Manejo de la rotura de la membrana de Descemet secundaria a traumatismo por fórceps durante el parto / Management of Descemet membrane detachment secondary to forceps assisted delivery in a newborn

Describir los signos clínicos y el manejo del desprendimiento de la membrana de Descemet (MD) secundario a un traumatismo relacionado con fórceps durante el parto. Un recién nacido a término de 2 días de edad se presentó con opacidad corneal del ojo derecho y antecedentes de parto con fórceps. La evaluación oftalmológica fue consistente para traumatismo corneal, y en la tomografía de coherencia óptica del segmento anterior (OCT-SA Visante®) se objetivó un desprendimiento de la membrana de Descemet (MD). El tratamiento tópico prolongado redujo considerablemente el edema, y después de 4 meses con este, el desprendimiento persistía en su porción superior, la inyección de aire en la cámara anterior llegado a este punto tampoco logró la reaplicación. El eje visual se mantuvo parcialmente transparente durante los meses siguientes, y se indicó terapia visual intensiva para evitar la ambliopía. El tratamiento tópico prolongado puede ser útil para reducir el edema y el riesgo de ambliopía severa en las lesiones de la MD secundarias al traumatismo por fórceps durante el parto, pero puede ser insuficiente en casos donde coexista también un desprendimiento de esta

To describe the clinical signs and management of Descemet membrane (DM) detachment after forceps-related trauma during birth. A 2-day-old term infant presented with right eye corneal clouding and history of forceps assisted delivery. Ophthalmic assessment was consistent for corneal trauma and anterior segment optical coherence tomography (AS-OCT Visante®) revealed DM detachment. Prolonged topical treatment considerably reduced edema, but after four months of treatment superior DM detachment persisted, anterior chamber air injection at this point also failed to achieve apposition. Central visual axis remained partially spared in the months to follow, and intensive amblyopia treatment was indicated. Prolonged topical treatment may be helpful to reduce edema and risk of severe amblyopia in DM tears secondary to forceps traumatism at birth, but insufficient in cases of large DM detachment

Management of Descemet membrane detachment secondary to forceps assisted delivery in a newborn. / Manejo de la rotura de la membrana de Descemet secundaria a traumatismo por fórceps durante el parto.

To describe the clinical signs and management of Descemet membrane (DM) detachment after forceps-related trauma during birth. A 2-day-old term infant presented with right eye corneal clouding and history of forceps assisted delivery. Ophthalmic assessment was consistent for corneal trauma and anterior segment optical coherence tomography (AS-OCT Visante®) revealed DM detachment. Prolonged topical treatment considerably reduced edema, but after four months of treatment superior DM detachment persisted, anterior chamber air injection at this point also failed to achieve apposition. Central visual axis remained partially spared in the months to follow, and intensive amblyopia treatment was indicated. Prolonged topical treatment may be helpful to reduce edema and risk of severe amblyopia in DM tears secondary to forceps traumatism at birth, but insufficient in cases of large DM detachment.

Infarto de nervio óptico asociado a síndrome de Sneddon / Optic nerve infarction in Sneddon's syndrome

CASO CLÍNICO: Se expone el caso de una mujer de 26 años con fenómeno de Raynaud y livedo reticularis de 2 años de evolución que se presentó con alteraciones del campo visual acompañadas de hipertensión arterial, hematuria y cefalea. En la exploración se objetivaron múltiples infartos retinianos y de cabeza del nervio óptico bilateral. DISCUSIÓN: El síndrome de Sneddon es una vasculitis que cursa con livedo reticularis, clinica neurológica y, menos frecuentemente, con infartos de miocardio, renales y retinianos. Revisando la literatura podemos decir que se trata del primer caso de síndrome de Sneddon descrito que se inició con infartos del nervio óptico

CLINICAL CASE: We report a case of a 26 year old woman with Raynaud's phenomenon and livedo reticularis 2 years onset, who presented with visual field defects accompanied by hypertension, hematuria, and headache. The examination revealed multiple retinal and optic nerve head infarcts in both eyes. DISCUSSION: Sneddon's syndrome is a vasculitis that produces livedo reticularis, neurological symptoms, and less frequently myocardial, renal and retinal infarction. After reviewing the literature, this is the first case described of Sneddon's syndrome presenting with optic nerve infarction

[Optic nerve infarction in Sneddon's syndrome]. / Infarto de nervio óptico asociado a síndrome de Sneddon.

CLINICAL CASE: We report a case of a 26 year old woman with Raynaud's phenomenon and livedo reticularis 2 years onset, who presented with visual field defects accompanied by hypertension, hematuria, and headache. The examination revealed multiple retinal and optic nerve head infarcts in both eyes. DISCUSSION: Sneddon's syndrome is a vasculitis that produces livedo reticularis, neurological symptoms, and less frequently myocardial, renal and retinal infarction. After reviewing the literature, this is the first case described of Sneddon's syndrome presenting with optic nerve infarction.