Bilateral neurosensory retinal detachment secondary to tadalafil treatment.

A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.

Desprendimiento neurosensorial retiniano bilateral secundario a tratamiento con tadalafilo / Bilateral neurosensory retinal detachment secondary to tadalafil treatment

Se presenta el caso de un varón de 53 años con desprendimiento retiniano neurosensorial (DNS) bilateral asintomático detectado en una revisión rutinaria. No se encontraron patologías sistémicas subyacentes, salvo hipertensión arterial controlada. En la anamnesis dirigida, el paciente reveló ingesta de tadalafilo, un inhibidor de la fosfodiesterasa 5 (IPDE5) utilizado en el tratamiento de la disfunción eréctil. Tras la retirada del fármaco, se observó una reabsorción del fluido subretiniano con persistencia de alteraciones crónicas y campimétricas en la tomografía de coherencia óptica (OCT). Los IPDE5 presentan efectos secundarios oculares entre los que se ha descrito el desprendimiento seroso retiniano. Aunque no se ha podido comprobar la relación causal directa, la inhibición de la fosfodiesterasa 5 (PDE5) a nivel coriorretiniano produce vasodilatación, aumento de la presión hidrostática coroidea y exudación al espacio subretiniano. En casos de DNS, es fundamental una historia farmacoterapéutica completa. Se debería advertir de los posibles efectos secundarios oculares de los IPDE5 a los pacientes usuarios de este tipo de fármacos (AU)

A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects (AU)

Escleritis nodular anterior idiopática. Hallazgos biomicroscópicos y tomográficos / Idiopathic nodular anterior scleritis. Biomicroscopic and tomographic findings

Varón de 65 años, sin antecedentes patológicos, que presenta nódulo escleral nasal hiperémico doloroso sugestivo de escleritis anterior nodular, sin otros hallazgos

Carcinoma epidermoide conjuntival de gran tamaño. Papel del tratamiento coadyuvante con interferón alfa-2b / Large-sized squamous carcinoma of the conjunctiva. Role of coadjuvant treatment with interferon alfa-2b

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Hipertensión craneal, silla turca vacía primaria y papiledema / Intracraneal hypertension, primary empty sella and papilloedema

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Membrana glial epipapilar bilateral en la papila de Bergmeister. Hallazgos tomográficos / Bilateral epipapillary glial membrane in Bergmeister's papilla. Tomographic findings

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Metástasis coroidea de adenocarcinoma pulmonar estudiada mediante angiografía por tomografía de coherencia óptica / Lung adenocarcinoma choroidal metastasis studied by optical coherence tomography angiography

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Macroaneurisma arterial retiniano: estudio mediante tomografía de coherencia óptica y retinografía / Retinal arterial macroaneurysm: A study using optical coherence tomography and retinography

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Síndrome de contracción capsular en retinitis pigmentosa: estudio mediante tomografía de coherencia óptica de segmento anterior / Capsule contraction syndrome in retinitis pigmentosa: Study using anterior segment optical coherence tomography

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Maculopatía bilateral por exposición a puntero láser: hallazgos en la angiografía mediante tomografía de coherencia óptica / Bilateral maculopathy after exposure to a laser pointer: Optical coherence tomography angiography findings

CASO CLÍNICO: Varón de 36 años consulta tras exposición bilateral a puntero láser el día anterior. En funduscopia se evidenciaron alteraciones pigmentarias maculares dispersas y en tomografía de coherencia óptica, desestructuración de las capas retinianas. La agudeza visual fue de contaje de dedos en ambos ojos. Nueve meses después se evidenció en la angiografía mediante tomografía de coherencia óptica una alteración del flujo vascular coriocapilar en la zona lesionada por el láser. Discusión: El láser afecta principalmente al epitelio pigmentario retiniano. Sin embargo, con este caso ponemos de manifiesto la posible afectación más allá del epitelio pigmentario retiniano, apareciendo alteración vascular coriocapilar tras la exposición a puntero láser

CASE REPORT: A 36-year-old man went to the emergency department the day after exposure to a laser pointer. Funduscopy revealed dispersed macular pigment alterations, and optical coherence tomography showed a disruption of the retinal layers. The visual acuity was counting fingers in both eyes. Nine months later, optical coherence tomography angiography showed a rarefaction in the choriocapillaris vascular flow in the area of the laser injuries. DISCUSSION: The retinal layer mainly damaged by the laser injury was the retinal pigment epithelium. However, it is suggested that the laser injury could involve tissues beyond the retinal pigment epithelium, since a rarefaction of the choriocapillaris was found after exposure to the laser

Macroaneurisma arterial retiniano e hipertensión: importancia del manejo multidisciplinar / Retinal arterial macroaneurysm and hypertension: Importance of the multidisciplinary approach

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Osteoma de coroides con excavación coroidea y membrana neovascular asociada: estudio mediante angiografía-TCO / Choroidal osteoma with choroidal excavation and associated neovascular membrane: An OCT-angiography study

CASO CLÍNICO: Presentamos un caso de osteoma de coroides unilateral con excavación coroidea y membrana neovascular asociada estudiado mediante angiografía-TCO. En TCO y angiografía-TCO se objetivó excavación coroidea y una membrana neovascular coroidea activa. Se administraron tres dosis de aflibercept estabilizando la neovascularización coroidea. DISCUSIÓN: La angiografía-TCO permitió el análisis morfológico de la red vascular superficial del osteoma así como el control evolutivo de la membrana neovascular

CLINICAL CASE: A case is presented of a unilateral choroidal osteoma with choroidal excavation and associated neovascular membrane that was studied using OCT-angiography. The OCT and OCT-angiography revealed an area of choroidal excavation and an active neovascular membrane. Three doses of aflibercept were administered to the patient, which stabilised the neovascularisation. DISCUSSION: OCT-angiography was used to analyse the morphology of the superficial vascular network of the osteoma, as well as to monitor the evolution of the neovascular membrane

Bilateral maculopathy after exposure to a laser pointer: Optical coherence tomography angiography findings. / Maculopatía bilateral por exposición a puntero láser: hallazgos en la angiografía mediante tomografía de coherencia óptica.

CASE REPORT: A 36-year-old man went to the emergency department the day after exposure to a laser pointer. Funduscopy revealed dispersed macular pigment alterations, and optical coherence tomography showed a disruption of the retinal layers. The visual acuity was counting fingers in both eyes. Nine months later, optical coherence tomography angiography showed a rarefaction in the choriocapillaris vascular flow in the area of the laser injuries. DISCUSSION: The retinal layer mainly damaged by the laser injury was the retinal pigment epithelium. However, it is suggested that the laser injury could involve tissues beyond the retinal pigment epithelium, since a rarefaction of the choriocapillaris was found after exposure to the laser.