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Publisher: Elsevier   (Total: 3123 journals)

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Showing 1 - 200 of 3120 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 26, 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: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 378, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 26, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
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: 237, 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   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
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: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 5)
Acute Pain     Full-text available via subscription   (Followers: 13)
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: 7, 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: 140, 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: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, 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: 4)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 9, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 12, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 23, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, 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: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 6, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 13)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, 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: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 7)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 6)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 47, 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: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 46, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 52, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 17, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
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: 22, 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: 27)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, 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: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 10)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, 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: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 9, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
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: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, 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: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, 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: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
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: 371, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
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: 31, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 45, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 338, 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: 433, 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: 42, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 3)
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: 8)
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: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, 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: 49, 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: 5)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 48, 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: 9, 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: 32, 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: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, 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: 207, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 61, 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: 24, 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: 26, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 36, 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: 60, 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: 36, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 173, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
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  
Animal Behaviour     Hybrid Journal   (Followers: 176, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)

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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  [3123 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)
       
  • 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
       
  • Pericentral hydroxychloroquine retinopathy in a Caucasian female

    • Authors: Nikhil Anand; Robert A. Prinzi; Cory Hoeferlin; Jiong Yan; Nieraj Jain
      Abstract: Publication date: Available online 13 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Nikhil Anand, Robert A. Prinzi, Cory Hoeferlin, Jiong Yan, Nieraj Jain
      Purpose To report a rare presentation of the pericentral pattern of hydroxychloroquine (HCQ) retinal toxicity in a Caucasian female. Observations The patient presented with 20 years of exposure to HCQ, at a daily dose of 5.2mg/kg of actual body weight, and manifested a pericentral-only phenotype of HCQ toxicity, as demonstrated with detailed structural and functional testing. Conclusions and importance Although rare, the pericentral pattern of HCQ toxicity may occur in Caucasian patients in the absence of paracentral changes.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.019
       
  • Bilateral superior rectus transposition and medial rectus recession for
           bilateral sixth nerve palsy

    • Authors: Shuan Dai; Vishaal Bhambhwani; Naz Raoof
      Abstract: Publication date: Available online 12 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Shuan Dai, Vishaal Bhambhwani, Naz Raoof
      Purpose To present the results of bilateral superior rectus transposition with medial rectus recession in a case of chronic bilateral sixth nerve palsy. Observation Bilateral superior rectus transposition with medial rectus recession resulted in full correction of esotropia with resolution of horizontal diplopia, improvement in abduction, and regain of stereoacuity in our case. There was minimal limitation of adduction, with no abnormal vertical or torsional changes. Conclusion and importance Bilateral superior rectus transposition with medial rectus recession appears to be a useful procedure for surgical treatment of bilateral sixth nerve palsy with minimal side effects. Given its potential for reduced risk of anterior segment ischemia (ASI), it may have especially good value in the select group of patients at risk for ASI. Studies with larger sample size and longer follow up are needed to further evaluate this procedure and elucidate the variables in surgical technique for superior rectus transposition.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.022
       
  • 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
       
  • Traumatic subhyaloid macular hemorrhage with complete resolution following
           Neodymium-Doped Yttrium Aluminium Garnet Laser

    • Authors: Motazz A. Alarfaj; Abdulmajeed A. Hasen; Saeed S. Al-Yami
      Abstract: Publication date: Available online 12 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Motazz A. Alarfaj, Abdulmajeed A. Hasen, Saeed S. Al-Yami
      Purpose To report a case of traumatic subhyaloid macular hemorrhage with severe sudden vision loss treated successfully with Neodymium-Doped Yttrium Aluminium Garnet Laser (Nd:YAG laser). Observations A 16-year-old boy presented to the eye clinic with acute vision loss secondary to blunt trauma by a stone to his left eye 3 days prior to consultation that caused subhyaloid macular hemorrhage. Nd:YAG laser was performed to open the hyaloid membrane and allow the blood to diffuse into the vitreous cavity and be absorbed. The patient demonstrated complete recovery as his visual acuity went from counting fingers to 20/20 within 20 days. No complications due to the treatment were reported. Conclusions and importance To the best of our knowledge, there have been no reported cases of subhyaloid macular hemorrhage treated with Nd:YAG laser in which the etiology was trauma and showed full, rapid recovery with no sequelae.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.020
       
