ABSTRACT
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Subject(s)
Humans , Clinical Trials as Topic , Biomedical Research/ethics , Helsinki Declaration , Knowledge , Health Literacy/ethicsSubject(s)
Clinical Trials as Topic/ethics , Ophthalmology , Adult , Amblyopia/drug therapy , Amblyopia/therapy , Carbidopa/adverse effects , Carbidopa/therapeutic use , Child , Clinical Trials as Topic/methods , Clinical Trials as Topic/standards , Eye Diseases/drug therapy , Eye Protective Devices/adverse effects , Fibrinolysin/adverse effects , Fibrinolysin/therapeutic use , Helsinki Declaration , Human Experimentation/standards , Humans , Intravitreal Injections/adverse effects , Levodopa/adverse effects , Levodopa/therapeutic use , Peptide Fragments/adverse effects , Peptide Fragments/therapeutic use , Quality of Life , Retinal Perforations/drug therapy , Risk AssessmentABSTRACT
Caso Clínico. Mujer de 45 años que acude a consultas de oftalmología por sensación de cuerpo extraño al parpadeo. A la exploración presenta una tumoración rojiza en la zona superior del canto interno de su ojo derecho. La paciente era tratada por síndrome de ojo seco, con lágrimas artificiales y suero autólogo. Llevaba tres meses con tapones lagrimales de tamaño mediano. Discusión. Destacamos la importancia de una correcta elección del tamaño del tapón lagrimal para disminuir la probabilidad de complicaciones. Presentamos el caso clínico de un granuloma piogénico del punto y canalículo lagrimal, en una portadora de tapones lagrimales (AU)
Case Report. A 45-year-old female was referred to our department due to foreign-body sensation in her right eye. Biomicroscopy examination showed a red ampullary lesion over the right inferior puncta, clinically diagnosed as pyogenic granuloma. This patient, with a longstanding history of dry eyes, had undergone previous treatment with autologous serum eye drops and preservative-free artificial eye drops. Also, for the last three months she was treated with medium size silicone punctal plugs. Discussion. We report a case of a pyogenic granuloma caused by a silicone lagrimal plug. It is important to emphasize the correct choice of plug size and its appropiate placement. Patients with this devices should be informed about possible complications (AU)
Subject(s)
Humans , Female , Middle Aged , Granuloma, Pyogenic/diagnosis , Lacrimal Duct Obstruction/etiology , Xerophthalmia/etiology , Risk Factors , Diagnosis, DifferentialABSTRACT
Introducción. La vigabatrina es un fármaco antiepiléptico eficaz en el tratamiento de las crisis parciales con o sin generalización, que actúa incrementando los niveles del GABA mediante una inhibición irreversible de la enzima GABA-transaminasa. En los últimos años aparecen diversas publicaciones referentes a la aparición de alteraciones de los campos visuales en pacientes en tratamiento con este fármaco. Objetivo. Estudiar la prevalencia y las características de las alteraciones de los campos visuales asociadas al tratamiento con vigabatrina en una consulta de epilepsia de adultos. Pacientes y métodos. Se realizó un estudio oftalmológico consistente en un interrogatorio acerca de síntomas oftalmológicos, estudio de fondo de ojo, campimetría tipo Humphrey, protocolo 30-2, potencial evocado visual y electrorretinograma a un grupo de 10 pacientes en tratamiento crónico con vigabatrina. Resultados. Seis pacientes de 10 (60 por ciento) presentaban alteraciones campimétricas; en dos de los casos (20 por ciento) eran graves. Únicamente los dos pacientes con alteraciones campimétricas graves referían alteraciones visuales en el interrogatorio y consistían esencialmente en golpearse de forma repetida con diversos objetos. En dos pacientes (20 por ciento) encontramos palidez del disco óptico. En dos casos, los que presentaban alteraciones campimétricas graves, encontramos alteraciones del electrorretinograma. Los potenciales evocados visuales eran en todos los casos normales. Conclusiones. La prevalencia de alteraciones de los campos visuales en los pacientes en tratamiento crónico con vigabatrina es muy elevada. Hasta fases avanzadas, no suele producir manifestaciones clínicas oftalmológicas. En un grupo de pacientes, se asocia palidez del nervio óptico. Es muy importante realizar estudios campimétricos seriados para detectar precozmente estas alteraciones (AU)
Subject(s)
Middle Aged , Adult , Male , Female , Humans , Vision Disorders , Visual Fields , Prevalence , Visual Field Tests , Vigabatrin , Anticonvulsants , 4-Aminobutyrate Transaminase , Electroretinography , Epilepsy , Enzyme Inhibitors , Optic DiskABSTRACT
INTRODUCTION: Vigabatrin is an effective antiepileptic drug for treatment of partial crises with or without generalization. It acts by increasing GABA levels by irreversible inhibition of the enzyme GABA-transaminase. In recent years there have been several reports published on the appearance of alterations of the visual fields of patients treated with this drug. OBJECTIVE: To study the prevalence and characteristics of the visual field changes associated with vigabatrin treatment in an adult epilepsy clinic. PATIENTS AND METHODS: Ophthalmological examination, consisting of questions about eye symptoms, study of the fundus oculi, Humphrey-type campimetry, protocol 30-2, visual evoked potentials and electroretinogram were done on a group of 10 patients on long-term vigabatrin treatment. RESULTS: Six of the ten patients (60%) had campimetric alterations, which were serious in two cases (20%). Only the two patients with severe field defects complained of sight changes when questioned and their complaints were mainly of repeatedly bumping into things. In two patients (20%) there was pallor of the optic nerve. In both cases, the patients with severe field defects showed alterations on the electroretinogram. Visual evoked potentials were normal in all cases. CONCLUSIONS: There is a very high prevalence of visual field defects in patients on long-term treatment with vigabatrin. Clinical ophthalmological signs are not usually seen until advanced stages. Pallor of the optic nerve was seen in a group of patients. It is very important that serial campimetric studies are done for early detection of such alterations.
Subject(s)
Anticonvulsants/adverse effects , Vigabatrin/adverse effects , Vision Disorders/chemically induced , Visual Fields/drug effects , 4-Aminobutyrate Transaminase/antagonists & inhibitors , Adult , Anticonvulsants/pharmacology , Electroretinography , Enzyme Inhibitors/adverse effects , Enzyme Inhibitors/pharmacology , Epilepsy/drug therapy , Female , Humans , Male , Middle Aged , Optic Disk/pathology , Prevalence , Vigabatrin/pharmacology , Vision Disorders/diagnosis , Vision Disorders/epidemiology , Vision Disorders/pathology , Visual Field TestsABSTRACT
The presence or absence of an interaction between topical diclofenac (nonsteroidal antiinflammatory agent) and topical timolol (beta-blocker) was studied in 37 eyes. We instilled one drop of diclofenac several times into the patient's right eye and one drop of timolol into the same eye. We measured intraocular pressure in both eyes twice and compared the results in both eyes with the baseline intraocular pressure and with the pressure after administration of diclofenac alone and timolol alone. The joint use of both drugs did not modify the decrease in the ocular pressure induced by timolol. We can therefore use timolol and diclofenac together when a combination of antiinflammatory and beta-blocker agents is required.
