Guías de uso de tomografía computarizada de haz cónico en ortodoncia: revisión narrativa / Guidelines for the use of cone-beam computed tomography in orthodontics: narrative review

Introducción: La tomografía computarizada de haz cónico (CBCT, del inglés Cone-Beam Computed Tomography) se ha masificado en odontología, incluyendo ortodoncia. Organismos internacionales proponen guías para la indicación de CBCT en odontología. Hasta la fecha no existen publicaciones que recopilen y analicen las guías actuales de uso de CBCT en ortodoncia. El propósito de la presente revisión narrativa es analizar las indicaciones de CBCT en ortodoncia en revisiones sistemáticas y guías actuales de organismos internacionales. Materiales y métodos: Se realizó una búsqueda principal en PubMed, Web of Science y Scopus. Para la búsqueda complementaria se usaron las listas de referencias de los artículos incluidos a texto completo obtenidos de la búsqueda principal y sitios web oficiales de instituciones guías de uso de CBCT en ortodoncia. Los criterios de inclusión correspondieron a guías, y revisiones sistemáticas sobre el uso de CBCT en ortodoncias no incluidas en las referencias de las guías, en idioma inglés. Resultados: Se encontraron 7 guías y 1 revisión sistemática. La CBCT no se recomienda para uso rutinario ni como examen imagenológico inicial en ortodoncia. Sus usos son en su mayoría para casos particulares, en que la radiografía convencional no aporta información suficiente para un correcto diagnóstico y posterior tratamiento. Conclusión: Las organizaciones internacionales concuerdan que la CBCT en ortodoncia se justifica solo cuando beneficia al paciente. La CBCT es una herramienta diagnóstica confiable en casos donde la evaluación en tres dimensiones es obligatoria para tomar la decisión terapéutica más adecuada. Aún falta nueva evidencia en esta área, la que debe considerar los principios de protección radiológica de optimización y justificación. (AU)

Introduction: Cone-beam computed tomography (CBCT) has been popularized in dentistry, including orthodontics. International organizations have published guidelines for the use of CBCT in dentistry. To date, there are no publications that compile and analyze the current guidelines for the use of CBCT in orthodontics. The aim of this narrative review is to analyze the indications for CBCT in orthodontics both in systematic reviews and current guidelines from international organizations. Materials and methods: A main search was conducted in PubMed, Web of Science, and Scopus. For the complementary search, the reference lists of the articles included in full text obtained from the main search and official websites of institutions with guidelines for the use of CBCT in orthodontics, were used. The inclusion criteria corresponded to guides on the use of CBCT in orthodontics, and systematic reviews not included in the references of the guides, in English. Review: Seven guidelines and one systematic review were found. CBCT is not recommended for routine use or as an initial imaging examination in orthodontics. The uses are mostly for particular cases, in which conventional radiography does not provide the information for a correct diagnosis and subsequent treatment. Conclusions: There is a consensus among international organizations regarding the use of CBCT in orthodontics, justifying its use only when it provides a benefit to the patient. CBCT is a reliable diagnostic tool in cases where three-dimensional evaluation is mandatory to take the most appropriate therapeutic decision. New evidence is still lacking in this area, which must consider the principles of optimization and exam justification. (AU)

Complicaciones de los pacientes con uveítis en un estudio poblacional español: proyecto UveCAM / Complications of uveitis in a Spanish population, UveCAM study

Objetivo Estimar la frecuencia poblacional de complicaciones de uveítis y evaluar sus principales factores de riesgo en los pacientes con uveítis del estudio UveCAM. Pacientes y método Desarrollo de complicaciones de los 386 pacientes con uveítis de toda el área sanitaria de la provincia de Toledo (estudio UveCAM) durante el periodo de un año. Descripción de complicaciones y estudio de los posibles determinantes mediante modelos de regresión multivariante. Resultados Se dispuso de información sobre el desarrollo de complicaciones en 371 de los 386 pacientes del estudio. El 45,8% de los pacientes presentó al menos una complicación, siendo las más frecuentes las sinequias posteriores (19,0%), la hipertensión ocular (14,0%), el edema macular (7,5%), la membrana epirretiniana (6,9%), el glaucoma (6,6%), la atrofia iridiana (5,6%) y las cataratas (5,5%). El riesgo de complicaciones aumenta con la edad, las formas intermedias y panuveítis, y las de evolución crónica o recurrente. Conclusión Las uveítis se asocian con una elevada frecuencia de complicaciones, especialmente en pacientes de edad avanzada, con localización intermedia o posterior del proceso inflamatorio y con evolución crónica o recurrente (AU)

