Clinical Features, Histopathological Analysis And Surgical Treatment Of A Free Floating Vitreous Cyst: A Case Report

The authors present a report of a 44-year-old female patient, with complaints of visual disturbances in the left eye. The symptoms were present for at least 5 years and worsenedin the last 2 years, impairing her activities. The patient reported perception of a floating circle, which blurred her vision. There was no previous history of trauma, infectious or inflammatory disease. Clinical evaluation included physical examination, laboratory testing, abdominal ultrasonography, thorax X-ray and head tomography. Ophthalmologic examination consisted of visual acuity, motility tests, biomicroscopy, tonometry and indirect ophthalmoscopy. Complementary investigation was done with α and β scan ocular ultrasonography. The chosen therapeutic approach to excise the cyst was pars plana vitrectomy, successfully performed. Anatomopathologic analysis revealed a pigmented vitreous cyst, of possible congenital origin, described as a cystic choristoma from the primitive hyaloid system. Benign evolution, clinical findings and histopathological analysis corroborated the diagnostic hypothesis of a cystic choristoma of the primitive hyaloid system. Surgery (pars plana vitrectomy) was successful and the patient returned with visual acuity of 20/20 in both eyes, and with no further complaints.695753755Tansley, J.O., Cyst of the vitreous (1899) Trans Am Ophthamol Soc, 8, pp. 507-509Cruciani, F., Santino, G., Salandri, A.G., Monolateral idiopathic cyst of the vitreous (1999) Acta Ophthalmol Scand, 77 (5), pp. 601-603. , ReviewJones, W.L., Free-floating vitreous cyst (1998) Optom Vis Sci, 75 (3), pp. 171-173Orellana, J., O'Malley, R.E., McPherson, A.R., Font, R.L., Pigmented free-floating vitreous cysts in two young adults. Electron microscopic observations (1985) Ophthalmology, 92 (2), pp. 297-302Nork, T.M., Millecchia, L.L., Treatment and histopathology of a congenital vitreous cyst (1998) Ophthalmology, 105 (5), pp. 825-830Awan, K.J., Biomicroscopy and argon laser photocystotomy of free-floating vitreous cysts (1985) Ophthalmology, 92 (12), pp. 1710-1711Ruby, A.J., Jampol, L.M., Nd: YAG treatment of a posterior vitreous cyst (1990) Am J Ophthalmol, 110 (4), pp. 428-429Asiyo-Vogel, M.N., El-Hifnawi, El.-S., Laqua, H., Ultrastructural features of a solitary vitreous cyst (1996) Retina, 16 (3), pp. 250-254Hasegawa, N., Kimura, T., Mizota, A., Sano, N., Adachi-Usami, E., Floating vitreous cyst (1996) Retina, 16 (6), pp. 540-542Steinmetz, R.L., Straatsma, B.R., Rubin, M.L., Posterior vitreous cyst (1990) Am J Ophthalmol, 109 (3), pp. 295-29

