Purpose: To describe the multicolor imaging (MCI) features in a series of patients diagnosed with a choroidal nevus and compare it vis-à-vis color fundus photography (CFP) in identifying the lesion. Methods: In this retrospective, descriptive case series at a tertiary referral center in South India, all patients diagnosed with the choroidal nevus underwent CFP, optical coherence tomography, MCI, and infrared reflectance (IR) imaging. Results: In this study, we found that on MCI, the choroidal nevus could be identified in only six of the 12 eyes. The lesions were seen as an area of hyperreflectance on IR image and orange-colored lesion on multicolor image. In one eye, there was a mixed pattern of hyper and hyporeflectance on IR imaging. The remaining five eyes with choroidal nevus lesions were not identified on MCI. Conclusion: The variable features of the choroidal nevus on MCI are most likely due to the variable melanin content within the nevus cells. Further studies are needed to validate these findings.
Purpose: To study the characteristics of focal choroidal excavation (FCE) in Indian eyes based on spectral-domain optical coherence tomography (SD-OCT) findings and their association with macular pathologies. Methods: Retrospective study of 26 patients diagnosed with FCE. All patients‘ clinical and imaging data were reviewed. Results: There were eight females and 18 males aged between 24 and 85 years. FCE was noted in 31 eyes of 26 patients – unilateral in 21 and bilateral in 5. The conforming type was noted in 13 and nonconforming in 19 eyes. The location was extrafoveal in 16 and subfoveal in 15 eyes. The morphology was bowl-shaped in 24, cone-shaped in six eyes, and mixed type in one eye. Associated pathologies were central serous chorioretinopathy in nine eyes, choroidal neovascular membrane in seven eyes, Stargardt‘s disease in three eyes, Best disease in four eyes, other retinal dystrophies in two eyes, polypoidal choroidal vasculopathy and moderate non-proliferative diabetic retinopathy, each in one eye. The mean FCE width was 1667.2 ± 817.7 μ, mean depth was 95.7 ± 46.4 μ, and the mean choroidal thickness under the FCE was 234.8 ± 85.9 μ. No abnormal choroidal tissue was found under any FCE. Conclusion: FCE is a relatively common entity and frequently associated with macular pathologies. The presence of an FCE did not alter the course or management of these conditions.
Amorphous twins are rare and the case reported here showed embryonic retinal tissue including the formation of rosettes. This appears to be the first case of such a twin showing retinal structures. The specimen was received in the laboratory as an "ovoid mass" attached to the placenta of a normal healthy male child born of a woman with two previous full-term normal deliveries. Investigations MACROS COPI CALThe specimen consisted of a placenta with the attached portion of the cord of the normal foetus towards one pole. The umbilical vessels of this cord traversed the placenta and were continuous with another shrivelled-up cord 6 cm. long hooded by a globular mass 6-8 cm. in diameter clothed with skin containing sparse hair. No definite structures were made out externally (Fig. i, overleaf). The cut surface showed a central cavity 3 cm. in diameter having dark brown tags surrounded by firm brown tissue with tiny glistening areas simulating cartilage with adjoining chips of bone. MICROSCOPICALThe skin showed well-developed stratified squamous epithelium and adnexa. The mass consisted essentially of loose connective tissue showing pronounced oedema. There were widely scattered numerous tiny blood vessels and endothelial lined spaces, possibly dilated lymphatics. A predominant additional feature was the richly vascularized foetal fat and strands of muscle fibres with characteristic transverse striations. Focal collections of sympathetic ganglion cells, in places forming large groups, were also seen. Individual ganglion cells were surrounded by a single or double layer of monocytoid cells, mostly resembling lymphocytes. In one group there was continuity of nerve fibres with the ganglionic mass. Several well-developed nerve fibres were also distributed irregularly throughout the specimen.In sections taken from the central cystic area the histological features were of great interest. The cavity wall was formed of loose connective tissue together with numerous blood-filled cavernous spaces and dilated channels. The space was partially but clearly lined by a single layer of cuboidal, flattened, or low columnar epithelium, in parts pseudo-stratified, resting on loose connective tissue. Some of these cells showed intracytoplasmic dark-brownish pigment. The close proximity in places of this lining to the overlying skin suggested a probable anatomical inter-relationship between the two, but no direct continuity could be traced in the sections examined.The most striking and characteristic feature was the presence of retinal elements which were arranged haphazardly, though mostly disposed around folded spaces or occurring as sparse islands
Purpose: To report a case of bilateral refractory macular edema in a diabetic macular edema in a diabetic with an underlying systemic illness. Case Report: A 65-year-old male presented with the symptom of blurred vision in both eyes for three months. He was a known diabetic patient and was also hypertensive for the last 10 years. The corrected distance visual acuity was 20/120 in the right eye and 20/80 in the left eye. Fundus examination revealed multiple deep and superficial retinal hemorrhages, cystoid macular edema, and serous macular detachment in both eyes. With a diagnosis of diabetic macular edema in both eyes, the patient was treated with multiple intravitreal injections of anti-vascular endothelial growth factor and steroids. Since he did not show a favorable response, the patient was further investigated and diagnosed with multiple myeloma. After undergoing treatment for the same, the patient was seen a year later and noted to have significant resolution of the macular edema and subretinal fluid in both eyes. Conclusion: In patients who suffer with atypical macular edema that is resistant to conventional treatment, it is imperative to look for underlying systemic illnesses such as immunoproliferative disorders and hematologic malignancies.
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