A Case of Nephrotic Syndrome with Bilateral Serous Retinal Detachment and Shallow Anterior Chamber Associated with Ciliary Body Edema
We report a case of severe SRD in both eyes and angle closure due to ciliary body edema caused by nephrotic syndrome. A 57-year-old man was admitted to the Department of Nephrology in our hospital for a thorough examination of his generalized edema. He was diagnosed with nephrotic syndrome but proved to be refractory to steroid treatment. Due to distortion symptoms in both eyes on the 30th day of hospitalization, the patient was referred to our department. Best-corrected visual acuity (BCVA) was 0.8 in the right eye and 1.0 in the left eye. Slit lamp examination and anterior segmental optical coherence tomography (OCT) sho...
Source: Case Reports in Ophthalmology - November 18, 2022 Category: Opthalmology Source Type: research
Purtscher-Like Retinopathy with Cardioembolic Stroke: Case Report and Literature Review
We present a case of PUR associated with a cardioembolic stroke in a patient following temporary cessation of anticoagulant therapy for a surgical procedure. Our patient presented with multiple risk factors for PUR and classic signs and symptoms including multiple peripapillary white retinal lesions near arterioles and sudden unilateral decrease in visual acuity. Optical coherence tomography showed inner retinal hyperreflectivity and thinning consistent with inner retinal ischemia, and fluorescein angiography showed delayed retinal filling. Her complement C5 factor was elevated on laboratory testing. Brain magnetic resonan...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Long-Term Resolution of Perifoveal Exudative Vascular Anomalous Complex after Intravitreal Injections of Anti-Vascular Endothelial Growth Factor
Perifoveal exudative vascular anomalous complex (PEVAC) is a perifoveal aneurysmal vascular lesion found in healthy subjects. A 68-year-old woman was diagnosed with a typical unilateral and unifocal PEVAC lesion after extensive multimodal imaging and was treated with three-monthly intravitreal injections of ranibizumab. An immediate and complete resolution of the intraretinal fluid was observed. Visual acuity returned to 20/20 without any recurrence of the exudative signs along the 5 years of follow-up. Therefore, an initial anti-VEGF treatment with three-monthly intravitreal injections may be considered as a first-line tr...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Implantation Cyst of Anterior Chamber: A Case Report
This clinical case report describes a single case of a progressively enlarging anterior chamber cyst arising in a patient with prior cataract surgery. We detail findings of a large implantation cyst within the anterior chamber, confirmed on ultrasound biomicroscopy. The patient was successfully treated with needle aspiration and injection of 5-fluorouracil without recurrence at 5 months. Anterior chamber cysts are a rare side effect of cataract surgery caused by intrusion of epithelial cells during surgery. Patients may present with a progressively enlarging mass requiring surgical intervention. Aspiration and injection of...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Intravitreal Injection of Brolucizumab for Recalcitrant Macular Edema due to Central Retinal Vein Occlusion: A Small Case Series
This was a single center, prospective uncontrolled nonrandomized case series. Two eyes with recalcitrant ME secondary to CRVO, who have received a minimum of ten intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections, underwent IVI brolucizumab (BRZ). Patients underwent best corrected visual acuity (BCVA) testing, ophthalmic examination, and optical coherence tomography at baseline and follow-up visits (weeks 4, 8, 12, and 16). Both patients demonstrated notable improvement in BCVA and reduction of fluid on SD-OCT lasting up to week 12. At week 16, though both the eyes maintained the visual acuity gain...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Superior Division Third Nerve Palsy as the Presenting Sign of Metastatic Breast Cancer
The third cranial nerve divides into superior and inferior branches at the level of anterior carotid sinus and superior orbital fissure. In extremely rare scenarios, metastatic lesions at this location may present with divisional third nerve involvement. We here describe an 85-year-old woman who presented with superior division third nerve palsy due to breast cancer metastasis. Our case demonstrates the rare presentation of double vision and ptosis because of superior division third nerve palsy. The differential diagnosis for this examination finding should include metastatic disease even in the absence of a known cancer d...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Relapse of Birdshot Uveitis after Stopping Immunosuppressive Treatment and Starting Immune Checkpoint Inhibitors for Lung Cancer
A 56-year-old Caucasian woman with birdshot uveitis had to stop immunosuppressive treatment with adalimumab due to metastatic squamous lung carcinoma. She was subsequently treated with chemotherapy and pembrolizumab, an immune checkpoint inhibitor (ICI). After stopping adalimumab and starting pembrolizumab, the patient had an inflammatory relapse of birdshot uveitis with macular oedema. Birdshot uveitis is triggered by an unknown antigen presented on the HLA-A29 molecule which activates cytotoxic T-cells. Although immunosuppressive therapy effectively stabilizes birdshot uveitis, it might induce a higher risk of developing...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Vitreous Hemorrhage as the Presenting Sign of Idiopathic Intracranial Hypertension
Vitreous hemorrhage from papilledema has rarely been reported in the literature. It likely results from an acute increase in intracranial pressure leading to venous compression and rupture. We herein describe a 32-year-old woman who presented with flashes and floaters and was found to have vitreous hemorrhage due to idiopathic intracranial hypertension (IIH). She was treated with acetazolamide, and at 6-month follow-up, regained normal visual function with resolution of optic nerve swelling and hemorrhage. Our case demonstrates that patients with IIH may rarely present with floaters due to vitreous hemorrhage from papilled...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Surgical Treatment for Adult-Onset Limbal Xanthogranuloma: A Case Report with 4-Year Follow-Up
Xanthogranuloma is a benign histiocytic disorder that generally appears in infants and children and often called juvenile xanthogranuloma (JXG). Typical reddish-yellow cutaneous papules or nodules are the most common presentation of JXG. Extracutaneous JXG affects eyes, brain, lungs, liver, spleen, and other sites. Isolated ocular manifestation without skin lesion is rare, especially in adult patients. Here, we report a case of a 27-year-old man who presented with gradually growing yellowish mass at the corneoscleral area of the left eye for 5 months. The patient had worn soft contact lenses for more than 10 years. With at...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
An Elderly Man with Atypical Multiple Evanescent White Dot Syndrome
A rare occurrence of an atypical case of multiple evanescent white dot syndrome (MEWDS) in a 75-year-old man without viral prodrome or white dots on fundus that presented with acute, severe left eye visual loss, which returned to baseline without treatment in several weeks. Multimodal imaging, including fluorescein angiography (FA), fundus autofluorescence (FAF), indocyanine green angiography (ICG), and optical coherence tomography (OCT) demonstrated classical presentation of MEWDS with wreath-like lesions and inflammatory foci in the retinal pigment epithelium that correlated among modalities. Possible underlying systemic...
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Surgical Approaches to Optic Disc Pit Maculopathy: A Clinical Case Series
In conclusion, all of these approaches for the surgical management of ODP-M were safe and effective. In this study, vitrectomy with endolaser was a good option for management of ODP-M.Case Rep Ophthalmol 2022;13:885 –891 (Source: Case Reports in Ophthalmology)
Source: Case Reports in Ophthalmology - November 17, 2022 Category: Opthalmology Source Type: research
Reactivation of Multifocal Choroiditis Associated with Treatment in Latent Tuberculosis
We present a case of the reactivation of bilateral multifocal choroiditis (MFC) in a patient with latent TB after commencing ATT. An asymptomatic 36-year-old Indian male was referred to an ophthalmologist with extensive inactive bilateral MFC close to his fovea despite no previous medical or ocular history. Latent TB was subsequently diagnosed via TB specific antigens and antibodies. After a period of stable observation without evidence of active eye or systemic disease, the patient was commenced on quadruple ATT with the aim of reducing the risk of visual loss with the MFC. However, after commencing treatment, MFC reactiv...
Source: Case Reports in Ophthalmology - November 16, 2022 Category: Opthalmology Source Type: research
Extensive Macular Atrophy with Pseudodrusen in a Japanese Patient Evaluated by Wide-Field OCTA
Extensive macular atrophy with pseudodrusen (EMAP) is a relatively newly proposed clinical entity that was first reported in 2009. Although no definitive diagnostic criteria have been defined, characteristic findings can distinguish it from other diseases, especially dry age-related macular dystrophy (AMD). Herein, we present the case of a patient with EMAP who underwent a comprehensive ophthalmic examination and whole-exome sequencing (WES). A 72-year-old Japanese man complained of progressive visual impairment in his right eye and nyctalopia. Ophthalmic examination revealed that the best-corrected visual acuity (BCVA) in...
Source: Case Reports in Ophthalmology - November 16, 2022 Category: Opthalmology Source Type: research
Retained Presumed Intraocular Cotton Fiber after Implantable Collemer Lens Implantation: A Case Report
In conclusion, cotton fibers are typically inert and usually do not lead to major complications. The decision of whether to surgically remove these fibers or not should only be made after weighing the benefits against the risks of such intervention. Recurrent inflammatory reactions or iridocyclitis related to the presence of cotton fibers could validate surgical intervention; however, the presence of cotton fibers solely does not necessitate early surgical removal.Case Rep Ophthalmol 2022;13:851 –855 (Source: Case Reports in Ophthalmology)
Source: Case Reports in Ophthalmology - November 16, 2022 Category: Opthalmology Source Type: research
Retinal Pigment Epithelial Detachment Associated with Immunoglobulin A Nephropathy: A Case Report
In conclusion, in IgA nephropathy, deposition of immune complexes on the RPE causes its inflammation, which may lead to PED. In cases of unexplained PED, the possibility of a systemic disea se as the cause should be considered.Case Rep Ophthalmol 2022;13:843 –850 (Source: Case Reports in Ophthalmology)
Source: Case Reports in Ophthalmology - November 10, 2022 Category: Opthalmology Source Type: research
