[Atypical melanocytic nevus of the limbus. A case report]. / Nevus melanocítico atípico limbar. A propósito de un caso.

CASE REPORT: A 78-year-old-woman presented with a corneal non-pigmented vascularised tumour of her left eye, of 2 months onset, but with no previous ocular disorders. Surgical excision was performed, and the histopathological study showed the lesion to be an atypical melanocytic nevus of the limbus. DISCUSSION: Corneal pigmented lesions tend to occur as a result of conjunctival or sclerocorneal limbus lesions spreading or arising de novo from melanocytic cells that have migrated following corneal injury. A biopsy should be carried out to type and distinguish benign lesions (nevus) from pre-malignant or malignant lesions (primary acquired melanosis or conjunctival melanoma).

[Diabetic retinopathy screening and teleophthalmology]. / Cribado de retinopatía diabética y teleoftalmología.

OBJECTIVE: To determine the prevalence of diabetic retinopathy (DR) and evaluate our experience in DR screening in a study carried out between the Ophthalmology Department of the University General Hospital of Alicante and Department 19 Primary Care of Alicante by using a non-retinal mydriatic camera and telemedicine. MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted on 2,435 diabetic patients from 1 February 2006 to 1 February 2009. Three 45° retinographies of both eyes of each patient were obtained and sent to the Department of Ophthalmology via the hospital intranet. These were then evaluated by 2 ophthalmologists, experts in the retina, with each issuing an individualized report for each patient. RESULTS: The prevalence of DR was 17.90%, with 80.73% of them having mild-moderate proliferative DR, 12.16% severe non-proliferative DR, 2.29% proliferative DR, and 4.82% with diabetic maculopathy associated with any level of retinopathy. The retinographies were considered low quality in 41 patients (1.69%). CONCLUSIONS: We highlight the benefits of the tele-ophthalmology in screening diabetic patients to enable early diagnosis and treatment, and improving the circuit of communication between primary and specialist care.

[Combined trabeculotomy-trabeculectomy as the initial surgical procedure of primary developmental glaucoma]. / Trabeculotomía-trabeculectomía combinada como tratamiento quirúrgico inicial del glaucoma congénito primario.

PURPOSE: To evaluate the long-term outcome of trabeculotomy-trabeculectomy as the primary surgical treatment for primary congenital glaucoma. METHODS: Twenty-two eyes of 14 consecutive patients with primary congenital glaucoma who underwent combined trabeculotomy-trabeculectomy as the initial procedure between 1981 and 2005 were selected for review. Records of ocular family history, age at onset of glaucoma, symptoms and signs, corneal integrity, intraocular pressure (IOP), gonioscopy, surgery, postoperative complications, visual acuity, refractive error, endothelial microscopy, axial length, visual fields and final status of the optic nerve head were entered into a computer database. The outcome, in terms of IOP obtained, was evaluated using Kaplan-Meier survival analysis. RESULTS: Cumulative probabilities of success, after performing combined trabeculotomy-trabeculectomy as the initial operative procedure, were 95.5% after 12 months and 78.2% after 24 months, with this rate being maintained during 15 years of follow-up. Four eyes (18.1%) required more than one operative procedure because of persistent raised IOP. Postoperative complications were rare. At the time of the last follow-up, of 12 eyes from 8 co-operative patients, the final best spectacle-corrected visual acuity was 0.5 (20/40) or better, in 75% (9 eyes). CONCLUSION: Combined trabeculotomy-trabeculectomy as the primary surgical procedure offers long-term high efficacy in the control of IOP without medical treatment, is rarely associated with surgical complications, and a low need for re-operations