American Journal of Ophthalmology Case Reports最新文献

{"title":"Self-inflicted transorbital intracranial foreign body following ingestion of hallucinogenic psilocybin mushrooms","authors":"Abigail M. Blanton ,&nbsp;Pooja Parikh ,&nbsp;Scott Zhou ,&nbsp;Mohamed Mohamed ,&nbsp;Rafael L. Ufret-Vincenty ,&nbsp;Ronald Mancini","doi":"10.1016/j.ajoc.2025.102359","DOIUrl":"10.1016/j.ajoc.2025.102359","url":null,"abstract":"<div><h3>Purpose</h3><div>Self-inflicted penetrating orbital trauma is a rare ophthalmologic emergency requiring timely intervention and neurological monitoring to identify and treat any possible intracranial complications and to prevent irreversible vision loss. This case report aims to describe a fatal case of self-inflicted ocular trauma following the consumption of psilocybin mushrooms, necessitating urgent multidisciplinary care by the ophthalmology and neurosurgery services.</div></div><div><h3>Observations</h3><div>A 21-year-old Hispanic male presented urgently to the emergency department (ED) after self-inflicted ocular trauma with a wood-cased pencil, which was embedded in the upper eyelid and transversed the left orbit, extending to the pons, as depicted on computed tomography (CT). Physical examination of the left eye was difficult due to the risk of displacement of the pencil within the brainstem and concern for further damage. The pencil was successfully removed via fluoroscopy-guided neuro-interventional catheterization and stenting. Following the removal of the foreign body, there was no apparent damage to the globe, and a canthotomy/cantholysis was performed due to increased retro-orbital pressure. The neurovascular damage sustained by the trauma led to a progressive neurological decline in the following days and, ultimately, a fatal outcome.</div></div><div><h3>Conclusions and importance</h3><div>With growing support in the literature for psilocybin and its therapeutic medicinal benefits for conditions such as depression and anxiety, this report details a case of self-inflicted trans-orbital trauma with brainstem injury following ingestion of this psychoactive hallucinogen along with the proper medical and surgical management.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102359"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230309","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":"Macular retinoschisis in a patient with multiple lymphoproliferative malignancies","authors":"Justine Cheng ,&nbsp;Paul Yang ,&nbsp;Andy I. Chen ,&nbsp;Todd Williams ,&nbsp;Christina Flaxel","doi":"10.1016/j.ajoc.2025.102358","DOIUrl":"10.1016/j.ajoc.2025.102358","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe a case of macular retinoschisis in a patient with multiple systemic lymphoproliferative disorders and the challenges of accurate diagnosis of uveal lymphoma.</div></div><div><h3>Observations</h3><div>A 66-year-old male presented with unilateral macular retinoschisis and choroidal thickening in the right eye had an unrevealing systemic work-up for inflammatory or neoplastic processes. The patient eventually developed mild vitritis and a diagnostic vitrectomy was performed. Flow cytometry of the vitreous showed clonal expansion consistent with a mature B cell lymphoma of the uveal tract. Repeat systemic work-up including bone marrow biopsy, however, revealed two additional systemic conditions: Waldenstrom macroglobulinemia (WM) and monoclonal B cell lymphocytosis. Based on B cell gene rearrangement testing, the choroidal lymphoma was found to be distinct from the systemic lymphoma. In total, the patient had three lymphoproliferative disorders. Soon after the diagnosis, the left eye also developed choroidal thickening. The patient received orbital external beam radiation and zanubrutinib to treat the systemic WM and the choroidal lymphoma with improvement of macular retinoschisis and choroidal thickening.</div></div><div><h3>Conclusions</h3><div>We present a case of macular retinoschisis in a patient with choroidal lymphoma and multiple systemic lymphoproliferative disorders. Both the systemic disease and the uveal lymphoma contributed to the unique ocular findings in this patient. Our case highlights the challenges of uveal lymphoma diagnosis and the importance of tissue biopsy, systemic work-up, and close monitoring.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102358"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220822","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":"Ectopic dacryops mimicking a lacrimal sac tumor: A case report and literature review","authors":"Abdulrahman Alfarhan ,&nbsp;Jawaher Alwatban ,&nbsp;Hamad Alsuliman ,&nbsp;Sahar Elkhamry ,&nbsp;Azza Maktabi ,&nbsp;Rawan Althaqib","doi":"10.1016/j.ajoc.2025.102355","DOIUrl":"10.1016/j.ajoc.2025.102355","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a rare case of dacryops found within the lacrimal sac, which mimicked a lacrimal sac tumor.</div></div><div><h3>Observations</h3><div>An adult female patient presented with epiphora and chronic swelling of the lacrimal sac, initially raising concerns for a possible lacrimal sac tumor. Imaging revealed a well-defined cystic lesion with a patent lacrimal drainage system. Histopathological examination confirmed the presence of a lacrimal gland cyst (dacryops) within the lacrimal sac.</div></div><div><h3>Conclusions and importance</h3><div>This case highlights the rare occurrence of lacrimal gland tissue within the lacrimal sac, a location that has eluded prior definitive descriptions in the literature. Recognition of this condition is crucial for appropriate diagnosis and management, as it can mimic more serious pathologies such as a lacrimal sac tumor.