Pub Date : 2024-07-01DOI: 10.1097/ICB.0000000000001431
Adrian T Fung, Ye Li
Purpose: To report a case of a focal scleral nodule (FSN) that demonstrated growth over three years.
Methods: Case report.
Results: An asymptomatic emmetropic 15-year-old female patient was referred with an incidental finding of a left fundus lesion on routine examination. On examination, there was an isolated 1.9-mm (vertical) × 1.4-mm (horizontal) diameter-raised, circular, pale, yellow-white lesion with an orange halo located along the inferotemporal vascular arcade. Enhanced-depth imaging optical coherence tomography (EDI-OCT) demonstrated a focal protrusion of the sclera with thinning of the overlying choroid, consistent with focal scleral nodule (FSN). On EDI-OCT, the horizontal basal diameter measured 3138 μm, and its height was 528 μm. Three years later, the lesion had increased in size to 2.7-mm (vertical) × 2.1-mm (horizontal) diameter on color fundus photography and a horizontal basal diameter of 3991 μm and height of 647 μm on EDI-OCT. The patient remained systemically well without visual complaints.
Conclusion: FSN can increase in size over time, suggesting that scleral remodeling within and around the lesion can occur. Longitudinal observation of FSN can help to inform its clinical course and shed insight into its pathogenesis.
{"title":"GROWTH OF A FOCAL SCLERAL NODULE.","authors":"Adrian T Fung, Ye Li","doi":"10.1097/ICB.0000000000001431","DOIUrl":"10.1097/ICB.0000000000001431","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of a focal scleral nodule (FSN) that demonstrated growth over three years.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>An asymptomatic emmetropic 15-year-old female patient was referred with an incidental finding of a left fundus lesion on routine examination. On examination, there was an isolated 1.9-mm (vertical) × 1.4-mm (horizontal) diameter-raised, circular, pale, yellow-white lesion with an orange halo located along the inferotemporal vascular arcade. Enhanced-depth imaging optical coherence tomography (EDI-OCT) demonstrated a focal protrusion of the sclera with thinning of the overlying choroid, consistent with focal scleral nodule (FSN). On EDI-OCT, the horizontal basal diameter measured 3138 μm, and its height was 528 μm. Three years later, the lesion had increased in size to 2.7-mm (vertical) × 2.1-mm (horizontal) diameter on color fundus photography and a horizontal basal diameter of 3991 μm and height of 647 μm on EDI-OCT. The patient remained systemically well without visual complaints.</p><p><strong>Conclusion: </strong>FSN can increase in size over time, suggesting that scleral remodeling within and around the lesion can occur. Longitudinal observation of FSN can help to inform its clinical course and shed insight into its pathogenesis.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313936","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}
Purpose: The purpose of this study was to report a case of Tourette syndrome, exacerbated in adulthood, that was diagnosed after bilateral lens luxation and recurrent retinal detachment due to self-injury.
Methods: This was a case report.
Results: A 35-year-old man presented with a sudden abnormality in vision and bilateral lens luxation. The patient successfully underwent bilateral lens extraction and intrascleral intraocular lens fixation; however, vitreous hemorrhage and retinal detachment occurred in the left eye. The retinal detachment was caused by a giant retinal tear and retinal dialysis. Vitrectomy was performed. However, retinal detachment recurred with proliferative vitreoretinopathy. Retinal detachment subsequently occurred in the right eye. Self-injury to the eye was observed before surgical treatment. The patient was consequently diagnosed with Tourette syndrome.
Conclusion: Tourette syndrome, which may be accompanied by self-injurious behavior, is a disorder that typically develops in childhood but rarely exacerbates during adulthood. A diagnosis of Tourette syndrome should be considered in cases of unexplained retinal detachment with traumatic features.
