.9 letters in EDTRS chart and a 94 μm reduction in central subfield thickness (no p-values provided).25 The most common ocular adverse effects were subconjunctival hemorrhage (10.2%), reduction in vision (7.9%) and eye pain (6.8%).
Current and emerging fixed combination therapies in glaucoma: a safety and tolerability review
Published in Expert Opinion on Drug Safety, 2020
Anastasios G. Konstas, Leopold Schmetterer, Vital P. Costa, Gábor Holló, Andreas Katsanos, Philippe Denis, Luciano Quaranta, Murat Irkec, Miguel A. Castejón, Miguel A. Teus, Alan L. Robin
Other common ocular adverse events were: instillation site pain (20%), corneal verticillata (15%), and conjunctival hemorrhage (11%). Instillation site discomfort, blurred, or reduced vision, eye pruritus, and increased watering were reported in 5–8% of patients. Corneal verticillata was not found to cause any visual functional change. Only 1% of patients discontinued the treatment due to corneal verticillata [115,116]. Although subconjunctival hemorrhage occurred in 11% of patients, it was graded as mild in all but one NLFC-treated patient, but no patient discontinued the treatment due to this adverse event [116]. Finally, the safety profile of NLFC over 12 months was consistent with that observed during the first 3 months of therapy [112,113]. In a pooled safety analysis of MERCURY-1 and MERCURY-2, the results were compatible with those of the individual studies, with negligible treatment-related serious, or systemic adverse events and common but relatively mild ocular adverse events [116].
The Efficacy of Posterior Subtenon Triamcinolone Acetonide Injection in Treatment of Irvine-Gass Syndrome
Published in Ocular Immunology and Inflammation, 2019
Burak Erden, Akın Çakır, Ali Cihat Aslan, Selim Bölükbaşı, Mustafa Nuri Elçioğlu
Twenty-one patients (11 females, 10 males) were enrolled in this retrospective study (single eye treated) based on our inclusion/exclusion criteria. The mean age of our patients was 76 ± 8.2 years. All cases had a history of uneventful phacoemulsification cataract extraction and into-the-bag posterior intraocular lens implantation. Eleven of the patients were operated at our ophthalmology department. All cataract surgeries of these 11 patients were performed by a single surgeon (BE) using a consistent phacoemulsification technique with a temporal 2.8 mm sutureless clear-cornea incision and two side-ports followed by into-the bag implantation of foldable hydrophobic intraocular lenses. According to our cataract patients’ medical records (11 cases; 4.8 months) or the personal history of the second group (10 cases; 13.7 months), the mean interval between the cataract surgery and diagnosis of Irvine-Gass syndrome at our retina department was 10.02 ± 5.6 (range: 2–18 months). Fifteen of the 21 (71%) patients had systemic hypertension; 8 of these 15 (53%) had cardiovascular diseases of different degrees. A self-limiting and transient subconjunctival hemorrhage at the incision site was observed in 8 of 21 patients (38%) at the postoperative day 1 visit. No further ocular or systemic complications were encountered in the study period.