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7.
Arch. Soc. Esp. Oftalmol ; 94(7): 343-346, jul. 2019. ilus
Article in Spanish | IBECS | ID: ibc-185189

ABSTRACT

El objetivo es describir un caso de persistencia de membrana de Descemet tras una queratoplastia penetrante, así como la importancia de la tomografía de coherencia óptica de segmento anterior para su diagnóstico y las posibles opciones terapéuticas. Se presenta un caso clínico y se hace una revisión bibliográfica. Se trata de un varón de 88 años que se sometió a una queratoplastia penetrante debido a una queratopatía bullosa avanzada, tras la cual se produjo una persistencia de la membrana de Descemet receptora. La persistencia pasó inadvertida hasta que el paciente comenzó con disminución de su agudeza visual, y en la exploración oftalmológica se observó la presencia de una membrana opalescente posicionada debajo del endotelio, que fue identificada como la membrana de Descemet del receptor. El tratamiento se llevó a cabo mediante membranotomía Nd:YAG, acorde a lo consultado en la literatura con éxito. Como conclusión se establece que la persistencia inadvertida de la membrana de Descemet es una complicación muy poco frecuente de la queratoplastia penetrante. La tomografía de coherencia óptica de segmento anterior permite un diagnóstico de certeza, y la membranotomía con láser Nd:YAG es uno de los tratamientos indicados


A case is presented of a retained Descemet's membrane after penetrating keratoplasty, highlighting the importance of the anterior segment optical coherence tomography (OCT) in the diagnosis and treatment planning of keratoplasty complications. A review of literature is also presented. An 88 year-old man underwent penetrating keratoplasty for bullous keratopathy. A retained host Descemet's membrane was detected. The retained membrane went unnoticed until the visual acuity decreased. The ophthalmological examination showed the presence of an opalescent membrane located below the endothelium, and was identified as the Descemet membrane of the receptor. Nd:YAG laser membranotomy was performed after the diagnosis. To conclude, it is noted that the inadvertent retention of the host Descemet membrane is a rare complication in penetrating keratoplasty. The anterior segment OCT was used to determine the diagnosis, and Nd:YAG laser membranotomy is an indicated treatment in these cases


Subject(s)
Humans , Male , Aged, 80 and over , Corneal Diseases/surgery , Descemet Membrane/surgery , Endothelium, Corneal/surgery , Keratoplasty, Penetrating , Lasers, Solid-State/therapeutic use , Postoperative Complications/surgery , Descemet Membrane/diagnostic imaging , Endothelium, Corneal/diagnostic imaging , Endothelium, Corneal/pathology , Postoperative Complications/diagnosis , Postoperative Complications/pathology , Slit Lamp , Tomography, Optical Coherence
11.
Arch Soc Esp Oftalmol (Engl Ed) ; 94(7): 343-346, 2019 Jul.
Article in English, Spanish | MEDLINE | ID: mdl-30890280

ABSTRACT

A case is presented of a retained Descemet's membrane after penetrating keratoplasty, highlighting the importance of the anterior segment optical coherence tomography (OCT) in the diagnosis and treatment planning of keratoplasty complications. A review of literature is also presented. An 88 year-old man underwent penetrating keratoplasty for bullous keratopathy. A retained host Descemet's membrane was detected. The retained membrane went unnoticed until the visual acuity decreased. The ophthalmological examination showed the presence of an opalescent membrane located below the endothelium, and was identified as the Descemet membrane of the receptor. Nd:YAG laser membranotomy was performed after the diagnosis. To conclude, it is noted that the inadvertent retention of the host Descemet membrane is a rare complication in penetrating keratoplasty. The anterior segment OCT was used to determine the diagnosis, and Nd:YAG laser membranotomy is an indicated treatment in these cases.


