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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Progressive multifocal leukoencephalopathy (PML) is a viral illness affecting principally cerebral white matter of patients, who have diminished immunologic resistance. A patient is presented, whose initial complaint was blurred vision. Relentless progression over a period of seven months to left hemianopsia, prosopagnosia, alexia with agraphia and eventually cortical blindness was observed. Accompanying the visual impairment was a steady deterioration of mental function. Sequential computerized axial tomography defined low density lesions in the occipital white matter with sparing of the cortical ribbon. As hemianopsia progressed to cortical blindness, the scans confirmed the evolution of bilaterial occipital lesions. The diagnosis was made clinically and established on histological and cultural grounds. Computerized tomography seems to be valuable in diagnosis and monitoring progress of PML.
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PMID:[Impaired visual perception in progressive multifocal leukoencephalopathy; a clinical diagnosis based on sequential computerized axial tomography (author's transl)]. 62 89

We report here an observation of severe chorio-retinitis in a kidney transplant patient presenting with a primary cytomegalovirus infection. This complication occurred three months after transplantation, following an aggressive treatment for an acute rejection episode (OKT3 associated with methylprednisolone bolus). The clinical manifestation was blurred vision without other evidence of viral infection. A rapid diagnosis of chorio-retinitis was achieved based on ophtalmoscopic findings and biological results. A prolonged treatment with DHPG was effective in halting the very progression involving the left macula and the righ peripheral retina.
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PMID:[Cytomegalovirus chorioretinitis: unusual and severe complications in renal transplantation. Importance of early diagnosis and prolonged treatment with DHPG]. 196 74

The ocular manifestations of viral infection vary greatly. Involvement of the anterior segment is generally mild and self-limited, except in cases of congenital infection which are often associated with significant alteration of ocular structures or in cases of childhood infection with herpes simplex virus or varicella-zoster virus, in which prolonged inflammation may lead to corneal thinning or perforation, glaucoma and cataract formation. Involvement of the posterior structures is potentially sight-threatening. Retinal or optic nerve involvement should be suspected in any patient who complains of acute onset of blurred vision in the absence of anterior segment inflammation or opacities in the ocular media. Fortunately retinal viral infection is rare in immunocompetent hosts. Optic neuropathy may occur as an isolated sign but is more often associated with more generalized involvement of the central nervous system. While specific therapy is not always available, early diagnosis of ocular viral disease should aid in the amelioration of acute symptoms and prevention of long term complications.
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PMID:Ocular viral infections. 608 28

In June 1993, in Taiwan, a woman admitted to a local hospital with cough, fever, chills, and difficult breathing who tested positive for HIV-1 infection was transferred to Taipei Veterans General Hospital. In January 1985, at a provincial hospital, then 46 years old, she underwent an anterior total hysterectomy and bilateral salpingo-oophorectomy during which she received two units of whole blood. One of the blood donors was an AIDS patient who had been treated at the same hospital in 1991 and who had died in 1993. In the interim between hospitalizations, she had two episodes of herpes zoster infection, including oral ulcers diagnosed as herpetic gingivostomatitis, and an episode of oral candidiasis. Physicians at the Taipei Veterans General Hospital diagnosed oral candidiasis, herpes simplex type 1 virus infection forming ulcers on her lips, and Pneumocystis carinii pneumonia in June 1993. Her CD4 count was 0 and her CD8 count was 20%. Treatment consisted of intravenous (IV) trimethoprim/sulfamethoxazole (TMP/SMX) and oral zidovudine, fluconazole, and acyclovir. She continued this medication after discharge in August 1993. She was readmitted to Taipei Veterans General Hospital in February 1994 for blurred vision. She was diagnosed with cytomegalovirus retinitis. Her CD4 count was up to 1% and her CD8 count was down to 8%. The candidiasis infection had extended from her oral cavity to the esophageal mucosa. She was put on IV ganciclovir, TMP/SMX, and fluconazole. She was discharged 3 weeks after admission. Her condition deteriorated thereafter, resulting in her death in August 1994. Up until this study, this HIV/AIDS case was listed with 79 other HIV/AIDS patients as unknown cause. During the 8 years between HIV exposure and her diagnosis of AIDS, she had unprotected sexual intercourse with her husband. Neither the husband nor any of her four children have AIDS. Screening for HIV-1 in Taiwan began in January 1988. The authors urgently recommend that anyone who received a blood transfusion between 1984 and 1987 in Taiwan and who currently suffers repeated episodes of opportunistic infections undergo an HIV-1 blood test.
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PMID:Transfusion-acquired AIDS in Taiwan. 864 96

