[Best's vitelliform macular dystrophy associated with choroidal neovascularization]. / Distrofia macular viteliforme de Best asociada a neovascularización coroidea.

CASE REPORT: We report the case of a child with a sudden loss of vision of the left eye. Ophthalmoscopic examination revealed vitelliform lesions in both foveal centers, as well as an adjacent hemorrhage in his left eye. Fluorescein angiography confirmed the presence of a neovascular membrane in his left eye. The electrooculogram showed disease. According to complementary studies the patient was diagnosed with Best's disease associated with choroidal neovascularization. DISCUSSION: The diagnosis of Best's vitelliform macular dystrophy is often a casual finding as visual acuity tends to remain stable for long periods of time. A sudden deterioration in vision may suggest complications, such as choroidal neovascularization.

Distrofia macular viteliforme de Best asociada a neovascularización coroidea / Best’s vitelliform macular dystrophy associated with choroidal neovascularization

Caso clínico: Se presenta el caso de un niño con pérdida súbita de visión en ojo izquierdo. El examen funduscópico revela una lesión foveal viteliforme bilateral, y una hemorragia adyacente en ojo izquierdo. La angiografía con fluoresceína confirma la presencia de una membrana neovascular en ojo izquierdo. El electrooculograma resulta patológico. Tras completar el estudio, es diagnosticado de enfermedad de Best asociada a neovascularización coroidea. Discusión: El diagnóstico de enfermedad de Best puede ser casual dado que la agudeza visual suele permanecer estable. Una pérdida súbita de visión ha de sugerirnos la aparición de complicaciones tales como neovascularización coroidea(AU)

Case report: We report the case of a child with a sudden loss of vision of the left eye. Ophthalmoscopic examination revealed vitelliform lesions in both foveal centers, as well as an adjacent hemorrhage in his left eye. Fluoresce in angiography confirmed the presence of a neovascular membrane in his left eye. The electrooculogram showed disease. According to complementary studies the patient was diagnosed with Best’s disease associated with choroidal neovascularization. Discussion: The diagnosis of Best’s vitelliform macular dystrophy is often a casual finding as visual acuity tends to remain stable for long periods of time. A sudden deterioration in vision may suggest complications, such as choroidal neovascularization(AU)

[Topical interferon alfa-2b for primary treatment of conjunctiva-cornea intraepithelial neoplasia]. / Interferón alfa-2b tópico como primera opción en las neoplasias intraepiteliales corneoconjuntivales.

We describe two cases of conjunctival-cornea intraepithelial neoplasia (CIN), treated with topical IFN alfa 2b. The traditional treatment for CIN is surgical excision usually with adjunctive cryotherapy. However, residual tumour may remain, which can lead to recurrence rates of more than 50%. 5-Fluorouracil, mitomicyn C and interferon α 2b are new pharmacological agents that have proved their efficacy in the treatment of CIN. As side effects are common, we present IFN α 2b as a single therapeutic agent as an effective and optimal treatment for presumed recurrent corneal and conjunctival intraepithelial neoplasia. It offers the benefits of topical therapy and avoids the risks of surgical or other interventions - specifically, ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cell deficiency.

[Treatment with photodynamic therapy of circumscribed choroidal hemangioma]. / Tratamiento mediante terapia fotodinámica del hemangioma coroideo circunscrito.

CASE REPORTS: The clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy. DISCUSSION: Photodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation. Some questions such as whether attempts should be made to obtain a complete tumour regression, laser settings or the way the spots must be applied remain unresolved.

Tratamiento mediante terapia fotodinámica del hemangioma coroideo circunscrito / Treatment with photodynamic therapy of circumscribed choroidal hemangioma

Casos clínicosSe presentan las características clínicas de tres pacientes con hemangioma coroideo circunscrito y exudación subfoveal, detectada mediante tomografía óptica de coherencia, tratados con éxito mediante terapia fotodinámica.DiscusiónLa terapia fotodinámica es actualmente la alternativa terapéutica más efectiva para tratar los hemangiomas coroideos circunscritos asociados a exudación subfoveal. Respecto a la utilización de este tratamiento quedan por definir algunas cuestiones como son si se debe buscar o no la desaparición total de la masa tumoral, los parámetros de láser más adecuados en estos casos o la forma de aplicación de los impactos(AU)

Case reportsThe clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy.DiscussionPhotodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation. Some questions such as whether attempts should be made to obtain a complete tumour regression, laser settings or the way the spots must be applied remain unresolved(AU)

[Retinal manifestations of infectious diseases]. / Manifestaciones retinianas de las enfermedades infecciosas.

