Optic disc and choroidal metastases secondary to breast cancer: A case report

2021 ◽  
pp. 112067212110362
Author(s):  
Rim Bouraoui ◽  
Khaled El Matri ◽  
Yousra Falfoul ◽  
Zied Chelly ◽  
Ahmed Chebil ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Optic Disc ◽  
Infrared Imaging ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Wide Field ◽  
Fundus Examination ◽  
Blurred Vision ◽  
Macular Lesion

Aim: To report an uncommon case of optic disc and multiple choroidal metastases secondary to breast cancer, assessed with swept source optical coherence tomography (SS-OCT), fluorescein (FA), and infracyanine (ICGA) angiographies. Methods: Observational case report. Case presentation: A 40-year-old woman with history of left breast carcinoma presented with blurred vision in her right eye (RE). Her visual acuity was 1/20 in the RE and 10/10 in the left eye. Fundus examination of the RE showed a large yellowish elevation of the posterior pole and a particular whitish nodular papillary cluster protruding from the optic disc into the vitreous. Infrared imaging enhanced the papillary nodular infiltrates. Characteristic findings of choroidal metastasis were noted within the macular lesion on SS-OCT and ICGA. SS-OCT showed specific “lumpy bumpy” irregularity of the anterior surface of the choroid and elevated hyperreflective nodular lesions of the optic disc associated to peripapillary subretinal fluid. The papillary lesions appeared as a bunch of hypofluorescent dots on both FA and ICGA, and ultra-wide field FA was helpful clearly delimiting the large macular lesion. Besides, comprehensive imaging and especially ICGA could detect two asymptomatic choroidal metastases in a systematic assessment of the fellow eye. Conclusion: Optic disc metastases are extremely rare. Their diagnosis can be easily done on fundus examination when presenting with characteristic whitish cluster nodular infiltrates of the optic disc. However multimodal imaging remains very useful for the assessment of the local extension of the lesion and for diagnosing associated asymptomatic choroidal lesions gone unnoticed at the fundus examination.

Twelve-year follow up of a case of autosomal recessive bestrophinopathy with transient resolution of retinal edema in one eye

2022 ◽  
pp. 112067212110732
Author(s):  
Lidia Remolí Sargues ◽  
Clara Monferrer Adsuara ◽  
Raquel Rodríguez López ◽  
Roberto Gallego Pinazo ◽  
Javier Montero Hernández ◽  
...  
Keyword(s):  
Case Report ◽  
Fundus Autofluorescence ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Dietary Therapy ◽  
Retinal Edema ◽  
Blurred Vision ◽  
First Case

Purpose To report 12-year follow-up of a patient with ARB. Case report A 25-year-old man presented with blurred vision in his both eyes (OU). Best-corrected visual acuity (BCVA) was 20/63 Snellen equivalent in the right eye (OD) and 20/32 Snellen equivalent in the left eye. The intraocular pressures and anterior segment examination were unrevealing in OU. Posterior segment examination revealed multiple yellowish flecks and dots in the posterior pole in OU. Optical coherence tomography (OCT) showed subretinal fluid (SRF), intraretinal hyporeflective spaces, elongated and shaggy photoreceptors and outer retinal defects. Fundus autofluorescence demonstrated mottling hyperautofluorescence and hypoautofluorescence in the posterior pole in OU. Fluorescein angiography illustrated hyperfluorescence in the posterior pole and surrounding the arcades in OU. Multifocal electroretinography objectified mild to markedly abnormal responses in all ring areas in OU. Molecular genetic testing confirmed two heterozygous sequence variations in the BEST1 gene. At 4 years of follow-up, OCT revealed a complete resolution of SRF and a partial resolution of intraretinal hyporeflective spaces in the OD with corresponding improvement in the BCVA to 20/23 Snellen equivalent in the OD, even though outer retinal defects persisted. Our patient denied recent changes in his alimentary habits and medical history at that time. Posteriorly, SRF and intraretinal hyporeflective spaces reappeared in the OD. Conclusion To the best of our knowledge, this is the first case report of ARB with a transient resolution of retinal edema in one eye without medical treatment and dietary therapy.

