Acquired night blindness due to bad eating patterns.

We report a case of acquired night blindness in a developed country (Spain) without risk factors for nutritional deficiency disease or family history of hereditary retinal disease. A 76-year-old woman presented with acquired night blindness of 6-month progression. After a thorough inquiry about eating patterns she becomes suspicious of vitamin A low dietary intake, which is analytically confirmed and successfully treated. Despite being very uncommon in our environment and even more in patients without digestive problems, in a patient reporting acquired night blindness vitamin A deficiency should not be discarded until eating patterns have been investigated. It might be especially relevant in certain socioeconomic situations and eating disorders such as bulimia or anorexia nervosa.

[Intermediate uveitis due to human T-cell lymphotropic virus type 1]. / Uveítis intermedia por virus linfotropo humano de células T Tipo 1.

CASE REPORT: The case of a 66-year-old woman with intermediate uveitis in both eyes and progressive weakness of lower limbs is reported. A human T-lymphotropic virus type 1 (HTLV-1) infection was detected in the serological study, with the patient being diagnosed with tropical spastic paraparesis and HTLV-1 intermediate uveitis. The patient made good progress with oral steroid treatment. DISCUSSION: The clinical and epidemiological aspects of HTLV-1 infection are discussed. We recommend a serological determination of the virus in intermediate uveitis of unknown origin in people from endemic areas or with neurological symptoms.

Uveítis intermedia por virus linfotropo humano de células T Tipo 1 / Intermediate uveitis due to human T-cell lymphotropic virus type 1

Caso Clínico: Se presenta el caso de una mujer de 66 años con uveítis intermedia bilateral y debilidad progresiva de miembros inferiores. En estudio serológico se detecta infección por virus linfotropo humano de células T tipo 1 (VLHT-1), siendo diagnosticada la paciente de paraparesia espástica tropical y uveítis intermedia por VLHT-1. La paciente evolucionó favorablemente con tratamiento corticoideo oral. Discusión: Se comenta la clínica y la epidemiología de la infección por VLHT-1. Se recomienda la realización de serología para el virus en uveítis intermedias no filiadas en inmigrantes de áreas endémicas o con síntomas neurológicos(AU)

Case Report: The case of a 66-year-old woman with intermediate uveitis in both eyes and progressive weakness of lower limbs is reported. A human T-lymphotropic virus type 1 (HTLV-1) infection was detected in the serological study, with the patient being diagnosed with tropical spastic paraparesis and HTLV-1 intermediate uveitis. The patient made good progress with oral steroid treatment. Discussion: The clinical and epidemiological aspects of HTLV-1 infection are discussed. We recommend a serological determination of the virus in intermediate uveitis of unknown origin in people from endemic areas or with neurological symptoms(AU)

[Visual acuity loss, the initial sympton of a spinal cord neoplasm]. / Disminución de agudeza visual, primer síntoma de un tumor medular.

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.

Determination of the pseudofacility by fluorophotometry in the human eye.

PURPOSE: Pseudofacility (decrease in aqueous humor flow in response to increase in the intraocular pressure (IOP)) has been evaluated in animals and in humans by a combination of different techniques that seriously alter the ocular physiology, such as the cannulation of the eyeballs, use of radioactive isotopes, perilimbic suction cups or tonography. Very different results have been obtained. Our objective is to relate the value of the aqueous humor flow in humans (as measured by fluorometry) with IOP. In order to obtain the widest range of IOP possible, we have performed this study in both normal as well as glaucoma patients. METHODS: 48 eyes were studied, corresponding to 31 subjects (mean age 58 +/- 14 years). Of these, 21 corresponded to normal subjects and 27 to glaucoma patients. The aqueous humor flow (F) was determined by fluorophotometry (Protocol of Yablonsky) and the IOP was measured thereafter. RESULTS: The mean value of F was 2.1 +/- 0.5 microliter/min for healthy eyes and 2.2 +/- 0.7 microliter/min for glaucoma-affected eyes. The values were not different (p > 0.1). The mean value of the IOP was 15.3 +/- 3.1 mmHg in the normal population and 22.1 +/- 4.3 mmHg in the glaucoma patients. A linear relationship between F and IOP was found (r = -0.41, p < 0.05, decrease in F = 0.081 microliter min-1 mmHg-1). CONCLUSIONS: The value of the pseudofacility in the humans can be estimated at 0.081 microliter min-1, mmHg-1, which constitutes 27% of the total outflow facility. This figure also makes it possible to estimate the role of the ultrafiltration in blood in the production of the aqueous humor since it is assumed that active secretion is pressure-independent. The results obtained are concordant with a secondary but no unimportant role of the plasmatic ultrafiltration with respect to the active secretion.

