American Journal of Ophthalmology Case Reports最新文献

{"title":"Surgical management of a case of severe leukemic retinopathy","authors":"Farzad Jamshidi ,&nbsp;Timothy M. Boyce ,&nbsp;R. Christopher Bowen ,&nbsp;H. Culver Boldt ,&nbsp;Elaine M. Binkley","doi":"10.1016/j.ajoc.2025.102417","DOIUrl":"10.1016/j.ajoc.2025.102417","url":null,"abstract":"<div><h3>Purpose</h3><div>To present a case of severe leukemic retinopathy requiring surgical rehabilitation. We report four-year follow up and associated post-remission pathology including cystoid macular edema (CME) and retinal ischemia.</div></div><div><h3>Observations</h3><div>This is a case report of a 35-year-old female with acute myelocytic leukemia (AML) who presented with hand motions (HM) vision in both eyes and severe multilayered hemorrhages. She underwent pars plana vitrectomy (PPV) in the left eye and subsequent PPV with internal limiting membrane (ILM) peel in the right eye after autologous bone marrow transplant. After cataract surgery and treatment of CME, visual acuity improved to 20/25 in each eye. Fundus examination and optical coherence tomography (OCT) revealed outer retinal loss outside of the fovea.</div></div><div><h3>Conclusions and importance</h3><div>Surgical intervention can be necessary for visual rehabilitation in some patients with leukemic retinopathy. With improved medical treatment for AML, patients survive longer, making visual rehabilitation more impactful and allowing for a better understanding of the natural history of leukemic retinopathy.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102417"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922547","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":"Mycobacterium chimaera choroidal granuloma: A case report and review of the literature","authors":"Matthew Pfannenstiel ,&nbsp;Mackenzie Penny ,&nbsp;Maram El-Geneidy ,&nbsp;Idaima Calderon ,&nbsp;Rachel Weihe ,&nbsp;Radwan S. Ajlan","doi":"10.1016/j.ajoc.2025.102422","DOIUrl":"10.1016/j.ajoc.2025.102422","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of a patient that developed a choroidal granulomatous lesion secondary to disseminated <em>Mycobacterium chimaera</em> (MC) infection that was successfully treated with systemic and ocular steroids.</div></div><div><h3>Observations</h3><div>A 60-year-old male with a history of multiple cardiothoracic surgeries complicated by disseminated MC was referred to retina clinic. On initial examination, bilateral choroidal lesions were noted consistent with MC choroiditis. These lesions were treated with systemic antimicrobials. Five months later, the patient was found to have a new choroidal lesion in his right eye concerning for a choroidal granuloma. Optical coherence tomography showed an elevated choroidal lesion with subretinal fluid. The granulomatous choroidal lesion regressed after starting systemic and local steroids. There was no recurrence of the granulomatous choroidal lesion at the most recent follow up visit.</div></div><div><h3>Conclusions and Importance</h3><div>This is an extremely rare report of a patient who received successful treatment for a MC related choroidal granulomatous lesion with accompanying multimodal imaging. The report suggests that similar lesions can be treated with systemic and ocular steroid therapy in combination with systemic antimicrobials.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102422"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118291","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":"Spontaneous separation of epiretinal membrane associated with retinal hemangioblastoma: a case report with 10-year follow-up","authors":"Eriko Inamura ,&nbsp;Yusuke Takeda ,&nbsp;Hidetoshi Yamashita ,&nbsp;Masahiko Sugimoto","doi":"10.1016/j.ajoc.2025.102427","DOIUrl":"10.1016/j.ajoc.2025.102427","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case with a spontaneous separation of a secondary epiretinal membrane (ERM) associated with a retinal hemangioblastoma, and its long-term follow-up after laser photocoagulation (PC) for the hemangioblastoma.</div></div><div><h3>Observations</h3><div>A 38-year-old man presented with a one-month history of decreased vision in his left eye (20/32) and was diagnosed with an ERM secondary to a retinal hemangioblastoma. Although PC was initially planned, he requested that the treatment be postponed. One month later, our examination showed a spontaneous separation of the ERM with a posterior vitreous detachment. His visual acuity improved from 20/32 to 20/20. PC was performed on the feeding vessels and hemangioblastoma later. We have followed this patient for 12 years, and his visual acuity is currently 20/16 without other complications or a recurrence of the ERM.