Pleomorphic Invasive Lobular Cancer of the Breast Presenting with Orbital Metastasis: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Ebru Yılmaz ◽  
Nilgün Güldoğan ◽  
Aydan Arslan ◽  
Ceyda Civan
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Cancer Metastasis ◽  
Left Breast ◽  
Breast Cancer Metastasis ◽  
Mri Findings ◽  
Blurred Vision ◽  
Orbital Metastasis ◽  
Invasive Lobular Cancer ◽  
Lobular Cancer

Background: Orbital metastasis of breast cancer is an unusual condition, especially in the absence of a previous diagnosis of primary breast cancer. The main MRI findings in patients with orbital metastasis are retroorbital soft tissue with thickening of extraocular muscles. Paradoxical enophtalmos secondary to fibrosis can be seen. Case Report: In this case report we present a 75-year-old female patient with left eye pain and blurred vision and retraction. Although there was no evidence of malignancy in the biopsy of the orbita; since the patient's complaints continued despite idiopathic pseudotumor treatment; mammography was recommended to rule out the possibility of breast cancer metastasis. Her mammography revealed a suspicious lesion in the left breast and proved to be pleomorphic invasive lobular cancer. Conclusion: Breast cancer metastasis should be kept in mind in women with pseudotumor -like involvement of the orbita.

Rescue intra-arterial chemotherapy in unilateral multirelapsed peripapillary retinoblastoma: Decision making and the role of MRI

2020 ◽  
pp. 112067212095758
Author(s):  
Sonia De Francesco ◽  
Paolo Galluzzi ◽  
Sandra Bracco ◽  
Alessandro Di Maggio ◽  
Arianna Sgheri ◽  
...  
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Optic Disc ◽  
Posterior Pole ◽  
Type Iv ◽  
Caucasian Girl ◽  
High Resolution Mri ◽  
Single Mass ◽  
Oncology Unit

Introduction: In this case report we report our experience with rescue intra-arterial chemotherapy in a case of multi-relapsed peripapillary Retinoblastoma (RB) and the importance of high resolution MRI in detecting possible optic disc infiltration. Case report: In 2007, a 14 month-old caucasian girl was referred to our ocular oncology unit for leukocoria. Only left eye was interested, with a single mass of the posterior pole. Patient underwent six cycles of systemic chemotherapy and focal laser consolidation. Several relapses occurred during follow-up. Selective intra-arterial chemotherapy (SIAC) with Melphalan was performed and type IV remission was achieved. A new relapse occurred next to the optic disc. MRI was performed and we decided to try to save the globe with a rescue cycle of SIAC. Conclusion: MRI has demonstrated to be useful in decision making in RB, giving us a last chance to save the globe.

scholarly journals Comparison of conventional and wide field direct ophthalmoscopy on medical students’ self-confidence for fundus examination: a 1-year follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabriel Ayub ◽  
Rafael Boava Souza ◽  
Andrelisa Marina de Albuquerque ◽  
José Paulo Cabral de Vasconcellos
Keyword(s):  
Medical Students ◽  
Optic Disc ◽  
Control Group ◽  
Practical Training ◽  
Wide Field ◽  
Fundus Examination ◽  
Self Confidence ◽  
One Year ◽  
Direct Ophthalmoscopy ◽  
Cup To Disc Ratio

Abstract Background Fundus examination is an easy, quick and effective way to diagnose sight- and life-threatening diseases. However, medical students and physicians report lack of proficiency and self-confidence in perform fundoscopy. The aim of this study was to compare students’ self-confidence in fundus examination, using two different direct ophthalmoscopes, 1 month and 1 year after practical training. Methods In this prospective cohort, medical students (MS) of the same class were divided in small groups for PanOptic (PO) or conventional (CO) direct ophthalmoscope training. The intervention group encompassed MS of the 4th -year (class of 2019), and the control group encompassed MS of year behind (class of 2020). A questionnaire to measure self-confidence in fundoscopy technique assessing optic nerve, cup-to-disc ratio and macula was translated and validated to Portuguese, and applied 1-month and 1-year after practical training. Results One-hundred and sixty-seven MS were enrolled (35 PO group, 38 CO group, and 94 control group). PO group had a significantly higher overall self-confidence comparing either control or CO groups, respectively (3.57 ± 0.65 vs. 2.97 ± 1.03 vs. 2.46 ± 0.87, p < 0.01) as well as in evaluate cup-to-disc ratio (3.09 ± 0.75 vs. 2.32 ± 0.87 vs. 1.46 ± 0.81, p < 0.01), optic disc margins (3.26 ± 0.85 vs. 2.71 ± 0.96 vs. 2.01 ± 0.97, p < 0.01) and macula (3.43 ± 1.12 vs. 2.89 ± 1.08 vs. 2.02 ± 0.89, p < 0.01) 1-month after practical training. One-year after intervention, CO group showed a significantly higher score compared to PO group in overall self-confidence (3.31 ± 0.69 vs. 3.18 ± 0.73, p = 0.03) and in optic disc margins assessing (3.16 ± 0.85 vs. 2.95 ± 0.78, p = 0.03), but not significant in the evaluation of cup-to-disc ratio (2.78 ± 0.97 vs. 2.68 ± 0.94, p = 0.08), and macula (3.34 ± 0.79 vs. 3.27 ± 0.98, p = 0.07). Conclusions Students were more confident in use PO as an instrument to perform direct ophthalmoscopy immediately after practical training, but confidence level of CO was higher compared to PO one year after practical training. These findings would help medical schools decide which ophthalmoscope to choose to teach fundus examination.

