To report multimodal imaging features of a novel association of non-arteritic anterior ischemic optic neuropathy (NAION), paracentral acute middle maculopathy (PAMM), and cilioretinal artery occlusion (CILRAO). A 74-year-old male patient presented complaining of an acute subjective decline in visual acuity in the right eye over the previous days. This patient underwent a comprehensive ophthalmological assessment, including multimodal retinal imaging and visual field test. The eye examination revealed yellowish optic disc edema in the right eye with peripapillary hemorrhages and a whitish lesion extending from the temporal margin of the optic nerve head towards the macula. Multimodal imaging confirmed the diagnosis of NAION in the right eye. Notably, the structural B-scan and en face OCT images revealed hyperreflective areas in the inner and mid retinal layers, indicating an association with CILRAO and PAMM. We herein describe the clinical findings of a previously unreported association among NAION, CILRAO and PAMM.
目的：报告非动脉炎性前部缺血性视神经病变（NAION）、旁中心急性中间黄斑病变（PAMM）和纤连视网膜动脉闭塞（CILRAO）的多模态成像特征。 一名 74 岁的男性患者前来就诊，主诉其右眼视力在前几天出现急性主观下降。患者接受了全面的眼科评估，包括多模态视网膜成像和视野测试。 眼部检查发现右眼视盘水肿呈淡黄色，伴有毛细血管周围出血和从视神经头颞侧向黄斑延伸的白色病变。多模态成像证实了右眼非结节性视网膜病变的诊断。值得注意的是，结构性 B 扫描和面阵 OCT 图像显示视网膜内层和中层有高反射区，表明与 CILRAO 和 PAMM 有关。 我们在本文中描述了以前从未报道过的非结节性视网膜病变、CILRAO 和 PAMM 之间关联的临床发现。
{"title":"Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) associated with Paracentral Acute Middle Maculopathy (PAMM) and Cilioretinal Artery Occlusion (CILRAO): multimodal imaging of a newly described clinical association.","authors":"Andrea Coletto, Sonia Serafino, Valentina Marica, Chiara Olivieri, Paola Marolo, Guglielmo Parisi, Michele Reibaldi, Enrico Borrelli","doi":"10.1097/icb.0000000000001624","DOIUrl":"https://doi.org/10.1097/icb.0000000000001624","url":null,"abstract":"\u0000 \u0000 To report multimodal imaging features of a novel association of non-arteritic anterior ischemic optic neuropathy (NAION), paracentral acute middle maculopathy (PAMM), and cilioretinal artery occlusion (CILRAO).\u0000 \u0000 \u0000 \u0000 A 74-year-old male patient presented complaining of an acute subjective decline in visual acuity in the right eye over the previous days. This patient underwent a comprehensive ophthalmological assessment, including multimodal retinal imaging and visual field test.\u0000 \u0000 \u0000 \u0000 The eye examination revealed yellowish optic disc edema in the right eye with peripapillary hemorrhages and a whitish lesion extending from the temporal margin of the optic nerve head towards the macula. Multimodal imaging confirmed the diagnosis of NAION in the right eye. Notably, the structural B-scan and en face OCT images revealed hyperreflective areas in the inner and mid retinal layers, indicating an association with CILRAO and PAMM.\u0000 \u0000 \u0000 \u0000 We herein describe the clinical findings of a previously unreported association among NAION, CILRAO and PAMM.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"80 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1097/icb.0000000000001623
Jose A. Ramirez, Rahul N. Khurana, Jay C. Wang
To report a case of endophthalmitis after intravitreal injection due to Paenibacillus yonginensis. This is a retrospective case report. An 87-year-old man with longstanding neovascular age-related macular degeneration (AMD) in his left eye presented with pain and loss of vision three days after intravitreal injection of aflibercept. Examination revealed a hypopyon and vitreous opacities. A diagnostic anterior chamber paracentesis and intravitreal injections of vancomycin and ceftazidime were performed. One month later, vitrectomy was performed for non-clearing vitreous opacities with a good final visual outcome. The causative bacterium, Paenibacillus yonginensis, was identified with polymerase chain reaction (PCR) sequencing from the aqueous specimen. We encountered a rare presentation of endophthalmitis caused by Paenibacillus yonginensis. Paenibacillus species have been implicated in human infection in recent years. DNA sequencing can allow for the identification of uncommon bacteria.
