RESUMO
CASO CLÍNICO: Mujer de 38 años con pérdida visual en ojo izquierdo y papiledema bilateral. La resonancia magnética nuclear (RMN) mostraba engrosamiento de la duramadre y la presión intracraneal estaba elevada. Se descartó enfermedad infecciosa, tumoral y autoinmune. DISCUSIÓN: La respuesta inicial a corticoides fue satisfactoria con desaparición del edema de disco óptico, mejoría de la agudeza visual y mejoría radiológica. Después de un año sin tratamiento presentó un nuevo brote, desarrollando una neuropatía óptica izquierda con pérdida irreversible de visión a pesar del retratamiento con corticoides y azatioprina
CASE REPORT: A 38-year-old female patient with bilateral papilledema who presented with loss of vision in her left eye. The Magnetic Resonance Imagining (MRI) showed thickening of the dura mater, and the intracranial pressure was elevated. A cancer, infectious, and autoimmune origin was ruled out. DISCUSSION: The initial response to high doses of corticoids was satisfactory, with disappearance of the optic disc enema, with visual acuity and an improvement in the MRI. However, after one year without treatment she had a new outbreak of the disease. Despite renewed treatment with corticoids and azathioprine, the patient developed a left optic neuropathy and irreversible visual loss
Assuntos
Humanos , Feminino , Meningite/metabolismo , Meningite/patologia , Atrofia Óptica/metabolismo , Atrofia Óptica/patologia , Corticosteroides/administração & dosagem , Corticosteroides/síntese química , Diplopia/congênito , Diplopia/patologia , Meningite/diagnóstico , Meningite/genética , Atrofia Óptica/diagnóstico , Atrofia Óptica/genética , Corticosteroides , Corticosteroides/farmacocinética , Diplopia/complicações , Diplopia/diagnósticoRESUMO
Moebius sequence is a congenital disorder that not only affects the oculomotor system but also the eyes themselves. Ocular involvement might be sight-threatening and needs regular follow-up by an ophthalmologist.
Assuntos
Ambliopia/congênito , Ambliopia/diagnóstico , Paralisia de Bell/congênito , Paralisia de Bell/diagnóstico , Doenças do Aparelho Lacrimal/congênito , Doenças do Aparelho Lacrimal/diagnóstico , Síndrome de Möbius/diagnóstico , Lágrimas/metabolismo , Diplopia/congênito , Diplopia/diagnóstico , Humanos , Erros de Refração/congênito , Erros de Refração/diagnóstico , Doenças do Nervo Trigêmeo/congênito , Doenças do Nervo Trigêmeo/diagnósticoRESUMO
INTRODUCTION: Brown syndrome is characterized by a restriction of active and passive elevation in adduction. It can be congenital, acquired, intermittent, or constant. Spontaneous improvement has been reported in all types but is less common in congenital and constant cases. METHODS: A retrospective review of patients seen between 1992 and 2002 was conducted at our tertiary referral center of all new referrals with a diagnosis of constant congenital Brown syndrome that was previously untreated. RESULTS: Thirty-two patients were identified (22 female and 10 male patients), with an age range at referral of between 1 and 14 years. The right eye was affected in 14 patients, and 3 patients had bilateral Brown syndrome. Twenty-nine (91%) demonstrated binocular vision. Nineteen patients had an abnormal head posture. Twenty-four (75%) patients had some improvement in their ocular movements without any intervention. The best improvement was from a -3 limitation to full movement. Of 6 patients with a "click," 5 improved. Pain was a problem in 10 patients, 8 of whom improved. Diplopia was a symptom in 13 patients, of whom 11 improved. The final review ranged from 6 months to 9.5 years after the first visit. Five patients who had no spontaneous improvement underwent surgery and obtained improvement. CONCLUSIONS: Spontaneous improvement occurred in 75% of patients. Our management is to be cautious with treatment and adopt an observational approach with these patients.
Assuntos
Movimentos Oculares/fisiologia , Transtornos da Motilidade Ocular/fisiopatologia , Transtornos da Motilidade Ocular/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Tendões/cirurgia , Adolescente , Criança , Pré-Escolar , Diplopia/congênito , Diplopia/fisiopatologia , Diplopia/cirurgia , Feminino , Humanos , Lactente , Masculino , Transtornos da Motilidade Ocular/congênito , Sistema de Registros , Remissão Espontânea , Estudos Retrospectivos , Procedimentos DesnecessáriosRESUMO
Dermolipoma e um tumor conjuntival benigno, congenito, usualmente bilateral, lentamente progressivo, que pode determinar prejuizos funcionais a motilidade ocular, com diplopia e desconforto. Entretnto, alteracoes cosmeticas sao geralmente os principais motivos de procura do oftalmologista. O tratamento e microcirurgico, devendo-se evitar lesoes nos musculos extra-oculares, ductos e glandula lacrimal, mesmo as custas de uma remocao apenas paarcial do dermolipoma. Quando pequenos e assintomaticos a conduta e essencialmente conservadora e expectante, para evitar riscos de lesoes operatorias. Dermolipomas oculares, embora raros, sao ocasionalmente relatados na literatura medica; este caso foi o unico encontrado em cerca de 7000 pacientes atendidos pela autora nos ultimos anos
