GMS ophthalmology casesPub Date : 2020-08-28eCollection Date: 2020-01-01DOI: 10.3205/oc000167
Sefik Can Ipek, Salih Kavukcu, Süleyman Men, Ali Osman Saatci
{"title":"Multimodal imaging features of a spontaneously resolved unilateral congenital macrovessel-related macular edema in a 13-year-old boy.","authors":"Sefik Can Ipek, Salih Kavukcu, Süleyman Men, Ali Osman Saatci","doi":"10.3205/oc000167","DOIUrl":"https://doi.org/10.3205/oc000167","url":null,"abstract":"<p><p><b>Purpose:</b> Congenital retinal macrovessels (CRM) are large aberrant blood vessels that cross the horizontal raphe. Visual acuity may be negatively affected in cases afflicted with CRM due to macular serous detachment, hemorrhage, exudation, foveolar cyst formation and retinal artery occlusion. Even the presence of an anomalous vessel itself running through the foveal avascular zone may compromise the visual acuity. In this case report, we discuss the multimodal imaging characteristics of a case of symptomatic unilateral CRM-related cystoid macular edema and serous macular detachment in a 13-year-old boy. <b>Observations:</b> Optical coherence tomography angiography (OCTA) imaging of the superficial retina revealed the aberrant vessel and anomalous arteriovenous communication between the aberrant vessel and the retinal artery. The foveal avascular zone also appeared partly distorted. <b>Conclusions:</b> The present case reports the second-youngest patient afflicted with unilateral CRM and associated macular edema. There was spontaneous resolution of macular edema within six weeks. In light of the observations in this case and the literature review, the need to refrain from rapid therapeutic intervention in the eyes of patients affected with CRM and macular edema must be emphasized.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc40"},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38408231","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 : 2020-08-28eCollection Date: 2020-01-01DOI: 10.3205/oc000168
Piergiacomo Grassi, Alberto Salicone
{"title":"Delayed spontaneous closure of traumatic macular hole in a 66-year-old patient - role of optical coherence tomography follow-up.","authors":"Piergiacomo Grassi, Alberto Salicone","doi":"10.3205/oc000168","DOIUrl":"https://doi.org/10.3205/oc000168","url":null,"abstract":"<p><p><b>Objective:</b> To report a case of delayed spontaneous closure of traumatic macular hole at 5 months in a 66-year-old man. Traumatic macular holes generally do not close spontaneously after 4 months and over 30 years of age. <b>Methods:</b> A 66-year-old man presented with central blurred vision and metamorphopsia in his right eye for 3 weeks after previous ocular blunt trauma occurring 2 months earlier. Best corrected visual acuity was 6/36 in his right eye, fundus examination and OCT revealed right traumatic macular hole. <b>Results:</b> 4 weeks later, best corrected visual acuity was 6/18, OCT showed initial reattachment of traumatic macular hole margins. 8 weeks later, best corrected visual acuity improved to 6/9, OCT showed almost complete reattachment of the margins, residual outer retinal defect being still present. At 12 weeks after initial presentation, best corrected visual acuity was 6/6, OCT showed normal neuroretinal profile. <b>Conclusion:</b> Clinical monitoring of traumatic macular holes might be performed up to 5 months even in patients >30 years before considering surgery.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc41"},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38408232","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 : 2020-08-26eCollection Date: 2020-01-01DOI: 10.3205/oc000166
Eric Ruff, Nataliya Pokeza, Inci Dersu
{"title":"Iridoschisis: visual outcome in treated versus untreated eye.","authors":"Eric Ruff, Nataliya Pokeza, Inci Dersu","doi":"10.3205/oc000166","DOIUrl":"https://doi.org/10.3205/oc000166","url":null,"abstract":"<p><p>A 67-year-old man was referred for iris color change. He was noted to have narrow angles with atrophic iris appearance and visually significant cataracts. The iris findings were consistent with iridoschisis. The patient was recommended to have cataract surgery. Unfortunately, he was lost to follow-up. One year later, he presented with chronic angle closure glaucoma on the right eye with very high pressure and very poor remaining vision. Left-eye vision was also compromised with cataract. Despite the presence of small pupil, abnormal iris stroma, and dense cataract, the patient underwent successful cataract surgery and achieved 20/20 vision post-operatively. Iridoschisis can cause substantial ocular morbidity if not treated timely.