GMS ophthalmology cases最新文献

Objective: To describe an interesting case of miliary tuberculosis mimicking retinoblastoma. Method: A retrospective case report. Result: The twin brother of a known case of retinobastoma presented with headache. On fundus examination, multiple yellowish-white lesions were noted in both eyes. Magnetic resonance imaging of the brain showed multiple enhancing lesions. A diagnosis of miliary tuberculosis was made and anti-tubercular therapy was started. Conclusion: Ocular tuberculosis can mimic retinoblastoma and lead to diagnostic dilemma especially in cases with family history of retinoblastoma.

Objective: Ocular surface squamous neoplasia (OSSN) is the most common type of non-melanocytic ocular surface tumor. Conjunctival intraepithelial neoplasia (CIN) is a type of OSSN that be medically managed by either topical interferon alpha-2b (IFN α-2b), 5-fluorouracil (5-FU), or mitomycin C. While a paradoxical response to IFN α-2b in the HIV population has been reported, we report a case of a paradoxical response in an immunocompetent individual. Methods: A 65-year-old immunocompetent female presents to the clinic with CIN. Results: She is started on topical IFN α-2b, resulting in an unexpected hypopyon, increased corneal epithelial defect, and increased size of the lesion. Switching to topical 5-FU resulted in decreasing size of the CIN lesion and resolution of the epithelial defect. Conclusions: Topical IFN α-2b can produce a paradoxical worsening of CIN lesions in some patients. Providers should be aware of this reaction, as well as the presenting signs and symptoms, to make appropriate treatment changes when treating CIN.

Background: Microbial keratitis is an important cause of ocular morbidity, with emerging organisms and drug resistance posing a real threat to vision of patients. Case presentation: A 30-year-old female presented with infective keratitis in the left eye. She had been using rose nectar as home remedy for her ailment. With no improvement in her symptoms, she presented to the eye emergency department, where she was started on empirical therapy with moxifloxacin, which was shifted to levofloxacin eye drops after the antimicrobial susceptibility test results came in. Microbiological examination revealed infection with rare gram-negative bacilli Citrobacter koseri. The patient responded well to the treatment with 1.5% levofloxacin eye drops and her vision improved from 20/120 to 20/30 over a course of 3 months. Conclusion: Treatment of microbial keratitis with those antibiotics that the organism is most sensitive to is of paramount importance today, where we often find patients on a cocktail of eye drops, which leads to further resistance and vision deterioration. Culturing of cornea scrapings and antimicrobial susceptibility testing of the isolated organism is now the standard guideline to be followed in the investigation of microbial keratitis.

Alopecia areata (AA) is an autoimmune disorder leading to non-scarring hair loss. As long as hair follicles are not destroyed, the potential for hair regrowth remains. Alopecia universalis is a severe form of AA and the chance of full hair regrowth is below 10%. We present a case of a 55-year-old woman with longstanding AA, who presented to the Outpatient Clinic of our Hospital Unit with almost full eyelashes and hair regrowth after an emotional stressful event. She reported no hair regrowth for the last 35 years. There are few case reports which have exhibited that hair follicles are still alive and may be reactivated after many years.

Objective: The aim of this case report is to report a new aphakic intraocular lens (IOL) that can be used for spherophakia. Methods: This is a single case report wherein the authors elaborate the technique of inserting the new IOL design in patients with spherophakia. Results: This new IOL design is very stable and is very promising in our follow-up of 6 months. Conclusion: The CM T-flex IOL can be a simple and alternate option for correcting aphakia.

Vogt-Koyanagi-Harada disease (VKH) is an autoimmune severe multisystem condition characterized by both ocular and systemic findings that should be promptly recognized and treated. Although invasive imaging modalities, namely fluorescein angiography and indocyanine green angiography, are still the gold standard for the diagnosis and follow-up of the ocular findings in VKH, the role of retinal non-invasive imaging including optical coherence tomography angiography (OCTA) is under investigation and is not mentioned in the current diagnostic criteria of VKH. The aim of this manuscript was to report the clinical course and the multimodal retinal imaging of a VKH case and to discuss the role of OCTA in this condition. Our case supports the evidence that OCTA is able to help determine disease activity and progression in VKH. We therefore contend that OCTA should be considered for future developing diagnostic criteria of this condition.

Management of large corneal-epibulbar dermoids always poses a challenge to the surgeons due to deeper corneal involvement. Also, there is a risk of limbal stem cell deficiency and formation of pseudopterygium with larger areas of limbal involvement. We report a novel surgical technique for the management of giant corneal-epibulbar dermoid with pre-descemetic deep anterior lamellar keratoplasty (DALK) and simple limbal epithelial transfer (SLET).

A new entity termed multilayered pigment epithelial detachment is seen to occur with the use of multiple intravitreal anti-VEGF agents. A distinct appearance of a spindle-shaped elevation with bands of hyporeflective and hyperreflective tissue is seen on optical coherence tomography. We describe a novel finding on optical coherence tomography angiography which includes a large type 1 choroidal neovascular membrane underlying this elevation. A large vascular network is seen. It is thought to be protective in nature and may prevent further degeneration.

Purpose: To describe a case of post-traumatic endophthalmitis with Moraxella in a child. Methods: Case report of an 11-year-old boy who presented with redness and profound visual loss in his left eye for 3 days following trauma with a sewing needle. Detailed ophthalmic examination showed hand movement vision, corneal edema with mobile hypopyon, as well as dot and clump echoes in Ultrasound B-scan. The clinical diagnosis of acute post-traumatic endophthalmitis was made. Result: The patient underwent pars plana vitrectomy and vitreous biopsy, and was given intravitreal antibiotics (vancomycin 1 mg/0.1 ml, ceftazidime 2.25 mg/0.1 ml, voriconazole 0.1 mg/0.1 ml). Non-pigmented small colonies growth was observed on culture plates which were identified as Moraxella. Conclusion: To date, no case report has been published regarding post-traumatic endophthalmitis due to Moraxella species in the pediatric age group.