Case Reports in Ophthalmological Medicine最新文献

{"title":"Removal of Subinternal Limiting Membrane Hemorrhage Secondary to Valsalva Retinopathy Using a Fovea-Sparing Internal Limiting Membrane Fissure Creation Technique.","authors":"Yasuyuki Sotani, Hisanori Imai, Maya Kishi, Hiroko Yamada, Wataru Matsumiya, Akiko Miki, Sentaro Kusuhara, Makoto Nakamura","doi":"10.1155/2024/2774155","DOIUrl":"10.1155/2024/2774155","url":null,"abstract":"<p><p><b>Introduction:</b> Valsalva retinopathy can cause submacular hemorrhage (SMH), which may lead to visual disturbances. SMH can extend into the subinternal limiting membrane (ILM) and vitreous spaces, sometimes occurring concomitantly with full-thickness macular holes (FTMHs). Herein, we describe a case in which sub-ILM hemorrhage was removed without peeling the ILM of the central fovea, thus preserving the foveal ILM. <b>Case Presentation:</b> A 48-year-old female patient developed rapid-onset bilateral visual impairment due to SMH secondary to Valsalva retinopathy. The SMH predominantly consisted of sub-ILM hemorrhage. However, detailed observation was challenging due to the dense sub-ILM hemorrhage in the left eye. Initial best-corrected visual acuity (BCVA) in the right and left eyes were 1.2 and 0.03, respectively. Intravitreal tissue plasminogen activator (tPA) and sulfur hexafluoride (SF6) gas injections were initially administered to displace the SMH in the left eye; however, the SMH could not be successfully displaced. A vitrectomy was then performed. Intraoperatively, an ILM fissure beyond the foveal region was created using ILM forceps. The balanced salt solution was sprayed onto the ILM, and the sub-ILM hemorrhage was drained into the vitreous cavity from the ILM fissure. The surgery successfully displaced the sub-ILM hemorrhage while preserving the foveal ILM. No postoperative complications were observed. Visual acuity remained at 1.2 in the right eye and improved to 1.2 in the left eye 6 months postoperatively. <b>Conclusion:</b> Removing foveal sub-ILM hemorrhage without peeling the foveal ILM can be a viable treatment option to preserve the foveal ILM.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"2774155"},"PeriodicalIF":0.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008371","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":"Combined Papillectomy and Autologous Conjunctival Membrane Graft as Management of Giant Papillae for Severe, Refractory Palpebral Vernal Keratoconjunctivitis-A Case Report.","authors":"Devina Nur Annisa, Hernawita Suharko, Hasiana Lumban Gaol, Viona Viona","doi":"10.1155/2024/9973441","DOIUrl":"10.1155/2024/9973441","url":null,"abstract":"<p><p><b>Introduction:</b> Vernal keratoconjunctivitis (VKC) is an allergic disease that predominantly affects young individuals, with a higher incidence among males. Traditionally seen as a condition of childhood that resolves at puberty, recent studies have shown persistent cases in some individuals, potentially influenced by hot and dry tropical environmental conditions. VKC is more prevalent in regions with a hot and humid climate and a high presence of airborne allergens, leading to significant morbidity and impacting the quality of life for affected individuals. Severe and chronic cases can lead to vision-threatening corneal complications, making effective management crucial. Although the clinical profile of VKC varies geographically, comprehensive studies in specific regions remain limited. <b>Case Presentation:</b> In this case report, we present an 18-year-old male patient with severe and refractory VKC. Despite initial treatments, including topical and oral medications, recurrent episodes occurred every 6 months, accompanied by giant papillae (GP) formation and corneal ulcers. The patient had a history of triamcinolone injection and papillectomy combined with amnion membrane transplantation, but presented with a refractory disease in a year. Surgical intervention involving papillectomy and autologous conjunctival membrane graft was performed, leading to a smooth upper tarsal conjunctiva during the 2-year follow-up period, without GP recurrence and maintaining a clear cornea. The patient's symptoms were effectively managed with topical medications. <b>Conclusion:</b> The management of VKC necessitates a comprehensive approach involving preventive measures, pharmacological treatment, and surgical interventions for refractory cases. This case highlights the potential benefits of surgical techniques, such as papillectomy and autologous conjunctival membrane graft, in managing severe and refractory VKC cases with a history of previous surgical procedure failure. However, it is essential to recognize that exposure avoidance and allergic control remain fundamental in VKC management. Further research and larger studies are required to validate the efficacy of these surgical techniques in managing VKC.