Intraocular schwannoma with extrascleral extension

2020 ◽  
pp. 112067212092021
Author(s):  
Sanika Udyaver ◽  
Li-Anne S Lim ◽  
Tatyana Milman ◽  
Arman Mashayekhi ◽  
Jerry A Shields ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Ultrasound Biomicroscopy ◽  
Orange Pigment ◽  
Neoplastic Processes ◽  
Benign Schwannoma ◽  
S 100 ◽  
History Of ◽  
The Right

Purpose To report a rare case of intraocular schwannoma with extrascleral extension in a patient with juvenile idiopathic arthritis and to review the literature for this topic. Methods Case report. Results A 19-year-old male with a history of juvenile idiopathic arthritis was referred for diagnosis and management of an episcleral mass, initially thought to be focal nodular scleritis. The ocular surface of the right eye revealed an elevated amelanotic episcleral nodule inferonasally, with thin strands of overlying sclera, feeding episcleral vessels, and measuring 11 mm × 11 mm in diameter and 5 mm in thickness. Ophthalmoscopic examination revealed a minimally pigmented ciliochoroidal tumor measuring 13 mm in diameter and 11.4 mm in total thickness and without associated subretinal fluid, orange pigment, or drusen. Ultrasound biomicroscopy and anterior-segment optical coherence tomography confirmed a solid mass with scleral disruption and extraocular extension. Shave biopsy revealed palisading spindle cells and interspersed eosinophilic fibrillary cytoplasmic processes, forming Verocay bodies. The specimen stained positive for S-100 and negative for Melan-A, consistent with benign schwannoma. Observation was recommended. Conclusion Intraocular schwannoma is a rare, benign uveal tumor that can demonstrate extrascleral extension, mimicking inflammatory and malignant neoplastic processes. Clinical diagnosis is challenging, and tissue biopsy is required for definite diagnosis.

Rare presentation of choroidal neovascularisation in a case of congenital hypertrophy of retinal pigment epithelium

2021 ◽  
Vol 14 (9) ◽  
pp. e244554
Author(s):  
Ramesh Venkatesh ◽  
Nikitha Gurram Reddy ◽  
Ram Snehith Pulipaka ◽  
Arpitha Pereira
Keyword(s):  
Retinal Pigment Epithelium ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Choroidal Neovascularisation ◽  
Rare Presentation ◽  
History Of ◽  
The Right ◽  
Congenital Hypertrophy

A 22-year-old woman presented with a 2-week history of decreased vision, a central scotoma and metamorphopsia in her right eye. Her presenting visual acuity was 6/75 in the right eye and 6/6 in the left eye. Anterior segment examination was normal. Fundus examination of both eyes showed features of bilateral congenital hypertrophy of retinal pigment epithelium (CHRPE) lesions and choroidal neovascularisation (CNV) in the right eye. She was treated with intravitreal injection bevacizumab 1.25 mg/0.05 mL. One month later, there was regression of the CNV and subretinal fluid and her vision improved to 6/12. At the final follow-up visit, her vision was maintained at 6/9 with regression of CNV noted. To conclude, CNV is a rare association of CHRPE. It can lead to vision-threatening problem if it involves the macula and should be identified promptly and managed appropriately.

scholarly journals “Old wine in a new bottle” - post COVID-19 infection, central serous chorioretinopathy and the steroids

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Srinivasan Sanjay ◽  
Poornachandra B. Gowda ◽  
Bhimasena Rao ◽  
Deepashri Mutalik ◽  
Padmamalini Mahendradas ◽  
...  
Keyword(s):  
Virus Disease ◽  
Anterior Segment ◽  
Central Serous Retinopathy ◽  
Oral Antibiotics ◽  
Rt Pcr ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
The Right

Abstract Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

scholarly journals Posterior Uveal Effusion after Cataract Surgery

2021 ◽  
pp. 62-67
Author(s):  
Annegret Abaza ◽  
Özlem Dikmetas ◽  
Irmingard Neuhann ◽  
Faik Gelisken
Keyword(s):  
Cataract Surgery ◽  
Corticosteroid Therapy ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Functional Improvement ◽  
Long Term Observation ◽  
The Right ◽  
Uveal Effusion

We report a case of posterior uveal effusion (UE) with a long-term follow-up that has occurred following cataract surgery. A 64-year-old woman presented with diminished vision of the right eye (RE) 3 weeks after an uneventful phacoemulsification and intraocular lens implantation. Complete ophthalmic examination including fluorescein angiography (FA), indocyanine green angiography (ICGA), echography and optical coherence tomography (OCT) were performed. Best corrected visual acuity (BCVA) of the RE was 20/50. Anterior segment and intraocular pressure were unremarkable. OCT revealed prominent folds of the choroid and retina, subretinal fluid and darkening of the choroid with reduced visibility of the choroidal vessels and the scleral border. The left eye (LE) was unremarkable. BCVA of the LE was: 20/20. After topical anti-inflammatory and systemic corticosteroid therapy for 5 months, no morphological change of the macula was seen. The patient was observed without any treatment. Forty-three months after the cataract surgery and 38 months after cessation of the corticosteroid therapy, OCT revealed a normal macular morphology and the BCVA improved to 20/25. Even though rare, UE at the posterior pole may occur after modern cataract surgery. OCT examination is a reliable tool in monitoring the macular morphology. Since morphological and functional improvement can be seen in long-term, observation may be considered for some cases of posterior UE with resistance to the therapy.

