Case Reports in Ophthalmology最新文献

{"title":"Eyelid Elevation and Ocular Surface Rehabilitation Using Quadrant-Asymmetric Scleral Contact Lenses in Facial Nerve Palsy with Keratoconus: A 2-Case Series.","authors":"Nir Erdinest, Zvi Gur, Michael Tabi, Noam Blum, Nadav Shemesh, Claudia Yahalom, Itay Lavy","doi":"10.1159/000552540","DOIUrl":"10.1159/000552540","url":null,"abstract":"<p><strong>Introduction: </strong>Facial nerve palsy (FNP) with associated ptosis and keratoconus (KC) presents a combined challenge of visual dysfunction, ocular-surface disease, and cosmetic impairment. While surgical procedures are frequently performed, scleral contact lenses can offer both ocular-surface protection and mechanical eyelid support. While scleral lenses have previously been described for exposure keratopathy and irregular corneal astigmatism, the present 2-case series provides objective margin reflex distance-1 (MRD1) documentation of eyelid elevation achieved through quadrant-asymmetric scleral contact lens (QASCL) fitting in elderly patients with concurrent FNP and KC requiring simultaneous KC rehabilitation - an outcome combination not previously reported in this population.</p><p><strong>Case presentation: </strong>Two elderly patients with KC and FNP were fitted with QASCL after poor tolerance of soft lenses. A 71-year-old man with severe lagophthalmos and brow ptosis showed MRD1 improvement from 1.0 mm to 3.5 mm and best-corrected visual acuity (BCVA) from 1.3 logMAR to 0.1 logMAR. His Ocular Surface Disease Index (OSDI) score decreased from 79.16 to 33.33 after 3 months, and the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) score was 11. A 74-year-old man with mild synkinesis had MRD1 increase from 0.5 mm to 3.0 mm and BCVA from 1.0 logMAR to 0.02 logMAR. His OSDI decreased from 91.66 to 45.83 after 3 months, and CLDEQ-8 was 16. Both patients exhibited reduced ocular-surface staining, improved meibomian gland function, and decreased conjunctival hyperemia over follow-up.</p><p><strong>Conclusion: </strong>QASCL fitting was associated with clinically meaningful improvements in eyelid elevation, visual acuity, and ocular-surface integrity, together with reductions in symptom severity as measured by OSDI and CLDEQ-8. In these two elderly patients with FNP and KC, QASCLs appeared safe, effective, and reversible nonsurgical option, providing sustained functional and anatomical benefit during long-term follow-up.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"661-673"},"PeriodicalIF":0.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418998","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 Orbital Extranodal NK/T-Cell Lymphoma: A European Case Report.","authors":"Alexander L Rattunde, Lukas M Möhwald, Catarina A Kunze, Simon Schallenberg, Eckart Bertelmann","doi":"10.1159/000551675","DOIUrl":"10.1159/000551675","url":null,"abstract":"<p><strong>Introduction: </strong>Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), is a rare and aggressive malignancy. Primary orbital involvement is exceptionally uncommon. We report a case of orbital ENKTL in a White patient presenting with rapidly progressive orbital symptoms.</p><p><strong>Case presentation: </strong>A 69-year-old woman presented with eyelid swelling, diplopia, and exophthalmos. An initial diagnosis of conjunctivitis by a community ophthalmologist proved unresponsive to treatment, prompting referral to a tertiary eye center. Orbital magnetic resonance imaging revealed a retrobulbar mass. Biopsy confirmed Epstein-Barr virus-associated ENKTL, and staging excluded systemic disease. The patient received age-adjusted modified SMILE (mSMILE) chemotherapy (dexamethasone, methotrexate, ifosfamide, l-asparaginase, etoposide) followed by concurrent platinum-based chemoradiotherapy. She achieved complete remission and reported substantial improvement in quality of life.</p><p><strong>Conclusions: </strong>Even exceptionally rare orbital lesions should be considered in cases of rapidly progressive orbital disease. Early imaging, appropriate biopsy, and multidisciplinary management are essential to achieve optimal outcomes.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"553-561"},"PeriodicalIF":0.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307259","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":"The Crescent Sign of Anterior Capsular Tear Detection Using Ultrasound Biomicroscopy.","authors":"Asaf Achiron, Tal Yahalomi, Duncan Leadbetter, Kieran Darcy, Derek Tole, Omar Elhaddad","doi":"10.1159/000552566","DOIUrl":"10.1159/000552566","url":null,"abstract":"<p><strong>Introduction: </strong>This case report describes a novel imaging sign denoting anterior lenticular capsular tear using ultrasound biomicroscopy (UBM) in a case of trauma with obscured direct visualization.