Beyoglu Eye Journal 2021This report describes the case of a patient who presented with bilateral vitritis that led to a diagnosis of small-cell lung cancer (SCLC). A 70-year-old man was...
This report describes the case of a patient who presented with bilateral vitritis that led to a diagnosis of small-cell lung cancer (SCLC). A 70-year-old man was examined due to bilateral gradual visual deterioration. Symmetrical vitritis was observed in both eyes with no evidence of other fundus pathology. The opthalmological diagnosis was bilateral paraneoplastic vitritis. The patient was an active smoker and had a short history of weight loss. A systemic evaluation resulted in a diagnosis of SCLC. The appropriate cancer treatment was provided, as well as a short-term oral steroid. The vitritis responded well to steroid treatment. Ocular manifestations can be an early sign of malignancy, and ophthalmologists should be aware of this possibility.
Germs Jun 2019Unilateral papillitis and neuroretinitis are uncommon manifestations of ocular infection and pose particularly challenging diagnosis problems. Due to the limited...
Unilateral papillitis and neuroretinitis are uncommon manifestations of ocular infection and pose particularly challenging diagnosis problems. Due to the limited accessibility of healthcare and poor socioeconomic status of a significant proportion of the population in Democratic Republic of the Congo, knowledge of seroprevalence rates for toxoplasmosis remains key to the health system. When papillitis or neuroretinitis is suspected, vitreous inflammatory reaction is usually present at various degrees on the initial examination as a diagnosis clue.
We report the case of a 37-year-old Congolese man who was managed in the University Hospital of Kinshasa, DR Congo, between October 2017 and April 2019 (18 months). The patient's informed consent was obtained for publication of his data. The patient developed presumed papillitis with complete absence of vitritis at presentation. He was in good general health and had a known contact with a cat. Ophthalmoscopic examination revealed unilateral inflammation in the left optic disc and peripapillary area coexisting with active juxtapapillary retinochoroiditis that could be confirmed in ocular coherence tomography. A retinochoroiditis scar was present in the right eye. Left visual field was severely altered in automated perimetry. titer was positive. Anti-HIV (ELISA) antibodies were negative. Rapid and favorable response to appropriate antiparasitic agents was observed without recurrence. Absence of vitritis and retinochoroiditis scar were confirmed during all the follow-up period.
Papillary toxoplasmosis is rare and potentially serious. Its diagnosis must be sought, even in the absence of vitritis, before taking into account any unilateral papillary edema. Our case report highlights the importance of detailed history and clinical examination to improve diagnostic decision making such as the need for complementary investigations, especially serologic testing, in a country with relatively limited financial resources in public health.
Curious case of bilateral non-resolving vitritis - Unmasking the masquerade on ultra-widefield imaging.Indian Journal of Ophthalmology Apr 2022Recognizing vitreous haze (VH) patterns on ultra-widefield imaging (UWFI) in nonresolving vitritis can reduce delay in suspecting vitreoretinal lymphoma (VRL) and in...
Recognizing vitreous haze (VH) patterns on ultra-widefield imaging (UWFI) in nonresolving vitritis can reduce delay in suspecting vitreoretinal lymphoma (VRL) and in performing an early vitreous biopsy for definitive diagnosis.
To demonstrate role of UWFI in providing a clue for suspecting VRL in case of bilateral nonresolving dense vitritis and demonstrate precautions for high yield of lymphoma cells on vitreous biopsy.
A 52-year-old healthy phakic lady came with gradual, painless blurred vision OS>OD for 6 months. Treated elsewhere for OU vitritis with steroids (local and systemic), anti-tubercular therapy for 2 months, and azathioprine, she had no improvement. Presenting best-corrected visual acuty was counting fingers OD and hand movement OS. Anterior segment OU was quiet. Fundus showed OD 3+ and OS 4+ vireous haze (VH). UWFI showed "aurora borealis" pattern of VH (OS>OD) and "string of pearls" OD. Ultrasonography B-scan OU showed complete posterior vitreous detachment and attached retina. OU VRL was suspected. MRI brain and orbit with contrast was found to be normal. After stopping steroids for 2 weeks, OS underwent pars plana vitrectomy (PPV) and intravitreal (IV) methotrexate 400 mcg/0.1 ml + rituximab 1mg/0.1ml. Vitreous sample sent for cytology and immunohistochemistry showed diffuse large B-cell non-Hodgkins lymphoma with CD20 and MUM1-positive cells. OD underwent two IV rituximab injections at monthly interval initially followed by PPV with IV rituximab and methotrexate. The patient remained in remission during close follow-up. Recognizing VH patterns on UWFI can reduce the delay in the diagnosis of VRL and early initiation of treatment.
