Presumed Sympathetic Ophthalmia after Scleral Buckling Surgery: Case Report

Abstract Background: Scleral buckling (SB) is usually considered an extraocular operation, and it is presumed to have low risk of sympathetic ophthalmia (SO). We aimed to report a rare case of presumed SO in a young female patient following SB. Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, BCVA was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was diagnosed as sympathetic Ophthalmia, and treated with intravenous corticosteroid pulse therapy and mycophenolate mofetil. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA became 20/20 in right eye and 20/50 in the left eye after six months. Systemic workup was negative for any extraocular disease or systemic involvement. Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we presented SO occurance after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.

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Presumed Sympathetic Ophthalmia after Scleral Buckling Surgery: Case Report

10.21203/rs.3.rs-35353/v2 ◽

2020 ◽

Author(s):

Seyedeh Maryam Hosseini ◽

Nasser Shoeibi ◽

Mahdieh Azimi Zadeh ◽

Mahdi Ghasemi ◽

Mojtaba Abrishami

Keyword(s):

Female Patient ◽

Visual Loss ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Sympathetic Ophthalmia ◽

Low Risk ◽

Systemic Involvement ◽

Break Site

Abstract Background: Scleral buckling (SB) is usually considered an extraocular operation, and it is presumed to have low risk of sympathetic ophthalmia (SO). We aimed to report a rare case of presumed SO in a young female patient following SB. Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, BCVA was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was diagnosed as sympathetic Ophthalmia, and treated with intravenous corticosteroid pulse therapy and mycophenolate mofetil. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA became 20/20 in right eye and 20/50 in the left eye after six months. Systemic workup was negative for any extraocular disease or systemic involvement.Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we presented SO occurance after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.

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Presumed Sympathetic Ophthalmia After Scleral Buckling Surgery: Case Report

10.21203/rs.3.rs-35353/v1 ◽

2020 ◽

Author(s):

Seyedeh Maryam Hosseini ◽

Nasser Shoeibi ◽

Mahdieh Azimi Zadeh ◽

Mahdi Ghasemi ◽

Mojtaba Abrishami

Keyword(s):

Visual Acuity ◽

Female Patient ◽

Visual Loss ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Sympathetic Ophthalmia ◽

Low Risk ◽

Break Site

Abstract Background: We aimed to report a rare case of presumed sympathetic ophthalmia (SO) in a young female patient following scleral buckling (SB). As SB is usually considered an extraocular operation, it is presumed to have low risk of SO.Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, visual acuity was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was treated with intravenous corticosteroid pulse therapy and mycpphenolate mofetile as a case of sympathetic ophthalmia. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA was 20/20 in right eye and 20/50 in the left eye. Systemic workup was negative for any extraocular disease or systemic involvement.Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we have shown that SO may occur after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.

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Persumed sympathetic Ophthalmia after scleral buckling surgery: case report

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-020-00233-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seyedeh Maryam Hosseini ◽

Nasser Shoeibi ◽

Mahdieh Azimi Zadeh ◽

Mahdi Ghasemi ◽

Mojtaba Abrishami

Keyword(s):

Retinal Detachment ◽

Female Patient ◽

Visual Loss ◽

Retinal Pigment ◽

Serous Retinal Detachment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Sympathetic Ophthalmia ◽

Low Risk ◽

Break Site

Abstract Background Scleral buckling (SB) is usually considered an extraocular operation premeditated to have a low risk of sympathetic ophthalmia (SO). Here we report a rare case of presumed SO in a young female patient following SB. Case presentation A nineteen-year-old female patient was referred for visual loss in her left eye due to macula off inferior long-standing rhegmatogenous retinal detachment (RRD). The best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band, an inferior segmental tire with one spot cryoretinopexy at the break site, and subretinal fluid drainage was performed. BCVA was improved to 20/80 and the retina was totally attached 1 week after the operation. The patient referred to the hospital 6 weeks later with severe visual loss in both eyes as counting finger 1 m. Patient examination indicated bilateral multifocal serous retinal detachment (SRD) and vitreous cells. The patient, diagnosed with SO, received intravenous corticosteroid pulse therapy and mycophenolate mofetil for treatment. The inflammation was controlled and SRD resolved after a 5-day intravenous treatment without being relapsed after 6 months. Consequently, BCVA became 20/20 and 20/50 in the right and left eye, respectively, after 6 months. The findings of systemic workup were negative for any extraocular disease or systemic involvement. Conclusion Since SB is a procedure without manipulating intraocular tissues, it is considered to impose a low risk for SO. This report presented SO occurrence after successful SB. Some factors may induce SO, including inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage.

