ABSTRACT
La cavitación intracoroidea es un hallazgo identificado con OCT descrito inicialmente en pacientes miopes, pero también aparece en pacientes no miopes. Puede presentarse tanto en el área peripapilar como en el polo posterior. El coloboma macular es un defecto del desarrollo embrionario del polo posterior, y en la OCT estructural es imprescindible la ausencia del epitelio pigmentario de la retina y de los vasos coroideos para su diagnóstico. Este caso presenta la cavitación intracoroidea circunscribiendo el coloboma macular, en ausencia de membrana intercalar. La imagen en face permite valorar la relación entre ambas estructuras, así como la magnitud de las mismas. (AU)
Intrachoroidal cavitation is a finding identified with OCT initially described in myopic patients, it also appears in non-myopic patients. It can occur in both the peripapillary area and the posterior pole. Macular coloboma is a defect of embryonic development of the posterior pole, in structural OCT the absence of the retinal pigment epithelium and choroidal vessels is essential. In this case, intrachoroidal cavitation circumscribes the macular coloboma, in the absence of an intercalary membrane. The face image allows us to assess the relationship between the two structures as well as their magnitude. (AU)
Subject(s)
Humans , Coloboma , Tomography , Myopia, Degenerative , Cavitation , OphthalmologyABSTRACT
Intrachoroidal cavitation is a finding identified with OCT initially described in myopic patients, it also appears in non-myopic patients. It can occur in both the peripapillary area and the posterior pole. Macular coloboma is a defect of embryonic development of the posterior pole, in structural OCT the absence of the retinal pigment epithelium and choroidal vessels is essential. In this case, intrachoroidal cavitation circumscribes the macular coloboma, in the absence of an intercalary membrane. The en face image allows us to assess the relationship between the two structures as well as their magnitude.
Subject(s)
Choroid Diseases , Coloboma , Macula Lutea/abnormalities , Myopia , Humans , Choroid/diagnostic imaging , Coloboma/diagnostic imaging , Choroid Diseases/diagnostic imagingABSTRACT
Reportar la formación de agujero macular durante la inyección intravítrea de perfluorocarbono líquido en la cirugía programada de desprendimiento de retina. Caso clínico Varón de 73 años con desprendimiento de retina regmatógeno superotemporal. Durante la inyección de perfluorocarbono líquido se produce un agujero macular de espesor completo con acumulación del perfluorocarbono en el espacio subretiniano. El líquido se extrajo a través del agujero macular. La tomografía de coherencia óptica confirmó un agujero macular de espesor total en el examen postoperatorio. Un mes después se repara con técnica de colgajo invertido de membrana limitante interna con resultado funcional satisfactorio. La inyección de perflurocarbono líquido intravítreo es electiva, facilita el drenaje del fluido subretiniano en los desprendimientos de retina. Algunas complicaciones han sido asociadas a su empleo, intraoperatorias y postoperatorias. Hasta el momento no ha sido reportado ningún caso de agujero macular completo producido durante la inyección intravítrea de perfluorocarbono (AU)
To describe a macular hole development during intravitreal injection of perfluorocarbon liquid used to repair a rhegmatogenous retinal detachment. Clinical case A 73-year-old man presented with superotemporal rhegmatogenous retinal detachment. During surgery, along the perflorocarbon liquid injection, a full thickness macular developed and perfluorocarbon was accumulated in subretinal space. Perfluorocarbon liquid was then extracted through the macular hole. Postoperatively, ocular coherence tomography confirmed the existence of a full-thickness macular hole. One month later, this macular hole was successfully treated with the use of an inverted internal limiting membrane flap. Intravitreous liquid PFC injection is a resource to aid in subretinal fluid exit. A number of complications, both intra and postoperative, have been associated with the use of PFC. This is the first reported case of a complete macular hole secondary to PFC injection (AU)
Subject(s)
Humans , Male , Aged , Retinal Perforations/chemically induced , Fluorocarbons/administration & dosage , Fluorocarbons/adverse effects , Retinal Detachment/surgery , Intravitreal Injections/adverse effectsABSTRACT
To describe a macular hole development during intravitreal injection of perfluorocarbon liquid used to repair a regmatogenous retinal detachment. CLINICAL CASE: A 73-year-old man presented with superotemporal regmatogenous retinal detachment. During surgery, along the perflorocarbon liquid injection, a full thickness macular developed and perfluorocarbon was accumulated in subretinal space. Perfluorocarbon liquid was then extracted through the macular hole. Postoperatively, ocular coherence tomography confirmed the existence of a full-thickness macular hole. One month later, this macular hole was successfully treated with the use of an Inverted internal limiting membrane flap. Intravitreous liquid PFC injection is a resource to aid in subretineal fluid exit. A number of complications, both intra and postoperative, have been associated with the use of PFC. This is the first reported case of a complete macular hole secondary to PFC injection.