{"title":"A novel case of endophthalmitis secondary to Paenibacillus yonginensis after intravitreal injection of aflibercept","authors":"Jose A. Ramirez, Rahul N. Khurana, Jay C. Wang","doi":"10.1097/icb.0000000000001623","DOIUrl":"https://doi.org/10.1097/icb.0000000000001623","url":null,"abstract":"\u0000 \u0000 To report a case of endophthalmitis after intravitreal injection due to Paenibacillus yonginensis.\u0000 \u0000 \u0000 \u0000 This is a retrospective case report.\u0000 \u0000 \u0000 \u0000 An 87-year-old man with longstanding neovascular age-related macular degeneration (AMD) in his left eye presented with pain and loss of vision three days after intravitreal injection of aflibercept. Examination revealed a hypopyon and vitreous opacities. A diagnostic anterior chamber paracentesis and intravitreal injections of vancomycin and ceftazidime were performed. One month later, vitrectomy was performed for non-clearing vitreous opacities with a good final visual outcome. The causative bacterium, Paenibacillus yonginensis, was identified with polymerase chain reaction (PCR) sequencing from the aqueous specimen.\u0000 \u0000 \u0000 \u0000 We encountered a rare presentation of endophthalmitis caused by Paenibacillus yonginensis. Paenibacillus species have been implicated in human infection in recent years. DNA sequencing can allow for the identification of uncommon bacteria.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":" 59","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1097/icb.0000000000001615
Jan Willem R. Pott, E. A. Huiskamp, J. Verheij
To report typical retinal findings in a girl with the presumed diagnosis of ESCS, attributed to the presence of a homozygous likely pathogenic variation in the NR2E3 gene. A retrospective case report with multimodal imaging studies Wide field OCT examination at the age of 11 years showed increased thickening of the midperipheral retina. In the area of retinal thickening delineation of retinal architecture was coarse, and photoreceptor outer segments thinned and disrupted. The retinal pigment epithelium appeared to be normal on autofluorescence imaging. In retrospect the retinal thickening was already apparent on conventional OCT at the age of 3 years. Wide field OCT is a valuable new tool in assessing typical retinal abnormalities in patients with NR2E3 mutations, by showing an abnormal but very characteristic thickening of the midperipheral retina.
{"title":"Midperipheral retinal thickening on wide field OCT in a patient with a mutation in the NR2E3 gene","authors":"Jan Willem R. Pott, E. A. Huiskamp, J. Verheij","doi":"10.1097/icb.0000000000001615","DOIUrl":"https://doi.org/10.1097/icb.0000000000001615","url":null,"abstract":"\u0000 \u0000 To report typical retinal findings in a girl with the presumed diagnosis of ESCS, attributed to the presence of a homozygous likely pathogenic variation in the NR2E3 gene.\u0000 \u0000 \u0000 \u0000 A retrospective case report with multimodal imaging studies\u0000 \u0000 \u0000 \u0000 Wide field OCT examination at the age of 11 years showed increased thickening of the midperipheral retina. In the area of retinal thickening delineation of retinal architecture was coarse, and photoreceptor outer segments thinned and disrupted. The retinal pigment epithelium appeared to be normal on autofluorescence imaging. In retrospect the retinal thickening was already apparent on conventional OCT at the age of 3 years.\u0000 \u0000 \u0000 \u0000 Wide field OCT is a valuable new tool in assessing typical retinal abnormalities in patients with NR2E3 mutations, by showing an abnormal but very characteristic thickening of the midperipheral retina.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"26 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141360262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1097/icb.0000000000001597
Jacinta A. McDonald, A. Barkmeier, L. Dalvin, Brittni A Scruggs
To report the rare clinical, optical coherence tomography (OCT), and OCT-angiography findings of a visually significant choroidal neovascular membrane (CNV) in the setting of focal choroidal excavation (FCE) in a child. Case report and literature review A 9-year-old girl with FCE-related central CNV based on clinical findings and multimodal imaging. Patient’s visual acuity and retinal findings progressed, and she started bevacizumab intravitreal therapy (off label) with resultant stepwise improvement of visual acuity and retinal imaging findings, including regression of a neovascular complex on OCT-A. This case highlights the successful use of bevacizumab for a rare choroidal neovascular complex associated with FCE in a child.