  • Intravitreal rituximab for the treatment of a secondary intraocular
           relapse of a large B-cell lymphoma

    • Authors: Jose J. Echegaray; Stephanie Llop; Melissa Sepulveda; Roman Velez-Rosario; Noel Perez; Armando L. Oliver
      Abstract: Publication date: Available online 11 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Jose J. Echegaray, Stephanie Llop, Melissa Sepulveda, Roman Velez-Rosario, Noel Perez, Armando L. Oliver
      Purpose To report a rare case of secondary intraocular lymphoma treated with intravitreal rituximab, following pars plana vitrectomy. Observations A 74-year-old female with history of parotid gland large B-cell lymphoma presented bilateral intraocular recurrence 10 years after the onset of the primary malignancy. Systemic work-up including PET/CT Scan, bone marrow biopsy, brain MRI and CSF analysis were unremarkable, and the patient declined to undergo systemic chemotherapy. Vision loss in her left eye was severe due to significant sub-retinal pigment epithelium (RPE) infiltration involving the macula; this eye was treated with external beam radiation therapy. On the right eye, the relapse manifested with vitreous involvement and fovea-sparing multifocal, sub-RPE infiltration for which the patient received monthly intravitreal rituximab injections, following pars plana vitrectomy. Through the course of therapy, the patient achieved good local control and maintained 20/20 visual acuity on her right eye. Brain magnetic resonance imaging (MRI) surveillance, every 3 months, was performed and revealed a cerebellar recurrence 24 months into the course of therapy. Conclusions and importance Our case illustrates how intravitreal immunotherapy with rituximab may provide local control of CD-20 positive secondary intraocular lymphoma; particularly in cases where systemic therapy is not amenable. In our case, a prior vitrectomy, did not appear to interfere with the therapeutic effect of intravitreal rituximab. Close quarterly surveillance with Brain MRI may help disclose central nervous system recurrences in such cases.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.032
       
  • 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
       
  • Optical coherence tomography angiography of a pigmented Fuchs' adenoma
           (age-related hyperplasia of the nonpigmented ciliary body epithelium)
           masquerading as a ciliary body melanoma

    • Authors: Nisha Nagarkatti-Gude; Yan Li; David Huang; David Wilson; Alison Skalet
      Abstract: Publication date: Available online 10 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Nisha Nagarkatti-Gude, Yan Li, David Huang, David Wilson, Alison Skalet
      Purpose To report a case of age-related hypertrophy of the nonpigmented ciliary epithelium (ARH-NPCE) clinically resembling a ciliary body melanoma and report the optical coherence tomography angiography (OCTA) findings associated with this lesion. Observations A 51-year-old male was referred for evaluation of a deeply pigmented ciliary body mass with extension through the iris root. Iridocyclectomy was performed due to concern for ciliary body melanoma. Histopathologic analysis was instead consistent with ARH-NPCE, also known as Fuchs' adenoma. Prior to surgery, OCTA images revealed abnormal vasculature in the area of the lesion. Vessels in the peripheral iris approaching the lesion appeared more tortuous and were non-radial as compared with normal iris vessels. The ciliary body mass itself could not be penetrated using an OCTA system operating at 1050 nm. Conclusions and importance ARH-NPCE may clinically resemble a pigmented ciliary body melanoma. This is the second case describing this clinical scenario, which may be more common than previously thought. Non-invasive imaging with OCTA revealed an abnormal peripheral iris vasculature pattern in the area of the iridociliary mass characterized by disorganized, tortuous, and non-radial vessels. Despite advances in longer wavelength OCTA systems, poor penetration of the ciliary body lesion precluded imaging of the intratumoral vessels in this location.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.015
       
  • Rapid neuroadaptation to surgically-induced aniseikonia in a 17-year-old
           patient with high preoperative anisometropia: A case report

    • Authors: Joshua Heczko; David Sierpina
      Abstract: Publication date: Available online 10 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Joshua Heczko, David Sierpina
      Purpose To report a case of rapid neuroadaptation to surgically-induced aniseikonia in a 17-year-old with preoperative anisometropia of 9.5 D. Observations A 17-year-old female with a history of retinopathy of prematurity (ROP) and progressive high myopia with resulting anisometropia secondary to conventional laser photocoagulation in her right eye was found to have diplopia after undergoing cataract surgery in that eye. Other etiologies of diplopia were ruled out and reversal of anisometropia remained the only viable diagnosis. Her diplopia fully resolved without intervention within one month of the surgery. Conclusion and Importance In cases of neuroadaptation to long standing anisometropia, even if that anisometropia develops in infancy, abrupt reversal following surgery can be surprisingly well tolerated.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.021
       
