Romanian journal of ophthalmology最新文献

{"title":"Transient third nerve palsy after percutaneous coronary intervention - A case report.","authors":"Divya Trivedi, Vinita Ramnani, Madhuri Nagori, Rahul Jain, Sakshi Ramnani","doi":"10.22336/rjo.2026.22","DOIUrl":"10.22336/rjo.2026.22","url":null,"abstract":"<p><p>Oculomotor nerve palsy is a rare complication of interventional cardiac procedures. We report a case of a 64-year-old male who developed diplopia after he underwent a percutaneous transluminal coronary angioplasty (PTCA) for double-vessel disease. Ocular examination revealed partial third nerve palsy in his right eye. His anterior and posterior segment examinations were within normal limits. Brain MRI revealed a hyperacute infarct in the right paramedian region of the superior colliculus. MR angiography displayed stenosis in his right internal carotid artery in the cervical region. He was managed conservatively with anticoagulants and statins, and his ocular movements gradually improved without any active ocular intervention. This case highlights the potential risk of neurological complications following an invasive cardiac procedure.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966446","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":"Pupillary Block and Secondary Iridocorneal Angle Closure Due to Posterior Chamber Air Following Deep Anterior Lamellar Keratoplasty.","authors":"Aysun Sanal Dogan, Damla Nur Dinc, Hilal Toprak Tellioğlu","doi":"10.22336/rjo.2026.23","DOIUrl":"10.22336/rjo.2026.23","url":null,"abstract":"<p><strong>Background: </strong>To describe the mechanism and non-invasive management of pupillary block and secondary angle closure caused by posterior migration of an anterior chamber air bubble following deep anterior lamellar keratoplasty (DALK).Material and method: A case report.</p><p><strong>Case presentation: </strong>A 27-year-old male with advanced keratoconus underwent DALK. On postoperative day 1, he developed pupillary block and secondary angle closure due to an air bubble that had migrated from the anterior to the posterior chamber. Intraocular pressure (IOP) was elevated, and the anterior chamber was shallow. Conservative treatment with mydriatics, systemic IOP-lowering agents, and head elevation led to rapid improvement. No surgical intervention was needed, and the graft remained clear, with a normal IOP, during follow-up.</p><p><strong>Discussion: </strong>Pupillary block caused by intracameral air has been reported mainly after endothelial keratoplasty procedures, whereas it is extremely rare following DALK. Unlike previously reported DALK cases that were associated with reverse pupillary block mechanisms, the present case involved posterior chamber migration of an anterior chamber air bubble, resulting in secondary angle closure.</p><p><strong>Conclusions: </strong>Although rare, pupillary block and secondary angle closure caused by an anterior chamber air bubble after DALK may occur. Early intervention with medical treatment and simple postural adjustment can help avoid surgical intervention.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"171-175"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966404","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 in a case of atypical choroidal osteoma: a 1-year follow-up.","authors":"Ashish Markan, Nikita Gupta, Ramandeep Singh, Basavaraj Tigari","doi":"10.22336/rjo.2026.16","DOIUrl":"10.22336/rjo.2026.16","url":null,"abstract":"<p><p>Choroidal osteomas are rare, benign, ossifying tumors of the choroid that are either flat or slightly elevated, located juxtapapillary, and usually have a well-defined geographic border. We describe a case of choroidal osteoma in a young male with atypical features, including a high elevation of the lesion, blurred margins, and a location away from the optic disc. We also describe the role of multimodal imaging, which allowed us to distinguish an atypical variant of choroidal osteoma from other choroidal mass lesions.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966369","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":"Early Keratometric and Scheimpflug Topographic Stabilization after Pterygium Excision with Conjunctival Autograft: A Prospective Cohort Study.","authors":"Farhat Siddiqui, Raj Nath Singh Kushwaha, Perwez Khan, Ankita Srivastava","doi":"10.22336/rjo.2026.11","DOIUrl":"10.22336/rjo.2026.11","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate early corneal stabilization following pterygium excision with conjunctival autograft, using keratometry and Scheimpflug imaging, and to compare outcomes with recent evidence.