Case Reports in Ophthalmological Medicine最新文献

{"title":"Macular Neovascular Membrane as a Late Complication of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) Managed With Intravitreal Aflibercept.","authors":"Ana Paula Couto, Bruno F Fernandes, Raul N G Vianna","doi":"10.1155/crop/3693224","DOIUrl":"10.1155/crop/3693224","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of a macular neovascular membrane (MNV) 14 years after an episode of acute posterior multifocal placoid pigment epitheliopathy (APMPPE).</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 22-year-old man presented with acute bilateral blurred vision. The best corrected visual acuity (VA) was 20/200 in both eyes. Fundus examination revealed bilateral multiple yellow-gray placoid lesions and macular serous detachments. Multimodal imaging and a systemic workup excluded systemic inflammatory or infectious diseases, confirming the diagnosis of APMPPE. The patient was treated with triamcinolone acetonide, an intravitreal injection in the right eye, and a posterior subtenon injection in the left eye. At the 8-week follow-up, the fundus lesions healed, with resolution of the macular serous detachment in both eyes. The VA improved to 20/63 bilaterally. After being lost to follow-up for 14 years, the patient presented sudden worsening of vision in the left eye. The VA decreased to 20/400 in the left eye due to an extensive subretinal hemorrhage and hard exudates in the macula. After diagnostic confirmation of a Type 2 MNV by optical coherence tomography angiography, the patient was treated with three monthly intravitreal injections of aflibercept. The VA improved to 20/160 a month after the treatment.</p><p><strong>Conclusion: </strong>The treatment with aflibercept in this rare case of MNV secondary to APMPPE effectively controlled membrane activity. However, the fibrosis and atrophy resulting from the MNV contributed to only a partial recovery of VA. Long-term follow-up of patients with APMPPE is recommended for early detection and treatment of possible MNV development to improve functional outcomes.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"3693224"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444338","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":"Metastatic Malignant Melanoma Masquerading as Tolosa-Hunt Syndrome.","authors":"Bashaer Aldhahwani, Benjamin I Meyer, Rodrigo Santoscoy-Valencia, Joshua Pasol","doi":"10.1155/crop/9124926","DOIUrl":"10.1155/crop/9124926","url":null,"abstract":"<p><strong>Background: </strong>This case report discusses cavernous sinus metastases arising from uveal melanoma, which manifested after a 7-year remission period. The diagnosis of systemic metastatic disease was made based on ocular symptoms. To our knowledge, this is the second reported case of metastatic uveal melanoma to the cavernous sinus. The initial presentation posed challenges as it resembled Tolosa-Hunt syndrome, supported by neuroimaging and response to steroid treatment. Initially, suspicion of malignancy was low due to the 7-year remission period with no ocular or systemic signs suggestive of metastasis. However, repeat imaging was performed due to worsening symptoms upon tapering of steroid treatment. Subsequently, a biopsy was obtained which confirmed the diagnosis.</p><p><strong>Case presentation: </strong>A 76-year-old male with a history of left eye choroidal melanoma treated 7 years earlier and achieving complete remission on subsequent follow-ups presented with worsening pain, diplopia, and left ophthalmoplegia upon tapering steroids. An initial MRI suggested Tolosa-Hunt syndrome. A follow-up MRI revealed enlargement of the left cavernous sinus with enhancing soft tissue, extending into the orbital fissures and foramen rotundum. A left orbital-zygomatic craniotomy biopsy confirmed malignant melanoma metastasis originating from the choroidal melanoma.</p><p><strong>Conclusion: </strong>This case underscores the challenge of overlapping clinical presentations and the potential for delayed recognition of metastatic malignancies in unusual sites. Therefore, it emphasizes the importance of vigilant follow-up and consideration of surgical biopsy, if feasible, to explore alternative causes.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"9124926"},"PeriodicalIF":0.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419029","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":"Corneal Anterior and Posterior Changes in a Patient With Keratitis Associated With <i>Mycobacterium chelonae</i>: A Case Report.","authors":"Ryo Kato, Takashi Ono, Takashi Suzuki, Yukako Taketani, Mikiko Kimakura, Tetsuya Toyono, Makoto Aihara, Takashi Miyai","doi":"10.1155/crop/9161714","DOIUrl":"10.1155/crop/9161714","url":null,"abstract":"<p><strong>Purpose: </strong>This report describes a patient with anterior and posterior corneal topographic changes who developed refractory keratitis due to <i>Mycobacterium chelonae</i>, associated with soft contact lens use.