Case Series of Progressive Retinal Detachments in Persistent Fetal Vasculature.

PURPOSE: Persistent fetal vasculature (PFV) may be associated with tractional retinal detachment due to tractional contraction of the fibrovascular stalk. PFV is often thought to be congenital and non-progressive. A rhegmatogenous component is far less common and is typically identified as a post-operative complication and has not been spontaneously reported. We present five cases illustrating potential progressive changes and complications that may arise in non-operated PFV. METHODS: A retrospective case series of five patients who presented with progressive retinal detachments from persistent fetal vasculature. RESULTS: Five unique cases of persistent fetal vasculature with significant progression from time of initial presentation, four of which included development of rhegmatogenous components. CONCLUSION: Patients with PFV and a seemingly stable tractional detachment should undergo evaluation with a retina specialist for risk stratification and management, as rhegmatogenous detachments may occur due to ocular growth and stretch breaks, and tractional detachments can continue to progress over time.

Epidemiologic Differences and Management of Eyelid Lesions in the Pediatric Population.

PURPOSE: To report the relative incidence of excised pediatric eyelid lesions and describe the correlation between the clinical and pathology diagnosis. METHODS: This was a retrospective analysis of 137 consecutive pathology-confirmed eyelid lesions excised at a U.S. quaternary children's hospital system. Chalazion was excluded from this study. RESULTS: Benign non-cystic epithelial lesions comprised 48.2% of all excised lesions, followed by mesenchymal (14.6%) and cystic (10.2%) lesions. The most common lesions were molluscum contagiosum (21.9%) and verruca vulgaris (19.0%). Hispanic White race represented 62.0% of cases, followed by non-Hispanic White (23.3%) and Black (8.8%). There were no malignant lesions. A specific preoperative clinical diagnosis was attempted in 70.1% of cases. Of these, 60.4% had a matching histopathology. CONCLUSIONS: The authors report a higher proportion of molluscum contagiosum and verruca vulgaris when compared to the literature; these differences may suggest geographic variance, management preference, or a general increase in incidence. Correlation with pathology showed the clinical diagnosis of eyelid lesions can be challenging even for ophthalmologists. However, malignancy in pediatric eyelid lesions is rare and submission for histopathology may be safely omitted, except in cases with atypical features or suspicion for syndromic disease. The decision for surgery should be methodically approached and take into consideration the most likely diagnosis, natural history of the disease, sociopsychological impact, anesthesia risk, and resource burden. [J Pediatr Ophthalmol Strabismus. 2022;59(6):405-409.].

Clinical challenge - scratching the surface of the sheath.

A 63-year-old Caucasian man with hypertension, hyperlipidemia, adrenal insufficiency, and history of metastatic spindle cell melanoma previously treated with ipilimumab, presented with unilateral papillitis in the left eye. The disc edema evolved to neuroretinitis with additional MRI findings of perineuritis. Broad laboratory evaluation confirmed active B. henselae infection, and he confirmed exposure to a newly adopted kitten. His vision improved following a course of antibiotics and oral steroids with resolution of clinical findings. To the best of our knowledge, this is the first reported case of cat-scratch neuroretinitis with MRI findings of optic nerve and optic nerve sheath enhancement.

Imaging Characteristics and Natural History of Macular Pseudo-Folds Mimicking Full-Thickness Postoperative Macular Folds Following Retinal Detachment Repair.

BACKGROUND AND OBJECTIVES: Postoperative retinal folds are a rare complication of retinal detachment repair. Folds involving the macula may result in decreased vision, metamorphopsia, and diplopia. There is no consensus on whether symptomatic folds require additional surgery, as both spontaneous regression and permanent vision loss have been described. The authors present three cases of symptomatic macular folds that demonstrated spontaneous resolution and identify key OCT prognostic signs. PATIENTS AND METHODS: The study presented is a retrospective case series. RESULTS: Three patients developed symptomatic postoperative macular folds. Despite funduscopic appearances indistinguishable from full-thickness folds, optical coherence tomography (OCT) imaging revealed that none of the folds involved the full thickness of the retina. All cases demonstrated spontaneous resolution with evidence of visual improvement within 2 months. CONCLUSION: OCT is essential in distinguishing between partial and full-thickness macular folds. The authors propose that partial-thickness folds should be termed "pseudo-folds," which represent a unique entity that has a favorable natural history. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:488-492.].