Coats retinopathy with pachychoroid and central serous chorioretinopathy in the fellow eye

2020 ◽  
Vol 13 (7) ◽  
pp. e235588
Author(s):  
Subhakar Reddy ◽  
Sumit Randhir Singh ◽  
Avinash Pathengay ◽  
Padmaja Kumari Rani

A 37-year-old man presented with blurring of vision and scotoma in the left eye since last 2 weeks and has a history of poor vision in his right eye since childhood. On examination, his best corrected visual acuity in the right eye was counting finger 1 m and 20/20, N/12 in the left eye. Fundus examination revealed features of Coats disease in the right eye and central serous chorioretinopathy (CSCR) in the left eye. He was given intravitreal triamcinolone acetonide injection in the right eye for reducing subretinal exudation. Simultaneously, focal laser photocoagulation was done to the CSCR leaks in the left eye to prevent the possible worsening of CSCR due to steroid injection in the fellow eye. He underwent cryotherapy to the retinal telangiectatic vessels 3 weeks after steroid injection in the right eye. Optical coherence tomography (OCT) of both eyes showed pachy vessels with a compression of overlying choriocapillaries. After 1 month, the condition of the right eye was unchanged and the CSCR in the left eye was completely resolved with the recovery of near visual acuity.

Author(s):  
Mojtaba Abrishami ◽  
Seyedeh Maryam Hosseini ◽  
Solmaz Momtahen ◽  
Ghodsieh Zamani

Abstract Purpose To report a patient with impaired vision due to foveal involvement of toxoplasmic retinochoroiditis, who was successfully treated with intravitreal clindamycin and dexamethasone and oral therapy with azithromycin, trimethoprim-sulfamethoxazole, and prednisolone and led to successful visual and anatomic recovery. Case presentation A 32-year-old man presented with three-day history of gradually decreasing visual acuity, redness, pain and photophobia of the right eye. Anterior chamber cellular reaction, vitritis and a white retinochoroiditis patch with adjacent retinal vasculitis in the fovea was suggestive of the toxoplasmic retinochoroiditis. He was treated with intravitreal clindamycin and dexamethasone injection followed by six-week regimen of azithromycin, trimethoprim-sulfamethoxazole, and prednisolone. In serial optical coherence tomography imaging, retinitis patch changed to cavitary foveal destruction. Fovea reorganized gradually, and visual acuity concurrently improved from counting finger 3 m to 20/25. Conclusion In foveal toxoplasmic retinochoroiditis lesions, timely treatment is associated with retinal reorganization and visual improvement.


2021 ◽  
Author(s):  
Mojtaba Abrishami ◽  
Seyedeh Maryam Hosseini ◽  
Solmaz Momtahen ◽  
Ghodsieh Zamani

Abstract Purpose: To report a patient with impaired vision due to foveal involvement of toxoplasmic chorioretinitis, who was successfully treated with intravitreal and oral therapy and led to successful visual and anatomic recovery.Case presentation: A thirty two-year-old man presented with three-day history of gradually decreasing visual acuity, redness, pain and photophobia of the right eye. Anterior chamber cellular reaction, vitritis and a white retinochoroiditis patch with adjacent retinal vasculitis in the fovea was suggestive of the toxoplasmic chorioretinitis. He was treated with intravitreal Clindamycin and Dexamethason injection followed by six-week regimen of Azithromycine, Trimethoprim-Sulfamethoxazole, and Prednisolone. In serial optical coherence tomography imaging, retinitis patch changed to cavitary foveal destruction. Fovea was regenerated gradually, and visual acuity was concurrently improved from counting finger 3m to 20/25. Conclusion: In foveal toxoplasmic chorioretinitis lesions, timely treatment is associated with retinal regeneration and visual improvement.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.


