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  • 1.

    【2hr】Hemiretinal Artery Occlusion in an 11-Year-Old Child with Dextrocardia

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    机译 一名11岁患有右旋心动过速的儿童的半动脉阻塞
    摘要：Purpose. To report a case of hemiretinal artery occlusion in a child with dextrocardia, visceral heterotaxia, and secondary polycythemia. Methods. Complete clinical examination, fundus photography, and retinal fluorescein angiography were performed. Laboratory testing included complete blood cell count, homocysteine, protein c, protein s, activated protein s, methyltetrahydrofolate and homocysteine activator genes, factor leiden V gene, antithrombin III, and activated protein c resistance. In addition, transthoracic and transesophageal echocardiogram and cardiac catheterism were performed. Results. We report an 11-year-old boy with a sudden, painless visual loss in his right eye. His past medical history is remarkable for a congenital cardiac disease. He presented with vision of light perception in the right eye and a relative afferent pupillary defect. Fundus findings included a macular cherry-red spot and inferior hemiretinal whitening consistent with hemiretinal artery occlusion. Laboratory testing showed increased red blood cell (RBC) count, hemoglobin, and hematocrit. The patient was treated with four phlebotomies with improvement of RBC count and after one month reperfusion of the retina and a visual acuity of 20/200 were observed. Thrombophilia and cardiac screening were negative, except for secondary polycythemia. Conclusion. Hemiretinal artery occlusion is extremely rare in children and is often associated with congenital cardiac disease and hypercoagulative states.
  • 2.

    【2hr】Location of a Dexamethasone Implant at the Macula after Intravitreal Injection in a Silicone Oil-Filled Eye

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    机译 玻璃体内注射硅油填充眼中地塞米松植入物在黄斑处的位置
    摘要：Here, we report a case with cystoid macular edema (CME) due to central retinal vein occlusion (CRVO) presented with a dexamethasone implant (Ozurdex) trapped at the macula in her silicone oil- (SO-) filled eye after injection. No additional complications such as intraocular pressure (IOP) rise or retinal damage were observed. The CME was resolved during the follow-up period. At the last visit, 3 months following the injection, Ozurdex implant was found to be mostly dissolved without any additional ocular complications.
  • 3.

    【2hr】Severe Corticosteroid-Induced Ocular Hypertension Requiring Bilateral Trabeculectomies in a Patient with Takayasu's Arteritis

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    机译 Takayasu动脉炎患者需要双侧小梁切除术的严重皮质类固醇诱发的眼高压
    摘要：We present a rare case of severe corticosteroid-induced ocular hypertension (OHT) after prolonged systemic corticosteroid use in a young woman with Takayasu's arteritis. As she did not sufficiently respond to ocular antihypertensive therapies, bilateral enhanced trabeculectomies were required to normalize her intraocular pressures. The systemic side effects of corticosteroids are well known, yet steroid-induced OHT and glaucoma remain silent causes of ocular morbidity. This case highlights the importance of IOP-monitoring in visually asymptomatic patients on systemic corticosteroids. It further emphasizes the need to raise awareness of the potential ocular side effects of steroids amongst physicians, in particular those looking after patients with autoimmune and inflammatory diseases.
  • 4.

    【2hr】Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation

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    机译 残留有机硅海绵表现为眼眶炎症的临床放射学相关性
    摘要：A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material.
  • 5.

    【2hr】Ectropion and Conjunctival Mass in a Patient with Primary Bilateral Conjunctival Amyloidosis

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    机译 原发性双眼结膜淀粉样变性患者的外翻和结膜肿块
    摘要：Background. Amyloidosis is a group of disorders characterized by deposition of an extracellular protein, known as amyloid, in an abnormal fibrillar form with highly characteristic histopathologic staining properties. The clinical presentation can vary from a focal, localized lesion where amyloidosis has minor clinical consequences to extensive systemic disease that can involve any organ system of the body. Ocular amyloidosis can occur as a localized lesion or as a part of a systemic disorder. Conjunctival amyloidosis is an uncommon condition that is rarely associated with systemic disease. It may be a manifestation of an immunologic disorder. Case Report. We report the case of a patient with bilateral conjunctival amyloidosis who was referred to us with the suspicion of a malignant conjunctival lesion. Examination of both eyes showed a yellow-pink mass with prominent intrinsic vessels, subconjunctival hemorrhage, and ectropion of the left lower eyelid. Diagnosis of primary localized conjunctival amyloidosis was made based on histopathologic evaluation of incisional biopsy and negative systemic work-up. Conclusion. Ocular amyloidosis is a rare disease that is slowly progressive and has a wide variety of clinical presentations. Consequently, the clinical diagnosis is often overlooked or delayed. Definitive diagnosis is achieved through histopathologic evaluation of biopsy specimen.
  • 6.

