scholarly journals Spontaneous Necrosis of a Large Choroidal Melanoma: Unusual Presentation in a 49-Year-Old Male

2019 ◽  
Vol 6 (3) ◽  
pp. 174-179
Author(s):  
Carmen Baumann ◽  
Danilo Iannetta ◽  
Sarah E. Coupland ◽  
Carl Groenewald ◽  
Mandagere Vishwanath ◽  
...  
Keyword(s):  
Choroidal Melanoma ◽  
Vitreous Haemorrhage ◽  
Tumour Mass ◽  
Mixed Cell ◽  
Ocular Tissues ◽  
Complete Lysis ◽  
Pars Plana ◽  
The Right ◽  
Good Vision ◽  
Viable Tumour

Purpose: To demonstrate a case of massive vitreous haemorrhage obscuring the underlying diagnosis of a large mixed-cell choroidal melanoma which had undergone spontaneous necrosis. Case Report: A 49-year-old man in good general health suddenly lost vision in his right eye due to an extensive vitreous haemorrhage 1 day after a workout at the gym. He reported good vision prior to that without any symptoms of flashes, floaters, or shadows. He was referred to the vitreoretinal department of a tertiary eye hospital, where he presented with a drop in vision to light perception only in the right phakic eye. Pars plana vitrectomy was performed in the right eye, which revealed intraoperatively massive retinal ischemia and choroidal haemorrhage, but no obvious tumour mass that could have been biopsied. The vitrectomy cassette specimen was sent for histopathology, where “ghost-like” melanoma cells were identified. The eye was subsequently enucleated, revealing an extensively necrotic and haemorrhagic choroidal melanoma of mixed cell type with only small viable tumour foci at the base and almost complete lysis of the detached retina. Conclusion: Some uveal melanomas (UMs) undergo spontaneous necrosis due to rapid growth, with the centre of the tumour outstripping its established blood supply in the “watershed area” of the eye, and becoming hypoxic with associated necrosis of intraocular structures. Such UMs are often associated with haemorrhage and/or inflammation and usually cause significant destruction of ocular tissues, resulting in enucleation as the only treatment option.

Plaque brachytherapy for choroidal melanoma with vitreous haemorrhage: a therapeutic challenge

2021 ◽  
Vol 14 (4) ◽  
pp. e240935
Author(s):  
Subina Narang ◽  
Awadhesh Kumar Pandey ◽  
Mannat Giran ◽  
Ravinder Kaur
Keyword(s):  
Pars Plana Vitrectomy ◽  
Choroidal Melanoma ◽  
Cataract Extraction ◽  
Posterior Pole ◽  
Vitreous Haemorrhage ◽  
Relative Afferent Pupillary Defect ◽  
Contrast Enhanced ◽  
Pars Plana ◽  
Definitive Management ◽  
Plaque Brachytherapy

A 47-year-old man presented with profound loss of vision in right eye and relative afferent pupillary defect. On fundus examination, posterior pole details were obscured due to dense vitreous haemorrhage. B-scan ultrasonography was performed that revealed a mushroom-shaped hyperechoic lesion with medium internal reflectivity on A-scan ultrasonography. After performing contrast-enhanced MRI of the orbit, a diagnosis of choroidal melanoma was established. Patient was managed using plaque brachytherapy based on multiplanar MRI. This was followed 10 months later by pars plana vitrectomy and cataract extraction. Vision postoperatively improved to 20/60. A systematic clinical assessment along with supportive ancillary investigations augments diagnostic accuracy and reduces delay in definitive management.

scholarly journals Vitreous haemorrhage caused by unusual giant macular tear: a case report

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095949
Author(s):  
Chunling Lei ◽  
Li Chen
Keyword(s):  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Vitreous Haemorrhage ◽  
Partial Restoration ◽  
Vein Occlusion ◽  
Pars Plana ◽  
The Right

Macular tears rarely occur without trauma. Here, we describe a patient with vitreous haemorrhage, which was caused by an unusual giant macular tear secondary to existing branch retinal vein occlusion. A 60-year-old woman presented with vision loss in the right eye because of vitreous haemorrhage. She had a history of branch retinal vein occlusion and had been treated with retinal photocoagulation 3 years prior. As treatment for vitreous haemorrhage, the patient underwent 23-gauge pars plana vitrectomy combined with silicone oil tamponade. During the operation, a large jagged tear was observed in the macula. We presumed that stretching of the fibrous proliferating membrane secondary to branch retinal vein occlusion was responsible for the macular tear and vitreous haemorrhage. Eventually, the results of pars plana vitrectomy led to anatomical closure of the macular tear and partial restoration of visual acuity.

