Giacomo Boscia, Arcangelo Clemente, Alba Chiara Termite, Ilaria Lolli, Ciro Borriello, Eleni Nikolopoulou Gisotti, Clemente Iodice, Marinetta Calicchio, Pasquale Viggiano, Francesco Boscia, Alfonso Savastano
{"title":"The F-Sign Technique for Human Amniotic Membrane Orientation During Vitreoretinal Surgery.","authors":"Giacomo Boscia, Arcangelo Clemente, Alba Chiara Termite, Ilaria Lolli, Ciro Borriello, Eleni Nikolopoulou Gisotti, Clemente Iodice, Marinetta Calicchio, Pasquale Viggiano, Francesco Boscia, Alfonso Savastano","doi":"10.1097/ICB.0000000000001969","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001969","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a simple, reproducible marking technique to confirm correct epithelial orientation of human amniotic membrane (hAM) during subretinal implantation in complex vitreoretinal surgery for massive subretinal hemorrhage.</p><p><strong>Methods: </strong>A single-surgeon case report of a patient with massive subretinal hemorrhage managed by 23-gauge pars plana vitrectomy, retinal turnover, and subretinal hAM implantation. Prior to intraocular insertion, an \"F\" letter mark was applied to the epithelial surface of the graft using gentian violet dye, enabling unambiguous identification of membrane orientation throughout folding and intraocular delivery.</p><p><strong>Results: </strong>The gentian violet \"F\" mark remained clearly visible at each surgical step - forceps insertion and subretinal placement - enabling immediate confirmation of graft orientation and correct apposition of the stromal surface against the retinal pigment epithelium. No intraoperative complications related to the dye were observed. Postoperative optical coherence tomography (OCT) confirmed anatomically correct graft positioning, stable retinal reattachment, and progressive improvement in best-corrected visual acuity (BCVA).</p><p><strong>Conclusion: </strong>Gentian violet \"F\" marking of the hAM epithelial surface is a straightforward, safe, and reproducible adjunct for orientation verification in complex vitreoretinal surgery, where tissue transparency and repeated intraocular manipulation pose a significant risk of incorrect graft placement.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Quarta, Tommaso Verdina, Daniela Bacherini, Maria Ludovica Ruggeri, Ruggero Tartaro, Lisa Toto, Rodolfo Mastropasqua
{"title":"Foveolar Columnar Hyperreflectivity and Silicone Oil Removal: a possible biomarker of Retinal Toxicity?","authors":"Alberto Quarta, Tommaso Verdina, Daniela Bacherini, Maria Ludovica Ruggeri, Ruggero Tartaro, Lisa Toto, Rodolfo Mastropasqua","doi":"10.1097/ICB.0000000000001967","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001967","url":null,"abstract":"<p><strong>Purpose: </strong>to report three cases of Silicone Oil-related Vision Loss (SOVRL) with an unreported Optical Coherence Tomography sign before and after removal.</p><p><strong>Methods: </strong>Three patients with SOVRL underwent multimodal retinal imaging, including spectral-domain OCT.</p><p><strong>Results: </strong>Three male patients underwent pars plana vitrectomy for rhegmatogenous retinal detachment (RRD). SO was used as intraocular tamponade in two cases with giant retinal tear (GRT) retinal detachment, and one case of macula-on retinal detachment and epiretinal membrane (ERM). In all cases, a foveal columnar hyperreflectivity (FOCOH) was identified before silicone oil removal (ROSO). Following ROSO, all the patients experienced reduction in visual acuity after an initial recovery. Two patients demonstrated regression of the FOCOH sign-one with concurrent visual recovery, while the other experienced persistent visual impairment despite disappearance of the sign (final VA 20/20 and 20/200). In the third case the hyperreflectivity persisted, accompanied by inner retinal cystoid spaces and poor final visual acuity (final VA 20/200). In the first case FOCOH disappeared after three months, in the second case the sign disappeared after one month from ROSO, and in the third case the FOCOH persisted for more than 2 months.</p><p><strong>Conclusions: </strong>The early presence of FOCOH under SO suggests its potential role as a predictive biomarker of visual decline. Recognizing FOCOH may provide additional clues for the early diagnosis of SOVLR and guide therapeutic interventions.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bhagyashree Verma, Sarang Nikhil Gokhale, Puja Chowdhury, Neha Priya, Anamika Biswas, Amit Bidasaria, Ahana Sen, Rupak Roy
