American Journal of Ophthalmology Case Reports最新文献_第7页

Subconjunctival dexamethasone implant (Ozurdex) for peripheral ulcerative keratitis 结膜下地塞米松植入治疗周围性溃疡性角膜炎

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-09 DOI: 10.1016/j.ajoc.2025.102379

Hashem H. Ghoraba, Chris Or, Aneesha Ahluwalia, Bethlehem Mekonnen, Cigdem Yasar, Negin Yavari, Quan Dong Nguyen

引用次数: 0

Macular hole closure following treatment of bilateral diffuse uveal melanocytic proliferation (BDUMP) with intravitreal methotrexate and systemic chemotherapy 玻璃体内甲氨蝶呤和全身化疗治疗双侧弥漫性葡萄膜黑色素细胞增生（BDUMP）后黄斑孔闭合

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102382

Arthur S. Zupelli , Victor C.F. Bellanda , João Victor N. Arcanjo , Fernando Chahud , Raul N.G. Vianna , Rodrigo Jorge

{"title":"Macular hole closure following treatment of bilateral diffuse uveal melanocytic proliferation (BDUMP) with intravitreal methotrexate and systemic chemotherapy","authors":"Arthur S. Zupelli , Victor C.F. Bellanda , João Victor N. Arcanjo , Fernando Chahud , Raul N.G. Vianna , Rodrigo Jorge","doi":"10.1016/j.ajoc.2025.102382","DOIUrl":"10.1016/j.ajoc.2025.102382","url":null,"abstract":"<div><h3>Purpose</h3><div>This report presents an unusual case of bilateral diffuse uveal melanocytic proliferation (BDUMP) associated with a macular hole that resolved after choroidal thinning following intravitreal methotrexate and systemic chemotherapy.</div></div><div><h3>Case report</h3><div>A 78-year-old male presented with progressive visual deterioration, significant weight loss and dyspnea. Ophthalmologic examination revealed multiple elevated yellowish-white lesions and few vitreous cells in both eyes, with a macular hole in the left eye. Optical coherence tomography showed subretinal fluid, hyperreflective lesions and choroidal irregularities at posterior pole in both eyes. Systemic screening revealed a pulmonary nodule, prompting further investigation. A pleural biopsy disclosed diffuse infiltration by mature-looking lymphocytes, positive for CD20 and BCL-2, indicating a marginal zone B-cell lymphoma. The patient received systemic chemotherapy and off-label intravitreal methotrexate injections. Notably, the macular hole in the left eye spontaneously closed following treatment, leading to significant visual improvement.</div></div><div><h3>Discussion</h3><div>BDUMP poses diagnostic and therapeutic challenges necessitating a multidisciplinary approach. This case is notable for the mechanism of macular hole closure after intravitreal methotrexate and choroidal thinning. We believe that systemic chemotherapy also played an effective role in ocular symptoms management.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102382"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632737","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}

引用次数: 0

Bilateral acute retinal necrosis after ofatumumab masquerading as intermediate uveitis in a patient with multiple sclerosis 多发性硬化症患者双侧急性视网膜坏死后，奥图单抗伪装成中间葡萄膜炎

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102377

Prabakaran Ganesh , Roxana A. Hojjatie , Sruthi Arepalli

{"title":"Bilateral acute retinal necrosis after ofatumumab masquerading as intermediate uveitis in a patient with multiple sclerosis","authors":"Prabakaran Ganesh , Roxana A. Hojjatie , Sruthi Arepalli","doi":"10.1016/j.ajoc.2025.102377","DOIUrl":"10.1016/j.ajoc.2025.102377","url":null,"abstract":"<div><h3>Purpose</h3><div>To report an unique case of bilateral acute retinal necrosis (ARN) associated with ofatumumab use masquerading as intermediate uveitis in a patient with multiple sclerosis.</div></div><div><h3>Observation</h3><div>A 47-year-old female with multiple sclerosis was transitioned to ofatumumab (Arzerra/Kesimpta, Novartis, Cambridge, MA, USA) for better systemic control of her disease. Two months later, she developed floaters with a scotoma in her right eye. Initially, she was diagnosed with intermediate uveitis secondary to a presumed multiple sclerosis flare. However, her symptoms worsened and she was referred to Emory University. Fundus examination revealed bilateral ARN. The patient discontinued the medication and was treated with systemic and intravitreal antivirals with improvement; however, she developed a retinal detachment in her right eye that required surgical repair.</div></div><div><h3>Conclusions and importance</h3><div>This is a unique case of bilateral ARN after starting ofatumumab medication for multiple sclerosis. This case also highlights the importance of discerning between intermediate uveitis associated with multiple sclerosis and infectious uveitis in the setting of immunocompromise.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102377"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694671","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}

