ABSTRACT
BACKGROUND: As retinoblastoma (RB) is the most frequent primary intraocular malignant tumor in childhood, it should be the main pathology to rule out in pediatric patients with leukocoria. Persistence of fetal vasculature (PFV) is within the differential diagnosis of leukocoria, a vitreous disorder arising from a defect in the involution of the hyaloid vasculature in the embryonic stage, which affects normal ocular development and commonly produces associated microophthalmia. An early diagnosis and timely treatment are crucial for a better prognosis and life expectancy of the child. CASE REPORT: We present a case of retinoblastoma and coexisting with PFV: a 2-years-and 11-months-old male with no red reflex, and vasculature and yellowish-white membrane behind the lens of the right eye. B-mode ultrasound with disorganization of the vitreous cavity with high reflectivity echoes suggestive of calcification. On examination we found an enlarged eyeball, rubeosis iridis, posterior vasculature, intraocular pressure 28 mmHg. Computed tomography with heterogeneous intraocular mass with hyperdense regions. With a diagnosis of probable retinoblastoma, enucleation was performed. Histopathology reported moderately differentiated retinoblastoma coexisting with PFV. CONCLUSIONS: The finding of these two diagnoses in the same eye is very rare due to the different pathophysiology.
INTRODUCCIÓN: El retinoblastoma (RB) es el tumor maligno primario intraocular más frecuente en la infancia y debe ser la principal patología a descartar en los pacientes pediátricos con leucocoria. La persistencia de la vasculatura fetal (PVF) está dentro del diagnóstico diferencial de la leucocoria, un trastorno del vítreo que surge de un defecto en la involución de la vasculatura hialoidea en la etapa embrionaria que afecta al desarrollo ocular normal y comúnmente produce microoftalmia asociada. El diagnóstico temprano y tratamiento oportuno son cruciales para un buen pronóstico y mejor esperanza de vida del infante. CASO CLÍNICO: Presentamos un caso de coexistencia de retinoblastoma y PVF: paciente de sexo masculino de 2 años y 11 meses sin reflejo rojo y vasculatura y membrana blanco-amarillenta detrás del cristalino en el ojo derecho. La ecografía en modo B con desorganización de la cavidad vítrea con ecos de alta reflectividad sugestivos de calcificación. A la exploración se observó globo ocular agrandado, rubeosis iridis, vasculatura posterior, presión intraocular 28 mmHg. Tomografía computarizada con masa intraocular heterogénea con regiones hiperdensas. Con diagnóstico de probable retinoblastoma, se realizó la enucleación. La histopatología informó el hallazgo de retinoblastoma moderadamente diferenciado coexistente con PVF. CONCLUSIONES: El hallazgo de estos dos diagnósticos en un mismo ojo es muy poco frecuente debido a la diferente fisiopatología.
Subject(s)
Calcinosis , Persistent Hyperplastic Primary Vitreous , Retinal Neoplasms , Retinoblastoma , Humans , Male , Child , Infant , Retinoblastoma/diagnosis , Persistent Hyperplastic Primary Vitreous/diagnosis , Persistent Hyperplastic Primary Vitreous/complications , Persistent Hyperplastic Primary Vitreous/pathology , Calcinosis/complications , Tomography, X-Ray Computed , Retinal Neoplasms/diagnosisABSTRACT
Resumen Introducción: El retinoblastoma (RB) es el tumor maligno primario intraocular más frecuente en la infancia y debe ser la principal patología a descartar en los pacientes pediátricos con leucocoria. La persistencia de la vasculatura fetal (PVF) está dentro del diagnóstico diferencial de la leucocoria, un trastorno del vítreo que surge de un defecto en la involución de la vasculatura hialoidea en la etapa embrionaria que afecta al desarrollo ocular normal y comúnmente produce microoftalmia asociada. El diagnóstico temprano y tratamiento oportuno son cruciales para un buen pronóstico y mejor esperanza de vida del infante. Caso clínico: Presentamos un caso de coexistencia de retinoblastoma y PVF: paciente de sexo masculino de 2 años y 11 meses sin reflejo rojo y vasculatura y membrana blanco-amarillenta detrás del cristalino en el ojo derecho. La ecografía en modo B con desorganización de la cavidad vítrea con ecos de alta reflectividad sugestivos de calcificación. A la exploración se observó globo ocular agrandado, rubeosis iridis, vasculatura posterior, presión intraocular 28 mmHg. Tomografía computarizada con masa intraocular heterogénea con regiones hiperdensas. Con diagnóstico de probable retinoblastoma, se realizó la enucleación. La histopatología informó el hallazgo de retinoblastoma moderadamente diferenciado coexistente con PVF. Conclusiones: El hallazgo de estos dos diagnósticos en un mismo ojo es muy poco frecuente debido a la diferente fisiopatología.
