Acute retinal pigment epitheliitis (ARPE). A case report.

A 35-year-old woman arrived in the emergency department due to loss of vision in the left eye. She had a subfoveal yellowish-looking lesion that, on optical coherence tomography (OCT), corresponded to a hyper-reflective lesion from the external nuclear layer to the retinal pigment epithelium. The lesion was reabsorbed at 6 weeks, leaving a discontinuity in the photoreceptor and retinal pigment epithelium lines. The patient was diagnosed with acute retinal pigmentary epitheliitis (ARPE). ARPE is a self-limiting disease with a good prognosis. Emphasis is placed on the importance of a correct diagnosis using funduscopy, OCT, and fluorescent angiography, in order to avoid unnecessary treatments.

Epitelitis pigmentaria retiniana aguda (EPRA). A propósito de un caso / Acute retinal pigment epitheliitis (ARPE). A case report

Mujer de 35 años de edad que acudió a urgencias por pérdida de visión en ojo izquierdo. Presentaba una lesión de aspecto amarillento subfoveal que, en la tomografía de coherencia óptica (OCT), se correspondía con una lesión hiperreflectiva desde la capa nuclear externa hasta el epitelio pigmentario de la retina. La lesión se reabsorbió a las 6 semanas dejando una discontinuidad en la línea de los fotorreceptores y del epitelio pigmentario de la retina. La paciente fue diagnosticada de epitelitis pigmentaria retiniana aguda (EPRA). Debido a que la EPRA es una enfermedad autolimitada en el tiempo y de buen pronóstico, queremos recalcar la importancia del diagnóstico correcto mediante la funduscopia, OCT y angiofluoresceingrafía para evitar tratamientos innecesarios (AU)

A 35-year-old woman arrived in the emergency department due to loss of vision in the left eye. She had a subfoveal yellowish-looking lesion that, on optical coherence tomography (OCT), corresponded to a hyper-reflective lesion from the external nuclear layer to the retinal pigment epithelium. The lesion was reabsorbed at 6 weeks, leaving a discontinuity in the photoreceptor and retinal pigment epithelium lines. The patient was diagnosed with acute retinal pigmentary epitheliitis (ARPE). ARPE is a self-limiting disease with a good prognosis. Emphasis is placed on the importance of a correct diagnosis using funduscopy, OCT, and fluorescent angiography, in order to avoid unnecessary treatments (AU)

Acute retinal pigment epitheliitis (ARPE). A case report. / Epitelitis pigmentaria retiniana aguda (EPRA). A propósito de un caso.

A 35-year-old woman arrived in the emergency department due to loss of vision in the left eye. She had a subfoveal yellowish-looking lesion that, on optical coherence tomography (OCT), corresponded to a hyper-reflective lesion from the external nuclear layer to the retinal pigment epithelium. The lesion was reabsorbed at 6 weeks, leaving a discontinuity in the photoreceptor and retinal pigment epithelium lines. The patient was diagnosed with acute retinal pigmentary epitheliitis (ARPE). ARPE is a self-limiting disease with a good prognosis. Emphasis is placed on the importance of a correct diagnosis using funduscopy, OCT, and fluorescent angiography, in order to avoid unnecessary treatments.

Sclerochoroidal calcification as casual finding. / Calcificaciones esclerocoroideas como hallazgo casual.

Sclerochoroidal calcification (SCC) is uncommon and benign. It is usually detected in a routine examination, finding multiple yellow-white lesions in the upper temporal region of the retina in middle-aged and elderly men. A case report is presented of a 79 year-old male patient, who during a routine examination with a pseudoexfoliative glaucoma in the right eye, as well as raised white-yellow subretinal lesions in the upper temporal region in both eyes. After establishing hypotensive treatment and performing autofluorescence, optical coherence tomography (OCT), ultrasound, ocular computed tomography (CT) and complete laboratory analysis, idiopathic SCC was diagnosed. SCC requires a complete ophthalmological and systemic study as it can be associated with endocrine disease. Periodic follow-up is also recommended, as well as to rule out possible complications, such as atrophy of the overlying pigment epithelium, serous detachment, or the appearance of neovascularization. The differential diagnosis should be made of benign and malignant lesions, in order to avoid unnecessary treatment.

