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Unilateral Painless Vision Loss Detected Incidentally During the Driver's Health Examination at the Family Medicine Polyclinic: Case Report

Yıl 2024, Cilt: 2 Sayı: 2, 77 - 79, 30.06.2024
https://doi.org/10.61845/agrimedical.1461263

Öz

Introduction: Family medicine encompasses a unique set of competencies and characteristics aimed at providing primary care with a patient-centered focus. In this paper, we aimed to present a case study demonstrating how family practice competencies were utilized in the management of central retinal vein occlusion (CRVO).

Case: A 48-year-old diabetic man, seeking a driving license health report, presented without complaints. Even though he self-reported normal vision, a comprehensive examination revealed a visual loss in his left eye, leading to a diagnosis of CRVO. Despite the absence of typical risk factors such as hypertension or hyperlipidemia, detailed examination and comprehensive evaluation of the patient offered the patient a chance for diagnosis and treatment.

Discussion: CRVO often manifests as painless unilateral vision loss. Family physicians play a crucial role in early detection through comprehensive assessments, even in asymptomatic patients. Rapidly diagnosis and prompt referral to ophthalmologists allow for timely intervention, as seen in this case where intravitreal bevacizumab injections led to improved visual acuity.

Conclusion: This case highlights the importance of family physicians detecting signs of disease, in patients without obvious symptoms. Family physicians contribute to the early diagnosis and effective management of many diseases with their comprehensive approach and patient-oriented care.

Kaynakça

  • Turkish Association of Family Physicians. European Definition of General Practice/Family Medicine. WONCA Europe 2005 Edition Turkish Translation. Turkish Association of Family Physicians Publications-4 April 2011.
  • AK M. Family Medicine as an Academic Discipline. J Turgut Ozal Med Cent. 2010;17(4):403-5.
  • WONCA Europe. The European Definition of General Practice/Family Medicine. WONCA Europe 2023 Edition [cited 2024 May 21]. Available from: https://www.woncaeurope.org/ file/41f61fb9-47d5-4721-884e 603f4afa6588/WONCA_European_Definitions_2_v7.pdf.
  • Ip M, Hendrick A. Retinal Vein Occlusion Review. Asia-Pacific Journal of Ophthalmology. 2018;7(1):p 40-45.
  • Schmidt-Erfurth U, Garcia-Arumi J, Gerendas BS, Midena E, Sivaprasad S, Tadayoni R, Loewenstein A. Guidelines for the management of retinal vein occlusion by the European Society of Retina Specialists (EURETINA). Ophthalmologica. 2019;242(3), 123-162.
  • Wu J, He X, Qi F, Zhao Z, Xu Z, Yan H. Efficacy, Safety, and Treatment Burden of Aflibercept 2 mg and Ranibizumab in Retinal Vein Occlusion: A Systematic Review and Meta-analysis. Ophthalmology and Therapy. 2024;1-15.
  • Hayreh SS, Klugman MR, Beri M, Kimura AE, Podhajsky P. Differentiation of ischemic from non-ischemic central retinal vein occlusion during the early acute phase. Graefe's archive for clinical and experimental ophthalmology. 1990;228:201-17.
  • An W, Zhao Q, Yu R, Han J. The role of optical coherence tomography angiography in distinguishing ischemic versus non-ischemic central retinal vein occlusion. BMC ophthalmology. 2022;22(1):413. https://doi.org/10.1186/s12886-022-02637-y
  • Vinay AS, Koushik T, FRCS, Manjot KG, Jason H, Jennifer IL, Francesco P. Central Retinal Vein Occlusion. American Academy of Ophtalmology. Eyewiki,2023. Available March 16, 2024. https://eyewiki.aao.org/Central_Retinal_Vein_Occlusion
  • Gewaily D, Muthuswamy K, Greenberg PB Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion. The Cochrane database of systematic reviews, 2015(9). https://doi.org/10.1002/14651858.CD007324.pub3
  • Ford JA, Clar C, Lois N, Barton S, Thomas S, Court R, Shyangdan D, Waugh N. Treatments for macular oedema following central retinal vein occlusion: systematic review. BMJ open, 2014;4(2). https://doi.org/10.1136/bmjopen-2013-004120
  • Lotfy A, Solaiman KAM, Abdelrahman A, Samir A. Efficacy and Frequency Of Intravitreal Aflibercept Versus Bevacizumab For Macular Edema Secondary To Central Retinal Vein Occlusion. Retina (Philadelphia, Pa.), 2018;38(9), 1795–1800. https://doi.org/10.1097/ IAE.0000000000001782

Aile Hekimliği Polikliniğinde Sürücü Sağlık Muayenesinde Tesadüfen Saptanan Tek Taraflı Ağrısız Görme Kaybı: Olgu Sunumu

Yıl 2024, Cilt: 2 Sayı: 2, 77 - 79, 30.06.2024
https://doi.org/10.61845/agrimedical.1461263

Öz

Giriş: WONCA Avrupa tarafından tanımlandığı şekliyle aile hekimliği, hasta merkezli, birinci basamak sağlık hizmeti sunan, benzersiz bir dizi yeterlilik ve özelliği sahip bir tıp disiplinidir. Bu disiplinin merkezinde birinci basamak yönetimi ve kapsamlı bir yaklaşım gibi çekirdek yeterlilikler bulunmaktadır. Bu vaka takdiminde, bu yeterliliklerin kullanılarak santral retinal ven tıkanıklığının (CRVO) tanısı ve yönetiminin tartışıldığı bir vaka sunmayı amaçladık.

