A rare presentation of exudative macroaneurysms in unilateral Eales’ disease

Background: A case of exudative macroaneurysms in unilateral Eales’ disease is reported. ‘Eales disease’ is an idiopathic bilateral occlusive periphlebitis with neovascularisation and mostly presents with vitreous hemorrhage. Case: A 30 year old male presented with diminution of vision in left eye (6/36) for 1 month. Slit Lamp examination of both eyes revealed normal anterior segment. Fundus examination of left eye with + 90 D lens revealed reddish lesions at the macula with surrounding circinate exudation. On peripheral examination hemorrhages were seen along with vasculitis in the superotemporal quadrant.The right eye fundus was normal.All laboratory investigations were found within normal limits. Conclusion: Eales’ disease is mostly a bilateral condition but this case is rare as there is uniocular involvement with exudative macroaneurysms.Laser therapy was instituted which was effective in management of this condition with restoration of normal visual acuity.There was no relapse on follow up for 2 years.

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Effect of monocular surgery for large-angle horizontal deviation in adults

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4275 ◽

1970 ◽

Vol 3 (1) ◽

pp. 27-30 ◽

Cited By ~ 3

Author(s):

S Ganguly ◽

R Pradhan

Keyword(s):

Visual Acuity ◽

Large Angle ◽

Anterior Segment ◽

Case Series ◽

Strabismus Surgery ◽

Slit Lamp ◽

Surgical Success ◽

Squint Surgery ◽

Indirect Ophthalmoscope

Background: Surgical success rate of strabismus is variable. Objective: To evaluate the outcome of monocular strabismus surgery for adults with largeangle deviation. Subjects and methods: This study was that of a retrospective interventional case series. A total of 48 consecutive adult patients with large-angle socially-noticeable strabismus underwent clinical evaluation for squint surgery. They were divided into 2 groups of which 28 had exotropia while 20 had esotropia with deviation ranging from 40 to 80 prism diopters (PD). Visual acuity measurement (V/A), cycloplegic refraction and orthoptic evaluation were done in all cases along with detailed anterior segment evaluation. Fundus examination was carried out with indirect ophthalmoscope and slit-lamp bio-microscopy with + 90 D lens. For each case, a repeat evaluation was done after a six-week interval. The surgical procedure was monocular recession and resection carried out under peri-bulbar anesthesia by the same surgeon. Post-operative visual acuity, fusion, stereopsis and ocular alignment were noted in all cases during follow up visits. Results: Successful ocular alignment (< 10 PD) was achieved in 40 patients while binocularity was noted in 3. Forty patients were happy with the cosmetic outcome and psychosocial rehabilitation. No statistically significant improvement was noted in visual acuity and binocular function. Successful alignment was related to pre-operative deviation of less than 30 degrees. Conclusion: Monocular surgery under peri-bulbar anesthesia is a useful procedure for large-angle horizontal strabismus. Key words: strabismus; exotropia; esotropia; fusion; binocularity DOI: 10.3126/nepjoph.v3i1.4275Nepal J Ophthalmol 2011;3(5):27-30

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Pre-Descemetic Placement of Intracorneal Ring Segments for Keratoconus after Mechanical Implantation

Case Reports in Ophthalmology ◽

10.1159/000520571 ◽

2021 ◽

pp. 940-943

Author(s):

Faady Yahya ◽

Christian F. Prünte ◽

Hendrik P.N. Scholl ◽

Zisis Gatzioufas

Keyword(s):

Visual Acuity ◽

High Resolution ◽

Femtosecond Laser ◽

Anterior Segment ◽

Slit Lamp ◽

Anterior Segment Oct ◽

Ring Segment ◽

Intracorneal Ring Segment

We report the case of a 23-year-old male who was referred to our clinic for a routine follow-up examination. The patient was treated for keratoconus 3 years ago in Colombia, where intracorneal ring segments were implanted mechanically in both eyes to improve his visual acuity. Surprisingly, we discovered a pre-descemetic placement of intracorneal ring segments, which could lead to potential complications, under circumstances. We illustrate this impressive finding with slit-lamp photography and high-resolution anterior segment OCT and advocate for the use of femtosecond laser as the method of choice for intracorneal ring segment insertion in order to provide maximal precision and safety.