</div></div><div><h3>Conclusions and importance</h3><div>A spontaneous separation of a secondary ERM can occur before any treatment with a rapid functional and anatomical recovery. Our findings indicate that clinicians need to assess the treatment options for secondly ERMs associated with a hemangioblastoma.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102427"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926144","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":"An autopsy case of bullous retinal detachment and hypopyon in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia","authors":"Miho Takenaka ,&nbsp;Yasuko Ikegami ,&nbsp;Seiya Kamino ,&nbsp;Tomio Arai ,&nbsp;Shigesaburo Miyakoshi ,&nbsp;Hiroko Takao ,&nbsp;Hiroki Yamamoto ,&nbsp;Miwako Yoshimoto ,&nbsp;Jiro Numaga","doi":"10.1016/j.ajoc.2025.102423","DOIUrl":"10.1016/j.ajoc.2025.102423","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the clinical and histopathological features of a case of bullous retinal detachment, hypopyon, and optic disc swelling in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL).</div></div><div><h3>Observations</h3><div>A 65-year-old Japanese woman presented with bilateral blurry vision. Four years earlier, she had been diagnosed with Ph + ALL and received chemotherapy. At initial examination, optical coherence tomography revealed subretinal detachment resembling central serous chorioretinopathy. A similar finding had been detected 1 month earlier during the remission phase, when the patient visited a clinic. Subretinal detachment resolved after systemic chemotherapy. Five months later, while in complete remission, she developed unilateral iritis and elevated intraocular pressure in the right eye, which improved with topical steroid treatment. Ten months after the initial presentation, she returned with decreased vision in both eyes. A slit-lamp examination revealed hypopyon uveitis in the right eye. Fundus examination revealed bilateral bullous retinal detachment and optic disc swelling, which was more pronounced in the right eye. At the same time, a bone marrow biopsy confirmed relapse of ALL. Therefore, systemic and intrathecal chemotherapy was initiated; however, her condition deteriorated, and she died 2 weeks later. Autopsy revealed widespread leukemic infiltration throughout the ocular tissues, resulting in multiple ocular manifestations. The findings suggested that ocular infiltration occurred either hematogenously or through direct extension from the meninges.</div></div><div><h3>Conclusion</h3><div>Leukemic infiltration of the eye was pathologically confirmed in a patient with Ph + ALL who developed ocular manifestations during the remission phase. Ocular evaluation is essential for confirming ocular relapse of ALL, and patients should be closely monitored to enable early detection and timely intervention.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102423"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007741","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 corneal pannus in Crohn's disease and assumed adalimumab-associated ocular surface disease","authors":"Nefeli Eleni Kounatidou,&nbsp;Johannes Birtel,&nbsp;Nicole Stuebiger","doi":"10.1016/j.ajoc.2025.102424","DOIUrl":"10.1016/j.ajoc.2025.102424","url":null,"abstract":"<div><h3>Purpose</h3><div>Anti-tumor necrosis factor (TNF)-alpha inhibitors are commonly used in the treatment of inflammatory bowel disease (IBD). Despite a beneficial risk-profile, dermatologic and ocular complications may particularly develop at higher doses. Here, we report a case of bilateral corneal pannus in a patient with Crohn's disease, which occurred following a prolonged adalimumab overdose.</div></div><div><h3>Observations</h3><div>A 19-year-old male with Crohn's disease presented with progressive bilateral blurred vision, conjunctival injection, and light sensitivity. Clinical examination, including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and funduscopy, revealed severe bilateral corneal pannus with vascularization extending superior to the limbus. The patient had been mistakenly administering adalimumab (40 mg) weekly instead of biweekly for over two years. Given the suspected medication-induced ocular surface disease, adalimumab was discontinued, and the α4β7 integrin antagonist vedolizumab was initiated. Adjunctive topical and systemic therapy was also implemented. At the 2-month follow-up, corneal pannus regressed, visual acuity improved, and ocular symptoms significantly decreased. Further improvement was observed at the 4-month follow-up.