Objective To estimate the population frequency of uveitis complications and to evaluate their main risk factors in the patients with uveitis from the UveCAM study. Patients and methods Development of complications in 386 patients with uveitis in the whole health area of the province of Toledo (UveCAM study) during a period of one year. Description of complications and study of their possible determinants by means of multivariate regression models. Results Information on the development of complications was available in 371 of the 386 patients of the UveCAM study. 45.8% of patients had at least one complication, the most frequent were posterior synechiae (19.0%), ocular hypertension (14.0%), macular oedema (7.5%), epiretinal membrane (6.9%), glaucoma (6.6%), iridian atrophy (5.6%), and atrophy (5.6%) and cataracts (5.5%). The risk of complications increases with age, intermediate and panuveitis locations, and those of chronic or recurrent evolution. Conclusion Uveitis is associated with a high frequency of complications, especially in older patients, with intermediate or posterior localization of the inflammatory process, and chronic or recurrent evolution (AU)

Complications of uveitis in a Spanish population, UveCAM study.

OBJECTIVE: To estimate the population frequency of uveitis complications and to evaluate their main risk factors in the patients with uveitis from the UVECAM study. PATIENTS AND METHODS: Development of complications in 386 patients with uveitis in the whole health area of the province of Toledo (UVECAM study) during a period of 1 year. Description of complications and study of their possible determinants by means of multivariate regression models. RESULTS: Information on the development of complications was available in 371 of the 386 patients of the UVECAM study. The most frequent complications were posterior synechiae (19.0%), ocular hypertension (14.0%), macular edema (7.5%), epirretinal membrane (6.9%), glaucoma (6.6%), iridian atrophy (5.6%) and cataract (5.5%). The risk of complications increases with age, intermediate and panuveitis locations, and those of chronic or recurrent evolution. CONCLUSION: Uveitis is associated with a high frequency of complications, especially in older patients, with intermediate or posterior localization of the inflammatory process and chronic or recurrent evolution.

Epidemiology of Uveitis in a Spanish Region: Prevalence and Etiology.

OBJECTIVE: To estimate the prevalence of uveitis and to describe its etiologic and anatomical patterns based on a population study carried out in a Spanish region. MATERIAL AND METHODS: A cross-sectional, descriptive, population-based multicenter study was conducted. The selection criteria consisted of having a diagnosis of uveitis. All data were collected from existing information in medical records.Clinical information was collected in all cases that had a diagnosis of uveitis, regardless of its etiology, in participating centers from the date of the study to the end of the following year. All patients underwent a complete ophthalmological examination, which included assessment of their visual acuity, biomicroscopy, applanation tonometry, and indirect ophthalmoscopy. RESULTS: During the study, 389 cases of uveitis were registered. The prevalence was 58.7 (95% confidence interval [CI] 53.0-64.9). The mean age was 47.0 ± 20.6 years and 57.8% were women. The most prevalent anatomical pattern was anterior uveitis (54.2; 95% CI 48.1-60.8). For adults, the idiopathic group constituted the highest prevalence (31.7; 95% CI: 27.1-36.9), while autoimmune etiology was most frequent for children (10.6; 95% CI: 5.8-17.7). CONCLUSION: The results of this population-based study offer a representative estimate of the magnitude of uveitis in this area of Spain.

Evaluation of 3-week-old layer chicks intratracheally challenged with Salmonella isolates from serogroup c1 (O:6,7) and Salmonella Enteritidis.

