Archives of Clinical Ophthalmology

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.

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.

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).

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.

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).

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. 

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.

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.

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. 

Acute macular neuroretinopathy (AMN), first described by Bos and Deutman in 1975 [1], is an infrequent yet increasingly diagnosed retinal condition, characterized by the acute onset of persisting paracentral scotomata with capricious vision loss in one or both eyes, associated with (peri)foveal petaloid (wedge-shaped) outer retinal lesions generally accepted to be caused by microvascular damage to the retinal capillary network of the macula [2,3].

Orbital lymphoproliferative disorders (OLPDs) consist of a spectrum of diseases ranging from benign to malignant lesions including reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma. OLPDs rarely present as an orbital mass lesion in children. Accurate discrimination of OLPDs is crucial for treatment planning. We report a case to investigate the clinical and pathological
features of OLPDs in children.

Vitreous cysts are regarded as ‘ocular curiosities’ as they are rarely seen and reported. They can be either congenital or acquired. Congenital vitreous cysts are usually isolated clinical findings and acquired cysts are observed in conditions like high myopia, ocular trauma, degenerative pathologies of the retina & choroid, and infections like Cysticercosis and Toxoplasmosis.

A 30-year-old woman who wears scleral contact lenses for keratoconus was brought to the emergency room after a motor vehicle collision where a deployed airbag hit her left eye. The patient was taken to the operating room for globe exploration and found to have two large scleral lacerations (one superiorly and one temporally) with significant uveal prolapse. 

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.