{"title":"Multimodal imaging in a case of bilateral Cuticular Drusen with pachychoroid phenotype and pachychoroid driven Central Serous Chorioretinopathy.","authors":"Bhagyashree Verma, Sarang Nikhil Gokhale, Puja Chowdhury, Neha Priya, Anamika Biswas, Amit Bidasaria, Ahana Sen, Rupak Roy","doi":"10.1097/ICB.0000000000001961","DOIUrl":"10.1097/ICB.0000000000001961","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of a 30-year-old male with bilateral cuticular drusen with bilateral pachychoroid phenotype and left eye pachychoroid driven central serous chorioretinopathy (CSC).</p><p><strong>Methods: </strong>Clinical fundus examination and multimodal imaging which included optical coherence tomography (OCT), fundus autofluorescence (FAF) and fundus fluorescein angiography (FFA) was done.</p><p><strong>Results: </strong>A patient presented to us with subretinal fluid at the macula in the left eye. FFA was done and the presence of ink blot pattern leakage confirmed the diagnosis of CSC in left eye, along with multiple, small, round, hyperfluorescent spots, creating a classic \"starry-sky\" pattern along the vascular arcades characteristic of cuticular drusen in both eyes. On OCT, we noted characteristic features of pachychoroid in both eyes.</p><p><strong>Conclusion: </strong>The role of multimodal imaging in diagnosing a rare case of cuticular drusen with pachychoroid CSC in a young adult is important.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Air Jet-Related Retinal Injury During Contemporary 25-Gauge Vitrectomy: Multimodal Imaging of 3 Cases.","authors":"Sosuke Ishiyama, Ryo Inoue, Hiroshi Nakashima, Kazuyuki Emi","doi":"10.1097/ICB.0000000000001965","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001965","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical and multimodal imaging characteristics of presumed air jet-related retinal injury occurring during contemporary 25-gauge pars plana vitrectomy and to discuss its likely mechanisms and preventive implications.</p><p><strong>Methods: </strong>We retrospectively reviewed 3 eyes of 3 patients who developed retinal injury during 25-gauge pars plana vitrectomy for macula-sparing rhegmatogenous retinal detachment. Surgical videos and multimodal imaging findings were analyzed.</p><p><strong>Results: </strong>In 2 eyes, localized retinal whitening developed intraoperatively; in the third eye, postoperative imaging showed localized retinal injury in a distribution corresponding to the presumed direction of the jet. The structural phenotype ranged from full-thickness macular tissue loss to inner retinal-predominant and outer retinal-predominant injury. Fundus autofluorescence delineated lesion extent more clearly than ultrawide-field color fundus photography.</p><p><strong>Conclusion: </strong>Presumed air jet-related retinal injury remains a possible complication even during modern 25-gauge vitrectomy. The lesions appear to represent predominantly mechanical retinal trauma involving both inner and outer retinal layers, with variable layer predominance. Attention to abrupt decompression, excessive aspiration under air, and infusion flow directed toward the macula may reduce risk.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Quarta, Rouzbeh Abbasgholizadeh, Ceren Soylu, Mai Alhelaly, Shinichiro Chujo, Jianfeng Huang, Giulia Corradetti, SriniVas R Sadda
{"title":"Paraneoplastic Acute Exudative Polymorphous Vitelliform Maculopathy Associated with Early Gastric Carcinoma.","authors":"Alberto Quarta, Rouzbeh Abbasgholizadeh, Ceren Soylu, Mai Alhelaly, Shinichiro Chujo, Jianfeng Huang, Giulia Corradetti, SriniVas R Sadda","doi":"10.1097/ICB.0000000000001957","DOIUrl":"10.1097/ICB.0000000000001957","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of presumed paraneoplastic acute exudative polymorphous vitelliform maculopathy (AEPVM) associated with early gastric carcinoma with subsequent slow regression of vitelliform lesions followed by localized outer retinal atrophy.</p><p><strong>Methods: </strong>a 58-year-old woman with a remote history of central serous chorioretinopathy presented with new metamorphopsia and multifocal subretinal yellowish deposits. Multimodal imaging-including spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography-was performed at baseline. Genetic and serologic testing as well as systemic evaluation with total-body MRI and endoscopy were conducted to exclude inherited or inflammatory causes and to identify a possible paraneoplastic association.