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc39"},"PeriodicalIF":0.0,"publicationDate":"2020-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343303","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 angioid streaks.","authors":"Sugandha Goel, Isha Gupta, Samarth Mishra, Barun Garg, Kumar Saurabh, Rupak Roy","doi":"10.3205/oc000165","DOIUrl":"https://doi.org/10.3205/oc000165","url":null,"abstract":"<p><p>Angioid streaks (AS) are irregular crack-like dehiscences in Bruch's membrane that are often associated with atrophic degeneration of the overlying retinal pigment epithelium. We herein report multimodal imaging of AS. Multicolor imaging highlighted AS in dark orange color. AS were better visualized in infrared reflectance as compared to green reflectance and blue reflectance. Peau d'orange appearance was seen as alternating dark and bright patches on color fundus photography with corresponding hyporeflective and hyperreflective patches on infrared reflectance. Comet lesions showed increased signal on infrared reflectance and hyperautofluorescence. Multicolor imaging is a non-invasive imaging modality which helps in clearly delineating these lesions.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc38"},"PeriodicalIF":0.0,"publicationDate":"2020-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343302","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 : 2020-08-25eCollection Date: 2020-01-01DOI: 10.3205/oc000164
Sophie Van Camp, Steffi Vande Walle, Ingele Casteels, Julie Jacob, Cathérine Cassiman, Carine Wouters, Pieter-Paul Schauwvlieghe
{"title":"Acute bilateral serous retinal detachments with spontaneous resolution in a 6-year-old boy.","authors":"Sophie Van Camp, Steffi Vande Walle, Ingele Casteels, Julie Jacob, Cathérine Cassiman, Carine Wouters, Pieter-Paul Schauwvlieghe","doi":"10.3205/oc000164","DOIUrl":"https://doi.org/10.3205/oc000164","url":null,"abstract":"<p><p>A healthy 6-year-old boy presented with acute bilateral vision loss, multiple serous retinal detachments between the vascular arcades and a thickened choroid. Spontaneous resolution occurred over several weeks. We hypothesize that the clinical constellation in our patient is suggestive of acute exudative polymorphous vitelliform maculopathy (AEPVM) or might be an atypical presentation of Vogt-Koyanagi-Harada (VKH) disease. We propose that it was caused by an autoimmune-mediated activation of inflammatory cells at the level of the choroid, induced by an unknown trigger.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc37"},"PeriodicalIF":0.0,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343301","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 : 2020-08-11eCollection Date: 2020-01-01DOI: 10.3205/oc000163
Hasim Uslu, Ayse Yagmur Kanra
{"title":"Combined treatment of transluminal Nd:YAG laser embolysis and hyperbaric oxygen for branch retinal artery occlusion.","authors":"Hasim Uslu, Ayse Yagmur Kanra","doi":"10.3205/oc000163","DOIUrl":"https://doi.org/10.3205/oc000163","url":null,"abstract":"<p><p><b>Objective:</b> To describe the clinical efficiency of transluminal Nd:YAG laser embolysis (TYE) and hyperbaric oxygen (HBO) as an off-label combined treatment for branch retinal artery occlusion (BRAO) with visible emboli. <b>Methods:</b> A 77-year-old woman had a history of seeing a \"shadow\" in the lower visual field of the left eye for three days. Platelet-fibrin embolus at the arterial bifurcation was disintegrated by TYE technique and the patient was referred to HBO treatment for 20 sessions. <b>Results:</b> One week after treatment, best-corrected visual acuity improved to 0.8 while a good arterial blood flow in the affected branch was seen. Platelet fibrin plaques had disappeared at fundus, and the pale appearance in the retina had decreased. <b>Conclusions:</b> TYE and HBO combination treatment may be an effective and feasible treatment for restoration of blood flow and vision in BRAO cases caused by visible platelet-fibrin emboli.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc36"},"PeriodicalIF":0.0,"publicationDate":"2020-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343845","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 : 2020-08-07eCollection Date: 2020-01-01DOI: 10.3205/oc000162
Dominika Pohlmann, Mirjam Rossel, Daniel J Salchow, Eckart Bertelmann
{"title":"Outcome of a penetrating keratoplasty in a 3-month-old child with sclerocornea.","authors":"Dominika Pohlmann, Mirjam Rossel, Daniel J Salchow, Eckart Bertelmann","doi":"10.3205/oc000162","DOIUrl":"https://doi.org/10.3205/oc000162","url":null,"abstract":"<p><p>Sclerocornea is a rare congenital anomaly with clouding of the peripheral cornea that possibly extends up to the center of the cornea. Characteristically, a clear distinction (limbus) between sclera and cornea is lacking. Early surgical treatment is essential for preventing amblyopia, but penetrating keratoplasty in children carries a relatively high risk of complications. Especially for sclerocornea, penetrating keratoplasty has generally been reported to have a poor surgical outcome and a high risk of complications, including corneoscleral adhesions. Here, we report the 4-year follow-up on a child with sclerocornea, who was successfully operated on at the age of 3 months and had a favorable outcome. Our findings suggest that in some cases, penetrating keratoplasty may be an option to treat sclerocornea in young children.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc35"},"PeriodicalIF":0.0,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343844","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 : 2020-08-06eCollection Date: 2020-01-01DOI: 10.3205/oc000157
