We describe an atypical case of bilateral ocular ischemic syndrome with neovascularization and secondary angle closure in a 28-year-old lady with features of antiphospholipid syndrome (APS) and Takayasu arteritis; the latter being detected on evaluation of the etiology of the ocular condition. She was treated with pan retinal photocoagulation in one eye and anterior retinal cryotherapy in the other eye (due to poor visualization of the retina initially) followed by cataract surgery. Systemic evaluation was done. Takayasu arteritis was detected and appropriate management was advised under specialist care. Her systemic condition was stable, ocular neovascularization was regressing, and visual acuity improved in the pseudophakic eye; a drop in visual acuity due to the progression of cataract and macular ischemia was noted in the phakic eye at follow-up. Timely detection and appropriate management of ocular and systemic conditions in such cases can preserve vision and limit further systemic morbidity.
{"title":"More to it than meets the eye- A case of Takayasu arteritis and antiphospholipid syndrome, associated with ocular ischemic syndrome, neovascularization and secondary angle closure","authors":"R. Philip, A. Iqbal, V. J. Prakash, M. Baskaran","doi":"10.4103/ijo.ijo_2753_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_2753_22","url":null,"abstract":"We describe an atypical case of bilateral ocular ischemic syndrome with neovascularization and secondary angle closure in a 28-year-old lady with features of antiphospholipid syndrome (APS) and Takayasu arteritis; the latter being detected on evaluation of the etiology of the ocular condition. She was treated with pan retinal photocoagulation in one eye and anterior retinal cryotherapy in the other eye (due to poor visualization of the retina initially) followed by cataract surgery. Systemic evaluation was done. Takayasu arteritis was detected and appropriate management was advised under specialist care. Her systemic condition was stable, ocular neovascularization was regressing, and visual acuity improved in the pseudophakic eye; a drop in visual acuity due to the progression of cataract and macular ischemia was noted in the phakic eye at follow-up. Timely detection and appropriate management of ocular and systemic conditions in such cases can preserve vision and limit further systemic morbidity.","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"17 1","pages":"757 - 759"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79253162","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}
Sequential restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) after macular hole (MH) surgery, over a period of 12 weeks, is reported for the first time. This case highlights the patho-anatomical process of restoration of ELM and EZ after successful macular hole surgery (MHS).
{"title":"Sequential restoration of external limiting membrane and ellipsoid zone on SD-OCT after macular hole surgery","authors":"Samya Singh, Priyanka Sharma, S. Saxena","doi":"10.4103/ijo.ijo_3401_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_3401_22","url":null,"abstract":"Sequential restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) after macular hole (MH) surgery, over a period of 12 weeks, is reported for the first time. This case highlights the patho-anatomical process of restoration of ELM and EZ after successful macular hole surgery (MHS).","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"71 1","pages":"776 - 778"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81649001","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}
Uroos Izhar, Naheed Akhtar, Abdul Waris, Siddharth Khanna
We share a case of a 20 yr old female who presented with drooping of left upper eyelid with down and outward deviation of left eye since birth and diminution of vision in left eye noticed since 2 yrs with retinal abnormalities suggestive of congenital ocular toxoplasmosis. The clinical and complementary examinations of the case are discussed. Ocular toxoplasmosis remains to be the most common cause of infectious posterior uveitis in immunocompetent and immunocompromised individuals with highly variable prognosis. A precise diagnosis of the disease is necessary to opt effective and rapid treatment. Hence, It is essential that clinicians be aware of antenatal and postnatal presenting signs and symptoms, as early diagnosis and treatment will minimise the possibility of sequelae as majority of affected infants may develop chorioretinitis, deafness and/or neurological symptoms if left untreated.
{"title":"Case report: Pupil sparing third nerve palsy in an immunocompetent host – A rare sequelae of congenital ocular toxoplasmosis","authors":"Uroos Izhar, Naheed Akhtar, Abdul Waris, Siddharth Khanna","doi":"10.4103/ijo.ijo_627_23","DOIUrl":"https://doi.org/10.4103/ijo.ijo_627_23","url":null,"abstract":"We share a case of a 20 yr old female who presented with drooping of left upper eyelid with down and outward deviation of left eye since birth and diminution of vision in left eye noticed since 2 yrs with retinal abnormalities suggestive of congenital ocular toxoplasmosis. The clinical and complementary examinations of the case are discussed. Ocular toxoplasmosis remains to be the most common cause of infectious posterior uveitis in immunocompetent and immunocompromised individuals with highly variable prognosis. A precise diagnosis of the disease is necessary to opt effective and rapid treatment. Hence, It is essential that clinicians be aware of antenatal and postnatal presenting signs and symptoms, as early diagnosis and treatment will minimise the possibility of sequelae as majority of affected infants may develop chorioretinitis, deafness and/or neurological symptoms if left untreated.","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"87 1","pages":"877 - 880"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85067266","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}
To report a rare case of bilateral optic disc edema as a presentation of brain metastasis. Case report. A 51-year-old healthy woman presented with complaints of headache, diplopia, and distortion of peripheral vision for the past one month. Examination of both the eyes showed massive optic disc edema, multiple radial hemorrhages, hard exudates at the disc margin, and absent venous pulsation. Magnetic resonance imaging (MRI and MRA) showed leptomeningeal enhancement with raised intracranial pressure: a sign of metastasis. She had undergone mastectomy and had received eight cycles of systemic chemotherapy and radiation for breast carcinoma two years ago. She was urgently referred to an oncologist for further management. This case highlights the importance of neuroimaging in patients presenting with bilateral disc edema and prior history of breast carcinoma to rule out metastasis.
