Bilateral Sturge-Weber syndrome and glaucoma controlled with ahmed valve implant

Sturge-Weber Syndrome is a rare neuro-oculocutaneous disorder. The authors describe the case of a 13 years old boy, presented with bilateral Sturge-Weber Syndrome and glaucoma. Surgical treatment with Ahmed valve implantation in both eyes was carried out achieving lower levels of intraocular pressure.

A síndrome de Sturge-Weber trata-se de uma doença neuro-óculocutânea rara. Os autores relatam o caso de um paciente do sexo masculino, de 13 anos de idade, que se apresentou com Síndrome de Sturge-Weber bilateral e glaucoma. Foi realizado o tratamento cirúrgico com implante de válvula de Ahmed em ambos os olhos e alcançado a redução da pressão intraocular bilateral.

Síndrome tóxica do segmento anterior / Toxic anterior segment syndrome

A síndrome tóxica do segmento anterior (STSA) é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.

Toxic anterior segment syndrome is acute inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in extracellular damage with necrosis and apoptosis during an immune response. We have the report of a case of toxic anterior segment syndrome (TASS), in which the authors seek to emphasize the most common causes of the appearance of these syndrome. They point out the care that must be taken in the process of sterilization of surgical material, in addition to reviewing the best conduct when faced with these cases. In conclusion, it was noted that the main focus should be on prevention, as treatment only seeks to suppress the secondary inflammatory response. Treatment in cases of toxic anterior segment syndrome (TASS) consists of intense instillation of topical steroids with strict follow-up and control of late complications such as glaucoma.

Ocular pulse amplitude in patients with asymmetric primary open-angle glaucoma.

AIM: To evaluate ocular pulse amplitude (OPA) using the dynamic contour tonometer (DCT) in patients with asymmetric primary open-angle glaucoma (POAG) and asymmetric intra-ocular pressure (IOP). METHODS: The participants consisted of 48 patients (96 eyes) with asymmetric POAG. Three measurements of IOP and OPA were taken using DCT. The diagnosis of asymmetry required a difference of glaucomatous visual field loss greater than 6 dB in the global index MD and a difference of 5 mmHg in IOP measured by Goldmann tonometry between the more affected and the contra-lateral eye. All participants underwent full ophthalmologic clinical assessment including ultrasonic pachymetry and biometric measurements. Exclusion criteria were corneal diseases or scars, topical or systemic glaucomatous medications, and previous ocular surgery. RESULTS: No difference (p = 0.142) was found between the axial length measurements of the better eyes group (22.95 ± 0.91 mm) and worse eyes group (22.85 ± 0.97 mm). There was a statistically significant difference (p = 0.011) between the central corneal thickness values of the better eyes group (537.08 ± 29.54 µm) and worse eyes group (534.40 ± 29.87 µm). The OPA values of the better eyes group (3.32 ± 1.14 mmHg) were significantly lower (p = 0.001) than those obtained in the worse eyes group (3.83 ± 1.27 mmHg). When correcting the OPA readings by the IOP there was no statistical difference between groups (p = 0.996). CONCLUSION: Higher OPA values were found in eyes with higher IOP levels and advanced glaucoma's lesions in asymmetric hypertensive POAG patients. However, after the OPA correction by the IOP levels there was no more statistical difference between eyes.

[Secondary glaucoma following carotid cavernous fistula resolved after fistula's embolization: case report]. / Glaucoma secundário à fístula carótido-cavernosa espontânea com resolução após a embolização da fístula: relato de caso.

Spontaneous carotid cavernous fistulas are a rare entity occurring more frequently in middle aged women. The authors report a case of a spontaneous carotid cavernous fistula in an elderly woman resulting in glaucoma of hard management. After surgical embolization of the fistula, the symptoms regressed and the intraocular pressure moved back to regular levels.

Glaucoma secundário à fístula carótido-cavernosa espontânea com resolução após a embolização da fístula: relato de caso / Secondary glaucoma following carotid cavernous fistula resolved after fistula's embolization: case report

Fístulas carótido-cavernosas espontâneas são raras e ocorrem mais frequentemente em mulheres de meia-idade. Os autores relatam um caso de uma fístula carótido-cavernosa espontânea em mulher idosa evoluindo com glaucoma de difícil controle. Após a embolização cirúrgica da fístula a paciente apresentou regressão da sintomatologia e normalização da pressão intraocular.