Subject(s)
Corneal Diseases/surgery , Descemet Membrane/surgery , Endothelium, Corneal/surgery , Keratoplasty, Penetrating , Lasers, Solid-State/therapeutic use , Postoperative Complications/surgery , Aged, 80 and over , Descemet Membrane/diagnostic imaging , Endothelium, Corneal/diagnostic imaging , Endothelium, Corneal/pathology , Humans , Male , Postoperative Complications/diagnosis , Postoperative Complications/pathology , Slit Lamp , Tomography, Optical Coherence
12.
An. sist. sanit. Navar ; 41(3): 393-396, sept.-dic. 2018. ilus, graf
Article in Spanish | IBECS | ID: ibc-179088

ABSTRACT

El síndrome de Michaelis-Manz es una tubulopatia de herencia autosómica recesiva asociada a mutaciones en las proteínas claudina 16 y 19 que se encuentran en el túbulo contorneado distal y asa de Henle en el riñón. La claudina 19 también se encuentra en el epitelio pigmentario de la retina. Clínicamente, el cuadro provoca hipomagnesemia, hipercalciuria y nefrocalcinosis que puede dar lugar a insuficiencia renal. Oftalmológicamente presentan colobomas maculares, estafilomas por miopía magna y nistagmo. Presentamos el caso de un varón de 18 años afectado de hipomagnesemia familiar con hipercalciuria y nefrocalcinosis, o síndrome de Michaelis-Manz, asociado a un coloboma macular con una agudeza visual estable


Michaelis-Manz syndrome is an autosomal recessive hereditary tubulopathy associated with mutations in the tight-junction proteins claudin-16 and claudin-19, which are present in the distal convoluted tubule and the loop of Henle in the kidney. Claudin-19 is also expressed in the retinal pigmentary epithelium. The clinical picture causes hypomagnesemia, hypercalciuria and nephrocalcinosis that can lead to renal failure, which is the condition that marks the prognosis of the disease. Ophthalmologically patients can present macular coloboma, myopic staphyloma and nystagmus. We present the case report of an 18-year-old man suffering from hereditary hypomagnesemia, hypercalciuria and nephrocalcinosis, or Michaelis-Manz syndrome, with macular coloboma and stable visual acuities


Subject(s)
Humans , Male , Adolescent , Macular Degeneration/diagnostic imaging , Macular Degeneration/drug therapy , Coloboma/diagnostic imaging , Visual Acuity , Magnesium Deficiency/complications , Hypercalciuria/complications , Nephrocalcinosis/complications , Coloboma/therapy , Retina/diagnostic imaging , Retina/pathology , Tomography, Optical Coherence/methods , Diagnosis, Differential
13.
An Sist Sanit Navar ; 41(3): 393-396, 2018 Dec 26.
Article in Spanish | MEDLINE | ID: mdl-30425385

ABSTRACT

Michaelis-Manz syndrome is an autosomal recessive hereditary tubulopathy associated with mutations in the tight-junction proteins claudin-16 and claudin-19, which are present in the distal convoluted tubule and the loop of Henle in the kidney. Claudin-19 is also expressed in the retinal pigmentary epithelium. The clinical picture causes hypomagnesemia, hyper-calciuria and nephrocalcinosis that can lead to renal failure, which is the condition that marks the prognosis of the disease. Ophthalmologically patients can present macular coloboma, myopic staphyloma and nystagmus. We present the case report of an 18-year-old man suffering from hereditary hypomagnesemia, hypercalciuria and nephrocalcinosis, or Mich-aelis-Manz syndrome, with macular coloboma and stable visual acuities. Keywords. Hypomagnesemia. Hypercalciuria. Nephrocalcinosis. Macular coloboma.


Subject(s)
Magnesium Deficiency , Nephrocalcinosis , Adolescent , Humans , Magnesium Deficiency/diagnosis , Magnesium Deficiency/therapy , Male , Nephrocalcinosis/diagnosis , Nephrocalcinosis/therapy
14.
Arch. Soc. Esp. Oftalmol ; 93(11): 567-570, nov. 2018. ilus
Article in Spanish | IBECS | ID: ibc-175143

