RESUMO
An atypical Advancing Wavelike Epitheliopathy case, consecutive to topical treatment for a 360º Conjunctival Intraepithelial Neoplasia, is presented. Mitomycin (0.2 mg/mL) and interferon (1 MUI/mL) drops were used. An atypical presentation, with migrating limbal focus, non clearly delimited in its hourly site through its evolution. Treated with flurometholone drops plus artificial tears, working to complete resolution.
Assuntos
Carcinoma in Situ , Neoplasias da Túnica Conjuntiva , Doenças da Córnea , Administração Tópica , Carcinoma in Situ/complicações , Carcinoma in Situ/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Doenças da Córnea/tratamento farmacológico , Humanos , Mitomicina/uso terapêuticoRESUMO
Se presenta un caso atípico de epiteliopatía progresiva en ondas consecutiva a tratamiento tópico de una neoplasia intraepitelial conjuntival en 360°. Se usaron colirios de mitomicina (0,2mg/ml) e interferón (1MUI/ml). Presentación atípica con foco limbar principal migratorio, y no claramente delimitado en su sitio horario a través de su evolución. Tratado con flurometolona y lágrimas artificiales, con resultado de resolución completa (AU)
An atypical Advancing Wavelike Epitheliopathy case, consecutive to topical treatment for a 360° Conjunctival Intraepithelial Neoplasia, is presented. Mitomycin (0.2mg/ml) and interferon (1MUI/ml) drops were used. An atypical presentation, with migrating limbal focus, non clearly delimited in its hourly site through its evolution. Treated with flurometholone drops plus artificial tears, working to complete resolution (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Carcinoma in Situ/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/complicações , Antibióticos Antineoplásicos/administração & dosagem , Interferons/administração & dosagem , Mitomicina/administração & dosagem , Doenças da Córnea/tratamento farmacológico , Administração TópicaRESUMO
Ophthalmological diabetic complications are one of the main causes of blindness worldwide, so careful diagnostic and management is important. The screening plans implemented in our population made possible an early diagnosis and treatment, trying to reduce the consequences. Diabetic retinopathy is widely known, however we present the case of a rare retinal condition, acute panedothelial retinal leakage. It typically affects patients with type 1 DM and poor glycemic control. Its diagnosis is important since a strict metabolic control is sufficient for its resolution, avoiding aggressive therapies.
Assuntos
Diabetes Mellitus Tipo 1 , Retinopatia Diabética , Hiperglicemia , Cegueira , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/diagnóstico , Humanos , RetinaRESUMO
Las complicaciones oftalmológicas derivadas de la diabetes son una de las principales causas de ceguera en edad laboral a nivel mundial, por lo que es importante un manejo minucioso. Gracias a los planes de cribado implantados en nuestra población, es posible un diagnóstico y tratamiento precoz con el fin de disminuir las secuelas. La retinopatía diabética (RD) es una entidad conocida por todos nosotros, no obstante, presentamos el caso de una rara afectación retiniana, la capilaropatía edematosa aguda. Típicamente afecta a pacientes con diabetes mellitus tipo 1 (DM1) y mal control glucémico. Es importante su diagnóstico puesto que llevar un estricto control metabólico es suficiente para la resolución de la misma, evitando terapias agresivas (AU)
Ophthalmological diabetic complications are one of the main causes of blindness worldwide, so careful diagnostic and management is important. The screening plans implemented in our population made possible an early diagnosis and treatment, trying to reduce the consequences. Diabetic retinopathy is widely known, however we present the case of a rare retinal condition, acute panedothelial retinal leakage. It typically affects patients with diabetes mellitus (DM) type 1 and poor glycemic control. Its diagnosis is important since a strict metabolic control is sufficient for its resolution, avoiding aggressive therapies (AU)
Assuntos
Humanos , Feminino , Adolescente , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/diagnóstico , Edema , Doença AgudaRESUMO
Ophthalmological diabetic complications are one of the main causes of blindness worldwide, so careful diagnostic and management is important. The screening plans implemented in our population made possible an early diagnosis and treatment, trying to reduce the consequences. Diabetic retinopathy is widely known, however we present the case of a rare retinal condition, acute panedothelial retinal leakage. It typically affects patients with diabetes mellitus (DM) type 1 and poor glycemic control. Its diagnosis is important since a strict metabolic control is sufficient for its resolution, avoiding aggressive therapies.
