Tianyu Liu, Apoorv P Chebolu, Caroline W Chung, Adam M Kruszewski, Nirali Bhatt, Alexander J Brucker
{"title":"BILATERAL UVEITIS, RETINAL PERIPHLEBITIS, AND OPTIC NEURITIS ASSOCIATED WITH NON-PINEAL CENTRAL NERVOUS SYSTEM GERMINOMA.","authors":"Tianyu Liu, Apoorv P Chebolu, Caroline W Chung, Adam M Kruszewski, Nirali Bhatt, Alexander J Brucker","doi":"10.1097/ICB.0000000000001523","DOIUrl":"10.1097/ICB.0000000000001523","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report a case of bilateral uveitis, retinal periphlebitis, and optic neuritis associated with a non-pineal central nervous system germinoma.</p><p><strong>Methods: </strong>This is a case report.</p><p><strong>Results: </strong>A 32-year-old man presented with episodes of acute painless visual disturbance in each eye and was found to have decreased VA, abnormal color vision, an afferent pupillary defect in the left eye, bilateral optic disc edema, perivenous sheathing, and candle-wax dripping exudates. Optical coherence tomography revealed bilateral intraretinal fluid and posterior vitreous hyperreflective opacities. Fluorescein angiography revealed bilateral optic disc leakage without active small vessel leakage. Magnetic resonance imaging of the brain and orbits revealed enhancing periventricular lesions and enhancement of the left optic nerve and bilateral perioptic nerve sheaths, posterior globes, and optic nerve heads. Brain biopsy was consistent with a central nervous system germinoma. His ocular signs and symptoms improved with chemotherapy for the germinoma.</p><p><strong>Conclusion: </strong>Central nervous system germinomas, including those located outside the pineal region, can be associated with optic neuritis, uveitis, and periphlebitis including characteristic candle-wax dripping exudates. Ocular signs and symptoms typically improve with treatment of the underlying germinoma.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"182-186"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801359","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}
Jonathan Thomas, Harris Ahmed, Kathryn Halbritter, Moises Enghelberg
{"title":"POOR VISUAL OUTCOMES IN SYPHILITIC UVEITIS ASSOCIATED WITH METHAMPHETAMINE USE: A CASE SERIES.","authors":"Jonathan Thomas, Harris Ahmed, Kathryn Halbritter, Moises Enghelberg","doi":"10.1097/ICB.0000000000001524","DOIUrl":"10.1097/ICB.0000000000001524","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the potential link between methamphetamine use and infectious syphilitic uveitis through a retrospective chart review of four patients with both conditions.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on four patients with a history of methamphetamine use and presented with vision loss at an emergency department or clinic that was ultimately diagnosed as syphilitic uveitis.</p><p><strong>Results: </strong>The average age of the four patients was 41.5 ± 9.8 years, and each presented with symptoms of blurry vision after an average of 3 weeks. Clinical and serologic examinations revealed variable severity of syphilitic uveitis in each patient, and a confirmed history of methamphetamine use was found on a review of social history. Each patient had worsening visual outcomes after the initial presentation and diagnosis.</p><p><strong>Conclusion: </strong>Syphilitic uveitis is a challenging diagnosis because of its similarity with other ocular pathologies. This case series highlights the importance of maintaining a high level of suspicion for syphilis in patients with a history of methamphetamine use and uveitis to enable rapid treatment and prevent visual decline. The poor visual outcomes observed in these four patients underscore the significance of identifying and treating syphilitic uveitis promptly in this population and the barriers to treatment completion.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"196-201"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804385","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}
Xavier Chan, Johnell Renz Amoroso, Quan V Hoang, Jesse J Jung
