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BackgroundMethodsResultsConclusionTo compare the treatment outcome and visual prognosis of Vogt-Koyanagi-Harada (VKH) disease presenting as papillitis vs. serous retinal detachment (SRD).Retrospective comparative cohort study of 35 patients with previously unknown VKH diagnosis, followed-up for ≥6 months. Outcomes measured: (1) time to achieve inflammatory control; (2) VKH relapse; (3) ocular complications (glaucoma, sunset glow fundus, cataract, and vision loss ≥2 Snellen lines); and (4) chances for developing a chronic-recurrent disease.Females predominated in both groups: 12/16 (75%) papillitis and 18/19 (94.7%) SRD. The mean age at presentation was 29 ± 12 years in the papillitis and 36 ± 14 years in the SRD group (p = 0.119), with an overall median follow-up of 26 months (6–180 months). The papillitis-onset VKH group’s mean time elapsed between symptoms onset and initial treatment was shorter (2.9 ± 1.0 vs. 4.6 ± 2.8 weeks, p = 0.024). Anterior segment inflammation was lower (56% vs. 79%, p = 0.018), requiring a shorter corticosteroids treatment duration (12.8 ± 16.1 vs. 32.7 ± 34.1 months, p = 0.040), achieving an earlier inflammatory control (1.9 ± 0.6 vs. 4.1 ± 3.2 months, p <0.001) with fewer ocular complications (13% vs. 74%, p <0.001), including sunset glow fundus (SGF) (0% vs. 63%, p <0.001). Conversely, SRD-onset VKH was a risk factor for developing disease relapse (HR: 4.53; 95% CI: 1.31–15.69, p = 0.017), ocular complications (OR: 19.60, 95% CI: 3.24–118.50, p = 0.001), and chronic-recurrent disease (OR: 20.63; 95% CI: 2.24–189.84, p = 0.008).Mexican-mestizo VKH patients with papillitis-onset VKH disease showed earlier inflammatory control, fewer recurrences, and better visual and ocular complication outcomes. [ABSTRACT FROM AUTHOR]

Cat-scratch disease (CSD) is a self-limited disease caused by Bartonella henselae, a fastidious gram-negative intracellular bacillus bacterium. Neuroretinitis, a form of optic neuropathy characterised clinically by optic disc swelling and a macular star, is an uncommon manifestation of CSD occurring in approximately 1–2% of cases. We report a case of a 14-year-old female who presented to the emergency department with a chief complaint of acute painless vision loss described as a large black spot in the centre of her right eye vision 2 weeks after being scratched by cats. Fundus examination revealed Frisen grade 5 disc oedema with an atypically diffuse disc and peripapillary haemorrhages with associated subretinal fluid and a macular star in the right eye. Optical coherence tomography (OCT) of the macula and retinal nerve fibre layer showed subretinal fluid involving the fovea, a serous retinal detachment of the nasal macula, and significant optic disc oedema in the right eye. The patient was admitted and treated with doxycycline, rifampin, and prednisone taper. After completing the treatment course, the patient's vision improved, fundus examination showed significantly improved disc oedema and haemorrhages, and OCT demonstrated resolution of the subretinal fluid in the right eye. [ABSTRACT FROM AUTHOR]

Background: Ocular involvement is relatively common in granulomatosis with polyangiitis (GPA); however, choroidal involvement is rare. We present a case of serous retinal detachment resulting from choroidal involvement in GPA. Case presentation: A 55-year-old male presented to our clinic with bilateral eye redness and pain. Ocular examination revealed bilateral conjunctival injection, and dilation of the episcleral and scleral vessels. Slit-lamp examination revealed anterior chamber cells. Optical coherence tomography (OCT) confirmed serous retinal detachment (SRD) in the left eye. The patient had recently been diagnosed with GPA following a lung biopsy and had received immunosuppressive therapy, including systemic steroids, cyclosporine, mycophenolate mofetil, and rituximab. Five weeks after treatment, the clinical symptoms of the patient, including SRD, improved with alleviation of systemic symptoms. However, tapering systemic steroids and immunosuppressants and discontinuing rituximab led to disease reactivation. OCT demonstrated a recurrence of subretinal fluid, which had previously resolved, and slit-lamp examination showed mild bilateral engorged scleral vessels. Conclusions: Choroidal involvement can present as SRD and may indicate disease activity in patients with GPA. [ABSTRACT FROM AUTHOR]

Abstract Background In this report, we describe a case of proliferative diabetic retinopathy that developed into exudative changes confusing with central serous chorioretinopathy (CSCR) following extensive endolaser pan retinal photocoagulation. Case description A 49-year-old male patient with diabetic retinopathy in both eyes presented with vitreous hemorrhage and 6/60 visual acuity in his left eye. Optical coherence tomography (OCT) scans at presentation revealed serous PEDs in both eyes. On day 10 after vitreoretinal surgery and complete peripheral endolaser PRP for the left eye, there was serous retinal detachment (SRD) and an increase in PED heights, mimicking CSCR. No additional treatment was considered. At the three-week post-operative visit, OCT scans revealed that the SRD had resolved and the PED heights had decreased without rupture. At the final follow-up visit, 12 weeks after surgery, the SRD had not recurred, and the PEDs had stabilized. Despite no additional ocular therapy for the right eye, the serous PED height had decreased. The choroidal thickness (CT) at the fovea at various points during the follow-up visits revealed a reduction in both eyes. Conclusion This case demonstrated the course of SRD, PED, and CT following extensive PRP. These changes may be associated with intraocular VEGF changes. In the presence of SRD and serous PED, the PED morphology may help differentiate the condition from CSCR. Although caution should be exercised when performing PRP during surgery or as an outpatient procedure, the SRD usually resolves without problem.

Purpose: to provide a clinical case of serous retinal detachment after non­penetrating antiglaucoma surgery. A patient with hypertension and type II diabetes mellitus underwent a non­penetrating deep sclerectomy in our clinic against the background of uncompensated glaucoma. Subtotal serous retinal detachment was found in the early postoperative period. Against the background of steroid therapy, the detachment resolved within 2 weeks. We believe that the cause of serous detachment is a significant gradient in the decrease in intraocular pressure against the background of uncompensated glaucoma as a result of surgery against the background of uncompensated glaucoma and endothelial dysfunction due to common diseases. Patients with comorbidities and initially severe condition require more thorough preoperative preparation, monitoring and correction of treatment in the postoperative period.

