ABSTRACT
CASE REPORT: A 70-year-old male patient diagnosed with bilateral adult-onset vitelliform dystrophy presented with a sudden decrease of vision in his left eye associated with the appearance of an occult type of neovascular membrane. It was treated with intravitreal ranibizumab due to juxtafoveal location of the membrane. Two injections were needed to induce total regression of the lesion. DISCUSSION: Intravitreal ranibizumab may be effective to induce morphological and functional improvement in cases of choroidal neovascularization secondary to adult-onset vitelliform foveomacular dystrophy. Further case series are required to confirm this observation.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Choroidal Neovascularization/drug therapy , Vitelliform Macular Dystrophy/complications , Aged , Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/etiology , Humans , Intravitreal Injections , Male , Ranibizumab , Tomography, Optical CoherenceABSTRACT
Caso clínico: Varón de 70 años diagnosticado de distrofia foveomacular viteliforme del adulto(DFVA) que en el curso de su enfermedad presenta disminución brusca de visión en el ojo izquierdo coincidiendo con la aparición de una membrana neovascular oculta. Dada la localización yuxtafove al de la membrana, se decidió tratar con ranibizumab intravítreo, siendo necesarias 2 inyecciones para lograr el cierre completo de la lesión neovascular. Discusión: El uso de ranibizumab intravítreo puede ser una opción de tratamiento eficaz en la neovascularización coroidea secundaria a DFVA, y se precisan series de casos más amplias para poder confirmar esta observación(AU)
Case report: A 70-year-old male patient diagnosed with bilateral adult-onset vitelliform dystrophy presented with a sudden decrease of vision in his left eye associated with the appearance of an occult type of neovascular membrane. It was treated with intravitreal ranibizumab due to juxtafoveal location of the membrane. Two injections were needed to induce total regression of the lesion. Discussion: Intravitreal ranibizumab may be effective to induce morphological and functional improvement in cases of choroidal neovascularization secondary to adult-onset vitelliform foveomacular dystrophy. Further case series are required to confirm this observation(AU)
Subject(s)
Humans , Male , Aged , Antibodies, Monoclonal/therapeutic use , Choroidal Neovascularization/drug therapy , Vitelliform Macular Dystrophy/complications , Intravitreal Injections , Visual AcuityABSTRACT
CASE: A 55-year-old male was diagnosed with exudative-hemorrhagic maculopathy, with no signs observed of drusen or pigmentary epithelium defects suggestive of age-related macular degeneration (ARMD). Fluorescein angiography (FA) and indocyanine green choroidal angiography (ICGA) showed retinal angiomatous proliferation (RAP). Afferent arteriole and retinal drainage venule connection was also observed. Treatment with a single Photodynamic Therapy provided an optimal outcome. DISCUSSION: RAP is a form of neovascular ARMD described in recent years; it consists of an angiomatous proliferation that originates from the retinal capillary system and extends posteriorly into the subretinal space. Our patient showed typical RAP findings without any sign of ARMD
Subject(s)
Photochemotherapy , Retinal Neovascularization/drug therapy , Humans , Macular Degeneration , Male , Middle Aged , Remission InductionABSTRACT
Caso clínico: Varón de 55 años, sin drusas ni alteraciones del epitelio pigmentario sugestivas de degeneración macular asociada a la edad (DMAE), que presentó maculopatía exudativo-hemorrágica. La angiografía con fluoresceína e indocianina verde mostraron la proliferación angiomatosa retiniana (PAR), la arteriola aferente y vénula retinianas de drenaje. La respuesta fue óptima a un único tratamiento con terapia fotodinámica. Discusión: La PAR es una lesión descrita en los últimos años en el contexto de la DMAE, cuya principal característica es la lesión neovascular formada a partir de capilares retinianos y su extensión posterior al espacio subretiniano. Nuestro paciente presentaba los hallazgos típicos de PAR sin DMAE
Case: A 55-year-old male was diagnosed with exudative- hemorrhagic maculopathy, with no signs observed of drusen or pigmentary epithelium defects suggestive of age-related macular degeneration (ARMD). Fluorescein angiography (FA) and indocyanine green choroidal angiography (ICGA) showed retinal angiomatous proliferation (RAP). Afferent arteriole and retinal drainage venule connection was also observed. Treatment with a single Photodynamic Therapy provided an optimal outcome. Discussion: RAP is a form of neovascular ARMD described in recent years; it consists of an angiomatous proliferation that originates from the retinal capillary system and extends posteriorly into the subretinal space. Our patient showed typical RAP findings without any sign of ARMD
Subject(s)
Male , Middle Aged , Humans , Photochemotherapy/methods , Corneal Diseases/therapy , Macular Degeneration/complications , Corneal Diseases/etiology , Corneal Diseases/diagnosisABSTRACT
CASE REPORTS: Three cases of pigmentary epithelial tears are described in this study. One of them was related to previous extrafoveal photocoagulation, whereas the other two were idiopathic. Fluorescein angiography (FA) and optical coherence tomography (OCT) were performed to confirm the clinical diagnosis. DISCUSSION: Few studies using OCT to assess pigmentary retinal epithelial (RPE) tears have been published in the world literature. The main findings of our study included hyper-reflectant line breaks, choroidal hyper-reflectance due to the lack of RPE and RPE double layering where it was folded. Images were frequently associated with RPE tears and neurosensorial retinal detachment.