引用次数: 0

Vitreoretinal lymphoma presenting as amaurosis fugax 玻璃体视网膜淋巴瘤表现为烟性黑朦

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102380

Andreas Arnold-Vangsted , Tomas Ilginis , Jens Folke Kiilgaard , Steffen Heegaard , Carsten Faber

引用次数: 0

Preserflo™ microshunt for the treatment of refractory childhood glaucoma: A case series study Preserflo™微分流治疗难治性儿童青光眼：病例系列研究

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102384

Yuri Tanaka , Shiho Kasahara , Ryo Tomita , Norie Nonobe , Kazuhide Kawase , Kenya Yuki

{"title":"Preserflo™ microshunt for the treatment of refractory childhood glaucoma: A case series study","authors":"Yuri Tanaka , Shiho Kasahara , Ryo Tomita , Norie Nonobe , Kazuhide Kawase , Kenya Yuki","doi":"10.1016/j.ajoc.2025.102384","DOIUrl":"10.1016/j.ajoc.2025.102384","url":null,"abstract":"<div><h3>Purpose</h3><div>We report the outcomes of five patients with pediatric glaucoma, who were treated with Preserflo™ microshunt surgery.</div></div><div><h3>Methods</h3><div>This prospective study included five consecutive patients who underwent Preserflo™ microshunt surgery at the Nagoya University Hospital. The main outcome measures evaluated in this study were mean intraocular pressure (IOP), number of glaucoma medications, and best corrected visual acuity (BCVA). Paired t-tests with Bonferroni correction were used to compare the baseline and follow-up periods, where p < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Average age at the time of surgery was 10 ± 4 years. Three patients had primary congenital glaucoma, one had Sturge-Weber syndrome, and one had juvenile open-angle glaucoma. Preoperative average IOP was 37.6 ± 4.7 mmHg. After microshunt surgery, IOP significantly decreased to 6.3 ± 1.2 mmHg in 1 day, 6.6 ± 1.7 mmHg in 1 week, 9.6 ± 6.1 mmHg in 1 month, 12.0 ± 7.4 mmHg in 3 months, 10.0 ± 5.2 mmHg in 6 months, 14.2 ± 8.7 mmHg in 9 months, and 10.5 ± 6.5 mmHg in 1 year (p < 0.01 for each paired <em>t</em>-test). One year postoperatively, we placed a Baerveldt glaucoma implant in case 1. No significant change was observed between the pre- and post-operative periods in BCVA. No postoperative complications, including choroidal detachment, shallow or flat anterior chamber, hypotony maculopathy, or conjunctival leak, were observed in this case series.</div></div><div><h3>Conclusion</h3><div>Microshunt surgery may be a useful option for treating glaucoma in pediatric patients, in whom trabeculotomy failed.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102384"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604094","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}

引用次数: 0

Tay-Sachs disease in a child of indigenous Guatemalan-Mayan origin with macular brown spots and perifoveal whitening 土著危地马拉-玛雅裔儿童患泰-萨克斯病，伴有黄斑棕色斑点和凹周白斑

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102381

Mya Abousy , Lauren Hucko , Audina Berrocal , Erick Vinicio Saenz

{"title":"Tay-Sachs disease in a child of indigenous Guatemalan-Mayan origin with macular brown spots and perifoveal whitening","authors":"Mya Abousy , Lauren Hucko , Audina Berrocal , Erick Vinicio Saenz","doi":"10.1016/j.ajoc.2025.102381","DOIUrl":"10.1016/j.ajoc.2025.102381","url":null,"abstract":"<div><h3>Purpose</h3><div>This report describes an unusual macular presentation of Tay-Sachs disease in a two-year-old female of Guatemalan-Mayan origin. This case serves to build upon the very limited literature regarding ophthalmic manifestations of Tay-Sachs disease in the non-Caucasian population.</div></div><div><h3>Observations</h3><div>The patient and family presented with concern for poor visual acuity and hyperacusis. A brown macular spot with perifoveal whitening was identified in both eyes on fundus examination. Laboratory studies revealed low hexosaminidase A levels, which confirmed the diagnosis of Tay-Sachs disease.</div></div><div><h3>Conclusions and importance</h3><div>This is an extremely rare case of Tay-Sachs disease in a patient of Guatemalan-Mayan origin diagnosed by enzyme studies and fundus examination. Further, it is one of the few documented cases of “brown spots” appreciated in association with Tay-Sachs disease, as opposed to the classic “cherry red spot”. This case presentation challenges the nomenclature of the “cherry red spot” to account for the variations in the fundus that may occur in different racial and ethnic groups that present with Tay-Sachs disease.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102381"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611927","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}