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102355"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116776","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":"A case of a young patient with progressive vision loss: An atypical presentation of the rare Wolfram Syndrome in a Middle Eastern individual","authors":"Meishar Meisel,&nbsp;Eran Berkowitz,&nbsp;Dana Irge,&nbsp;Beatrice Tiosano,&nbsp;Anat Kesler","doi":"10.1016/j.ajoc.2025.102354","DOIUrl":"10.1016/j.ajoc.2025.102354","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe an atypical presentation of a rare disease in a young middle eastern woman with a relatively adult-onset type 1 diabetes mellitus, bilateral optic atrophy and progressive decreased vision diagnosed as the Wolfram disease.</div></div><div><h3>Observation</h3><div>A 38-year-old female patient presented with progressive bilateral loss of vision and dyschromatopsia during a 4-year follow-up. On examination at the neuro-ophthalmology clinic the visual acuity was 20/100 in the right eye and 20/80 in the left eye. Color vision evaluated with Ishihara color plates was 0/12 in each eye, optic discs were pale, while visual field testing revealed bilaterally constriction. Optical coherence tomography (OCT) scans showed gross thinning of optic nerve and macular layers. The medical history revealed diabetes mellitus type 1 at the age of 33 years-old. On follow-up visits further progressive vision loss was observed with additional complaints of mild hearing loss. The patient was referred for genetic testing.</div></div><div><h3>Conclusion and importance</h3><div>Wolfram syndrome (WFS) is an autosomal recessive rare neurodegenerative disorder characterized by early onset diabetes mellitus and progressive optic atrophy in the first decade of life, hence known as 'DIDMOAD' syndrome, standing for diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA) and deafness (D)(1). Early onset DM and OA are usually the first manifestations of the syndrome, presenting classically in childhood. In contrast, the present patient presented later with type 1 diabetes mellitus and optic atrophy demonstrating a variability inherent to this syndrome. This is a case of Wolfram Syndrome in an individual of Middle Eastern ancestry. A high index of suspicion is crucial when evaluating patients who present with both diabetes mellitus and optic atrophy, as this combination may indicate atypical manifestations of rare genetic disorders such as Wolfram Syndrome DM and OA. Genetic testing of family members and offspring of patients is required to confirm the diagnosis. There is no definite treatment to date for this disease (2).</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102354"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098877","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":"Intravitreal triamcinolone acetonide for subretinal fluid resolution in bilateral diffuse uveal melanocytic Proliferation: Two case reports","authors":"Yu-Yang Lin ,&nbsp;Chung-May Yang ,&nbsp;Chang-Hao Yang","doi":"10.1016/j.ajoc.2025.102356","DOIUrl":"10.1016/j.ajoc.2025.102356","url":null,"abstract":"","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102356"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089662","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":"Inappropriate administration of mitomycin in a cataract patient","authors":"Gibran Merchant,&nbsp;Aaron DeWeerd,&nbsp;Jackson Mooney,&nbsp;Manahil Khan,&nbsp;Dasa V. Gangadhar","doi":"10.1016/j.ajoc.2025.102357","DOIUrl":"10.1016/j.ajoc.2025.102357","url":null,"abstract":"<div><h3>Purpose</h3><div>This case report describes the improper administration of intracameral mitomycin after cataract extraction in an 83-year-old male, demonstrating the need for system improvements to prevent “never events.”</div></div><div><h3>Observations</h3><div>An 83-year-old male presented with visually significant bilateral cataracts, (right eye (OD): 20/80, left eye (OS): 20/70). He underwent technically uncomplicated cataract surgery in the right eye. At postoperative visit one, vision was 20/250 OD, less than anticipated for unclear reasons. On subsequent visits, the patient was found to have worsening photophobia, increasing conjunctival inflammation, corneal edema, and an elevated intraocular pressure of 27 mmHg. Given the variety and complexity of symptoms despite an otherwise uncomplicated surgery, an investigation was launched. An investigation for Toxic Anterior Segment Syndrome (TASS) revealed a mix-up between Cefuroxime and Mitomycin during medication preparation and administration. It was determined that mitomycin was inadvertently injected intracamerally into the patient's eye, causing intraocular toxicity and ultimately, loss of vision.</div></div><div><h3>Conclusions and importance</h3><div>This case underscores the significance of system failures in the healthcare environment and how “never events” may occur even with appropriate protocols in place. The improper administration of mitomycin emphasizes the need for enhanced safety measures, including improved medication labeling, consistent use of time-outs, and reinforcing their importance in high-volume environments. System changes are essential to reduce the risk of errors and protect patient safety. The use of off-label, compounded medications should be minimized when possible. Ophthalmologists and the pharmaceutical industry should continue to seek an FDA-approved antibiotic for intraocular use in cataract surgery.