GMS ophthalmology cases最新文献

{"title":"Acute zonal occult outer retinopathy: optical coherence tomography angiography findings and treatment response.","authors":"Erhan Özyol,&nbsp;Pelin Özyol","doi":"10.3205/oc000203","DOIUrl":"https://doi.org/10.3205/oc000203","url":null,"abstract":"<p><p>Acute zonal occult outer retinopathy (AZOOR) is a rare condition primarily affecting the outer retina based on electrophysiologic studies. In addition to characteristic fundus appearance, spectral domain optical coherence tomography and fundus autofluorescence are unique in diagnosing AZOOR. There are a few reports on optical coherence tomography anjiography (OCTA) in AZOOR disease. In this report, we present a case using multimodal imaging including OCTA and treatment response to combined systemic antiviral, antiinflammatory, and immunosuppressive drugs. En-face OCTA outer retinal slab may provide useful tips for diagnosis and treatment response.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc16"},"PeriodicalIF":0.0,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9285114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572443","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":"Toxoplasmosis chorioretinitis mimicking cytomegalovirus retinitis in an immunocompromised pediatric patient following bone marrow transplantation.","authors":"Anubhav Garg,&nbsp;Bryon R McKay,&nbsp;Carolina L M Francisconi,&nbsp;Rajeev H Muni","doi":"10.3205/oc000201","DOIUrl":"https://doi.org/10.3205/oc000201","url":null,"abstract":"<p><strong>Objective: </strong>To review a case of toxoplasmosis chorioretinitis mimicking cytomegalovirus retinitis in an immunocompromised patient following bone marrow transplantation.</p><p><strong>Methods: </strong>Retrospective chart review of a 14-year-old female who had a history of leukemia and allogeneic bone marrow transplants prior to her ocular symptoms.</p><p><strong>Results: </strong>Anterior chamber fluid analysis was positive for <i>Toxoplasma gondii</i>. The patient responded well when cytomegalovirus retinitis treatment was switched to intravitreal clindamycin with systemic sulfadiazine and prednisone.</p><p><strong>Conclusions: </strong>This case demonstrates the challenges of diagnosing and treating retinal infections in immunocompromised patients as they may present with atypical findings that mimic other pathologies and may have contraindications against standard treatment.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572439","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":"Acute myeloid leukemia presenting as unilateral central retinal vein occlusion.","authors":"Ashok Kumar,&nbsp;Sandeep Shankar,&nbsp;Divya Kochhar,&nbsp;Amit Arora,&nbsp;Kapil Kumar","doi":"10.3205/oc000202","DOIUrl":"https://doi.org/10.3205/oc000202","url":null,"abstract":"<p><p>Ocular manifestations of leukemia are often bilateral and involve all ocular structures with non-specific features like retinal hemorrhages, cotton wool spots and choroidal infiltrates. We report a rare, atypical initial presentation of acute myeloid leukemia with unilateral central retinal vein occlusion in a middle-aged male. This case will raise awareness among ophthalmologists to recognize and diagnose underlying systemic disease early and decrease systemic morbidity in consultation with a hematologist.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9285115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572441","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":"Choroidal metastasis as a presenting feature in a metastatic lung carcinoma.","authors":"Mukesh Jain,&nbsp;Deepika C Parameswarappa","doi":"10.3205/oc000200","DOIUrl":"https://doi.org/10.3205/oc000200","url":null,"abstract":"<p><p>We report a case of a 65-year-old female who presented to us with diminution of vision in the right eye. She was only able to perceive light in the right eye, and the left eye had a vision of 20/20, N6. Anterior segment examination in both eyes was unremarkable except for senile cataract in the left eye. Posterior segment examination revealed features of choroidal metastasis in both eyes and exudative retinal detachment in the right eye. Multimodal imaging helped in the further confirmation of metastatic lesions. Right-eye fundus autofluorescence showed hyperautofluorescent lesions, ultrasound B-scan showed an elevated mass lesion in the choroid with moderate to high internal echogenicity, and optical coherence tomography showed a lumpy-bumpy appearance of the retinal pigment epithelium as well as an elevated choroidal mass lesion beneath it. On detailed systemic evaluation, the primary site of cancer was found to be the lungs. The patient was referred to a pulmonologist and an oncologist for chemotherapy and further management.