Intravitreal Ranibizumab As Adjuvant Treatment For Neovascular

The purpose of this study was to describe a prospective case series of 5 eyes treated with intravitreal ranibizumab injection for neovascular glaucoma (NVG). Five patients with clinically uncontrolled NVG secondary to proliferative diabetic retinopathy (4 patients) and central retinal vein occlusion (1 patient), non-responsive to maximal tolerable medication and panretinal photocoagulation, received intravitreal ranibizumab injection (0.5 mg). Patients were seen at 1st, 3rd and 7th day after the ranibizumab injection and when it was necessary. Success was defined as intraocular pressure (IOP) 21, despite maximal tolerable medication, underwent trabeculectomy with 0.5mg/ml mitomycin C (MMC) for 1 minute. Failure was defined as IOP > 21 mmHg, phthisis bulbi, loss of light perception or additional glaucoma surgery. The primary outcome was 6-month IOP control. Mean IOP before the ranibizumab injection was 37 mmHg (7 mmHg SD). Two out of five eyes underwent only ranibizumab injection, having an IOP control after the procedure. Three patients were submitted to trabeculectomy with MMC on the 7th day after the injection. At 6-month follow-up, the mean IOP was 12mmHg (3 mmHg SD). All eyes showed regression of rubeosis iridis and IOP control. Visual acuity improved in 2 eyes worsened in 1 eye, and remained stable in 2 eyes. These data suggest that intravitreal ranibizumab injection may be a useful tool in the treatment of NVG.722119121Allingham, R.R., Damji, K.F., Freedman, S., Moroi, S.E., Shafranov, G., (2005), pp. 328-46. , Shields textbook of glaucoma. 5th ed. Philadelphia, PA: Lippincott Williams & WilkinsParrish, R., Hershler, J., Eyes with end-stage neovascular glaucoma.Natural history following successful modified filtering operation (1983) Arch Ophthalmol, 101 (5), pp. 745-6Beutel, J., Peters, S., Lüke, M., Aisenbrey, S., Szurman, P., Spitzer, M.S., Yoeruek, E., Bevacizumab Study Group, Grisanti S. Bevacizumab as adjuvant for neovascular glaucoma (2010) Acta Ophthalmol, 88 (1), pp. 103-9. , Comment in Acta Ophthalmol. 2010;88(4):e133Douat, J., Auriol, S., Mahieu-Durringer, L., Ancèle, E., Pagot-Mathis, V., Mathis, A., [Intravitreal bevacizumab for treatment of neovascular glaucoma. Report of 20 cases] (2009) J Fr Ophtalmol, 32 (9), pp. 652-63Saito, Y., Higashide, T., Takeda, H., Ohkubo, S., Sugiyama, K., Beneficial effects of preoperative intravitreal bevacizumab on trabeculectomy outcomes in neovascular glaucoma (2010) Acta Ophthalmol, 88 (1), pp. 96-10

Endorsement Of Reporting Guidelines Is Our Next Step

[No abstract available]772Wagoner, K., Ao mestre com carinho, 365 reflexões sobre a arte de ensinar (2002), São Paulo: PublifolhaEnhancing the QUAlity and Transparency Of Health Research [Internet]. http://www.equator-network.org/, The EQUATOR Network. OxfordCentre for Statistics in Medicina [cited 2014 Feb 20] Available from:Shamseer, L., Galipeau, J., Turner, L., Moher, D., Improving the reporting and usability of research studies (2013) Can J Anaesth., 60 (4), pp. 337-344Moher, D., Reporting research results: a moral obligation for all researchers (2007) Can J Anaesth., 54 (5), pp. 331-335Groves, T., Enhancing the quality and transparency of health research (2008) BMJ., 337, pp. a718Altman, D.G., Schulz, K.F., Moher, D., Egger, M., Davidoff, F., Elbourne, D., The revised CONSORT statement for reporting randomized trials: explanation and elaboration (2001) Ann Intern Med., 134 (8), pp. 663-694. , Comment in: Aust Occup Ther J. 2009;56(1):72-3Med Clin (Barc). 2005124(11):439Ann Intern Med. 2002;136(12):926-7author reply 926-7Hopewell, S., Dutton, S., Yu, L.M., Chan, A.W., Altman, D.G., The quality of reports of randomised trials in 2000 and 2006: comparative study of articles indexed in PubMed (2010) BMJ., 340, pp. c723. , Comment in: BMJ. 2010;340:c143

Good Reporting Practices And The Consort

[No abstract available]75285Simera, I., Moher, D., Hirst, A., Hoey, J., Schulz, K.F., Altman, D.G., Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network (2010) BMC Med., 8, p. 24Jüni, P., Altman, D.G., Egger, M., Systematic reviews in health care: assessing the quality of controlled clinical trials (2001) BMJ., 323 (7303), pp. 42-46Chan, A.W., Altman, D.G., Epidemiology and reporting of randomised trials published in PubMed journals (2005) Lancet, 365 (9465), pp. 1159-1162Glasziou, P., Meats, E., Heneghan, C., Shepperd, S., What is missing from descriptions of treatment in trials and reviews? (2008) BMJ., 336 (7659), pp. 1472-1474Moher, D., Hopewell, S., Schulz, K.F., Montori, V., Gotzsche, P.C., Devereaux, P.J., Elbourne, D., Submitted for publication: April 11, 2012 Accepted for publication: April 11, 2012Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., PRISMA Group. Preferred reporting items for systematic reviews and meta-analysis: the PRISMA statement (2009) BMJ, 339, pp. b2535-b2540von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., Gøtzsche, P.C., Vandenbroucke, J.P., STROBE Initiative Strengthening the reporting of observational studies in epidemio logy (STROBE) statement: guidelines for reporting observational studies (2007) BMJ., 335 (7624), pp. 806-808. , Comment in: BMJ. 2007;335(7624):783-4. Arch Dermatol. 2008144(9):1200-4. BMJ. 2007335(7626):90