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102357"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108117","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":"Iris and anterior chamber angle melanoma masquerading as benign melanocytic lesion","authors":"Mai-Linh N. Ton ,&nbsp;Maria Del Valle Estopinal ,&nbsp;Kapil Mishra","doi":"10.1016/j.ajoc.2025.102353","DOIUrl":"10.1016/j.ajoc.2025.102353","url":null,"abstract":"<div><h3>Purpose</h3><div>Demonstrates the importance of integrating clinical findings, immunohistochemistry, and next-generation sequencing of somatic mutations in differentiating complex ocular melanocytic lesions. This study highlights distinct differences between benign conjunctival nevus, iris melanoma with extrascleral extension, and conjunctival melanoma with intraocular invasion.</div></div><div><h3>Observations</h3><div>A 62-year-old male presented with painless vision loss and multiple pigmented lesions on the ocular surface. Initial impression was a benign conjunctival nevus but concerning for melanoma due to secondary changes of vision loss and increased intraocular pressure. Further investigation revealed an iris melanoma involving the anterior chamber angle with extrascleral extension. Enucleation confirmed atypical melanocytic cells infiltrating the iris stroma, anterior chamber angle, sclera, and conjunctiva. Immunohistochemistry showed SRY-Box Transcription Factor 10 (SOX10) and melanoma antigen (Melan-A) positivity. Gene sequencing identified a Guanine nucleotide-binding protein, alpha-11 (GNA11) mutation, suggesting uveal origin.</div></div><div><h3>Conclusions and importance</h3><div>Highlights the value of a comprehensive diagnostic approach in evaluating ocular melanocytic lesions. The progression from an initial impression of benign conjunctival nevus to the discovery of iris melanoma with extrascleral extension emphasizes the need for thorough investigation, especially when pathological changes such as increased intraocular pressure and vision loss occur.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102353"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083912","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":"Small lymphocytic lymphoma presenting as bilateral medial lower eyelid ectropion","authors":"Sonia Anchouche ,&nbsp;Kenneth Chang ,&nbsp;Christopher MKL Yao ,&nbsp;Carlo Hojilla ,&nbsp;Navdeep Nijhawan ,&nbsp;Georges Nassrallah","doi":"10.1016/j.ajoc.2025.102352","DOIUrl":"10.1016/j.ajoc.2025.102352","url":null,"abstract":"<div><h3>Purpose</h3><div>Herein, we present a case of new-onset medial ectropion of the lower eyelids and persistent painless cervical lymphadenopathy in an 85-year-old man highlighting a unique presentation of small lymphocytic lymphoma (SLL).</div></div><div><h3>Observations</h3><div>Physical examination revealed bilateral medial ectropion with associated follicular changes to the palpebral conjunctiva and extensive cervical lymphadenopathy. Conjunctival biopsies were taken during ectropion repair in addition to fine needle biopsy of the cervical lymphadenopathy which both independently confirmed a diagnosis of SLL. Surgical intervention, including bilateral lateral tarsal strip and medial spindle procedures, yielded excellent postoperative outcomes. Given the patient's staging, he remained under observation until treatment was warranted to address progressive lymphadenopathy.</div></div><div><h3>Conclusions and importance</h3><div>This report contributes valuable new insight into the ocular manifestations of lymphoproliferative disease.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102352"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089667","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":"Acute macular neuroretinopathy after Covid 19 in an eye with a congenital retinal macrovessel – a case report","authors":"A. Vienne-Jumeau ,&nbsp;E. Souied ,&nbsp;F. Amoroso","doi":"10.1016/j.ajoc.2025.102349","DOIUrl":"10.1016/j.ajoc.2025.102349","url":null,"abstract":"<div><h3>Purpose</h3><div>To present a case of an acute macular neuroretinopathy (AMN) occurring after Covid 19 infection in an eye with a retinal macrovessel.</div></div><div><h3>Observations</h3><div>We report a case of a 48-year-old woman who presented to our center with a 10-day scotoma in her right eye, in the context of a recently diagnosed Covid 19 infection. The funduscopy demonstrated a petaloid brown lesions temporal to the fovea in the right eye. A retinal macrovessel, passing adjacent to the lesions was also present. The left eye was normal. Multimodal imaging confirmed the diagnostic of AMN and optical coherence tomography angiography showed defects in the deep capillary plexus colocalizing with the lesions.</div></div><div><h3>Conclusions and importance</h3><div>Ischemic events have been known to complicate macrovessel, and we reckon that the occurrence of AMN in this patient could have been the resultant of the conjunction of Covid 19 infection and abnormal retinal vasculature.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"38 ","pages":"Article 102349"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936055","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":"New surgical technique for scleral fixation: A novel sutured approach for Carlevale lens implantation","authors":"Christopher Stewart ,&nbsp;Jaskaran Singh-Bhangu ,&nbsp;Sushrutha Dissanayake","doi":"10.1016/j.ajoc.2025.102343","DOIUrl":"10.1016/j.ajoc.2025.102343","url":null,"abstract":"","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102343"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072163","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}