Spontaneous carotid cavernous fistulas are a rare entity occurring more frequently in middle aged women. The authors report a case of a spontaneous carotid cavernous fistula in an elderly woman resulting in glaucoma of hard management. After surgical embolization of the fistula, the symptoms regressed and the intraocular pressure moved back to regular levels.

Freqüência dos tipos de desvios oculares no ambulatório de motilidade ocular extrínseca do Hospital do Servidor Público Estadual de São Paulo / Frequency of ocular deviations at the strabismus sector of the Hospital do Servidor Público Estadual de São Paulo

OBJETIVO: Identificar os tipos de desvios oculares e suas freqüências nos pacientes encaminhados ao ambulatório de motilidade ocular extrínseca do Hospital do Servidor Público Estadual de São Paulo. MÉTODOS: Foram revisados 935 prontuários do ambulatório de motilidade ocular extrínseca do ano de 2005. Os pacientes foram avaliados quanto à idade, sexo e tipo de desvio apresentado na posição primária do olhar, sendo submetidos esses dados à avaliação estatística. RESULTADOS: A esotropia foi o desvio com maior prevalência na população estudada (44,52 por cento). Neste grupo houve predomínio de indivíduos do sexo masculino (p=0,001). Este desvio foi mais freqüente na faixa etária de 0-2 anos (p=0,009). Já a exotropia (12,25 por cento) mostrou-se mais freqüente entre as mulheres (p=0,046), sendo predominante na faixa etária superior aos 47 anos de idade (p=0,001) CONCLUSÃO: Observou-se maior número de esodesvios em relação aos exodesvios. As esotropias foram mais freqüentes no sexo masculino em faixas etárias mais jovens. Já as exotropias se apresentaram em maior número no sexo feminino em faixas etárias mais elevadas. O maior número de exoforias foi encontrado em pacientes com idades entre 16 e 20 anos.

PURPOSE: To evaluate the frequency of different types of ocular deviations in patients referred to the strabismus sector at the Hospital do Servidor Público Estadual de São Paulo - Brazil. METHODS: A retrospective study of 935 records of patients examined at the strabismus sector in 2005 was conducted to evaluate sex, age and types of misalignments in the primary position. Statistical analysis was applied to these data. RESULTS: Esotropia was the most prevalent misalignment in this population (44.52 percent). There were more males in this group (p=0.001) with a predominance of the age group 0-2 years (p=0.009). Exotropia (12.25 percent) was more frequent in females (p=0.046) in the age group 46 years and over (p=0.001). CONCLUSION: Esodeviations were more frequent than exodeviations. Esotropia was more prevalent in males early in life, while exotropia was more frequent in older females. The larger number of exophorias was found in the age group 16-20 years.

[Frequency of ocular deviations at the strabismus sector of the Hospital do Servidor Público Estadual de São Paulo]. / Freqüência dos tipos de desvios oculares no ambulatório de motilidade ocular extrínseca do Hospital do Servidor Público Estadual de São Paulo.

PURPOSE: To evaluate the frequency of different types of ocular deviations in patients referred to the strabismus sector at the Hospital do Servidor Público Estadual de São Paulo - Brazil. METHODS: A retrospective study of 935 records of patients examined at the strabismus sector in 2005 was conducted to evaluate sex, age and types of misalignments in the primary position. Statistical analysis was applied to these data. RESULTS: Esotropia was the most prevalent misalignment in this population (44.52%). There were more males in this group (p=0.001) with a predominance of the age group 0-2 years (p=0.009). Exotropia (12.25%) was more frequent in females (p=0.046) in the age group 46 years and over (p=0.001). CONCLUSION: Esodeviations were more frequent than exodeviations. Esotropia was more prevalent in males early in life, while exotropia was more frequent in older females. The larger number of exophorias was found in the age group 16-20 years.