Retinal pigment epithelium atrophy after epiretinal membrane and internal limiting membrane peeling: case reports.

Objective: To describe the development of retinal pigment epithelium (RPE) atrophy after uncomplicated pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and/or internal limiting membrane (ILM) peeling in 2 patients. Cases description: Case 1: A 79-years-old female with diagnosis of a full-thickness macular hole in her right eye (OD) with best corrected visual acuity (BCVA) of: 20/100 and left eye (OS): 20/70. After surgery she developed large RPE hyperplasia and presented hand movement that did not improve with pinhole. Case 2: A 69-years-old female patient who had ERM in her OS with BCVA of 20/30 in both eyes (OU). PPV was assisted with brilliant blue (BB) to better visualize the ILM. During follow-up visits we evidenced RPE atrophy in the zone where peeling was done. In the last control after 2-years, her visual acuity was 20/40 that did not improve with pinhole. Discussion: There are three possible mechanisms to explain this complication: toxic damage, mechanical trauma during the membrane removal with forceps, or a combination of both. In our cases, a combination of them is probably the cause of the presence of RPE atrophy. Conclusion: Vitrectomy with membrane removal is successful in most cases with low rate of complications. Because RPE atrophy is infrequent, our suggestion is to continue performing this technique and if possible, it should be done without dye staining to minimize risks. Abbreviations: ERM = epiretinal membrane, ILM = internal limiting membrane, MH = macular hole, RPE = Retinal pigment epithelium, OD = right eye, BCVA = Best corrected visual acuity, OS = left eye, OU = both eyes, IOL = intraocular lens, OCT = Optical coherence tomography, BB = Brilliant blue, TB = Trypan blue, ICG = indocyanine green.

Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report.

BACKGROUND: Moxifloxacin is a fourth-generation fluoroquinolone used as a second-line treatment for multiple bacterial infections. Uveitis has been described as an adverse effect related to this medication. Although several case reports have been published describing uveitis and bilateral acute iris transillumination syndrome related to moxifloxacin, we present a unique case of a patient with severe sequelae associated with bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin. CASE PRESENTATION: A 45-year-old Colombian hispanic female presented bilateral conjunctival hyperemia, decreased visual acuity, blurred vision, photophobia, and ocular pain after 15 days of treatment with systemic moxifloxacin for an upper tract respiratory infection. The patient presented unilateral anterior chamber pigment dispersion, mydriatic and nonreactive pupils, extensive iris transillumination defects, and secondary glaucoma. Blood and aqueous humor tests were negative for infectious and autoimmune diseases. Moxifloxacin-induced bilateral acute iris transillumination syndrome was diagnosed. Permanent sequelae such as ocular pain, photophobia, and focus difficulty secondary to severe bilateral iridian atrophy and inability of synkinetic reflex were left. Additionally, glaucoma was diagnosed, and Ahmed valve implantation was required. CONCLUSIONS: We should be aware of the possible association between moxifloxacin and bilateral acute iris transillumination syndrome. A detailed anamnesis, adequate examination, and laboratory tests are necessary to reach an early diagnosis and treatment to avoid unnecessary therapies. Larger studies should be carried out to understand the pathophysiology, diagnosis, management, and sequelae of the disease.

High frequency of ocular toxoplasmosis in Quindío, Colombia and risk factors related to the infection.

OBJECTIVES: To determine the frequency of retinochoroidal lesions by ocular toxoplasmosis and their relationships with risk factors, in residents of two districts with high exposure to Toxoplasma, in Armenia-Quindío, Colombia. METHODS: Cross-sectional analyses of fundoscopy screening, serological tests, and questionnaires were performed to determine risk factors associated with ocular toxoplasmosis retinochoroidal lesions. Differences in proportions were analyzed using the chi-squared test. RESULTS: Of 161 individuals examined, 17 (10.5%) exhibited retinochoroidal scars suggestive of old inactive Toxoplasma gondii infection. All 17 individuals were seropositive for T. gondii antibodies. Consumption of bottled water was protective against T. gondii infection among individuals in this study. There were no specific epidemiological risk factors associated with ocular toxoplasmosis retinochoroidal lesions. CONCLUSION: Ocular toxoplasmosis is an important cause of visual impairment in Armenia-Quindío, Colombia. The consumption of boiled or bottled water is a major preventive public health measure to reduce infection by T. gondii and the subsequent onset of OT.

Oftalmía nodosa en el trópico / Ophthalmia nodosa in the tropics

Antecedentes: La oftalmía nodosa (ON) fue descrita por primera vez por Schön en 1861, y desde entonces ha recibido múltiples nombres, ampliando la identificación de los agentes causales. En Colombia no se tienen referencias precisas sobre dichos agentes. Objetivo: Realizar revisión de tema sobre una enfermedad subdiagnosticada como la ON. Material y métodos: Análisis retrospectivo y narrativo de la literatura, a propósito de la publicación de cinco casos diagnosticados con ON en la Clínica Barraquer, Bogotá, Colombia, de enero de 1983 a diciembre de 2020. Resultados: Los pacientes valorados en nuestra institución presentaron resolución completa de los síntomas una vez que se realizó tratamiento descrito de manera oportuna. Conclusiones: La ON es una enfermedad conocida que requiere alta sospecha clínica para ser diagnosticada. Los corticoesteroides tópicos son la primera línea de tratamiento y se recomienda la retirada del cuerpo extraño siempre que sea posible.

Background: Ophthalmia nodosa (ON) was first described by Schön in 1861, and since then it has received multiple names, broadening the identification of the causal agents. In Colombia there are no precise references to these agents. Objective: To perform a review of an underdiagnosed entity such us ON. Material and methods: To report of five patients diagnosed with ON in Clinica Barraquer, Bogotá, Colombia from January 1983 to December 2020. Retrospective and narrative literature analysis. Results: Patients presented complete resolution once the described treatment was carried out on time. Conclusions: ON is a well-known disease that requires a high clinical suspicion to be diagnosed. Topical corticosteroids are the first line of treatment and removal of the foreign body is recommended.