Múltiples desprendimientos de epitelio pigmentario idiopático: a propósito de un caso / Multiple retinal pigment epithelial detachments: a case report

CASO CLÍNICO: Mujer de 47 años de edad presenta múltiples desprendimientos de epitelio pigmentario (DEP) idiopáticos bilaterales en una revisión rutinaria. Se muestra esta enfermedad como una manifestación clínica rara cuya evolución será la resolución, atrofia localizada del epitelio pigmentario y el buen pronóstico funcional. DISCUSIÓN: El DEP es una manifestación clínica frecuente en múltiples enfermedades coriorretinianas. La degeneración macular asociada a la edad (DMAE) es donde con mayor frecuencia se manifiesta. La forma idiopática se puede englobar dentro de la coriorretinopatía central serosa (CCS) tipo II . La angiografía (AFG) y la tomografía de coherencia óptica (OCT) son pruebas complementarias en el estudio del número, la extensión y la naturaleza serosa de estos DEP

CASE REPORT: A 47 year-old female who presented with a bilateral idiopathic multiple pigment epithelial detachment (PED) in a routine visit. This pathology is shown as a rare clinical manifestation, where the outcome is resolution of localized atrophy of the pigment epithelium, with a good functional prognosis. DISCUSSION: PED is a common clinical manifestation in several chorioretinal diseases, particularly in macular degeneration associated with age. Idiopathic PED can be considered as a kind of central type II serous chorioretinopathy. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are complementary tests to study the number, extension, and nature of these PED

Desprendimiento viteliforme adquirido en paciente con drusas cuticulares tratado con bevacizumab / Bevacizumab treatment for acquired vitelliform detachment in patient with cuticular drusen

Caso clínico: Varón de 30 años, diagnosticado de desprendimiento viteliforme adquirido (DVA) secundario a drusas cuticulares que presentaba metamorfopsias en su OD. Se trató con inyecciones intravítreas de bevacizumab (Avastin), respondiendo favorablemente. Discusión: Enfermedad independiente, de fenotipo genético aún desconocido, debida a una disfunción generalizada del epitelio pigmentario retiniano (EPR). Evoluciona en un 50% a DVA; con la ayuda de nuevas pruebas complementarias llegamos a un diagnóstico certero. Sin tratamiento efectivo hasta el momento. Dada la frecuencia con la que se desarrolla neovascularización coroidea (NVC), creemos que el tratamiento con fármacos anti-VEGF podría ayudarnos en la estabilización o mejoría funcional y/o anatómica del cuadro (AU)

Case report: We report a case of a 30-year-old male with acquired vitelliform detachment (AVD) secondary to cuticular drusen and suffering from metamorphopsia in his right eye. Intravitreal bevacizumab (Avastin) was administered, achieving successful results. Discussion: An independent disease, of unknown genetic phenotype, caused by a generalized dysfunction of the retinal pigment epithelium (RPE). About 50% of patients develop AVD, and a correct diagnosis can be made with the help of new complementary tests. With no effective treatment currently available, and because of the incidence of developing choroidal neovascularization (NVC), treatment with anti-VEGF could help stabilize or improve the disease functionally and/or anatomically (AU)

[Multiple retinal pigment epithelial detachments: a case report]. / Múltiples desprendimientos de epitelio pigmentario idiopático: a propósito de un caso.

CASE REPORT: A 47 year-old female who presented with a bilateral idiopathic multiple pigment epithelial detachment (PED) in a routine visit. This pathology is shown as a rare clinical manifestation, where the outcome is resolution of localized atrophy of the pigment epithelium, with a good functional prognosis. DISCUSSION: PED is a common clinical manifestation in several chorioretinal diseases, particularly in macular degeneration associated with age. Idiopathic PED can be considered as a kind of central type II serous chorioretinopathy. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are complementary tests to study the number, extension, and nature of these PED.

[Bevacizumab treatment for acquired vitelliform detachment in patient with cuticular drusen]. / Desprendimiento viteliforme adquirido en paciente con drusas cuticulares tratado con bevacizumab.

CASE REPORT: We report a case of a 30-year-old male with acquired vitelliform detachment (AVD) secondary to cuticular drusen and suffering from metamorphopsia in his right eye. Intravitreal bevacizumab (Avastin) was administered, achieving successful results. DISCUSSION: An independent disease, of unknown genetic phenotype, caused by a generalized dysfunction of the retinal pigment epithelium (RPE). About 50% of patients develop AVD, and a correct diagnosis can be made with the help of new complementary tests. With no effective treatment currently available, and because of the incidence of developing choroidal neovascularization (NVC), treatment with anti-VEGF could help stabilize or improve the disease functionally and/or anatomically.

