Case Reports in Ophthalmology最新文献

{"title":"Working under Pressure: Scleroderma Presenting with Bilateral Exudative Retinal Detachment in the Context of Scleroderma Renal Crisis: A Case Report.","authors":"Rem Aziz, Cody Lo, James T Denstedt, Bernard Hurley","doi":"10.1159/000530973","DOIUrl":"https://doi.org/10.1159/000530973","url":null,"abstract":"<p><p>This is an observational case report to detail a novel case of scleroderma renal crisis presenting as bilateral exudative retinal detachments in a patient with newly diagnosed systemic sclerosis. An otherwise healthy 58-year-old female presented primarily with vision complaints and was found to have malignant hypertension (230/120 mm Hg) and bilateral exudative retinal detachment on dilated fundus examination and macular OCT scan. Further history revealed sclerodactyly, mild dysphagia, and dyspnea. She was diagnosed with diffuse systemic sclerosis and Sjogren's syndrome complicated by an episode of scleroderma renal crisis based on initial medical workup. She was admitted to intensive care for management of refractory hypertension with IV antihypertensive therapy. Three months after treatment, her visual symptoms and ocular findings resolved. The presence of exudative retinal detachment among other signs of hypertensive retinopathy warrants thorough systemic screening for underlying causes of malignant hypertension, including systemic sclerosis. Treatment of the underlying disease with urgent antihypertensive therapy resolved the exudative retinal detachments and restored vision in the case of a scleroderma renal crisis.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544008","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":"Management of Painful Blind Eye with Bilateral Symblepharon: A Case Report.","authors":"Octarina Ervianti, Sutjipto Sutjipto","doi":"10.1159/000541251","DOIUrl":"https://doi.org/10.1159/000541251","url":null,"abstract":"<p><strong>Introduction: </strong>Symblepharon is a challenging condition characterized by a painful blind eye. The main goal of treatment is to alleviate discomfort and improve the patient's physical and mental well-being.</p><p><strong>Case presentation: </strong>An Indonesian male, 38 years old, complained of vision loss and ocular pain in his right eye 1 month ago. The pain frequently manifests as a rapid, piercing, or scorching feeling that extends from the right eye to encompass the entire head. Both of his eyes exhibited symblepharon and xerophthalmia. At the age of 11, he experienced a previous occurrence of raised and blister-like skin lesions. Following his recovery, a gradual formation of membranes occurred, covering both of his eyes. His right eye had light perception for visual acuity, and the intraocular pressure was determined to be soft upon examination. The B-scan ultrasound revealed the presence of a long-term inflammatory or scarring process and a decrease in the length of the axis. The patient underwent surgery without experiencing any improvement. A psychological evaluation identified a headache caused by an eye condition, and we administered antipyretic, anticonvulsant, antidepressant, and multivitamin treatments. The patient saw a reduction in pain intensity from a level of 9 to 5 after undergoing treatment for a duration of 1 week. Patients who have previously undergone surgical treatment for symblepharon should have a comprehensive evaluation when they encounter symptoms of vision loss and ocular discomfort.</p><p><strong>Conclusion: </strong>The psychological factor is essential for the treatment's success. Treatment of the underlying cause is essential, and the patient must understand the irreversible loss of visual function. A management plan primarily aims to mitigate the adverse impact on the overall well-being and standard of living.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544003","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 Severe Case of Infectious Necrotizing Anterior Scleritis Caused by <i>Pseudomonas aeruginosa</i> after Vitreoretinal Surgery.","authors":"Mariko Kayazawa, Aya Kodama-Takahashi, Koji Sugioka, Mai Yunoki, Shunji Kusaka","doi":"10.1159/000541163","DOIUrl":"https://doi.org/10.1159/000541163","url":null,"abstract":"<p><strong>Introduction: </strong>This report describes a case of necrotizing scleritis caused by <i>Pseudomonas aeruginosa</i> infection soon after vitreous surgery, which caused severe scleral melting and rapidly progressive necrosis that led to scleral perforation and bacterial endophthalmitis.