16 results on '"V. Do"'
Search Results
2. Traumatic chorioretinitis sclopetaria: Risk factors, management, and prognosis
- Author
-
Diana V. Do, Ryan A Shields, Darius M. Moshfeghi, Vinit B. Mahajan, and Cassie A. Ludwig
- Subjects
Pars plana ,medicine.medical_specialty ,genetic structures ,Sclopetaria ,medicine.medical_treatment ,Vitrectomy ,Case Report ,Cochrane Library ,Traumatic chorioretinal rupture ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Ophthalmology ,Median follow-up ,Interquartile range ,Ophthalmology ,Traumatic chorioretinitis sclopetaria ,medicine ,10. No inequality ,Receiver operating characteristic ,business.industry ,Chorioretinitis ,medicine.disease ,eye diseases ,3. Good health ,Chorioretinitis proliferans ,medicine.anatomical_structure ,Retinitis proliferans ,lcsh:RE1-994 ,Vitreous hemorrhage ,030221 ophthalmology & optometry ,sense organs ,Traumatic proliferative chorioretinitis of Lagrange ,business ,030217 neurology & neurosurgery - Abstract
Purpose: To describe new cases of sclopetaria and evaluate the risk factors, management, and visual prognosis of all reported cases in the literature. Observations: We performed a retrospective, observational case series. This study included six cases (median age 23, interquartile range 33) of sclopetaria. Additionally, literature searches were conducted in the PubMed and Cochrane Library databases to uncover risk factors associated with all published cases of sclopetaria. Main outcome measure was best corrected visual acuity (BCVA) worse than 20/20. Sixty-seven cases (71 eyes) of sclopetaria have been reported, of which 59 cases (61 eyes) met inclusion criteria in this study. Most were young (median age 19.5 years) men (51/59, 88.1%). Thirty-seven eyes were observed while 24 underwent immediate surgery including six pars plana vitrectomies and three scleral buckles. Compared to initial presentation, BCVA improved in 31/48 (64.6%) eyes, remained stable in 12/48 eyes (25.0%), and worsened in 5/48 eyes (10.4%). Ten patients (16.4%) achieved a final BCVA of 20/20 with median follow up time of seven months. In a multivariate model, location of sclopetaria in the macula, temporal retina, or immediate orbital foreign body removal predicted poor final BCVA with an area under receiver operating characteristic curve of 0.767. Conclusions and importance: Traumatic chorioretinitis sclopetaria is rare, but reports have increased dramatically over the past two decades. While pars plana vitrectomy may be required for the management of retinal detachments and non-clearing vitreous hemorrhage, close observation is appropriate in most cases. Visual prognosis is poor with most patients attaining 20/200 vision or worse. Keywords: Traumatic chorioretinitis sclopetaria, Sclopetaria, Traumatic chorioretinal rupture, Chorioretinitis proliferans, Retinitis proliferans, Traumatic proliferative chorioretinitis of Lagrange
- Published
- 2019
3. Alendronate induced chorioretinitis: The importance of meticulous assessments
- Author
-
Qian Ying, Muhammad Sohail Halim, Muhammad Hassan, Nam V. Nguyen, Arash Maleki, Quan Dong Nguyen, Yasir J. Sepah, and Diana V. Do
- Subjects
Septate ,medicine.medical_specialty ,genetic structures ,Humerus fracture ,Case Report ,Lesion ,Uveitis ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Ophthalmology ,Ophthalmology ,medicine ,medicine.diagnostic_test ,Alendronate ,business.industry ,Chorioretinitis ,Bisphosphonates ,Drug-induced ,medicine.disease ,Dilated fundus examination ,Fluorescein angiography ,eye diseases ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Optic nerve ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Purpose: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy. Observations: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past medical and surgical history revealed a history of hypertension, gout, hyperthyroidism, osteoporosis, and humerus fracture. She was started on alendronate three months before developing ocular symptoms. On ocular examination, best corrected visual acuity was 20/30 in the right and 20/25 in the left eye. Slit-lamp examination demonstrated normal anterior chamber examination in both