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Gu J, Chen Q, Zhang P, Zhang T, Zhou X, Zhang K, Jiang T, Liu S, Chen W, Zhou M, Jiang R, Huang X, Xu G, Chang Q. Characteristics of Vitreoretinal Lymphoma in B-Scan Ultrasonography: A Case-Control Study. Ophthalmol Retina 2024; 8:264-269. [PMID: 37820767 DOI: 10.1016/j.oret.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/10/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE To explore the characteristics of vitreoretinal lymphoma (VRL) in B-scan ultrasonography. DESIGN Single-center case-control study. PARTICIPANTS A total of 106 eyes of 56 patients with biopsy-proven VRL and 86 eyes of 59 patients with uveitis were included. METHODS B-scan ultrasonography of the included eyes was performed. Evaluated were the ultrasonographic signs as well as a special pattern termed centrifugal condensation, which refers to the peripherally hyperreflective appearance of the vitreous haze in ultrasonography. MAIN OUTCOME MEASURES Posterior vitreous detachment, vitreoretinal adhesion, location of vitreous haze, thickening or occupying lesions of the retina, retinal detachment, and centrifugal condensation pattern of vitreous haze were evaluated through B-scan ultrasonography. The incidences of these signs were compared between the 2 groups; odds ratios (ORs) were calculated. RESULTS The incidence of vitreoretinal adhesion in patients with VRL (6/106) was lower than in patients with uveitis (20/86; P = 0.001; OR: 0.195; 95% confidence interval [CI]: 0.073-0.522). The incidence of retinal thickening or occupying lesions in patients with VRL (21/106) was higher than that in patients with uveitis (1/86; P = 0.005; OR: 19.068; 95% CI: 2.455-148.265). The incidences of posterior vitreous detachment and retinal detachment were not significantly different between the 2 groups (P = 0.453 and P = 0.310, respectively). The centrifugal condensation pattern was more likely to be observed in patients with VRL (49/106) than in patients with uveitis (13/86; P < 0.001; OR: 4.831; 95% CI: 2.416-9.660). CONCLUSIONS B-scan ultrasonography might help to provide clues for the suspicion of VRL. Thickening or occupying lesions of the retina and centrifugal condensation pattern of vitreous haze might be suggestive of VRL. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Junxiang Gu
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qian Chen
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Peijun Zhang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ting Zhang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinyi Zhou
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Kaiyu Zhang
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Tingting Jiang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Shixue Liu
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenwen Chen
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Min Zhou
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Rui Jiang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xin Huang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qing Chang
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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Cai C, Zhou J, Wang Q, Li W, Liu D. Case report: An intraretinal macrocyst with crystalline content and retinal detachment. Front Med (Lausanne) 2022; 9:1051181. [PMID: 36590947 PMCID: PMC9797852 DOI: 10.3389/fmed.2022.1051181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction An intraretinal macrocyst is a cavity located in the outer plexiform layer of the retina. It is commonly filled with liquid or blood. To date, few case reports of intraretinal macrocysts with crystalline content and retinal detachment have been published. Case presentation A 44-year-old woman with no history of other diseases complained of decreased vision in her right eye that had persisted for 20 days. The best corrected visual acuity of the right eye was hand motion. Comprehensive ophthalmic examinations were performed, including a vision test, slit lamp fundus examination, ocular B-scan ultrasound, and orbital magnetic resonance imaging. We performed vitrectomy and retinotomy to sufficiently remove the macrocyst and relieve retinal traction. We then reattached the retina and filled it with silicone oil. During the surgery, we found that the cyst had crystalline content, which has not been previously reported, to the best of our knowledge. Finally, the pathological results confirmed a final diagnosis of intraretinal macrocyst. Six months later, we performed a second operation to remove the silicone oil and implant an intraocular lens. After both surgeries, the best corrected visual acuity of the patient's right eye was restored to 20/200, and the retina had repositioned. Conclusion Intraretinal macrocysts are very rare. Both orbital magnetic resonance imaging and ocular B-scan ultrasound are essential for their diagnosis. Our results indicated that vitrectomy was the best way to remove the cyst and reattach the retina.
