ABSTRACT
Reportamos el caso de una mujer de 59 años, que refería disminución de agudeza visual (AV) en el ojo izquierdo (OI). Mediante la exploración, se objetivó en dicho ojo una AV corregida de cuenta dedos a 30 cm, y en la lámpara de hendidura se observó la presencia de edema corneal moderado, con pliegues en la membrana de Descemet. También se apreciaron sinequias iridianas anteriores, atrofia de iris y corectopia. Se diagnosticó de síndrome iridocórneo endotelial (ICE). Se decidió un abordaje terapéutico quirúrgico mediante una cirugía combinada de catarata y queratoplastia endotelial automatizada con disección de la membrana de Descemet (DSAEK). No se reportaron complicaciones intraoperatorias. La recuperación anatómica y funcional fue exitosa, presentando una AV corregida al año de 0,8. Este resultado apoya la eficacia de la DSAEK en el síndrome ICE animando a la realización de más estudios que soporten igualmente su eficacia en este síndrome
The case is reported of a 59-year-old woman, who reported decreased visual acuity (VA) in the left eye (LE). On examination, a corrected VA of finger count/ 30cm was observed in LE. Corneal oedema and folds in the Descemet's membrane were observed using the slit lamp. Anterior synechiae, iris atrophy, and corectopia were also found. ridocorneal endothelial syndrome (ICE) was diagnosed. The treatment option was a combination of cataract surgery and automated endothelial keratoplasty with Descemet's membrane dissection (DSAEK). There were no complications during the operation, with a successful anatomical and functional recovery, with a VA of 0,8 being observed after one year. This result supports the efficacy of DSAEK in ICE syndrome, encouraging more studies to be carried out that should also support its efficacy in this syndrome
Subject(s)
Humans , Female , Middle Aged , Iridocorneal Endothelial Syndrome/surgery , Cataract Extraction/methods , Iridocorneal Endothelial Syndrome/complications , Cataract/complications , Corneal Edema/etiology , Slit Lamp Microscopy , Tomography, Optical Coherence , Iridocorneal Endothelial Syndrome/diagnostic imaging , Cataract/diagnostic imaging , Visual AcuityABSTRACT
OBJECTIVE: To compare corneal densitometry and topography variables in patients with primary congenital glaucoma (PCG) and healthy subjects. MATERIAL AND METHODS: Cross sectional study, consecutive recruitment with gender- and age-matched control group. Forty eyes of 40 patients in each group were studied with Pentacam corneal topography. The variables compared between the two groups were: intraocular pressure (IOP), visual acuity (VA) and Pentacam (Oculus, Wetzlar, Germany) corneal topography measurements: mean and maximum keratometry (Km, Kmax), cylinder (Cyl), anterior elevation apex (AEA), central anterior elevation (CAE), maximum anterior elevation (MAE), posterior elevation apex (PEA), central posterior elevation (CPE), maximum posterior elevation (MPE), pachymetry and anterior, mid-stromal and posterior corneal densitometry in the 0-2mm, 2-6mm, 6-10mm zones. RESULTS: Significant differences between patients and healthy controls were detected in the topographic variables MAE (P=0.002) and MPE (P<0.001), and in all the densitometry variables (anterior, mid-stromal, posterior for the 0-2mm, 2-6mm and 6-10mm zones) (P<0.001 each). In the PCG group, negative correlation was observed between VA and total densitometry (r=-0.49; P=0.004). CONCLUSION: Patients with PCG and healthy subjects display differences in corneal densitometry and topographic measurements. PCG patients show greater corneal density with an inverse relationship between visual acuity and higher elevation (anterior and posterior values).
