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Case Reports in Ophthalmology 2020Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is...
Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is not possible. We report the case of a 25-year-old female who presented complaining of blurred vision in her left eye associated with photopsias and metamorphopsias of 3 months duration. Initial visual acuity in the right eye was 20/20 and 20/100 in the left eye. Upon indirect ophthalmoscopy in the left eye, a yellow-white, dome-shaped, elevated lesion with foveal involvement was observed. The rest of the ophthalmological examination proved normal. With clinical findings and images, submacular cysticercosis was diagnosed, and vitreoretinal surgery was suggested. Nevertheless, the patient did not accept the treatment; therefore, medical management was initiated. Central nervous system involvement was ruled out, and treatment with praziquantel and systemic prednisolone was initiated. Cysticercosis was resolved with significant improvement of her symptoms and visual acuity.
PubMed: 32774298
DOI: 10.1159/000508030 -
Case Reports in Ophthalmology 2021We report a case of morning glory disc anomaly in a young patient with tractional retinal detachment successfully repaired with complex pars plana vitrectomy, membrane...
We report a case of morning glory disc anomaly in a young patient with tractional retinal detachment successfully repaired with complex pars plana vitrectomy, membrane peel, laser, and oil tamponade. A 19-year-old female with a history of right morning glory disc anomaly associated with PAX6 gene mutation presented with floaters, photopsia, central scotoma, and visual acuity (VA) of 1/200. A complex macula-involving tractional retinal detachment centered around the optic nerve with a morning glory disc anomaly. Retinal detachment was treated with 25-gauge pars plana vitrectomy with difficult separation of the posterior hyaloid. Fibrous preretinal membranes were peeled, a temporal relaxing retinotomy was required, subretinal fluid was drained through a superonasal retinotomy during air-fluid exchange, endolaser was applied, and tamponade was achieved with 1,000-centistoke silicone oil. The retina remained attached at 1-year follow-up, with VA count fingers throughout. Morning glory disc is a rare congenital anomaly associated with PAX6 gene mutation that most often occurs unilaterally. It is rarely associated with tractional retinal detachment. Optimization of visual outcome is imperative despite a poor visual prognosis.
PubMed: 34177542
DOI: 10.1159/000516205 -
Choroidal melanoma overlying scleral buckle evading detection treated with proton beam radiotherapy.American Journal of Ophthalmology Case... Jun 2020to present a case of a choroidal melanoma located along a scleral buckle contour and was successfully treated with proton beam radiotherapy, without disturbing the...
PURPOSE
to present a case of a choroidal melanoma located along a scleral buckle contour and was successfully treated with proton beam radiotherapy, without disturbing the scleral buckle.
OBSERVATIONS
A 60-year-old woman presented with photopsias and history of retinal detachment repair with scleral buckle 36 years prior. She had annual dilated exams with her ophthalmologist over the last several years. While initially diagnosis of choroidal detachment, hemorrhage and intraocular buckle intrusion were suspected, the patient was referred to an ophthalmic oncology center and choroidal melanoma was confirmed. The patient underwent tantalum marker placement, trans-retinal biopsy and proton beam radiotherapy. Despite no evidence of metastatic disease on systemic imaging, prognostic genetic testing of the tumor revealed high-risk alterations for future metastasis, and the patient enrolled in an adjuvant clinical trial.
CONCLUSIONS
The location of this choroidal melanoma along a scleral buckle contour presented a unique therapeutic challenge. We successfuly treated the tumor with proton beam radiotherapy without disturbing the scleral buckle.
IMPORTANCE
chorioretinal elevations adjacent a scleral buckle may be presumed to be due to the buckle element; ultrasound can be helpful in distinguishing an intraocular tumor. Proton beam radiotherapy has the advantage over plaque brachytherapy in this setting as removing the scleral buckle is not needed and placing a plaque over the scleral buckle risks altering the effective radiotherapy dose.
