Glaucoma due to ciliary body cysts and pseudoplateau iris: a systematic review of the literature / Glaucoma associado a cistos de corpo ciliar e íris pseudoplateau: revisão sistemática da literatura

ABSTRACT The diagnosis of angle-closure glaucoma secondary to iridociliary cysts is challenging and lacks compiled literature support. We present a rare case of bilateral angle-closure glaucoma associated with pseudoplateau iris due to multiple ciliary cysts and conducted a systematic review of the literature to find similar case reports published between November 2006 and November 2016. Only 19 case reports present treatment modalities, and most cases required more than one therapeutic approach for controlling the intraocular pressure. Pseudoplateau iris attributed to iridociliary cysts should be considered in the differential diagnosis of patients with narrow angles, particularly those with ocular hypertension and glaucoma, in which management is complex. In addition to gonioscopy, ultrasound biomicroscopy is considered the conclusive method for accurate diagnosis.

RESUMO O diagnóstico de glaucoma de ângulo fechado secundário a cistos iridociliares é desafiador e não possui suporte da literatura compilada. Apresentamos um caso bilateral raro de glaucoma de ângulo fechado associado à íris pseudoplateau devido a cistos ciliares múltiplos e realizamos uma revisão sistemática da literatura de relatos de casos similares publicados entre novembro de 2006 e novembro de 2016. Apenas 19 relatos de casos apresentaram as modalidades de tratamento e na maioria deles foi necessário mais de uma abordagem terapêutica para controlar a pressão intra-ocular. Íris pseudoplateau atribuída a cistos iridociliários deve ser considerada no diagnóstico diferencial de pacientes com ângulos estreitos, particularmente aqueles com hipertensão ocular e glaucoma, em que o manejo é complexo. Além da go nioscopia, a biomicroscopia ultra-sônica é considerada o método conclusivo para o diagnóstico correto.

Melanocitoma de la cabeza del nervio óptico en un adulto joven / Melanocytoma of the optic nerve head in a young adult

Se describe el caso clínico de un paciente de 34 años edad que en abril de 2012 asistió a la consulta de retina del Hospital General Docente "Dr. Juan Bruno Zayas" de Santiago de Cuba por presentar, desde hacía 3 meses aproximadamente, disminución progresiva de la visión en el ojo izquierdo. Los resultados de los exámenes oftalmológicos y complementarios efectuados confirmaron el diagnóstico de melanocitoma de la cabeza del nervio óptico

The case report of a 34 years patient that attended the retina service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba in April, 2012 is described. He had for 3 months approximately, progressive vision decrease in the left eye. The results of the ophthalmologic and complementary tests confirmed the diagnosis of melanocytoma of the optic nerve head

Estudo comparativo das estruturas do segmento anterior de olhos de cães normais e com catarata, portadores ou não de Diabetes mellitus, avaliados por biomicroscopia ultrassônica / Comparison of anterior ocular segment structures in healthy dogs, with diabetic or no diabetic cataract, by ultrasound biomicroscopy

A catarata representa uma das principais causas de cegueira em cães, sendo que as alterações metabólicas provocadas pelo Diabetes mellitus (DM), constituem a segunda causa mais comum de catarata nesta espécie. A biomicroscopia ultrassônica (UBM) é um método ultrassonográfico de alta frequência (50 MHz) que permite a obtenção de imagens do modo B de qualidade microscópica. Este estudo objetivou, por meio do uso da UBM, comparar as estruturas do segmento anterior de olhos de cães com catarata, diabética e não-diabética, às de cães normais, para verificar possíveis alterações decorrentes do DM. Os parâmetros avaliados foram espessura da córnea, profundidade da câmara anterior, aumento de celularidade no interior da câmara anterior e medida do ângulo iridocorneal. Foram realizados exames de 87 olhos de 47 animais da espécie canina, divididos em 3 grupos: grupo controle (GCO), grupo de portadores de catarata não-diabéticos (GCAT) e o grupo dos diabéticos (GDM). Os resultados revelam que o grupo dos diabéticos apresentou maiores espessuras de córnea que os demais grupos enquanto o grupo controle apresentou maiores câmaras anteriores. Encontrou-se aumento de celularidade em câmara anterior apenas nos grupos com catarata. Quando analisadas as medidas do ângulo iridocorneal, não houve diferença entre os 3 grupos. Com base no que foi aferido, permite-se concluir que olhos de cães diabéticos com catarata apresentam maior espessura de córnea central que olhos de cães com catarata de outras etiologias e de cães normais, que há diminuição da câmara anterior, com aumento de celularidade, em olhos de cães com catarata, quando comparados a cães normais e que não há diferença na medida do ângulo iridocorneal em olhos de cães com catarata, diabética ou não, e de cães normais.