</p><p><strong>Methods: </strong>In this prospective cohort of 70 eyes (February 2019-February 2020), primary nasal pterygium excision with conjunctival autograft was performed using either fibrin glue (n = 35) or Autologous plasma (n = 35). Keratometric and Scheimpflug parameters [corneal astigmatism, index of surface variance (ISV), index of vertical asymmetry (IVA), maximum keratometry (Kmax), posterior corneal astigmatism] were assessed preoperatively, and at 1- and 2-month follow-up. Outcomes were compared using paired t-tests and subgroup analysis.</p><p><strong>Results: </strong>Mean keratometric astigmatism decreased from 1.35 ± 1.12 D preoperatively to 0.71 ± 0.65 D at 2 months (p < 0.001). Scheimpflug-derived astigmatism reduced from 1.22 ± 0.95 D to 0.89 ± 0.71 D (p < 0.001). ISV improved from 42.6 ± 6.4 to 33.2 ± 4.9 (p < 0.01), IVA from 0.38 ± 0.12 to 0.29 ± 0.10 (p < 0.01), and Kmax decreased modestly (p < 0.05). Outcomes were comparable between glue and suture groups (p > 0.05). Recurrence occurred in 3 eyes (4.3%).</p><p><strong>Discussion: </strong>The present study demonstrated early stabilization of keratometric and Scheimpflug parameters following pterygium excision with conjunctival autograft, suggesting that significant corneal remodeling occurs within the early postoperative period.</p><p><strong>Conclusions: </strong>Pterygium excision with conjunctival autograft yields a significant early reduction in astigmatism and an improvement in corneal surface regularity by 2 months, independent of fixation technique. These results support early refractive rehabilitation and spectacle planning after surgery.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"80-84"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966430","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":"HIV and Low Vision: A Narrative Review.","authors":"Ragni Kumari","doi":"10.22336/rjo.2026.04","DOIUrl":"10.22336/rjo.2026.04","url":null,"abstract":"<p><p>Human Immunodeficiency Virus (HIV) continues to be a significant global public health concern, affecting over 38 million individuals globally. Although the introduction of Highly Active Antiretroviral Therapy (HAART) has led to a significant decline in HIV-related mortality and opportunistic infections, the ocular manifestations of HIV remain a major contributor to morbidity, particularly in low-resource settings. Among the spectrum of visual complications, low vision is an under-recognized yet profoundly disabling consequence that adversely impacts quality of life, independence, and mental health. HIV-related low vision can result from multiple pathophysiological mechanisms, including direct viral damage, opportunistic infections such as cytomegalovirus (CMV) retinitis, neuro-ophthalmic complications, and HIV-associated malignancies. Clinical presentations may vary from asymptomatic retinal microvasculopathy to irreversible blindness secondary to necrotizing retinitis or optic neuropathy. The burden of ocular disease remains disproportionately high in low- and middle-income countries due to delayed diagnosis, limited access to ophthalmic care, and late initiation of antiretroviral therapy. This narrative review provides an in-depth exploration of the epidemiology, clinical spectrum, diagnostic approaches, management strategies, and rehabilitation options for low vision in the context of HIV. Special emphasis is placed on the psychosocial challenges associated with dual stigmatization from HIV and visual impairment, as well as the pressing need for integrated models of care. Emerging innovations such as portable fundus imaging, artificial intelligence-assisted diagnostics, and sustained-release ocular drug delivery systems are also discussed as part of the evolving landscape of HIV ophthalmology. Ultimately, a multidisciplinary approach-combining infectious disease management, ophthalmologic intervention, and low vision rehabilitation-is essential to address the complex needs of HIV-positive individuals at risk for or living with low vision. Early recognition and holistic care can mitigate disability, enhance functional outcomes, and improve overall quality of life in this vulnerable population.