The retina and the choroids are richly vascularised structures and can therefore be colonised by germs via the haematogenous route in the course of a systemic infectious disease. The germs responsible for this type of infection can be fungi, viruses, bacteria and parasites. Ocular candidiasis is outstanding amongst these colonisations because of its frequency; it can manifest itself as an endophthalmitis with a slow and hidden course. The so-called ocular histoplasmosis syndrome, although it is infrequent in our setting, is an important cause of choroidal neovascularisation. The viruses that most frequently affect the retina are of the herpes type and can produce devastating symptoms in immunoincompetent patients, named acute retinal necrosis syndrome. Retinitis due to cytomegalovirus is more frequent in immunodepressed patients, as in the case of AIDS, but it must also be contemplated in patients with lymphoma and immunomodulatory treatment. The most frequent bacterial diseases that affect the retina are syphilis and tuberculosis. Disease due to cat scratches, caused by a borrelia, can produce a neuroretinitis. Toxoplasmosis is the most common of the infectious diseases caused by a parasite and gives rise to chorioretinitis. Toxocariasis, also caused by a parasite, is second in importance, giving rise to choroidal granulomas and retinal tractions.

Manifestaciones retinianas de las enfermedades infecciosas / Retinal manifestations of infectious diseases

La retina y la coroides son estructuras ricamentevascularizadas por lo que pueden ser colonizadas porgérmenes a través de la vía hematógena en el curso deuna enfermedad infecciosas sistémica. Los gérmenesresponsables de este tipo de infección pueden ser hongos,virus, bacterias y parásitos. Entre estas colonizacionesdestaca por su frecuencia la candidiasis ocular,que se puede manifestar como una endoftalmitis decurso lento y larvado. El presunto síndrome de histoplasmosisocular, aun siendo infrecuente en nuestromedio, es una causa importante de neovascularizacióncoroidea. Los virus que con más frecuencia afectan laretina son del tipo herpes pudiendo producir un cuadrodevastador en pacientes inmunocompetentesdenominado síndrome de necrosis retiniana aguda. Laretinitis por citomegalovirus es más frecuente enpacientes inmunodeprimidos como es el caso del SIDA,pero también se debe tener en cuenta en pacientes conlinfoma y tratamiento inmunomodulador. Las enfermedadesbacterianas más frecuentes que afectan la retinason la sífilis y la tuberculosis. La enfermedad por arañazode gato, causada por una borrelia, puede produciruna neuroretinitis. La toxoplasmosis es la enfermedadinfecciosa de origen parasitario más frecuente ycausa una coriorretinitis. La toxocariasis también causadapor un parásito es la segunda más importantedando lugar a granulomas coroideos y tracciones retinianas

The retina and the choroids are richlyvascularised structures and can therefore becolonised by germs via the haematogenous route inthe course of a systemic infectious disease. Thegerms responsible for this type of infection can befungi, viruses, bacteria and parasites. Ocularcandidiasis is outstanding amongst thesecolonisations because of its frequency; it canmanifest itself as an endophthalmitis with a slow andhidden course. The so-called ocular histoplasmosissyndrome, although it is infrequent in our setting, isan important cause of choroidal neovascularisation.The viruses that most frequently affect the retina areof the herpes type and can produce devastatingsymptoms in immunoincompetent patients, namedacute retinal necrosis syndrome. Retinitis due tocytomegalovirus is more frequent inimmunodepressed patients, as in the case of AIDS,but it must also be contemplated in patients withlymphoma and immunomodulatory treatment. Themost frequent bacterial diseases that affect the retinaare syphilis and tuberculosis. Disease due to catscratches, caused by a borrelia, can produce aneuroretinitis. Toxoplasmosis is the most common ofthe infectious diseases caused by a parasite andgives rise to chorioretinitis. Toxocariasis, alsocaused by a parasite, is second in importance, givingrise to choroidal granulomas and retinal tractions (AU)