RESUMO
En los casos graves de parálisis del abducens o sexto par craneal resultan útiles las transposiciones de rectos superiores y rectos inferiores hacia el recto lateral paralítico. Se han descrito numerosas técnicas a lo largo del tiempo para la realización de estas transposiciones, como son las de Hummelsheim, OConnor, Jensen, Foster o Nishida. Las 4 primeras llevan aparejado un aumento del riesgo de isquemia del segmento anterior. Presentamos el caso de una parálisis de sexto par craneal bilateral de larga data de evolución, secundaria a un traumatismo craneoencefálico grave. Para minimizar el riesgo de isquemia del segmento anterior se optó por la realización de la técnica de Nishida, asociada a inyección de toxina botulínica en ambos rectos medios para tratar de resolver la contractura muscular asociada a la larga evolución del caso, obteniendo buenos resultados a los 6 y 12 meses del procedimiento quirúrgico
In severe cases of abducens or sixth cranial nerve palsy, transpositions of the superior rectus and inferior rectus into the paralytic lateral rectus have been demonstrated to be useful. Numerous techniques have been described over time to carry out these transpositions, such as the Hummelsheim, OConnor, Jensen, Foster, or Nishida technique. The first 4 techniques mentioned above have an increased risk of anterior segment ischaemia. The case is presented of a long-standing bilateral sixth cranial nerve palsy secondary to a severe cranial injury. Given the risk of ischaemia of the anterior segment, the Nishida technique was chosen in order to reduce the risk of suffering from this complication. This is combined with botulinum toxin in both middle rectus to try to resolve the muscle contracture associated with the long evolution of the case, obtaining good results at 6, and 12 months after the surgical procedure
Assuntos
Humanos , Masculino , Adulto , Doenças do Nervo Abducente/terapia , Toxinas Botulínicas/uso terapêutico , Procedimentos Cirúrgicos Oftalmológicos/métodos , Doenças do Nervo Abducente/patologia , Terapia Combinada , Fatores de TempoRESUMO
In severe cases of abducens or sixth cranial nerve palsy, transpositions of the superior rectus and inferior rectus into the paralytic lateral rectus have been demonstrated to be useful. Numerous techniques have been described over time to carry out these transpositions, such as the Hummelsheim, O'Connor, Jensen, Foster, or Nishida technique. The first 4 techniques mentioned above have an increased risk of anterior segment ischaemia. The case is presented of a long-standing bilateral sixth cranial nerve palsy secondary to a severe cranial injury. Given the risk of ischaemia of the anterior segment, the Nishida technique was chosen in order to reduce the risk of suffering from this complication. This is combined with botulinum toxin in both middle rectus to try to resolve the muscle contracture associated with the long evolution of the case, obtaining good results at 6, and 12 months after the surgical procedure.
Assuntos
Doenças do Nervo Abducente/terapia , Toxinas Botulínicas/uso terapêutico , Procedimentos Cirúrgicos Oftalmológicos/métodos , Doenças do Nervo Abducente/patologia , Adulto , Terapia Combinada , Humanos , Masculino , Fatores de TempoRESUMO
La angiografía de sustracción digital (ASD), es una técnica empleada en el diagnóstico de alteraciones vasculares cerebrales. La oclusión de arteria central de la retina (OACR) es una complicación descrita tras la realización de técnicas endovasculares que implican la movilización de placas arterioscleróticas produciendo émbolos. Presentamos el caso de un varón que inicia una pérdida de agudeza visual durante la ASD. En la funduscopia presenta palidez y mancha rojo cereza, y la angiografía es compatible con la presencia de un trombo en la salida de la arteria central de la retina. Se diagnostica una OACR que se trata sin éxito mediante masaje ocular, hipotensores tópicos, acetazolamida vía oral y paracentesis de cámara anterior, obteniendo una agudeza visual final inferior a 0,05. La OACR, pese a ser una complicación rara, se debe por su mal pronóstico considerar en la realización de procedimientos neuro-radiológicos como la ASD
Digital subtraction angiography (DSA) is a technique used in interventional radiology for the diagnosis of vascular cerebral conditions. Central retinal artery occlusion (CRAO) is a complication of endovascular procedures that involve atherosclerotic plaque removal with subsequent embolisation. The case is presented on a patient who noticed a sudden vision loss during a DSA. Funduscopy showed retinal pallor and a cherry red spot. The angiography showed a structure suggesting the presence of an embolus in the central retinal artery. The patient was diagnosed with a CRAO, and unsuccessfully treated with ocular massage, topical hypotensive drugs, oral acetazolamide, and anterior chamber paracentesis, with a final visual acuity of 0.05. Central retinal artery occlusion is a rare complication, but due to its poor prognosis, it must be considered when performing neuroradiological procedures such as DSA
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Angiografia Digital/efeitos adversos , Oclusão da Artéria Retiniana/etiologia , Doença IatrogênicaRESUMO
Digital subtraction angiography (DSA) is a technique used in interventional radiology for the diagnosis of vascular cerebral conditions. Central retinal artery occlusion (CRAO) is a complication of endovascular procedures that involve atherosclerotic plaque removal with subsequent embolisation. The case is presented on a patient who noticed a sudden vision loss during a DSA. Funduscopy showed retinal pallor and a cherry red spot. The angiography showed a structure suggesting the presence of an embolus in the central retinal artery. The patient was diagnosed with a CRAO, and unsuccessfully treated with ocular massage, topical hypotensive drugs, oral acetazolamide, and anterior chamber paracentesis, with a final visual acuity of 0.05. Central retinal artery occlusion is a rare complication, but due to its poor prognosis, it must be considered when performing neuroradiological procedures such as DSA.