ABSTRACT

OBJETIVO: Presentamos una serie de casos de miasis ocular externa en nuestra región asociados a unos factores epidemiológicos comunes. Nuestro objetivo es mejorar el conocimiento acerca de su tratamiento. MATERIAL Y MÉTODOS: Se muestran 4 casos clínicos de pacientes con miasis ocular externa causada por larvas del díptero Oestrus ovis. RESULTADOS: La miasis ocular es una infección parasitaria por estados larvarios de moscas. Puede afectar al globo ocular de forma externa y/o interna, siendo más frecuente la externa. El organismo que con mayor frecuencia afecta al ojo es la larva de Oestrus ovis. CONCLUSIÓN: La miasis ocular externa es una afección poco frecuente en humanos. En la serie de casos se establece un factor de riesgo común para la infección: la exposición a actividades ganaderas y/o agrícolas. Un adecuado tratamiento a tiempo puede evitar el paso de la forma externa a la interna, así como sus posibles complicaciones


OBJECTIVE: To report a case series of external ophthalmomyiasis in a region of Spain together with its common epidemiological factors and treatment. MATERIAL AND METHODS: A presentation is made of four clinical cases of patients with external ocular myiasis caused by Oestrus ovis larvae. RESULTS: Ocular myiasis is a parasitic infection by larval stages of flies. It can affect the ocular globe externally and / or internally, with the former being the most frequently found condition. The organism that mainly affects the eyes is the Oestrus ovis larvae. CONCLUSION: Ocular external myiasis is a rare condition that occasionally can occur in humans. In this case series, a common risk factor for infection is established: the previous exposure to livestock and / or agricultural activity. An adequate diagnosis and treatment could avoid the transition from external to internal form, as well as its complications


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Myiasis/epidemiology , Myiasis/drug therapy , Risk Factors , Tobramycin/therapeutic use , Ivermectin/therapeutic use , Diptera/parasitology , Eye Infections, Parasitic/epidemiology , Myiasis/parasitology , Spain/epidemiology , Eye Infections/parasitology , Microscopy , Eye Infections, Parasitic/drug therapy
15.
Arch. Soc. Esp. Oftalmol ; 93(9): 447-450, sept. 2018. ilus
Article in Spanish | IBECS | ID: ibc-175010

ABSTRACT

OBJETIVO: Presentar el caso clínico de una paciente con el síndrome de la transiluminación iridiana aguda bilateral (BAIT). MÉTODOS: El síndrome de BAIT es una nueva entidad clínica caracterizada por una transiluminación iridiana, dispersión de pigmento en la cámara anterior y una pupila en midriasis media que no responde o es poco sensible a la luz debido a una parálisis del esfínter. Los pacientes con BAIT suelen presentar dolor ocular agudo, fotofobia y ojo rojo. DISCUSIÓN: Presentamos el caso clínico de una mujer de 53 años que, tras ser tratada de una infección del tracto respiratorio superior con moxifloxacino, desarrolló un síndrome de BAIT, diagnosticado en primera instancia de uveítis anterior aguda. CONCLUSIÓN: Este es, hasta donde se conoce, el primer caso reportado en Navarra, aunque es necesaria mayor casuística para establecer patrones claros acerca de esta enfermedad


OBJECTIVE: To present a case report of a patient with a bilateral acute iris transillumination syndrome (BAIT). METHODS: BAIT syndrome is a new clinical condition characterised by severe transillumination of the iris, acute onset of pigment dispersion in the anterior chamber, and a medial mydriatic pupil that is unresponsive or poorly responsive to light, due to a sphincter paralysis. Patients with BAIT generally present with acute ocular pain, photophobia, and red eyes. DISCUSSION: The case is presented of a 53 year-old woman, who, after being treated with moxifloxacin for an upper respiratory tract infection, developed a BAIT syndrome, which was initially diagnosed as acute anterior uveitis. CONCLUSION: As far as is known this is the first case reported in Navarra, but more case reports are needed to establish clear patterns about this condition


Subject(s)
Humans , Female , Middle Aged , Anterior Chamber/physiopathology , Anterior Chamber/radiation effects , Mydriasis/diagnostic imaging , Uveitis/diagnosis , Iris Diseases/diagnostic imaging , Mydriasis/complications , Intraocular Pressure/radiation effects , Iris/physiopathology , Iris/radiation effects , Fluoroquinolones/adverse effects , Visual Acuity , Tomography, Optical Coherence , Gonioscopy
16.
Arch Soc Esp Oftalmol (Engl Ed) ; 93(11): 567-570, 2018 Nov.
Article in English, Spanish | MEDLINE | ID: mdl-30025990