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"9973441"},"PeriodicalIF":0.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970720","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":"Primary Conjunctival Basal Cell Carcinoma Mimicking an Ocular Surface Squamous Neoplasia in a Young Adult Filipino: A Case Report and Literature Review.","authors":"Lorenz Jacob Mangahas, Rowena Wea Reyes, Richmond Siazon","doi":"10.1155/2024/3113342","DOIUrl":"10.1155/2024/3113342","url":null,"abstract":"<p><p><b>Objective:</b> To describe the morphological and histopathological features of primary conjunctival basal cell carcinoma (BCC) in a young adult Filipino. <b>Introduction:</b> Malignant conjunctival tumors arise from different cells, the most common of which are squamous cell carcinomas (SCCs), (including ocular surface squamous neoplasia [OSSN]), melanomas, and lymphomas. Primary conjunctival BCC is rare and can mimic the clinical features of OSSN. Only seven reported cases were published. Most cases are in the 6th-8th decades of life, and we report the first case in a young adult male. <b>Case Summary:</b> A 37/M, HIV-seronegative, presenting with a 3-year history of enlarging fleshy, pedunculated mass on the right eye measuring 8.5 mm × 8.0 mm at the superonasal limbus encroaching on the cornea, with prominent feeder vessels. Whitish-to-grayish plaques were observed on the surface of the lesions. Wide excision of the mass using the no-touch technique was performed under local anesthesia. Four cycles of mitomycin C (0.02%) were administered as chemoadjuvant therapy. Histopathology showed basaloid cells with peripheral palisading, most consistent with BCC. Immunohistochemistry was positive for Bcl-2 and CD10 markers and negative for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), confirming conjunctival BCC. Eight weeks postoperatively, fibrovascular tissue proliferation was noted at the excision site. Anterior segment-optical coherence tomography (AS-OCT) revealed a thickened hyperreflective band that was continuous with the epithelium, indicating possible recurrence. Resection with rush frozen section revealed fibrotic tissue that was negative for tumor cells. The bare sclera was covered with conjunctival autograft. There was no recurrence of the lesion after 16 months of follow-up. <b>Conclusion:</b> Primary BCC of the conjunctiva is rarely encountered, especially in young individuals, mimicking squamous neoplasia both in morphology and histopathology. Therefore, this should be considered in the differential diagnosis of OSSN. Immunostaining is crucial in differentiating between the two conditions and confirming the diagnosis. In most cases, wide surgical excision is sufficient. In addition, adjuvant therapies may be beneficial in preventing tumor recurrence.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"3113342"},"PeriodicalIF":0.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723130","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":"Hyperreflective Dots in Central Fovea Visualized by a Novel Application of Visible-Light Optical Coherence Tomography.","authors":"Michael A Krause, Marta Grannonico, Brooke P Tyler, David A Miller, Weijia Fan, Mingna Liu, Roman V Kuranov, Hao F Zhang, Xiaorong Liu, Peter A Netland","doi":"10.1155/2024/5823455","DOIUrl":"10.1155/2024/5823455","url":null,"abstract":"<p><p>Visible-light optical coherence tomography (vis-OCT) is a novel noninvasive retinal imaging system that offers improved resolution compared to conventional near-infrared (NIR) OCT systems. Here, we utilized vis-OCT to produce fibergrams (vis-OCTF) for the first time in human patients, enabling <i>en face</i> visualization and precise quantification of hyperreflective dots in the central fovea in two patients. We also directly compare the imaging qualities of conventional vis-OCT and NIR-OCT. Vis-OCT generated a 3 × 3 mm² <i>en face</i> image with an impressive axial resolution of 1.3 <i>μ</i>m, whereas NIR-OCT produced an <i>en face</i> image with a larger field of view (FOV) (9 × 9 mm²) but a lower resolution of 7.0 <i>μ</i>m. Moreover, vis-OCTF unveiled clear images of hyperreflective dots in the fovea of both patients, which were not discernible in the NIR-OCT <i>en face</i> images. Foveal dots have often been linked to several age-related and pathological conditions. The high-resolution images generated by vis-OCTF enable more precise characterization of changes in retinal sublayers within the central fovea.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"5823455"},"PeriodicalIF":0.