Background: In this report, we describe a case of proliferative diabetic retinopathy that developed into exudative changes confusing with central serous chorioretinopathy (CSCR) following extensive endolaser pan retinal photocoagulation. Case description: A 49-year-old male patient with diabetic retinopathy in both eyes presented with vitreous hemorrhage and 6/60 visual acuity in his left eye. Optical coherence tomography (OCT) scans at presentation revealed serous PEDs in both eyes. On day 10 after vitreoretinal surgery and complete peripheral endolaser PRP for the left eye, there was serous retinal detachment (SRD) and an increase in PED heights, mimicking CSCR. No additional treatment was considered. At the three-week post-operative visit, OCT scans revealed that the SRD had resolved and the PED heights had decreased without rupture. At the final follow-up visit, 12 weeks after surgery, the SRD had not recurred, and the PEDs had stabilized. Despite no additional ocular therapy for the right eye, the serous PED height had decreased. The choroidal thickness (CT) at the fovea at various points during the follow-up visits revealed a reduction in both eyes. Conclusion: This case demonstrated the course of SRD, PED, and CT following extensive PRP. These changes may be associated with intraocular VEGF changes. In the presence of SRD and serous PED, the PED morphology may help differentiate the condition from CSCR. Although caution should be exercised when performing PRP during surgery or as an outpatient procedure, the SRD usually resolves without problem. [ABSTRACT FROM AUTHOR]

This article presents two case studies of patients with metastatic melanoma who experienced daily fluctuations of serous retinal detachment (SRD) while being treated with a combination of encorafenib and binimetinib. The patients reported acute blurred vision that worsened in the morning and resolved by noon. Ophthalmologic examinations and scans revealed an increase in SRD between 8 and 11 AM, followed by complete resolution by 12 PM. The fluctuations persisted throughout the day and were observed during follow-up visits. Despite the subjective complaints, the treatment was not discontinued due to preserved visual acuity and the medications being the last-line therapy for metastatic melanoma. The authors suggest that the timing and dosage of the medication may be correlated with the rapid fluctuation of SRD, and emphasize the importance of appropriate follow-up for patients undergoing this therapy. [Extracted from the article]

Introduction: In this paper, we report a case of visual impairment during treatment with sunitinib in a patient with metastatic renal cell carcinoma. Methods: Retrospective chart review was used. Case Presentation: We describe a 74-year-old male with metastatic renal cell carcinoma who was treated with sunitinib and experienced severe loss of visual acuity due to serous retinal detachment and intraretinal fluid. Upon discontinuation of sunitinib, the retinal fluid resolved, and visual acuity was restored. Conclusion: Serous retinal detachment has been described as a side effect of sunitinib use. Discontinuing sunitinib promptly resolved the subretinal fluid collections and restored vision.

Purpose: We report a patient with recurrent optic disc pit (ODP) maculopathy after Valsalva's maneuver and discuss its pathophysiology. We also hypothesize the role of Valsalva's maneuver in its genesis. Method: Case report of one patient, male, 12 years old. Results: Serous retinal detachment may occur in association with the ODP, a developmental anomaly of the optic nerve head. Histopathologically, it consists of a dysplastic retina herniation into a pocket extending posteriorly through a defect in the lamina cribrosa into the subarachnoid space. These three different compartments--intraocular space, optic nerve head, and subarachnoid space--and the dynamic interactions among them should be understood as the key factors for the occurrence of ODP-related serous retinal detachment. Conclusion: Based on the possibility that serous retinal detachment secondary to the ODP could be related to the Valsalva's maneuver, we strongly recommend that patients with ODP be advised to avoid intense physical or work activities that may increase abdominal, thoracic, and cerebral pressure and to refrain from playing wind instruments to avoid pretreatment, per treatment, and post-treatment intercurrences. [ABSTRACT FROM AUTHOR]

Purpose: Erdafitinib is a fibroblast growth factor receptor inhibitor indicated for the treatment of cancer. A case of fibroblast growth factor receptor inhibitor-associated retinopathy that resulted in significant visual symptoms and chronic subretinal abnormalities is reported. Methods: A 73-year-old man with a history of relapsed multiple myeloma was treated with erdafitinib. Soon after his fourth treatment cycle, he developed blurred vision in both eyes. Therapy with erdafitinib was subsequently discontinued. Results: Funduscopic examination and optical coherence tomography of both eyes revealed multifocal subretinal fluid in the macula of both eyes. Eleven weeks after cessation of the erdafitinib, the visual acuity improved but the patient reported bilateral annular scotomas. Evaluation was notable for resolution of the subretinal fluid with the development irregular subfoveal thickening in both eyes. The patient's symptoms improved, but the subfoveal abnormalities were persistent at 14 months follow-up. Conclusion: Erdafitinib may be associated with permanent retinal pigment epithelium toxicity. [ABSTRACT FROM AUTHOR]

Background: Ocular involvement is relatively common in granulomatosis with polyangiitis (GPA); however, choroidal involvement is rare. We present a case of serous retinal detachment resulting from choroidal involvement in GPA. Case presentation: A 55-year-old male presented to our clinic with bilateral eye redness and pain. Ocular examination revealed bilateral conjunctival injection, and dilation of the episcleral and scleral vessels. Slit-lamp examination revealed anterior chamber cells. Optical coherence tomography (OCT) confirmed serous retinal detachment (SRD) in the left eye. The patient had recently been diagnosed with GPA following a lung biopsy and had received immunosuppressive therapy, including systemic steroids, cyclosporine, mycophenolate mofetil, and rituximab. Five weeks after treatment, the clinical symptoms of the patient, including SRD, improved with alleviation of systemic symptoms. However, tapering systemic steroids and immunosuppressants and discontinuing rituximab led to disease reactivation. OCT demonstrated a recurrence of subretinal fluid, which had previously resolved, and slit-lamp examination showed mild bilateral engorged scleral vessels. Conclusions: Choroidal involvement can present as SRD and may indicate disease activity in patients with GPA.

Introduction: In this paper, we report a case of visual impairment during treatment with sunitinib in a patient with metastatic renal cell carcinoma. Methods: Retrospective chart review was used. Case Presentation: We describe a 74-year-old male with metastatic renal cell carcinoma who was treated with sunitinib and experienced severe loss of visual acuity due to serous retinal detachment and intraretinal fluid. Upon discontinuation of sunitinib, the retinal fluid resolved, and visual acuity was restored. Conclusion: Serous retinal detachment has been described as a side effect of sunitinib use. Discontinuing sunitinib promptly resolved the subretinal fluid collections and restored vision. [ABSTRACT FROM AUTHOR]

Background: A case of bilateral multifocal serous retinal detachments and dry eye complicated with unilateral peripheral ulcerative keratitis (PUK) during erdafitinib therapy is described. Case description: A 76-year-old male underwent a baseline examination two months after initiating 8 mg erdafitinib therapy (April 2023) due to metastatic urothelial carcinoma. Left subfoveal serous retinal detachment was observed initially but the treatment was resumed as he was asymptomatic. In May 2023, bilateral multifocal subretinal fluid pockets were identified, and the patient was still asymptomatic. However, in June 2023 he complained of bilateral redness and a stinging sensation in his right eye. Bilateral severe dry eye and right PUK were diagnosed. He was prescribed dexamethasone eye drops and sodium hyaluronate artificial tears for both eyes. One week later corneal staining decreased, and progression of PUK ceased. Erdafitinib therapy was discontinued in June 2023 due to the planned transurethral prostatectomy. By July 2023, after discontinuation of the drug and administration of the topical treatment, the dry eye improved and the PUK became inactive. There was also resolution of subretinal fluid pockets in the right eye and a reduction of subretinal fluid pockets in the left eye. After the reinitiation of erdafitinib therapy, serous retinal detachments recurred in both eyes in September 2023, but both corneas remained stable with topical low-dose dexamethasone, cyclosporine-A and artificial tear usage. Conclusion: Erdafitinib therapy may lead to concurrent anterior and posterior segment complications. Multidisciplinary monitoring is crucial for patients undergoing erdafitinib therapy to prevent possible visual disturbances.

