Daltonmccoy5462
Traumatic injury to the optic chiasm is rare and most frequently caused by high-velocity head trauma. It classically results in bitemporal hemianopsia and often presents in conjunction with multiple other traumatic injuries, such as skull fractures and cerebrospinal fluid leaks. We present the case of a 40-year-old woman with pre-existing thyroid orbitopathy who struck her forehead after a fall from standing height.
This patient suffered immediate profound unilateral vision loss from traumatic optic neuropathy and possible optic nerve avulsion. The fellow eye manifested a temporal hemianopsia with delayed retinal nerve fiber layer and nasal hemimacular ganglion cell layer thinning on optical coherence tomography, consistent with chiasmal pathology. Magnetic resonance imaging showed no definitive lesions at the optic chiasm or more posteriorly along the afferent visual pathway.
This patient's severe vision loss suggests that proptosis from thyroid orbitopathy can sensitize the anterior visual pathway to trauma. In this case, we propose that the lack of laxity in the intra-orbital optic nerves allowed transmission of stretching forces to the optic chiasm in the setting of low-velocity blunt trauma.
This patient's severe vision loss suggests that proptosis from thyroid orbitopathy can sensitize the anterior visual pathway to trauma. In this case, we propose that the lack of laxity in the intra-orbital optic nerves allowed transmission of stretching forces to the optic chiasm in the setting of low-velocity blunt trauma.
To describe the clinical course and microbial properties of the first two reported cases of nutritionally variant Streptococci (
and
) endophthalmitis following intravitreal anti-vascular endothelial growth factor injection (IVI).
A 74 year-old female developed
endophthalmitis following IVI. The patient underwent a pars plana vitrectomy and visual acuity recovered to 20/30 in six weeks. Similarly, an 88 year-old male developed
endophthalmitis after IVI. After a pars plana vitrectomy, the visual acuity recovered to 20/60 at five weeks.
Endophthalmitis due to
species has traditionally resulted in uniformly poor visual outcomes. However, nutritionally variant Streptococci, now reclassified as
and
species, appear to have a less aggressive clinical course and better visual acuity outcomes. To the authors' knowledge, these are the first reports of nutritionally variant Streptococci following IVI related endophthalmitis.
Endophthalmitis due to Streptococcus species has traditionally resulted in uniformly poor visual outcomes. However, nutritionally variant Streptococci, now reclassified as Granulicatella and Abiotrophia species, appear to have a less aggressive clinical course and better visual acuity outcomes. To the authors' knowledge, these are the first reports of nutritionally variant Streptococci following IVI related endophthalmitis.Optical coherence tomography angiography (OCTA) is a non-invasive technique that is useful in the diagnosis and management of patients with posterior uveitis. Here we report the use of swept source OCTA (SS-OCTA) in a patient with tuberculosis (TB) associated serpiginous like choroiditis (TB-SLC) that made a full visual recovery following treatment with ATT, local and systemic corticosteroids, and systemic immune modulation. By comparing en face images of choriocapillaris (CC) blood flow before and after treatment, we conclude that the patient's visual recovery was associated with resolution of extensive CC flow deficits. NVP-2 clinical trial This case highlights the utility of SS-OCTA in the multimodal evaluation of patients with choroidal inflammation, and the potential for good visual recovery in patients treated for TB-SLC.
To report the outcomes of two cases of infectious scleritis with severe scleral thinning managed using combined mechanical debridement, cryopreserved umbilical amnion (UA) and amniotic membrane (AM) grafts, and antimicrobial therapy.
Two patients presented with severe infectious scleritis with progressive scleral melts secondary to
subsequent to pterygium surgery and intravitreal injection, respectively. Surgical debridement was followed by UA grafting, AM transplantation, and antimicrobial therapy. Epithelialization and vascularization were seen within 1-4 weeks post-operatively. At last follow up of 5-6 months, the structural integrity of the sclera remained preserved with no infection recurrence, graft necrosis, or wound dehiscence.
This case series highlights the utilization of UA grafting along with AM transplantation and topical and systemic antibiotics to preserve the globe in cases of severe infectious scleritis.
This case series highlights the utilization of UA grafting along with AM transplantation and topical and systemic antibiotics to preserve the globe in cases of severe infectious scleritis.
Verruca Vulgaris is a common benign cutaneous lesion which only reported occasionally to have malignant potential. Our purpose is to report a rare case of verruca vulgaris involving the eyelid and subsequently transformed into the combination of squamous cell carcinoma and basal cell carcinoma.
We reported a case of a 97-year-old female with a chronic biopsy proven verruca vulgaris involving the left lateral canthus. She presented with pain and swelling 5 years after the biopsy. Physical examination showed a painful warty crushed growth mass surrounded by erythematous skin changes, sized 40×40mm. Excisional biopsy showed squamous cell carcinoma and a microscopic focus of basal cell carcinoma.
Our case demonstrates the oncogenic potential of verruca vulgaris into the combination of squamous cell carcinoma and basal cell carcinoma within one lesion. Size, chronicity and UV radiation may increase the risk of malignancy. Early surgical excision should be considered in eyelid involving chronic verruca vulgaris.
Our case demonstrates the oncogenic potential of verruca vulgaris into the combination of squamous cell carcinoma and basal cell carcinoma within one lesion. Size, chronicity and UV radiation may increase the risk of malignancy. Early surgical excision should be considered in eyelid involving chronic verruca vulgaris.