Choroidal macrovessel and persistent metamorphopsia after epiretinal membrane surgery.

We report the case of a 59-year-old man with decreased visual acuity and metamorphopsia in both eyes in the context of bilateral epiretinal membrane (ERM) who underwent retinovitreal surgery (chromovitrectomy plus peeling of internal limiting membrane). He recovered visual acuity in his left eye. However, the visual results of his right eye were not satisfactory, with persistence of metamorphopsia in that eye. The multimodal imaging study that included color and red filter retinographies, enhanced depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), OCT angiography (OCTA) and OCT en face, were useful to diagnose a choroidal macrovessel. This ran from the fovea to the temporal macula. EDI-OCT revealed that the choroidal macrovessel generated a foveal deformation of both the ellipsoid zone (EZ) and the retinal pigment epithelium (RPE). This paper discusses whether structural changes in the fovea generated by the choroidal macrovessel are related to persistent metamorfopsia in the affected eye.

Nepafenac for cystoid macular oedema secondary to paclitaxel.

Paclitaxel is used to treat a wide range of malignant tumours. This type of drug is known to cause ocular adverse effects, with cystoid macular oedema being a known, but rare complication, of this therapy. Although most cases resolve after discontinuation of the drug, several authors have attempted various treatments to accelerate resolution, or when paclitaxel therapy cannot be discontinued. A case is presented of a 62 year-old man who presented with decreased visual acuity due to bilateral cystoid macular oedema after administration of paclitaxel for oesophageal cancer. As part of the study, optical coherence tomography angiography (OCTA) was performed at the time of diagnosis, and later when the symptoms subsided. Nepafenac eye drops were prescribed as treatment.

Possible relation between borderline ovarian cancer and endocervical adenocarcinoma: case report.

Case: The patient, a 74-year-old women was diagnosed with intestinal-type endocervical adenocarcinoma that developed after 11 years from borderline ovarian cancer. The diagnosis was based on biopsy and magnetic resonance imaging; hysterectomy with pelvic lymphadenectomy was then performed.

Role of purines on hepatic ischemia-reperfusion lesions in rabbit.

In this work, we evaluate the effects of adenosine 5' triphosphate (ATP) on hepatic lesions caused by ischemia/reperfusion (I/R) in liver rabbit. Rabbits were pretreated with ATP (15 mg/kg IV) or saline solution 0.9% (SS), before the hepatic I/R procedure. We evaluated the effects of ATP on hepatic injury before and after I/R. The warm hepatic I/R procedure caused profound acute liver injury, as indicated by elevated serum aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels, as well as a high apoptotic cell count. All these changes were attenuate by ATP treatment before the hepatic I/R procedure. These results suggested that ATP exerted protective effects on hepatic I/R lesions in the rabbit. This ATP effect may be related to improved energy metabolism during reperfusion in ischemic livers protecting against functional damage of cellular and subcellular membranes during lipid peroxidation.

[Surgical removal of peripapillary choroidal neovascularization in young patients]. / Extracción quirúrgica de la neovascularización coroidea peripapilar en pacientes jóvenes.

PURPOSE: To analyze anatomical and visual outcomes after subretinal surgery for peripapillary choroidal neovascularization (CNV) not associated with age-related macular degeneration (AMD). METHODS: Five eyes from five patients with peripapillary CNV who had been treated by subretinal surgery were retrospectively analyzed. RESULTS: The patients averaged 32 years of age (range, 11 to 49, SD 14.5 years) and mean follow-up was 31.4 months (range, 8 to 48, SD 20.8 months). Best corrected visual acuity was 0.05 (range, 0.001 to 0.16, SD 0.07) before surgery and 0.64 (range, 0.2 to 0.9, SD 0.26) after surgery (p=0.005; Student's t test for paired data). Neither intraoperative nor postoperative incidences occurred. CONCLUSIONS: Surgical removal may be considered one of the therapeutic options to treat peripapillary CNV not related to AMD.

[Photodynamic therapy with verteporfin in choroidal neovascularization after refractive surgery]. / Terapia fotodinámica con verteporfina en neovascularización coroidea después de cirugía refractiva.

