Development of a clinical prototype of a miniature hand-held optical coherence tomography probe for prematurity and pediatric ophthalmic imaging.

We report a novel design and operation of a highly integrated miniature handheld OCT probe, with high-speed angiography function that can be used in clinical settings for young children and infants, providing rapid, non-invasive structural and angiographic imaging of the retina and choroid. The imaging system is operated at 200 kHz, with 3D OCT and OCTA scan time of 0.8 and 3.2 seconds, respectively, and the scanning angle on the pupil is ± 36°, covering the full perifoveal region. Operator assisting features of the direct-view iris camera and on-probe display are integrated into the hand-held probe, and the fixation target can display animations to attract the attention of young subjects. Compared to conventional OCT systems, the high-speed hand-held OCT system significantly improves the operator's experience and scanning efficiency, which is important for imaging infants. Imaging results indicate a significant reduction in total time consumption in pediatric ophthalmic imaging sessions, as well as the image quality of OCT angiography.

Sudden unilateral vision loss in an adult with Behcet disease: A case report.

RATIONALE: Behcet disease is an autoimmune vasculitis, involving multiple systems and organs. It is often chronic and recurrent, and involves all levels of arteries and veins. PATIENT CONCERNS: A 40-year-old Chinese male with sudden vision loss in his right eye for 3 days was reported. DIAGNOSES: The patient was diagnosed as bilateral uveitis (obstructive retinal vasculitis in the right eye) and Behcet disease. INTERVENTIONS: The patient was given topical corticosteroids and compound tropicamide eye drops in our department. In addition, he was also hospitalized in the Rheumatology Department, and received systemic infusion of methylprednisolone and cyclophosphamide. OUTCOMES: Best corrected visual acuity vision acuity of the left eye was 20/20 and that of the right eye was no light perception after 2 weeks. During the telephonic follow-up after 1 year, the patient reported 2 recurrent episodes of uveitis in the left eye, which improved after treatment at the local hospital. LESSONS: It cautions ophthalmologists of the high possibility of vasculitis in young and middle-aged patients with retinal vascular occlusion. It also reminds the ophthalmologists investigate systemic diseases, and obtain detailed medical history, not just depending on specific laboratory findings. This case further suggests that Behcet disease has diverse manifestations, complex diagnosis, and severe lesions, and the recurrence rate must be controlled to minimize irreversible consequences such as sudden vision loss during recurrence.

Acute bilateral retina hemorrhages beneath internal limiting membrane: An unusual ophthalmological case report of acute leukemia during complete clinical remission.

RATIONALE: Leukemia is a common hematologic disease that causes various systemic complications, such as ophthalmological disorders. The venous congestion is considered to be the main clinical sign that occurs during the initial stage of the disease, whereas white-centered hemorrhages are the most typical manifestations in leukemic retinopathy. These complications usually manifest when the disease presents with clinical and hematological symptoms. In the present study, we report a patient who was diagnosed with leukemic retinopathy. The initial signs of this disease were bilateral hemorrhages that occurred during complete clinical remission. Previous studies regarding this condition are quite rare. PATIENT CONCERNS: We report a 26-year-old man who was diagnosed with leukemic retinopathy and exhibited the initial signs of the disease, namely bilateral hemorrhages with a distinct appearance beneath the internal limiting membrane. In addition, flame-shaped hemorrhages were observed surrounding the optic discs and/or along the vessels in the absence of venous congestion. All these changes were present during complete clinical remission. DIAGNOSES: Bilateral acute leukemic retinopathy, acute lymphoblastic leukemia (pro-B lymphocyte, BCR-ABL chimeric gene-positive). INTERVENTIONS: Clinical remission was achieved following effective systemic chemotherapy that was applied for leukemia in the hematology department. A dynamic observation was applied actively in the absence of surgery and/or medical treatment for ophthalmologic treatment. OUTCOMES: Best corrected visual acuity was 20/40 in the right eye and 20/60 in the left eye, which was considerably better than those noted at the initial visit of the patient (20/250 in the right eye and 20/400 in the left eye). LESSONS: The cautious expectant treatment is safe and helpful for acute leukemic retinopathy. A long-term follow-up is inevitable. Effective systemic chemotherapy that is required for leukemia treatment can achieve clinical remission, which might be helpful in controlling the pathological changes of the eyes.

Analysis of the characteristics of optical coherence tomography angiography for retinal cavernous hemangioma: A case report.

RATIONALE: Retinal cavernous hemangioma is a rare congenital vascular malformation with typical fundus changes. Optical coherence tomography angiography (OCTA), which is in rise in the recent years, is a rapid and noninvasive technology to assist in obtaining information regarding the blood flow changes in the fundus lesions from different layers without injecting a contrast agent. PATIENT CONCERNS: A 40-year-old male patient with visual occlusion in the right eye for >1 month was reported. DIAGNOSES: Retinal cavernous hemangioma was diagnosed by fundus examination, fluorescein angiography (FA) and OCTA, and the characteristics of OCTA images were analyzed. INTERVENTIONS: The lesion occurred outside the macula, the central vision remained basically normal, and no significant complications were noted in this patient. Therefore, we preferred to regularly follow-up without therapeutic intervention. CONCLUSIONS: OCTA can display fundus blood flow and vascular lesions noninvasively and rapidly. On OCTA, retinal cavernous hemangiomas showed characteristic changes and have good correspondence with fundus imaging and FA examinations. Moreover, OCTA remains more sensitive to vascular abnormalities, and imaging remains clearer, providing new diagnosis and follow-up route for this disease.