Search

Significance: This article reports two cases reported of combined treatment with topical dorzolamide and intravitreal bevacizumab injections, successfully treating small full-thickness macular hole without the need for traditional macular hole surgery., Purpose: This study aimed to report the potential effectiveness of combination treatment with topical dorzolamide and bevacizumab intravitreal injection therapy for small macular holes., Case Reports: Case 1 was a 68-year-old woman presented with distorted and decreased vision in her right eye for 9 months. Fundus examination showed a full-thickness macular hole, which was confirmed with spectral domain optical coherence tomography measuring 96 μm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete hole closure and visual improvement in just 1 month. Case 2 was a 73-year-old woman who presented with distorted and decreased vision in her right eye for 8 months. Fundus examination showed a full-thickness macular hole in the right eye, confirmed with spectral domain optical coherence tomography, measuring 76 μm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete closure at 2 months and improvement in visual acuity., Conclusions: The combination of topical dorzolamide and bevacizumab intravitreal injection is a reasonable consideration for small macular holes with vascular components before considering surgery. Both cases had early macular closure in less than 3 months., Competing Interests: Conflict of Interest Disclosure: No financial conflict of interest exist for any author., (Copyright © 2021 American Academy of Optometry.)

Significance: This case report highlights the merits of using fine needle aspiration biopsy to obtain gene expression profiling of individual choroidal melanomas when more than one tumor arises in the same eye. It is also the first such case to document laser ablation therapy as the primary treatment., Purpose: This report describes a case of two primary choroidal melanomas with different genetic profiles in the same eye., Case Report: An 80-year-old man presented to the office with a neoplasm of uncertain behavior in the left eye. The patient's visual acuity and IOP in the left eye, respectively, at the time of his first visit to the office were 20/25 and 8 mmHg. A dilated fundus examination revealed that there were two choroidal lesions in the left eye. The macular lesion was classified as type 1A, and the ciliochoroidal lesion was classified as type 1B. The patient underwent a vitrectomy of the left eye, followed by endolaser ablation of the tumors. The patient was also injected with bevacizumab. To date, the patient is free of known metastasis. Most recently, his visual acuity and IOP in the left eye were 20/30 and 14 mmHg, respectively., Conclusions: Although rare, multiple melanomas in the same eye may have differing genetic profiles, which may alter prognosis and management, depending on the class of tumor detected., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2021 American Academy of Optometry.)

Significance: This study aimed to highlight the association of stellate neuroretinitis occurring secondary to endogenous candidemia., Purpose: We report an unusual presentation of endogenous Candida endophthalmitis as a stellate neuroretinitis in the setting of Cornelia de Lange syndrome., Case Report: A 34-month-old girl with severe Cornelia de Lange syndrome and a history of parenteral nutrition dependence requiring a chronic central venous catheter presented with bilateral endophthalmitis secondary to candidemia. In one eye, the endophthalmitis had the atypical presentation as a stellate neuroretinitis., Conclusions: This case represents a unique association of stellate neuroretinitis secondary to Candida infection in a patient with Cornelia de Lange syndrome., Competing Interests: Conflict of Interest Disclosure: The authors declare no conflict of interest., (Copyright © 2021 American Academy of Optometry.)

Significance: The case report highlights the possible complications of undergoing neck manipulation within a critical time period after intravitreal injection., Purpose: This study aimed to describe a case of traumatic hemorrhagic choroidal detachment after cervical manipulation during a chiropractic treatment session., Case Report: A 43-year-old male patient with a history of complex rhegmatogenous retinal detachment repair and recurrent cystoid macular edema presented with decreased vision and sudden pain in the right eye after chiropractic manipulation of the neck, status post-intravitreal injection of triamcinolone, which was performed earlier that day. Vision in the right eye was hand motion and 20/20 in the left eye. IOPs were 8 and 11 mmHg, respectively. Slit lamp examination of the right eye revealed blood-tinged steroid residues in the anterior chamber. There was no view to the posterior pole. Ultrasonography showed a lobulated mass with heterogeneous echogenicity consistent with a large hemorrhagic choroidal detachment. No central kissing was observed. Left eye examination was unremarkable., Conclusions: With the increasing use of complementary and alternative medicine, a better understanding of potential complications to raise awareness is becoming essential.