ABSTRACT
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Subject(s)
Humans , Child , Brain Diseases/complications , Vision Disorders/etiology , Vision Disorders/diagnosis , Vision Disorders/therapyABSTRACT
CASE REPORT: An 11 year-old girl with progressive muscle weakness due to dermatomyositis and hemophagocytic lymphohistiocytosis in which multiple cotton exudates, venous tortuosity and flame haemorrhages are detected in the funduscopic examination, leading to the diagnosis of Purtscher-like retinopathy. DISCUSSION: Purstcher's retinopathy is a microvascular disorder with clinical signs of probable thrombotic origin. Its treatment is controversial, with systemic corticosteroids being the most widespread choice.
Subject(s)
Blindness/complications , Dermatomyositis/complications , Lymphohistiocytosis, Hemophagocytic/complications , Retinal Diseases/complications , Child , Female , HumansABSTRACT
CASE REPORT: A 7 year-old boy with Xeroderma Pigmentosum (XP) and who presents a recurrent conjunctival atypical fibroxanthoma after two surgeries. This is the third procedure and the patient is treated with a surgical excision of the tumour and cryotherapy at the surgical bed. Due to the risk of recurrence, topical Mitomycin C 0,02% was added at post-operative care achieving a good clinical outcome. DISCUSSION: Surgical exeresis with cryotherapy and topical Mitomycin C is an effective treatment for a case of an atypical fibroxanthoma with a high potential for recurrence and invasion. An ophthalmologic follow-up is required for these patients, as well as general paediatric care and support aids.
Subject(s)
Conjunctival Diseases/etiology , Xanthomatosis/etiology , Xeroderma Pigmentosum/complications , Child , Conjunctival Diseases/surgery , Humans , Male , Recurrence , Xanthomatosis/surgeryABSTRACT
CASO CLÍNICO: Un lactante de 10 meses fue remitido para estudio de leucocoria izquierda de un mes de evolución. En la exploración se detectó un retinoblastoma que ocupaba el área macular. Fue tratado con quimioterapia intraarterial con 6 mg de melfalán, sin requirir posteriores intervenciones para el control de la enfermedad. DISCUSIÓN: El melfalán es un agente quimioterápico muy efectivo, con uso limitado por la toxicidad sistémica que genera. La quimioterapia intraarterial permite la liberación selectiva en la arteria oftálmica, lo que limita la toxicidad sistémica. Esta combinación de eficacia, seguridad y precisión la hacen una alterativa terapéutica atractiva para el manejo del retinoblastoma
CASE REPORT: A 10-month old infant was referred for the study of a leukocoria of the left eye of one month onset. On examination, a retinoblastoma occupying the macular area was detected. Treatment with intra-arterial chemotherapy (melphalan 6 mg) was performed, with no further intervention required for disease control. DISCUSSION: Melphalan is an effective chemotherapeutic agent. However, its use is limited by the systemic toxicity that may occur. Intra-arterial chemotherapy allows the selective release of melphalan into the ophthalmic artery, thus limiting its systemic toxicity. This combination of efficiency, safety and accuracy makes it an attractive therapeutic alternative for the management of retinoblastoma
Subject(s)
Humans , Infant , Male , Retinoblastoma/complications , Retinoblastoma/diagnosis , Retinoblastoma/therapy , Melphalan/therapeutic use , Drug Therapy/trends , Drug Therapy , Retinoblastoma/drug therapy , Retinoblastoma/prevention & control , RetinoblastomaABSTRACT
CASE REPORT: A 10-month old infant was referred for the study of a leukocoria of the left eye of one month onset. On examination, a retinoblastoma occupying the macular area was detected. Treatment with intra-arterial chemotherapy (melphalan 6 mg) was performed, with no further intervention required for disease control. DISCUSSION: Melphalan is an effective chemotherapeutic agent. However, its use is limited by the systemic toxicity that may occur. Intra-arterial chemotherapy allows the selective release of melphalan into the ophthalmic artery, thus limiting its systemic toxicity. This combination of efficiency, safety and accuracy makes it an attractive therapeutic alternative for the management of retinoblastoma.
Subject(s)
Antineoplastic Agents, Alkylating/therapeutic use , Melphalan/therapeutic use , Retinal Neoplasms/drug therapy , Retinoblastoma/drug therapy , Antineoplastic Agents, Alkylating/administration & dosage , Humans , Infant , Infusions, Intra-Arterial , Male , Melphalan/administration & dosage , Ophthalmic Artery , Radiography, Interventional , Remission Induction , Retinal Neoplasms/diagnostic imaging , Retinoblastoma/diagnostic imagingABSTRACT
OBJECTIVE: The aim of this article is to study the effect of unilateral congenital cataract surgery on ocular growth and corneal flattening. METHODS: This is a cross-sectional study of 59 patients operated on due to a unilateral congenital cataract. The median age of the patients at the time of diagnosis was 17 months (interquartile range, 5-39 months). The median age at cataract the time of surgery was 28 months (interquartile range, 8-52 months), and the mean follow-up between cataract surgery and assessments was 149.7±69.9 months (range, 30-319 months). Axial length and corneal curvature were measured in both operated and non-operated eyes, comparing the results between them. RESULTS: There were no statistically significant differences for axial length growth or corneal flattening between operated and non-operated eyes: axial length (P=.327, Student t test) and corneal curvature (P=.078, Student t test). A sub-analysis was performed using the visual acuity and the age of the patient at the time of surgery. The only statistically significant data (P=.007, Student t test) was a lower axial length in operated eyes compared to non-operated eyes, in the non-deep-amblyopia group. CONCLUSIONS: No significant axial length growth modifications were observed between operated and non-operated eyes. Only the non-deep-amblyopia group presented with a lower axial length in the operated eyes compared to non-operated eyes. No significant differences in corneal flattening were found between groups after unilateral congenital cataract surgery.
Subject(s)
Cataract Extraction , Cataract/congenital , Cornea/ultrastructure , Eye/growth & development , Amblyopia/etiology , Amblyopia/pathology , Anthropometry , Aphakia, Postcataract/complications , Cataract/complications , Cataract Extraction/adverse effects , Child , Child, Preschool , Contact Lenses , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Infant , Lens Implantation, Intraocular , Male , Pseudophakia/complicationsABSTRACT
OBJECTIVE: To prepare a protocol for the treatment of retinopathy of prematurity (ROP) agreed by the majority of Spanish ophthalmologists dedicated to this topic. MATERIAL AND METHOD: A draft of the protocol was produced taking into account the experience of the participants and up to date publications. This draft was corrected by all the ophthalmologists participating in the project, and the final document was agreed by all of them. RESULTS: We present general guidelines as an aid for the treatment of ROP, including treatment criteria, treatment methods, a calendar of action, and follow-up. CONCLUSIONS: It is important to have a common working protocol for the treatment of ROP to improve care and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.
Subject(s)
Retinopathy of Prematurity/therapy , Clinical Protocols , Humans , Practice Guidelines as Topic , SpainABSTRACT
OBJECTIVE: To prepare a retinopathy of prematurity (ROP) screening program as agreed by most of Spanish ophthalmologists dedicated to this topic. MATERIALS AND METHODS: A draft of the protocol was produced taking into account the experience of the participants and current publications. This draft was corrected by all the ophthalmologists participating in the project and the final document produced was agreed by all of them. RESULTS: We present general guidelines to help in the screening of ROP, including treatment criteria, treatment methods, and a calendar of action. CONCLUSIONS: It is important to have a common working protocol in the screening of ROP to improve the action and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.