Multimodal imaging of pigmented paravenous retinochoroidal atrophy

2020 ◽  
pp. 112067212096548
Author(s):  
Ratnesh Ranjan ◽  
Arvind Jain M ◽  
Shishir Verghese ◽  
George J Manayath ◽  
Venkatapathy Narendran
Keyword(s):  
Multimodal Imaging ◽  
Early Stage ◽  
Anterior Segment ◽  
Fundus Examination ◽  
Swept Source ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Pigmented Paravenous Retinochoroidal Atrophy ◽  
Best Corrected Visual Acuity ◽  
Ocular Coherence Tomography Angiography

Aim: To describe the multimodal imaging findings of pigmented paravenous retinochoroidal atrophy. Methods: A 23-year-old female presented to us for a routine ocular examination. She had a best-corrected visual acuity of 6/6 in both eyes. Anterior segment examination was unremarkable. Fundus examination showed pigmentary changes along the retinal vasculature extending from mid periphery to post-equatorial retina suggesting a diagnosis of pigmented paravenous retinochoroidal atrophy. Swept-source optical coherence tomography of the macula showed choriocapillaris thinning at the mid periphery whereas coherence tomography angiography at the mid periphery showed a relatively normal choriocapillaris vasculature in the early stage of the disease. Conclusion: A relatively normal choriocapillaris structure was seen on ocular coherence tomography angiography which could have been due to a milder form of the disease in a young patient.

scholarly journals Isolated bilateral optic neuritis revealing a Lyme Disease : case report

2020 ◽  
Vol 7 (3) ◽  
pp. 145-149
Author(s):  
MIRAY LOUIS DE GONZAGUE
Keyword(s):  
Visual Acuity ◽  
Lyme Disease ◽  
Optic Neuritis ◽  
Anterior Segment ◽  
Central Nervous System Involvement ◽  
Optic Disk ◽  
Fundus Examination ◽  
Corrected Visual Acuity ◽  
Disease Case ◽  
Best Corrected Visual Acuity

Optic neuritis (ON) is an inflammation of the optic nerve and one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme optic neuritis  is a rare ocular manifestation of Lyme Disease. We report a case of a 13-year-old male patient, previously healthy, with decreased central visual acuity on his both eyes . On examination, best-corrected visual acuity on both eyes was 0,3 LogMar. Anterior segment biomicroscopy showed no inflammatory signs and the intraocular pressure was normal. A fundus examination performed under mydriasis revealed a swollen optic disk on both eyes confirmed by fluorescein angiography. The cerebrospinal fluid examination and Lyme Disease blood findings were positive. The diagnosis of Lyme disease-related optic neuritis was made. Treated with Ceftriaxone and Doxicycline, there was a vision recovery. We can state that isolated bilateral optic neuritis is uncommon and exceptional especially in children during Lyme disease.

scholarly journals A case of subretinal hemorrhage due to choroidal tear in right eye following blunt trauma in a 35 years old female

2021 ◽  
Vol 9 (12) ◽  
pp. 3689
Author(s):  
Shrushti Doshi ◽  
Yamini B. Sangada ◽  
Stuti V. Juneja
Keyword(s):  
Asian Indian ◽  
Complete Resolution ◽  
Anterior Segment ◽  
Subretinal Hemorrhage ◽  
Fundus Examination ◽  
Corrected Visual Acuity ◽  
Oral Steroids ◽  
History Of ◽  
Choroidal Hemorrhage ◽  
Best Corrected Visual Acuity

A 35-year-old Asian Indian female presented to our institute with a history of fall on road and accidental hit by stone over her right eyebrow, grossly no anterior segment abnormality was noted. On dilated fundus examination, a superotemporal choroidal tear was noted which led to choroidal hemorrhage. Patient was managed conservatively by giving oral steroids and tablet vitamin C. After 2 months of treatment there was complete resolution of the lesion with a final best corrected visual acuity of 6/6.

scholarly journals Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Zahra Ashena ◽  
Thomas Hickman-Casey ◽  
Mayank A. Nanavaty
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

scholarly journals Anterior-Segment Swept-Source Ocular Coherence Tomography and Scheimpflug Imaging Agreement for Keratometry and Pupil Measurements in Healthy Eyes

2021 ◽  
Vol 10 (24) ◽  
pp. 5789
Author(s):  
Francisco Pérez-Bartolomé ◽  
Carlos Rocha-De-Lossada ◽  
José-María Sánchez-González ◽  
Silvia Feu-Basilio ◽  
Josep Torras-Sanvicens ◽  
...  
Keyword(s):  
Pupil Diameter ◽  
Anterior Segment ◽  
Swept Source ◽  
Ocular Coherence Tomography ◽  
Scheimpflug Imaging ◽  
Angle Kappa ◽  
Student’S T ◽  
Thickness Measurements ◽  
Healthy Eyes ◽  
Student’S T Test