Subject(s)
Fluorocarbons , Retinal Detachment , Retinal Perforations , Male , Humans , Aged , Retinal Detachment/etiology , Retinal Perforations/etiology , Retinal Perforations/surgery , Fluorocarbons/adverse effects , Visual Acuity , Vitrectomy/adverse effects , Vitrectomy/methods , Intravitreal Injections , Iatrogenic DiseaseABSTRACT
CLINICAL CASE: 49-year-old man with diabetic macular edema refractory to antiangiogenics, it is decided to perform therapy with intravitreal dexamethasone implant (Ozurdex; Allergan, California, United States of America). Seven days after treatment, he showed acute endophthalmitis suggestive signs. Despite the intravitreal injection of antibiotics, the patient got worse. Vitreous sampling was repeated for Gram and cultures, and vitrectomy was performed via pars plana. The culture suggested the development of Brevibacterium species. Through an additional test, the presence of Brevibacterium casei was confirmed. Despite the treatment adjusted by antibiogram, retinal ischemia and macular atrophy was evident. DISCUSSION: Brevibacterium casei is a Gram-positive bacterium, barely pathogenic, that mainly affects immunodepressed patients. Only two cases of endophthalmitis are described, one endogenous and the other one secondary to vegetal trauma. This is the first case of endophthalmitis, secondary to an ophthalmological procedure.
Subject(s)
Brevibacterium , Diabetic Retinopathy , Endophthalmitis , Macular Edema , Dexamethasone/therapeutic use , Drug Implants , Endophthalmitis/drug therapy , Humans , Macular Edema/drug therapy , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Cogan Syndrome/diagnostic imaging , Cogan Syndrome/pathologyABSTRACT
Caso clínico Hombre de 49años, con edema macular diabético refractario a antiangiogénicos, en el que se realizó terapia intravítrea con implante de dexametasona (Ozurdex; Allergan, California, Estados Unidos). Tras 7días presentó signos sugerentes de endoftalmitis aguda. Pese a la inyección intravítrea de antibióticos, el paciente empeoró. Se repitió la toma de muestras en vítreo para Gram y cultivos, y se realizó vitrectomía vía pars plana. El cultivo sugirió el desarrollo de Brevibacterium species. Mediante una prueba adicional, se confirmó la presencia de Brevibacterium casei. Pese al tratamiento ajustado por antibiograma, se evidenció isquemia retiniana y atrofia macular. Discusión Brevibacterium casei es una bacteria grampositiva, escasamente patógena, que afecta principalmente a inmunodeprimidos. Se han descrito solo dos casos de endoftalmitis, una endógena y otra secundaria a trauma vegetal. Este es el primer caso de endoftalmitis por Brevibacterium casei secundaria a procedimiento oftalmológico (AU)
Clinical case A 49-year-old man with diabetic macular edema refractory to antiangiogenics was treated with intravitreal dexamethasone implant (Ozurdex; Allergan, California, USA). Seven days after treatment, he showed acute endophthalmitis suggestive signs. Despite the intravitreal injection of antibiotics, the patient got worse. Vitreous sampling was repeated for Gram and cultures, and vitrectomy was performed via pars plana. The culture suggested the development of Brevibacterium species. Through an additional test, the presence of Brevibacterium casei was confirmed. Despite the treatment adjusted by antibiogram, retinal ischemia and macular atrophy was evident. Discusion Brevibacterium casei is a Gram-positive bacterium, barely pathogenic, that mainly affects immunodepressed patients. Only two cases of endophthalmitis are described, one endogenous and the other one secondary to vegetal trauma. This is the first case of Brevibacterium casei endophthalmitis, secondary to an ophthalmological procedure (AU)
Subject(s)
Humans , Male , Middle Aged , Brevibacterium , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/drug therapy , Dexamethasone/therapeutic use , Endophthalmitis/diagnosis , Endophthalmitis/microbiology , Macular Edema/drug therapyABSTRACT
CLINICAL CASE: A 49-year-old man with diabetic macular edema refractory to antiangiogenics was treated with intravitreal dexamethasone implant (Ozurdex; Allergan, California, USA). Seven days after treatment, he showed acute endophthalmitis suggestive signs. Despite the intravitreal injection of antibiotics, the patient got worse. Vitreous sampling was repeated for Gram and cultures, and vitrectomy was performed via pars plana. The culture suggested the development of Brevibacterium species. Through an additional test, the presence of Brevibacterium casei was confirmed. Despite the treatment adjusted by antibiogram, retinal ischemia and macular atrophy was evident. DISCUSION: Brevibacterium casei is a Gram-positive bacterium, barely pathogenic, that mainly affects immunodepressed patients. Only two cases of endophthalmitis are described, one endogenous and the other one secondary to vegetal trauma. This is the first case of Brevibacterium casei endophthalmitis, secondary to an ophthalmological procedure.
