1. Articles from casereports.bmj.com

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    1. Role of wide-angle optical coherence tomography angiography in the detection of clinically non-apparent neovascularisation in proliferative diabetic retinopathy

      Role of wide-angle optical coherence tomography angiography in the detection of clinically non-apparent neovascularisation in proliferative diabetic retinopathy

      Description A 69-year-old man was referred by his physician for a routine fundus evaluation. He was known to have type 2 diabetes mellitus, hypertension and left-sided hemiparesis due to a history of stroke. Best-corrected visual acuity was 20/25; N6 in both eyes. Fundus evaluation indicated the presence of a few microaneurysms in the posterior pole and preretinal haemorrhages, just above the arcades, in both eyes ( figure 1A,B ). He was imaged using wide-angle swept source optical coherence angiography (SS OCTA) 12×12 mm field of view (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA) which showed the presence ...

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    2. Role of wide-angle optical coherence tomography angiography in detection of proliferative diabetic retinopathy in a patient with dense asteroid hyalosis

      Role of wide-angle optical coherence tomography angiography in detection of proliferative diabetic retinopathy in a patient with dense asteroid hyalosis

      A 56-year-old woman presented with painless diminution of vision in her left eye since the last 2 months. She is a known case of type 2 diabetes mellitus on insulin. Her best-corrected visual acuity in right eye was 20/60; N8 and left eye were only counting fingers close to face. She was a known case of primary angle-closure glaucoma and had previously undergone peripheral iridotomy in both eyes elsewhere. She had early cataractous lens changes in both eyes. Her left eye, in addition, also showed faint iris neovascularisation at 2’o clock. Her intraocular pressure in the right and ...

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    3. Conjunctival stromal tumour (COST): anterior-segment OCT findings

      Conjunctival stromal tumour (COST): anterior-segment OCT findings

      Conjunctival stromal tumour (COST) is a recently described rare conjunctival tumour of mesenchymal origin with only four publications describing a handful of cases thus far. In this report, we describe the anterior-segment optical coherence tomography (AS-OCT) characteristics in a case of COST for the first time, in addition to the clinical and histopathological characteristics. The AS-OCT showed an elevated, dome-shaped hyporeflective homogenous lesion in the conjunctival stroma lined by hyperreflective outer layer with mild posterior shadowing, consistent with histological description of a paucicellular tumour with large myxoid collagenous material inside. Immunohistochemistry showed positive CD34 and vimentin but negative S100 and ...

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    4. Optical coherence tomography angiography of foveal neovascularisation in proliferative diabetic retinopathy

      Optical coherence tomography angiography of foveal neovascularisation in proliferative diabetic retinopathy

      A 52-year-old man, a known case of type 2 diabetes mellitus and hypertension, who presented to us with bilateral diminution of vision since 1 year. He was diagnosed as a case of bilateral proliferative diabetic retinopathy and hypertensive retinopathy. A non-invasive imaging modality, optical coherence tomography angiography (OCTA), detected foveal neovascularisation in a background of diffuse diabetic macular oedema which would have been obscured by other investigations like fluorescein angiography.

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    5. Retinal and choroidal circulation determined by optical coherence tomography angiography in patient with amyloidosis

      Retinal and choroidal circulation determined by optical coherence tomography angiography in patient with amyloidosis

      A 43-year-old woman who was diagnosed with the cryopyrine-associated periodic syndrome (CAPS) with severe renal failure and heart failure due to amyloid accumulation was examined by swept source optical cohernce tomography (OCT) (SS-OCT; DRI-OCT, Topcon, Tokyo, Japan) and optical coherence tomography angiography (OCTA) (RTVue XR Avanti, Optovue, Fremont, CA). Her best-corrected visual acuity was 20/40 OD and 20/25 OS. A hyporeflective band of about 100 µm thickness was seen just inferior to the retinal pigment epithelium in the cross-sectional SS-OCT images, but the deeper choroidal structures were clearly visible. In the OCTA images, the density of the retinal ...

