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*

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

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 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: Solitary fibrous tumor (SFT) is a rare tumor of the pleura, mediastinum, pericardium and other organs affecting predominantly middle-aged patients. SFT arising in the orbit is extremely rare, and its malignant form is even rarer. The authors herein describe a case of malignant solitary fibrous tumor of the orbit. CASE SUMMARY: A 67-year-old male presented with a 4-month history of right proptosis. On ophthalmologic examination, 9-mm proptosis was observed in the right eye, and extraocular movements were limited in all directions of gaze. CT scan and MR imaging showed a lobulated, well-enhancing mass adjacent to the lateral rectus muscle in the superolateral retrobulbar space. Excisional biopsy through a lateral orbitotomy was performed. Histopathological examination showed proliferation of spindle cells with a fascicular pattern interspersed with bands of collagen, increased cellularity, cellular pleomorphism, hemorrhage, necrosis and high mitotic activity. Immunohistochemical staining revealed diffuse positivity for CD34, CD99, Ki67 and p53, and malignant SFT was diagnosed. CONCLUSIONS: Malignant SFT should be considered in the differential diagnosis of acutely progressing unilateral proptosis.
Aged ; Biopsy ; Collagen ; Diagnosis, Differential ; Exophthalmos ; Eye ; Hemorrhage ; Humans ; Male ; Mediastinum ; Muscles ; Necrosis ; Orbit* ; Pericardium ; Pleura ; Solitary Fibrous Tumors*

PURPOSE: To report 2 cases of cytomegalovirus retinitis treated with intravitreal ganciclovir. CASE SUMMARY: A 29-year-old female (Case 1) who received immunosuppressive therapy with tacrolimus and mycophenolate mofetil for 3 months after pancreatic transplantation, was given an intravitreal Bevacizumab injection 4 times in each eye under the suspicion of bilateral central retinal vein occlusion. During follow-up, a new lesion with white opacification and multiple snowballs appeared in the left eye. Suspecting cytomegalovirus retinitis, we administered an intravitreal ganciclovir injection resulting in a decrease of white opacification and improvement of visual acuity. A 66-year-old male (Case 2) who was receiving treatment for general weakness and heart failure, presented with visual disturbance in both eyes. Fundoscopic examination revealed white opacification, multiple snowballs and retinal hemorrhage in the left eye; diagnostic vitrectomy was performed. Macular edema and subretinal fluid continued after the vitrectomy and the serologic testing revealed an IgG titer positive for cytomegalovirus, therefore, an intravitreal injection of ganciclovir was given. Macular edema and subretinal fluid decreased and visual acuity improved. CONCLUSIONS: Intravitreal ganciclovir can be an effective treatment option for the management of CMV retinitis.
Antibodies, Monoclonal, Humanized ; Cytomegalovirus ; Cytomegalovirus Retinitis ; Eye ; Female ; Follow-Up Studies ; Ganciclovir ; Heart Failure ; Humans ; Immunoglobulin G ; Intravitreal Injections ; Macular Edema ; Male ; Mycophenolic Acid ; Retinal Hemorrhage ; Retinal Vein ; Retinitis ; Serologic Tests ; Subretinal Fluid ; Tacrolimus ; Transplants ; Visual Acuity ; Vitrectomy ; Bevacizumab

PURPOSE: To report a case of a young male patient with retinitis pigmentosa (RP) accompanied by vitritis and neovascularization of the optic disk in both eyes who underwent unilateral vitrectomy for the treatment of vitreous hemorrhage in the right eye. CASE SUMMARY: An 8-year-old boy visited our clinic with a complaint of night blindness. Both eyes showed inflammatory cells in the anterior vitreous and neovascularization of the optic disk confirmed by fluorescein angiography. Extensive vitreous hemorrhage developed in his right eye and he underwent unilateral vitrectomy. His final visual acuity was 0.6 in both eyes. CONCLUSIONS: Vitreous hemorrhage may be related to chronic inflammation in the vitreous and is a very rare RP complication. Vitrectomy can be an effective treatment option for RP complicated by vitreous hemorrhage.
Eye ; Fluorescein Angiography ; Humans ; Inflammation ; Male ; Night Blindness ; Optic Disk ; Retinitis ; Retinitis Pigmentosa ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage