[This corrects the article DOI: 10.1159/000546007.].

Background: Idiopathic giant retinal cyst (IGRC) is a rare entity that may mimic a range of retinal or choroidal lesions. Accurate diagnosis and tailored surgical management are essential to achieve anatomical and functional outcomes. Case Presentation: We present the case of a 27-year-old female with decreased vision in the left eye due to a large intraretinal cyst. Multimodal imaging including OCT, fluorescein angiography, and B-scan ultrasonography confirmed an intraretinal macrocyst. The patient underwent pars plana vitrectomy with retinotomy and cyst resection. Despite multiple reoperations for recurrent detachment, final best-corrected visual acuity stabilized at 2/50. Conclusion: IGRC is an uncommon condition. Surgical management, including cyst resection and vitrectomy, may restore anatomy, although functional prognosis is limited in chronic cases with macular involvement. Multimodal imaging plays a crucial role in differentiating IGRC from other mimicking entities.

Introduction: Hypotony is a potentially vision-threatening condition that may persist despite conservative management, often necessitating surgical or interventional treatment. We present a case where a minimally invasive injection of 100% sulfur hexafluoride (SF6) into the anterior chamber (AC) successfully reversed refractory hypotony secondary to ciliary body shut-down. Case Presentation: A 72-year-old male with advanced pseudoexfoliation glaucoma and a nonfunctioning trabeculectomy presented with hypotony, decreased vision, a deep AC, and 360° serous choroidal effusions. After excluding other etiologies, ciliary body shutdown was presumed. Conventional measures, including topical steroids, cycloplegia, and AC viscoelastic injection, failed to restore intraocular pressure (IOP). Given the refractory course, 100% SF6 gas was injected into the AC. Within 24 hours, a reverse pupillary block developed, leading to a rapid IOP increase. The gas fully reabsorbed within weeks, with resolution of the choroidal effusions and normalization of IOP. At six months, the patient maintained stable IOP and visual acuity without further intervention. Conclusion: This case highlights the potential of SF6 gas injection as a minimally invasive and effective treatment for refractory hypotony, even when the underlying mechanism is not over-filtration.

Introduction: In this study, we report a case of an acquired fixed vitreous cyst associated with a pigmented epiretinal membrane (ERM) that developed approximately 10 years after vitrectomy for vitreous hemorrhage (VH) secondary to branch retinal vein occlusion (BRVO). Case Presentation: In this study involved an 85-year-old male who had previously undergone a vitrectomy in November 2014 for a VH caused by BRVO. The patient's postoperative recovery was favorable, however, at a follow-up visit in January 2023 a pigmented ERM was observed, along with an adjacent cyst approximately one-third optic-disc diameter. Initially, the lesion presented as cystoid macular edema (CME) with multiple cystoid spaces, one of which that had gradually enlarged and eventually formed into a pigmented vitreous cyst of approximately two optic-disc diameters in size by January 2025. The cyst was surgically excised, and histological analysis revealed that the cyst wall demonstrated a bilayered structure; i.e., the outer layer consisting of retinal pigment epithelial (RPE), while the inner layer being composed of glial lineage cells. Conclusion: Based on our findings, we hypothesize that the wall of a cystoid space in CME formed a protrusion from the retina into the vitreous cavity, which subsequently developed into a vitreous cyst through migration and proliferation of reactive Müller cells and RPE cells due to structural compromise of the retina.

Introduction: Scleral rupture during intraocular surgery is a rare but serious complication, most often associated with prior buckling, scleritis, trauma, or high myopia. We report a unique case of scleral penetration by a cryoprobe during primary buckling surgery for traumatic rhegmatogenous retinal detachment. Case presentation: A 59-year-old man developed localized rhegmatogenous retinal detachment nine days after sustaining blunt ocular trauma from a baseball. During surgery, an area of scleral thinning was noted between the lateral and superior rectus muscles. While performing cryocoagulation for the causative retinal tear, the tip of the cryoprobe penetrated the sclera, resulting in a 4-mm L-shaped rupture beneath the superior rectus muscle. The rupture was successfully repaired with sutures, a silicone sponge, and intravitreal SF6 injection, followed by additional pars plana vitrectomy and photocoagulation for persistent subretinal fluid. Six months postoperatively, the retina remained attached without proliferative vitreoretinopathy, and visual acuity improved to better than 20/20. Conclusion: This case illustrated that blunt ocular trauma can cause occult scleral fragility, even without preoperative signs, emphasizing the need for meticulous intraoperative assessment to avoid rare iatrogenic complications.

