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Publisher: Elsevier   (Total: 3175 journals)

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Showing 1 - 200 of 3175 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 28, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 33, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 376, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 235, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 128, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 28, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 14)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 10)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 21)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 6)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 42, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 7)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 54, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 14, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 7)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 23)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 1, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 18, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 375, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 333, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 429, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 50, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 42, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 42, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 189, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 61, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 165, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)

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Journal Cover American Journal of Ophthalmology Case Reports
  [6 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Online) 2451-9936
   Published by Elsevier Homepage  [3175 journals]
  • Refractory interface haze developing after epithelial ingrowth following
           laser in situ keratomileusis and small aperture corneal inlay implantation
           

    • Authors: Rafic Antonios; Nada S. Jabbur; Mohammed A. Ahmed; Shady T. Awwad
      Pages: 10 - 12
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Rafic Antonios, Nada S. Jabbur, Mohammed A. Ahmed, Shady T. Awwad
      Purpose To report the occurrence and the management of refractory interface haze that developed after epithelial ingrowth following small aperture inlay implantation. Observations A 52 year-old man with sub-clinical anterior basement membrane dystrophy (ABMD) underwent combined hyperopic laser in situ keratomileusis and KAMRA corneal inlay implantation to correct presbyopia. Post-operatively, epithelial ingrowth developed requiring debridement and KAMRA removal. Significant diffuse interface haze, ground-glass in texture, involving the central 6 mm of the cornea developed the next day, and was refractory to topical and systemic steroids, necessitating flap irrigation, gentle scraping, and MMC application to the residual stromal bed after 12 days. The interface haze gradually improved to near complete resolution over 12-months. Conclusions and importance Epithelial ingrowth can lead to flap interface haze refractory to medical therapy. Early surgical intervention is key to haze resolution.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.034
      Issue No: Vol. 10 (2018)
       
  • Benign yellow dot maculopathy

    • Authors: Elad Moisseiev
      Pages: 13 - 15
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Elad Moisseiev
      Purpose To describe a new family with benign yellow dot maculopathy. Observations A young male patient was found to have bilateral multiple small yellow dots in both maculae. Visual acuity and color vision were normal, and no pathological findings were demonstrated on automated visual field, optical coherence tomography (OCT) and electrophysiological testing. Examination of his parents revealed similar findings in his mother, suggesting autosomal dominant inheritance. No deterioration of vision occurred over long term follow up. These findings are consistent with the newly described phenotype of benign yellow dot maculopathy. Conclusions and importance This is the first report of patients with benign yellow dot maculopathy since its original description, and the first to document it in a family of North African descent. This report will serve to raise awareness to this phenotype, which may be more common than currently known.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.040
      Issue No: Vol. 10 (2018)
       
  • Morning glory disc anomaly and ipsilateral sporadic optic pathway glioma

    • Authors: Michael Kinori; Natasha Pillay Smiley; Janice Lasky Zeid
      Pages: 16 - 17
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Michael Kinori, Natasha Pillay Smiley, Janice Lasky Zeid
      Purpose To present a rare case of morning glory disc anomaly in association with an ipsilateral low grade glioma. Observations A 5 year old male presented with a unilateral morning glory disc anomaly and an ipsilateral sporadic optic pathway glioma with chiasmal involvement. After a strict patching regimen his vision improved from 20/400 to 20/80. Conclusions and importance This report strengthens the recommendation for brain magnetic resonance imaging in patients with morning glory disc anomaly. Patching of the contralateral eye should be attempted since the role of amblyopia may be significant.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.035
      Issue No: Vol. 10 (2018)
       
  • HLA-A29 negative Birdshot-like chorioretinopathy associated with common
           variable immunodeficiency

    • Authors: Razek Georges Coussa; Fares Antaki; David E. Lederer
      Pages: 18 - 24
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Razek Georges Coussa, Fares Antaki, David E. Lederer
      Purpose To report the longest ophthalmic follow-up and the associated ocular complications of HLA-A29 negative Birdshot-like chorioretinopathy (BLCR) associated with common variable immunodeficiency (CVID). Observations A 22-year-old man known for CVID presented with a 3-month history of decreased visual acuity OS. Funduscopy revealed significant cystoid macular edema OS, as well as optic disk edema and chorioretinal infiltrates without signs of vitritis OU. No infectious, inflammatory or neoplastic etiologies were identified. He subsequently received one dose of intravitreal triamcinolone OS which completely resolved the macular edema. The optic nerve edema persisted despite the addition of intravenous immunoglobulin. His visual acuity was 20/20 OU at the 24th follow-up month. Conclusion and importance: To our knowledge, this is the third case of HLA-A29 negative BLCR associated with CVID. It is the first case with long-term follow-up providing, in consequence, the best understanding of the natural history and possible complications of this rare disease. Aggressive systemic treatment, in collaboration with an immunologist, is generally needed to control the ophthalmic complications.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.024
      Issue No: Vol. 10 (2018)
       
  • Calcified amorphous tumor: A rare cause of central retinal artery
           occlusion

    • Authors: Jeffrey H. Ma; Manjot K. Gill
      Pages: 25 - 27
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Jeffrey H. Ma, Manjot K. Gill
      Purpose We report the case of a central retinal artery occlusion secondary to presumed embolus from a calcified amorphous tumor of the heart, a very rare non-neoplastic cardiac mass. Observations A 60-year-old female presented with acute unilateral vision loss of the left eye. Examination revealed hand motion visual acuity of the left eye and a left relative afferent pupillary defect. Fundoscopy showed whitening of the macula with a cherry red spot, consistent with a central retinal artery occlusion. Initial workup was unremarkable, including hypercoagulability labs, magnetic resonance imaging of the brain, and magnetic resonance angiography of the head and neck. Transthoracic echocardiogram (TTE) showed calcification of the mitral valve but no masses. Subsequently, transesophageal echocardiogram (TEE) was performed, which revealed a mobile calcified amorphous tumor of the heart. Conclusions Calcified amorphous tumor of the heart is a very rare cardiac mass that may cause retinal artery occlusion. TEE is a more sensitive imaging modality to assess for potential cardio-embolic sources if TTE is unrevealing.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.038
      Issue No: Vol. 10 (2018)
       
  • Rare corneal complication following selective laser trabeculoplasty

    • Authors: Sarah Dougherty Wood; Angela Elam; Sayoko Moroi
      Pages: 28 - 31
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Sarah Dougherty Wood, Angela Elam, Sayoko Moroi
      Purpose This case report describes two glaucoma patients who underwent selective laser trabeculoplasty (SLT) and developed a rare post-procedure corneal complication and subsequent permanent corneal distortions and reduced acuity. Observations Both patients experienced early post-procedure corneal edema, reduced visual acuity, and pain. Each patient was treated with topical steroids with resolution of the edema, but each patient had irregular corneal astigmatism which was not present pre-operatively and did not resolve. Conclusions and importance There are very few reported cases of post-SLT corneal edema and these typically resolve without long-term complications. The following two cases represent an uncommon adverse event of irregular corneal astigmatism despite resolution of the corneal edema. The exact mechanism of these corneal effects is not known. Practitioners should inform patients of this rare, but possible complication following SLT and consider extra precautions in patients susceptible to corneal edema.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.028
      Issue No: Vol. 10 (2018)
       
  • Disseminated silicone granulomatosis in the face and orbit

    • Authors: Tiffany A. Chen; Carmel L. Mercado; Katie L. Topping; Benjamin P. Erickson; Kimberly P. Cockerham; Andrea L. Kossler
      Pages: 32 - 34
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Tiffany A. Chen, Carmel L. Mercado, Katie L. Topping, Benjamin P. Erickson, Kimberly P. Cockerham, Andrea L. Kossler
      Purpose To report a case of disseminated silicone granulomatosis presenting with ptosis, proptosis and vision loss. Observations A 56-year-old female presented with ptosis, proptosis, and vision loss and was noted to have palpable, erythematous masses involving the orbit, face, trunk, and body. She had a history of bilateral silicone breast implants and cosmetic facial filler injections. Orbital biopsy demonstrated non-caseating granulomas with foreign-body giant cells and vacuoles containing material consistent with silicone. Removal of the patient's breast implants and systemic immunosuppression led to dramatic granuloma regression. Conclusions Silicone can induce a severe, systemic inflammatory response and should be considered in the differential for facial and periorbital granulomas in patients with a history of silicone breast implants. Management of disseminated silicone granulomatosis is challenging and requires multimodal treatment with silicone removal and systemic immunomodulation.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.037
      Issue No: Vol. 10 (2018)
       
