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1.
Arch. Soc. Esp. Oftalmol ; 89(1): 22-26, ene. 2014. ilus, tab
Article in Spanish | IBECS | ID: ibc-129250

ABSTRACT

INTRODUCCIÓN: La pars planitis (PP) es una uveítis intermedia idiopática que presenta múltiples complicaciones en el segmento posterior, las cuales incluyen el edema macular quístico o cistoideo (EM) y la formación de membranas epirretinianas (MER). Comúnmente se decide realizar tratamiento antiinflamatorio o inmunosupresor ante la presencia de EM. Sin embargo, este puede coexistir con la presencia de MER y, por lo tanto, existe la posibilidad de que el enfoque del tratamiento deba ser diferente. OBJETIVOS: Determinar la asociación que existe entre la presencia de MER con EM en PP. MATERIALES Y MÉTODOS: Serie de casos y controles donde se analizaron de manera retrospectiva los expedientes de pacientes con PP, todos ellos seguidos con angiografía con fluoresceína (AF) y tomografía de coherencia óptica de dominio espectral (SD-OCT). Se determinó la presencia de MER por SD-OCT, mientras que el EM fue determinado por AF. Se realizaron tablas de contingencia para determinar cómo influyen las MER como factores de riesgo para desarrollar EM. RESULTADOS: 31 ojos presentaron MER. 16 ojos presentaron EM. La razón de riesgo para presentar EM por MER fue de 0,971 con un valor de p determinada por χ2 de 0,77. CONCLUSIONES: No existe una asociación significativa entre la formación de MER y el desarrollo de EM. No existe evidencia que sugiera considerar un abordaje quirúrgico como primera línea de tratamiento ante la presencia de MER en PP


INTRODUCTION: Pars planitis (PP) is a form of intermediate uveitis that manifests with several posterior segment complications, including cystoid macular edema (CME) and epiretinal membrane formation (ERM). On the presence of CME the patient is usually treated with anti-inflammatory and/or immunosuppressive drugs. However the presence of CME may coexist with ERM formation, and therefore the treatment could be different. PURPOSE: To determine the association between ERM and CME in PP. MATERIALS AND METHODS: Case control series. The charts of patients diagnosed with PP were retrospectively reviewed. All patients had fluorescein angiogram (FA) and spectral domain optical coherence tomography (SD-OCT). Presence of ERM was determined by SD-OCT, while CME was determined by FA. Contingency tables were used to determine the risk of developing CME with ERM. RESULTS: 31 eyes presented ERM. 16 eyes presented CME. Relative risk to have CME and ERM was 0.971, with a P value of 0.77 (χ2). CONCLUSIONS: There is no association between ERM formation and the development of CME. There is no evidence to suggest a surgical approach as first line of treatment with the presence of ERM in PP


Subject(s)
Humans , Epiretinal Membrane/complications , Macular Edema/complications , Pars Planitis/complications , Tomography, Optical Coherence , Spectrometry, Fluorescence , Case-Control Studies
2.
Arch. Soc. Esp. Oftalmol ; 89(1): 27-30, ene. 2014. ilus
Article in Spanish | IBECS | ID: ibc-129251

ABSTRACT

CASO CLÍNICA: Paciente femenina de 45 años con antecedente de crisis convulsivas, presenta cefalea, náusea, vómito y disminución de la agudeza. Campos visuales 24-2 con hemianopsia heterónima bitemporal. La resonancia magnética revela una aracnoiditis de cisternas basales e hidrocefalia supratentorial. La tomografía computarizada de cráneo demostró calcificaciones supratentoriales, escólex en región occipital izquierda e hidrocefalia a expensas de atrapamiento de cuarto ventrículo, integrando el diagnóstico de neurocisticercosis. Discusión: La neurocisticercosis puede producir hemianopsia bitemporal por compresión quiasmática secundaria a hidrocefalia. Pacientes con hidrocefalia y antígenos negativos pueden presentar secuelas de infección sin parásitos vivos