Adult Foveomacular Vitelliform Dystrophy

Adult foveomacular vitelliform dystrophy is a rare pathology. Less than 1% of the reported cases display perifoveal capillary permeability. The three-year follow-up period of the case revealed a rare form, which had not yet been documented. The patient was a 40-year-old female with normal visual acuity, and a minor complaint of metamorphopsia on the left eye. Retinography showed a perifoveal yellowish subretinal area OS. Angiography showed perifoveal leakage OS. Follow up showed that, over 3 years, capillary incompetence disappeared and the yellow area underwent alterations, becoming atrophic OS. Angiography also showed hyperfluorescence (windows defect). Towards the end, it resembled the appearance of late stage of Best's Disease.723197199Renner, A.B., Tillack, H., Kraus, H., Kohl, S., Wissinger, B., Mohr, N., Morphology and functional characteristics in adult vitelliform macular dystrophy (2004) Retina., 24 (6), pp. 929-939Gass, J.D., A clinicopathologic study of a peculiar foveomacular dystrophy (1974) Trans Am Ophthalmol Soc., 72, pp. 139-156Fishman, G.A., Trimble, S., Rabb, M.F., Fishman, M., Pseudovitelliform macular degeneration (1977) Arch Ophthalmol., 95 (1), pp. 73-76Sabates, R., Pruett, R.C., Hirose, T., Pseudovitelliform macular degeneration (1982) Retina, 2 (4), pp. 197-205Dubovy, S.R., Hairston, R.J., Schatz, H., Schachat, A.P., Bressler, N.M., Finkelstein, D., Grenn, W.R., Adult-onset foveomacular pigment epithelial dystrophy:clinicopathology correlation of three cases (2000) Retina, 20 (6), pp. 638-649Gutman, T., Walsh, J.B., Henkind, P., Vitelliform macular dystrophy and butterfly-shaped epithelial dystrophy:a continuum? (1982) Br J Ophthalmol., 66 (3), pp. 170-173Epstein, G.A., Rabb, M.F., Adult vitelliform macular degeneration:diagnosis and natural history (1980) Br J Ophthalmol., 64 (10), pp. 733-74

Epiretinal Membrane Formation Associated With Idiopathic Macular Telangiectasia: Case Report