</p><p><strong>Case presentation: </strong>A 40-year-old intravenous drug user was presented to the emergency department after injuring his right eye with a used hypodermic needle 4 days previously. Slit-lamp examination revealed an intense anterior segment reaction with corneal edema, limiting the view to deeper structures. UBM allowed lens visualization, which demonstrated a crescent hyperechoic anterior subcapsular shadow, which was not present in the fellow eye. As the anterior segment inflammation and corneal edema cleared with topical steroid treatment and antibiotic treatment, the traumatic cataract, posterior synechiae, and lens particles in the anterior chamber became evident. A review of published literature demonstrated a similar sign of crescent hyperechoic anterior subcapsular shadow that has been documented in two previous cases with disrupted anterior capsules and lens-particle glaucoma.</p><p><strong>Conclusion: </strong>UBM can be used for assessing anterior lenticular integrity and may aid in diagnosing lenticular injuries where a direct view is impossible. Lens crescent sign is a UBM finding that suggests lenticular injuries.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"674-680"},"PeriodicalIF":0.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13363134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435211","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":"Treat-and-Extend Faricimab for Macular Neovascularization in Angioid Streaks: A Report of Two Cases.","authors":"Norihiko Nakagawa, Kohei Maruyama, Mika Tsukamoto, Miki Sawa","doi":"10.1159/000552451","DOIUrl":"10.1159/000552451","url":null,"abstract":"<p><strong>Introduction: </strong>Angioid streaks (AS) are a rare retinal disorder that leads to progressive vision loss, particularly when complicated by macular neovascularization (MNV). Anti-vascular endothelial growth factor agents are the first-line treatment for MNV with AS; however, the optimal treatment strategy remains controversial. Herein, we present two cases of type 2 MNV secondary to AS treated with intravitreal faricimab (IVF), the first bispecific antibody, using a treat-and-extend (T&E) protocol over a 1-year follow-up.</p><p><strong>Case presentations: </strong>Case 1: A 63-year-old male patient achieved dry macula after three monthly IVF injections, with visual acuity (VA) improving from 20/25 to 20/16. Subretinal fluid recurred 19 weeks after the loading phase, promoting treatment interval adjustment to 16 weeks. Fluid was subsequently controlled with two additional IVF injections with a 16-week interval. Over 1 year, VA was maintained at 20/16 with five IVF injections. Case 2: A 78-year-old female patient achieved dry macula with four monthly IVF injections, and VA improved from 20/32 to 20/16. The treatment interval was managed despite a recurrence at 16 weeks after the loading phase, leading to seven IVF injections over 1 year. VA remained stable at 20/16, although pre-existing focal macular atrophy slightly expanded. No subretinal fibrosis or severe ocular complications were observed in both cases.</p><p><strong>Conclusion: </strong>These findings support the efficacy and safety of IVF in the T&E regimen in managing AS-associated type 2 MNV, emphasizing the potential of dual-pathway inhibition for this challenging pathology.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"632-638"},"PeriodicalIF":0.6,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403611","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":"Phenotypic Divergence in C19ORF44-Associated Retinal Degeneration despite an Identical Genotype: A Case Report.","authors":"Lucas Yan Bin Ng, Mathieu Quinodoz, Tien-En Tan, Rachael W C Tang, Carlo Rivolta, Beau J Fenner","doi":"10.1159/000552545","DOIUrl":"10.1159/000552545","url":null,"abstract":"<p><strong>Introduction: </strong><i>C19ORF44</i> has recently been identified as a gene associated with autosomal recessive inherited retinal disease (IRD). The function of the gene remains poorly understood, and a previously reported case with identical primary genotype demonstrated a Stargardt-like macular dystrophy phenotype.</p><p><strong>Case presentation: </strong>We describe a 65-year-old Chinese female with long-standing nyctalopia and progressive visual field loss. Multimodal retinal imaging demonstrated a peripheral-predominant retinitis pigmentosa phenotype with relative macular sparing, distinct from the previously reported Stargardt-like macular dystrophy associated with the same genotype. Genetic testing identified compound heterozygous stop-gain and frameshift deletion variants in <i>C19ORF44</i>, both predicted to result in loss of function.