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Persumed Sympathetic Ophthalmia after Scleral Buckling Surgery: Case Report

10.21203/rs.3.rs-35353/v4 ◽

2020 ◽

Author(s):

Seyedeh Maryam Hosseini ◽

Nasser Shoeibi ◽

Mahdieh Azimi Zadeh ◽

Mahdi Ghasemi ◽

Mojtaba Abrishami

Keyword(s):

Retinal Detachment ◽

Female Patient ◽

Visual Loss ◽

Retinal Pigment ◽

Serous Retinal Detachment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Sympathetic Ophthalmia ◽

Low Risk ◽

Break Site

Abstract Background: Scleral buckling (SB) is usually considered an extraocular operation premeditated to have a low risk of sympathetic ophthalmia (SO). Here we report a rare case of presumed SO in a young female patient following SB. Case Presentation: A nineteen-year-old female patient was referred for visual loss in her left eye due to macula off inferior long-standing rhegmatogenous retinal detachment (RRD). The best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band, an inferior segmental tire with one spot cryoretinopexy at the break site, and subretinal fluid drainage was performed. BCVA was improved to 20/80 and the retina was totally attached 1 week after the operation. The patient referred to the hospital 6 weeks later with severe visual loss in both eyes as counting finger 1 meter. Patient examination indicated bilateral multifocal serous retinal detachment (SRD) and vitreous cells. The patient, diagnosed with SO, received intravenous corticosteroid pulse therapy and mycophenolate mofetil for treatment. The inflammation was controlled and SRD resolved after a 5-day intravenous treatment without being relapsed after 6 months. Consequently, BCVA became 20/20 and 20/50 in the right and left eye, respectively, after 6 months. The findings of systemic workup were negative for any extraocular disease or systemic involvement.Conclusion: Since SB is a procedure without manipulating intraocular tissues, it is considered to impose a low risk for SO. This report presented SO occurrence after successful SB. Some factors may induce SO, including inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage.

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The Role of Imaging in Planning Treatment for Central Serous Chorioretinopathy

Pharmaceuticals ◽

10.3390/ph14020105 ◽

2021 ◽

Vol 14 (2) ◽

pp. 105

Author(s):

Stefano Da Pozzo ◽

Pierluigi Iacono ◽

Alessandro Arrigo ◽

Maurizio Battaglia Parodi

Keyword(s):

Central Serous Chorioretinopathy ◽

Therapeutic Strategy ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Subretinal Space ◽

Planning Treatment ◽

Multiple Biomarkers ◽

Effective Procedures

Central serous chorioretinopathy (CSC) is a controversial disease both in terms of clinical classification and choice of therapeutic strategy. Choroidal layers, retinal pigment epithelium (RPE), photoreceptors, and retina are involved to varying degrees. Beyond well-known symptoms raising the clinical suspect of CSC and slit-lamp fundus examination, multimodal imaging plays a key role in assessing the extent of chorioretinal structural involvement. Subretinal fluid (SRF) originating from the choroid leaks through one or multiple RPE defects and spreads into the subretinal space. Spontaneous fluid reabsorption is quite common, but in some eyes, resolution can be obtained only after treatment. Multiple therapeutic strategies are available, and extensive research identified the most effective procedures. Imaging has carved a significant role in guiding the choice of the most appropriate strategy for each single CSC eye. Multiple biomarkers have been identified, and all of them represent a diagnostic and prognostic reference point. This review aims to provide an updated and comprehensive analysis of the current scientific knowledge about the role of imaging in planning the treatment in eyes affected by CSC.