  • Multimodal imaging of macular subretinal deposits following intravitreal
           ocriplasmin injection

    • Authors: Nicholas Chow; Thomas Hong; Andrew Chang
      Abstract: Publication date: Available online 10 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Nicholas Chow, Thomas Hong, Andrew Chang
      Purpose Ocriplasmin is effective in closing macular holes due to vitreomacular traction. We present a case of macular subretinal material deposition observed with spectral-domain optical coherence tomography (SD-OCT) and multimodal imaging, following successful closure of a macular hole following intravitreal ocriplasmin injection. Observations An 81-year-old male presented with decreased vision in the left eye due to a full-thickness macular hole secondary to vitreomacular traction. Ocriplasmin (Jetrea) was injected into the vitreous and hole closure was observed after one week. Macular subretinal material deposition developed along the outer surface of the resultant serous detachment on OCT one week post-injection. Fluorescein angiography demonstrated no expanding hyperfluorescence due to retinal or choroidal leak, or staining of the lesion. The material was mildly autofluorescent. The macular subretinal material complex spontaneously decreased with no significant effect on vision over 60 weeks. Conclusions and importance Macular subretinal material deposition has not previously been reported following intravitreal ocriplasmin injection. This material is likely composed of photoreceptor outer segments. It is important to recognize that macular subretinal deposits can occur following intravitreal ocriplasmin injection as it may cause diagnostic confusion and potentially influence the visual and anatomical outcomes following successful hole closure.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.016
       
  • Immunoglobulin G4-related dacyroadenitis presenting as bilateral
           chorioretinal folds from severely enlarged lacrimal glands

    • Authors: Toru Kurokawa; Hideaki Hamano; Takashi Muraki; Takeshi Uehara; Shiori Masuo; Toshinori Murata
      Abstract: Publication date: Available online 10 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Toru Kurokawa, Hideaki Hamano, Takashi Muraki, Takeshi Uehara, Shiori Masuo, Toshinori Murata
      Purpose To describe a case of immunoglobulin G4 (IgG4)-related dacyroadenitis presenting as bilateral chorioretinal folds from eyeball compression by massively enlarged lacrimal glands. Observations A 51-year-old woman with severely enlarged bilateral lacrimal glands was diagnosed as having IgG4-related dacryoadenitis. The glands strongly compressed the globes, forming chorioretinal folds resembling those found in orbital malignancy. Eventual treatment with oral prednisolone dramatically reduced the volume of the lacrimal glands and released globe compression on magnetic resonance imaging. However, the chorioretinal folds remained in the right fundus and symptoms of blurred vision improved but persisted. Conclusions and importance This is the first account of chorioretinal fold formation by severely enlarged lacrimal glands appearing in IgG4-related dacryoadenitis. Chorioretinal fold formation by an enlarged lacrimal gland occurring bilaterally may represent a basis for suspecting IgG4-related dacryoadenitis. Prompt treatment is recommended for patients presenting with very large lacrimal glands to avoid visual impairment.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.017
       
  • Spectral optical coherence tomography findings in an elderly patient with
           syphilitic bilateral chronic panuveitis

    • Authors: Ariel Schlaen; Mariana Ingolotti; Cristobal Couto; Mario Saravia
      Abstract: Publication date: Available online 8 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Ariel Schlaen, Mariana Ingolotti, Cristobal Couto, Mario Saravia
      Purpose To report the spectral domain optical coherence tomography (SD-OCT) features of a focal retinitis in an elderly male patient with bilateral syphilitic panuveitis. Observations In the left eye (LE), spectral domain SD-OCT images during the active period revealed hyperreflectivity extending through the full thickness of the retina with no individualization of the layers, except for the retinal pigment epithelium. Once the lesion healed, SD-OCT imaging revealed an inner retinal atrophy and a mild disruption of the retinal pigment epithelium. Conclusions and importance In our patient, treponemal infection seemed to produce full-thickness retinal damage with partial involvement of the retinal pigment epithelium. The severe retinal damage, in this case, led to a poorer visual outcome than in other forms of syphilitic retinal involvement.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.012
       
