The Histopathological Finding of the Surgically Extracted Atypical Dome-Shaped Choroidal Osteoma

Purpose. To report a case of atypical dome-shaped choroidal osteoma, which was diagnosed by histopathological finding of surgically extracted tumor. Case Report. A 35-year-old woman presented with visual field abnormality in the left eye (OS). Her best-corrected visual acuity with Landolt ring chart was 1.0 OS. The funduscopic examination revealed a yellowish dome-shaped choroidal tumor located in the temporal side of the macula with exudative retinal detachment. 25-gauge pars plana vitrectomy and the extraction of the tumor were performed for the definitive diagnosis. Results. As a result of histopathological finding from the extracted tumor, she was diagnosed with choroidal osteoma. 10 months after the last surgery, the BCVA is 0.7 OS. The tumor is not relapsed. Conclusions. We must keep in mind that choroidal osteoma can be one of the differential diagnoses for the dome-shaped choroidal tumor.

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The Level of Cytokines in the Vitreous Body of Severe Proliferative Diabetic Retinopathy Patients Undergoing Posterior Vitrectomy

Current Pharmaceutical Design ◽

10.2174/1381612824666180926110704 ◽

2018 ◽

Vol 24 (27) ◽

pp. 3276-3281 ◽

Cited By ~ 3

Author(s):

Dorota Raczyńska ◽

Katarzyna A. Lisowska ◽

Krzysztof Pietruczuk ◽

Joanna Borucka ◽

Mateusz Ślizień ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Vitreous Body ◽

Control Group ◽

Slit Lamp ◽

Corrected Visual Acuity ◽

Cytokine Levels ◽

Pars Plana ◽

Eye Examination

Objective: The objective of the study was to compare cytokine levels in the vitreous body of patients with proliferative diabetic retinopathy (PDR) undergoing posterior vitrectomy. Patients and methods: The study included 39 patients (39 eyes) undergoing pars plana vitrectomy (PPV). Patients were divided into three groups: patients with proliferative diabetic retinopathy (PDR) without aflibercept injection prior to the surgery, PDR patients administered aflibercept injection prior to the surgery, and patients without diabetes mellitus (control group). All patients underwent a comprehensive eye examination one day before and 3 weeks after the surgery, including measurements of: best-corrected visual acuity (BVCA) and intraocular pressure (IOP), slit-lamp examination and spectral domain optical coherence tomography (SOCT). Concentrations of cytokines: IL-6, IL-8, IL-12p70, TNF, IL-10, IL-1β were measured in the vitreous body of patients with BD™ Cytometric Bead Array (CBA) Human Inflammatory Cytokines Kit. Results: PDR patients who received pretreatment with aflibercept injection showed significantly lower concentrations of IL-12p70, TNF, IL-10 and IL-1β in the vitreous body compared to the control group. Meanwhile, patients without prior aflibercept injection had a significantly higher concentration of IL-8. There was also a significant positive correlation between IOP before PPV and IL-8 concentration in both PDR patients’ groups. Conclusion: Findings of our study suggest an important role of IL-8 in the development of severe PDR. Aflibercept administration on the day before elective vitrectomy facilitated the surgery.

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Occupational eye hazard – a case of perforating industrial nail injury to the eye

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v15i1.164 ◽

2016 ◽

Vol 15 (1) ◽

pp. 43-46

Author(s):

Elin Lee ◽

Wagle Ajeet Madhav

Keyword(s):