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Luo J, Chen Y, Yang Y, Zhang K, Liu Y, Zhao H, Dong L, Xu J, Li Y, Wei W. Prognosis Prediction of Uveal Melanoma After Plaque Brachytherapy Based on Ultrasound With Machine Learning. Front Med (Lausanne) 2022; 8:777142. [PMID: 35127747 PMCID: PMC8816318 DOI: 10.3389/fmed.2021.777142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Uveal melanoma (UM) is the most common intraocular malignancy in adults. Plaque brachytherapy remains the dominant eyeball-conserving therapy for UM. Tumor regression in UM after plaque brachytherapy has been reported as a valuable prognostic factor. The present study aimed to develop an accurate machine-learning model to predict the 4-year risk of metastasis and death in UM based on ocular ultrasound data. MATERIAL AND METHODS A total of 454 patients with UM were enrolled in this retrospective, single-center study. All patients were followed up for at least 4 years after plaque brachytherapy and underwent ophthalmologic evaluations before the therapy. B-scan ultrasonography was used to measure the basal diameters and thickness of tumors preoperatively and postoperatively. Random Forest (RF) algorithm was used to construct two prediction models: whether a patient will survive for more than 4 years and whether the tumor will develop metastasis within 4 years after treatment. RESULTS Our predictive model achieved an area under the receiver operating characteristic curve (AUC) of 0.708 for predicting death using only a one-time follow-up record. Including the data from two additional follow-ups increased the AUC of the model to 0.883. We attained AUCs of 0.730 and 0.846 with data from one and three-time follow-up, respectively, for predicting metastasis. The model found that the amount of postoperative follow-up data significantly improved death and metastasis prediction accuracy. Furthermore, we divided tumor treatment response into four patterns. The D(decrease)/S(stable) patterns are associated with a significantly better prognosis than the I(increase)/O(other) patterns. CONCLUSIONS The present study developed an RF model to predict the risk of metastasis and death from UM within 4 years based on ultrasound follow-up records following plaque brachytherapy. We intend to further validate our model in prospective datasets, enabling us to implement timely and efficient treatments.
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Affiliation(s)
- Jingting Luo
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuning Chen
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuhang Yang
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Zhang
- InferVision Healthcare Science and Technology Limited Company, Shanghai, China
| | - Yueming Liu
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hanqing Zhao
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Xu
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yang Li
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Jarocki A, Durrani A, Zhou Y, Miller JML. On-Call Examinations for Acute Onset of Flashes, Floaters, or Curtain by Junior Ophthalmology Residents: Outcomes, Safety, and Resource Use. Ophthalmol Retina 2020; 5:330-336. [PMID: 32795660 DOI: 10.1016/j.oret.2020.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine whether an on-call system serviced by junior residents can safely triage patients with symptoms concerning for posterior vitreous detachment, retinal tear, and retinal detachment. DESIGN Quality improvement study structured as a prospective cohort study. PARTICIPANTS All symptomatic patients seen in 2017 by an on-call junior resident were followed up (257 patients). Those with follow-up within 6 months of initial presentation (228 patients, 246 unique encounters) were included. METHODS We prospectively tracked all symptomatic patients seen on-call by a junior resident in 2017 at a major academic medical center. MAIN OUTCOME MEASURES Incidence and predictors of true retinal tears or detachments, false-positive tears or detachments, false-negative tears or detachments, and resource use. RESULTS Of 246 symptomatic encounters, 83 (33.7%) had a perceived retinal tear or detachment. Residents used B-scan ultrasonography in a high number of encounters (41.0%). Ten (4.1%) false-positive tears or detachments were identified, with the presence of intraretinal hemmorhage predicting a false-positive examination (adjusted odds ratio, 3.86; 95% confidence interval, 1.1-13.5). Thirteen (5.3%) false-negative tears and no false-negative detachments were identified. Eleven (84.6%) false-negative tears underwent follow-up within days based on high-risk characteristics, and no false-negative tears progressed to detachment at follow-up. Measures of resource use included an in-person confirmation of examination findings by the senior resident or fellow in 59 encounters (24.0%) and shorter follow-up times to a retina rather than a nonretina clinic for 52 of 151 patients who showed no pathologic features on initial examination. CONCLUSIONS Junior residents can safely provide on-call triage of patients with symptoms concerning for a posterior vitreous detachment, retinal tear, or retinal detachment. The system requires moderate resource use, including occasional confirmatory examinations by a second physician and shorter follow-up times to retina clinic for high-risk patients.