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    6. Spontaneous anterior dislocation of lens in a case of ectopia lentis et pupillae: a rare entity treated by a novel technique of microscope integrated optical coherence tomography (MIOCT) guided intralenticular lens aspiration

      Spontaneous anterior dislocation of lens in a case of ectopia lentis et pupillae: a rare entity treated by a novel technique of microscope integrated optical coherence tomography (MIOCT) guided intralenticular lens aspiration

      A 7-year-old girl presented with watering and redness in the left eye for 2 months. Her parents reported poor vision in both eyes for 4 years. Visual acuity was finger counting at 1 m and finger counting close to face in the right and left eyes, respectively. Slit lamp examination of the right eye revealed corectopia, aphakia in the pupillary area, temporally subluxated clear crystalline lens, persistent pupillary membrane, irido-hyaloidal adhesion and poorly dilating pupil. Left eye revealed central corneal oedema with descemet scarring, anteriorly dislocated clear crystalline lens with lenticulo-corneal touch. Ultrasound examination of the left eye was normal ...

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    7. Optical coherence tomography of iris mammillations

      Optical coherence tomography of iris mammillations

      A 10-year-old girl presented with blurred vision of 2 months. Uncorrected visual acuity was 20/20 in both eyes (OU). Refraction revealed 0.75 diopters of astigmatism OU. Visual blur was related to a moderate convergence insufficiency. The superior 90% of the left iris was darkly pigmented and velvety in consistency with regularly spaced protuberances (mammillations) (figure 1).

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    8. Suction-induced retinopathy: optical coherence tomography correlations

      Suction-induced retinopathy: optical coherence tomography correlations

      We report a clinical case of a teenager whose eyes were exposed to highly negative suction pressures for brief seconds. The patient presented with a bilateral cystoid macular oedema associated with a thickening of outer nuclear layer evidenced by optical coherence tomography. The patient’s constellation of findings is most easily explained by the abrupt expansion and traction of a cohesive vitreous base onto the retinal layers.

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    9. Surgical removal of a giant iris stromal cyst: an intraoperative optical coherence tomography-guided approach

      Surgical removal of a giant iris stromal cyst: an intraoperative optical coherence tomography-guided approach

      An 11-year-old girl was brought with the chief complaint of progressive diminution of vision in her right eye for the past 3 months. There was no history of ocular trauma or any ocular surgery. Systemic and family history was insignificant. Visual acuity was 20/20 in her left eye and counting finger close to face with projection of rays being accurate in her right eye. Slit lamp examination of her right eye showed large cystic lesion filling almost entire anterior chamber. With the help of various imaging modalities like anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy diagnosis of ...

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    10. Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique

      Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique

      Optimal visual recovery following full-thickness traumatic wound dehiscence in a case of operated deep anterior lamellar keratoplasty (DALK) is rarely seen. Here we report a case of 22-year-old male patient presented to our casualty department with complaint of sudden-onset diminution of vision in his right eye following blunt trauma of 1 day duration. DALK had been performed 11 months ago for advanced keratoconus in the same eye. Best-corrected visual acuity (BCVA) in the right eye was hand movement close to face with accurate projection of rays and in the left eye was 20/20. Slit-lamp examination showed the presence of ...

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    11. Wasp sting induced STEMI with complete coronary artery occlusion: a case of Kounis syndrome

      Wasp sting induced STEMI with complete coronary artery occlusion: a case of Kounis syndrome

      A 45-year-old previously healthy man with minimal coronary artery disease on imaging presented with an acute MI after sustaining a wasp sting following previous non-eventful exposures throughout his life. This is the first case of Kounis syndrome with optical coherence tomography imaging and proven IgE wasp venom hypersensitivity. The Hymenoptera venom is composed of allergenic proteins and vasoactive amines which are responsible for venom toxicity. This patient also has a history of atopy giving a predisposition for developing IgE-mediated allergic reactions. Hymenoptera stings can be severe in atopic individuals and anaphylaxis may ensue. However, it is a rare cause of ...

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    12. Optic disc coloboma with pit treated as glaucoma: diagnostic utility of ultrasound and swept source optical coherence tomography

      Optic disc coloboma with pit treated as glaucoma: diagnostic utility of ultrasound and swept source optical coherence tomography

      A 6-year-old boy presented as a known case of developmental glaucoma and was using topical travoprost in the right eye (RE) since 1 year. Highest recorded intraocular pressure (IOP) was 24 mm Hg in RE, whereas central corneal thickness was 540 µm. Visual acuity was 6/6 in both eyes. On examination, the anterior segment of both eyes was unremarkable. IOP was 16 mm Hg in RE and 20 mm Hg in the left eye. Fundus examination of RE revealed a large and pale optic disc, with a nearly absent inferior neuroretinal rim. The origin of the inferior vascular bundle ...

