Case Reports in Ophthalmological Medicine http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Benign Lymphoid Hyperplasia Presenting as Bilateral Scleral Nodules Tue, 01 Sep 2015 08:34:07 +0000 http://www.hindawi.com/journals/criopm/2015/179609/ Purpose. To report a case of transient lymphoid hyperplasia presenting as bilateral nodular scleral mass in a young male patient. Design. Observational case report. Methods. Chart review. Causes of scleritis were considered and excluded based on detailed history, physical examination, and laboratory investigations. Results. Excisional biopsy of scleral lesions indicated lymphoid tissue. Immunohistochemical studies revealed a polyclonal population of T and B cells consistent with a benign reactive process. Conclusions. Chronic exposure of the ocular adnexa to many allergens and irritants may lead to activation of the inflammatory cascade. In severely allergic patients activation may be exponential and elicit an immune-mediated response resulting in a transient lymphoid reactive process. Ricardo J. Cumba and Rene Vazquez-Botet Copyright © 2015 Ricardo J. Cumba and Rene Vazquez-Botet. All rights reserved. Posterior Cortical Atrophy Presenting with Superior Arcuate Field Defect Mon, 31 Aug 2015 13:08:20 +0000 http://www.hindawi.com/journals/criopm/2015/796381/ An 80-year-old female with reading difficulty presented with progressive arcuate field defect despite low intraocular pressure. Over a 5-year period, the field defect evolved into an incongruous homonymous hemianopia and the repeated neuroimaging revealed progressive posterior cortical atrophy. Further neuropsychiatric assessment demonstrated symptoms and signs consistent with Benson’s syndrome. Sue Ling Wan, Danuta M. Bukowska, Stephen Ford, and Fred K. Chen Copyright © 2015 Sue Ling Wan et al. All rights reserved. Bilateral Coats’ Disease Combined with Retinopathy of Prematurity Sun, 30 Aug 2015 09:32:17 +0000 http://www.hindawi.com/journals/criopm/2015/364395/ Purpose. To report a case of bilateral Coats’ disease combined with retinopathy of prematurity (ROP). Case. Retinal vascularization was complete in the right eye, whereas zone III, stage 3 ROP and preplus disease were observed in the left eye at 43 weeks of postmenstrual age (PMA) in a 31-week premature, 1200-g neonate. Intraretinal exudates developed and retinal hemorrhages increased in the left eye at 51 weeks of PMA. Diode laser photocoagulation (LP) was applied to the left eye. Exudates involved the macula, and telangiectatic changes developed one month following LP. Additional LP was applied to the left eye combined with intravitreal bevacizumab (IVB) injection at 55 weeks of PMA. Disease regressed one month after the additional therapy. At the 14-month examination of the baby, telangiectatic changes and intraretinal exudates were observed in the right eye. Diode LP was applied to the right eye combined with IVB injection. Exudates did not resolve completely, and cryotherapy was applied one month following LP. Retinal findings regressed three months following the cryotherapy. Conclusion. This is the first report of presumed bilateral Coats’ disease combined with ROP. If Coats’ disease could be diagnosed at early stages, it would be a disease associated with better prognosis. Huseyin Gursoy, Nazmiye Erol, Mustafa Deger Bilgec, Hikmet Basmak, Ozden Kutlay, and Huseyin Aslan Copyright © 2015 Huseyin Gursoy et al. All rights reserved. Adie’s Tonic Pupil in Systemic Sclerosis: A Rare Association Thu, 27 Aug 2015 12:54:50 +0000 http://www.hindawi.com/journals/criopm/2015/491795/ We report a rare association of Adie’s tonic pupil in a patient with systemic sclerosis who was otherwise systemically stable. This paper is an effort to unravel whether the tonic pupil and systemic sclerosis are an association by chance (which may be the case) or systemic sclerosis is the source of the tonic pupil. Anusha Venkataraman, Bijnya Birajita Panda, and Chandrasekhar Sirka Copyright © 2015 Anusha Venkataraman et al. All rights reserved. Sub-Tenon Injections of Triamcinolone Acetonide Had Limited Effect on Cystoid Macular Edema Secondary to Nanoparticle Albumin-Bound-Paclitaxel (Abraxane) Sun, 23 Aug 2015 12:01:13 +0000 http://www.hindawi.com/journals/criopm/2015/181269/ Purpose. To report the first case of cystoid macular edema (CME) induced by nanoparticle albumin-bound- (nab-) paclitaxel treated with sub-Tenon injections of triamcinolone acetonide (STTA) with detailed long-term follow-up. Case. A 39-year-old Japanese woman with breast cancer