American Journal of Ophthalmology Case Reports最新文献

{"title":"Rare presentation of Behçet's disease in a 22-year-old male with combined retinal artery and vein occlusions","authors":"Brennan Isaac ,&nbsp;Ahmad Rehmani ,&nbsp;Lee Angioletti","doi":"10.1016/j.ajoc.2025.102434","DOIUrl":"10.1016/j.ajoc.2025.102434","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate how the systemic work-up of a combined retinal and vein occlusion (CRAVO) led to a diagnosis of Behcet's disease.</div></div><div><h3>Observations</h3><div>A 22-year-old male presented with sudden, profound vision loss in the left eye upon waking up. Presenting visual acuity was no light perception (NLP) in the left eye and fundus examination revealed findings consistent with both central retinal artery and vein occlusion. Laboratory workup for common infectious etiologies was negative; however, inflammatory markers were elevated. Further testing revealed human leukocyte antigen (HLA)∗B51 positivity as well as a patent foramen ovale (PFO) that was found on echocardiogram. The patient was initiated on high dose steroids and immunosuppressants for Behçet's Disease and underwent surgical closure of PFO.</div></div><div><h3>Conclusions and importance</h3><div>This study highlights the value of a proper diagnostic approach in patients presenting with CRAVO without suspected risk factors. Investigation of autoimmune, genetic, cardiologic, and inflammatory diseases led to the diagnosis of Behçet's Disease, an uncommon condition where timely recognition and early treatment can prevent further vision loss and reduce the risk of future vascular events.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102434"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118288","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":"High-dose topotecan (90 and 180 μG) for recurrent subretinal and vitreous seeding in retinoblastoma","authors":"David H. Abramson ,&nbsp;Jasmine H. Francis","doi":"10.1016/j.ajoc.2025.102437","DOIUrl":"10.1016/j.ajoc.2025.102437","url":null,"abstract":"<div><h3>Purpose</h3><div>To report on the use of intravitreal high-dose topotecan (90 and 180 μG) for recurrent subretinal and vitreous retinoblastoma, the toxicity of these injections, and the use of a 180-μG injection of intravitreal topotecan in humans.</div></div><div><h3>Observations</h3><div>High-dose (90 and 180 μG) intravitreal topotecan was effective in treating recurrent subretinal and vitreous retinoblastoma without anterior segment or retinal toxicity or altered electroretinogram function in two cases.</div></div><div><h3>Conclusion and importance</h3><div>Recurrent subretinal and vitreous retinoblastoma after intraarterial chemotherapy are difficult to treat. High-dose intravitreal topotecan (90 and 180 μG) was used to salvage two such eyes without measurable toxicity.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102437"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106355","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 novel presentation of ocular chronic lymphocytic leukemia","authors":"Lauren A. Nakhleh ,&nbsp;Jamie A. Keen ,&nbsp;Elisabeth Sledz ,&nbsp;Meenakshi Chaku ,&nbsp;Brooke Johnson ,&nbsp;Larissa K. Ghadiali","doi":"10.1016/j.ajoc.2025.102433","DOIUrl":"10.1016/j.ajoc.2025.102433","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe a rare presentation of chronic lymphocytic leukemia (CLL) involving the conjunctiva and caruncle.</div></div><div><h3>Observations</h3><div>A 64-year-old male with a history of systemic CLL and a blind right eye due to retinal vascular disease and optic neuropathy presented with gradually worsening redness and foreign body sensation in the same eye. Anterior exam revealed chemosis, thickened conjunctiva, an enlarged caruncle with an irregular surface, and large pale superior and inferior forniceal follicles, altogether concerning for infiltration of the conjunctiva by CLL. Conjunctival and caruncular biopsies demonstrated small CD5⁺ B-cell lymphoma, consistent with CLL.</div></div><div><h3>Conclusions and importance</h3><div>CLL is the most common form of leukemia in the western world, though there is a relatively low prevalence of ocular manifestations. Our case revealed a unique presentation of this disease manifesting in the conjunctiva and caruncle. Performing an incisional biopsy of the abnormal appearing tissue for analysis with cell typing was essential to confirming this diagnosis. This case reveals a novel presentation of CLL involving the caruncle and emphasizes the importance of obtaining a tissue biopsy in patients presenting with atypical changes seen on the conjunctiva and caruncle with a history of known hematologic malignancy.