Cataracts represent the leading cause of blindness in dogs. The second most common cause of cataract in dogs is a result of metabolic alterations caused by Diabetes mellitus (DM). Ultrasound biomicroscopy (UBM) is a high-frequency (50 MHz) ultrasonographic method that produces B mode images of microscopic quality. The objective of this study was, by means of UBM use, to compare the anterior segment structures of the canine eyes, both with diabetic and non-diabetic cataract, in order to detect changes caused by DM. The parameters evaluated were: cornea thickness, anterior chamber's depth, increased cellularity inside the anterior chamber, and iridocorneal angle measurement. Eighty-seven eyes of 47 dogs were examined, divided into three groups: control (GCO), non-diabetic cataract (GCAT) and diabetic cataract (GDM). The results showed that the diabetic group presented a higher cornea thickness than the other groups. The control group showed deeper anterior chambers without increased cellularity. When the iridocorneal angle measurements were analyzed, it was found that there were no statistically significant differences between the three groups. Based on these results, we can conclude that: the eyes of diabetic dogs with cataract showed a central cornea higher thickness compared to the eyes of dogs with cataract of different etiologies, and to dogs with normal eyes; there is a decrease of the anterior chamber depth and a increase of cellularity in the eyes of dogs with cataract compared to normal eyes, there is no significant difference between the iridocorneal angle measurement in the eyes of dogs with cataract, diabetic or not, and normal dogs.

Posición efectiva del lente intraocular en la facoemulsificación diagnosticado por biomicroscopia ultrasónica / Effective position of the intraocular lens diagnosed with ultrasonic biomicroscopy in phacoemulsification

OBJETIVO: Determinar la posición efectiva del lente intraocular en la facoemulsificación diagnosticado por biomicroscopia ultrasónica y su relación con la "sorpresa refractiva" posquirúrgica. MÉTODOS: Se realizó un estudio descriptivo y prospectivo de una muestra de 176 ojos de 100 pacientes operados de catarata por facoemulsificación con la técnica de Pre chop, en el Servicio de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", a los que se le determinó la posición efectiva del lente intraocular en la facoemulsificación diagnosticado por biomicroscopia ultrasónica y su relación con la "sorpresa" refractiva posquirúrgica. RESULTADOS: La mayoría de los pacientes estudiados, fueron del sexo masculino de la tercera edad, se diagnóstico la posición efectiva del lente intraocular en saco-surco por biomicroscopia ultrasónica, con lo que se logró la mejor agudeza visual corregida posoperatoria en todos los grupos de estudio, la distancia de la cara posterior del iris al lente intraocular, diagnosticada por biomicroscopia ultrasónica, en pacientes con lente intraocular en saco capsular demostró un valor constante, la mayoría de pacientes normo corregidos tenían el lente intraocular en saco capsular, los lente intraocular ubicados en la posición saco-surco, cuya háptica se encontraba con mayor angulación, tenían un cilindro posoperatorio promedio mayor, no se encontraron diferencias significativas entre el cilindro posoperatorio promedio obtenido. CONCLUSIONES: Queda demostrada la importancia de la biomicroscopia ultrasónica en la determinación de la posición del lente intraocular en los pacientes operados. Es determinante la localización del lente intraocular en el defecto refractivo posoperatorio, se destaca en la posición saco surco la existencia de un cilindro posoperatorio mayor.

