Pérdida visual aguda en el embarazo causada por craneofaringioma / Acute visual loss in pregnancy caused by craniopharyngioma

CASO CLÍNICO: Gestante de 38 años, acude a urgencias por déficit visual agudo y afectación campimétrica. Las pruebas de neuroimagen ponen de manifiesto una tumoración compatible con craneofaringioma. Se realiza la resección quirúrgica mejorando la función visual y continuando su embarazo normalmente. DISCUSIÓN: Es conocido que los adenomas hipofisarios pueden crecer en el embarazo, sin embargo este hecho es inusual en los craneofaringiomas. Estos suelen manifestarse con clínica visual dada su topografía supraselar. El tratamiento de elección es quirúrgico, dependiendo el pronóstico fundamentalmente de su resección completa

CASE REPORT: A 38-year-old female, at 20-weeks gestation, experienced a sudden visual loss and visual-field abnormalities. The neuroimaging tests showed a craniopharyngioma. Surgical removal was performed with a successful outcome as regards the pregnancy and visual function. DISCUSSION: It is known that pituitary adenomas may grow during pregnancy; however this is unusual in craniopharyngiomas. They usually present with visual problems due to their suprasellar topography. Surgery is the treatment of choice, the outcome essentially depending on its complete resection

[Acute visual loss in pregnancy caused by craniopharyngioma]. / Pérdida visual aguda en el embarazo causada por craneofaringioma.

CASE REPORT: A 38-year-old female, at 20-weeks gestation, experienced a sudden visual loss and visual-field abnormalities. The neuroimaging tests showed a craniopharyngioma. Surgical removal was performed with a successful outcome as regards the pregnancy and visual function. DISCUSSION: It is known that pituitary adenomas may grow during pregnancy; however this is unusual in craniopharyngiomas. They usually present with visual problems due to their suprasellar topography. Surgery is the treatment of choice, the outcome essentially depending on its complete resection.

Subclinical keratoconus and inflammatory molecules from tears.

BACKGROUND/AIMS: Tissue degradation in corneal thinning disorders, such as keratoconus (KC), involves the expression of inflammatory mediators. The purpose of this study was to determine the levels of proinflammatory cytokines and matrix metalloproteinase 9 (MMP-9) in tears from both eyes of unilateral keratoconus (KC) patients. METHODS: Thirty patients diagnosed as having asymmetrical KC (30 KC eyes, and 30 subclinical KC eyes) and 20 normal control subjects (one eye) were studied in a prospective, cross-sectional study. Keratoconus screening programmes were performed on these participants. Ten microlitres of tears was collected from each eye. The concentrations of cytokines (interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-alpha)) and MMP-9 were measured by ELISA. RESULTS: Mean values for IL-6 levels were similar in KC and subclinical KC samples (5.5 (4.9 to 6.9) vs 5.7 (4.5 to 6.2) pg/ml, p = 0.131), but significantly higher in relation to the control group (2.2 (1.0 to 4.1) pg/ml, p<0.0001). Significant differences were found in TNF-alpha levels between KC and subclinical KC eyes (5.4 (4.1 to 6.8) vs 4.8 (4.2 to 6.0) pg/ml, p = 0.032) and control group (1.8 (1.5 to 2.3) pg/ml, p<0.0001). Increased values of MMP-9 were found in KC (59.4 (50.6 to 66.1) ng/ml) vs subclinical KC eye (7.0 (4.8 to 8.6) ng/ml) (p<0.0001). MMP-9 levels in the control group (6.1 (3.9 to 8.3) ng/ml) and subclinical KC were similar (p = 0.203). CONCLUSIONS: IL-6 and TNF-alpha are overexpressed in the tears of subclinical and KC eyes. Increased MMP-9 levels were found only in the KC eye. These results indicate that the pathogenesis of KC may involve chronic inflammatory events.

Histopathological and ultrasound biomicroscopy findings in a case of irreversible mydriasis after keratoplasty in keratoconus.

This report describes the histopathological and ultrasound biomicroscopy findings of a 35-year-old woman with keratoconus who developed an irreversible mydriasis after keratoplasty.