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    13. Aborted choroidal coloboma: fundus imaging and optical coherence tomography

      Aborted choroidal coloboma: fundus imaging and optical coherence tomography

      Choroidal coloboma is characterised by poor embryonic development of chorioretinal structures and is of different types. We present a case of choroidal coloboma where the retinal pigment epithelium was present, clinically and on imaging, but rest of the structures were poorly formed. This observation suggests that in some cases, fusion of the fetal cleft may occur aberrantly, resulting in an aborted choroidal coloboma. .

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    14. Very early great saphenous vein graft aneurysm treated by percutaneous coronary intervention under ChromaFlo imaging guidance

      Very early great saphenous vein graft aneurysm treated by percutaneous coronary intervention under ChromaFlo imaging guidance

      A 73-year-old man, who had undergone coronary artery bypass grafting (CABG) 10 days prior, presented with a great saphenous vein graft aneurysm (SVGA). CT revealed the increasing size of the aneurysm. Since the SVGA occurred immediately after CABG and there were no other complications, the aneurysm was treated percutaneously. While intravascular ultrasonography (IVUS) and optical coherence tomography failed to detect the entry point, an IVUS catheter with the addition of ChromaFlo imaging clearly revealed the entry point, size and length of the SVGA. To prevent migration and edge restenosis associated with covered stents, the covered stent (3.0×19 mm ...

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    15. Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment

      Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment

      Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM). 1–3 Shimada et al 4 described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction. 5 6 Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography ...

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    16. Optical coherence tomography of the Kayser-Fleischer ring: an ancillary diagnostic tool for Wilsons disease in children

      Optical coherence tomography of the Kayser-Fleischer ring: an ancillary diagnostic tool for Wilsons disease in children

      This report presents anterior segment optical coherence tomography (AS-OCT) images of Kayser-Fleischer ring (KFR) in a child. The AS-OCT images highlight differential reflectivity of the KFR depending on amount of copper deposited in cornea, thus supporting the role of AS-OCT as a follow-up tool. Utility of AS-OCT for diagnosing and documenting the KFR in children otherwise uncooperative for detailed slit lamp examination is discussed.

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    17. ERG and OCT findings of a patient with a clinical diagnosis of occult macular dystrophy in a patient of Ashkenazi Jewish descent associated with a novel mutation in the gene encoding RP1L1

      ERG and OCT findings of a patient with a clinical diagnosis of occult macular dystrophy in a patient of Ashkenazi Jewish descent associated with a novel mutation in the gene encoding RP1L1

      A 57-year-old man with a past medical history of diabetes presented for consultation with a several year history of slowly progressive vision loss in both eyes, which continued to deteriorate over 7 years of follow-up. Multimodal imaging was performed and was significant for the following: on spectral domain optical coherence tomography, a gap lesion was present in the ellipsoid layer, beneath the umbo, as well as subtle macular changes on auto fluorescence imaging. Multifocal electroretinography was performed and was abnormal, and a clinical diagnosis of occult macular dystrophy was made. The patient was subsequently evaluated with genetic testing that revealed ...

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    18. Intravitreal cysticercosis with full thickness macular hole: management outcome and intraoperative optical coherence tomography features

      Intravitreal cysticercosis with full thickness macular hole: management outcome and intraoperative optical coherence tomography features

      Ocular cysticercosis is a serious condition with a potential for complete vision loss if left untreated. Intravitreal cysticercosis is the most common ocular form of cysticercosis and is associated with retinal detachment, retinal traction, subretinal scarring and vitritis. To the best of our knowledge, there is no report of the occurrence of a live intravitreal cysticercosis with a full thickness macular hole (FTMH) in the literature. We here report a case of live intravitreal cysticercosis with a FTMH along with its management and intraoperative optical coherence tomography features of the live cysticercus.

