Carotid artery dissection associated with Purtscher-like retinopathyPurtscher retinopathy was first described in 1910 by Otmar Purtscher in a man who suffered a traumatic head injury.1 Patients commonly present with a loss of visual acuity and a recent history of injury such as head trauma or chest compression.2,3 In the case of a nontraumatic injury, the terminology commonly used is “Purtscher-like retinopathy.” It is associated with various systemic diseases, including acute pancreatitis, pancreatic adenocarcinoma, thrombotic thrombocytopenic purpura, connective tissue disorders, and hemolytic uremic syndrome.
Severe chorioretinal atrophy in Boucher-Neuhauser syndromeA 51-year-old woman was seen in the neuro-ophthalmology clinic. She reported difficulties with night vision dating back to approximately age 10 and an abnormal gait since childhood, which was described as unsteady and hesitant with stiffness of both legs. Ten years previously she was noted to have nystagmus by her family practitioner and was referred to an ophthalmologist, who diagnosed her with probable retinitis pigmentosa (RP). At that time, visual evoked potentials showed delayed P100 responses bilaterally.
Wet age-related macular degeneration refractory to aflibercept but responsive to systemic everolimusA 69-year-old Caucasian woman with a history of metastatic breast cancer had been receiving injections of aflibercept every 4–8 weeks for wet age-related macular degeneration in her right eye for the past 4 years. Despite the regular frequency of the aflibercept injections, her optical coherence tomography had always demonstrated significant levels of intraretinal fluid (Fig. 1). It was decided in the past to maintain her schedule of aflibercept in order to maintain her baseline level of vision of 20/60.
Triple-hit lymphoma of the cavernous sinusDiffuse large B-cell lymphoma (DLBCL) is the most common non–Hodgkin-type lymphoma in adults, and the myriad of clinical presentations is well known to neuro-ophthalmologists.1 Traditionally, DLBCL was treated with standard chemotherapy, including R-CHOP (i.e., rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Newer cytogenetic, fluorescent in situ hybridization (FISH), and next-generation sequencing (NGS) techniques, however, have shown the presence of genomic abnormalities that have significant treatment and prognostic implications.
Concurrent cerebral toxoplasmosis and cytomegalovirus retinitis in a patient with human immunodeficiency virusA 35-year-old previously healthy female recently emigrated from Honduras and presented with a five-day history of sudden onset decreased vision in her right eye, pain with extraocular movements, fevers, and a 3-day history of right upper and lower extremity weakness and numbness. On exam, she was afebrile, and mental status was normal. She had no light perception in the right eye, a right relative afferent pupillary defect, right lower facial weakness, 4/5 strength of proximal and distal right upper and lower extremities, and decreased sensation in the right face, arm, and leg.