Use of micropulse trans-scleral cyclophotocoagulation for acute rise in intraocular pressure due to anterior segment inflammation

2020 ◽  
pp. 112067212092434
Author(s):  
Shotaro Asano ◽  
Victor Koh Teck Chang ◽  
Maria Cecilia Domingo Aquino ◽  
Paul Chew Tec Kuan
Keyword(s):  
Intraocular Pressure ◽  
Rescue Therapy ◽  
Anterior Segment ◽  
Poor Response ◽  
Posterior Capsular Opacification ◽  
Nd:Yag Laser Capsulotomy ◽  
Pressure Spike ◽  
History Of ◽  
The Right ◽  
Rescue Procedure

Purpose The aim of this study was to report the use of micropulse trans-scleral cyclophotocoagulation as an adjunct therapy for two cases of medically uncontrolled intraocular pressure spikes due to anterior segment inflammation. Case description: Case 1 had previous cataract surgery and exhibited an intraocular pressure spike due to phacoantigenic uveitis (right eye intraocular pressure = 52 mmHg). Despite medical treatment, the right eye intraocular pressure remained high (43 mmHg), thus micropulse trans-scleral cyclophotocoagulation was carried out as a rescue therapy. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 3 weeks was 9 and 16 mmHg, respectively. Case 2 had a history of previous blunt ocular trauma and 180° of angle recession. Both eyes were pseudophakia and underwent right eye Nd:YAG laser capsulotomy for posterior capsular opacification. Immediately after the procedure, the right eye intraocular pressure increased to 64 mmHg. Due to poor response to medical therapy, rescue micropulse trans-scleral cyclophotocoagulation was performed. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 2 months was 12 and 21 mmHg, respectively. Conclusion Micropulse trans-scleral cyclophotocoagulation successfully decreased intraocular pressure in both cases of acute rise in intraocular pressure. Micropulse trans-scleral cyclophotocoagulation can potentially be useful as a rescue procedure to safely reduce medically uncontrollable intraocular pressure spike due to anterior segment inflammation.

scholarly journals Intraosseous Schwannoma of the Proximal Humarus With Pathologic Fracture

2021 ◽  
Author(s):  
huajun jiang ◽  
Wei Qu ◽  
Yuxuan Wu ◽  
Jingjing Yang
Keyword(s):  
Proximal Humerus ◽  
Pathologic Fracture ◽  
Bone Allograft ◽  
Excisional Biopsy ◽  
Pathological Examination ◽  
Ki 67 ◽  
Benign Schwannoma ◽  
S 100 ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Purpose Intraosseous schwannomas are extremely rare in the humerus, and less than 5 cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. we herein present this case for discussing the reason for its rarity and sharing our experience of management.Case presentation A 55-year-old female patient who presented with pain in the right shoulder, which caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, The tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The ki-67 index was about 10%. No mitoses or features of malignancy were identified. Finally, a diagnosis of benign schwannoma with focal of actively proliferated cells was made.Methods The treatment for intraosseous neurilemmomais with pathologic fracture include excisional biopsy, curettage, bone allograft, and fracture fixation. Results The patient recovered well. After the surgery, the patient gradually regained mobility and pain subsided. There was no recurrence after 6 months follow-up by X-ray.Conclusion In our case, the tumor with higher CD68 staining were likely to demonstrate that the tumor volume increase is not only based on cell proliferation, but also intratumoral hemorrhage, vascularization, and inflammation, which may be produce rarefaction of the bone and lead to bone fracture after a trivial trauma.

scholarly journals Intraosseous schwannoma of the proximal humarus with pathologic fracture

2021 ◽  
Author(s):  
Huajun Jiang ◽  
Wei Qu ◽  
Yuxuan Wu ◽  
Jingjing Yang
Keyword(s):  
Proximal Humerus ◽  
Pathologic Fracture ◽  
Bone Allograft ◽  
Excisional Biopsy ◽  
Pathological Examination ◽  
Ki 67 ◽  
Benign Schwannoma ◽  
S 100 ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Purpose: Intraosseous schwannomas are extremely rare in the humerus, and less than 5 cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. we herein present this case for discussing the reason for its rarity and sharing our experience of management.Case presentation: A 55-year-old female patient who presented with pain in the right shoulder, which caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, The tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The ki-67 index was about 10%. No mitoses or features of malignancy were identified. Finally, a diagnosis of benign schwannoma with focal of actively proliferated cells was made.Methods: The treatment for intraosseous neurilemmomais with pathologic fracture include excisional biopsy, curettage, bone allograft, and fracture fixation.Results: The patient recovered well. After the surgery, the patient gradually regained mobility and pain subsided. There was no recurrence after 6 months follow-up by X-ray.Conclusion: In our case, the tumor with higher CD68 staining were likely to demonstrate that the tumor volume increase is not only based on cell proliferation, but also intratumoral hemorrhage, vascularization, and inflammation, which may be produce rarefaction of the bone and lead to bone fracture after a trivial trauma.