  • Lagophthalmos caused by cicatricial adhesion of orbital adipose tissue to
           orbital roof: A case report

    • Authors: Yoshiyuki Kitaguchi; Jacqueline Mupas-Uy; Yasuhiro Takahashi; Hirohiko Kakizaki
      Abstract: Publication date: Available online 6 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Hirohiko Kakizaki
      Purpose To report a case of lagophthalmos caused by cicatricial adhesion of orbital adipose tissue to the orbital roof. Observations A 23-year-old female was presented with right lagophthalmos. Five months prior to consult at our clinic, she suffered from a penetrating trauma to the frontal lobe of the brain through the right orbital roof with cerebrospinal fluid leakage. Decompressive craniectomy was performed immediately after the injury using a coronal incision, which was followed by reconstruction with an artificial bone 1 month later. On examination at our clinic, she showed right exposure keratopathy with best corrected visual acuity of 20/100 due to corneal opacity. The palpebral contracted scar was first elongated using Z-plasty technique but excursion of the upper eyelid under a finger force assistance was insufficient to eliminate lagophthalmos. However, complete eyelid closure under a finger force assistance was achieved after sharp dissection of the cicatrized adipose tissue from the orbital roof. An autogenous dermis-fat was grafted on the orbital roof and superior orbital rim to avoid adhesion of orbital adipose tissue onto the bone again. Conclusion and importance Cicatricial adhesion of an orbital adipose tissue to the orbital roof is one of the possible causes of posttraumatic lagophthalmos in patients with an orbital roof fracture. Surgeons need to be aware of this condition in planning of surgical repair when such a fracture is encountered.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.014
       
  • Descemet membrane endothelial keratoplasty for corneal decompensation due
           to iridoschisis

    • Authors: Miles F. Greenwald; Philip I. Niles; A. Tim Johnson; Jesse M. Vislisel; Mark A. Greiner
      Abstract: Publication date: Available online 5 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Miles F. Greenwald, Philip I. Niles, A. Tim Johnson, Jesse M. Vislisel, Mark A. Greiner
      Purpose To report a case of bilateral iridoschisis with cataracts and corneal decompensation in a patient who underwent cataract extraction and superficial iridectomy followed by Descemet membrane endothelial keratoplasty (DMEK). Observations A 58-year-old man with previously diagnosed iridoschisis, cataracts, and diabetes mellitus experienced progressive vision loss bilaterally due to corneal decompensation. Slit lamp examination revealed iridoschisis with iris fibrils contacting the corneal endothelium, stromal edema, and mild guttate changes bilaterally. Corneal findings were more severe in the right eye, including the presence of bullous keratopathy at the time of presentation. Cataract extraction with intraocular lens implantation and superficial iridectomy were performed in the right eye, followed by DMEK. These same procedures were performed subsequently in the left eye. Postoperatively, the patient had significant improvement in visual acuity and corneal edema. Conclusions and importance DMEK can be performed safely and successfully after staged cataract surgery with superficial iridectomy in eyes with endothelial decompensation caused by iridoschisis.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.010
       
  • Central retinal artery occlusion during vitrectomy: Immediate retinal
           revascularization following induction of posterior vitreous detachment

    • Authors: Abdallah A. Ellabban; Ajay D. Patil; Mark T. Costen; Atiq R. Babar
      Abstract: Publication date: Available online 5 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Abdallah A. Ellabban, Ajay D. Patil, Mark T. Costen, Atiq R. Babar
      Purpose To describe a patient with acute central retinal artery occlusion (CRAO) during vitrectomy surgery and the possible role of vitrectomy in acute CRAO management. Observations An 84-year-old man presented with broad vitreomacular traction and epiretinal membrane in the right eye. Preoperative assessment clearly showed normal retinal vasculature. On starting vitrectomy, complete CRAO with marked segmentation of all retinal vessels was noted. Vitrectomy was performed in the usual manner and once the posterior hyaloid detached from the disc, immediate complete revascularization of the retinal vessels was noted. The patient had a complete visual recovery. Conclusions and Importance Immediate vitrectomy with induction of posterior vitreous detachment may have a role in selected cases of acute CRAO, particularly if performed within a short window.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.008
       
  • Ranibizumab-induced retinal reperfusion and regression of
           neovascularization in diabetic retinopathy: An angiographic illustration