{"title":"Focal choroidal excavation (FCE)-related choroidal neovascular membrane (CNV) in a child","authors":"Jacinta A. McDonald, A. Barkmeier, L. Dalvin, Brittni A Scruggs","doi":"10.1097/icb.0000000000001597","DOIUrl":"https://doi.org/10.1097/icb.0000000000001597","url":null,"abstract":"\u0000 \u0000 To report the rare clinical, optical coherence tomography (OCT), and OCT-angiography findings of a visually significant choroidal neovascular membrane (CNV) in the setting of focal choroidal excavation (FCE) in a child.\u0000 \u0000 \u0000 \u0000 Case report and literature review\u0000 \u0000 \u0000 \u0000 A 9-year-old girl with FCE-related central CNV based on clinical findings and multimodal imaging. Patient’s visual acuity and retinal findings progressed, and she started bevacizumab intravitreal therapy (off label) with resultant stepwise improvement of visual acuity and retinal imaging findings, including regression of a neovascular complex on OCT-A.\u0000 \u0000 \u0000 \u0000 This case highlights the successful use of bevacizumab for a rare choroidal neovascular complex associated with FCE in a child.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"6 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141356456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1097/icb.0000000000001606
Julia Meade, Kanwal Nischal, Karl R. Olsen
To demonstrate the response of a juxtapapillary retinal hemangioblastoma (JRH) to belzutifan in a patient with Von-Hippel-Lindau syndrome (VHL). This case report includes fundus photography and optical coherence tomography to compare a juxtapapillary retinal hemangioblastoma (JRH) before and 24 months after treatment with belzutifan. An 18-year-old woman with VHL was diagnosed with a juxtapapillary retinal hemangioblastoma (JRH) at age 13. The retinal lesion progressively worsened over 5 years and required two sessions of laser therapy with minimal improvement but loss of visual field. She was treated with the oral HIF2a-inhibitor, belzutifan, with minimal side effects. At 24 months of therapy her JRH has decreased in height from 1258 microns to 874 microns and width from 4448 µm to 3786 µm and vision is 20/20. Belzutifan demonstrates impressive clinical activity in VHL-associated JRH.
{"title":"Response of a von Hippel-Lindau-associated optic nerve hemangioblastoma to belzutifan.","authors":"Julia Meade, Kanwal Nischal, Karl R. Olsen","doi":"10.1097/icb.0000000000001606","DOIUrl":"https://doi.org/10.1097/icb.0000000000001606","url":null,"abstract":"\u0000 \u0000 To demonstrate the response of a juxtapapillary retinal hemangioblastoma (JRH) to belzutifan in a patient with Von-Hippel-Lindau syndrome (VHL).\u0000 \u0000 \u0000 \u0000 This case report includes fundus photography and optical coherence tomography to compare a juxtapapillary retinal hemangioblastoma (JRH) before and 24 months after treatment with belzutifan.\u0000 \u0000 \u0000 \u0000 An 18-year-old woman with VHL was diagnosed with a juxtapapillary retinal hemangioblastoma (JRH) at age 13. The retinal lesion progressively worsened over 5 years and required two sessions of laser therapy with minimal improvement but loss of visual field. She was treated with the oral HIF2a-inhibitor, belzutifan, with minimal side effects. At 24 months of therapy her JRH has decreased in height from 1258 microns to 874 microns and width from 4448 µm to 3786 µm and vision is 20/20.\u0000 \u0000 \u0000 \u0000 Belzutifan demonstrates impressive clinical activity in VHL-associated JRH.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"24 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1097/icb.0000000000001605
Victoria Stöckl, M. Stattin, Claus Zehetner, Patricia Bui, K. Krepler, S. Ansari-Shahrezaei
To describe a case of unilateral epiretinal neovascularization (ERN) secondary to an old ischemic retinal vein occlusion (RVO) in a patient with bilateral proliferative macular teleangiectasia type 2 (MacTel 2; Toto stage 4) and its response to treatment as documented by multimodal imaging. Retrospective case report A 75-year-old woman with a six-year-history of MacTel 2 and the consecutive development of proliferative outer retinal neovascularization in both eyes over time presented with an ERN in addition to neovascularization of the optic disc, delayed filling of the retinal veins, peripheral capillary ischemia and intravitreal hemorrhage only in her left eye in September 2023. She was therefore treated with anti-vascular endothelial growth factor (anti-VEGF; aflibercept 2mg) intravitreally. The ERN responded well to a single intravitreal injection of anti-VEGF, while flow in the outer retinal proliferation persisted. Diagnosis and treatment with anti-VEGF were observed via optical coherence tomography angiography. We believe that the ERN formation was a reaction to ischemia of the inner retinal capillary plexus due to a preceding RVO. The herein presented case provides a new perspective on the development and treatment of ERN in MacTel 2.
