[Complications in the treatment of ocular surface squamous neoplasia with interferon α­2b in rheumatoid arthritis]. / Komplikationen der Behandlung von Neoplasien des konjunktivalen Plattenepithels mit Interferon-α-2b bei rheumatoider Arthritis.

BACKGROUND: Interferon α­2b (IFN α­2b) is an established and well-tolerated treatment for ocular surface squamous neoplasia (OSSN). METHOD: Report of complications in two patients with OSSN and rheumatoid arthritis treated with adjuvant topical IFN α­2b. RESULTS: One patient developed a scleral melt and the other one severe keratitis. After discontinuing treatment with IFN α­2b both patients showed considerable improvement. CONCLUSION: Immunosuppressed patients with OSSN under topical IFN α­2b should be closely monitored for early detection of complications.

[Botulinum toxin for ocular complications after facial palsy]. / Botulinumtoxin bei okulären Folgen nach Fazialisparese.

Sequelae of facial palsy are often underdiagnosed. The ophthalmologist plays a pivotal role in the acute, subacute and chronic treatment of this condition. Goals are to provide corneal protection, restoration of facial asymmetry and facial movements and the treatment of crocodile tears. Botulinum toxin is the first line treatment for sequelae due to aberrant regeneration. The indications and techniques for treatment with botulinum toxin in patients with facial palsy are presented.

Influence of deep scleral flap size on intraocular pressure after deep sclerectomy.

PURPOSE: To study the effect of several morphometric characteristics of the deep scleral flap on intraocular pressure (IOP) control after deep sclerectomy. METHODS: The authors conducted a nonrandomized prospective study of 56 eyes of 51 patients who underwent deep sclerectomy alone or combined with phacoemulsification. A reticulated hyaluronic acid implant was used in all cases. The surface, volume, and weight of the dissected deep scleral flap were measured and recorded. The correlation between these parameters and the postoperative IOP was evaluated at 6 and 12 months postoperatively. RESULTS: Forty-nine eyes (87.50%) achieved an IOP of 21 mmHg or less without treatment, and the need for medication was decreased significantly (p<0.001) at 12 months postoperatively. The authors found a significant inverse correlation between the mean postoperative IOP at 6 months and the surface, volume, and weight of the deep scleral flap, but not at 12 months postoperatively. CONCLUSIONS: Greater weight, surface area, and volume of the deep scleral flap dissected during deep sclerectomy achieve significantly lower postoperative IOPs in the early postoperative period.

[Weill-Marchesani's syndrome: familial involvement]. / Síndrome de Weill-Marchesani: afectación familiar.

CASE REPORT: We report the case of a child short in stature with brachydactyly and brachymorphy who was referred to our office complaining of poor vision. This was a case of Weill-Marchesani's syndrome described in a family, in which four of the eight children were affected by spherophakia, brachymorphy and brachydactyly. DISCUSSION: There are few familial cases of Weill-Marchesani's syndrome reported in the literature. Both autosomal dominant and recessive inheritances have been described. The opththalmologist plays a crucial role in its diagnosis and management, since the ocular involvement is the most severe one.

Síndrome de Weill-Marchesani: afectación familiar / Weill-Marchesani's syndrome: familial involvement

Caso clínico: Presentamos el caso clínico de unniño con talla baja, braquidactilia y braquimorfiaremitido a la consulta por baja visión. Se trata de uncaso de síndrome de Weill-Marchesani en una familiaen la que cuatro de los ocho hijos presentan esferofaquia,braquimorfia y braquidactilia.Discusión: Existen pocos casos familiares del síndromede Weill-Marchesani reflejados en la literatura.Se han descrito patrones de herencia tantoautosómico dominante como recesivo. El papel deloftalmólogo en su diagnóstico y manejo es esencial,ya que la afectación oftalmológica es la más grave

Case report: We report the case of a child short in ;;stature with brachydactyly and brachymorphy who ;;was referred to our office complaining of poor ;;vision. This was a case of Weill-Marchesani’s syndrome ;;described in a family, in which four of the ;;eight children were affected by spherophakia, ;;brachymorphy and brachydactyly. ;;Discussion: There are few familial cases of Weill- ;;Marchesani’s syndrome reported in the literature. ;;Both autosomal dominant and recessive inheritances ;;have been described. The opththalmologist ;;plays a crucial role in its diagnosis and management, ;;since the ocular involvement is the most severe ;;one

[In vivo confocal microscopy in blepharitis]. / Konfokale In-vivo-Mikroskopie bei Blepharitis.

