Uso de triamcinolona intracameral sin conservantes en cirugía de la catarata pediátrica. Utilidad diagnóstica y terapéutica / Use of intracameral triamcinolone in pediatric cataract surgery. Diagnostic and therapeutic usefulness

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[Congenital candida infections]. / Kongenitale Candidainfektionen.

Congenital candida infection is a rare disease, although the incidence of candida vaginitis during pregnancy is high. We report on five cases each showing patterns considered typical for candida infection. The infective agent can cause chorioamnionitis even in the presence of intact fetal membranes. An intrauterine device (IUD) has been proved to be a risk factor for a congenital candida infection. The pathogenetic significance of contamination with candida for the fetus appears to depend largely on gestational age. A premature infant with a birth-weight less than 1500 g presented with bilateral candida endophthalmitis which was cured by intravenous Fluconazole therapy. Another premature infant weighing 800 g at birth developed a systemic candida infection. The other three more mature infants had milder symptoms, two of them presented with cutaneous candidiasis.

Bilateral anophthalmia and unilateral microphthalmia in two siblings.

A family pedigree consisting of four uneventful pregnancies and deliveries is described. The 2nd sibling suffered from bilateral anophthalmia while the 4th presented a unilateral microphthalmia. Although the microphthalmia was originally interpreted as a possible manifestation of the same genetic trait expressed as bilateral anophthalmia in the elder sister, careful ophthalmic examination unveiled the real cause. A central corneal scar along with cataractous lens and a relatively clear peripheral cornea observed in the microphthalmic eye were compatible with an in utero perforation of the globe. Indeed, we believe that the perforation occurred at the time of the amniocentesis performed during midtrimester of this pregnancy.

Morphology of congenital microphthalmia in chicks (Gallus gallus).

This study examines the morphology of sporadic congenital microphthalmia in 1-day-old chicks, with particular emphasis on the neural retina. On the basis of the size of the eyeball it is possible to classify microphthalmia into two groups, severe and mild. In severe microphthalmia (less than 5 mm in equatorial diameter), the eyeball is severely malformed, but in most cases it shows evidence of an organized neural retina. Although ganglion cells and an optic nerve head are present in a small proportion of these retinae, we could not trace an optic nerve projection to the brain. These results indicate that some ganglion cells are able to be sustained after the period of naturally occurring cell death, suggesting either that those ganglion cells have established some contact with the central nervous system or that the presence of their axons in a rudimentary optic nerve is adequate for survival. In mild microphthalmia (greater than 5 mm in equatorial diameter), the most consistent abnormality is a defect in the pecten, which together with other abnormalities such as orbital cysts and colobomas indicates that the major abnormality occurs in the region of the choroid fissure. Associated with these defects are abnormalities within the ganglion cell layer. In some cases the number of ganglion cells was reduced, and in others the numbers of both ganglion and displaced amacrine cells were reduced. Unexpectedly, there were localized regions completely devoid of cells in the ganglion cell layer. The timing of the congenital defect may provide some clue as to the presence of a critical period in which displaced amacrine cells are formed or are sensitive to events related to ganglion cell loss.

Congenital herpes simplex virus, type 2, bilateral endophthalmitis.

A set of dizygotic twins, both born prematurely, developed herpes simplex encephalitis shortly after birth. The second twin had unilateral keratoconjunctivitis and bilateral endophthalmitis and subsequently died from disseminated herpes infection. Herpes simplex, type 2, was isolated from conjunctiva of both eyes, cerebrospinal fluid, nasopharynx and trachea. Histologic examination of the eyes revealed bilateral endophthalmitis with a necrotizing retinitis. Intranuclear inclusion bodies were demonstrated by light microscopy in the retina, choroid and iris, and virus particles were demonstrated by electron microscopy in the retina. The other twin recovered from a much milder disseminated herpes simplex infection without apparent ocular involvement. During pregnancy, the mother had vaginitis which was suspected, but not documented, as being herpetic in origin. The father was diagnosed as having a penile infection caused by herpes simplex. Repeated attempts to locate the family of the surviving baby girl in order to obtain follow-up information have failed.

Congenital herpes simplex virus, type 2, bilateral endophthalmitis.

A set of dizygotic twins, both born prematurely, developed herpes simplex encephalitis shortly after birth. The second twin had unilateral keratoconjunctivitis and bilateral endophthalmitis and subsequently died from disseminated herpes infection. Herpes simplex, type 2, was isolated from conjunctiva of both eyes, cerebrospinal fluid, nasopharynx and trachea. Histologic examination of the eyes reveaed bilateral endophthalmitis with a necrotizing retinitis. Intranuclear inclusion bodies were demonstrated by light microscopy in the retina, choroid and iris, and virus particles were demonstrated by electron microscopy in the retina. The other twin recovered from a much milder disseminate herpes simplex infection without apparent ocular involvement. During pregnancy, the mother had vaginitis which was suspected, but not documented, as being herpetic in origin. The father was diagnosed as having a penile infection caused by herpes simplex.