ABSTRACT
CASE REPORT: Two patients (80 and 67 year-old) presented with diplopia for a sudden right 3rd cranial nerve palsy without other ocular or systemic symptoms related to temporal arteritis. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Subsequent biopsy of the superficial temporal artery confirmed the diagnosis of temporal arteritis. DISCUSSION: Patients with ocular nerve palsy could have occult temporal arteritis. Aged patients with an acute ocular ischemic lesion, without elevated erythrocyte sedimentation rate, C-reactive protein levels and systemic symptoms, should raise a high index of suspicion for temporal arteritis.
Subject(s)
Giant Cell Arteritis/complications , Oculomotor Nerve Diseases/etiology , Aged , Aged, 80 and over , Female , Giant Cell Arteritis/diagnosis , Humans , MaleABSTRACT
Caso clínico: Se describen dos pacientes (80 y 67años) con diplopía por parálisis del tercer par cranealsin otros síntomas de afectación ocular o sistémicade arteritis de la temporal. La velocidad desedimentación globular y la proteína C-reactivafueron normales. La biopsia de la arteria temporalsuperficial confirmó el diagnóstico de arteritis de latemporal.Discusión: Pacientes con parálisis de los nerviosoculomotores podrían tener una arteritis de latemporal oculta. En los ancianos con lesionesoculares isquémicas, sin elevación de la velocidadde sedimentación, con niveles normales de proteínaC-reactiva y sin síntomas sistémicos, el índicede sospecha de arteritis de la temporal debe ser alto(AU)
Case report: Two patients (80 and 67 year-old)presented with diplopia for a sudden right 3rd cranialnerve palsy without other ocular or systemicsymptoms related to temporal arteritis. Erythrocytesedimentation rate and C-reactive protein levelswere normal. Subsequent biopsy of the superficialtemporal artery confirmed the diagnosis of temporalarteritis.Discussion: Patients with ocular nerve palsy couldhave occult temporal arteritis. Aged patients withan acute ocular ischemic lesion, without elevatederythrocyte sedimentation rate, C-reactive proteinlevels and systemic symptoms, should raise a highindex of suspicion for temporal arteritis(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Oculomotor Nerve Diseases , Diplopia/etiology , Arteritis , Temporal Arteries/pathology , SedimentationABSTRACT
CASE REPORT: We describe a 58-year-old man, without history of radiation therapy, who presented with transient episodic diplopia following sustained lateral gaze lasting around 30-50 seconds. He developed a large angle exotropia of the left eye that gradually returned to normal after 50 seconds. Between episodes he was asymptomatic. Partial resolution of his symptoms was obtained after treatment with carbamazepine. DISCUSSION: Neuromyotonia must be considered when evaluating a patient with intermittent diplopia.
Subject(s)
Isaacs Syndrome , Oculomotor Muscles , Humans , Isaacs Syndrome/diagnosis , Isaacs Syndrome/drug therapy , Male , Middle AgedABSTRACT
Caso clínico: Se describe un paciente de 58 años, sin antecedentes de radioterapia, que presenta episodios de diplopía después de una mirada lateral y mantenida de 30-50 segundos de duración. Durante el episodio desarrolla una exotropía de gran ángulo en el ojo izquierdo retornando a la normalidad después de 50 segundos. El paciente se encontraba asintomático entre los episodios de diplopía. El paciente fue tratado con carbamacepina con resolución parcial de los síntomas. Discusión: La neuromiotonía ocular debe ser considerada cuando se evalúa un paciente con diplopía intermitente
Case report: We describe a 58-year-old man,without history of radiation therapy, who presentedwith transient episodic diplopia following sustainedlateral gaze lasting around 30-50 seconds. He developeda large angle exotropia of the left eye that graduallyreturned to normal after 50 seconds. Betweenepisodes he was asymptomatic. Partial resolution ofhis symptoms was obtained after treatment withcarbamazepine.Discussion: Neuromyotonia must be consideredwhen evaluating a patient with intermittent diplopia
Subject(s)
Male , Middle Aged , Humans , Isaacs Syndrome/diagnosis , Isaacs Syndrome/drug therapy , Diplopia/complications , Diplopia/diagnosis , Exotropia/complications , Exotropia/diagnosis , Carbamazepine/therapeutic use , Diagnosis, Differential , Isaacs Syndrome/radiotherapy , Exotropia/therapyABSTRACT
OBJECTIVE: To measure erythropoietin (Epo) levels in the vitreous body from patients with proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: Undiluted vitreous samples were obtained from 44 patients who had not undergone prior vitreous or intraocular surgery. Patients were divided into two groups: A (n= 24) patients with PDR and B (n= 20) patients with retinal detachment, preretinal macular membranes and macular holes. Epo was determined using radioimmunoassay. RESULTS: Epo vitreous concentration in group A was 512 mU/mL (range 120-880) and in group B was 25.1 mU/mL (range 5.2-201) (p< 0.001). CONCLUSIONS: These results show that the concentration of Epo in the vitreous body was significantly higher in patients with PDR than in the control group.