Subject(s)
Retinal Perforations/diagnosis , Tomography, Optical Coherence , Aged , Aged, 80 and over , Diabetic Retinopathy/complications , Female , Fluorescein Angiography , Humans , Laser Coagulation/adverse effects , Male , Optic Disk Drusen/complications , Papilledema/complications , Photochemotherapy , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Pseudophakia/complications , Radiography , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Perforations/diagnostic imaging , Retinal Perforations/drug therapy , Retinal Perforations/etiology , Verteporfin , Visual AcuityABSTRACT
Casos clínicos: Se presentan 3 pacientes con desgarro de epitelio pigmentario retiniano (EPR). En dos de ellos, éste se produjo de manera espontánea, estando el tercero en relación con la fotocoagulación de una neovascularización extrafoveal. Se realizaron angiografías (AGF) y estudio con tomografia óptica de coherencia (OCT) que confirmaron el diagnóstico. Discusión: Existen pocos estudios sobre OCT en desgarro del EPR. Las principales características son: interrupción de la línea hiperreflectante del EPR, hiperreflectividad de la coroides en la zona de ausencia de EPR y doble capa de EPR donde éste está replegado. Es frecuente el desprendimiento de EPR y neurosensorial asociado
Case reports: Three cases of pigmentary epithelial tears are described in this study. One of them was related to previous extrafoveal photocoagulation, whereas the other two were idiopathic. Fluorescein angiography (FA) and optical coherence tomography (OCT) were performed to confirm the clinical diagnosis. Discussion: Few studies using OCT to assess pigmentary retinal epithelial (RPE) tears have been published in the world literature. The main findings of our study included hyper-reflectant line breaks, choroidal hyper-reflectance due to the lack of RPE and RPE double layering where it was folded. Images were frequently associated with RPE tears and neurosensorial retinal detachment
Subject(s)
Male , Female , Middle Aged , Aged , Humans , Retinal Perforations/complications , Retinal Perforations/diagnosisABSTRACT
PURPOSE: To determine the incidence of cystoid macular edema (CME) by means of clinical evaluation and subclinical assessment by means of ocular coherence tomography (OCT), and to compare the incidence between diabetic and non-diabetic groups of patients. METHODS: Prospective study of 260 consecutive cataract surgeries operated from September 2004 to March 2005. The procedures were performed by means of phacoemulsification plus intraocular acrylic lens implantation. Group A: 208 eyes of non-diabetic patients; Group B: 42 eyes of patients with diabetes and Group C: 10 eyes of diabetic patients with macular edema that received an intravitreal injection of triamcinolone at the end of surgery. Postoperative follow-up visits were performed 6 days (basal visit), 5 weeks and 12 weeks after surgery. Each visit included posterior pole biomicroscopy and OCT. RESULTS: Central macular thickness measured by OCT was significantly increased in group B compared with group A (241.6 versus 204.6 microm; p<0.001). No clinical evidence of CME was found in group A, although 4 eyes (1.92%) showed macular thickness equal to or greater than 43.74 microm (2 standard deviations of the basal value for group A). In group B, clinical evidence of CME was found in 6 eyes, with decreased visual acuities (14.2%). The differences between these groups were statistically significant (p<0.001). The 10 eyes that received an intravitreal injection of triamcinolone after the surgical procedure showed a mean decrease in central retinal thickness of 77 microm after 12 weeks postoperative. CONCLUSIONS: This study has shown a low incidence of clinical CME. OCT showed increased macular thickness in both groups of patients in a small percentage of cases, and significantly increased macular thickness in diabetic patients.
Subject(s)
Macular Edema/diagnosis , Pseudophakia/complications , Tomography, Optical Coherence , Aged , Cataract Extraction/adverse effects , Female , Fluorescein Angiography , Fundus Oculi , Glucocorticoids/administration & dosage , Humans , Incidence , Macular Edema/etiology , Male , Prospective Studies , Triamcinolone/administration & dosageABSTRACT
Objetivo: Detectar la incidencia de edema macularquístico (EMQ) tras cirugía de catarata tanto clínicocomo subclínico, mediante «ocular coherencetomography» (OCT) y comparar dicha incidenciaentre un grupo de pacientes diabéticos y otro de nodiabéticos.Material y métodos: Estudio prospectivo de 260ojos intervenidos de forma consecutiva de cataratamediante facoemulsificación con implante de lenteintraocular acrílica, desde septiembre de 2004 amarzo de 2005. Grupo A: 208 ojos de pacientes nodiabéticos, grupo B: 42 ojos de pacientes diabéticos,grupo C: 10 ojos de pacientes diabéticos conedema macular y que recibieron triamcinolonaintravítrea (TAIV) al finalizar la cirugía. En cadarevisión efectuada a los 6 días (basal), 5 semanas y12 semanas se realizó biomicroscopía de polo posteriory OCT.Resultados: El espesor macular en la OCT, fue significativamentesuperior en el grupo B que en elgrupo A (241,6 versus 204,6 μm p=43,74 μm (2 DE del valor basal del grupo A). En elgrupo B, seis ojos presentaron EMQ clínicamentesignificativo, con disminución de agudeza visual(14,2%), en 12 ojos detectamos aumento del espesormacular (28,5%). Las diferencias entre gruposfueron significativas (p<0,001). En los 10 ojos querecibieron TAIV se observó una disminución mediadel espesor central de 77 μm a las 12 semanas.Conclusiones: La incidencia de EMQ clínico hasido muy baja en esta serie. La OCT detectó unaumento del espesor macular en ambos grupos enun pequeño porcentaje de pacientes y significativamentemayor en el grupo de pacientes diabéticos
Purpose: To determine the incidence of cystoid macular edema (CME) by means of clinical evaluation and subclinical assessment by means of ocular coherence tomography (OCT), and to compare the incidence between diabetic and non-diabetic groups of patients. Methods: Prospective study of 260 consecutive cataract surgeries operated from September 2004 to March 2005. The procedures were performed by means of phacoemulsification plus intraocular acrylic lens implantation. Group A: 208 eyes of nondiabetic patients; Group B: 42 eyes of patients with diabetes and Group C: 10 eyes of diabetic patients with macular edema that received an intravitreal injection of triamcinolone at the end of surgery. Postoperative follow-up visits were performed 6 days (basal visit), 5 weeks and 12 weeks after surgery. Each visit included posterior pole biomicroscopy and OCT. Results: Central macular thickness measured by OCT was significantly increased in group B compared with group A (241.6 versus 204.6 μm; p<0,001). No clinical evidence of CME was found in group A, although 4 eyes (1.92%) showed macular thickness equal to or greater than 43.74 μm (2 standard deviations of the basal value for group A). In group B, clinical evidence of CME was found in 6 eyes, with decreased visual acuities (14.2%). The differences between these groups were statistically significant (p<0.001). The 10 eyes that received an intravitreal injection of triamcinolone after the surgical procedure showed a mean decrease in central retinal thickness of 77 μm after 12 weeks postoperative. Conclusions: This study has shown a low incidence of clinical CME. OCT showed increased macular thickness in both groups of patients in a small percentage of cases, and significantly increased macular thickness in diabetic patients
Subject(s)
Male , Female , Aged , Humans , Macular Edema/diagnosis , Cataract Extraction/adverse effects , Tomography, Optical Coherence/methods , Prospective Studies , Diabetic Retinopathy/diagnosis , Case-Control Studies , Pseudophakia/diagnosisABSTRACT
