Retinal detachment and gyrate atrophy of the choroid and retina: case report / Descolamento de retina e atrofia girata da coroide e retina: relato de caso

To report a case of gyrate atrophy of the choroid and retina associated with retinal detachment. Hyperornithinemia confirmed the diagnosis of gyrate atrophy. Pars plana vitrectomy with silicone oil infusion was performed with good anatomical results, despite the persistence of low visual acuity. Retinal detachment is a rare complication of gyrate atrophy and can be managed with pars plana vitrectomy and silicone oil. We discuss the possible mechanisms that led to low visual acuity.

Descrever um caso de atrofia girata da coroide e retina associado com descolamento de retina. Altos níves de ornitina sérica confirmaram o diagnóstico de atrofia girata. Vitrectomia via pars plana com infusão de óleo de silicone foi realizada, com bom resultado anatômico, apesar da baixa acuidade visual persistente. Descolamento de retina é uma rara complicação da atrofia girata e pode ser manejada com vitrectomia via pars plana e óleo de silicone. Discutiremos os possíveis mecanismos que levaram à baixa acuidade visual.

Scleral suspension pars-plana lensectomy for ectopia lentis followed by suture fixation of intraocular lens.

PURPOSE: To describe a simple technique of scleral suspension-pars plana lensectomy (SS-PPL) in acquired and congenital ectopia lentis and scleral fixation of intraocular lens (IOL). MATERIALS AND METHODS: Twenty eyes of 16 patients (12 unilateral and 4 bilateral cases of "essential familial lens subluxation") aged 10-40 years (mean 25 years) underwent SS-PPL with implantation of scleral fixated IOL. Indications for surgery were best-corrected visual acuity < 6/18, bisection of pupil by the lens, and lens-induced glaucoma. Prerequisites for SS-PPL were, visibility of part of the lens in the pupillary area and soft lens. RESULTS: Postoperative visual acuity ranged from 6/6 - 6/36. Lens tilt in 3 cases(15%) and small decentration in 2 cases(10%) were seen; however these did not seriously compromise the visual result. Scant vitreous bleeding on the first postoperative day was seen in 3 cases (15%). CONCLUSION: The advantages of the scleral suspension of subluxated lens prior to lensectomy include stabilization; it allows proper viewing of the lens, avoids injury to the iris and ciliary body during lensectomy and reduces the possibility of dislocation of the lens.

Management of combined rhegmatogenous retinal and choroidal detachment

In a retrospective review, we describe operative difficulties and results after treatment of rhegmatogenous retinal detachment complicated by choroidal detachment. During a 14 year period, 42 patients presented with both rhegmatogenous retinal detachment and choroidal effusion; 50% of eyes had large retinal tears, 30% had giant retinal tears and 20% had multiple tears. All eyes were hypotonus and 80% had been neglected for over three months' duration. Treatment included preoperative systemic and topical corticosteroids and cyclopegic agents. The suprachoroidal fluid was evacuated with subsequent retinopexy and scleral buckling. Intravitreal air injection was mandatory at the end of surgery. Patients were followed for a period of two years. In the early postoperative period, 70% of eyes had reattached retinas. However, proliferative vitreoretinopathy occurred within two months postoperatively in 85% of these eyes. At the end of the follow-up period, 30% of cases remained attached. Rhegmatogenous retinal detachment complicated by choroidal detachment has a guarded prognosis. Most cases develop to advanced stages of proliferative vitreoretinopathy that may not be amenable to treatment. The exudative process seems to occur simultaneously, both in the suprachoroidal and intravitreal spaces

Osificación de la coroides / Ossification of the choroid

Se exponen en el trabajo los aspectos esenciales que en relación con la osificación de la coroides hacen referencia otros autores, tanto en su definición, sintomatología y patogenia. Se expone la experiencia de esta afección mediante la presentación de un paciente con el diagnóstico clínico oftalmológico de opacificación de la coroide, y al cual se le realizaron investigaciones como: radiografías de órbitas, tomografía simple y tomografía computarizada, así como ultrasonografía. Se confirmó el diagnóstico por el estudio histopatológico. Se destaca el interés científico de esta enfermedad poco frecuente, y consideramos que nuestra paciente constituye el primer caso registrado en nuestro país