    • Authors: Shruti Chandra; Jay Sheth; Giridhar Anantharaman; Mahesh Gopalakrishnan
      Abstract: Publication date: Available online 4 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Shruti Chandra, Jay Sheth, Giridhar Anantharaman, Mahesh Gopalakrishnan
      Purpose To report regression of neovascularization and reperfusion of ischemic areas of the retina on Wide-field Digital Fluorescein Angiography following anti-vascular endothelial growth factor injections in a patient with active Proliferative Diabetic Retinopathy. Observations Case report of sixty-one-year-old male patient with proliferative diabetic retinopathy and diabetic macular edema documented on wide field digital fluorescein angiography. The patient was treated with three intravitreal injections of ranibizumab given at monthly intervals. Repeat angiography after third intravitreal injection revealed complete regression of new vessels. Moreover, there was evident improvement in perfusion in the previously noted ischemic areas of the retina. Conclusion and Importance Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are a valuable treatment option for reversing neovascularization in eyes with proliferative diabetic retinopathy with fewer side effects when compared to standard pan-retinal photocoagulation. Additionally, we also illustrate restoration of retinal perfusion post anti-VEGF therapy indicative of pre-existingsalvageableischemic retina tissue.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.006
       
  • Optical coherence tomography angiography changes in radial peripapillary
           capillaries in Leber hereditary optic neuropathy

    • Authors: Mitsuhiro Matsuzaki; Yasuhiko Hirami; Hirofumi Uyama; Yasuo Kurimoto
      Abstract: Publication date: Available online 4 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Mitsuhiro Matsuzaki, Yasuhiko Hirami, Hirofumi Uyama, Yasuo Kurimoto
      Purpose To present a report of longitudinal changes in radial peripapillary capillaries (RPC) and changes in retinal full thickness (RFT) and peripapillary retinal nerve fiber layer (RNFL) in a patient with Leber hereditary optic neuropathy (LHON). Observations A 42-year-old man presented with acute- and presymptomatic-stage LHON in the left (OS) and right (OD) eyes, respectively, at the initial visit. Onset of LHON in the OD was observed 2 months after the initial visit. Once the temporal RNFL started to decrease in thickness, the areas of temporal RPC defects and RFT thinning gradually increased, indicating that these factors might be correlated. Conclusions and Importance Optical coherence tomography angiography showed LHON from the presymptomatic stage. The results indicate that temporal RPC defects and RFT thinning start to spread once the pseudoedema begins to resolve.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.003
       
  • Retinal vasproliferative tumor in a case of X-linked retinoschisis
           detachment

    • Authors: Nimesh A. Patel; Diana Laura; Kimberly D. Tran; Stanley Chang; Gaetano Barile; Audina M. Berrocal
      Abstract: Publication date: Available online 4 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Nimesh A. Patel, Diana Laura, Kimberly D. Tran, Stanley Chang, Gaetano Barile, Audina M. Berrocal
      Purpose To describe the first published case of X-linked retinoschisis (XLRS) detachment with retinal vasoproliferative tumor (RVPT) and provide a literature review of the subject. Observations The authors describe a case of a 17 year old male with X-linked retinoschisis who presented with a retinal detachment and a retinal vasoproliferative tumor. The patient was treated with pars plana vitrectomy, endolaser, subtenon's kenalog and anti-VEGF (vascular endothelial growth factor) intravitreal injections. He regained 20/60 vision with a flat macula and had significant resolution of the associated vasoproliferative leakage seen on fluorescein angiography. Conclusions and Importance This case adds XLRS to the conditions associated with RVPT and gives support for treatment with laser photocoagulation and anti-VEGF therapy with bevacizumab to control the exudative process.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.002
       
  • Intravitreal bevacizumab as therapy for refractory neovascular glaucoma
           secondary to iris metastasis of breast carcinoma

    • Authors: Stephanie Vale; Lorena Montalvo; Emilio Baez; Armando L. Oliver
      Abstract: Publication date: Available online 4 January 2018
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Stephanie Vale, Lorena Montalvo, Emilio Baez, Armando L. Oliver
      Purpose To report a case of refractory glaucoma secondary to iris metastasis from breast cancer which was successfully treated with intravitreal bevacizumab. Observations A 72-year-old woman presented with left ocular pain, vision loss and neovascular glaucoma secondary to iris metastasis from breast cancer. A single intravitreal injection of bevacizumab resulted in prolonged resolution of iris neovascularization, reduction of intraocular pressure and ocular pain relief. Iris tumor regression was later noted following the reinstatement of systemic chemotherapy. Conclusions & Importance A single intravitreal bevacizumab injection may be sufficient to achieve palliative control of neovascular glaucoma secondary to iris breast cancer metastasis. To our knowledge, this is the first case report in which a single intravitreal bevacizumab injection was used for the effective management of this condition.

