RESUMEN
Retinal venous occlusions comprise central retinal vein occlusion, hemiretinal vein occlusions, and branch retinal vein occlusions. They are associated with arterial hypertension and glaucoma. Retinal vein occlusions occur more frequently in males, at a median age of 55. The pathogenesis of retinal venous occlusions remains obscure. The clinical presentation of the disease is variable. In most cases, there is a unilateral visual loss over days with a painless, white and quiet eye. However, retinal venous occlusions may also present as an abrupt and profound loss of vision, or be asymptomatic. The course of the disease may be chronic, often with exacerbations. The most severe complication is the onset of extensive capillary non-perfusion, with a high risk of neovascular glaucoma. The most frequent complication is macular edema due to breakdown of the blood-retinal barrier, which can originate from the macula itself and/or from the disc. The treatment is symptomatic. Retinal venous occlusions may resolve either because of the recanalization of the affected vein, or because of the establishment of an efficient collateral circulation. Intravitreal anti-VEGF antibodies or steroids may transiently improve vision, as well as laser photocoagulation, focused or not on macroaneurysms. Visual sequelae are frequent.
Asunto(s)
Oclusión de la Vena Retiniana , Glaucoma/complicaciones , Glaucoma/epidemiología , Glaucoma/terapia , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Hipertensión/terapia , Inyecciones Intravítreas , Fotocoagulación , Ranibizumab/administración & dosificación , Oclusión de la Vena Retiniana/complicaciones , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/epidemiología , Oclusión de la Vena Retiniana/terapia , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/epidemiología , Trastornos de la Visión/etiología , Trastornos de la Visión/terapiaRESUMEN
PURPOSE: Idiopathic epiretinal membranes most commonly develop in patients over 50 years of age. Posterior vitreous detachment seems to play a role in their formation. Epiretinal membranes are uncommon in young subjects. Surgical intervention is indicated in eyes with true functional symptoms and loss of visual acuity. METHOD: We report 3 cases with spontaneous separation of epiretinal membranes imaged by Optical Coherence Tomography. RESULTS: All patients reported improvement in functional symptoms after spontaneous separation of the epiretinal membrane. Anatomic recovery with reappearance of the foveolar depression was observed on Optical Coherence Tomography. CONCLUSION: A longer period of observation may be indicated in young patients with epiretinal membrane, due to the higher rate of spontaneous separation.
Asunto(s)
Membrana Epirretinal , Adolescente , Adulto , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/etiología , Membrana Epirretinal/cirugía , Lesiones Oculares/complicaciones , Fóvea Central , Glaucoma de Ángulo Abierto/complicaciones , Humanos , Masculino , Seudofaquia , Desprendimiento de Retina/cirugía , Rotura Espontánea , Escotoma/etiología , Tenis/lesiones , Tomografía de Coherencia Óptica , Desprendimiento del Vítreo/complicacionesRESUMEN
Ocular involvement secondary to thyroid carcinomas is uncommon. Uveal metastasis may occur. More rarely, they can be responsible for paraneoplastic syndromes. We report the case of a 64-year-old woman who presented with a severe bilateral panuveitis with venous vasculitis associated with hyperthyroidism from a multinodular goiter, complicated by papillary carcinoma. Systemic steroid therapy was initiated; ocular symptoms resolved completely after total thyroidectomy. Other causes of panuveitis with venous vasculitis were ruled out. This is the first reported case of panuveitis associated with papillary thyroid carcinoma. The occurrence of the ocular symptoms with hyperthyroidism and their remission after surgery supports the possibility that this association may not be coincidental. A paraneoplastic phenomenon is suspected.