{"title":"EXACERBATED TOURETTE SYNDROME DIAGNOSED IN ADULTHOOD AFTER RECURRENT BILATERAL RETINAL DETACHMENT.","authors":"Tsuyoshi Mito, Hajime Okemoto, Akane Kawasaki, Hiroshi Sasaki","doi":"10.1097/ICB.0000000000001421","DOIUrl":"10.1097/ICB.0000000000001421","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to report a case of Tourette syndrome, exacerbated in adulthood, that was diagnosed after bilateral lens luxation and recurrent retinal detachment due to self-injury.</p><p><strong>Methods: </strong>This was a case report.</p><p><strong>Results: </strong>A 35-year-old man presented with a sudden abnormality in vision and bilateral lens luxation. The patient successfully underwent bilateral lens extraction and intrascleral intraocular lens fixation; however, vitreous hemorrhage and retinal detachment occurred in the left eye. The retinal detachment was caused by a giant retinal tear and retinal dialysis. Vitrectomy was performed. However, retinal detachment recurred with proliferative vitreoretinopathy. Retinal detachment subsequently occurred in the right eye. Self-injury to the eye was observed before surgical treatment. The patient was consequently diagnosed with Tourette syndrome.</p><p><strong>Conclusion: </strong>Tourette syndrome, which may be accompanied by self-injurious behavior, is a disorder that typically develops in childhood but rarely exacerbates during adulthood. A diagnosis of Tourette syndrome should be considered in cases of unexplained retinal detachment with traumatic features.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567970","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001414
Wei Kiong Ngo, Yariv Keshet, Richard F Spaide
Purpose: To describe a patient with venous overload choroidopathy in whom venous bulbosities masqueraded as polyps and intervortex venous anastomosis mimicked a branching vascular network, giving the appearance of polypoidal choroidal vasculopathy.
Methods: The patient had complete ophthalmic examination including indocyanine green angiography and optical coherence tomography. Venous bulbosities were defined on indocyanine green angiography as focal dilations in which the diameter of the dilation is two times that of the host vessel.
Results: A 75-year-old woman presented with combined subretinal and subretinal pigment epithelium hemorrhages in the right eye. During indocyanine green angiography, focal nodular hyperfluorescent lesions connected to a network of vessels were observed, which looked like polyps and branching vascular network in polypoidal choroidal vasculopathy. In both eyes, the midphase angiogram had multifocal choroidal vascular hyperpermeability. There was late-phase placoid staining nasal to the nerve in the right eye. During enhanced depth imaging-optical coherence tomography evaluation, there were no retinal pigment epithelium elevations that would be expected with polyps or branching vascular network in the right eye. A double-layer sign was seen corresponding to the placoid area of staining. Diagnosis of venous overload choroidopathy and choroidal neovascularization membrane was made. She was treated with intravitreal antivascular endothelial growth factor injections for the choroidal neovascularization membrane.
Conclusion: Indocyanine green angiography findings in venous overload choroidopathy may mimic polypoidal choroidal vasculopathy, but differentiation is essential because it has implications for treatment. Similar findings may have been misinterpreted in the past and may have previously contributed to conflicting clinical and histopathologic descriptions of polypoidal choroidal vasculopathy.