eyes. Dilated fundus examination revealed geographic chorioretinal lesions around the optic nerve head in both eyes, more extensively in the right eye; and superior and temporal to the macula in the right eye. Past ocular records in February 2015 did not reveal any such findings. Fundus autofluorescence demonstrated hyper-autofluorescence in the peripapillary lesions in both eyes. The lesion adjacent to the macula in right eye displayed mixed hyper and hypo-autofluorescence. Fluorescein angiography showed combined hyper- and hypo-fluorescence compatible with window defect, staining and blockage. However, no leakage was appreciated in the macula, peripapillary, and peripheral lesions in both eyes. Optical coherence tomography scan showed septate hyporeflective intraretinal spaces in the right eye. Conclusion and importance: The index report underscore the importance of considering alendronate as an etiologic cause of chorioretinitis, especially in subjects with atypical lesions developing after alendronate therapy. We, therefore, recommend discontinuation of this medication in subjects who develop chorioretinitis after employing this medication. Keywords: Uveitis, Drug-induced, Alendronate, Chorioretinitis, Bisphosphonates
- Published
- 2019
4. Serous retinal detachment as a presenting sign of acute lymphoblastic leukemia: A case report and literature review
- Author
-
Malini Veerappan Pasricha, Quan Dong Nguyen, Natalia F. Callaway, and Diana V. Do
- Subjects
medicine.medical_specialty ,cotton wool spots, (CWS) ,Exudative retinal detachment ,Central serous chorioretinopathy ,Acute lymphocytic leukemia ,Case Report ,Acute lymphoblastic leukemia ,serous retinal detachment, (SRD) ,Serous Retinal Detachment ,03 medical and health sciences ,0302 clinical medicine ,magnetic resonance imaging, (MRI) ,Medicine ,intravenous, (IV) ,optical coherence tomography, (OCT) ,medicine.diagnostic_test ,business.industry ,retinal pigment epithelium, (RPE) ,Acute lymphoid leukemia ,Serous retinal detachment ,RE1-994 ,medicine.disease ,Fluorescein angiography ,eye diseases ,fluorescein angiogram, (FA) ,central serous chorioretinopathy, (CSR) ,Cotton wool spots ,Ophthalmology ,medicine.anatomical_structure ,autofluorescence, (AF) ,030221 ophthalmology & optometry ,Choroid ,Radiology ,sense organs ,medicine.symptom ,business ,Vasculitis ,030217 neurology & neurosurgery ,Retinopathy ,Acronyms: Acute lymphoblastic leukemia, (ALL) - Abstract
Purpose To describe a unique case of unilateral serous retinal detachment as the presenting sign of B-cell acute lymphoblastic leukemia (ALL). Observations A 74 year old woman presented with right eye blurry vision and was found to have an underlying serous retinal detachment, along with cotton wool spots, inner retinal hemorrhages, and retinal pigment epithelial changes throughout her bilateral fundi. Fluorescein angiography demonstrated bilateral vasculitis and ultrasonography revealed asymmetric thickening and enhancement of the affected eyes’ choroid. This prompted a systemic lab workup and results were suspicious for an underlying hematologic malignancy. The patient was admitted to the hospital for bone marrow biopsy confirming B-cell ALL, underwent intensive intravenous and intrathecal chemotherapy, and was discharged one month later. Follow up appointment in the ophthalmology clinic demonstrated functional and anatomic improvement in the serous retinal detachment and choroidal thickening suggestive of infiltration in her right eye. Conclusions SRDs are an uncommon ocular manifestation of leukemia, and even less common as a presenting sign of the disease. A comprehensive literature review demonstrated 11 other cases reported worldwide. We present the first such case with additional findings of leukemic retinopathy, optic nerve and choroidal infiltration, and vasculitis, as well as a complete library of ophthalmic imaging from the patient's initial presentation. Importance A new diagnosis of serous retinal detachment(s) without any obvious cause should raise suspicion for leukemia and prompt further workup. Early recognition of this hematologic malignancy is crucial for prompt initiation of life-saving therapy.