</p><p><strong>Case: </strong>A 42-year-old man presented with blurred vision and pain in his right eye. He used disposable soft contact lenses for 2 weeks with appropriate care. He had open-angle glaucoma, atopic dermatitis, and diabetes mellitus. At the initial presentation, a corneal epithelial defect, cell infiltration, strong hyperemia, hypopyon, and inflammation in the anterior chamber were observed. Anterior segment optical coherence tomography disclosed corneal edema and cloudiness, and the central corneal thickness had increased to 988 <i>μ</i>m. The best-corrected visual acuity was counting fingers at 10 cm. The patient did not respond to the initial treatment with ofloxacin and steroids. The culture of the scraped sample from the contact lens case grew M. chelonae, and topical tobramycin was administered, which was effective based on antimicrobial susceptibility. It took 4 months to treat the keratitis, and the best-corrected visual acuity improved to 0.5, although anterior and posterior corneal irregularities remained.</p><p><strong>Conclusion: </strong>Nontuberculous M. chelonae should be considered in patients with treatment-resistant keratitis, especially in contact lens users. Topographic changes are important for evaluating corneal edema and irregular astigmatism, which impair visual function after keratitis.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"9161714"},"PeriodicalIF":0.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419085","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":"Refractory <i>Staphylococcus hominis</i> Endophthalmitis With Corneal Involvement Following Cataract Surgery: A Case Report.","authors":"Issac Levy, Aaminah Haq, Mayank A Nanavaty","doi":"10.1155/crop/7782331","DOIUrl":"10.1155/crop/7782331","url":null,"abstract":"<p><p>We report an unusual case of delayed-onset, refractory endophthalmitis caused by <i>Staphylococcus hominis</i> following uncomplicated cataract surgery, characterized by recurrent anterior chamber hypopyon and progressive corneal infiltration requiring tectonic keratoplasty for definitive management. A 74-year-old patient with well-controlled Type 2 diabetes mellitus underwent uncomplicated phacoemulsification with intraocular lens implantation, achieving best corrected visual acuity of 6/6 (Snellen) at 1 month postoperatively. The patient subsequently developed acute vision loss with clinical endophthalmitis. Despite multiple interventions, including vitreous tap, two pars plana vitrectomies with intravitreal antibiotics, and intensive topical therapy, the infection persisted for 5 months with recurrent corneal wound infiltration and hypopyon. All initial vitreous and aqueous cultures remained negative. Following referral to our tertiary center, sequential anterior chamber washes, corneal biopsies, and intracameral antibiotics were performed. <i>S. hominis</i> was eventually isolated from corneal sampling. After the identification of <i>S. hominis</i>, treatment was converted to systemic linezolid and intensive topical vancomycin. Given persistent corneal involvement despite maximal medical therapy, a superior 6-mm tectonic keratoplasty was performed. Following this definitive surgical intervention combined with targeted antimicrobial therapy, the infection was successfully controlled, and intraocular inflammation was completely resolved. This represents the first reported case of <i>S. hominis</i> endophthalmitis presenting with recurrent anterior chamber hypopyon and progressive corneal wound involvement successfully treated with tectonic keratoplasty. The case highlights that <i>S. hominis</i> should be considered in the setting of persistent postoperative endophthalmitis, particularly in diabetic patients, and that tectonic keratoplasty may be required for definitive source control when medical therapy fails to eradicate the infection.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"7782331"},"PeriodicalIF":0.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403705","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":"Retrograde Maculopathy or Microcystic Macular Degeneration in Patients With Optic Neuritis due to Neuromyelitis Optica.","authors":"Daniel Kim, Leanne Stunkel","doi":"10.1155/crop/2502132","DOIUrl":"10.1155/crop/2502132","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to highlight findings of retrograde maculopathy (RM) on optical coherence tomography (OCT) as a sequela of neuromyelitis optica associated optic neuropathy.</p><p><strong>Observations: </strong>We report two patients with demyelinating lesions involving the visual pathways due to neuromyelitis optica in whom RM was seen, and in whom the location of the RM corresponded to their visual deficits. In one case, we describe a patient who had a demyelinating chiasmal lesion with bitemporal hemianopia and who had corresponding binasal RM. In another case, we describe a patient who had generalized vision loss in the right eye and who had corresponding diffuse RM in the right macula.</p><p><strong>Conclusions and importance: </strong>RM is a potential sequela of severe optic neuropathy in neuromyelitis optica and topographically corresponds to severe visual field defects, as well as severe ganglion cell complex loss. Providers should recognize this finding and be aware that they do not need to pursue diagnostic evaluation due to concern for primary macular disease.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"2502132"},"PeriodicalIF":0.