Unusual Case ◽

Silicone Oil ◽

Posterior Pole ◽

Foreign Body Removal ◽

Corrected Visual Acuity ◽

Initial Injury ◽

Pars Plana ◽

Silicone Oil Tamponade ◽

Chinese Male ◽

Scleral Fixated Intraocular Lens

Purpose: To report the management and outcome of an unusual case of occupational perforating ocular industrial nail injury involving the posterior pole. Methods: Observational case report. A 48-year-old Chinese male construction worker presented with perforating industrial nail injury.Results: The patient underwent primary globe repair and foreign body removal followed by staged pars plana vitrectomy with endophotocoagulation and cyclopropane gas tamponade for repair of the vitreous incarceration at the posterior exit wound, a subsequent laser retinopexy with silicone oil tamponade for an inferior retinal detachment extending from the perforation site and finally silicone oil removal with a scleral fixated intraocular lens implant. His best-corrected visual acuity improved to 20/100 six months after the initial injury. Conclusion: Perforating ocular injuries involving the posterior pole often present with severe visual impairment and significant management challenges. We report a case of perforating ocular nail injury, which was managed successfully with staged surgical procedures.

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Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

Journal of Ophthalmology ◽

10.1155/2020/3742306 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Anan Wang ◽

Zhenquan Zhao

Keyword(s):

Surgical Approach ◽

Ultrasound Biomicroscopy ◽

Success Rates ◽

Corrected Visual Acuity ◽

Pars Plana ◽

The Difference ◽

Anatomical Success ◽

Anatomical Success Rate ◽

Cyclodialysis Cleft

Background. Various techniques have been described for repairing cyclodialysis clefts, but there is no consensus regarding the optimal treatment. This study investigated the clinical efficacy of a novel surgical approach that is used to manage traumatic cyclodialysis. Methods. We prospectively enrolled 7 patients (7 eyes) with traumatic cyclodialysis of the concomitant lens and other vitreous diseases. Ultrasound biomicroscopy was used to diagnose cyclodialysis, and all eyes underwent pars plana vitrectomy with air endotamponade. The main outcome measures were postoperative anatomical success rates, best-corrected visual acuity (BCVA), and intraocular pressure (IOP). Results. All patients were male, and their age ranged from 46 to 64 years (mean: 54.3 years). After the surgical intervention, the extent of the cyclodialysis cleft ranged from 1 to 4 clock hours (mean: 2.3 clock hours) and the detached ciliary body of all cases was completely restored; the anatomical success rate was 100%. The BCVA significantly increased from 1.40 ± 0.49 to 0.42 ± 0.31 (P = 0.002). The IOP increased from 8.91 ± 1.77 to 14.67 ± 6.38, but the difference was not significant (P = 0.056). The postoperative IOP of most patients was temporarily elevated or lowered after surgery. At the last follow-up, there were still two abnormal cases, including one with ocular hypertension and one with hypotony. Conclusions. This study revealed that vitrectomy with air endotamponade is an effective and minimally invasive alternative surgical approach for small traumatic cyclodialysis clefts.

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Effect of Bevacizumab Injection before Vitrectomy on Intravitreal Hemorrhage in Pseudophakic Patients with Proliferative Diabetic Retinopathy

Ophthalmology and Eye Diseases ◽

10.4137/oed.s12352 ◽

2013 ◽

Vol 5 ◽

pp. OED.S12352 ◽

Cited By ~ 5

Author(s):

