GMS ophthalmology cases最新文献

{"title":"The enigma of a subluxated globe.","authors":"Pratheeba Devi Nivean, T S Mohammed Sayee, Sonam Nisar, Nivean Madhivanan","doi":"10.3205/oc000236","DOIUrl":"10.3205/oc000236","url":null,"abstract":"<p><p>Spontaneous globe subluxation (SGS) is an uncommon condition wherein the equator of the globe protrudes anteriorly beyond the eyelid aperture causing severe lagophthalmos, proptosis and exposure keratopathy. SGS can lead to an emotional disturbance leading to anxiety and fear, thereby affecting one's quality of life. The patients might often be able to reduce the globe on their own, but permanent measures must be taken to prevent recurrence and vision-threatening sequelae of SGS. We present this case due to its rarity and to highlight the importance of a simple, cost-effective and cosmetically acceptable bilateral tarsorrhaphy in management of SGS.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"14 ","pages":"Doc04"},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11106630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077209","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":"Ocular surface squamous neoplasia masquerading as pseudoepitheliomatous hyperplasia in chronic vernal keratoconjunctivitis.","authors":"Aditi Ghosh Dastidar, Deepika Khedia, Sugandha Goel","doi":"10.3205/oc000234","DOIUrl":"10.3205/oc000234","url":null,"abstract":"<p><p>We report a rare case of ocular surface squamous neoplasia (OSSN) masquerading as pseudoepitheliomatous hyperplasia in chronic vernal keratoconjunctivitis (VKC). A 24-year-old man presented with a history of bilateral VKC since childhood with a superior limbal mass in the right eye. There was a history of use of intermittent corticosteroids in the past. He underwent impression cytology followed by excision biopsy with wide margins (no touch technique), cryotherapy and amniotic membrane transplantation. Histopathological analysis confirmed the diagnosis of OSSN with mild to moderate dysplasia. This case highlights the importance of strong clinical suspicion and detailed cytological and histopathological examination for early detection and management of OSSN.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"14 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934503","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":"Xerophthalmia secondary to bowel malabsorption after Roux-en-Y gastric bypass.","authors":"José Arturo Oyervides-Alvarado, Schenny Murra-Anton, Ethel Guinto-Arcos, Laura Alejandra González-Dibildox, Nallely Ramos-Betancourt","doi":"10.3205/oc000233","DOIUrl":"10.3205/oc000233","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin A is a fat-soluble vitamin, obtained through diet. Vitamin A deficiency is the leading cause of preventable blindness in children in developing countries due to impaired intake (Phanachet et al. 2018). Nevertheless, it is uncommon in the developed world where malabsorption takes a prominent role.</p><p><strong>Case description: </strong>A fifty-one-year-old female presented complaining of foreign body sensation, pain, tearing, fluctuating visual acuity, nyctalopia, diarrhea, polyphagia and weight loss. She had history of Roux-en-Y gastro-jejunal bypass, Lynch syndrome and right hemicolectomy with ileo-colonic anastomosis, she also referred to an additional unspecified bowel resection. In the ophthalmologic examination, best corrected visual acuity was 20/30, intraocular pressure was 11 mmHg in both eyes. Anterior segment biomicroscopy revealed a dry and thickened conjunctiva with wrinkles, multiple grey-white small, round, confluent, foamy lesions in the interpalpebral conjunctiva of both eyes, compatible with Bitot's spots, and superficial punctate keratitis.</p><p><strong>Discussion: </strong>The rise of bariatric surgery, inflammatory bowel disease and end stage liver disease has led to an increase in cases of malabsorption syndrome and nutrient deficiencies in the developed world. Retinoids are essential for corneal and conjunctival epithelial cells differentiation and its deficiency is associated with a wide spectrum of ocular surface manifestations known as xerophthalmia. In this case, a gastric bypass and another unspecified bowel resection should raise the suspicion of malabsorption and nutrient deficiencies. In our patient, the diagnosis was made early and appropriate treatment was implemented before irreversible damage arose, however, vitamin A deficiency can be easily overlooked.</p><p><strong>Conclusion: </strong>In patients with xerophthalmia, interrogation should include previous history of gastrointestinal surgery, especially since bariatric surgery has become a popular technique. This is, to our knowledge, the first case report of xerophthalmia in a patient with Lynch syndrome.