ABSTRACT
CASO CLÍNICO: Varón de 68 años que consulta por disminución de agudeza visual progresiva en ojo derecho en el último año. En la exploración destaca una catarata moderada y un engrosamiento anular coroideo. Mediante ecografía ultrasónica, angiografía fluoresceínica y verde de indocianina, se confirma el diagnóstico de efusión uveal. El estudio hematológico diagnostica una gammapatía monoclonal de significado indeterminado tipo IgM lambda. Se decide tratamiento quirúrgico de la catarata e inyección subtenoniana de triamcinolona, consiguiendo un resultado visual muy satisfactorio a corto plazo. CONCLUSIÓN: Esta asociación no ha sido descrita previamente en la literatura, por lo que la gammapatía monoclonal de significado indeterminado IgM lambda podría incluirse en la lista de enfermedades asociadas a efusión uveal
CASE REPORT: A 68-year-old man was referred to the hospital with progressive decreased vision in the right eye over the past year. A moderate cataract and annular choroidal thickening were found. The diagnosis of uveal effusion was confirmed by ultrasound and fluorescein and indocyanine green angiography. Laboratory studies showed an IgM lambda subtype monoclonal gammopathy of undetermined significance. The patient underwent cataract surgery, and a sub-Tenon's triamcinolone injection with a satisfactory short-term outcome. CONCLUSION: This association has not been previously reported, and it shows that IgM lambda subtype monoclonal gammopathy of undetermined significance should be added to the list of disorders associated with uveal effusion
Subject(s)
Humans , Male , Middle Aged , Uveal Neoplasms/complications , Uveal Neoplasms/diagnosis , Triamcinolone/therapeutic use , Retinal Detachment/complications , Retinal Detachment/physiopathology , Retinal Detachment , Monoclonal Gammopathy of Undetermined Significance/complications , Monoclonal Gammopathy of Undetermined Significance/diagnosis , Multiple Myeloma/complications , Ultrasonography , Electron Probe Microanalysis/trends , Angiography/methodsABSTRACT
CASE REPORT: A 68-year-old man was referred to the hospital with progressive decreased vision in the right eye over the past year. A moderate cataract and annular choroidal thickening were found. The diagnosis of uveal effusion was confirmed by ultrasound and fluorescein and indocyanine green angiography. Laboratory studies showed an IgM lambda subtype monoclonal gammopathy of undetermined significance. The patient underwent cataract surgery, and a sub-Tenon's triamcinolone injection with a satisfactory short-term outcome. CONCLUSION: This association has not been previously reported, and it shows that IgM lambda subtype monoclonal gammopathy of undetermined significance should be added to the list of disorders associated with uveal effusion.
Subject(s)
Immunoglobulin M , Paraproteinemias/complications , Uveal Diseases/etiology , Aged , Exudates and Transudates , Humans , Male , Paraproteinemias/classification , Paraproteinemias/immunologyABSTRACT
PURPOSE/METHODS: Subfoveal perfluorocarbon liquid (SPCL) causes vision loss and central scotoma. We present two clinical cases with this complication and we review the 5 clinical cases reported in the literature to analyse their potential prognostic factors. RESULTS/CONCLUSIONS: SPCL extraction involves an early visual acuity recovery and a central scotoma disappearance. The visual acuity recovery degree does not depend on the patient's age, the onset visual acuity or the evolution time when this last one is less than 3 months.