Mehmet Demir ◽

Ersin Oba ◽

Efe Can ◽

Orhan Kara ◽

Sonmez Cinar

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Pars Plana Vitrectomy ◽

Intravitreal Bevacizumab ◽

Central Macular Thickness ◽

Intraoperative Bleeding ◽

Corrected Visual Acuity ◽

Pars Plana ◽

The Mean

We evaluated the effect of intravitreal bevacizumab (IVB) injection before pars plana vitrectomy (PPV) on intravitreal hemorrhage (VH) during and after vitrectomy for postoperative the first day and the first month in pseudophakic patients with proliferative diabetic retinopathy (PDR). This retrospective study was performed on 44 eyes of 44 patients who underwent vitrectomy for PDR. Patients were divided into PPV (n = 22 eyes) and PPV + IVB (n = 22 eyes) groups. Injection of bevacizumab (1.25 mg/0.05 mL) was performed 3 days before vitrectomy. Outcomes of visual acuity as well as intraoperative and postoperative VH were compared between the two groups. One month after surgery, visual acuity improved in PPV and PPV + IVB groups ( P = 0.005, P = 0.006), respectively. There was no difference between the two groups in best corrected visual acuity at baseline and after vitrectomy ( P = 0.71). Intraoperative bleeding into the vitreous was recorded in 14 (63.6%) cases in the PPV group and in 7 (31.8%) cases in the PPV + IVB group. The first month, intravitreal hemorrhage was recorded in six patients in the PPV group and in two patients in the PPV + IVB group ( P = 0.03). The mean pre-postoperative central macular thickness was similar in both groups. Intravitreal injection of IVB before vitrectomy decreased the rate of VH at the time of surgery and at the first postoperative month in patients with PDR.

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Repair of Traumatic Rhegmatogenous Retinal Detachment Combined with Congenital Falciform Retinal Detachment

Case Reports in Ophthalmology ◽

10.1159/000485550 ◽

2018 ◽

Vol 9 (1) ◽

pp. 55-59

Author(s):

Fukutaro Mano ◽

Kuo-Chung Chang ◽

Tomiya Mano

Keyword(s):

Retinal Detachment ◽

Patient Outcomes ◽

Rhegmatogenous Retinal Detachment ◽

Scleral Buckling ◽

Retrospective Case ◽

Hand Motion ◽

Corrected Visual Acuity ◽

Pars Plana Lensectomy ◽

Pars Plana

Purpose: To report a case of surgical repair of traumatic rhegmatogenous retinal detachment combined with congenital falciform retinal detachment (FRD). Methods: A retrospective case report. Results: A 36-year-old man with traumatic rhegmatogenous retinal detachment complicating a previously known FRD was successfully treated despite residual FRD following pars plana lensectomy, vitrectomy, and encircling scleral buckling. His best corrected visual acuity improved from hand motion at 50 cm to 20/1,000. Conclusion: We concluded that the root of the FRD is susceptible to trauma because of the contraction of fibrovascular tissue. The early intervention of modern vitrectomy to traumatic rhegmatogenous retinal detachment complicating a previously known FRD is an important consideration for enhanced quality of care and optimal patient outcomes.

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Retinoschisis in Coats Disease: Clinical Picture, Therapeutic Considerations, and Management Outcomes

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420954306 ◽

2020 ◽

pp. 247412642095430

Author(s):

Nathan L. Scott ◽

Linda A. Cernichiaro-Espinosa ◽

Jonathan F. Russell ◽

Timothy G. Murray ◽

Sander R. Dubovy ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Pigment ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Retinal Pigment Epithelial Cells ◽

Clinical Feature ◽

Exudative Retinal Detachment ◽

Corrected Visual Acuity ◽

Coats Disease ◽

Best Corrected Visual Acuity

Purpose: Retinoschisis in inflammatory and exudative retinopathy is a known but rare entity. We describe the presentation and clinical and surgical outcomes of a series of patients with retinoschisis in the setting of Coats disease. Methods: This retrospective case series of patients with Coats disease recorded visual acuity and the number and type of treatments (eg, angiography-guided photocoagulation, intravitreal bevacizumab, sub-Tenon triamcinolone, or vitreoretinal surgery). Results: Eighteen of 133 patients with Coats disease were diagnosed with retinoschisis by color imaging. All (100%) of the areas of schisis or macrocyst were associated with dense subretinal exudation, whereas only 7 (38.8%) were associated with exudative retinal detachment. Initial best-corrected visual acuity in the schisis cohort was 1.14 ± 1.19 (Snellen equivalent, 20/276) vs 1.42 ± 1.40 (Snellen, 20/526) in those without ( P = .56). Final best-corrected visual acuity was 1.76 ± 1.37 (Snellen, 20/1150) and 1.45 ± 1.44 (Snellen, 20/563), respectively ( P = .43). The mean number of treatments in individuals with schisis was 4.8 ± 2.9 for angiography-guided photocoagulation, 4.5 ± 2.9 for intravitreal bevacizumab, and 1.7±1.2 for sub-Tenon triamcinolone. Intraocular surgery was required in 39% (7 of 18) of patients with schisis vs 22% (25 of 115) for patients without schisis ( P = .14). One eye required enucleation, and histopathology of the schisis pocket was obtained. Conclusions: The pathophysiology of retinoschisis in Coats disease is not completely understood. We propose that telangiectatic leakage, hypoxia, and toxicity to the retinal pigment epithelial cells play a role in cavity development, and therefore may represent a clinical feature of advanced or uncontrolled disease.

