The COVID-19 pandemic has posed a challenge for many medical schools, as they have had to adjust their curricula into an online format. This was particularly problematic for anatomy courses as in person dissections have historically been preferred for providing students with a three-dimensional learning environment. In this study, we aim to share our experience with conducting anatomy lectures for medical student using a virtual reality (VR) workspace. Additionally, we discuss the advantages of using VR and expand on how it may be used to improve students' understanding of anatomy in comparison to various other online lecture formats. To do this, we utilized a post-lecture survey to gain feedback from the medical students that participated in a VR anatomy workspace. We found that many of our participants expressed that having access to their course material from anywhere and anytime via a virtual space, and being able to manipulate anatomical structures by moving and modifying them provided the student with a strong advantage. Although there are still limitations, we hope that our experience will assist other anatomy teachers with improving their lecture methods, especially during the pandemic.
Background
Choroidal sarcoid granulomas are often diagnosed in patients without a prior history of sarcoidosis. They are often mistaken for choroidal metastasis, choroidal nevi, amelanotic choroidal melanomas, and uveal lymphomas; however, are easily treatable when accurately identified.
Observations
We searched PubMed, Medline, and Scopus for English-Language case reports published before September 2021. Additionally, we presented a case of a 45-year-old woman with a right-sided amelanotic choroidal mass whose diagnosis was delayed by a COVID-19 infection. Of the 26 cases reported in the literature, 46% were female, 38% were African American, and 19% had bilateral involvement. There was a mean age of 42.15 years and a mean follow-up period of 27 months. The most common complaint was of a progressive, painless blurring of vision, and only five patients had been previously diagnosed with sarcoidosis. The choroidal granulomas were typically described as yellow lesions, single or multiple, found temporal to or at the macula. Most patients were administered steroids, with 69% receiving them systemically, 5% topically, and 8% locally with a triamcinolone injection. All patients reported symptomatic improvement at their final follow-up with resolution of the mass in 65% of patients and improved visual acuity in 76%.
Conclusion
Primary testing including fundoscopy, fluorescein angiography, fundus autofluorescence, A/B-scan, and OCT are useful for diagnosis, differentiation from other choroidal lesions, and monitoring treatment response. Steroids are a mainstay of treatment for sarcoidosis and are effective at treating choroidal granulomas. Therefore, early recognition and diagnosis of choroidal granulomas is imperative as treatment can be curative and sight-sparing.
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