Respuesta a «Síndrome de Terson y ecografía orbitaria / Reply to «Terson syndrome and ocular ultrasound»

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Calcificaciones esclerocoroideas asociadas a hipovitaminosis D / Sclerochoroidal calcification associated with hypovitaminosis D

CASO CLÍNICO: Mujer de 69 años que presenta en una exploración funduscópica rutinaria unas lesiones subretinianas blanco-amarillentas en la periferia media temporal superior de ambos ojos. Ecográficamente eran hiperecogénicas, situándose a nivel esclerocoroideo. Se realizó una tomografía axial computarizada que mostró calcificaciones esclerocoroideas posterolaterales. El estudio metabólico reveló una deficiencia severa de vitamina D sin otros hallazgos significativos. Discusión: Las calcificaciones esclerocoroideas son lesiones poco frecuentes que se producen como consecuencia del depósito de calcio a nivel de la esclera y la coroides. Tienen un aspecto clínico característico y en la mayor parte de los casos son idiopáticas. En ocasiones se asocian a enfermedades que cursan con alteraciones del metabolismo del calcio y fósforo, por lo que es necesario realizar un estudio metabólico completo. Se presenta un caso de calcificaciones esclerocoroideas bilaterales asociadas a una hipovitaminosis D de grado severo sin otros hallazgos metabólicos

CASE REPORT: A 69 year-old woman was referred for a routine visit, during which funduscopy revealed white-yellow subretinal lesions in the superotemporal mid-periphery of both eyes. A and B scan ultrasound showed hyperechogenic lesions located at scleral and choroidal level. Computed tomography revealed posterolateral sclerochoroidal calcifications. Metabolic studies showed a severe vitamin D deficiency with no other remarkable findings. Discussion: Sclerochoroidal calcifications are an infrequent finding that occur as a result of calcium deposit at scleral and choroidal level. They have a characteristic clinical picture and are idiopathic in most cases, but may be associated with some systemic diseases, such as calcium and phosphorous metabolic disorders; this fact warrants a thorough metabolic study. We report a case of bilateral sclerochoroidal calcifications associated with severe vitamin D deficiency with no other significant metabolic findings

Hemorragia subhialoidea macular, tratada mediante ruptura de la hialoides posterior con láser YAG en un síndrome de Terson / Subhyaloid macular haemorrhage in Terson syndrome, treated by rupture of the posterior hyaloid using YAG laser

CASO CLÍNICO: se presenta el caso de un varón de 48 años, con vómitos, cefalea y pérdida de conciencia de instauración brusca debido a una hemorragia subaracnoidea secundaria a la ruptura de un aneurisma. Tras recuperar la conciencia, el ojo izquierdo presentaba una agudeza visual de bultos, evidenciándose en el fondo de ojo una hemorragia subhialoidea de grandes dimensiones. DISCUSIÓN: La asociación de una hemorragia subaracnoidea con hemorragia vítrea se denomina síndrome de Terson. A continuación se discute las particularidades en el tratamiento, mediante láser YAG, de este caso

CASE REPORT: We present the case of a 48 year-old man who had a sudden onset of vomiting, headache and loss of consciousness. The visual acuity was severely reduced in the left eye, with a large subhyaloid haemorrhage being observed in the fundus. DISCUSSION: The combination of subarachnoid haemorrhage and a vitreous haemorrhage is called Terson syndrome. The details of the treatment of this case with YAG laser are also discussed

[Subhyaloid macular haemorrhage in Terson syndrome, treated by rupture of the posterior hyaloid using YAG laser]. / Hemorragia subhialoidea macular, tratada mediante ruptura de la hialoides posterior con láser YAG en un síndrome de Terson.

CASE REPORT: We present the case of a 48 year-old man who had a sudden onset of vomiting, headache and loss of consciousness. The visual acuity was severely reduced in the left eye, with a large subhyaloid haemorrhage being observed in the fundus. DISCUSSION: The combination of subarachnoid haemorrhage and a vitreous haemorrhage is called Terson syndrome. The details of the treatment of this case with YAG laser are also discussed.

[Sclerochoroidal calcification associated with hypovitaminosis D]. / Calcificaciones esclerocoroideas asociadas a hipovitaminosis D.

CASE REPORT: A 69 year-old woman was referred for a routine visit, during which funduscopy revealed white-yellow subretinal lesions in the superotemporal mid-periphery of both eyes. A and B scan ultrasound showed hyperechogenic lesions located at scleral and choroidal level. Computed tomography revealed posterolateral sclerochoroidal calcifications. Metabolic studies showed a severe vitamin D deficiency with no other remarkable findings. DISCUSSION: Sclerochoroidal calcifications are an infrequent finding that occur as a result of calcium deposit at scleral and choroidal level. They have a characteristic clinical picture and are idiopathic in most cases, but may be associated with some systemic diseases, such as calcium and phosphorous metabolic disorders; this fact warrants a thorough metabolic study. We report a case of bilateral sclerochoroidal calcifications associated with severe vitamin D deficiency with no other significant metabolic findings.

Queratoprotésis en la enfermedad de la córnea y la superficie ocular / Keratoprosthesis in cornea and ocular surface diseases

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Tracolimus en el tratamiento de la queratoconjuntivitis atópica / Tacrolimus in the treatment of atopic kerato-conjunctivitis

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Electrofisiología ocular / Ocular electrophysiology

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Presentación atípica de un síndrome de Terson: a propósito de un caso / Atypical presentation of Terson syndrome: Presentation of a case

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Medicina regenerativa corneal: aplicaciones en oftalmología / Regenerative corneal medicine: Ophthalmology applications

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Evolución histórica de las lentes de contacto / Evolution and history of contact lenses

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Queratopatía cristalina en el tratamiento del pterigión: a propósito de un caso / Crystalline keratopathy in pterigium treatment: Case report

Caso clínico: Mujer de 65 años que relata la aparición de una mancha blanca en el ojo izquierdo, que ha crecido en el último año. A la exploración se observa un infiltrado intraestromal blanco, con aspecto de cristales de morfología arboriforme, con una mínima respuesta inflamatoria. Se instaura tratamiento tópico sin franca mejoría, requiriendo una queratoplastia penetrante. Discusión: La queratopatía cristalina es una manifestación poco frecuente, y característica, aunque no exclusiva, de queratitis infecciosa por Streptococcus del grupo viridans. Se ha relacionado con el uso prolongado de corticoides tópicos tras queratoplastia penetrante y suele presentar mala respuesta al tratamiento médico(AU)

Case report: A 65 year-old female who consulted due to the emergence of a white spot in the eye that had grown over the last year. The physical examination showed an intrastromal white crystal-like infiltrate and a tree-like morphology, with minimal inflammatory response. It was treated topically with no clear improvement, requiring a penetrating keratoplasty. Discussion: A crystalline keratopathy is a rare event and characteristic of, but not exclusively, to a Streptococcus viridans infectious keratitis. It has been associated with prolonged use of topical steroids after penetrating keratoplasty and usually has a poor response to treatment(AU)