</div></div><div><h3>Conclusions and importance</h3><div>Bilateral corneal pannus can be a rare ocular complication of long-term TNF-alpha inhibitor therapy. Particularly in young IBD patients, dermatologic and ocular complications should be considered. In severe cases, modification of the immunosuppressive agent along with targeted therapy should be implemented to prevent vision loss.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102424"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046503","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":"Ocular complications in a patient with history of bariatric surgery","authors":"Jose Miguel Mora Correa ,&nbsp;Arslon Humayun ,&nbsp;Stephen G. Schwartz ,&nbsp;Jaime D. Martinez","doi":"10.1016/j.ajoc.2025.102420","DOIUrl":"10.1016/j.ajoc.2025.102420","url":null,"abstract":"<div><h3>Purpose</h3><div>This case report aims to highlight the potential for severe ocular complications due to vitamin A deficiency (VAD) following bariatric surgery, emphasizing the importance of long-term nutritional monitoring and compliance. We present a case report of corneal ulceration and ocular surface keratinization occurring eight years post-biliopancreatic diversion with duodenal switch (BPD-DS) and discuss its management in the context of limited access to intramuscular vitamin A therapy.</div></div><div><h3>Observations</h3><div>VAD can present years after bariatric surgery and cause severe ocular complications. In this case, inconsistent multivitamin intake led to xerophthalmia and progressive vision loss, thus highlighting the importance of long-term adherence to supplementation in patients with a history of bariatric surgery. Due to a nationwide shortage of intramuscular vitamin A at the time, high-dose oral therapy was used. Despite being well tolerated, the condition progressed to the point of requiring surgical intervention. This case highlights the importance of early detection, timely treatment, and long-term nutritional monitoring in bariatric patients to prevent irreversible vision loss.</div></div><div><h3>Conclusions and importance</h3><div>VAD can present years after bariatric surgery and cause serious ocular risks. While oral supplementation showed potential, it was insufficient to prevent surgical intervention. This case report aims to raise awareness of post-surgical risks to vision and highlight the importance of long-term nutritional monitoring and early diagnosis in patients with a history of bariatric surgery.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102420"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932441","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":"Development of secondary epiretinal membrane after vitrectomy with inverted ILM flap technique to treat a macular hole","authors":"Yoko Mase ,&nbsp;Hisashi Matsubara ,&nbsp;Natsuki Ueji ,&nbsp;Shinichiro Chujo ,&nbsp;Yoshitsugu Matsui ,&nbsp;Kumiko Kato ,&nbsp;Akiko Kubo ,&nbsp;Mineo Kondo","doi":"10.1016/j.ajoc.2025.102416","DOIUrl":"10.1016/j.ajoc.2025.102416","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a rare case of secondary epiretinal membrane (ERM) formation that appeared to be associated with the temporal hemi-inverted internal limiting membrane (ILM) flap, and to discuss its possible pathogenic mechanism.</div></div><div><h3>Observations</h3><div>A 74-year-old woman visited our hospital because she was aware that the central vision of her left eye was not normal. Her decimal best-corrected visual acuity (BCVA) in the left eye was 1.0. She was diagnosed with stage 3 MH with a diameter of 162 μm, and she underwent phacovitrectomy using the temporal hemi-inverted ILM flap technique. The MH was closed, and the decimal BCVA was still 1.0 one week post-surgery. However, at 13 months after the surgery, metamorphopsia developed with an M-chart score of 0.5°, and the decimal BCVA was reduced to 0.8. Optical coherence tomography revealed a secondary ERM with strong traction on the papillomacular bundle (PMB) of the retina. Several days later as the traction increased, the BCVA decreased to 0.6, and a second vitrectomy was performed. At one month after the reoperation, the BCVA had improved to 0.9, and at six months post-surgery, the M-chart score improved from 0.6° to 0°.