Orbital intramuscular hydatid cyst causing compressive optic neuropathy: a case report and literature review.

BACKGROUND: Echinococcosis, commonly known as hydatid disease, is a zoonotic infection resulting from the tapeworm Echinococcus granulosus. The occurrence of hydatid cysts in the orbital region is uncommon, representing less than 1% of all reported hydatid cases. This report details a unique case of an intramuscular hydatid cyst in the orbital region that led to compressive optic neuropathy. CASE PRESENTATION: A 22-year-old male from Kabul, Afghanistan presented with a five-month history of progressive proptosis in his left eye, associated with a gradual decrease in vision over the past three weeks. The left eye exhibited upward globe dystopia, ocular motility limitation, mild conjunctival injection, and chemosis. Diagnosis was achieved through imaging and histopathological examination. Treatment involves surgical removal of the cyst and prolonged albendazole therapy. The postoperative course showed significant improvement in the patient's condition and restoration of his vision. CONCLUSIONS: Despite its rarity, this case underscores the importance of awareness and knowledge of hydatid disease among physicians, especially those working in endemic areas. It emphasizes the importance of including hydatid disease in the differential diagnosis of orbital masses, particularly in endemic regions.

Retinoblastoma in adults: a case report and literature review.

PURPOSE: To report a case of adult retinoblastoma with a wrong diagnosis of melanoma. CASE REPORT: Herein, we present an adult retinoblastoma case who was misdiagnosed as melanoma in fine-needle aspiration biopsy with intravitreal hemorrhage and later neovascular glaucoma after biopsy. The diagnosis of retinoblastoma was confirmed after enucleation. CONCLUSION: Retinoblastoma should be considered in the differential diagnosis of an intraocular mass in adults, especially when media haziness precludes adequate ophthalmoscopic visualization.

Regression patterns in treated retinoblastoma with chemotherapy plus focal adjuvant therapy.

PURPOSE: The aim of this study was evaluation of the regression patterns after 3, 6, and 8 months of treatment. METHODS: A total of 100 retinoblastoma tumors (57 eyes of 35 patients) were treated with 6 (n = 8) or 8 (n = 92) cycles of systemic chemoreduction and tumor consolidation (transpupillary thermotherapy [TTT] or cryotherapy) during this prospective study. RESULTS: After 3 months of treatment, type 3 was the predominant pattern (n = 57%, 57%), while after 6 and 8 months of treatment the tumors regressed to type 4 most often (44% and 52%, respectively). Smaller tumors and the peripheral tumors were likely to regress to type 4, whereas larger tumors and those nearer to fovea were more likely to become type 1 pattern. Tumors consolidated with cryotherapy mostly showed type 4 regression (3rd month: 40%, 6th month: 90%, and 8th month: 87.5%). Whereas, those treated with TTT rather regressed to type 3 after 3 months (57.9%) and to type 4 after 6 and 8 months of treatment (51.4% and 59.5%, respectively). Recurrence of the tumor was 40% in our cases with defined correlation with tumor location, size, and subretinal seeds. CONCLUSION: We conclude that regression patterns of tumors in patients undergoing systemic chemoreduction with focal adjuvant treatments predominantly changed over time and their changes are dependent on tumor size, location, and type of treatment. It appears that subretinal seeds, tumor size, and location of tumors are the most important factors predicting tumor recurrence.

Pattern of pediatric eye injuries in Tehran, Iran.

Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. This prospective study was conducted to explore the profile of eye injuries in pediatric patients referring to a tertiary eye center in Tehran, Iran. Six hundred consecutive pediatric patients aged 17 or less who presented to emergency department of Farabi Hospital were enrolled. Age and sex of pediatric patients, time of trauma, time between trauma and presentation, place of injury, etiology of eye injury, visual acuity, and type of injury based on Birmingham Eye Trauma Terminology were collected. Mean (±SD) age of cases was 7.9 ± 4.8. Male to female ratio was 2.3:1. More than 70 % of the patients presented less than 12 h after ocular trauma. Most injuries occurred at home (57.7 %) followed by street (20.3 %). Twelve patients had visual acuity lower than 0.1 at initial visit. Projectile trauma was the most common cause (35.8 %) followed by blunt trauma (33.3 %). 86.3 % of traumatic events consisted in closed globe injuries. Parents should be involved more effectively in care and supervision of their children especially for boys, at home and on holidays.

Sutureless tunnel trabeculectomy without peripheral iridectomy: a new modification of the conventional trabeculectomy.

The purpose of this study was to describe the results of a new modification of the trabeculectomy technique, sutureless tunnel trabeculectomy without peripheral iridectomy (PI), in a group of patients with chronic open-angle glaucoma (COAG). Patients with uncontrolled COAG who were candidates for trabeculectomy underwent sutureless tunnel trabeculectomy without PI. Patients were examined before surgery and at 1, 3, 6 and 12 months after surgery. Pre- and post-operative data including intraocular pressure (IOP), visual acuity, number of anti-glaucoma medications and intraoperative and post-operative complications were recorded. Surgical success was defined as final IOP < 21 mmHg and > 20 % reduction from baseline (criterion A) and as final IOP < 18 mmHg and > 25 % reduction from baseline (criterion B), without further glaucoma surgery or complications that required returning the patient to the operating room. Success was further classified as complete when these criteria were obtained without medications and qualified with or without medical therapy. Eighteen eyes of 18 patients were recruited into the study. All patients had 6 months of follow-up and 15 patients (83.3 %) completed 12 months of follow-up. Mean (SD) age of the patients was 57.2 (5.7) years. Mean (SD) IOP decreased from 23.7 (4.5) mmHg pre-operatively to 14.7 (3.4) mmHg at final follow-up visit (p < 0.001), and the mean (SD) number of glaucoma medications decreased from 2.89 (0.32) pre-operatively to 1 (0.84) at last visit (p < 0.001). Post-operatively, IOP and number of glaucoma medications were decreased in comparison with baseline at all follow-up visits (p < 0.001 for all visits). Qualified and complete surgical success rates were 78 and 50 % for criterion A, and 72 and 50 % for criterion B. Sutureless tunnel trabeculectomy without PI effectively reduced IOP and number of medications in COAG patients during 6-12 months of follow-up. Further controlled studies are needed to better characterize the safety and efficacy of this technique.