Intrapapillary hemorrhage with concurrent peripapillary and vitreous hemorrhage in two healthy young patients

BACKGROUND: Cases of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage usually appear in myopic eyes with tilted optic discs, can improve without any specific treatment, and very rarely recur. But there has been no report of the use of advanced multimodal imaging such as spectral domain optical coherence tomography. We describe two rare cases of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in an 11-year-old female and a 16-year-old male. CASE PRESENTATION: An 11-year-old female with no past history presented with floaters in her right eye. Her BCVA (best-corrected visual acuity) by the Snellen was 20/20. Fundus examination, optical coherence tomography (OCT) revealed intrapapillary hemorrhage, peripapillary subretinal hemorrhage. After 3 weeks, all hemorrhage was resolved. Similarly, a 16-year-old male with no past history presented with blurry vision, black filamentous floaters. His BCVA was 20/20 in both eyes. Fundus examination showed intrapapillary hemorrhage, peripapillary subretinal hemorrhage while OCT revealed peripapillary edema in his right eye. Multimodal imaging did not reveal any presence of optic disc drusen. After 4 weeks of observation, the hemorrhage resolved. Cases of intrapapillary hemorrhage with peripapillary subretinal hemorrhage have rarely been reported. CONCLUSIONS: This condition generally affects monocularly, in myopic eyes with tilted discs. Despite an unknown cause, the hemorrhages spontaneously resolved without any treatment. Consistent with the good visual prognosis reported previously, the vision, optic nerve function of the two patients were preserved. It should be differentiated from other causes of subretinal hemorrhage.ope

Comparison of Ocular Surface Mucin Expression After Topical Ophthalmic Drug Administration in Dry Eye-Induced Mouse Model

PURPOSE: To determine the mucinogenic effect of dry eye (DE) treatment drugs currently in use, we compared the levels of mucin production and inflammatory cytokine expression on the ocular surfaces using a DE-induced mice model. METHODS: C57BL/6 mice were separated into 6 groups: a control group, DE-induced mice with the vehicle and treated with cyclosporine A (CsA), rebamipide (Reb), diquafosol tetrasodium (DQS), or prednisolone (Pred). The mRNA expression of MUC 1, 4, 16, 5AC, and proinflammatory cytokines on the corneal epithelia were determined by quantitative real-time polymerase chain reaction. Expression of each MUC was evaluated using flow cytometry and immunohistostaining. Conjunctival goblet cells were analyzed through periodic acid-Schiff (PAS) staining. RESULTS: Desiccating stress significantly decreased both mRNA and protein levels of all MUCs in the cornea. CsA mainly enhanced MUC5AC, with an increase in PAS-positive cells, whereas DQS chiefly increased membrane-associated mucins (MM). However, Reb only minimally increased expression of MUC5AC and Pred only increased MUC4. MUC16 did not show any significant change in any group. On the contrary, the mRNA levels of interleukin (IL)-1β, -6, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were increased in the DE corneas of the control mice and were reduced by all treatments; in particular, IL-6 was significantly suppressed. CONCLUSION: Topical DQS and CsA not only ameliorated ocular surface inflammation under desiccating stress but also upregulated both MM and secretory mucins (SM) and contributed to conjunctival goblet cell recovery, compared to Reb and Pred. Both anti-inflammatory and secretory factors should be considered simultaneously when measuring the treatment effect of DE drugs.restrictio

Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients

BACKGROUND: To analyze the optical coherence tomography (OCT) characteristics and visual outcome of vitrectomy in myopic foveoschisis (MF) patients and identify prognostic factors. METHODS: This study is a retrospective clinical cohort study in tertiary care hospital. Thirty-two eyes of 32 patients who underwent MF-related vitrectomy in were investigated retrospectively. Best-corrected visual acuity (BCVA) measured at 1 year post surgery and changes in central foveal thickness (CFT) and co-existing macular pathologies, such as foveal detachment (FD), lamellar holes, and macular holes were the main outcome measures. Prognostic factors were identified using multivariate linear regression analysis. RESULTS: Average BCVA (in logarithm of the minimum angle of resolution) and mean CFT had improved from 0.46 ± 0.06 to 0.37 ± 0.07 (P = 0.089) and from 485.72 ± 164.69 to 341.71 ± 109.70 (P < 0.001), respectively. Univariate analysis identified baseline BCVA, epiretinal membrane, no coexisting OCT features other than MF, FD on OCT, and gas injection as significantly associated with visual outcome (P < 0.001, 0.014, 0.022, < 0.001, and 0.030). Better baseline BCVA and absence of FD on OCT remained significant (P < 0.001 and < 0.001, respectively) after multivariate analysis. CONCLUSION: Good preoperative visual acuity and absence of FD pre-surgery are important predictors of good visual prognosis. Thus, timely surgical intervention, before development of macular complications, may improve visual outcome after surgical treatment of patients with MF.restrictio