Choroidal nevus through a broader vision: Retinal imaging acquisition captured with Broad Line Fundus Imaging technology.

OBJECTIVE: To describe the peculiarities in imaging acquisition of fourteen patients with choroidal nevus using the Broad Line Fundus Imaging (BLFI) technology. METHODS: Single-center, retrospective, cross-sectional analysis. RESULTS: All images were acquired using the BLFI technology. We have found that choroidal nevus is undetectable in the blue channel (BC) (435-500 nm) and the green channel (GC) (500-585 nm). The only visible changes are related to the drusen, which appeared in BC and GC as light focal dots, correlated to the yellowish foci in the true-color image. On the red channel (RC) (585-640 nm), all lesions revealed the same pattern: a well-defined dark spot, with enhanced contrast, allowing the better visualization, measuring, and characterization of the nevus when compared with the other color channels, including the true-color imaging. CONCLUSION: BLFI application in choroidal nevus might be helpful at presentation, refining the diagnostic reliability, and monitoring, as it allows for better detection of alterations in the lesions. The peculiarities of the choroidal nevus are better assessed when using the RC due to its longer wavelength and deeper penetration in the retina and choroid.

Visualization of Short Posterior Ciliary Artery Insertion Due to Posterior Staphyloma and Myopic Chorioretinal Atrophy.

This case report describes the visualization of a short posterior ciliary artery insertion as a result of posterior staphyloma and chorioretinal atrophy in a patient in their 50s with pathologic myopia.

Novel OCT findings in choroidal osteoma: brief report.

The aim of this article is to report the presence of choroidal loculation of fluid and choroidal cavern in a case of choroidal osteoma, previously undescribed in this disease.

Granular Cell Tumor Located in the Bulbar Subconjunctival Space.

AIM: To report an unusual case of granular cell tumor. METHODS: Case report. RESULTS: A 14-year-old male presented with a bulbar conjunctival yellowish nonmovable mass, in the left eye. The tumor was removed and histopathologic evaluation revealed a granular cell tumor. CONCLUSION: Granular cell tumor can occur at the bulbar subconjunctival space.

Optic Disc Pyogenic Granuloma.

AIM: The aim of this paper was to report a rare presentation of adenoid cystic carcinoma. METHOD: This is a case report presenting clinical, radiographic, and histopathologic findings. RESULTS: A 72-year-old female with no reported ocular symptoms was found to have an incidental right orbital mass on imaging. Additional studies revealed multiple liver lesions, which were biopsied and found to be consistent with adenoid cystic carcinoma. She was then referred to the ophthalmology service, where ocular examination demonstrated 2.5 mm of right proptosis with elevation and abduction deficits. Diplopia could be elicited in extreme upgaze and right lateral gaze. An excisional biopsy of the orbital mass was performed, with histopathology confirming the diagnosis of primary adenoid cystic carcinoma of the lacrimal gland, thereby also supporting the initial suspicion that the hepatic adenoid cystic carcinoma lesions represented metastases. CONCLUSION: The authors describe a rare presentation of adenoid cystic carcinoma of the lacrimal gland, initially asymptomatic, with metastatic lesions restricted to the liver at the time of diagnosis. Three previous cases of adenoid cystic carcinoma with isolated metastatic hepatic lesions at the time of diagnosis have been reported; all of these cases localized the primary tumor to the salivary glands.

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma / Autofluorescência e tomografia de coerência óptica de domínio espectral do melanocitoma do disco óptico