{"title":"Bilateral optic disc edema as the presenting sign of brain metastasis","authors":"Abhishek Das, P. Shah, V. Narendran","doi":"10.4103/ijo.ijo_2985_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_2985_22","url":null,"abstract":"To report a rare case of bilateral optic disc edema as a presentation of brain metastasis. Case report. A 51-year-old healthy woman presented with complaints of headache, diplopia, and distortion of peripheral vision for the past one month. Examination of both the eyes showed massive optic disc edema, multiple radial hemorrhages, hard exudates at the disc margin, and absent venous pulsation. Magnetic resonance imaging (MRI and MRA) showed leptomeningeal enhancement with raised intracranial pressure: a sign of metastasis. She had undergone mastectomy and had received eight cycles of systemic chemotherapy and radiation for breast carcinoma two years ago. She was urgently referred to an oncologist for further management. This case highlights the importance of neuroimaging in patients presenting with bilateral disc edema and prior history of breast carcinoma to rule out metastasis.","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"13 1","pages":"869 - 870"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86035816","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}
Ashapurna Borgohain, Mahesh Gopalakrishnan, A. Giridhar
Foveal neovascularization (FNV) is a rare clinical finding in conditions with vascular compromise, leading to ischemia of the retina. We present a case of proliferative diabetic retinopathy (PDR) with FNV, where optical coherence tomography angiography (OCTA) confirmed the architecture, extent, activity, and origin of a hemorrhage-like clump at the fovea. Digital Florescein Angiography (DFA) showed PDR (both eyes), but intra-retina microvascular abnormalities (IrMAs) or FNV could not be differentiated at the site of leak in right eye fovea. OCTA confirmed a FNV breaching the internal limiting membrane (ILM), protruding into vitreous, and determined its origin from superficial vascular plexus (SVC). Also, segmentation revealed flow voids in choriocapillaris slab, suggesting choroidal ischemia.
{"title":"Foveal neovascularization in proliferative diabetic retinopathy: Characterization with OCTA","authors":"Ashapurna Borgohain, Mahesh Gopalakrishnan, A. Giridhar","doi":"10.4103/ijo.ijo_739_23","DOIUrl":"https://doi.org/10.4103/ijo.ijo_739_23","url":null,"abstract":"Foveal neovascularization (FNV) is a rare clinical finding in conditions with vascular compromise, leading to ischemia of the retina. We present a case of proliferative diabetic retinopathy (PDR) with FNV, where optical coherence tomography angiography (OCTA) confirmed the architecture, extent, activity, and origin of a hemorrhage-like clump at the fovea. Digital Florescein Angiography (DFA) showed PDR (both eyes), but intra-retina microvascular abnormalities (IrMAs) or FNV could not be differentiated at the site of leak in right eye fovea. OCTA confirmed a FNV breaching the internal limiting membrane (ILM), protruding into vitreous, and determined its origin from superficial vascular plexus (SVC). Also, segmentation revealed flow voids in choriocapillaris slab, suggesting choroidal ischemia.","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"29 1","pages":"767 - 769"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83080054","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}
{"title":"Bilateral peripapillary myelinated nerve fiber in a case of Stargardt's phenotype","authors":"R. Hirawat, H. Vaidya","doi":"10.4103/ijo.ijo_2744_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_2744_22","url":null,"abstract":"","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"1 1","pages":"966 - 966"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88479963","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}
Acute acquired comitant esotropia (AACE) has been a topic of interest among ophthalmologists for almost a century. Possibility of its association with neurological pathologies creates a diagnostic challenge for ophthalmologist. Therefore, a multidisciplinary approach to its etiological diagnosis with involvement of neurologist and radiologist has always been followed. AACE is an uncommon strabismus, but the incidence is gradually increasing. Most articles described AACE in children and adolescents. We present a case series of five young adults (age 20 to 30 years) with AACE to highlight the peculiarities of presentation, diagnostic challenges, and management.
{"title":"Acute acquired comitant esotropia—A case series","authors":"S. Dhar, Tanmay K. Mohapatra, P. Singh, S. Goel","doi":"10.4103/ijo.ijo_933_23","DOIUrl":"https://doi.org/10.4103/ijo.ijo_933_23","url":null,"abstract":"Acute acquired comitant esotropia (AACE) has been a topic of interest among ophthalmologists for almost a century. Possibility of its association with neurological pathologies creates a diagnostic challenge for ophthalmologist. Therefore, a multidisciplinary approach to its etiological diagnosis with involvement of neurologist and radiologist has always been followed. AACE is an uncommon strabismus, but the incidence is gradually increasing. Most articles described AACE in children and adolescents. We present a case series of five young adults (age 20 to 30 years) with AACE to highlight the peculiarities of presentation, diagnostic challenges, and management.","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"17 1","pages":"863 - 866"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74422856","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}
{"title":"An unusual complication following a routine cataract surgery","authors":"N. Menia, P. Verma, Payal Saini","doi":"10.4103/ijo.ijo_3084_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_3084_22","url":null,"abstract":"","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"2 10","pages":"901 - 902"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72388275","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}
{"title":"Central clearing-like appearance of focal hyperpigmentation of chronic VKH and its swept source OCT features","authors":"Anamika Patel, A. Pathengay","doi":"10.4103/ijo.ijo_3145_22","DOIUrl":"https://doi.org/10.4103/ijo.ijo_3145_22","url":null,"abstract":"","PeriodicalId":93298,"journal":{"name":"Indian journal of ophthalmology. Case reports","volume":"21 1","pages":"908 - 909"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72402522","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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