Diagnóstico oftalmológico de una caso de telangiectasia hemorrágica hereditaria o enfermedad de Rendy-Osler-Weber / Ophthalmologic diagnosis of hereditary hemorrhagic telangiectasia or Rendu- Osler-Weber disease

Caso clínico: Mujer de 45 años con episodios recurrentes de epífora hemática espontánea. La paciente presentaba epistaxis de repetición no filiadas y, tenía antecedentes familiares de hemorragia digestiva, además una de sus hijas sufría de epistaxis. Discusión: El diagnóstico de telangiectasia hemorrágica hereditaria por oftalmólogos es un hecho infrecuente. La presencia de lágrimas con sangre o epífora hemática espontánea, en un paciente con historia de hemorragias de repetición en forma de epistaxis o hemorragia digestiva, nos tiene que hacer sospechar y buscar la presencia de esta enfermedad. La historia y exploración clínica son fundamentales en el diagnóstico de dicha enfermedad

Case report: Our patient was a 45-year-old woman who had recurrent episodes of hematic epiphora, repeated epistaxes for which no cause was found and a family history of gastric hemorrhage. One of her daughters also suffered from spontaneous hemorrhages. Discussion: Hereditary hemorrhagic telangiectasia is rarely diagnosed by an ophthalmologist; however the occurrence of bloody tears occurring spontaneously in a patient with epistaxis or gastric hemorrhage should lead to suspicion of hereditary hemorrhagic telangiectasia or Rendu-Osler-Weber disease. It should never be forgotten that clinical examination and appropriate investigations are basic components of disease diagnosis (Arch Soc Esp Oftalmol 2008; 83: 381-384)

Anterior uveitis and meningococcemia: a case report.

PURPOSE: To describe a case of meningococcemia with anterior uveitis. METHODS: Observational case report. RESULTS: A 38-year-old woman developed meningococcal septicemia caused by Neisseria meningitidis type B. During her admission, she had pain in her left eye, inflammatory cells, and a fibrinous exudate in the anterior chamber and multiple posterior synechiae, all in the context of an anterior uveitis. She was treated with topical steroids and mydriatics with resolution of ocular inflammation. CONCLUSIONS: This case illustrates the possible association between anterior uveitis and a meningococcal septicemia, and the need for careful ophthalmologic examination when a red eye develops in this clinical context.

[Spontaneous resolution of branch retinal vein occlusion in cases with non-ischemic macular edema. Significance of a waiting period before considering treatment with vitrectomy]. / Resolución espontánea en casos de obstrucción venosa de rama retiniana asociada a edema macular no isquémico. Importancia de un período de espera previo al tratamiento mediante vitrectomía.

OBJECTIVES/METHODS: It is well established that some patients with branch retinal vein occlusion undergo a spontaneous resolution after a suitable waiting period. We present a series of 22 patients with initial acuity under 0.2 for whom we allowed three months of observation before considering vitrectomy. RESULTS/CONCLUSIONS: 13% of the patients developed enough spontaneous improvement to be excluded from subsequent treatment. We thus believe a waiting period should be considered before instituting treatment in patients with this particular problem.

Resolución espontánea en casos de obstrucción venosa de rama retiniana asociada a edema macular no isquémico. Importancia de un período de espera previo al tratamiento mediante vitrectomía / Spontaneous resolution of branch retinal vein occlusion in cases with non-ischemic macular edema. Significance of a waiting period before considering treatment with vitrectomy

Objetivo/métodos: En esta comunicación se estudia la posible evolución hacia la resolución espontánea de un porcentaje de los enfermos afectos de obstrucción de rama venosa de la retina (ORVR) tras un tiempo de espera.Se presenta una serie de 22 enfermos afectos de ORVR con visiones iniciales inferiores a 0,2 para los que se respeta un período de tres meses desde el comienzo de síntomas antes de considerar vitrectomía.Resultados/Conclusiones: Un 13% de los enfermos estudiados presentaron una mejoría clínica espontánea suficiente que desaconsejó el tratamiento, por lo que creemos debe considerarse un período de espera previo al tratamiento para este tipo de enfermos (AU)

Objectives/Methods: It is well established that some patients with branch retinal vein occlusion undergo a spontaneous resolution after a suitable waiting period. We present a series of 22 patients with initial acuity under 0.2 for whom we allowed three months of observation before considering vitrectomy. Results/Conclusions: 13% of the patients developed enough spontaneous improvement to be excluded from subsequent treatment. We thus believe a waiting period should be considered before instituting treatment in patients with this particular problem (AU)