presents with decreased vision in both eyes while receiving nab-paclitaxel. Two STTA treatments were administered for persistent CME in her right eye. Central retinal thickness (CRT) of the treated eye decreased after the first STTA, but there was no change after the second STTA. CRT of the other eye and bilateral visual acuity (VA) showed no change after each treatment. However, this patient experienced gradual recovery of visual function after nab-paclitaxel treatment was completed, 3 months after the second STTA. Improvements in VA and CRT did not overlap in time. Moreover, there was a big improvement time lag in VA between the eyes. Conclusion. Cessation of nab-paclitaxel could lead to resolution of CME more than STTA, although STTA had some effect. Since nab-paclitaxel has been recently approved for treating more types of malignancies, the number of the patients with this CME is expected to increase in the near future. Patients and physicians should understand this side effect and prepare for other treatment options. Naoki Matsuoka, Hiruma Hasebe, Tetsuji Mayama, and Takeo Fukuchi Copyright © 2015 Naoki Matsuoka et al. All rights reserved. Congenital Upper Eyelid Coloboma: Clinical and Surgical Management Sun, 23 Aug 2015 08:57:16 +0000 http://www.hindawi.com/journals/criopm/2015/286782/ Purpose. The goal was to describe our experience in the surgical management and treatment of four patients with congenital upper eyelid colobomas. Methods. A descriptive, observational, retrospective study was performed including patients with congenital eyelid colobomas referred to Asociación para Evitar la Ceguera en México I.A.P. “Dr. Luis Sánchez Bulnes” between 2004 and 2014 and assessed by the Oculoplastics and Orbit Service. Results. The four cases required surgical treatment of the eyelid defects before one year of age and their evolution was monitored from the time of referral to the present day. One of the patients needed a second surgical procedure to repair the eyelid defect and correct the strabismus. Conclusions. Eyelid colobomas are a potential threat to vision at an early age, which requires close monitoring of the visual development of patients. José María Ortega Molina, Eduardo Ramón Mora Horna, Andrés David Salgado Miranda, Rosa Rubio, Ana Solans Pérez de Larraya, and Guillermo Salcedo Casillas Copyright © 2015 José María Ortega Molina et al. All rights reserved. Detailed Morphological Changes of Foveoschisis in Patient with X-Linked Retinoschisis Detected by SD-OCT and Adaptive Optics Fundus Camera Tue, 18 Aug 2015 11:20:24 +0000 http://www.hindawi.com/journals/criopm/2015/432782/ Purpose. To report the morphological and functional changes associated with a regression of foveoschisis in a patient with X-linked retinoschisis (XLRS). Methods. A 42-year-old man with XLRS underwent genetic analysis and detailed ophthalmic examinations. Functional assessments included best-corrected visual acuity (BCVA), full-field electroretinograms (ERGs), and multifocal ERGs (mfERGs). Morphological assessments included fundus photography, spectral-domain optical coherence tomography (SD-OCT), and adaptive optics (AO) fundus imaging. After the baseline clinical data were obtained, topical dorzolamide was applied to the patient. The patient was followed for 24 months. Results. A reported RS1 gene mutation was found (P203L) in the patient. At the baseline, his decimal BCVA was 0.15 in the right and 0.3 in the left eye. Fundus photographs showed bilateral spoke wheel-appearing maculopathy. SD-OCT confirmed the foveoschisis in the left eye. The AO images of the left eye showed spoke wheel retinal folds, and the folds were thinner than those in fundus photographs. During the follow-up period, the foveal thickness in the SD-OCT images and the number of retinal folds in the AO images were reduced. Conclusions. We have presented the detailed morphological changes of foveoschisis in a patient with XLRS detected by SD-OCT and AO fundus camera. However, the findings do not indicate whether the changes were influenced by topical dorzolamide or the natural history. Keiichiro Akeo, Shuhei Kameya, Kiyoko Gocho, Daiki Kubota, Kunihiko Yamaki, and Hiroshi Takahashi Copyright © 2015 Keiichiro Akeo et al. All rights reserved. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions Mon, 17 Aug 2015 11:22:38 +0000 http://www.hindawi.com/journals/criopm/2015/680474/ Great discrepancies are often encountered between the distance fixation and the near-fixation esodeviations and exodeviations. They are all attributed to either anomalies of the AC/A ratio or anomalies of the fusional convergence or divergence amplitudes. We report a case with pseudoconvergence insufficiency and another one with pseudoaccommodative convergence excess. In both cases, conv./div. excess and insufficiency were erroneously attributed to anomalies of the AC/A ratio or to anomalies of the fusional amplitudes. Our purpose is to show that numerous factors, other than anomalies in the AC/A ratio or anomalies in the fusional conv. or divergence amplitudes, can contaminate either the distance or the near deviations. This results in significant discrepancies between the distance and the near deviations despite a normal AC/A ratio and normal fusional amplitudes, leading to erroneous diagnoses and inappropriate treatment models. Edward Khawam, Bachir Abiad, Alaa Boughannam, Joanna Saade, and Ramzi Alameddine Copyright © 2015 Edward Khawam et al. All rights reserved. The Diagnostic and Therapeutic Challenges of Posttraumatic Iris Implantation Cysts: Illustrative Case Presentations and a Review of the Literature Wed, 12 Aug 2015 07:31:02 +0000 http://www.hindawi.com/journals/criopm/2015/375947/ Posttraumatic iris implantation cysts are rare ocular findings that are often associated with poor visual outcomes. Iris implantation cysts can present clinicians with diagnostic and therapeutic challenges given their variable presentations and frequently destructive nature. In this paper, we provide descriptions of two unusual cases of posttraumatic iris implantation cysts. The first case is of a recurrent keratin-filled iris implantation cyst that developed after open globe injury and intraocular implantation of cilia and was treated with cyst debulking procedures, injections of 5-Fluorouracil, and iridocyclectomy. The second case is of recurrent posttraumatic serous iris implantation cysts that were treated with laser, cyst aspiration, and injections of 5-Fluorouracil. We use these cases as a platform to discuss the different manifestations of implantation cysts, the roles of anterior segment optical coherence tomography, ultrasound biomicroscopy, and histopathology in facilitating timely and accurate diagnosis and review the range of available therapeutic modalities. We discuss conservative treatment approaches, including the novel use of 5-Fluorouracil therapy as an adjunct therapy, as well as more aggressive surgical excision requiring ocular reconstruction. Through a discussion of these cases and review of the literature, we provide recommendations to assist clinicians in managing this uncommon but vision-threatening condition and minimizing complications. Nandini Venkateswaran, Steven S. T. Ching, William Fischer, Frank Lee, Gabrielle Yeaney, and Holly B. Hindman Copyright © 2015 Nandini Venkateswaran et al. All rights reserved. Managing Drawbacks in Unconventional Successful Glaucoma Surgery: A Case Report of Stent Exposure Wed, 29 Jul 2015 15:37:46 +0000 http://www.hindawi.com/journals/criopm/2015/847439/ Traditional options in managing failed trabeculectomy (bleb needling, revision, additional incisional surgery and tube surgery) have a relatively high failure and complication rate. The use of microinvasive glaucoma surgery (MIGS) has generally been reserved to mild to moderate glaucoma cases, proving good safety profiles but significant limitations in terms of efficacy. We describe a patient who underwent MIGS (XEN Aquesys subconjunctival shunt implantation) after a prior failed trabeculectomy. After the surgery, the IOP was well controlled but as the stent was close to an area of scarred conjunctiva of the previous trabeculectomy, it became partially exposed. As a complete success was achieved, we decided to remove the conjunctiva over the exposed area and replace it by an amniotic membrane transplantation and a conjunctiva autograft. Six months after surgery, the unmedicated IOP is still well controlled with complete visual acuity recovery. Antonio Fea, Paola Maria Loredana Cannizzo, Giulia Consolandi, Carlo Alessandro Lavia, Giulia Pignata, and Federico M. Grignolo Copyright © 2015 Antonio Fea et al. All rights reserved. Presentation of Complex Homozygous Allele in ABCA4 Gene in a Patient with Retinitis Pigmentosa Thu, 02 Jul 2015 09:36:12 +0000 http://www.hindawi.com/journals/criopm/2015/452068/ Retinitis pigmentosa is a degenerative retinal disease characterized by progressive photoreceptor damage, which causes loss of peripheral and night vision and the development of tunnel vision and may result in loss of central vision. This study