Subject(s)
Fluorocarbons/adverse effects , Fovea Centralis , Retinal Diseases/chemically induced , Aged , Humans , Male , Middle AgedABSTRACT
Objetivo/método: El perfluorocarbono líquidosubfoveal (PCLS) produce disminución de la visióny un escotoma central. Se presentan dos casos conesta complicación y se revisan los cinco casos descritosen la literatura mundial para valorar la existenciao no de factores pronóstico.Resultados/conclusiones: La extracción del(PCLS) comporta una pronta recuperación de laagudeza visual con la desaparición del escotomacentral. El grado de recuperación de la visión nodepende de la edad del paciente, de la agudezavisual inicial ni del tiempo de evolución cuandoeste es inferior a tres meses(AU)
Purpose/methods: Subfoveal perfluorocarbonliquid (SPCL) causes vision loss and central scotoma.We present two clinical cases with this complicationand we review the 5 clinical cases reported inthe literature to analyse their potential prognosticfactors.Results/conclusions: SPCL extraction involves anearly visual acuity recovery and a central scotomadisappearance. The visual acuity recovery degreedoes not depend on the patients age, the onsetvisual acuity or the evolution time when this lastone is less than 3 months(AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Fluorocarbons , Fluorocarbons/adverse effects , Fluorocarbons/analysis , Vitrectomy , Scotoma , Vision, Low , Diabetes Mellitus , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapyABSTRACT
PURPOSE: Long term assessment of the evolution of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) in symptomatic patients treated by laser photocoagulation. METHODS: We carried out a retrospective study involving seven eyes in six patients with visual impairment, affected by IPCV, confirmed by indocyanine green angiography. All were treated by laser photocoagulation and monitored during a period of at least one year. The controls were evaluated during the first, third, sixth and twelfth month, in order to assess whether it was necessary to repeat the treatment. RESULTS: Of the six patients with IPCV lesions, two were men and four were women (1:2) aged between 58 and 81 years (mean = 73 years), and monitored for a time interval of 18 and 75 months (mean = 39 months). The average initial visual acuity was 0.25, and the final was 0.15. All the patients had the other eye also affected: three had a macular disciform scar, secondary to the previous haemorrhagic episodes, two had asymptomatic polyps and in one patient we defined active bilateral IPCV which was treated by laser photocoagulation. In two eyes it appeared as a macular haemorrhage, in four eyes as a serosanguinous retinal pigment epithelial (RPE) detachment and in one eye as a serous RPE detachment. Three eyes suffered a relapse which required further laser photocoagulation treatment. CONCLUSIONS: Laser photocoagulation is a palliative treatment for IPCV. Final vision achieved is poor and relapse is frequent. Other procedures should be used to treat this disease.
Subject(s)
Choroid Diseases/surgery , Choroid/blood supply , Laser Coagulation , Vascular Diseases/surgery , Aged , Aged, 80 and over , Choroid/diagnostic imaging , Choroid Diseases/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Retrospective Studies , Time Factors , Vascular Diseases/diagnostic imagingABSTRACT
Objetivo: Valorar la evolución a largo plazo, de la vasculopatía coroidal polipoidea idiopática (VCPI) en pacientes sintomáticos, tratados mediante fotocoagulación (FCG) láser.Sujetos, material y métodos: Se ha realizado un estudio retrospectivo en siete ojos de seis pacientes con pérdida visual, afectos de VCPI, confirmada mediante angiografía con verde indocianina. Fueron tratados con FCG láser y con un seguimiento superior a un año. Se controlaron al primer, tercer, sexto y decimosegundo mes para valorar posibles retratamientos.Resultados: Los seis pacientes fueron dos hombres y cuatro mujeres (1:2) cuya edad oscilaba entre 58 y 81 años (x = 73). El seguimiento varió entre 18 y 75 meses ( x = 39). La agudeza visual inicial media fue de 0,25 mientras que la final fue de 0,15. El ojo contralateral se encontraba afectado en todos los pacientes: tres padecían cicatriz macular secundaria a la enfermedad, en otros dos pacientes se apreciaron pólipos asintomáticos y en un paciente se apreció la enfermedad activa bilateral por lo que fotocoagulamos ambos ojos. En dos ojos se presentó en forma de hemorragia macular. En cuatro como desprendimiento serohemorrágico del epitelio pigmentario (EP) y en un ojo como desprendimiento seroso del mismo. Tres ojos sufrieron recaídas por lo que precisaron nuevas FCG.Conclusiones: La FCG láser es un tratamiento paliativo para la VCPI. La agudeza visual final es mediocre y la recaída es frecuente. Deben intentarse otros procedimientos para el tratamiento de este padecimiento
Purpose: Long term assessment of the evolution of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) in symptomatic patients treated by laser photocoagulation.Methods: We carried out a retrospective study involving seven eyes in six patients with visual impairment, affected by IPCV, confirmed by indocyanine green angiography. All were treated by laser photocoagulation and monitored during a period of at least one year. The controls were evaluated during the first, third, sixth and twelfth month, in order to assess whether it was necessary to repeat the treatment.Results: Of the six patients with IPCV lesions, two were men and four were women (1:2) aged between 58 and 81 years (mean = 73 years), and monitored for a time interval of 18 and 75 months (mean = 39 months). The average initial visual acuity was 0.25, and the final was 0.15. All the patients had the other eye also affected: three had a macular disciform scar, secondary to the previous haemorrhagic episodes, two had asymptomatic polyps and in one patient we defined active bilateral IPCV which was treated by laser photocoagulation. In two eyes it appeared as a macular haemorrhage, in four eyes as a serosanguinous retinal pigment epithelial (RPE) detachment and in one eye as a serous RPE detachment. Three eyes suffered a relapse which required further laser photocoagulation treatment.Conclusions: Laser photocoagulation is a palliative treatment for IPCV. Final vision achieved is poor and relapse is frequent. Other procedures should be used to treat this disease