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626078","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":"Phacoemulsification in Nanophthalmic Eye, a Way to Manage Glaucoma: Case Report.","authors":"Dania Bamefleh, Konrad Schargel, Valmore A Semidey, Faisal A Altahan, Edward Schargel","doi":"10.1155/2024/2633679","DOIUrl":"https://doi.org/10.1155/2024/2633679","url":null,"abstract":"<p><p>A rare condition called nanophthalmos causes variable degrees of vision impairment. One may present with nanophthalmos as a hereditary or sporadic condition. There have been documented cases of nanophthalmos treated with bilateral cataract extraction and intraocular lens (IOL) implantation for intractable secondary glaucoma or chronic angle-closure glaucoma. We describe a case of closed-angle glaucoma in a nanophthalmic eye with increased intraocular pressure (IOP) on full medical treatment, along with concurrent drug side effects. As a first surgical procedure, we recommend phacoemulsification of the clear lens + IOL. The challenge in treating nanophthalmic eyes lies in managing the possibility of developing glaucoma in an eye where anatomical conditions make surgery extremely risky. This must be balanced against the advantages of lessening exposure contact in the trabecular meshwork and optimizing the anterior chamber for potential future glaucoma surgery, which can improve the prognosis in these cases. Lastly, it is critical to have a thorough conversation with the patient about the aims, risks, and advantages. The patient's understanding and expectations should also be crystal apparent. The primary objective should always be to enhance the circumstances for the most effective glaucoma therapy, not to perform refractive surgery.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"2633679"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280667","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":"A Rare Tick Tale: A Novel Case of the Australian Paralysis Tick Causing Multiple Cranial Neuropathies.","authors":"Sujan A Surendran, Philomena McNamara, Jonathan N Hyer, Charles S Su","doi":"10.1155/2024/3449614","DOIUrl":"10.1155/2024/3449614","url":null,"abstract":"<p><p>The Australian paralysis tick (<i>Ixodes holocyclus</i>) is found along the east coast of Australia. Tick bites may result in paralysis ranging from muscular weakness to ascending paralysis requiring respiratory support. Ocular complications and facial nerve involvement are rare. We present a rare occurrence of tick-bite-associated visual loss, proptosis, and multiple cranial neuropathies not previously reported in the literature. The tick was removed, and the patient's symptoms improved following treatment with steroids and oral doxycycline. The vision and sensory changes are not explained by the <i>Ixodes</i> toxin; thus, we hypothesize this is related to orbital apex inflammation.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"3449614"},"PeriodicalIF":0.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497151","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":"Type II Acute Macular Neuroretinopathy Secondary to Malaria.","authors":"Alastair David Bezzina, Jeremy Spiteri Bailey, Isaac Bertuello","doi":"10.1155/2024/1577127","DOIUrl":"10.1155/2024/1577127","url":null,"abstract":"<p><p>To the best of our knowledge, we present the first case of type II acute macular neuroretinopathy (AMN) exhibiting in a patient suffering from malarial retinopathy concomitant with cerebral malaria acquired after travelling to West Africa without taking the necessary antimalarial prophylaxis. The patient complained of bilateral blurring of vision after being removed off sedation whilst at the intensive care unit. Subsequent examination revealed bilateral retinal haemorrhages, cotton-wool spots, and foveal pigmentary changes in keeping malarial retinopathy. Macular optical coherence tomography (OCT) revealed patchy hyperreflective changes at the level of the outer plexiform and outer nuclear layers (ONL) in keeping with the areas of deep capillary plexus flow void noted on OCT-angiography (OCT-A). This case report sheds more light on the extent of neurosensory retinal ischaemia in malarial retinopathy and showcases a new imaging biomarker which may be utilized in assessing and quantifying the functional deficit created by this disease.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"1577127"},"PeriodicalIF":0.