Abstract Background: As retinoblastoma (RB) is the most frequent primary intraocular malignant tumor in childhood, it should be the main pathology to rule out in pediatric patients with leukocoria. Persistence of fetal vasculature (PFV) is within the differential diagnosis of leukocoria, a vitreous disorder arising from a defect in the involution of the hyaloid vasculature in the embryonic stage, which affects normal ocular development and commonly produces associated microophthalmia. An early diagnosis and timely treatment are crucial for a better prognosis and life expectancy of the child. Case report: We present a case of retinoblastoma and coexisting with PFV: a 2-years-and 11-months-old male with no red reflex, and vasculature and yellowish-white membrane behind the lens of the right eye. B-mode ultrasound with disorganization of the vitreous cavity with high reflectivity echoes suggestive of calcification. On examination we found an enlarged eyeball, rubeosis iridis, posterior vasculature, intraocular pressure 28 mmHg. Computed tomography with heterogeneous intraocular mass with hyperdense regions. With a diagnosis of probable retinoblastoma, enucleation was performed. Histopathology reported moderately differentiated retinoblastoma coexisting with PFV. Conclusions: The finding of these two diagnoses in the same eye is very rare due to the different pathophysiology.
ABSTRACT
OBJECTIVE: To compare the completeness and quality of information about diabetic retinopathy on Wikipedia in the world's leading spoken languages in 2020. DESIGN AND METHODS: An observational, descriptive, cross-sectional study. The information on diabetic retinopathy obtained from the free encyclopedia Wikipedia® was assessed in languages with one hundred million or more total speakers. The term "diabetic retinopathy" was accessed in the corresponding Wikipedia entry in English, while the "more languages" function gives access to other languages. The information on the sites was collected by three ophthalmologist observers. A database was created with the most important subtopics for the education of patients with diabetic retinopathy in any of its classifications, based on a 25-question survey. The results were stratified on a scale from 0 to 4. A confirming correlation was found in the statistical analysis among the observers. RESULTS: No language achieved the label "excellent"; 2 languages were rated as "fair "; 4 languages qualified as "substandard"; and 7 languages were scored as "poor." No information could be found in five languages. CONCLUSIONS: As would be expected, the quality of content is variable across different languages. However, if anyone can edit Wikipedia, health professionals can do so as well to improve the quality and quantity of information for patients.
Subject(s)
Consumer Health Information , Diabetic Retinopathy/pathology , Internet , Language , Humans , Surveys and QuestionnairesABSTRACT
BACKGROUND: Brachiocephalic trunk (BCT) variants may have a clinical impact during surgical procedures, some of which could be fatal. The objective of this study was to classify height positions of the BCT and report their prevalence in a Mexican population. METHODS: Patients: A retrospective, descriptive, observational, and cross-sectional was performed using computed tomography angiography (CTA) of adult (> 18 years of age) patients, without gender distinction, of Mexican origin. Measuring techniques were standardized using the suprasternal notch to analyze linear and maximum heights, linear and curved lengths, and the vertebral origin and bifurcation levels of the BCT. RESULTS: A total of 270 CTA were obtained (66.7% men and 33.3% women). A high position of BCT was present in 64.81% (n 175/270). The mean linear medial height was 0.58 ± 1.91 cm, the maximum height of the free edge was 3.85 ± 2.04 cm, side length of the midline at the maximum height of the free edge was 1.46 ± 2.59, linear length 3.72 ± 0.70, and a curve length 3.99 ± 0.79. The BCT origin was most predominant at the T3 (57.9%) and T4 (27.0%) vertebral levels, with the bifurcation at T2 (57.9%) and T1 (36.2%). CONCLUSIONS: There is a high prevalence of high position BCT in our population. Patients should be assessed before any procedures in the area, due to the potential risk of complications.