- Published
- 2021
5. Yet another case of ocular sarcoidosis
- Author
-
Jaclyn Joyce Hwang, Neil Onghanseng, Huy V. Nguyen, Brandon Pham, Huy Luong Doan, Diana V. Do, Than Trong Tuong Ngoc, Muhammad Sohail Halim, Quan Dong Nguyen, Gunay Uludag, Doan Luong Hien, and Yasir J. Sepah
- Subjects
medicine.medical_specialty ,Sarcoidosis ,Mimicking ,Posterior pole ,Vitreous balls ,Case Report ,Lung biopsy ,03 medical and health sciences ,0302 clinical medicine ,Endophthalmitis ,lcsh:Ophthalmology ,Prednisone ,Pan-uveitis ,Amphotericin B ,medicine ,Voriconazole ,Infectious endophthalmitis ,business.industry ,medicine.disease ,Fungal endophthalmitis ,Dermatology ,Ophthalmology ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Differential diagnosis ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose To report a case of bilateral pan-uveitis resembling fungal and viral endophthalmitis in a patient who was ultimately diagnosed with sarcoidosis. Observation A 64-year-old female presented with a four-day history of painless vision loss in the right eye. She presented with multiple concurrent systemic complaints, including a history of oral and genital sores, patches of hypopigmented skin on her forearms, and occasional shortness of breath. Upon further examination, she was noted to have bilateral pan-uveitis, which was more severe in the right than left eye. Posterior pole examination of the right eye revealed dense vitritis with multiple large whitish round balls that seemed suggestive of fungal or viral endophthalmitis. Initial therapies included intravitreal (IVT) foscarnet and intravenous (IV) acyclovir, followed by IV amphotericin B and oral voriconazole, which did not improve ocular signs and symptoms. Further evaluations ruled out infectious etiologies and lymphoma. Chest computerized tomography (CT) scan revealed findings suggestive of sarcoidosis, which was confirmed with lung biopsy. Anti-viral and -fungal treatments were discontinued, and the patient was started on IV methylprednisolone followed by oral prednisone and mycophenolate mofetil. Ocular symptoms improved, and the patient remained stable after treatment. Conclusion and Importance The index report illustrates a case of ocular sarcoidosis that imitated the presentation of infectious endophthalmitis. Though ocular sarcoidosis is known to masquerade as a range of disorders and constitutes part of the differential diagnosis for infectious endophthalmitis, sarcoidosis has not been reported in recent literature to imitate the presentation of fungal endophthalmitis. The index case suggests that ocular sarcoidosis should be considered in the differential diagnoses of fungal endophthalmitis.
- Published
- 2020
6. Severe vision loss secondary to retinal arteriolar occlusions after multiple intravitreal brolucizumab administrations
- Author
-
M. Sohail Halim, Guoping Kuang, Arshad M. Khanani, Wataru Matsumiya, Yasir J. Sepah, Diana V. Do, Sophaktra Chea, Quan Dong Nguyen, Atul Jain, and Cigdem Yasar
- Subjects
medicine.medical_specialty ,Central retinal artery ,Visual acuity ,genetic structures ,Case Report ,Drusen ,Retinal occlusive vasculitis ,chemistry.chemical_compound ,Retinal vasculitis ,lcsh:Ophthalmology ,Ophthalmology ,medicine.artery ,medicine ,medicine.diagnostic_test ,business.industry ,Vaso-occlusion ,Age-related macular degeneration ,Retinal ,Neovascular ,Macular degeneration ,medicine.disease ,Fluorescein angiography ,eye diseases ,chemistry ,lcsh:RE1-994 ,Brolucizumab ,Retinal arteriolar occlusion ,sense organs ,medicine.symptom ,business ,Intravitreal - Abstract
Purpose To describe a case of unilateral retinal arteriolar occlusion following multiple intravitreal brolucizumab injections for neovascular age-related macular degeneration (nAMD). Observations A 92-year-old Caucasian woman presented with blurry vision in her left eye (OS) after receiving the third dose of intravitreal brolucizumab. At the time of presentation, visual acuity (VA) was 20/40 in her right eye (OD) and had decreased from 20/150 to count finger (CF) at 1-foot OS. On examination, there was no evidence of active inflammation in the anterior chamber OU. Dilated fundus examination showed no vitritis in OD and 1+ vitreous cells OS, flame-shaped hemorrhage at the superior optic disc margin, and retinal whitening surrounding the proximal portion of the supero-temporal branch of the central retinal artery. There were drusen in OS and retinal pigment epithelial (RPE) changes in the maculae of OU. Intra-arteriolar greyish deposits were seen OS. Fluorescein angiography (FA) showed hyper-fluorescence in the maculae corresponding to fibrovascular pigment epithelial detachments (PED) OU. No peri-vascular leakage was noted OU. Delayed filling of multiple arterioles in early and late phases OS was observed on FA. The patient was diagnosed with retinal arteriolar occlusion associated with repeated intravitreal brolucizumab administrations. Conclusion Retinal arteriolar occlusion with severe vision loss, possibly secondary to inflammatory responses, can occur after subsequent intravitreal brolucizumab injections, even if no inflammation occurred after initial administrations. Vaso-occlusive disease should be considered as a potential ocular complication, with acute as well as delayed onset, following intravitreal brolucizumab therapy.