OBJECTIVE: To determine the effective position of the intraocular lens in the phacoemulsiphication diagnosed by ultrasonic biomicroscopy and its relationship to the postsurgical refractive surprise. METHODS: A prospective and descriptive study was performed in a sample of 176 eyes from 100 patients, who had been operated on from cataract with phacoemulsiphication using Pre Chop technique in the Ocular Microsurgery Service of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology". The effective position of their intraocular lens diagnosed by ultrasonic biomicroscopy in the phacoemulsiphication and their relationship to the post surgery refractive surprise was determined. RESULTS: Most of the studied patients were older adult males. The ultrasonic biomicroscopy diagnosed the effective position of the intraocular lens in sac-sulcus to achieve the best postoperative corrected visual acuity in all the studied groups. The distance from the posterior face of the iris to the intraocular lens found in patients with intraocular lens in capsular sac showed a constant value. Most of the normocorrected patients had their intraocular lens in the capsular sac whereas the intraocular lens located in sac-sulcus position, whose haptics exhibited bigger angle, had bigger postoperative average cylinder, no significant differences were found among the postoperative average cylinders. CONCLUSIONS: The importance of the ultrasonic biomicroscopy is demonstrated in the determining the position of the intraocular lens in the surgical patients. The location of the intraocular lens is decisive in the postoperative refractive defect; bigger postoperative cylinder was more often found in the sac-sulcus position.

Biomicroscopia ultrasónica en nuestra experiencia con lentes fáquicos Artiflex para la corrección de alta miopía / The use of ultrasound biomicroscopy in our experience with Artiflex phakic lenses to correct high myopia

OBJETIVO: Determinar la relación de la posición de los LIOs Artiflex implantados con las estructuras del segmento anterior en el Instituto Cubano de Oftalmología Ramón Pando Ferrer en el período de enero del 2006 a enero del 2008. MÉTODOS: Se realizó un estudio prospectivo, descriptivo. El universo estuvo constituido por el total de ojos (20) a los cuales se les implantó estos lentes. RESULTADOS: Se obtuvo en el 100 por ciento de los casos distancias LIO-córnea y LIO-cristalino =1,5mm y =0,3mm respectivamente. CONCLUSIONES: La posición de los lentes ofreció márgenes seguros con respecto a las estructuras del segmento anterior

OBJECTIVE: To determine the association of the position of the implanted Artiflex intraocular lenses and the anterior segment structures at Ramón Pando Ferrer Cuban Institute of Ophthalmology in January 2006 _ January 2008 period. METHODS: A prospective and descriptive study was carried out in which the universe of study was 20 eyes implanted with this type of lenses. RESULTS: In all the cases, the intraocular lenses- cornea and the intraocular lenses _ crystalline distances were =1,5mm y =0,3mm respectively. CONCLUSIONS: The position of the lenses provided safe margins with respect to the anterior segment structures

Correlación entre la localización del lente intraocular, según biomicroscopia ultrasónica,y diferentes parámetros quirúrgicos en pacientes operados de catarata / Correlation between the location of the intraocular lens according to ultrasonic biomicroscopy and several surgical parameters in patients operated from cataract