</div></div><div><h3>Conclusions and importance</h3><div>The temporal hemi-inverted technique is beneficial in improving the closure of MHs, and it reduces the risk of iatrogenic damage of the PMB. It also preserves macular sensitivity. However, for small MHs, the relatively high rate of spontaneous closure combined with the potential risk of postoperative ERM formation in the long term, suggests that the temporal hemi-inverted ILM flap technique should not be used in such cases. Conventional ILM peeling may be more appropriate as a primary treatment for small MHs.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102416"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922546","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":"Bubble inside bubble: Nested perfluoro-decalin within a silicone oil bubble in the anterior chamber","authors":"Ignacio Leonardo Pueyo-Bestue ,&nbsp;Remi Dewispelaere ,&nbsp;Nathan Hupin","doi":"10.1016/j.ajoc.2025.102428","DOIUrl":"10.1016/j.ajoc.2025.102428","url":null,"abstract":"","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102428"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933141","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":"Glaucoma drainage device erosion rescued with upper eyelid forniceal conjunctival pedicle flap","authors":"Jacob King ,&nbsp;John Nguyen ,&nbsp;Kevin Halenda","doi":"10.1016/j.ajoc.2025.102425","DOIUrl":"10.1016/j.ajoc.2025.102425","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of Ahmed glaucoma drainage device tube erosion due to suspected mitomycin C-induced ischemia of surrounding conjunctival tissue and its successful management using a forniceal pedicle flap.</div></div><div><h3>Observation</h3><div>A 71-year-old female with a history of prior failed trabeculectomy with mitomycin C (MMC) presented with tube erosion one month postoperatively following Ahmed glaucoma drainage device (GDD) implantation. The patient underwent primary repair with an amniotic membrane graft. Due to rapid, extensive, recurrent erosion seven weeks later, MMCtissue toxicity was suspected as the etiology of tube exposure. A forniceal conjunctival pedicle flap reconstruction was utilized to reestablish vascularity and successfully prevented recurrent erosion.</div></div><div><h3>Conclusion and importance</h3><div>Tube erosion due to MMC-induced ischemia may cause recurrent degradation of the surrounding conjunctival tissue, posing an infectious risk. Reconstruction with a forniceal pedicle flap is a powerful technique to repair GDD erosions in the setting of large tissue defects and/or poor vascularity.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102425"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046502","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 ischemic cortical blindness with tenecteplase","authors":"Rui Tang ,&nbsp;Maryam Naser ,&nbsp;Saif Aldeen Alryalat ,&nbsp;Osama Al deyabat ,&nbsp;Andrew G. Lee","doi":"10.1016/j.ajoc.2025.102415","DOIUrl":"10.1016/j.ajoc.2025.102415","url":null,"abstract":"<div><h3>Purpose</h3><div>Tenecteplase (TNK) is a bioengineered variant of alteplase that has a longer half-life, a higher fibrin binding specificity, and a lower effect on systemic fibrinolytic activity. We reported a case of reversible bilateral vision loss to homonymous hemianopsia after TNK administration.</div></div><div><h3>Case description</h3><div>A 56-year-old African American male presented with acute onset of visual loss to no light perception (NLP) in both eyes (OU), left hemiparesis, decreased sensation, and dysarthria. Brain MRI revealed acute infarct involving the right posterior cerebral artery distribution without evidence of hemorrhagic transformation. CTA showed 4mm long segmental occlusion on the right P2 PCA. After the patient was given intravenous 23mg TNK after two and half hours since symptom onset, he recovered vision from NLP OU to 20/25 OU, but he had a residual left homonymous hemianopsia (HH), in addition to hemiparesis and decreased sensation on the left. The patient was eventually discharged to rehabilitation and outpatient follow up.</div><div>At the two-month follow up, patient only had residual left HH.</div></div><div><h3>Conclusions and importance</h3><div>Clinicians should be aware of the various treatment options in acute ischemia related cortical visual loss such as TNK. Future providers should also add comprehensive ophthalmological exam before and after patient receiving TNK to determine if our case is generalizable.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"40 ","pages":"Article 102415"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926141","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}