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85


Another 'BEE'? - Brain-Eye-Ear (BEE) Disease Secondary to HbSC Disease Masquerading as Multiple Sclerosis [Case Report]

Wallach, Asya Izraelit; Borja, Maria J; Chen, Duan; Eisenberg, Rachel; Modi, Yasha S; Zhang, Cen; Shepherd, Timothy M; Nath, Avindra; Smith, Bryan; Scher, Jose U; Cho, Catherine; Kister, Ilya
Recurrent episodes of neurological dysfunction and white matter lesions in a young adult raise suspicion for multiple sclerosis (MS). However, occlusive retinopathy, hearing loss and absence of CSF oligoclonal bands are atypical for MS and should make the clinician consider an alternative diagnosis. We describe a man with hearing loss, visual signs and symptoms, and an accumulating burden of brain lesions, who was treated for a clinical diagnosis of MS for nearly two decades. Genetic testing revealed a unifying diagnosis.
PMID: 33482571
ISSN: 1532-8511
CID: 4761032

Posterior Pigment Deposition as a Marker of Persistently Open Retinectomy Edge Following Retinal Detachment Repair

Nair, Archana A; Pandit, Saagar; Eliott, Dean; Modi, Yasha S
Posterior pigment dispersion is a rare ophthalmic finding that has been reported in patients undergoing retinectomy with silicone oil placement and in patients who underwent significant anterior segment manipulation and vitrectomy. The pigment release is believed to occur from retinal pigment epithelium (RPE) cells in the former and the posterior iris in the latter. The exact timing of this pre-retinal pigment deposition is unknown but typically is mild and occurs over several months. A rapid progression of diffuse preretinal pigmentation is uncommon and may be suggestive of persistent RPE release from an open break or continued iris trauma with posterior pigment release. This report describes a case of profound posterior pigment deposition more than 4 months after retinectomy and oil in a patient with a persistently open retinectomy edge with anterior retinal detachment. The rapidity of pigment deposition was the clue to recognizing this subtle anterior detachment under silicone oil. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:47-49.].
PMID: 33471915
ISSN: 2325-8179
CID: 4798732

ASSESSING THE ABILITY OF PREOPERATIVE QUANTITATIVE SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY CHARACTERISTICS TO PREDICT VISUAL OUTCOME IN IDIOPATHIC MACULAR HOLE SURGERY

Mehta, Nitish; Lavinsky, Fabio; Larochelle, Ryan; Rebhun, Carl; Mehta, Nihaal B; Yanovsky, Rebecca L; Cohen, Michael N; Lee, Gregory D; Dedania, Vaidehi; Ishikawa, Hiroshi; Wollstein, Gadi; Schuman, Joel S; Waheed, Nadia; Modi, Yasha
PURPOSE/OBJECTIVE:To determine which spectral domain optical coherence tomography biomarkers of idiopathic macular hole (MH) correlate with the postoperative best-corrected visual acuity (BCVA) in anatomically closed MH. METHODS:Retrospective analysis of spectral domain optical coherence tomography scans of 44 patients presenting with MH followed for a mean of 17 months. Widths of MH aperture, base, and ellipsoid zone disruption were calculated from presenting foveal spectral domain optical coherence tomography B-scans. Macular hole base area and ellipsoid zone disruption area were calculated through the custom in-house software. RESULTS:Poorer postoperative BCVA correlated with increased preoperative choroidal hypertransmission (r = 0.503, P = 0.0005), minimum diameter (r = 0.491, P = 0.0007), and base diameter (r = 0.319, P = 0.0348), but not with preoperative ellipsoid zone width (r = 0.199, P = 0.2001). Applying en-face analysis, the BCVA correlated weakly with preoperative ellipsoid zone loss area (r = 0.380, P = 0.013), but not with preoperative MH base area (r = 0.253, P = 0.1058). CONCLUSION/CONCLUSIONS:Increased MH minimum diameter, base diameter, base area, and choroidal hypertransmission are correlated with a poorer postoperative BCVA. Ellipsoid zone loss measurements were not consistently correlated with a BCVA. Choroidal hypertransmission width may be an easy-to-visualize predictive imaging biomarker in MH surgery.
PMID: 32251240
ISSN: 1539-2864
CID: 4378752

Ophthalmic Artery Occlusion after Internal Carotid Artery Stenosis

Dempsey, Katharine S; Breazzano, Mark P; Modi, Yasha S
PMID: 33413794
ISSN: 2468-6530
CID: 4771322

Ziv-aflibercept and bevacizumab for exudative age-related macular degeneration: A retrospective comparison of clinical outcomes and cost at 1 year

Singh, Sumit Randhir; Parikh, Ravi; Sakurada, Yoichi; Uplanchiwar, Bhushan; Mansour, Ahmad; Goud, Abhilash; Modi, Yasha S; Chhablani, Jay
PURPOSE/OBJECTIVE:The purpose of this study was to compare intravitreal ziv-aflibercept (IVZ) monotherapy to intravitreal bevacizumab (IVB) monotherapy in patients with exudative age-related macular degeneration (eAMD). MATERIALS AND METHODS/METHODS:Patients with treatment-naïve eAMD treated with pro re nata (PRN) monotherapy of IVZ (1.25 mg/0.05 ml) or IVB (1.25 mg/0.05 ml) with a minimum follow-up of 12 months were retrospectively analyzed. Study outcomes included change in best-corrected visual acuity (BCVA), central macular thickness, mean number of injections, and total medication cost in both the groups at 12 months. RESULTS:= 0.029). Direct medication cost of IVZ and IVB in our cohort on PRN basis was an average of US$78 (2.6 × US$30) and US$175 (3.5 × US$50), respectively, through 1 year. CONCLUSION/CONCLUSIONS:IVZ-PRN monotherapy resulted in improved visual acuity, reduced treatment burden, and reduced direct medication cost in comparison to IVB-PRN monotherapy through 1 year.
PMCID:7787097
PMID: 33437603
ISSN: 2211-5072
CID: 4762352

Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion

Au, Adrian; Hilely, Assaf; Scharf, Jackson; Gunnemann, Frederic; Wang, Derrick; Chehaibou, Ismael; Iovino, Claudio; Grondin, Christelle; Farecki, Marie-Louise; Falavarjani, Khalil Ghasemi; Phasukkijwatana, Nopasak; Battista, Marco; Borrelli, Enrico; Sacconi, Riccardo; Powell, Brittany; Hom, Grant; Greenlee, Tyler E; Conti, Thais F; Ledesma-Gil, Gerardo; Teke, Mehmet Yasin; Choudhry, Netan; Fung, Adrian T; Krivosic, Valerie; Baek, Jiwon; Lee, Mee Yon; Sugiura, Yoshimi; Querques, Giuseppe; Peiretti, Enrico; Rosen, Richard; Lee, Won Ki; Yannuzzi, Lawrence A; Zur, Dinah; Loewenstein, Anat; Pauleikhoff, Daniel; Singh, Rishi; Modi, Yasha; Hubschman, Jean Pierre; Ip, Michael; Sadda, SriniVas; Freund, K Bailey; Sarraf, David
Purpose/UNASSIGNED:To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Methods/UNASSIGNED:Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. Results/UNASSIGNED:108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 µm) compared to the group with deep hemorrhages alone (455 ± 273 µm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). Conclusions/UNASSIGNED:NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
PMID: 32460316
ISSN: 1552-5783
CID: 4451782

Inner Retinal Layer Reflectivity as Predictor of Retinal Vein Occlusion Visual Acuity Outcomes

Greenlee, Tyler E; Cutler, Nathan E; Mehta, Nitish; Hom, Grant L; Wai, Karen; Conti, Felipe F; Conti, Thais F; Bena, James F; Modi, Yasha; Singh, Rishi P
PMID: 31810899
ISSN: 2468-7219
CID: 4530412

Binocular Diplopia Caused by an Epiretinal Membrane With Foveal Displacement

Gold, Doria M; Modi, Yasha S; Warren, Floyd A; Rucker, Janet C
A 73-year-old woman with 3 years of monocular visual distortion and progressive binocular diplopia. She was found to have a comitant left hypertropia due to an epiretinal membrane causing inferior foveal drag. Displacement of the fovea from an epiretinal membrane is a likely under-recognized cause ocular cause of a comitant binocular diplopia.
PMID: 31306185
ISSN: 1536-5166
CID: 3977662

Gun-Related Eye Injuries: A Primer

Erickson, Benjamin P; Feng, Paula W; Ko, Marcus J; Modi, Yasha S; Johnson, Thomas E
Gun-related eye injuries are relatively common in the context of gunshot wounds to the head and neck. Many of the fundamental principles of gunshot wound management apply to the care of these patients, but the complex anatomy and functional relationships of the periocular region do pose special challenges. We provide a focused primer for physicians seeking a more in depth understanding of gun related eye injuries and present three representative cases outlining the spectrum of pathology, provide a focused review of the relevant ballistics concepts, and discuss the management of injuries to the periocular soft tissues, orbital structures, and globe. We found that good cosmetic and functional results can often be achieved with appropriate early intervention, but visual prognosis may remain guarded despite optimal treatment.
PMID: 31229522
ISSN: 1879-3304
CID: 3963462

MACROANEURYSMS ASSOCIATED WITH CONGENITAL RETINAL MACROVESSELS

Sebrow, Dov B; Cunha de Souza, Eduardo; Belucio Neto, Jose; Roizenblatt, Marina; Zett Lobos, Claudio; Paulo Bonomo, Pedro; Modi, Yasha; Schuman, Joel S; Freund, K Bailey
PURPOSE: Congenital retinal macrovessels are large aberrant retinal blood vessels that cross the horizontal raphe and can traverse the central macula. Using multimodal imaging and optical coherence tomography angiography, we describe 2 cases of congenital retinal macrovessel associated with macroaneurysms. METHODS: Two patients presented for evaluation and were found to have congenital retinal macrovessels associated with macroaneurysms. Color photography, optical coherence tomography, fundus autofluorescence fluorescein angiography, and optical coherence tomography angiography were performed and used to establish the diagnosis and monitor resolution at follow-up visits. RESULTS: The first patient presented with central vision loss in the right eye and was noted to have a ruptured macroaneurysm and scattered microaneurysms along the course of a venous macrovessel. After 3 months of observation, the patient's vision improved. The second patient presented for evaluation of a cataract in her left eye and was incidentally found to have an arterial macrovessel in her right eye with an associated macroaneurysm. Both cases demonstrated an intricate capillary network in the central macula best visualized on optical coherence tomography angiography. CONCLUSION: Macroaneurysms can occur on both arterial and venous macrovessels. After rupture of these lesions, hemorrhage and exudation can resolve with observation alone. Macrovessels can also present with microaneurysms. Optical coherence tomography angiography can effectively image the complex capillary network associated with these vascular anomalies.
PMCID:5807243
PMID: 28799971
ISSN: 1937-1578
CID: 2664232