ABSTRACT
No disponible
Subject(s)
Humans , Coloboma/diagnostic imaging , Retinal Neoplasms/diagnostic imaging , Fluorescein Angiography/methods , Tomography, Optical Coherence/methods , Fluorescence , Retina/diagnostic imaging , Choroid/diagnostic imaging , Retinal Detachment/etiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Retinal Artery , Aneurysm/diagnosis , Hypertension/complications , Antihypertensive Agents/therapeutic use , Vitreoretinal Surgery/methods , Patient Care Team , Aneurysm/therapy , Treatment OutcomeABSTRACT
OBJETIVO: Evaluar la eficacia y seguridad de la resección y autoinjerto conjuntival adherido con Tissucol® en casos seleccionados de pterigión de gran tamaño en los que la orientación del injerto se adapta a la morfología del lecho escleral para una mejor cobertura libre de tracción, perdiendo la orientación limbo-limbo, con un seguimiento de 12 meses. MÉTODO: Estudio prospectivo, no comparativo, de 10 casos de pterigión grado II o superior (7 primarios, 3 recurrentes) con al menos 8mm de extensión limbar. Después de la resección de la lesión se obtuvo un lecho escleral amplio, con necesidad de injerto grande para cubrir el defecto. Se disecó el autoinjerto conjuntival superior y se fijó a esclera mediante Tissucol®, adaptando la orientación a la morfología del lecho, perdiéndose la posición limbar. Se realizó seguimiento periódico de la recurrencia y complicaciones durante un año. RESULTADOS: Se registraron complicaciones menores en 4 ojos. En un caso se formó un ojal al tallar el injerto. Dos presentaron una pequeña dehiscencia limbar, que epitelizó completamente durante la primera semana. En otro caso fue necesario aumentar los corticosteroides tópicos por granuloma piógeno en la zona donante, con aumento secundario de la presión intraocular (PIO). No hubo ningún caso de recurrencia después de 12 meses de seguimiento. CONCLUSIONES: Un injerto conjuntival de tamaño adecuado adaptado a la morfología del lecho escleral que asegure una buena cobertura libre de tensiones proporciona buenos resultados quirúrgicos en casos de pterigión seleccionados, independientemente de la conservación de la orientación limbo-limbo, sin recidivas tras un año de seguimiento
OBJECTIVE: To perform a 12 month follow-up study to assess the safety and effectiveness of resection and conjunctival autograft fixed with Tissucol® in selected cases of large pterygium. The orientation of the graft was adapted to the morphology of the scleral bed for a better coverage free of traction, with limbal position being lost. METHODS: A prospective, non-comparative study of 10 cases of grade II or superior pterygium (7 primary, 3 recurrent) with at least 8mm of limbal extension. A wide scleral bed was obtained after pterygium and Tenon resection, with larger grafts being required to cover the defects. A superior conjunctival autograft was harvested and fixed to bare sclera using Tissucol. The orientation was adapted to the morphology of the scleral bed and limbal position was lost. Patients were periodically assessed for recurrence and complications for a period of 12 months. RESULTS: Minor complications occurred in 4 eyes. In one case a buttonhole was formed during dissection of the graft. Two presented with small limbal dehiscence, but epithelialisation was completed in the first week. In a third case, it was necessary to increase topical corticosteroids for pyogenic granuloma on the donor site, with secondary increased intraocular pressure (IOP). There were no recurrences after 12 months follow-up. CONCLUSIONS: A conjunctival graft of appropriate size adapted to the morphology of the scleral bed to ensure good coverage free of tension, provides good surgical results in selected cases of pterygium, regardless of the conservation the limbal orientation, with no recurrences after one year follow-up
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Pterygium/surgery , Pterygium , Transplantation, Autologous/methods , Conjunctiva/surgery , Conjunctiva , Conjunctival Diseases/surgery , Surgical Wound Dehiscence/complications , Ophthalmologic Surgical Procedures/methods , Ophthalmologic Surgical Procedures , Recurrence , Prospective Studies , Helsinki Declaration , Data Analysis/methodsABSTRACT
OBJECTIVE: To perform a 12 month follow-up study to assess the safety and effectiveness of resection and conjunctival autograft fixed with Tissucol® in selected cases of large pterygium. The orientation of the graft was adapted to the morphology of the scleral bed for a better coverage free of traction, with limbal position being lost. METHODS: A prospective, non-comparative study of 10 cases of grade II or superior pterygium (7 primary, 3 recurrent) with at least 8mm of limbal extension. A wide scleral bed was obtained after pterygium and Tenon resection, with larger grafts being required to cover the defects. A superior conjunctival autograft was harvested and fixed to bare sclera using Tissucol. The orientation was adapted to the morphology of the scleral bed and limbal position was lost. Patients were periodically assessed for recurrence and complications for a period of 12 months. RESULTS: Minor complications occurred in 4 eyes. In one case a buttonhole was formed during dissection of the graft. Two presented with small limbal dehiscence, but epithelialisation was completed in the first week. In a third case, it was necessary to increase topical corticosteroids for pyogenic granuloma on the donor site, with secondary increased intraocular pressure (IOP). There were no recurrences after 12 months follow-up. CONCLUSIONS: A conjunctival graft of appropriate size adapted to the morphology of the scleral bed to ensure good coverage free of tension, provides good surgical results in selected cases of pterygium, regardless of the conservation the limbal orientation, with no recurrences after one year follow-up.