Abstract While combined use of BRAF/MEK inhibitors has elicited dramatic clinical efficacy in incurable melanoma, drug‐associated retinopathy has become an emerging adverse event. We present two Japanese men with advanced melanoma who developed visual impairment due to serous retinal detachments (SRDs) with cystoid macular edema (CME) immediately after initial administration of encorafenib/binimetinib, a BRAF and MEK inhibitor. One case had drug‐intolerable retinopathy on repeat dosing. Both cases were switched to another BRAF/MEK inhibitors, dabrafenib/trametinib, with no recurrence of SRDs. Co‐existing CME may be a confounding risk for the early development of SRDs with encorafenib/binimetinib therapy, providing attention during drug administration.

We present a patient with bilateral multifocal serous retinal detachments after multiple trauma in a car accident without preceding corticosteroid treatment. A 37-year-old patient was admitted to our hospital after he had suffered multiple body injuries in a car accident. After being woken from an induced coma, he complained of blurry vision in his left eye, so he underwent a complete ophthalmic examination – several serous retinal detachments were found at the posterior pole of both eyes, along with thickened choroids. As there was no intraocular inflammation, accelerated hypertension or other changes indicating other causes of serous retinal detachments, and since we observed a steady spontaneous subretinal fluid resorption, we classified our case as an atypical central serous chorioretinopathy. Alternatively, serous retinal detachments could have occurred due to transient alterations in choroidal circulation following cerebral injury. In conclusion, this case report adds new data on the occurrence of serous retinal detachments and discusses their possible aetiology in the trauma setting. Care must be taken not to miss any other underlying pathology needing treatment.

Abstract Purpose To describe imaging characteristics of severe macular complications occurring in glaucoma and discuss available treatments. Methods Retrospective case series of glaucomatous patients with macular retinoschisis (MR) and/or serous retinal detachment (SRD). Patients underwent a complete ophthalmological examination and multimodal imaging including retinography, SD-OCT, fluorescein and indocyanine green angiography (FA & ICGA) and adaptive optics (AO). Results Ten eyes (8 patients) were included. Initial BCVA was 1.04 ± 1.12 logMAR and IOP was 24.0 ± 9.3mmHg. All eyes presented with MR while SRD was present in 5 eyes (5 patients), with a central macular thickness of 573 ± 152 μm. FA and ICGA allowed to exclude leakage in all cases. A focal lamina cribrosa defect (LCD) was found in four eyes (4 patients) using OCT, with AO providing en-face visualization of the defect in one eye. Outer retinal hole was present in 3 eyes (3 patients). No visual improvement or resolution of the macular retinoschisis was observed in eyes with medical or surgical IOP control (N = 9). Vitrectomy with internal membrane limiting peeling and gas tamponade was performed in one eye with good visual results. Conclusions Multimodal high-resolution imaging is essential to diagnose severe macular complications associated with advanced glaucoma.

Purpose: To study the alteration of cytokine factors in aqueous humor and retinal microstructure in the formation of serous retinal detachment (SRD) secondary to retinal vein occlusion. Methods: The subjects were 39 patients with RVO, of whom 31 patients had SRD (RVO-SRD). Spectral Domain Optical Coherence Tomography (SD-OCT) was used to measure the completeness of photoreceptor inner segment/outer segment (IS/OS) and the external limiting membrane (ELM) as well as the structure of RVO-SRD, including the height and shape of SRD. The aqueous humor was collected before intravitreal injection of Ranibizumab. The concentrations of VEGF, MCP-1, IL-8, IL-6, b-FGF and TNF-α in the aqueous humor were measured. All patients participated in the 6-month follow-up examinations, which included visual acuity, intraocular pressure, ophthalmologic examination, and SD-OCT. The time of recurrence of RVO-SRD was recorded. Results: The formation of SRD was associated with the area of congested vein, disrupted IS/OS, ELM layers and high VEGF, MCP-1, IL-8, IL-6 levels. However, the height and shape of SRD were not relevant to any inflammatory factors. Moreover, high levels of MCP-1, IL-8 and IL-6 were found in large areas of congested veins. High levels of MCP-1 and IL-6 were observed in the patients with incomplete IS/OS and ELM. The recurrence of SRD was related to the high MCP-1 level. Conclusion: High concentrations of cytokine factors in aqueous humor could induce vascular leakage, exacerbate the extent of macular edema, disrupt the structure of ELM and IS/OS, and develop SRD in RVO.

Purpose: To report Vogt-Koyanagi-Harada (VKH) disease in a patient with extreme anisometropia. Observations: A 56-year-old woman was referred to our hospital. Her past medical history was significant for amblyopia in the right eye. At the initial visit, decimal best-corrected visual acuity (BCVA) was 0.03 (Snellen equivalent 5/160) in the right eye and 0.03 (Snellen equivalent 5/160) in the left eye, and axial length was 28.44 mm and 22.36 mm, respectively. Anterior chamber inflammation was seen predominantly in the right eye with fibrin exudates. Swept-source optical coherence tomography demonstrated choroidal thickening and folds predominantly in the left eye. Additionally, serous retinal detachment (SRD) was much more evident in the left eye than in the right eye. Subfoveal choroidal thickness (SCT) was 417 μm in the right and over 800 μm in the left eye. Cerebrospinal fluid examination revealed lymphocyte-dominant hypercellularity. Based on these findings, we diagnosed the patient with VKH disease and treated her with a high-dose systemic corticosteroid. One month after the initiation of treatment, SRD in both eyes fully resolved, and SCT decreased to 105 μm in the right and 311 μm in the left eye. Conclusions and Importance: The marked discrepancy in axial length between the right and left eyes might contribute to the different severity of inflammation in VKH disease.