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"14 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934504","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":"Focal reactive nodular gliosis: an extremely rare retinal astrocytic tumor.","authors":"Saúl Villoria-Díaz, María Antonia Saornil-Álvarez, Ciro García-Álvarez, Elena García-Lagarto, Irene Bermúdez-Castellanos","doi":"10.3205/oc000230","DOIUrl":"10.3205/oc000230","url":null,"abstract":"<p><p>Focal reactive nodular gliosis (FRNG) is an extremely rare benign retinal reactive astrocytic tumor that results from the proliferation of well-differentiated glial cells secondary to a variety of retinal conditions. We describe a case of this tumor in a 64-year-old male in association with a chorioretinal scar he has had since childhood. The symptom was sudden painful vision loss. In the clinical examination, iris rubeosis, posterior synechiae, cataract, vitreous haze and a suspected fundus mass were showed. B-scan ultrasonography demonstrated a retinal mass consistent with choroidal melanoma. The magnetic resonance imaging (MRI) showed a well-circumscribed mass with T1 hyperintensity and T2 hypointensity. Enucleation was performed and histopathologic and immunohistochemical studies confirmed the diagnosis of FRNG.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc22"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814650","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":"Infliximab-induced retrobulbar optic neuritis in a patient with ankylosing spondylitis.","authors":"Sema Dündar, Mimbay Yaşar, Harun Çakmak, Nefati Kıylıoğlu, Alparslan Ünsal","doi":"10.3205/oc000232","DOIUrl":"https://doi.org/10.3205/oc000232","url":null,"abstract":"<p><strong>Objective: </strong>To present a case with infliximab-induced retrobulbar optic neuritis.</p><p><strong>Case description: </strong>A 58-year-old woman presented to our clinic with a two-day history of blurred vision in her right eye. She had numerous uveitis attacks previously, and she was on infliximab treatment for ankylosing spondylitis. Her best-corrected visual acuity was counting fingers and 20/25 in the right and left eye, respectively. Optic discs seemed healthy in fundoscopic examination. The right optic nerve showed high signal intensity on magnetic resonance imaging (MRI). Infliximab treatment was discontinued and systemic steroid therapy was started. After the treatment her best-corrected visual acuity improved to 20/20 in her right eye.</p><p><strong>Conclusion: </strong>Infliximab is a chimeric human-murine monoclonal antibody used in autoimmune diseases. Optic neuritis is a rare but important side effect of infliximab. Thus, infliximab-induced optic neuritis should be kept in mind for patients receiving infliximab treatment.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc24"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814656","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":"Multimodal analysis in symptomatic MIDD-associated retinopathy. A case report and literature review.","authors":"Katarzyna Chwiejczak, Daniel Byles, Paul Gerry, Hirut Von Lany, Anastasia Tasiopoulou, Andrew Hattersley","doi":"10.3205/oc000231","DOIUrl":"https://doi.org/10.3205/oc000231","url":null,"abstract":"<p><strong>Purpose: </strong>To present results of contemporary multimodal ophthalmic imaging in a case of maternally inherited diabetes and deafness (MIDD) and a literature review of MIDD.</p><p><strong>Methods: </strong>A case of a 47-year-old female with diabetes mellitus, severe insulin resistance, familial lipodystrohy, deafness and increasing problems with vision is reported. A full ophthalmic examination was done, including best corrected visual acuity (BCVA, LogMAR), funduscopy, and imaging studies: optical coherence tomography (OCT), OCT angiography (OCT-A), fundus autofloresence (FAF), visual fields (HVF) 10-2 , electrophysiology (EP) and genetic testing were performed. Literature available on the topic was reviewed.</p><p><strong>Results: </strong>BCVA was 0.06 LogMAR in the right eye and 0.1 LogMAR in the left. Funduscopy revealed atrophy (AT) and pigmentary changes but no diabetic retinopathy. HVF confirmed corresponding defects. The imaging and diagnostic tests showed the following abnormalities: FAF: hypoautofluoresence in areas of AT and mottled appearance in the macular and peripapillary area; OCT: attenuation of outer retinal layers and retinal pigment epithelium (RPE) in the AT; OCT-A: thinning of the deep capillary plexus and choriocapillaris; EP: abnormalities on full field electroretinogram (ERG), 30 Hz flicker and single cone flash response; multifocal ERG: reduced responses; genetic testing: A-to-G transition mutation at position 3243 of the mitochondrial genome, typical for MIDD. After one year OCT ganglion cell analysis showed loss of thickness.</p><p><strong>Conclusions: </strong>Genetic testing should be considered in diabetic patients with pigmentary retinopathy. Imaging studies and diagnostic testing showed structural and functional retinal changes, confined to the macula and progressive in nature.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc23"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814657","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 presentation of a common carotid artery occlusion.","authors":"Amber Demeuleneere, Julie Lambert, Jelle Demeestere, Robin Lemmens, Inge Fourneau, Sabrina Houthoofd, Pieter-Paul Schauwvlieghe, Julie Jacob, Catherine Cassiman","doi":"10.3205/oc000228","DOIUrl":"https://doi.org/10.3205/oc000228","url":null,"abstract":"<p><strong>Background: </strong>A common carotid artery occlusion (CCAO) is very rare and the clinical features of CCAO have rarely been described. Since the blood supply of the eye and orbit is derived from the internal carotid artery, a CCAO may present with various ophthalmological symptoms, ranging from incidental findings to complete visual loss but also other neuro-ophthalmological abnormalities.