{"title":"A case of primary vasoproliferative tumor with full-thickness macular hole","authors":"P. Rishi, Janani Sreenivasan","doi":"10.3205/oc000189","DOIUrl":"https://doi.org/10.3205/oc000189","url":null,"abstract":"A 53-year-old female presented with defective vision in the left eye of one week duration with a best-corrected visual acuity (BCVA) of 6/9. Fundus examination showed a primary retinal vasoproliferative tumor (RVPT) at the inferotemporal quadrant and a small full-thickness macular hole (MH). The patient underwent cryotherapy for RVPT, followed later by vitrectomy with internal limiting membrane peeling and gas tamponade. The tumor regressed and the MH was closed with BCVA of 6/9. RVPT can present with remote macular complications like epiretinal membrane, cystoid macular edema, macular exudates, and rarely full-thickness MH. Management should be directed towards the tumor as well as the complication.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46541268","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}
C. Estacia, A. G. Gameiro Filho, Izadora Bouzeid Estacia da Silveira, Rodrigo Rosa Gameiro, Anna Laura Salabert Della Barba
{"title":"Melkersson-Rosenthal syndrome: a rare variant of the monosymptomatic form","authors":"C. Estacia, A. G. Gameiro Filho, Izadora Bouzeid Estacia da Silveira, Rodrigo Rosa Gameiro, Anna Laura Salabert Della Barba","doi":"10.3205/oc000191","DOIUrl":"https://doi.org/10.3205/oc000191","url":null,"abstract":"Melkersson-Rosenthal syndrome (MRS) is a rare condition without any known etiology. It is characterized by the triad facial paralysis, facial swelling, and the development of folds and furrows at the tongue (fissured tongue). This study aims to report a case of a 59-year-old patient complaining about asymmetric eyelid swelling that had started two years before, associated with pain and redness on her right eye, without repercussions on her visual acuity. The patient underwent a skin biopsy of the right eye’s lower eyelid, which was compatible with the monosymptomatic form of MRS. Consequently, five injections of triamcinolone were performed for the period of one year, with gradual and satisfactory improvement. One year after the end of the treatment, the patient returned with recurrence of the swelling, and therapy with triamcinolone associated with oral steroids was started. However, due to the lack of improvement, Tacrolimus ointment 0.03% was initiated. The patient evolved with an important and significant reduction of the eyelid edema, still being followed at the Hospital Federal dos Servidores do Estado do Rio de Janeiro.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"747 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41283293","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":"Lose the Nintendo and thou shall be healed! Restoring vision in malingering","authors":"Michel van Lint, Dave Kloeck, E. V. van Aken","doi":"10.3205/oc000192","DOIUrl":"https://doi.org/10.3205/oc000192","url":null,"abstract":"Non-organic visual loss can be hard to prove or explain to the parents of affected children at times. Here, we describe a simple yet effective approach that may help solve both issues by ensuring that the patient refrains from visual stimuli.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215431","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}
Aditi G Dastidar, Sugandha Goel, D. Kundu, J. Biswas, E. Nigam, Preeti Sharma
{"title":"A case of anterior scleritis in association with posterior scleritis – a diagnostic riddle","authors":"Aditi G Dastidar, Sugandha Goel, D. Kundu, J. Biswas, E. Nigam, Preeti Sharma","doi":"10.3205/oc000188","DOIUrl":"https://doi.org/10.3205/oc000188","url":null,"abstract":"We herein report a case of a young female presenting with multiple nodular scleral abscesses mimicking infective scleritis with exudative retinal detachment. Repeated diagnostic scraping for microbiological and histopathological analysis was inconclusive. The patient’s systemic and collagen disease work-up was non-contributory. She was treated with multiple surgical debridement and de-roofing of the abscesses along with antibiotic irrigation. Topical and oral steroid was stopped on worsening of the condition, and the patient was maintained on topical and oral antibiotics. Complete resolution of scleritis and exudative detachment was noted at 1 month follow-up and no recurrence was noted until 6 months.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43992211","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}
Marie Jeazelle H. Redondo-Villanueva, G. V. Mercado
{"title":"Intravitreal melphalan for persistent retinoblastoma vitreous seeds","authors":"Marie Jeazelle H. Redondo-Villanueva, G. V. Mercado","doi":"10.3205/oc000190","DOIUrl":"https://doi.org/10.3205/oc000190","url":null,"abstract":"A 7-month-old male presented with bilateral retinoblastoma, initially group E OD and group C OS (International Intraocular Retinoblastoma Classification). The patient underwent enucleation with adjuvant chemotherapy and radiotherapy on the right eye for extraocular retinoblastoma. The main tumors on the left eye regressed with combined neoadjuvant chemotherapy with focal therapy, but had persistent sphere vitreous seeds overlying the tumor at the superotemporal mid-periphery and at the inferior periphery. Intravitreal injection of melphalan was performed. Vitreous seeds were clinically undetectable after 2 cycles of injection. Six months from the 2nd intravitreal injection of melphalan, there was no evidence of new tumors nor vitreous seeds in the left eye. No documented complications of intravitreal melphalan injection were experienced. This is the first documented successful treatment of vitreous seeds with intravitreal melphalan at the Ocular Oncology/Retinoblastoma Unit of the University of the Philippines, Philippine General Hospital.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44667132","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}
Johanna Wiedemann, Lebriz Altay, Antje Neugebauer, Tim Krohne, Claus Cursiefen