{"title":"Response to treatment of epiretinal neovascularization secondary to ischemic retinal vein occlusion in proliferative MacTel 2","authors":"Victoria Stöckl, M. Stattin, Claus Zehetner, Patricia Bui, K. Krepler, S. Ansari-Shahrezaei","doi":"10.1097/icb.0000000000001605","DOIUrl":"https://doi.org/10.1097/icb.0000000000001605","url":null,"abstract":"\u0000 \u0000 To describe a case of unilateral epiretinal neovascularization (ERN) secondary to an old ischemic retinal vein occlusion (RVO) in a patient with bilateral proliferative macular teleangiectasia type 2 (MacTel 2; Toto stage 4) and its response to treatment as documented by multimodal imaging.\u0000 \u0000 \u0000 \u0000 Retrospective case report\u0000 \u0000 \u0000 \u0000 A 75-year-old woman with a six-year-history of MacTel 2 and the consecutive development of proliferative outer retinal neovascularization in both eyes over time presented with an ERN in addition to neovascularization of the optic disc, delayed filling of the retinal veins, peripheral capillary ischemia and intravitreal hemorrhage only in her left eye in September 2023. She was therefore treated with anti-vascular endothelial growth factor (anti-VEGF; aflibercept 2mg) intravitreally. The ERN responded well to a single intravitreal injection of anti-VEGF, while flow in the outer retinal proliferation persisted. Diagnosis and treatment with anti-VEGF were observed via optical coherence tomography angiography.\u0000 \u0000 \u0000 \u0000 We believe that the ERN formation was a reaction to ischemia of the inner retinal capillary plexus due to a preceding RVO. The herein presented case provides a new perspective on the development and treatment of ERN in MacTel 2.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"5 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1097/icb.0000000000001602
Angelica Piccini, Ryan S. Meshkin, Sandra Hoyek, David J Doobin, Celine Chaaya, Nimesh A. Patel
To report a case of tilted sutureless intrascleral fixated IOL, emphasizing its management with 23-gauge laser to strengthen the haptic-optic junction. Case report. A 27-year-old man was referred for treatment of traumatic cataracts in his left eye. He underwent pars plana vitrectomy, lensectomy, membrane peel, and capsulectomy without complications. Five days after the surgery, he developed ocular hypertension that ultimately required insertion of an Ahmed glaucoma valve in the left eye. 16 months after the initial procedure, the patient underwent secondary lens implantation with a CT Lucia 602 IOL in the left eye using the Yamane technique. The day following surgery, the patient presented with a significantly tilted lens. Three weeks later, the patient underwent surgery for IOL repositioning. The manipulation of the haptics was ineffective in repositioning the IOL. The temporal sclerotomy was removed and a 23-gauge probe was used to laser both optic-haptic junctions while a light pipe held the lens in place. The tilt was corrected, and visual acuity improved to 20/40 at one year follow-up. Successful repositioning of tilted sutureless intrascleral fixated IOLs can be achieved using 23-gauge laser reinforcement at the haptic-optic junction. Consideration could be made to perform this laser at the time of implantation as a prophylactic approach to mitigate tilt and reduce the risk of reoperation.