BACKGROUND: Dysfunction of the meibomian glands with inflammation and obstruction has been suggested to be an important factor in the pathogenesis of chronic blepharitis. Few objective tests are, however, available to examine the meibomian glands directly. PATIENTS AND METHODS: Nineteen patients with anterior blepharitis, meibomitis, meibomian gland dysfunction or severe keratoconjunctivitis sicca associated with blepharitis as well as 10 patients with normal lid margins were examined with the HRTII/RCM in vivo confocal microscope. Scans of the tear film, the tarsal conjunctiva, the hair follicles and the meibomian glands were analysed by a masked observer. RESULTS: Patients with normal lid margins exhibited a minimal round cell infiltrate in the tarsal conjunctival epithelium and largely normal ducts of the meibomian glands lined with a multilayered epithelium as well as normal gland acini. In patients with anterior blepharitis, blepharitis associated with autoimmune peripheral ulcerative keratitis and blepharitis in the context of severe dry eye, confocal microscopy disclosed normal meibomian glands. In 12 patients with blepharitis/meibomitis or meibomian gland dysfunction, profound pathology was visible with dilatation and obstruction of the meibomian gland ducts. In 15 of 19 patients with blepharitis/meibomitis, but not in meibomian gland dysfunction, an intense inflammation was observed in the tarsal conjunctival epithelium and stroma. In one patient, demodex folliculorum was evident in vivo. In patients with normal lid margins as well as in patients with blepharitis, hair follicles appeared within normal limits. CONCLUSIONS: In vivo confocal microscopy allowed the examination of the tear film, the tarsal conjunctiva, the lid margin including the lash follicles and the meibomian glands. In patients with meibomian gland disease pathological changes could be visualised and documented objectively. The presence of an inflammatory infiltrate permitted us to differentiate between meibomitis and meibomian gland dysfunction. Changes of the lash follicles do not seem to play an important role in blepharitis. Thus, in vivo confocal microscopy represents an objective technique in the classification and follow-up of patients with blepharitis.

[Serpiginous choroiditis in a patient with lung carcinoma]. / Coroiditis serpinginosa en paciente con carcinoma pulmonar.

CASE REPORT: We report the case of a 66-year-old patient with serpiginous-like choroiditis and terminal epidermoid lung carcinoma. DISCUSSION: Serpiginous choroiditis is an idiopathic disease, although similar lesions have been described in association with tuberculosis, sarcoidosis, systemic lymphoma, herpes virus infection and Crohn's disease. The coexistence of serpiginous-like choroiditis and a lung carcinoma has not previously been described.

Coroiditis serpinginosa en pacientes con carcinoma pulmonar / Serpenginous choroiditis in a patient with lung carcinoma

Caso clínico: Presentamos el caso clínico de un paciente varón de 66 años con lesiones coroideas de tipo serpinginoso y carcinoma pulmonar en fase terminal.Discusión: La coroiditis serpinginosa es una enfermedad idiopática, si bien se han descrito lesiones similares asociadas a tuberculosis, sarcoidosis, linfoma sistémico, infección por herpes virus y enfermedad de Crohn. La coexistencia de lesiones coroideas de tipo serpinginoso y un carcinoma pulmonar no ha sido descrita hasta el momento en la literatura (AU)

Case report: We report the case of a 66-year-old patient with serpiginous-like choroiditis and terminal epidermoid lung carcinoma.Discussion: Serpiginous choroiditis is an idiopathic disease, although similar lesions have been described in association with tuberculosis, sarcoidosis, systemic lymphoma, herpes virus infection and Crohn´s disease. The coexistence of serpiginous-like choroiditis and a lung carcinoma has not previously been described (AU)