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Affiliation(s)
| | - Asad Durrani
- Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
| | - Yunshu Zhou
- Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
| | - Jason M L Miller
- Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
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Wei Y, Shao J, Shen H, Wang Y, Cao G, Chen W, Zhang J, Yin L. The inhibitory role of recombinant P-selectin glycoprotein ligand immunoglobulin G on portal vein thrombosis based on a novel rat model. Exp Ther Med 2019; 17:3589-3597. [PMID: 30988741 PMCID: PMC6447773 DOI: 10.3892/etm.2019.7394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 12/27/2018] [Indexed: 11/06/2022] Open
Abstract
The current study aimed to reveal a novel method for constructing a portal vein thrombosis (PVT) model in rats and to evaluate the inhibitory role of recombinant P-selectin glycoprotein ligand immunoglobulin G (rPSGL-Ig) on the formation of PVT. The PVT model was constructed in rats through intermittent portal vein obstruction (IPVO) combined with endangium destruction. A total of 4 mg/kg rPSGL-Ig was intraperitoneally pre-injected into rats 1 h prior to model construction. Changes in the thrombus size and vessel diameter were observed by B-scan ultrasonography. Histopathological changes in the portal vein, central hepatic vein and vasa intestini tenuis were observed using hematoxylin and eosin staining. Additionally, histopathological changes in the portal vein were observed by transmission electron microscopy. A total of 8 mg/kg rPSGL-Ig or 2×104 U/kg urokinase were used to compare the thrombolytic effects and thrombus sizes. The PVT model was successfully constructed in rats, and exhibited a significantly greater thrombus size and vessel diameter compared with the control group (P<0.05). Intervention with rPSGL-Ig significantly inhibited the formation of PVT, and resulted in a significantly lower thrombus size and vessel diameter compared with the model group (P<0.05). Additionally, histopathological changes in the portal vein, central hepatic vein and vasa intestini tenuis in PVT rats were considerably reversed following the intervention with rPSGL-Ig. rPSGL-Ig demonstrated a lower thrombolytic effect compared with that of URO. IPVO combined with endangium destruction effectively constructed a PVT model in rats. rPSGL-Ig effectively prevented PVT in rats. rPSGL-Ig may be used in future studies for the treatment of patients with PVT.
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Affiliation(s)
- Yunhai Wei
- Surgical Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Jie Shao
- Integrated Traditional Chinese and Western Medicine Surgery, Huzhou Maternal and Child Health Care Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Hua Shen
- Surgical Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Yan Wang
- Surgical Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Guoliang Cao
- Surgical Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Wenxian Chen
- Ultrasonography Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Jinyu Zhang
- Surgical Department, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Lei Yin
- Department of Gastrointestinal Surgery, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang 313000, P.R. China
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Kishimoto T, Fukuda K, Nishiuchi T, Hayashi N, Fukushima A. Unilateral serous retinal detachment with choroidal thickening as a first presenting sign of acute myeloid leukemia. Am J Ophthalmol Case Rep 2019; 14:51-54. [PMID: 30859142 PMCID: PMC6396195 DOI: 10.1016/j.ajoc.2019.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Serous retinal detachment is rare in leukemia, but bilateral or unilateral cases have been reported as the presenting sign of acute leukemia or the first sign of relapsing leukemia. We here report a case of unilateral serous retinal detachment with choroidal thickening before the detection of atypical lymphocytes or myeloblasts as the initial manifestation of subsequently diagnosed acute myeloid leukemia. Observations A 43-year-old woman presented with serous retinal detachment in her left eye. Choroidal thickening was also revealed by B-scan ultrasonography and optical coherence tomography. Atypical lymphocytes or myeloblasts were not apparent on hematologic analysis at initial presentation, but an increased leukocyte count and the presence of 40% blasts in a peripheral smear were detected 1 month later. A bone marrow biopsy led to a diagnosis of acute promyelocytic leukemia. The retinal detachment and choroidal thickening showed amelioration 4 days after the onset of chemotherapy and had resolved 2 months later. Conclusions and importance The present findings suggest that, although retinal detachment is not a common manifestation in patients with leukemia, unilateral serous retinal detachment with choroidal thickening may be a presenting sign of acute myeloid leukemia.