{"title":"Laser of the Haptic-Optic Junction to Fix a Tilted Yamane Intrascleral-Fixated Lens","authors":"Angelica Piccini, Ryan S. Meshkin, Sandra Hoyek, David J Doobin, Celine Chaaya, Nimesh A. Patel","doi":"10.1097/icb.0000000000001602","DOIUrl":"https://doi.org/10.1097/icb.0000000000001602","url":null,"abstract":"\u0000 \u0000 To report a case of tilted sutureless intrascleral fixated IOL, emphasizing its management with 23-gauge laser to strengthen the haptic-optic junction.\u0000 \u0000 \u0000 \u0000 Case report.\u0000 \u0000 \u0000 \u0000 A 27-year-old man was referred for treatment of traumatic cataracts in his left eye. He underwent pars plana vitrectomy, lensectomy, membrane peel, and capsulectomy without complications. Five days after the surgery, he developed ocular hypertension that ultimately required insertion of an Ahmed glaucoma valve in the left eye. 16 months after the initial procedure, the patient underwent secondary lens implantation with a CT Lucia 602 IOL in the left eye using the Yamane technique. The day following surgery, the patient presented with a significantly tilted lens. Three weeks later, the patient underwent surgery for IOL repositioning. The manipulation of the haptics was ineffective in repositioning the IOL. The temporal sclerotomy was removed and a 23-gauge probe was used to laser both optic-haptic junctions while a light pipe held the lens in place. The tilt was corrected, and visual acuity improved to 20/40 at one year follow-up.\u0000 \u0000 \u0000 \u0000 Successful repositioning of tilted sutureless intrascleral fixated IOLs can be achieved using 23-gauge laser reinforcement at the haptic-optic junction. Consideration could be made to perform this laser at the time of implantation as a prophylactic approach to mitigate tilt and reduce the risk of reoperation.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"32 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1097/icb.0000000000001603
Joseph B. Alsberge, Zakary Hoffelt
To report a patient who developed retinal toxicity following inadvertent subretinal mitomycin C injection during glaucoma surgery. Case report and review of the literature. A 73-year-old man underwent glaucoma tube shunt surgery with sub-Tenon’s mitomycin C injection. Postoperatively he developed retinal edema, hemorrhages, and occlusive vasculopathy localized to the quadrant of the mitomycin C injection. It was determined that the sclera had been inadvertently punctured during mitomycin C injection, resulting in subretinal placement of the medication and resultant retinal toxicity. At postoperative month one, there was diffuse chorioretinal atrophy in the area of the injection. The macula was spared and he retained his preoperative visual acuity. Inadvertent subretinal mitomycin C injection may occur when attempting to inject the drug into the sub-Tenon’s space and can result in localized retinal toxicity.
报告一名在青光眼手术中不慎将丝裂霉素 C 注射到视网膜下而导致视网膜中毒的患者。 病例报告和文献综述。 一名 73 岁的男性接受了青光眼管分流手术，并在视网膜下注射丝裂霉素 C。术后，他出现视网膜水肿、出血和闭塞性血管病变，局部位于丝裂霉素 C 注射的象限。经确定，注射丝裂霉素 C 时不慎刺破了巩膜，导致药物进入视网膜下，造成视网膜中毒。术后一个月，注射区域出现弥漫性脉络膜视网膜萎缩。黄斑幸免于难，视力保持在术前水平。 在尝试将丝裂霉素 C 注射到天农膜下间隙时，可能会发生意外的视网膜下丝裂霉素 C 注射，并可能导致局部视网膜中毒。
{"title":"Retinal toxicity secondary to inadvertent subretinal mitomycin C injection","authors":"Joseph B. Alsberge, Zakary Hoffelt","doi":"10.1097/icb.0000000000001603","DOIUrl":"https://doi.org/10.1097/icb.0000000000001603","url":null,"abstract":"\u0000 \u0000 To report a patient who developed retinal toxicity following inadvertent subretinal mitomycin C injection during glaucoma surgery.\u0000 \u0000 \u0000 \u0000 Case report and review of the literature.\u0000 \u0000 \u0000 \u0000 A 73-year-old man underwent glaucoma tube shunt surgery with sub-Tenon’s mitomycin C injection. Postoperatively he developed retinal edema, hemorrhages, and occlusive vasculopathy localized to the quadrant of the mitomycin C injection. It was determined that the sclera had been inadvertently punctured during mitomycin C injection, resulting in subretinal placement of the medication and resultant retinal toxicity. At postoperative month one, there was diffuse chorioretinal atrophy in the area of the injection. The macula was spared and he retained his preoperative visual acuity.\u0000 \u0000 \u0000 \u0000 Inadvertent subretinal mitomycin C injection may occur when attempting to inject the drug into the sub-Tenon’s space and can result in localized retinal toxicity.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"46 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141103488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.1097/icb.0000000000001601
Sarah Hershko, Jonas Van den Heurck, Ingrid Neetens, Carl Claes
To describe the management of a case of retinal detachment combined with extensive intraocular ossification (IOO) using an innovative surgical technique of repair. Surgical procedures involved open sky approach and the use of a bone punch instrument for the removal of the ossified structures. The applied surgical techniques effectively removed the ossified material, contributing to retinal reattachment and preservation of functional vision. Particularly challenging was the rapid rebleeding and re-ossification observed after the removal of intraocular ossification, a phenomenon not yet described in the existing literature. This necessitated an additional vitrectomy using a similar approach. This paper highlights the challenges associated with IOO and the innovative surgical approach used for its management. The utilization of a bone punch instrument, although effective, necessitates caution due to its non-standard application in intraocular surgery. Further investigation and clinical experience are essential to refine the methodology and evaluate long-term outcomes in IOO management.