  • Aerial drone misadventure: A novel case of trauma resulting in ocular
           globe rupture

    • Authors: Eliza E. Moskowitz; Yonaton M. Siegel-Richman; George Hertner; Thomas Schroeppel
      Pages: 35 - 37
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Eliza E. Moskowitz, Yonaton M. Siegel-Richman, George Hertner, Thomas Schroeppel
      Purpose The purpose of this case report is to present the novel findings of a drone causing such a traumatic ocular injury and provide recommendations for how it might be prevented. Observations We report on a recent case where a child presented to our Emergency Department after incurring a blow to the face by the propeller of a remote controlled drone. The patient suffered significant trauma including rupture of the right globe. Conclusions As drone sales continue to rise, it is important that physicians be prepared to treat the potential injuries that may result from using these devices. Furthermore, in an attempt to reduce the number of visits associated with remote controlled drones, physicians should be prepared to provide advice as to how patients can reduce the risks of injury. Importance We hope that the framework and recommendations below will help physicians decrease adverse outcomes related to this unusual injury pattern.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.039
      Issue No: Vol. 10 (2018)
       
  • Long-term visual outcomes of laser anterior ciliary excision

    • Authors: AnnMarie Hipsley; Brad Hall; Karolinne Maia Rocha
      Pages: 38 - 47
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): AnnMarie Hipsley, Brad Hall, Karolinne Maia Rocha
      Purpose To determine the long-term visual outcomes of six eyes of 3 patients up to 13 years following the Laser Anterior Ciliary Excision (LaserACE) procedure. Methods Three male patients of ages 59, 59, and 60 presented for evaluation at Storm Eye Institute, Medical University of South Carolina at 8, 10, and 13 years after the LaserACE procedure for presbyopia, respectively. All 3 patients had a history of laser vision correction (LVC) prior to LaserACE treatment. Visual performance was evaluated using ray-tracing aberrometry, specifically higher-order aberrations, visual Strehl of the optical transfer function (VSOTF), depth of focus (DoF), and effective range of focus (EROF). VSOTF was computed as a function of defocus using a through-focus curve. Subjective DoF was overlaid on the VSOTF through-focus curve to establish the best image quality metric threshold value for correlation between subjective and objective DoF. EROF was determined by measuring the difference in diopters between the near and distance DoF curves, at 50% of VSOTF. Results Distance-corrected visual acuity, distance-corrected intermediate visual acuity, and distance-corrected near visual acuity for all patients remained at 20/20 or better up to 13 years postoperatively. EROF averaged 1.56 ± 0.36 (D) for all eyes. Conclusions and Importance LaserACE provided improvement in near vision functionality in these LVC patients with long-term stability. The LaserACE procedure is not on the visual axis, therefore these patients could still receive correction to their hyperopic regression.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.033
      Issue No: Vol. 10 (2018)
       
  • Orbital implant exposure after Acanthamoeba panophthalmitis

    • Authors: Meredith S. Baker; Amanda C. Maltry; Nasreen A. Syed; Richard C. Allen
      Pages: 48 - 50
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Meredith S. Baker, Amanda C. Maltry, Nasreen A. Syed, Richard C. Allen
      Purpose Acanthamoeba is a protozoa that can lead to severe ocular disease and sequelae. Although intraocular Acanthamoeba infection is rare, the following case demonstrates an unusual presentation of recurrent Acanthamoeba infection in a 30 year old contact lens wearing male. Observations After presenting with recurrent Acanthamoeba keratitis and undergoing various treatments, the patient developed nodular scleritis, which evolved into panophthalmitis, and ultimately, required enucleation. Eight months post-operatively, the patient developed orbital implant exposure secondary to persistent Acanthamoeba infection and underwent removal of the implant and aggressive, systemic treatment involving a multispecialty care team. He then underwent placement of a dermis fat graft and had no signs of persistent infection at the time of last follow-up, which was 24 months after placement of the dermis fat graft. Conclusions and Importance: To the authors' knowledge, this is the first known case of Acanthamoeba infection causing orbital implant exposure. Persistent infection should be considered in Acanthamoeba patients who have undergone enucleation and have orbital implant exposure. Better knowledge regarding the pathogenesis and extracorneal complications of this challenging disease may improve patient care and outcomes.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.043
      Issue No: Vol. 10 (2018)
       
  • Cryptococcal choroiditis in advanced AIDS with clinicopathologic
           correlation

    • Authors: Christopher M. Aderman; Ian R. Gorovoy; Daniel L. Chao; Michele M. Bloomer; Anthony Obeid; Jay M. Stewart
      Pages: 51 - 54
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Christopher M. Aderman, Ian R. Gorovoy, Daniel L. Chao, Michele M. Bloomer, Anthony Obeid, Jay M. Stewart
      Purpose To describe a case of disseminated cryptococcal meningitis with multifocal choroiditis and provide optical coherence tomography (OCT) findings correlated with described histopathology in a patient with advanced acquired immunodeficiency syndrome (AIDS). Observations The patient was a 54-year-old man with AIDS who presented with dyspnea and headache followed by acute vision loss. OCT demonstrated a lesion with a small area of fluid that was limited by a more prominent and irregular external limiting membrane with underlying nodular choroidal thickening, mild RPE disorganization, and hyperreflectivity of the overlying photoreceptor layer. Patient was found to have disseminated cryptococcal infection and passed away despite aggressive therapy. Autopsy was performed including bilateral enucleation and a Cryptococcus lesion was confirmed on histopathology. Conclusion and importance This case highlights the clinical, imaging, and histopathologic findings of cryptococcal choroiditis and provides a review of the updated treatment recommendations for disseminated infection in a patient with advanced AIDS. Although currently fundoscopy has proven most useful in directing the diagnostic algorithm in choroiditis in the setting of advanced immunosuppression, OCT may provide insight into the spread of Cryptococcus within the eye.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.045
      Issue No: Vol. 10 (2018)
       
  • Rescue technique for complete removal of an accidentally ruptured orbital
           dumbbell deep dermoid cyst: A case report

    • Authors: Pei-Hsuan Lin; Yoshiyuki Kitaguchi; Jacqueline Mupas-Uy; Yasuhiro Takahashi; Hirohiko Kakizaki
      Pages: 55 - 58
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Pei-Hsuan Lin, Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Hirohiko Kakizaki
      Purpose To report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst. Observations A 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone. There was a small defect of the epithelial lining at the inferoposterior margin of the cyst. Granulomatous inflammation of the lacrimal gland was found adjacent to the defect site. The cyst was completely removed and the lacrimal inflammation subsided after the operation. Conclusions and importance Opening of the cyst is a useful technique to remove the entire epithelial lining of an accidentally ruptured dumbbell dermoid cyst.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.044
      Issue No: Vol. 10 (2018)
       
  • Solitary retinal hemangioblastoma findings in OCTA pre- and post-laser
           therapy