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    19. Use of optical coherence topography for objective assessment of fundus torsion

      Use of optical coherence topography for objective assessment of fundus torsion

      Objective assessment of fundus torsion is currently performed with indirect ophthalmoscopy or fundus photography. Using the infrared image of the macular scan of the optical coherence tomography one can assess the presence and amount of fundus torsion. In addition, the line scan through the fovea can be used as a reference to confirm the position of the foveal pit in relation to the optic nerve head. Two cases are used to demonstrate how to assess fundus torsion with the use of the optical coherence tomography.

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    20. Intraoperative OCT assisted descemetopexy with stromal vent incisions and intracameral gas injection for case of non-resolving Descemet's membrane detachment

      Intraoperative OCT assisted descemetopexy with stromal vent incisions and intracameral gas injection for case of non-resolving Descemet's membrane detachment

      Descemet's membrane detachment (DMD) though uncommon in the present day scenario of advancing surgical techniques is a significant complication that requires prompt diagnosis and management. A middle-aged man presented to our hospital with poor gain of vision following cataract surgery. There was significant corneal oedema with DMD which was confirmed on anterior segment optical coherence tomography. We describe a modified continuous intraoperative-guided approach for the management of DMD in cases with oedematous hazy corneas. The aim of this technique is to allow early reattachment of Descemet's membrane in chronic cases where fluid pockets prevent reattachment of the posterior ...

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    21. Optical coherence tomography angiography and fundus autofluorescence in the eyes with choroideremia

      Optical coherence tomography angiography and fundus autofluorescence in the eyes with choroideremia

      A 65-year-old man with presumed choroideremia with preserved central vision was examined by fundus autofluorescence (FAF) and optical coherence tomography angiography (OCTA). FAF showed an isolated area of hyperautofluorescence that involved the fovea. Although the choroid capillary slab of the OCTA showed the medium and large choroidal vessels inferior to the area of retinal pigment epithelium (RPE) atrophy, the choriocapillaris was visible in a relatively wider area than the hyperautofluorescent area in the FAF images. FAF and OCTA images allowed us to detect damage of the RPE before the choriocapillaris atrophy in a case of presumed choroideremia with preserved central ...

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      Mentions: Hideki Koizumi
    22. Optical coherence tomography of band keratopathy

      Optical coherence tomography of band keratopathy

      Band keratopathy is a chronic degenerative disease characterised by the gradual deposition of greyish opacity in superficial cornea over months or years in eyes with chronic uveitis or on intensive topical therapies containing phosphates. The mechanism of calcium deposition in the interpalpebral area of the cornea is multifactorial: salt precipitation as tears evaporate, necrotic debris from superficial keratitis, inflammatory changes in the pH of the ocular surface and the breakdown of phosphates. 1 , 2 Band keratopathy can result in severe visual loss from corneal opacification. The main goal of surgery is to …

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    23. OCT angiography in the management of choroidal neovascular membrane secondary to Sorsby fundus dystrophy

      OCT angiography in the management of choroidal neovascular membrane secondary to Sorsby fundus dystrophy

      We describe the management of a woman aged 52 years with molecularly confirmed Sorsby fundus dystrophy, who presented with acute visual deterioration in her right eye. Fundus examination identified a right macular lesion suggestive of a choroidal neovascular membrane (CNVM). Optical coherence tomography angiography (OCTA) confirmed the presence of a CNVM. She was treated with 2 monthly intravitreal injections of bevacizumab, associated with OCTA evidence of regression of the CNVM and improvement in her visual acuity. OCTA is a novel, non-invasive method of imaging the retinal vasculature. Images are acquired rapidly, with no associated side effects, offering advantages over the ...

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    24. Anterior segment optical coherence tomography of silicone oil keratopathy

      Anterior segment optical coherence tomography of silicone oil keratopathy

      A 77-year-old woman underwent pars plana vitrectomy for recurrent retinal detachment with silicone oil injection 10 years before presentation. Also the patient was placed on antiglaucoma medications. The patient had a history of recurrent corneal ulcerations in both eyes due to severe dry eyes. Examination revealed no light perception with a disfiguring central opaque corneal bulge in the left eye (figure 1). Anterior segment optical coherence tomography (OCT) revealed a marked thickening …

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    1-24 of 47 1 2 »
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