Keratoconus and central serous chorioretinopathy are two rare diseases. They can occur together in some individuals. We report a case of a 48-year-old man, who presented to our clinic with decreased visual acuity on his left eye. Physical examination, biomicroscopy, corneal topography, and optical coherence tomography revealed keratoconus and central serous chorioretinopathy. We discuss the possible connection between these two conditions.
A 39-year-old woman, without any systemic or ocular history, presented with a paracentral scotoma in her right eye with normal visual acuity. Humphrey's visual fields showed a reversible enlargement of the right blind spot. The final diagnosis was acute idiopathic blind spot enlargement which was successfully treated with intravenous steroids. Although differential diagnosis of blind spot enlargement can be challenging, multimodal imaging with combination of visual field's assessment can help us make the right diagnosis.
BackgroundIn this study, we aimed to determine the diagnostic performance of optic nerve head (ONH), macular, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements of wide-field maps (12 × 9 mm) using swept-source optical coherence tomography (SS-OCT) compared to measurements of the ONH and RNFL parameters measured by Heidelberg Retina Tomograph (HRT3). MethodologyThis case-control study included 39 eyes of 39 glaucoma patients and 36 eyes of 36 normal subjects (control group). All participants underwent standard automated perimetry (SAP) as well as structural measurements by SS-OCT (DRI-OCT, Triton; Topcon Inc., Tokyo, Japan) and HRT3 (Heidelberg Engineering, Heidelberg, Germany). The abilities of the continuous parameters to discriminate between glaucoma and control groups were assessed using areas under the receiver operating characteristic curves (AUCs). To assess the glaucoma diagnostic abilities of each of the categorical variables, sensitivity, specificity, positive predictive value, and negative predictive value were tested. ResultsThe highest sensitivities were achieved by the DRI-OCT categorical parameters of Superpixel-200 map and cpRNFL (12 sectors) thickness analysis. The best performing HRT3 continuous parameter was rim volume (AUC = 0.829, 95% confidence interval (CI) = 0.735-0.922), and the best continuous parameter for DRI-OCT wide-field was vertical cdr (AUC = 0.883, 95% CI = 0.805-0.951), followed by total cpRNFL thickness (AUC = 0.862, 95% CI = 0.774-0.951). AUCs for disc area, rim area, linear cdr, and RNFL thickness were not significantly different between the two technologies. Using either the most or the least specific criteria, SuperPixel-200 map always showed the highest sensitivity among the categorical parameters of both technologies (82.1% and 89.7%, respectively). The highest sensitivity among HRT3 classification parameters was shown by MRA and GPS classification algorithms. ConclusionsBoth wide-field DRI-OCT maps and HRT3 showed good diagnostic performance in discriminating glaucoma. Although DRI-OCT thickness values and normative diagnostic classification showed the best performance, more studies are required to determine the clinical role of wide-field DRI-OCT scan in glaucoma diagnosis.
Ocular trauma is a major cause of visual impairment. Corneal injuries can range from minor and insignificant to major and vision-threatening. This report describes the case of a healthy 21-year-old soldier who presented to the emergency department with a major ocular trauma to his left eye caused by a bayonet. The bayonet had penetrated the cornea and reached the anterior chamber. Under general anesthesia, we washed the anterior chamber, filled it with viscoelastic, and sutured the trauma. Visual acuity was 10/10 in his left eye after the surgery. We report this case because there is a limited number of patients with penetrating corneal bayonet injuries reported in the literature and to emphasize the importance of immediate and correct treatment for a good visual outcome.
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