Laura Tabuenca Del Barrio, Marcos Mozo Cuadrado, Luiz Miguel Nova Camacho, Alicia Zubicoa Enériz, Miren Dolores Aranguren Laflin, Araceli Alcaine Soler
{"title":"Epithelial conjunctival neoplasias - the importance of an early diagnosis and optimal treatment.","authors":"Laura Tabuenca Del Barrio, Marcos Mozo Cuadrado, Luiz Miguel Nova Camacho, Alicia Zubicoa Enériz, Miren Dolores Aranguren Laflin, Araceli Alcaine Soler","doi":"10.3205/oc000157","DOIUrl":"https://doi.org/10.3205/oc000157","url":null,"abstract":"<p><p><b>Objective:</b> To emphasize the importance of an early diagnosis and an adequate treatment in conjunctival tumors. <b>Methods:</b> We present two clinical cases and compare the course of each case: one of conjunctival intraepithelial neoplasia (CIN) which took a positive course, and a fatal case of squamous cell carcinoma (SCC) with intraocular and orbital extension. <b>Results:</b> Epithelial conjunctival malignancies are one of the most prevalent ocular surface tumors. Among these, CIN are the most common. CIN have an excellent prognosis, given adequate treatment. However, when the diagnosis of CIN is late, the epithelial basement membrane will be affected, resulting in SCC. SCC may have poorer results due to its capacity to infiltrate near tissues and create distant metastasis. <b>Conclusion:</b> It is not common today to treat patients with orbital extension of SCC; however, it is crucial to note the importance of an early diagnosis of conjunctival malignancies. An early diagnosis is essential to prevent the transformation to other life-threatening types.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc30"},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343839","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":"Macular hole and submacular hemorrhage secondary to retinal arterial macroaneurysm - successfully treated with a novel surgical technique.","authors":"Ramin Nourinia, Nazanin Behnaz, Hossein Hassanpour, Zahra Karjoo, Kiana Hassanpour","doi":"10.3205/oc000158","DOIUrl":"https://doi.org/10.3205/oc000158","url":null,"abstract":"<p><p><b>Purpose:</b> To present a 65-year-old patient with macular hole (MH) and submacular hemorrhage (SMH) secondary to a ruptured retinal arterial macroaneurysm (RAM) which was successfully treated with a novel surgical technique. <b>Patient:</b> A 65-year-old woman presented with a 1-week history of sudden-onset visual loss in her right eye. Her best-corrected visual acuity (BCVA) was hand motion in the right eye. Her fundus examination revealed intraretinal and massive subretinal hemorrhage with macular involvement. An MH with an approximate diameter of 600 microns was also noted. The patient was treated by a standard pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling, followed by 10 µg recombinant tissue plasminogen activator injection into the submacular space via the MH with a 25-gauge vitrectomy probe. BCVA of the patient increased to 20/320 and 20/60, one and four weeks after surgery, respectively. Optical coherence tomography (OCT) images confirmed the complete anatomical closure of the MH and the restoration of the outer retinal layers such as the external limiting membrane and the ellipsoid zone. <b>Conclusion:</b> This case report expands our knowledge about the management of MH in combination with SMH after a ruptured RAM. We suggest the use of a vitrectomy probe and MH for subretinal recombinant tissue plasminogen activator (rtPA) injection.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc31"},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343840","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 : 2020-08-06eCollection Date: 2020-01-01DOI: 10.3205/oc000160
Nils Alexander Steinhorst, Martin Spitzer, Christos Skevas
{"title":"Bevacizumab as a treatment option for choroidal neovascularisation due to large optic nerve drusen in a 14-year-old girl.","authors":"Nils Alexander Steinhorst, Martin Spitzer, Christos Skevas","doi":"10.3205/oc000160","DOIUrl":"https://doi.org/10.3205/oc000160","url":null,"abstract":"<p><p><b>Purpose:</b> To report the effects of a single intravitreous injection of bevacizumab for the treatment of secondary choroideal neovascularisation due to large optic disc drusen. <b>Methods:</b> A 14-year-old female patient with painless loss of vision in one eye presented with unusually large optic disc drusen and juxtapapillary choroidal neovascularisation with subretinal hemorrhage. She was treated with a single intravitreous injection of bevacizumab. <b>Results:</b> Visual acuity increased from 20/100 to 20/25 within 4 weeks after injection and remained at this level during the 12-month follow-up period. <b>Conclusions:</b> Bevacizumab is a possible primary treatment option for secondary choroidal neovascularisation due to large optic disc drusen in children as an alternative to other more invasive or complex procedures.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"10 ","pages":"Doc33"},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343842","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}