{"title":"THE SPECTRUM OF RELENTLESS PLACOID AND ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY: A MULTIMODAL IMAGING ANALYSIS.","authors":"Xavier Chan, Johnell Renz Amoroso, Quan V Hoang, Jesse J Jung","doi":"10.1097/ICB.0000000000001555","DOIUrl":"10.1097/ICB.0000000000001555","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to showcase the spectrum between acute posterior multifocal placoid pigment epitheliopathy and relentless placoid utilizing ultra-widefield imaging findings of a case of acute posterior multifocal placoid pigment epitheliopathy progressing to relentless placoid chorioretinitis.</p><p><strong>Methods: </strong>A 23-year-old White woman presented with worsening vision in both eyes. Clinical examination and multimodal imaging modalities including fundus photographs, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral domain optical coherence tomography and angiography were utilized to diagnose acute posterior multifocal placoid pigment epitheliopathy and clinically follow the patient.</p><p><strong>Results: </strong>Clinical examination of the patient initially revealed posterior lesions consistent with acute posterior multifocal placoid pigment epitheliopathy, but subsequent multimodal images including ultra-widefield fluorescein angiography and indocyanine green angiography revealed newer, more peripheral lesions more typical of relentless placoid chorioretinitis.</p><p><strong>Conclusion: </strong>When compared with standard multimodal imaging, ultra-widefield imaging is an effective tool to delineate nuances between acute posterior multifocal placoid pigment epitheliopathy and relentless placoid chorioretinitis through identification of peripheral lesions, which may be of clinical importance when determining management and therapeutics for patients.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"148-151"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029590","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":"CASE SERIES OF PROGRESSIVE RETINAL DETACHMENTS IN PERSISTENT FETAL VASCULATURE.","authors":"Nicole Somani, Jiwei Sheng, Prethy Rao, Emmanuel Chang","doi":"10.1097/ICB.0000000000001547","DOIUrl":"10.1097/ICB.0000000000001547","url":null,"abstract":"<p><strong>Purpose: </strong>Persistent fetal vasculature may be associated with tractional retinal detachment due to tractional contraction of the fibrovascular stalk. Persistent fetal vasculature is often believed to be congenital and nonprogressive. A rhegmatogenous component is far less common and is typically identified as a postoperative complication and has not been spontaneously reported. The authors present five cases illustrating potential progressive changes and complications that may arise in nonoperated persistent fetal vasculature.</p><p><strong>Methods: </strong>This was a retrospective case series of five patients who presented with progressive retinal detachments from persistent fetal vasculature.</p><p><strong>Results: </strong>Five unique cases of persistent fetal vasculature with significant progression from time of initial presentation, four of which included development of rhegmatogenous components.</p><p><strong>Conclusion: </strong>Patients with persistent fetal vasculature and a seemingly stable tractional detachment should undergo evaluation with a retinal specialist for risk stratification and management because rhegmatogenous detachments may occur due to ocular growth and stretch breaks, and tractional detachments can continue to progress over time.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"267-272"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081040","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":"OCCLUSIVE RETINAL VASCULITIS AS A PRESENTING FEATURE OF PRIMARY VITREORETINAL LYMPHOMA RELAPSE.","authors":"Manasi Ketkar, Niroj Sahoo, Vishal Raval","doi":"10.1097/ICB.0000000000001551","DOIUrl":"10.1097/ICB.0000000000001551","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report a case of primary vitreoretinal lymphoma (PVRL) relapse presenting as occlusive retinal vasculitis with secondary neovascularization.</p><p><strong>Methods: </strong>This study was a retrospective case report.</p><p><strong>Results: </strong>A 40-year-old woman presented to the clinic with complaints of blurring of vision in the left eye for 4 months. Her best-corrected VA (BCVA) was 20/20 and 20/500 in the right and left eye, respectively. The vitreous cavities of both eyes showed vitreous opacities (2+). Both eyes fundus showed multifocal yellowish-white subretinal infiltration. A diagnostic vitreous and subretinal biopsy of the left eye revealed large lymphoid cells with CD-20 positivity, confirming the diagnosis of PVRL. The patient received 12 intravitreal methotrexate injections in both eyes over a course of 2 months, after which the lesions completely resolved. However, after 5 months, the left eye showed characteristic subretinal lesions along with perivascular exudates and retinal hemorrhages, diagnosed as PVRL relapse presenting as occlusive retinal vasculitis. Fluorescein angiography revealed retinal neovascularization, for which panretinal photocoagulation was performed along with repeated intravitreal methotrexate injections.</p><p><strong>Conclusion: </strong>Primary vitreoretinal lymphoma is a great masquerader, and although rare, PVRL relapse can present as occlusive retinal vasculitis with secondary neovascularization, thereby delaying diagnosis and subsequent treatment.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"210-213"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081043","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}