    • Authors: Brian W. Chou; Peter L. Nesper; Lee M. Jampol; Rukhsana G. Mirza
      Pages: 59 - 61
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Brian W. Chou, Peter L. Nesper, Lee M. Jampol, Rukhsana G. Mirza
      Purpose To report optical coherence tomography angiography (OCTA) findings pre- and post-thermal laser therapy of a rare, asymptomatic, unilateral, isolated retinal hemangioblastoma. Observations A 40-year-old asymptomatic Caucasian man was found to have an isolated, unilateral retinal hemangioblastoma after referral for possible retinal hole. Comparison of OCTAs pre- and post-thermal laser therapy demonstrated a significant reduction of blood flow toward and within the lesion, in addition to contraction of the lesion and constriction of the accompanying feeder vessels. A 4-month follow-up OCTA showed marked reduction of lesion size, and caliber of treated vessels. Conclusions and importance Non-invasive OCTA imaging of a retinal hemangioblastoma demonstrated decreased blood flow signal and vessel caliber after treatment. OCTA shows potential as a new tool to improve our understanding of the effectiveness of therapy in these lesions.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.036
      Issue No: Vol. 10 (2018)
       
  • Visual acuity of 20/32, 13.5 years after a retinal pigment epithelium and
           choroid graft transplantation

    • Authors: Elsbeth J.T. van Zeeburg; Kristel J.M. Maaijwee; Jan C. van Meurs
      Pages: 62 - 64
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Elsbeth J.T. van Zeeburg, Kristel J.M. Maaijwee, Jan C. van Meurs
      Purpose To present the 13.5-year-survival of an autologous retinal pigment epithelium (RPE) and choroid graft transplantation with good visual acuity results. Observations A 72-year old patient presented with a 5-weeks-old visual acuity deterioration to excentric finger counting at half a meter. Fundoscopy showed a fibrotic macular scar, a large subretinal hemorrhage, partly recent, combined with intraretinal fluid, blood, and hard exudates. RPE-choroid graft surgery was performed, and visual acuity improved to 20/32, and maintained up until 13.5 years postoperative. Microperimetry performed at the same time revealed a 3.4 dB sensitivity, with fixation on the graft. During the postoperative years glaucoma developed, an uveitis anterior was treated, and to treat a small Coats' like lesion; one bevacizumab injection was administered. Conclusions and importance A best corrected visual acuity of 20/32 could be achieved and maintained up to 13.5 years after an RPE-choroid graft transplantation, despite an unfavorable preoperative presentation and some early and late complications. This case is a proof of principle that an RPE-choroid graft harvested from the midperiphery can support the macular metabolism up to 13.5 after surgery in a patient with severe exudative AMD. It also represents a rationale for pursuing stem cell derived RPE replacement. Anti-vascular endothelial growth factor injections are nowadays the mainstay of therapy for choroidal neovascularization and/or small hemorrhages and offer good results. Nevertheless, selected patients that cannot benefit from this therapy may profit from an autologous RPE-choroid graft transplantation.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.042
      Issue No: Vol. 10 (2018)
       
  • Advanced pigment dispersion glaucoma secondary to phakic intraocular
           collamer lens implant

    • Authors: Clara Ye; Cajal K. Patel; Anna C. Momont; Yao Liu
      Pages: 65 - 67
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Clara Ye, Cajal K. Patel, Anna C. Momont, Yao Liu
      Purpose We report a case of pigment dispersion glaucoma secondary to uncomplicated phakic intraocular collamer lens (ICL) (Visian ICL™, Staar Inc., Monrovia, CA) implant that resulted in advanced visual field loss. Observations A 50-year-old man presented for routine follow-up status post bilateral phakic intraocular collamer lens (ICL) placement 8 years earlier. He was incidentally found to have a decline in visual acuity from an anterior subcapsular cataract and elevated intraocular pressure (IOP) in the left eye. There were signs of pigment dispersion and no evidence of angle closure. Diffuse optic nerve thinning was consistent with advanced glaucomatous visual field defects. Pigment dispersion was also present in the patient's right eye, but without elevated IOP or visual field defects. The patient was treated with topical glaucoma medications and the phakic ICL in the left eye was removed concurrently with cataract surgery to prevent further visual field loss. Conclusions and importance Pigment dispersion glaucoma is a serious adverse outcome after phakic ICL implantation and regular post-operative monitoring may prevent advanced visual field loss.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.01.046
      Issue No: Vol. 10 (2018)
       
  • Bariatric surgery and its impact on pseudotumor cerebri: A case report

    • Authors: Norberto Mancera; Michel M. Murr; Mitchell Drucker
      Pages: 68 - 70
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Norberto Mancera, Michel M. Murr, Mitchell Drucker
      Purpose Pseudotumor cerebri is a debilitating condition that causes severe headaches and progressive visual field loss. In this report, we present a patient with Class III obesity, with pseudotumor cerebri who failed medical management and attempted weight loss via diet and exercise. Observations After undergoing bariatric surgery, the patient had significant weight loss and improvement of visual field defects. Conclusion and importance These results suggest that bariatric surgery may be an effective option for patients with rapidly progressing visual loss due to pseudotumor cerebri.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.01.047
      Issue No: Vol. 10 (2018)
       
  • Solitary eyelid neurofibroma presenting as tarsal cyst: Report of a case
           and review of literature

    • Authors: Nisar Sonam Poonam; Md Shahid Alam; Dipankar Das; Jyotirmay Biswas
      Pages: 71 - 73
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Nisar Sonam Poonam, Md Shahid Alam, Dipankar Das, Jyotirmay Biswas
      Purpose To report a rare case of solitary eyelid neurofiboma presenting as tarsal cyst. Observation A 64 year old male, presented with a painless, non progressive swelling in the right upper eye lid. Examination revealed a non tender, firm, mass adherent to the underlying tarsus. Excision via a conjunctival approach was performed and the histopathology was suggestive of neurofibroma. Immunohistochemistry was positive for Vimentin and focally positive for S-100. The patient did not have any features of neurofibromatosis. Conclusion and Importance: Solitary neurofibroma of the eyelid does not have any systemic association with neurofibromatosis, and only seven such cases have been reported in English literature. We report a case of solitary neurofibroma of the eyelid presenting as tarsal cyst. A thorough review of literature of previously reported cases is included.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.02.002
      Issue No: Vol. 10 (2018)
       
  • Visual recovery after surgical repair of chronic macular detachment
           associated with peripheral retinoschisis

    • Authors: Vaidehi S. Dedania; Devon H. Ghodasra; Mark W. Johnson
      Pages: 74 - 76
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Vaidehi S. Dedania, Devon H. Ghodasra, Mark W. Johnson
      Purpose To report 2 cases of chronic macular detachment associated with peripheral retinoschisis in which surgical repair resulted in significant visual recovery. Observations A 44-year-old man and 60-year-old woman were evaluated for chronic macular detachment, with a duration of 5 years and 6 months, respectively. In each case, optical coherence tomography was used to establish a diagnosis of full-thickness macular detachment resulting from peripheral retinoschisis and to confirm or identify the pathogenic outer layer breaks. After surgical repair with pars plana vitrectomy, endolaser photocoagulation of outer layer breaks, and gas tamponade, both patients had significant improvement in vision. The best-corrected visual acuity improved from 20/50- to 20/20 at one year post-operatively in the first patient and from 20/1250 to 20/200 at 8 months post-operatively in the second. Conclusion and importance In cases of chronic schisis-detachment involving the macula, surgical intervention can sometimes result in unexpected levels of visual recovery.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.01.005
      Issue No: Vol. 10 (2018)
       
  • Is it melanoma-associated retinopathy or drug toxicity' Bilateral
           cystoid macular edema posing a diagnostic and therapeutic dilemma