VH patterns in VRL depend on state of vitreous liquefaction and syneresis. Aurora borealis pattern on UWFI results from linear opacities with lymphoma cells uniformly aligned along formed vitreous fibrils. String of pearls pattern results from clumps of lymphoma cells and inflammatory material over the scaffold of vitreous fibrils. These patterns provide high index of suspicion for considering VRL as d iagnosis.IV rituximab has minimal side effects and has been effective in managing VRL with isolated ocular involvement.
Topics: Endophthalmitis; Eye Neoplasms; Female; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Methotrexate; Middle Aged; Retinal Neoplasms; Retrospective Studies; Rituximab; Vitreous Body
Clinical Case Reports Apr 2022Ovarian adenocarcinoma is an unusual cause of head or brain metastasis and seeding to the eye ball is extremely rare. A high index of suspicion and a careful ophthalmic...
Ovarian adenocarcinoma is an unusual cause of head or brain metastasis and seeding to the eye ball is extremely rare. A high index of suspicion and a careful ophthalmic examination can guide the patient work up. In this particular case, rubeotic glaucoma and vitritis antedated the diagnosis of ovarian malignancy.
Topical dexamethasone-cyclodextrin nanoparticle eye drops for non-infectious Uveitic macular oedema and vitritis - a pilot study.Acta Ophthalmologica Aug 2015To evaluate the safety and efficacy of 1.5% dexamethasone nanoparticle (DexNP) drops in eyes with non-infectious uveitic macular oedema and vitritis.
To evaluate the safety and efficacy of 1.5% dexamethasone nanoparticle (DexNP) drops in eyes with non-infectious uveitic macular oedema and vitritis.
In a prospective pilot study, DexNP drops were administered four times a day for 4 weeks followed by drops tapering over a period of another 4 weeks. Follow-up time was 12 weeks.
Five eyes with macular oedema and three eyes with vitritis were included in the study. Best corrected visual acuity (BCVA) significantly improved from a median of 0.2 logMAR to a median of 0.15 logMAR at 4 weeks' time (p < 0.05). Median BCVA was 0.175 logMAR and 0.2 logMAR, at week 8 and 12, respectively (p > 0.05). Macular oedema significantly improved at all time-points as compared to baseline (p < 0.05) and resolved in all eyes during follow-up. One eye had macular oedema relapse at week 12. Vitritis improved in all eyes and resolved completely in two eyes. One eye had intraocular pressure (IOP) elevation which was well controlled with topical antihypertensive treatment, and one eye had cataract progression.
This short pilot study demonstrates favourable effect of 1.5% DexNP eye drops on eyes with non-infectious uveitic macular oedema and vitritis. Further comparative long-term studies are warranted to assess this effect.
Topics: Administration, Topical; Aged; Dexamethasone; Eye Diseases; Female; Follow-Up Studies; Glucocorticoids; Humans; Macular Edema; Male; Middle Aged; Nanoparticles; Ophthalmic Solutions; Pilot Projects; Prospective Studies; Retina; Uveitis; Visual Acuity; Vitreous Body; beta-Cyclodextrins
The Journal of International Medical... Nov 2021Pseudorabies virus (PRV) is a herpesvirus of swine. PRV is also called suid herpesvirus 1 and is a member of the Alphaherpesvirinae subfamily within the family...
Pseudorabies virus (PRV) is a herpesvirus of swine. PRV is also called suid herpesvirus 1 and is a member of the Alphaherpesvirinae subfamily within the family Herpesviridae. The number of PRV cases worldwide is small, but in susceptible individuals, infection with this virus has a poor prognosis. Therefore, it is urgent to improve our understanding of this disease in clinical practice to avoid misdiagnosis and to identify optimal treatments. We report a patient with PRV infection who was admitted to hospital with viral encephalitis and subsequently developed intraocular infection. Because to the lack of relevant clinical experience in the treatment of this disease, we carried out experimental treatment with good therapeutic effect. This case provides a basis for clinical diagnosis and treatment of patients with PRV.