[Vitreous fluorophotometry and nocturnal GH secretion in young insulin-dependent diabetics treated with oral pirenzepine]. / Fluorofotometría vítrea y secreción nocturna de G.H. en jóvenes diabéticos insulino-dependientes tratados con pirenzepina oral.

With the aim of finding a correlation between the blocking of G.H. secretion and the irregularities in the permeability of the hematoretinal barrier, we have studied the average nocturnal G.H. levels (NAGHL) and the vitreous penetration rate (VPR) in five young diabetic patients. These patients, 3 males and 2 females, were between the ages of 12 and 17 years with a mean age of 16.0. They were studies both before and after receiving treatment for one month with an oral nocturnal dose of 0.6 mg/kg of pirenzepine (gastrozepin) and 1 mg/kg during the subsequent five months. We also tried to find a relationship between the VPR post-treatment and the evolution time of their illness and with their BA1C. The most important results found in this study were: 1) the nocturnal oral pirenzepine modified the NAGHL in the study population (10.48 +/- 4.94 vs; 4.34 +/- 2.53 ng/ml; p < 0.05). 2) Ingestion of the aforementioned drug did not affect the VPR (4.84 +/- 2.08 vs 4.53 +/- 2.54 x 10(-6)/min; p > 0.05). We have not found a relationship between the VPR after treatment with either the HBA1C levels or with the evolution time of the illness. Therefore, we conclude that the dose of oral pirenzepine used for 6 months, although it definitely decreases G.H. secretion, does not modify the permeability of the B.H.R. within this group of young diabetics. Hence, we can infer that the G.H. hypersecretion does not seem to have a relationship, at least exclusively, with the development of diabetic retinopathy.

A fluorophotometric study on the aqueous humor dynamics in primary open angle glaucoma.

One hundred and ten eyes in 40 normal persons with no ocular pathology, 20 with ocular hypertension and 50 with primary open angle glaucoma were studied. The value of the aqueous humor flow was obtained and then compared with the different samples and with general (age, sex) and ocular factors (intraocular pressure, tonographic outflow facility, campimeter and disk/cup ratio, among others).

Study on the aqueous humor flow measured by fluorophotometry after argon laser trabeculoplasty.

We have investigated the variations in the aqueous humor flow (F) after argon laser photocoagulation (ALT) in the trabecular meshwork. The research has been done on 60 eyes with primary open angle glaucoma within initial stages. The argon laser trabeculoplasty was made around 360 degrees in anterior trabecular meshwork with 100 burns. The flow (F) has been studied by fluorophotometry using Yablonsky's protocol. Aqueous humor flow has been measured after 24 hours and after 7 days, to determine the immediate effects of laser trabeculoplasty; and also after 6 months for the long term effects. The initial aqueous humor flow was 1.35 microliters/min. By means of ANOVA we found statistically significant differences on aqueous humor flow after the 7th day (F = 1.67 microliters/min, p < 0.01), which remain six months later (F = 1.71 microliters/min, p < 0.01). This findings suggest that the effects of argon laser trabeculoplasty, either by mechanical or biological changes in the trabecular meshwork do not appear until the 7th day and remain throughout the follow up study.