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Affiliation(s)
- Tatsuma Kishimoto
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
| | - Ken Fukuda
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
| | - Takashi Nishiuchi
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
| | - Nobutsugu Hayashi
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
| | - Atsuki Fukushima
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan
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Naik AU, Rishi P, Prakash VJ, Rishi E. Retinal detachment with hemorrhagic intraretinal macrocyst clinically presenting as pseudo-choroidal melanoma. Oman J Ophthalmol 2019; 12:62-64. [PMID: 30787541 PMCID: PMC6380148 DOI: 10.4103/ojo.ojo_136_2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 23-year male with complaint of diminution of vision in left eye was referred to us as a suspect case of inflammatory choroidal mass/melanoma. Examination revealed a total retinal detachment with a reddish brown lesion in the superior hemi-fundus. B-scan ultrasonography demonstrated the ‘mass’ to be intra-retinal without choroidal involvement. A diagnosis of haemorrhagic intraretinal macrocyst (HIM) was made. We report this case to highlight the importance of correctly diagnosing an HIM and utilizing ultrasound to rule out choroidal pathologies, especially melanoma. This is essential as the management and prognosis of the two disorders is entirely different.
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Affiliation(s)
- Anmol U Naik
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Pukhraj Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - V Jaya Prakash
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Ekta Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
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Liu D, Li Z, Zhang X, Zhao L, Jia J, Sun F, Wang Y, Ma D, Wei W. Assessment of intracranial pressure with ultrasonographic retrobulbar optic nerve sheath diameter measurement. BMC Neurol 2017; 17:188. [PMID: 28962603 PMCID: PMC5622417 DOI: 10.1186/s12883-017-0964-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/11/2017] [Indexed: 12/05/2022] Open
Abstract
Background Ultrasonograpic retrobulbar optic nerve sheath diameter (ONSD) measurement is considered to be an alternative noninvasive method to estimate intracranial pressure,but the further validation is urgently needed. The aim of the current study was to investigate the association of the ultrasonographic ONSD and intracranial pressure (ICP) in patients. Methods One hundred and ten patients whose intracranial pressure measured via lumbar puncture were enrolled in the study. Their retrobulbar ONSD with B-scan ultrasound was determined just before lumber puncture. The correlation between the ICP and the body mass index (BMI), ONSD or age was established respectively with the Pearson correlation coefficient analysis. The discriminant analysis was used to obtain a discriminant formula for predicting ICP with the ONSD、BMI、gender and age. Another 20 patients were recruited for further validation the efficiency of this discriminant equation. Results The mean ICP was 215.3 ± 81.2 mmH2O. ONSD was 5.70 ± 0.80 mm in the right eye and 5.80 ± 0.77 mm in the left eye. A significant correlation was found between ICP and BMI (r = 0.554, p < 0.001), the mean ONSD (r = 0.61, P < 0.001), but not with age (r = −0.131, p = 0.174) and gender (r = 0.03, p = 0.753). Using receiver operating characteristic (ROC) curve analysis, the critical value for the risk mean-ONSD was 5.6 mm from the ROC curve, with the sensitivity of 86.2% and specificity of 73.1%. With 200 mmH2O as the cutoff point for a high or low ICP, stepwise discriminant was applied, the sensitivity and specificity of ONSD predicting ICP was 84.5%-85.7% and 86.5%-92.3%. Conclusions Ophthalmic ultrasound measurement of ONSD may be a good surrogate of invasive ICP measurement. This non-invasive method may be an alternative approach to predict the ICP value of patients whose ICP measurement via lumbar puncture are in high risk. The discriminant formula, which incorporated the factor of BMI, had similar sensitivity and higher specificity than the ROC curve.
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Affiliation(s)
- Dachuan Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment; Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, 100730, China.,Department of Ophthalmology,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhen Li
- Department of Ophthalmology,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xuxiang Zhang
- Department of Ophthalmology,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liping Zhao
- Department of Ophthalmology,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianping Jia
- Department of Neurology,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Beijing, China
| | - Yaxing Wang
- Beijing Institute of Ophthalmology, Beijing, China
| | - Daqing Ma
- Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, and Chelsea and Westminster Hospital, London, UK
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment; Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, 100730, China.