引用次数: 0

Pigmented perivascular epithelioid cell tumors of the orbit with NONO::TFE3 fusion: Molecular evaluation and literature review 眼眶色素血管周围上皮样细胞瘤与NONO::TFE3融合：分子评价和文献复习

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102378

Naoko Takeda-Miyata , Ken-ichi Yoshida , Miho Shirono , Akihide Watanabe , Yoji Kukita , Chie Sotozono , Eiichi Konishi

{"title":"Pigmented perivascular epithelioid cell tumors of the orbit with NONO::TFE3 fusion: Molecular evaluation and literature review","authors":"Naoko Takeda-Miyata , Ken-ichi Yoshida , Miho Shirono , Akihide Watanabe , Yoji Kukita , Chie Sotozono , Eiichi Konishi","doi":"10.1016/j.ajoc.2025.102378","DOIUrl":"10.1016/j.ajoc.2025.102378","url":null,"abstract":"<div><h3>Purpose</h3><div>To elucidate the clinical characteristics of rare orbital pigmented perivascular epithelioid cell tumors (PEComa) with <em>transcription factor E3</em> (<em>TFE3</em>) rearrangement through a literature review.</div></div><div><h3>Observations</h3><div>A 49-year-old female was referred to our hospital with a mass measuring 16 × 14 mm in the extraconal space of the right orbit. Suspecting hemangioma or distended hematoma clinically, the tumor was completely excised through the right nasal conjunctiva. Although initial histological evaluation raised the suspicion of malignant melanoma, subsequent immunohistochemistry and molecular analyses led to a diagnosis of <em>TFE3</em>-rearranged PEComa with the <em>NONO</em>::<em>TFE3</em> fusion gene. The patient's visual function was preserved 14 months postoperatively, with no evidence of recurrence.</div></div><div><h3>Conclusions and importance</h3><div>Although rare, <em>TFE3-</em>rearranged PEComa should be considered in the differential diagnosis of pigmented orbital tumors.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102378"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611580","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}

引用次数: 0

Incidental detection of retinal nerve fiber layer thinning with slowed progression following optic nerve-carotid artery decompression: A case report 视神经-颈动脉减压后意外发现视网膜神经纤维层变薄且进展缓慢1例

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI: 10.1016/j.ajoc.2025.102376

Hidenori Takahashi , Keisuke Ohtani , Takeshi Hara , Kensuke Kawai

{"title":"Incidental detection of retinal nerve fiber layer thinning with slowed progression following optic nerve-carotid artery decompression: A case report","authors":"Hidenori Takahashi , Keisuke Ohtani , Takeshi Hara , Kensuke Kawai","doi":"10.1016/j.ajoc.2025.102376","DOIUrl":"10.1016/j.ajoc.2025.102376","url":null,"abstract":"<div><h3>Purpose</h3><div>This report aims to present a case of the retinal nerve fiber layer (NFL) thinning, in which the progression of thinning was slowed following optic nerve-carotid artery decompression surgery.</div></div><div><h3>Observations</h3><div>A 41-year-old ophthalmologist incidentally noticed a generalized thinning of NFL in his left eye using optical coherence tomography (OCT). Five years earlier, the OCT showed only mild thinning. While visual acuity and visual fields were normal, the patient reported a blurriness. The MRI revealed an ectatic and tortuous left internal carotid artery compressing the left optic nerve. Due to the lack of reports on the correlation between NFL thickness and visual acuity, an internal review was conducted. We searched for cases with a progression from healthy visual acuity to blindness, and in the only case identified, we investigated the correlation between NFL thickness and visual acuity. Applying this correlation, it was predicted that the patient would lose vision by age 48. As a result, the patient decided to receive decompression surgery. Following the surgery, the rate of NFL thinning significantly slowed from −1.9 μm/year to −0.57 μm/year (p < .0001). At the current age of 48, the patient's corrected visual acuity is 20/16, and visual field remains normal. The predicted onset of blindness has been postponed by 10 years.</div></div><div><h3>Conclusions and importance</h3><div>We report a case in which compression of the optic nerve by the internal carotid artery was observed in a patient with retinal nerve fiber layer (NFL) thinning. A slowing of NFL thinning was noted following surgical decompression.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102376"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632826","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}