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102433"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118290","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":"Saloon Door Technique – “open sky” IOL exchange utilising flanged haptic fixation behind a pre-existing Artificial Iris","authors":"Kilian Roth ,&nbsp;Konstantin Seiller-Tarbuk ,&nbsp;Michael Amon","doi":"10.1016/j.ajoc.2025.102431","DOIUrl":"10.1016/j.ajoc.2025.102431","url":null,"abstract":"<div><h3>Purpose</h3><div>This paper introduces a novel surgical approach, the “Saloon Door Technique”, which allows intraocular lens (IOL) replacement behind a pre-existing Artificial Iris (AI) without its removal.</div></div><div><h3>Observations</h3><div>A 57-year-old patient with a history of complicated cataract surgery, AI implantation, and recurrent corneal decompensation presented with a dislocated anterior chamber IOL. To prevent further corneal decompensation, we performed an IOL exchange and penetrating keratoplasty under open-sky conditions while preserving the AI. The AI was radially incised at two opposite sites to allow the insertion of a new 3-piece IOL through the ‘saloon door’ into the posterior chamber. The haptics were then externalized and flanged with a Forceps Needle using a modified Yamane technique. The postoperative course was uneventful, with stable IOL positioning and a clear corneal graft at follow-up.</div></div><div><h3>Conclusions and importance</h3><div>The Saloon Door Technique enables IOL implantation behind a pre-existing AI while preserving its integrity. By making two controlled incisions in the AI, the IOL can be carefully maneuvered through the “saloon door”, followed by scleral fixation using a modified Yamane technique. This technique represents a valuable advancement in anterior segment surgery for complex cases involving AI and IOL exchange.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102431"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059914","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":"Virtual reality perimetry facilitates visual field evaluation in a previously non-assessable eye with severe glaucoma","authors":"Grant T. Slagle ,&nbsp;Sylvia L. Groth ,&nbsp;Sean P. Donahue ,&nbsp;William E. Sponsel","doi":"10.1016/j.ajoc.2025.102430","DOIUrl":"10.1016/j.ajoc.2025.102430","url":null,"abstract":"<div><h3>Purpose</h3><div>Virtual reality perimetry (VRP) is rapidly growing in popularity. Advantages of these devices have been noted in the literature: they require less capital investment than table-mounted perimeters, have a smaller footprint, and improve patient comfort. Unlike traditional perimeters, virtual reality perimeters can assess both eyes simultaneously, which it does by default on most of its testing algorithms. This novel function leads to an advantage of VRP over traditional perimetry that has not yet been reported: the ability to assess the visual field of an eye with poor fixation. We report a patient with advanced glaucoma who could not perform reliable standard perimetry due to a central scotoma in one eye but could perform VRP testing of each eye simultaneously.</div></div><div><h3>Observations</h3><div>A 23-year-old male with advanced congenital glaucoma in the left eye presented for follow-up perimetry testing. In prior visits, his right eye consistently demonstrated a normal visual field, but left eye showed a progressively worsening global defect with poor reliability indices. At the present visit the patient performed VRP, which tested both eyes simultaneously. Good fixation with the right eye facilitated a reliable visual field of the left eye.</div></div><div><h3>Conclusions and importance</h3><div>The virtual reality perimeters tests both eyes simultaneously, which traditional perimeters cannot do. In this case, fellow eye fixation facilitated the acquisition of a clinically meaningful visual field from a poorly fixing eye due to advanced glaucoma.