</p><p><strong>Results: </strong>At presentation OCT revealed shallow serous detachments with hyperreflective subretinal material consistent with multifocal vitelliform lesions. At seven months, partial regression of lesions was noted, leading to systemic evaluation that uncovered an early intramucosal gastric adenocarcinoma, successfully treated by endoscopic submucosal dissection alone. Over seven years multimodal imaging demonstrated near-complete resorption of vitelliform material and the development of a localized zone of retinal pigment epithelium and outer retinal atrophy along the superior arcade. Best-corrected visual acuity remained 20/20 throughout. No ocular or systemic immunosuppressive therapy was administered.</p><p><strong>Conclusion: </strong>AEPVM may be associated with early gastric carcinoma and spontaneous regression of vitelliform lesions evolving into localized atrophy without visual decline. Long-term follow-up is essential given the late progression to atrophy.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica A Kraker, Amit K Reddy, Talisa E de Carlo Forest
{"title":"Nivolumab-induced hypoalbuminemia causing serous retinal detachment.","authors":"Jessica A Kraker, Amit K Reddy, Talisa E de Carlo Forest","doi":"10.1097/ICB.0000000000001960","DOIUrl":"10.1097/ICB.0000000000001960","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of nivolumab induced hypoalbuminemia causing a serous retinal detachment.</p><p><strong>Methods: </strong>Multimodal imaging including optical coherence tomography, fundus photography, and fluorescein angiography was performed.</p><p><strong>Results: </strong>A 59-year-old female with a history of metastatic renal cell carcinoma on nivolumab/ipilimumab immunotherapy with a recent hospitalization for anasarca, ascites, pleural effusion, and hypotension developed bilateral chemosis and a serous retinal detachment in the right eye. There were no pachychoroid vessels, intraocular inflammation, or leakage on fluorescein angiography to suggest central serous chorioretinopathy or a Vogt-Koyanagi-Harada-like reaction to immunotherapy. The third spacing and hypoalbuminemia was thought to be due to nivolumab-induced capillary leak syndrome, and the offending medication was stopped. The conjunctival chemosis and subretinal fluid improved with correction of underlying systemic hypoalbuminemia.</p><p><strong>Conclusion: </strong>This case highlights a case of nivolumab-induced hypoalbuminemia causing a serous retinal detachment. This serves as an excellent teaching case as the authors discuss pertinent clinical exam and multimodal imaging features that allow differentiation of serous retinal detachments due to medications, central serous chorioretinopathy, and Vogt-Koyanagi-Harada syndrome.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suganeswari Ganesan, Henna V Valakkadavil, Charanya C, Krishnakumar Subramanian, Julius Xavier Scott, Satish Srinivas K, Christopher John, Dhaarini Jayaraman, Latha M Sneha
{"title":"Exploding retinoblastoma- Management of spontaneous scleral rupture in an infant with bilateral retinoblastoma.","authors":"Suganeswari Ganesan, Henna V Valakkadavil, Charanya C, Krishnakumar Subramanian, Julius Xavier Scott, Satish Srinivas K, Christopher John, Dhaarini Jayaraman, Latha M Sneha","doi":"10.1097/ICB.0000000000001963","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001963","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of spontaneous globe rupture in an infant with bilateral retinoblastoma (RB) and the challenges faced during its management.</p><p><strong>Methods: </strong>An infant with bilateral retinoblastoma on treatment, presented with spontaneous globe rupture in the eye with advanced disease, after an episode of conjunctivitis while on neoadjuvant chemotherapy with VEC (vincristine, etoposide and carboplatin) regimen, and was managed by urgent enucleation followed by chemotherapy and radiotherapy.</p><p><strong>Results: </strong>Metastatic workup, post enucleation was negative, and she had good regression of lesions in the other eye with chemotherapy and maintains a Cardiff acuity of 6/24. Follow up of 2 years showed no recurrences.</p><p><strong>Conclusion: </strong>Spontaneous globe rupture is an exceptionally rare complication of retinoblastoma, this being the second reported case worldwide. Advanced disease stage, high intraocular pressure, chemotherapy induced immunosuppression, and superadded infection could all be the possible etiologies in this case. This condition carries a significant risk of life-threatening metastasis.