</p><p><strong>Case presentation: </strong>The patient was an 86-year-old man with a history of type 2 diabetes mellitus who underwent pars plana vitrectomy (PPV) for vitreous hemorrhage in his right eye. On postoperative day 10, he complained of severe ocular pain and was found to have conjunctival edema and eyelid swelling, which was treated by topical and general systemic antibiotics. His ocular symptoms improved but subsequently worsened. On postoperative day 25, hypopyon and a fibrinous exudative membrane were observed in the anterior chamber, and the fundus could not be visualized. PPV was repeated with addition of silicone oil tamponade. During the surgery, the retina was found to be completely detached with severe anterior scleral melting, perforation, and necrosis, as well as abscess formation. Culture of an eye discharge specimen detected <i>P. aeruginosa</i>. After surgery, antibiotics were administered and the eye was washed with polyvinyl alcohol-iodine solution daily. Ten days later, the eye pain and eyelid swelling were significantly improved. The scleral inflammation gradually resolved without recurrence.</p><p><strong>Conclusion: </strong>In this case, rapidly progressive necrotizing scleritis caused by <i>P. aeruginosa</i> infection was controlled by a combination of antibiotics, removal of necrotic tissue, and daily eye washing with polyvinyl alcohol-iodine solution.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543997","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":"Roller Coasters and Retinal Detachment: Case Series and Review of Acceleration-Deceleration Retinal Injury.","authors":"Lauren Pickel, Miguel Cruz Pimentel, Sumana Naidu, Robert G Devenyi, Efrem Mandelcorn, Peng Yan","doi":"10.1159/000540878","DOIUrl":"https://doi.org/10.1159/000540878","url":null,"abstract":"<p><strong>Introduction: </strong>Anecdotal reports and limited reports suggest a possible link between activities involving rapid acceleration and retinal detachment. We present two novel such cases and review existing literature to investigate the plausibility of this association and delineate in what populations such an association may be more likely.</p><p><strong>Case presentation: </strong>We report 2 cases of retinal detachment following roller coaster riding. The first, a 24-year-old woman with a family history of retinal detachment, presented with floaters after consecutive rides and was found to have an inferior temporal macula-sparing retinal detachment with associated retinal breaks. The second case, a 25-year-old female with a history of high myopia, presented with visual field defect and was found to have a macula-on retinal detachment with an accompanying tear at the edge of an area of lattice degeneration. Both were successfully treated with pneumatic retinopexy followed by laser retinopexy.</p><p><strong>Conclusion: </strong>Rapid acceleration/deceleration forces, such as those experienced on roller coasters, could potentially lead to retinal detachment. Structural predisposition is likely necessary for acceleration/deceleration injury to lead to retinal detachment, with all known cases having risk factors, including high myopia and positive family history. These same forces in eyes without structural predisposition have resulted in hemorrhage, but not detachment.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544006","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":"Retinal Pigment Epithelial Proliferation Secondary to Retinal Ischemia: A Case Report and Literature Review.","authors":"Abdullah F Alnaim, Wael A Alsakran, Hammam A Alotaibi","doi":"10.1159/000540771","DOIUrl":"https://doi.org/10.1159/000540771","url":null,"abstract":"<p><strong>Introduction: </strong>Antiphospholipid syndrome is one of the most common causes of acquired hypercoagulable conditions which is correlated with ocular conditions not least of which is retinal ischemia due to arterial or venous occlusive insults.</p><p><strong>Case presentation: </strong>We describe a case of unilateral retinal ischemia in the setting of combined central retinal artery and vein occlusion with associated proliferation of retinal pigment epithelium. The patient was worked-up for the etiology of her presentation which was found to be antiphospholipid syndrome.</p><p><strong>Conclusion: </strong>Although pigment epithelial proliferation occurs commonly after retinal ischemia, no study has reported complete multimodal imaging of such a pathology or proposed the possible mechanisms explaining such an association.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544005","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":"Aspheric Macular Lens for Complication in Cataract Surgery.","authors":"Nadav Shemesh, Avi Ohayon, Eliya Levinger, Asaf Achiron","doi":"10.1159/000539820","DOIUrl":"https://doi.org/10.1159/000539820","url":null,"abstract":"<p><strong>Introduction: </strong>In this case report, we demonstrate the application of an aspheric macular lens (Grieshaber, Alcon) for conducting posterior segment procedures after a posterior capsular rupture (PCR) occurrence during cataract surgery.