ABSTRACT
Chronic uveitis, a challenging intraocular inflammatory condition, presents complexities in diagnosis and management due to its diverse etiologies and manifestations. Anterior-segment optical coherence tomography (AS-OCT) has emerged as a pivotal tool in evaluating uveitis, offering high-resolution imaging of anterior segment structures. We present the case of a 49-year-old man diagnosed with neurosarcoidosis and chronic intermediate uveitis, where AS-OCT revealed unique findings. Clinical examination identified a Koeppe nodule. AS-OCT evaluation unveiled hyperreflectivity in the iris stroma and the adjacent nodule. Notably, AS-OCT documented the absence of the hyperreflective anterior limiting layer signal, a novel observation in uveitis assessment. This unprecedented finding underscores the significance of AS-OCT in elucidating uveitis pathophysiology and emphasizes its potential in refining diagnostic and therapeutic strategies for this complex ocular condition.
ABSTRACT
Purpose: This study aimed to elucidate the frequency of surgery-induced iris abnormalities after Descemet membrane endothelial keratoplasty (DMEK) and their impact on postoperative clinical outcomes. Methods: In this retrospective study, medical records of 32 eyes from 28 consecutive patients (mean age, 65.7±13.4 years; 14 men, 18 women) who underwent DMEK (or triple DMEK) were reviewed. In all patients, inferior peripheral iridectomy was created leaving full intracameral air tamponade at the end of surgery. Sulfur hexafluoride gas was not used in any cases. Surgery-induced iris abnormalities such as pupillary shape changes and iris depigmentation were evaluated by 3 masked observers. Pre-existing abnormalities were excluded. Eyes were divided into two groups based on the presence of surgery-induced iris changes: Group A (with iris abnormalities) and Group B (without). Impacts on postoperative clinical outcomes such as vision and endothelial cell density were analyzed. Results: Surgery-induced iris abnormalities were seen in 15 eyes (Group A, 9 with pupillary shape change and 6 with iris depigmentation; 46.9%), and 17 eyes showed no abnormalities (Group B, 53.1%). No significant differences were detected between groups in age, sex, indication, simultaneous cataract surgery, pre- and 6-month postoperative vision, donor age, donor endothelial cell density, and 6- and 12-month postoperative endothelial cell density. Conclusions: Surgery-induced iris abnormalities were noted in almost half of the eyes after DMEK (46.9%) in this study. However, there was no association between visual outcomes or postoperative endothelial cell density and the iris changes.
ABSTRACT
ABSTRACT Here we report a case of surgical pupilloplasty in an adult with true polycoria. A 44-year old man was referred to our clinic with a best-corrected visual acuity (BCVA) of 0.5 diopters (D) in his left eye. Biomicroscopy revealed two pupils within a 2.5-mm central zone, with diameters of 1.2 and 1.1 mm. Both pupils had real iris sphincters and responded to light and chemical stimulation. Therefore, we surgically cut the bridge between the two pupils without any intraoperative or postoperative complications. One month after the surgery, BCVA had improved to 0.9 D, and the final pupil was almost round, measuring 2.7 mm in diameter.
RESUMO Relatamos um caso de pupiloplastia cirúrgica em um paciente adulto com policoria verdadeira. Um homem de 44 anos de idade foi encaminhado ao nosso serviço com acuidade visual melhor corrigida (BCVA) de 0,5 em seu olho esquerdo. Biomicroscopia revelou 2 pupilas, dentro de uma zona central de 2,5 milímetros com dimensões de 1,2 mm e 1,1 mm de diâmetro. Ambas as pupilas apresentavam esfíncteres irianos reais que respondiam à luz e a drogas. A ponte entre as 2 pupilas foi cortada cirurgicamente. Não houve complicações transoperatórias ou pós-operatórias. A BCVA melhorou para 0,9, e a pupila ficou quase circunferencial com 2,7 mm de diâmetro, um mês após a cirurgia.
Subject(s)
Humans , Male , Iris/abnormalities , Iris/surgery , Pupil Disorders/surgery , PupilABSTRACT
ABSTRACT A 42-year-old woman was admitted to our clinic with a complaint of glare in both eyes. Biomicroscopic examination of both the eyes revealed iris and lens colobomas in the inferior quadrant. Fundus examination of the right eye revealed an oval and gray inferotemporal optic pit and two choroid colobomas in the inferior quadrant. In the left eye, two choroid colobomas were detected that were inferior to the optic nerve head. Furthermore, a 21-year-old man presented to our clinic for a routine ophthalmologic examination. Bilateral biomicroscopic examination was normal. Fundus examination of the left eye revealed an oval and gray inferotemporal optic pit and a choroid coloboma that was inferior to the optic nerve head. Here we describe optic pits co-occurring with iris, lens, and choroidal colobomas. On the basis of these cases, a defect in the closure of the embryonic fissure is the most plausible etiology of the optic pit.
RESUMO Uma mulher de 42 anos de idade foi internada em nossa clínica com queixa de ofuscamento em ambos os olhos. O exame biomicroscópico revelou coloboma de íris e cristalino no quadrante inferior em ambos os olhos. O exame de fundo do olho direito revelou um fosseta óptica oval e acinzentada na região inferotemporal e dois colobomas coroide no quadrante inferior. No olho esquerdo, dois colobomas de coroide foram detectados inferiormente à da cabeça do nervo óptico. Outro homem de 21 anos apresentou-se em nossa clínica para um exame oftalmológico de rotina. O exame biomicroscópico foi normal, bilateralmente. O exame de fundo do olho esquerdo revelou uma fosseta oval e acinzentada de nervo óptico óptico inferotemporal e um coloboma coroide inferior à cabeça do nervo óptico. Nestes relatos nós descrevemos fossetas ópticas ocorrendo simultaneamente com colobomas de íris, cristalino, e coroide. Com base nestes casos, o defeito no fechamento da fissura embrionária é uma provável etiologia da fosseta óptica.