引用次数: 0

Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways 通过结膜淋巴通道引流结膜下出血

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-01 DOI: 10.1016/j.ajoc.2025.102368

Ashton Zheng-Boon Lau , Grace YF. Tang , William H. Morgan , Geoffrey ZP. Chan

{"title":"Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways","authors":"Ashton Zheng-Boon Lau , Grace YF. Tang , William H. Morgan , Geoffrey ZP. Chan","doi":"10.1016/j.ajoc.2025.102368","DOIUrl":"10.1016/j.ajoc.2025.102368","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate the role of ocular lymphatic involvement in aiding the drainage and resolution of subconjunctival hemorrhage.</div></div><div><h3>Methods</h3><div>We present the case of a 63-year-old Caucasian female who developed a subconjunctival hemorrhage following the administration of a subconjunctival anesthetic during cataract surgery. Intraoperative optical coherence tomography was utilized to image these structures within the deep and middle conjunctival-Tenon's space.</div></div><div><h3>Results</h3><div>Subconjunctival hemorrhage was visualized and saccular blood-filled structures developed adjacent to sites of hemorrhage. Intraoperative optical coherence tomography confirmed the presence of blood within structures containing partitions reminiscent of valvular leaflets, indicating their lymphatic origin. Rapid resolution of the subconjunctival hemorrhage was noted during the immediate postoperative period.</div></div><div><h3>Conclusion</h3><div>Subconjunctival hemorrhage may have its resolution assisted by conjunctival lymphatic vessels. Our findings confirm that lymphatic structures may play an under-appreciated role in assisting the clearance of macromolecules from the subconjunctival space.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102368"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572697","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}

引用次数: 0

Late onset bilateral annular subepithelial corneal haze after LASIK LASIK术后迟发性双侧环形上皮下角膜混浊

American Journal of Ophthalmology Case Reports Pub Date : 2025-06-28 DOI: 10.1016/j.ajoc.2025.102371

Michelle Y. Ko , Ben J. Glasgow , Reza Ghaffari

{"title":"Late onset bilateral annular subepithelial corneal haze after LASIK","authors":"Michelle Y. Ko , Ben J. Glasgow , Reza Ghaffari","doi":"10.1016/j.ajoc.2025.102371","DOIUrl":"10.1016/j.ajoc.2025.102371","url":null,"abstract":"<div><h3>Purpose</h3><div>Corneal haze is uncommon after laser assisted in situ keratomileusis (LASIK). Post-LASIK haze and scarring can develop due to different conditions such as infectious keratitis, LASIK flap complications, diffuse lamellar keratitis (DLK), corneal photo disruption and damage to the basement membrane due to effects of femtosecond laser, or unknown causes such as in central toxic keratopathy (CTK). In this report, we describe a patient with bilateral late onset annular subepithelial corneal haze which presented more than 20 years after LASIK.</div></div><div><h3>Observations</h3><div>A 65-year-old woman who presented with decreased vision in both eyes (Best corrected visual acuity [BCVA] 20/80 in right eye and 20/300 in the left eye) over 20 years after LASIK. The patient had history of gout, chromic kidney disease, dry eyes, and chronic cigarette smoking. Clinical examination and anterior segment optical coherence tomography revealed bilateral annular subepithelial corneal haze in the paracentral and midperipheral zone in an annular pattern. Following superficial keratectomy and mitomycin-C application, the uncorrected corrected visual acuity improved to 20/60 in the right eye at 7 months but the final BCVA decreased to 20/300 at 11 months after the surgery due to recurrence of subepithelial haze. The postoperative BCVA improved to 20/30 in the left eye 7 months after the surgery. Histologic examination of the excised corneal tissue revealed presence of subepithelial fibrous tissue and epithelial basement membrane thickening.</div></div><div><h3>Conclusions and importance</h3><div>Although uncommon, delayed onset bilateral annular subepithelial haze and scarring can develop after LASIK. Although the reason for this clinical presentation is unknown, it is possible that chronic ocular surface breakdown due to a combination of systemic and local factors such as gout, chronic kidney disease, dry eyes, and chronic cigarette smoking contributed to development of subepithelial haze in this patient.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102371"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548826","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}

引用次数: 0