describes a patient with retinitis pigmentosa caused by a mutation in the ABCA4 gene with complex allele c.1622T>C, p.L541P; c.3113C>T, p.A1038V in homozygous state. Māreta Audere, Katrīna Rutka, Svetlana Šepetiene, and Baiba Lāce Copyright © 2015 Māreta Audere et al. All rights reserved. Phenotypic Spectrum of Granular Corneal Dystrophy Type II in Two Italian Families Presenting an Unusual Granular Corneal Dystrophy Type I Clinical Appearance Mon, 29 Jun 2015 12:22:52 +0000 http://www.hindawi.com/journals/criopm/2015/703418/ Clinical, instrumental, and genetic findings are reported in Italian families with Type II Granular Corneal Dystrophies (GCD2) presenting an initial unusual presentation of a Granular Corneal Dystrophy Type I (GCD1) phenotypic spectrum in female descendants. Slit-lamp examinations showed the typical phenotypic features of GCD2 in both mothers and a phenotypic appearance of GCD1 in both daughters. Despite the different phenotypic onset, the genetic diagnostic testing revealed the presence of a mutation in the TGFB-I gene, typical of GCD2 in both cases, excluding GCD1. Patients who were clinically suspected of corneal dystrophy need a genetic confirmatory testing for certain diagnosis. Genetic test may help to find the specific mutation distinguishing between different phenotypic spectra with relative diagnostic and prognostic implications. The study demonstrates that the phenotypic spectrum of genetically confirmed granular corneal dystrophies in patients may change over time. Since the R124H mutation has also been described in clinically asymptomatic individuals prior to LASIK, who then develop dramatic deposition, suggesting that this particular mutation and phenotype may be sensitive to, precipitated, or modified by central cornea trauma, a careful familial anamnesis excluding cornel dystrophies and specific preoperative genetic test are recommended prior to LASIK. Cosimo Mazzotta, Claudio Traversi, Stefano Baiocchi, Stefano Barabino, and Alessandro Mularoni Copyright © 2015 Cosimo Mazzotta et al. All rights reserved. Brittle Cornea Syndrome: Case Report with Novel Mutation in the PRDM5 Gene and Review of the Literature Mon, 29 Jun 2015 11:39:48 +0000 http://www.hindawi.com/journals/criopm/2015/637084/ A 3-year-old boy presented with acute corneal hydrops on the left eye and spontaneous corneal rupture on the right eye. A diagnosis of brittle cornea syndrome was confirmed by molecular analysis. A novel mutation, the homozygous variant c.17T>G, p.V6G, was found in the gene for PR-domain-containing protein 5 (PRDM5) in exon 1. Brittle cornea syndrome is a rare connective tissue disease with typical ocular, auditory, musculoskeletal, and cutaneous disorders. Almost all patients suffer from declined vision due to corneal scarring, thinning, and rupture. The most common ophthalmologic findings include keratoconus, progressive central corneal thinning, high myopia, irregular astigmatism, retinal detachment, and high risk for spontaneous corneal or scleral rupture. In addition to describing the case with a novel mutation here we review the current literature on brittle cornea syndrome pathogenesis, clinical findings, and therapy. Georgia Avgitidou, Sebastian Siebelmann, Bjoern Bachmann, Juergen Kohlhase, Ludwig M. Heindl, and Claus Cursiefen Copyright © 2015 Georgia Avgitidou et al. All rights reserved. Posterior Chamber Hemorrhage during Fluorescein Angiography Sun, 28 Jun 2015 07:07:21 +0000 http://www.hindawi.com/journals/criopm/2015/728070/ This paper provides the first reported case of acute posterior chamber hemorrhage during fluorescein angiography (FA). This is a case review with serial color photographs of the anterior segment. A 76-year-old male was referred for angiographic control of age-related macular degeneration. He was pseudophakic OU, BCVA 20/40 OU. He had mild hypertension, but not diabetes. He had had two previous angiograms without adverse effects. Difficulty was experienced in obtaining the images owing to a progressive reduction in the transparency of the media. A dense hemorrhage in the posterior chamber of the right eye was found, involving the visual axis. Thorough biomicroscopy, gonioscopy, and ultrasonic biomicroscopy showed that part of one of the haptics of the right intraocular lens (IOL) was touching and tearing the posterior face of the iris, without any visible synechiae, iris, or angle neovascularization. Anterior segment FA and posterior ultrasonography were normal. No similar case has been described in the literature involving dense