scholarly journals DMEK IN KERATOCONUS WITH ACUTE HYDROPS: A CASE REPORT

Author(s):  
Lucio V L Maranhão ◽  
Paulo E C Dantas ◽  
Natalia R L Ramalho ◽  
Wanessa P Pinto

We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft.  

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Laura Hernandez-Moreno ◽  
Natacha Moreno Perdomo ◽  
Tomas S. Aleman ◽  
Karthikeyan Baskaran ◽  
Antonio Filipe Macedo

The purpose of this report is to describe a case of bilateral foveal hypoplasia in the absence of other ophthalmological or systemic manifestations. We characterize the case of a 9-year-old Caucasian male who underwent full ophthalmologic examination, including functional measures of vision and structural measurements of the eye. Best corrected visual acuity was 0.50 logMAR in the right eye and 0.40 logMAR in the left eye. Ophthalmoscopy revealed a lack of foveal reflex that was further investigated. Optical coherence tomography (OCT) confirmed the absence of foveal depression (pit). OCT images demonstrated the abnormal structure of retina in a region in which we expected a fovea; these findings were decisive to determine the cause of reduced acuity in the child.


2019 ◽  
pp. 112067211989242 ◽  
Author(s):  
Pierluigi Iacono ◽  
Maurizio Battaglia Parodi ◽  
Sandro Saviano ◽  
Mariacristina Parravano ◽  
Monica Varano

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.


2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Qinxiang Zheng ◽  
Ronghan Wu ◽  
Wensheng Li

Introduction. To report a case of anterior sclera staphyloma and vitreous hemorrhage occurring over 38 years after bilateral cataract surgery.Methods. A 58-year-old man presented with anterior sclera staphyloma and vitreous hemorrhage in the right eye, after bilateral cataract surgery, over 38 years ago. We performed combined anterior sclera staphylectomy and vitrectomy of right eye for anterior sclera staphyloma and vitreous hemorrhage.Results. Forty-eight months after the combined surgery, best-corrected visual acuity was 0.3 (+10.00/−4.50 × 60) with eutopic stitches of the corneoscleral junction on the superior nasal quadrant and a stable ocular surface.Conclusions. This is the first reported case of anterior sclera staphyloma with vitreous hemorrhage successfully managed by combined surgery.


2015 ◽  
Vol 9 (1) ◽  
pp. 33-35
Author(s):  
Michiko Iida ◽  
Tatsuya Mimura ◽  
Mari Goto ◽  
Yuko Kamei ◽  
Aki Kondo ◽  
...  

Purpose : To report the clinical and histopathological findings of a patient who had bilateral persistent pupillary membrane with exotropia and high hyperopia. Methods : Case Report: A 7-year-old boy presented with a persistent pupillary membrane in both eyes. His best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the left eye with exotropia of 18 prism diopters. He underwent surgical resection of both membranes. At 5 months postoperatively, BCVA was 20/20 with final bilateral refraction of +6.5 D in both eyes. Exotropia and photophobia showed improvement immediately after surgery. Histopathological examination revealed typical features of normal iris tissue in the excised membranes. Conclusion : Bilateral persistent pupillary membranes were excised successfully without injury to other ocular tissues, including the crystalline lens. Surgical treatment may be required for the management of persistent pupillary membrane associated with visual impairment such as exotropia or photophobia.


2019 ◽  
Vol 4 (2) ◽  
pp. 144-147
Author(s):  
Lincoln T. Shaw ◽  
Sidney A. Schechet ◽  
Ema Avdagic ◽  
William F. Mieler ◽  
Seenu M. Hariprasad

Purpose: This case report discusses the management of a patient with a superior chorioretinal coloboma-associated retinal detachment (RD), including surgical management, along with a review of the literature. Methods: A case report is presented. Results: A 58-year-old man presented with a chronic RD of the right eye that was symptomatic for approximately 1 year prior to presentation. On examination, he was found to have a macula-off RD associated with superior chorioretinal coloboma. He underwent 23-gauge pars plana vitrectomy with membrane peel, endolaser, and perfluoropropane (14%) gas tamponade. Three months after his surgery, his best-corrected visual acuity in his right eye was 20/250 distance and 20/80 near, and his retina remained attached. Conclusions: This case report describes surgical management of a superior chorioretinal coloboma-associated RD.