OBJETIVO: Determinar la correlación entre la localización del lente intraocular en cámara posterior por biomicroscopia ultrasónica, diferentes parámetros quirúrgicos en pacientes operados de catarata. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y transversal en el Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el período de enero a junio del 2007. Se estudiaron variables como: edad, sexo, etiología de la catarata, técnica quirúrgica, localización del lente intraocular según biomicroscopia ultrasónica, así como complicaciones transoperatorias y posoperatorias. RESULTADOS: El 79 por ciento de todos los pacientes operados tenían entre 60 y 79 años de edad y algo más de la mitad correspondió al sexo femenino con un 59 por ciento. La catarata senil fue la etiología que predominó con un 74 por ciento y en el 68 por ciento de los casos el lente se localizó por biomicroscopia ultrasónica en el saco capsular. En los ojos donde el lente intraocular se localizó fuera del saco, la proporción de complicaciones transoperatorias y posoperatorias fueron significativamente mayoritarias, mientras que en los ojos donde el lente intraocular se encontraba en el saco, la mayoría no presentó complicaciones transoperatorias ni posoperatorias. CONCLUSIONES: Las diferencias entre las distintas localizaciones del lente intraocular se encontraron con significación estadística en el tipo de catarata, la presencia de complicaciones transoperatorias y posoperatorias, sin embargo, no se encontró relación estadística significativa entre la localización del lente intraocular con la técnica quirúrgica utilizada

OBJECTIVE: To determine the correlation between the location of the intraocular lens in the posterior chamber using ultrasonic biomicroscopy and the different surgical parameters in patients operated from cataract. METHODS: A prospective, descriptive and cross-sectional study was carried out in Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period of January to June 2007. The studied variables were age, sex, etiology of cataracts, surgical technique, location of the intraocular lens using ultrasonic biomicroscopy, as well as transoperative and postoperative complications. RESULTS: Seventy nine percent of all the surgical patients were 60-79 years of age and 59 percent were females. The senile cataract was the prevailing etiology for 74 percent and the lens was located in the capsular sac using ultrasonic biomicroscopy in 68 percent of the cases. In those eyes where the intraocular lens was off the sac, the ratio of transoperative and postoperative complications was significantly higher, whereas most of the eyes with the IOL placed in the sac did not have either transoperative or postoperative complications. CONCLUSIONS: The differences between the different locations of the intraocular lens were statistically significant in terms of the type of cataract; however, there was not any significant statistical association between the location of the intraocular lens and the surgical technique

Posición efectiva del lente intraocular según biomicroscopia ultrasónica y resultados visuales en pacientes operados de catarata / Effective position of the intraocular lens according to the ultrasound biomicroscopy and visual results in patients operated on from cataract

OBJETIVO: Determinar la correlación entre la posición efectiva del lente intraocular en cámara posterior por biomicroscopia ultrasónica con los resultados visuales en pacientes operados de catarata. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y transversal en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, durante el período de enero a junio del 2007, donde se estudiaron variables como: edad, sexo, etiología de la catarata, localización del lente intraocular según biomicroscopia ultrasónica, equivalente esférico, resultados refractivos y agudeza visual posoperatoria. RESULTADOS: La mayoría de los pacientes se encontraban entre 60 y 79 años de edad, siendo el sexo femenino el que prevaleció, y la catarata senil el tipo que predominó (74 por ciento). En la mayoría de los pacientes (68 por ciento) el lente se localizó por biomicroscopia ultrasónica en el saco capsular, y en la mitad de los ojos operados se encontró error en los resultados refractivos posoperatorios. CONCLUSIONES: Las diferencias entre las distintas localizaciones del lente intraocular se encontraron con significación estadística en el tipo de catarata, el equivalente esférico de la refracción posoperatoria y en los resultados refractivos poscirugía. No existieron diferencias entre el lugar de implantación del lente intraocular y la agudeza visual alcanzada

OBJECTIVE: To determine the correlation between the effective positioning of the intraocular lens in the posterior chamber using ultrasound biomicroscopy and the visual results achieved in patients operated on from cataract. METHODS: Prospective, cross-sectional and descriptive study was conducted in Ramón Pando Ferrer Cuban Institute of Ophthalmology from January to June 2007, in which variables such as age, sex, etiology of the cataract, location of the intraocular lens using ultrasound biomicroscopy, spheral equivalent, refractive results and postoperative visual acuity were analyzed. RESULTS: Most of the patients were 60 to 79 years-old, females prevailed and senile cataract was the most common type (74 percent). In 68 percent of patients, ultrasound biomicroscopy located the intraocular lens in the capsular sac whereas half of the operated eyes presented some error in the postoperative refractive results. CONCLUSIONS: Differences between the various locations of the intraocular lens were found but they were statistically significant in the type of cataract, the spheral equivalent of the postoperative refraction and in the postsurgical refractive results. There were no differences between the site of implantation of the IOL and the achieved visual acuity