ABSTRACT

OBJECTIVE: To report a case series of external ophthalmomyiasis in a region of Spain together with its common epidemiological factors and treatment. MATERIAL AND METHODS: A presentation is made of four clinical cases of patients with external ocular myiasis caused by Oestrus ovis larvae. RESULTS: Ocular myiasis is a parasitic infection by larval stages of flies. It can affect the ocular globe externally and / or internally, with the former being the most frequently found condition. The organism that mainly affects the eyes is the Oestrus ovis larvae. CONCLUSION: Ocular external myiasis is a rare condition that occasionally can occur in humans. In this case series, a common risk factor for infection is established: the previous exposure to livestock and / or agricultural activity. An adequate diagnosis and treatment could avoid the transition from external to internal form, as well as its complications.


Subject(s)
Diptera , Eye Infections, Parasitic/parasitology , Myiasis/parasitology , Agricultural Workers' Diseases/parasitology , Animals , Antibiotic Prophylaxis , Conjunctivitis/drug therapy , Conjunctivitis/etiology , Dexamethasone/therapeutic use , Diptera/growth & development , Eye Infections, Parasitic/epidemiology , Female , Humans , Larva , Male , Middle Aged , Myiasis/epidemiology , Spain/epidemiology , Tobramycin/therapeutic use , Young Adult
17.
Arch Soc Esp Oftalmol (Engl Ed) ; 93(9): 447-450, 2018 Sep.
Article in English, Spanish | MEDLINE | ID: mdl-29398234

ABSTRACT

OBJECTIVE: To present a case report of a patient with a bilateral acute iris transillumination syndrome (BAIT). METHODS: BAIT syndrome is a new clinical condition characterised by severe transillumination of the iris, acute onset of pigment dispersion in the anterior chamber, and a medial mydriatic pupil that is unresponsive or poorly responsive to light, due to a sphincter paralysis. Patients with BAIT generally present with acute ocular pain, photophobia, and red eyes. DISCUSSION: The case is presented of a 53 year-old woman, who, after being treated with moxifloxacin for an upper respiratory tract infection, developed a BAIT syndrome, which was initially diagnosed as acute anterior uveitis. CONCLUSION: As far as is known this is the first case reported in Navarra, but more case reports are needed to establish clear patterns about this condition.


Subject(s)
Glaucoma, Open-Angle/etiology , Iris/pathology , Mydriasis/etiology , Acute Disease , Anti-Bacterial Agents/adverse effects , Diagnostic Errors , Female , Glaucoma, Open-Angle/chemically induced , Glaucoma, Open-Angle/diagnosis , Humans , Middle Aged , Moxifloxacin/adverse effects , Mydriasis/chemically induced , Mydriasis/diagnosis , Respiratory Tract Infections/drug therapy , Syndrome , Uveitis, Anterior/diagnosis
18.
An Sist Sanit Navar ; 40(3): 461-466, 2017 Dec 29.
Article in Spanish | MEDLINE | ID: mdl-29215661

ABSTRACT

Horner's Syndrome (HS) is a neurological syndrome characterised by the triad incomplete pupillary miosis, palpebral ptosis and facial anhidrosis, due to a lesion of the oculosympathetic pathway, formed of three neurons from the hipothalamus to the eye. Identifying its cause is a diagnostic challenge since in spite of its apparent lack of clinical importance, HS can be the first or only manifestation of a serious, or even potentially mortal disorder. We present the case of a 19-year-old male patient with a history of nonspecific ocular pains of two months evolution. He attended the emergency ophthalmological clinic where he was diagnosed with an HS as the first clinical manifestation of Hodgkin lymphoma.