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Abdolrahimzadeh S, Piraino DC, Scavella V, Abdolrahimzadeh B, Cruciani F, Gharbiya M, Recupero SM. Spectral domain optical coherence tomography and B-scan ultrasonography in the evaluation of retinal tears in acute, incomplete posterior vitreous detachment. BMC Ophthalmol 2016; 16:60. [PMID: 27215604 PMCID: PMC4878030 DOI: 10.1186/s12886-016-0242-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 05/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the extension and traction effects of posterior vitreous detachment (PVD) complicated with retinal tears using spectral domain optical coherence tomography (OCT) and B-scan ultrasonography. Methods Complete ophthalmological examination, B-scan ultrasonography and spectral domain OCT were performed in patients with acute PVD and retinal tears. Vitreous detachment was classified as complete or incomplete, based on extent of posterior pole or peripheral vitreous detachment. Retinal tear location and persistent traction on the retinal flap was evaluated with B-scan ultrasonography and OCT. Categorical data were evaluated with Fisher’s exact test. Statistical significance was considered as P < 0.05. Results Twenty-six eyes of 25 patients were assessed. Four eyes (15 %) presented complete PVD with detachment at the posterior pole and periphery. 22 eyes (85 %) presented incomplete PVD with detachment in the periphery. Twenty eyes presented retinal tears in the superior quadrants with respect to only 6 in the inferior quadrants (p = 0.006). There was a higher incidence of retinal tears in the pre with respect to post-equatorial areas (19 vs 7 eyes, p = 0.019). B-scan ultrasonography and OCT revealed persistent traction on the retinal tear flap in 19 and 15 eyes, respectively. Conclusions In acute PVD, retinal tears are prevalently associated with peripheral vitreous detachment. The impact of complete or incomplete PVD can be of clinical value when evaluating patients with retinal tears.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, DAI Head/Neck, Azienda Policlinico Umberto I, University of Rome "Sapienza", viale del Policlinico 155, Rome, 00161, Italy.
| | - Domenica Carmen Piraino
- Ophthalmology Unit, Department of Sense Organs, University of Rome "Sapienza", viale del Policlinico 155, Rome, 00161, Italy
| | - Vittorio Scavella
- Ophthalmology Unit, Department of Sense Organs, University of Rome "Sapienza", viale del Policlinico 155, Rome, 00161, Italy
| | | | - Filippo Cruciani
- Ophthalmology Unit, Department of Sense Organs, University of Rome "Sapienza", viale del Policlinico 155, Rome, 00161, Italy
| | - Magda Gharbiya
- Ophthalmology Unit, Department of Sense Organs, University of Rome "Sapienza", viale del Policlinico 155, Rome, 00161, Italy
| | - Santi Maria Recupero
- Opthalmology Unit, NESMOS Department, University of Rome "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-1039, Rome, 00189, Italy
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Abstract
Posterior scleritis is rare in both the adult and pediatric age groups. Increased awareness and availability of advanced diagnostic facilities aid in early diagnosis and management. Visual recovery is possible with systemic steroids and immunosuppression. We report the case of a 12-year-old male child who presented with poor vision in his right eye and was found to have retinal striae and disc edema due to posterior scleritis.
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Affiliation(s)
- Radha Shenoy
- Department of Ophthalmology, Armed Forces Hospital, Muscat, Sultanate of Oman
| | - Milind Suryawanshi
- Department of Ophthalmology, Armed Forces Hospital, Muscat, Sultanate of Oman
| | - Roshini Isaac
- Department of Ophthalmology, Armed Forces Hospital, Muscat, Sultanate of Oman
| | - Santhosh K Philip
- Department of Ophthalmology, Armed Forces Hospital, Muscat, Sultanate of Oman
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11
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Abstract
A 50 year-old male patient was referred to our clinic due to a floating mass in the right eye. The uncorrected visual aquity was 10 / 10 in both eyes.The patient did not have any systemic disorder and trauma history. His ophthalmological examination revealed an unremarkable anterior segment with no signs of inflammation. Indirect opthalmoscopy and posterior segment biomicroscopy performed with 90D lens was unremarkable in the left eye, while in the right eye a single oval cyst was identified floating freely in the vitreous. The cyst was partially masking the underlying retinal vasculature. B-scan ultrasound revealed an echo-free, round-shaped cyst that was free from surrounding vitreous strands or retina localised at the posterior vitreous. Fluorescein angiography (FA) ruled out the presence of intra and overlying vascularisation of the cyst. Indeed, FA showed a clear-edged hypofluorescence due to a pre-retinal masking effect. The indirect hemaglutinin tests of the patient for ecinococcus and cysticercosis were negative. Eosinophilia was not detected in the preripheral blood smear. Based on these findings the patient was diagnosed as primary vitreal cyst. The presented case was mild symptomatic so the patient was decided to be followed up without any treatment.