</p><p><strong>Case presentation: </strong>During a cataract surgery on a 70-year-old female patient, a PCR was identified, accompanied by the descent of the lens into the vitreous, and prompted subsequent interventions. This involved performing posterior-assisted levitation, anterior segment phacoemulsification, and anterior segment vitrectomy. Subsequently, due to the absence of a BIOM posterior viewing system in the operating room, an aspheric macular lens (Grieshaber, Alcon) was positioned on the patient's eye. Subsequently, pars plana vitrectomy was performed, along with the extraction of residual lens cortical remnants. The procedure concluded with gradually inserting a 3-piece intraocular lens into the sulcus.</p><p><strong>Conclusion: </strong>When managing posterior capsular rupture, using an aspheric macular lens, such as the Grieshaber (Alcon), can be beneficial.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544000","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 Presentation of Myelin Oligodendrocyte Glycoprotein-Associated Optic Neuritis with Venous Stasis Retinopathy and Premacular Hemorrhage: A Case Report.","authors":"Worapot Srimanan, Yaninsiri Ngathaweesuk","doi":"10.1159/000540776","DOIUrl":"https://doi.org/10.1159/000540776","url":null,"abstract":"<p><strong>Introduction: </strong>Myelin oligodendrocyte glycoprotein (MOG)-associated disorders can cause inflammation of the central nervous system in various specific organs. Ocular involvement manifests as optic neuritis is one of the most common presentations; other ocular presentations are uncommon. Recently, rare ocular complications have been reported in conjunction with MOG-associated optic neuritis. We reported a rare case of acute venous stasis retinopathy co-occurring with bilateral optic neuritis.</p><p><strong>Case presentation: </strong>A 27-year-old woman complained of a throbbing headache for 2 weeks before developing visual loss in her right eye. She was diagnosed with presumed central retinal vein occlusion and was scheduled for further investigations. Two days later, she suddenly lost vision in her left eye and was admitted to the hospital. An eye examination revealed tortuous and dilated veins and optic disk swelling, notably in the right eye, compatible with venous stasis retinopathy in both eyes. Her right eye also had a premacular hemorrhage and vitreous hemorrhage. Magnetic resonance imaging showed an enhancement of bilateral optic nerves, and MOG antibody was detected in her serum. She successfully achieved a rapid improvement of vision in the left eye with intravenous methylprednisolone. However, her vision in the right eye did not recover due to dense vitreous hemorrhage.</p><p><strong>Conclusion: </strong>Venous stasis retinopathy is a rare complication of MOG-associated optic neuritis. High-dose corticosteroids result in a rapid response and excellent symptom recovery. Ongoing reports may uncover new clinical presentations associated with this disorder.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543996","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":"Spontaneous Retinal Reattachment following Multiple Vitreoretinal Interventions: Case Report.","authors":"Nathan Nash Wise, Eric K Chin, David R P Almeida","doi":"10.1159/000540346","DOIUrl":"https://doi.org/10.1159/000540346","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to document and analyze a rare case of spontaneous retinal reattachment in a patient after successive unsuccessful vitreoretinal surgeries and to explore potential mechanisms contributing to this unexpected outcome.</p><p><strong>Case presentation: </strong>A 61-year-old patient with a history of high myopia presented with a rhegmatogenous retinal detachment. After undergoing multiple vitreoretinal procedures, including pars plana vitrectomy with silicone oil tamponade, anatomical reattachment was not achieved, and the patient developed complex retinal detachment associated with myopic foveoschisis. Surprisingly, spontaneous reattachment of the retina was observed during routine follow-up. Comprehensive ocular examination, optical coherence tomography (OCT), and fundus autofluorescence imaging were utilized to confirm and document the retinal status. A thorough review of patient history, surgical reports, and postoperative imaging was performed to discern potential contributory factors. The patient's retina remained attached for 12 months after the last intervention without additional surgical or medical treatment. OCT images revealed normalization of retinal architecture with reestablishment of the foveal contour and partial recovery of visual acuity. No signs of proliferative vitreoretinopathy or other commonly associated complications were observed. Immunological assays and genetic testing ruled out systemic conditions that could predispose to spontaneous reattachment.