GMS ophthalmology cases最新文献

{"title":"Cancer-associated retinopathy secondary to gallbladder carcinoma.","authors":"Karel Goyvaerts, Tanja Coeckelbergh, Pieter-Paul Schauwvlieghe, Michel van Lint","doi":"10.3205/oc000243","DOIUrl":"10.3205/oc000243","url":null,"abstract":"<p><strong>Objective: </strong>To present a rare case of cancer-associated retinopathy secondary to gallbladder carcinoma.</p><p><strong>Methods: </strong>Retrospective case report. Drugs used in case report: methylprednisolone (Medrol), CAS number: 83-43-2, producer: Pfizer; carboplatin, CAS number: 41575-94-4, producer: Accor; etoposide, CAS number: 33419-42-0, producer: Teva; methotrexate (Ledertrexate), CAS number: 59-05-2, producer: Pfizer.</p><p><strong>Results: </strong>A 57-year-old Moroccan man was referred with bilateral progressive vision loss in the last 4 months. At presentation, best corrected visual acuity (BCVA) was counting fingers for the right eye and 20/500 for the left eye. Examination demonstrated signs of vitritis, an electronegative full-field electroretinography (FF-ERG), ocular coherence tomography (OCT) abnormalities and multiple hyperautofluorescent round lesions on fundus autofluorescence imaging (FAF). The diagnosis of cancer-associated retinopathy (CAR) was considered, thus a positron emission tomography-computed tomography (PET-CT) was performed and revealed the presence of a metastasized gallbladder carcinoma. Additional fluorescence in situ hybridization (FISH) showed seropositivity for anti-retinal autoantibodies. High-dose corticosteroids together with anti-tumoral medication (carboplatin-etoposide) gradually improved the BCVA to 20/66 for the right eye and 20/20 for the left eye.</p><p><strong>Conclusions: </strong>Consider the diagnosis of CAR in patients with progressive concentric visual field loss, uveitis and fundus abnormalities, especially if bilateral. If CAR is suspected, perform a full work-up: FF-ERG, OCT, and whole-body PET-CT. In the treatment of CAR, immunosuppressives are mostly used, combined with antitumoral therapy. However, in the long-term, progressive visual loss is expected in most cases.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395693","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}

{"title":"Epithelial downgrowth masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-FU treatment.","authors":"Colin P Froines, Alexander D Lin, Kaivon Pakzad-Vaezi, Gordana Juric-Sekhar, Caitlin S Latimer, Kathryn P Scherpelz, C Dirk Keene, Eissa M Hanna, Michael R Banitt, Luis F Gonzalez-Cuyar","doi":"10.3205/oc000245","DOIUrl":"10.3205/oc000245","url":null,"abstract":"<p><strong>Purpose: </strong>Highlight an unusual case of epithelial downgrowth (EDG) masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-fluorouracil (5-FU) treatment.</p><p><strong>Case description: </strong>A 33-year-old man presented after multiple corneal surgeries and neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomies with subacute angle closure, pain, light sensitivity, and decreased vision. Exam was notable for granulomatous keratic precipitates, an opacified lens capsule, and vitreous cell/haze. An anterior chamber paracentesis was sent for 16 s (pan-bacterial) and 28 s (pan-fungal) rRNA polymerase chain reaction testing, which returned negative. Diagnostic argon laser photocoagulation was performed on the iris and lens capsule, which blanched upon laser photocoagulation, and subsequent iris biopsy confirmed the presence of epithelial downgrowth (EDG). The patient was treated with multiple injections of 5-FU with repeat biopsy demonstrating both a reduction and apparent resolution in epithelial cell burden after 5-FU.</p><p><strong>Conclusion: </strong>This case demonstrates an unusual presentation of EDG in a young patient with granulomatous anterior and intermediate uveitis, where simple office-based procedures of Argon laser photocoagulation and anterior chamber paracentesis helped aid in diagnosis and management. Histopathological examination in serial specimens demonstrated the effect of 5-FU on EGD. To our knowledge, this case is the first to describe histopathological reduction in epithelial cell burden with sustained resolution.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395725","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}