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Affiliation(s)
- Yasin Toklu
- Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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12
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Jammal HM, Khader Y, Shawer R, Al Bdour M. Posterior segment causes of reduced visual acuity after phacoemulsification in eyes with cataract and obscured fundus view. Clin Ophthalmol 2012; 6:1843-8. [PMID: 23152664 PMCID: PMC3497462 DOI: 10.2147/opth.s38303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine posterior segment causes of reduced visual acuity after phacoemulsification in eyes with cataract and obscured fundus view. Patients and methods Retrospective review of medical records of patients with cataract, obscured fundus view, and normal B-scan ultrasonography, undergoing phacoemulsification from May 2005 to March 2012 was conducted. Eyes with fundus pathology, previous trauma, surgery, glaucoma, amblyopia, or uveitic cataract were excluded. Ocular comorbid conditions, preoperative visual acuity (VA), intraoperative and early postoperative complications, and final best corrected visual acuity (BCVA) at 1 month were abstracted from the records. Results All 201 eyes of 179 patients studied had a preoperative VA of ≤6/60. Preoperative ocular comorbidity was present in 31 eyes (15.5%). Intraoperative complications occurred in 20 eyes (10%). Postoperative complications developed in 34 eyes (17.0%). One month postoperatively, 175 eyes (87.1%) achieved a BCVA of ≥6/12; whereas 26 eyes (12.9%) achieved a BCVA of ≤6/18. The most common posterior segment causes of reduced VA in the 26 eyes were age-related macular disease in ten eyes (38.5%) and diabetic maculopathy in six eyes (23.1%). Similar fundus pathology was seen preoperatively in the fellow fundus in 10 of the 26 eyes (38.5%). Conclusion One month after phacoemulsification in eyes with cataract and obscured fundus view, age-related macular disease and diabetic maculopathy were the most common posterior segment causes of reduced final BCVA. To avoid postsurgical dissatisfaction, patients with obscured fundus view in their preoperative eye should be counseled, especially if posterior segment pathology exists in their fellow eye.
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Affiliation(s)
- Hisham M Jammal
- Department of Ophthalmology, Jordan University of Science and Technology, Irbid, Jordan ; Department of Ophthalmology, King Abdullah University Hospital, Irbid, Jordan
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13
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Mohmad Z, Kah TA, Yong KC, Abdul Halim WHW, Kong Yong T. Melanocytoma of the optic nerve head - a diagnostic dilemma. Clin Pract 2011; 1:e60. [PMID: 24765321 PMCID: PMC3981369 DOI: 10.4081/cp.2011.e60] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 07/28/2011] [Indexed: 11/23/2022] Open
Abstract
The clinical features, autofluorescence, B-scan ultrasonography, optical coherence tomography and fluorescein angiography of the lesion were described. Multiple investigation modalities are needed to confirm the benign nature of the lesion. Careful evaluation and follow-up is crucial to avoid misdiagnosis and erroneous management.
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Affiliation(s)
- Zalilawati Mohmad
- Department of Ophthalmology, Faculty of Medicine, University Kebangsaan Malaysia
| | - Tan Aik Kah
- Department of Ophthalmology, Faculty of Medicine, University Kebangsaan Malaysia; ; Department of Ophthalmology, Faculty of Medicine and Health Sciences, University Malaysia Sarawak (UNIMAS), Malaysia
| | - Ku Chui Yong
- Department of Ophthalmology, Faculty of Medicine, University Kebangsaan Malaysia
| | | | - Then Kong Yong
- Department of Ophthalmology, Faculty of Medicine, University Kebangsaan Malaysia
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