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Spectral OCT-Angiography in En Face Mode for Detection of Morphological Changes in the Retinal Pigment Epithelium before and after Selective Micro-Pulse Laser Exposure in Patients with Central Serous Chorioretinopathy

Ophthalmology in Russia ◽

10.18008/1816-5095-2019-2-192-201 ◽

2019 ◽

Vol 16 (2) ◽

pp. 192-201

Author(s):

P. L. Volodin ◽

E. V. Ivanova ◽

E. Iu. Polyakova ◽

A. V. Fomin

Keyword(s):

Retinal Pigment Epithelium ◽

Central Serous Chorioretinopathy ◽

Morphological Changes ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Laser System ◽

Subretinal Fluid ◽

Micropulse Laser ◽

En Face ◽

Before And After

Purpose — to study the morphological changes of the retinal pigment epithelium (RPE) by optical coherence tomography-angiography (OCT-A) in En Face mode before and after selective micropulse laser irradiation in patients with central serous chorioretinopathy (CSC), determine the correspondence between the topographic location of RPE defects and detachment on the OCT-angiogram in En Face mode and points of leakage on the FAG.Patients and methods. There were 20 patients (21 eyes) with CSC before and after laser treatment under the observation. All patients underwent high-resolution FAG and OCT-A using Angio Retina 2×2 or 3×3 mm protocol and Angio Retina HD 6×6 mm. The treatment was carried out in a selective micropulse mode with individual selection of parameters using the Navilas 577s navigation laser system (OD-OS, Germany) or the IQ 577 laser system (IRIDEX, USA).Results were evaluated at 2 weeks and 1 month after treatment. Results. In all cases, the leaking points of the subretinal fluid on FAG corresponded to the topographic location of defects and detachments of RPE detachment on OKT-A En Face. According to OCT-A En Face, the following morphological changes were revealed: in 5 cases — single defects of RPE, in 7 cases — multiple defects of RPE, in 9 cases of slit-like detachment of RPE, in 3 patients a combination of slit-like detachment and defect RPE. The sizes of RPE defects varied in the range from 21 to 159 microns, while their rounded shape prevailed. 1 month after the selective micropulse laser effect on OCT-A in the En Face mode, the defects were closed and the RPE detachments fit in all patients, which resulted in resorption of the subretinal fluid and the neurosensory retina attachment.Findings. OCT-A in En Face mode is a highly informative diagnostic method that allows noninvasive detection of morphological changes in RPE with a clear topographic localization relative to the retinal vascular network, as well as evaluating the effectiveness of selective micropulse laser treatment in patients with CSC.

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Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i3.7461 ◽

2020 ◽

Author(s):

Mahdieh Azimizadeh ◽

Seyedeh Maryam Hosseini ◽

Esmaeil Babaei

Keyword(s):

Choroidal Neovascularization ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Retinal Hemorrhage ◽

Retinal Layers ◽

Choroidal Osteoma ◽

Focal Choroidal Excavation ◽

Neurosensory Retina ◽

The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

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Central Serous Chorioretinopathy Induced by Work Stress: A Case Report

e-CliniC ◽

10.35790/ecl.v8i2.31107 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

Ade J. Nursalim ◽

Vera Sumual

Keyword(s):

Risk Factors ◽

Work Stress ◽

Central Serous Chorioretinopathy ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Blurred Vision ◽

