Purtscher-like retinopathy associated with dermatomyositis and hemophagocytic lymphohistiocytosis. / Retinopatía Purtscher-like asociada a dermatomiositis y linfohistiocitosis hemofagocítica.

CASE REPORT: An 11 year-old girl with progressive muscle weakness due to dermatomyositis and hemophagocytic lymphohistiocytosis in which multiple cotton exudates, venous tortuosity and flame haemorrhages are detected in the funduscopic examination, leading to the diagnosis of Purtscher-like retinopathy. DISCUSSION: Purstcher's retinopathy is a microvascular disorder with clinical signs of probable thrombotic origin. Its treatment is controversial, with systemic corticosteroids being the most widespread choice.

Recurrent conjunctival atypical fibroxanthoma in Pigmentosum Xeroderma. / Fibroxantoma atípico conjuntival recurrente en el xeroderma pigmentoso.

CASE REPORT: A 7 year-old boy with Xeroderma Pigmentosum (XP) and who presents a recurrent conjunctival atypical fibroxanthoma after two surgeries. This is the third procedure and the patient is treated with a surgical excision of the tumour and cryotherapy at the surgical bed. Due to the risk of recurrence, topical Mitomycin C 0,02% was added at post-operative care achieving a good clinical outcome. DISCUSSION: Surgical exeresis with cryotherapy and topical Mitomycin C is an effective treatment for a case of an atypical fibroxanthoma with a high potential for recurrence and invasion. An ophthalmologic follow-up is required for these patients, as well as general paediatric care and support aids.

Effect of unilateral congenital cataract surgery on ocular axial length growth and corneal flattening.

OBJECTIVE: The aim of this article is to study the effect of unilateral congenital cataract surgery on ocular growth and corneal flattening. METHODS: This is a cross-sectional study of 59 patients operated on due to a unilateral congenital cataract. The median age of the patients at the time of diagnosis was 17 months (interquartile range, 5-39 months). The median age at cataract the time of surgery was 28 months (interquartile range, 8-52 months), and the mean follow-up between cataract surgery and assessments was 149.7±69.9 months (range, 30-319 months). Axial length and corneal curvature were measured in both operated and non-operated eyes, comparing the results between them. RESULTS: There were no statistically significant differences for axial length growth or corneal flattening between operated and non-operated eyes: axial length (P=.327, Student t test) and corneal curvature (P=.078, Student t test). A sub-analysis was performed using the visual acuity and the age of the patient at the time of surgery. The only statistically significant data (P=.007, Student t test) was a lower axial length in operated eyes compared to non-operated eyes, in the non-deep-amblyopia group. CONCLUSIONS: No significant axial length growth modifications were observed between operated and non-operated eyes. Only the non-deep-amblyopia group presented with a lower axial length in the operated eyes compared to non-operated eyes. No significant differences in corneal flattening were found between groups after unilateral congenital cataract surgery.

[A protocol for the treatment of retinopathy of prematurity in Spain]. / Protocolo de tratamiento de la retinopatía del prematuro en España.

OBJECTIVE: To prepare a protocol for the treatment of retinopathy of prematurity (ROP) agreed by the majority of Spanish ophthalmologists dedicated to this topic. MATERIAL AND METHOD: A draft of the protocol was produced taking into account the experience of the participants and up to date publications. This draft was corrected by all the ophthalmologists participating in the project, and the final document was agreed by all of them. RESULTS: We present general guidelines as an aid for the treatment of ROP, including treatment criteria, treatment methods, a calendar of action, and follow-up. CONCLUSIONS: It is important to have a common working protocol for the treatment of ROP to improve care and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.

Screening program for retinopathy of prematurity in Spain.

OBJECTIVE: To prepare a retinopathy of prematurity (ROP) screening program as agreed by most of Spanish ophthalmologists dedicated to this topic. MATERIALS AND METHODS: A draft of the protocol was produced taking into account the experience of the participants and current publications. This draft was corrected by all the ophthalmologists participating in the project and the final document produced was agreed by all of them. RESULTS: We present general guidelines to help in the screening of ROP, including treatment criteria, treatment methods, and a calendar of action. CONCLUSIONS: It is important to have a common working protocol in the screening of ROP to improve the action and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.

[Assessment of intra-operative techniques to prevent visual axis opacification in congenital cataract surgery]. / Valoración de técnicas intraoperatorias para la prevención de la opacificación del eje visual en la cirugía de cataratas congénitas.

OBJECTIVE: To evaluate the effectiveness of various surgical procedures in the management of posterior capsule and anterior vitreous on the prevention of visual axis opacification. SUBJECTS, MATERIAL AND METHODS: We retrospectively reviewed 120 eyes operated for unilateral congenital cataracts, with a median age at the time of cataract surgery of 21 months (interquartile range, 6-52 months). The eyes were divided into 3 groups: group 1 (eyes with intact posterior capsule, n=39), group 2 (eyes with posterior continuous curvilinear capsulorhexis, n=38), group 3 (eyes with posterior continuous curvilinear capsulorhexis and anterior vitrectomy, n=43). RESULTS: To determine the effect of posterior continuous curvilinear capsulorhexis on visual axis opacification we compared group 2 with group 1 (chi-square Pearson test, P=.281), therefore in this study the implementation of the posterior continuous curvilinear capsulorhexis did not show any decreases in the incidence of visual axis opacification. To study the effect of posterior continuous curvilinear capsulorhexis associated anterior vitrectomy, we compared group 3 with group 1 (chi-square Pearson test, P=.014), demonstrating that the combination of both techniques (posterior continuous curvilinear capsulorhexis and anterior vitrectomy) decreases the incidence of visual axis opacification. CONCLUSION: Posterior continuous curvilinear capsulorhexis as a single technique did not show any decrease in the incidence of visual axis opacification. Posterior continuous curvilinear capsulorhexis together with anterior vitrectomy are required to prevent visual axis opacification and to decrease reoperation rate.

Enfermedad de Hansen, córnea y anejos oculares

Examinamos 37 pacientes diagnosticados de lepra estudiando sus alteraciones en anejos y córnea. De ellos eran formas lepromatosas, 2 borderline lepromatosas, 2 borderline tuberculoide y 2 tuberculoides. La mayor parte se encontraban entre la 6ª y 7ª década. En 6 casos no encontramos lesiones de ningún tipo. En los restantes observamos una disminución de la agudeza visual directemante relacionada con la duración de la enfermedad. el hallazgo más frecuente fue la madarosis supraciliar, seguido de la falta parcial de pestañas y madarosis. Debilidad del orbicular y/o lagoftalmos encontramos en 6 casos. La opacidades debidas a queratopatías leprosas típicas, queratopatía "en banda", por oxposición pannus y lepromas corneales, fueron los hallazgos corneales más frecuentes. La presencia de neovascularización fue detectada en 5 pacientes. Concluimos destacando la importancia del estudio de la lepra en oftalmología.