Purpose: To report a case of multiple retinal capillary hemangioma associated with neurofibromatosis type 1 and resulting neovascularglaucoma.Case summary: A 13-year-old boy was admitted with complaint of visual disturbance and dull pain in his left eye which had beguntwo weeks prior. Lisch nodules were observed in his left iris and corneal opacity with neovascularization of the iris and anglewere detected in the same eye. Multiple retinal capillary hemangiomas with increased tortuosity and congestion of feeding retinalvessels were observed on the upper equator of the left retina; in addition, vitreous hemorrhage was observed. There were noother abnormalities except iris mammillations in the right eye. Numerous café au lait macules were observed on the patient’s entirebody. He also exhibited axillary freckling. On brain magnetic resonance imaging, T2-weighted signal intensity was increasedin the basal ganglia, left thalamus, and cerebellar white matter; however, no vessel abnormalities were observed on magneticresonance angiography. High intraocular pressure (IOP) persisted despite the use of IOP lowering agents and IOP was normalizedafter trabeculectomy with mitomycin C administration. Conclusions This case shows that multiple retinal capillary hemangiomas can be accompanied by neurofibromatosis type 1,which may result in neovascular glaucoma.

No abstract available.
Ehlers-Danlos Syndrome*

Bacteria ; Colon ; Crystallins ; Freezing ; Inflammation ; Microscopy, Electron, Scanning ; Mucous Membrane ; Peri-Implantitis ; Titanium

Purpose: To report a case of extensive syphilitic punctate inner retinitis (SPIR) triggering bilateral macular ischemia after intravitreal triamcinolone injections, and the multimodal retinal imaging findings.Case summary: A 69-year-old male patient with nonproliferative diabetic retinopathy was transferred to our hospital because of bilateral visual deterioration (to counting fingers) after the first intravitreal triamcinolone injection. Fundus examination revealed numerous yellow punctate precipitates in the superficial retinae, retinal arteriolitis, and vitritis. The punctate lesions and surrounding retinal regions showed decreased vascular density on optical coherence tomography angiography, and focal hypofluorescence on fluorescein angiography. The patient was positive for all of the Venereal Disease Research Laboratory test, the fluorescent treponemal antibody-absorption test, and Treponema pallidum hemagglutination; we diagnosed bilateral SPIR. After treatment with aqueous crystalline penicillin solutions (24 million units per day for 14 days), the punctate lesions reduced but arteriolitis progressed to obliterative vasculitis. After 6 months, the bilateral SPIR and vitritis resolved, and the bilateral visual acuity improved to 20/100. However, inner retinal and macular ischemia persisted because of capillary nonperfusion attributable to obliterative vasculitis. Conclusions Extensive SPIR can develop after an initial intravitreal steroid injection; the inner retinal ischemia and visual loss may persist after treatment because obliterative vasculitis develops. Therefore, patients scheduled for intravitreal steroid injections should be screened for syphilis infection.

Objective: This study examined the effect of social situations on risky decision-making in individuals with a borderline personality tendency (BT). Methods: Fifty-eight participants with either high or low levels of BT were included in this study. Those who met the screening criteria were assigned to one of the two social situations (exclusion vs. inclusion) and they played the Cyberball game. Next, the participants were required to play the “Game of Dice” task to measure their decision-making pattern. Results: The results revealed that individuals with high BT (n=28) showed significantly higher risky decision-making, compared with low BT (n=30) in the exclusion condition. However, no significant difference was found in the social inclusion condition. Conclusion In the social exclusion condition, individuals with high BT made risky decision in response to negative feedback, regardless of the previous decision. These findings can be applied to develop appropriate interventions in psychotherapy for individuals with borderline personality disorder/tendency.

