Maculopatía solar bilateral en un paciente con trastorno bipolar / Bilateral solar maculopathy in a patient with bipolar disorder

Se describe el caso clínico de un varón de 36 años, con antecedentes de trastorno bipolar, que fue diagnosticado de maculopatía solar en ambos ojos (AO). El paciente refería visión directa del sol, mantenida y en múltiples ocasiones, coincidiendo con descompensación del trastorno bipolar. En la exploración oftalmológica completa presentaba una agudeza visual de 0,3 en AO, con presión intraocular y biomicroscopia normales. En el fondo de ojo se objetivó un halo perimacular con pérdida del reflejo foveolar en AO. En la tomografía de coherencia óptica macular se halló una disrupción de la línea de elipsoides y del epitelio pigmentario de la retina de AO y en la campimetría visual defectos centrales en AO. Tras 6 meses de seguimiento, la clínica visual continúa estable con el mismo grado de agudeza visual. La maculopatía solar es una afectación debida a los efectos fototóxicos de la radiación por exposición directa al sol que cursa con disminución de la agudeza visual, siendo característica en la tomografía de coherencia óptica la disrupción en la capa de fotorreceptores (AU)

A case of solar maculopathy is described in a 36-year-old man with a history of bipolar disorder. The patient reported directly looking at the sun for several hours in the setting of a bipolar disorder decompensation. The visual acuity was 0.3 in both eyes (BE). Intraocular pressure and anterior segment were normal. In the fundus exam, a peri-macular halo with loss of the foveolar reflex was observed in BE. The macular optical coherence tomography revealed a disruption of the ellipsoid line and the retinal pigment epithelium. Bilateral central defects were seen in the Humphrey 24-2 visual field. After 6 months of follow-up, the visual clinical picture remains stable with the same degree of visual acuity. Solar maculopathy is a disorder due to the phototoxic effects of radiation, which cause a decrease in visual acuity by disrupting the retinal photoreceptor layer (AU)

Bilateral solar maculopathy in a patient with bipolar disorder.

A case of solar maculopathy is described in a 36-year-old man with a history of bipolar disorder. The patient reported directly looking at the sun for several hours in the setting of a bipolar disorder decompensation. The visual acuity was 0.3 in both eyes (BE). Intraocular pressure and anterior segment were normal. In the fundus exam, a peri-macular halo with loss of the foveolar reflex was observed in BE. The macular optical coherence tomography revealed a disruption of the ellipsoid line and the retinal pigment epithelium. Bilateral central defects were seen in the Humphrey 24-2 visual field. After 6 months of follow-up, the visual clinical picture remains stable with the same degree of visual acuity. Solar maculopathy is a disorder due to the phototoxic effects of radiation, which cause a decrease in visual acuity by disrupting the retinal photoreceptor layer.

Manifestaciones oftalmológicas del SARS-CoV-2: Revisión de la literatura / Ocular manifestations of SARS-CoV-2: Literature review

En esta revisión resumimos las principales publicaciones que informan sobre las potenciales manifestaciones oculares de la enfermedad por el nuevo coronavirus (COVID-19). La evidencia científica se basa en cartas al editor, casos clínicos aislados y series de casos, principalmente de corte transversal. Hasta la fecha, incluimos la conjuntivitis viral, una conjuntivitis inmunomediada y parálisis oculomotoras (POM). Se discute la posibilidad de retinopatía. La conjuntivitis viral puede aparecer aislada o asociada al cuadro sistémico, principalmente pulmonar, antes o después del inicio de los síntomas respiratorios. Puede ser tanto unilateral como bilateral, es típica la presencia de folículos, y presenta una duración variable entre 5 y 20 días. La conjuntivitis inmunomediada consiste en un enrojecimiento ocular acompañada de eritrodermia y febrícula. Aparece más frecuentemente en los niños y se ha asociado a un cuadro «Kawasaki-like» y síndrome del shock tóxico. Las POM pueden presentarse de forma aislada, o formando parte de un síndrome de Miller-Fisher, junto con ataxia e hiporreflexia. Los oftalmólogos presentamos un riesgo considerable de contraer la COVID-19 debido a un contacto estrecho con el paciente, exposición a las lágrimas y a las secreciones oculares y al uso de multitud de equipos y aparatos susceptibles de contaminarse

In this review, a summary is presented of the main reports regarding the potential ocular manifestations of the new coronavirus disease (COVID-19). Scientific evidence is based on letters to the editor, clinical cases and case series, cross-sectional, and a few longitudinal studies. To date, it includes viral conjunctivitis, immune conjunctivitis, and oculomotor palsies (OCP) due to the novel coronavirus. Retinopathy is discussed. A viral conjunctivitis outbreak can be isolated or associated with the systemic picture, mainly pulmonary, before or after the onset of respiratory symptoms. It can be both unilateral and bilateral, follicles are typical, and duration is variable between 5 and 21 days. Immune-mediated conjunctivitis consists of eye redness, together with erythroderma and fever. It appears more frequently in children, and has been associated with a «Kawasaki-like» disease and toxic shock syndrome. OCP can present on its own, or as part of Miller-Fisher syndrome, along with ataxia, and hyporeflexia. Ophthalmologists have a considerable risk of developing COVID-19 due to close contact with the patient, exposure to tears and eye secretions, and the use of various pieces of equipment and devices susceptible to contamination

Ocular manifestations of SARS-CoV-2: Literature review. / Manifestaciones oftalmológicas del SARS-CoV-2: Revisión de la literatura.

In this review, a summary is presented of the main reports regarding the potential ocular manifestations of the new coronavirus disease (COVID-19). Scientific evidence is based on letters to the editor, clinical cases and case series, cross-sectional, and a few longitudinal studies. To date, it includes viral conjunctivitis, immune conjunctivitis, and oculomotor palsies (OCP) due to the novel coronavirus. Retinopathy is discussed. A viral conjunctivitis outbreak can be isolated or associated with the systemic picture, mainly pulmonary, before or after the onset of respiratory symptoms. It can be both unilateral and bilateral, follicles are typical, and duration is variable between 5 and 21 days. Immune-mediated conjunctivitis consists of eye redness, together with erythroderma and fever. It appears more frequently in children, and has been associated with a «Kawasaki-like¼ disease and toxic shock syndrome. OCP can present on its own, or as part of Miller-Fisher syndrome, along with ataxia, and hyporeflexia. Ophthalmologists have a considerable risk of developing COVID-19 due to close contact with the patient, exposure to tears and eye secretions, and the use of various pieces of equipment and devices susceptible to contamination.

Bilateral solar maculopathy in a patient with bipolar disorder. / Maculopatía solar bilateral en un paciente con trastorno bipolar.

A case of solar maculopathy is described in a 36-year-old man with a history of bipolar disorder. The patient reported directly looking at the sun for several hours in the setting of a bipolar disorder decompensation. The visual acuity was 0.3 in both eyes (BE). Intraocular pressure and anterior segment were normal. In the fundus exam, a peri-macular halo with loss of the foveolar reflex was observed in BE. The macular optical coherence tomography revealed a disruption of the ellipsoid line and the retinal pigment epithelium. Bilateral central defects were seen in the Humphrey 24-2 visual field. After 6 months of follow-up, the visual clinical picture remains stable with the same degree of visual acuity. Solar maculopathy is a disorder due to the phototoxic effects of radiation, which cause a decrease in visual acuity by disrupting the retinal photoreceptor layer.