With the exception to Salmonella enterica serotype Typhimurium and S. Enteritidis (serogroups B [O:4] and D [O:9], respectively), there have been very few studies conducted on the respiratory tract as route of infection in chickens with salmonellas from serogroup C1 (O:6,7). Therefore, the purpose of this present study was to determine the potential organ invasion by Salmonella enterica serotype Potsdam (SP), S. Mbandaka (SM), and S. Infantis (SI) from serogroup C1 (O:6,7) and compare their characteristics with those of S. Enteritidis (SE) on intratracheally (IT) challenged 3-week-old layer chicks. A total of 360 one-day-old White Leghorn layer chicks were acquired from a commercial hatchery and randomly assigned into four treatment groups (SP, SM, SI, and SE, respectively), consisting of three independent trials. Chicks were grown up to 21 days (3 weeks) and IT-challenged thereafter with 106 CFU of respective salmonella organisms per group (n = 30). Chicks (n = 5) were humanely sacrificed every 24 h for 6 days post-IT infection and organs such as lung, heart, liver, spleen, kidney and caecal content were cultured for salmonella. All treatment groups exhibited colonization of lungs and caecal contents at 1 d (P = 0.475) and 4 d (P = 0.696) post-IT infection, respectively. There was no isolation of SP, SM, and SI in heart, liver, spleen, and kidney. In contrast, SE was obtained from heart, liver, and spleen of IT-infected chicks. The findings of this study contribute to a better understanding of the importance of the respiratory route in salmonella infection in poultry.

[Psychomotor development in late preterms at two years of age: a comparison with full-term newborn infants using two different instruments]. / Desarrollo psicomotor en prematuros tardios a los dos años de edad: comparacion con recien nacidos a termino mediante dos herramientas diferentes.

INTRODUCTION: Late preterm infants currently constitute 70% of preterm infant births. They present greater comorbidity, including neurodevelopment disorders, which may not manifest until the school age. AIM: To identify the existence of difficulties in the neurodevelopment at the age of two years. SUBJECTS AND METHODS: The psychomotor development was performed at two years of age in late preterm infants and term control group born at our center between January and September 2014, with Brunet-Lezine Revised test and Ages and Stages Questionnaires (ASQ-3) questionnaire. RESULTS: 88 children were included. Late preterm infants had lower scores in the language area and postural developmental. Girls achieved better results than males at global developmental age, oculo-motor coordination, language area and sociability. The ASQ-3 questionnaire detected differences in communication and socio-individual. Prematurity and male sex were identified as an independent risk factor to present a developmental disorder, prematurity for language impairment and male sex for younger developmental age and language impairment. The correlation between language assessment with the Brunet-Lezine Revised test and the ASQ-3 questionnaire was good, with a Pearson correlation coefficient of 0.7 (p < 0.001), showing the usefulness of the questionnaire. CONCLUSIONS: Late preterm infants have a lower developmental age in the language area at two years. Prematurity and male sex are risk factors for developmental disorder. Language assessment with the ASQ-3 questionnaire may be a useful tool to detect disorders and intervene early.

TITLE: Desarrollo psicomotor en prematuros tardios a los dos años de edad: comparacion con recien nacidos a termino mediante dos herramientas diferentes.Introduccion. Los prematuros tardios constituyen actualmente el 70% de los nacimientos prematuros. Presentan mayor comorbilidad, incluyendo las alteraciones del neurodesarrollo, que pueden no manifestarse hasta la escolarizacion. Objetivo. Identificar dificultades en el desarrollo neurologico a los dos años de edad. Sujetos y metodos. Se valoro el desarrollo psicomotor a los dos años de los prematuros tardios y del grupo control a termino nacidos en nuestro centro entre enero y septiembre del año 2014 mediante la escala de Brunet-Lezine revisada y el cuestionario de edades y etapas para la deteccion de trastornos del neurodesarrollo Ages and Stages Questionnaires (ASQ-3). Resultados. Se incluyo a 88 niños. Los prematuros tardios presentaron puntuaciones inferiores en el lenguaje y el desarrollo postural. Las niñas obtuvieron resultados superiores en la edad de desarrollo global, la coordinacion oculomotriz, el lenguaje y la sociabilidad. El cuestionario ASQ-3 detecto las diferencias en comunicacion y socioindividuales. Se identificaron como factores de riesgo para presentar alteracion del desarrollo la prematuridad, para alteracion del lenguaje, y el sexo masculino, para menor edad de desarrollo y alteracion del lenguaje. La correlacion entre la valoracion del lenguaje con la escala de Brunet-Lezine revisada y el cuestionario ASQ-3 fue buena, con un coeficiente de correlacion de Pearson de 0,7 (p < 0,001), lo que muestra la utilidad del cuestionario. Conclusiones. Los prematuros tardios presentan menor desarrollo del lenguaje a los dos años. La prematuridad y el sexo masculino son factores de riesgo para presentar alteracion. La valoracion del lenguaje con el cuestionario ASQ-3 puede ser util para detectar alteraciones.