scholarly journals Choroidal Nevus and Melanoma in Patients with Oculocutaneous Albinism

2019 ◽  
Vol 6 (1) ◽  
pp. 31-34
Author(s):  
Pukhraj Rishi ◽  
Mihir Trivedi ◽  
Kummamuri Sreelakshmi
Keyword(s):  
Histopathological Examination ◽  
Choroidal Melanoma ◽  
Case Series ◽  
Oculocutaneous Albinism ◽  
Large Tumor ◽  
Mixed Cell ◽  
Asian Patients ◽  
Melanocytic Lesions ◽  
Choroidal Nevus ◽  
The Right

Background: There are limited reports of uveal “melanocytic” lesions in patients with oculocutaneous albinism, with no reports from Asia. Objectives: In this study, we report 3 eyes with uveal “melanocytic” lesions in Asian patients with oculocutaneous albinism. Methods: Retrospective small case series. Three eyes of 2 Asian patients with oculocutaneous albinism were included. Case 1 was a 54-year-old female who presented with juxtapapillary choroidal melanoma and underwent enucleation. Case 2 was a 39-year-old male with pigmented choroidal nevus in the right eye and suspicious nevus/choroidal variegation in the left eye. Results: For case 1, metastatic workup including ultrasound of the abdomen, liver function test, and chest X-ray was unremarkable. Magnetic resonance imaging of the cranium ruled out extraocular extension. The left eye was enucleated due to the large tumor size and poor visual potential, and histopathological examination confirmed the diagnosis of choroidal melanoma with mixed cell type. At the last follow-up 6 months after enucleation, there was no evidence of metastasis. Case 2 was observed. Conclusion: Pigmented choroidal nevus and melanoma are rarely observed in patients with oculocutaneous albinism.

Venous-air embolism during vitrectomy for endoresection of choroidal melanoma: Case report

2021 ◽  
pp. 112067212199510
Author(s):  
Miroslava Paolah Meraz Gutiérrez ◽  
Efrain Jose Camara Rodriguez ◽  
Alejandra Pando Cifuentes ◽  
Grecia Yael Ortiz-Ramirez ◽  
Vidal Soberón Ventura
Keyword(s):  
Vision Loss ◽  
Choroidal Melanoma ◽  
Air Embolism ◽  
Orotracheal Intubation ◽  
Venous Air Embolism ◽  
Vascular Arcade ◽  
Pars Plana ◽  
The Right ◽  
Melanoma Case

Introduction: The purpose of this study is to report a case of venous-air embolism during a vitrectomy for endoresection of choroidal melanoma. Case description: A 31-year-old man went to the clinic because of photopsias and vision loss in his right eye. On fundoscopy of the right eye, a choroidal mass with an associated retinal detachment was found near the inferotemporal vascular arcade. Multimodal imaging was performed and diagnosis of choroidal melanoma was made. Metastatic workup ruled out systemic extension. The patient underwent pars plana vitrectomy for endoresection of the lesion. During the application of laser under air, he started complaining of chest pain and dyspnea. He presented signs of supraventricular tachycardia, tachypnea, hypotension and oxygen desaturation. He was managed with orotracheal intubation, bronchodilators and vasopressor support, and stabilization was achieved. He was discharged 2 days after with no sequalae. After 1-year of follow-up, the patient has a visual acuity of counting fingers and no signs of tumor recurrence or systemic extension. Conclusions: Although rare, vitreoretinal surgeons should be aware of this potentially fatal complication and take steps to prevent it.

scholarly journals Meningitis as a recurrent manifestation of anti-AQP4/anti-MOG negative neuromyelitis optica spectrum disorder: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chenyang Zhang ◽  
Kang Zhang ◽  
Bing Chen ◽  
Jiao Yin ◽  
Miaomiao Dong ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Area Postrema ◽  
Neurological Diseases ◽  
Brain Magnetic Resonance Imaging ◽  
Transverse Myelitis ◽  
Corticosteroid Treatment ◽  
Neck Stiffness ◽  
Mixed Cell ◽  
Glucose Levels ◽  
The Right