Objetivo: Valorar la eficacia de la terapia fotodinámica (TFD) en el tratamiento de neovascularización subretiniana (NVSR) causada por DMAE (degeneración macular asociada a la edad) y miopía. Material y método: Se estudiaron 102 pacientes con neovascularización coroidea yuxta o subfoveolar tratados con TFD en los que se valoró: Agudeza visual (AV), examen oftalmoscópico y angiografía fluoresceínica. El retratamiento se realizó cuando fue necesario cada tres meses. Resultados: La etiología de la neovascularización coroidea fue: 75,5% por DMAE y 24,5% miópica. El tiempo de seguimiento medio fue de 15,94 meses (9-33). Un 88% de las NVSR eran angiográficamente clásicas en los miopes y un 40% en las DMAE. La supervivencia de la membrana resultó significativa en función del tipo de NVSR, presentando una mejor evolución en los pacientes miopes (p=0,0018). La AV mejoró en 48% de los pacientes miopes y en 28,6% de las DMAE. No se objetivaron complicaciones severas atribuibles al tratamiento. Conclusiones: La TFD es un tratamiento moderadamente efectivo y sin complicaciones para el tratamiento de la NVSR sub/yuxta foveolar(AU)
Purpose: To evaluate the efficacy of photodynamic therapy with photodynamic therapy (PDT) in the management of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) and myopia. Methods: 102 eyes with subfoveal or yuxtafoveal CNV underwent visual acuity (VA) testing, ophthalmic examination, and fluorescein angiography. Retreatment of persistent CNV was done after three months. Results: CNV was caused by AMD in 75.5% of patients, pathologic myopia in 24.5%. Follow up ranged from 9 to 33 months (mean: 15.94 months). 88% of CNV caused by pathologic myopia was classic and 40% was in lesions caused by AMD. CNV survival was shorter in lesions caused by pathologic myopia with a significant difference (p=0.0018). VA improved in 48% of lesions caused by pathologic myopia and in 28.6% of lesions caused by AMD. We did not observe any severe complication caused by PDT. Conclusion: PDT is a moderately effective treatment without complications in treating subfoveal CNV(AU)
Subject(s)
Humans , Choroidal Neovascularization/therapy , Photochemotherapy/methods , Fluorescein Angiography , Ophthalmoscopy , Retinal Degeneration/therapy , Myopia/therapyABSTRACT
PURPOSE: To evaluate the incidence, clinical features and evolution of polypoidal choroidal vasculopathy (PCV) in our population. METHODS: Retrospective study of patients diagnosed with exudative and/or hemorrhagic maculopathy including age-related macular degeneration in the last two years and who have undergone a complete ophthalmologic exploration and videoangiography with fluorescein and indocyanine green. RESULTS: 250 patients were included in the study, 8 patients (3.2%) had clinical and angiographic criteria of PCV. The mean age was 68 years-old, 62.5% were men and 85.7% were caucasian. Ninety percent of cases presented clinically as a predominantly hemorrhagic macular detachment. The initial clinical diagnosis before indocyanine green angiography was exudative age-related macular degeneration in 90% of cases. The mean visual acuity was 0.2 at baseline and after follow-up. Laser treatment was performed in 4 eyes, achieving good anatomic and visual acuity results in 2 of them; both eyes of one patient were treated by photodynamic therapy with poor angiographic and functional outcome. CONCLUSIONS: Polypoidal choroidal vasculopathy is a clinical entity which is relatively frequent among patients previously diagnosed with exudative maculopathy. Indocyanine green angiography increases the number of correct diagnoses. Treatment must be individualized depending on the location of the lesions and the severity of the disease.