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT) findings of two consecutive patients who presented with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Os autores descrevem os achados do exame de autofluorescência do fundo de olho (AF) e da tomografia de coerência óptica (TCO) de domínio-espectral em dois pacientes consecutivos apresentando melanocitoma disco óptico (MDO) em um estudo retrospectivo, por revisão dos prontuários e exames oftalmológicos de imagem. Os achados no exame de tomografia de coerência óptica foram hiperrefletividade e elevação da superfície anterior da lesão, desorganização da retina adjacente, e, sombreamento óptico posterior. Sementes vítreas foram encontrados em um paciente. O exame de autofluorêscencia do fundo de olho revelou hipoautofluorescência marcante na área do tumor e isoautofluorescência nas demais áreas da retina. As características encontradas na tomografia de coerência óptica dos pacientes apresentados são consistentes com os achados relatados na literatura atual. A autofluorêscencia do fundo de olho tem sido utilizada na avaliação de tumores melanocíticos da coroide, mas ainda não em melanocitomas. Acreditamos que este seja a primeira descrição dos achados de autofluorêscencia do fundo de olho em pacientes com melanocitoma de disco óptico e que, quando seu padrão de tornar-se claramente definido, a autofluorêscencia do fundo de olho será uma ferramenta útil para evitar erros de diagnóstico em casos suspeitos.

Fundus autofluorescence in blunt ocular trauma.

PURPOSE: To describe the findings of fundus autofluorescence (FAF) imaging in patients with blunt ocular trauma. METHODS: In this non-interventional retrospective study, we reviewed medical records and imaging examination results. The data analyzed included gender, age, laterality, trauma etiology, time between trauma and imaging, visual acuity, changes in the retinal periphery, fundus examination results, and FAF imaging findings. FAF imaging was performed using a Topcon TRC-50DX Retinal Camera (Tokyo, Japan). RESULTS: Eight eyes from 8 patients were studied. The mean age was 27.6 years (range, 19-43 years). Men (n=7) were more frequently affected by blunt ocular trauma than women (n=1). Physical aggression was the most common trauma etiology (n=3), followed by accidents with fireworks (n=2). Other causes were car accidents (n=1), occupational trauma caused by a grinder (n=1), or being hit by a stone (n=1). Visual acuity ranged from 20/80 to light perception. Traumatic pigment epitheliopathy (TPE) was identified in 5 cases, choroidal rupture in 3 cases, subretinal hemorrhage in 3 cases, and Purtscher's retinopathy in 1 case. Hypoautofluorescence was observed in cases of choroidal rupture, recent subretinal hemorrhage, and intraretinal hemorrhage, and in two cases of TPE. Hyperautofluorescence was observed in cases of old subretinal hemorrhage and at the edge of the lesion in two cases of choroidal rupture. Mild hyperautofluorescence was observed in the posterior pole in Purtscher's retinopathy. Three cases of TPE exhibited hypoautofluorescence with diffuse hyperautofluorescent areas. CONCLUSION: FAF imaging is a non-invasive method for assessing changes in the posterior segment of the eye resulting from blunt ocular trauma. Furthermore, this technique provides valuable information. We described the findings of FAF imaging in cases of TPE, choroidal rupture, subretinal hemorrhage, and Purtscher's retinopathy.

Fundus autofluorescence in blunt ocular trauma / Autofluorescência do fundo de olho no trauma ocular contuso

Purpose: To describe the findings of fundus autofluorescence (FAF) imaging in patients with blunt ocular trauma. Methods: In this non-interventional retrospective study, we reviewed medical records and imaging examination results. The data analyzed included gender, age, laterality, trauma etiology, time between trauma and imaging, visual acuity, changes in the retinal periphery, fundus examination results, and FAF imaging findings. FAF imaging was performed using a Topcon TRC-50DX Retinal Camera (Tokyo, Japan). Results: Eight eyes from 8 patients were studied. The mean age was 27.6 years (range, 19-43 years). Men (n=7) were more frequently affected by blunt ocular trauma than women (n=1). Physical aggression was the most common trauma etiology (n=3), followed by accidents with fireworks (n=2). Other causes were car accidents (n=1), occupational trauma caused by a grinder (n=1), or being hit by a stone (n=1). Visual acuity ranged from 20/80 to light perception. Traumatic pigment epitheliopathy (TPE) was identified in 5 cases, choroidal rupture in 3 cases, subretinal hemorrhage in 3 cases, and Purtscher's retinopathy in 1 case. Hypoautofluorescence was observed in cases of choroidal rupture, recent subretinal hemorrhage, and intraretinal hemorrhage, and in two cases of TPE. Hyperautofluorescence was observed in cases of old subretinal hemorrhage and at the edge of the lesion in two cases of choroidal rupture. Mild hyperautofluorescence was observed in the posterior pole in Purtscher's retinopathy. Three cases of TPE exhibited hypoautofluorescence with diffuse hyperautofluorescent areas. Conclusion: FAF imaging is a non-invasive method for assessing changes in the posterior segment of the eye resulting from blunt ocular trauma. Furthermore, this technique provides valuable information. We described the findings of FAF imaging in cases of TPE, choroidal rupture, subretinal hemorrhage, and Purtscher's retinopathy. .