[De novo sporadic mutation in the KCND3 gene in a patient with early onset chronic ataxia]. / Mutacion puntual de novo en el gen KCND3 en un paciente con ataxia cronica de inicio precoz.

TITLE: Mutacion puntual de novo en el gen KCND3 en un paciente con ataxia cronica de inicio precoz.

[Restless legs syndrome in patients diagnosed with attention deficit hyperactivity disorder]. / Sindrome de piernas inquietas en pacientes diagnosticados de trastorno por deficit de atencion/hiperactividad.

INTRODUCTION: Restless legs syndrome (RLS) is a common neurological disease. RLS has been linked to various psychiatric disorders, especially with attention deficit hyperactivity disorder (ADHD). AIMS: The main objective was to describe the frequency of RLS in pediatric patients diagnosed with ADHD. Secondary objectives of the study were describe other sleep disorders in ADHD patients. PATIENTS AND METHODS: A multicentre prospective study was conducted in nine Spanish centers. We included children aged 6-18 years diagnosed with ADHD between January and June 2015. Data were collected by 13 researchers doctors through an interview with the parent/caregiver and with the child. To assess the degree of functioning of patients with ADHD we used the Children's Global Assessment Scale. The Sleep Disturbance Scale for Children was applied to screening sleep disorders in childhood. RESULTS: A sample of 73 patients was collected. Five patients (6.8%) met diagnostic criteria for RLS: four of them definitive and one probable. CONCLUSIONS: RLS is a frequent condition in adulthood but also in adolescence and childhood. ADHD patients have an increased risk of an RLS.

TITLE: Sindrome de piernas inquietas en pacientes diagnosticados de trastorno por deficit de atencion/hiperactividad.Introduccion. El sindrome de piernas inquietas (SPI) es una patologia neurologica comun. Se ha relacionado con diferentes trastornos psiquiatricos, especialmente con el trastorno por deficit de atencion/hiperactividad (TDAH). Objetivos. El objetivo principal fue describir la frecuencia del SPI en pacientes pediatricos diagnosticados de TDAH. Los objetivos secundarios del estudio fueron describir otros trastornos del sueño en pacientes con TDAH. Pacientes y metodos. Se realizo un estudio descriptivo prospectivo multicentrico en nueve centros españoles de niños de 6-18 años con diagnostico de TDAH entre enero y junio de 2015. Los datos fueron recogidos por 13 medicos investigadores mediante entrevista con el padre/cuidador y con el menor. Para valorar el grado de funcionamiento de los pacientes con TDAH se utilizo la Children's Global Assessment Scale. Se aplico la Sleep Disturbance Scale for Children de Bruni para el cribado del trastorno de sueño de la infancia. Resultados. Se recogio una muestra de 73 pacientes. Cinco pacientes (6,8%) cumplen criterios diagnosticos de SPI: cuatro de ellos definitivos y uno probable. Conclusiones. El SPI es una entidad frecuente en la edad adulta, pero tambien en la adolescencia y en la infancia. Los pacientes con TDAH tienen un riesgo aumentado de presentar de manera concomitante un SPI.