    • Authors: Sachi R. Patel; Stavros N. Moysidis; Nicole Koulisis; Philip P. Storey; Amir H. Kashani; Narsing A. Rao; Damien C. Rodger
      Pages: 77 - 80
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Sachi R. Patel, Stavros N. Moysidis, Nicole Koulisis, Philip P. Storey, Amir H. Kashani, Narsing A. Rao, Damien C. Rodger
      Purpose To report the clinical presentation, multimodal imaging, and management of a patient with metastatic melanoma who presented with cystoid macular edema (CME). Observations We report a case of a 71-year-old Caucasian male with metastatic melanoma who presented with bilateral cystoid macular edema after being on treatment with a programmed T cell death ligand 1 inhibitor, MPDL3280, for 1 year. Multimodal imaging techniques, including color fundus photographs, autofluorescence, spectral domain optical coherence tomography (OCT), fluorescein angiography (Spectralis, Heidelberg, Germany), and spectral-domain OCT angiography (Zeiss; California, USA) were performed to evaluate the etiology of his CME and to monitor his response to treatment. Clinical examination and multimodal imaging revealed 1 + chronic vitreous cells, an epiretinal membrane, and mild macular edema in both eyes. Fundus autofluorescence showed paravenous hypoautofluorescence in the right eye and scattered hypoautofluorescent spots in the left eye. Optical coherence tomography angiography (OCTA) revealed mild drop out of superficial vessels in the peri-foveal region bilaterally. These findings were concerning for melanoma-associated retinopathy, drug-related uveitis, or activation of a previous chronic autoimmune process. The patient was started on prednisone 30 mg oral daily and ketorolac tromethamine 0.5% 1 drop four times daily. He was then treated with bilateral sustained-release dexamethasone intravitreal implants (Ozurdex). He had complete resolution of CME, and was tapered off of oral steroids within 6 weeks. Conclusions and Importance Melanoma-associated retinopathy can be accompanied by CME, which presents a diagnostic and therapeutic dilemma in cases where a new drug has been recently initiated. By treating the condition locally, the ophthalmologist may be able to taper systemic immunosuppression more quickly.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.01.030
      Issue No: Vol. 10 (2018)
       
  • Orbital apex syndrome from bacterial sinusitis without orbital cellulitis

    • Authors: Margaret L. Pfeiffer; Helen A. Merritt; Lucy A. Bailey; Karina Richani; Margaret E. Phillips
      Pages: 84 - 86
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Margaret L. Pfeiffer, Helen A. Merritt, Lucy A. Bailey, Karina Richani, Margaret E. Phillips
      Purpose To describe a case of orbital apex syndrome as a result of isolated bacterial sinusitis. Observations A 63-year-old woman presented with an orbital apex syndrome from isolated bacterial sinusitis with rapidly declining visual acuity to no light perception. We compared our case with 6 similar cases of severe vision loss from isolated bacterial sinusitis. In contrast to previously published cases, our patient presented with good vision yet deteriorated to no light perception despite appropriate treatment. Conclusions and importance Orbital apex syndrome can present as a constellation of cranial neuropathies including optic neuropathy from conditions affecting the orbital apex. Although vision loss remained permanent, prompt initiation of broad-spectrum antibiotics and antifungals and surgical intervention prevented further extension of infection into intracranial structures.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.01.041
      Issue No: Vol. 10 (2018)
       
  • Late-onset bleb-associated endophthalmitis and continuous positive airway
           pressure

    • Authors: Erich J. Berg; John B. Davies; Mark R. Buboltz; Thomas W. Samuelson
      Pages: 87 - 90
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Erich J. Berg, John B. Davies, Mark R. Buboltz, Thomas W. Samuelson
      Purpose To raise awareness of a possible association between continuous positive airway pressure (CPAP) devices and postoperative bleb-related infection. Observations A 57-year old patient on CPAP presented with unilateral bleb-associated endophthalmitis 32 months after routine ExPress Trabeculectomy with mitomycin C. The offending organism, Streptococcus mitis, is a nonmotile and generally non-virulent pathogen which predominates in the normal human respiratory flora. Conclusions and importance This conceptual report underscores a potential relationship between CPAP use and bleb-associated endophthalmitis. Streptococcal species are the most commonly reported causative organisms in bleb-associated endophthalmitis, and S. mitis is of particular concern as the most abundant microbe among all human oral flora. A logical risk factor for infection, the CPAP device may inadvertently deliver such organisms to the vulnerable conjunctival filtering bleb.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.02.007
      Issue No: Vol. 10 (2018)
       
  • Severe visual loss and recovery post trabeculectomy- A case report

    • Authors: Sana' Muhsen
      Pages: 91 - 95
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Sana' Muhsen
      Purpose Glaucoma is a progressive optic neuropathy and a leading cause of blindness. Neural losses from glaucoma are irreversible, and so the aim of glaucoma treatment is to slow progression and minimize the risk of further damage. Visual loss post filtration surgery in patients with advanced glaucomatous optic nerve damage is a rare but dreaded complication. Functional improvement is not expected. We report the case of a patient who experienced a significant loss of vision following glaucoma surgery that was followed by late visual recovery. We will also review the literature regarding this phenomenon. Case presentation/Observations A 60-year old male presented with a history of right pseudoexfoliative glaucoma and uncontrolled intraocular pressure(IOP) on medical and laser treatment. He underwent a successful right Mitomycin C augmented trabeculectomy combined with phacoemulsification. Unexpectedly, he experienced a marked decrease in vision from 0.3 to hand motion with no identifiable explanation. The loss of vision continued for almost 4 months before a significant improvement in vision occurred and his visual acuity came up to 0.6. Although the mechanism of loss or improved vision cannot be proven, it is likely that post operative IOP spikes which were repeatedly above 30 mmHg in the first week, resulted in ganglion cell dysfunction rather than apoptosis which can explain the improvement in vision in the later months when pressure was maintained at target. Conclusion and Importance: Although rare, Wipe out phenomenon is possible in the setting of advanced glaucomatous optic neuropathy. However, functional improvements may occur following IOP control. Glaucoma surgery should be offered early to those with advanced disease.

      PubDate: 2018-02-16T15:55:11Z
      DOI: 10.1016/j.ajoc.2018.02.003
      Issue No: Vol. 10 (2018)
       
  • Acute macular neuroretinopathy associated with influenza vaccination with
           decreased flow at the deep capillary plexus on OCT angiography

    • Authors: Jeffrey C. Liu; Peter L. Nesper; Amani A. Fawzi; Manjot K. Gill
      Pages: 96 - 100
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Jeffrey C. Liu, Peter L. Nesper, Amani A. Fawzi, Manjot K. Gill
      Purpose We report a case of acute macular neuroretinopathy (AMN) following routine annual inactivated influenza vaccination. Projection-resolved optical coherence tomography angiography (PR-OCTA) was used to analyze the retinal capillary flow within the AMN lesion. Observations Our patient reported visual symptoms of her right eye nine days after routine annual influenza vaccination. Multimodal imaging revealed small vessel peripheral vasculitis and AMN in the affected eye. Infectious, immunologic, and hypercoagulable etiologies were investigated and excluded. PR-OCTA B-scans within the AMN lesion demonstrated reduced flow in the deep capillary plexus (DCP) at baseline with relatively improved flow signal in the DCP on follow up, 3 weeks later. Conclusions and importance We report a new association of AMN following routine inactivated influenza immunization. Recent influenza vaccination should be included in the differential diagnosis for patients presenting with AMN. PR-OCTA demonstrated compromised DCP flow in the AMN lesion which has not been previously described.

      PubDate: 2018-02-26T19:46:49Z
      DOI: 10.1016/j.ajoc.2018.02.008
      Issue No: Vol. 10 (2018)
       
  • Hemorrhagic choroidal melanoma

    • Authors: Patrick Oellers; Natalie Wolkow; Frederick A. Jakobiec; Ivana K. Kim
      Pages: 105 - 107
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Patrick Oellers, Natalie Wolkow, Frederick A. Jakobiec, Ivana K. Kim
      Purpose To demonstrate the clinical pathologic correlation in a hemorrhagic choroidal melanoma. Observations A 52 year old patient presented with a large choroidal mass associated with vitreous and retinal hemorrhage. The eye was enucleated and histopathology demonstrated epithelioid-type MART1 positive tumor cells consistent with choroidal melanoma. The tumor had broken through Bruch's membrane, which led to localized vascular compression with bleeding into the subretinal space, retina and vitreous. Conclusions and importance Choroidal melanoma rarely presents with hemorrhage. Tumor rupture through Bruch's membrane may result in a tourniquet effect on the tumor vasculature leading to massive hemorrhage, as in this case. A high level of clinical suspicion is required to make the diagnosis.