Objetivo: Descrever os achados do exame de autofluorescência do fundo de olho (AFF) em pacientes vítimas de trauma ocular contuso. Métodos: Estudo retrospectivo, não intervencionista, realizado através da revisão de prontuários e exames de imagem. Os dados analisados foram: sexo, idade, lateralidade, etiologia do trauma, tempo decorrente entre o trauma e a realização do exame, acuidade visual, alterações na periferia da retina, diagnóstico fundoscópico e achados ao exame de AFF (realizada no aparelho Topcon TRC-50DX Retinal Camera). Resultados: Oito olhos de 8 pacientes foram estudados. A idade média foi de 27,6 anos (de 19 a 43 anos), o sexo masculino (n=7) foi mais acometido do que o feminino (n=1), agressão física foi a etiologia mais comum do trauma (n=3), seguido de acidente com fogos de artifício (n=2). Outras causas foram acidente automobilístico (n=1), trauma ocupacional com lixadeira (n=1) e pedrada (n=1). A acuidade visual variou de 20/80 a percepção luminosa. Epiteliopatia pigmentar traumática (EPT ) foi identificada em 5 casos, rotura de coroide em 3, hemorragia subretiniana em 3 e retinopatia de Purtscher em 1 caso. Hipoautofluorescência foi observada nos casos de rotura de coroide, hemorragia subretiniana recente, hemorragia intrarretiniana e em 2 casos de EPT. Hiperautofluorescência foi visualizada nos casos de hemorragia subretiniana em degradação, na borda de 2 casos de roturas de coroide e discretamente no polo posterior na retinopatia de Purtcher. Três casos de EPT apresentaram hipoautofluorescência com pontos hiperautofluorescentes difusos. Conclusão: O exame de AFF permite avaliar as alterações do segmento posterior do olho decorrentes do trauma ocular contuso de forma não invasiva, somando informações valiosas. Foram descritos achados do exame ...

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma.

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT) findings of two consecutive patients who presented with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Retinal vasoproliferative tumor.

Retinal vasoproliferative tumor is a rare disease that has capillary hemangioma as the most frequent diferential diagnosis. The tumor is considered to be of reactive nature. It can be idiophatic or secondary to other ocular diseases such as: uveitis, retinitis pigmentosa, sickle cell disease, previous surgery and retinopathy of prematurity. Lesions with no exsudation or visual decrease can be observed. Lesions that need treatment can be managed by on or more modalities such as cryotherapy, a variety of lasers, surgical excision, radiation, and antiangiogenic intravitreal injections.

Retinal vasoproliferative tumor / Tumor vasoproliferativo da retina

Retinal vasoproliferative tumor is a rare disease that has capillary hemangioma as the most frequent diferential diagnosis. The tumor is considered to be of reactive nature. It can be idiophatic or secondary to other ocular diseases such as: uveitis, retinitis pigmentosa, sickle cell disease, previous surgery and retinopathy of prematurity. Lesions with no exsudation or visual decrease can be observed. Lesions that need treatment can be managed by on or more modalities such as cryotherapy, a variety of lasers, surgical excision, radiation, and antiangiogenic intravitreal injections.