Trasplante autólogo de limbo como nuevo tratamiento de la distrofia corneal epitelial de Lisch / Keratolimbal autograft transplantation as a possible new treatment of Lisch epithelial corneal dystrophy

CASO CLÍNICO: Presentamos el caso de una mujer de 64 años con agudeza visual de 20/40 en su ojo derecho, debida a una opacificación grisácea y plumosa con microquistes en el epitelio corneal, compatible con una distrofia epitelial de Lisch. Se trató secuencialmente con varios desbridamientos epiteliales, lente de contacto y mitomicina C, a pesar de los cuales, recidivaba. La extirpación de un sector limbar y el trasplante de limbo autólogo obtuvieron buenos resultados y sin recurrencia. CONCLUSIÓN: El trasplante autólogo de limbo tras extirpar la zona de limbo afectado puede ser considerado como una nueva opción terapéutica en el tratamiento de la distrofia epitelial de Lisch asimétrica, cuando otros tratamientos han fallado

CASE REPORT: The case concerns 64-year-old woman with visual acuity of 20/40 in the right eye. Slit-lamp examination revealed a grey, feathery corneal opacification with intraepithelial microcysts compatible with Lisch epithelial corneal dystrophy (LECD). It was treated with epithelial debridements, contact lenses and mitomycin C, but the opacification recurred within months. The removal of limbus sector and autologous limbal transplantation (KLAT) were used successfully without recurrence. Conclusions: After removal of damaged limbus, KLAT should be considered as a treatment option for asymmetric LECD when other treatments have failed

Keratolimbal autograft transplantation as a possible new treatment of Lisch epithelial corneal dystrophy. / Trasplante autólogo de limbo como nuevo tratamiento de la distrofia corneal epitelial de Lisch.

CASE REPORT: The case concerns 64-year-old woman with visual acuity of 20/40 in the right eye. Slit-lamp examination revealed a grey, feathery corneal opacification with intraepithelial microcysts compatible with Lisch epithelial corneal dystrophy (LECD). It was treated with epithelial debridements, contact lenses and mitomycin C, but the opacification recurred within months. The removal of limbus sector and autologous limbal transplantation (KLAT) were used successfully without recurrence. CONCLUSIONS: After removal of damaged limbus, KLAT should be considered as a treatment option for asymmetric LECD when other treatments have failed.

Efusión uveal inducido por escitalopram / Uveal effusion induced by escitalopram

CASO CLÍNICO: Mujer de 73 años en tratamiento con escitalopram que presentó glaucoma agudo de ángulo cerrado secundario a efusión uveal tras duplicar la dosis de dicho fármaco 3 días antes. Evolucionó favorablemente tras la suspensión del antidepresivo además de tratamiento hipotensor tópico y prednisona vía oral. DISCUSIÓN: La efusión uveal secundaria a fármacos es un síndrome infrecuente. Se puede acompañar de miopización y glaucoma agudo por cierre angular. El diagnóstico correcto y la suspensión del fármaco conducen a la resolución de esta nosología

CASE REPORT: A 73 year-old woman with depression treated with escitalopram developed acute secondary angle closure glaucoma related to uveal effusion after duplicating the drug dose 3 days before. She evolved favorably once the antidepressant treatment was suspended and a new treatment with topical hypotensive therapy and oral prednisone was used. DISCUSSION: The uveal effusion syndrome associated to medicines is rare; it may be associated with acute myopic shift and acute angle closure glaucoma. The correct diagnosis and discontinuation of the drug lead to the resolution of this nosology

Substituent and solvent effects on the UV-vis absorption spectrum of the photoactive yellow protein chromophore.

Solvent effects on the UV-vis absorption spectra and molecular properties of four models of the photoactive yellow protein (PYP) chromophore have been studied with ASEP/MD, a sequential quantum mechanics/molecular mechanics method. The anionic trans-p-coumaric acid (pCA(-)), thioacid (pCTA(-)), methyl ester (pCMe(-)), and methyl thioester (pCTMe(-)) derivatives have been studied in gas phase and in water solution. We analyze the modifications introduced by the substitution of sulfur by oxygen atoms and hydrogen by methyl in the coumaryl tail. We have found some differences in the absorption spectra of oxy and thio derivatives that could shed light on the different photoisomerization paths followed by these compounds. In solution, the spectrum substantially changes with respect to that obtained in the gas phase. The n → π1* state is destabilized by a polar solvent like water, and it becomes the third excited state in solution displaying an important blue shift. Now, the π → π1* and π → π2* states mix, and we find contributions from both transitions in S1 and S2. The presence of the sulfur atom modulates the solvent effect and the first two excited states become practically degenerate for pCA(-) and pCMe(-) but moderately well-separated for pCTA(-) and pCTMe(-).