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc13"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9285108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572442","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":"Simultaneous bilateral inflammatory choroidal neovascularization in a case of healed serpiginous-like choroiditis.","authors":"Gitanjli Sood,&nbsp;Ramanuj Samanta,&nbsp;Devesh Kumawat,&nbsp;Prateek Nishant","doi":"10.3205/oc000199","DOIUrl":"https://doi.org/10.3205/oc000199","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory choroidal neovascularization (i-CNV) is an infrequent but sight-threatening complication of posterior uveitis. Although it can occur in a wide range of infectious and non-infectious uveitides, presence of simultaneous bilateral i-CNV is rare. In this report, we present a unique case of bilateral simultaneous i-CNV in a young patient of healed tubercular serpiginous-like choroiditis.</p><p><strong>Method: </strong>A 20-year-old male presented with recent worsening of vision in the right eye for one month. Fundus examination revealed bilateral multifocal healed choroiditis lesions with right eye tiny subfoveal hemorrhage raising the suspicion of an underlying choroidal neovascularization. Fundus fluorescein angiography and optical coherence tomography confirmed presence of choroidal neovascular membrane in both eyes.</p><p><strong>Result: </strong>Resolution of activity was noted in both eyes after bilateral sequential intravitreal bevacizumab injections.</p><p><strong>Conclusion: </strong>Inflammatory choroidal neovascularization may be seen in patients with healed tubercular serpiginous-like choroiditis, after a long period of quiescence. Simultaneous bilateral presentation is rare but possible, requiring mandatory multimodal imaging of both eyes under high index of suspicion. Early institution of anti-vascular endothelial growth factor may salvage optimum vision in such a scenario.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc12"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571987","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 imaging of a sporadic retinal astrocytic hamartoma simulating retinoblastoma in a newborn.","authors":"Bilge Batu Oto,&nbsp;Aslihan Yilmaz Çebi,&nbsp;Oguzhan Kiliçarslan,&nbsp;Ahmet Murat Sarici","doi":"10.3205/oc000198","DOIUrl":"https://doi.org/10.3205/oc000198","url":null,"abstract":"<p><strong>Introduction: </strong>To report a sporadic astrocytic hamartoma simulating retinoblastoma in a newborn.</p><p><strong>Methods: </strong>Clinical data was reviewed retrospectively.</p><p><strong>Results: </strong>A 3-month-old baby with a history of perinatal asphyxia was referred to our ocular oncology clinic with suspected retinoblastoma in the left eye. Dilated fundoscopy revealed a solitary tumor covering the optic disc at the left eye. The whitish-yellow lesion was well-defined, opaque, and minimally calcified. High internal reflectivity and posterior shadowing due to the intralesional calcification, and intratumoral cystic spaces were observed in B-scan ultrasound imaging. Optical coherence tomography imaging showed an intraretinal tumor with cystic spaces and posterior shadowing. The tumor was diagnosed as an astrocytic hamartoma. The systemic evaluation was negative for phacomatoses. The lesion has been observed with multimodal imaging for six years without significant changes.</p><p><strong>Conclusions: </strong>Retinal astrocytic hamartomas are benign tumors that arise within the retinal nerve fiber layer. Differential diagnosis constitutes high importance since they may be misdiagnosed as retinoblastoma, and therefore may be overtreated. Whereas retinoblastoma requires immediate treatment, retinal astrocytic hamartomas are commonly followed-up. Multimodal imaging with B-scan ultrasonography and optical coherence tomography are useful in distinguishing those two entities.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572440","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":"Intraoperative optical coherence tomography (I-OCT) assisted passage of the encircling element during retinal detachment surgery","authors":"A. Markan, N. Gupta, Basavaraj Tigari, Ramandeep Singh, M. Dogra","doi":"10.3205/oc000197","DOIUrl":"https://doi.org/10.3205/oc000197","url":null,"abstract":"Objective: To describe the role of microscope integrated optical tomography (Mi-OCT) in passage of the encircling element during retinal detachment surgery. Materials and methods: Mi-OCT was switched on while passing scleral anchoring sutures to secure the encircling element. The depth of the suture tract was seen in real time while the needle was passed through the sclera. The amount of scleral intend achieved was assessed using Mi-OCT at the end of the surgery. Results: The depth of needle tract through the sclera and the amount of scleral indentation achieved while tying the sutures could be successfully analyzed using Mi-OCT. Conclusion: Mi-OCT can be used as an adjunct while training vitreoretinal fellows and trainees in surgical procedures like passage of scleral sutures for anchoring the encircling element.