      PubDate: 2018-02-26T19:46:49Z
      DOI: 10.1016/j.ajoc.2018.02.001
      Issue No: Vol. 10 (2018)
       
  • Improvement of chronic corneal opacity in ocular surface disease with
           prosthetic replacement of the ocular surface ecosystem (PROSE) treatment

    • Authors: Anna Cressey; Deborah S. Jacobs; Crystal Remington; Karen G. Carrasquillo
      Pages: 108 - 113
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Anna Cressey, Deborah S. Jacobs, Crystal Remington, Karen G. Carrasquillo
      Purpose To demonstrate clearing of chronic corneal opacities and improvement of visual acuity with the use of BostonSight prosthetic replacement of the ocular surface ecosystem (PROSE) treatment in ocular surface disease. Observations We undertook retrospective analysis of the medical records of a series of patients who underwent PROSE treatment from August 2006 to December 2014. Patients were referred for ocular surface disease of various etiologies. Primary inclusion criterion was corneal opacity that improved with PROSE treatment. Patients were excluded if topical steroids or adjuvant therapy used once PROSE treatment was initiated. Underlying disease, prior treatment, clinical presentation, and clinical course were extracted from the medical record. Four patients are included in this series. There were three females and one male; median age at time of treatment initiation was 30 years (range = 0.5–58 years). Median duration of PROSE treatment at time of retrospective analysis was 3.5 years (range = 1–8 years). Two cases had corneal opacification in the context of neurotrophic keratopathy: a unilateral case due to presumed herpes simplex keratitis and a bilateral case due to congenital corneal anesthesia associated with familial dysautonomia. One case had corneal opacity from exposure related to seventh nerve palsy, and one had corneal opacification associated with recurrent surface breakdown, neurotrophic keratopathy, and limbal stem deficiency of uncertain etiology. After consistent wear of prosthetic devices used in PROSE treatment for support of the ocular surface, visual acuity improved and clearing of the opacities was observed, without use of topical steroids or adjuvant therapy. Conclusions and importance These cases demonstrate clearing of chronic corneal opacity with PROSE treatment for ocular surface disease. This clearing can occur with no adjuvant therapy, suggesting that restoration of ocular surface function and integrity allows for corneal remodeling.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.010
      Issue No: Vol. 10 (2018)
       
  • Use of Nd:YAG laser to recanalize occluded Cypass Micro-Stent in the early
           post-operative period

    • Authors: Claudio I. Perez; Sunee Chansangpetch; Yen C. Hsia; Shan C. Lin
      Pages: 114 - 116
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Claudio I. Perez, Sunee Chansangpetch, Yen C. Hsia, Shan C. Lin
      Purpose To report the first case of Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser use to recanalize a CyPass occluded with a clot in the early postoperative follow-up. Observations A 66 year-old woman with primary open angle glaucoma and cataract received combined cataract surgery plus CyPass in the right eye. Surgery was uneventful, however, there was a small amount of hyphema related to bleeding around the site of Cypass insertion. Intraocular pressure (IOP) was between 6 and 7 mmHg in the first week on no glaucoma medications. At the second postoperative week, IOP jumped to 30 mmHg and a clot was observed obstructing the CyPass lumen. We disrupted the clot with a single shot from a Nd:YAG laser. Twenty minutes after the laser, the IOP was 8 mmHg. CyPass was recanalized without complications. IOP was 11 mmHg at 1 month postoperatively with timolol 0.5% twice a day. Conclusions and importance It is important to perform gonioscopy to evaluate for CyPass obstruction in cases of IOP spike. Nd:YAG laser may be a useful approach to recanalize the CyPass in the early postoperative follow-up.

      PubDate: 2018-02-26T19:46:49Z
      DOI: 10.1016/j.ajoc.2018.02.011
      Issue No: Vol. 10 (2018)
       
  • Combination nivolumab- and cabiralizumab-associated acute bilateral
           anterior and posterior scleritis and anterior uveitis

    • Authors: John A. Gonzales; Jessica Shantha; Nisha R. Acharya
      Pages: 117 - 118
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): John A. Gonzales, Jessica Shantha, Nisha R. Acharya
      Purpose To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone. Conclusions and importance Ophthalmologists should be aware of the possibility of acute ocular inflammation developing with cancer immunotherapy. Systemic corticosteroids play a first-line role in managing such immune-mediated side effects.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.005
      Issue No: Vol. 10 (2018)
       
  • Retinal pigment epithelium changes in Kartagener syndrome

    • Authors: Maria D. Garcia; Camila V. Ventura; João R. Dias; Ta Chen P. Chang; Audina M. Berrocal
      Pages: 119 - 121
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Maria D. Garcia, Camila V. Ventura, João R. Dias, Ta Chen P. Chang, Audina M. Berrocal
      Purpose We present the first case in the literature of a patient with Kartagener syndrome and ocular findings of nonexudative age-related macular degeneration. Observations A 55-year-old woman with Kartagener syndrome and chronic angle closure glaucoma presented for evaluation of the retina. Optos ultra-widefield imaging of the fundus showed glaucomatous cupping, drusen, and retinal pigment epithelium changes within the macular region. Humphrey visual field testing confirmed glaucomatous changes. Drusenoid pigment epithelial detachments were observed bilaterally with optical coherence tomography. Conclusions and importance We hypothesize that in addition to the lungs, spermatozoa and the Fallopian tubes, the retinal pigment epithelium may also be affected by ciliary dysfunction in individuals with Kartagener syndrome. Given recent advances in our knowledge of retinal ciliopathies, further studies are needed to understand how ciliary dysfunction affects the retina in Kartagener syndrome.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.006
      Issue No: Vol. 10 (2018)
       
  • Possible dissemination of conjunctival melanoma along tear flow path

    • Authors: Toshinobu Kubota; Tomonori Kawasaki
      Pages: 122 - 123
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Toshinobu Kubota, Tomonori Kawasaki


      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.017
      Issue No: Vol. 10 (2018)
       
  • Orbital melanocytoma: When a tumor becomes a relieving surprise

    • Authors: Haytham E. Nasr; Mohamed A. Nouh; Rania A. Ahmed; Abdelrahman M. Elhusseiny
      Pages: 124 - 127
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Haytham E. Nasr, Mohamed A. Nouh, Rania A. Ahmed, Abdelrahman M. Elhusseiny
      Purpose Melanocytomas are rare pigmented tumors that arise form melanocytes and have been reported in the central nervous system. Orbital melanocytomas “also known as blue nevus” are rarely reported. The occurrence of choroidal melanoma and orbital melanocytomas has never been described. Observations This is a case of orbital melanocytoma in a 34 year old female who presented with left proptosis and ecchymosis. She has the right eye enucleated to treat a large choroidal melanoma, 6 years earlier. Orbital metastasis was suspected. After orbital imaging and systemic evaluation, incisional biopsy was planned yet the mass could be totally excised and it turned out to be melanocytoma. The condition was not associated with nevus of Ota and the patient is not known to have any predisposing condition for melanocytic lesions. Conclusion and importance Melanocytoma and malignant melanoma share the same cell of origin. The benign course, the well differentiated cells, absence of anaplasia and the positive reaction to Human Melanoma Black-45 (HMB-45) and S-100 proteins established the diagnosis of the former. Such diagnosis was a relief for this one eyed patient. (HMB-45:human melanoma black-45).