O tumor vasoproliferativo da retina é uma lesão rara, cujo principal diagnóstico diferencial é o hemangioma capilar da retina. O tumor tem natureza reacional. Pode ser idiopático ou secundário a outras doenças como: uveítes, retinose pigmentar, retinopatia da anemia falciforme, cirurgia prévia e retinopatia da prematuridade. Lesões sem exsudação ou baixa visual podem ser observadas. Quando há indicação de tratamento este pode ser feito pela crioterapia, vários tipos de lasers, excisão cirúrgica, radioterapia e injeções intravítrea de antiangiogênicos, isoladamente ou em associação.

Capsulorrexe em duplo anel: estudo clínico patológico / Double ring capsulorhexis: clinic opathologic study

Apresentamos caso de capsulorrexe em duplo anel em paciente feminina de 81 anos. O espécime cirúrgico foi submetido a estudo anatomopatológico que evidenciou os achados típicos da capsulorrexe em duplo anel. Comentamos a possível relação com a exfoliação capsular verdadeira. Salientamos que é possível realizar a cirurgia com bom resultado mesmo que o duplo anel não seja completo - como no caso apresentado - , porém desde que os folhetos capsulares estejam fundidos de forma contínua.

We present a case of double ring capsulorhexis in a 81 year-old female patient. Surgical specimen was submitted to histopathologic study resulting in typical double ring capsulorhexis findings. We discuss the questioned relation to true capsular exfoliation. We call attention to the fact that it is possible to obtain a good surgical result even when the double ring is not complete - as the case presented - , since both capsular flaps are fused in a continuous form.

Inflamação esclerosante idiopática da órbita: estudo clinico-patológico / Idiopathic sclerosing orbital inflammation: clinicopathologic study

OBJETIVO: Descrever oito casos de inflamação esclerosante idiopática da órbita, incluindo a análise clínica e histopatológica. MÉTODOS: Estudo retrospectivo através do livro de registros do Laboratório de Patologia Ocular (LPO) do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, no período de 1974 a 2010. Além de revisão de lâminas de todos os casos e das imagens clínicas e de exames complementares recuperadas dos arquivos pessoais dos autores. RESULTADOS: Dentre o total de espécimes submetidos ao LPO (7546) apenas 8 casos receberam diagnóstico final de inflamação esclerosante idiopática da órbita. Em todos os casos houve piora ou deterioração da acuidade visual à despeito do tratamento, com exceção de um, que permaneceu com a mesma visão (percepção luminosa). Em nosso estudo, observamos envolvimento orbitário predominantemente apical. Todos os nossos pacientes foram submetidos à biópsia incisional com finalidade diagnóstica. Também submeteram-se à corticoterapia e em um caso foi associada à radioterapia anti-inflamatória; em dois destes casos, foi utilizado também ciclofosfamida. Dois pacientes com acuidade final sem percepção luminosa tiveram que ser submetidos à exenteração parcial da órbita para tratamento de dor incontrolável. CONCLUSÃO: A inflamação esclerosante orbitária idiopática permanece como uma doença pouco conhecida, de péssimo prognóstico visual.

PURPOSE: To describe the clinical and histopathologic findings of eight cases of idiophatic sclerosing orbital inflammation. METHODS: A retrospective study from the file of the Ophthalmic Pathology Laboratory of the Hospital Universitário Professor Edgard Santos, Federal University of Bahia, during the period from 1974 to 2010. The clinical data, computed tomography and histopathologic sections obtained by biopsy of all cases were reviewed. RESULTS: From 10312 specimens submitted to the Ophthalmic Pathology Laboratory, eight (0,08%) had a final diagnosis of idiopathic sclerosing orbital inflammation. All cases were unilateral and in all of them vision acuity decreased or was lost despite of treatment, except for one case that remained with light perception as in the first examination. A predominance of diffuse orbital involvement was observed by computed tomography. Histopathologic evaluation disclosed dense fibrosis and collagen deposition with paucicellular inflammation in all cases. All patients were treated by immunosupression with steroids and one case had an association of anti-inflammatory radiotherapy. Two patients were also treated with ciclophosphamide. Partial orbital exenteration was necessary in two cases due to uncontrollable pain. CONCLUSION: Idiopathic sclerosing orbital inflammation remains as a disease with poor response to treatment ans a very bad visual prognosis.