2018 ◽  
Vol 29 (6) ◽  
pp. 694-697
Author(s):  
Mohammad Soleimani ◽  
Reza Mirshahi ◽  
Seyed Ali Tabatabaei ◽  
Bita Momenaei ◽  
Mirataollah Salabati ◽  
...  

Purpose: To introduce a new surgical technique for the localization of corneal bulla to drain a massive corneal hydrops. Methods: Four consecutive cases with acute large protruded hydrops were selected. A limbal paracentesis was made via 15° blade. Afterward, trypan blue with a concentration of 0.1% was injected into the anterior chamber. Upon pooling trypan blue in the bulla, the surgeon immediately marked the primary site of stromal staining before further spreading of the dye. Anterior chamber irrigation was then carried out using balanced salt solution, and the excess of trypan blue was washed out. Subsequently, the surgeon made a beveled venting incision to decompress bulla via 15° blade resulting in a stream of dye egressed from the venting incision. At the end of the surgery, 20% diluted SF6 was injected into the anterior chamber. Results: Postoperatively, Descemet’s membrane was attached up to the second postoperative day. The corneal edema was resolved up to 3 weeks. Contact lens–corrected visual acuity was improved in all cases. Conclusion: Venting incision under the guide of injected trypan blue into the anterior chamber combined with intracameral SF6 injection could be effectively used for a large acute hydrops. This technique could prevent other interventions like passing full-thickness corneal suturing and subsequent complications.


2020 ◽  
Vol 12 ◽  
pp. 251584142094793
Author(s):  
Riccardo Sacconi ◽  
Enrico Borrelli ◽  
Francesco Bandello ◽  
Giuseppe Querques

‘Perifoveal Exudative Vascular Anomalous Complex’ (PEVAC) is a perifoveal, unilateral, isolated, perifoveal aneurysm, in otherwise healthy patients. Here, we report a case of PEVAC in a highly myopic eye of a 86-year-old woman affected by a visual decline in the right eye (best-corrected visual acuity of 20/100). She had no other relevant past conditions and/or ocular impairment. Fundus examination in the right eye showed myopic chorioretinal degeneration with a concomitant PEVAC. Structural optical coherence tomography (OCT) showed a round lesion with a hyperreflective wall associated with intraretinal cystic spaces. OCT-angiography nicely disclosed an isolated large aneurysmal retinal dilation featuring the PEVAC with detectable flow in superficial capillary plexus, deep capillary plexus, and avascular slab. This case highlights the importance of discerning between different vascular disorders of the macula, in order to be able to offer the right treatment and/or follow-up to the patient.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mitsuru Otsubo ◽  
Reiko Kinouchi ◽  
Takayuki Kamiya ◽  
Akitoshi Yoshida