2020 ◽  
pp. 112067212096205
Author(s):  
Erol Havuz ◽  
Seda Güdül Havuz

Background: Lyme disease, caused by Borrelia burgdorferi, is a spirochetal disease. Lyme disease-related ocular findings may also provide important clues. Ocular involvement is most commonly seen as uveitis, chorioretinitis, conjunctivitis, keratitis, episcleritis, papillitis, panuveitis, ischemic optic neuropathy, papilledema, and retinal vasculitis. Case: A 27-year-old male patient was admitted with a history of fatigue, malaise, and sudden loss of vision in his left eye for 3 days. The best visual acuity was found 20/20 in the right eye and 20/400 in the left eye. Fluorescein fundus angiography showed no pathological findings in the right eye; but hyperfluorescence that was compatible with choroiditis foci was seen in the left eye. Optical coherence tomography (OCT) showed choroidal thickening in the left eye compared to the right eye. Lyme IgM antibody was found to be positive, explaining choroiditis etiology, while IgG values were found to be negative. Western blot verification test was positive. The patient was treated with 2 × 100 mg doxycycline (21 days) with a diagnosis of Lyme disease, prednol 1 mg/kg/day (10 days) for choroiditis. Omeprazole tablets were given 1 × 1 during the period of cortisone intake. On the third day of treatment, visual acuity increased to 20/200 and continued to increase until reaching 20/20 in the second week. Conclusions: Lyme disease is rare, but must be kept in mind when investigating the etiology of chorioretinitis and retinal vasculitis. The patient reported here is, to our knowledge, the second case reported in literature that shows atypical clinic for Lyme disease with unilateral chorioretinitis without Erythema chronicum migrans (ECM).


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Khalid Al Rubaie ◽  
Juan V. Espinoza ◽  
Andres F. Lasave ◽  
Dario Savino-Zari ◽  
Fernando A. Arevalo ◽  
...  

Objective. To report the visual and anatomic outcomes of pneumatic displacement with perfluoropropane (C3F8) gas and intravitreal tissue plasminogen activator (IVTPA) for subretinal subfoveal hemorrhage after focal laser photocoagulation in central serous chorioretinopathy (CSCR).Method. Interventional, retrospective case report of one eye (one patient). Outcome measures included visual acuity (VA), central macular thickness (CMT), and size of the lesion at two weeks of followup. Fluorescein angiography (FA) and optical coherent tomography (OCT) were used to measure anatomic outcomes.Results. A 35-year-old man with history of chronic CSCR received focal laser photocoagulation in the right eye two days before presentation. At initial examination, VA was 20/200 (ETDRS chart), CMT was 398 μ, and a subretinal subfoveal hemorrhage was seen. Tissue plasminogen activator (tPA) at a dose of 25 µg/0.1 mL was injected intravitreally before intravitreal C3F8 injection, and prone positioning was indicated postoperatively. At 24 hours, the hemorrhage had been displaced inferiorly and VA improved to 20/100. Two weeks later, VA improved to 20/80, CMT decreased to 225 μ, and the hemorrhage decreased without foveal involvement.Conclusions. The technique seems safe and effective in treating visually significant subretinal subfoveal hemorrhage.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ruoyan Wei ◽  
Meiyan Li ◽  
Weiming Yang ◽  
Haipeng Xu ◽  
Joanne Choi ◽  
...  

Purpose: To report the clinical outcomes of phototherapeutic keratectomy (PTK) for pediatric band keratopathy after treatment for retinoblastoma.Methods: A 5-year-old boy presented with a 2-year history of poor visual acuity and a horizontal gray-white band across the central cornea in the right eye. He was diagnosed with band keratopathy after chemo-laser-cryotherapy for retinoblastoma. The band keratopathy was treated via PTK using the Mel-90 excimer laser with an optical treatment zone of 7.0 mm and ablation depth of 120 μm. The patient was followed at 1 week and 3 months postoperatively.Results: Surgery and postoperative follow-up were uneventful. At the 3-month follow-up, the uncorrected distant visual acuity of the right eye improved to 20/125, and the corrected distance visual acuity improved to 20/70 with a refraction of +10.00 D/−2.50 DC × 15. The clarity of the ablated area was evidently improved. The central corneal thickness decreases from 612 to 584 μm. The optical coherence tomography showed the thin band of hyperreflectivity in the ablated area disappeared, corneal transparency improved and the corneal surface smoothened.Conclusions: PTK is a safe and effective procedure to treat band keratopathy following treatment of retinoblastoma in children. Early intervention can reduce the risk of developing deprivation amblyopia.