progressive bleeding located in the capsular bag and posterior chamber, without any detectable triggering ocular event other than mydriasis and fluorescein injection. Contact of the iris or sulcus with part of the intraocular lens, aggravated by the intense use of mydriatics during the FA procedure, probably caused bleeding to happen. Manuel A. P. Vilela Copyright © 2015 Manuel A. P. Vilela. All rights reserved. Bilateral Iris Atrophy after the Femtosecond Assisted Laser In Situ Keratomileusis Surgery Sun, 14 Jun 2015 12:57:35 +0000 http://www.hindawi.com/journals/criopm/2015/127806/ Purpose. To report an unknown complication of laser in situ keratomileusis (LASIK) surgery. Case Presentation. A 28-year-old female presented with photophobia and glare to our eye service. She stated in her medical history that she had undergone femtosecond assisted LASIK surgery in both eyes 15 months ago and her symptoms started just after this surgery. On admission, her best-corrected visual acuity was 10/10 in both eyes. She had mydriatic pupils with no direct light reflex. Examination of the anterior segment revealed bilateral iris atrophy projecting within the LASIK ablation zone and a transillumination defect was remarkable on the slit lamp examination. Conclusion. We hypothesized that this condition may have been caused by the abnormally increased IOP that resulted in ischemia in the iris vascular plexus during the suction process of surgery. Kenan Olcay, Akin Cakir, Sercan Koray Sagdic, Eyup Duzgun, and Yildiray Yildirim Copyright © 2015 Kenan Olcay et al. All rights reserved. Cataract Surgery with a Refractive Corneal Inlay in Place Thu, 11 Jun 2015 09:01:36 +0000 http://www.hindawi.com/journals/criopm/2015/230801/ Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place. Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL) power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in both eyes in a usual manner. Results. On day one postoperatively, the patient achieved binocular uncorrected distance visual acuity 20/20 and uncorrected near visual acuity J1. The vision remained stable during the one-year follow-up period. Conclusion. Cataract surgery was performed in a standard manner in a patient with Presbia Microlens corneal inlay in place. Visual outcomes for both near and distance vision were satisfactory. N. R. Stojanovic, S. I. Panagopoulou, and I. G. Pallikaris Copyright © 2015 N. R. Stojanovic et al. All rights reserved. Increase in Central Retinal Edema after Subthreshold Diode Micropulse Laser Treatment of Chronic Central Serous Chorioretinopathy Tue, 09 Jun 2015 17:12:45 +0000 http://www.hindawi.com/journals/criopm/2015/813414/ Purpose. Subthreshold diode micropulse laser (SDM) treatment is believed to be safe method of treating clinical entities involving retinal edema. We present a case of serous edematous reaction of the retina to SDM treatment. Methods. Case report. Results. A patient with chronic central serous chorioretinopathy (CSCR) was treated with SDM Yellow multispot laser. Procedure had been preceded by careful titration of the laser power, which after achieving of the threshold parameter was decreased by 50%. The follow-up visit two days after treatment revealed significant central retinal edema and subretinal fluid. Fundus autofluorescence image showed thermal reaction from the RPE in the form of small spots of hyperfluorescence corresponding to the laser multispot pattern used for treatment. Retinal edema resolved after topical bromfenac and single intravitreal bevacizumab injection. Slight pigmentary reaction from the RPE persisted. Conclusion. In the treatment of CSCR, there is a need to significantly reduce threshold SDM power parameters or simply use very low power without titration. Maciej Gawęcki Copyright © 2015 Maciej Gawęcki. All rights reserved. Submacular Parasite Masquerading as Posterior Pole Granuloma Tue, 09 Jun 2015 12:38:22 +0000 http://www.hindawi.com/journals/criopm/2015/910383/ Parasites enter the eye through hematogenous spread. The interaction with host immune system may result in its destruction but not without collateral damage to the vital retinal structures. Currently, the accepted treatment for ocular parasitosis is surgical removal or direct laser photocoagulation. A 24-year-old Indian woman presented with abrupt painless loss of vision to 5/300. A large yellow-white lesion centered at macula was observed with associated retinal and subretinal hemorrhage and neurosensory retinal detachment. A parasite was seen protruding at the center of the