Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision.</p> <p>Case presentation</p> <p>A 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye). He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication.</p> <p>Conclusion</p> <p>Functional vision can be regained despite long-standing retinal detachment.</p

Histopathology of optic nerve pit-associated maculopathy

John B Christoforidis, William Terrell, Frederick H DavidorfCollege of Medicine, The Ohio State University, Columbus, OH, USAPurpose: To describe the histopathologic findings of an eye bank specimen containing an optic nerve pit with associated serous elevation of the macula and cavernous atrophy of the optic nerve.Methods: An eye bank specimen found to have an optic nerve pit with serous elevation of the macula was grossly examined and photographed. The globe was processed for both light and scanning electron microscopy.Results: The scanning electron microscopic study of this eye with an optic nerve pit revealed holes in the diaphanous membrane overlying the nerve at the edge of the optic pit. Serial histopathology sections revealed a connection between the holes overlying the optic pit and the subretinal space via a schisis-like cavity in the retina.Conclusion: The discovery of an optic nerve pit with coexisting serous detachment of the macula in an eye bank eye and subsequent pathological evaluation provides support for current theories into the mechanism of the visual loss in this condition. Our finding supports syneretic vitreous to be the source of the subretinal fluid.Keywords: optic nerve pit, light microscopy, electron microscopy, retinal detachmen

Brachytherapy for patients with uveal melanoma: historical perspectives and future treatment directions

Beatrice Y Brewington,1 Yusra F Shao,2 Fredrick H Davidorf,1 Colleen M Cebulla1 1Havener Eye Institute, Department of Ophthalmology and Visual Science, Ohio State University, 2Medical Student Research Program, The Ohio State University College of Medicine, Columbus, OH, USA Abstract: Surgical management with enucleation was the primary treatment for uveal melanoma (UM) for over 100 years. The Collaborative Ocular Melanoma Study confirmed in 2001 that globe-preserving episcleral brachytherapy for UM was safe and effective, demonstrating no survival difference with enucleation. Today, brachytherapy is the most common form of radiotherapy for UM. We review the history of brachytherapy in the treatment of UM and the evolution of the procedure to incorporate fine-needle-aspiration biopsy techniques with DNA- and RNA-based genetic prognostic testing. Keywords: brachytherapy, uveal melanoma, UM, fine-needle-aspiration biopsy, genetic prognostic testing, molecular marker