Subject(s)
Diabetic Retinopathy/metabolism , Erythropoietin/analysis , Vitreous Body/chemistry , Aged , Erythropoietin/biosynthesis , Female , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: We examined the influence of non-ophthalmic parameters as risk factors of clinically significant macular edema (CSME). METHODS: The authors reviewed clinical records of all clinically significant macular edema between 1995 and 2005. The association between the presence of CSME and HgbA1c, onset and duration of diabetes, blood pressure, body mass index, lipid status, sex, tobacco smoking and urinary albumin excretion was evaluated. RESULTS: 208 eyes met the study criteria. Patients ranged in age from 14 to 82 years (mean, 66 years) and had 8 to 64 years (mean, 47.5 years) of history of diabetes. Significant risk factors for CSME were older age, high levels of HgbA1c, high values of blood pressure, tobacco smoking, high cholesterol and LDL-cholesterol and high levels of proteinuria and microalbuminuria. CONCLUSION: Independent on the type of diabetes, patients with long standing diabetes have a high risk to develop diabetic maculopathy, but other closely-related risk factors are hypertension, hyperglycemia, lipids, tobacco smoking and renal status.
Subject(s)
Diabetic Retinopathy/complications , Macular Edema/complications , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk FactorsABSTRACT
Objetivo: Determinar los niveles de eritropoyetina (Epo) en el vítreo de pacientes con retinopatía diabética proliferante (RDP). Material y método: Mediante vitrectomía vía pars plana, se recogieron muestras no diluidas de vítreo de 44 pacientes sin antecedentes de cirugía vítrea o intraocular previa, que fueron divididos en dos grupos: A (n=24) pacientes con RDP y B (n=20) pacientes con desprendimiento de retina, membrana premacular y agujero macular. La concentración de Epo se determinó mediante radioinmunoensayo. Resultados: La concentración vítrea de Epo en el grupo A fue 512 mU/mL (rango 120-880) y en el grupo B fue 25,1 mU/ml (rango 5,2-201) (p< 0,001). Conclusiones: Estos resultados demuestran que la concentración vítrea de Epo está más elevada en los pacientes con RDP en comparación con el grupo control
Objective: To measure erythropoietin (Epo) levels in the vitreous body from patients with proliferative diabetic retinopathy (PDR). Patients and methods: Undiluted vitreous samples were obtained from 44 patients who had not undergone prior vitreous or intraocular surgery. Patients were divided into two groups: A (n= 24) patients with PDR and B (n= 20) patients with retinal detachment, preretinal macular membranes and macular holes. Epo was determined using radioimmunoassay. Results: Epo vitreous concentration in group A was 512 mU/mL (range 120-880) and in group B was 25.1 mU/mL (range 5.2-201) (p< 0.001). Conclusions: These results show that the concentration of Epo in the vitreous body was significantly higher in patients with PDR than in the control group (Arch Soc Esp Oftalmol 2008; 83: 169-172)
Subject(s)
Humans , Male , Female , Middle Aged , Diabetic Retinopathy/metabolism , Diabetic Retinopathy/surgery , Erythropoietin/analysis , Vitreous Body/chemistry , Case-Control Studies , Biomarkers/analysis , Radioimmunoassay , VitrectomyABSTRACT
Objetivo: Estudiar los factores de riesgo sistémico del edema macular clínicamente significativo(EMCS) en una población de diabéticos. Método: Se revisaron las historias clínicas de los pacientes diabéticos diagnosticados de edemamacular clínicamente significativo entre 1995 y2005. Se evaluó la asociación entre EMCS yHgbA1c, comienzo y duración de la diabetes, hipertensión arterial, índice masa corporal, nivel de lípidos, sexo, fumar y excreción urinaria de albúmina. Resultados: 208 ojos fueron considerados con los criterios del estudio. Los pacientes tenían un rango de edad entre 15 y 82 años (media, 66 años) y tenían entre 8 y 64 años (media, 47,5 años) de historia de diabetes. Factores de riesgo significativos para desarrollar EMCS fueron edad avanzada, cifras elevadas de HgbA1c, hipertensión arterial, fumar, valores elevados de colesterol y LDL-colesterol y niveles elevados de proteinuria y microalbuminuria. Conclusiones: Independientemente del tipo de diabetes, los pacientes con diabetes mellitus de larga evolución tienen un elevado riesgo de desarrollar maculopatía diabética, pero otros factores de riesgo asociados son la hipertensión, la hiperglucemia, los lípidos, el tabaquismo y el estado renal
Objective: We examined the influence of non-ophthalmic parameters as risk factors of clinically significant macular edema (CSME). Methods: The authors reviewed clinical records of all clinically significant macular edema between1995 and 2005. The association between the presence of CSME and HgbA1c, onset and duration of diabetes, blood pressure, body mass index, lipid status, sex, tobacco smoking and urinary albumin excretion was evaluated. Results: 208 eyes met the study criteria. Patients ranged in age from 14 to 82 years (mean, 66 years)and had 8 to 64 years (mean, 47.5 years) of history of diabetes. Significant risk factors for CSME were older age, high levels of HgbA1c, high values of blood pressure, tobacco smoking, high cholesterol and LDL-cholesterol and high levels of proteinuria and microalbuminuria. Conclusion: Independent on the type of diabetes, patients with long standing diabetes have a high riskto develop diabetic maculopathy, but other closely related risk factors are hypertension, hyperglycemia, lipids, tobacco smoking and renal status
