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 globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). CASE SUMMARY: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. CONCLUSIONS: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.
Acupuncture ; Acupuncture Therapy ; Adult ; Blepharospasm ; Disaccharides ; Epiretinal Membrane ; Eye ; Female ; Humans ; Intraocular Pressure ; Korea ; Light Coagulation ; Needles ; Nerve Fibers ; Retinal Perforations ; Retinaldehyde ; Tomography, Optical Coherence ; Vision Disorders ; Visual Acuity ; Visual Field Tests ; Visual Fields ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To report a case of Purtscher's retinopathy with diffuse serous macular detachment. CASE SUMMARY: A 63-year-old male patient presented to the hospital with decreased visual acuity. Three days prior to visiting the hospital, he had an blunt injury to the thoracic region caused by a steel beam, and his best corrected visual acuity was 20/50 in the right eye and 20/160 in the left eye. On slit lamp examination nothing unusual was observed in either eye, but fundus examinations showed retinal hemorrhages and a cotton wool spots on the posterior pole of the left eye and nothing unusual in the right eye. On fluorescein angiography, severe nonperfusion was observed at the posterior pole of the left eye. On optical coherence tomography, there was diffuse serous retinal detachment at the posterior pole and inferior retina of the left eye while mild subretinal fluid was observed at the posterior pole of the right eye. Under the suspicion of Purtscher's retinopathy in both eyes, oral prednisolone (40 mg) was prescribed and the dosage was gradually reduced. Six weeks after the treatment, best corrected visual acuity improved to 20/20 in the right eye, and 20/30 in the left eye. Additionally, subretinal fluid in the right eye completely disappeared. CONCLUSIONS: Purtscher's retinopathy is known as an ocular disease occurring after traumatic events. However, serous detachment of the macula has rarely been observed in Purtscher's retinopathy, and herein we report a case with diffuse serous macular detachment which responded to oral steroid treatment.
Eye ; Fluorescein Angiography ; Humans ; Male ; Prednisolone ; Retina ; Retinal Detachment ; Retinal Hemorrhage ; Steel ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Wool ; Wounds, Nonpenetrating

PURPOSE: To report a case of sudden orbital cellulitis presenting 2 weeks after strabismus surgery in a patient who had previously undergone retinal surgery for rhegmatogenous retinal detachment. CASE SUMMARY: A 45-year-old male visited the ophthalmology clinic with a 3-day history of left eye pain and lid swelling which suddenly developed 2 weeks after left lateral rectus muscle recession surgery for secondary sensory exotropia. The patient had undergone trans pars plana vitrectomy twice, scleral encircling, oil injection and removal for rhegmatogenous retinal detachment 1.3 years prior. His best corrected visual acuity was 0.2 in his left eye and physical examination revealed eyelid edema, chemosis, and subconjunctival hemorrhage of the left eye. The next day, eye movements were moderately restricted. Computed tomography scanning with contrast enhancement demonstrated diffuse periorbital soft tissue swelling and enhanced fat stranding suggesting left orbital cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. He was discharged after a 5-day course of intravenous antibiotic treatment, but readmitted for symptom aggravation and purulent discharge from the left conjunctival fornix. Culture of conjunctival fornices revealed penicillin-resistant staphylococcus aureus. Intravenous anitibiotics were maintained for 11 days additionally and left eye swelling, tenderness and ocular movement restrictions were improved. The patient was discharged from the hospital with a best corrected visual acuity of 0.2.
Anti-Bacterial Agents ; Edema ; Exotropia ; Eye ; Eye Movements ; Eye Pain ; Eyelids ; Hemorrhage ; Humans ; Male ; Muscles ; Ophthalmology ; Orbit ; Orbital Cellulitis ; Physical Examination ; Retinal Detachment ; Retinaldehyde ; Staphylococcus aureus ; Strabismus ; Visual Acuity ; Vitrectomy

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