Orbital metastases from prostate adenocarcinoma: Case report and review of the literature.

Introduction: Prostate carcinoma metastasizes usually to lymph nodes and bone. Its metastases to the orbital cavity remain very rare. Observation: We report here the case of an 80-year-old man diagnosed with a non-metastatic prostate adenocarcinoma 9 months earlier, who was found to have an orbital metastasis revealed by a proptosis of his left eye. He received hormonal therapy, chemotherapy and radiotherapy. Discussion: Orbital metastases from prostate carcinoma have many similarities to other orbital metastases in their presentation. Their diagnosis is easily done when there is a history of a primary tumor. Presenting symptoms include proptosis, limitation of eye movements, diplopia and decreased vision. Conclusion: Through this case report and a review of literature, we discuss the incidence, the clinical presentation and the management of these tumors.

Leber's idiopathic stellate neuroretinitis: A clinical case.

Introduction: In 1916, Leber's idiopathic stellate neuroretinitis (LISN) was described by Theodore Leber as a rare disease characterized by optic disc swelling associated with a macular star. This fundus appearance can have multiple causes but the etiology of Leber's idiopathic stellate neuroretinitis remains unknown. Case report: A 40 year-old man consulted for a progressive decline in visual acuity and a blurred vision in his left eye. Corrected Visual acuity of the left eye was hand motion, Funduscopy of the left eye revealed a stellate maculopathy with loss of foveolar depression and a normal optic disc. The angiography confirmed an optic disc oedema. Laboratory investigations were normal. No infectious nor inflammatory etiology was found. Brain imaging was normal. Patient received 3 days of intravenous methylprednisolone at 10mg/kg/D for 3 days in a row and an oral relay was started with a progressive degression over 2 weeks. The evolution after treatment was satisfactory, the visual acuity 3 weeks after the intravenous injection of corticoids increased to 2/10. Discussion: Leber's idiopathic stellate neuroretinitis (LISN) is a disorder characterized by disc oedema, peripapillary and macular hard exudates and, often, the presence of vitreous cells. The changes in the optic nerve are the primary cause of reduced vision in this condition. The more common treatable causes must be excluded wich are cat scratch disease (CSD) and vascular disease. 50% of cases have no identifiable cause and are labeled idiopathic neuroretinitis. There is no consensus regarding optimal treatment. The prognosis of Leber's idiopathic stellate neuroretinitis is good in most cases. Conclusion: The cause of neuroretinitis must be aggressively pursued before a diagnosis of lebre's idiopathic neuroretinis can be retained in order to formulate an appropriate treatment strategy.

Sclerochoroidal calcification associated with chondrocalcinosis: A clinical case.

INTRODUCTION: Sclerochoroidal calcifications is a rare condition corresponding to senile plaques due to the deposition of calcium and phosphate in the sclera and choroid. It is an elderly patient's pathology. In most cases, it is idiopathic. However, some patients have systemic disorders leading to disturbances in phosphocalcic metabolism, which are at the origin of this disorder. A check-up is therefore necessary to detect them. OBSERVATION: We report the case of a 65 year old patient admitted to the ophthalmology department for a renewal of optical correction. The patient is known to have articular chondrocalcinosis on anti-inflammatory medication. Fundus examination revealed multiple white supra macular choroidal lesions with tumour-like appearance in both eyes. The ultrasound perfomed showed the calcic nature of the lesions. Fluorescein and indocyanine green angiograms showed no sign of activity or presence of neovessels.A complete metabolic work-up, mainly phosphocalcic, was ordered again and the systemic diagnosis of articular chondrocalcinosis was retained. DISCUSSION: Shields et al. first described, in 1997, a case of sclerochoroidal calcification in a patient with chondrocalcinosis and a normal metabolic profile. Few more have been added to the literature. It is generally considered to be predominantly bilateral and is most often seen as yellowish lesions. Two types of calcifications have been described to date, the plaque type and the pseudotumor type. Given the asymptomatic presentation, a fundus examination should be performed in patients with chondrocalcinosis. Generally, no treatment is necessary. CONCLUSION: Sclerochoroidal calcifications usually manifests as multiple discrete yellow placoid lesions in elderly asymptomatic patients. Visual prognosis for sclerochoroidal classification is good since the lesions tend to be away from the macula. They should not be confused with choroidal metastasis or achromic melanoma which require more extensive treatment.