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.018
      Issue No: Vol. 10 (2018)
       
  • Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct
           syndrome associated with severe cough

    • Authors: Angela Jinsook Oh; Bryan Alexander Lanzman; Yaping Joyce Liao
      Pages: 128 - 131
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Angela Jinsook Oh, Bryan Alexander Lanzman, Yaping Joyce Liao
      Purpose Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Observations A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1–2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500–3000 mg per day. Conclusions and importance We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.009
      Issue No: Vol. 10 (2018)
       
  • Multimodal imaging characteristics of quiescent type 1 neovascularization
           in an eye with angioid streaks

    • Authors: Jale Mentes; Irmak Karaca; Figen Sermet
      Pages: 132 - 136
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Jale Mentes, Irmak Karaca, Figen Sermet
      Purpose To present the multimodal imaging characteristics including optical coherence tomography angiography (OCTA) as well as indocyanine green angiography (ICGA) of quiescent type 1 neovascularization (NV) in an asymptomatic eye with angioid streaks (AS). Observations A 67-year-old male patient was admitted to our clinic for routine eye examination. The presence of a quiescent type 1 NV was detected on both ICGA and OCTA in juxtafoveal localization under the retinal pigment epitheliumin the right eye. At the end of the one year of follow-up, the patient was asymptomatic and the type 1 NV was still quiescent. Conclusions and Importance In comparison to ICGA, OCTA seems to be an easily repeatable non-invasive imaging tool which enables us early detection and monitoring of type 1 NV lesions even in asymptomatic patients with AS.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.014
      Issue No: Vol. 10 (2018)
       
  • Clinical features and visual function in a patient with Fish-eye disease:
           Quantitative measurements and optical coherence tomography

    • Authors: Masanori Kanai; Shizuka Koh; Daisaku Masuda; Masahiro Koseki; Kohji Nishida
      Pages: 137 - 141
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Masanori Kanai, Shizuka Koh, Daisaku Masuda, Masahiro Koseki, Kohji Nishida
      Purpose We describe a case of fish-eye disease (FED) where the clinical features and visual function were investigated using anterior segment optical coherence tomography (OCT) and quantitative measurements. Observations A 36-year-old Japanese woman with FED presented with bilateral corneal opacities and visual complaints. Both contrast sensitivity and straylight were measured and OCT imaging was performed. Contrast sensitivity and straylight measurements revealed remarkably decreased visual function, despite good visual acuity. OCT demonstrated homogenously hyper-reflective corneal opacification, and a normal total corneal thickness. Conclusions and Importance The findings from this case suggest that OCT is useful for analyzing the clinical features of FED, and that the quantitative measurement of visual function furthers the understanding of vision-related symptoms in FED, despite good visual acuity.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.016
      Issue No: Vol. 10 (2018)
       
  • Silicone oil droplets following intravitreal bevacizumab injections

    • Authors: Jea H. Yu; Esmeralda Gallemore; Jisoo K. Kim; Rocky Patel; Jorge Calderon; Ron P. Gallemore
      Pages: 142 - 144
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Jea H. Yu, Esmeralda Gallemore, Jisoo K. Kim, Rocky Patel, Jorge Calderon, Ron P. Gallemore
      Purpose To report the transient resurgence of symptomatic silicone oil droplets following intravitreal bevacizumab injections. Observations We report seven patients presenting with silicone oil droplets following intravitreal bevacizumab injections. These were the first cases noted in 10 years using the same supplier of preloaded syringes in an estimated 90,413 injections performed by 7 physicians. They occurred during a 4 month period (06–10/2016), suggesting they may have been related to a batch or batches of syringes. Symptomatic floaters attributed to the droplets were noted on an average of 6.7 ± 1.5 days following the injection and followed an average of 10.4 ± 3.75 injections over a period of 3.4 ± 1.9 years and resolved in 5 of our 7 patients within 9 months. Conclusions and importance Symptomatic intravitreal silicone oil droplets are a rare complication of intravitreal injections. Symptoms are generally transient and not clinically significant and hence the benefits of treating potentially blinding eye diseases in this fashion appear to outweigh the limited risk of the rare, temporary floaters. The current series may be related to a batch or batches of syringes.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2017.07.009
      Issue No: Vol. 10 (2018)
       
  • Disseminated Nocardiosis with retinal abscess in a patient treated for
           bullous pemphigoid

    • Authors: Sidharth Puri; Amir Hadayer; Andrea Breaux; Charles C. Barr
      Pages: 145 - 147
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Sidharth Puri, Amir Hadayer, Andrea Breaux, Charles C. Barr
      Purpose To report a case of disseminated Nocardiosis with retinal and intracranial lesions. Observations A 49-year-old woman immunosuppressed because of treatment given for bullous pemphigoid presented with altered mental status and multiple intracranial lesions on imaging. The patient was found to have multiple retinal lesions in both eyes, including a subretinal abscess in the right eye. The patient underwent brain biopsy, confirming Nocardia farcinica histopathologically and in culture. Conclusions and Importance Ocular Nocardiosis is a rare disease with varying prognosis that requires prompt diagnosis to ensure appropriate medical therapy.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.015
      Issue No: Vol. 10 (2018)
       
  • Isolated orbital mass as the primary presentation of a triple-hit lymphoma
           transformed from a systemic follicular lymphoma

    • Authors: Xiao Yi Zhou; Xinyan Lu; Kirtee Raparia; Yi-Hua Chen
      Pages: 156 - 158
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Xiao Yi Zhou, Xinyan Lu, Kirtee Raparia, Yi-Hua Chen
      Purpose Triple-hit lymphoma is a highly aggressive B-cell lymphoma. We report a case of triple-hit lymphoma transformed from systemic follicular lymphoma (FL) after 9-year remission and presented primarily as an isolated orbital mass without systemic symptoms or lymphadenopathy. Observations A 58-year-old female presented with intermittent vertical binocular diplopia, left upper eyelid swelling and pain and was found to have a 2.9 cm orbital mass. Histological section revealed a CD10-positive large B-cell lymphoma, consistent with transformation of FL. Fluorescent in situ hybridization (FISH) analysis demonstrated rearrangements involving C-MYC, BCL-2 and BCL-6 genes, indicating a high grade, triple-hit lymphoma. Conclusions and importance Triple-hit lymphoma transformed from a low-grade lymphoma may initially present as an isolated orbital mass without systemic evidence of transformation. Early recognition of double or triple-hit lymphomas is important since these patients require aggressive chemotherapy.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.012
      Issue No: Vol. 10 (2018)
       
  • Spontaneous regression of epithelial downgrowth from clear corneal
           phacoemulsification wound

    • Authors: Ryan M. Jaber; Mark Harrod; Jeffrey M. Goshe
      Pages: 159 - 162
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Ryan M. Jaber, Mark Harrod, Jeffrey M. Goshe
      Purpose To report a case of spontaneous regression of optical coherence tomography (OCT) and confocal microscopy-supported epithelial downgrowth associated with clear corneal phacoemulsification wound. Observations A 66-year-old Caucasian male presented two years after phacoemulsification in the left eye with an enlarging cornea endothelial lesion in that eye. His early post-operative course had been complicated by corneal edema and iris transillumination defects. The patient presented to our clinic with a large geographic sheet of epithelial downgrowth and iris synechiae to the temporal clear corneal wound. His vision was correctable to 20/25 in his left eye. Anterior segment OCT showed a hyperreflective layer on the posterior cornea with an abrupt transition that corresponded to the clinical transition zone of the epithelial downgrowth. Confocal microscopy showed polygonal cells with hyperreflective nuclei suggestive of epithelial cells in the area of the lesion with a transition to a normal endothelial cell mosaic. Given the lack of glaucoma or inflammation and the relatively good vision, the plan was made to closely monitor for progression with the anticipation that he may require aggressive surgery. Over course of subsequent follow-up visits at three, seven and ten months; the endothelial lesion receded significantly. Confocal imaging in the area of the previously affected cornea showed essentially normal morphology with anan endothelial cell count of 1664 cells/mm2. Conclusions and importance Epithelial downgrowth may spontaneously regress. Though the mechanism is yet understood, contact inhibition of movement may play a role. Despite this finding, epithelial downgrowth is typically a devastating process requiring aggressive treatment.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.020
      Issue No: Vol. 10 (2018)
       