To report a case of secondary bilateral choroiditis in a patient with primary Sjögren's syndrome(pSS). Case report. A 69-year-old woman visited our hospital for consultation due to decreased visual acuity in both eyes for 1 month. At the first visit, best corrected visual acuity (BCVA) was 0.2 and 0.3 in her right and left eyes, respectively. Intraocular pressure values were 15 mmHg and 16 mmHg in her right and left eyes, respectively. Examination revealed edema of the eyelids and conjunctiva,and corneal fluorescence staining was positive. No inflammation in the anterior chamber or vitreous opacities were observed. Bilateral multiple retinal detachments were observed on the posterior fundus, and optical coherence tomography revealed bilateral multiple areas of retinal neuroepithelial detachment, choroidal thickening, and choroidal folds. No abnormal fluorescence leakage was observed on fundus fluorescein angiography or indocyanine green angiography. In addition, systematic manifestations included recurrent bilateral parotid gland enlargement. Labial gland biopsy revealed dilated glandular ducts, scattered interstitial glands, and lymphocytic foci. Salivary gland scintigraphy revealed severe impairment of glandular excretory function. Moreover, blood tests for anti-Ro/SSA and anti-La/SSBantibodies were positive. The patient was diagnosed with primary Sjögren's syndrome. After 2 months treatment with oral prednisolone acetate combined with hydroxychloroquine, her BCVAimproved to 0.8 and 1.0 in the right and left eyes, respectively. The fundus also recovered to normal, and no recurrence was observed during the 1-year follow-up period. The current case highlights that pSS, which usually manifests with dry eye and keratoconjunctivitis, may manifest with chronic choroiditis in both eyes as well. Based on our experience with this case, patients with clinically suspected bilateral choroiditis should be evaluated for pSS. [ABSTRACT FROM AUTHOR]

We presented our observation with dexamethasone (DEX) implant in six eyes of three patients with Vogt–Koyanagi–Harada (VKH) disease who experienced hepatic dysfunction due to the systemic immunosuppressive therapy during their follow-up. Three cases who could not continue with the azathioprine (AZA) or adalimumab (ADA) treatment due to elevated liver enzymes were given consecutive bilateral DEX implant injections during the follow-up. In the first case, oral AZA was discontinued due to an elevation of the liver enzymes at the 2nd month of AZA treatment, and then she received five bilateral DEX implant administrations during the follow-up of 61 months without any intraocular pressure rise or disease recurrence. The remaining two patients had an elevation of the liver enzymes when ADA treatment was added to the prophylactic isoniazid therapy and they each received three bilateral DEX implant administrations within a year again without any complications and disease recurrence. DEX implant can be a safe and effective alternative for individuals with VKH disease whose systemic treatment is ceased due to adverse effects of the systemic treatment and intravitreal therapy with DEX implant can be beneficial to achieve a recurrence-free follow-up. [ABSTRACT FROM AUTHOR]

We present the case of a pregnant young woman with symptomatic diffuse choroidal hemangioma (CH), diagnosed with Sturge-Weber syndrome (SWS). Three months postpartum, there was full spontaneous resolution of the subretinal fluid and improvement in the visual acuity (VA). A 29-year-old, 31-week pregnant female with a coagulation disorder and enoxaparin (clexane) treatment, complained of a left visual disturbance of 2 weeks duration. On examination, the right eye was normal; left eye VA was 6/12 (20/40) with a left eyelid port-wine stain and on funduscopic examination there was a serous retinal detachment. On ultrasound, there was diffuse thickening of the choroid with a focus superior and nasal to the disc with active vascularization - a diagnosis of diffuse CH was made. Magnetic resonance imaging (MRI) and MR venography studies of the brain and orbit revealed engorged orbital vasculature, and the diagnosis of SWS was made. Three months after Cesarean section with birth of a healthy baby boy, VA returned to 6/9 with full resorption of subretinal fluid. On fundoscopic exam, there were no retinal or vein occlutions but there were tortuous blood vessels with A-V crossing. This is a rare case of newly diagnosed SWS with symptomatic diffuse CH in pregnancy. Postpartum, there was full resolution of the subretinal fluid. A watchful waiting approach can be considered in such cases. [ABSTRACT FROM AUTHOR]

Abstract A 53-year-old man who has stage 4 non-small cell lung carcinoma and treated with Dabrafenib-Trametinib combination chemotherapy; presented with decreased bilateral visual acuity. We checked out slit lamp examination, fundoscopy, optical coherence tomography and fundus fluorescein angiography. In slit lamp biomicroscopy; bilateral posterior synechiae, granulomatous keratic precipitates and + 4 cells in the anterior chamber were detected. Cystoid macular edema and subretinal fluid accumulation were revealed in optical coherence tomography. Dabrafenib and Trametinib treatments were discontinued and systemic methylprednisolone, topical corticosteroid and topical cyclopentolate were started. His best corrected visual acuity was increased from counting fingers from 2 m to 0,9 bilaterally and cystoid macular edema and serous retinal detachment were completely regressed as a result of systemic and topical corticosteroid treatment.

While combined use of BRAF/MEK inhibitors has elicited dramatic clinical efficacy in incurable melanoma, drug‐associated retinopathy has become an emerging adverse event. We present two Japanese men with advanced melanoma who developed visual impairment due to serous retinal detachments (SRDs) with cystoid macular edema (CME) immediately after initial administration of encorafenib/binimetinib, a BRAF and MEK inhibitor. One case had drug‐intolerable retinopathy on repeat dosing. Both cases were switched to another BRAF/MEK inhibitors, dabrafenib/trametinib, with no recurrence of SRDs. Co‐existing CME may be a confounding risk for the early development of SRDs with encorafenib/binimetinib therapy, providing attention during drug administration. [ABSTRACT FROM AUTHOR]

Purpose: To describe imaging characteristics of severe macular complications occurring in glaucoma and discuss available treatments. Methods: Retrospective case series of glaucomatous patients with macular retinoschisis (MR) and/or serous retinal detachment (SRD). Patients underwent a complete ophthalmological examination and multimodal imaging including retinography, SD-OCT, fluorescein and indocyanine green angiography (FA & ICGA) and adaptive optics (AO). Results: Ten eyes (8 patients) were included. Initial BCVA was 1.04 ± 1.12 logMAR and IOP was 24.0 ± 9.3mmHg. All eyes presented with MR while SRD was present in 5 eyes (5 patients), with a central macular thickness of 573 ± 152 μm. FA and ICGA allowed to exclude leakage in all cases. A focal lamina cribrosa defect (LCD) was found in four eyes (4 patients) using OCT, with AO providing en-face visualization of the defect in one eye. Outer retinal hole was present in 3 eyes (3 patients). No visual improvement or resolution of the macular retinoschisis was observed in eyes with medical or surgical IOP control (N = 9). Vitrectomy with internal membrane limiting peeling and gas tamponade was performed in one eye with good visual results. Conclusions: Multimodal high-resolution imaging is essential to diagnose severe macular complications associated with advanced glaucoma. [ABSTRACT FROM AUTHOR]

Mitogen-activated protein kinase inhibitor-associated retinopathy, which presents similarly to FGFR inhibitor-associated retinopathy, often begins soon after drug initiation, and self-resolves despite treatment continuation.[2] The aetiology of mitogen-activated protein kinase inhibitor-associated retinopathy and FGFR-associated retinopathy remains unknown but may follow a similar pathomechanism, as FGFR lies upstream of mitogen-activated protein kinase on the RAS/RAF/MEK/ERK pathway. Keywords: Central serous chorioretinopathy; fibroblast growth factor receptor; pemigatinib; serous retinal detachment EN Central serous chorioretinopathy fibroblast growth factor receptor pemigatinib serous retinal detachment 560 563 4 07/11/23 20230701 NES 230701 Introduction Systemically administered chemotherapies have been associated with ocular side effects. Optical coherence tomography demonstrated a serous retinal detachment with subretinal fluid in a dome-shaped morphology in the right eye and splitting of the interdigitation zone from the retinal pigment epithelium in the left eye (Figure 1B). [Extracted from the article]

