Rotura ocular posterior traumática / Traumatic posterior ocular rupture

El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visuales(AU)

The ocular trauma is an important cause of ophthalmological morbidity in the world with significant socio-economic implications for the patient and its relatives. It generally occurs in young adults, with good visual acuity at the beginning of the traumatic event, which may be affected by the trauma severity, the ocular structures that it affects and the possible complications. This is the report on two patients with posterior scleral rupture secondary to blunt open-globe ocular trauma. The customized management, the follow-up of each case and the visual results achieved were all described(AU)

Caracterización de los pacientes con traumatismo ocular en el área de salud Julián Grimau / Characterization of patients with ocular trauma in Julián Grimau health area

Se efectuó un estudio observacional, descriptivo y transversal de 65 pacientes con traumas oculares, pertenecientes al área de salud del Policlínico Universitario Julián Grimau de Santiago de Cuba, desde Junio del 2010 hasta igual mes del 2011, con vistas a identificar las principales características clinicoepidemiológicas de los afectados. En la serie predominaron las contusiones (32,3 por ciento), las heridas corneales (32,9 por ciento), las erosiones corneales (27,6 por ciento), así como las hemorragias subconjuntivales y los hifemas (23,7 por ciento, cada uno). Por tales razones se recomendó realizar estudios que reflejen la prevalencia e incidencia de la mencionada afección en esta provincia

An observational descriptive and cross-sectional study was carried out in 65 patients with ocular trauma, belonging to the health area of Julián Grimau University Polyclinic in Santiago de Cuba, from June 2010 to the same month of 2011 with the purpose of identifying the main clinical and epidemiological characteristics of those affected. Contusions (32.3 percent), corneal wounds (32.9 percent) and corneal erosions (27.6 percent) prevailed in the series, as well as subconjunctival hemorrhage and hyphema (23.7 percent each). For these reasons it was recommended to carry out studies reflecting the prevalence and incidence of the condition in this province

Avaliação clínica e histopatológica do bulbo do olho de cães, após aplicação de flunixin meglumine por via subconjuntival

Frente à eficácia do uso de flunixin meglumine nas inflamações oculares em cães, pelas vias oral, intravenosa, intramusculare subcutânea, concebeu-se testar a via de administração subconjuntival, para uso oftálmico, nesta espécie e os efeitos destefármaco sobre os tecidos oculares. Animais da espécie canina, adultos, machos e fêmeas, clinicamente sadios receberam,por aplicação subconjuntival, flunixin meglumine na dose de 1,1 mg/kg em olho direito, durante três dias consecutivos. O olhocontralateral (controle) recebeu solução salina a 0,9% em volume idêntico ao do fármaco. Estudaram-se as eventuais alteraçõessobre o bulbo do olho mediante exames clínico e histopatológico. Os resultados obtidos mostraram blefarospasmo,hiperemia conjuntival e quemose transitórias no sítio de aplicação e blefarospasmo. Os bulbos oculares foram coletados aotérmino do protocolo terapêutico. A histopatologia dos olhos submetidos à aplicação do flunixin meglumine revelou infiltradocelular moderado, sob a conjuntiva, em olhos direito de cinco animais e leve em olho esquerdo de um cão. Pode-se observara manutenção da integridade do segmento posterior do olho em todos os animais, mormente pela coesão das três túnicasoculares.

Necrotizing Conjunctival Ulceration following Subconjunctival Atropine Depot Injection

PURPOSE: To report a case of severe conjunctival necrosis associated with scleral melting following subconjunctival atropine depot injection in treating posterior synechiae associated with uveitis. METHODS: A 31-year-old male patient visited our clinic after subconjunctival injection of 1% atropine, 0.4 ml, in treating circular posterior synechiae associated with uveitis in his left eye. The marked conjunctival injection and chemosis around the limbus were noted. Three days after first visit to our clinic, remarkable necrosis had developed around the whole limbus, and newly developed whitish necrotic tissue was noted over sclera and episclera. We debrided the necrotic conjunctiva and episclera, and the exposed sclera was grafted with amniotic membrane. REUSLTS: After 4 weeks, the complete re-epithelization of necrotized defect was shown and there were no evidence of inflammation, symblepharon, or scleral melting. CONCLUSIONS: In usage of atropine, especially to eyes locally, subconjunctival injection should be avoided due to direct toxicity to the conjunctiva and sclera to form necrosis and melting. The damaged lesions of conjunctiva and sclera due to usage of this drug generally cause chronic inflammation and persistent surface defect. In order to restore and re-epithelize the necrotic defect, more aggressive treatment such as an amniotic membrane transplantation would be needed.

Expression of LFA-3(CD58) After Intracorneal Infection of Candida albicans in Rabbits

In this immunohistochemical study we applied a monoclonal antibody(mAb) to evaluate the expression pattern of lymphocyte functionassociated antigen 3(LFA-3) in rabbit`s corneas before and after intracorneal injection of Candida albicans. Ten right eyes were induced to get immunocompromized cornea with subconjunctival injection of 2mg of dexamethasone once a day for 3 days(group I), and 10 left eyes had normal cornea without subconjunctival injection of dexamethazone(group II). Each 2 corneas in both group I and II were resected at 3, 12, 24 and 72 hours after intracorneal injection of C. albicans. Each 2 corneas without intracorneal injection of C. albicans in both groups were used as a control. The results were as follows: LFA-3 was expressed weakly on corneal epithlium in control of group I and group II. Expression of LFA-3 on vascular endothelium of group II was somewhat stronger than that of group I, LFA-3 was expressed moderately on vascular endothelium, and was detected on corneal stroma at 3 hors after intracorneal injection in both groups. Expression of LFA-3 on corneal stroma was slightly increased in both group II, and markedly increased in group I at 12 hours after intracorneal injection. Group II showed slightly increased LFA-3 expression on corneal and II to be expressed on corneal endothelium and inflammatory cells at 24 hours after injection. Its expression on corneal epithelium, stroma and endothelium was more increased in group II than in group I at that time. Group I showed moderate LFA-3 expression on corneal epithelium, corneal endothelium and inflammatory cells, and strong expression on corneal stroma and vascular endothelium at 72 hours after infection. Otherwise, LFA-3 expression in group II was weak to moderate n corneal epithelium, corneal endothelium and inflammatory cell, and moderate on corneal stroma and vascular endothelium. In this study, it was found that expression of LFA-3 in group I was weaker than that in group II in control and at 3 hours after intracorneal injection of C. albicans, but group I showed more strong LFA-3 expression than group II after 12 hours of intracorneal injection.