ABSTRACT
CASE REPORT: A 46-year-old woman, who presented with right visual acuity loss, was found to have papilledema, and subsequently shown to have ventricular dilatation in a cerebral Magnetic Resonance Imaging (MRI) assessment. Elevated protein levels were found in the cerebrospinal fluid. Spinal MRI revealed the presence of a spinal cord neoplasm. After surgical removal of the tumor, which turned out to be a neurilemmoma, the patient's visual acuity was restored. DISCUSSION: The ocular presentation and the relationship between intracranial hypertension and spinal tumors are discussed. Likewise, the importance of considering the various causes of papilledema is emphasized.
Subject(s)
Neurilemmoma/complications , Spinal Cord Neoplasms/complications , Vision Disorders/etiology , Cerebral Ventricles/pathology , Cerebrospinal Fluid Proteins/analysis , Dilatation, Pathologic/etiology , Female , Humans , Laminectomy , Magnetic Resonance Imaging , Middle Aged , Neurilemmoma/cerebrospinal fluid , Neurilemmoma/diagnosis , Neurilemmoma/surgery , Papilledema/etiology , Spinal Cord Neoplasms/cerebrospinal fluid , Spinal Cord Neoplasms/diagnosis , Spinal Cord Neoplasms/surgery , Thoracic Vertebrae , Visual Acuity , Visual Field TestsABSTRACT
Caso clínico: Se presenta el caso de una mujer de 46 años con disminución de agudeza visual en el ojo derecho y papiledema, con dilatación ventricular en la Resonancia Magnética Nuclear (RMN) cerebral. En la punción lumbar se detectó hiperproteinorraquia. La RMN medular reveló la presencia de una neoplasia de la médula espinal. La paciente recuperó la agudeza visual tras la extirpación quirúrgica del tumor, que resultó ser un neurilemoma. Discusión: Se comenta la presentación ocular y la fisiopatología de la hipertensión intracraneal en el tumor espinal. Asimismo se destaca la importancia del diagnóstico etiológico del papiledema
Case report: A 46-year-old woman, who presented with right visual acuity loss, was found to have papilledema, and subsequently shown to have ventricular dilatation in a cerebral Magnetic Resonance Imaging (MRI) assessment. Elevated protein levels were found in the cerebrospinal fluid. Spinal MRI revealed the presence of a spinal cord neoplasm. After surgical removal of the tumor, which turned out to be a neurilemmoma, the patient’s visual acuity was restored. Discussion: The ocular presentation and the relationship between intracranial hypertension and spinal tumors are discussed. Likewise, the importance of considering the various causes of papilledema is emphasized (Arch Soc Esp Oftalmol 2008; 83: 437-440)
Subject(s)
Humans , Female , Middle Aged , Brain Stem Neoplasms/complications , Brain Stem Neoplasms/diagnosis , Neurilemmoma/complications , Neurilemmoma/diagnosis , Intracranial Hypertension/complications , Intracranial Hypertension/diagnosis , Magnetic Resonance Imaging/methods , Visual Field Tests/methods , Spinal Cord/pathology , Intracranial Hypertension/therapy , Papilledema/complications , Hydrocephalus, Normal Pressure/complicationsABSTRACT
PURPOSE/METHOD: A case of a patient with Weill-Marchesani syndrome who developed a secondary glaucoma due to synechiae in both eyes is described. As intraocular pressure (IOP) could not be controlled with medical treatment in the left eye (LE), the patient underwent glaucoma filtering surgery. IOP was controlled and no complications occurred. However, 15 months later, athalamia stage 1 was diagnosed in the LE, without any alterations in the posterior pole. To solve this complication, a vitrectomy with lens extraction and intraocular lens implantation in the LE was performed. Currently, IOP is 12 mmHg and the anterior chamber remains deep. RESULTS/CONCLUSIONS: The association of vitrectomy and lens surgery in those cases where there is a predisposition to forward movement of the lens, might reduce intra and postoperative complications.