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42263874","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":"Reversal of vision after bleomycin injection in orbital lymphangioma","authors":"Pratheeba Devi Nivean, Nivean Madhivanan","doi":"10.3205/oc000196","DOIUrl":"https://doi.org/10.3205/oc000196","url":null,"abstract":"Lymphangiomas are benign hemartomatous tumors that can occur in all parts of the body, but most frequently in the neck (75%), as well as in the axilla and inguinal areas. Surgical removal is very difficult, as it is very fragile and tumor dissection is very difficult. Ultrasound-guided bleomycin injection directly into the cyst collapses the cyst and shrinks the tumor. It reduces proptosis, discomfort, and cosmetic blemish. We present this case who had gross defective vision and relative afferent pupillary defect in her right eye for 10 days which tremendously improved after injection.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43236055","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":"Multimodal imaging in choroidal osteomas","authors":"Sugandha Goel, Sudipta Das, A. J. Rijey, D. Das","doi":"10.3205/oc000194","DOIUrl":"https://doi.org/10.3205/oc000194","url":null,"abstract":"Choroidal osteoma is a rare benign tumor which is found in the posterior pole of the eye. We herein describe multimodal imaging in two cases of choroidal osteoma. Fundus of our first case showed a yellowish-orange colored subretinal lesion at the posterior pole. Multicolor imaging highlighted the lesion with greenish hue. Infrared reflectance showed hyporeflectance. A dense echogenic plaque persisting in lower gain was noted on B-scan. FFA showed hyperfluorescence with corresponding hypocyanescence on ICG. EDI OCT showed an increase in choroidal thickness with elevated retinal pigment epithelium. The second case showed choroidal osteoma with active choroidal neovascular membrane that responded to intravitreal injection of Ranibizumab.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41824905","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":"Atypical lymphoid proliferation of the orbit","authors":"Lee Tomas Obias Tan, Felice Katrina C. Trio-Ranche","doi":"10.3205/oc000193","DOIUrl":"https://doi.org/10.3205/oc000193","url":null,"abstract":"Objective: Lymphoproliferative disorders are a group of lesions characterized by abnormal proliferation of lymphocytes. In the orbit, they can occur in the ocular adnexae. These neoplasms have defined clinical and pathologic characteristics and account for more than 20% of all orbital tumors. Several types of lymphoproliferative lesions have been described in the orbit. One example is lymphoid hyperplasia, which commonly involves the lacrimal gland. A benign lesion like lymphoid hyperplasia will show a general normal archetype of the tissues-involved lacrimal gland. We expect a polyclonal group of cells with more or less normal architecture of a follicle. On the other hand, lymphoma will show less organized arrangement of cells, and we expect them to be of monoclonal lineage. Methods: This is a case report of a 55-year-old Filipino female who came in for blurring of vision of both eyes. During her assessment, there was an incidental finding of bilateral upper eyelid swelling, and a 30x15 mm palpable firm mass under the right superior orbital rim and a 30x10 mm mass under the left were noted. The right globe was displaced inferiorly, but no proptosis was seen on exophthalmometry. On plain CT scan, we noted a homogenous mass with molding or contouring around the orbital structures. On coronal view, we noted homogenous masses that mold around the globe and recti, and this also confirmed on axial cuts. A section biopsy was done via anterior orbitotomy. Results: Our patient’s histopath had features of both. On scanning magnification, we noted a very cellular round cell tumor. The round cell lesion seemed to be reminiscent of a germinal center of a lymph node. Around it we noticed the glandular structures, which were expected, since this specimen was from the lacrimal gland. A closer view of the lesion on high power showed these lymphocytes within a germinal center. These are large macrophages that actively phagocytose apoptotic lymphoid cells in germinal centers. We expect to see a lot of them in benign hyperplasia, but only a few will be present in malignancies. In summary, our patient had both benign and malignant features, resulting in a histopath result of atypical lymphoid proliferation. Conclusion: Atypical lymphoid proliferation is a rare orbital tumor with benign and malignant features. There is no standard protocol for treatment, and proper multi-specialty coordination is important. External beam radiation therapy with linear accelerator (LINAC) appears to be an effective treatment, with no recurrence in our patient after 5 months.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45532420","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}