ABSTRACT
El carcinoma microcítico de pulmón puede afectar al ojo directamente mediante proliferación metastásica o indirectamente a través de síndromes paraneoplásicos. La coroides es el lugar más afectado entre las metástasis uveales; no obstante, el iris puede estar envuelto en una proporción pequeña de casos (<10%). Visión borrosa, dolor, hiperemia, fotofobia, glaucoma, hipema o defectos en el campo visual pueden originarse por la afectación metastásica. La mediana de supervivencia en pacientes con metástasis iridianas es de 4 meses. El glaucoma secundario que se origina puede ser manejado con tratamiento tópico y oral, ciclo fotoablación transescleral, trabeculoplastia con láser, anti-VEGF, MIGS, cirugía filtrante o enucleación. Se presenta un caso único que desarrolló un cáncer microcítico de pulmón primario con metástasis iridianas. Las metástasis provocaron un cierre angular, refractario al tratamiento tópico. Se realizó radioterapia local para conseguir una respuesta local (AU)
Small-cell lung cancer may directly affect the eye by metastatic proliferation or indirectly by paraneoplastic syndromes. The choroid is the most common site for uveal metastasis (90%); however, the iris can be involved in a smaller proportion of cases (incidence <10%). Blurred vision, pain, redness, photophobia, glaucoma, hyphema and visual field defects can arise from this metastatic involvement. The median survival time for patients with iris metastasis is reported to be 4 months. Secondary glaucoma can be managed with topical and oral treatment, transscleral cyclophotocoagulation, laser trabeculoplasty, anti-VEGF, minimally invasive glaucoma surgery (MIGS), filtering surgery, shunting surgery or enucleation. A case of primary small-cell lung cancer with iris metastasis is presented. The metastases produced an angle-closure glaucoma, which was refractory to topical treatment. Local radiotherapy was administered, obtaining a good local response (AU)
Subject(s)
Humans , Male , Middle Aged , Glaucoma, Neovascular/diagnostic imaging , Glaucoma, Neovascular/etiology , Carcinoma, Small Cell/complications , Carcinoma, Small Cell/secondary , Lung Neoplasms/complications , Lung Neoplasms/secondaryABSTRACT
Small-cell lung cancer may directly affect the eye by metastatic proliferation or indirectly by paraneoplastic syndromes. The choroid is the most common site for uveal metastasis (90%); however, the iris can be involved in a smaller proportion of cases (incidence <10%). Blurred vision, pain, redness, photophobia, glaucoma, hyphema and visual field defects can arise from this metastatic involvement. The median survival time for patients with iris metastasis is reported to be 4 months. Secondary glaucoma can be managed with topical and oral treatment, transscleral cyclophotocoagulation, laser trabeculoplasty, anti-VEGF, Minimally Invasive Glaucoma Surgery (MIGS), filtering surgery, shunting surgery or enucleation. A case of primary small-cell lung cancer with iris metastasis is presented. The metastases produced an angle-closure glaucoma, which was refractory to topical treatment. Local radiotherapy was administered, obtaining a good local response.
Subject(s)
Glaucoma, Neovascular , Glaucoma , Lung Neoplasms , Humans , Glaucoma, Neovascular/etiology , Intraocular Pressure , Glaucoma/surgery , Iris/pathology , Vision Disorders , Lung Neoplasms/pathologyABSTRACT
Se describen las manifestaciones clínicas y pruebas diagnósticas complementarias de dos hermanas de 26 y 31 años, con diagnóstico de enfermedad de Stargardt y su diferente evolución. Una de ellas presentó una agudeza visual (AV) inicial de 0,7, con disminución progresiva de la visión central por atrofia de las capas externas de la retina a nivel subfoveal, y fue reclutada para participar en un ensayo clínico con Avancincaptad Pegol (Zimura®), un inhibidor del factor de complemento C5. La otra hermana permaneció asintomática, con AV de 1 en ambos ojos. En los dos casos se apreciaron lesiones pisciformes blanco-amarillentas distribuidas en el polo posterior. No existe un tratamiento curativo para esta enfermedad, aunque en la actualidad hay numerosas líneas de investigación. La clínica y las pruebas diagnósticas permiten confirmar la enfermedad y dar a los pacientes un pronóstico adecuado (AU)
The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis (AU)
Subject(s)
Humans , Female , Adult , Eye Diseases, Hereditary/diagnosis , Eye Diseases, Hereditary/drug therapy , Visual Acuity , Complement Inactivating Agents/therapeutic use , Treatment OutcomeABSTRACT
The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis.
Subject(s)
Retina , Vision Disorders , Adult , Atrophy , Female , Humans , Stargardt Disease , Vision Disorders/diagnosis , Visual AcuityABSTRACT
The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis.
ABSTRACT
BACKGROUND: A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. MATERIAL AND METHODS: A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis. RESULTS: Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few studies. The presence of periapical lesions (PALs) was significantly associated to TSM (OR=2.43 (95%CI:1.71-3.46); I2=34.5%) and to odontogenic maxillary sinusitis (OMS) (OR=1.77 (95%CI: 1.20-2.61); I2=35.5%). CONCLUSIONS: The presence of PALs increases the probability of TSM and OMS up to 2.4-fold and 1.7-fold respectively. The risk differences suggests that about 58 and 37 of out every 100 maxillary sinuses having antral teeth with PALs are associated with an increased risk TSM and OMS respectively. The meta-evidence obtained in this study was of moderate certainty, and although the magnitude of the observed associations may vary, their direction in favor sinus disorders appearance, would not change as a result.