PubMed: 32309677
DOI: 10.1016/j.ajoc.2020.100688 -
The Kaohsiung Journal of Medical... Oct 2018
Topics: Adult; Chordoma; Humans; Magnetic Resonance Imaging; Male; Optic Chiasm; Sphenoid Sinus; Vision Disorders; Visual Fields
PubMed: 30309489
DOI: 10.1016/j.kjms.2018.03.003 -
Case Reports in Ophthalmological... 2016Background. The authors describe a case of recurrent photopsias in a 56-year-old woman following repeat treatments with systemic intravenous bevacizumab for stage IV...
Background. The authors describe a case of recurrent photopsias in a 56-year-old woman following repeat treatments with systemic intravenous bevacizumab for stage IV ovarian cancer. To our knowledge, this is the first report of photopsias following systemic bevacizumab treatments in a patient with a normal eye exam. Case Presentation. A 56-year-old Caucasian female complained of onset of floaters and flashes in the temporal peripheral field of the right eye 1 day after receiving intravenous of 30 g of 25 mg/mL of systemic bevacizumab for treatment of stage IV ovarian cancer. Ophthalmic examination, including dilated fundus exam, spectral domain optical coherence tomography (SD-OCT) of the optic nerve head, and enhanced depth imaging SD-OCT of the macula, revealed no significant abnormalities. Possible mechanisms are reviewed. Conclusion. We propose that patients who undergo intravenous bevacizumab treatments are questioned for any ocular symptoms and that more systematic evaluations of retinal nerve fiber layer and choroidal effects are obtained in those patients who are on long-term treatment at high doses.
PubMed: 27069702
DOI: 10.1155/2016/1926178 -
American Journal of Ophthalmology Case... Mar 2023To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) following COVID-19 infection.
PURPOSE
To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) following COVID-19 infection.
OBSERVATIONS
A 17-year-old female developed central scotomas and photopsias two weeks after SARS-CoV-2 diagnosis with polymerase chain reaction studies. She presented with poor visual acuity of 3/60 on the Feinbloom eye chart in the left eye. Dilated examination and multi-modal retinal imaging were consistent with the diagnosis of APMPPE, with noteworthy subretinal fluid. The patient was treated with an oral prednisone taper starting at 60mg with rapid resolution in subretinal fluid and improvement of visual acuity. Five weeks after presentation, visual acuity improved to 20/20 OU with complete resolution of the creamy white choroidal lesions and subretinal fluid.
CONCLUSION
There is a growing body of literature reporting the ocular manifestations of COVID-19. Rarely inflammation of the retina or choroid have been associated with the infection. To the best of our knowledge, there are no prior reports that describe the clinical course or visual outcome in a patient with APMPEE associated with recent COVID-19 infection. Accordingly, we are not aware of any other reports that describe the treatment of APMPEE associated with COVID-19 with corticosteroids. The mechanism linking COVID-19 infection to inflammatory ocular disorders in unclear and likely multi-factorial.
PubMed: 36597447
DOI: 10.1016/j.ajoc.2022.101790 -
Frontiers in Bioscience (Elite Edition) Dec 2021The purpose of the study was to analyze the frequency of the spontaneous posterior vitreous detachment (PVD) in patients admitted to an Emergency Eye Department in Italy... (Observational Study)
Observational Study
The purpose of the study was to analyze the frequency of the spontaneous posterior vitreous detachment (PVD) in patients admitted to an Emergency Eye Department in Italy (EED) during the COVID-19 pandemic national lockdown in 2020 compared with the similar time period in 2019. In this retrospective observational study, patient records for ophthalmology EED patients in the month of April 2020 during the COVID-19 Italian national lockdown, were compared with those for an equivalent one-month period in 2019. Diagnoses, gender, and age were assessed. Unpaired Student -tests were used for continuous variables. Poisson regression was used for count analysis to compare categorical variables. Chi-square test was applied to asses proportion differences. In comparison with the 2019 equivalent period, there was a significant decrease in the overall number of EED visits and in the number of patients presenting with a spontaneous PVD during the 2020 lockdown (-41.6% and -49%, respectively). During the 2020 lockdown, all diagnostic categories showed less patient admittance, however, the proportions remained stable when considering the entire cohort. The proportion of urgent visits was 90% in 2020 and 86% in 2019 ( = 0.66). The proportion of EED patients affected by spontaneous PVD was comparable between the two study periods (8.4% in 2020 vs. 9.6% in 2019, = 0.34). Patients presenting with spontaneous PVD in both periods were significantly older when compared to patients with other pathologies (mean age of 63years in 2020 and 64years in 2019, < 0.001). There was a significant bias in female gender (61.2% in 2019 and 60% in 2020, < 0.05). There was a significant decrease of accesses to the EED during COVID-19 2020 lockdown. Patients affected by spontaneous PVD were about 50% less compared with the same period of 2019. Risk factors for the development of spontaneous PVD were older age and female gender. PVD represents a potentially visual function threatening condition because it can cause retinal ruptures and retinal detachment. Patients need to be educated to get urgent ophthalmic assessments in the presence of important acute signs and symptoms, like floaters and flashes, even in the presence of a lockdown.
