Paracentral Acute Middle Maculopathy Associated With Cilioretinal Artery Insufficiency Following COVID-19 Vaccination in a Young Patient.

We aim to present a unique case of unilateral paracentral acute middle maculopathy (PAMM) associated with cilioretinal artery insufficiency following the coronavirus disease 2019 (COVID-19) vaccination. A 28-year-old male complained of a sudden blurring of vision in his left eye 40 days after receiving the second dose of COVID-19 immunization. The optical coherence tomography revealed a diffuse paracentral area of hyper-reflective change in the inner plexiform layer and an increase in the inner nuclear layer volume, consistent with PAMM along the course of the cilioretinal artery. PAMM has been connected to an assortment of retinal vasculature anomalies. Considering COVID-19 vaccination, we hypothesize that the immunogenic cascade following vaccination dysregulated coagulation and led to retinal vascular thrombosis. However, the link between COVID-19 vaccination and retinal vascular occlusion disease remains unknown.

Spontaneous Visual Acuity Recovery After Cilioretinal Artery Occlusion Combined With Central Retinal Vein Occlusion in a Young Patient.

This work illustrates the case of cilioretinal artery occlusion (CilRAO) combined with central retinal vein occlusion (CRVO) in a young patient that resolved spontaneously. A 17-year-old male with an unremarkable medical history presented with acute painless loss of vision unilaterally. Upon ophthalmologic examination, retinal hemorrhages in all four quadrants and edema extending from the optic disc to the macula were reported. Using optical coherence technology (OCT) imaging and fundus fluorescein angiography (FFA), combined CilRAO/CRVO was diagnosed. The full medical evaluation was unremarkable. Within the next month, the patient had regained full visual acuity (VA) in the affected eye, and the retinal findings resolved without intervention. Combined CilRAO/CRVO is a common vascular pathology in young, otherwise healthy patients. It is commonly considered a hemodynamic block in the capillary bed, hence its hopeful prognosis. Nonetheless, several risk factors have been proposed that need to be eliminated. Despite the initial alarming symptoms, young patients with CilRAO/CRVO should be monitored closely, and intervention should be resorted to when necessary.

Ligneous conjunctivitis associated with type I plasminogen deficiency: A rare case.

Ligneous conjunctivitis is a rare form of chronic, recurrent conjunctivitis characterized by wood-like, fibrinous pseudomembranes, which may be associated with systemic disease manifestations. It has been associated with congenital plasminogen (PLG) deficiency that is inherited with an autosomal recessive pattern due to mutations in the PLG gene and a variety of other genes, leading to disturbed wound healing. In this case report, we present the clinical, laboratory, and histopathological findings of a 36-year-old female patient who presented at the ophthalmology department with complaints of redness, irritation for the previous few weeks, and appearance of membranous lesions mainly on the tarsal conjunctivae. During biomicroscopic examination we found thick, yellowish-white pseudomembranes, and conjunctival proliferation with ligneous induration on the conjunctiva, located on the upper eyelids. Histopathological evaluations showed up ligneous conjunctivitis and laboratory evaluation confirmed a severe plasminogen deficiency (PLG < 2%). The patient was treated with topical fresh frozen plasma (FFP), topical steroids, heparin eye drops, and artificial tear drops daily, without systemic therapy.