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466398","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":"Outer Retinopathies Associated with COVID-19 Infection: Case Reports and Review of Literature.","authors":"Naima Zaheer, Mohammad O Tallouzi, N Ajith Kumar, Sreekanth Sreekantam","doi":"10.1155/2024/7227086","DOIUrl":"10.1155/2024/7227086","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease (COVID-19) is a highly contagious disease with profound health implications. It can affect any part of the body with variable severity. Various ophthalmic manifestations of coronavirus disease have been documented. <i>Case Presentations</i>. We reported three cases of outer retinopathies associated with COVID-19 infection. All three patients were young females. The first two patients presented within days of COVID-19 infection with complaints of black spots in the eyes. Multimodal retinal imaging showed lesions consistent with acute macular neuroretinopathy. Lesions were bilateral in the first patient and unilateral in the second one. Our third patient presented with blurred vision in one eye, 3 months after a suspected COVID-19 infection. Retinal imaging showed outer retinopathy. Our patients' vision was good and maintained during the follow-up. All three were monitored on observation only, and symptoms and lesions improved with time.</p><p><strong>Conclusion: </strong>In conclusion, COVID-19-related thromboinflammatory response can result in localized vascular inflammation and hypoperfusion in any of the retinal capillary plexuses or choriocapillaris resulting in ischemia of the corresponding retinal or choroidal layers.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"7227086"},"PeriodicalIF":0.9,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142791","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 Ocular Relapse of Acute Myeloid Leukaemia Post Allogeneic Stem Cell Transplant.","authors":"M H Tong, A Kwok, A Walsh, P Heydon, E S Koh, N McNamara, A Bryant","doi":"10.1155/2024/2235819","DOIUrl":"10.1155/2024/2235819","url":null,"abstract":"<p><p>We present a rare case of a 39-year-old female with extramedullary relapse of acute myeloid leukaemia (AML) isolated to the left eye 2 months post allogeneic haematopoietic stem cell transplant. She initially presented with painless left eye erythema, swelling, and visual impairment. Initial ophthalmology review revealed conjunctival chemosis, raised intraocular pressure, and serous retinal detachments. She was initially treated for suspected orbital cellulitis with intravenous antibiotic and antifungal therapy but clinically progressed so was then treated with intravenous corticosteroids. One week later, she progressed to angle-closure glaucoma with development of a hypopyon and an enlarging subconjunctival mass. She proceeded to urgent subconjunctival biopsy and drainage of subretinal fluid which confirmed extramedullary relapse of AML. Notably, further investigation found no evidence of bone marrow or central nervous system relapse. She proceeded to localized radiotherapy with gradual resolution of the subconjunctival mass and serous retinal detachment and was for consideration of donor lymphocyte infusions and azacitidine therapy; unfortunately, she developed respiratory sepsis and passed away despite maximal efforts. This case represents a rare and unusual presentation of isolated ocular extramedullary relapse of AML and emphasises the importance of early ophthalmology involvement and tissue biopsy when there is high clinical suspicion of the disease.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"2235819"},"PeriodicalIF":0.9,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989420","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":"Lacrimal Drainage System and Nasal Cavity Melanoma after Complete Treatment of Conjunctival Melanoma.","authors":"Amirreza Veisi, Zahra Dastborhan, Mohsen Dastmardi, Mozhgan Rezaie Kanavi, Saeid Rezaei","doi":"10.1155/2024/1034939","DOIUrl":"10.1155/2024/1034939","url":null,"abstract":"<p><p>Malignant melanoma of the conjunctiva is a rare tumor of the ocular surface with potential fatal consequences and a high likelihood of recurrence. Although routes for extending the tumor, including local, hematogenous, and lymphatogenous, are pretty straightforward, the indirect extension through free-floating tumoral cells to the nasolacrimal duct is not described thoroughly. We report a case of malignant melanoma of the conjunctiva which presented with local recurrence in the intranasal cavity and lacrimal sac two years after the primary surgery (without involvement of the ocular surface and punctum on the second occasion). However, there was no evidence of distant metastasis on either occasion. This case demonstrates the possible noncontiguous spreading route of melanoma tumoral cells and highlights the need for attention to the surgical technique, and careful follow-up to detect further disease activity.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2024 ","pages":"1034939"},"PeriodicalIF":0.9,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10869194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740497","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}