[Uveal effusion induced by escitalopram]. / Efusión uveal inducido por escitalopram.

CASE REPORT: A 73 year-old woman with depression treated with escitalopram developed acute secondary angle closure glaucoma related to uveal effusion after duplicating the drug dose 3 days before. She evolved favorably once the antidepressant treatment was suspended and a new treatment with topical hypotensive therapy and oral prednisone was used. DISCUSSION: The uveal effusion syndrome associated to medicines is rare; it may be associated with acute myopic shift and acute angle closure glaucoma. The correct diagnosis and discontinuation of the drug lead to the resolution of this nosology.

A case-control study of post-operative endophthalmitis diagnosed at a Spanish hospital over a 13-year-period.

A retrospective case-control study of patients who had undergone cataract extraction at a Spanish hospital over a 13-year period was conducted to identify the risk factors for developing post-operative endophthalmitis (POE). During the study period, the type of antibiotic prophylaxis was changed from subconjunctival gentamicin to the addition of both vancomycin and gentamicin to the irrigating solution. The overall incidence of POE was 0·19% (35 cases/18 287 operations). For the period prior to the change in antibiotic prophylaxis, the incidence rate of POE was 3·4 cases/1000 operations while in the latter period the incidence rate decreased to 0·34 cases/1000 operations. All patients who presented a virulent microorganism had a final visual acuity worse than 20/200. The only significant risk factor identified was the type of prophylaxis used (odds ratio 1·97, 95% confidence interval 0·94-4·14, P = 0·07). There were no significant differences between cases and controls although choice of surgeon approached significance.

Ambliopía secundaria a quiste de iris / Amblyopia secondary to iris cyst

CASO CLÍNICO: Varón de 5 años de edad con ambliopía anisometrópica meridional secundaria a quiste de epitelio pigmentario de iris. Es evaluado mediante biomicroscopia ultrasónica (BMU) y tomografía de coherencia óptica de polo anterior (OCT Visante). DISCUSIÓN: La OCT de polo anterior, aunque con limitaciones, es una herramienta útil en la evaluación de lesiones de polo anterior. Puede ser preferible, en la infancia, a la BMU

CLINICAL CASE: A 5 year-old child diagnosed with moderate anisometropic amblyopia secondary to primary cyst of iris pigment epithelium. He was evaluated with ultrasound biomicroscopy (BMU) and optical coherence tomography (OCT) of anterior segment. DISCUSSION: The OCT, although with some limitations, is a useful tool to study the anterior segment. It is probably more recommendable than BMU in the childhood (AU)

Macroadenoma del epitelio no pigmentado del cuerpo ciliar / Macroadenoma of the non-pigmented ciliary epithelium

CASO CLÍNICO: Se describen los hallazgos clínicos y la cirugía conservadora de un paciente con un adenoma no pigmentado del cuerpo ciliar. El adenoma presentaba un tamaño de 5 × 7 mm. El paciente fue intervenido con una cirugía conservadora mediante iridociclectomía parcial asociada a esclerouvectomía lamelar. DISCUSIÓN: Los adenomas del cuerpo ciliar clínicamente pueden imitar a los melanomas amelanóticos. La cirugía conservadora del globo ocular permite realizar un diagnóstico y un tratamiento del paciente manteniendo la función visual

CASE REPORT: We report the clinical features and surgery of a patient with an adenoma of the non-pigmented ciliary epithelium. The adenoma measured 5 × 7 mm. The patient underwent radical ocular surgery consisting of partial iridocyclectomy associated to lamellar sclerouvectomy. DISCUSSION: Adenomas of ciliary body can mimic clinically amelanotic melanomas. We present details of the patient's medical records and review the literature. Clinically, adenoma in ciliary body can mimic amelanotic melanomas. Conservative surgery of the eye allows diagnosis and treatment, maintaining visual function

[Microbiological study of infectious endophthalmitis with positive culture within a 13 year-period]. / Estudio microbiológico de los casos de endoftalmitis infecciosa con cultivo positivo en un periodo de 13 años.

