PURPOSE: To report a case of an orbital mass diagnosed as metastasis from small cell lung cancer and to provide a review of the literature. CASE SUMMARY: A 66-year-old male with a history of diabetes mellitus and hypertension presented with decreased visual acuity and exophthalmos in his left eye. He had been diagnosed with age-related macular degeneration 13 years prior and had a history of pneumonia that was treated for one month. The best corrected visual acuity was hand-motion in the right eye and 0.04 in the left eye. Optic disc swelling and splint hemorrhage of the left eye was observed on fundus examination. The left eye was protruded and eye movement was limited. On orbital magnetic resonance imaging, an irregular mass in the left intraconal space was found. Incisional biopsy was performed, and histopathologic examination revealed a small round tumor. According to the results of immunohistochemical staining, metastatic tumors were suspected. After systemic evaluation, the patient was diagnosed with primary small cell lung cancer with multiple metastases. After 2 months, the visual acuity was hand-motion and proptosis was not resolved. CONCLUSIONS: In patients with orbital masses, the possibility of metastatic tumors should be considered during differential diagnosis and early biopsy should be performed.
Aged ; Biopsy* ; Diabetes Mellitus ; Diagnosis, Differential ; Exophthalmos ; Eye Movements ; Hemorrhage ; Humans ; Hypertension ; Macular Degeneration ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Orbit* ; Pneumonia ; Small Cell Lung Carcinoma* ; Splints ; Visual Acuity

Dengue fever is an acute febrile disease that is caused by a mosquito-borne flavivirus. It has become a major infectious disease threat in tropical and subtropical areas. In Korea, travel-associated dengue fever is increasing. Thirty-five Koreans went to Sri Lanka to do volunteer activities. Eight of the volunteers developed fever, myalgia, and rash; they were diagnosed with dengue fever. Two patients had macular hemorrhages and edema with no ophthalmic symptoms. The maculopathy caused by the dengue fever improved without specific treatment.
Communicable Diseases ; Dengue* ; Edema ; Exanthema ; Eye Manifestations ; Fever ; Flavivirus ; Hemorrhage ; Humans ; Korea ; Myalgia ; Sri Lanka* ; Volunteers*

Acupuncture Therapy ; adverse effects ; Adolescent ; Adult ; Eye ; blood supply ; Eye Diseases ; therapy ; Hemorrhage ; etiology ; Humans ; Male

PURPOSE: To present easily measurable 2D orbit computed tomography (CT) reference data that can be used in a preoperative study for orbital decompression and classification of individual orbital morphologies. METHODS: The study sample was composed of 77 patients with orbital contusion (42 Asian males + 35 Asian females = 154 orbits) who visited the emergency room of the Korea University Guro Hospital from September 2012 to June 2013. Patients with orbital wall fracture, retrobulbar hemorrhage, or eyeball rupture were excluded. Medical records including 2D orbit or facial bone CT were retrospectively reviewed and 4 orbital parameters (orbital length, OL; globe length, GL; GL/OL ratio and 2D cone angle) were measured. RESULTS: The average OL was 42.53 +/- 2.46 mm (35.63-49.09 mm) and average GL was 24.83 +/- 1.09 mm (22.75-28.13 mm). The average GL/OL ratio using these 2 parameters was 0.59 +/- 0.04 (0.50-0.68). The posterior cone angle was on average, 45.96 +/- 5.91degrees (29.35-60.04degrees). CONCLUSIONS: Simple measurement of 4 parameters using 2D orbit CT and classification of Asian individual orbital morphology may help in the choice of the most effective surgical technique for decompression surgery in thyroid eye disease patients.
Asian Continental Ancestry Group ; Classification ; Contusions ; Decompression* ; Emergency Service, Hospital ; Eye Diseases* ; Facial Bones ; Female ; Humans ; Korea ; Male ; Medical Records ; Orbit* ; Retrobulbar Hemorrhage ; Retrospective Studies ; Rupture ; Thyroid Gland*