We present the case of a pregnant young woman with symptomatic diffuse choroidal hemangioma (CH), diagnosed with Sturge–Weber syndrome (SWS). Three months postpartum, there was full spontaneous resolution of the subretinal fluid and improvement in the visual acuity (VA). A 29-year-old, 31-week pregnant female with a coagulation disorder and enoxaparin (clexane) treatment, complained of a left visual disturbance of 2 weeks duration. On examination, the right eye was normal; left eye VA was 6/12 (20/40) with a left eyelid port-wine stain and on funduscopic examination there was a serous retinal detachment. On ultrasound, there was diffuse thickening of the choroid with a focus superior and nasal to the disc with active vascularization – a diagnosis of diffuse CH was made. Magnetic resonance imaging (MRI) and MR venography studies of the brain and orbit revealed engorged orbital vasculature, and the diagnosis of SWS was made. Three months after Cesarean section with birth of a healthy baby boy, VA returned to 6/9 with full resorption of subretinal fluid. On fundoscopic exam, there were no retinal or vein occlutions but there were tortuous blood vessels with A-V crossing. This is a rare case of newly diagnosed SWS with symptomatic diffuse CH in pregnancy. Postpartum, there was full resolution of the subretinal fluid. A watchful waiting approach can be considered in such cases.

We presented our observation with dexamethasone (DEX) implant in six eyes of three patients with Vogt–Koyanagi–Harada (VKH) disease who experienced hepatic dysfunction due to the systemic immunosuppressive therapy during their follow-up. Three cases who could not continue with the azathioprine (AZA) or adalimumab (ADA) treatment due to elevated liver enzymes were given consecutive bilateral DEX implant injections during the follow-up. In the first case, oral AZA was discontinued due to an elevation of the liver enzymes at the 2nd month of AZA treatment, and then she received five bilateral DEX implant administrations during the follow-up of 61 months without any intraocular pressure rise or disease recurrence. The remaining two patients had an elevation of the liver enzymes when ADA treatment was added to the prophylactic isoniazid therapy and they each received three bilateral DEX implant administrations within a year again without any complications and disease recurrence. DEX implant can be a safe and effective alternative for individuals with VKH disease whose systemic treatment is ceased due to adverse effects of the systemic treatment and intravitreal therapy with DEX implant can be beneficial to achieve a recurrence-free follow-up.

Purpose: To describe the demographic pattern, clinical characteristics, treatment modalities, and visual outcome in Vogt–Koyanagi–Harada (VKH) disease patients observed at a tertiary eye care centre in South India. Methods: A prospective chart analysis of 38 patients with VKH disease. Results: Of the 38 VKH patients, 31 (81.6%) were female, the mean age was 39.8 years, and the median duration of symptoms was 10 days (range: 2 to 180 days). The most common ocular complaint was a defective vision (70 eyes or 92.1%). Extraocular manifestations were headache (13 patients or 34.2%) and tinnitus (4 patients or 10.5%). Twenty-four patients (63.2%) presented with bilateral panuveitis, and 12 patients (31.6%) had posterior uveitis. The most common posterior segment presentation included bilateral serous retinal detachment (100%), disc oedema (37 eyes or 48.7%), and vitritis (31 eyes or 40.8%). All patients (100%) were treated with oral and topical prednisolone, based on the ocular inflammation status, 9 patients (23.7%) required dexamethasone (intramuscular), 39 eyes (51.3%) required posterior subtenon triamcinolone, 16 patients (28.9%) required methotrexate, 1 (2.6%) required cyclophosphamide, 1 (2.6%) required azathioprine. At the final visit, the majority of the patients had statistically significant good visual outcomes. Conclusion: Prompt diagnosis and early initiation of treatment with systemic, local steroid and immunosuppressive therapy showed faster recovery with good visual outcome.

Aim. To determine the incidence and the clinical course of retinal complications of intracameral administration of cefuroxime in minimally invasive cataract surgery.Methods. From 2016 to 2021, a prospective clinical study was conducted at the Volga District Medical Center of the Federal Medical and Biological Agency of Russia, which included patients with cataract in one or two eyes to be surgically treated. All patients received 1 mg of cefuroxime injected into the anterior chamber at the end of surgery. All patients underwent ophthalmological examination including evaluation of best corrected visual acuity with determination of logarithm of minimum angle of resolution (logMAR), tonometry, biomicroscopy, and ophthalmoscopy. Each patient before and the day after surgery underwent optical coherence tomography of the retina on a spectral optical tomograph RTVue-100 (Optovue). The dynamics of the condition was evaluated on days 3 and 7 after surgery.Results. Five cases of retinal complications of intracameral cefuroxime injection were identified during the 5-year study period. According to data of optical coherence tomography, retinal edema was localized in the internal nuclear layer of the retina, and the height of serous retinal detachment in the fovea area on the next day after surgery was 315.0 ± 11.0 µm and reduced statistically significantly to 59.8 ± 42.3 µm on the 3rd day after the intervention (p = 0.043). One week later, all patients had complete retinal adherence and recovery of visual function. Retinal edema did not recur in the long term after surgery.Conclusion. Serous retinal detachment with macular edema is the most common clinically relevant complication of intracameral antibiotic prophylaxis, which develops both in compliance with the dilution protocol and in overdose, and has a favourable prognosis.

Objectives:To evaluate the frequency and treatment response of eyes with bacillary layer detachment (BLD) in acute Vogt-Koyanagi-Harada (VKH) disease using spectral-domain optical coherence tomography (SD-OCT).Materials and Methods:We retrospectively reviewed the medical records of 58 eyes of acute VKH patients with at least 6 months of follow-up between January 2009 and March 2021. SD-OCT, color fundus photographs, and fluorescein angiography images were analyzed in all patients.Results:The study included 58 eyes of 29 patients. BLD was detected in 33 of the 58 eyes (56.9%) at baseline. Mean serous retinal detachment (SRD) height was 918.50±336.64 μm in the BLD group and 215.33±167.83 μm in the group without BLD (p

A 36-year-old primigravid woman with suspected gestational hypertension was referred to our hospital for further examination and treatment of bilateral serous retinal detachment (SRD). At the previous hospital immediately after the onset of visual symptoms (decreased visual acuity), the best-corrected visual acuity (BCVA) had been 0.1 in the right eye (RE) and 0.08 in the left eye (LE). Funduscopy revealed diffuse SRD and white discoloration at the posterior pole but no retinal tear in both eyes (BE). Optical coherence tomography (OCT) also revealed SRD. One day after the onset, we diagnosed bilateral SRD due to preeclampsia with HELLP syndrome because of elevated blood pressure, hemolysis, elevated liver enzymes, and low platelet and performed an emergency cesarean section. One week after the onset, BCVA improved to 0.3 in BE. Funduscopy showed resolution of SRD and the remaining white discoloration at the posterior pole. OCT showed complete resolution of SRD, blurred external limiting membrane, and an invisible ellipsoid zone. OCT angiography (OCTA) segmentation of the deep retinal layer (using en face imaging) revealed multiple white materials, mainly in the macula. Although funduscopy and OCT showed almost normal appearance by 2 months after the onset, BCVA was not completely improved. OCTA using en face imaging revealed shrinkage of multiple white materials but remnant material at the posterior pole. One year after the onset, BCVA was 0.9 in the RE and 0.8 in the LE. OCTA using en face imaging revealed remnant white materials but marked improvement overall.