Orbital parasitosis.

Orbital parasitoses are uncommon diseases. Due to specific characteristics of orbital space, many different diseases, such as tumors and inflammatory disease, can present with similar clinical manifestations. The aim of this study is to review the most important clinical, epidemiological, and treatment aspects of orbital parasitoses described worldwide.

Isolated uveal tuberculoma masquerading as an intraocular tumor in an immunocompetent patient-a clinical-pathologic study with diagnosis by PCR.

PURPOSE: The aim of this article is to report a case of uveal tuberculoma simulating an intraocular tumor in which the diagnosis was only possible by polymerase chain reaction (PCR) analysis. METHOD: This is a case report. RESULTS: A36-year-old male presented with a progressive growing intraocular tumor and no history or positive test for other systemic disease. The eye eventually turned blind and painful and was enucleated. Histopathologic analysis revealed a granulomatous reaction and caseation necrosis but failed to identify any causative microorganisms. Final tuberculosis diagnosis was only possible by quantitative PCR. CONCLUSION: Isolated uveal tuberculoma can present in an otherwise healthy patient with negative systemic tuberculosis evaluation. PCR can be used to confirm tuberculosis when other methods have failed.

Dupla membrana de Descemet após ceratoplastia penetrante - abordagem cirúrgica durante a facoemulsificação: relato de caso / Double Descemet's membrane after penetrating keratoplasty - surgical approach during phacoemulsification: case report

Apresentamos um caso retenção inadvertida de membrana de Descemet durante ceratoplastia penetrante por distrofia endotelial de Fuchs. Comentamos as dificuldades encontradas para sua remoção durante a cirurgia de catarata subsequente, bem como propomos uma nova abordagem cirúrgica.

A case of inadvertent retention of Descemet's membrane after penetrating keratoplasty for Fuchs dystrophy is reported. The challenges to remove it during cataract surgery are commented, as well as a proposal of a new surgical approach.

Alterações oculares em micose fungóide associada com vírus linfotrópico de células t humanas tipo I / Ocular fidings in mycosis fungoides associated with human t-lymphotropic virus type I

São relatados dois casos da associação de micose fungóide e HTLV-I. Os achados oftalmológicos observados foram, no caso 1: ceratopatia ponteada e ceratoconjuntivite seca e; no caso 2: ceratoconjuntivite seca, espessamento e nódulos difusos em bordas palpebrais. A associação de micose fungóide e HTLV-I nos dois casos sugere envolvimento deste vírus na etiopatogenia da doença. Maior conhecimento e realização de estudos bem controlados poderão ser úteis na determinação precisa desta hipótese.

Two cases of mycosis fungoides associated with HTLV-I are reported. The ophthalmological findings were, in the first case, punctate keratopathy and keratoconjunctivitis sicca, and in the second case, keratoconjunctivitis sicca, thickening and difuse nodulos on eyelid margin. The association of mycosis fungoides and HTLV-I in these cases suggests involvement of this agent in the pathogenesis of the disease.

Optical coherence tomography findings in acute phase of branch retinal artery occlusion: case report.

PURPOSE: to report a case of branch retinal artery occlusion in the acute phase, using optical coherence tomography to evaluate the morphologic changes. A 27 year-old man had a sudden superior scotoma in the right eye, with fundus examination compatible with inferior temporal branch retinal artery obstruction. The optical coherence tomography revealed increase in thickness and hyper-reflectivity of the inner retinal layers in affected area, with decreased reflectivity of photoreceptor and retinal pigment epithelial layers. The optical coherence tomography findings are consistent with intracellular edema, and not with secondary vascular leakage of extracellular fluid, according to histopathological theories of retinal ischemia and necrosis that occurs after retinal artery occlusion.