Abstract Background Neuromyelitis optica spectrum disorders (NMOSD), a group of autoimmune neurological diseases, involve the optic nerve, spinal cord, and brain. Meningitis is rarely reported as the primary clinical manifestation of both anti-aquaporin-4 (AQP4)/ anti-myelin oligodendrocyte glycoprotein (MOG) antibody-negative NMOSD (NMOSDneg). Case presentation A 30-year-old man initially presented with fever, headache, and neck stiffness. Lumbar puncture revealed mixed cell reaction and decreased glucose levels. As a result, tuberculous meningitis was suspected. After 1 month, the patient developed longitudinally extensive transverse myelitis and area postrema syndrome. This was followed by the presentation of meningitis-like symptoms once again in the third attack, but his condition eventually improved after corticosteroid treatment without relapse for 2 years. However, he was readmitted to our hospital owing to symptoms of diplopia, hiccup, and numbness in the right hand. Brain magnetic resonance imaging (MRI) revealed that the area postrema still contained lesions. Spinal MRI revealed several segmental enhancements at the C4–C5, T1, and T5 levels. Anti-AQP4 and anti-MOG antibodies were persistently absent in the serum and cerebrospinal fluid (CSF). The patient was finally diagnosed with NMOSDneg. Conclusions Meningitis could be a recurrent manifestation of NMOSDneg and requires more careful evaluation.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

scholarly journals Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aluisio Rosa Gameiro Filho ◽  
Guilherme Sturzeneker ◽  
Ever Ernesto Caso Rodriguez ◽  
André Maia ◽  
Melina Correia Morales ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Serous Retinal Detachment ◽  
Central Nervous System Involvement ◽  
Choroidal Melanoma ◽  
Posterior Pole ◽  
Pancreatic Metastasis ◽  
Small Areas ◽  
History Of ◽  
The Right

Abstract Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.

scholarly journals Identification of Diagnostic and Prognostic microRNAs for Recurrent Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (12) ◽  
pp. 2217 ◽  
Author(s):  
Parviz Mammadzada ◽  
Juliette Bayle ◽  
Johann Gudmundsson ◽  
Anders Kvanta ◽  
Helder André
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Control Group ◽  
Ocular Tissues ◽  
Recurrent Hemorrhage ◽  
Pars Plana ◽  
And Control ◽  
Insight Into ◽  
Recurrent Vitreous Hemorrhage

MicroRNAs (miRNAs) can provide insight into the pathophysiological states of ocular tissues such as proliferative diabetic retinopathy (PDR). In this study, differences in miRNA expression in vitreous from PDR patients with and without incidence of recurrent vitreous hemorrhage (RVH) after the initial pars-plana vitrectomy (PPV) were analyzed, with the aim of identifying biomarkers for RVH. Fifty-four consented vitreous samples were analyzed from patients undergoing PPV for PDR, of which eighteen samples underwent a second surgery due to RVH. Ten of the sixty-six expressed miRNAs (miRNAs-19a, -20a, -22, -27a, -29a, -93, -126, -128, -130a, and -150) displayed divergences between the PDR vitreous groups and to the control. A significant increase in the miRNA-19a and -27a expression was determined in PDR patients undergoing PPV as compared to the controls. miRNA-20a and -93 were significantly upregulated in primary PPV vitreous samples of patients afflicted with RVH. Moreover, this observed upregulation was not significant between the non-RVH and control group, thus emphasizing the association with RVH incidence. miRNA-19a and -27a were detected as putative vitreous biomarkers for PDR, and elevated levels of miRNA-20a and -93 in vitreous with RVH suggest their biomarker potential for major PDR complications such as recurrent hemorrhage incidence.

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

A case of air pollution-induced Valsalva retinopathy

2021 ◽  
Vol 3 (2) ◽  
pp. 107-112
Author(s):  
Yii Hern Eng ◽  
Ing Hong Lim
Keyword(s):  
Pars Plana Vitrectomy ◽  
Sudden Onset ◽  
Vitreous Haemorrhage ◽  
Medical Illness ◽  
Effective Treatment Option ◽  
Valsalva Retinopathy ◽  
Haze Pollution ◽  
Persistent Cough ◽  
Pars Plana ◽  
Visual Acuity Loss

This is a case of Valsalva retinopathy during the season of annual transboundary haze pollution in Sarawak. A 22-year-old man with no known medical illness developed sudden onset of painless visual acuity loss preceded by persistent cough. Left eye fundus showed dense preretinal haemorrhage covering optic disc extendinginferiorly with breakthrough vitreous haemorrhage. The patient underwent pars plana vitrectomy, endolaser, and fluid gas exchange in view of persistent dense vitreous haemorrhage after a month of conservative management. In conclusion, pars plana vitrectomy can be considered as a safe and effective treatment option for patients with Valsalva retinopathy developing extensive premacular haemorrhage.

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