Subject(s)
Hodgkin Disease/complications , Horner Syndrome/etiology , Humans , Male , Young Adult
19.
An. sist. sanit. Navar ; 40(3): 461-466, sept.-dic. 2017. tab, ilus
Article in Spanish | IBECS | ID: ibc-169782

ABSTRACT

El Síndrome de Horner (SH) es un síndrome neurológico que se caracteriza por la triada miosis pupilar incompleta, ptosis palpebral y anhidrosis facial debido a la lesión de la vía oculosimpática, compuesta por tres neuronas, desde el hipotálamo hasta el ojo. Identificar su causa representa un reto diagnóstico ya que, a pesar de su aparente levedad clínica, el SH puede ser la primera o única manifestación de un trastorno grave o incluso potencialmente mortal. Presentamos el caso de un paciente varón de 19 años con una historia de molestias oculares inespecíficas de dos meses de evolución. Acudió a la consulta de urgencias de Oftalmología en la que fue diagnosticado de un SH como primera manifestación clínica de linfoma de Hodgkin (AU)


Horner’s Syndrome (HS) is a neurological síndrome characterised by the triad incomplete pupillary miosis, palpebral ptosis and facial anhidrosis, due to a lesión of the oculosympathetic pathway, formed of three neurons from the hipothalamus to the eye. Identifying its cause is a diagnostic challenge since in spite of its apparent lack of clinical importance, HS can be the first or only manifestation of a serious, or even potentially mortal disorder. We present the case of a 19-year-old male patient with a history of nonspecific ocular pains of two months evolution. He attended the emergency ophthalmological clinic where he was diagnosed with an HS as the first clinical manifestation of Hodgkin lymphoma (AU)


Subject(s)
Humans , Male , Young Adult , Horner Syndrome/complications , Hodgkin Disease/diagnosis , Conjunctivitis, Allergic/diagnosis , Diagnosis, Differential , Hyperhidrosis/etiology , Blepharoptosis/etiology
20.
An. sist. sanit. Navar ; 40(2): 299-302, mayo-ago. 2017. ilus
Article in Spanish | IBECS | ID: ibc-165880

ABSTRACT

La ciclodiálisis es el resultado de la separación de las fibras longitudinales del músculo ciliar de su inserción escleral, creando estados de hipotonía ocular. Es causada principalmente por traumatismos. La gonioscopia ha sido tradicionalmente la prueba diagnóstica para esta entidad, sin embargo, en la actualidad está siendo sustituida por otras técnicas, como la biomicroscopía ultrasónica (BMU). Presentamos el caso de un varón de 57 años que tras sufrir un traumatismo en el ojo izquierdo con un disco de sierra radial, presentó perforación corneal y hemorragia vítrea con edema panretiniano. La gonioscopia fue normal a pesar de la existencia de hipotonía ocular persistente. La realización de una BMU permitió diagnosticar una pequeña ciclodiálisis, inferior de diez grados. El tratamiento quirúrgico permitió recuperar una presión intraocular normal (AU)


Cyclodialysis is the result of the separation of the longitudinal fibres of the ciliary muscle from their scleral insertion, creating states of ocular hypotony. It is mainly caused by traumatisms. Gonioscopy has traditionally been the diagnostic test for this entity, however, at present it is being replaced by other techniques, such as ultrasound biomicroscopy (UBM). We present the case of a 57-year-old male who, following a traumatism in the left eye caused by the disc of a radial saw, presented corneal perforation and vitreous haemorrhage with pan-retinal edema. The gonioscopy was normal in spite of the existence of persistent ocular hypotony. The realization of a UBM enabled diagnosis of a small cyclodialysis of less than ten degrees. Surgical treatment made it possible to recover normal intraocular pressure (AU)


Subject(s)
Humans , Male , Middle Aged , Vitrectomy/instrumentation , Ciliary Body/injuries , Ciliary Body/surgery , Cryosurgery/methods , Eye Injuries/surgery , Vitrectomy/methods , Sulfur Hexafluoride/therapeutic use , Eye Injuries/diagnosis , Eye Injuries/etiology , Microscopy , Muscle Hypotonia , Ocular Hypotension , Muscle Hypotonia/surgery , Ocular Hypotension/surgery , Visual Acuity , Gonioscopy , Macular Degeneration/surgery
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