Case Reports in Ophthalmology最新文献

{"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":"15 1","pages":"678-682"},"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":"15 1","pages":"669-677"},"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":"15 1","pages":"663-668"},"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":"15 1","pages":"656-662"},"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":"15 1","pages":"642-647"},"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}

{"title":"Enhancing Visual Acuity through Combined Intraocular Lens Fixation, Penetrating Keratoplasty, and Vitrectomy: The Role of Temporary Landers Wide-Field Keratoprosthesis.","authors":"Takahiro Zusho, Takashi Ono, Yukako Taketani, Mikiko Kimakura, Tetsuya Toyono, Koichiro Sugimoto, Taku Toyama, Takashi Ueta, Makoto Aihara, Takashi Miyai","doi":"10.1159/000540287","DOIUrl":"10.1159/000540287","url":null,"abstract":"<p><strong>Introduction: </strong>Complex corneal conditions present surgical challenges and necessitate innovation. Here, we present two cases where we performed intraocular lens trans-scleral fixation using the double-needle Yamane technique, followed by penetrating keratoplasty and vitrectomy using a temporary Landers wide-field keratoprosthesis.</p><p><strong>Case presentation: </strong>Case 1 involved a 70-year-old man with an aphakic eye of bullous keratopathy and corneal opacity owing to multiple penetrating and endothelial keratoplasty, endophthalmitis, and herpetic keratitis. His visual acuity was counting fingers at 20 cm before surgery. Penetrating keratoplasty with vitrectomy and intraocular lens scleral fixation was performed using the double-needle Yamane technique, and 10 months postoperatively, his best-corrected visual acuity improved to 0.6, presenting a clear cornea. Case 2 involved a 62-year-old man who underwent penetrating keratoplasty twice for corneal perforation and therapeutic penetrating keratoplasty with vitrectomy for traumatic globe rupture, resulting in the loss of the intraocular lens. The patient exhibited graft failure, and his best-corrected visual acuity was 0.03. Utilizing a temporary Landers wide-field keratoprosthesis, we performed penetrating keratoplasty and intraocular lens trans-scleral fixation without complications. His final best-corrected visual acuity improved to 0.15 with a clear cornea.</p><p><strong>Conclusions: </strong>Trans-scleral fixation of intraocular lens with penetrating keratoplasty, using temporary Landers wide-field keratoprosthesis, yielded positive clinical outcomes without serious complications.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"15 1","pages":"648-655"},"PeriodicalIF":0.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981805","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":"Cat Scratch Disease Presenting with Right Branch Retinal Artery Occlusion and Left Neuroretinitis.","authors":"Samira Jafari, Jonathan A Micieli","doi":"10.1159/000540125","DOIUrl":"10.1159/000540125","url":null,"abstract":"<p><strong>Introduction: </strong><i>Bartonella henselae</i>, the causative agent of cat scratch disease (CSD), presents with diverse ocular manifestations, posing diagnostic challenges. This study aimed to elucidate the diagnostic complexities through a unique case.</p><p><strong>Case presentation: </strong>A 42-year-old male presented with vision loss in the right eye, subsequent to flu-like symptoms following exposure to a stray kitten. Clinical examination revealed branch retinal artery occlusion (BRAO) in the right eye and neuroretinitis in the left, indicating concurrent ocular manifestations of CSD. Thorough investigations, including serological testing, ruled out alternative causes, highlighting the rarity of such coexisting ocular complications.</p><p><strong>Conclusions: </strong>The coexistence of BRAO and neuroretinitis in different eyes underscores the variable presentation of CSD. Recognition of infectious etiologies, particularly <i>Bartonella</i>, is paramount in diagnosing ocular vasculopathies. This case emphasizes the importance of considering <i>Bartonella</i> infection in patients with ocular vascular occlusions, especially in the context of recent cat exposure and systemic symptoms suggestive of CSD.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"15 1","pages":"628-632"},"PeriodicalIF":0.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981803","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":"Bilateral Endogenous Bacterial Endophthalmitis with Asynchrony for 14 Months due to <i>Klebsiella pneumoniae</i>: A Case Report.","authors":"Pedro Javier Nuova","doi":"10.1159/000540471","DOIUrl":"10.1159/000540471","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to describe a very rare case of endogenous bacterial endophthalmitis caused by <i>Klebsiella pneumoniae</i> in both eyes with a difference in the onset of symptoms of 14 months in an immunocompetent patient.