  • Case of progressive hyperopia due to flattening of cornea

    • Authors: Hiromasa Hirai; Shinji Maruoka; Tadanobu Yoshikawa; Nahoko Ogata
      Pages: 169 - 171
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Hiromasa Hirai, Shinji Maruoka, Tadanobu Yoshikawa, Nahoko Ogata
      Purpose To report a case that had a progressive decrease in the visual acuity caused by a progressive increase in the hyperopia due to a flattening of the cornea. Observations A 50-year-old woman complained of decreased vision in both eyes. Her decimal best-corrected visual acuity was 1.2 in the right and 0.5 in the left eyes, and the refractive error (spherical equivalent) was +3.75 diopters (D) for the right eye and +6.5 D for the left eye. Slit-lamp examinations showed clear corneas but Descemet‘s folds and fine pigmentations and opacities were present beneath the corneal epithelium in both eyes. Analysis of the corneal shape by anterior segment optical coherence tomography showed that the corneas were flattened, and the corneal refractive power was decreased in both eyes. The large values of the higher-order aberration in the cornea and total eye displayed bilateral irregular astigmatism. She obtained good vision by wearing hard contact lenses but her refractive power continued to decrease for at least 1 year. Conclusions and Importance: We report a rare case of progressive hyperopia and irregular astigmatism due to a flattening of the cornea. Folds were present in Descemet‘s membrane but the cornea was not edematous.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.013
      Issue No: Vol. 10 (2018)
       
  • Case series: Pyramidal cataracts, intact irides and nystagmus from three
           novel PAX6 mutations

    • Authors: Bharesh K. Chauhan; Anagha Medsinge; Matthew P. Baumgartner; Hannah L. Scanga; Smaragda Kamakari; Eva Gajdosova; Carlos J. Camacho; Ken K. Nischal
      Pages: 172 - 179
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Bharesh K. Chauhan, Anagha Medsinge, Matthew P. Baumgartner, Hannah L. Scanga, Smaragda Kamakari, Eva Gajdosova, Carlos J. Camacho, Ken K. Nischal
      Purpose To investigate the association between novel PAX6 mutations to bilateral anterior pyramidal congenital cataracts (APyC), complete and intact irides, and nystagmus. Observations This is a retrospective observational case series in a multi-center setting with genetic testing. Three female patients were diagnosed with bilateral APyC, intact irides and nystagmus. Genetic testing identified the three patients had novel missense mutations in PAX6 – c.128C > T; p.Ser43Phe (S43F), c. 197T > A; p.Ile66Asn (I66N) and c.781C > G; p.Arg261Gly (R261G). Conclusions and importance This study demonstrates a novel phenotype of bilateral APyC, intact irides, and nystagmus in whom genetic testing for PAX6 identified novel missense mutations (S43F, I66N, R261G) in highly conserved DNA-binding domains. Implications of understanding why the iris is present in these cases is discussed.

      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.02.021
      Issue No: Vol. 10 (2018)
       
  • Herpes zoster ophthalmicus: Pre-eruption phase sine herpete

    • Authors: Rohini R. Sigireddi; Lance J. Lyons; Hilary A. Beaver; Andrew G. Lee
      Pages: 201 - 202
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Rohini R. Sigireddi, Lance J. Lyons, Hilary A. Beaver, Andrew G. Lee


      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.03.004
      Issue No: Vol. 10 (2018)
       
  • Do no harm: Observation only in a 98-year-old woman with a suspicious
           large intraocular tumour

    • Authors: Ido Didi Fabian; Mandeep S. Sagoo
      Pages: 206 - 207
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Ido Didi Fabian, Mandeep S. Sagoo


      PubDate: 2018-03-19T04:18:55Z
      DOI: 10.1016/j.ajoc.2018.03.011
      Issue No: Vol. 10 (2018)
       
  • Morpho-functional evaluation of torpedo maculopathy with optical coherence
           tomography angiography and microperimetry

    • Authors: Gabriela Grimaldi; Andrea Scupola; Maria G. Sammarco; Michele Marullo; Maria A. Blasi
      Abstract: Publication date: Available online 3 March 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Gabriela Grimaldi, Andrea Scupola, Maria G. Sammarco, Michele Marullo, Maria A. Blasi
      Purpose To report the case of a 13-year-old girl with torpedo maculopathy, evaluated with multimodal morpho-functional retinal imaging, including fundus photography, infra-red and blue fundus autofluorescence, swept-source optical coherence tomography (OCT), en face OCT, OCT angiography and microperimetry (MP). Observations On fundus examination, a torpedo-like hypopigmented lesion was observed temporal to the fovea in the left eye. OCT showed disruption of outer retinal layers and the presence of a subretinal cleft. On OCTA, a diffuse attenuation of signal from choriocapillaris was observed along the lesion. Functional analysis with MP revealed a reduction of retinal sensitivity over the lesion. Conclusions and importance: On OCTA, torpedo maculopathy is characterized by vascular alterations of the choriocapillaris along the lesion.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.019
       
  • Ocular involvement in neurolymphomatosis

    • Authors: Katy C. Liu; Meridith A. Hennessey; Chad M. McCall; Alan D. Proia
      Abstract: Publication date: Available online 2 March 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Katy C. Liu, Meridith A. Hennessey, Chad M. McCall, Alan D. Proia
      Purpose To describe the ophthalmic symptoms and histopathological findings in a case of primary neurolymphomatosis (NL). Observations A man in his 60s with a prior diagnosis of chronic inflammatory demyelinating polyneuropathy developed facial numbness, diplopia, drooling, and difficulty swallowing. Over a 3-month period, he developed total ptosis and ophthalmoplegia of the right eye with a dilated, non-reactive pupil considered secondary to cranial nerve III and VI palsies. His left pupil subsequently became non-reactive to light and accommodation, and extraocular motility of the left eye was partially limited in all directions of gaze without ptosis. Autopsy findings included primary NL, diffuse large B-cell lymphoma of activated B-cell subtype, involving right and left cranial nerves V, VI, IX, and X; spinal nerve roots; both femoral nerves; and extrascleral, intrascleral, and intraocular short and long posterior ciliary nerves with extension into the adjacent choroid of both eyes. No evidence of lymphoma was identified elsewhere in the body. Conclusions and importance Our patient is only the second histological demonstration of ciliary nerve involvement by NL, and the first, to our knowledge, of primary NL spreading secondarily from the ciliary nerves into the choroid. Our patient demonstrates that NL, though rare, should be included in the differential diagnosis of ocular cranial nerve palsies and ophthalmoplegia.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.023
       
  • Macular edema associated with intraocular ointment after cataract surgery

    • Authors: Asaka Kudo; Takashi Kudo; Daisuke Takahashi; Tomomi Metoki; Yukihiko Suzuki; Mitsuru Nakazawa
      Abstract: Publication date: Available online 2 March 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Asaka Kudo, Takashi Kudo, Daisuke Takahashi, Tomomi Metoki, Yukihiko Suzuki, Mitsuru Nakazawa
      Purpose To report a case with macular edema associated with uveitis, a decreased corneal endothelial cell density, and vitreous opacity caused by migrated intraocular antibiotic ointment after uneventful cataract surgery. Observations A 63-year-old man underwent uneventful sutureless superior clear corneal phacoemulsification and implantation of an intraocular lens in his right eye. Eleven months later, he complained of blurred vision when he gazed downward. Three months later, uveitis, vitreous opacity, and retinal hemorrhage were noted. Optical coherence tomography and fluorescein angiography demonstrated macular edema in the right eye. A slit-lamp examination revealed many tiny oily deposits on the iris surface. One month later, a globular oily droplet was detected at the 12 o'clock position of the iridocorneal angle. Because the corneal endothelial cell density appeared to be progressively decreased, the oily droplet was removed, and the anterior chamber was irrigated with a balanced salt solution using an irrigation-aspiration cannula. After surgery, the macular edema, vitreous opacity, and retinal hemorrhage disappeared. Conclusions and importance In this case, ofloxacin ointment had presumably migrated into the anterior chamber through a corneal incision after cataract surgery. The fact that the droplet of ointment was able to be detected more than one year after the cataract surgery suggests that dispersed tiny droplets can slowly coalesce into a globular droplet and wander between the anterior and posterior chambers, thereby causing uveitis, corneal endothelial cell damage, and macular edema. The removal of the intraocular ointment resolved these complications. This is the first report of intraocular ointment causing macular edema.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.027
       
  • Optiwave Refractive Analysis may not work well in patients with previous
           history of radial keratotomy

    • Authors: Fuxiang Zhang
      Abstract: Publication date: Available online 2 March 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Fuxiang Zhang
      Purpose To report a case of significant hyperopic outcome (both eyes) following Optiwave Refractive Analysis (ORA) intraocular lens (IOL) power recommendation in a cataract patient with history of 8 cut radial keratotomy (RK) in each eye. Observations It is hypothesized that increased intraocular pressure (IOP) from phacoemulsification could make the RK cuts swell, and change cornea shape intraoperatively. In this unique scenario, the corneal curvature readings from ORA could be quite different from preoperative readings or from stabilized postoperative corneal measurements. The change in corneal curvature could also affect the anterior chamber depth and axial length readings, skewing multiple parameters on which ORA bases recommendations for IOL power. Conclusions and importance ORA has been widely used among cataract surgeons on patients with history of RK, but it's validation, unlike for laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK), has yet to be established by peer reviewed studies. Surgeons should be cautious when using ORA on RK patients.