Nephrotic syndrome is a disease that causes fluid retention in the body due to loss of protein in the blood, which can lead to serous retinal detachment (SRD) in the macula. We report a case of severe SRD in both eyes and angle closure due to ciliary body edema caused by nephrotic syndrome. A 57-year-old man was admitted to the Department of Nephrology in our hospital for a thorough examination of his generalized edema. He was diagnosed with nephrotic syndrome but proved to be refractory to steroid treatment. Due to distortion symptoms in both eyes on the 30th day of hospitalization, the patient was referred to our department. Best-corrected visual acuity (BCVA) was 0.8 in the right eye and 1.0 in the left eye. Slit lamp examination and anterior segmental optical coherence tomography (OCT) showed shallow anterior chambers in both eyes. Fundus and macular OCT demonstrated severe SRD in the posterior pole of both eyes. After observing the presence of hypoalbuminemia, we considered the possibility of SRD and angle closure due to ciliary edema that resulted from the leaks associated with the nephrotic syndrome. Thereafter, ocular findings improved in conjunction with systemic symptom improvements associated with ultrafiltration and low-density lipoprotein apheresis. On the 60th day of hospitalization, his BCVA improved to 1.2 in both eyes, SRD disappeared, and the anterior chamber depth normalized. This case demonstrates the importance of recognizing SRD and angle closure associated with ciliary body edema as complications linked with nephrotic syndrome.

Kenan Calisir,1 Adil Barut,2 Mohamed Salad Kadiye1 1Mogadishu Somalia Turkey Training and Research Hospital, Department of Ophthalmology, Mogadishu, Somalia; 2Mogadishu Somalia Turkey Training and Research Hospital, Department of Obstetrics and Gynecology, Mogadishu, SomaliaCorrespondence: Kenan Calisir, Mogadishu Somalia Turkey Training and Research Hospital, Department of Ophthalmology, Banadir, Mogadishu, Somalia, Tel +90 544 582 8442, Email ke_nan33@hotmail.comAbstract: A 29-year-old preeclamptic postpartum patient with no symptoms of hypertension in her medical history before pregnancy was referred to the ophthalmology outpatient clinic with the complaint of sudden bilateral vision loss. Slit-lamp fundus examination and B-scan ultrasonography showed serous retinal detachment (SRD) in both eyes. She was diagnosed with bullous SRD due to preeclampsia (PE). The patient’s fundoscopy findings regressed spontaneously, and visual acuities improved within one month. SRD should be considered in case of vision loss before or after birth in patients with PE, and such patients should undergo retinal examination.Keywords: preeclampsia, serous retinal detachment, sudden vision loss, pregnancy

Purpose: The purpose of the study was to investigate clinical relevance of fibrin membranous structure (FMS) in the photoreceptor outer segments on spectral‐domain optical coherence tomography (SD‐OCT) in untreated initial‐onset acute Vogt‐Koyanagi‐Harada (VKH) disease. Methods: Clinical charts of 39 patients (78 eyes) diagnosed with initial‐onset VKH disease were retrospectively reviewed. Age, gender, period from the onset of symptoms to first visit, visual acuity (VA), intraocular pressure (IOP), anterior chamber cells, serous retinal detachment (SRD), SD‐OCT findings, as well as fluorescein (FA), and indocyanine green angiography (ICGA) were collected. Results: FMS was observed in 24 out of 39 VKH patients in either eye (61.5%). VKH patients with FMS (FMS group) were significantly younger and had the shorter period from the onset of symptoms to the first visit compared with those without FMS (non‐FMS group). Mean logMAR VA and proportion of pooling of dye, mean central retinal thickness (CRT) were significantly higher in FMS group than in non‐FMS group. In contrast, hyperfluorescence of the optic disc on FA was more in non‐FMS group than in FMS group. Significant positive correlations between CRT and logMAR VA or IOP were only observed in the FMS group. Total amount of corticosteroids was significantly greater in FMS group than in non‐FMS group. However, there were no significant differences in LogMAR VA and IOP between two groups at 6 months after treatment initiation. Conclusion: FMS on SD‐OCT is a critical feature observed in the early stage of initial‐onset acute VKH disease, which is more common in younger patients and is related to the disease activity. [ABSTRACT FROM AUTHOR]

A 53-year-old man who has stage 4 non-small cell lung carcinoma and treated with Dabrafenib-Trametinib combination chemotherapy; presented with decreased bilateral visual acuity. We checked out slit lamp examination, fundoscopy, optical coherence tomography and fundus fluorescein angiography. In slit lamp biomicroscopy; bilateral posterior synechiae, granulomatous keratic precipitates and + 4 cells in the anterior chamber were detected. Cystoid macular edema and subretinal fluid accumulation were revealed in optical coherence tomography. Dabrafenib and Trametinib treatments were discontinued and systemic methylprednisolone, topical corticosteroid and topical cyclopentolate were started. His best corrected visual acuity was increased from counting fingers from 2 m to 0,9 bilaterally and cystoid macular edema and serous retinal detachment were completely regressed as a result of systemic and topical corticosteroid treatment. [ABSTRACT FROM AUTHOR]

We describe an unusual case of a 39-year-old woman with bilateral serous retinal detachments presenting in the setting of preeclampsia without hypertension. The patient was followed using multimodal ophthalmic imaging and found to have complete resolution of subretinal fluid with no sequelae. Purpose: To report a case of bilateral serous retinal detachments in a patient with preeclampsia without hypertension using multimodal ophthalmic imaging. Methods: Case report. Results: This case demonstrates the rare presentation of bilateral serous retinal detachment in a patient with preeclampsia without hypertension. Characteristic subretinal fluid was seen on examination and optical coherence tomography. No leakage was noted on fluorescein angiography. Treatment was deferred, and the subretinal fluid resolved within 3 weeks. Conclusion: Practitioners should be aware of the rare presentation of serous retinal detachments in preeclampsia, even in the absence of hypertension. Long-term sequelae are uncommon and usually only seen in severe disease. Delivery should be considered once serous retinal detachment develops. [ABSTRACT FROM AUTHOR]

Serous retinal detachment is a rare complication of preeclampsia and is usually bilateral. Chemosis and presumed bacillary layer detachment are even rarer complications. The combination of unilateral chemosis, serous retinal detachment, and bacillary layer detachment has never before been described in a patient with preeclampsia. Background/Purpose: To report a case of unilateral chemosis, serous retinal detachment (SRD), and presumed bacillary layer detachment in pregnancy. Methods: Clinical examination and multimodal imaging findings were reviewed and analyzed. Results: A 17-year-old female patient with severe preeclampsia was found to have unilateral chemosis and bullous SRD. Postpartum optical coherence tomography revealed thickened choroid and presumed bacillary layer detachment. Two weeks later, chemosis and SRD resolved, leaving behind mottled hyperpigmentation, drusen, and subretinal drusenoid deposits. Conclusion: The combination of chemosis and SRD in preeclampsia is exceedingly, rare and it has never previously been reported to occur unilaterally. With delivery, visual acuity, chemosis, choroidal thickness, and SRD all normalize. [ABSTRACT FROM AUTHOR]