scholarly journals Vitreous Metastasis in a Case of Metastatic Breast Cancer

2020 ◽  
Vol 6 (5) ◽  
pp. 323-327
Author(s):  
Rony Gelman ◽  
Song Eun Lee ◽  
Neuza Rocha ◽  
Larisa G. Kayserman ◽  
Robert V. Vallar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Wide Field ◽  
Blurred Vision ◽  
Metastatic Focus ◽  
Infectious Process ◽  
Metastatic Cells ◽  
History Of ◽  
Vitreous Metastasis

A 35-year-old female with a history of metastatic breast cancer (BC) presented with unilateral blurred vision and floaters over 6 weeks. Examination findings showed vitreous opacities and a vasculitis concerning for an infectious process. Diagnostic vitrectomy revealed no infectious cause, but rather metastatic cells in the vitreous, with no obvious retinal or choroidal metastatic focus. In this report we illustrate a case of vitreous metastasis in a patient with metastatic BC, highlighting the importance of recognizing this rare entity which can mimic an inflammatory or infectious process. Novel to this report is the use of modern wide-field retinal imaging, spectral-domain optical coherence tomography, and a surgical video to document the findings of this disease entity.

scholarly journals Unilateral Vogt-Koyanagi-Harada Disease: A Clinical Case Report

2015 ◽  
Vol 6 (3) ◽  
pp. 361-365 ◽  
Author(s):  
Arminda Neves ◽  
Ana Cardoso ◽  
Mariana Almeida ◽  
Joana Campos ◽  
António Campos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Retinal Detachment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Exudative Retinal Detachment ◽  
The Right ◽  
Clinical Records ◽  
Vkh Disease

Purpose: To report a case of a 20-year-old female with decreased visual acuity (VA) in the left eye (LE). Methods: This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results: A 20-year-old female presented with decreased VA in the LE for 3 days. Best-corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/40 in the LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal, and in the LE it revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and showed thickening of the posterior choroid also revealed by orbital ultrasound and magnetic resonance imaging (MRI). Fluorescein angiography showed angiographic features typical of Vogt-Koyanagi-Harada (VKH) disease: disseminated spotted choroidal hyperfluorescence and choroidal multifocal hypofluorescence, multifocal profuse leakage in the retina with pooling, serous retinal detachment and optic disc hyperfluorescence. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was normal. The patient received systemic steroids and cyclosporine. LE BCVA improved up to 20/20 at 18 months after the diagnosis, with complete reabsorption of subretinal fluid and normal retinal and choroidal thickness by OCT. Conclusion: Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease, and ophthalmologists should be aware to recognize this rare clinical variant of the disease.

scholarly journals Melanocytoma of the optic disc – a case report

2012 ◽  
Vol 4 (2) ◽  
pp. 323-325 ◽  
Author(s):  
H Sharma ◽  
L R Puri
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Visual Impairment ◽  
Fluorescein Angiography ◽  
Optic Disc ◽  
Benign Lesion ◽  
Fundus Examination ◽  
The Right

Introduction: Melanocytoma of the optic disc is a benign lesion. Objective: To describe a case of optic disc melanocytoma Case: A 48-year old lady presented with gradual visual impairment associated with a floater. The right eye fundus examination showed a mass uniformly dark black in colour on the optic disc. The mass completely obscured the fluorescence on fluorescein angiography and was thus differentiated from malignant melanoma. Conclusion: Optic disc melanocytoma can present with visual impairment and a floater. Fluorescein angiography can be useful to differentiate between malignDOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6553 Nepal J Ophthalmol 2012; 4 (2): 323-325

Structural and vascular features in cavitary congenital optic disc anomaly associated with metaphyseal acroscyphodysplasia