Abstract Background Cystoid macular edema is a rare, vision-threatening side effect of the taxane family of anticancer agents. There is no established treatment or standard treatment protocol for taxane-related cystoid macular edema. Here, we report two cases of taxane-related cystoid macular edema that were treated with topical dorzolamide. Case presentation In case 1, a 72-year-old Japanese woman with bilateral geographic choroiditis reported for a follow-up visit with a complaint of blurred vision in both eyes for 2 months after starting nanoparticle albumin-bound paclitaxel chemotherapy for multiple metastases of her breast cancer. Her best-corrected visual acuity had dropped from 1.2 to 0.9 in the right eye and from 1.0 to 0.4 in the left eye. Fundus examination showed no newly active geographic choroiditis lesion, but optical coherence tomography exhibited cystoid macular edema. We suspected taxane-related cystoid macular edema and terminated nanoparticle albumin-bound paclitaxel, and started topical dorzolamide treatment. Cystoid macular edema nearly resolved within 6 weeks in the right eye and within 10 weeks in the left eye after starting topical dorzolamide treatment. The resolution of cystoid macular edema without leaving a chorioretinal scar after discontinuation of paclitaxel confirmed our initial diagnosis of taxane-related cystoid macular edema. A few inconspicuous cystoid spaces persisted at the parafovea for a year after dorzolamide treatment ended, but regressed after restarting dorzolamide treatment without any side effects. Best-corrected visual acuity improved to 1.2 in the right eye and 1.0 in the left eye. In case 2, a 70-year-old Japanese man, who received nanoparticle albumin-bound paclitaxel for pancreatic cancer with multiple metastases, developed bilateral cystoid macular edema. Best-corrected visual acuity was 0.3 bilaterally. Cystoid macular edema resolved within 5 weeks after stopping nanoparticle albumin-bound paclitaxel and starting topical dorzolamide treatment confirming the diagnosis of taxane-related cystoid macular edema. Nine weeks later, best-corrected visual acuity improved to 0.8 in the right eye and 1.0 in the left eye. Conclusions Cystoid macular edema in each case resolved within a few months without any side effects using topical dorzolamide and terminating taxane-based chemotherapy. Topical dorzolamide appears to be a safe and effective treatment option for patients with taxane-related cystoid macular edema whose quality of life is threatened by visual disturbances.


2021 ◽  
Vol 14 (7) ◽  
pp. e242557
Author(s):  
Anusha Sachan ◽  
Deeksha Rani ◽  
Suman Lata ◽  
Rohan Chawla

An 18-year-old man presented with decreased vision in the right eye (OD) noticed for 1 month. On examination, OD best-corrected visual acuity was 3/60 and the left eye (OS) was 6/6 with intraocular pressure of 12 mm Hg in both the eyes (OU). OD fundus revealed an inferior optic-disc-pit with macular-retinoschisis and an inferior choroidal coloboma. OS fundus was normal. On swept-source optical coherence tomography (SSOCT) radial scans, peripapillary-retinoschisis was seen not only in the macular region but in all the four quadrants. To the best of our knowledge, no such case has been reported of optic disc pit with multiquadrant peripapillary retinoschisis and choroidal coloboma coexisting in the same eye. SSOCT radial scans can help detect subclinical retinoschisis as in this case.


2014 ◽  
Vol 6 (2) ◽  
pp. 140-144
Author(s):  
Yuan Zeng ◽  
Jiang-wen Deng ◽  
Jian-hua Gao

Introduction: In manual, tunnel-incision cataract surgery, nucleus extraction has remained a crucial issue and a challenge. It is also the period when serious complications easily occur, especially for beginners and when the nucleus is large and dense.  Objectives: To report a modified vectis technique for nucleus extraction in sutureless, manual, small-incision cataract surgery (MSICS) to improve the safety and ease of performance.Materials and methods: A novel nucleus extraction technique using a vectis in MSICS is presented. After capsulorhexis and hydrodissection, the nucleus is moved into the anterior chamber and extracted by pulling with a Sinskey hook and pressuring on the scleral bed near the posterior wound margin with an irrigating vectis. Main outcome measures: The operating time for the whole surgery and nucleus extraction, best corrected visual acuity postoperatively and complications during and after operation were recorded. Results: In a series of 1,180 eyes, the operating time for the whole surgery and nucleus extraction were 8±3.4 minutes and 5.1±4.6 seconds respectively. Among all the eyes, 88.98 % achieved a best-corrected visual acuity of 5/10 or better two months postoperatively. The complications were posterior capsule rupture (4 eyes, 0.34 %) and transient corneal edema (12 eyes, 1.02 %). Neither vitreous loss nor dislocation of the nucleus into the vitreous was noted in the whole series of the surgery. Conclusions: We found that the “scleral bed” vectis technique for nucleus extraction improved the ease of performance, safety of MSICS, and did not require expensive instrumentation.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11708Nepal J Ophthalmol 2014; 6 (12): 140-144 


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