</p><p><strong>Conclusion: </strong>This case represents a remarkable instance of spontaneous retinal reattachment without surgical intervention after multiple failed procedures. The mechanisms underlying this phenomenon remain speculative; however, they may involve delayed postoperative cellular proliferation and migration, subtle intraocular pressure changes, or unrecognized vitreous traction resolution. Further investigation into similar cases may provide insights into the natural history of retinal detachment and potential self-resolving dynamics, which could inform future therapeutic strategies.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544007","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":"Iatrogenic Corneal Puncture at the Beginning of Cataract Surgery Which Was Managed Uneventfully.","authors":"Seonghwan Kim, Jeong Hyun Lee","doi":"10.1159/000540603","DOIUrl":"https://doi.org/10.1159/000540603","url":null,"abstract":"<p><strong>Introduction: </strong>Cataract surgery is one of the most commonly performed surgical procedures worldwide. Intraoperative and postoperative complications of cataract surgery include posterior capsule rupture, retinal detachment, suprachoroidal hemorrhage, cystoid macular edema, endophthalmitis, and intraocular lens dislocation. As corneal perforation is rarely related to cataract surgery, we report a case of intraoperative iatrogenic corneal puncture that led to a full-thickness laceration that was managed without severe complications.</p><p><strong>Case presentation: </strong>An 81-year-old woman underwent immediate sequential bilateral cataract surgery. Cataract grading of both eyes was nuclear color grade II and cortical cataract grade III, according to the lens opacity classification system III. While performing cataract surgery on her right eye, a corneal puncture with a keratome incidentally occurred just before making the main temporal incision, resulting in a 3-mm full-thickness laceration at the peripheral cornea. One-bite of 10-0 nylon suture was placed, and the remaining procedure was performed through a superior main incision. Three-bites of 10-0 nylon suture were placed at the laceration site at the end of the procedure. The uncorrected visual acuity was 20/40 in both eyes the following day. Corneal astigmatism increased in the right eye, and the refractive error was more myopic than targeted. No leakage was observed.</p><p><strong>Conclusion: </strong>Slight corneal contact with a keratome can lead to full-thickness laceration when the anterior chamber is filled with an ophthalmic viscosurgical device during cataract surgery. Caution should be exercised while manipulating sharp surgical instruments to avoid such complications.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544002","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":"Novel Fundoscopic Features in Mucopolysaccharidosis Type VI: Multimodal Evaluation of Scleral Deposits.","authors":"Augusto Magalhães, Margarida Ribeiro, Jorge Meira, Ana Filipa Moleiro, Esmeralda Rodrigues, Elisa Leão-Teles","doi":"10.1159/000540015","DOIUrl":"https://doi.org/10.1159/000540015","url":null,"abstract":"<p><strong>Introduction: </strong>Mucopolysaccharidosis type VI (MPS VI) is a rare inherited metabolic disorder, primarily attributed to the deficiency of the enzyme N-acetylgalactosamine-4-sulfatase, responsible for the degradation of dermatan sulfate and chondroitin-4-sulfate. Therefore, there is a widespread accumulation of partially degraded glycosaminoglycans. Corneal opacification is the hallmark ocular feature in the MPS. Retinal and scleral involvement in this MPS is extremely rare. The purpose of this work was to describe novel fundoscopic alterations present in patients with MPS VI.</p><p><strong>Case presentation: </strong>This is a case series involving three non-related patients referred to our department from the Unit of Inherited Metabolic Diseases. Multimodal imaging was performed in every patient. Fundus photography and enhanced depth imaging optical coherence tomography (EDI-OCT) were performed. Multiple areas of yellow/orange patches were observed on fundus photography, corresponding to areas in which deposits of intermediate reflectivity in the EDI-OCT could be seen at the scleral level with associated choroidal thinning. This finding suggested the presence of scleral deposits of glycosaminoglycans.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first case series in the literature encompassing patients with MPS VI with suspected deposits of glycosaminoglycans in the sclera. The better control of the systemic comorbidities, the increase in life expectancy, and the timely management of corneal disease have allowed the identification of new, late-onset ocular manifestations in MPS patients. In addition, new imaging techniques have introduced the possibility of better characterizing and understanding these manifestations.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544004","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}