Idiopathic sclerochoroidal calcifications: Case report, metabolic causes and differential diagnosis / Calcificações esclerocoroidais idiopáticas: relato de caso, causas metabólicas e diagnóstico diferencial

Abstract Sclerochoroidal calcifications (SC) are a rare and benign ocular condition characterized by yellow-white irregular subretinal lesions usually found in the supero-temporal arcade of the midperipheral fundus in middle-aged elderly men. We present a clinical case of a 79- year-old patient who during a fundus examination presented raised whitish nodules in the supero-temporal arcade in the right eye. After performing optical coherence tomography, ultrasound, ocular computed tomography and laboratory analysis, she was diagnosed with idiopathic sclerochoroidal calcifications The pathogenesis of sclerochoroidal calcifications remains unclear but systemic conditions should be discarded. It is important to distinguish sclerochoroidal calcifications from other conditions such as tumors.

Resumo Calcificações esclerocoroidais (SC) são uma condição ocular rara e benigna caracterizada por lesões sub-retinianas irregulares amarelo-brancas, geralmente encontradas na arcada superotemporal do fundo médio-periférico em homens idosos de meia-idade. Apresentamos um caso clínico de uma paciente de 79 anos que durante exame de fundo apresentou nódulos esbranquiçados elevados na arcada superotemporal do olho direito. Após realizar tomografia de coerência óptica, ultra-sonografia, tomografia computadorizada ocular e análise laboratorial, ela foi diagnosticada com calcificações esclerocoroidais idiopáticas A patogênese das calcificações esclerocoroidais permanece incerta, mas as condições sistêmicas devem ser descartadas. É importante distinguir calcificações esclerocoroidais de outras condições, como tumores.

Spontaneous scleral rupture associated with retinochoroidal coloboma / Ruptura espontânea de esclera associada a coloboma coriorretiniano

Abstract We reported a case of ocular hypotony due to spontaneous scleral rupture in retinochoroidal coloboma and the treatment which was performed. This is a prospective case report in which a 21-year-old woman complained of abrupt vision loss in her left eye. Ocular hypotony due to spontaneous scleral rupture in retinochoroidal coloboma was identified through tests. An ultrassonography confirmed the scleral lesion but magnetic resonance imaging and fluorescein angiography have also proven to be useful. Due to the posterior location of the perforation, we opted for a sub-tenon injection of autologous blood and intraocular gas tamponade, which were successful, resulting in improved visual acuity and intraocular pressure. In this case, an alternative to invasive surgical procedure in the treatment of spontaneous scleral perforation and retinochoroidal coloboma was presented.

Resumo Relatamos um caso de hipotensão ocular secundária a ruptura escleral espontânea em coloboma coriorretiniano e o tratamento realizado. Trata-se de estudo de caso prospectivo de uma mulher de 21 anos de idade que se apresentou queixando perda súbita de visão no olho esquerdo. Ao exame, foi evidenciado hipotensão ocular em virtude de ruptura espontânea de esclera em coloboma coriorretiniano. Ultrassonografia confirmou a lesão da esclera embora ressonância magnética e angiofluoresceinografia também tenham sido úteis. Em virtude da localização posterior da perfuração, optamos por injeção sub-tenoniana de sangue autólogo e tamponamento intraocular com gás, que demonstraram ser úteis, resultando em melhora da acuidade visual e da pressão intraocular. Neste caso, apresentamos uma alternativa a procediemnto cirúrgico invasivo para tratamento de perfuração espontânea de esclera em coloboma coriorretiniano.

Drusa de nervo ótico associada à estafiloma peripapilar congênito / Optic disk drusen associated with congenital peripapillary staphyloma

Resumo Nós descrevemos uma rara associação entre estafiloma peripapilar congênito e drusa de disco óptico em uma mulher de 47 anos de idade e visão normal.

Abstract We described a rare association between peripapillary staphyloma and optic disk drusen in a woman with 47 years old and normal vision.