{"title":"BULBOSITIES AND INTERVORTEX VENOUS ANASTOMOSIS IN VENOUS OVERLOAD CHOROIDOPATHY MASQUERADING AS POLYPOIDAL CHOROIDAL VASCULOPATHY.","authors":"Wei Kiong Ngo, Yariv Keshet, Richard F Spaide","doi":"10.1097/ICB.0000000000001414","DOIUrl":"10.1097/ICB.0000000000001414","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a patient with venous overload choroidopathy in whom venous bulbosities masqueraded as polyps and intervortex venous anastomosis mimicked a branching vascular network, giving the appearance of polypoidal choroidal vasculopathy.</p><p><strong>Methods: </strong>The patient had complete ophthalmic examination including indocyanine green angiography and optical coherence tomography. Venous bulbosities were defined on indocyanine green angiography as focal dilations in which the diameter of the dilation is two times that of the host vessel.</p><p><strong>Results: </strong>A 75-year-old woman presented with combined subretinal and subretinal pigment epithelium hemorrhages in the right eye. During indocyanine green angiography, focal nodular hyperfluorescent lesions connected to a network of vessels were observed, which looked like polyps and branching vascular network in polypoidal choroidal vasculopathy. In both eyes, the midphase angiogram had multifocal choroidal vascular hyperpermeability. There was late-phase placoid staining nasal to the nerve in the right eye. During enhanced depth imaging-optical coherence tomography evaluation, there were no retinal pigment epithelium elevations that would be expected with polyps or branching vascular network in the right eye. A double-layer sign was seen corresponding to the placoid area of staining. Diagnosis of venous overload choroidopathy and choroidal neovascularization membrane was made. She was treated with intravitreal antivascular endothelial growth factor injections for the choroidal neovascularization membrane.</p><p><strong>Conclusion: </strong>Indocyanine green angiography findings in venous overload choroidopathy may mimic polypoidal choroidal vasculopathy, but differentiation is essential because it has implications for treatment. Similar findings may have been misinterpreted in the past and may have previously contributed to conflicting clinical and histopathologic descriptions of polypoidal choroidal vasculopathy.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9110664","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001416
Hannah M Istre-Wilz, Maura Di Nicola, James J Augsburger, Basil K Williams
Purpose: To describe the case of a woman who developed rapid progression of a choroidal melanoma after 19 years of observation of a previously treated choroidal nevus.
Methods: A 71-year-old woman with a 22-year history of a choroidal nevus was observed for 19 years after undergoing transpupillary thermotherapy for a localized, macula-involving, exudative, retinal detachment. Five months after her most recent stable examination, she presented for routine follow-up.
Results: The lesion was noted to have increased thickness with the development of lipofuscin and subretinal fluid, suggestive of malignant transformation. In the 1 month between diagnosis and treatment with iodine-125 plaque brachytherapy, the lesion continued to expand, requiring a radiation dose adjustment.
Conclusion: Choroidal nevus transformation into melanoma has been well-documented, highlighting the need for routine follow-up. Treatment within 1 month is typically sufficient for appropriate management. Occasionally, melanomas may grow substantially between diagnosis and treatment, suggesting that repeat measurement may be necessary in rare instances to ensure appropriate radiation treatment.
{"title":"MALIGNANT TRANSFORMATION OF A CHOROIDAL NEVUS AFTER 19 YEARS OF OBSERVATION FOLLOWED BY RAPID PROGRESSION OF THE CHOROIDAL MELANOMA.","authors":"Hannah M Istre-Wilz, Maura Di Nicola, James J Augsburger, Basil K Williams","doi":"10.1097/ICB.0000000000001416","DOIUrl":"10.1097/ICB.0000000000001416","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the case of a woman who developed rapid progression of a choroidal melanoma after 19 years of observation of a previously treated choroidal nevus.</p><p><strong>Methods: </strong>A 71-year-old woman with a 22-year history of a choroidal nevus was observed for 19 years after undergoing transpupillary thermotherapy for a localized, macula-involving, exudative, retinal detachment. Five months after her most recent stable examination, she presented for routine follow-up.</p><p><strong>Results: </strong>The lesion was noted to have increased thickness with the development of lipofuscin and subretinal fluid, suggestive of malignant transformation. In the 1 month between diagnosis and treatment with iodine-125 plaque brachytherapy, the lesion continued to expand, requiring a radiation dose adjustment.</p><p><strong>Conclusion: </strong>Choroidal nevus transformation into melanoma has been well-documented, highlighting the need for routine follow-up. Treatment within 1 month is typically sufficient for appropriate management. Occasionally, melanomas may grow substantially between diagnosis and treatment, suggesting that repeat measurement may be necessary in rare instances to ensure appropriate radiation treatment.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9125808","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001418
Shefali Sood, Scott Friedman
Background/purpose: To present a case of sclerochoroidal calcification (SCC) associated with dural calcification along the optic nerves and severe visual loss.
Methods: Case report.
Results: A 74-year-old white female patient with a 25-year history of primary hyperparathyroidism and surgical removal of a single parathyroid gland presented with blurred vision. On presentation, she had a calcium level of 12.6 mg/dL (reference range: 8.7-10.3 mg/dL). Her best-corrected visual acuity (BCVA) was 20/40 in both eyes, and she was diagnosed with bilateral SCC. After 2 years, the patient returned with a complaint of progressive vision loss, and the BCVA was 20/150 in the right eye and hand motion in the left eye. She had stable focal SCC on fundus examination with no significant changes from the previous examination. The fluorescein angiogram was unremarkable with no leakage. Optical coherence tomography (OCT) of the macula showed no edema or subretinal fluid and was not significantly changed from the first OCT. B-scan showed areas of calcification in the sclera consistent with the SCC. Computerized tomography (CT) scans showed dural calcifications along both optic nerves. She had no enlargement of SCC lesions and no other ocular or neurologic pathology associated with her vision loss.
Conclusion: We present a patient with bilateral SCC and associated calcification in both globes. Unlike previous reports of SCC, our case demonstrated progressive severe vision loss because of dural calcification along the optic nerves. Patients with SCC and decreased vision should receive a CT scan to look for this rare associated finding.
{"title":"SCLEROCHOROIDAL CALCIFICATION WITH OPTIC NERVE CALCIFICATION IN A PATIENT WITH PRIMARY HYPERPARATHYROIDISM AND SEVERE VISION LOSS.","authors":"Shefali Sood, Scott Friedman","doi":"10.1097/ICB.0000000000001418","DOIUrl":"10.1097/ICB.0000000000001418","url":null,"abstract":"<p><strong>Background/purpose: </strong>To present a case of sclerochoroidal calcification (SCC) associated with dural calcification along the optic nerves and severe visual loss.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 74-year-old white female patient with a 25-year history of primary hyperparathyroidism and surgical removal of a single parathyroid gland presented with blurred vision. On presentation, she had a calcium level of 12.6 mg/dL (reference range: 8.7-10.3 mg/dL). Her best-corrected visual acuity (BCVA) was 20/40 in both eyes, and she was diagnosed with bilateral SCC. After 2 years, the patient returned with a complaint of progressive vision loss, and the BCVA was 20/150 in the right eye and hand motion in the left eye. She had stable focal SCC on fundus examination with no significant changes from the previous examination. The fluorescein angiogram was unremarkable with no leakage. Optical coherence tomography (OCT) of the macula showed no edema or subretinal fluid and was not significantly changed from the first OCT. B-scan showed areas of calcification in the sclera consistent with the SCC. Computerized tomography (CT) scans showed dural calcifications along both optic nerves. She had no enlargement of SCC lesions and no other ocular or neurologic pathology associated with her vision loss.</p><p><strong>Conclusion: </strong>We present a patient with bilateral SCC and associated calcification in both globes. Unlike previous reports of SCC, our case demonstrated progressive severe vision loss because of dural calcification along the optic nerves. Patients with SCC and decreased vision should receive a CT scan to look for this rare associated finding.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198681","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001422
Franco Benvenuto, Maria F Colorado-Zavala, Raul E Ruiz-Lozano, Maria L Gonzalez-Dutra, Carina Kadzielski, David Ancona-Lezama
Purpose: We present a case of an ischemic retinopathy with severe vision loss secondary to a childhood stroke.
Methods: Case report.
Results: An otherwise healthy 9-year-old girl presented with a 1-day history of impaired gait and speech. After performing computed tomography and magnetic resonance imaging, thrombosis of the left internal carotid artery was observed and a diagnosis of ischemic stroke was established. Serological autoimmune, coagulation, and viral panels were unrewarding. Cardiac, inflammatory, and coagulation disorders were ruled out. The cause was attributed to a focal cerebral arteriopathy, a common cause of childhood stroke. The patient was treated with mechanical thrombectomy followed by anticoagulation. The day after, the patient referred vision loss of 20/100 in the left eye. Fundus evaluation of the left eye depicted diffuse intraretinal hemorrhages and cotton-wool spots and there was retinal whitening at the posterior pole. Six weeks after, VA dropped to counting fingers.
