[Quality of life in patients with choroidal melanoma]. / Calidad de vida en pacientes con melanoma de coroides.

PURPOSE: To determine whether iodine 125 brachytherapy or enucleation is better for quality of life in patients treated for choroidal melanoma. PATIENTS AND METHODS: Sixty-five patients with choroidal melanoma were treated with a modified version of VF-14 iodine 125 brachytherapy, enucleation or both. Results of this treatment were then statistically analyzed. RESULTS: Statistically significant differences were found between visual acuity in the affected eye and binocular vision (initial and final), with an important decline after the treatment. The global medial score in the VF questionnaire decreased in a statistically significant manner after the treatment. CONCLUSION: We can confirm that patients treated with brachytherapy had better health-related quality of life than those who had their eye enucleated and were more likely to have higher (better) scores on the VF questionnaire items. On the other hand, the binocular vision and time after the treatment correlated with the quality of life in long-term follow-up.

[Acute retinal pigment epitheliitis: a case report]. / Epitelitis retiniana aguda. A propósito de un caso.

CLINICAL CASE: We report the case of a 45-year-old male who attended our emergency service with loss of vision in his left eye after an attack of influenza. The vision in his left eye was slightly inferior to that in the right eye. Ophthalmoscopy showed small orange lesions in the macular and foveolar area. Fluorescein angiography was carried out producing features like an acute retinal epitheliitis. DISCUSSION: Acute retinal epitheliitis is a clinical picture seen in younger patients often following a viral illness. Spontaneous resolution usually occurs.

[Treatment of angioid streaks with phothodynamic therapy]. / Tratamiento con terapia fotodinámica en las estrías angioides.

CLINICAL CASE: A patient had bilateral angioid streaks complicated by cicatricial degeneration in the left eye and subfoveal choroidal neovascularization in the right eye. Photodynamic therapy resulted in a favorable response with normalization of the visual acuity and angiographic resolution of the lesions. DISCUSSION: The most serious complication of angioid streaks is choroidal neovascularization. Today photodynamic therapy is an effective treatment of subfoveal choroidal neovascularization. It also appears useful in the treatment of choroidal neovascularization in angioid streaks.

[Assessment of clinical practice guidelines about cataract management]. / Evaluación de guías de práctica clínica sobre catarata.

PURPOSE: To evaluate the quality of clinical practice guidelines (CPG) about the management of cataract in adults. MATERIAL AND METHOD: A bibliographic search was carried out selecting the CPG based on the evidence or on the expert consensus, published since the year 2000. The guidelines selected were assessed with the AGREE Instrument. RESULTS: Six guidelines were assessed. Three were classified as "recommend with provisos or alterations" and the others "would not be recommended". In accordance with the AGREE Instrument criteria, no guidelines can be recommended for their use in the clinical practice if they were not modified previously.

[Diffuse uveal melanoma. A clinical case]. / Melanoma uveal difuso. A propósito de un caso.

CASE REPORT: We report the case of a 58-year-old man who presented at our emergency department with ocular pain and progressive loss of vision in his left eye. Ophthalmic examination detected a pigmented mass in the iridocorneal angle, involving the ciliary body. Glaucoma had also developed secondary to the melanotic lesion. Ophthalmoscopy showed a large pigmented choroidal tumor. After enucleation, pathologic examination confirmed the diagnosis of a diffuse ocular melanoma. DISCUSSION: Diffuse uveal melanoma is a malignant tumor that metastasises early. Enucleation is the treatment of choice.

Epitelitis retiniana aguda. A propósito de un caso / Acute retinal pigment epitheliitis: a case report

Caso clínico: Se presenta el caso de varón de 45 años que acudió por urgencias con pérdida de visión en ojo izquierdo tras cuadro gripal. No otros datos de interés. La visión del ojo izquierdo fue ligeramente inferior al ojo derecho. La oftalmoscopia mostró pequeñas lesiones anaranjadas en área macular y foveolar. Se realizó una angiografía fluoresceínica cuyos hallazgos fueron compatibles con el diagnóstico de Epitelitis Retiniana Aguda. Discusión: La epitelitis retiniana aguda es un cuadro clínico que afecta a pacientes jóvenes y suele estar precedido de un proceso vírico. Su resolución es espontánea y precoz