Retinal angioma of Von hippel-lindau disease: A case report.

INTRODUCTION: Von Hippel-Lindau disease (VHL), also known as Von Hippel-Lindau syndrome, is a rare genetic disorder with multisystem involvement. It is characterised by the development of multiple vascularised tumours, particularly cerebellar, retinal and/or visceral. The disease can occur at any age and usually starts with retinal hemangioblastomas. CASE REPORT: We report the case of a 45-year-old female patient with no particular pathological history, who. consulted the ophthalmology department for a change of optical correction.The funds examination showed an uncomplicated bilateral hemangioma with no other associated signs. Fluorescein angiography confirmed the diagnosis by showing in the left eye a multiple retinal hemangioma visible in the mid-periphery facing the branches of the superior temporal arches. The brain MRI showed a multifocal hemangioblastoma in the posterior cerebral fossa. A renal ultrasound returned normal. The patient had undergone photocoagulation of the retinal lesions to avoid any complications. DISCUSSION: The German ophthalmologist Eugen von Hippel first described angiomas in the eye. The term Von Hippel-Lindau disease was first used in 1936; however, its use became common only in the 1970s.Tumours called hemangioblastomas are characteristic of von Hippel-Lindau syndrome. These growths are made of newly formed blood vessels and occurs in the periphery of the retina. Spontaneous progression occurs leading to visual impairment as a result of maculopathy or exudative retinal detachment.Early recognition and treatment of specific manifestations of VHL can substantially decrease complications and improve quality of life.Conventional treatment of the retinal hemangioblastomas is laser photocoagulation or cryotherapy depending on the location and size of the lesions. It must be based on the patient's visual symptoms and tumor progression. CONCLUSION: Management of patients with VHL disease often requires a multidisciplinary approach. The role of the ophthalmologist is important in the management of this condition since the ocular involvement may be indicative of the disease.

Gillespie syndrome: An atypical form and review of the literature.

INTRODUCTION: Gillespie syndrome (GS) is a rare genetic disorder that combines ocular and cerebral defects.It was first described in 1965, by Frederick D. Gillespie. He reported a triad of congenital aniridia, cerebellar ataxia and mental retardation in a 22-year-old woman and her 19-year-old brother. Its etiology is still unknown.To date, less than 30 patients have been reported in the literature. OBSERVATION: We report the case of a 2 years old child, born of a consanguineous marriage. At the age of 8 months, the parents consulted for a delay in psychomotor acquisition for which the MRI performed showed a vermian hypoplasia. It was only at the age of 2 years, following a contusive trauma of the left eye that a partial aniridia was objectified on both eyes associated with a lens coloboma on the left eye. In view of these clinico-radiological data, the diagnosis of Gillespie syndrome was retained. DISCUSSION: Gillespie syndrome is a genetic disease. It combines ocular and neurological abnormalities. It was first described in 1965 by Gillespie. The ocular manifestations of Gillespie syndrome mainly concern the iris. Aniridia is always present with, in most cases, a scalloped appearance of the pupillary margin. It can be accompanied with additional ocular findings such as foveal, optic nerve hypoplasia, retinal hypopigmentation, and/or pigmentary macular changes leading to reduced visual acuity.In addition to ocular abnormalities, the Gillespie syndrome. (GS) includes neurological deficiencies, particularly axial hypotonia, lack of coordination, dysarthria and static and kinetic ataxia. CONCLUSION: The diagnosis of Gillespie Syndrome should be evoked in any hypotonic child presenting with bilateral but partial aniridia. Prognosis depends on the proper management and anticipation of ocular and mental symptoms and disabilities.