Diagnostics

A 36-year-old contact lens wearer presented with a five-day history of pain, redness, tearing, and photophobia in the right eye. Best-corrected visual acuity (BCVA) was 1.0 logMAR. Examination revealed diffuse corneal edema without ulceration. Corneal and conjunctival cultures obtained before antimicrobial treatment showed no bacterial or yeast growth, while in vivo confocal microscopy and clinical findings supported Acanthamoeba keratitis. Following seven days of topical chlorhexidine-based treatment, BCVA improved to 0.3 logMAR, and the epithelium was intact at discharge. Ten days later, the patient was readmitted with extensive stromal melting, central perforation, and light perception without projection. Both corneal and conjunctival cultures yielded Pseudomonas aeruginosa after 48 h, and subsequent antimicrobial treatment was guided by susceptibility testing. Progressive destruction necessitated emergency therapeutic penetrating keratoplasty with a 10.0 mm graft. At two months, BCVA was 1.0 logMAR, the epithelium was fully healed, and no clinical recurrence or graft rejection was observed. The biphasic course supports secondary bacterial superinfection, although initial coinfection cannot be excluded. This case highlights the importance of repeat microbiological sampling after clinical deterioration and documents short-term anatomical salvage; long-term graft survival remains undetermined.

Background/Objectives: Osteoid osteoma (OO) is a painful benign bone tumor whose nidus is best depicted on computed tomography (CT). This exploratory study introduces InceptionTurkerNeXt, a compact convolutional neural network, and evaluates a deep feature engineering (DFE) framework built on it for image-level OO classification. Methods: The backbone was pretrained on a public 26-class multi-cancer dataset of 130,000 images. The DFE framework extracts global and patch features, selects them with cumulative weighted iterative neighborhood component analysis and classifies them with a t-algorithm-based k-nearest neighbors ensemble. The single-center OO set contains 359 axial CT images (184 OO and 175 control) from 82 patients. The primary protocol was patient-grouped 10-fold cross-validation with all selection steps fitted on the training folds. Results: The backbone reached 98.94% accuracy on the 26,000-image multi-cancer test set. Under the primary protocol, the DFE framework reached 90.81% image-level accuracy (95% confidence interval 86.35–94.71%), 91.30% sensitivity and 90.29% specificity. Patient-level voting gave 93.90% accuracy (82 patients), and a separate patient-level hold-out set gave 91.55% image-level accuracy (71 images). The earlier image-level estimate (98.33%) was optimistic by 7.52 percentage points. Four fine-tuned standard backbones reached 83.29–88.02% on the same partitions. Conclusions: The framework separated OO and control CT images with approximately 91% image-level accuracy under patient-grouped validation at one center. External multi-center validation is required before clinical use.

Posterior lenticonus is a congenital developmental defect of the ocular lens. It is an abnormal conical protrusion of the posterior lens capsule and usually occurs as an isolated defect. The diameter of the conical protrusion is typically between 2 and 7 mm. The pathogenesis of this condition is still not fully understood. Proposed but unconfirmed mechanisms include vitreous inflammation combined with excessive proliferation of posterior lens fibers, leading to lens opacification, traction on the posterior lens capsule by remnants of the hyaloid artery system, abnormalities within the tunica vasculosa lentis. The average age at diagnosis of posterior lenticonus is between 3 and 7 years. The most common complication of posterior lenticonus is amblyopia. Other frequent coexisting conditions include cataract, strabismus, and loss of central fixation. It has been observed that, over time, cataractous changes may develop within the cone and may spread to the adjacent subcapsular lens cortex. We present anterior segment optical coherence tomography (OCT) scans and a slit-lamp photograph of a 7-year-old child with posterior lenticonus, whose parents brought the patient to the Ophthalmology Clinic due to reduced visual acuity. Best corrected visual acuity (BCVA) in the right eye was 0.6. Slit-lamp examination and anterior segment OCT revealed posterior lenticonus. Pharmacological treatment was temporarily initiated, and surgery was withheld.