Atypical presentation of Best Disease. / Presentación atípica de la enfermedad de Best.

CLINICAL CASE: A 43-year-old man was treated for reduced visual acuity, initially attributed to strabismic amblyopia. On fundus examination, bilateral neurosensory detachments (NSD) were observed in posterior pole, surrounded by deposits of lipofuscin. His 3-year-old son was also examined and circumscribed NSD was observed with the presence of pseudohypopyon in OD and a fibrosis scar in OS. The Arden ratio were decreased in electrooculography (EOG) in both patients, and genetic studies revealed a single mutation of the BEST1 gene. DISCUSSION: The existence of extensive bilateral NSD may be an unusual form of presentation of Best disease. Family history, EOG, and genetic study supported this diagnosis.

[Diffuse large B cell lymphoma presenting with a bilateral serous macular detachment]. / Desprendimiento seroso macular bilateral como forma de presentación de linfoma B difuso de célula grande.

CLINICAL CASE: A 42 year-old male was assessed for a subacute, bilateral and progressive visual loss. His medical history included chronic hepatitis C infection and Evans syndrome. On fundal examination, multiple areas of neurosensorial and retinal pigmented epithelium detachment were observed in the region of both macula. A few days later, his general health deteriorated and he was noted to have a high fever and adenopathy. Biopsy of an enlarged lateral cervical lymph node demonstrated the existence of a diffuse large B cell lymphoma. After several cycles of chemotherapy, he experienced a progressive and bilateral improvement of his vision, which was accompanied by a reattachment of the previously detached areas. DISCUSSION: A bilateral and serous macular detachment may be the initial manifestation of a diffuse large B cell lymphoma. The prognosis of these retinal lesions may be favourable if lymphoma remission is achieved.

[Subconjunctival mitomycin C for the treatment of ocular cicatricial pemphigoid]. / Mitomicina C subconjuntival en el tratamiento del penfigoide ocular cicatricial.

PURPOSE: We study the efficacy of treating ocular cicatricial pemphigoid (OCP) with subconjuctival mitomycin C (MMC). METHODS: The patients were eligible for treatment under two criteria: 1. Significant complications of systemic immunosuppressant therapy. 2. Avanced stage of OCP. All patients received an injection of 0.25 ml of 0.2 mg/ml mitomycin C to both the upper and lower bulbar conjunctiva in both eyes. RESULTS: Four patients were treated with subconjunctival mitomycin C (both eyes) and were followed for an average of 17 months (range 9-26 months). Three of four patients showed progression of the conjunctival disease and required concomitant systemic immunosuppressive therapy after subconjuctival mitomycin C. CONCLUSION: No complications of subconjunctival mitomycin C treatment were noted but, contrary to what other authors had referred, its use was not effective in preventing progression of conjunctival cicatrization in our patients with OCP.