Subject(s)
Abnormalities, Multiple , Iridectomy , Lens, Crystalline/abnormalities , Postoperative Complications/etiology , Adult , Cataract Extraction , Combined Modality Therapy , Drug Resistance , Dwarfism , Female , Fingers/abnormalities , Glaucoma, Angle-Closure , Hand Deformities, Congenital , Humans , Intraocular Pressure/drug effects , Lens Implantation, Intraocular , Lens, Crystalline/surgery , Mitomycins/therapeutic use , Phacoemulsification , Postoperative Complications/surgery , Sulfonamides/therapeutic use , Syndrome , Thiophenes/therapeutic use , Trabeculectomy , VitrectomyABSTRACT
Objetivo/Método: Se presenta el caso clínico de una paciente diagnosticada de síndrome de Weill-Marchesani que desarrolló un glaucoma secundario por sinequias anteriores en ambos ojos (AO). Al no controlarse la presión intraocular (PIO) del ojo izquierdo (OI) con tratamiento médico, se realizó cirugía filtrante antiglaucomatosa. La evolución postoperatoria fue favorable y sin complicaciones. Sin embargo, a los 15 meses, se diagnosticó una atalamia grado I en OI, sin alteraciones en el segmento posterior. Para solucionar esta complicación, se llevó a cabo una vitrectomía, con extracción del cristalino e implantación de lente intraocular. Actualmente, la paciente mantiene una PIO de 12 mm Hg en OI, con una cámara anterior de profundidad normal. Resultados/Conclusiones: La asociación de vitrectomía y cirugía de cristalino en aquellos casos en los que existe predisposición al desplazamiento anterior del cristalino, puede reducir el número de complicaciones (AU)
Subject(s)
Adult , Female , Humans , Iridectomy , Abnormalities, Multiple , Sulfonamides , Thiophenes , Trabeculectomy , Vitrectomy , Syndrome , Lens Implantation, Intraocular , Phacoemulsification , Mitomycins , Postoperative Complications , Combined Modality Therapy , Cataract Extraction , Dwarfism , Drug Resistance , Intraocular Pressure , Lens, Crystalline , Hand Deformities, Congenital , Fingers , Glaucoma, Angle-ClosureABSTRACT
PURPOSE: To assess the clinical and epidemiological characteristics, diagnostic and therapeutic methods, and the final visual outcome of a group of patients with ocular sarcoidosis. METHODS: Retrospective study of 18 patients diagnosed of ocular sarcoidosis between March 1989 and May 1999. In every patient the following data were obtained: age, sex, bilaterality, initial and final visual outcome, systemic and ocular manifestations, stage of chest x-ray, serum markers, gallium scan, results of biopsy, medical and surgical treatment, and complications of treatment. RESULTS: The mean age at onset was 49.7 years (S.D. 19.9). Fourteen patients (77.8%) were female and 4 (22.2%) were male. The average follow-up time was 40.3 months (S.D. 28.7). Nine patients (50.0%) underwent a biopsy. The presence of non-caseating granulomata was observed in 7 (77.8%). Gallium scanning was positive in 16 cases (88.8%). The most frequent ocular manifestation was panuveitis (40.0%). Among the 30 eyes studied, conjunctival involvement was found in 10 (33.3%), secondary cataracts in 9 (30.0%), and secondary glaucoma in 6 (20.0%). Eleven patients (61.1%) were treated with oral corticosteroids and 10 (55,5%) with cyclosporine A. When sarcoidosis was diagnosed, 11 eyes (36.6%) had a visual acuity better than 0.6. At the end of the follow-up, the final visual outcome was better than 0.6 in 17 eyes (56.6%). CONCLUSIONS: An adequate control of ocular inflammation may improve the prognosis in patients with ocular sarcoidosis. Posterior segment involvement (posterior uveitis, macular edema or epiretinal membrane) may be associated with a worse visual prognosis.