- Published
- 2020
7. Retinal arterial occlusive vasculitis following intravitreal brolucizumab administration
- Author
-
Sara J. Haug, Arshad M. Khanani, M. Sohail Halim, Gunay Uludag, Doan Luong Hien, Sherin Lajevardi, Than Trong Tuong Ngoc, Diana V. Do, and Yasir J. Sepah
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Retinal arterial occlusion ,Case Report ,03 medical and health sciences ,0302 clinical medicine ,Retinal vasculitis ,lcsh:Ophthalmology ,Ophthalmology ,Medicine ,medicine.diagnostic_test ,business.industry ,Age-related macular degeneration ,Macular degeneration ,medicine.disease ,Fluorescein angiography ,eye diseases ,Delayed hypersensitivity ,lcsh:RE1-994 ,Brolucizumab ,030221 ophthalmology & optometry ,Intraocular inflammation ,medicine.symptom ,business ,Vasculitis ,030217 neurology & neurosurgery ,Uveitis ,Occlusive vasculitis - Abstract
Purpose To describe retinal arterial occlusion and vasculitis following intravitreal brolucizumab administration in a patient with neovascular age-related macular degeneration (nAMD). Observation An 88-year-old Caucasian woman with neovascular age-related macular degeneration (nAMD) complained of painless loss of vision with light sensitivity in both eyes (OU) four weeks after bilateral intravitreal brolucizumab. Upon examination, her visual acuity decreased to 20/40 in the right eye (OD) and 20/50 in the left eye (OS). Examination revealed 0.5+ and 1+ anterior chamber cells in OD and OS, respectively. The patient was treated with 1% prednisolone acetate eyedrops in both eyes, and after several weeks, the anterior chamber cells resolved. However, the patient still reported a decline in visual acuity (VA). Fluorescein angiography (FA) revealed retinal arterial occlusion, vasculitis, and optic nerve inflammation in the left eye. Retinal intra-arterial grayish materials were also detected. Laboratory evaluations were performed for common infectious and inflammatory causes and were normal or negative. A delayed inflammatory reaction to brolucizumab was suspected as the cause of the ocular inflammation and retinal vasculitis. An intravitreal dexamethasone implant was inserted into the left eye to treat the inflammation. One week after the dexamethasone implant, VA improved to 20/40 in OU; FA showed improvement, but residual peri-vascular leakage remained. Conclusion Medication-associated uveitis is a rare adverse effect that can lead to vision loss. The index report illustrates a case of intraocular inflammation, retinal arterial vaso-occlusion and vasculitis associated with intravitreal brolucizumab. The delay in developing uveitis suggests that the inflammation is due to a delayed hypersensitivity reaction which can occur several days or weeks after administration of the inciting agent. Recently, several cases of uveitis and vasculitis associated with brolucizumab have been presented and those cases have similar features compared to the index case (1). Therapy with steroids (either intraocular or systemic), after infectious etiologies have been excluded, may be beneficial in halting inflammation and preventing further vision loss.
- Published
- 2020
8. Acute lymphocytic leukemia masquerading as acute retinal necrosis
- Author
-
Quan Dong Nguyen, Muhammad Hassan, Kaylene L. Carter, and Diana V. Do
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Acute lymphocytic leukemia ,Retinal necrosis ,Case Report ,chemistry.chemical_compound ,lcsh:Ophthalmology ,Ophthalmology ,Biopsy ,medicine ,medicine.diagnostic_test ,business.industry ,Retinal detachment ,Retinal ,medicine.disease ,eye diseases ,Leukemia ,medicine.anatomical_structure ,chemistry ,lcsh:RE1-994 ,Acute retinal necrosis ,medicine.symptom ,business ,Optic disc - Abstract
Purpose To report a case of B-cell acute lymphocytic leukemia (ALL) relapse presenting as acute retinal necrosis. Observations An 11-year old boy with history of B-cell ALL undergoing maintenance therapy presented with a three-month history of intermittent blurry vision and pain in the right eye when a routine lumbar puncture indicated an elevated lymphoblast-predominant white blood cell count. Bone marrow biopsy revealed 42% lymphoblasts, confirming ALL relapse. Ophthalmic imaging demonstrated a hyperemic optic disc, retinal whitening, perivascular sheathing, retinal hemorrhages, and retinal detachment in the right eye. Vitreous fluid biopsy revealed presence of rare atypical lymphoblasts. Chemotherapy, orbital radiation, and systemic prednisone resulted in improvement of visual acuity and retinal hemorrhages, and resolution of retinal detachment. Conclusions and importance We have described the clinical features, treatment, and response in a case of B-cell ALL relapse with presenting signs of acute retinal necrosis. The uncommon finding in B-cell ALL highlights the possibility of intraocular involvement and the importance of routine ophthalmologic evaluation in leukemia remission.