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OCT Angiography of Persistent Hyaloid Artery: A case report

10.21203/rs.2.9132/v2 ◽

2019 ◽

Author(s):

Hansol Jeon ◽

Jinsoo Kim ◽

Soonil Kwon

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Vitreous Hemorrhage ◽

Oct Angiography ◽

Fundus Examination ◽

Healthy Patient ◽

Slit Lamp ◽

Blurred Vision ◽

Case Presentation ◽

Slit Lamp Examination

Abstract Background A persistent hyaloid artery is a rare fetal remnant. Several complications such as amblyopia, vitreous hemorrhage, and retinal detachment have been reported. Here, we present a case of vitreous hemorrhage with a persistent hyaloid artery. Case presentation A healthy 16-year-old male presented with blurred vision in his left eye. Vitreous hemorrhage occurred and absorbed spontaneously. Slit-lamp examination demonstrated a Mittendorf’s dot and fundus examination revealed a persistent hyaloid artery. Optical coherence tomography showed a Bergmeister’s papilla. The blood flow of the persistent hyaloid artery via the Bergmeister’s papilla was found by OCT angiography. Conclusion The persistent hyaloid artery should be considered as a cause of spontaneous vitreous hemorrhage of young healthy patient. The OCT angiography will be a useful noninvasive approach to confirm the patency of the persistent hyaloid artery.

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Multimodal Imaging and Histopathological Evaluation of Berger’s Space

Ocular Oncology and Pathology ◽

10.1159/000495724 ◽

2019 ◽

Vol 6 (1) ◽

pp. 3-9

Author(s):

Virginia Mares ◽

Marcio B. Nehemy ◽

Diva R. Salomão ◽

Shannon Goddard ◽

Jaime Tesmer ◽

...

Keyword(s):

Multimodal Imaging ◽

Histological Study ◽

Anterior Segment ◽

Vitreous Hemorrhage ◽

Slit Lamp ◽

Anterior Segment Oct ◽

Pathological Conditions ◽

Actual Space ◽

In Vivo Analysis

Objective: To demonstrate the multimodal imaging and histopathology of Berger’s space. Methods: We conducted a retrospective in vivo analysis of 4 patients demonstrating Berger’s space with intraocular pathological conditions, documented by slit-lamp biomicroscopic photography and, in 2 patients, also by optical coherence tomography (OCT). Additionally, we carried out a retrospective histological study of 7 enucleated eyes with retinoblastoma demonstrating Berger’s space. A review of the literature was also performed. Results: Two eyes had slit-lamp photographs. One case showed Berger’s space surrounded by vitreous hemorrhage. In the other case, amyloid was trapped within Berger’s space. In another 2 eyes that were pseudophakic, Berger’s space was visible on anterior segment OCT. One had amyloid trapped in Berger’s space that could be seen with OCT. The histological review of the 7 enucleated eyes with advanced retinoblastoma demonstrated the presence of pyknotic cells in Berger’s space. Conclusions: Berger’s space is an actual space in pathological conditions and can be an important site of pathology. Additionally, to our knowledge, this is the first time that Berger’s space has been documented by anterior segment OCT in a clinical setting.

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A Study to Analyse the Presentation of Autoimmune and Idiopathic Serpiginous Choroiditis in Indian Population

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/43 ◽

2021 ◽

Vol 8 (04) ◽

pp. 224-229

Author(s):

Arvind Babu ◽

Narayanan Balakrishnan ◽

Uma Maheshwari ◽

Praveena V ◽

Dharssana Periyathambi

Keyword(s):

Pigment Epithelium ◽

Retinal Pigment ◽

Correct Diagnosis ◽

Anterior Segment ◽

Inflammatory Disorder ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Serpiginous Choroiditis ◽

Vitreous Haze

BACKGROUND Serpiginous choroiditis (SC) is an intraocular inflammatory disorder displaying a geographic pattern of choroiditis, extending from the juxtapapillary choroid and intermittently spreading centrifugally. It involves the overlying retinal pigment epithelium (RPE), the outer retina including the choriocapillaries and the choroid.1,2,3 Infectious diseases like tuberculous (TB) uveitis, herpes simplex virus (HSV) uveitis whose fundus changes mimic SC are termed as serpiginous-like choroidopathy (SLC). On slit lamp examination, anterior segment usually appears quiet, non-granulomatous anterior uveitis with mild vitritis and / or fine pigmented cells within the vitreous can be seen. The pattern of fundus involvement varies between the two groups. Fundus fluorescein angiography and indocyanine green angiography (FFA and ICG) are important modalities of investigation that help in differentiating the pattern of involvement and confirming clinical findings. The duration of follow up, reactivation of lesions and complications vary. Hence, it is important to differentiate between SC and SLC for proper diagnosis and appropriate management. The aim of this study is to highlight important features of serpiginous choroiditis and serpiginous like choroidopathy that will aid in the correct diagnosis of these two entities. METHODS This is a retrospective study of 40 patients. Following variables were analysed - age, gender, laterality, visual acuity, and intraocular inflammation through slit lamp examination, pattern of involvement, choroidal-neovascularization, reactivation, clinical investigations and diagnosis. RESULTS 32 patients had serpiginous choroiditis (SC) and eight patients had serpiginous like choroiditis (SLC). Mean age was 50 and 51 years (SC and SLC respectively). Males were predominantly affected (65.5 % in serpiginous choroiditis and 62.5 % in serpiginous like choroiditis). Bilaterality was 80 % in SC-group and 46 % in the SLC-group. Vitreous haze was lesser than or equal to 1 + in SC group. The juxtapapillary-area was involved in 90 % in SC eyes and 0 % in SLC-group. Midperiphery of fundus was involved in 54 % of SLC-group. Reactivation is more common in SLC group than in SC group in a follow up period of one year. Choroidal-neovascularisation was found in two patients only in SLC-group. CONCLUSIONS In cases where vitreous haze is greater than 1 + with unilateral involvement and disease free peripapillary area is present, an infectious aetiology has to be strongly suspected, as an immunomodulatory therapy could have severe consequences. KEYWORDS Serpiginous Choroiditis, Serpiginous like Choroiditis, Autoimmune

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Pituitary Macroadenoma: A Rare Presentation of Hypothyroidism

Endocrinology and Disorders ◽

10.31579/2640-1045/107 ◽

2021 ◽

Vol 5 (8) ◽

pp. 01-03

Author(s):

Sajjad Ali Khan ◽

Nanik Ram ◽

Dania Ali ◽

Muhammad Saleem

Keyword(s):

Acanthosis Nigricans ◽

Pituitary Macroadenoma ◽

Mri Scan ◽

Rare Presentation ◽

Correct Treatment ◽

Endocrine Disease ◽

Laboratory Investigations ◽

Systemic Examination ◽

Normal Laboratory

Hypothyroidism is a common endocrine disease which occurs when the levels of Thyroid hormones produced by the Thyroid gland are decreased. Here we present a case of a 19-year-old female, who presented with symptoms of hyperprolactinemia, weight gain, unilateral blurring of eyes and headache. Examination findings of the patient were significant for presence of Acanthosis Nigricans and Hirsutism. Rest of the systemic examination was normal. Laboratory investigations revealed Hyperprolactinemia, Hypothyroid profile and dyslipidemia. MRI brain and pituitary done showed findings consistent with Pituitary macroadenoma. Patient was treated along the lines of hypothyroidism with Thyroxine. Follow-up after 3 months showed improvement of her symptoms and disappearance of lesion of MRI scan. This case was a rare presentation of Hypothyroidism. Such unusual and uncommon presentations should be reported and studied in detail to prevent misdiagnosis and provide the correct treatment to the patients.

