Mcknightnoel5943

Often misdiagnosed as melanoma, melanocytoma of the optic disc is a rare benign ocular lesion that requires minimal active intervention, but demands a life time follow-up. We present a case of a 32-year-old man who was referred to our institute for the management of choroidal melanoma of the optic disc, which was detected by chance when the patient presented to a general ophthalmologist with chief complaint of itching in both eyes. The patient had normal visual acuity and fundoscopy revealed classical optic disc melanocytoma. The ancillary tests confirmed the diagnosis. The patient was kept under follow-up for four years, which showed no increase in size of the lesion. The purpose of this presentation was to highlight the identifying features of ocular melanocytoma and differentiate it from other conditions requiring urgent intervention.As the first and only presenting feature of acute myeloid leukemia (AML), unilateral proptosis in children is uncommon. We report the cases of two girls who had no systemic clinical manifestations of AML. Orbital imaging showed space-occupying infiltrating lesions without surrounding bone erosion. Incisional biopsy and immunohistochemistry were diagnostic for myeloid sarcoma. Systemic workup and bone marrow examination showed features of AML. Systemic chemotherapy was administered to both children, who responded well to the treatment. Myeloid sarcoma should be kept in the differentials of the children presenting with isolated proptosis. Immunohistochemistry may provide an accurate diagnosis and early treatment may lead to a prompt recovery with a good prognosis.Objective To report a case of hypercorrection of astigmatism (Cyl) after implantation of 2 segments of short arch ring for keratoconus treatment and to describe its replacement by long arch segment. Methods This is a case report of a patient with keratoconus and no adaptation to glasses or contact lenses, who was implanted 2 ring segments upper nasal (155º/ 200μm) and inferior temporal (155º/ 250μm). Results First postoperative month CVA = 20/ 50 (-10.50-2.50x135°) and SimK K1 = 48.4x143° and K2 = 51.2x53° (Cyl 2,8D). In the 3rd year CVA 20/ 30 (-6.00-2.50x135º), with inversion of the axes K1 = 49,5x60º and K2 = 52,0x150º (Cyl 2,6D). The hypercorrection increased up to the 8th year CVA = 20/40 (-4,50-6,00x75º) and SimK 47,8x51º/ 60,4x141º (Cyl 12,6D). The 2 segments were replaced for a single segment (320º/ 300μm) and after 1 month CVA = 20/ 25 (-5,75 spherical) with SimK 46,8x38º/ 48,9x128º (Cyl 2,1D). Conclusion The ring aims to flatten the most curved meridian, but surpassing the previous value induces astigmatism in the opposite meridian. The hypercorrection of the 2 short segments must occur due to its movement of the extremities, which does not occur with the single long arc segment (≥ 300º). Abbreviations CVA = Corrected visual acuity, SimK = Simulated keratometry, LE = Left eye, RE = Right eye.Case Description A 16-year-old male patient presented with a 12-days sudden painless loss of vision in his left eye after diving in a lake. Best corrected visual acuity (BCVA) in the left eye was counting fingers. Anterior segment was unremarkable. Fundoscopy in the left eye revealed a pre-retinal hemorrhage in the macular region and swept-source ocular coherence tomography (SS-OCT) confirmed the location in the sub-inner limiting membrane (ILM) space. An NeodymiumYAG (NdYAG) laser membranotomy was performed the next day in order to drain the hemorrhage into the vitreous cavity. A couple of days after, the BCVA in the left eye improved to 20/ 25, at fundoscopy the blood being almost reabsorbed and the SS-OCT showing a resolution of the sub-ILM hemorrhage. Discussion Due to Valsalva retinopathy, sub-ILM hemorrhage may lead to a sudden painless vision loss. Spontaneous resolution of the hemorrhage is possible but absorption may take a long time. During this period, intraretinal tissue migration and proliferation may lead to permanent structural damage. Posterior vitrectomy is a treatment option but the fact that it is an invasive procedure fuels the search for less invasive treatment methods and NdYAG laser membranotomy fits this place. Conclusion Given the excellent results and low complication rates, NdYAG laser membranotomy is highly recommended to treat this condition as it offers a simple, relatively safe and a non-invasive treatment option for drainage of sub-ILM hemorrhages.Iodine is an essential mineral that is necessary for the synthesis of thyroid hormones, which can cause many diseases in the body. The application of adding potassium iodate to table salts started in Turkey in 1998. High doses of iodate cause retinal toxicity, leading to significant vision loss. A 42-year-old paranoid schizophrenic patient who attempted suicide with pure iodine was admitted with bilateral vision loss. Widespread retinal pigment epithelium (RPE), ellipsoid zone (EZ) and interdigitation zone (IZ) damage were present in the optical coherence tomography (OCT) assessment. Fundus autofluorescence (FAF) findings, which included hypoautofluorescence areas that supported this condition, were also found. In conclusion, iodate in high doses is toxic on RPE, EZ and IZ. This situation could be irreversible depending on the dose.A 53-year-old lady presented with inferior retinal detachment (RD) following focal laser for retinal artery macroaneurysm (RAM). She underwent focal laser with intravitreal gas injection elsewhere; however, no retinal break was localized on the examination. The patient was taken up for vitreoretinal surgery. Intraoperatively, it was noted that the retinal detachment was not extending to the retinal periphery and primary retinal break was not localized even during the scleral depression. Colcemid Under high magnification, using a macular lens, a slit-like retinal break was noted at the area of previous focal laser. Focal laser for RAM probably caused this retinal break leading to RD. The clinician needs to be aware that during focal laser of ruptured RAM, haemorrhage may preclude the view of retinal structures leading to inadvertent use of excessive laser energy. Retinal breaks may form at the site of laser due to coagulative necrosis. During surgical management of RD in such cases, the area of focal laser should be thoroughly examined under high magnification to avoid missed breaks.