      PubDate: 2018-01-15T04:44:24Z
      DOI: 10.1016/j.ajoc.2018.01.007
       
  • Removal of choroidal neovascular membrane in a case of macular hole after
           anti-VEGF therapy for age-related macular degeneration

    • Authors: Akira Hirata; Ken Hayashi; Kazuhisa Murata; Kei-ichiro Nakamura
      Pages: 14 - 17
      Abstract: Publication date: March 2018
      Source:American Journal of Ophthalmology Case Reports, Volume 9
      Author(s): Akira Hirata, Ken Hayashi, Kazuhisa Murata, Kei-ichiro Nakamura
      Purpose The formation of macular hole after receiving anti-vascular endothelial growth factor (anti-VEGF) therapy is rare. We report a case of macular hole that occurred after intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD) in a patient, who underwent vitrectomy combined with choroidal neovascularization (CNV) removal. Observations A 64-year-old female with AMD affecting her right eye received an intravitreal injection of an anti-VEGF agent. After treatment, we identified a full thickness macular hole (MH) that was associated with the rapid resolution of the macular edema and contraction of the CNV. After performing vitrectomy combined with CNV removal, the MH closed and her visual acuity improved. Examination of the removed CNV revealed a network of microvessels devoid of pericytes. Conclusions and Importance: The present findings suggest that rapid resolution of macular edema and contraction of the CNV and/or mild increase in the vitreous traction after anti-VEGF therapy could potentially cause MH. CNV removal via the MH may be an acceptable procedure, if the MH remains open, the CNV is of the classic type, and it spares a central portion of the fovea.

      PubDate: 2017-12-21T10:01:21Z
      DOI: 10.1016/j.ajoc.2017.12.003
      Issue No: Vol. 9 (2017)
       
  • Acute-onset endophthalmitis caused by Staphylococcus lugdunensis

    • Authors: Robert B. Garoon; Darlene Miller; Harry W. Flynn
      Abstract: Publication date: Available online 24 December 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Robert B. Garoon, Darlene Miller, Harry W. Flynn
      Purpose To report a series of patients with acute-onset bacterial endophthalmitis caused by culture proven Staphylococcus lugdunensis, and to characterize clinical outcomes and microbiologic susceptibilities of this organism. Observations The study included six eyes of 6 patients. The etiologies included cataract surgery (3), open globe injury (2), and intravitreal injection (1). Isolates of S. lugdunensis demonstrated sensitivity to vancomycin in all cases reported. Three of 6 isolates of S. lugdunensis demonstrated resistance to oxacillin and 1 isolate demonstrated resistance to ciprofloxacin. Best-corrected visual acuity was ≥20/400 in 6/6 (100%) of eyes and ≥20/40 in 3/6 (50%) of cases. Conclusion and Importance Acute-onset endophthalmitis caused by S. lugdunensis is associated with variable visual outcomes. Vancomycin provides consistent coverage of acute-onset endophthalmitis cause by S. lugdunensis.

      PubDate: 2017-12-27T12:01:01Z
      DOI: 10.1016/j.ajoc.2017.12.006
       
  • Optical coherence tomography angiography showing perifoveal capillary
           stability 30 years after fluorescein angiography

    • Authors: Nikisha Kothari; Nidhi Relhan; Harry W. Flynn
      Abstract: Publication date: Available online 21 December 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Nikisha Kothari, Nidhi Relhan, Harry W. Flynn
      Purpose To report the Optical Coherence Tomography Angiography (OCTA) results as a novel non-invasive diagnostic modality which provides useful information regarding the status of blood flow in diabetic retinopathy. The current study is a long-term follow-up of eyes of patients with proliferative diabetic retinopathy managed with panretinal photocoagulation. Observations Two patients with proliferative diabetic retinopathy (PDR) were treated with panretinal photocoagulation (PRP) in both eyes in the early 1980s. Fluorescein angiography performed at the baseline visit and follow-up Optical Coherence Tomography Angiography performed at 30 years after initial PRP treatment showed remarkable stability of the perifoveal capillary network. Visual acuity initially and at last follow-up remained 20/25 or better in these patients. Conclusions and importance Fluorescein angiography and Optical Coherence Tomography Angiography demonstrated that the integrity of the perifoveal capillary network remained remarkably stable at 30 years. Similarly, the visual outcomes were stable inspite of advanced PDR at baseline.