lesion. Fluorescein angiography demonstrated disc leakage and vessel wall staining. Ultrasonography demonstrated a highly reflective subretinal lesion with aftershadowing. Serological test was positive for anti-cysticercus (IgM) antibody. Treatment with prednisolone and albendazole resulted in resolution of the lesion within 2 months with improvement of visual acuity to 20/400. A noncystic form of subretinal cysticercosis is likely with suggestive B-scan ultrasonography and serological investigations. Jatinder Singh and Rajbir Singh Copyright © 2015 Jatinder Singh and Rajbir Singh. All rights reserved. Bilateral Dome-Shaped Macula with Serous Macular Detachment in a Child Mon, 01 Jun 2015 11:17:25 +0000 http://www.hindawi.com/journals/criopm/2015/213968/ Dome-shaped macula is a structural disorder and optical coherence tomography (OCT) helps us to confirm macular convexity. We describe the first case of bilateral dome-shaped macula in an 8-year-old boy with subretinal fluid. The patient was diagnosed using spectral-domain OCT and received indocyanine green angiography-guided half-fluence photodynamic therapy as treatment. Zafer Cebeci and Nur Kir Copyright © 2015 Zafer Cebeci and Nur Kir. All rights reserved. Epithelial Downgrowth after Intraocular Surgery Treated with Intracameral 5-Fluorouracil Thu, 28 May 2015 13:39:11 +0000 http://www.hindawi.com/journals/criopm/2015/325485/ Purpose. To present the clinical and histopathologic correlation of two cases of epithelial downgrowth (EDG) after prior intraocular surgery. Methods. Observational case reports. Results. We present two cases of EDG occurring after intraocular surgery. In both cases, after two anterior chamber injections of 5-fluorouracil (5FU), the area of EDG initially regressed. In Case 1, a limited area of EDG eventually recurred, and penetrating keratoplasty with cryotherapy was curative. In Case 2, subsequent corneal edema required Descemet-stripping automated endothelial keratoplasty, and the patient remained clinically free of EDG without further treatment. Conclusion. Intracameral 5FU may have a role in the treatment of EDG after intraocular surgery, though its precise utilization and impact remain to be defined. Nina Ni, Marc A. Goldberg, Ralph C. Eagle Jr., Christopher J. Rapuano, and Julia A. Haller Copyright © 2015 Nina Ni et al. All rights reserved. Surgical Excision of Orbital Progressive Granular Cell Tumour Mon, 18 May 2015 13:59:23 +0000 http://www.hindawi.com/journals/criopm/2015/420490/ Granular cell tumour (GCT) is mostly benign lesion first described by Abrikossoff and named after him. Most cases are reported in the head and neck area, where the tongue is the most common site. Here we review previous cases in the literature for GCT in the orbit and present a new case. A 49-year-old male presented with apparent exophthalmos. Examination of the patient revealed the presence of a mass in the bottom side of the orbit. A substantial progress was noted after two months from the initial examination using computed tomography (CT) scan. An orbital mass was extracted and histological analysis showed signs typical for GCT. Immunohistochemistry was positive for S-100; the biopsy showed no mitotic or necrotic areas. Proptosis was resolved after surgery and a six-year follow-up CT scan was performed. We conclude that rapid progress of the tumour does not necessarily suggest malignancy. Demetrio Germanò, Hossein Mostafa Elbadawy, Diego Ponzin, Daniele Ferro, and Leonardo Priore Copyright © 2015 Demetrio Germanò et al. All rights reserved. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature Mon, 18 May 2015 12:48:27 +0000 http://www.hindawi.com/journals/criopm/2015/368950/ A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature. A. Altun, S. A. Kurna, T. Sengor, G. Altun, A. Oflaz, and H. S. Sonmez Copyright © 2015 A. Altun et al. All rights reserved. Epidermoid Cyst of Orbit in a Newborn Wed, 13 May 2015 14:21:40 +0000 http://www.hindawi.com/journals/criopm/2015/848427/ A 3-day-old male newborn presented with a severe proptosis of the left eye leading to exposure keratopathy. He underwent debulking of the cyst and biopsy of the tumour and received the pathological diagnosis of epidermoid cyst of orbit. Clinicopathological features of this rare disease are discussed. Handan Canan, Rana Altan-Yaycioglu, Nebil Bal, Birgin Törer, Bilin Çetinkaya-Çakmak, and Hande Gülcan Copyright © 2015 Handan Canan et al. All rights reserved. Corneal Collagen Cross-Linking in Pellucid Marginal Degeneration: 2 Patients, 4 Eyes Mon, 11 May 