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"20-34"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966442","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":"Isolated Third Nerve Palsy and Alternate Hemiparesis in Brain Stem Stroke: A Case Report.","authors":"Rizaldy Taslim Pinzon, Marlyna Afifudin, Cornelius Ricky Nitema Ziliwu","doi":"10.22336/rjo.2026.17","DOIUrl":"10.22336/rjo.2026.17","url":null,"abstract":"<p><p>A very rare sign of brain stem stroke is Weber's Syndrome. Ipsilateral third nerve palsy and contralateral hemiparesis are the hallmarks of Weber's Syndrome. Midbrain infarction is the most frequent cause of Weber's Syndrome. The perforating branches of the basilar bifurcation or occlusion of the posterior cerebral artery commonly cause the infarction. We report the case of a 58-year-old female diagnosed with Weber's syndrome. The risk factors were hypertension and dyslipidemia. This patient presented with acute right-side motor weakness and left medial gaze palsy (third nerve palsy). A brain Computed Tomography (CT) scan revealed a lesion on the right side of the mesencephalon, which was consistent with an acute brainstem infarction. Subsequent Transcranial Doppler (TCD) and Digital Subtraction Angiography (DSA) revealed severe stenosis of the posterior circulation. We diagnosed and treated this patient as having Weber's syndrome based on the symptoms, signs, and imaging findings.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966379","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":"Intraocular pressure control after implantation of experimental antiglaucoma shunt versus trabeculectomy.","authors":"Maria Iacubitchii, Ala Paduca, Oleg Arnaut, Eugeniu Bendelic","doi":"10.22336/rjo.2026.10","DOIUrl":"10.22336/rjo.2026.10","url":null,"abstract":"<p><strong>Introduction: </strong>Glaucoma treatment includes various methods, such as eye drops, laser treatment, and surgery. The known complications of trabeculectomy have motivated the development of alternative filtering devices, including an antiglaucoma shunt with a valve.The research aims to assess the efficacy of the antiglaucoma shunt in rabbits with induced hypertension.</p><p><strong>Materials and methods: </strong>The preclinical study compared intraocular pressure (IOP) values in 42 rabbits' eyes with induced steroid-induced intraocular hypertension that underwent trabeculectomy (Group A, n=21) versus antiglaucoma shunt implantation (Group B, n=21). Statistical analysis used a linear mixed model, with model validation through residual diagnostics, Q-Q plots, and evaluation of random effects.</p><p><strong>Results: </strong>Both surgical methods produced a significant and sustained reduction in IOP compared with induced ocular hypertension values (average decrease ≈ of 6,5 mmHg per time unit, p < 0,001). Group A and B did not differ statistically in their ability to lower IOP at any period of examination (baseline: p=0.91; induced hypertension: p=0.92; 1 month postoperative: p=0.11; and 3 months postoperative: p=0.18). There was no systemic group bias, but random effects analysis indicated moderate inter-subject variability.</p><p><strong>Discussion: </strong>The results demonstrate that in a steroid-induced rabbit model of intraocular hypertension, both the new design shunt and conventional trabeculectomy offer efficient and sustained IOP reduction. Across all time points, the absence of significant differences between the groups indicates that the antiglaucoma shunt performs comparably to the established surgical technique.</p><p><strong>Conclusions: </strong>The implantation of the antiglaucoma shunt with valve showed IOP-lowering efficacy comparable to that of traditional trabeculectomy, maintaining sustained pressure decrease over the 3-month follow-up. According to these findings, the antiglaucoma shunt may be a viable surgical alternative for glaucoma treatment, warranting further research through long-term animal studies and clinical trials. It offers new possibilities in glaucoma treatment, with a postoperative IOP decrease of 35% or more.