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Kenworthy MK, Kenworthy SJ, Bhosale A, Raja V. Giant pars plana cysts and a diagnostic approach to peripheral retinal elevation with the assistance of multimodal imaging. BMJ Case Rep 2023; 16:e253762. [PMID: 37068842 PMCID: PMC10111892 DOI: 10.1136/bcr-2022-253762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
A man in his 50s was referred for a suspected superotemporal retinal tear in the right eye. Fundus examination showed multiple areas of elevated retina temporally in both eyes which were immobile and did not reappose with scleral depression. No retinal breaks were present. Ultra-widefield colour fundus photography with Optos captured these areas of elevated retina in both eyes temporally, which on fundus autofluorescence where hypoautofluorescent with no leading hyperautofluorescent edge. On ultrasound biomicroscopy, an immobile lesion with a single hyperechoic convexity towards the vitreous body was noted. The patient was diagnosed with bilateral giant pars plana cysts which were managed conservatively.The multimodal imaging in our case is its distinguishing feature which can be used to help ensure accurate diagnosis when one is presented with an area of peripheral retina elevation.
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Affiliation(s)
| | - Sarah Jane Kenworthy
- School of Medicine, Deakin University - Geelong Waurn Ponds Campus, Geelong, Victoria, Australia
| | - Anant Bhosale
- Retina and Vitreous, Aravind Eye Hospital, Coimbatore, India
| | - Vignesh Raja
- Ophthalmology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Gao F, Dong J, Wang D, Chen F, Hu F, Chang Q, Xu P, Liu W, Li J, Huang Y, Wu J, Xu G. Comprehensive analysis of genetic and clinical characteristics of 30 patients with X-linked juvenile retinoschisis in China. Acta Ophthalmol 2021; 99:e470-e479. [PMID: 33124204 PMCID: PMC8359357 DOI: 10.1111/aos.14642] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/05/2020] [Accepted: 09/06/2020] [Indexed: 12/13/2022]
Abstract
Purpose To provides the clinical and genetic characteristics of a series of Chinese patients with X‐linked juvenile retinoschisis (XLRS) through multimodal imaging and next‐generation sequencing. Methods Thirty patients (60 eyes) from 29 unrelated families of Chinese origin with XLRS were screened using multigene panel testing, and underwent a complete clinical evaluation. All variants identified in this study and reported in the Human Gene Mutation Database were analysed. Results Twenty‐five distinct variants in the retinoschisin gene were identified, of which eight were novel, and one was de novo. Missense mutations were the most prevalent type, and mutation hot spot was localized in the discoidin domain. The mean Snellen best‐corrected visual acuity was 0.28 ± 0.17. Of all eyes presenting with schisis, 92.86% had lamellar schisis and 62.5% had peripheral schisis. Schisis changes mostly involved inner and outer nuclear layers. X‐linked juvenile retinoschisis (XLRS) patients had a high incidence of complications, and peripheral schisis was a risk factor for it. No obvious genotype–phenotype association was observed. Conclusion This study provides comprehensive analyses of the genetic and clinical characteristics of XLRS in a cohort of Chinese patients. The fourth de novo mutation in RS1 was identified. And we show that XLRS has a wide spectrum of clinical characteristics; hence, molecular diagnosis is crucial for its diagnosis, differential diagnosis and genetic counselling. Peripheral schisis is a risk factor for the high incidence of complications, and no clear genotype–phenotype correlations were found.
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Affiliation(s)
- Feng‐Juan Gao
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Jian‐Hong Dong
- Department of Ophthalmology Central Hospital of Xuhui District Shanghai China
| | - Dan‐Dan Wang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Fang Chen
- BGI‐Shenzhen Shenzhen China
- Laboratory of Genomics and Molecular Biomedicine Department of Biology University of Copenhagen Copenhagen Denmark
- Shenzhen Engineering Laboratory for Birth Defects Screening BGI‐Shenzhen Shenzhen China
| | - Fang‐Yuan Hu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Qing Chang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ping Xu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Wei Liu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Jian‐Kang Li
- BGI‐Shenzhen Shenzhen China
- Department of Computer Science City University of Hong Kong Kowloon Hong Kong SAR China
| | - Ying Huang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
| | - Ji‐Hong Wu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ge‐Zhi Xu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
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Wang Y, Hu Z, Jiang Y, Liu H, Fang X. UBM-guided scleral buckling for Schwartz-Matsuo syndrome with tear of nonpigmented epithelium of the ciliary body: a case report. BMC Ophthalmol 2021; 21:49. [PMID: 33468097 PMCID: PMC7816455 DOI: 10.1186/s12886-021-01809-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Tears in Schwartz-Matsuo syndrome are generally confirmed by preoperative ophthalmoscopic examination. A case of Schwartz-Matsuo syndrome with a tear detected by ultrasound biomicroscopy (UBM) and treated by UBM-guided scleral buckling was reported, and its mechanism was analysed. Case presentation A 40-year-old Chinese man presented with blurry vision and intermittent eye pain in his left eye for three days. The visual acuity of the left eye decreased from 20/20 to 20/40, and the intraocular pressure (IOP) fluctuated dramatically from 24.0 mmHg to 56.7 mmHg at the first visit. Gonioscopy revealed that the chamber angle remained open. A macula-involving inferior retinal detachment extending from 4:30 to 9:30 with no obvious causative break was observed through ophthalmoscopic examination. However, a single small tear was detected at the nonpigmented epithelium of pars plana of the ciliary body at approximately 7–8 o’clock by UBM. The loss of photoreceptor outer segments and ellipsoid zone and the existence of macular microcysts in the inner and outer nuclear layers were observed in the detached macula by optical coherence tomography. Then, he underwent successful scleral buckling guided by UBM. Three months later, the retina was flat with normal IOP, and the best corrected visual acuity of his left eye gradually improved to 20/25. UBM confirmed the closure of the tear. Conclusions Tear of the nonpigmented epithelium of the ciliary body is a rare condition associated with Schwartz-Matsuo syndrome. UBM plays a key role in detecting occult tears of the nonpigmented epithelium of the ciliary body, guiding scleral buckling surgery, and observing the closure of the tear postoperatively.
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Affiliation(s)
- Yao Wang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China.
| | - Zhongli Hu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China.,Department of Ophthalmology, Zhuji People's Hospital of Zhejiang Province, 311800, Zhuji, China
| | - Yifan Jiang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China.,Department of Ophthalmology, People's Hospital of Kaihua, Zhejiang Province, 324300, Kaihua, China
| | - Huan Liu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China.,Department of Ophthalmology, the First People's Hospital of Lin'an District, 311300, Hangzhou City, Zhejiang Province, China
| | - Xiaoyun Fang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China
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