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102430"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007739","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":"Durysta pellet occlusion of XEN gel stent","authors":"Arkadiy Yadgarov","doi":"10.1016/j.ajoc.2025.102413","DOIUrl":"10.1016/j.ajoc.2025.102413","url":null,"abstract":"","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102413"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020178","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":"Limbal stem cell deficiency secondary to vitrectomy in the context of an autoimmune polyendocrine syndrome type","authors":"Francesc March de Ribot ,&nbsp;Anna March de Ribot ,&nbsp;Javier Núñez Pérez ,&nbsp;Joshua M. Huang ,&nbsp;Jordan J. Huang ,&nbsp;Jaime D. Martinez","doi":"10.1016/j.ajoc.2025.102421","DOIUrl":"10.1016/j.ajoc.2025.102421","url":null,"abstract":"<div><h3>Purpose</h3><div>Autoimmune polyendocrine syndromes (APS) are rare diseases characterized by immunologic activity against multiple endocrine organs. Bilateral keratitis and limbal stem cell deficiency are manifestations described.</div></div><div><h3>Methods</h3><div>A 28-year-old man presented to our service with discomfort in his left eye. Past medical history included autoimmune polyendocrine syndrome, under hormonal treatment. Ocular history included an idiopathic bilateral peripheral occlusive vascular retinal disease, with areas of non-perfusion, neovascularization, and bleeding, treated with laser photocoagulation. He presented with a vitreous hemorrhage which was treated with a 20-gauge pars plana vitrectomy and endolaser. On review of family history, the patient reported having an older brother also affected by APS, developing the same bilateral retinal affection.</div></div><div><h3>Results</h3><div>Examination of the anterior segment of the left eye revealed a superior corneal epithelial irregularity. Fundus examination was significant for retinal arteries with segmental blood flow, box-carring, along with peripheral laser scars over previously ischemic areas. Corneal scraping and impression cytology demonstrated goblet cells on the corneal surface epithelium. A diagnosis of limbal stem cell insufficiency was made, and the patient was started on ocular lubricating drops and topical corticosteroids. At follow-up, the patient has been stable.</div></div><div><h3>Conclusions</h3><div>We describe a case of iatrogenic limbal stem cell insufficiency related to vitrectomy in a patient with autoimmune polyendocrine syndrome, a risk factor for this presentation. We propose that surgical trauma near the limbus and damage to the corneal sub‐basal nerve plexus during vitrectomy may result in the development of limbal stem cell deficiency in a predisposed eye, as postulated in this patient with an APS.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102421"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007738","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":"De novo pediatric choroidal Osteoma: A longitudinal observation since inception and through treatment","authors":"Brian Soetikno,&nbsp;Purna Nangia,&nbsp;Prithvi Mruthyunjaya","doi":"10.1016/j.ajoc.2025.102429","DOIUrl":"10.1016/j.ajoc.2025.102429","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a pediatric case of choroidal osteoma documented from its earliest detectable stage, characterize its growth pattern, and evaluate the impact of photodynamic therapy (PDT) on tumor progression.</div></div><div><h3>Observations</h3><div>A 4-year-old female underwent cataract surgery in the right eye and was consequently followed regularly. At age 8.8 years old (4 years of follow-up), a subtle, amelanotic choroidal juxtapapillary lesion was detected in the left eye on fundus examination. A retrospective review of fundus photographs prior to this examination revealed no readily visible lesion at age 6.7 years. Subtle changes on fundus photography in intermediate timepoints were apparent only on close inspection. Multimodal imaging confirmed the diagnosis of choroidal osteoma. The lesion's effective basal diameter growth rate before PDT was 1.94 mm/year, faster than reported in pediatric cases. After PDT, the growth rate was 1.78 mm/year, which was not statistically different (p = 0.558). Over a five-year follow-up period, the patient maintained 20/20 visual acuity in the affected eye despite subfoveal involvement of the tumor.