Clinical case: We report the case of a 45-year-old male who attended our emergency service with loss of vision in his left eye after an attack of influenza. The vision in his left eye was slightly inferior to that in the right eye. Ophthalmoscopy showed small orange lesions in the macular and foveolar area. Fluorescein angiography was carried out producing features like an acute retinal epitheliitis. Discussion: Acute retinal epitheliitis is a clinical picture seen in younger patients often following a viral illness. Spontaneous resolution usually occurs

Tratamiento con terapia fotodinámica en las estrías angioides / Treatment of angioid streaks with photodynamic therapy

Caso clínico: Paciente con estrías angioides bilaterales complicadas con degeneración cicatricial en el ojo izquierdo y posterior aparición de una membrana neovascular subfoveal en el ojo derecho. Se plantea tratamiento con terapia fotodinámica y la paciente responde favorablemente con recuperación de la agudeza visual y regresión angiográfica de la lesión. Discusión: Las membranas neovasculares son la complicación más grave de las estrías angioides. Hoy en día uno de los posibles tratamientos de las membranas neovasculares subfoveales es la terapia fotodinámica, siendo ésta, también, un tratamiento eficaz en algunas membranas neovasculares subfoveales secundarias a estrías angioides

CClinical case: A patient had bilateral angioid streaks complicated by cicatricial degeneration in the left eye and subfoveal choroidal neovascularization in the right eye. Photodynamic therapy resulted in a favorable response with normalization of the visual acuity and angiographic resolution of the lesions. Discussion: The most serious complication of angioid streaks is choroidal neovascularization. Today photodynamic therapy is an effective treatment of subfoveal choroidal neovascularization. It also appears useful in the treatment of choroidal neovascularization in angioid streaks

Evaluación de guías de práctica clínica sobre catarata / Assessment of clinical practice guidelines about cataract management

Propósito: Evaluar la calidad de las guías de práctica clínica (GPC) sobre el manejo de la catarata en adultos. Material y método: Se realizó una búsqueda bibliográfica seleccionando aquellas GPC basadas en la evidencia o en el consenso de expertos, publicadas a partir del año 2000. Las guías seleccionadas se evaluaron mediante el Instrumento AGREE. Resultados: Se incluyeron seis guías, tres de ellas resultaron «recomendadas con condiciones o modificaciones », y las otras fueron «no recomendadas». Según los criterios del Instrumento AGREE, ninguna de las guías podría ser recomendada para su uso clínico, si no es sometida previamente a modificaciones

Purpose: To evaluate the quality of clinical practice guidelines (CPG) about the management of cataract in adults. Material and method: A bibliographic search was carried out selecting the CPG based on the evidence or on the expert consensus, published since the year 2000. The guidelines selected were assessed with the AGREE Instrument. Results: Six guidelines were assessed. Three were classified as «recommend with provisos or alterations » and the others «would not be recommended ». In accordance with the AGREE Instrument criteria, no guidelines can be recommended for their use in the clinical practice if they were not modified previously

Melanoma uveal difuso. A propósito de un caso / Diffuse uveal melanoma. A clinical case

Caso clínico: Se presenta el caso de un varón de 58 años que acudió a urgencias con dolor ocular y pérdida progresiva de visión del ojo izquierdo. La exploración oftalmológica detectó una masa pigmentada en el ángulo iridocorneal afectando cuerpo ciliar. El paciente presentaba glaucoma secundario a la lesión melánica. La oftalmoscopia mostró una tumoración coroidea pigmentada de gran tamaño. Tras la enucleación ocular, el estudio anatomopatológico confirmó el diagnóstico de melanoma ocular difuso. Discusión: El melanoma uveal difuso es un tumor maligno que produce metástasis en los primeros años tras su diagnóstico, siendo la enucleación el tratamiento indicado

Case report: We report the case of a 58-year-old man who presented at our emergency department with ocular pain and progressive loss of vision in his left eye. Ophthalmic examination detected a pigmented mass in the iridocorneal angle, involving the ciliary body. Glaucoma had also developed secondary to the melanotic lesion. Ophthalmoscopy showed a large pigmented choroidal tumor. After enucleation, pathologic examination confirmed the diagnosis of a diffuse ocular melanoma. Discussion: Diffuse uveal melanoma is a malignant tumor that metastasises early. Enucleation is the treatment of choice