Vaka: Ehliyet sağlık raporu almak isteyen 48 yaşındaki diyabet tanılı erkek hasta şikayetsiz olarak başvurdu. Görüşünün normal olduğunu bildirmesine rağmen, kapsamlı muayene sonucunda sol gözde görme kaybı olduğu tespit edildi. Hastaya ileri değerlendirme ile CRVO tanısı konuldu. Hipertansiyon veya hiperlipidemi gibi tipik risk faktörlerinin bulunmamasına rağmen hastanın ayrıntılı muayenesi ve kapsamlı değerlendirilmesi hastaya tanı ve tedavi şansı sunmuştur.

Tartışma: CRVO sıklıkla ağrısız tek taraflı görme kaybı olarak kendini gösterir. Aile hekimleri, asemptomatik hastalarda bile kapsamlı değerlendirmeler yaparak erken teşhisin sağlanmasında önemli bir rol oynamaktadır. Hızlı tanı ve oftalmologlara hızlı sevk; intravitreal bevacizumab enjeksiyonlarının görme keskinliğinde iyileşme sağladığı bu vakada görüldüğü gibi zamanında müdahaleye olanak tanır.

Sonuç: Bu vaka, aile hekimlerinin, belirgin semptomları olmayan hastalarda bile, hastalıkların bulgularını tespit etmelerinin önemini vurgulamaktadır. Aile hekimleri kapsamlı yaklaşımları ve hasta odaklı bakımlarıyla birçok hastalığın erken tanısına ve etkili yönetimine katkıda bulunur.

Kaynakça

  • Turkish Association of Family Physicians. European Definition of General Practice/Family Medicine. WONCA Europe 2005 Edition Turkish Translation. Turkish Association of Family Physicians Publications-4 April 2011.
  • AK M. Family Medicine as an Academic Discipline. J Turgut Ozal Med Cent. 2010;17(4):403-5.
  • WONCA Europe. The European Definition of General Practice/Family Medicine. WONCA Europe 2023 Edition [cited 2024 May 21]. Available from: https://www.woncaeurope.org/ file/41f61fb9-47d5-4721-884e 603f4afa6588/WONCA_European_Definitions_2_v7.pdf.
  • Ip M, Hendrick A. Retinal Vein Occlusion Review. Asia-Pacific Journal of Ophthalmology. 2018;7(1):p 40-45.
  • Schmidt-Erfurth U, Garcia-Arumi J, Gerendas BS, Midena E, Sivaprasad S, Tadayoni R, Loewenstein A. Guidelines for the management of retinal vein occlusion by the European Society of Retina Specialists (EURETINA). Ophthalmologica. 2019;242(3), 123-162.
  • Wu J, He X, Qi F, Zhao Z, Xu Z, Yan H. Efficacy, Safety, and Treatment Burden of Aflibercept 2 mg and Ranibizumab in Retinal Vein Occlusion: A Systematic Review and Meta-analysis. Ophthalmology and Therapy. 2024;1-15.
  • Hayreh SS, Klugman MR, Beri M, Kimura AE, Podhajsky P. Differentiation of ischemic from non-ischemic central retinal vein occlusion during the early acute phase. Graefe's archive for clinical and experimental ophthalmology. 1990;228:201-17.
  • An W, Zhao Q, Yu R, Han J. The role of optical coherence tomography angiography in distinguishing ischemic versus non-ischemic central retinal vein occlusion. BMC ophthalmology. 2022;22(1):413. https://doi.org/10.1186/s12886-022-02637-y
  • Vinay AS, Koushik T, FRCS, Manjot KG, Jason H, Jennifer IL, Francesco P. Central Retinal Vein Occlusion. American Academy of Ophtalmology. Eyewiki,2023. Available March 16, 2024. https://eyewiki.aao.org/Central_Retinal_Vein_Occlusion
  • Gewaily D, Muthuswamy K, Greenberg PB Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion. The Cochrane database of systematic reviews, 2015(9). https://doi.org/10.1002/14651858.CD007324.pub3
  • Ford JA, Clar C, Lois N, Barton S, Thomas S, Court R, Shyangdan D, Waugh N. Treatments for macular oedema following central retinal vein occlusion: systematic review. BMJ open, 2014;4(2). https://doi.org/10.1136/bmjopen-2013-004120
  • Lotfy A, Solaiman KAM, Abdelrahman A, Samir A. Efficacy and Frequency Of Intravitreal Aflibercept Versus Bevacizumab For Macular Edema Secondary To Central Retinal Vein Occlusion. Retina (Philadelphia, Pa.), 2018;38(9), 1795–1800. https://doi.org/10.1097/ IAE.0000000000001782
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Göz Hastalıkları, Halk Sağlığı (Diğer)
Bölüm Olgu Sunumu
Yazarlar

Nebi Sökmen 0000-0001-7487-5887

Bahaeddin Onur 0009-0008-0174-5801

Funda Ekimci Deniz 0000-0002-8308-5024

Yayımlanma Tarihi 30 Haziran 2024
Gönderilme Tarihi 29 Mart 2024
Kabul Tarihi 4 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 2 Sayı: 2

Kaynak Göster

AMA Sökmen N, Onur B, Ekimci Deniz F. Unilateral Painless Vision Loss Detected Incidentally During the Driver’s Health Examination at the Family Medicine Polyclinic: Case Report. Ağrı Med J. Haziran 2024;2(2):77-79. doi:10.61845/agrimedical.1461263