PURPOSE: To report a case of a full-thickness macular hole after a single intravitreal injection of ranibizumab in a patient with choroidal neovascularization associated with age-related macular degeneration. CASE SUMMARY: A 63-year-old woman presented to our department with gradually decreasing vision in her right eye. Best corrected visual acuity (BCVA) was measured as 0.7 in the right eye and 1.0 in the left eye. Examination of the macula showed a choroidal neovascularization associated with subretinal hemorrhage in the right eye. Optical coherence tomography (OCT) confirmed incomplete posterior vitreous detachment, subretinal hemorrhage and serous elevation. The patient subsequently received an intravitreal ranibizumab injection. After 1 month, the best corrected visual acuity in the right eye was decreased to 0.4, and fundus examination revealed posterior vitreous detachment and a macular hole. The patient underwent pars plana vitrectomy with internal limiting membrane peeling and fluid-air exchange, SF6 gas injection, phacoemulsification and posterior chamber intraocular lens implantation. Three months later, the macular hole had closed completely and best visual acuity was 1.0. CONCLUSIONS: Although the occurrence of a full-thickness macular hole after intravitreal ranibizumab injection is uncommon, physicians should be well acquainted with this complication.
Antibodies, Monoclonal, Humanized ; Choroidal Neovascularization ; Eye ; Female ; Hemorrhage ; Humans ; Intravitreal Injections ; Lens Implantation, Intraocular ; Macular Degeneration ; Membranes ; Phacoemulsification ; Retinal Perforations ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; Vitreous Detachment ; Ranibizumab

PURPOSE: To report a case of ischemic retinopathy due to suspicious gentamicin retinal toxicity after primary repair of a scleral laceration. CASE SUMMARY: A 45-year-old man presented to our department with decreasing vision in his right eye after ocular trauma. Best corrected visual acuity (BCVA) was 0.02 in the right eye and slit lamp examination revealed scleral laceration. Both intravenous and topical antibiotics (10% cefazolin and 2% gentamicin) were immediately administered. On intraoperative examination, a scleral laceration located 5 mm to 11 mm from nasal limbus, prolapsed vitreous body and partial division of medial rectus muscle were observed. After irrigation with gentamincin 0.2% around the wound, primary repair was performed. On postoperative day 3, fundus examination revealed a retinal break, barrier laser was performed. On postoperative day 4, diffuse retinal edema with intraretinal hemorrhage was observed as well as, superonasal ghost vessels. Subsequently, fluorescein angiography showed diffuse leakage of retinal vessels and a nonperfusion area at the periphery, especially on the nasal side. As vitreous opacity became worse, the patient underwent pars plana vitrectomy with endolaser. One month later, vitreous cavity was clearer and best visual acuity was 0.2. CONCLUSIONS: Large doses of intraocular gentamicin ccan cause retinal toxicity. Increased gentamicin application through a scleral laceration may lead to toxic antibiotic levels. When a scleral laceration wound irrigation is performed, precautions are necessary to prevent retinal ischemia associated with gentamicin toxicity.
Anti-Bacterial Agents ; Cefazolin ; Eye ; Fluorescein Angiography ; Gentamicins ; Hemorrhage ; Humans ; Ischemia ; Lacerations ; Muscles ; Papilledema ; Retinal Perforations ; Retinal Vessels ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; Vitreous Body

PURPOSE: To report a case of severe vaso-occlusive retinopathy with significant decrease of bilateral visual acuity as the first manifestation associated with systemic lupus erythematosus (SLE). CASE SUMMARY: A 23-year-old man was referred to our clinic with bilateral visual impairment of hand motion (HH). Fundus examination revealed severe retinal hemorrhage, cotton-wool patch, occlusive retinal vasculitis with vascular engorgement, and diffuse retinal edema in both eyes. Because of a malar rash on both cheeks, generalized edema was observed on initial examination with hypertension, azotemia, anemia, and thrombocytopenia, The patient was diagnosed with SLE, strongly positive to antinuclear antibody (ANA), and received an intravitreal injection of Bevacizumab (Avastin, Genentech Inc., San Francisco, CA, USA) in the left eye in addition to hemodialysis, transfusion, systemic corticosteroid and immunosuppressant treatment due to lupus nephritis. Eighteen months later, the retinal edema, cotton-wool patch and hemorrhage resolved, leaving epiretinal membrane without traction in his left eye and diffuse degeneration of the right eye. Final visual acuity was HM in the right eye and 20/100 in the left eye. CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. In a patient with a high possibility of SLE retinopathy, a periodic fundus examination and intensive management of systemic disease should be considered.
Anemia ; Antibodies, Antinuclear ; Antibodies, Monoclonal, Humanized ; Azotemia ; Cheek ; Edema ; Epiretinal Membrane ; Exanthema ; Eye ; Hand ; Hemorrhage ; Humans ; Hypertension ; Intravitreal Injections ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Papilledema ; Renal Dialysis ; Retinal Hemorrhage ; Retinal Vasculitis ; San Francisco ; Thrombocytopenia ; Traction ; Vision Disorders ; Visual Acuity ; Bevacizumab

