RESUMO
CASO CLÍNICO: Paciente con sida y uveítis por virus Epstein-Barr (VEB). La PCR de VEB fue positiva para humor acuoso y vítreo. Las cuantificaciones del virus fueron 56,602 × 106 copias/ml en humor vítreo, 173.400 copias/ml en sangre periférica y negativo en líquido cefalorraquídeo (LCR). El paciente desarrolló un linfoma no-Hodgkin (LNH) diagnosticado en la necropsia. CONCLUSIÓN: La uveítis por VEB es poco frecuente y para el diagnóstico es necesario realizar una PCR cuantitativa. Una elevada cantidad de DNA de VEB se ha asociado con mayor incidencia de LNH
CLINICAL CASE: Patient with AIDS and Epstein-Barr virus (EBV) uveitis. The PCR of the aqueous and vitreous humor was positive for EBV, and DNA quantification was 56.602 × 106 copies/ml in the vitreous humor, 173,400 copies/ml in the peripheral blood, and negative in the cerebrospinal fluid (CSF). The patient developed a non-Hodgkin's lymphoma (NHL), diagnosed in the autopsy. CONCLUSION: The EBV is a rare cause of uveitis and it may be necessary to perform a quantitative PCR to reach the diagnosis. High amounts of EBV DNA are associated with a greater incidence of NHL
Assuntos
Humanos , Masculino , Linfoma/metabolismo , Linfoma/patologia , Linfoma não Hodgkin/genética , Linfoma não Hodgkin/metabolismo , Sistema Nervoso Central/anormalidades , Sistema Nervoso Central/metabolismo , Toxoplasma/genética , Hepatite/metabolismo , Hepatite/patologia , Linfoma/classificação , Linfoma/complicações , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Sistema Nervoso Central/citologia , Sistema Nervoso Central/lesões , Toxoplasma/metabolismo , Hepatite/complicações , Hepatite/diagnósticoRESUMO
CLINICAL CASE: Patient with AIDS and Epstein-Barr virus (EBV) uveitis. The PCR of the aqueous and vitreous humor was positive for EBV, and DNA quantification was 56.602×10(6) copies/ml in the vitreous humor, 173,400 copies/ml in the peripheral blood, and negative in the cerebrospinal fluid (CSF). The patient developed a non-Hodgkin's lymphoma (NHL), diagnosed in the autopsy. CONCLUSION: The EBV is a rare cause of uveitis and it may be necessary to perform a quantitative PCR to reach the diagnosis. High amounts of EBV DNA are associated with a greater incidence of NHL.
Assuntos
Neoplasias Encefálicas/patologia , Infecções por Vírus Epstein-Barr/patologia , Linfoma Relacionado a AIDS/patologia , Linfoma de Células B/patologia , Pan-Uveíte/patologia , Infecções Oportunistas Relacionadas com a AIDS/complicações , Adulto , Antivirais/uso terapêutico , Neoplasias Encefálicas/virologia , Coriorretinite/tratamento farmacológico , Coriorretinite/patologia , DNA Viral/análise , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Evolução Fatal , Ganciclovir/uso terapêutico , Herpesvirus Humano 4/isolamento & purificação , Humanos , Linfoma Relacionado a AIDS/virologia , Linfoma de Células B/virologia , Masculino , Pan-Uveíte/tratamento farmacológico , Pan-Uveíte/virologia , VitrectomiaRESUMO
OBJETIVO: Evaluar a pacientes 24 meses después de ser intervenidos mediante esclerectomía profunda no perforante (EPNP) con implante supraciliar y determinar la existencia de factores predictivos de la eficacia de la técnica mediante la exploración biomicroscópica (BMU). MATERIAL Y MÉTODOS: Se incluyen 26 ojos de 23 pacientes explorados con UBM 24 meses después de ser intervenidos mediante EPNP con implante de hema supraciliar. RESULTADOS: Se ha encontrado un descenso significativo de la presión intraocular (PIO) de 25,6 ± 6,4 mmHg a 16,2 ± 3,4 mmHg y en el número de medicaciones antiglaucomatosas de 2,5 ± 0,6 por paciente a 0,5 ± 0,5 (p < 0,001). No se evidenciaron cambios significativos en la agudeza visual. Mediante BMU no se ha podido correlacionar la PIO con el diámetro horizontal (r = −0,05; p = 0,71) ni vertical (r = −0,1; p = 0,63) del lago intraescleral, su altura (r = 0,28; p = 0,25) ni volumen (r = −0,08; p = 0,79), el grosor de la MBTD (r = −0,07; p = 0,73) ni su longitud (r = 0,39; p = 0,13), la presencia de ampolla filtrante (p = 0,3) ni de un área hipogénica en el espacio supracoroideo (p = 0,2). CONCLUSIONES: La inserción del implante de hema en el espacio supraciliar durante la cirugía no perforante del glaucoma es segura y efectiva en el glaucoma de ángulo abierto (GAA) pero no hemos podido establecer factores