INTRODUCTION: Our objectives are to describe the microbial spectrum and antimicrobial susceptibility of isolates from patients with culture-proven endophthalmitis. MATERIAL AND METHODS: Retrospective study of patients with microbiological diagnosis of endophthalmitis treated at the Ophthalmology Department of the General Hospital La Mancha Centro in the period 1996-2008. The identification of isolates was performed using the automated VITEK-2® and Api galleries (bioMérieux, Spain SA). The antimicrobial susceptibility was performed by the VITEK-2® system (bioMérieux, Spain SA), E-test strips (MIC Test Strip, Liofilchem, Italy) and Sensititre® YeastOne trading system (Trek Diagnostic Systems, Ohio, USA) for Candida species. RESULTS: Forty four (70%) of 63 cases of endophthalmitis were culture positive. Gram-positive bacteria were much more common than gram-negative bacteria in both postoperative endophthalmitis (POE) and post-traumatic endophthalmitis (PTE). Staphylococcus epidermidis was predominant in POE, while Bacillus sp. predominated in the PTE; furthermore, the 75% of total fungal isolates corresponded to postraumatic cases. The isolated strains showed 100% susceptibility to vancomycin, ceftazidime and amikacin, while resistance to ciprofloxacin was greater than 15%. The empirical antifungal therapy failed in 50% of cases. The visual prognosis was significantly less favorable in the PTE. CONCLUSIONS: Based on the susceptibility of our isolates, vancomycin, ceftazidime and amikacin are good choices for empirical treatment of endophthalmitis, unlike ciprofloxacin. We recommend conducting antifungal prophylaxis after penetrating ocular trauma in a rural environment.

[Macroadenoma of the non-pigmented ciliary epithelium]. / Macroadenoma del epitelio no pigmentado del cuerpo ciliar.

CASE REPORT: We report the clinical features and surgery of a patient with an adenoma of the non-pigmented ciliary epithelium. The adenoma measured 5 × 7 mm. The patient underwent radical ocular surgery consisting of partial iridocyclectomy associated to lamellar sclerouvectomy. DISCUSSION: Adenomas of ciliary body can mimic clinically amelanotic melanomas. We present details of the patient's medical records and review the literature. Clinically, adenoma in ciliary body can mimic amelanotic melanomas. Conservative surgery of the eye allows diagnosis and treatment, maintaining visual function.

Amblyopia secondary to iris cyst.

CLINICAL CASE: A 5 year-old child diagnosed with moderate anisometropic amblyopia secondary to primary cyst of iris pigment epithelium. He was evaluated with ultrasound biomicroscopy (BMU) and optical coherence tomography (OCT) of anterior segment. DISCUSSION: The OCT, although with some limitations, is a useful tool to study the anterior segment. It is probably more recommendable than BMU in the childhood.

Toxicidad corneal por amantadina / Corneal toxicity due to amantadine

Caso clínico: Mujer de 64 años en tratamiento con amantadina durante 2 años por enfermedad de Parkinson, que presentó edema corneal bilateral de inicio brusco. Inicialmente se trató como una endotelitis herpética sin mejoría, al desconocer la medicación empleada por la enferma. Finalmente el edema se resolvió tras la suspensión del fármaco. Discusión: El hidrocloruro de amantadina puede producir disfunción endotelial. El edema corneal puede ser reversible tras su suspensión, pero la densidad endotelial permanece baja. Sería necesario realizar un control oftalmológico previo al inicio del tratamiento para valorar el riesgo/beneficio del mismo, sobre todo en los pacientes que presenten baja densidad endotelial o un endotelio alterado (AU)

Case report: A 64 year-old female with Parkinson disease treated with amantadine for two years who suddenly suffered bilateral corneal oedema. It was initially treated as herpetic endotheliitis without improvement as we lacked information on her chronic treatment. The corneal oedema finally resolved after withdrawing the drug. Discussion: Amantadine hydrochloride may produce endothelial dysfunction. Once the amantadine treatment is stopped, the corneal oedema may be reversible but endothelial density remains low. An ophthalmologist examination should be performed before the initiation of amantadine treatment in order to establish a risk: benefit ratio, especially in those patients with low endothelial density or any endothelial anomaly (AU)