Ocular involvement in a patient with Sweet syndrome: report of a case and review of the literature. / Afectación oftalmológica en el contexto de un síndrome de Sweet: comunicación de un caso y revisión de la literatura.

The case presented is a 66-year-old woman who attended the emergency department due to skin lesions on the limbs, facial oedema, and eye redness accompanied by haemorrhagic conjunctivitis. The symptoms resolved after one week of systemic steroid treatment. Skin biopsy confirmed Sweet syndrome. Sweet syndrome is rare disorder and unknown by most ophthalmologists despite its frequent ophthalmological manifestations. Ocular involvement is present in one third of patients, with episcleritis and conjunctivitis being the most repeated. Pathology findings confirm the diagnosis which is also characterised by a rapid response to systemic corticosteroids.

[Amniotic membrane transplantation with fibrin glue as treatment of refractory conjunctivochalasis]. / Injerto de membrana amniótica con adhesivo tisular en el tratamiento de la conjuntivocalasia refractiva.

CASE REPORT: A 63-year-old man with bilateral conjunctivochalasis presented with tearing, irritation, foreign body sensation and a delayed fluorescein clearance test. After no symptomatic improvement with topical treatment, surgery was carried out, with amniotic membrane transplantation and fibrin sealant. DISCUSSION: Conjunctivochalasis is a frequent disorder that shares symptoms with dry eye syndrome. When there is no response to topical treatment, surgical treatment is needed. The surgical technique described by Tseng, and based on amniotic membrane transplantation without suture, resulted in a very useful response, due to less inflammation and a rapid resolution and improvement of symptoms.

Optical coherence tomography to monitor photodynamic therapy in pathological myopia.

AIM: To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularisation (CNV) activity before and after photodynamic therapy (PDT) in patients with pathological myopia. METHODS: 33 patients (33 eyes) with pathological myopia and being treated with PDT were included. Every 3 months all patients were evaluated and presence or absence of leakage on fluorescein angiography, presence of intraretinal or subretinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT, were determined at each examination. RESULTS: The macular thickness decreased significantly after PDT at 6 months (p = 0.001) and at 12 months follow up (p = 0.01). However, no significant changes in CNV thickness were measured after PDT at 6 months of follow up (p = 0.418) and at 12 months of follow up (p = 0.521). Once the diagnosis of CNV associated with pathological myopia was established, before treatment, OCT had a sensitivity of 96.96% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.23%) and a moderate specificity (69,69%) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 79.62%. CONCLUSIONS: OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with pathological myopia.

[Silicone oil hypotonic maculopathy treatment]. / Aceite de silicona para el tratamiento de la maculopatía hipotónica.

CASE REPORT: We report a case of a man who developed hypotonic maculopathy after vitreoretinal surgery for anterior proliferative vitreoretinopathy. After an injection of intravitreal triamcinolone, the ocular pressure did not increase, therefore silicone oil was injected. After this, the visual acuity increased and the choroidal and retinal folds regressed. DISCUSSION: Hypotonic maculopathy is a frustrating problem, often resulting in poor visual acuity. There are not many effective treatments. The injection of silicone oil could be an alternative to increase the intraocular pressure and re-establish the normal anatomy of the eye, improving the visual acuity in some patients.

[Central serous chorioretinopathy as a complication of epitheliopathy under treatment with glucocorticoids]. / Coroidopatía serosa central como complicación de epitelitis en tratamiento con corticoides.

CASE REPORT: We present cases of two patients who were examined in our department with the diagnosis of epitheliopathy following treatment with oral and topical glucocorticoids. They were referred because of loss of visual acuity. The ophthalmic examination established the diagnosis of central serous chorioretinopathy and it was decided to stop treatment with glucocorticoids. DISCUSSION: The pathogenesis of the central serous chorioretinopathy is still imprecisely known, but it has been related to several situations characterized by exposure to high levels of endogenous or exogenous glucocorticoids. Both of these cases provide more evidence of the potential association between corticosteroids and the acute manifestations of central serous chorioretinopathy.

[Prevalence and risk factors of pseudoexfoliation syndrome in institutionalized geriatric patients in Navarra]. / Prevalencia y factores de riesgo del síndrome pseudoexfoliativo en una población institucionalizada en Navarra.

PURPOSE: To establish the prevalence of pseudoexfoliation syndrome (PSX) in an institutionalized geriatric population in Navarra. To study the risk factors for the development of this disease. MATERIAL AND METHODS: 268 nursing home residents were studied, with a mean age of 81 years. The presence of PSX material in the anterior segment was best appreciated by slit lamp after pupillary dilation. We assessed its association with 13 ocular factors and 14 systemic factors. RESULTS: We found 10.1% (27) of subjects with PSX, 19 cases were unilateral and 8 bilateral. The frequency detected in subjects from Navarra was 7.9% versus 21.2% in subjects from other regions (p=0.02), although the significance was lost after multivariant logistic regression. The PSX was 3.5 times more frequent in patients suffering heart failure (p=0.01). The PSX was associated with anti-glaucomatous treatment, which multiplies the risk by 3.2 times (p=0.02); patients affected with age-related geographic macular atrophy had a 2.6 fold increased frequency (p=0.03), both after adjusting for age remained significant. We did not find any association between the PSX and other systemic factors (systemic hypertension and diabetes mellitus) or ocular factors (senile arc and cataract). CONCLUSIONS: The prevalence of PSX syndrome seems to be lower in an institutionalized population in Navarra than in other Spanish regions. The correlation with heart failure and age-related geographic macular atrophy suggests the possibility of a vascular role. The epidemiological association with increased IOP is confirmed.