No abstract

The presence of SMD may be a baseline predictive factor for ranibizumab treatment outcomes in BRVO patients, with no influence in the number of treatments needed between patients with or without SMD at baseline. Further studies are needed in order to confirm the role of SMD as an independent predicitive factor in cases of BRVO.

Introduction: An entirely new type of staphyloma has been recently described as dome-shaped macula (DSM). It is characterized by an abnormal convex macular contour within the concavity of a posterior staphyloma. We found DSM associated with serous macular detachment (SMD) and tilted disc in two consecutive cases. Case Reports: Case 1: A 37-year-old female presented to our department because of sudden onset blurred vision in her right eye (OD). The best-corrected visual acuity (BCVA) was 0.5 in both eyes. Funduscopy evidenced bilateral tilted disc associated with posterior staphyloma. Optical coherence tomography (OCT) demonstrated a DSM with SMD in her OD. After 15 months of follow-up, BCVA of her OD remained stable with chronic SMD. Case 2: A 32-year-old female presented to our department because of blurred vision in her OD. The BCVA was 0.4 in the OD and 1.0 in the left eye (OS). Bilateral tilted disc and posterior staphyloma were evidenced in the funduscopy. OCT demonstrated a bilateral DSM with SMD in her OD. After 45 months of follow-up, two further episodes of transient SMD were observed in her OD and seven in her OS. The final BCVA was 0.63 in the OD and 0.8 in the OS. Discussion: SMD associated with tilted disc constitutes a potential cause of subretinal fluid accumulation in myopic patients. OCT is essential for the detection of both SMD and DSM.

Ranibizumab intravitreal injections are effective in the short-term BCVA improvement in patients with AOFVD.

Health Organization (WHO) grades I to III according to the histological appearance. Distant metastasis are exceptional in grade I but account for 10% of grade II and for 71% of grade III chondrosarcoma; these occurs in the lung, femur, sternum, liver, pleura and ureter. The presence of metastasis is associated with a 5-year survival rate of 18%. Heart and brain metastasis are exceptionally rare and scarcely documented [1]. Herein we report a case of chest-wall chondrosarcoma with metastasis to the lung, brain, and choroid.A 53-year-old female was referred to the department of ophthalmology because of progressive visual loss in her right eye (OD) for the 2 previous months. Her past medical history was significant for a rib chondrosarcoma grade II treated with excisional surgery 10 years before, and a recent mestastasic lesion in the right lung tissue which was being treated with chemotherapy using adriamycin.Her best-corrected visual acuity was 20/60 in the OD and 20/25 in the left eye. Fundus examination revealed an elevated yellowish choroidal lesion within the macular area in her OD (Fig. 1a). The left eye was unremarkable. In the OCT we observed a serous detachment with a swelling of macula (Fig. 1b). Fluorescence angiography was performed, revealing early hypofluorescence with late pinpoint hyperfluorescence (Fig. 1c 1-3 ).Standardized B-scan ultrasonography of the OD demonstrated a plateau-shaped choroidal mass of 8 ×3 mm (Fig. 2a). Cerebral magnetic resonance imaging showed metastatic lesions in the right cerebellum hemisphere and the OD choroid (Fig. 2b). Fine needle aspiration biopsy and photodynamic therapy was refused by the patient, who was lost to follow-up.Metastasic cells reach the eye exclusively by the hematogenous route, since there are no intraocular lymphatic channels. The most frequently affected ocular tissue is the choroid, which has the highest metastatic efficiency index of any tissue [2], because of its marked vascularization and its high blood flow. We are unaware of previously reported cases of chondrosarcoma metastatic to the choroid in the indexed literature [3]. This case report has not been presented at any conference.