Enfermedad de Von Hippel Lindau: estudio familiar / Von Hippel-Lindau disease: family study

Caso clínico: Familia con cinco miembros afectos de enfermedad de Von Hippel Lindau (VHL). Observamos como manifestación oftalmológica más frecuente, y a menudo la primera, el hemangioma capilar retiniano (HCR). La hemorragia vítrea y el desprendimiento de retina traccional serían las principales complicaciones de estos pacientes. Discusión: La enfermedad de VHL es una dolencia poco frecuente pero muy grave e incluso mortal, de ahí la importancia del diagnóstico precoz a través de la oftalmoscopia, que puede modificar el pronóstico visual y vital no solo del paciente, sino también de sus familiares afectos(AU)

Case report: The case of 5 members of a family who suffer from Von Hippel-Lindau disease (VHL) is presented. It is shown that retinal capillary hemangioma was the main ophthalmic symptom, with hemovitreous and tractional retinal detachment as the main complications. Discussion: VHL disease is rare, but very serious, even fatal, thus it is important to obtain an early diagnosis by ophthalmoscopy, in order to change the visual prognosis and life expectancy, not only for the patient, but also for the family(AU)

[Von Hippel-Lindau disease: family study]. / Enfermedad de Von Hippel Lindau: estudio familiar.

CASE REPORT: The case of 5 members of a family who suffer from Von Hippel-Lindau disease (VHL) is presented. It is shown that retinal capillary hemangioma was the main ophthalmic symptom, with hemovitreous and tractional retinal detachment as the main complications. DISCUSSION: VHL disease is rare, but very serious, even fatal, thus it is important to obtain an early diagnosis by ophthalmoscopy, in order to change the visual prognosis and life expectancy, not only for the patient, but also for the family.

[Choroidal neovascularization secondary to pseudoxanthoma elasticum treated with ranibizumab: a report of 2 cases]. / Neovascularización coroidea secundaria a seudoxantoma elástico tratada con ranibizumab: a propósito de dos casos.

CASE REPORT: We report 2 cases of pseudoxanthoma elasticum with angioid streaks and choroidal neovascularization (CNV) in both eyes. Intravitreal ranibizumab (Lucentis) was administered with successful results in both cases. DISCUSSION: CNV has been reported to occur in 72% to 86% of patients with angioid streaks. Although uncommon, the impact of CNV is important because it tends to affect people of working age. Based on the effectiveness of ranibizumab in other secondary CNVs, we decided to use it in our patients, observing the functional and anatomical improvement.

Neovascularización coroidea secundaria a seudoxantoma elástico tratada con ranibizumab: a propósito de dos casos / Choroidal neovascularization secondary to pseudoxanthoma elasticum treated with ranibizumab: a report of 2 cases

Caso clínico: Se presentan dos pacientes diagnosticados de seudoxantoma elástico (PXE), que presentaban estrías angioides (EA) en ambos ojos y neovascularización coroidea (NVC) secundaria de manera unilateral. Ambos fueron tratados con inyecciones intravítreas de ranibizumab (Lucentis), obteniendo una respuesta favorable en ambos casos. Discusión: La NVC afecta al 72-86% de los pacientes con estrías angioides. Es una enfermedad poco frecuente pero importante, ya que se presenta en pacientes con vida laboral activa. Se decidió emplear este tratamiento teniendo en cuenta la efectividad del ranibizumab en NVC secundarias a otros procesos patológicos, observando la mejoría anatómica y funcional del cuadro(AU)

Case report: We report 2 cases of pseudoxanthoma elasticum with angioid streaks andchoroidal neovascularization (CNV) in both eyes. Intravitreal ranibizumab (Lucentis) was administered with successful results in both cases. Discussion: CNV has been reported to occur in 72% to 86% of patients with angioid streaks. Although uncommon, the impact of CNV is important because it tends to affect people of working age. Based on the effectiveness of ranibizumab in other secondary CNVs, we decided to use it in our patients, observing the functional and anatomical improvement(AU)