Different Types of Maculopathy in Eyes after a High-Voltage Electrical Shock Injury

Background: We report a case of different types of maculopathy in eyes after a high-voltage electrical shock injury. Case Report: A 43-year-old male suffered high-voltage electrical injury through his left arm. He underwent cataract surgery in both eyes 3 months after the injury, but there was no vision improvement. Ocular examination, including spectral domain optical coherence tomography, revealed diffuse retinal atrophy in the left eye which did not change until the final visit. In the right eye, an impending macular hole was observed but regressed spontaneously 9 months after the injury, and the visual acuity improved to 20/32 at the final visit. Conclusion: Two different types of maculopathy can occur in each eye after high-voltage electrical shock injury, and this might be due to asymmetric pathogenesis of the eyes according to the proximity to the route of electrical current.
Case Rep Ophthalmol 2019;10:19–23

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The Difficulty of Diagnosing Invasive Aspergillosis Initially Manifesting as Optic Neuropathy

Background: Invasive aspergillosis is often fatal. Here, we report a patient with invasive aspergillosis primarily involving the optic nerve diagnosed on autopsy. Case Presentation: A 77-year-old female with underlying diabetes mellitus, hyperlipidemia, and hypertension presented with disc swelling of the left eye. Although mini-pulse steroid therapy improved visual acuity (VA) of the left eye, it abruptly decreased to no light perception within a month, followed by a decrease in VA of the right eye to 0.5. At referral, VA was 0.3 in the right eye, and there was no light perception in the left eye. Results: Fundus examination revealed optic disc swelling of both eyes. Goldmann perimetry showed irregular visual field defects, whereas magnetic resonance imaging (MRI), general, and cerebrospinal fluid (CSF) examinations revealed no distinct abnormalities. We suspected anterior ischemic optic neuropathy and invasive optic neuropathy. As with the left eye, steroid pulse therapy temporarily improved VA of the right eye and then decreased to 0.2. Additional anticoagulant therapy did not improve VA. Concurrent to therapy, the patient became febrile with depressed consciousness. Repeat MRI identified suspected midbrain infarction, and CSF examination indicated cerebral meningitis. In spite of administering transfusions and antibiotics, she died on hospital day 40. Autopsy revealed large amounts of Aspergillus hyphae mainly localized in the dura mater of the optic nerve and destruction of the cerebral artery wall, suggesting an etiology of subarachnoid hemorrhage. Conclusions: When examining refractory and persistent disc swelling, we should rule out fungal infections of the optic nerve.
Case Rep Ophthalmol 2019;10:11–18

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Delayed hemolysis, elevated liver enzymes, low platelet count syndrome in succession of switches of preventive anticoagulant treatment in a 41-year-old patient with a history of recurrent assisted implantation failures: a case report

For the past decades the mean age of primiparae in Western societies is constantly increasing. At the same time, there is a growing demand for assisted reproductive technologies such as in vitro fertilization and...

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