A 46-year-old woman complained of blurred and distorted vision in both eyes. Ophthalmic examination showed that visual acuity was 20/200 for the right eye and counting fingers left eye. Fundoscopy revealed perimacular hemorrhages, aneurismal dilatation of the vessels in the posterior pole, and a white and elevated lesion adjacent to vascular changes. We report a case of idiopathic macular telangiectasia and epiretinal membrane that occurs concomitantly. To our knowledge, this is the first report that describes an association between idiopathic macular telangiectasia and epiretinal membrane formation.774264266Gass, J.D., Oyakawa, R.T., Idiopathic juxtafoveal retinal telangiectasis (1982) Arch Ophthalmol, 100 (5), pp. 769-780Abujamra, S., Telangiectasias perimaculares idiopáticas (2012) Rev Bras Oftalmol, 71 (4), pp. 213-216Bonanomi, M.T., Cresta, F.B., Abujamra, S., Telangiectasia retiniana justafoveolar idiopática do grupo 2A: hiperpigmentação macular incomum em dois pacientes (2001) Arq Bras Oftalmol, 64 (6), pp. 569-572Rentsch, F.J., The ultrastructure of preretinal macular fibrosis (1977) Albrecht Von Graefes Arch Clin Exp Ophthalmol, 203 (3-4), pp. 321-337Beach, J.M., Schwenzer, K.J., Srinivas, S., Kim, D., Tiedeman, J.S., Oximetry of retinal vessels by dual-wavelength imaging: calibration and influence of pigmentation (1999) J Appl Physiol (1985), 86 (2), pp. 748-758Yannuzzi, L.A., Bardal, A.M., Freund, K.B., Chen, K.J., Eandi, C.M., Blodi, B.C., Idiopathic macular telangiectasia (2006) Arch Ophthalmol, 124 (4), pp. 450-460. , Comment in: Arch Ophthalmol. 2006;124(4):573-4Charbel Issa, P., van der Veen, R.L., Stijfs, A., Holz, F.G., Scholl, H.P., Berendschot, T.T., Quantification of reduced macular pigment optical density in the central retina in macular telangiectasia type 2 (2009) Exp Eye Res, 89 (1), pp. 25-31Bringmann, A., Pannicke, T., Grosche, J., Francke, M., Wiedemann, P., Skatchkov, S.N., Muller cells in the healthy and diseased retina (2006) Prog Retin Eye Res, 25 (4), pp. 397-424Paunescu, L.A., Ko, T.H., Duker, J.S., Chan, A., Drexler, W., Schuman, J.S., Idiopathic juxtafoveal retinal telangiectasis: new findings by ultrahigh-resolution optical coherence tomography (2006) Ophthalmology, 113 (1), pp. 48-57Olson, J.L., Mandava, N., Macular hole formation associated with idiopathic parafoveal telangiectasia (2006) Graefe's Arch Clin Exp Ophthalmol, 244 (3), pp. 411-41

Ocular Masquerade Syndrome Associated With Extranodal Nasal Natural Killer/t-cell Lymphoma: Case Report

A 33-year-old woman complained of unilateral eyelid edema and blurred vision. Initial ophthalmic examination disclosed anterior chamber reaction with keratic precipitates on the cornea, without posterior abnormalities. Anterior uveitis was treated. Despite that, patient showed rapidly progressive unilateral vision loss with optic nerve swelling. Systemic workup was inconclusive, as well as cranial magnetic resonance imaging and cerebrospinal fluid examination. Based on the hypothesis of optic neuritis, intravenous methylprednisolone pulse was performed with no success. During the following days, the patient presented pericardial effusion and cardiac tamponade, progressing to death. Necropsy was performed and diagnosis of extranodal natural killers/T-cell lymphoma, nasal type with ocular involvement was confirmed by immunohistochemistry.756430432Nussenblatt, R.B., Whitcup, S.M., Uveitis: fundamentals and clinical practice (2004), pp. 409-419. , 3rd ed. St. Louis, MO: CV MosbyTheodore, F.H., Conjunctival carcinoma masquerading as chronic conjunctivitis (1967) Eye Ear Nose Throat Mon, 46 (11), pp. 1419-1420Swerdlow, S.H., Campo, E., Harris, N.L., Jaffe, E.S., Pileri, S.A., Stein, H., Thiele, J., Vardiman, J.W., World classification of tumours of haematopoietic and lymphoid tissues (2008), 5th ed. Lyon: IARC PressCoupland, S.E., Damato, B., Lymphomas involving the eye and the ocular adnexa (2006) Curr Opin Ophthalmol, 17 (6), pp. 523-531Sjö, L.D., Ophthalmic lymphoma: epidemiology and pathogenesis (2009) Acta Ophthalmologica, 87 (1 THESIS), pp. 1-20Fredrick, D.R., Char, D.H., Ljung, B.M., Brinton, D.A., Solitary intraocular lymphoma as an initial presentation of widespread disease (1989) Arch Ophthalmol, 107 (3), pp. 395-397Chan, J.K.C., Jaffe, E.S., Ralfkiaer, E., Extranodal NK/Tcell lymphoma, nasal type. World classification of tumours of haematopoietic and lymphoid tissues (2008), pp. 204-207. , Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW, editors. 5th ed. Lyon: IARC PressKwong, Y.L., Chan, A.C., Liang, R.H., Natural Killer cell lymphoma/leukaemia: pathology and treatment (1997) Hematol Oncol, 15 (2), pp. 71-79Jaffe, E.S., Chan, J.K., Su, I.J., Frizzera, G., Mori, S., Feller, A.C., Ho, F.C., Report of the Workshop on Nasal and Related Extranodal Angiocentric T/Natural Killer cell lymphomas: definitions, differential diagnosis and epidemiology (1996) Am J Surg Pathol, 20 (1), pp. 103-111Cimino, L., Chan, C.C., Shen, D., Masini, L., Ilariucci, F., Masetti, M., Asioli, S., Ocular involvement in nasal natural kille T-cell lymphoma (2009) Int Ophthalmol, 29 (4), pp. 275-279Lee, E.J., Kim, T.W., Heo, J.W., Yu, H.G., Chung, H., Natural killer/T-cell lymphoma of nasal type with intraocular involvement: case report. (2010) Eur J Ophthalmol, 20 (1), pp. 215-217Yoo, J.H., Kim, S.Y., Jung, K.B., Lee, J.J., Lee, S.J., Intraocular involvement of a nasal natural killer T-cell lymphoma: a case report (2012) Korean J Ophthalmol, 26 (1), pp. 54-57Hon, C., Kwok, A.K., Shek, T.W., Chim, J.C., Au, W.Y., Vision-threatening complications of nasal T/NK lymphoma (2002) Am J Ophthalmol, 134 (3), pp. 406-41