Biomicroscopia ultrasónica en pacientes operados de catarata traumática / Ultrasound biomicroscopy used in patients operated from trauma cataract

Caracterizar a los pacientes operados de catarata traumática mediante su evaluación con biomicroscopia ultrasónica. Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo en el servicio de microcirugía del Instituto Cubano de Oftalmología Ramón Pando Ferrer, en el período comprendido entre enero de 2006 a enero de 2007. La muestra la conformaron 72 pacientes quienes recibieron tratamiento quirúrgico por diferentes técnicas con implante de lente intraocular. El 72,2 por ciento fueron del sexo masculino y prevaleció el grupo de edad entre 40 y 49 años. La subluxación del cristalino estuvo presente en el 16,7 por ciento. El 68,1 por ciento presentó una amplitud de la cámara anterior normal independientemente del tipo de trauma. Los hallazgos más frecuentes por Biomicroscopía Ultrasónica fueron: el leucoma corneal, la desinserción zonular y la ruptura de cápsula posterior. Presentaron el mayor porcentaje de buena agudeza visual con corrección posoperatoria y sin ella los pacientes con lente intraocular en saco, localización más frecuente por biomicroscopia ultrasónica. Predominó la ruptura de las fibras zonulares por temporal. La biomicroscopia ultrasónica (BMU) es un medio diagnóstico de gran importancia para la detección de alteraciones del segmento anterior en pacientes operados de catarata traumática.

To characterize the patients operated from trauma cataract through their evaluation with ultrasound biomicroscopy. A longitudinal, prospective, observational and descriptive study was conducted in the Microsurgery Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January 2006 to January 2007. The sample was made up of 72 patients who had been surgically treated using different techniques for intraocular lens implant. Male sex was 72,2 percent and the prevailing age group was 40 to 49 years. Crystalline subluxation was found in 16,7 percent of cases. Sixty eight percent of patients had normal anterior chamber amplitude regardless of the type of trauma. The most frequent findings by ultrasound biomicroscopy were corneal leukoma, zonular desinsertion, and posterior capsule rupture. The highest percentage with good visual acuity with/without correction after surgery was found in patients with IOL placed in the sac, the most frequent location according to ultrasound biomicroscopy. Rupture of zonular fibers predominated. Ultrasound biomicroscopy is a diagnostic means of great importante for detection of alterations in the anterior segment of patients operated from traumatic cataract.

Queratectasia: a propósito de un caso / Keratectasia: a case report

Se presenta un caso de queratectasia en una paciente de 8 años de edad, de raza blanca, femenina, de nacionalidad boliviana. El diagnóstico se realizó por los antecedentes patológicos personales y familiares referidos por la madre y el examen físico mediante la oftalmoscopia directa y la biomicroscopia. Se realizó una investigación de dicho tema por lo poco frecuente que resulta esta enfermedad ocular.

A case of keratectasia in a 8 years old female patient of white race and Bolivian citizenship was presented. The diagnosis was carried out through the personal and family pathologic antecedents, which were referred by the patient’s mother and the physical exam, by means of the direct ophthalmoscopy and the biomicroscopy. A research on this topic was done because of the lack of frequency this ocular disease presents.

Biomicroscopia ultra-sônica aplicada à caracterização do esôfago / Ultrasound biomicroscopy applied to the characterization of the esophagus

This work has the objective to present images of the in vitro esophagus wall with a high frequency ultrasound (US) system. The ultrasound pulse echo system setup consists of a monocycle pulse generator exciting a PVDF transducer and a high frequency pre-amplifier...