{"title":"Implications of intraocular ossification after repeated vitrectomies: exploring a novel surgical intervention.","authors":"Sarah Hershko, Jonas Van den Heurck, Ingrid Neetens, Carl Claes","doi":"10.1097/icb.0000000000001601","DOIUrl":"https://doi.org/10.1097/icb.0000000000001601","url":null,"abstract":"\u0000 \u0000 To describe the management of a case of retinal detachment combined with extensive intraocular ossification (IOO) using an innovative surgical technique of repair.\u0000 \u0000 \u0000 \u0000 Surgical procedures involved open sky approach and the use of a bone punch instrument for the removal of the ossified structures.\u0000 \u0000 \u0000 \u0000 The applied surgical techniques effectively removed the ossified material, contributing to retinal reattachment and preservation of functional vision. Particularly challenging was the rapid rebleeding and re-ossification observed after the removal of intraocular ossification, a phenomenon not yet described in the existing literature. This necessitated an additional vitrectomy using a similar approach.\u0000 \u0000 \u0000 \u0000 This paper highlights the challenges associated with IOO and the innovative surgical approach used for its management. The utilization of a bone punch instrument, although effective, necessitates caution due to its non-standard application in intraocular surgery. Further investigation and clinical experience are essential to refine the methodology and evaluate long-term outcomes in IOO management.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"11 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141112569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15DOI: 10.1097/icb.0000000000001592
Chiara Angeli, Laura Di Leo, R. Frisina
The authors present a case of both traumatic subluxated lens with zonular dialysis and a traumatic retinal detachment with posterior retinal tear. Some fragments have dropped into the vitreous chamber during phaco-emulsification and one of them has even passed through the retinal tear and has been removed from the subretinal space. A 3-piece intraocular lens with a tension ring supporting the capsular bag was implanted. Pars plana vitrectomy with accurate vitreous base shaving was approached by 23-gauge system. Subretinal fluid was removed by a complete fluid-air exchange. A large macular internal limiting membrane (ILM) peeling was performed and the posterior retinal tear was covered by multiple inverted ILM flaps. Postoperatively, retinal reattachment was achieved, the retinal break was flat. The ILM flaps were well positioned within the retinal tear and covered the preoperatively bared RPE. The surgical treatment of injuries after a blunt ocular trauma are not standardizable. In this case surgical outcomes suggest the effectiveness of the surgeon’s intraoperative unusual maneuvers.
{"title":"AN UNUSUAL WAY TO INDUCE THE CLOSURE OF A POSTERIOR POLE RETINAL TEAR IN A TRAUMATIC RETINAL DETACHMENT","authors":"Chiara Angeli, Laura Di Leo, R. Frisina","doi":"10.1097/icb.0000000000001592","DOIUrl":"https://doi.org/10.1097/icb.0000000000001592","url":null,"abstract":"\u0000 \u0000 The authors present a case of both traumatic subluxated lens with zonular dialysis and a traumatic retinal detachment with posterior retinal tear.\u0000 \u0000 \u0000 \u0000 Some fragments have dropped into the vitreous chamber during phaco-emulsification and one of them has even passed through the retinal tear and has been removed from the subretinal space. A 3-piece intraocular lens with a tension ring supporting the capsular bag was implanted. Pars plana vitrectomy with accurate vitreous base shaving was approached by 23-gauge system. Subretinal fluid was removed by a complete fluid-air exchange. A large macular internal limiting membrane (ILM) peeling was performed and the posterior retinal tear was covered by multiple inverted ILM flaps.\u0000 \u0000 \u0000 \u0000 Postoperatively, retinal reattachment was achieved, the retinal break was flat. The ILM flaps were well positioned within the retinal tear and covered the preoperatively bared RPE.\u0000 \u0000 \u0000 \u0000 The surgical treatment of injuries after a blunt ocular trauma are not standardizable. In this case surgical outcomes suggest the effectiveness of the surgeon’s intraoperative unusual maneuvers.\u0000","PeriodicalId":510632,"journal":{"name":"RETINAL Cases & Brief Reports","volume":"52 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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