Corneal Endothelial Rejection After Penetrating Keratoplasty Treated With Intravenous And Topic Corticosteroid. One Year Follow Up

Objective: To analyze the recovery of visual acuity (VA) and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP) treated with intravenous (IV) and topic corticosteroid. Methods: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. Results: A total of 32 eyes from 32 patients (13 male and 19 female) were included in the study. The mean VA (in number of letters) before rejection was 48 (22 to 88 letters). Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001). Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047). Conclusion: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.7214245Patel, S.V., Graft survival after penetrating keratoplasty (2011) Am J Ophthalmol., 151 (3), pp. 397-398Williams, K.A., Lowe, M.T., Barlett, C.M., Kelly, L., Coster, D.J., (2007) Australian corneal graft registry, , report Adelaide: Flinders University Press2007Tan, D.T., Janardhanan, P., Zhou, H., Chan, Y.H., Htoon, H.M., Ang, L.P., Penetrating keratoplasty in Asian eyes: the Singapore Corneal Transplant Study (2008) Ophthalmology., 115 (6), pp. 975-982Patel, S.V., Diehl, N.N., Hodge, D.O., Bourne, W.M., Donor risk factors for graft failure in a 20-year study of penetrating keratoplasty (2010) Arch Ophthalmol., 128 (4), pp. 418-425Hill, J.C., Ivey, A., Corticosteroids in corneal graft rejection: double versus single pulse therapy (1994) Cornea., 13 (5), pp. 383-388Tandon, R., Verma, K., Chawla, B., Sharma, N., Titiyal, J.S., Kalaivani, M., Intravenous dexamethasone vs methylprednisolone pulse therapy in the treatment of acute endothelial graft rejection (2009) Eye (Lond)., 23 (3), pp. 635-639Costa, D.C., Castro, R.S., Camargo, M.S., Kara-Jose, N., Rejeição de transplantes de córnea: tratamento tópico vs (2008) pulsoterapia - resultados de 10 anos. Arq Bras Oftalmol., 71 (1), pp. 57-61Krueger, R.R., Ramos-Esteban, J.C., Kanellopoulos, A.J., Staged intrastromal delivery of riboflavin with UVA cross-linking in advanced bullous keratopathy: laboratory investigation and first clinical case (2008) J Refract Surg., 24 (7), pp. S730-S736. , Comment in J Refract Surg. 2009;25(8):687author reply 687-8Panda, A., Vanathi, M., Kumar, A., Dash, Y., Priya, S., Corneal graft rejection (2007) Surv Ophthalmol., 52 (4), pp. 375-396. , ReviewMeyer, P.A., Watson, P.G., Franks, W., Dubord, P., 'Pulsed' immunosuppressive therapy in the treatment of immunologically induced corneal and scleral disease (1987) Eye (Lond)., 1 (PART 4), pp. 487-49