    【2hr】A Case of Solitary Nonvascularized Corneal Epithelial Dysplasia

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    机译 孤立性非血管化角膜上皮异常增生1例
    摘要：Background. Epithelial dysplasia is categorized as conjunctival/corneal intraepithelial neoplasia which is a precancerous lesion. The lesion is usually developed at the limbal region and grows towards central cornea in association with neovascularization into the lesion. Here, we report a case of isolated nonvascularized corneal epithelial dysplasia surrounded by normal corneal epithelium with immune histochemical finding of ocular surface tissues cytokeratins, for example, keratin 13 and keratin 12. Case Presentation. A 76-year-old man consulted us for visual disturbance with localized opacification of the corneal epithelium in his left eye. His visual acuity was 20/20 and 20/200 in his right and left eye, respectively. Slit lamp examination showed a whitish plaque-like lesion at the center of his left corneal epithelium. No vascular invasion to the lesion was found. The lesion was surgically removed and subjected to histopathological examination and diagnosed as epithelial dysplasia. Amyloidosis was excluded by direct fast scarlet 4BS (DFS) staining. Immunohistochemistry showed that the dysplastic epithelial cells express keratin 13 and vimentin, but not keratin 12, indicating that the neoplastic epithelial cells lacked corneal-type epithelium differentiation. Conclusions. The lesion was diagnosed as nonvascularized epithelial dysplasia of ocular surface. Etiology of the lesion is not known.
  • 7.

    【2hr】Dengue Fever-Associated Maculopathy and Panuveitis in Australia

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    机译 澳大利亚与登革热相关的黄斑病和胰腺炎
    摘要：Purpose. To describe a case of dengue fever-associated maculopathy and panuveitis to raise awareness of these ophthalmic complications of dengue in Australia in the light of recent increasing numbers of outbreaks from equatorial through to tropical Australia. Case Report. A 37-year-old Caucasian Australian male returning from Cambodia presented with a bilateral dengue fever-associated maculopathy with left panuveitis diagnosed clinically and haematologically. Automated perimetry revealed bilateral paracentral scotomas while optical coherence tomography demonstrated the maculopathies to be of the diffuse retinal thickening type in the right eye and acute macular neuroretinopathy (AMN) type in the left eye. He was treated conservatively with only topical steroids and cycloplegia and made a full clinical visual recovery. Conclusion. Our case study underscores the importance of the awareness of the ophthalmic complications of dengue fever as despite their rarity they can be potentially sight threatening. The incidence of these complications is likely to rise in Australia with increased global warming and the distribution of Aedes aegypti into subtropical Australia.
  • 8.

    【2hr】Anti-VEGF in a Marathon Runner's Retinopathy Case

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    机译 马拉松运动员视网膜病变病例中的抗VEGF
    摘要：Central retinal vein occlusion (CRVO) is one of the most common retinal vascular disorders. Intense exercise associated CRVO have been described in otherwise healthy young patients. We describe a case of a young male ultramarathoner who presented with a CRVO, presumably associated with dehydration, making part of a marathon runner's retinopathy. Resolution of macular edema and subretinal fluid, with visual acuity improvement, was observed after 3 monthly injections of ranibizumab. Our case suggests that dehydration could be involved in the mechanism of CRVO in healthy young patients and ranibizumab may be an effective treatment option for marathon runner's retinopathy.
  • 9.

    【2hr】Herpetic Stromal Keratitis following Selective Laser Trabeculoplasty

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    机译 选择性激光小梁成形术后疱疹性基质角膜炎
    摘要：This is a case report describing two cases of disciform corneal edema following uncomplicated selective laser trabeculoplasty (SLT) thought to be secondary to herpes simplex virus (HSV) given the presence of a dendrite, decreased corneal sensation, corneal thinning, and response to therapy with oral and topical antivirals. Corneal edema after SLT treatment has been reported before, but the etiology has been unclear. Our cases highlight HSV as a likely etiology, which may help with prevention and better management of such cases in the future.
  • 10.