Subject(s)
Conjunctiva/transplantation , Pterygium/surgery , Sclera/surgery , Aged , Female , Fibrin Tissue Adhesive , Follow-Up Studies , Humans , Male , Middle Aged , Ophthalmologic Surgical Procedures/methods , Prospective Studies , Pterygium/pathology , Rotation , Transplantation, Autologous/methods , Treatment OutcomeABSTRACT
CASO CLÍNICO: Varón de 60 años con lesión conjuntival diagnosticada de neoplasia intraepitelial corneal conjuntival (NICC), iniciándose tratamiento con mitomicina C. Tras 3 semanas y mínima mejoría, se reemplaza por interferón alfa 2B. Seis meses después, con completa remisión, se suspende el tratamiento sin signos de recidiva. DISCUSIÓN: Actualmente, el tratamiento de estas lesiones se realiza con agentes quimioterapéuticos o inmunomoduladores como la mitomicina C, el 5-fluorouracilo y el interferón alfa 2B. Este último, a pesar de ser menos utilizado, presenta excelentes resultados con efectos secundarios menores que la mitomicina C, resultando una alternativa óptima para el tratamiento no invasivo de las NICC
CLINICAL CASE: The case of a 60 year-old male with a conjunctival lesion diagnosed as conjunctival intraepithelial neoplasia (CIN), who was treated with mitomycin-C for 3 weeks with minimal improvement. The therapy was change to interferon 2B. Six month later, and after a complete remission of the lesion, the treatment was suspended, with no signs of relapse. DISCUSSION: The treatment of these lesions is currently made with chemotherapy and immunotherapy agents, such as mitomycin-C, 5-fluorouracil, and interferon alfa 2B. The latter, even although is the least used, gives excellent results with fewer secondary effects than mitomycin-C, resulting in an optimal therapy for the non-invasive treatment of CIN lesions
Subject(s)
Humans , Male , Middle Aged , Conjunctival Neoplasms/drug therapy , Interferon-alpha/therapeutic use , Mitomycin/therapeutic use , Eye Neoplasms/drug therapy , Drug Resistance, NeoplasmABSTRACT
CLINICAL CASE: The case of a 60 year-old male with a conjunctival lesion diagnosed as conjunctival intraepithelial neoplasia (CIN), who was treated with mitomycin-C for 3 weeks with minimal improvement. The therapy was change to interferon 2B. Six month later, and after a complete remission of the lesion, the treatment was suspended, with no signs of relapse. DISCUSSION: The treatment of these lesions is currently made with chemotherapy and immunotherapy agents, such as mitomycin-C, 5-fluorouracil, and interferon alfa 2B. The latter, even although is the least used, gives excellent results with fewer secondary effects than mitomycin-C, resulting in an optimal therapy for the non-invasive treatment of CIN lesions.
Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma in Situ/drug therapy , Conjunctival Neoplasms/drug therapy , Interferon-alpha/therapeutic use , Mitomycin/therapeutic use , Salvage Therapy , Drug Resistance, Neoplasm , Drug Substitution , Humans , Hyperemia/etiology , Interferon alpha-2 , Male , Middle Aged , Recombinant Proteins/therapeutic use , Remission InductionABSTRACT
Objetivo/Métodos: La coroiditis serpiginosa es un trastorno bilateral, infrecuente, crónico, progresivo y recurrente, que afecta primariamente a la coriocapilar y al epitelio pigmentario de la retina. La forma típica de evolución se presenta en forma de pseudópodos a partir de la papila, afectando habitualmente a la mácula y región foveal. Resultados/Conclusiones: Presentamos 3 casos de coroidopatía geográfica, atendiendo al aspecto oftalmoscópico y la angiografía fluoresceínica del fondo de ojo, caracterizada por las lesiones típicas del cuadro. Finalmente, exponemos algunas consideraciones acerca del diagnóstico diferencial entre los procesos inflamatorios del epitelio pigmentario (AU)
No disponible