Subject(s)
Brachiocephalic Trunk/anatomy & histology , Adult , Brachiocephalic Trunk/diagnostic imaging , Computed Tomography Angiography , Cross-Sectional Studies , Female , Humans , Male , Mexico , Middle Aged , Neck/anatomy & histology , Neck/diagnostic imaging , Retrospective StudiesABSTRACT
Primary acquired nasolacrimal duct obstruction is greater in women over 40 years and has been associated with morphometric variations in the osseous nasolacrimal duct, which varies according to age and sex. The objective is to determine variations regarding sex and age of the nasolacrimal duct and osseous fossa for lacrimal gland. One hundred sixteen dry orbits from Mexican population were analyzed; subdivided into four groups based on age and sex. The length, transverse and anteroposterior diameters of the bone entrance of the nasolacrimal duct, and the length and width of the fossa for lacrimal gland were determined. Statistical tests were applied to determine the significance of the differences found between groups. The nasolacrimal duct in women had shorter length than men in both age groups. The entrance had a wider transverse diameter in women than men independently of age and its anteroposterior diameter was shorter in men under 40 years than over 40 years. The fossa for lacrimal gland was larger in women under 40 years than in men of same age group and women over 40 years old. The lower third of the was wider in women under 40 years than in women over 40 years. Our study confirms significant differences between sex and age groups in some of the morphometric measurements of bony nasolacrimal duct and fossa for lacrimal gland in Mexican population. Comparative studies with and without clinical illness are needed to clarify if the bony characteristics of those structures participate in the etiopathogenesis and distribution differences observed in sex, age and ethnicity of thisillness.
La obstrucción de la vía lagrimal inferior es mayor en mujeres mayores de 50 años y se ha asociado a variaciones morfométricas en la entrada ósea del conducto nasolagrimal (CNL), las cuales varían según edad y sexo. El objetivo del presente estudio es determinar las variaciones respecto a sexo y edad de los diámetros de la entrada ósea del CNL, longitud del CNL y fosa de la glángula lagrimal (FL) ósea. Se analizaron 116 órbitas secas de población mexicana, los cuales a su vez fueron subdivididos en dos subgrupos en base a la edad y sexo. Se determinaron los diámetros transverso y anteroposterior de la entrada ósea del CNL, la longitud del CNL y la longitud y anchura de la FL. Se aplicaron pruebas estadísticas para determinar la significancia de las diferencias entre los grupos de estudio. La longitud del CNL fue menor en mujeres que en hombres en ambos grupos de edad. En cuanto a la entrada ósea del CNL, el diámetro transverso de fue significativamente menor en hombres que en mujeres independientemente de la edad y el diámetro anteroposterior fue menor en hombres < 40 que en > 40. La longitud de la FL fue mayor en mujeres < 40 años que en hombres del mismo rango de edad y que en mujeres > 40 años. La anchura de la FL en el tercio inferior fue menor en mujeres > 40 años que < 40 años. El resto de las mediciones de la FL no presentó diferencias significativas por sexo ni grupo de edad. Nuestro estudio confirmó que existen diferencias entre sexo y grupo de edad en algunas mediciones morfométricas del CNL y FL óseas en población mexicana. Se necesitan estudios comparativos entre personas con y sin obstrucción clínica de vía lagrimal inferior para esclarecer si las características óseas de estas estructuras participan o no en la etiopatogenia y las diferencias de distribución en género, edad y etnia de esta enfermedad.