This study examines agreement between the devices Anterion® and Pentacam HR® used for corneal and pupil measurements in healthy eyes. The parameters compared between the two devices were: anterior Km (D), anterior K2 (D), anterior K1 (D), anterior K1 axis (°), anterior astigmatism (D), anterior K max (D), posterior Km (D), posterior K2 (D), posterior K1 (D), posterior K1 axis (°), posterior astigmatism (D), CCT (µm), thinnest point thickness (µm), thinnest point X-coordinate (mm), thinnest point Y-coordinate (mm), pupil diameter (mm), pupil center-corneal vertex distance (mm) (angle kappa), pupil centroid angle (°), pupil centroid X-coordinate (mm), and pupil centroid Y-coordinate (mm). The Student’s t test for independent samples identified significant differences (p < 0.005) between devices for the measurements anterior and posterior flat K axis, posterior flat K, steep K, and mean K. For these last three measurements, although significant, none of the differences were clinically relevant. Corneal power and thickness measurements except Kf axis showed excellent agreement between Anterion and Pentacam. In a clinical setting we would not recommend the interchangeable use of Pentacam and Anterion for measurement of pupil parameters.

Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome

2018 ◽  
Vol 28 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Priya Narang ◽  
Amar Agarwal ◽  
Dhivya Ashok Kumar
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Segment ◽  
Anterior Chamber Angle ◽  
Single Pass ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Chamber Angle ◽  
Best Corrected Visual Acuity

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.

Large choroidal excavation in pachychoroid disease: A case report

2019 ◽  
pp. 112067211989242 ◽  
Author(s):  
Pierluigi Iacono ◽  
Maurizio Battaglia Parodi ◽  
Sandro Saviano ◽  
Mariacristina Parravano ◽  
Monica Varano
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Indocyanine Green ◽  
Choroidal Neovascularization ◽  
Indocyanine Green Angiography ◽  
Fundus Examination ◽  
Corrected Visual Acuity ◽  
Focal Choroidal Excavation ◽  
The Right ◽  
Best Corrected Visual Acuity

Purpose: To report the morphological and clinical features of a case of pachychoroid disease with focal choroidal excavation and large choroidal excavation complicated by choroidal neovascularization. Methods: The patient underwent a complete ophthalmologic examination including best-corrected visual acuity assessment, anterior segment and dilated fundus examination, fluorescein and indocyanine green angiography, and spectral-domain optical coherence tomography. Results: During the previous follow-up, the 57-year-old man received a diagnosis of central serous chorioretinopathy in the right eye with a late appearance of a choroidal neovascularization. The best-corrected visual acuity was 20/125 and 20/20 in the right and left eye, respectively. Dilated fundus examination, fluorescein angiography, and indocyanine green angiography confirmed a large subretinal fibrosis corresponding to the evolution of the choroidal neovascularization in the right eye. Spectral-domain optical coherence tomography clearly demonstrated in the right eye a large choroidal excavation below the fibrotic neovascular lesion with multiple hyperreflective foci inside the cavity, and in the left eye, a conforming focal choroidal excavation, bowl-shape type, associated with increased choroidal thickness with pachyvessels. Conclusion: Large choroidal excavation has been rarely reported. Although the pathogenetic mechanisms leading to the formation of large choroidal excavation are still only hypotheses, a combination of primary degenerative inflammatory factors sustaining the focal choroidal excavation formation and disruptive process of the choroidal neovascularization could be retained responsible for the large choroidal excavation.

scholarly journals Decompression Retinopathy after ExPRESS Shunt Implantation for Steroid-Induced Ocular Hypertension: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Khawla Abu Samra ◽  
Sandra Fernando Sieminski ◽  
Vimal Sarup
Keyword(s):  
Ocular Hypertension ◽  
Fundus Examination ◽  
Filtration Surgery ◽  
Unique Case ◽  
Drainage Device ◽  
Corrected Visual Acuity ◽  
Shunt Implantation ◽  
Choroidal Effusion ◽  
Decompression Retinopathy ◽  
Best Corrected Visual Acuity

Purpose. To present a unique case of decompression retinopathy after the implantation of ExPRESS drainage device.Method. A 25-year-old female patient underwent implantation of ExPRESS drainage device in the left eye for the management of steroid-induced ocular hypertension.Results. On the postoperative day one, best-corrected visual acuity in the left eye was 20/50. Fundus examination revealed diffuse intraretinal hemorrhages, some white-centered, throughout the retina. There was also marked tortuosity to the retinal vasculature and no evidence of choroidal effusion. Intravenous fluorescein angiography and indocyanine green did not contribute to the aetiopathogenesis.Conclusion. Decompression retinopathy can occur following the implantation of ExPRESS drainage device. It is very important to be aware of this complication in patients with relatively high intraocular pressure who is planned for filtration surgery, including the ExPRESS implant.

