Archives of Clinical Ophthalmology

While rare, retinoblastoma is the most common (1:16000 – 18000 live births) intraocular and life threatening tumor of childhood. According to the World Health Organization (WHO), 66% of children present with symptoms before 2 years of age and 95% before 5 years of age. About 8000 new cases are detected annually with the highest incidence in Africa and India. In fact, more than 1400 cases each year are from India. According to Mukesh et al., 43% of the global burden lives in 6 countries of Asia (India, China, Indonesia, Pakistan, Bangladesh & Philippines).

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that can result in permanent vision loss. Over 25% of CRAO are associated with acute cerebral ischemia, and there are many parallels between CRAO and acute ischemic stroke. There are no definitive treatment algorithms for CRAO, however there may be opportunities to treat CRAO as an “eye stroke”. Given the similarities to acute ischemic stroke, multidisciplinary involvement and stroke algorithms should be considered and tested for this disease.

Recently, several studies and investigators have shown the beneficial effects of high dose dietary riboflavin (vitamin B2) in the treatment of keratoconus, post-refractive (LASIK, PRK & Radial Keratotomy) ectasia (with sunlight exposure) and patients treated with our own protocol (NIH Clinical Study – www.clinicaltrials.gov - # NCT 03095235) discovered significant relief for intractable migraine headaches and/or ophthalmic migraine (classic migraine visual symptoms without headache).

Last year’s article In the International Journal of Clinical and Experimental Ophthalmology [1] highlighted that Cortical Visual Impairment (CVI) is now the leading cause of visual impairment in the developed world [2]. It also provided a definition of CVI [3,4], and summarized its functional deficits, and methods of assessment. 

This is the first reported case of COVID-19 associated optic neuritis (ON) presenting with classic Uhtoff’s phenomenon typically associated with multiple sclerosis (MS). Uhthoff phenomenon, also known as Uhthoff sign or syndrome, is a transient worsening of neurological function lasting less than 24 hours that can occur in multiple sclerosis patients due to increases in core body temperature.

In the process of rhegmatogenous retinal detachment (RRD), retinal homeostasis may be adversely affected with resultant modifications in retinal and choroidal tissue. Hypoxia and nutrient deprivation along with inflammation at the detached retina may lead to morphological and microvascularity alterations. These changes imply that the functional status of the macula may not be entirely restored despite anatomical repair.

To evaluate the repeatability of corneal tomographic parameters in keratoconus patients across different body mass index (BMI) categories. This prospective study was conducted at the University of Auckland, New Zealand, from June 2021 to June 2022. A total of 243 eyes from keratoconus patients aged 18-45 years were categorized into normal (BMI ≤24.9; n=55), overweight (BMI 25.0-29.9; n=58), and obese (BMI ≥30.0; n=130) groups. Patients underwent three consecutive scans using the Pentacam AXL.

The case of a young girl with Dengue fever presenting with seizures and bilateral visual loss is presented. At the time of presentation, she had right hemiplegia and dysarthria but was not dysphasic. Fundoscopy revealed presence of macular and disc oedema in the right eye and vitreous haemorrhage in the left eye.

Joubert syndrome (JS) is a rare congenital neurodevelopmental disease which is basically a primary Ciliopathy. It’s characteristic manifestation on imaging is so called ‘molar tooth sign’ in the brainstem and cerebellum. JS can involve multiple organs, mainly including retina, kidney, bone and liver. Clinical signs of early onset JS include hypotonia, developmental delay, breathing abnormalities, and ocular motor apraxia. 

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that can result in permanent vision loss. Over 25% of CRAO are associated with acute cerebral ischemia, and there are many parallels between CRAO and acute ischemic stroke. There are no definitive treatment algorithms for CRAO, however there may be opportunities to treat CRAO as an “eye stroke”. Given the similarities to acute ischemic stroke, multidisciplinary involvement and stroke algorithms should be considered and tested for this disease.

Focal aggregate of normal or near normal uveal melanocytes (FANNUM) of the choroid is a term the author has proposed to categorize small melanocytic choroidal lesions that are not detectably thicker than surrounding normal choroid by B-scan ocular ultrasonography. In this article, the author describes the clinical features of small melanotic choroidal lesions he categorizes clinically as FANNUMs and discusses the presumed compositional spectrum of such lesions.