Pleomorphic xanthoastrocytoma(PXA) is a rare neoplasm with favorable prognosis despite of its aggressive histological features. The authors report three cases of pleomorphic xanthoastrocytomas. The masses were in the temporal or parietal lobe of children or adolscence and presented as complex partial seizures. Total removal of mass was performed in all three cases and the seizure was abscent postoperatively. It is important to differentiate of pleomorphic xanthoastrocytoma from other malignant brain tumors and identify this type of glioma as a distinct entity.
Brain Neoplasms ; Child ; Glioma ; Humans ; Parietal Lobe ; Prognosis ; Seizures

Schwannoma is a benign tumor originating from the peripheral nerve sheath. A 16-year-old man have experienced progressive swelling of the nasal tip over 4 years. Computed tomography scan showed a 2.5 cm sized soft tissue density at the nasal tip. It distorted and dislocated the lower lateral cartilage. The mass was resected using an external rhinoplasty approach. The nasal tip was reconstructed by tip surgery and the soft tissue defect under the skin due to mass was filled with autologous dermal graft. The pathologic diagnosis was a schwannoma. A nasal tip schwannoma is extremely rare. Here, we present and discuss the clinical and surgical aspects of schwannoma arising on the nasal tip.
Adolescent ; Cartilage ; Humans ; Neurilemmoma ; Nose ; Peripheral Nerves ; Rhinoplasty ; Skin ; Transplants

Purpose: To investigate characteristics of optical coherence tomography angiography (OCTA) findings in chronic inactive branch retinal vein occlusion (BRVO) with quantitative analysis. Methods: The medical records of 48 eyes diagnosed with unilateral ischemic acute BRVO, and without recurrence for 6 months after the acute treatment, were reviewed retrospectively. We manually segmented the abnormal vessels of the superficial and deep capillary plexus (SCP-AV and DCP-AV, respectively) and vascular congestion of DCP (DCP-VC) from 6 × 6 mm2 macular OCTA images and automatically calculated the area, vessel density, and average retinal thickness of each corresponding region. Correlations were analyzed between the OCTA parameters of the segmentation area and the baseline characteristics. Results: The DCP-AV area was always wider than that of the SCP-AV (p < 0.001), with a transitional zone (TZ) between the two areas. About two-thirds of the DCP-VC area was distributed in the TZ. The vessel density of the DCP-VC was higher than that of the normal capillary plexus (all, p < 0.001). The average retinal thickness of the DCP-VC was greater than those of SCP-AV and DCP-AV areas (all, p < 0.001), but not different from the normal capillary plexus. The greater the extent of the DCP-VC distribution under the SCP-AV, the fewer the number of injections required to reach stabilization (r = -0.314, p = 0.030). Conclusions DCP-VC in chronic inactive BRVO was mainly distributed in the TZ with high vessel density. DCP-VC seems to provide a drainage pathway with minimal resistance against elevated intravenous pressure, which may sustain the anatomical stability of chronic BRVO.

Purpose: To investigate characteristics of optical coherence tomography angiography (OCTA) findings in chronic inactive branch retinal vein occlusion (BRVO) with quantitative analysis. Methods: The medical records of 48 eyes diagnosed with unilateral ischemic acute BRVO, and without recurrence for 6 months after the acute treatment, were reviewed retrospectively. We manually segmented the abnormal vessels of the superficial and deep capillary plexus (SCP-AV and DCP-AV, respectively) and vascular congestion of DCP (DCP-VC) from 6 × 6 mm2 macular OCTA images and automatically calculated the area, vessel density, and average retinal thickness of each corresponding region. Correlations were analyzed between the OCTA parameters of the segmentation area and the baseline characteristics. Results: The DCP-AV area was always wider than that of the SCP-AV (p < 0.001), with a transitional zone (TZ) between the two areas. About two-thirds of the DCP-VC area was distributed in the TZ. The vessel density of the DCP-VC was higher than that of the normal capillary plexus (all, p < 0.001). The average retinal thickness of the DCP-VC was greater than those of SCP-AV and DCP-AV areas (all, p < 0.001), but not different from the normal capillary plexus. The greater the extent of the DCP-VC distribution under the SCP-AV, the fewer the number of injections required to reach stabilization (r = -0.314, p = 0.030). Conclusions DCP-VC in chronic inactive BRVO was mainly distributed in the TZ with high vessel density. DCP-VC seems to provide a drainage pathway with minimal resistance against elevated intravenous pressure, which may sustain the anatomical stability of chronic BRVO.