      PubDate: 2018-03-07T00:19:32Z
      DOI: 10.1016/j.ajoc.2018.02.026
       
  • Acute primary angle-closure in Sturge-Weber syndrome

    • Authors: Wei-Wen
      Abstract: Publication date: June 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 10
      Author(s): Wei-Wen Su
      Purpose Sturge-Weber syndrome (SWS) is a neurocutaneous disorder characterized by facial cutaneous venous dilatation (port-wine stain), leptomeningeal angioma, and ocular abnormalities. Here we report a case of SWS who experienced acute primary angle-closure in the same side of the nevus flammeus. Observations A 64-years-old female patient with SWS port wine stain on the left side of her face was referred to our ER for acute primary angle-closure (PAC). The IOP was 64 mmHg in the left eye (12 mmHg in OD) and the visual acuity was 20/100. The acute PAC was aborted after medical treatment with intravenous Mannitol and oral Acetazolamide, but laser iridotomy (LI) was not performed because of the risk of bleeding. After the acute episode, her IOP remained stable in midteen under 3 topical medications. However, the patient reported several subacute attacks in the following month. We arranged phacoemulsification and intraocular lens (IOL) implantation two months after the initial PAC attack. The post-op condition was smooth with 20/20 visual acuity, and the angle opened dramatically on anterior segment optical coherence tomography (AS-OCT). Her IOP was around 13 mmHg without medication and there was no more acute PAC attack. Conclusions SWS with ipsilateral acute PAC has seldom been reported. Lens extraction and IOL implantation can be an option in treating such patients since conventional laser iridotomy may cause bleeding.

      PubDate: 2018-02-26T19:46:49Z
       
  • MRI findings of contralateral oculomotor nerve palsy in Parry-Romberg
           syndrome

    • Authors: Emily K. Tam; Marcela Lonngi; Joseph L. Demer
      Abstract: Publication date: Available online 2 February 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Emily K. Tam, Marcela Lonngi, Joseph L. Demer
      Purpose To study a case of right Parry Romberg syndrome associated with contralateral oculomotor nerve palsy using high-resolution cerebral and orbital magnetic resonance imaging (MRI). Observations There were no brain MRI abnormalities. However, there was marked enophthalmos on the right with reduction of orbital fat. Extraocular muscles contracted normally in the right eye, but in the left eye, there was reduced contractility of the medial, inferior, and superior rectus. The intraorbital motor nerves were unremarkable bilaterally, and the right optic nerve was tortuous. Conclusions and importance Parry Romberg syndrome is a disease of unknown etiology with various ophthalmologic manifestations. This case study contributes extensive MRI data to the limited literature on ophthalmological anatomic findings in a patient who had Parry Romberg syndrome with contralateral strabismus.

      PubDate: 2018-02-05T13:24:33Z
      DOI: 10.1016/j.ajoc.2018.01.048
       
  • Inner retinal vasculopathy in Zika virus disease

    • Authors: Mandeep S. Singh; Maria Carolina Marquezan; Revaz Omiadze; Ashvini K. Reddy; Rubens Belfort; William N. May
      Abstract: Publication date: Available online 17 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Mandeep S. Singh, Maria Carolina Marquezan, Revaz Omiadze, Ashvini K. Reddy, Rubens Belfort, William N. May
      Purpose Zika virus infection is associated with vision-threatening ocular complications including uveitis and outer retinopathy. The aim of this report is to describe a case of an adult patient with serologically confirmed Zika infection who presented with retinal vascular abnormalities that coincided with systemic post-viral neurological manifestations of the disease. Observations A 34-year-old white female presented with symptoms of peripheral neuropathy following serologically confirmed Zika virus infection that was acquired in Puerto Rico four months prior to presentation. Ocular evaluation revealed perifoveal microaneurysms which were not associated with visual symptoms. Conclusions and Importance These data potentially expand the phenotypic spectrum of Zika virus retinopathy. In addition to outer retinal abnormalities which are well-described in infants and adults, inner retinal vascular abnormalities may also occur and may be temporally associated with post-viral neurological sequelae of Zika virus infection. Clinicians should be aware of potential retinal involvement in affected patients who present with neurological symptoms after recovery from acute Zika virus infection.

      PubDate: 2018-01-26T09:43:13Z
      DOI: 10.1016/j.ajoc.2018.01.023
       
  • ND:YAG laser for preretinal hemorrhage in diabetic retinopathy

    • Authors: Dimitrios Karagiannis; Georgios A. Kontadakis; Declan Flanagan
      Abstract: Publication date: Available online 12 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Dimitrios Karagiannis, Georgios A. Kontadakis, Declan Flanagan
      Purpose To present fundus images of a case with severe preretinal hemorrhage in diabetic retinopathy that was treated with posterior hyaloidotomy with an Nd:YAG laser. Observations A 35-year-old diabetic patient presented with sudden painless loss of vision due to severe preretinal hemorrhage over the macular area and high risk proliferative diabetic retinopathy. Her visual acuity was counting fingers. Posterior hyaloid face was treated with Nd:YAG laser (posterior hyaloidotomy). Panretinal laser photocoagulation was first performed to control the proliferative diabetic retinopathy. Blood drained inferiorly into the vitreous cavity with clearance of the premacular area. Conclusions and importance Prompt treatment with Panretinal laser photocoagulation followed by posterior hyaloidotomy with the YAG laser is a viable option in order to avoid further proliferative diabetic retinopathy complications and vision loss. The current image clearly depicts treatment efficacy.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.027
       
  • Nocardial scleritis: A case report and a suggested algorithm for disease
           management based on a literature review

    • Authors: Laura Pires da Cunha; Verena Juncal; Cecília Godoy Carvalhaes; Sylvia Cardoso Leão; Erica Chimara; Denise Freitas
      Abstract: Publication date: Available online 10 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Laura Pires da Cunha, Verena Juncal, Cecília Godoy Carvalhaes, Sylvia Cardoso Leão, Erica Chimara, Denise Freitas
      Purpose To report a case of nocardial scleritis and to propose a logical treatment algorithm based on a literature review. Observations It is important to suspect a nocardial infection when evaluating anterior unilateral scleritis accompanied by multiple purulent or necrotic abscesses, especially in male patients with a history of chronic ocular pain and redness, trauma inflicted by organic materials, or recent ophthalmic surgery. A microbiological investigation is essential. In positive cases, a direct smear reveals weakly acid-fast organisms or Gram-positive, thin, beading and branching filaments. Also, the organism (usually) grows on blood agar and Lowenstein–Jensen plates. An infection can generally be fully resolved by debridement of necrotic areas and application of topical amikacin drops accompanied by systemic sulfamethoxazole–trimethoprim. Conclusions and significance Together with the case report described, we review data on a total of 43 eyes with nocardial scleritis. Our proposed algorithm may afford a useful understanding of this sight-threatening disease, facilitating easier and faster diagnosis and management.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.018
       
 
 
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