Refractory macular edema in X-linked juvenile retinoschisis

X-linked juvenile retinoschisis (XLRS) is one of the most common X-linked inherited, bilateral vitreoretinal dystrophiesaffecting males in the first two decades of life. In this article, we present a case report of a young man whopresented with gradual decrease in visual acuity in both eyes that was attributed to macular edema and foveal schisisin the inner retinal layers. He was investigated by appropriate ocular images which were consistent with a diagnosisof XLRS. He was treated by anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection, dorzolamideeye drops and intravitreal steroids injection without improvement

Surgical pearls: combined retinal detachment and choroidal detachment — can you insert an infusion cannula?

Combined retinal detachment and choroidal detachment is an uncommon diagnosis that a surgeon will occasionallyface. Although the experienced vitreoretinal surgeon can manage nearly all obstacles during the surgery, an inexperiencedvitreoretinal surgeon will face a few difficulties during certain steps. In this article, we describe a case reportand highlight some of these obstacles and suggest some options to overcome them

Retinoma — the first identified case in Jordan

Retinoma (or retinocytoma) is a rare benign intraocular tumor with characteristic features and can be diagnosed clinically. In this article, we present a case report and a review of literature about retinoma. The case is about an incidentally diagnosed retinoma in an asymptomatic young female who presented for vision checkup and was found to have an intraocular translucent-grey, elevated mass extending into the vitreous cavity from the retina with the characteristic features of retinoma. The main differential diagnosis included retinoblastoma and astrocytic hamartoma. The mass showed no growth over a period of 6 months of follow up with colored fundus photography and ultrasound. This case is, to the best of our knowledge, the first case of retinoma diagnosed in Jordan

Spontaneous closure of stage two idiopathic macular hole with persistent vitreous attachment

The classical rule was so far to observe idiopathic macular holes of stage 1a and 1b because of the high probability of spontaneous closure of the hole, while in higher stages surgical treatment was recommended. However, a growing number of case reports are available nowadays that suggest that even a more advanced stage macular hole may occasionally close spontaneously. In this article, we present a case of a 71-year-old female patient who presented with gradual bilateral decrease of vision, which was attributed to a combination of cataract and macular holes in both eyes. The macular hole in one eye was stage 1A and the other eye was stage 2. Follow up over a period of 6 months revealed conversion of the stage 1A hole to lamellar hole and spontaneous closure of the stage 2 hole

A rare case of posttraumatic bilateral orbital myositis in a young boy — a case report

Orbital myositis (OM) is a benign inflammatory disease of the orbit characterised by a polymorphous lymphoid infiltrate with varying degrees of fibrosis, without a known local or systemic cause. In this paper, we present a case of a young boy who sustained a trauma to his eyes a few days prior to admission, after which he developed bilateral orbital pain and ocular motility limitation. He underwent the appropriate investigations including orbital imaging and blood laboratory workup, which were all consistent with a diagnosis of posttraumatic bilateral orbital myositis. He was treated with steroids for few weeks, and when the dose of steroids was tapered, he had a relapse of the same disease with a different presentation, which was later controlled with a higher dose of steroids, after which the patient went into remission

Graves’ ophthalmopathy – thyroid eye disease

Graves’ disease (GD) is an autoimmune disorder that affects thyroid. It is caused by antibody, named thyroid-stimulating immunoglobulin (TIS) that acts like thyroid stimulating hormone (TSH), resulting in thyroid hormone overproduction – condition called hyperthyroidism. TSH receptors are located on thyroid cells, but also on ocular fibroblasts – that’s why Graves’ disease can result in ocular manifestations also known as Graves ophthalmopathy (GO). Typically patients with hyperthyroidism are affected by ophthalmopathy, but it can occur in hypothyroid or euthyroid patients as well. It is estimated that 20-35% of patients with Graves' disease develop thyroid eye disease. In most cases symptoms are mild and do not require specialist treatment. Decision about therapy should be made considering severity of the disease and it is influence on quality of life

Magnetic resonance imaging evaluation of retro-bulbar optic nerve in patients with optic disc pit maculopathy

Background: Optic disc pit (ODP) is a congenital anomaly characterized by indented area of the optic nerve head most likely originating from the incomplete closure of the superior edge of the embryonic fissure. Maculopathy can occasionally complicate this anomaly as intra-retinal and sub-retinal fluid at the macula. In result, maculopathy is associated with a poor visual prognosis due to a serous macular detachment, formation of macular hole, or atrophy of the retinal pigmented epithelium. In this case series, we report of three patients with unilateral ODP. Case report: We attempted to analyze the morphologic changes seen in the ODP and evaluate patients with a complete ophthalmologic evaluation, fundus color photography, spectral-domain optical coherence tomography (SD-OCT) scanning, and magnetic resonance imaging (MRI) of globe and orbit. Magnetic resonance imaging scan was done for optic disc diameter (ODD) and optic nerve sheath diameter (ONSD). Conclusion: We noticed that in the patient who presented with neurosensory detachment in the macula, the ONSD is larger than in the fellow eye and is larger than the remaining two patients with ODP and without neurosensory detachment of the retina

Assessment of retinal and optic disc vascular perfusion density in retinitis pigmentosa patients by optical coherence tomography angiography

Background: The aim of the study was to evaluate the vascular flow density measured by optical coherence tomography angiography in patients with retinitis pigmentosa and to compare it with normal subjects. Material and methods: This was a cross-sectional case control study employing 16 eyes of eight patients with retinitis pigmentosa and 16 eyes of eight healthy subjects. Optical coherence tomography angiography was performed in all subjects. The macula was imaged with a 3 × 3 mm scan, whereas for the optic nerve head, a 4.5 × 4.5 mm scan was taken. Macular and optic disc vascular flow perfusion densities were measured. In addition, the FAZ area was calculated. All data were compared in the two groups. Results: The vascular flow perfusion density in the macular and in the optic nerve head was significantly lower in the retinitis pigmentosa group when compared with the control group. On the other hand, the foveal avascular zones area was not significantly different from controls. Conclusion: Patients with retinitis pigmentosa show a decreased macular and optic nerve head perfusion density compared with healthy subject

Perfluorocarbon droplets in the anterior chamber – Case Report

Perfluorocarbonated liquids (PFCL) are occasionally used in vitreoretinal surgery. In this article, we present a case of a young man who sustained a trauma to his eye resulting in a traumatic cataract and retinal detachment. He underwent combined cataract extraction, intraocular lens implantation and a vitrectomy for retinal detachment. Perfluorodecaline was used to stabilize the retina during the surgery. One day after surgery he was found to have many small bubbles of perfluorodecaline settling in the lower half of the anterior chamber. He was managed conservatively and followed up for a period of 1 year during which there were no sequel for the retained PFCL

Scleromalacia perforans as the presenting sign for rheumatoid arthritis — a case report

Scleromalacia perforans is a rare but well-recognised extra-articular complication of rheumatoid arthritis. It is diagnosedusually late in the course of the disease. In this paper we present a case of scleromalacia perforans in which the patient was not diagnosed with rheumatoid arthritis previously; the elderly female presented with bilateral foreign body sensation and was found to have scleromalacia perforans, which was treated medically with a bolus dose of steroids followed by combined oral steroids and methotrexate, from which she developed the devastating side effect of thrombocytopaenia. The patient was planned for surgical therapy for the scleromalacia, but unfortunately she passed away during the follow-up