{"title":"Pseudophakic corneal edema caused by Descemet membrane detachment using high-resolution swept-source OCT imaging.","authors":"Maximilian K Köppe, Ramin Khoramnia, Gerd U Auffarth, Victor A Augustin","doi":"10.3205/oc000244","DOIUrl":"10.3205/oc000244","url":null,"abstract":"<p><strong>Background: </strong>Small Descemet membrane detachments after cataract surgery are relatively common and most cases do not require any secondary surgical intervention and can be treated conservatively. However, in case of advanced Descemet membrane detachment (DMD), it needs to be recognized and treated appropriately. The advent of anterior segment imaging using optical coherence tomography (OCT) technology has made diagnosing pathologies of the anterior segment accurate and time efficient and has proven as an invaluable tool to guide decision making.</p><p><strong>Case presentation: </strong>A 71-year-old patient presented after complicated cataract surgery with decreased visual acuity and cloudy vision. On examination, best corrected visual acuity was 1.5 logMAR. A high-resolution swept-source OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) was used to better evaluate and visualize the extent of DMD. An anterior chamber gas bubble was injected to reattach the Descemet membrane (DM) to the corneal stroma. The success of the surgery was visualized using the high-resolution swept-source OCT. This revealed a completely attached Descemet membrane.</p><p><strong>Conclusions: </strong>Clinically, it can be difficult to distinguish the etiology of epithelial and stromal edema post cataract surgery. This case demonstrated the clinical usefulness using high resolution swept source imaging to guide clinical decision making in evaluating timing and treatment success of pneumodescemetopexy after complicated cataract surgery.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395726","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}

{"title":"Diffuse preretinal infiltrates in a patient with orbital atypical T-cell lymphoproliferative infiltration masquerading posterior uveitis.","authors":"Bilge Batu Oto, Oğuzhan Kılıçarslan, Didar Uçar, Samira Hagverdiyeva, Ahmet Murat Sarıcı","doi":"10.3205/oc000242","DOIUrl":"10.3205/oc000242","url":null,"abstract":"<p><strong>Purpose: </strong>To report an aggressive and rapidly progressive case of atypical T-cell lymphoproliferative infiltration both with intraocular and orbital involvement and preretinal infiltrates.</p><p><strong>Methods: </strong>Medical records and imaging of the patient were retrospectively reviewed.</p><p><strong>Case presentation: </strong>A 25-year-old woman presented first with preretinal infiltrates resembling uveitis and developed orbital and intracranial signs eventually during her evaluation. Clinical presentation worsened gradually. The patient developed bilateral proptosis, pupillary dilation and uvula deviation. Diagnostic orbital incision biopsy revealed T-cell lymphoproliferative disease.</p><p><strong>Conclusion: </strong>This case gives evidence that intraocular involvement due to T-cell lymphoproliferative disease may present as a masquerade syndrome and should be kept in mind in patients with extraordinary presentation.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395694","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}

{"title":"Combined use of intravitreal bevacizumab and oral steroid treatment in three diabetic papillopathy patients: a diagnostic and treatment challenge.","authors":"Burcu Taşkıran Kandeğer, Mehmet Argun, Levent Tök, Özlem Tök","doi":"10.3205/oc000238","DOIUrl":"10.3205/oc000238","url":null,"abstract":"<p><p>Diabetic papillopathy (DP), a form of optic disc edema, is characterized by decreased visual acuity and mild to severe visual field defects. While there is no consensus about treatment, some publications report that intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection may be beneficial. To our knowledge, however, no research reports on the effects of combining anti-VEGF injection and oral steroids in DP treatment. In this case report we present three DP cases that showed rapid improvement following therapy with intravitreal bevacizumab and oral steroids. Optic disc edemas were significantly decreased, and visual acuities were markedly increased in the first week of treatment. This report suggests that combined use of these therapies may be safely used in patients diagnosed with DP.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592280","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}

{"title":"Unilateral alacrimia as a presenting symptom of Meckel's cave tumour.","authors":"Ignacio Manuel López Miñarro, Laura Prieto Domínguez, Víctor Manuel Asensio-Sánchez","doi":"10.3205/oc000241","DOIUrl":"10.3205/oc000241","url":null,"abstract":"<p><p>Meckel's cave tumour, a rare benign tumour originating from the Schwann cells surrounding the trigeminal nerve within the Meckel's cave region, can present with a variety of clinical manifestations. We report a case of a 44-year-old male patient who presented with symptoms of tear deficiency, including dryness, ocular discomfort, and blurred vision. Diagnostic evaluation revealed the presence of a Meckel's cave tumour harming the trigeminal nerve, leading to alacrimia. This case highlights the association between Meckel's cave tumour and tear deficiency disorders.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592291","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}

{"title":"A case of endogenous endophthalmitis caused by Escherichia coli septicemia.","authors":"Tejinder Talwar, Prateek Chandra, Sugandha Goel, Kuntal Patel","doi":"10.3205/oc000239","DOIUrl":"10.3205/oc000239","url":null,"abstract":"<p><p>Endogenous endophthalmitis is a severe sight-threatening condition that requires urgent intervention. It is a rare complication of <i>Escherichia coli</i> septicemia. We herein report a case of left eye endogenous endophthalmitis with uncontrolled type 2 diabetes mellitus with pyelonephritis associated with <i>Escherichia coli</i> septicemia. Vitrectomy was done along with intravitreal antibiotics and steroids. There was significant improvement in vision after vitrectomy.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592637","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}