Prediction of Best-Corrected Visual Acuity With Swept-Source Optical Coherence Tomography Parameters in Keratoconus

Cornea ◽  
2019 ◽  
Vol 38 (9) ◽  
pp. 1154-1160 ◽  
Author(s):  
Yuri Esaka ◽  
Takashi Kojima ◽  
Murat Dogru ◽  
Asato Hasegawa ◽  
Akeno Tamaoki ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optical Coherence ◽  
Swept Source ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Effect of Circular Keratotomy on Progression of Keratoconus

2016 ◽  
Vol 5 (2) ◽  
pp. 57-62
Author(s):  
Jörg H Krumeich ◽  
Nino Hirnschall
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Patient Outcomes ◽  
Early Stage ◽  
Statistical Analyses ◽  
Stage I ◽  
Time Points ◽  
Corrected Visual Acuity ◽  
Retrospective Clinical Study ◽  
Best Corrected Visual Acuity

ABSTRACT Purpose Studies on keratoconus treatment with regard to the stage of the disease have not been published. We evaluated patient outcomes over a 5-year period after circular keratotomy (CKT) to treat stage I and II progressive keratoconus. Setting Clinic Krumeich, Bochum, Germany. Design Retrospective clinical study. Materials and methods We retrospectively evaluated the outcomes of 185 consecutive CKT procedures to treat early, progressing keratoconus. A 7-mm trephine incision, with a depth that was 90% of the thinnest pachymetry value but not less than 400 µm, was made with the guided trephine system concentric to the pupil and sutured with a double running anti-torque suture. Keratometry readings and astigmatism measurements at 1-year postsurgery were compared with values obtained at 3 and 5 years postsurgery. Preoperative values of best-corrected visual acuity with glasses were compared with values obtained at 3 and 5 years postsurgery. Statistical analyses for significance were performed. Results Keratometric readings revealed stability at 5 years postsurgery in 84.3% (n= 51) of those eyes for which all values at all time points were available. Likewise, astigmatism values revealed stability in 92.2% of eyes. Best-corrected visual acuity improved significantly from preoperative to 5 years in 73.68% (n = 38). Best-corrected visual acuity did not change in 18.42% (n = 36). Conclusion Circular keratotomy halted the progression of early-stage keratoconus for at least 5 years in 84.3% of the eyes studied. The stable keratometric results suggest that CKT treatment should be considered for patients diagnosed early in the progression of this disease. How to cite this article Krumeich JH, Hirnschall N. Effect of Circular Keratotomy on Progression of Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):57-62.

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia

2019 ◽  
pp. 112067211987715
Author(s):  
Pablo Sanjuán ◽  
Borja Salvador-Culla ◽  
Maria Isabel Canut ◽  
Rafael I Barraquer
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
High Myopia ◽  
Anterior Segment ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Visual Axis ◽  
Filtering Bleb ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia. Clinical case: A 33-year-old woman with high myopia (–18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye. Best-corrected visual acuity was 0.65 and intraocular pressure was 20 mmHg. Slit-lamp examination showed a filtering bleb in the upper-temporal quadrant, which extended and dissected the proximal cornea without affecting the visual axis. The morphology and content of the bleb was studied with anterior segment optical coherence tomography, which ruled out a corneal-scleral fistulization into the subconjunctival space. The spontaneous filtering bleb was resected surgically. Due to her high myopia, two strips of fascia lata were used to strengthen the area. In the postoperative period, a complete resection of the bleb was confirmed, without apparent leaking points and with a well-vascularized conjunctiva. No complications were noted. The patient maintained the same best-corrected visual acuity and intraocular pressure than before surgery. Conclusion: The formation of a spontaneous filtering bleb is a rare entity in patients with high myopia, whose risk increases due to their thinned sclerae. The risk is even greater if they have undergone ocular surgeries. Resection of the filtering bleb in our case halted the progression of the corneal dissection, therefore respecting the transparency of the visual axis and preserving visual acuity.

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