An 8-year-old Shih Tzu, a 5-year-old Maltese, and a 10-year-old Maltese presented with conjunctival hyperemia and peripheral corneal edema. Severe conjunctival thickening with varying degrees of corneal extension was observed. Cytological examination showed many large lymphocytes with malignant changes in the conjunctiva which was consistent with findings in fine-needle aspiration samples taken from regional lymph nodes. They were diagnosed as having Stage V multicentric lymphoma. When conjunctival thickening is observed in canine patients with multicentric lymphoma, conjunctival metastasis with infiltration of neoplastic lymphoid cells should be included in the differential diagnosis.
Animals ; Biopsy, Fine-Needle ; Child ; Child, Preschool ; Conjunctiva ; Cornea ; Corneal Edema ; Diagnosis, Differential ; Dogs ; Humans ; Hyperemia ; Lymph Nodes ; Lymphocytes ; Lymphoma ; Neoplasm Metastasis ; Uvea

PURPOSE: We report two cases of uveo-meningeal syndrome involving the retina, uvea, and optic disc in both eyes after viral meningitis. CASE SUMMARY: A 16-year-old female was referred to our department with blurred vision in both eyes. She was hospitalized in the pediatric ward with viral meningitis. She showed a norma best-corrected visual acuity (BCVA) and normal intraocular pressure in both eyes, but had severe inflammation in the anterior chamber on slit lamp examination, and optic disc edema and multiple whitish lesions on fundus examination. She was treated with intravenous antibiotic injections and steroid eye drops. After close observation, inflammation in the anterior chamber, optic disc edema, and the multiple whitish lesions in the retina were improved. A 27-year-old male who was treated for viral meningitis at the neurology department was referred to us with blurred vision in both eyes. His BCVAs were 0.7 (right eye) and 0.6 (left eye). The intraocular pressure was normal in both eyes. Slit lamp examination revealed inflammation in the anterior chamber and optic disc edema, and a fundus examination revealed multiple infiltrations. He received treatment for presumed herpes virus infection. After close observation, inflammation in the anterior chamber, optic disc edema, and multiple infiltrations with hemorrhage in the retina were improved. CONCLUSIONS: Clinicians should consider the possibility of uveo-meningeal syndrome, which can cause inflammation in the uvea,retina, and optic disc simultaneous with viral meningitis accompanying blurred vision.
Adolescent ; Adult ; Anterior Chamber ; Edema ; Female ; Hemorrhage ; Humans ; Inflammation ; Intraocular Pressure ; Male ; Meningitis ; Meningitis, Viral ; Neurology ; Ophthalmic Solutions ; Retina ; Slit Lamp ; Uvea ; Vision Disorders ; Visual Acuity

Systemic lupus erythematosus (SLE) is a complex connective tissue disease involving multiple organs including various ocular structures including the eyelid, orbit, ocular adnexa, sclera, cornea, retina, uvea, and optic nerve. Keratoconjunctivitis sicca is the most common ocular manifestation resulting in patients that suffer from dry eye symptoms, whereas severe vaso-occlusive lupus retinopathy is the most vision-threatening condition associated with the disease. SLE is a serious systemic disease that may first present with ocular manifestations. In addition, ocular manifestations are often associated with severe systemic inflammation and can be a marker for systemic prognosis. Thus, it is important for ophthalmologists to be aware of the association of visual disorders with SLE to detect and treat the ocular manifestations of SLE.
Connective Tissue Diseases ; Cornea ; Eyelids ; Humans ; Inflammation ; Keratoconjunctivitis Sicca ; Lupus Erythematosus, Systemic* ; Optic Nerve ; Orbit ; Prognosis ; Retina ; Sclera ; Uvea ; Vasculitis ; Vision Disorders

Eye globe abnormalities can be readily detected on dedicated and non-dedicated CT and MR studies. A primary understanding of the globe anatomy is key to characterising both traumatic and non-traumatic globe abnormalities. The globe consists of three primary layers: the sclera (outer), uvea (middle), and retina (inner layer). The various pathological processes involving these layers are highlighted using case examples with fundoscopic correlation where appropriate. In the emergent setting, trauma can result in hemorrhage, retinal/choroidal detachment and globe rupture. Neoplasms and inflammatory/infective processes predominantly occur in the vascular middle layer. The radiologist has an important role in primary diagnosis contributing to appropriate ophthalmology referral, thereby preventing devastating consequences such as vision loss.
Adult* ; Diagnosis ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Ophthalmology ; Pathologic Processes ; Referral and Consultation ; Retina ; Rupture ; Sclera ; Uvea