Subject(s)
Choroid Diseases , Aged , Aged, 80 and over , Choroid Diseases/diagnostic imaging , Choroid Diseases/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Radiography , Retrospective Studies , Vascular Diseases/diagnosis , Vascular Diseases/epidemiologyABSTRACT
PURPOSE: To evaluate the clinical evolution and treatment of serpiginous choroiditis in 11 diagnosed patients. METHODS: Retrospective study of 11 cases diagnosed with serpiginous choroiditis in our area, from 1980 to the present. We analyzed age at onset of symptoms, systemic diseases, ophthalmological symptoms at presentation, the location of lesions, initial and final visual acuity, recurrences, treatment régime and development of subretinal neovascularization. A complete ophthalmological examination and fluorescein angiograms were performed in all of them. RESULTS: The mean period of follow-up was 4 years. Average age was 56 years, predominantly in men (10/1). Five patients had known ischemic cardiopathy and systemic hypertension, one patient underwent a kidney transplant. All of them were treated with oral prednisone (1-1.5 mg/kg/daily) in the active stages. Three patients received triple therapy (prednisone, cyclosporine and azathioprine) that did not prevent the recurrences. Five patients developed a subretinal neovascularization, bilateral in three of them. CONCLUSIONS: The serpiginous choroiditis is a rare entity and the visual outcome prognosis is determined by the macular involvement. Men are predominantly affected in our series and corticosteroid treatment is effective in acute inflammatory episodes. Recurrences could not be prevented by triple therapy with immunosuppressive agents in our three patients.
Subject(s)
Choroiditis , Aged , Choroiditis/diagnostic imaging , Choroiditis/drug therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Retrospective StudiesABSTRACT
PURPOSE: To evaluate the efficacy of photodynamic therapy with photodynamic therapy (PDT) in the management of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) and myopia. METHODS: 102 eyes with subfoveal or yuxtafoveal CNV underwent visual acuity (VA) testing, ophthalmic examination, and fluorescein angiography. Retreatment of persistent CNV was done after three months. RESULTS: CNV was caused by AMD in 75.5% of patients, pathologic myopia in 24.5%. Follow up ranged from 9 to 33 months (mean: 15.94 months). 88% of CNV caused by pathologic myopia was classic and 40% was in lesions caused by AMD. CNV survival was shorter in lesions caused by pathologic myopia with a significant difference (p=0.0018). VA improved in 48% of lesions caused by pathologic myopia and in 28.6% of lesions caused by AMD. We did not observe any severe complication caused by PDT. CONCLUSION: PDT is a moderately effective treatment without complications in treating subfoveal CNV.
Subject(s)
Choroidal Neovascularization/drug therapy , Photochemotherapy , Aged , Choroidal Neovascularization/etiology , Female , Humans , Macular Degeneration/complications , Male , Myopia/complicationsABSTRACT
PURPOSE: To assess the effects of photodynamic therapy (PDT) with verteporfin on visual acuity (VA) and fluorescein angiography, in patients with subfoveal choroidal neovascularization (CNV) not secondary to age related macular degeneration (AMD) or pathologic myopia. METHODS: 113 eyes from 104 patients underwent PDT due to subfoveal CNV from July 2001 to June 2002. In this study only those patients with CNV not related to AMD or pathologic myopia were included. Fluorescein angiography and visual acuity were evaluated. RESULTS: 9 eyes from 8 patients (8.03%) showed distinct causes of CNV: 3 were idiopathic cases, 1 suffered angioid streaks, 1 was secondary to laser photocoagulation due to diabetic retinopathy, 2 had polypoidal choroidal vasculopathy and 2 central serous choroiditis. Regarding VA results, 77.7% improved or mantained the previous VA. Angiography resolution was observed in 55.5% of the cases (80% with just one PDT session). Average follow up was 10.5 months. Systemic or local complications were not observed. CONCLUSION: PDT may be useful in the treatment of different types of CNV due to causes other than AMD or high myopia.