{"title":"Bilateral reversible optic neuropathy as the first sign of Waldenström macroglobulinema.","authors":"Yoshiaki Shimada, Yoshiki Akatsuka, Kazuya Nokura","doi":"10.3205/oc000240","DOIUrl":"10.3205/oc000240","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of bilateral reversible optic neuropathy as the first sign of Waldenström macroglobulinemia (WM).</p><p><strong>Methods: </strong>Observational case report.</p><p><strong>Results: </strong>A 52-year-old man had a sudden loss of vision in the left eye. Examinations revealed the presence of a serum monoclonal immunoglobulin (IgM kappa) in the serum. Even after a session of steroid pulse therapy, optic neuropathy became bilateral and then resolved almost completely after 4 months. The condition progressed to WM with multiorgan lesions years later. There was no evidence of optic neuropathy recurrence. The literature revealed two cases of monoclonal gammopathy (MG): a 64-year-old man with multiple myeloma (MM) with IgA lambda and a 51-year-old man with MM with IgG kappa. These cases have similar conditions: 1) visual reduction as an initial symptom of MG, 2) bilateral involvement, 3) no sign of central nervous system (CNS) infiltration shown by normal brain magnetic resonance images, and 4) recovery to a visual acuity of ≥1.0 bilaterally with no reoccurrence. The excessive Igs or B-cell hyperactivity may activate an autoimmune mechanism that reversibly interferes with the bilateral optic nerves.</p><p><strong>Conclusion: </strong>Bilateral optic neuropathy was the initial symptom of WM. There was no evidence of CNS infiltration; it recovered and then did not reoccur. The pathogenesis remained unknown, but two cases of MG were reported in the literature with remarkably similar conditions.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592279","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}

{"title":"A rare case report of bilateral Purtscher-like retinopathy in juvenile dermatomyositis.","authors":"Nidhi Paharia, Shruti Agrawal, Nikhil Agrawal, Jayesh Shah","doi":"10.3205/oc000237","DOIUrl":"10.3205/oc000237","url":null,"abstract":"<p><strong>Purpose: </strong>To report a rare case of bilateral Purtscher-like retinopathy (PLR) in a young adult diagnosed with dermatomyositis.</p><p><strong>Method: </strong>A case report with multi-modal imaging.</p><p><strong>Result: </strong>A 17-year-old male presented with subacute marked diminution of vision along with arthralgia, weakness of all four limbs and development of multiple rashes around body. Fundus examination revealed bilateral multiple Purtscher flecken, pseudo-cherry red spot, and intra-retinal haemorrhages with cotton wool spots. Systemic and laboratory examinations, magnetic resonance imaging (MRI) and biopsy of tissue confirmed the diagnosis of juvenile dermatomyositis with PLR.</p><p><strong>Conclusion: </strong>Dermatomyositis, being a rare cause of PLR, should essentially be considered as one of the differentials as timely intervention can alter the course of disease and prove life-saving for the patient.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332648","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}

{"title":"Rare metastasis in a patient with BRAF-mutated rectal cancer: choroidal metastasis - case report and literature review.","authors":"Hacer Demir, Mustafa Muhterem Ekim, Esra Özgül, Sena Ece Davarci, Meltem Baykara","doi":"10.3205/oc000235","DOIUrl":"10.3205/oc000235","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancers are common and have high mortality, and metastasis is common in follow up. Choroidal metastasis is encountered rarely in rectum cancers, and there is no previous case reported from Turkey. We present our patient who developed choroidal metastasis in his cancer follow-up.</p><p><strong>Case report: </strong>A 74-year-old male patient had undergone operation due to the diagnosis of rectum cancer two years ago, and lung (L) metastasis developed in the 4^th month after the adjuvant therapy, but he refused to receive treatment and remained out of follow-up. The patient presented with complaints of decreased vision and light flashes in his eye 21 months after the diagnosis.</p><p><strong>Management and outcome: </strong>Ocular examination revealed a choroidal mass and radiologically choroidal and multiple brain metastases were detected. In our case, whole-brain radiotherapy was administered in the treatment since there were also multiple brain metastases. However, as the ECOG (Eastern Cooperative Oncology Group) performance status of the patient was 3-4 after radiotherapy, systemic treatment was not considered appropriate, and the best supportive care was given. The patient died 2 months after the diagnosis of choroidal metastasis.</p><p><strong>Conclusion: </strong>Currently, there are few suggestions in case reports regarding appropriate treatment approaches for the treatment of rectal cancerchoroidal metastases. Multidisciplinary approaches may be effective for local and systemic treatment. Our case highlights a pathological entity with poor prognosis, which is rarely encountered during the course of rectal adenocarcinomas, and it is the first case of choroidal metastasis reported from our country. However, we believe that it will be important to draw attention to the fact that it is the first reported case of choroid metastasis in a rectal cancer patient with a BRAF V600 E mutation, and patients with BRAF V600 E mutation may develop metastasis to atypical areas due to their aggressive biology.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11106631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077111","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}