      PubDate: 2017-12-27T12:01:01Z
      DOI: 10.1016/j.ajoc.2017.12.005
       
  • Retinal pigment epithelium changes in pediatric patients with glaucoma
           drainage devices

    • Authors: Carla J. Osigian; Sara Grace; Maria P. Fernandez; Camila V. Ventura; Susan Azar; Ta C. Chang; Elizabeth Hodapp; Sander R. Dubovy; Audina Berrocal
      Abstract: Publication date: Available online 15 December 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Carla J. Osigian, Sara Grace, Maria P. Fernandez, Camila V. Ventura, Susan Azar, Ta C. Chang, Elizabeth Hodapp, Sander R. Dubovy, Audina Berrocal
      Purpose Retinal changes secondary to hypotony are usually described as wrinkling or folding of the inner portion of the choroid, the retinal pigment epithelium (RPE), and the outer retinal layers in the macular area due to scleral wall collapse. We describe a new retinal finding in children with suspected hypotony after implantation of Baerveldt Glaucoma Implant (BGI). Observations Four patients in our series developed significant RPE defects after BGI implant. The RPE defects appeared as elongated white lines observed solely in the posterior pole, in no particular pattern, and seemed to be worse in infants with anterior segment dysgenesis and with collagen disorders. Conclusion and importance Children have thinner and more elastic scleral walls than adults. This characteristic may cause the inward scleral wall to collapse when the eye is hypotonic. The resulting redundancy of the retina leads to wrinkling and RPE defects characterized by hypopigmented lines predominantly in the macular area. Such findings, to our knowledge, have not been previously reported in pediatric patients.

      PubDate: 2017-12-21T10:01:21Z
      DOI: 10.1016/j.ajoc.2017.12.001
       
  • A case of hyperrophic herpes simplex virus affecting the eyelid and cornea
           masquerading as IgG4-related disease

    • Authors: Prachi Dua; Roman Shinder; Derek B. Laskar; Douglas R. Lazzaro; Allison E. Rizzuti
      Abstract: Publication date: Available online 13 December 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Prachi Dua, Roman Shinder, Derek B. Laskar, Douglas R. Lazzaro, Allison E. Rizzuti
      Purpose To report a case of hypertrophic herpes simplex virus (HSV) of the eyelid and cornea masquerading as IgG4-related disease. Observations A 37-year old African American female with a past medical history of human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) and a recent history of treated genital herpes, presented with an ulcerative lesion of the left upper and lower eyelids, and severe conjunctival inflammation with symblepharon. Initially, eyelid biopsy revealed findings consistent with IgG4-related disease, and the patient was treated with high dose oral prednisone. After two weeks of therapy, there was no improvement noted in the patient's ocular condition. The patient subsequently developed a corneal epithelial defect which progressed to chronic ulceration. Repeat biopsy and corneal cultures revealed herpes simplex virus type 2. The patient was treated with high dose acyclovir, and the lid lesion improved. The conjunctival inflammation and corneal epithelial defect resolved but symblepharon restricting her eye movement remained. She also developed corneal vascularization and opacification affecting approximately 50% of the cornea. Conclusions and importance Chronic hypertrophic herpes simplex virus infection is a rare condition reported in patients with HIV. While there have been few reports of hypertrophic HSV affecting the eyelid, this is the first reported case of hypertrophic HSV affecting the eye, resulting in severe vision loss.