Conclusion: A macular optical coherence tomography revealed diffuse atrophic changes in the inner retinal layers at the macula, and the angio-optical coherence tomography showed an enlarged foveal avascular zone. We propose ischemia-reperfusion as the primary explanation of this unusual event.
{"title":"RETINAL ISCHEMIA AFTER FOCAL CEREBRAL ARTERIOPATHY IN A YOUNG GIRL.","authors":"Franco Benvenuto, Maria F Colorado-Zavala, Raul E Ruiz-Lozano, Maria L Gonzalez-Dutra, Carina Kadzielski, David Ancona-Lezama","doi":"10.1097/ICB.0000000000001422","DOIUrl":"10.1097/ICB.0000000000001422","url":null,"abstract":"<p><strong>Purpose: </strong>We present a case of an ischemic retinopathy with severe vision loss secondary to a childhood stroke.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>An otherwise healthy 9-year-old girl presented with a 1-day history of impaired gait and speech. After performing computed tomography and magnetic resonance imaging, thrombosis of the left internal carotid artery was observed and a diagnosis of ischemic stroke was established. Serological autoimmune, coagulation, and viral panels were unrewarding. Cardiac, inflammatory, and coagulation disorders were ruled out. The cause was attributed to a focal cerebral arteriopathy, a common cause of childhood stroke. The patient was treated with mechanical thrombectomy followed by anticoagulation. The day after, the patient referred vision loss of 20/100 in the left eye. Fundus evaluation of the left eye depicted diffuse intraretinal hemorrhages and cotton-wool spots and there was retinal whitening at the posterior pole. Six weeks after, VA dropped to counting fingers.</p><p><strong>Conclusion: </strong>A macular optical coherence tomography revealed diffuse atrophic changes in the inner retinal layers at the macula, and the angio-optical coherence tomography showed an enlarged foveal avascular zone. We propose ischemia-reperfusion as the primary explanation of this unusual event.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9275150","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001417
Giorgio Lari, Marco Battista, Alessandro Marchese, Alessandro Bordato, Rosangela Lattanzio, Giuseppe Querques, Giulio Modorati, Francesco Bandello, Elisabetta Miserocchi
Purpose: Our aim was to report a comprehensive multimodal imaging case of unilateral frosted branch angiitis in a 40-year-old White woman.
Methods: Case report involving clinical examination, ultra-wide field fundus photograph, ultra-wide field fluorescein angiography, optical coherence tomography (OCT) and OCT angiography.
Results: A 40-year-old patient presented with unilateral acute vision loss. On fundus examination, extensive retinal veins sheathing, macular edema, and vascular congestion were observed while ultra-wide field fluorescein angiography revealed a hyperfluorescent "hot" optic disc and blood retinal barrier disruption. Optical coherence tomography angiography displayed foveal avascular zone enlargement and excluded papillary neovascularization. Extensive laboratory workup for infectious, autoimmune, and inflammatory disorders was negative; thus, a diagnose of acute idiopathic unilateral frosted branch angiitis was made. Intravitreal injection of dexamethasone implant was administered with a good clinical response.
Conclusion: Multimodal imaging is crucial to correctly diagnose and treat frosted branch angiitis. To the best of our knowledge, the use of optical coherence tomography angiography as a complementary tool to the diagnostic process in frosted branch angiitis has been described in literature just once as a photographic essay of cytomegalovirus-related frosted branch angiitis 1 and it might be of great value for better characterizing clinical features of this disorder and for following disease activity in a noninvasive fashion.
