Posterior Precortical Vitreous Pocket in Stickler Syndrome: A Report of Two Cases.

Stickler syndrome is a genetic disorder characterized by collagen abnormalities leading to various ocular manifestations, such as retinal detachment. We present two cases of siblings clinically diagnosed with Stickler syndrome who exhibited retinal detachment. Case 1, a seven-year-old girl, and case 2, her 14-year-old brother, both displayed severe myopia and other clinical signs consistent with Stickler syndrome. Despite their ages, neither case showed evidence of posterior precortical vitreous pocket (PPVP) on imaging or during surgical intervention. These findings suggest a potential relationship between collagen abnormalities and PPVP dysplasia in Stickler syndrome.

Validation of a new technique using 4-0 nylon thread as a guide for tube insertion of the Ahmed glaucoma valve into the ciliary sulcus.

ABSTRACT: In this study, we validated the new technique for inserting the tube of the Ahmed glaucoma valve (AGV) into the ciliary sulcus. AGV tube insertion was performed by introducing a 4-0 nylon thread into the anterior chamber from the corneal incision on the opposite side of the AGV. The thread was placed in the lumen of a 23-G needle that was inserted into the sclera and ciliary sulcus from the AGV side. Withdrawing the 23-G needle, the thread was led out of the eye from the scleral wound, passing through the ciliary sulcus. The thread was then placed in the AGV tube lumen, and the tube was inserted through the scleral wound into the ciliary sulcus by using the thread as a guide, as per the Seldinger technique. In all seven eyes, the tube was precisely inserted into the ciliary sulcus without serious intraoperative complications such as vitreous straying of the tube.

A CASE OF EALES DISEASE OBSERVED BY WIDEFIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PURPOSE: The purpose of this study was to report a 30-year-old woman with Eales disease, showing bilateral proliferative tissue. The retinal vessels were evaluated using widefield optical coherence tomography angiography (widefield OCTA), which has a wider angle of view compared with conventional instruments. METHODS: This is a case report. RESULTS: Widefield OCTA showed an extensive nonperfusion area and A-V shunt in both eyes and a vascular structure in the left eye that appeared to be retinal neovascularization. Ultra-widefield fluorescein angiography revealed no filling delay in the early phase, a vast nonperfusion area from the midperiphery to the ora serrata in bilateral eyes, and retinal neovascularization in the left eye. Based on the results of ultra-widefield angiography, OCTA examination, and systemic examination, a diagnosis of Eales disease was finally made after all the differential diseases had been excluded. CONCLUSION: In a patient with Eales disease, the peripheral nonperfusion area and retinal neovascularization that were consistent with the ultra-widefield angiography findings were noninvasively confirmed by widefield OCTA. Widefield OCTA is useful in the detection of peripheral changes of the fundus.

A case of Elschnig's spots observed using optical coherence tomography-angiography after stenting for internal carotid artery dissection.

PURPOSE: We report the case of a 28-year-old man who developed Elschnig's spots after stenting for an internal carotid artery dissection using optical coherence tomography angiography (OCTA). METHODS: A case report. RESULTS: The patient developed a visual field defect in the left eye immediately after endovascular stenting for left internal carotid artery dissection. Fundus examination revealed white lesions and numerous mottled orange-red lesions in the posterior pole and mid-periphery of the left eye. Indocyanine green angiography revealed mottled hypofluorescein areas in the early and late stages, coinciding with the orange-red lesions. OCTA showed flow void areas in the choriocapillaris layer, consistent with the orange-red lesions, which were diagnosed as Elschnig's spots associated with choroidal circulatory failure. The spots disappeared approximately 2 months after surgery, and the flow void on OCTA also disappeared. CONCLUSION: We report a case of Elschnig's spots associated with transient choroidal circulatory failure after stenting for internal carotid artery dissection. OCTA detected improved circulation at the level of the choriocapillaris with the disappearance of Elschnig's spots.

Clinical characteristics of pachydrusen in central serous chorioretinopathy.

PURPOSE: To evaluate the clinical characteristics of pachydrusen in central serous chorioretinopathy (CSC) and investigate the relationship between choroidal circulation and pachydrusen. METHODS: In a retrospective case series of 302 eyes of 151 patients with treatment-naïve CSC, we assessed the incidence of pachydrusen and their features on indocyanine green angiography (ICGA) and optical coherence tomography (OCT). RESULTS: Pachydrusen were observed in 82 of the 302 eyes (27.2%). The patients with pachydrusen were significantly older than those without pachydrusen. In 36 of the 82 eyes with pachydrusen, the choriocapillaris perfusion phase of ICGA was recorded. Pachydrusen were localized within the geographic filling delay of the choriocapillaris in 26 of the 36 eyes (72.2%). In the late phase of ICGA, pachydrusen corresponded to punctate hyperfluorescent spots in 69 of the 82 eyes (84.1%) and localized within sites of choroidal vascular hyperpermeability in 45 eyes (54.9%). En face OCT revealed pachydrusen to be localized over the dilated outer choroidal vessels in 70 of the 82 eyes (85.4%). B-mode OCT showed pachydrusen under the retinal pigment epithelium (RPE) in 72 of the 82 eyes (87.8%). There was no significant difference in central choroidal thickness between eyes with and without pachydrusen. CONCLUSIONS: Pachydrusen in patients with CSC were frequently localized within the choriocapillaris filling delay and over the dilated outer choroidal vessels. Moreover, they were frequently observed under the RPE and corresponded to punctate hyperfluorescent spots on ICGA. These findings suggest that inner choroidal circulation impairment due to dilatation of outer choroidal vessels might induce pachydrusen.