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Endophthalmitis after dropless (Tri-Moxi injection) cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672119852505 ◽

2019 ◽

Vol 30 (5) ◽

pp. NP29-NP31 ◽

Cited By ~ 1

Author(s):

Caleb Ng ◽

Kakarla V Chalam

Keyword(s):

Cataract Surgery ◽

Staphylococcus Epidermidis ◽

Vision Loss ◽

Hand Motion ◽

Corrected Visual Acuity ◽

Case Summary ◽

Keratic Precipitates ◽

Vitreous Sample ◽

Severe Vision Loss ◽

Pars Plana

Introduction: A case of endophthalmitis after dropless cataract surgery with intravitreal Tri-Moxi associated with severe vision loss. Case summary: An 82-year-old male developed severe vision loss in the left eye 24 days after dropless cataract surgery with intravitreal Tri-Moxi injection. Best corrected visual acuity was hand motion in the left eye. Intraocular pressure was 13, with inferior keratic precipitates, 4 + cell with 1 mm layered hypopyon, and a plaque on the posterior capsule that blocked direct exam of the posterior segment. Ultrasonography revealed extensive vitritis without retinal or choroidal detachments. Conclusion: Endophthalmitis resolved and vision improved after management with vitreous tap, intravitreal and fortified topical antibiotics, and subsequent prompt pars plana vitrectomy. Vitreous sample grew fluoroquinolone-resistant staphylococcus epidermidis.

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Ocriplasmin in the Treatment of Vitreomacular Traction in a Patient with Central Retinal Vein Occlusion: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000491487 ◽

2018 ◽

Vol 9 (2) ◽

pp. 357-364

Author(s):

Alessandra Rosati ◽

Raffaele Antonio Esposito ◽

Giuseppe Mannino ◽

Gianluca Scuderi

Keyword(s):

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Vitreomacular Traction ◽

Treatment Results ◽

Vein Occlusion ◽

Corrected Visual Acuity ◽

Before And After ◽

Pars Plana ◽

Central Retinal Vein

Aim: To investigate the efficacy of intravitreal injection of ocriplasmin (JETREA®) in the treatment of vitreomacular traction (VMT). Materials and Methods: An 81-year-old man with VMT associated with central retinal vein occlusion in his left eye, was treated with a single intravitreal injection of ocriplasmin (25 μg). Best corrected visual acuity (BCVA), ocular fundus, and optical coherence tomography were examined before and after treatment. Results: Complete release of VMT produced a reduction of central macular thickness, ranging from 459 to 141 μm. BCVA remained stable. Discussion and Conclusions: The use of ocriplasmin was effective in the treatment of VMT. Ocriplasmin represents a valid alternative to conventional pars plana vitrectomy.

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Cluster endophthalmitis due to Stenotrophomonas maltophilia following intravitreal bevacizumab: outcomes of patients from North India

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313131 ◽

2018 ◽

Vol 103 (9) ◽

pp. 1278-1283 ◽

Cited By ~ 2

Author(s):

Aniruddha Kishandutt Agarwal ◽

Kanika Aggarwal ◽

Ramanuj Samanta ◽

Archana Angrup ◽

Manisha Biswal ◽

...