- Published
- 2020
9. A case of complex macula-off retinal detachment following traumatic globe rupture
- Author
-
William Rhoades, Daniel V. Arkfeld, Andrew J Baldwin, and Diana V. Do
- Subjects
0301 basic medicine ,Globe rupture ,medicine.medical_specialty ,business.industry ,Retinal detachment ,medicine.disease ,03 medical and health sciences ,Ophthalmology ,030104 developmental biology ,0302 clinical medicine ,lcsh:Ophthalmology ,lcsh:RE1-994 ,Case report ,030221 ophthalmology & optometry ,Medicine ,business - Published
- 2017
10. Alendronate induced chorioretinitis: The importance of meticulous assessments
- Author
-
Muhammad Hassan, Arash Maleki, Qian Ying, Nam Nguyen, Muhammad Sohail Halim, Yasir J. Sepah, Diana V. Do, and Quan Dong Nguyen
- Subjects
Ophthalmology ,RE1-994 - Abstract
Purpose: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy. Observations: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past medical and surgical history revealed a history of hypertension, gout, hyperthyroidism, osteoporosis, and humerus fracture. She was started on alendronate three months before developing ocular symptoms. On ocular examination, best corrected visual acuity was 20/30 in the right and 20/25 in the left eye. Slit-lamp examination demonstrated normal anterior chamber examination in both eyes. Dilated fundus examination revealed geographic chorioretinal lesions around the optic nerve head in both eyes, more extensively in the right eye; and superior and temporal to the macula in the right eye. Past ocular records in February 2015 did not reveal any such findings. Fundus autofluorescence demonstrated hyper-autofluorescence in the peripapillary lesions in both eyes. The lesion adjacent to the macula in right eye displayed mixed hyper and hypo-autofluorescence. Fluorescein angiography showed combined hyper- and hypo-fluorescence compatible with window defect, staining and blockage. However, no leakage was appreciated in the macula, peripapillary, and peripheral lesions in both eyes. Optical coherence tomography scan showed septate hyporeflective intraretinal spaces in the right eye. Conclusion and importance: The index report underscore the importance of considering alendronate as an etiologic cause of chorioretinitis, especially in subjects with atypical lesions developing after alendronate therapy. We, therefore, recommend discontinuation of this medication in subjects who develop chorioretinitis after employing this medication. Keywords: Uveitis, Drug-induced, Alendronate, Chorioretinitis, Bisphosphonates
- Published
- 2019
- Full Text
- View/download PDF
11. Traumatic chorioretinitis sclopetaria: Risk factors, management, and prognosis
- Author
-
Cassie A. Ludwig, Ryan A. Shields, Diana V. Do, Darius M. Moshfeghi, and Vinit B. Mahajan
- Subjects
Ophthalmology ,RE1-994 - Abstract
Purpose: To describe new cases of sclopetaria and evaluate the risk factors, management, and visual prognosis of all reported cases in the literature. Observations: We performed a retrospective, observational case series. This study included six cases (median age 23, interquartile range 33) of sclopetaria. Additionally, literature searches were conducted in the PubMed and Cochrane Library databases to uncover risk factors associated with all published cases of sclopetaria. Main outcome measure was best corrected visual acuity (BCVA) worse than 20/20. Sixty-seven cases (71 eyes) of sclopetaria have been reported, of which 59 cases (61 eyes) met inclusion criteria in this study. Most were young (median age 19.5 years) men (51/59, 88.1%). Thirty-seven eyes were observed while 24 underwent immediate surgery including six pars plana vitrectomies and three scleral buckles. Compared to initial presentation, BCVA improved in 31/48 (64.6%) eyes, remained stable in 12/48 eyes (25.0%), and worsened in 5/48 eyes (10.4%). Ten patients (16.4%) achieved a final BCVA of 20/20 with median follow up time of seven months. In a multivariate model, location of sclopetaria in the macula, temporal retina, or immediate orbital foreign body removal predicted poor final BCVA with an area under receiver operating characteristic curve of 0.767. Conclusions and importance: Traumatic chorioretinitis sclopetaria is rare, but reports have increased dramatically over the past two decades. While pars plana vitrectomy may be required for the management of retinal detachments and non-clearing vitreous hemorrhage, close observation is appropriate in most cases. Visual prognosis is poor with most patients attaining 20/200 vision or worse. Keywords: Traumatic chorioretinitis sclopetaria, Sclopetaria, Traumatic chorioretinal rupture, Chorioretinitis proliferans, Retinitis proliferans, Traumatic proliferative chorioretinitis of Lagrange