Matias Soifer, Nam V Nguyen, Boonkit Purt, Sunil Bellur, Shilpa Kodati
{"title":"INDOCYANINE GREEN ANGIOGRAPHY OF OPTIC DISK GRANULOMA IN OCULAR SARCOIDOSIS.","authors":"Matias Soifer, Nam V Nguyen, Boonkit Purt, Sunil Bellur, Shilpa Kodati","doi":"10.1097/ICB.0000000000001534","DOIUrl":"10.1097/ICB.0000000000001534","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report novel indocyanine green angiography findings of optic disk granulomas secondary to sarcoidosis.</p><p><strong>Methods: </strong>This was an observational case report.</p><p><strong>Results: </strong>A 36-year-old White man, who had previously been evaluated for birdshot chorioretinopathy and tested HLA-A29 negative, was referred for evaluation of choroidal lesions in both eyes. Fundus examination revealed ovoid choroidal lesions bilaterally in the posterior pole. Optical coherence tomography demonstrated bilateral focal choroidal elevations in the posterior pole and optic disks consistent with granulomas. Indocyanine green angiography revealed diffuse choroidal hypocyanescent spots with late-phase focal hypercyanescence of the optic disks in both eyes corresponding to the granulomas. After 3 months of prednisone and immunomodulatory treatment, the granulomas improved, and the optic disk hypercyanescence resolved.</p><p><strong>Conclusion: </strong>The authors describe a case of ocular sarcoidosis mimicking birdshot-like lesions, and indocyanine green angiography findings revealed late hypercyanescence, which resolved with treatment.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"193-195"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maurizio Battaglia Parodi, Alessio Antropoli, Alessandro Arrigo, Maria Vittoria Cicinelli, Lorenzo Bianco, Andrea Saladino, Enea Moretti, Francesco Bandello, Ahmad Mansour
{"title":"ACUTE ATROPHIC EVOLUTION OF DRUSENOID PIGMENT EPITHELIUM DETACHMENT AFTER PHOTOBIOMODULATION.","authors":"Maurizio Battaglia Parodi, Alessio Antropoli, Alessandro Arrigo, Maria Vittoria Cicinelli, Lorenzo Bianco, Andrea Saladino, Enea Moretti, Francesco Bandello, Ahmad Mansour","doi":"10.1097/ICB.0000000000001529","DOIUrl":"10.1097/ICB.0000000000001529","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report the acute onset of macular atrophy soon after photobiomodulation (PBM) administration in a patient with intermediate age-related macular degeneration.</p><p><strong>Methods: </strong>Optical coherence tomography was performed in the study eye before and after PBM.</p><p><strong>Results: </strong>A patient with drusenoid pigment epithelium detachment (D-PED) underwent PBM. A few weeks after PBM, the D-PED collapsed, resulting in complete retinal pigment epithelium and outer retinal atrophy with visual acuity worsening.</p><p><strong>Conclusion: </strong>Thinning of the outer retinal layers over a D-PED and posterior hypertransmission may represent bad prognostic factors for PBM, accelerating the lesion's natural history toward atrophic evolution.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"225-227"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801144","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 CASE REPORT OF TEMPORAL MACULAR THINNING ASSOCIATED WITH ALPORT SYNDROME.","authors":"Paul S Bernstein","doi":"10.1097/ICB.0000000000001593","DOIUrl":"10.1097/ICB.0000000000001593","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to report a case of severe temporal macular thinning in a patient with Alport syndrome. Bilateral temporal thinning is rarely associated with any other systemic conditions, so it is important that ophthalmologists be aware of the significance of this finding and refer for further internal medicine evaluation appropriately.</p><p><strong>Methods: </strong>Clinical examination and multimodal imaging are provided from a clinic visit one month after inpatient treatment for a hypertensive crisis associated with renal failure.</p><p><strong>Results: </strong>The 19-year-old patient had resolving hypertensive retinopathy. High-resolution optical coherence tomography confirmed that he had temporal thinning indices consistent with his underlying clinical diagnosis of Alport syndrome.