We present a case of macular serous retinal detachment after pars plana vitrectomy and panretinal photocoagulation that was characterized by a reticular network of hyperreflective bands in the subretinal space on optical coherence tomography. Serous retinal detachment resolved spontaneously with standard postoperative regimen. Purpose: To describe a novel optical coherence tomography finding in a case of macular serous retinal detachment after pars plana vitrectomy and panretinal photocoagulation. Methods: Retrospective case report. Results: A 52 year old male with diabetes underwent uncomplicated pars plana vitrectomy with panretinal photocoagulation for non-clearing vitreous hemorrhage, Postoperative course was complicated by significantly decreased vision and a macular serous retinal detachment that was characterized on optical coherence tomography by a reticular network of hyperreflective bands in the subretinal space. Fluid and hyperreflective material in the subretinal space resolved by postoperative Week 6 with standard postoperative eye drops. However, persistent ellipsoid zone disruption was seen up to postoperative Week 20. Conclusion: Extensive subretinal bands can be seen after panretinal photocoagulation. This novel finding can pose diagnostic and management challenges but may resolve with conservative medical management. [ABSTRACT FROM AUTHOR]

We report 30 months follow-up of bilateral diffuse uveal melanocytic proliferation using multimodal imaging. Massive fibrin reaction was observed after cataract surgery. Secondary macular neovascularization was treated with antivascular endothelial growth factor therapy. Sudden increase in choroidal thickness at Month 23 occurred simultaneously with progress of lymph node metastases. Purpose: To report a case of bilateral diffuse uveal melanocytic proliferation over 30 months follow-up. Methods: Multimodal imaging including ultra-wide-field color fundus photography, blue light fundus autofluorescence, swept-source optical coherence tomography, fluorescein angiography, and indocyanine green angiography. Results: A 49-year-old woman presented with decreased vision 2 months after bladder cancer surgery. Exudative retinal detachment and leopard spot pattern chorioretinopathy were observed in the right eye. Chemotherapy and cystectomy were initiated. Progressive bilateral vision loss occurred with melanocytic proliferation, choroidal thickening, subretinal fibrosis, fluid extravasation, rapid development of mature cataract, multiple iris cysts, and rubeosis, despite plasmapheresis and IV immunoglobulins. After cataract surgery, massive fibrin reaction resulted in a ciliolenticular block. One year later, positron emission tomography–computed tomography revealed absence of metastases. At Month 23, choroidal thickness increased in line with tumor progression. Palliative systemic therapy was initiated. Secondary macular neovascularization was treated with intravitreal antivascular endothelial growth factor injections. Visual acuity was light perception in the right eye and 20/200 in the left eye at last follow-up. Conclusion: Bilateral diffuse uveal melanocytic proliferation results in progressive melanocyte proliferation and exudation, leading to severe visual loss. In our case, visual acuity was preserved at a low level in one eye under continuous systemic treatment. Systemic corticosteroids are recommended for cataract surgery in the setting of bilateral diffuse uveal melanocytic proliferation to prevent massive fibrin reaction. Intravitreal antivascular endothelial growth factor injections may be indicated if secondary macular neovascularization develops. [ABSTRACT FROM AUTHOR]

The aim of this paper was to report the cases of 3 consecutive patients with mitogen-activated protein kinase kinase inhibitor (MEKi)-associated retinopathy with characteristic multiple serous retinal detachments (SRDs). A functional analysis of the retinal pigment epithelium was performed in 2 patients by electro-oculography (EOG). In all 3 patients, SRD lesions were observed in the posterior pole including the fovea of both eyes. Interestingly, neither obvious leakage in fluorescein/indocyanine angiography nor abnormal fundus autofluorescence was associated. SRDs and associated cystoid macular edema in one case rapidly resolved with the cessation of MEKi but recurred quickly after treatment resumption. In EOG tests, three of four eyes with multiple SRDs showed a marked decrease in the light-peak-to-dark-trough ratio (LP:DT ratio). The LP:DT ratio in EOG reflects the transepithelial potential of the retinal pigment epithelium, suggesting the involvement of disrupted tight junctions and impaired active transport of fluid/ions in MEKi-associated retinopathy. The latter may be the major cause of SRDs as we observed that fluid leakage in angiography was absent in the areas of the patients' SRDs.

Abstract Background To analyze and compare the characteristics of macular morphology and microcirculation in diabetic macular edema (DME) patients with and without macular serous retinal detachment (SRD). Methods One hundred eyes in 81 patients diagnosed with the DME (the central macular thickness (CMT) of ≥ 300 μm) from March 2020 to November 2020 were selected. According to whether complicated with SRD, patients were divided into DME with SRD (60 eyes) and without SRD (40 eyes) groups. We analyzed the following parameters: CMT, central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), number of hyperreflective foci (HF) in the complete retina, inner retina, outer retina, and subretinal space, the integrity of the ellipsoid zone (EZ) and external limiting membrane (ELM), the presence of disorganization of inner retinal layers (DRIL), foveal avascular zone (FAZ) area, and the vascular flow density of superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris. Results (1) Compared to the group without SRD, the group with SRD had a greater CMT (P 0.05); 6. The presence of the SRD was correlated with the integrity of the ELM, the number of HF in the complete retina, outer retina, and subretinal space (χ2 = 26.930, OR = 0.707, 0.263, 0.995, P

Preeclampsia is a pregnancy-specific syndrome characterized by hypertension and proteinuria. We retrospectively investigated the clinical features, including choroidal layer thickness and luminal area to stromal area ratio, in a case series of preeclampsia with serous retinal detachment (SRD). The subjects were pregnant women with SRD during hospitalization for preeclampsia from October 2014 to June 2021. Based on medical records, affected eyes, time of onset, fundus examination findings, and subfoveal choroidal thickness (SCT), the choroidal layer thickness and choroidal vascular index (CVI) in each patient was examined. Thirteen eyes from seven patients (mean age 30.7 ± 4.7 years) were included in the study. In all cases, SRD improved without topical ocular treatment. The mean SCT at the initial visit was 424.4 ± 70.5 μm, and all patients had choroidal thickening, which significantly decreased to 286.0 ± 57.9 μm (p < 0.01) at the last visit. The mean choroidal inner layer was 162.7 ± 69.4 μm at the initial visit and 122.3 ± 35.5 μm at the final follow-up visit (p = 0.06), showing no significant difference; however, the mean choroidal outer layer was 261.7 ± 47.6 μm at the initial visit and 163.7 ± 37.1 μm at the final follow-up visit (p < 0.01), thus showing a significant decrease. The mean CVI was 67.2 ± 1.3% at the initial visit, yet it had significantly decreased to 65.4 ± 1.1% (p < 0.01) at the final follow-up visit. The findings of this study show that SRD with preeclampsia is associated with increased thickening of the choroidal outer layer, especially in the choroidal luminal area. [ABSTRACT FROM AUTHOR]