</p><p><strong>Conclusion: </strong>This case demonstrates that identical genotypes (biallelic loss-of-function variants in <i>C19ORF44</i>) can result in markedly different retinal phenotypes, highlighting substantial genotype-phenotype variability in this newly described IRD.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"625-631"},"PeriodicalIF":0.6,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403567","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 Orbital Wall Fracture Secondary to Neglected Graves' Orbitopathy: A Case Report and Review of Current Literature.","authors":"Reza Nabie, Ghazal Heydarzadeh, Fateme Tahmasbi","doi":"10.1159/000552467","DOIUrl":"10.1159/000552467","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous orbital wall fracture, or bony auto-decompression, is an uncommon manifestation of advanced thyroid eye disease (TED) and results from chronic intraorbital hypertension driven by extraocular muscle hypertrophy.</p><p><strong>Case presentation: </strong>We report a 72-year-old woman with a 10-year history of untreated Graves' disease who presented with severe right-sided ocular pain, massive proptosis, and corneal melting. Orbital computed tomography demonstrated marked bilateral enlargement of the superior, inferior, and medial rectus muscles and a large spontaneous orbital floor fracture in the left eye with inferior rectus herniation and entrapment, despite no history of trauma.</p><p><strong>Conclusion: </strong>Existing reports consistently indicate that spontaneous orbital wall fractures originate from sustained mechanical pressure on the thin medial or inferior orbital walls in the setting of significant extraocular muscle enlargement. These fractures may present with pain, swelling, or mobility limitation, or may remain asymptomatic and be detected only on imaging. Understanding auto-decompression is crucial for both diagnostic and future surgery planning.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"639-644"},"PeriodicalIF":0.6,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410603","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":"Traumatic Optic Neuropathy in Survivors of Torture: Two Case Reports and Review of the Literature.","authors":"Saffire Hanna Krance, Shayaan Kaleem, Jonathan Micieli, Myrna Lichter","doi":"10.1159/000552522","DOIUrl":"10.1159/000552522","url":null,"abstract":"<p><strong>Introduction: </strong>Survivors of torture and violence may develop traumatic optic neuropathy after blunt cranio-orbital trauma incurred during torture, and diagnosis is often delayed by displacement and limited access to care.</p><p><strong>Case presentations: </strong>Two survivors of torture with optic neuropathy were evaluated in a trauma-informed mobile eye clinic conducted between June 2023 and June 2024 in Toronto, Canada. Case 1 was a woman in her early 30s with 11 years of no light perception vision loss in the right eye that began immediately after blunt periocular trauma incurred during torture. Examination demonstrated a relative afferent pupillary defect (RAPD) and optic disc pallor; optical coherence tomography (OCT) showed marked retinal nerve fiber layer and macular thinning. Case 2 was a man in his early 30s with 4 years of right-sided vision loss that began immediately after blunt head trauma incurred during torture. He had reduced visual acuity, RAPD, and diminished color vision in the affected eye. OCT demonstrated diffuse retinal nerve fiber layer and ganglion cell complex thinning. Since neither patient underwent imaging at the time of injury, acute findings such as optic canal fracture, orbital fracture, or globe injury could not be assessed.</p><p><strong>Conclusion: </strong>These cases describe chronic traumatic optic neuropathy after torture-related blunt trauma and underscore the importance of trauma-informed ophthalmic screening and linkage to rehabilitation services for displaced survivors, particularly when acute injury records and imaging are unavailable.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"645-651"},"PeriodicalIF":0.6,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410552","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":"Argon Laser as Adjunctive Therapy for Refractory Alternaria Fungal Keratitis: A Case Report.","authors":"Geovanny Chuchuca-Carrión, April Tituaña Carvajal, Melanie Paucar, Dayana Osorio, Josué Rivadeneira, Edy Quizhpe","doi":"10.1159/000552130","DOIUrl":"10.1159/000552130","url":null,"abstract":"<p><strong>Introduction: </strong>Fungal keratitis is an ocular emergency that requires early and appropriate management. It can lead to significant visual loss. Standard treatment includes topical and systemic antifungals. In refractory cases, adjuvant therapies have been explored. The argon laser has shown higher cure rates than other traditional therapies.