Introduction: Fish-eye disease (FED) is a rare autosomal recessive disorder caused by a partial deficiency of lecithin-cholesterol acyltransferase (LCAT) activity. It is characterized by progressive corneal opacification and dyslipidemia in the absence of systemic manifestations. We describe the clinical presentation, optical coherence tomography (OCT) imaging findings, and Scheimpflug-based corneal densitometry results in a patient with FED carrying both a pathogenic variant and a novel missense variant of the LCAT gene not reported in the current literature. Case Presentation: We present a rare case of a 25-year-old female with bilateral corneal opacities, reduced plasma high-density lipoprotein cholesterol (< 5 mg/dL), and elevated low-density lipoprotein cholesterol levels (> 133 mg/dL). Visual acuity remained 20/20 in both eyes. Slit-lamp examination revealed diffuse subepithelial and anterior stromal deposits. The central corneal thickness was thinner than normal on Scheimpflug tomography, measuring 419 µm OD and 409 µm OS. OCT findings confirmed stromal thinning (479 µm OD and 470 µm OS), with preserved central epithelial thickness, and demonstrated corneal opacities throughout the cornea. The cholesteryl ester–to–total cholesterol ratio remained within normal range. Genetic analysis identified a previously reported pathogenic variant in exon 4 of LCAT (c.440C>T, p.Thr147Ile) and a novel missense mutation in exon 5 (c.715G>A, p.Gly239Ser), classified as a variant of uncertain significance. Conclusion: FED is a rare genetic disorder that is associated with corneal clouding and dyslipidemia. Genetic analysis confirmed the diagnosis with a compound heterozygous genotype, while OCT and corneal densitometry were effective modalities for quantifying and characterizing lipid deposits in FED.

Introduction: The Port Delivery Platform (PDS) with ranibizumab is a novel, surgically implanted device designed for continuous intraocular anti-VEGF delivery, approved for neovascular age-related macular degeneration and other retinal vascular diseases, including diabetic macular edema (DME) and diabetic retinopathy. While it can reduce treatment burden, the PDS implant introduces unique surgical considerations, particularly during subsequent ocular procedures. Case Presentation: We report a case of successful cataract extraction and intraocular lens implantation in a 72-year-old female with a PDS implant for DME, enrolled in the Pagoda trial. Cataract surgery was performed via clear corneal incisions while carefully avoiding manipulation of the conjunctiva or implant. The procedure was uneventful, and the implant remained stable intraoperatively and postoperatively. The patient experienced improved visual acuity and underwent an uncomplicated implant refill after 15 days with confirmation of adequate implant coverage at the 6-month follow-up. Conclusion: This case highlights key surgical considerations to preserve implant integrity and conjunctival health during cataract surgery in eyes with PDS implants. To our knowledge, this is the first report of cataract surgery in a PDS-implanted eye outside a clinical trial, emphasizing that standard phacoemulsification techniques can be safely adapted with proper precautions in this context.

IntroductionCoats disease is a rare, nonhereditary retinal disorder, and early detection and treatment are crucial for preserving visual function. This case report details a pediatric case where Coats disease was diagnosed during follow-up for amblyopia.Case PresentationAn 8-year-old boy with a history of bilateral hyperopic amblyopia and right congenital ptosis underwent eyeglass and occlusion therapy starting at age 2. By age 4, he had achieved good visual acuity. At a routine follow-up 4 years later, fundus examination revealed exudative lesions in the left macula. Optical coherence tomography (OCT) showed macular hyperreflective lesions and the thickened choroid in his left eye, leading to a diagnosis of Coats disease. The patient was treated with retinal photocoagulation. Ten months after treatment, his visual acuity remained stable, and a follow-up OCT showed a reduction in the hyperreflective lesions in the outer macular layers.ConclusionRoutine dilated fundus examinations and OCT-based retro-choroidal morphology for anisometropic amblyopia facilitated early detection and timely intervention for Coats disease, which lacks overt symptoms in its early stages. This case highlights the importance of retinal monitoring in amblyopic eyes to preserve visual function.

IntroductionNeuromyelitis optica spectrum disorder (NMOSD) is a relapsing autoimmune demyelinating disease, characterized by severe attacks of optic neuritis and transverse myelitis. Distinguishing true relapses from infection-related pseudo-exacerbations is essential, particularly in immunosuppressed patients where clinical presentations may be atypical.Case PresentationAn 83-year-old woman with AQP4-IgG-positive NMOSD and Parkinson’s disease presented with acute visual loss and altered mental status, initially suspected to represent a relapse. Empirical intravenous corticosteroids were administered, but her condition worsened with new hallucinations. Magnetic resonance imaging revealed no new demyelinating lesions. Urinalysis and culture confirmed a urinary tract infection due to Klebsiella oxytoca. Corticosteroids were discontinued, and antibiotic therapy initiated, leading to resolution of mental status changes and a return to baseline vision. Follow-up neuro-ophthalmic examination confirmed stability without new inflammatory activity.ConclusionUrinary tract infection can masquerade as an NMOSD exacerbation, complicating diagnosis in elderly immunosuppressed patients.