    【2hr】Orbital Infarction due to Sickle Cell Disease without Orbital Pain

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    机译 镰状细胞病引起的眼眶梗塞，无眼眶疼痛
    摘要：Sickle cell disease is a hemoglobinopathy that results in paroxysmal arteriolar occlusion and tissue infarction that can manifest in a plurality of tissues. Rarely, these infarcted crises manifest in the bony orbit. Orbital infarction usually presents with acute onset of periorbital tenderness, swelling, erythema, and pain. Soft tissue swelling can result in proptosis and attenuation of extraocular movements. Expedient diagnosis of sickle cell orbital infarction is crucial because this is a potentially sight-threatening entity. Diagnosis can be delayed since the presentation has physical and radiographic findings mimicking various infectious and traumatic processes. We describe a patient who presented with sickle cell orbital crisis without pain. This case highlights the importance of maintaining a high index of suspicion in patients with known sickle cell disease or of African descent born outside the United States in a region where screening for hemoglobinopathy is not routine, even when the presentation is not classic.
  • 11.

    【2hr】Ophthalmic Manifestations of Hematopoietic Malignancy

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    机译 造血系统恶性肿瘤的眼科表现
    摘要：Purpose. To report the ocular findings in patients with hematopoietic malignancy with optic nerve involvement and abducens nerve palsy. Methods. The medical records of all cases of hematopoietic cancer with ophthalmic involvements seen in the Department of Ophthalmology of the National Center for Global Health and Medicine between 2009 and 2014 were reviewed. Results. Eight patients with hematopoietic cancer with optic nerve invasion or abducens nerve palsy were studied. The primary diseases were 3 cases of multiple myeloma, 1 case of acute lymphocytic leukemia, 1 case of follicular lymphoma, and 3 cases of AIDS-related lymphoma. Six cases had optic nerve invasion, 2 cases had abducens nerve palsy, and 1 case had optic nerve invasion of both eyes. The median visual acuity of eyes with optic nerve invasion was 0.885 logarithm of the minimum angle of resolution (logMAR) units. The final visual acuity of eyes with optic nerve invasion was 1.25 logMAR units, and that of those with sixth-nerve palsy was −0.1 logMAR units. Six cases died during the five-year follow-up period. An ophthalmic involvement in patients with hematopoietic cancer, especially AIDS-related lymphoma, was associated with poor prognosis. Conclusion. Because ophthalmic involvement in patients with hematopoietic malignancy has a poor prognosis, an early diagnosis of the cancers by the ophthalmologic findings by ophthalmologists could improve the prognosis.
  • 12.

    【2hr】Central Retinal Artery Occlusion in Takayasu's Arteritis as the First Presentation of the Disease

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    机译 Takayasu的动脉炎中视网膜中央动脉阻塞是该疾病的首发表现
    摘要：Takayasu's arteritis (TA) is a chronic inflammatory granulomatous vasculitis which affects large and medium arterial vessels. The disease involves especially subclavian arteries and aortic branches but it can consist of any arteries. The major pathology is granulomatous panarteritis with intima proliferation and defects of the elastic lamina of the vessels. We present a case of central retinal artery occlusion in TA as the first presentation of the disease. To the best of our knowledge, the present case is the first case that demonstrates central retinal artery occlusion as an initial manifestation in TA. A 48-year-old woman was admitted to our clinic with the complaint of sudden and painless vision loss in her right eye for one day. Although retinal artery involvement is a very rare presentation in TA, it is important to recall TA particularly in young patients with retinal artery occlusion.
  • 13.