Subject(s)
Choroidal Neovascularization/drug therapy , Photochemotherapy , Aged , Female , Humans , Macular Degeneration , Male , Middle Aged , Myopia , Retrospective StudiesABSTRACT
Objetivo: Valorar los efectos de la terapia fotodinámica (TFD) en la agudeza visual (AV) y la angiografía en pacientes con neovascularización subretiniana (NVSR) foveal no debida ni a degeneración macular asociada a la edad (DMAE) ni a miopía patológica. Material y Métodos: Se evaluaron de un total de 104 pacientes (113 ojos) a los que se les realizó TFD por NVSR foveal, desde julio de 2001 a junio de 2002, aquellos cuya causa no era DMAE o miopía patológica. Se valoró la evolución angiográfica y de la agudeza visual (AV). Resultados: 9 ojos de 8 pacientes presentaban otras causas de NVSR (8,03 por ciento): 3 idiopáticas, 1 en estrías angioides, 1 secundaria a fotocoagulación láser en retinopatía diabética, 2 en vasculopatia coroidea polipoidal y 2 en coroiditis serosa central. El 77,7 por ciento presentó estabilización o mejoría en su AV y el 55,5 por ciento presentó resolución angiográfica, el 80 por ciento de ellos con una sola sesión de TFD. El tiempo de seguimiento medio fue de 10,5 meses. No se objetivaron complicaciones ni a nivel local ni sistémico. Conclusión: La TFD puede ser de utilidad en NVSR no debidas a DMAE o miopía patológica (AU)
Purpose: To assess the effects of photodynamic therapy (PDT) with verteporfin on visual acuity (VA) and fluorescein angiography, in patients with subfoveal choroidal neovascularization (CNV) not secondary to age related macular degeneration (AMD) or pathologic myopia. Methods: 113 eyes from 104 patients underwent PDT due to subfoveal CNV from July 2001 to June 2002. In this study only those patients with CNV not related to AMD or pathologic myopia were included. Fluorescein angiography and visual acuity were evaluated. Results: 9 eyes from 8 patients (8.03%) showed distinct causes of CNV: 3 were idiopathic cases, 1 suffered angioid streaks, 1 was secondary to laser photocoagulation due to diabetic retinopathy, 2 had polypoidal choroidal vasculopathy and 2 central serous choroiditis. Regarding VA results, 77.7% improved or mantained the previous VA. Angiography resolution was observed in 55.5% of the cases (80% with just one PDT session). Average follow up was 10.5 months. Systemic or local complications were not observed. Conclusion: PDT may be useful in the treatment of different types of CNV due to causes other than AMD or high myopia (AU)
Subject(s)
Middle Aged , Aged , Male , Female , Humans , Photochemotherapy , Myopia , Retrospective Studies , Choroidal Neovascularization , Macular DegenerationABSTRACT
PURPOSE: To evaluate the utility of dynamic angiography with fluorescein and indocyanine green with scanning laser ophthalmoscope (SLO) in exudative age-related macular degeneration. METHOD: We retrospectively studied 95 patients with exudative age-related macular degeneration (ARMD) between April 98 and April 01. RESULTS: We studied 102 eyes of 95 patients with ARMD. Mean age was 75.3 years with a mean follow-up time of 16.8 months. We found an occult or mixed angiographic membrane pattern with fluorescein angiography in 85 eyes (83.3%). Angiography with indocyanine green showed choroidal neovascular membranes in 94 of 102 eyes (92.1%). The most frequent location found was sub-foveal (53.2%). Laser photocoagulation was used in 55 eyes and photodynamic therapy in 5 eyes. In 17 eyes laser treatment failed to close the membrane. CONCLUSION: Dynamic angiography with fluorescein or indocyanine green allowed neovascular membrane identification in more than 90% of the cases of ARMD. Successful treatment was achieved in 42% of cases.
