Postsurgical sympathetic ophthalmia: retrospective analysis of a rare entity.

PURPOSE: To describe clinical manifestations, management and visual outcome in postsurgical sympathetic ophthalmia (SO). METHODS: Retrospective study. RESULTS: Mean age of the patients was 41.1 years, and males were affected 1.8 times than the female. Vitrectomy and scleral buckling were the most common inciting surgeries followed by cataract surgery. Among 10 eyes with anterior uveitis, mutton-fat keratic precipitate was seen in only two eyes. Mean follow-up duration was 1556.50 ± 1470.75 days. Vision significantly improved in 11 patients (78.6%; p = 0.005). CONCLUSION: Postsurgical SO is a rare entity, but it is a bilateral blinding disease and SO following surgical intervention can have variable presentations. Rapid, effective management of postsurgical sympathetic ophthalmia can give improved visual outcomes.

Pilomatrix carcinoma of the eyebrow.

Pilomatrix carcinoma is an uncommon malignant neoplasm originating from the hair follicle matrix. It occurs more frequently in head and neck region and rarely on the eyelid and eyebrow. It is often clinically misdiagnosed. The diagnosis is confirmed by excision biopsy and histopathological examination. A 68-year-old woman presented with a mass on her left eyebrow mimicking sebaceous cyst. An excisional biopsy with 4-mm margin was performed under frozen section. Histopathology demonstrated pilomatrix carcinoma with cystic degeneration. Periocular malignancies can have unusual origins with specific clinical features. Preoperative clinical examination is mandatory to rule out unusual features and thereby ensure appropriate management to prevent serious complications.

Bilateral Occlusive Vasculitis Associated with Retinitis Pigmentosa - A Case Report.

PURPOSE: To report a case of bilateral occlusive vasculitis associated with retinitis pigmentosa (RP). METHOD: Case report. CASE REPORT: A 34-year male presented with blurred vision in left eye (OS) for two weeks and right eye (OD) for one day. He had night blindness for five years. His best corrected visual acuity (BCVA) was OD 20/63 and OS 20/200. Ophthalmoscopy revealed bilateral RP with OD inflammatory central retinal vein occlusion (CRVO) and OS occlusive vasculitis with bilateral macular edema. Presumed intraocular tuberculosis (IOTB) was suspected based on clinical features, positive Mantoux and high-resolution computed tomography chest findings. Oral steroids and antitubercular therapy (ATT) were started. OD received six intravitreal ranibizumab injections. At his 7-month follow-up, BCVA improved, OD 20/40 and OS 20/80. CONCLUSION: RP rarely can be associated with presumed IOTB. Oral steroids with ATT are helpful; however, in inflammatory CRVO, intravitreal ranibizumab can give good results.

Vogt Koyanagi Harada disease following a recent COVID-19 infection.

A 23-year-old female presented with a 3-day history of bilateral (OU) diminution of vision 3 weeks after COVID-19 infection. Best corrected visual acuity (BCVA) was 20/30 in right eye and 20/40 in left eye. Anterior segment showed OU 1+ cells in anterior chamber and anterior vitreous face. Fundus OU showed disc hyperemia and multiple pockets of subretinal fluid (SRF), confirmed on optical coherence tomography. Fundus fluorescein angiography showed multiple pin point leaks suggestive of Vogt Koyanagi Harada disease. Oral corticosteroids 1 mg/kg/day were started. At 2-months' follow-up, her BCVA improved to 20/25 OU with complete resolution of SRF.

Interleukins and cytokine biomarkers in uveitis.

Interleukins and cytokines are involved in the pathogenesis of uveitis of heterogeneous origin. Understanding the basics of the ocular immune privilege is a fulcrum to discern their specific role in diverse uveitis to potentially translate as therapeutic targets. This review attempts to cover these elements in uveitis of infectious, noninfectious and masquerade origin. Insights of the molecular targets in novel therapy along with the vision of future research are intriguing.

Ocular Toxoplasmosis in Tropical Areas: Analysis and Outcome of 190 Patients from a Multicenter Collaborative Study.

PURPOSE: To describe clinical findings and outcomes for ocular toxoplasmosis in an international multicenter collaborative study. METHODS: Retrospective analysis of 190 patients diagnosed with ocular toxoplasmosis from three study sites (Brazil, India, and Singapore). RESULTS: There were 93 (48.9%) females with a mean age of 32.8 years. The most common symptoms were isolated blurring of vision (36.8%), followed by blurring of vision with floaters (21.1%). Treatment regimens varied largely from monotherapy to multiple combination therapies. Final visual acuity of ≥20/40 was achieved in 106 (74.2%) patients. In a median follow-up period of 31 weeks (range 12-749 weeks), 83/190 (43.7%) patients suffered a relapse. CONCLUSIONS: There appears to be geographical variation in the presentation of ocular toxoplasmosis. Compared to previous studies, we did not observe the '"dual peak" phenomenon of chronic and active disease based on age at presentation, and there was less bilateral and macular involvement (but more peripheral involvement).

Varicella Zoster-related Occlusive Retinal Vasculopathy--A Rare Presentation.

PURPOSE: To report a case of occlusive retinal vasculopathy following varicella zoster infection in an immunocompetent adult. DESIGN: Observational case report. METHODS: A patient with defective vision following chickenpox was evaluated with fluorescein angiography, spectral domain optical coherence tomography and fundus auto fluorescence. RESULTS: Fundus showed multiple cotton wool spots and a well-demarcated zone of retinal ischemia in the posterior pole with normal optic disc without any evidence of anterior or posterior uveitis. Fluorescein angiography, spectral domain optical coherence tomography and fundus auto fluorescence findings revealed occlusive vasculopathy as the cause of defective vision. CONCLUSIONS: We report a hitherto undescribed case of purely occlusive vasculopathy following varicella zoster infection without features of vasculitis or anterior and posterior uveitis in an immunocompetent individual.

Spectral domain optical coherence tomography-guided laser treatment of central serous chorioretinopathy in a pregnant woman.

PURPOSE: To report a case of central serous chorioretinopathy treated with focal laser photocoagulation guided by spectral domain optical coherence tomography (SD-OCT) without fluorescein angiography. METHODS: In this interventional case report, a 27-year-old pregnant lady with central serous chorioretinopathy was evaluated with fundus photography and SD-OCT. She was treated with focal laser photocoagulation to the area of micro rip on the summit of pigment epithelial detachment identified by SD-OCT. RESULTS: Successful treatment of serous macular detachment using SD-OCT in a pregnant lady. CONCLUSION: We report a case of central serous chorioretinopathy evaluated and treated successfully with SD-OCT without the use of fluorescein angiography.