OBJETIVE: To evaluate patients 24 months after deep sclerectomy (DE) with supraciliary implant, and identify any predictive success factors by examination with ultrasound biomicroscopy (UBM). MATERIAL AND METHODS: This study included 26 eyes of 23 patients evaluated by UBM 24 months after a deep sclerectomy with a supraciliary hema implant. RESULTS: There was a significant reduction in intraocular pressure (IOP), changing from a preoperative mean of 25.6 ± 6.4 mmHg to a postoperative mean of 16.2 ± 3.4 mmHg (P<.001). The number of preoperative glaucoma medications also decreased from 2.5 ± 0.6 drugs per patient to 0.5 ± 0.5 (P<.001). No change was observed in the best-corrected visual acuity. The anatomical characteristics of the surgical area, and its relationship with IOP were examined using UBM. There was no correlation between the level of IOP at the time of UBM and the horizontal (r=−.05: P=.71) and vertical diameter (r=−.1; P=.63), the height (r=.28; P=.25) and the volume of intrascleral space (r=−.08; P=.79), the thickness (r=−.07;P=.73) and the length (r=.39; P=.13) of trabeculo-Descemet's membrane (TDM), the presence of filtering bleb (P=.30) and the hypoechoic area in the supraciliary space (P=.24). CONCLUSIONS: The insertion of a hema implant in the supraciliary space is an effective and safe surgery for patients with open angle glaucoma (OAG). No predictive success factors for supraciliary implant were found using the UBM study
Assuntos
Humanos , Doenças da Esclera/cirurgia , Escleroplastia/métodos , Glaucoma/cirurgia , Corpo Ciliar/cirurgia , Microscopia/métodos , Complicações Pós-Operatórias/diagnóstico , Malha Trabecular/fisiologia , Úvea/fisiologiaRESUMO
OBJECTIVE: To evaluate patients 24 months after deep sclerectomy (DE) with supraciliary implant, and identify any predictive success factors by examination with ultrasound biomicroscopy (UBM) MATERIAL AND METHODS: This study included 26 eyes of 23 patients evaluated by UBM 24 months after a deep sclerectomy with a supraciliary hema implant. RESULTS: There was a significant reduction in intraocular pressure (IOP), changing from a preoperative mean of 25.6 ± 6.4 mmHg to a postoperative mean of 16.2 ± 3.4 mmHg (P<.001). The number of preoperative glaucoma medications also decreased from 2.5 ± 0.6 drugs per patient to 0.5 ± 0.5 (P<.001). No change was observed in the best-corrected visual acuity. The anatomical characteristics of the surgical area, and its relationship with IOP were examined using UBM. There was no correlation between the level of IOP at the time of UBM and the horizontal (r=-.05: P=.71) and vertical diameter (r=-.1; P=.63), the height (r=.28; P=.25) and the volume of intrascleral space (r=-.08; P=.79), the thickness (r=-.07; P=.73) and the length (r=.39; P=.13) of trabeculo-Descemet's membrane (TDM), the presence of filtering bleb (P=.30) and the hypoechoic area in the supraciliary space (P=.24). CONCLUSIONS: The insertion of a hema implant in the supraciliary space is an effective and safe surgery for patients with open angle glaucoma (OAG). No predictive success factors for supraciliary implant were found using the UBM study.
Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma/diagnóstico por imagem , Microscopia Acústica , Esclera/cirurgia , Idoso , Humor Aquoso , Terapia Combinada , Feminino , Seguimentos , Glaucoma/tratamento farmacológico , Glaucoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/uso terapêutico , ReologiaRESUMO
The commonest cause for ocular pain, presenting to an ophthalmic emergency centre, is due to corneal foreign bodies. Although the problem is transient, the degree of morbidity is often underestimated. The object of this study was to assess the degree of pain associated with these lesions.