目的:我们的目的是报告一例综合多模态成像的单侧磨砂支血管炎病例,患者是一名 40 岁的白人女性:病例报告包括临床检查、超宽视野眼底照片、超宽视野荧光素血管造影、光学相干断层扫描(OCT)和 OCT 血管造影:一名 40 岁患者出现单侧急性视力下降。眼底检查发现广泛的视网膜静脉鞘、黄斑水肿和血管充血,超宽视野荧光素血管造影显示高荧光 "热 "视盘和视网膜血屏障破坏。光学相干断层血管造影显示眼窝无血管区扩大,排除了乳头状新生血管。对感染性、自身免疫性和炎症性疾病进行了广泛的实验室检查,结果均为阴性,因此诊断为急性特发性单侧磨砂支血管炎。患者接受了地塞米松植入剂的静脉注射,临床反应良好:结论:多模态成像对于正确诊断和治疗磨砂支血管炎至关重要。据我们所知,将光学相干断层血管造影作为磨砂支血管炎诊断过程中的辅助工具,在文献中仅作为巨细胞病毒相关磨砂支血管炎的摄影论文描述过一次1,它可能对更好地描述这种疾病的临床特征和以无创方式跟踪疾病活动具有重要价值。
{"title":"CLINICAL CHARACTERISTICS AND MULTIMODAL IMAGING FINDINGS IN UNILATERAL FROSTED BRANCH ANGIITIS: A CASE REPORT.","authors":"Giorgio Lari, Marco Battista, Alessandro Marchese, Alessandro Bordato, Rosangela Lattanzio, Giuseppe Querques, Giulio Modorati, Francesco Bandello, Elisabetta Miserocchi","doi":"10.1097/ICB.0000000000001417","DOIUrl":"10.1097/ICB.0000000000001417","url":null,"abstract":"<p><strong>Purpose: </strong>Our aim was to report a comprehensive multimodal imaging case of unilateral frosted branch angiitis in a 40-year-old White woman.</p><p><strong>Methods: </strong>Case report involving clinical examination, ultra-wide field fundus photograph, ultra-wide field fluorescein angiography, optical coherence tomography (OCT) and OCT angiography.</p><p><strong>Results: </strong>A 40-year-old patient presented with unilateral acute vision loss. On fundus examination, extensive retinal veins sheathing, macular edema, and vascular congestion were observed while ultra-wide field fluorescein angiography revealed a hyperfluorescent \"hot\" optic disc and blood retinal barrier disruption. Optical coherence tomography angiography displayed foveal avascular zone enlargement and excluded papillary neovascularization. Extensive laboratory workup for infectious, autoimmune, and inflammatory disorders was negative; thus, a diagnose of acute idiopathic unilateral frosted branch angiitis was made. Intravitreal injection of dexamethasone implant was administered with a good clinical response.</p><p><strong>Conclusion: </strong>Multimodal imaging is crucial to correctly diagnose and treat frosted branch angiitis. To the best of our knowledge, the use of optical coherence tomography angiography as a complementary tool to the diagnostic process in frosted branch angiitis has been described in literature just once as a photographic essay of cytomegalovirus-related frosted branch angiitis 1 and it might be of great value for better characterizing clinical features of this disorder and for following disease activity in a noninvasive fashion.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567972","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001406
Jaime E Brown, Benjamin J Fowler, Roomasa Channa
Purpose: To demonstrate the use of urology retractable three-pronged grasping forceps in the removal of a large, round, and nonmagnetic intraocular foreign body (IOFB) that was difficult to remove with other surgical instruments.
Methods: Extraction of a 3.0 mm lead shot pellet embedded in vitreous hemorrhage was attempted with multiple surgical instruments including an intraocular magnet, IOFB forceps, and two tools designed for urology stone removal: a three-pronged grasping forceps and a nitinol basket extractor.
Results: Owing to the round and smooth surface, large size, and nonmagnetic nature of the IOFB, extraction was challenging and failed with multiple other surgical instruments. The wide and secure grasp of the grasping forceps allowed for swift IOFB extraction without iatrogenic injury to the retina.
Conclusion: The grasping forceps offer an effective and safe method for removal of large, round, and nonmagnetic IOFBs.