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Rieger’s Anomaly without Posterior Embryotoxon: A Rare Presentation

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45906.14335 ◽

2020 ◽

Author(s):

. Shrinkhal ◽

Mood Mahesh ◽

Ajai Agrawal ◽

Ramanuj Samanta ◽

Anupam Singh

Keyword(s):

Autosomal Dominant ◽

Anterior Segment ◽

Dominant Inheritance ◽

Rare Presentation ◽

Current Case ◽

Anterior Segment Dysgenesis ◽

Iris Defect ◽

Ocular Defect ◽

Diagnostic Criterion

Rieger’s anomaly is a rare congenital ocular defect with autosomal dominant inheritance, characterised by dysgenesis of the anterior segment. Ocular features of typical Reiger’s anomaly include a prominent anteriorly displaced Schwalbe's line (posterior embryotoxon), iris stromal hypoplasia, corectopia, and glaucoma. An atypical presentation of Rieger’s anomaly is described in the current case report. A 26-year-old female presented with diminution of vision in right eye and mild photophobia in both eyes, since childhood. On examination, it was recognised as an atypical isolated case of Rieger’s anomaly with several classical features including segmental full thickness iris defect and ectropion uveae. This was associated with total cataract in right eye and persistent pupillary membrane in left eye, without posterior embryotoxon and glaucoma. There were no other associated ocular or systemic anomalies. Patient was operated for cataract surgery in right eye under guarded visual prognosis. The postoperative visual acuity was 3/60, signifying pre-existing amblyopia. The patient was kept on close follow-up for the development of glaucoma. This is a rare case of Anterior Segment Dysgenesis (ASD) manifesting as atypical Rieger’s anomaly without posterior embryotoxon and any systemic association, signifying the fact that posterior embryotoxon is not an essential diagnostic criterion.

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OCT Angiography of Persistent Hyaloid Artery: A case report

10.21203/rs.2.9132/v4 ◽

2019 ◽

Author(s):

Hansol Jeon ◽

Jinsoo Kim ◽

Soonil Kwon

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Vitreous Hemorrhage ◽

Oct Angiography ◽

Fundus Examination ◽

Healthy Patient ◽

Slit Lamp ◽

Blurred Vision ◽

Case Presentation ◽

Slit Lamp Examination

Abstract Background A persistent hyaloid artery is a rare fetal remnant. Several complications such as amblyopia, vitreous hemorrhage, and retinal detachment have been reported. Here, we present a case of vitreous hemorrhage with a persistent hyaloid artery. Case presentation A healthy 16-year-old male presented with blurred vision in his left eye. Vitreous hemorrhage occurred and absorbed spontaneously. Slit-lamp examination demonstrated a Mittendorf’s dot and fundus examination revealed a persistent hyaloid artery. Optical coherence tomography (OCT) showed a Bergmeister’s papilla. The blood flow of the persistent hyaloid artery via the Bergmeister’s papilla was found by OCT angiography. Conclusion The persistent hyaloid artery should be considered as a cause of spontaneous vitreous hemorrhage of young healthy patient. The OCT angiography will be a useful noninvasive approach to confirm the patency of the persistent hyaloid artery.

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A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

10.21203/rs.2.11405/v3 ◽

2019 ◽

Author(s):

Yuan Yang ◽

Tengteng Yao ◽

Yali Zhou ◽

Yixiao Wang ◽

Zhaoyang Wang

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Anterior Segment ◽

Vitreous Hemorrhage ◽

Fixation Technique ◽

Absorbable Sutures ◽

Corneal Endothelial Cell Density ◽

Support Methods ◽

Iol Fixation

Abstract Background: To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods: Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions: The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

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A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

10.21203/rs.2.11405/v1 ◽

2019 ◽

Author(s):

Yuan Yang ◽

Tengteng Yao ◽

Yali Zhou ◽

Yixiao Wang ◽

Zhaoyang Wang

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Anterior Segment ◽

Vitreous Hemorrhage ◽

Fixation Technique ◽

Absorbable Sutures ◽

Support Methods ◽

Iol Fixation ◽

Iol Dislocation

Abstract Background To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsule support. Methods Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create angled sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the ends of the haptics and guide haptic externalization through sclerotomy. After externalization, a sufficient flange was created at the end of the haptics and fixed under the scleral flaps. The best corrected visual acuity (BCVA), previous surgery history, and complications were determined. Results Fourteen cases were analyzed. The majority of eyes exhibited an improvement in BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No postoperative cystoid macular edema, vitreous hemorrhage, IOL dislocation, or endophthalmitis was observed. Conclusions The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to manipulate with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

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