- Published
- 2019
- Full Text
- View/download PDF
12. Yet another case of ocular sarcoidosis
- Author
-
Doan Luong Hien, Neil Onghanseng, Than Trong Tuong Ngoc, Jaclyn Joyce Hwang, Brandon Huy Pham, Huy Luong Doan, Huy V. Nguyen, Muhammad Sohail Halim, Gunay Uludag, Yasir J. Sepah, Diana V. Do, and Quan Dong Nguyen
- Subjects
Pan-uveitis ,Sarcoidosis ,Infectious endophthalmitis ,Fungal endophthalmitis ,Vitreous balls ,Mimicking ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report a case of bilateral pan-uveitis resembling fungal and viral endophthalmitis in a patient who was ultimately diagnosed with sarcoidosis. Observation: A 64-year-old female presented with a four-day history of painless vision loss in the right eye. She presented with multiple concurrent systemic complaints, including a history of oral and genital sores, patches of hypopigmented skin on her forearms, and occasional shortness of breath. Upon further examination, she was noted to have bilateral pan-uveitis, which was more severe in the right than left eye. Posterior pole examination of the right eye revealed dense vitritis with multiple large whitish round balls that seemed suggestive of fungal or viral endophthalmitis. Initial therapies included intravitreal (IVT) foscarnet and intravenous (IV) acyclovir, followed by IV amphotericin B and oral voriconazole, which did not improve ocular signs and symptoms. Further evaluations ruled out infectious etiologies and lymphoma. Chest computerized tomography (CT) scan revealed findings suggestive of sarcoidosis, which was confirmed with lung biopsy. Anti-viral and -fungal treatments were discontinued, and the patient was started on IV methylprednisolone followed by oral prednisone and mycophenolate mofetil. Ocular symptoms improved, and the patient remained stable after treatment. Conclusion and Importance: The index report illustrates a case of ocular sarcoidosis that imitated the presentation of infectious endophthalmitis. Though ocular sarcoidosis is known to masquerade as a range of disorders and constitutes part of the differential diagnosis for infectious endophthalmitis, sarcoidosis has not been reported in recent literature to imitate the presentation of fungal endophthalmitis. The index case suggests that ocular sarcoidosis should be considered in the differential diagnoses of fungal endophthalmitis.
- Published
- 2020
- Full Text
- View/download PDF
13. Severe vision loss secondary to retinal arteriolar occlusions after multiple intravitreal brolucizumab administrations
- Author
-
Atul Jain, Sophaktra Chea, Wataru Matsumiya, M. Sohail Halim, Çigdem Yaşar, Guoping Kuang, Yasir J. Sepah, Arshad M. Khanani, Diana V. Do, and Quan Dong Nguyen
- Subjects
Age-related macular degeneration ,Brolucizumab ,Intravitreal ,Neovascular ,Retinal vasculitis ,Vaso-occlusion ,Ophthalmology ,RE1-994 - Abstract
Purpose: To describe a case of unilateral retinal arteriolar occlusion following multiple intravitreal brolucizumab injections for neovascular age-related macular degeneration (nAMD). Observations: A 92-year-old Caucasian woman presented with blurry vision in her left eye (OS) after receiving the third dose of intravitreal brolucizumab. At the time of presentation, visual acuity (VA) was 20/40 in her right eye (OD) and had decreased from 20/150 to count finger (CF) at 1-foot OS. On examination, there was no evidence of active inflammation in the anterior chamber OU. Dilated fundus examination showed no vitritis in OD and 1+ vitreous cells OS, flame-shaped hemorrhage at the superior optic disc margin, and retinal whitening surrounding the proximal portion of the supero-temporal branch of the central retinal artery. There were drusen in OS and retinal pigment epithelial (RPE) changes in the maculae of OU. Intra-arteriolar greyish deposits were seen OS. Fluorescein angiography (FA) showed hyper-fluorescence in the maculae corresponding to fibrovascular pigment epithelial detachments (PED) OU. No peri-vascular leakage was noted OU. Delayed filling of multiple arterioles in early and late phases OS was observed on FA. The patient was diagnosed with retinal arteriolar occlusion associated with repeated intravitreal brolucizumab administrations. Conclusion: Retinal arteriolar occlusion with severe vision loss, possibly secondary to inflammatory responses, can occur after subsequent intravitreal brolucizumab injections, even if no inflammation occurred after initial administrations. Vaso-occlusive disease should be considered as a potential ocular complication, with acute as well as delayed onset, following intravitreal brolucizumab therapy.