</div></div><div><h3>Conclusions and importance</h3><div>This case represents a rare instance of photographic documentation of choroidal osteoma during its earliest identifiable stages, providing unique insight into this rare tumor's natural history and progression. While PDT was performed, it neither halted the tumor's progression completely nor prevented it from extending sub-foveally. These findings underscore the importance of early detection, longitudinal imaging, and continued exploration of management strategies for pediatric choroidal osteomas.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102429"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007740","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":"Bilateral acute macular neuroretinopathy after Epstein-Barr virus encephalitis","authors":"Daniella Socci da Costa ,&nbsp;Raul N.G. Vianna ,&nbsp;Remo Turchetti Moraes ,&nbsp;Gilberto dos Passos Junior ,&nbsp;Aluisio Rosa Gameiro Filho","doi":"10.1016/j.ajoc.2025.102418","DOIUrl":"10.1016/j.ajoc.2025.102418","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of a 11-year-old girl, who developed a bilateral acute macular neuroretinopathy (AMN) after Epstein-Barr virus (EBV) encephalitis.</div></div><div><h3>Observations</h3><div>Clinical findings and multimodal imaging including fundus photography, near-infrared reflectance, spectral-domain, and enhanced-deep imaging optical coherence tomography (OCT) of a patient with bilateral acute macular neuroretinopathy after Epstein-Barr virus encephalitis.</div></div><div><h3>Conclusions and importance</h3><div>After conducting a literature review in August 2024 using PubMed and Google Scholar, using the keywords “acute macular neuroretinopathy”, “AMN”, “Epstein-Barr”, “Epstein-Barr virus”, “EBV”, “encephalitis” “Epstein-Barr encephalitis” “EBV encephalitis” we did not find any previous reports of AMN associated with EBV encephalitis, such as in our case. Near infrared imaging and spectral-domain optical coherence tomography are key diagnostic tools for this condition, even when fundoscopic findings are subtle.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102418"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007737","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":"Lupus retinopathy manifesting unilateral neovascular alterations: A case with 15 years of follow-up","authors":"Yusuke Takeda ,&nbsp;Kazunobu Ichikawa ,&nbsp;Masafumi Watanabe ,&nbsp;Hidetoshi Yamashita ,&nbsp;Masahiko Sugimoto","doi":"10.1016/j.ajoc.2025.102419","DOIUrl":"10.1016/j.ajoc.2025.102419","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a rare case of lupus retinopathy, characterized by unilateral neovascular alterations and asymmetrical clinical progression.</div></div><div><h3>Observations</h3><div>A 32-year-old woman diagnosed with systemic lupus erythematosus (SLE) was referred to the ophthalmology department with decreased and blurred vision in the right eye. The patient was diagnosed with SLE at 31 years of age owing to cutaneous lupus, oral ulcers, and arthritis with a positive antinuclear antibody. Initial fundus assessment showed bilateral cotton wool spots predominantly in the right retina, and fluorescein angiography revealed nonperfusion areas exclusively in the right retina. Therefore, bilateral lupus retinopathy was diagnosed. Laboratory tests indicated the absence of concurrent antiphospholipid syndrome. The patient discontinued follow-up visits to the ophthalmology department for 1 year. Upon re-examination, a prominent neovascular membrane and vitreous hemorrhage were observed in the right eye, whereas cotton wool spots in the left eye resolved. The patient underwent lens-sparing pars plana vitrectomies two times. In the 15-year period after the vitrectomies, no recurrence of neovascular alterations in the right eye was noted.</div></div><div><h3>Conclusions and importance</h3><div>Although lupus retinopathy generally presents with similar severity in both eyes, the patient in this study demonstrated unilateral neovascular alterations and asymmetrical clinical progression. These findings indicate the requirement for careful monitoring of patients with asymmetrical lupus retinopathy, even in those without antiphospholipid syndrome.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102419"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932440","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}