{"title":"RETRACTABLE UROLOGY THREE-PRONGED GRASPING FORCEPS FOR REMOVAL OF LARGE, NONMAGNETIC INTRAOCULAR FOREIGN BODIES.","authors":"Jaime E Brown, Benjamin J Fowler, Roomasa Channa","doi":"10.1097/ICB.0000000000001406","DOIUrl":"10.1097/ICB.0000000000001406","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the use of urology retractable three-pronged grasping forceps in the removal of a large, round, and nonmagnetic intraocular foreign body (IOFB) that was difficult to remove with other surgical instruments.</p><p><strong>Methods: </strong>Extraction of a 3.0 mm lead shot pellet embedded in vitreous hemorrhage was attempted with multiple surgical instruments including an intraocular magnet, IOFB forceps, and two tools designed for urology stone removal: a three-pronged grasping forceps and a nitinol basket extractor.</p><p><strong>Results: </strong>Owing to the round and smooth surface, large size, and nonmagnetic nature of the IOFB, extraction was challenging and failed with multiple other surgical instruments. The wide and secure grasp of the grasping forceps allowed for swift IOFB extraction without iatrogenic injury to the retina.</p><p><strong>Conclusion: </strong>The grasping forceps offer an effective and safe method for removal of large, round, and nonmagnetic IOFBs.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10555942","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001411
Michael S Ramos, Danny A Mammo, Alex Yuan, Sumit Sharma
Background/purpose: To describe a case of primary vitreoretinal lymphoma with central nervous system involvement in a patient with sarcoidosis.
Methods: Single, retrospective chart review.
Patient: A 59-year-old man with sarcoidosis.
Results: The patient presented with a 3-year history of bilateral panuveitis thought secondary to his sarcoidosis diagnosed 11 years before. Shortly before presentation, the patient demonstrated recurrent uveitis with a lack of response to aggressive immunosuppression therapy. At presentation, ocular examination showed significant anterior and posterior inflammation. Fluorescein angiography demonstrated hyperfluorescence of the optic nerve with late and small vessel leakage in the right eye. The patient also described a two-month history of memory and word-finding deficits. An inflammatory and infectious disease work-up was unremarkable. A brain MRI showed multiple enhancing periventricular lesions with vasogenic edema, whereas a lumbar puncture was negative for malignant cells. A diagnostic pars plana vitrectomy confirmed a diagnosis of large B-cell lymphoma.
Conclusion: Sarcoidosis and vitreoretinal lymphoma are known masqueraders. Recurrent inflammation typical of sarcoid uveitis may mask a more sinister diagnosis such as vitreoretinal lymphoma. Furthermore, sarcoid uveitis treatment with corticosteroids may transiently improve symptoms, but further delay a timely diagnosis of primary vitreoretinal lymphoma.
{"title":"VITREORETINAL LYMPHOMA WITH CENTRAL NERVOUS SYSTEM INVOLVEMENT IN A PATIENT WITH SARCOIDOSIS: A CASE REPORT.","authors":"Michael S Ramos, Danny A Mammo, Alex Yuan, Sumit Sharma","doi":"10.1097/ICB.0000000000001411","DOIUrl":"10.1097/ICB.0000000000001411","url":null,"abstract":"<p><strong>Background/purpose: </strong>To describe a case of primary vitreoretinal lymphoma with central nervous system involvement in a patient with sarcoidosis.</p><p><strong>Methods: </strong>Single, retrospective chart review.</p><p><strong>Patient: </strong>A 59-year-old man with sarcoidosis.</p><p><strong>Results: </strong>The patient presented with a 3-year history of bilateral panuveitis thought secondary to his sarcoidosis diagnosed 11 years before. Shortly before presentation, the patient demonstrated recurrent uveitis with a lack of response to aggressive immunosuppression therapy. At presentation, ocular examination showed significant anterior and posterior inflammation. Fluorescein angiography demonstrated hyperfluorescence of the optic nerve with late and small vessel leakage in the right eye. The patient also described a two-month history of memory and word-finding deficits. An inflammatory and infectious disease work-up was unremarkable. A brain MRI showed multiple enhancing periventricular lesions with vasogenic edema, whereas a lumbar puncture was negative for malignant cells. A diagnostic pars plana vitrectomy confirmed a diagnosis of large B-cell lymphoma.</p><p><strong>Conclusion: </strong>Sarcoidosis and vitreoretinal lymphoma are known masqueraders. Recurrent inflammation typical of sarcoid uveitis may mask a more sinister diagnosis such as vitreoretinal lymphoma. Furthermore, sarcoid uveitis treatment with corticosteroids may transiently improve symptoms, but further delay a timely diagnosis of primary vitreoretinal lymphoma.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9104740","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 : 2024-07-01DOI: 10.1097/ICB.0000000000001429
Prithvi Ramtohul, K Bailey Freund
Purpose: To report the long-term (23 years) clinical and multimodal imaging features of acquired vitelliform lesions (AVLs) associated with nonneovascular age-related macular degeneration.
