ABSTRACT
A 45-year-old woman with ptosis and diplopia was found to have myasthenia gravis (MG) associated with amyloidosis of the thymus gland. Systemic MG is frequently associated with thymomas or thymic hyperplasia but has only once previously been reported in association with amyloidosis of the thymus. This case demonstrates that isolated ocular MG rarely may also be associated with amyloidosis of the thymus.
Subject(s)
Amyloidosis/diagnosis , Lymphatic Diseases/diagnosis , Myasthenia Gravis/diagnosis , Thymus Gland/pathology , Amyloidosis/drug therapy , Autoantibodies/blood , Blepharoptosis/diagnosis , Blepharoptosis/drug therapy , Diplopia/diagnosis , Diplopia/drug therapy , Female , Glucocorticoids/therapeutic use , Humans , Lymphatic Diseases/surgery , Magnetic Resonance Imaging , Middle Aged , Myasthenia Gravis/therapy , Receptors, Cholinergic/immunology , Thymectomy , Thymus Gland/surgeryABSTRACT
INTRODUCTION: Iridoschisis is a rare condition in which there is localized cleavage of the iris stroma into 2 layers. It can be associated with plateau iris and more often with either angle closure or open-angle glaucoma. It usually presents in later life as a bilateral progressive condition, however, in this article we present a young adult with bilateral iridoschisis and incomplete plateau iris configuration. CASE PRESENTATION: We report the case of a 22-year-old male with bilateral sensorineural hearing loss who presented to clinic for general ophthalmology evaluation. He had no prior ocular history. Examination findings revealed bilateral iridoschisis with incomplete plateau iris configuration. His ocular examination was otherwise unremarkable except for bilateral retinal pigment epithelium mottling. His work-up for glaucoma including optic disc evaluation, visual field testing, and imaging was all within normal limits. CONCLUSIONS: This case is unusual in its presentation of a young patient with bilateral iridoschisis and incomplete plateau iris configuration. Iridoschisis is more commonly a senile process and the presence of iridoschisis in a young adult prompts a review of congenital causes and associations. Although this patient had no evidence of glaucoma at this time, given the associated risk, it is important that he continue to have regular follow-up at this time.
Subject(s)
Iris Diseases/diagnosis , Iris/pathology , Atrophy , Hearing Loss, Sensorineural/diagnosis , Humans , Intraocular Pressure/physiology , Male , Visual Acuity/physiology , Young AdultABSTRACT
A 23-year-old woman with history of headaches and auditory changes presented with acute-onset visual field loss in the right eye. The combination of multiple retinal branch artery occlusions of the right eye on funduscopic examination, characteristic white matter lesions in the corpus callosum on magnetic resonance imaging, and hearing loss on audiometric testing led to a diagnosis of Susac's syndrome. Ultra-widefield fluorescein angiography revealed involvement of the retinal veins, which has not been previously reported with this condition. Additionally, ultra-widefield indocyanine green angiography demonstrated changes in the choroidal circulation, which are controversial in this syndrome.