    【2hr】Endogenous Fusarium Endophthalmitis in Diabetes Mellitus

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    机译 糖尿病的内源性镰刀菌性眼内炎
    摘要：Endogenous endophthalmitis accounts for 2% to 8% of cases of endophthalmitis. Immunocompromised state and intravenous drug use are the 2 most common causes of endogenous endophthalmitis due to molds fungi. Aspergillus, Fusarium, and Scedosporium are the common organisms in mold endophthalmitis. We report a case of Fusarium endophthalmitis in a patient with uncontrolled diabetes. While diabetes mellitus is a well-known risk factor for endogenous endophthalmitis, we did not find any reported case of Fusarium endophthalmitis in a case of diabetes mellitus. The patient presented with granulomatous uveitis masquerading as noninfectious uveitis with a very good response to steroids. The characteristic clinical features were established late in the clinical course associated with poor outcome. This case highlights the significance of uncontrolled diabetes as a risk factor for Fusarium endophthalmitis and also the presentation of endophthalmitis as a masquerade syndrome. The clinician should have high index of suspicion as these cases have poor outcomes.
  • 14.

    【2hr】Atypical Presentation of Idiopathic Bilateral Optic Perineuritis in a Young Patient

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    机译 一名年轻患者特发性双侧视神经炎的非典型表现
    摘要：A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels.
  • 15.

    【2hr】Unilateral Eyelid Edema as Initial Sign of Orbital Sarcoidosis

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    机译 单侧眼睑水肿是眼眶结节病的初步征兆
    摘要：Introduction. Sarcoidosis is a rare multisystemic granulomatous inflammatory disease of unknown etiology affecting the respiratory system, skin, and eyes. Sarcoidosis outside the lacrimal gland is rare. The case study concerns a patient with a final diagnosis of orbital sarcoidosis. Case Report. A 37-year-old male patient went to the ophthalmic emergency room complaining of pain in the left eye, diplopia, and decreased visual acuity. An external eye examination showed hard and cold edema of the lower eyelid, ocular motility with limitation of adduction, and discreet ipsilateral proptosis. Magnetic resonance of the orbit showed left eye proptosis and thickening and increase of soft tissues associated with heterogeneous impregnation of contrast in the infralateral region of the left eyelid. A biopsy of the lesion showed a chronic inflammatory process, with numerous compact nonnecrotizing granulomas surrounded by lamellar hyaline collagen, providing histological confirmation of sarcoidosis. Discussion. A biopsy of the orbital tumor is essential for the diagnosis of sarcoidosis, in addition to the search for systemic findings such as hilar adenopathy or parenchymal lung disease found in 90% of patients.
  • 16.

    【2hr】A Gel Formulation Containing a New Recombinant Form of Manganese Superoxide Dismutase: A Clinical Experience Based on Compassionate Use-Safety of a Case Report

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    机译 一种含有新型重组形式的锰超氧化物歧化酶的凝胶制剂：基于同情使用安全性的临床报告
    摘要：Background. We report a case of bilateral posterior subcapsular cataracts (PSCs) in a 24-year-old man with an allergic conjunctivitis history caused by a long-term therapy with glucocorticoids. Case Presentation. The patient showed a visual acuity of 9/10 for both eyes. He followed a therapy with ketotifen and bilastine for four years. During the last six months before our evaluation, he was treated with chloramphenicol and betamethasone, interrupted for onset of cataracts and increased intraocular pressure. We treated him with ophthalmic gel preparation containing a new recombinant form of manganese superoxide dismutase (rMnSOD) at a concentration of 12.5 μg/mL, only for the right eye, while left eye was treated with standard protocol of Bendazac-lysine g 0.5. Conclusion. This case report shows the protective effects of rMnSOD versus PSC disease, probably due to the capacity of rMnSOD of countering free radical species.
  • 17.

    【2hr】Bimatoprost Induced Serous Macular Detachment after Cataract Surgery

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    机译 白内障手术后比马前列素引起浆液性黄斑脱离。
    摘要：We report a case of bimatoprost induced serous macular detachment and choroidal folds following uneventful cataract surgery. A 66-year-old male using topical bimatoprost in both eyes for open angle glaucoma underwent uneventful cataract surgery in the right eye. Postoperatively, he was restarted on topical bimatoprost and antibiotic-steroids combination drops. One week after surgery, he presented with conjunctival hyperemia, serous macular detachment, and choroidal folds at the posterior pole. Fundus fluorescein angiography showed perifoveal leaks in early stage with pooling of dye in late stage. Discontinuation of bimatoprost led to resolution of serous detachment and choroidal folds within 3 weeks with significant improvement in visual acuity. Occurrence of serous macular detachment and choroidal folds in this case could be probably related to the proinflammatory property of bimatoprost. Hence, it should be used with caution in the immediate postoperative period after cataract surgery.
  • 18.

