Retinal Cases & Brief Reports 

About: Retinal Cases & Brief Reports is an academic journal published by Lippincott Williams & Wilkins. The journal publishes majorly in the area(s): Medicine & Visual acuity. It has an ISSN identifier of 1935-1089. Over the lifetime, 2117 publications have been published receiving 9357 citations. The journal is also known as: Retinal cases and brief reports.

Bilateral drug (ipilimumab)-induced vitritis, choroiditis, and serous retinal detachments suggestive of vogt-koyanagi-harada syndrome.

Abstract: Purpose:To report a case of bilateral drug (ipilimumab)-induced vitritis, choroiditis, and serous retinal detachments suggestive of Vogt–Koyanagi–Harada syndrome.Methods:This is a single case report.Results:A 43-year-old woman with metastatic melanoma reported a 1-day history of blurry vision after

Presumed foveal bacillary layer detachment in a patient with toxoplasmosis chorioretinitis and pachychoroid disease.

Abstract: Purpose To report a detachment that apparently separated photoreceptor inner segment myoids from inner segment ellipsoids as a manifestation of toxoplasmosis chorioretinitis in a patient with pachychoroid spectrum disease. Methods Multimodal imaging including fundus photography, spectral domain and enhanced-depth imaging optical coherence tomography (OCT), indocyanine green angiography, and OCT angiography. Results A 33-year-old man with a history of toxoplasmosis chorioretinitis reported 1 week of decreased vision to 20/200 in his right eye. Examination of the right eye demonstrated mild vitritis with recurrent chorioretinitis inferior to the fovea and adjacent to a chorioretinal scar. A dome-shaped, foveal photoreceptor layer-splitting detachment was noted on OCT. Because degenerating cone photoreceptors are capable of shedding their inner segments, we inferred the location of the detachment at the level of the inner segment myoid and provided a histological example of such from an unrelated donor case. In addition, multimodal imaging revealed dilated choroidal veins (pachyvessels) with attenuation of the inner choroid in both eyes and asymptomatic findings of central serous chorioretinopathy in the left eye. After 1 month of antibiotic and steroid therapy, the chorioretinitis resolved, as did the detachment. Hyperreflective foci on the vitreoretinal interface were appreciated with en face OCT that appeared to aggregate throughout the course of therapy, induce inner retinal striae, and resolve without inducing epiretinal membrane formation. Conclusion Patients with preexisting pachychoroid spectrum disease may manifest a more significant retinal fluid accumulation in the setting of superimposed chorioretinal inflammation. In this case of macular toxoplasmosis chorioretinitis, inflammation manifested as a retinal detachment at the level of photoreceptor inner segment myoids that we named as a bacillary layer detachment. In this case, inflammatory sequelae of toxoplasmosis reactivation responded well to oral and intravitreal therapy.

Pembrolizumab administration associated with posterior uveitis.

Abstract: To describe the development of uveitis and retinal vasculitis in association with pembrolizumab treatment for metastatic uveal melanoma. A case report and a brief review of the literature are presented. Information collected and reported include the patient's clinical course, physical examination findings, fluorescein angiogram images, retinal photographs, and her response to treatment. A 54-year-old woman was diagnosed with a large choroidal malignant melanoma and had the affected eye enucleated. Pathology confirmed a mixed cell choroidal melanoma, and gene expression profiling was Class 2. Seventeen months after enucleation, the patient was diagnosed with metastatic uveal melanoma to the liver. Disease progression was observed during ipilimumab treatment. Pembrolizumab treatment was initiated, and after four infusions, she presented to clinic complaining of floaters and blurred vision. Examination revealed a nongranulomatous panuveitis characterized by perivascular retinal pigment epithelium pigmentary changes, retinal venous sheathing, 1+ anterior chamber and vitreous cellular reaction, 2+ vitreous haze, and optic disk edema. A dexamethasone sustained-release implant was administered and the uveitis regressed. A relapse in symptoms occurred but quickly subsided with a repeat injection. Pembrolizumab may induce a uveitic reaction. There is mounting evidence that patients using prembrolizumab should be educated and monitored for signs of uveitis.

A case for the case.

Abstract: © 2015 Bloor I have always had a soft spot for CASE (Computer Aided Software Engineering, although I’d prefer to make that “Systems” engineering, myself). CASE modelling, done properly, can be a robust basis for systems development. It lets you think through the “essential” model of the business system that subset of its characteristics that makes a widget processing system, say, a widget processing system and not something else – and remove the most fundamental defects of all (misunderstandings of what the business does) before you invest in expensive technology. Note, that I’m not bothering with any distinctions between “lower” and “upper” CASE tools here – the Wikipedia link covers that if you are interested. There were real issues with early large-scale CASE tools – which were usually associated with mainframes – including lock-in to expensive proprietary technology, a need for computing power that often wasn’t easily available, rigidity (the inability to cope with the idea that not every detail of the system is known when you start) and so on; and these brought the CASE concept into disrepute in many quarters. But these are really implementation issues – companies like Uniface managed to make model-driven development work, and are still around today, producing web applications for large enterprises. And companies like OutSystems and Mendix have updated model-driven development into the PaaS world – they wouldn’t use the term CASE, but you could think of them as smaller, more agile CASE tools. Perhaps the time has come to revisit the CASE world on the mainframe. CA Gen is a case [sorry] in point. Originally, it was IEF (Information Engineering Facility), which was used successfully by Texas Instruments and marketed to a select group of largeenterprise customers, especially in government. It has been re-branded several times in its life (initially as Composer) and sold, first to Sterling Software and then to CA Technologies, where it became CA Gen. It is still used and still being updated (CA Gen 8.5 Incremental Release 2 was delivered in December 2014). While still largely a mainframe tool (half its customer base continues to rely on the mainframe), in addition to the DB2 DBMS and Cobol, it now supports, for example, Linux, Oracle, Microsoft SQL Server, ODBC, JDBC, C# and Java code generation and ASP.NET web clients. It supports component-based development of modern web applications, as well as the creation of client/server applications, so there’s a mainframe modernisation story here, re-using tried-and-tested mainframe assets. It is worth noting that model-driven development (which is more or less what CASE is) does require A case for CASE

Optical coherence tomography angiography of sickle cell maculopathy.

Abstract: PURPOSE To report a case of sickle cell retinopathy imaged with optical coherence tomography angiography. METHODS Case report. RESULTS An asymptomatic 33-year-old man with known sickle cell anemia (SS) presented for routine eye examination. Ultrawide-field fluorescein angiography confirmed areas of temporal nonperfusion without neovascularization and subtle enlargement of the foveal avascular zone in the left eye. Spectral domain optical coherence tomography showed thinning of the inner layers of the temporal macula in both eyes. Optovue split-spectrum amplitude decorrelation angiography optical coherence tomography was performed and showed reduced flow within the superficial and deep macular plexuses of each eye, most severely within the deep retinal capillary plexus. This abnormality was more extensive than could it be appreciated with conventional angiography. CONCLUSION This report provides evidence that optical coherence tomography angiography may be more sensitive in detecting macular capillary nonperfusion than fluorescein angiography. It also provides further evidence that the ischemic vasculopathy of sickle cell retinopathy preferentially affects the deep capillary plexus.