There are several treatment options now available for patients with CMV retinitis, a sight-threatening viral infection of the eye, and the benefits and drawbacks of each are detailed. Vitrasert implants are the top choice, selected by nearly half of all people with CMV retinitis. The implants can cause blurred vision for up to four weeks, and retinal detachment is a potential side effect. Physicians also recommend systemic CMV treatment, generally IV ganciclovir, to accompany the implant. Cidofovir (Vistide), another IV therapy, is time-consuming to administer and has severe side effects. ISIS 2922, the experimental drug fomivirsen, is a promising treatment that is currently in advanced trials; it is injected directly into the eye. Oral ganciclovir therapy, used for mild retinitis cases, requires 12 pills a day, at a cost of $1,200 per month, and is generally less effective than other treatments. Concerns about developing drug resistance are expressed.
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PMID:Saving sight. 1136 57

A 29-year-old patient with HIV developed a facial angioedema hypersensitivity reaction to aciclovir when treated for acute retinal necrosis secondary to a herpes virus infection. She developed a similar reaction to famciclovir. Successful rapid desensitisation with oral aciclovir was performed and she became tolerant to aciclovir. She successfully completed 28 months of continuous treatment with no further reactions. However, 28 months later she experienced blurred vision and resumed taking oral aciclovir without a preceding desensitisation regimen. No allergic reaction occurred.
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PMID:Aciclovir desensitisation and rechallenge. 2270 4

Puumala virus infection causes epidemic nephropathia (NE), a certain type of haemorrhagic fever with renal syndrome (HFRS). Myopic shift is considered a pathognomonic sign of NE and HFRS but rates of ocular involvement vary. The aim of the study was to evaluate whether clinical and laboratory findings are associated with ophthalmic involvement in NE in Austria. We found that blurred vision and myopic shift are frequent in Puumala virus infections in Austria but are independent of disease severity.
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PMID:Blurred vision and myopic shift in Puumala virus infections are independent of disease severity. 2290

To report the case of a patient with bilateral herpetic lineal endotheliitis successfully treated with topic steroids and systemic antiviral. 17 year old female with blurred vision, at evaluation localized edema was observed on both corneas associated to Descemet folds and a line of pigmented precipitates. Topic prednisolone and oral acyclovir are initiated with complete resolution of signs and symptoms. Lineal endotheliitis is produced as an answer of endotelial cells to viral infection; maybe due to an immune reaction against some antigens from herpes virus family. It has the potential of relapses even in the absence of viral replication, with secondary untreatable stromal edema. It responds well to antiviral and steroids treatment, although, on those patients who don't improve, is necesary to make additional tests.
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PMID:Bilateral lineal endotheliitis: case report. 2382 74

Acute retinal necrosis syndrome (ARN) is a viral infection characterized by focal retinal necrosis. Viral meningitis complicated by ARN is relatively rare. In the present case study, a 44-year-old male presented with fever, headache and mental disorder. After four days, the patient developed blurred vision. The patient was diagnosed with viral encephalitis complicated by bilateral ARN, based on the examination results. After treatment with antivirals and systemic glucocorticoids, the symptoms of the patient improved. Viral encephalitis may be an important risk factor for ARN. For a patient with viral encephalitis who experiences decreased visual acuity or vitreous opacification, the possibility of ARN should be considered.
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PMID:Viral encephalitis complicated by acute retinal necrosis syndrome: A case report. 2662 38