BACKGROUND: Intraocular lymphoma (IOL) is a rare malignant lymphoma that most closely resembles a diffuse large B-cell lymphoma, and it is a subtype of primary central nervous system lymphoma (PCNSL). IOL is located inside the eye in the retina, uvea, and/or optic nerve. We retrospectively analyzed IOL patient data to identify treatment patterns and survival rates in Korea. METHODS: Cytological confirmation for a diagnosis of IOL was performed for all patients. The clinical data collected from medical records included Ann Arbor stage, International Prognostic Index, performance status, date of diagnosis, treatment modality and response, date of relapse, and date of last follow-up. RESULTS: Twenty patients who were diagnosed with IOL, between December 2007 and June 2014 at multiple centers in Korea, were included in the analysis. Four patients were diagnosed with IOL alone, not involving the CNS. Two patients with isolated IOL later developed PCNSL. Nine patients developed CNS lesions before the onset of ocular lymphoma. Five patients had simultaneous onset in the eye and CNS. Twelve patients were treated by intravitreal injection of methotrexate for IOL. The median progression-free survival (PFS) for patients was 19.7 months (95% CI, 8.7-30.7 mo). The estimated 3-year overall survival (OS) for all patients was 75.1%. CONCLUSION: Treatment for IOL patients included radiotherapy and intraocular chemotherapy. IOL patients showed favorable PFS and OS. These patients would require long-term follow-up to identify relapse and adverse effects of radiotherapy or intraocular chemotherapy.
Central Nervous System ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Intraocular Lymphoma* ; Intravitreal Injections ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Medical Records ; Methotrexate ; Optic Nerve ; Radiotherapy ; Recurrence ; Retina ; Retrospective Studies ; Survival Rate ; Uvea

PURPOSE: To report a case of delayed-onset expulsive suprachoroidal hemorrhage due to trauma after removal of a penetrating keratoplasty suture. CASE SUMMARY: A 66-year-old man had penetrating keratoplasty for bullous keratopathy performed in his left eye. After 1 year, the continuous suture was removed for adjustment of astigmatism. Four days after removal of the suture, the patient struck his left eye with the back of his hand, although at the time of injury he had no specific symptoms. Two days later, the patient noticed abrupt pain, decreased visual acuity, and massive hemorrhage in his left eye. Examination revealed an inferior wound dehiscence of approximately 8 clock hours (2 thru 10 o'clock) with prolapsed intraocular contents such as the uvea and retina. The patient underwent cornea graft resuturing with resection of ocular contents, which could not be repositioned. Although bleeding was controlled after the operation, vision was lost in his left eye. After two months, according to decrement of intraocular hematoma, the patient had a phthisis bulbi with low intraocular pressure in his left eye. CONCLUSIONS: Persistent low intraocular pressure due to wound leakage through the graft-host junction likely resulted in delayed onset of expulsive suprachoroidal hemorrhage. The risk of traumatic corneal graft rupture after penetrating keratoplasty is significant and is associated with a poor visual outcome and eyeball viability. Therefore, patients should be cautioned. In addition, the importance of eye examination after trauma should be emphasized.
Aged ; Astigmatism ; Cornea ; Eye ; Hand ; Hematoma ; Hemorrhage ; Humans ; Intraocular Pressure ; Keratoplasty, Penetrating ; Retina ; Rupture ; Sutures ; Transplants ; Uvea ; Vision, Ocular ; Visual Acuity

Vogt-Koyanagi-Harada (VKH) syndrome is an uncommon multisystem autoimmune disease affecting the melanocytes located in the uvea, inner ear, skin, hair, and meninges. The syndrome is frequently reported by ophthalmologists since the most consistent finding is uveitis. Hearing loss, tinnitus and vertigo are the symptoms of VKH syndrome. The authors report one case of VKH syndrome with hearing loss and vertigo with related literature.
Autoimmune Diseases ; Ear, Inner ; Hair ; Hearing ; Hearing Loss ; Melanocytes ; Meninges ; Skin ; Tinnitus ; Uvea ; Uveitis ; Uveomeningoencephalitic Syndrome ; Vertigo