Subject(s)
Cornea/diagnostic imaging , Glaucoma/congenital , Glaucoma/diagnosis , Adolescent , Adult , Case-Control Studies , Child , Child, Preschool , Cornea/pathology , Corneal Topography , Cross-Sectional Studies , Densitometry , Female , Glaucoma/pathology , Humans , Infant , Infant, Newborn , Male , Organ Size , Prognosis , Young AdultABSTRACT
El manejo actual del glaucoma implica de forma general tratamiento tópico médico, tratamiento láser y cirugía con el objetivo de controlar las cifras de presión intraocular, y evitar así la progresión de la enfermedad. A pesar de que el seguimiento de los pacientes con glaucoma suele realizarse con tomas de medidas de presión intraocular esporádicas y aisladas, la literatura ya indica que quizá esta no es la mejor forma de manejar esta enfermedad. Este artículo revisa la importancia de la monitorización de la presión intraocular durante las 24 horas del día basándose en estudios y publicaciones que existen al respecto hasta la fecha. De forma crítica se repasa la metodología de estas publicaciones, y la necesidad de estudiar más en detalle los cambios de presión intraocular en los diferentes tipos de glaucoma y con las diferentes terapias que usamos en glaucoma para optimizar el manejo de la enfermedad
Current management of glaucoma generally involves medical, laser, or surgical treatment in order to achieve an intraocular pressure (IOP) control which is commensurate with either stability or delayed progression of the disease. Although the follow-up of glaucoma patients is usually carried out with sporadic and isolated intraocular pressure measurements, the literature already indicates that this might not the best option to manage glaucoma patients. This article reviews the importance of 24 hours intraocular pressure monitoring based on studies and publications that exist in this regard to date. A critical review on the methodology of these publications has been conducted. The need is stressed for further studies on the intraocular pressure patterns in different types of glaucoma, as well as the pattern with different therapies used in glaucoma aimed at optimising the management of the disease
Subject(s)
Humans , Intraocular Pressure , Glaucoma/diagnosis , Disease Progression , Glaucoma/therapy , Diagnostic Techniques, Ophthalmological/instrumentationABSTRACT
The case is reported of a 59-year-old woman, who reported decreased visual acuity (VA) in the left eye (LE). On examination, a corrected VA of finger count/ 30cm was observed in LE. Corneal oedema and folds in the Descemet's membrane were observed using the slit lamp. Anterior synechiae, iris atrophy, and corectopia were also found. Iridocorneal endothelial syndrome (ICE) was diagnosed. The treatment option was a combination of cataract surgery and automated endothelial keratoplasty with Descemet's membrane dissection (DSAEK). There were no complications during the operation, with a successful anatomical and functional recovery, with a VA of 0,8 being observed after one year. This result supports the efficacy of DSAEK in ICE syndrome, encouraging more studies to be carried out that should also support its efficacy in this syndrome.
ABSTRACT
Current management of glaucoma generally involves medical, laser, or surgical treatment in order to achieve an intraocular pressure (IOP) control which is commensurate with either stability or delayed progression of the disease. Although the follow-up of glaucoma patients is usually carried out with sporadic and isolated intraocular pressure measurements, the literature already indicates that this might not the best option to manage glaucoma patients. This article reviews the importance of 24hours intraocular pressure monitoring based on studies and publications that exist in this regard to date. A critical review on the methodology of these publications has been conducted. The need is stressed for further studies on the intraocular pressure patterns in different types of glaucoma, as well as the pattern with different therapies used in glaucoma aimed at optimising the management of the disease.
Subject(s)
Glaucoma/therapy , Monitoring, Physiologic/methods , Tonometry, Ocular/methods , Antihypertensive Agents/therapeutic use , Blood Pressure , Circadian Rhythm , Disease Progression , Exfoliation Syndrome/physiopathology , Exfoliation Syndrome/therapy , Forecasting , Glaucoma/physiopathology , Glaucoma/surgery , Humans , Intraocular Pressure , Monitoring, Physiologic/economics , Monitoring, Physiologic/instrumentation , Ocular Hypertension/physiopathology , Ocular Hypertension/therapy , Ophthalmic Solutions/therapeutic use , Prostheses and Implants , TrabeculectomySubject(s)
Hemangioma, Capillary/therapy , Hyphema/therapy , Iris Diseases/therapy , Adrenergic beta-Antagonists/therapeutic use , Aged , Conservative Treatment , Female , Glucocorticoids/therapeutic use , Humans , Intraocular Pressure , Iris/blood supply , Muscarinic Antagonists/therapeutic use , Tropicamide/therapeutic useABSTRACT
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