2021 ◽  
pp. 112067212199574
Author(s):  
Federica Fossataro ◽  
Luca D’Andrea ◽  
Gilda Cennamo
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Systemic Disease ◽  
Wide Field ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Optic Disc Coloboma ◽  
Retinal Epithelium ◽  
The Right ◽  
Optic Disc Anomaly

Purpose: To evaluate the radial peripapillary vascular plexus of a cavitary congenital optic disc anomaly in a young patient with recessive autosomal metaphyseal acroscyphodysplasia using optical coherence tomography angiography (OCTA). Methods: Observational case report. Results: A 17-year-old man, with diagnosis of metaphyseal acroscyphodysplasia was referred to Eye Clinic for fundus examination and multimodal imaging for retinal epithelium hypertrophy in the right eye. Clinical examination showed cup-shaped metaphyses, short stature, hyperthelorism, and telecanthus. An optic disc coloboma was detected in the right eye on fundus examination. Wide field en-face Optical Coherence Tomography (OCT) showed a hyporeflective area corresponding to the right optic disc coloboma. At OCTA examination, the whole papillary region revealed a rarefaction of the vascular network, while the ganglion cell complex’s and retinal fiber layers’ parameters were normal in both eyes. Conclusion: The presence of coloboma disc congenital defect linked to embryological abnormalities during the development process could pave the way for a wider understanding of the pathogenesis of metaphyseal acroscyphodysplasia by increasingly framing it as a systemic disease.

scholarly journals Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 896
Author(s):  
Yi-Fen Lai ◽  
Ching-Long Chen ◽  
Ke-Hao Huang ◽  
Yi-Hao Chen
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Visual Loss ◽  
Early Recognition ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Fundus Examination ◽  
Blurred Vision ◽  
Foveal Thickness ◽  
The Right

Background and Objectives: This case report discusses possible causes of chorioretinal fold (CRF) formation. Materials and Methods: A case report. Results: A 48-year-old man presented with a history of high myopia and primary open-angle glaucoma in both eyes. He underwent a trabeculectomy followed by phacoemulsification in both eyes. Two months later, he complained of blurred vision in the right eye. The intraocular pressure (IOP) was 17 mmHg in the left eye and 9 mmHg in the right eye. Refraction showed a hyperopic shift in both eyes. Slit-lamp examination showed a deep anterior chamber without cells and a well-functional bleb without leakage. Fundus examination revealed CRFs in the macula of the right eye. No papilledema, choroidal lesions, or other retinal lesions were found. Wrinkling of CRFs at the macula, an increase in central foveal thickness, and a fluid cleft were demonstrated by spectral-domain optical coherence tomography. After using steroid eye drops, the IOP in the right eye and refraction in both eyes recovered to the baseline level. Visual acuity improved in both eyes. Conclusions: CRFs in trabeculectomized eyes with normal IOP after phacoemulsification have not been reported. This case demonstrated that the trabeculectomized eye remains at risk of CRF formation, even if the IOP is normal without hypotony. The importance of a detailed fundus examination in patients with unexplained blurred vision may be necessary after having undergone these procedures. The early recognition of the cause of visual loss may facilitate immediate treatment and may avoid irreversible changes with permanent visual loss.

Electric Shock Retinopathy: Case Report of a Late Retinal Manifestation

2020 ◽  
Vol 4 (2) ◽  
pp. 139-143
Author(s):  
Diego Alejandro Valera-Cornejo ◽  
Marlon García-Roa ◽  
Paulina Ramírez-Neria ◽  
Verónica Romero-Morales ◽  
Yolanda Villalpando-Gómez ◽  
...  
Keyword(s):  
Case Report ◽  
Family History ◽  
Optic Disc ◽  
High Voltage ◽  
Electric Shock ◽  
Vision Loss ◽  
Inflammatory Diseases ◽  
Anterior Segment ◽  
Electrical Injury ◽  
Fundus Examination

Purpose: This is a case report of a male patient who suffered a high-voltage electrical burn and presented with bilateral pigmentary retinopathy. Methods: A 40-year-old man presented with bilateral vision loss following a high-voltage electrical injury sustained 10 years earlier. Family history, ocular history, and anterior segment evaluation were unremarkable. Results: Fundus examination revealed bilateral optic disc pallor, widespread areas of chorioretinal atrophy, and pigmentary changes surrounding the optic disc that partially involved the macula with some spared areas located on the superior retina. Conclusions: Retinal manifestations following a high-voltage electrical injury can resemble other hereditary and inflammatory diseases with similar clinical patterns, therefore, a meticulous family, medical, and clinical evaluation is essential.

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