      PubDate: 2017-12-21T10:01:21Z
      DOI: 10.1016/j.ajoc.2017.12.002
       
  • Novel use of fibrin sealant for scleral suture free placement of a
           glaucoma drainage device in advanced scleral thinning

    • Authors: Justin D. Harvey; Ronald L. Gross; Brian D. McMillan
      Abstract: Publication date: Available online 23 October 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Justin D. Harvey, Ronald L. Gross, Brian D. McMillan
      Purpose This reports a case using fibrin glue to secure a glaucoma drainage device plate to the sclera where there is a concern with the use of suture. Observations A 13-year-old patient with congenital aniridia and associated glaucoma refractory to topical medications underwent implantation of a glaucoma drainage device (GDD) for improved intraocular pressure (IOP) control. The patient had substantial scleral thinning with staphyloma formation, potentially making the use of traditional suturing techniques problematic. Fibrin glue was used to attach the GDD plate, as well the tube and patch graft which has been previously described, without sutures. The patient tolerated the procedure well with a 41% reduction in IOP at six months follow-up with no migration of the GDD from its original position. Conclusions and importance The use of fibrin glue in ophthalmology can be expanded to include attachment of the GDD plate to the sclera in patients with suturing contraindications.

      PubDate: 2017-10-29T14:28:11Z
      DOI: 10.1016/j.ajoc.2017.10.007
       
  • Bull's eye maculopathy and subfoveal deposition in two
           mucopolysaccharidosis type I patients on long-term enzyme replacement
           therapy

    • Authors: Heather G. Mack; R.C. Andrew Symons; Gerard de Jong
      Abstract: Publication date: Available online 4 October 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Heather G. Mack, R.C. Andrew Symons, Gerard de Jong
      Purpose To report retinal findings in two patients with mucopolysaccharidosis type I (MPS I) receiving human recombinant alpha-l-iduronidase (Laronidase) as enzyme replacement therapy. Observations Patient 1 had visual acuity 20/20 both eyes and unremarkable anterior segment and retinal examination. Optical coherence tomography (OCT) scanning demonstrated parafoveal thinning and subfoveal hyperreflectant material. Patient 2 had visual acuity 20/20 both eyes, with dense nuclear cataract both eyes. Retinal examination demonstrated bull's eye maculopathy both eyes. OCT scanning confirmed parafoveal atrophy and demonstrated similar appearing subfoveal hyperreflectant material, more prominent than in case 1. Conclusions and Importance These two patients with MPS I receiving Laronidase treatment have developed bull's eye maculopathy changes and subfoveal deposition of hyperreflectant material despite excellent compliance and good tolerance of the standard dose of enzyme therapy for this disorder. Further studies are required to determine the nature of the material, the incidence and the effect of enzyme replacement therapy on these findings in patients with MPS I.

      PubDate: 2017-10-07T22:55:13Z
      DOI: 10.1016/j.ajoc.2017.10.006
       
  • Juvenile xanthogranuloma involving concurrent iris and skin: Clinical,
           pathological and molecular pathological evaluations

    • Authors: Peter Meyer; Elisabeth Graeff; Corina Kohler; Francis Munier; Elisabeth Bruder
      Abstract: Publication date: Available online 23 September 2017
      Source:American Journal of Ophthalmology Case Reports
      Author(s): Peter Meyer, Elisabeth Graeff, Corina Kohler, Francis Munier, Elisabeth Bruder
      Purpose To report a case of juvenile xanthogranuloma involving the iris and skin that clincally was diagnosed with an obvious cutaneous lesion. Observations A four month-old girl with hyphema and increased intraocular pressure of the left eye persisting for 2 weeks. A suspicious yellow-brown mass with nodular surface and traversed by irregular vascularization was noted on the inferior iris surface. Ultrasound biomicroscopy (UBM; 35 MHz) of the mass revealed multiple nodular irregular hyperreflective lesions in the peripheral iris. Using a biopsy of an obvious cutaneous abdominal skin lesion a diagnosis was made based on histopathological analyses. The biopsy showed dense dermal infiltrate consisting of foamy histiocytes. Additional stains revealed CD68 positivity and CD1a and S100 negativity. This mass revealed histopathologic features identical to juvenile xanthogranuloma and was concurrent with the iris lesion. Next-generation sequencing using Ion AmpliSeqTM Cancer Hotspot Panel revealed a missense mutation of FGFR3 (p.F386L). Conclusion and importance The diagnosis of a xanthogranuloma of the iris with hyphema can be made easier in patients with obvious cutaneous lesions as described in our case. The significance of FGFR3 mutation in association with JXG is unknown and should be further investigated.

      PubDate: 2017-09-24T10:35:24Z
      DOI: 10.1016/j.ajoc.2017.09.004
       
 
 
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