ABSTRACT
La uveítis es una patología ocular que se define como la inflamación del tracto uveal del ojo, que pudiera estar asociada a la inflamación de otras estructuras oculares o adyacentes a la cavidad orbitaria, por la proximidad que hay entre los tejidos. En el campo odontológico la uveitis se manifiesta de manera secundaria ante infecciones focales, las cuales se caracterizan por presentar un foco séptico primario, en donde la infección se propaga a otras estructuras del macizo facial. Entre las lesiones que generan un foco infeccioso primario en cavidad bucal, se describen: quiste periapical, granuloma periapical, afecciones pulpares, pericoronaritis y enfermedad periodontal, siendo esta última motivo del caso clínico que se presenta a continuación
Uveitis is an eye condition that is defined as inflammation of the uveal tractor and may be associated with inflammation of other ocular structures or adjacent to the orbital cavity, and the proximity between the tissues. In the dental field uveitis manifests itself secondary to focal infections, which are characterized by a primary septic focus, where the infection spreads to other craniofacial structures. Among lesions that produce a primary infection in oral cavity, are described: periapical cyst, periapical granuloma, pulpal disease, and periodontal disease pericoronaritis, the latter being the occasion of the clinical case is presented below
Subject(s)
Humans , Female , Middle Aged , Mouth/microbiology , Mouth Diseases/microbiology , Uveal Diseases/diagnosis , Periodontitis/pathology , Radicular Cyst/pathology , Uveitis/pathologyABSTRACT
We report a rare case of multicentric Castleman's disease that presented with ophthalmic involvement, along with a review of the literature. A 63-year-old male presented with decreased visual acuity in both eyes. Both eyes had serous elevations of the retinas with shifting subretinal fluid and annular choroidal detachment. No retinal breaks were found. Laboratory tests revealed pancytopenia, hypergammaglobulinemia, and an increased erythrocyte sedimentation rate. Chest and abdominal computed tomographies showed multiple lymphadenopathies in the mediastinum, abdomen, and in both inguinal areas. Histological examination of the inguinal lymph node biopsy was consistent with Castleman's disease. After combination chemotherapy, the serous elevations of both retinas and the annular choroidal detachments of both eyes disappeared. Ophthalmic involvement in Castleman's disease is very rare, and to the authors' knowledge, this is the first report of ophthalmic involvement of Castlemans's disease in Korea.
Subject(s)
Aged , Humans , Male , Choroid Diseases/etiology , Drug Therapy, Combination , Exudates and Transudates/metabolism , Fluorescein Angiography , Fundus Oculi , Castleman Disease/complications , Hypergammaglobulinemia/complications , Magnetic Resonance Imaging , Syndrome , Tomography, Optical Coherence , Treatment Outcome , Uveal Diseases/diagnosisABSTRACT
Descrição de um caso de efusão uveal secundária a metástase de coróide e revisão dos principais diagnósticos diferenciais. Uma paciente com baixa da acuidade visual, no olho esquerdo, apresentou nódulos ao nível da coróide, dispersão pigmentar retiniana e descolamento seroso da retina. O exame angiofluoresceinográfico demonstrou padrão "leopard spots", semelhante ao encontrado nos casos de efusão uveal. A ecografia ocular demonstrou a presença do descolamento seroso da retina, presença de espessamento e nódulos na coróide e a tomografia de coerência óptica evidenciou ruptura do epitélio pigmentado da retina, presença de nodulações coroidianas hiperrefletivas e áreas de descolamento de retina seroso. Após ser submetido a exames diagnósticos de imagem, constatou-se a presença de nódulo único no ápice pulmonar esquerdo. As metástases de coróide podem levar a um quadro similar à síndrome de efusão uveal. Esta possibilidade deve sempre ser pensada diante de um quadro de efusão uveal atípica e avaliação sistêmica para pesquisa de carcinoma deverá ser solicitada.
We report a case of choroidal metastasis simulating uveal effusion syndrome. This patient with uveal metastasis from lung carcinoma presented with decreased vision in the left eye. Fundoscopic examination revealed pigmentary clumping, multiple choroidal nodules and serous retinal detachment. Fluorescein angioraphy revealed a leopard spots pattern similar to uveal effusion syndrome. Ultrasound revealed the presence of choroidal nodules with moderate internal reflectivity, choroidal thickening and serous retinal detachment. Optical coherence tomography showed retinal pigment epithelium tear and hyper-reflective nodules within the choroid and areas of serous retinal detachment. Image investigation demonstrated the presence of a solitary pulmonary nodule at the left apical lung. Choroidal metastasis can lead to a scenario that simulates uveal effusion syndrome. This possibility must be considered when having an atypical uveal effusion symptomatoloy and a systemic screening for systemic cancer should be performed.
Subject(s)
Aged , Female , Humans , Choroid Neoplasms/secondary , Lung Neoplasms , Uveal Diseases/diagnosis , Choroid Neoplasms/diagnosis , Diagnosis, Differential , Fluorescein Angiography , Lung Neoplasms , Syndrome , Tomography, Optical CoherenceABSTRACT
Se ha hecho una descripción de las lesiones coroídeas capaces de ser diagnosticadas mediante ecografía combinada A/B Scan, haciéndose mayor énfasis en imágenes bidimensionales. Con un número limitado de casos se ilustran las descripciones con los hallazgos encontrados personalmente en los pacientes referidos para su estudio durante un período de poco más de un año, desde abril de 1987 a la fecha. Se clasifican las modalidades ecográficas de lesiones coroídales en dos rubros generales: engrosamiento y solevantamientos, subdividiendo estos últimos en líquidos y sólidos. Por su mayor relevancia se describen haciendo una exposición más extensa los solevantamientos tumorales, destacando los melanomas, carcinomas y angiomas, planteando su diagnóstico diferencial entre sí y con lesiones no tumorales de comportamiento acústico parecido. Se ilustran algunos ecotomogramas en blanco y negro, mostrando así su facilidad para demostrar distintos tonos de reflectividad acústica
Subject(s)
Choroid Neoplasms/diagnosis , Choroid/physiopathology , Ultrasonography , Uveal Diseases/diagnosisABSTRACT
As uveítes posteriores mais comuns na infância säo as formas endógenas e tem uma importância clínica grande porque raramente se acompanham de sinais anteriores e näo säo detectadas pois as crianças näo se queixam de borramento de visäo. A toxoplasmose é a forma mais frequente. Outras formas congênitas e adquiridas säo descritas com ênfase na precocidade do diagnóstico e do tratamento