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 59-year-old woman with refractory uveitis.","authors":"Lisa R Koenig, Eli L Diamond, Jasmine H Francis","doi":"10.1097/ICB.0000000000001962","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001962","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel use of melphalan delivered via ophthalmic artery chemosurgery (OAC) in the treatment of refractory histiocytosis, and to demonstrate a durable response at four years of follow-up.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>We present a case of histiocytosis, specifically Rosai-Dorfman-Destombes disease (RDD), masquerading as refractory anterior uveitis and nodular scleritis. The patient was effectively treated with cobimetinib and melphalan via OAC. The ophthalmic manifestations remain resolved, and the visual acuity is 20/20 at four years of follow-up.</p><p><strong>Conclusions: </strong>The novel and durable use of OAC melphalan in the management of ophthalmic RDD is described herein.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert E Morris, Cole Richardson, Cary Baxter, Ferenc Kuhn
{"title":"Maculopexy Resolves Cystic Macular Edema After Branch Retinal Vein Occlusion.","authors":"Robert E Morris, Cole Richardson, Cary Baxter, Ferenc Kuhn","doi":"10.1097/ICB.0000000000001956","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001956","url":null,"abstract":"<p><strong>Purpose: </strong>Using retrospective data, we demonstrate a technique of grid laser retinopexy together with vitrectomy and gas tamponade (pneumatic maculopexy) to permanently resolve branch retinal vein occlusion (BRVO)-related cystoid macular edema (CME).</p><p><strong>Methods: </strong>After laser ablation to ischemic peripheral retina, and six months of unsuccessful medical therapy with intravitreal bevacizumab injections, we performed vitrectomy with grid laser treatment to superotemporal macular edema, and C3F8 15% gas tamponade (pneumatic maculopexy).</p><p><strong>Results: </strong>Immediately after resolution of gas tamponade all CME had resolved, and visual acuity had improved from 20/40 to 20/30. Twenty-four months after vitrectomy and without further therapy, visual acuity had improved to 20/25 and the macula remained dry.</p><p><strong>Conclusion: </strong>When medical therapy is insufficiently effective, maculopexy by grid laser combined with intravitreal drying agents and/or gas tamponade can achieve long-term resolution of cystoid macular edema in selected cases. Parafoveal laser treatment must be precisely performed.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lily C Farrell, Jose S Pulido, Yoav J Gutterman, Rebecca S Simstein, Justin C Muste
{"title":"Visual Snow-Like Symptoms, Ellipsoid Zone Disruption, and Outer Retinal Pigmentary Changes in a Patient with Chronic Kratom Use: A Case Report.","authors":"Lily C Farrell, Jose S Pulido, Yoav J Gutterman, Rebecca S Simstein, Justin C Muste","doi":"10.1097/ICB.0000000000001959","DOIUrl":"10.1097/ICB.0000000000001959","url":null,"abstract":"<p><strong>Purpose: </strong>To report a novel case of kratom ( Mitragyna speciosa )-associated ocular toxicity presenting with visual snow and ellipsoid zone disruption, expanding the known ophthalmic complications of chronic kratom use.</p><p><strong>Methods: </strong>A case report and literature review were performed.</p><p><strong>Results: </strong>A 70-year-old man with 4 years of daily kratom use (6.8 g daily) presented with worsening nyctalopia and a visual snow-like phenomenon. OCT showed bilateral ellipsoid zone disruption and peripheral RPE changes. Fundus autofluorescence showed macular hypo-autofluorescence. Indocyanine Green and Fluorescein Angiographies were unremarkable. ERG was also unremarkable. His MRI showed chronic, nonspecific age-related changes. Cutaneous hyperpigmentation was also noted. Urine mitragynine was positive.</p><p><strong>Conclusions: </strong>This case raises the possibility that chronic kratom use may be associated with visual snow-like symptoms, ellipsoid zone disruption, and RPE changes. Consider multimodal retinal imaging in chronic users, especially with dermatologic signs. More studies are needed to define kratom's ocular toxicity profile.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}