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"71-79"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966435","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":"Clinical Outcomes and Astigmatism Vector Analysis of High Toricity Visian ICL.","authors":"Silvia Victoria Prodescu, Paul Filip Curcă, Cătălina Ioana Tătaru, Călin Petru Tătaru","doi":"10.22336/rjo.2026.15","DOIUrl":"10.22336/rjo.2026.15","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate visual, refractive, and astigmatism vector outcomes following toric implantable collamer lens (ICL) implantation in eyes with high astigmatism.</p><p><strong>Methods: </strong>A retrospective real-world study was conducted on 25 eyes (16 patients) undergoing toric ICL implantation. Visual acuity, refractive outcomes, and astigmatic correction were assessed at 1 year postoperatively. Vector analysis was performed according to current reporting standards. Postoperative vault and its association with biometric parameters were also analyzed.</p><p><strong>Results: </strong>Mean UDVA improved from counting fingers to 0.16 ± 0.16 logMAR, and CDVA from 0.26 ± 0.21 to 0.09 ± 0.11 logMAR. The mean residual spherical equivalent was -0.56 ± 0.77D, and the mean residual astigmatism was 0.99 ± 0.72D. Vector analysis showed a correction index of 0.94 ± 0.25, indicating effective and proportional correction. The mean vault measured 615.5 ± 192.3 µm, and was significantly associated with ICL size (p=0.002), whereas no significant correlation was found with white-to-white measurements (ρ=0.15).</p><p><strong>Discussion: </strong>Slightly lower refractive predictability may reflect the inclusion of higher astigmatism eyes and limitations of available ICL toricity, while the lack of correlation between white-to-white measurements and vault highlights the role of internal anatomical factors in ICL sizing.</p><p><strong>Conclusions: </strong>Toric ICL implantation is safe and effective for high astigmatism. Vector analysis confirms accurate astigmatic correction, while postoperative vault is primarily influenced by ICL size rather than external biometric measurements. These findings support sizing strategies based on internal ocular anatomy and offer insights into the astigmatic outcomes in a cohort with high astigmatism, a subgroup underrepresented in current literature.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"121-136"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966445","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":"From Structure to Strategy: Rethinking Early Detection Paradigms in Modern Ophthalmology.","authors":"Ruxandra Pîrvulescu","doi":"10.22336/rjo.2026.01","DOIUrl":"https://doi.org/10.22336/rjo.2026.01","url":null,"abstract":"","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966354","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":"Hemorrhagic giant retinal cyst: a rare complication of a retinal vasoproliferative tumor.","authors":"Alejandro Verdu Reyes, Jose Ignacio Vela Segarra, Carlos Oribio-Quinto, Anna Hermosa Masdeu, Marta Caminal I Carames, Pilar Piquer Perez","doi":"10.22336/rjo.2026.19","DOIUrl":"10.22336/rjo.2026.19","url":null,"abstract":"<p><strong>Objective: </strong>To present a rare case of a giant cyst with intralesional hemorrhage associated with a peripheral retinal vasoproliferative tumor (RVPT).</p><p><strong>Methods: </strong>A 57-year-old male with vision loss in the right eye had an epiretinal membrane. Surgery revealed a yellowish-red mass with a large cyst in the retina, which was diagnosed as a peripheral RVPT. The lesion was observed until intralesional hemorrhage and progressive growth developed.</p><p><strong>Results: </strong>Intravitreal anti-VEGF injection reduced intralesional bleeding, and external cryotherapy achieved regression and stability of both the tumor and the cyst.</p><p><strong>Discussion: </strong>The differential diagnoses for this entity primarily included other retinal tumors and pars plana cysts. We suspected that this rare presentation of RVPT associated with a giant cyst might be due to contraction of the glial tissue. Intralesional hemorrhage resulting from vascular penetration inside the cyst was resolved with intravitreal anti-VEGF treatment, resulting in intrinsic vascular regression.</p><p><strong>Conclusion: </strong>Giant haemorrhagic retinal cysts are a rare, previously undescribed complication of peripheral retinal vasoproliferative tumours, in which anti-VEGF therapy may reduce bleeding.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 1","pages":"151-153"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966400","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}