Methods: Retrospective case report. Color and red-free fundus photographs, high-resolution optical coherence tomography, fluorescein and indocyanine green angiography, and optical coherence tomography-angiography were performed.
Results: A 58-year-old man presented with bilateral AVLs in the setting of nonneovascular age-related macular degeneration. At baseline, his best-corrected visual acuity was 20/30 in his right eye and 20/20 in his left eye. Red-free fundus photographs showed AVLs with cuticular drusen in both eyes corresponding to a "stars-in-the-sky" pattern on fluorescein. Indocyanine green angiography showed no evidence of macular neovascularization. Throughout the 23-year follow-up, the patient reported consuming 20 mg/day of lutein supplement. At the end of follow-up, his best-corrected visual acuity was 20/20 in both eyes. Color fundus photographs showed resorption of the AVLs in both eyes and High-Res optical coherence tomography showed relative preservation of the outer retinal bands in the fovea. Optical coherence tomography-angiography confirmed the absence of macular neovascularization.
Conclusion: In nonneovascular age-related macular degeneration, spontaneous resorption of AVLs may be associated with long-term maintenance of visual acuity and relative preservation of the outer retinal morphology.
{"title":"LONG-TERM PRESERVATION OF VISUAL ACUITY AFTER RESORPTION OF ACQUIRED VITELLIFORM LESIONS IN AGE-RELATED MACULAR DEGENERATION.","authors":"Prithvi Ramtohul, K Bailey Freund","doi":"10.1097/ICB.0000000000001429","DOIUrl":"10.1097/ICB.0000000000001429","url":null,"abstract":"<p><strong>Purpose: </strong>To report the long-term (23 years) clinical and multimodal imaging features of acquired vitelliform lesions (AVLs) associated with nonneovascular age-related macular degeneration.</p><p><strong>Methods: </strong>Retrospective case report. Color and red-free fundus photographs, high-resolution optical coherence tomography, fluorescein and indocyanine green angiography, and optical coherence tomography-angiography were performed.</p><p><strong>Results: </strong>A 58-year-old man presented with bilateral AVLs in the setting of nonneovascular age-related macular degeneration. At baseline, his best-corrected visual acuity was 20/30 in his right eye and 20/20 in his left eye. Red-free fundus photographs showed AVLs with cuticular drusen in both eyes corresponding to a \"stars-in-the-sky\" pattern on fluorescein. Indocyanine green angiography showed no evidence of macular neovascularization. Throughout the 23-year follow-up, the patient reported consuming 20 mg/day of lutein supplement. At the end of follow-up, his best-corrected visual acuity was 20/20 in both eyes. Color fundus photographs showed resorption of the AVLs in both eyes and High-Res optical coherence tomography showed relative preservation of the outer retinal bands in the fovea. Optical coherence tomography-angiography confirmed the absence of macular neovascularization.</p><p><strong>Conclusion: </strong>In nonneovascular age-related macular degeneration, spontaneous resorption of AVLs may be associated with long-term maintenance of visual acuity and relative preservation of the outer retinal morphology.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9412385","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}