Keyword(s):

Stenotrophomonas Maltophilia ◽

Anterior Segment ◽

Intravitreal Bevacizumab ◽

North India ◽

Positive Staining ◽

Corrected Visual Acuity ◽

Persistent Inflammation ◽

Pars Plana ◽

Toxic Anterior Segment Syndrome ◽

Culture Positive

PurposeTo study features, management and outcomes of cluster endophthalmitis following intravitreal bevacizumab (BCZ) injection in North India.MethodsIn this retrospective study, 28 patients (23 men) (mean age of 59.07±13 years) who received intravitreal injection of BCZ were included. Demographic details, best corrected visual acuity (BCVA), clinical features, microbiological findings and management of patients who developed endophthalmitis after injection of contaminated BCZ injections were reviewed. The organism isolated was Stenotrophomonas maltophilia.ResultsAll patients suffered from painful diminution of vision within 24–48 hours. Of the 28 eyes, 12 had lid and corneal oedema, raised intraocular pressure (IOP) (difference between mean preinjection and postinjection IOP: 4.42 mm Hg; p=0.005) and toxic anterior segment syndrome-like picture. 16 eyes presented with clear cornea, severe vitritis and poor media clarity. Among these, three eyes showed posterior hypopyon. Seventeen eyes underwent primary pars plana vitrectomy (PPV) and intravitreal vancomycin+ceftazidime based on severity of inflammation. Eleven eyes underwent primary tap and inject. Among these, four eyes required PPV due to persistent inflammation. Eleven eyes showed positive staining for Gram-negative bacilli. Seven eyes were culture positive for S. maltophilia. Mean preinjection BCVA was 0.77±0.48. The first recorded postinjection BCVA was 2.52±0.82. BCVA (at 1 month) improved to 0.88±0.66.ConclusionsS. maltophilia can be found contaminating hospital surfaces and water supply. Early PPV, prompt intravitreal antibiotics and close communication with microbiologists greatly aided in salvaging all eyes from our cohort. Majority of the patients recovered their preinjection BCVA and IOP and achieved quiescence of inflammation.

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The Comparison of the Surgical Outcome for the Full-Thickness Macular Hole with/without Lamellar Hole-Associated Epiretinal Proliferation

Journal of Ophthalmology ◽

10.1155/2017/9640756 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Yuri Ubukata ◽

Hisanori Imai ◽

Keiko Otsuka ◽

Masaya Nishizaki ◽

Rumiko Hara ◽

...

Keyword(s):

Macular Hole ◽

Surgical Outcome ◽

Full Thickness ◽

External Limiting Membrane ◽

Minimum Diameter ◽

Corrected Visual Acuity ◽

Full Thickness Macular Hole ◽

Pars Plana ◽

The Mean ◽

Lamellar Hole

Aims. To compare the surgical outcome of pars plana vitrectomy (PPV) for full-thickness macular hole (FTMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Methods. This retrospective study included 158 eyes of 158 patients with FTMH treated with PPV. The following variables were analyzed: sex, age, preoperative best corrected visual acuity (pre-BCVA), BCVA 6 months after the surgery (6M-BCVA), the axial length of eye, the minimum diameter of FTMH, the diameter of basal side of FTMH, postoperative continuity of subfoveal ellipsoid zone (EZ) and external limiting membrane (ELM), and the preoperative presence of LHEP. Results. Twenty-eight eyes had FTMH with LHEP and 130 without LHEP. The mean ± SD age (years) was 72.6 ± 7.9 and 68.6 ± 8.7, respectively (p=0.02). 6M-BCVA was 0.38 ± 0.30 and 0.26 ± 0.25, respectively (p=0.03). The diameter of basal side of FTMH (μm) was 901.5 ± 404.9 and 658.9 ± 288.1, respectively (p=0.00027). EZ was disrupted in 24 eyes and 63 eyes, respectively (p=0.00071). ELM was disrupted in 15 eyes and 23 eyes, respectively (p=0.00015). The FTMH diameters and the presence of LHEP were inversely correlated with the continuity of EZ and ELM. Conclusion. The preoperative appearance of LHEP could be one of the prognostic factor for the treatment of FTMH.

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