Sarcoidosis is a granulomatous disease that can involve any organ, although it primarily involves the lungs, intrathoracic lymph nodes, skin, and eyes. We present a case of sarcoidosis with pancytopenia, resulting from bone marrow involvement. A 35-year-old man was admitted to hospital for chronic cough and blurred vision. On chest computed tomography, there were multiple pulmonary nodules and mediastinal lymph nodes enlargement. As the patient also showed pancytopenia, we performed a bone marrow biopsy, as well as a transbronchial lung biopsy. Both biopsies showed non-caseating granulomas. We diagnosed the patient with sarcoidosis with pulmonary, bone marrow, uvea, liver and spleen involvement. After oral steroid therapy, the patient's symptoms as well as his pancytopenia improved. We present this case to demonstrate the significance of bone marrow biopsy in cases of sarcoidosis with pancytopenia, as well the possibility of clinical improvement with steroid treatment.
Adult ; Biopsy ; Bone Marrow ; Cough ; Eye ; Granuloma ; Humans ; Liver ; Lung ; Lymph Nodes ; Multiple Pulmonary Nodules ; Pancytopenia ; Sarcoidosis ; Skin ; Spleen ; Thorax ; Uvea ; Vision, Ocular

PURPOSE: We present a case of plexiform neurofibroma that extensively invaded cranial and temporal bone, eyelid, orbit and uveal tissues, showing signs of severe ptosis and proptosis and symptoms of headache and ocular pain. METHODS: A 24-year old woman visited our clinic with pain and progressive proptosis, which had persisted for 2 weeks. She had a history of congenital neurofibromatosis. There were multiple Cafe-au-lait spots on her extremities, trunk, and face. Also, she had severe ptosis in her upper left eyelid, proptosis, and a distorted and asymmetric facial form. The cornea was markedly edematous. An enhanced computed tomography scan revealed an uncertain circumscribed soft tissue mass with enlargement of the eyeball and orbit, coupled with sphenoid wing dysplasia and herniation of the dura mater into the orbit due to expansion and bony destruction of the superior orbital wall. Under general anesthesia, the patient underwent excision and histopathologic biopsy of intraocular neurofibroma through evisceration. RESULTS: The tumor had black-colored multilobular nodules whose dimensions were 1.5x1.2x0.4 cm. After a histopathologic examination, the tumor was determined to be a pigmentary hamartoma of the uvea. Based on the clinical and histologic findings, we diagnosed the patient with plexiform neurofibroma with type I neurofibromatosis.
Anesthesia, General ; Biopsy ; Cafe-au-Lait Spots ; Cornea ; Dura Mater ; Exophthalmos* ; Extremities ; Eyelids ; Female ; Hamartoma ; Headache ; Humans ; Neurofibroma ; Neurofibroma, Plexiform* ; Neurofibromatoses ; Orbit ; Temporal Bone ; Uvea ; Young Adult

PURPOSE: Juvenile xanthogranuloma usually affects the anterior uvea before the age of 1 year, and it may less frequently involve the corneoscleral limbus. We report a case of juvenile xanthogranuloma of the corneoscleral limbus in a 7-year-old boy. METHODS: A 7-year-old boy was referred for the evaluation of a painless limbal mass in the left eye, noticed 1 month previously. On examination, the visual acuity was 16/20 (OD) and 10/20 (OS) without correction, and the corrected visual acuity was 20/20 in both eyes. The other ocular findings were normal, except for an elevated, well circumscribed, smooth surfaced mass measured 9x6 mm at the upper temporal corneoscleral limbus of the left eye. After the excision of the mass, the frozen biopsy and the immunohistochemical staining for CD68 and S100 protein were performed. RESULTS: The lesion consisted of a red-brown, vascular, and raised mass. Histopathologically, there was a chronic granulomatous inflammation with stromal fibrosis, which included many giant cells immunoreactive for CD68 and S100 protein. There was no evidence of recurrence during follow-up period of 5 months and 20 months. CONCLUSIONS: The case was diagnosed as juvenile xanthogranuloma by the clinical and histopathologic findings. The juvenile xanthogranuloma of the corneoscleral limbal involvement is very rare and it can be treated with the surgical excision for the purpose of improvement of cosmetic problems without any recurrence. It seems to have very good prognosis when completely excised.
Biopsy ; Child ; Fibrosis ; Follow-Up Studies ; Giant Cells ; Humans ; Inflammation ; Male ; Prognosis ; Recurrence ; Uvea ; Visual Acuity ; Xanthogranuloma, Juvenile*