Stage 4 pancreatic adenocarcinoma harbouring an FGFR2-TACC2 fusion mutation with complete response to erdafitinib a pan-fibroblastic growth factor receptor inhibitor

We report a case of a frail 68-year-old woman with stage 4 pancreatic carcinoma harbouring a fibroblastic growth factor receptor 2 (FGFR2) fusion who achieved a durable complete response after treatment with erdafitinib a pan-FGFR inhibitor. The FGFR2-TACC2 fusion was detected on comprehensive tumour somatic mutation profiling. There is ongoing complete response at 10 months after initiation of erdafitinib. Transient central serous retinopathy, grade 2 hyperphosphataemia and diarrhoea were the adverse events encountered.

Central Serous Retinopathy in a Post COVID-19 Asymptomatic Healthcare Worker at a Tertiary Care Hospital: A Unique Case Report

Aim: Early detection and management of stress-related Central Serous Retinopathy caused due to COVID-19. Background: CSR has been associated with stress and is usually self-resolving. COVID-19 is known to induce psychological stress and its effects are many, one of them may be CSR. The importance of understanding the psychological impact of the disease, its consequences, and the counseling of even asymptomatic patients to ensure stress reduction needs to be understood by the treating physician. Case Report and Discussion: We report the first case of CSR associated with COVID-19 related stress in an asymptomatic health care worker and the follow-up and treatment plan for this case. It has been shown that unfavourable psychic factors influence endogenous hormonal secretion which in turn increases the levels of corticosteroids and catecholamines which have been found to induce CSR. Conclusion: This study highlights the importance of understanding the psychological effect of the pandemic and recognising this and early treatment will reduce the ill effects of the stress induced by COVID-19.

“Old wine in a new bottle” - post COVID-19 infection, central serous chorioretinopathy and the steroids

Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

Sub-Threshold Micro Pulse Laser (810NM): Treatment for Chronic Central Serous Retinopathy

Purpose: To find the effectiveness of sub-threshold (810nm) micropulse diode laser treatment (SMT) in chronic central serous retinopathy (CSR). Study Design: Interventional case series. Place and Duration of Study: Layton Rahmatulla benevolent trust eye hospital, from April 2019 to July 2020. Methods: The patients of chronic CSR (≥ 6 months) participated in the study. We used Spectral Domain Optical coherence tomography (SD-OCT) to record baseline central retinal thickness (CT). Best corrected visual acuity (BCVA) was recorded with Snellen’s chart and converted to Log MAR for statistical analysis. All patients underwent treatment with sub-threshold laser (810nm) in micropulse mode with 5% duty cycle (DC). Results: Twenty five eyes with chronic CSR were enrolled in the study. The patients were treated with laser and final assessment was made at 6 months. Mean BCVA at presentation was 0.46 Log MAR ± 0.12 and a mean baseline CT of 362.2 μm ± 32.6µm. At final follow-up there was a mean decrease in CT of 97.2 μm ± 21.8 from the baseline. After treatment mean BCVA was 0.33 Log MAR ± 0.12 and mean CT was 266 μm ± 20.9. Nineteen out of twenty-five eyes (76%) achieved a gain of vision between 1 to 3 lines and gain of 3 lines was achieved in 8% of cases. At the final follow-up there was incomplete resolution of sub retinal fluid in 4 eyes (16%) with no improvement in BCVA. Conclusion: SMT (810 nm) is an effective and minimally invasive treatment modality for chronic CSR. Key Words: Sub-Threshold micropulse laser, Central serous retinopathy, Central retinal thickness, sub retinal fluid.