- Published
- 2020
- Full Text
- View/download PDF
14. Acute lymphocytic leukemia masquerading as acute retinal necrosis
- Author
-
Kaylene L. Carter, Muhammad Hassan, Diana V. Do, and Quan Dong Nguyen
- Subjects
Acute lymphocytic leukemia ,Retinal necrosis ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report a case of B-cell acute lymphocytic leukemia (ALL) relapse presenting as acute retinal necrosis. Observations: An 11-year old boy with history of B-cell ALL undergoing maintenance therapy presented with a three-month history of intermittent blurry vision and pain in the right eye when a routine lumbar puncture indicated an elevated lymphoblast-predominant white blood cell count. Bone marrow biopsy revealed 42% lymphoblasts, confirming ALL relapse. Ophthalmic imaging demonstrated a hyperemic optic disc, retinal whitening, perivascular sheathing, retinal hemorrhages, and retinal detachment in the right eye. Vitreous fluid biopsy revealed presence of rare atypical lymphoblasts. Chemotherapy, orbital radiation, and systemic prednisone resulted in improvement of visual acuity and retinal hemorrhages, and resolution of retinal detachment. Conclusions and importance: We have described the clinical features, treatment, and response in a case of B-cell ALL relapse with presenting signs of acute retinal necrosis. The uncommon finding in B-cell ALL highlights the possibility of intraocular involvement and the importance of routine ophthalmologic evaluation in leukemia remission.
- Published
- 2020
- Full Text
- View/download PDF
15. Subcutaneous repository corticotropin gel for non-infectious panuveitis: Reappraisal of an old pharmacologic agent
- Author
-
Aniruddha Agarwal, Muhammad Hassan, Yasir J. Sepah, Diana V. Do, and Quan Dong Nguyen
- Subjects
ACTH ,Retinal vasculitis ,Panuveitis ,Non-infectious uveitis ,Melanocortins ,Ophthalmology ,RE1-994 - Abstract
Purpose: To describe the clinical course of a patient with non-infectious idiopathic unilateral panuveitis and retinal vasculitis treated with subcutaneous repository adrenocorticotropic hormone (ACTH) gel. Observations: A 33-year-old male presented with blurry vision and floaters in the left eye (OS). The best-corrected visual acuity was 20/20 in the right eye (OD) and 20/50 in OS at the time of initial presentation. Slit-lamp examination revealed mild anterior segment inflammation in OS. There were 1 + vitreous haze and 2 + cells noted in OS. Clinical examination and ancillary imaging assessment including fluorescein angiography revealed retinal vasculitis and optic nerve head inflammation. After infectious etiologies were ruled out, the patient was started on oral corticosteroids and enrolled in a clinical trial employing intravenous tocilizumab therapy. Six months after completion of the tocilizumab trial, the patient demonstrated recurrence of disease. Twice weekly subcutaneous ACTH gel was initiated and the patient demonstrated improvement of retinal vascular inflammation. Conclusions and importance: Repository subcutaneous ACTH gel formulation may be a safe and viable therapeutic option for patients with non-infectious uveitis and retinal vasculitis. Clinical trials using this formulation in a larger patient cohort with longer monitoring are indicated to evaluate its tolerability and bioactivity.
- Published
- 2016
- Full Text
- View/download PDF
16. A case of complex macula-off retinal detachment following traumatic globe rupture
- Author
-
Daniel Arkfeld, William Rhoades, Andrew Baldwin, and Diana V. Do
- Subjects
Ophthalmology ,RE1-994 - Published
- 2017
- Full Text
- View/download PDF
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