Background. Orbital squamous cell carcinoma (SCC) is a rare entity. It is often a result of local invasion of SCC originating from the skin, nasopharynx, nasal cavity, paranasal sinuses, conjunctiva, lacrimal glands, or sac or less commonly occurs through hematogenous metastasis. Herein, we report a patient with orbital SCC with a history of multiple myeloma (MM). Case presentation. A 45-year-old woman with a history of MM in the past two years presented to our clinic complaining of gradual right eye proptosis for six months. The relative afferent pupillary defect was detected in the right eye on her examination. Ocular movements of the right eye were limited in all directions. Orbital magnetic resonance imaging demonstrated an infiltrative mass in the right orbit extended from the anterior to the orbital apex and the optic canal. The patient underwent debulking, and a histopathology examination revealed SCC results. No other secondary site was found to be the origin of the tumor. Result. The patient underwent chemotherapy and subsequent radiotherapy. To our knowledge, this is the first report of concomitant MM and primary orbital SCC.

Objectives: Systemic sclerosis is a severe and rare chronic auto-immune multisystem disorder characterized by vasculopathy and skin stiffness. Ethnic and geographical origin can influence the outcomes. In this study, we compared the phenotypic characteristics of Iranian and French patients. Methods: This cross-sectional study was performed on 200 Iranian and 268 French systemic sclerosis patients. Iranian patients collected from the Iranian systemic sclerosis cohort of the Rheumatology Research Center, Shariati hospital, Tehran University of Medical Sciences. The French population was monocentric, and it was constituted by the patients included locally in the EUSTAR database in December 2016. Results: The mean age at onset was significantly lower in Iranian patients (35.58 ± 11.68 vs 47.06 ± 13.54, p-value < 0.001). The female-to-male ratio was approximately 5.2:1 and was not different in the two populations. The prevalence of diffuse cutaneous systemic sclerosis was significantly higher in Iranian patients (60.2% vs 42.85%, p-value < 0.001). Calcinosis cutis and joint synovitis were more prevalent in French patients (p-value = 0.013, <0.001). The positivity of anti-topoisomerase antibody was higher in Iranian patients, whereas the anti-centromere antibody predominated in French cases (p-value < 0.001). Restrictive pattern of pulmonary function test was more common in Iranian patients (p-value < 0.001), while estimated pulmonary arterial pressure by echocardiography was higher in French patients (p-value < 0.001). Conclusion: It seems that systemic sclerosis occurred in younger ages among Iranian female with the predominance of diffuse cutaneous subtype. In addition, lung interstitial disease appeared to be more prevalent and severe in Iranians than French patients.

We report two cases of corneal graft rejection following immunization with COVID-19-inactivated vaccine Sinopharm and describe the practical implications of this phenomenon in the clinical setting. A 36-year-old woman with a history of unilateral repeated PKP received the first dose of inactivated Sinopharm vaccine. Seven days later, she presented with symptoms and signs of unilateral corneal graft rejection on slit-lamp examination. A 54-year-old woman with a history of unilateral PKP secondary to herpes simplex keratitis (HSK) developed signs of unilateral corneal graft rejection just a week after injection of the first dose of the similar vaccine. Rejection in both patients was treated successfully with topical steroids. To the best of our knowledge, this is the first report of corneal graft rejection following the COVID-19-inactivated Sinopharm vaccine which occurred through the short period after the injection. We hypothesized that the rejection is the result of an allogenic reaction and the immunogenic role of aluminum hydroxide as an adjuvant of this type of vaccine. However, as the second case had a history of rejection following the HSK, a reactivation could not be definitely ruled out. Ophthalmologists should consider these types of adverse reactions after COVID-19 immunization and also monitor a close follow-up of graft health postimmunization. Patients should be informed about the signs and symptoms of rejection, urgent referral, and treatment.

Optic nerve head (ONH) edema is a clinical manifestation of many ocular and systemic disorders. Ocular and central nervous system imaging has been used to differentiate the underlying cause of ONH edema and monitor the disease course. ONH vessel abnormalities are among the earliest signs of impaired axonal transportation. Optical coherence tomography angiography (OCTA) is a noninvasive method for imaging ONH and peripapillary vessels and has been used extensively for studying vascular changes in ONH disorders, including ONH edema. In this narrative review, we describe OCTA findings of the most common causes of ONH edema and its differential diagnoses including ONH drusen.

Background Several factors affect the surgical success ofَAhmed Glaucoma Valve (AGV) implantation. Choroidal detachment (CD) remains a common complication after filtering surgeries. In the present study, we aimed to investigate the effect of choroidal detachment on the success of AGV. Methods In this case-control study, patients who underwent AGV implantation and developed CD were included as a case group. A control group matched for age, sex, systemic disease, lens status, baseline IOP, glaucoma type, and the number of previous glaucoma surgeries using coarsened exact matching were also included. The patients’ data, including intraocular pressure (IOP), number of glaucoma medications, and complications, were retrospectively extracted from the patients’ records. The primary outcome was the AGV success rate 5 < IOP < 18 and a 20-percent reduction from the baseline. IOP and Glaucoma medications were considered secondary outcomes. Results Seventeen patients were enrolled as a case group, and 38 matched individuals were included as controls. The average age of participants was 53.2 ± 16.2 years. Preoperative visual acuity of patients was 1.3 ± 0.8 logMAR. The patients in the case group showed higher IOP in all time intervals. However, the average IOP only reached a statistically significant difference at month 3 (17.94 ± 6.78 vs. 13.39 ± 3.09, P = 0.003). The mean survival duration was significantly shorter in patients with CD (10.4 ± 0.7 months vs. 11.7 ± 0.2 for controls LogRANK = 4.1, P = 0.04). In total patients, the cumulative probability of success was 98.2% and 89.1% in months 3 and 6. Conclusion Choroidal detachment after AGV implantation could be a risk factor for failure after 12 months. The patients experiencing CD in the postoperative period had significantly lower survival duration. A larger prospective with a longer follow-up duration is required to confirm the present study results.