RESUMEN
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.
Asunto(s)
Meningitis/complicaciones , Enfermedades del Nervio Óptico/etiología , Corticoesteroides/uso terapéutico , Adulto , Femenino , Humanos , Hipertrofia , Inmunosupresores/uso terapéutico , Meningitis/patología , Enfermedades del Nervio Óptico/tratamiento farmacológico , Recurrencia , Insuficiencia del TratamientoRESUMEN
CASE REPORT: An 80 year old woman operated on by trabeculectomy for primary open-angle glaucoma due to increased pressure, who started treatment with latanoprost. Monitoring of blood pressure (BP) showed a statistically significant increase in both systolic and diastolic BP, coinciding with the use of topical hypotensive, which resolved by voluntarily suspending treatment, thus increasing again to reintroduce the prostaglandin. DISCUSSION: Prostaglandin analogs reduce intraocular pressure to produce vasodilation of the episcleral and ciliary arteries, increasing the outflow of aqueous humor. Cardiovascular effects are rare, but have been described by the vasoconstrictor effect that can trigger the reversible increase in BP, as in this case.
Asunto(s)
Hipertensión/inducido químicamente , Complicaciones Posoperatorias/inducido químicamente , Prostaglandinas F Sintéticas/efectos adversos , Anciano de 80 o más Años , Presión Sanguínea/efectos de los fármacos , Femenino , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Glaucoma de Ángulo Abierto/cirugía , Humanos , Presión Intraocular/efectos de los fármacos , Latanoprost , Prostaglandinas F Sintéticas/farmacología , Prostaglandinas F Sintéticas/uso terapéutico , Factores de Riesgo , Trabeculectomía , Sistema Vasomotor/efectos de los fármacosRESUMEN
CASE REPORT: An alcoholic patient with loss of vision in his right eye and a peripapillar haemorrhage, who then presented with a venous thrombosis. Blood analysis revealed hyperhomocysteinemia with coagulation parameters within the normal range. In the follow-up he developed a bilateral optic neuropathy. DISCUSSION: An increase in homocysteine levels is common in alcoholics, and it has been considered a vascular risk factor. Folic acid and vitamins B6 and B12 deficiency may lead to hyperhomocysteinemia, as they participate in its metabolism. CONCLUSIONS: When presented with a retinal occlusive disease or ischemic optic neuropathy in young patients, coagulation disorders and elevated levels of homocysteine should be ruled out.