PURPOSE: To analyze the results obtained with Photodynamic Therapy (PDT) to treat subfoveal and juxtafoveal Choroidal Neovascularization (CNV) in patients with high myopia corrected by Laser-Assisted in situ Keratomileusis (LASIK) or by implanting a Phakic Intraocular Lens (PIOL). METHODS: We analyzed the results from 14 highly myopic eyes corrected by LASIK (seven cases) or by PIOL implantation (seven cases), which later developed CNV and were treated by PDT with verteporfin. RESULTS: Mean Best Corrected Visual Acuity (BCVA) after refractive surgery was 0.45 SD 0.17 (range, 0.2 to 0.8), with residual spherical equivalent (RSE) -0.5 SD 1.8 D (range, 1 to 5.5 D). After CNV appearance, BCVA was 0.10 SD 0.19 (range, 0.025 to 0.7). CNV was treated in all cases by PDT (mean, 2.0 SD 0.8 treatments). After CNV closure, the mean BCVA improved up to 0.22 SD 0.18 (range, 0.1 to 0.63) (RSE -1.4 SD 1.4 D, range, 0.5 to -4 D). Differences in RSE after refractive surgery and after PDT, and differences between BCVA after CNV appearance and final were not statistically significant (p=0.82 and p=0.06, respectively, Student's t test paired data). CONCLUSION: We consider that PDT is effective in achieving closure of CNV in myopic patients after refractive surgery without inducing changes in spherical equivalent.

Optical coherence tomography predictive factors for macular hole surgery outcome.

AIM: To evaluate the use of preoperative optical coherence tomography (OCT) findings as predictive factors for macular hole (MH) surgery outcomes. METHODS: 46 eyes from 46 patients with a diagnosis of MH were included in this study. In all cases, a pars plana 25-gauge vitrectomy with peeling of the internal limiting membrane was performed. Before and after surgery, a complete clinical examination and a detailed macular analysis, which included the MH minimum and base diameter, the MH height, the Macular Hole Index (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI), were performed. Predictive factors for visual prognosis after surgery were obtained by receiver operating characteristic curve analysis. RESULTS: Minimum and base diameter as well as THI and MHI correlated significantly (p<0.01, p = 0.01, p = 0.04, p = 0.03, respectively) with postoperative best spectacle corrected visual acuity at 3 months, but DHI and MH height did not. Cut-off values of 311 microm and 1.41 were obtained for the minimum diameter and THI, respectively, from receiver operating characteristic curve analysis, providing an acceptable sensitivity and specificity. CONCLUSION: An MH minimum diameter of <311 microm or a THI >1.41 are predictive factors for a good visual prognosis after MH surgery.

Lesiones de varicela en cavidad bucal: reporte de un caso / Chicken pox lesions in oral cavity: report of a case

La Varicela es una enfermedad viral que se presenta con frecuencia en la población infantil, cursa con lesiones cutáneas y en ciertas ocasiones en cavidad bucal. Se presenta un caso de paciente masculino de 5 años de edad, quien consulta por presentar lesiones en cavidad bucal, ademàs de las lesiones cutáneas. Fue tratado con antivirales tópico y sistémico, notándose mejoría de las lesiones en dos semanas.

The Chicken pox is a viral infection that is presented frequently in the infantile population, it presented with skin lesions and, in certain occasions, in oral cavity. A 5 years old male patient, who consult for present vesicles in oral cavity and skin lesions, it was treated with topical and systemic antiviral, being noticed improvement of the lesions in two weeks.

Symptom prevalence in the last week of life.

Palliative care is the management of patients with progressive, far-advanced disease for whom the prognosis is limited and the focus of care is quality of life. During the last days of life, it is important to redefine the goals, as previously present symptoms may increase and new symptoms may appear. To assess these symptoms, 176 patients were evaluated. A questionnaire evaluated symptoms during the last week of life and compared these prevalences with those at the first evaluation. The patients comprised 121 men and 55 women. The mean age was 67.7 years. Metastases were present in 66.5% and were multiple in 52%. The most frequent symptoms at the end of life (> 50%) were anorexia, asthenia, dry mouth, confusion, and constipation. The majority of patients died at home (64.2%). We observed good control of "reversible" symptoms, but many symptoms were difficult to control at the end of life. Symptom assessment is important in this population.

[Abnormalities of sexual development in Puerto Rico: status report]. / Anomalías de desarrollo sexual en Puerto Rico: estado de situación.

Puerto Rico presents the highest incidence in the world of anomalous sexual development. The authors have collected over 3100 cases in the past 19 years. Clinical and laboratory studies suggest possible estrogenic contamination of meats and poultry products. Variation in diet provides protection to a significant number of patients. The possibility of mycotic contamination of food employed in animal husbandry by Fusarium sp., and mycotoxins capable of estrogenic effects have been suggested in a preliminary study. Private and government investigators are active in the study of the condition, but more fiscalizing action is needed. A detailed study of food components for possible contaminants determination is considered mandatory.