CASE PRESENTATION: A 45-year-old woman with a history of seizures, headaches, nausea, vomiting, and decreased visual acuity of 5 years. Visual field detected a bitemporal heteronymous hemianopia. Magnetic resonance imaging revealed basal cistern arachnoiditis and supratentorial hydrocephalus. Cranial computed tomography revealed supratentorial calcifications, scolex in the left occipital region, and hydrocephalus secondary to entrapment of the fourth ventricle. Discussion: Neurocysticercosis can cause bitemporal hemianopsia due to chiasmatic compression secondary to obstructive hydrocephalus. The positivity of anti-cysticercus antibodies determined by ELISA evidence active disease. However patients with hydrocephalus and negative antigen may have sequelae of infection with non-living parasites


Subject(s)
Humans , Female , Middle Aged , Hemianopsia/etiology , Neurocysticercosis/complications , Hydrocephalus/complications , Seizures/etiology , Optic Chiasm/physiopathology , Arachnoiditis/complications , Diagnostic Imaging
3.
Arch Soc Esp Oftalmol ; 89(1): 22-6, 2014 Jan.
Article in Spanish | MEDLINE | ID: mdl-24332688

ABSTRACT

INTRODUCTION: Pars planitis (PP) is a form of intermediate uveitis that manifests with several posterior segment complications, including cystoid macular edema (CME) and epiretinal membrane formation (ERM). On the presence of CME the patient is usually treated with anti-inflammatory and/or immunosuppressive drugs. However the presence of CME may coexist with ERM formation, and therefore the treatment could be different. PURPOSE: To determine the association between ERM and CME in PP. MATERIALS AND METHODS: Case control series. The charts of patients diagnosed with PP were retrospectively reviewed. All patients had fluorescein angiogram (FA) and spectral domain optical coherence tomography (SD-OCT). Presence of ERM was determined by SD-OCT, while CME was determined by FA. Contingency tables were used to determine the risk of developing CME with ERM. RESULTS: 31 eyes presented ERM. 16 eyes presented CME. Relative risk to have CME and ERM was 0.971, with a P value of 0.77 (χ(2)). CONCLUSIONS: There is no association between ERM formation and the development of CME. There is no evidence to suggest a surgical approach as first line of treatment with the presence of ERM in PP.


Subject(s)
Epiretinal Membrane/etiology , Macular Edema/etiology , Pars Planitis/complications , Adolescent , Adult , Case-Control Studies , Child , Epiretinal Membrane/pathology , Female , Fluorescein Angiography , Fovea Centralis/pathology , Humans , Macular Edema/pathology , Male , Pars Planitis/pathology , Retrospective Studies , Risk , Tomography, Optical Coherence , Young Adult
4.
Arch Soc Esp Oftalmol ; 89(1): 27-30, 2014 Jan.
Article in Spanish | MEDLINE | ID: mdl-24269412

ABSTRACT

CASE PRESENTATION: A 45-year-old woman with a history of seizures, headaches, nausea, vomiting, and decreased visual acuity of 5 years. Visual field detected a bitemporal heteronymous hemianopia. Magnetic resonance imaging revealed basal cistern arachnoiditis and supratentorial hydrocephalus. Cranial computed tomography revealed supratentorial calcifications, scolex in the left occipital region, and hydrocephalus secondary to entrapment of the fourth ventricle. DISCUSSION: Neurocysticercosis can cause bitemporal hemianopsia due to chiasmatic compression secondary to obstructive hydrocephalus. The positivity of anti-cysticercus antibodies determined by ELISA evidence active disease. However patients with hydrocephalus and negative antigen may have sequelae of infection with non-living parasites.


Subject(s)
Hemianopsia/etiology , Hydrocephalus/etiology , Neurocysticercosis/complications , Animals , Antibodies, Helminth/blood , Arachnoiditis/etiology , Calcinosis/diagnostic imaging , Calcinosis/etiology , Enzyme-Linked Immunosorbent Assay , Epilepsy/etiology , False Negative Reactions , Female , Humans , Hydrocephalus/diagnostic imaging , Hydrocephalus/surgery , Magnetic Resonance Imaging , Middle Aged , Nerve Compression Syndromes/etiology , Neurocysticercosis/diagnostic imaging , Neurocysticercosis/parasitology , Taenia/immunology , Taenia/isolation & purification , Tomography, X-Ray Computed
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