PURPOSE: To introduce a case of complicated ophthalmopathy in herpes zoster ophthalmicus including vitreous opacity, retinal hemorrhage and optic neuropathy having components of anterior ischemic optic neuropathy and optic neuritis. CASE SUMMARY: A 59-year-old man visited our clinic because of visual disturbance in the right eye which occurred after right facial pain and vesicles. There were inflammatory cells in the anterior chamber, retinal hemorrhage in the retina and vitreous opacity was found. Track-like high signal intensity along the right optic nerve was found on T1 MRI. Partial filling defect of optic disc was observed on fluorescein angiography (FAG). The patient was diagnosed with herpes zoster ophthalmicus complicated by anterior uveitis and optic neuropathy having components of anterior ischemic optic neuropathy and optic neuritis. The patient was started on intravenous acyclovir at a dose of 10 mg/kg every 8 hours for 5 days and Herpesid eye ointment 5 times daily. After the initial treatment, oral acyclovir 400 mg was given 3 times daily for 14 days. Skin symptoms and fundus findings improved but the visual acuity did not improve because of optic atrophy. CONCLUSIONS: Ophthalmopathy including anterior uveitis, vitreous opacity, retinal hemorrhage and optic neuropathy having components of anterior ischemic optic neuropathy and optic neuritis should be considered in herpes zoster ophthalmicus patients.
Acyclovir ; Anterior Chamber ; Eye ; Facial Pain ; Fluorescein Angiography ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Optic Nerve ; Optic Nerve Diseases ; Optic Neuritis ; Optic Neuropathy, Ischemic ; Retina ; Retinal Hemorrhage ; Retinaldehyde ; Skin ; Uveitis, Anterior ; Visual Acuity

PURPOSE: To report a case of bilateral occlusive retinal vasculitis presumed to be associated with intravenous ceftriaxone injection. CASE SUMMARY: A 26-year-old woman presented with a sudden visual impairment which developed 2 days earlier in her left eye combined with an anaphylactoid reaction. The patient was administered intravenous ceftriaxone (2 g / day) 9 times for 14 days due to aggravation of chronic osteomyelitis on her left ankle. There were no adverse events until the 7th intravenous ceftriaxone administration. However, anaphylactoid reactions occurred shortly after the 8th and 9th administration. On the 1st visit, her best corrected visual acuity in the right eye was 1.0, and in the left eye 0.1. On fundus examination, retinal hemorrhages and perivascular sheathing were observed in the superonasal area in the right eye and in the entire retina in the left eye. Anterior chamber cell reactions were not noted on slit lamp examination, and vitritis was absent in both eyes. Laboratory data showed no conclusive evidence of autoimmune or origin of infection. On the last visit, 25 months after the initial visit, the patient's best corrected visual acuity was 0.02 in the left eye and visual acuity and fundus appearance were normal in the right eye. CONCLUSIONS: Bilateral occlusive retinal vasculitis may be associated with intravenous ceftriaxone injection, and immunological and serological tests should be performed thoroughly along with history taking to clarify the cause of retinal vasculitis.
Animals ; Ankle ; Anterior Chamber ; Ceftriaxone ; Drug Hypersensitivity ; Eye ; Female ; Humans ; Hypersensitivity ; Osteomyelitis ; Retina ; Retinal Hemorrhage ; Retinal Vasculitis ; Retinaldehyde ; Serologic Tests ; Vision Disorders ; Visual Acuity

PURPOSE: To evaluate the effect of intravitreal expansile gas (C3F8) with anti-VEGF injection for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (ARMD). METHODS: In this report, 18 eyes of 18 patients with large SMH secondary to ARMD were treated with a simultaneous injection of 0.3 cc C3F8 and 0.05 ml anti-VEGF intravitrealy. RESULTS: The mean age was 64.89 +/- 5.68 years and the mean size of SMH was 4.44 +/- 1.25 disc diameters (DD). The minimum follow-up period was 12 months (range: 12-17 months). Mean preoperative best corrected visual acuity (BCVA) was 1.72 +/- 0.56 log MAR which improved significantly to 1.01 +/- 0.68 log MAR at 12 months (p = 0.002). SMH displacement occurred in all eyes. BCVA improved 2 or more lines in 11 eyes (61.1%) and deteriorated in 1 eye (5.6%). CONCLUSIONS: In this report, intravitreal injection of an expansible gas (C3F8) with anti-VEGF produced successful results in anatomical displacement of SMH and early visual improvement.
Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Visual Acuity