ABSTRACT
In developed countries, the main etiology of posterior uveitis is of infectious origin, Herpes is the most common viral agent as it has a wide spectral of ocular manifestations. These manifestations could depend on the patient's immunologic state, ranging from a mild focal form of non-necrotizing herpetic renitis (NNHR) to a severe form of Acute retinal necrosis (ARN). We present a case of NNHR by VHS 2 and the different differential diagnostics previous to its diagnosis: atypical ocular toxoplasmosis, ocular tuberculosis and ARN. During its evolution, it presented a drastic drop in the visual acuity despite of the antiviral treatment, and with systemic corticoids and the injury's clinical improvement. This event led to reevaluate the suspected entities, establishing the NNHR as a definitive diagnostic by exclusion that constituted a challenging diagnostic.
Subject(s)
Herpes Simplex , Herpesviridae Infections , Retinal Necrosis Syndrome, Acute , Retinitis , Uveitis, Posterior , Herpes Simplex/diagnosis , Herpesviridae Infections/complications , Humans , Retinal Necrosis Syndrome, Acute/diagnosis , Retinal Necrosis Syndrome, Acute/drug therapy , Retinitis/complications , Retinitis/diagnosis , Retinitis/drug therapy , Uveitis, Posterior/diagnosisABSTRACT
En países en vías de desarrollo la principal etiología de uveítis posterior es de origen infeccioso, siendo el herpes virus el agente viral más común, con un amplio espectro de manifestaciones oculares que puede depender del estado inmunológico del paciente: desde una forma leve focal de retinitis herpética no necrosante (RHNN) hasta una forma severa de necrosis retiniana aguda. Presentamos un caso de RHNN por VHS 2 y los diferentes diagnósticos diferenciales planteados previos a su diagnóstico: toxoplasmosis ocular atípica, tuberculosis ocular y necrosis retiniana aguda. Durante su evolución presentó una caída súbita de la agudeza visual a pesar del tratamiento antiviral y con corticoides sistémicos y de la mejoría clínica de la lesión. Este evento conllevó a replantear las entidades sospechadas, estableciendo la RHNN como diagnóstico definitivo por exclusión, lo cual constituyó un reto diagnóstico. (AU)
In developed countries, the main origin of posterior uveitis is an infection. Herpes is the most common viral agent, as it has a wide spectrum of ocular manifestations. These manifestations may depend on the immunological state of the patient, and range from a mild focal form of non - necrotising herpetic retinitis (NNHR) to a severe form of acute retinal necrosis (ARN). A case of NNHR due to Herpes simplex virus type 2 (HSV-2) is reported, along with the different differential diagnostics prior to its diagnosis: atypical ocular toxoplasmosis, ocular tuberculosis, and ARN. During its course, despite the antiviral treatment, systemic corticoids and the clinical improvement of the injury, there was a drastic drop in the visual acuity. This event led to the re-evaluation of the suspected entities, establishing the NNHR as a definitive diagnostic by exclusion, which was a diagnostic challenge (AU)
Subject(s)
Humans , Female , Adult , Retinitis/diagnosis , Retinitis/virology , Herpesvirus 2, Human , Herpesviridae Infections/complications , Uveitis, Posterior/diagnosis , Uveitis, Posterior/virology , Diagnosis, DifferentialABSTRACT
In developed countries, the main origin of posterior uveitis is an infection. Herpes is the most common viral agent, as it has a wide spectrum of ocular manifestations. These manifestations may depend on the immunological state of the patient, and range from a mild focal form of non - necrotising herpetic retinitis (NNHR) to a severe form of acute retinal necrosis (ARN). A case of NNHR due to Herpes simplex virus type 2 (HSV-2) is reported, along with the different differential diagnostics prior to its diagnosis: atypical ocular toxoplasmosis, ocular tuberculosis, and ARN. During its course, despite the antiviral treatment, systemic corticoids and the clinical improvement of the injury, there was a drastic drop in the visual acuity. This event led to the re-evaluation of the suspected entities, establishing the NNHR as a definitive diagnostic by exclusion, which was a diagnostic challenge.
ABSTRACT
Presentamos el caso de un preescolar varón de 3 años con un coristoma óseo epibulbar. El paciente presentaba una masa subconjuntival de consistencia dura de 8×10 mm en el cuadrante superotemporal del ojo derecho con vascularización y presencia de cilios largos de aproximadamente 8 a 10 mm que tocaban la superficie corneal. El estudio histopatológico evidenció la presencia de trabéculas de hueso compacto maduro rodeado de tejido fibroso, canales de Havers con anillos concéntricos de hueso laminar sin médula ósea y con osteocitos normales, lo cual definió el diagnóstico de coristoma óseo epibulbar. El coristoma óseo es el tipo más raro de coristomas oculares y debe considerar en el diagnóstico diferencial de los tumores epibulbares pediátricos
We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8 × 10 mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10 mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumour
Subject(s)
Humans , Male , Child, Preschool , Ossification, Heterotopic/pathology , Scleral Diseases/pathology , Choristoma/pathology , Ossification, Heterotopic/surgery , Scleral Diseases/surgery , Diagnosis, Differential , Eye Neoplasms/diagnosis , Choristoma/surgeryABSTRACT
We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8×10mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumours.