Topics: Animals; Herpesvirus 1, Suid; Humans; Pseudorabies; Retinal Vasculitis; Swine
Primary Intraocular Diffuse Large B-cell Lymphoma: Diagnostic Difficulties in Deep Retinal Infiltrations with Vitritis.Indian Journal of Hematology & Blood... Jun 2016Primary intraocular lymphoma (PIOL) is a rare malignancy with an aggressive clinical course. It is usually considered as a subset of primary central nervous system...
Primary intraocular lymphoma (PIOL) is a rare malignancy with an aggressive clinical course. It is usually considered as a subset of primary central nervous system lymphoma. Differential diagnosis should include infectious and non-infectious aetiologies, particularly the common masqueraders sarcoidosis, tuberculosis, viral retinitis and syphilis.
The article presents a case of bilateral vitreoretinal lymphoma manifesting as uveitis and vitritis resistant to corticosteroid therapy. The final diagnosis was based on a retinal biopsy.
The patient was successfully treated with systemic and local therapy. Long-term complete remission (CR) was reached. The relapse of diffuse large B-cell lymphoma was revealed in the frontal left lobe after 48 months of CR duration.
The diagnosis of PIOL is always very difficult. Cooperation of pathologists, ophthalmologists and hematologists is required for a quick and accurate diagnosis. Local and systemic treatment is needed to achieve CR, but the relapse rate remains very high.
Bilateral papillitis and vitritis as the initial ophthalmologic finding in a patient with complex medical history, leading to diagnosis of multisystem sarcoidosis.American Journal of Ophthalmology Case... Mar 2019To report a case of bilateral papillitis as the initial ophthalmologic presentation in a patient with complex medical history and multisystemic symptoms, eventually...
To report a case of bilateral papillitis as the initial ophthalmologic presentation in a patient with complex medical history and multisystemic symptoms, eventually revealing a diagnosis of sarcoidosis.
Retrospective interventional case report.
A 54-year-old Caucasian woman presented with bilateral decreased vision, photophobia and eye pain for a month. She was referred for evaluation of disc edema with questionable history of vitritis. She had a complicated medical history and systemic symptoms, including: multiple tick bites; focal neurologic symptoms including tingling, headache, numbness of fingers, and stiff neck; systemic immune disease with thyroid nodule; and chest strain, mild shortness of breath, and palpitations, leading to a large differential diagnosis. Further workup ruled out infectious diseases and multiple sclerosis. After chest imaging, she was finally diagnosed via biopsy with sarcoidosis. Therapy included combined high dose prednisone taper and ongoing methotrexate. Both ocular and systemic symptoms improved after treatment, but there was limited improvement of scotoma in the left eye.
This report provides a case for ophthalmologists for papillitis as the initial manifestation of sarcoidosis, but with various potential differential diagnoses during work up.
IgG4-related disease presenting as posterior scleritis and vitritis, progressing to multifocal orbital involvement.BMJ Case Reports Apr 2017IgG4-related disease (IgG4-RD) is a rare, chronic inflammatory condition that may involve nearly every organ system. Originally identified as a cause of autoimmune...
IgG4-related disease (IgG4-RD) is a rare, chronic inflammatory condition that may involve nearly every organ system. Originally identified as a cause of autoimmune pancreatitis, its characteristic histological and clinical features have been found in a wide variety of inflammatory presentations, including the eye and orbit. Here we describe an example of a case of IgG4-RD initially presenting as scleritis and vitritis, with further progression to multifocal bilateral orbital involvement. Tissue biopsy of an orbital mass was highly characteristic of IgG4-RD histology and a rapid clinical response to corticosteroids was observed. This case highlights IgG4-RD as a rare cause of intraocular inflammation that may progress to involve the orbit.
Topics: Adrenal Cortex Hormones; Aged, 80 and over; Biopsy; Diagnosis, Differential; Disease Progression; Female; Humans; Immunoglobulin G; Orbital Diseases; Scleritis; Vitreous Body
Indian Journal of Ophthalmology Feb 2019