{"title":"Visual complaints in pregnancy: (pre)eclampsia as a chameleon.","authors":"Johanna Wiedemann, Lebriz Altay, Antje Neugebauer, Tim Krohne, Claus Cursiefen","doi":"10.3205/oc000208","DOIUrl":"https://doi.org/10.3205/oc000208","url":null,"abstract":"Objective: The visual system often is affected in patients with preeclampsia and even more in cases of eclampsia, a life-threatening pregnancy complication. Symptoms include blurred vision and deterioration of visual acuity. Pregnancy can also affect pre-existing conditions, such as diabetic retinopathy. In this case series, we describe three patients with the same underlying condition, i.e. (pre)eclampsia who experienced acute visual disturbance whereas the final diagnosis was different: disseminated intravascular coagulopathy (DIC), posterior reversible encephalopathy syndrome (PRES), and diabetic retinopathy. Methods and results: All patients underwent a thorough slit lamp examination and ocular coherence tomography (OCT). All patients presented with acute impaired vision and subretinal fluid and-/or fibrin. Conclusions: These cases highlight the importance of early involvement of ophthalmologists when pregnant women complain about visual disorders.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"12 ","pages":"Doc21"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439264","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}
Mohammad Zarei, Sima Sheikhghomi, Masoud Aghsaei Fard
{"title":"Hemi-central retinal artery occlusion following methanol toxicity.","authors":"Mohammad Zarei, Sima Sheikhghomi, Masoud Aghsaei Fard","doi":"10.3205/oc000207","DOIUrl":"https://doi.org/10.3205/oc000207","url":null,"abstract":"<p><strong>Objective: </strong>To describe a patient with hemi-retinal artery occlusion following methanol toxicity.</p><p><strong>Methods: </strong>Observational case report.</p><p><strong>Results: </strong>We report a case presented with an acute altitudinal visual field loss in the right eye following consumption of illicit alcoholic drink. In fundus photography, a well demarcated superior hemi-retinal whitening with foveal sparing was noted. Careful inspection of the optic nerve head in the right eye revealed that there was no main trunk of the central retinal artery anterior to the lamina cribrosa. Two separately emerging superior and inferior arterial trunks were noted. In fundus fluorescein angiography, earlier dye filling in the territory of the superior arterial trunk compared to the inferior arterial trunk was evident.</p><p><strong>Conclusion: </strong>Hemi-central retinal occlusion may happen as an ocular consequence of methanol toxicity in patients with a proximal bifurcation of the central retinal artery.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"12 ","pages":"Doc20"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439263","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":"Active removal of anterior segment-migrated dexamethasone implant (Ozurdex®)","authors":"Jozef Adelson M. Depla, M. Veckeneer, I. Bleyen","doi":"10.3205/oc000195","DOIUrl":"https://doi.org/10.3205/oc000195","url":null,"abstract":"Background: Ozurdex® (Allergan plc., Dublin, Ireland) is an intravitreal sustained-release dexamethasone (DEX) implant. The implant has been reported to migrate into the anterior chamber, potentially causing corneal decompensation. Prompt removal or relocation in the vitreous cavity is advised but troublesome due to its fragility. Several techniques exist, but elaborate setup and specialized surgical skills that are required may cause delay in treatment. We report a novel technique that avoids these shortcomings. Case presentation: A 59-year-old woman presented to the emergency department with visual loss due to an anterior chamber-migrated DEX implant and corneal edema. Using an ophthalmic viscosurgical device (OVD) and a bent 19-gauge needle, the implant has promptly been removed in a one-minute procedure under topical anesthesia. Conclusion: Aspirating an anterior chamber-migrated DEX implant using a 19-gauge bent needle is a cost-effective, time-efficient and safe technique, not requiring specialized surgical skills.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49599786","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":"Unilateral simultaneous optic nerve and choroidal infiltration - unusual presentation of metastatic disease in breast carcinoma.","authors":"Poninder Kumar, Ashok Kumar, Srujana Dubakka, Jaya Kaushik, Mohini Agrawal","doi":"10.3205/oc000187","DOIUrl":"https://doi.org/10.3205/oc000187","url":null,"abstract":"<p><p>Breast carcinoma metastasis can involve any ocular structures, but involvement of the optic nerve is extremely rare. Choroidal metastasis is usually multifocal as well as bilateral and occurs late. We report an unusual initial presentation of metastasis from breast cancer; unilateral infiltrative optic neuropathy with concurrent choroid metastatic deposits in an adequately treated middle-aged female. Our present case, wherein for the first time in the literature, we illustrated unilateral infiltrative optic neuropathy and choroidal metastatic deposits secondary to breast carcinoma, will increase our knowledge about the various potential ocular presentations of this relatively common malignant disease.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39519115","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}
GMS ophthalmology casesPub Date : 2021-08-04eCollection Date: 2021-01-01DOI: 10.3205/oc000186
Ujjwala Narang, Laura Maubon, Vishal Shah, Vijay Wagh
{"title":"Ocular trauma or Oedipism: completing the evisceration.","authors":"Ujjwala Narang, Laura Maubon, Vishal Shah, Vijay Wagh","doi":"10.3205/oc000186","DOIUrl":"https://doi.org/10.3205/oc000186","url":null,"abstract":"<p><p>Self-enucleation, also known as Oedipism, is a rare form of ocular trauma. The objective of this clinical case report is to highlight the importance of diagnosing this unusual injury and thus ensuring its appropriate management. We herein describe a case of a 58-year-old man who presented to hospital with a bleeding left eye. Initially, limited history was provided, however, on further enquiry it was revealed that he had paranoid schizophrenia. The patient eventually had to be sectioned with assistance from the Police and Psychiatry team, upon discovery of self-inflicted mechanism of injury. Subsequently, the patient had evisceration of the left eye and afterwards, demonstrated insight into the pre-operative problems. Literature review emphasizes the importance of close cooperation required between medical specialities to ensure that the underlying cause, usually schizophrenia, is managed in conjunction to the eye injury in order to provide optimum care for the patient.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc13"},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430091","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}