2015 13:44:11 +0000 http://www.hindawi.com/journals/criopm/2015/840687/ Purpose. To report the long-term results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A irradiation in 4 eyes of 2 patients affected by pellucid marginal degeneration (PMD). Methods. This study involved the retrospective analysis of 4 eyes of 2 patients with PMD that underwent CXL treatment. Of the eyes, three had only CXL treatment and one had CXL treatment after an intrastromal corneal ring segment implantation. We have pre- and postoperatively evaluated uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), corneal topography (Pentacam), specular microscopy, and pachymetry. Results. Patient 1 was a woman, aged 35, and Patient 2 was a man, aged 33. The right eye of Patient 1 showed an improvement in her BCDVA, from 16/40 to 18/20 in 15 months, and her left eye improved from 12/20 to 18/20 in 20 months. Patient 2’s right eye showed an improvement in his BCDVA, from 18/20 to 20/20 in 43 months, and his left eye improved from 16/20 to 18/20 in 22 months. No complications were recorded during or after the treatment. Conclusion. CXL is a safe tool for the management of PMD, and it can help to stop the progression of this disease. Serife Bayraktar, Zafer Cebeci, Merih Oray, and Nilufer Alparslan Copyright © 2015 Serife Bayraktar et al. All rights reserved. Cytomegalovirus Uveitis with Hypopyon Mimicking Bacterial Endophthalmitis Mon, 11 May 2015 13:18:03 +0000 http://www.hindawi.com/journals/criopm/2015/489813/ We report an 83-year-old immune-competent female with unilateral endophthalmitis extraordinarily caused by cytomegalovirus (CMV). Since she was suspected of suffering possible bacterial endophthalmitis, she was referred to our hospital. At the first visit, hypopyon in the anterior chamber and the opacity of vitreous body were observed in the left eye. The best-corrected visual acuity (BCVA) of the left eye was counting fingers and the intraocular pressure (IOP) was 20 mmHg. Bacterial and fungus culture of the aqueous humor revealed no infection. However, the density of corneal endothelial cell was less than the measurable range and CMV was detected by PCR of the aqueous humor. She was immune-competent and the data indicated neither systemic infections nor diseases. Systemic valganciclovir and corticosteroid were administered. After that, hypopyon in the anterior chamber and the opacity of vitreous body of the left eye were improved, and the BCVA of the left eye was 20/200 one year after the first visit. However, the inflammation of the anterior chamber recurred accompanied by elevated IOP after the discontinuance of administering valganciclovir. CMV-induced uveitis accompanied with hypopyon is quite rare. Therefore, it can be easily misdiagnosed as bacterial endophthalmitis. Atsushi Yoshida, Hiroto Obata, and Hidetoshi Kawashima Copyright © 2015 Atsushi Yoshida et al. All rights reserved. Infected Baerveldt Glaucoma Drainage Device by Aspergillus niger Thu, 07 May 2015 15:58:50 +0000 http://www.hindawi.com/journals/criopm/2015/249419/ Fungal endophthalmitis is rare but may complicate glaucoma drainage device surgery. Management is challenging as the symptoms and signs may be subtle at initial presentation and the visual prognosis is usually poor due to its resistant nature to treatment. At present there is lesser experience with intravitreal injection of voriconazole as compared to Amphotericin B. We present a case of successfully treated Aspergillus endophthalmitis following Baerveldt glaucoma drainage device implantation with intravitreal and topical voriconazole. Nurul-Laila Salim, Yaakub Azhany, Zaidah Abdul Rahman, Roziawati Yusof, and Ahmad Tajudin Liza-Sharmini Copyright © 2015 Nurul-Laila Salim et al. All rights reserved. Ultrasound Biomicroscopy and Scheimpflug Imaging in Anterior Megalophthalmos: Changes Seen after Cataract Surgery Thu, 07 May 2015 14:07:49 +0000 http://www.hindawi.com/journals/criopm/2015/195950/ Purpose. With this report we describe ultrasound biomicroscopic (UBM) findings in a patient with anterior megalophthalmos before and after undergoing phacoemulsification with posterior chamber intraocular lens implantation. Methods. Phacoemulsification was carried out for nuclear sclerosis in both eyes of a patient diagnosed with anterior megalophthalmos. The patient was subjected to detailed ophthalmic examination including ultrasound biomicroscopy and Scheimpflug imaging prior to and after surgery. Preoperative ultrasound biomicroscopy revealed a deep anterior chamber with posterior