Report of a case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment in a young patient with chronic kidney disease with six-month follow-up. Purpose: Report a case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment in a young patient with chronic kidney disease. Methods: Observational case report. Results: An 18-year-old man with Grade 5 chronic kidney disease, systemic high blood pressure, secondary acute pulmonary edema, and acute uremic syndrome was referred to our service complaining of bilateral decreased vision starting one week ago. The patient was treated at that moment with hemodialysis and losartan. At initial examination, the patient's blood pressure was 170/120 mmHg; dilated fundus examination evidenced optic disk edema, hypertensive chorioretinopathy, and massive serous retinal detachment with best-corrected visual acuity of hand motion in both eyes. The case was diagnosed as undertreated hypertension and was referred to the nephrologist for treatment adjustments. At 1-month follow-up, blood pressure was 160/90 mmHg; there was clinical improvement in both eyes but with ischemic sequelae. At the final follow-up 6 months later, blood pressure was 100/60 mmHg, best-corrected visual acuity was 20/80 in the right eye and count fingers at 2 min the left eye, and there was a complete resolution of the retinal serous detachment in both eyes. Conclusion: Patients with massive serous detachments due to systemic hypertension are atypical so it is of immense importance for the ophthalmologists to recognize the ocular manifestations of systemic diseases that put the patient's life at risk as in this case. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the frequency and treatment response of eyes with bacillary layer detachment (BLD) in acute Vogt-Koyanagi- Harada (VKH) disease using spectral-domain optical coherence tomography (SD-OCT). Materials and Methods: We retrospectively reviewed the medical records of 58 eyes of acute VKH patients with at least 6 months of follow-up between January 2009 and March 2021. SD-OCT, color fundus photographs, and fluorescein angiography images were analyzed in all patients. Results: The study included 58 eyes of 29 patients. BLD was detected in 33 of the 58 eyes (56.9%) at baseline. Mean serous retinal detachment (SRD) height was 918.50±336.64 µm in the BLD group and 215.33±167.83 µm in the group without BLD (p<0.05). A positive correlation was found between SRD height and the presence of BLD (r=0.783, p<0.05). BLD was significantly more common in patients with a baseline SRD height greater than 500 µm (p<0.05). As subfoveal central choroidal thickness (CCT) could not be measured by enhanced depth imaging-OCT at baseline due to extreme choroidal thickness in all eyes, the earliest post-treatment CCT measurements were analyzed. At the completion of pulse steroid therapy, mean CCT was 425±82.87 µm in the BLD group and 385.58±82.87 µm in the group without BLD (p=0.04). The mean time to BLD resolution was 12.88±6.5 days (range: 2-26). Conclusion: BLD is a common tomographic finding in eyes with acute VKH disease and can be differentiated from the associated SRD through careful SD-OCT analysis. Though it is mostly observed in patients with more serious disease, the presence of BLD has no negative effect on long-term visual function. [ABSTRACT FROM AUTHOR]

Central serous chorioretinopathy (CSCR) is a disease characterized by serous detachment of the neurosensory retina in the macular area, caused by increased choroidal vascular permeability. The disease is more common in young and middle-aged men (20-50 years old), it has been shown to be highly correlated with an increased level of stress in patients. Other risk factors for the central serous chorioretinopathy are: type A personality (ambitious, nervous and emotional people), use of steroids, Cushing’s syndrome, helicobacter pylori infection, gastroesophageal reflux, hypertension, sleep apnea. The disease leads to visual impairment: metamorphopsia, blurred vision, color vision impairment, impaired contrast and vision in the dark. CSCR diagnostics include funduscopic examination of the eye through the Volk lens revealing focus of circular retinal elevation, optical coherence tomography (OCT), which is a quick and non-invasive test that allows the diagnosis and monitoring of the disease. In the past, the diagnosis was based on fluorescein angiography, the dye spilling out fills the detachment space, revealing the leak center. In most cases the shunt stops spontaneously and spontaneous resorption of the subretinal fluid occurs without the need for treatment. The chronic form of CSCR ongoing more than 4 months requires initiation of therapeutic procedures. The first- line treatment is laser therapy. Micropulse laser therapy of the retina stimulates the pigment epithelium to produce anti-angiogenic factors and inhibit the inflammatory process, as a consequence, the resorption of the subretinal fluid occurs with minimal damage to the retina.

BackgroundAplastic anemia can cause ophthalmic abnormalities in patients. Vision loss in a child with aplastic anemia due to massive retinal hemorrhages at various levels is rare.Case presentationA pediatric patient with aplastic anemia presented with retinal hemorrhages at multiple levels along with a serous retinal detachment in both eyes and subsequent retinal changes after pars plana vitrectomy.ConclusionAnemia and thrombocytopenia in aplastic anemia could cause severe retinal hemorrhages and result in retinal atrophy and retinal edema. Vitrectomy can be performed to remove vitreous hemorrhage, but risk factors for retinal atrophy and edema need further investigation.

To report a case of acute exudative polymorphous vitelliform maculopathy associated with primary Epstein–Barr virus infection. Multimodal imaging initially revealed bilateral diffuse thickening of the ellipsoid zone, hyperautofluorescence at the posterior pole, and foveal subretinal fluid which progressed to multiple vitelliform lesions. Purpose: To report a case of acute exudative polymorphous vitelliform maculopathy associated with primary Epstein–Barr virus infection. Methods: Multimodal imaging including color fundus photography, spectral-domain optical coherence tomography, blue-light fundus autofluorescence, fluorescein angiography, and indocyanine green angiography. Results: A 24-year-old otherwise healthy woman presented with an acute bilateral visual disturbance associated with cervical lymphadenopathy. Spectral-domain optical coherence tomography showed bilateral foveal serous retinal detachment (SRD) with thickening of the ellipsoid zone throughout the posterior pole corresponding to hyperautofluorescence on fundus autofluorescence, faint diffuse hyperfluorescence on fluorescein angiography without leakage, and mild late hyperfluorescence on indocyanine green angiography. Systemic workup revealed an acute Epstein–Barr virus infection. Within several weeks, multifocal SRDs developed in the macula and paramacula. The SRDs then became increasingly hyperautofluorescent with spectral-domain optical coherence tomography showing subretinal hyperreflective material. This vitelliform material then slowly resolved while the thickness of the surrounding ellipsoid zone normalized. The fluorescein angiography and indocyanine green angiography appeared normal at Month 8. Visual acuity was 20/20 in both eyes at all times. No treatment was initiated. Conclusion: Acute exudative polymorphous vitelliform maculopathy may be associated with an acute Epstein–Barr virus infection. Acutely, multimodal imaging revealed findings consistent with RPE dysfunction and reduced photopigment density. Subsequent accumulation of vitelliform material gradually resolved over an 8-month follow-up. [ABSTRACT FROM AUTHOR]