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374572","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":"Necrotizing Scleritis in Granulomatosis With Polyangiitis: A Clinical Challenge for an Ophthalmologists.","authors":"Poonam Lavaju, Sangeeta Shah, Ashmita Jha, Binay Kamat, Kushal Gurung","doi":"10.1155/crop/5056070","DOIUrl":"10.1155/crop/5056070","url":null,"abstract":"<p><strong>Introduction: </strong>Granulomatosis with polyangiitis (GPA) is a granulomatous disease with multisystem involvement, frequently with ocular manifestations. It can lead to ocular morbidity due to tissue melting and necrosis.</p><p><strong>Case description: </strong>A 35-year-old male presented with a painless nodular lesion in the left eye, along with gradual diminution of vision and redness for 2 months. Eight months ago, he was diagnosed with GPA and left eye anterior uveitis. He was treated with topical steroids, topical cycloplegic, pulse cyclophosphamide, oral prednisolone, and azathioprine. At presentation, best corrected visual acuity in the right eye was 6/6 and 1/60 in the left. Left eye showed scleral thinning and necrosis in the superonasal quadrant with +1 cells in the anterior chamber. Intraocular pressure was 10 mmHg. Funduscopy examination showed exudative retinal detachment with hyperemic disc. Since refractory to topical and systemic immunomodulators, he underwent corneoscleral patch graft in the left eye for the progressive scleral thinning along with injection rituximab. Significant improvement was seen at 1 month with corneoscleral patch graft in situ, decreased inflammation with formed anterior chamber depth. However, at 2 months follow-up, the left eye showed worsening of ocular symptoms with progressive scleral thinning, necrosis, and graft lysis with total retinal detachment.</p><p><strong>Conclusion: </strong>GPA-associated necrotizing scleritis is challenging. A collaborative timely management with aggressive compliant immunosuppressive therapy is a necessity to avoid ocular morbidity.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"5056070"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366979","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":"Ocular and Systemic Phenotyping of Bardet-Biedel Syndrome Type 7 (BBS7) in a Palestinian Male: Case Report and Literature Review.","authors":"Ibrahim Taha, Lubna Abusamra, Sundus F Shalabi, Khalil Huraibat, Liana Al-Labadi, Khaled R Beshtawi, Feras Abujaber, Mutasem Khalaf, Rema Obar","doi":"10.1155/crop/7604431","DOIUrl":"10.1155/crop/7604431","url":null,"abstract":"<p><strong>Introduction: </strong>Bardet-Biedl syndrome (BBS) is a rare autosomal recessive ciliopathy with at least 26 identified causative genes. BBS7 accounts for approximately 1.5% of cases. The syndrome is characterized by retinal degeneration, obesity, polydactyly, intellectual disability, and renal anomalies. BBS7 encodes a core subunit of the BBSome complex, which is essential for ciliary function and intracellular signaling.</p><p><strong>Case presentation: </strong>We report a 9-year-old Palestinian boy with BBS7, confirmed by whole exome sequencing identifying a homozygous pathogenic variant in the BBS7 gene [c.712_715del]; both parents were heterozygous carriers. To our knowledge, this is the first genetically confirmed case of BBS7 in Palestine. Written informed consent was obtained from the father, the legal guardian. The patient exhibited postaxial polydactyly, generalized obesity (BMI 32.8), developmental delay, learning difficulties, hypothyroidism, and mild craniofacial dysmorphism. Ocular findings included a best-corrected visual acuity of 20/33 bilaterally, compound myopic astigmatism (spherical equivalents: -7.12 D OD and -7.25 D OS), and 15 prism diopters of constant left exotropia. Optical coherence tomography revealed marked thinning of the retinal nerve fiber layer and ganglion cell complex consistent with progressive retinal degeneration. Fundus imaging demonstrated tilted optic discs, bone spicule pigmentation, and peripapillary atrophy. Full-field electroretinography confirmed rod-cone dystrophy with significantly reduced amplitudes and prolonged implicit times. Corneal topography showed no evidence of keratoconus.</p><p><strong>Discussion: </strong>This case contributes novel region-specific clinical and genetic data on BBS7, with comprehensive ophthalmic phenotyping including OCT, full-field ERG, and corneal topography. It underscores the value of early multidisciplinary evaluation and genetic testing, particularly in consanguineous populations. Continued reporting of genetically confirmed BBS7 cases will strengthen understanding of genotype-phenotype correlations and support improved clinical management.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"7604431"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374608","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":"Persistent Subretinal Fluid in a Case With Central Serous Chorioretinopathy and Progressive Retinal Changes: An 18-Month Longitudinal Case Report.","authors":"Ryoh Funatsu, Naohisa Mihara, Hiroto Terasaki","doi":"10.1155/crop/7754197","DOIUrl":"10.1155/crop/7754197","url":null,"abstract":"<p><strong>Introduction: </strong>This study is aimed at reporting detailed longitudinal changes in best-corrected visual acuity (BCVA) and retinal structure in a patient with central serous chorioretinopathy (CSC) and persistent serous retinal detachment over one and a half years.