bowing of the midperipheral iris in both eyes. The ciliary processes were inserted on the posterior surface of the iris. UBM was repeated postoperatively as well. Results. Phacoemulsification and posterior chamber intraocular lens implantation (IOL) were carried out successfully in both eyes. The IOLs were well centered and captured within the anterior capsulorhexis. The anterior chambers were hyperdeep, 6.24 mm (OD) and 6.08 mm (OS), respectively. The posterior bowing of the midperipheral iris was absent, with the iris having a more flat profile. Conclusion. UBM findings in anterior megalophthalmos seemed to partially resolve after cataract surgery. The anterior chamber deepens appreciably as well. Nishant Nawani, Arun K. Jain, and Ramandeep Singh Copyright © 2015 Nishant Nawani et al. All rights reserved. Complete Disappearance of Choroidal Metastasis from Lung Adenocarcinoma Treated with Bevacizumab and Chemotherapy Thu, 07 May 2015 07:08:17 +0000 http://www.hindawi.com/journals/criopm/2015/142408/ Choroidal metastasis from lung cancer is uncommon. We report a case of choroidal metastasis as an inaugural manifestation of lung adenocarcinoma, successfully treated by docetaxel, cisplatinum, and intravenous bevacizumab as an antiangiogenesis therapy. A complete remission was obtained after 4 cycles and maintained after six cycles. This case report demonstrates the importance of the systemic bevacizumab and chemotherapy in the treatment of choroidal metastasis from adenocarcinoma of the lung. Hampig Raphael Kourie, Joelle Antoun, Alexandre Schakal, Elie Nasr, Marwan Sahyoun, and Joseph Kattan Copyright © 2015 Hampig Raphael Kourie et al. All rights reserved. Bilateral Sturge-Weber and Phakomatosis Pigmentovascularis with Glaucoma, an Overlap Syndrome Wed, 06 May 2015 09:11:52 +0000 http://www.hindawi.com/journals/criopm/2015/106932/ Aim. To report a case of bilateral Sturge-Weber and Phakomatosis pigmentovascularis with secondary glaucoma in a child. Method. Case report. Results. A 4-year-old male child was referred to us for control of intraocular pressure (IOP). Sleeping IOP was 36 mm Hg in right eye and 28 mm Hg in the left eye. The sclera of both the eyes showed bluish black pigmentation—melanosis bulbi. Fundus examination of both eyes showed diffuse choroidal hemangiomas with glaucomatous cupping. Nevus flammeus was present on both sides of face along all the 3 divisions of trigeminal nerve with overlying hypertrophy of skin and on left forearm. Nevus fuscocaeruleus was present on upper trunk. All skin lesions were present since birth and were stationary in nature. CT scan of head revealed left-sided cerebral atrophy. Intraocular pressure was controlled after treatment with topical antiglaucoma medications. Pulsed Dye Laser has been advised by dermatologist for skin lesions. Patient has been advised for regular follow-up. Conclusion. The two overlapping dermatological disorders and their association with glaucoma are a rare entity. Management should be targeted both for dermatological and eye conditions. Bharat Patil, Gautam Sinha, Bhagabat Nayak, Reetika Sharma, Sadhana Kumari, and Tanuj Dada Copyright © 2015 Bharat Patil et al. All rights reserved. A Case of Goldenhar Syndrome Associated with a New Retinal Presentation: Exudative Vitelliform Maculopathy Sun, 03 May 2015 09:17:06 +0000 http://www.hindawi.com/journals/criopm/2015/626027/ Goldenhar syndrome is a rare clinical disturbance with a wide range of clinical manifestations. We report on a 6-year-old male with peculiar retinal presentation of Goldenhar syndrome. The patient was referred to Ophthalmology for central scotoma in the left eye, where visual acuity was 20/100. Fundus examination was unremarkable, except for yellowish material in the central macula. SD-OCT revealed interruption of the external limiting membrane and inner and outer segment junctions, with disorganized material in the vitelliform space and subretinal fluid. Six months later, fundus and SD-OCT examinations were unchanged without treatment, but visual acuity in the left eye had improved to 20/50. Five years later, he had similar clinical manifestations in the right eye. He was started on systemic steroids. After 15 days, his visual acuity improved to 20/20 and subretinal fluid and yellowish material in the vitelliform space disappeared. Goldenhar syndrome has variable presentation, including vitelliform maculopathy. Claudia Bruè, Cesare Mariotti, Silvia Celani, Ilaria Rossiello, and Alfonso Giovannini Copyright © 2015 Claudia Bruè et al. All rights reserved.