</p><p><strong>Case report: </strong>A 61-year-old woman presented with acute monocular vision loss and an elevation deficit of the right eye. Fluorescein angiography showed delayed filling of both the retinal and choroidal vasculature, without occlusion/embolisms of the retinal arteries. Vascular imaging showed a right CCAO.</p><p><strong>Conclusion: </strong>CCAO has a variable presentation. In patients with acute unilateral visual loss a CCAO should be considered, especially when ocular motility deficits are present. Fluorescein angiography examination can aid in the localization and diagnosis of the vascular insult. Urgent referral for a systemic work-up is essential.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc20"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814645","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":"Recurrent multiple eye muscle palsy as a first sign of sarcoidosis.","authors":"Isabel Deboutte, Daisy Godts, Michel Van Lint","doi":"10.3205/oc000229","DOIUrl":"https://doi.org/10.3205/oc000229","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian female.</p><p><strong>Methods: </strong>Case report with clinical imaging.</p><p><strong>Results: </strong>A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months. Three years later she was diagnosed with a sixth nerve palsy in the fellow eye followed by a complete palsy of the left third cranial nerve four months after. Medical history consisted of migraine and hypercholesterolemia. Further neurological and ophthalmic work-up was unrevealing at first. After repeated magnetic resonance imaging, an enhancing lesion in the left cavernous sinus was seen, which was initially diagnosed as a meningioma. However, imaging of the chest revealed an image of sarcoidosis, and the lesion and ophthalmoplegia of the left eye disappeared with systemic corticosteroid treatment.</p><p><strong>Discussion: </strong>Sarcoidosis is the ultimate imitator and the possibility of neurosarcoidosis must be taken into account when presented with unexplained ophthalmoplegia. Neurosarcoidosis has imaging properties very similar to other diseases such as a meningioma, and misdiagnosis occurs easily. Spontaneous recovery of ophthalmoplegia can rarely occur in neurosarcoidosis.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc21"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814658","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":"Intraocular twin cysticercosis.","authors":"Rohini Grover,&nbsp;Abhishek Varshney,&nbsp;Supreet Juneja,&nbsp;Upma Awashti,&nbsp;Sonali R Singh","doi":"10.3205/oc000226","DOIUrl":"10.3205/oc000226","url":null,"abstract":"A 20-year-old vegetarian male presented with a history of painful diminution of vision in the right eye for the past month. The patient had dense vitritis. B-scan ultrasonography (USG) revealed two cysts with scolices, one subretinally along with retinal detachment and another one in vitreous cavity. Orbital USG revealed no cystic lesions in the orbit or extraocular muscle. He underwent 23 gauge pars plana vitrectomy. Both intravitreal and subretinal cysts were cut and aspirated using cutter and removed from the eye, and silicon oil was injected. Postoperatively he was started on oral steroids and advised to maintain prone positioning for two weeks. At two months his best corrected visual acuity (BCVA) in the right eye was 20/125 with silicon oil in situ.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc18"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241747","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":"Toxic anterior segment syndrome following trabeculectomy with mitomycin C.","authors":"Helen Ginger-Eke,&nbsp;Chimdia Ogbonnaya,&nbsp;Annamalai Odayappan,&nbsp;Jude Shiweobi","doi":"10.3205/oc000225","DOIUrl":"10.3205/oc000225","url":null,"abstract":"<p><strong>Objective: </strong>Toxic anterior segment (TASS) is a rare acute sterile anterior segment inflammation that typically develops within 12 to 24 hours after an anterior segment surgery. The purpose of this case report is to alert surgeons to the possibility of this complication following any anterior segment surgery, including trabeculectomy, and to highlight the possible etiologies and measures to prevent it.</p><p><strong>Patient and method: </strong>A 58-year-old male glaucoma patient was initially managed medically for primary open angle glaucoma with antiglaucoma medications. There was rapidly progressive glaucomatous optic nerve damage in his left eye within the following year, despite the use of antiglaucoma medications, hence the need for trabeculectomy.</p><p><strong>Result: </strong>The post-operative condition of the patient's eye was stormy with diffuse limbus-to-limbus corneal edema and profound Descemet's membrane folds, among other features of TASS, with associated deteriorating visual acuity.</p><p><strong>Conclusion: </strong>Although there is no documented report of TASS following trabeculectomy with mitomycin C, surgeons should be alerted to this possibility. Preventive measures include extreme care to avoid errors while preparing and administering diluted solutions, especially medications that are administered into the intracameral space.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"13 ","pages":"Doc17"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241750","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}