</p><p><strong>Conclusion: </strong>This case report emphasizes the important role of optical coherence tomography as a commonly available noninvasive retinal imaging modality that can readily demonstrate the temporal macular thinning that is characteristic of Alport syndrome and just a few other conditions. Optical coherence tomography can be an attractive alternative to the much more invasive renal biopsy testing for Alport syndrome when genetic testing is ambiguous or when renal biopsy is considered too risky for the patient.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":"19 2","pages":"157-159"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505948","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":"DELAYED SPONTANEOUS CLOSURE OF A FULL-THICKNESS MYOPIC MACULAR HOLE WITH GOOD VISUAL RECOVERY.","authors":"Jin Kyun Oh, Stanley Chang","doi":"10.1097/ICB.0000000000001535","DOIUrl":"10.1097/ICB.0000000000001535","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to present the longitudinal progression of a myopic macular hole with eventual closure and excellent visual recovery over a decade after initial full-thickness hole formation.</p><p><strong>Methods: </strong>The patient was monitored using time domain and spectral domain optical coherence tomography images over 16 years.</p><p><strong>Results: </strong>A 68-year-old man with high myopia was referred for surgical evaluation of a full-thickness macular hole and retinal detachment of his left eye, which were repaired. At the initial presentation, the fellow eye demonstrated a lamellar hole, which eventually also progressed to become a full-thickness macular hole. The patient subsequently declined surgery and was observed semiannually over the course of 16 years. At 10 years after the initial injury, the full-thickness macular hole closed spontaneously. The visual recovery was excellent with an acuity of 20/25.</p><p><strong>Conclusion: </strong>Although surgical intervention remains the mainstay of treatment for macular holes, patients who are not surgical candidates may still have good visual and anatomic outcomes even long after initial hole formation. Lamellar hole epiretinal proliferation material is frequently seen in myopic full-thickness macular holes and may be associated with eventually delayed hole closure because of their slow progression.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"244-247"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801716","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}
Janet S Sunness, Rivka Hadassah Sunness, David B Hellmann
{"title":"HYDROXYCHLOROQUINE CAN BE RESUMED WITH CLOSE MONITORING AFTER RETINOPATHY HAS DEVELOPED, WITHOUT MAJOR VISUAL LOSS: CASE REPORT.","authors":"Janet S Sunness, Rivka Hadassah Sunness, David B Hellmann","doi":"10.1097/ICB.0000000000001536","DOIUrl":"10.1097/ICB.0000000000001536","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to present a patient with systemic lupus erythematosus on longstanding hydroxychloroquine (HCQ) use for whom HCQ was stopped because of signs of toxicity and then resumed four years later because of dire systemic need.</p><p><strong>Methods: </strong>This is a long-term retrospective study. Humphrey visual fields (10-2 and 24-2), fundus autofluorescence imaging, and spectral domain optical coherence tomography (OCT) were used to follow progression over time.</p><p><strong>Results: </strong>The patient was on HCQ for 26 years, with a cumulative dose over 3,000 g. HCQ was stopped in 2011 because of macular toxicity. She remained off HCQ for four years, during which time she developed type 1 diabetes due to an immunologic attack on the pancreas and then JC (John Cunningham) viremia after a period of treatment with mycophenolate, which put her at risk for progressive multifocal leukoencephalopathy. Mycophenolate was discontinued, and HCQ was resumed with careful follow-up over the next 7 years. The toxic maculopathy showed only mild slow progression since HCQ was resumed.</p><p><strong>Conclusion: </strong>Careful annual monitoring using Humphrey visual field 10-2 and spectral domain OCT imaging remains the standard of care for the patients on HCQ. However, it may be possible with close monitoring when there is compelling systemic need to resume HCQ after it has been stopped, with only slow progression of the retinopathy. This allowed the patient to have an improved quality of life and reduced the risk of severe morbidity and mortality.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049772","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}