scholarly journals Ultrasonography and Ultrasound Biomicroscopy in Ophthalmology

2017 ◽  
pp. 75-80
Keyword(s):  
Cataract Surgery ◽  
Real Time ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Sound Waves ◽  
Significant Information ◽  
Screening Techniques ◽  
Basic Features ◽  
The Right ◽  
Biometric Information

In this review, we aimed to give information about the basic features of screening techniques and major indications of ultrasonography in ophthalmology. This is a cheap, modern visualization modality and provides images in real-time. Sound waves travel through the eye reflect and these echoes form a picture of the structure of the eye. It also measures the size of the eye. These measurements determine the right power of a lens implant before cataract surgery. In addition realtime images help clinicians to evaluate inside of the eye that cannot be seen directly. Ultrasound biomicroscopy provides diagnostically significant information about anterior segment structures (Anatomic or pathologic structures, crucial biometric information.).

scholarly journals Third nerve paralysis due to cranial metastasis of prostate tumor

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Rao Muhammad Rashad Qamar ◽  
Qasim Mansoor ◽  
Majeed T
Keyword(s):  
Previous History ◽  
Anterior Segment ◽  
Petrous Apex ◽  
Nerve Paralysis ◽  
History Of ◽  
Total Body ◽  
The Right ◽  
Cranial Metastasis ◽  
Oncology Unit ◽  
Third Nerve

A 90 years old man presented with outward deviated right eye with droopy lid. These symptoms were developed over a period of two weeks and there was no pain behind the eye. There was no previous history of Diabetes mellitus, hypertension etc. He had a treatment for adenocarcinoma of prostate six years ago. On examination his best-corrected visual acuity was 6/60 in each eye. There was right complete third nerve paralysis with pupil involvement. Anterior segment examination showed nucleosclerotic changes on both sides. Posterior segment examination showed ARMD (dry type) in both eyes. Intraocular pressure and discs were normal. Contrast enhanced MR scan brain revealed a destructive mass at the base of skull at petrous apex on the right side extending forward to orbital apex on the same side. Total body bone scan also showed multiple metastatic lesions. Patient was referred to oncology unit for further management

Presumed Choroidal Metastasis From Oncocytic Carcinoma of the Parotid Gland: A Case Report

2019 ◽  
Vol 4 (3) ◽  
pp. 253-256
Author(s):  
Yousef J. Cruz-Iñigo ◽  
Stephen A.M. De Souza
Keyword(s):  
Parotid Gland ◽  
External Beam Radiotherapy ◽  
Subretinal Fluid ◽  
Malignant Neoplasm ◽  
Distant Metastases ◽  
Choroidal Metastasis ◽  
Current Case ◽  
Oncocytic Carcinoma ◽  
History Of ◽  
The Right

Purpose: This article reports a case of presumed choroidal metastasis from an oncocytic carcinoma of the parotid gland. Methods: A 70-year-old man with history of an oncocytic carcinoma of the parotid gland presented owing to a 1-month history of progressive blurred central vision shortly after metastatic surveillance workup revealed liver, lung, and spine metastases. Fundus examination of the right eye showed a yellow choroidal mass surrounding the optic nerve and extending inferonasally, which is associated with subretinal fluid involving the foveal center. A-scan and B-scan ultrasonography were remarkable for a dome-shaped choroidal mass with medium-to-high internal reflectivity. Fluorescein angiography revealed pinpoint foci of hyperfluorescence over the choroidal lesion with late leakage. Magnetic resonance imaging of the brain showed evidence of metastatic disease to the cerebellum. While the patient underwent systemic chemotherapy, external beam radiotherapy was used to treat the eye. Results: Four months later, visual acuity improved, the tumor reduced in size, and the subretinal fluid resolved. Systemic workup disclosed no new metastases. Conclusion: Oncocytic carcinoma of the parotid gland is a rare and aggressive malignant neoplasm with frequent recurrences and distant metastases. The current case suggests that oncocytic carcinoma can metastasize to the choroid and, consequently, ocular metastasis surveillance is advised in these patients.

Treatment of Probable Vogt-Koyanagi-Harada with Single Intravitreal Triamcinolone Acetonide

2020 ◽  
Author(s):  
Meghana Kalavar ◽  
Nimesh A Patel ◽  
Hasenin Al-Khersan ◽  
Anibal Ale ◽  
Nicolas A Yannuzzi ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Subretinal Fluid ◽  
Term Treatment ◽  
Short Term Treatment ◽  
Intravitreal Triamcinolone ◽  
Full Field ◽  
Intravitreal Triamcinolone Acetonide ◽  
Ocular Manifestations ◽  
History Of ◽  
The Right

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.

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