Reading Text ◽

Neurosensory Retinal Detachment ◽

The Right

Abstrak: Central serous chorioretinopathy (CSC) adalah terkumpulnya cairan serosa di bawah lapisan epitel pigmen retina yang mengakibatkan terlepasnya retina neurosensorik (detachment). Keadaan ini dapat disebabkan oleh berbagai faktor risiko, termasuk stres psikologik. Jenis kelamin laki-laki merupakan salah satu faktor risiko CSC. Terapi kondisi psikologik merupakan pena-nganan utama CSC yang diinduksi oleh stres kerja. Kami melaporkan seorang laki-laki berusia 27 tahun yang datang ke Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Hospital dengan keluhan kekaburan mata kanan yang mendadak sejak seminggu lalu tanpa didahului oleh nyeri pada mata. Pasien juga mengalami kesulitan dalam membaca teks dan mengenali wajah bila hanya menggunakan mata kanannya. Pasien telah pergi ke optik tetapi tidak mendapatkan ukuran kacamata yang sesuai. Pasien bekerja sebagai tenaga administrasi dan akhir-akhir ini mendapatkan beban kerja berlebihan. Pasien mengakui bahwa ia mengalami kesulitan dalam mengatur aktivitasnya, dan merasakan kelelahan sepanjang hari serta kehilangan minat kerja. Hasil pemeriksaan mata mendapatkan visus 6/15 untuk mata kanan dan visus 6/6 untuk mata kiri, dan metamorphopsia sedangkan hasil pemeriksaan oftalmoskopi memperlihatkan adanya edema dengan lingkaran kekuningan dan berbatas tidak jelas pada mata kanan. Pemeriksaan lanjut dengan OCT menunjukkan adanya cairan subretinal pada mata kanan disertai terlepasnya lapisan epitel pigmen. Saat kontrol setelah 36 hari, visus mata kanan telah membaik 6/6F2 dan peme-riksaan OCT menunjukkan penurunan tebal makula dari 289 μm pada kunjugan pertama men-jadi 190 μm, serta tidak tampak adanya cairan subretinal. Simpulan kasus ini ialah central serous chorioretinopathy yang diinduksi oleh stres kerja, dengan penanganan utama ialah terapi psikologik untuk memperbaiki kualitas hidup.Kata kunci: central serous chorioretinopathy (CSC), stres kerja Abstract: Central serous chorioretinopathy (CSC) is a condition where serous fluid builds up in the retinal pigment epithelium layer which causes neurosensory retinal detachment. This condition is affected by many risk factors, including psychological stress. Male gender is one of the risk factors for CSC. Treatment to the patient's psychological condition can be the main therapy in handling CSC induced by work stress. We reported a 27-year-old male came to the eye clinic at Prof. dr. R. D. Kandou Hospital complaining of sudden blurred vision in his right eye a week ago without initial pain in the eye. The patient also experienced difficulty in reading text and recognizing people’s face using the right eye. The patient went to an optic store but he did not find suitable glasses. The patient works as an administrative employee and is currently getting a heavy workload at his workplace. The patient admitted that he had issues in managing his life in a day. Patients felt tired throughout the day and had no interest in making any activities. The results of the eye examination showed vision 6/15 in the right eye and 6/6 in the left eye, metamorphopsia, edema with a yellowish circle with an unclear border on the right eye using ophthalmoscopy examination, and a subretinal fluid image in the patient's right eye with epithelial detachment pigment acquired through the examination with OCT. After 36 days from the first visit, the right eye vision was improved to 6/6 F2 and OCT examination resulted in a decrease in macula thickness from 289 μm at the first visit to 190 μm, and there was no subretinal fluid. In conclusion, this was a CSC case induced by work stress, and the main treatment was psychological therapy in order to improve the quality of life (QoL).Keywords: central serous chorioretinopathy (CSC), work stress

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Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

Journal of Ophthalmology ◽

10.1155/2016/9803547 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Vicktoria Vishnevskia-Dai ◽

Dinah Zur ◽

Shiran Yaacobi ◽

Iris Moroz ◽

Hadas Newman ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Retinal Thickness ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Choroidal Melanoma ◽

Case Series ◽

Subretinal Fluid ◽

Optical Coherence ◽

Choroidal Melanomas ◽

Anterior Choroidal

Purpose.To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface.Methods.This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well.Results.OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p=0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p<0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors.Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface.

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Inherited Macular Dystrophies and Differential Diagnostics

Medicina ◽

10.3390/medicina48090072 ◽

2012 ◽

Vol 48 (9) ◽

pp. 72 ◽

Cited By ~ 1

Author(s):

Rasa Liutkevičienė ◽

Vaiva Lesauskaitė ◽

Virginija Ašmonienė ◽

Arvydas Gelžinis ◽

Dalia Žaliūnienė ◽

...

Keyword(s):

Differential Diagnosis ◽

Visual Loss ◽

Autosomal Recessive ◽

Autosomal Dominant ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Genetic Research ◽

Gene Mutations ◽

Disease Spread ◽

Differential Diagnostics

The inherited macular dystrophies are characterized by different grade central visual loss and different character macula atrophy, because of retinal pigment epithelium lesion. The cause of photoreceptors degeneration is still not known. In this article, we review subjective and objective ophthalmological examines essential to diagnosis and differential diagnosis of inherited autosomal dominant and autosomal recessive macular dystrophies. It is known seven gene mutations (ABCA4, ELOVL4, PROML1, VMD2, Peripherin/RDS, TIMP3, XLRS), which may cause inherited macular dystrophies development. Inheritance type of inherited macular dystrophies, prevalence, beginning of disease, spread of the disease between female and male, clinic, electroretinography, electrooculography, differential diagnosis, genetic research and prognosis are also reviewed.

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