ABSTRACT
PURPOSE: To report, with the aid of original imaging, an unusual differential diagnosis of an iris tumor. OBSERVATIONS: A 60-year-old Caucasian man visited our clinic with a large amelanotic iris mass in the left eye in the absence of concomitant extraocular inflammation or neoplastic evidence. The patient reported an ocular trauma caused by a wire 5 years prior to his visit, which resolved after a short course of antibiotic eye drops. Orbital magnetic resonance imaging with contrast enhancement was consistent with an iris tumor; ultrasound biomicroscopy indicated a semi-solid, mid-stromal iris formation continuous with the lens. Surgical inspection was performed. Surgery showed the presence of a hypermature cataract with a fine break in the anterior capsule of the lens covered by the iris surface. The liquefied cortex infiltrated the iris without diffusing into the aqueous humor. CONCLUSIONS AND IMPORTANCE: A so-called morgagnian cataract developed, likely following a penetrating ocular wound. The progressive, slow infiltration of the iris stroma by the crystalline matrix mimicked the appearance of an amelanotic iris tumor.
ABSTRACT
BACKGROUND: To correlate the three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) features of retinal-choroidal anastomosis (RCA) to conventional angiography. METHODS: This is a retrospective chart review of consecutive patients diagnosed with RCA who underwent 3D SD-OCT between July 2007 and June 2010. Main outcome measures were the diagnostic capabilities of 3D SD-OCT, and the correlation between 3D findings and the features distinguished by conventional angiography. RESULTS: Eighteen eyes of 18 patients [five males, 13 females, mean age 79.5 ± 19.4 years (range, 70-93 years)] were included in the analysis. In eyes (n = 3) showing a focal staining on angiography, 3D OCT revealed a slight convex prominence of the inner retinal surface in correspondence of a small dome-shaped retinal pigment epithelium (RPE) elevation (which represented the early RCA). In eyes (n = 7) showing a "hot spot" without pigment epithelium detachment (PED) on angiography, 3D OCT revealed a convex prominence of the inner retinal surface in correspondence with a well-demarcated prominence of RPE with steep margins (which represented the RCA). In eyes (n = 8) showing a "hot spot" with PED on angiography, 3D OCT revealed a convex prominence of the inner retinal surface in correspondence with a convex RPE prominence with a peak at the top. CONCLUSIONS: 3D SD-OCT provides a map of the retina and RPE, allowing a realistic visualization of the different pathological features in the disease development, and may be able to provide clinically relevant information to complement angiography in the diagnosis of RCA.
Subject(s)
Arteriovenous Fistula/diagnosis , Choroid/blood supply , Choroidal Neovascularization/diagnosis , Retinal Neovascularization/diagnosis , Retinal Vessels/abnormalities , Tomography, Optical Coherence , Aged , Aged, 80 and over , Coloring Agents , Female , Fluorescein Angiography , Humans , Imaging, Three-Dimensional , Indocyanine Green , Macular Degeneration/diagnosis , Male , Retrospective StudiesABSTRACT
This short communication describes a case of human conjunctival dirofilariosis by Dirofilaria immitis. A 51-year-old man from the Emilia-Romagna region of northeastern Italy referred for ocular foreign body sensation in his right eye. A slight swelling of the bulbar conjunctiva was observed. A live, whitish, 10-cm-long nematode was extracted from the subconjunctival space. Histology revealed typical features of a filarioid nematode belonging to the genus Dirofilaria sp. Molecular analysis with polymerase chain reaction confirmed that the extracted nematode was a male of D. immitis. The removal of the parasite leads to complete resolution of symptoms. Ocular human dirofilariosis caused by infection with the filarioid nematode D. immitis is extremely rare, but should be considered in humans living in Italian endemic areas.