Author(s):  
Hoon Dong Kim

Abstract Purpose To present a case of activation of Leber hereditary optic neuropathy (LHON) following head and ocular trauma of the fellow eye in the patient with no remarkable symptoms and normal visual acuity prior to trauma. Case summary A 31-year-old healthy man was referred to our hospital after a traffic accident. He had blowout fractures of medial and inferior orbital wall of the left eye, subcutaneous hematoma of the left forehead, and bony fragment that compressed the left optic nerve. Initially, best-corrected visual acuity (BCVA) was 20/20 in the right and 20/1000 in the left eyes. Relative afferent pupillary defect of the left eye was apparent, and fundus examination revealed choroidal rupture circumferentially crossing the macular area. Nine months later, the patient complained with gradual vision loss in the right eye, which was the contralateral eye of the ocular trauma. BCVA was 20/200, and perimetry revealed cecocentral scotoma in the right eye. BCVA in both eyes reduced to 20/2000 1 year post-trauma. Visual evoked potentials revealed markedly decreased in amplitudes and elongated latencies for both eyes. Mitochondrial DNA analysis revealed a G11778A mutation; therefore, a diagnosis of activation of LHON followed by trauma was made for the previously unaffected carrier. Conclusions This is a case in which activation of LHON occurred in a healthy carrier following head and ocular trauma of the fellow eye. This observation suggests the possibility that LHON activation in healthy carriers may occur in patients who experience head or ocular trauma even in the fellow eye.


2020 ◽  
Author(s):  
Meghana Kalavar ◽  
Nimesh A Patel ◽  
Hasenin Al-Khersan ◽  
Anibal Ale ◽  
Nicolas A Yannuzzi ◽  
...  

Abstract Background A 36-year-old woman with a history of poorly controlled diabetes was diagnosed with probable Vogt-Koyanagi-Harada (VKH). We are reporting the use of intravitreal triamcinolone acetonide (0.4 mg) to both eyes to successfully treat the ocular manifestations of VKH.Findings Nine days after injection, subretinal fluid in the right eye improved and 13 days later, the serous detachment had almost completely resolved. One month after injections, both the right and left eye showed decreased leakage and fewer punctate lesions on fluorescein angiography. Ocular examination remained stable other than development of ocular hypertension bilaterally, which was treated with topical hypertensive drops. Two years later, patient developed a cataract in the right eye, for which the patient underwent phacoemulsification. Three years after treatment, visual acuity remains 20/20 while imaging studies and bilateral full field electroretinogram remained normal.Conclusion Intravitreal steroids can be considered as treatment in VKH in situations where systemic corticosteroids are contraindicated, such as patients with a history of poorly controlled diabetes. Complications of local steroids need to be carefully considered, even after a single injection. In some patients short-term treatment of VKH with local corticosteroid may result in long-term visual stability.


Author(s):  
Marouen Berguiga ◽  
Alain Saad

ABSTRACT Purpose To report a case of post-LASIK unilateral corneal ectasia. Setting Department of anterior segment and Refractive surgery, Rothschild Foundation, Paris. Case report A 33-year-old woman was referred with a history of unilateral post-LASIK ectasia in her left eye, 18 months post operatively. Her best-corrected visual acuity was 20/20 with a manifest refraction of +1.75 (–4.75 × 90). Orbscan ii® revealed an inferior steepening associated with irregular astigmatism. The preoperative Placido topographies revealed a slight skewed radial axis in the right eye associated with an inferior-superior keratometry difference of 1.6 Diopters at 3 mm. in the left eye that developed ectasia, regular symmetric astigmatism was present. Uncorrected visual acuity improved to 20/25 2 weeks after keraRing® segment insertion. How to cite this article Berguiga M, saad a, Gatinel D. Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a slight asymmetry in the Contralateral Eye. int J kerat Ect Cor Dis 2014;3(1):47-51.


2021 ◽  
Vol 14 (2) ◽  
pp. e238936
Author(s):  
Sucheta Parija ◽  
Koyel Chakraborty

Retinitis pigmentosa (RP) patients are at higher risk for macular oedema, anterior capsular phimosis and spontaneous dislocation of the implanted lens after cataract surgery. A 70-year-old hypertensive woman presented with diminution of vision in her left eye since 2 years. She had history of cataract surgery in the right eye 1 year ago. Her visual acuity was 20/200 in right eye and hand movements in left eye. Slit-lamp examination showed anterior capsular phimosis with intraocular lens in the right eye and pseudoexfoliation in both the eyes. Fundus examination revealed features of RP in both the eyes. Optical coherence tomography showed bilateral foveal atrophy. The patient underwent phacoemulsification cataract surgery with intraocular lens implantation in left eye and Nd:YAG laser capsulotomy in right eye. Postoperative best corrected distance visual acuity was 20/125 in right eye and 20/80 in left eye. This case highlights a rare coincidence of pseudoexfoliation syndrome in a patient with RP and the precautions undertaken during cataract surgery for an optimal visual outcome.


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