Topics: COVID-19; Emergency Service, Hospital; Female; Humans; Italy; Male; Middle Aged; Pandemics; Quarantine; Vitreous Detachment
PubMed: 34937313
DOI: 10.52586/E883 -
American Journal of Ophthalmology Case... Sep 2021To describe a patient who developed concurrent acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and posterior scleritis.
PURPOSE
To describe a patient who developed concurrent acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and posterior scleritis.
OBSERVATIONS
We describe a middle-aged woman that developed eye pain and photopsia. She was found to have a "T-sign" on ultrasound of the right eye and multiple, nearly confluent, ill-defined subretinal whitish lesions in both eyes. After an extensive laboratory evaluation and neuroimaging, her photopsia, pain with eye movements, and subretinal lesions began to regress on high dose systemic corticosteroids.
CONCLUSIONS AND IMPORTANCE
This is the first reported case of bilateral APMPPE and concurrent posterior scleritis. Our case highlights the importance of performing a full review of systems, specifically eliciting neurological changes, and dilated eye examination in all new uveitis cases.
PubMed: 34278050
DOI: 10.1016/j.ajoc.2021.101159 -
Journal of Ophthalmic & Vision Research 2020To report a case of non-paraneoplastic autoimmune retinopathy (npAIR) treated with intravenous immunoglobulin (IVIG).
PURPOSE
To report a case of non-paraneoplastic autoimmune retinopathy (npAIR) treated with intravenous immunoglobulin (IVIG).
CASE REPORT
A 12-year-old boy presented with progressive visual field loss, nyctalopia, and flashing for three months. He had suffered from common cold two weeks before the onset of these symptoms. On the basis of clinical history and paraclinical findings, he was diagnosed with npAIR, and IVIG without immunosuppressive therapy was started. During the one-year follow-up period after the first course of IVIG, flashing disappeared completely. Visual acuity remained 10/10, but nyctalopia did not improve. Multimodal imaging showed no disease progression.
CONCLUSION
Although established retinal degenerative changes seem irreversible in npAIR, IVIG may be a suitable choice to control the disease progression.
PubMed: 32308960
DOI: 10.18502/jovr.v15i2.6743 -
American Journal of Ophthalmology Case... Jun 2022To report a case of a branch retinal vein occlusion (BRVO) following mRNA COVID-19 vaccination.
PURPOSE
To report a case of a branch retinal vein occlusion (BRVO) following mRNA COVID-19 vaccination.
OBSERVATIONS
A 34-year-old healthy male presented with blurriness in the inferior visual field, intermittent photopsia, multiple retinal hemorrhages, dilated and tortuous retinal vessels, and cotton wools spots in the right eye. The clinical examination and ancillary tests confirmed the diagnosis of a right eye BRVO. The visual symptoms started 2 days following first dose COVID-19 vaccination with the BNT162b2 (Pfizer-BioNTech) mRNA vaccine.
CONCLUSIONS AND IMPORTANCE
This is a rare case of BRVO in an otherwise healthy young man, presenting after vaccination for COVID-19 in the absence of other coagulable risk factors. As the literature on venous thrombosis after COVID-19 vaccinations remains sparse, it is critical to raise awareness that BRVO could be a vaccine-related thrombotic adverse event. We highlight that as more of the population is vaccinated, an increased incidence of BRVO may confirm the link to COVID-19 vaccination.
PubMed: 35211659
DOI: 10.1016/j.ajoc.2022.101445