</p><p><strong>Case report: </strong>A man in his 40s presented with unilateral mild vision loss. On the initial examination, the BCVA was 20/25 OS. Optical coherence tomography (OCT) revealed macular serous retinal detachment, and fluorescein angiography identified two focal leakage spots within this area, leading to the diagnosis of CSC. Despite the persistence of serous retinal detachment after several focal photocoagulations, the patient refused photodynamic therapy, which resulted in the serous retinal detachment remaining for 18 months. In the affected eye, the BCVA and outer nuclear layer (ONL) thickness were initially 20/25 and 86 <i>μ</i>m, respectively. These values subsequently deteriorated to 20/67 and 73 <i>μ</i>m at 6 months and further decreased to 20/200 and 46 <i>μ</i>m at 18 months. The reflectivity of the photoreceptor layer progressively increased, leading to the formation of intraretinal hyperreflective foci 18 months from baseline.</p><p><strong>Conclusions: </strong>A patient with CSC and persistent serous retinal detachment may present a relatively rapid decline in BCVA and progressive retinal damage. The chronicity of CSC is associated with specific structural findings, such as thinning of the ONL and photoreceptor layer and increased photoreceptor reflectivity leading to intraretinal hyperreflective foci.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"7754197"},"PeriodicalIF":0.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359638","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":"Suprachoroidal Triamcinolone Injection for the Management of Chronic Uveitis-Associated Ocular Hypotony.","authors":"Dan Spiegelman, Isabella Song, Erin Sieck","doi":"10.1155/crop/2476023","DOIUrl":"10.1155/crop/2476023","url":null,"abstract":"<p><strong>Purpose: </strong>This study is aimed at describing the use of suprachoroidal triamcinolone injection for the treatment of refractory uveitis-associated ocular hypotony presumed secondary to ciliary body shutdown.</p><p><strong>Methods: </strong>We report a case of a 58-year-old woman with a 26-year history of idiopathic, noninfectious bilateral panuveitis complicated by recurrent cystoid macular edema and a steroid-induced ocular hypertension. After treatment with an intravitreal dexamethasone implant and an Ahmed glaucoma valve, she developed persistent hypotony in the right eye with intraocular pressure (IOP) of 2-4 mmHg despite controlled inflammation. Evaluation with gonioscopy and ultrasound biomicroscopy revealed no cyclodialysis cleft or cyclitic membranes. Prior treatments, including topical steroids, repeat dexamethasone implant, Ahmed valve revision, and serial anterior chamber viscoelastic injections, produced only transient improvement. Suprachoroidal triamcinolone (40 mg) was administered.</p><p><strong>Results: </strong>Before injection, IOP ranged from 2 to 6 mmHg. Following treatment, IOP remained ≥ 6 mmHg for approximately 2 months. Best corrected visual acuity improved from 20/80 to 20/50, and additional viscoelastic injections were not required during this period. Numerical hypotony recurred 8 months later.</p><p><strong>Conclusion: </strong>Suprachoroidal triamcinolone may represent a targeted treatment for refractory uveitis-associated hypotony when ciliary body dysfunction is suspected and other steroid delivery routes are limited. Further study is needed to evaluate durability and broader applicability.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"2476023"},"PeriodicalIF":0.8,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343541","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":"Montage Error in Ultra-Widefield Imaging of Retinal Hemangioblastomas.","authors":"Mohamed Belmouhand, Jens Folke Kiilgaard, Carsten Faber","doi":"10.1155/crop/3979304","DOIUrl":"10.1155/crop/3979304","url":null,"abstract":"<p><p>A 20-year-old male presented with three large retinal hemangioblastomas in the left eye. At the 5-week follow-up, automated montage ultra-widefield imaging appeared to demonstrate a fourth lesion, suggesting possible disease progression. Clinical examination, however, confirmed the presence of only three tumors. Re-evaluation of the automated image stitching revealed misidentification of the optic nerve head in one of the source images, resulting in image misalignment and the false appearance of an additional lesion. Systemic evaluation demonstrated central nervous system hemangioblastomas and a renal cyst, and genetic testing confirmed von Hippel-Lindau disease. This case illustrates both the diagnostic utility and limitations of ultra-widefield montage imaging and highlights the importance of clinical verification of apparent lesion increase before concluding true progression.</p>","PeriodicalId":9603,"journal":{"name":"Case Reports in Ophthalmological Medicine","volume":"2026 ","pages":"3979304"},"PeriodicalIF":0.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315947","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}