    【2hr】Bacillus Panophthalmitis with Posterior Extension to the Prechiasmatic Optic Nerve

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    机译 芽孢杆菌性眼炎向后裂前视神经延伸
    摘要：A rare case of Bacillus panophthlamitis with extension to the prechiasmatic optic nerve secondary to hematogenous spreading after intravenous drug use is presented. A 27-year-old man with a recent history of trauma to the left eye presented with severe left eye pain following a binge of intravenous drug use. Visual acuity (VA) was LP. On examination he had chemosis, proptosis, elevated intraocular pressure, and a complete hyphema. CT-scan identified preseptal swelling, but no evidence of any posterior extension of the anterior process or orbital fractures. Topical and systemic therapy were initiated. On follow-up clinical examination less than 12 hours after presentation he had signs of a keratitis with worsening ophthalmoplegia and repeat imaging demonstrated posterior extension to the prechiasmatic optic nerve. Shortly after the cornea ruptured with cultures growing Bacillus. The patient underwent enucleation and has had no further progression of infection. To the best of our knowledge, this is the first report of Bacillus panophthalmitis presenting with signs of trauma with posterior extension to the prechiasmatic optic nerve.
  • 19.

    【2hr】Juvenile Vogt-Koyanagi-Harada Disease in Which Good Visual Prognosis Was Derived from Swift and Definitive Diagnosis

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    机译 早期Vogt-Koyanagi-Harada幼年病的快速和明确诊断源于良好的视觉预后
    摘要：We report an 8-year-old girl who manifested Vogt-Koyanagi-Harada (VKH) disease. At the first visit, conjunctival hyperemia, inflammation in the anterior chamber, serous retinal detachment, and papillitis were observed in both eyes. Fluorescein angiography (FA) revealed bilateral subretinal fluid and papillitis. Ocular computed tomography (OCT) showed subretinal fluid and choroidal hypertrophy underneath macula in both eyes. Cerebrospinal fluid examination indicated aseptic meningitis. Systemic data did not suggest the other systemic diseases. Therefore, she was diagnosed with incomplete VKH disease. After corticosteroid pulse therapy, oral prednisolone was administered for seven months. Eighteen days after the induction of the treatments, inflammation in the anterior chamber and serous retinal detachment of both eyes disappeared completely. For seven months after the induction of the treatments, she had no relapses of any symptoms. Cerebrospinal fluid examination and FA for children are difficult to conduct, since it is difficult to get informed consent of these examinations from their parents. However, those thorough examinations enable us to make a swift and definitive diagnosis of VKH disease, thus assuring good visual prognosis. We have to bear in mind that juvenile VKH disease is very rare, yet when it occurs, ophthalmologic examinations help us diagnose and treat it.
  • 20.

    【2hr】Malignant Hypertensive Retinopathy in an Infant with Mid-Aortic Occlusion

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    机译 婴儿中主动脉阻塞的恶性高血压视网膜病变
    摘要：Purpose. Case report describing an eight-month-old infant presenting with intermittent esotropia and irritability who was found to have malignant (grade 4) hypertensive retinopathy and mid-aortic syndrome. Methods. Visual acuity was 6/140 in the right eye and not recordable in the left eye. Blood pressure was as high as 230/120 mmHg. Fundoscopy revealed bilateral optic disc swelling, macular stars, and serous retinal detachment in the left eye, findings that are consistent with malignant (grade 4) hypertensive retinopathy. CT abdominal angiogram revealed a severe mid-aortic syndrome with occlusion of the abdominal aorta at T12. Results. The patient was treated with medical management of his hypertension, improving the subretinal exudate. Binocular visual acuity improved to 6/9.5 over 9 months. There was a persistent left relative afferent pupillary defect and moderate left esotropia. Conclusion. This is the first reported case of malignant hypertensive retinopathy in an infant with concomitant mid-aortic occlusion. The authors emphasize the need for an ophthalmological and pediatric examination in a child presenting with intermittent squint and irritability. The esotropia was found to be a false localizing sign of raised intracranial pressure secondary to the severe mid-aortic syndrome.
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