Subject(s)
Fluorescein Angiography/methods , Macular Degeneration/diagnostic imaging , Aged , Aged, 80 and over , Aging , Female , Fluorescein , Fluorescein Angiography/instrumentation , Fluorescent Dyes , Follow-Up Studies , Humans , Indocyanine Green , Laser Coagulation , Macular Degeneration/pathology , Macular Degeneration/therapy , Male , Microscopy, Confocal , Photochemotherapy , Radiography , Retinal Neovascularization/diagnostic imaging , Retinal Neovascularization/pathology , Retinal Neovascularization/therapy , Retrospective StudiesABSTRACT
Propósito: Confirmar la utilidad del estudio angiográfico dinámico con fluoresceína e indocianina verde, utilizando un láser confocal de barrido, en el diagnóstico y tratamiento de la degeneración macular asociada a la edad (DMAE) de tipo exudativo. Método: Se han revisado las historias clínicas y angiografías de 95 pacientes diagnosticados de DMAE exudativa en Nuestro Servicio, desde abril del 98 a abril del 2001.Resultados: La edad media de los 95 pacientes estudiados fue de 75,3 años, con un tiempo medio de seguimiento de 16,8 meses. De los 102 ojos evaluados, la angiografía fluoresceínica (AGF) mostró un patrón de membrana oculta o mixta en 85 ojos (83,3 por ciento). Mediante la angiografía con indocianina verde (AVI) se localizó membrana neovascular en 94 de los 102 ojos (92,1 por ciento). La localización más frecuente de la membrana neovascular fue la sub-foveal (53,2 por ciento de los casos). Se aplicó tratamiento láser argón en 55 ojos y terapia fotodinámica en 5 ojos; en total 58,8 por ciento de los ojos pudieron tratarse. En 17 de estos ojos no se consiguió el cierre de la membrana neovascular. Conclusiones: La angiografía dinámica con fluoresceína e indocianina verde permite la localización de membrana neovascular en más del 90 por ciento de los casos de DMAE exudativa. El tratamiento con éxito de los neovasos se pudo realizar en 42 por ciento de los casos (AU)
Subject(s)
Aged, 80 and over , Aged , Male , Female , Humans , Retinal Neovascularization , Microscopy, Confocal , Laser Coagulation , Photochemotherapy , Retrospective Studies , Fluorescein , Aging , Macular Degeneration , Indocyanine Green , Fluorescein Angiography , Follow-Up Studies , Fluorescent DyesABSTRACT
CASE REPORT: A case of an immunocompetent patient presenting primary systemic toxoplasma infection involving the eye (condition seen in less than 3% of primary infections). The patient showed reactivation of this primary focus two years later. DISCUSSION: Diagnosis of toxoplasm retinitis is based on a typical lesion consisting in an area of active retinitis adjacent to an inactive corioretinal scar. Differential diagnosis must consider other causes of retinal coroiditis in primary infection cases: sarcoidosis, tuberculosis, syphilis as well as viral and fungal infections. Ocular toxoplasmosis was confirmed by serum tests.
Subject(s)
Retinitis/parasitology , Toxoplasmosis, Ocular , Adult , Humans , Immunocompetence , MaleABSTRACT
Caso clínico: Presentamos el caso de un paciente inmunocompetente con una primoinfección toxoplásmica sistémica que presentó afectación ocular, situación que se da en menos del 3 por ciento de las primoinfecciones. El mismo paciente presentó una reactivación de este foco primario dos años después. Discusión: El diagnóstico de coriorretinitis toxoplásmica está basado en el examen funduscópico de la típica lesión de un área de retinitis junto a una cicatriz coriorretiniana inactiva. En los casos de primoinfección toxoplásmica debe establecerse el diagnóstico diferencial con otras entidades como son la sarcoidosis, la tuberculosis, la sífilis e infecciones virales. En nuestro caso confirmamos el diagnóstico de retinocoroiditis toxoplásmica serológicamente (AU)
Subject(s)
Adult , Male , Humans , Toxoplasmosis, Ocular , Retinitis , ImmunocompetenceABSTRACT
UNLABELLED: PURPOSE/MATERIAL AND METHOD: Cyanoacrylate tissue adhesive is indicated when a small corneal perforation is present. We report the case of a 23 year-old man who was attacked being thrown cyanoacrylate to both of his eyes. RESULTS/CONCLUSION: Wound healing has been laborious, however performed with low morbidity. This case is reported for being a bilateral injury and after finding no precedented cases in the literature.
Subject(s)
Burns, Chemical/etiology , Cyanoacrylates/adverse effects , Eye Burns/chemically induced , Adult , Aggression , Burns, Chemical/surgery , Debridement/methods , Eye Burns/surgery , Humans , MaleABSTRACT
Objetivo/Método: El cianocrilato se utiliza en oftalmología para el tratamiento de pequeñas perforaciones corneales. Presentamos el caso de un varón de 23 años que fue agredido con el lanzamiento sobre ambos ojos de un pegamento cuyo componente fundamental es el cianocrilato. Resultados/Conclusiones: A pesar de la aparatosidad de la situación y la laboriosidad de la extracción de las placas, la morbilidad fue baja. Sin embargo, ya que las referencias bibliográficas en oftalmología sólo se refieren a las instilaciones accidentales y a la rareza de bilateralidad del caso, aportamos este caso clínico junto con una revisión de la bibliografía (AU)