</p><p><strong>Case presentation: </strong>A 66-year-old immunocompetent man presented with asynchronous bilateral endogenous endophthalmitis produced by the <i>K. pneumoniae</i> bacterium at the starting point of a liver abscess after cholecystectomy surgery, causing endophthalmitis 1 year and 2 months apart between an eye and another. The first was diffuse anteroposterior endophthalmitis in the left eye that ended in visual loss and phthisis bulbi due to delayed initial diagnosis and established treatment, and the second was focal endophthalmitis in the right eye that preserved the organ and resulted in a vision of 20/20 due to early suspected diagnosis and rapid instituted treatment.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first published case of a long asynchronous bilateral endogenous bacterial endophthalmitis caused by <i>K. pneumoniae</i> with a prolonged difference of 14 months in the onset of symptoms between one eye and another. This case is a vision-threatening ophthalmologic emergency that can be associated with life-threatening systemic morbidities. The early diagnosis of infection represents a challenge for clinicians, ophthalmologists, and microbiologists.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"15 1","pages":"633-641"},"PeriodicalIF":0.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981802","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 Vitreoretinal Lymphoma Presenting Solely with Asymptomatic Peripheral Drusenoid Lesions.","authors":"Brianna Lu, Jovi C Y Wong, Justin Kritzinger, David T Wong","doi":"10.1159/000540051","DOIUrl":"10.1159/000540051","url":null,"abstract":"<p><strong>Introduction: </strong>Primary vitreoretinal lymphoma (PVRL) is a rare malignant tumor that typically involves the retina, vitreous, or optic nerve head. PVRL often occurs concurrently with central nervous system lymphoma. Here, we present the first report of a patient with biopsy-confirmed PVRL presenting solely with asymptomatic peripheral drusenoid lesions.</p><p><strong>Case presentation: </strong>A woman in her 70s presented with new elevated amelanotic yellow lesions with overlying pigment in both of her eyes not previously seen prior to cataract surgery. Over the next 4 months, there was waxing and waning of lesions which resolved and first appeared in the right eye and then the left. A diagnostic vitrectomy of the left eye revealed B-cell lymphoma. The patient elected for initial treatment with radiation therapy of both orbits. A new lesion was identified in her right eye nearly 18 months after starting maintenance therapy with ibrutinib, following which systemic chemotherapy with methotrexate was initiated.</p><p><strong>Conclusion: </strong>Elevated clinical suspicion for a malignant process is needed for patients with progressive new retinal lesions in older age. Local radiation therapy to the orbits alone may not be sufficient to prevent progression despite initial presentation showing confinement of disease to the intraocular space.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"15 1","pages":"607-613"},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981809","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 Temporal Association between Regression of Pachydrusen and Use of Proprotein Convertase Subtilisin Kexin 9 Inhibitor: A Case Report.","authors":"Yodpong Chantarasorn, Kriengsak Funilkul","doi":"10.1159/000540014","DOIUrl":"10.1159/000540014","url":null,"abstract":"<p><strong>Introduction: </strong>We aim to report the clinical course of a patient with pachychoroidopathy who experienced regression of subfoveal drusen during cholesterol treatment using PCSK9 inhibitors.</p><p><strong>Case presentation: </strong>A 62-year-old woman who was visually asymptomatic complained of recent visual loss in the left eye (OS). She was diagnosed with foveal pachydrusen (OS) that had remained stable for 10 years. Three months after starting cholesterol treatment with a PCSK9 inhibitor, the latest class of lipid-lowering medication, her vision improved in parallel with gradual regression of material deposited beneath the retinal pigment epithelium (RPE). Recurrence of drusen was observed after discontinuing the drug.</p><p><strong>Conclusions: </strong>Use of PCSK9 inhibitors may improve the retina's lipid homeostasis by increasing the number of RPE-LDL receptors and partly contribute to the improvement of ocular phenotypes associated with dysfunctional RPE in pachychoroidopathy.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"15 1","pages":"614-620"},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981788","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}