Subject(s)
Eye Diseases , Sarcoidosis , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Age Factors , Aged , Child , Cyclosporins/therapeutic use , Eye Diseases/diagnosis , Eye Diseases/drug therapy , Eye Diseases/epidemiology , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Prognosis , Retrospective Studies , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Sarcoidosis/epidemiology , Sex Factors , Time Factors , Uveitis, Posterior/diagnosis , Visual AcuityABSTRACT
Objetivos: Analizar las características clínicas y epidemiológicas, los métodos diagnósticos y terapéuticos empleados, y la agudeza visual (AV) en un grupo de pacientes con sarcoidosis ocular. Métodos: Estudio retrospectivo de 18 pacientes diagnosticados de sarcoidosis ocular entre marzo de 1989 y mayo de 1999. Se evaluó la edad, sexo, bilateralidad, AV inicial y final, manifestaciones clínicas sistémicas y oculares, estadío radiológico del tórax, marcadores serológicos, gammagrafía con galio-67, realización de biopsia y resultado de la misma, tratamiento médico y quirúrgico, y complicaciones del tratamiento. Resultados: La edad media en el momento del diagnóstico fue de 49,7 años (D.E. 19,9). Catorce (77,8 por ciento) fueron mujeres y 4 (22,2 por ciento) varones. El seguimiento medio fue de 40,38 meses (D.E. 28,7). Se realizó biopsia en 9 pacientes (50,0 por ciento). De ellos, en 7 (77,8 por ciento) se demostró la presencia de granulomas no caseificantes. La gammagrafía con galio fue positiva en 16 casos (88,8 por ciento). La manifestación ocular más frecuente fue la panuveítis (40,0 por ciento). De los 30 ojos analizados, se describió afectación conjuntival en 10 (33,3 por ciento), de cataratas secundarias en 9 (30,0 por ciento), y glaucoma secundario en 6 (20,0 por ciento). Once pacientes (61,1 por ciento) fueron tratados con corticoides orales y 10 (55,5 por ciento) con ciclosporina A. En el momento del diagnóstico, 11 ojos (36,6 por ciento) presentaban una AV mayor de 0,6. Al final del seguimiento, el número de ojos con AV mayor de 0,6 era de 17 (56,6 por ciento). Conclusiones: Un control adecuado de la inflamación ocular puede mejorar el pronóstico de los pacientes con sarcoidosis ocular. La afectación del segmento posterior (uveítis posterior, edema de mácula o membrana epirretiniana) puede relacionarse con un peor pronóstico visual (AU)
Subject(s)
Middle Aged , Child , Adolescent , Adult , Aged , Male , Female , Humans , Sarcoidosis , Eye Diseases , Sex Factors , Time Factors , Uveitis, Posterior , Retrospective Studies , Prognosis , Cyclosporins , Adrenal Cortex Hormones , Age Factors , Immunosuppressive Agents , Follow-Up Studies , Visual AcuityABSTRACT
Objetivo/Método: Se presenta el caso clínico de una paciente que desarrolló episodios recurrentes de queratitis epitelial herpética tras comenzar tratamiento con latanoprost. Entre sus antecedentes oftalmológicos sólo destacaba un episodio de queratitis herpética hacía 21 años. Resultados/Conclusiones: Los episodios de queratitis herpética sólo pudieron ser controlados al retirar el latanoprost. La paciente no ha vuelto a presentar nuevos brotes de queratitis herpética desde entonces. El uso de latanoprost podría estar asociado a la aparición de queratitis herpéticas recurrentes en pacientes con historia previa de herpes ocular (AU)
Subject(s)
Aged , Female , Humans , Keratitis, Herpetic , Recurrence , Prostaglandins F, Synthetic , Antihypertensive Agents , Intraocular PressureABSTRACT
PURPOSE/METHOD: We present a case of a patient who developed recurrent epithelial herpes simplex keratitis after starting treatment with latanoprost. Her ophthalmic history was only remarkable for a past episode of herpetic keratitis 21 years previously. RESULTS/CONCLUSIONS: Episodes of herpetic keratitis were under remission only when latanoprost was discontinued. No recurrences of herpes simplex keratitis have been observed since then. Latanoprost usage might be associated with recurrent episodes of herpes simplex keratitis in patients with previous history of ocular herpes simplex virus infection.