The thickness of the retina, choroid and sclera in different posterior sclera shape in high myopia / 中华眼底病杂志

Objective To observe the thickness of the retina,retinal nerve fiber layer (RNFL),choroid and sclera among the difference posterior sclera shape (PSS) in high myopia (HM).Methods Sixty HM patients (96 eyes) were enrolled in this study.There were 18 males (25 eyes) and 42 females (71 eyes).The mean age was (51.32±10.06) years.The mean spherical equivalent was (-14.38±6.31) DS.The mean axial length was (29.49±2.44) mm.The eyes were evaluated from deep range imaging optical coherent tomography (DRI-OCT) Atlantis 3D model,and divided as four groups include PSS-Ⅰ (27 eyes),PSS-Ⅱ (46 eyes),PSS-Ⅲ (11 eyes) and PSS-Ⅸ (12 eyes) according to the Curtin classification method.The thickness of the retina,RNFL,choroid and sclera were measured in the EDTRS Grid area.Results There were statistically significant differences in the thickness of retina of the central,first circle,second circle in the EDTRS Grid area among PSS-Ⅰ,PSS-Ⅱ,PSS-Ⅲ and PSS-Ⅸ groups (F=4.48,5.03,4.98;P＜0.01).There was no statistically significant differences in the thickness of RNFL among four groups (F=0.13,P=0.93).There was no statistically significant differences in the central choroidal thickness (F=0.3 1,P=0.81).There were statistically significant differences in the first circle,second circle choroidal thickness among four groups (F=2.86,2.96;P=0.04,0.04).There was no statistically significant differences in the thickness of sclera under macular fovea among four groups (F=0.80,P=0.49).Conlusions There are changes of thickness of the retina,choroid present in the difference EDTRS Grid area among the difference PSS in HM,and changes in PSS-Ⅸ is most obvious.

Severe scleral dellen as an early complication of pterygium excision with simple conjunctival closure and review of the literature / "Dellen" escleral grave como complicação precoce de excisão de pterígio com fechamento conjuntival simples e revisão da literatura

We describe a patient with acute scleral dellen (SD) after pterygium excision with simple conjunctival closure. In addition, we present a PUBMED review on the medical literature on early SD after pterygium surgery. This case describes a 45-year-old man who presented with severe SD, 7 days after pterygium surgery with minimal cauterization of episcleral vessels and simple conjunctival closure. No other adjunctive therapy was used intraoperatively. The patient refused conjunctival flap coverage of the lesion. Therefore, medical treatment consisted of antibiotic ointment, patching, and daily follow-up. After 7 days, the patching was changed for intensive ocular lubrication. Five weeks later, the surrounding conjunctiva had completely covered the affected sclera. To the best of our knowledge, this is the first report of early SD following pterygium excision and simple conjunctival closure with no other adjunctive therapy. When performing pterygium excision with conjunctival coverage of the sclera, a close follow-up is recommended to rule out wound dehiscence and SD, even when surgical wound closure is considered to prevent SD. If this complication is detected, the treatment can be conservative.

Descrevemos um paciente com "dellen" escleral agudo (SD) após excisão de pterígio com fechamento conjuntival simples. Uma revisão adicional da literatura médica sobre SD precoce após a cirurgia de pterígio também é realizada. Este caso descreve um homem de 45 anos de idade, que apresentou SD grave, sete dias após a cirurgia de pterígio com cauterização mínima de vasos episclerais e fechamento conjuntival simples. Nenhuma outra terapia adjuvante foi utilizada no intraoperatório. O paciente recusou-se à cobertura de retalho conjuntival da lesão. Portanto, o tratamento médico consistiu em pomada antibiótica, oclusão e acompanhamento diário. Após sete dias, a oclusão foi mudada para a lubrificação ocular intensiva. Cinco semanas após, a conjuntiva cobriu completamente a esclera afetada. Ao melhor de nosso conhecimento, este é o primeiro relato de SD precoce após a excisão do pterígio e fechamento conjuntival simples com nenhuma outra terapia adjuvante. Ao realizar a excisão do pterígio com cobertura conjuntival da esclera, um acompanhamento frequente é recomendado para descartar a deiscência da ferida e SD. Se esta complicação for detectada, o tratamento pode ser conservador.