</p><p><strong>Case presentation: </strong>We describe the case of a 55-year-old farmer with a 20-day history of foreign body sensation. The condition was classified as a fungal corneal ulcer caused by <i>Alternaria</i> spp. Argon laser treatment was performed with a 500-um spot for 0.2 s at 900 mW power. This led to a reduction in the corneal epithelial defect and complete healing.</p><p><strong>Conclusion: </strong>Argon laser treatment for this refractory fungal ulcer resulted in complete healing of the epithelial defect, with minimal corneal opacity.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"619-624"},"PeriodicalIF":0.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403577","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":"Radial Optic Neurotomy for Progressive Visual Field Loss Associated with Optic Nerve Head Drusen: A Case Report.","authors":"Chiara Vivarelli, Paola Ferri, Marco Pellegrini, Ginevra Giovanna Adamo, Pietro Maria Talli, Carla Enrica Gallenga, Francesco Parmeggiani, Marco Mura","doi":"10.1159/000551992","DOIUrl":"10.1159/000551992","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report the use of radial optic neurotomy (RON) as an experimental surgical approach for progressive visual field loss associated with extensive bilateral optic nerve head drusen (ONHD).</p><p><strong>Case presentation: </strong>A 27-year-old female with extensive bilateral ONHD presented with rapidly progressive and severe concentric visual field loss, more severe in the left eye, despite normal intraocular pressure and topical hypotensive therapy. Multimodal imaging confirmed ONHD with significant retinal nerve fiber layer thinning and severe concentric visual field loss sparing central vision in the left eye. RON was performed at the nasal edge of the optic disc without complications.</p><p><strong>Conclusion: </strong>RON may represent a potential therapeutic option in carefully selected young patients with ONHD and progressive, severe visual field loss. Further studies are required to establish optimal timing, appropriate indications, and long-term outcomes.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"610-618"},"PeriodicalIF":0.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435250","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":"Meningeal Carcinomatosis with Bilateral Optic Disc Edema in the Absence of Intracranial Hypertensive Symptoms: A Case Report.","authors":"Takayuki Doi, Daisuke Nakata, Kana Tanimura, Fumi Utsumi, Masahiro Shimura, Makoto Urano, Yasuhiro Otaka, Yoshiaki Shimada, Atsuhiro Tanikawa","doi":"10.1159/000552019","DOIUrl":"10.1159/000552019","url":null,"abstract":"<p><strong>Introduction: </strong>We report a case of meningeal carcinomatosis (MC) presenting with bilateral optic disc edema and an absence of symptoms of intracranial hypertension, such as headache or vomiting.</p><p><strong>Case presentation: </strong>A 54-year-old woman presented with a 2-week history of bilateral blurred vision and new-onset floaters in the left eye. She had a history of surgeries for both ovarian and gastric cancer while undergoing chemotherapy for recurrent ovarian cancer. Fundoscopic examination revealed bilateral optic disc edema. Although intracranial hypertension was suspected, non-contrast computed tomography and non-contrast magnetic resonance imaging showed no intracranial lesions or enlarged ventricles. Cerebrospinal fluid examination revealed normal opening pressure and cytology demonstrated adenocarcinoma cells, confirming MC. The cell morphology suggested that the metastasis likely originated from her previous gastric cancer. Two weeks after the initial ophthalmologic examination, the patient developed headache and vomiting, and her general condition deteriorated rapidly. Radiation therapy was considered, but the patient died 1 month after the initial presentation.</p><p><strong>Conclusion: </strong>A diagnosis of MC should be considered in patients with a history of malignancy who present with bilateral optic disc edema, even in the absence of typical symptoms of intracranial hypertension.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"464-470"},"PeriodicalIF":0.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223440","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}