Efusión uveal inducido por escitalopram / Uveal effusion induced by escitalopram

CASO CLÍNICO: Mujer de 73 años en tratamiento con escitalopram que presentó glaucoma agudo de ángulo cerrado secundario a efusión uveal tras duplicar la dosis de dicho fármaco 3 días antes. Evolucionó favorablemente tras la suspensión del antidepresivo además de tratamiento hipotensor tópico y prednisona vía oral. DISCUSIÓN: La efusión uveal secundaria a fármacos es un síndrome infrecuente. Se puede acompañar de miopización y glaucoma agudo por cierre angular. El diagnóstico correcto y la suspensión del fármaco conducen a la resolución de esta nosología

CASE REPORT: A 73 year-old woman with depression treated with escitalopram developed acute secondary angle closure glaucoma related to uveal effusion after duplicating the drug dose 3 days before. She evolved favorably once the antidepressant treatment was suspended and a new treatment with topical hypotensive therapy and oral prednisone was used. DISCUSSION: The uveal effusion syndrome associated to medicines is rare; it may be associated with acute myopic shift and acute angle closure glaucoma. The correct diagnosis and discontinuation of the drug lead to the resolution of this nosology

[Uveal effusion induced by escitalopram]. / Efusión uveal inducido por escitalopram.

CASE REPORT: A 73 year-old woman with depression treated with escitalopram developed acute secondary angle closure glaucoma related to uveal effusion after duplicating the drug dose 3 days before. She evolved favorably once the antidepressant treatment was suspended and a new treatment with topical hypotensive therapy and oral prednisone was used. DISCUSSION: The uveal effusion syndrome associated to medicines is rare; it may be associated with acute myopic shift and acute angle closure glaucoma. The correct diagnosis and discontinuation of the drug lead to the resolution of this nosology.

Estudio de la tracción vitreorretiniana periférica mediante HRA-II con lente de Staurenghi 230 / Peripheral vitreoretinal traction exploration by Staurenghi 230 lens and HRA-II

Objetivo: Comunicar una nueva técnica de exploraciónde la retina periférica en pacientes con desprendimientoagudo de vítreo posterior.Material y métodos: En una muestra de 65 pacientesdiagnosticados de desprendimiento agudo devítreo posterior se estudia la retina periféricamediante el HRA-II combinado con la lente panfunduscópicade Staurenghi SLO 230. El objetivode esta técnica es la detección y localización de desgarrosretinianos y de tracciones vítreo-retinianas.Resultados: En nuestro estudio, utilizando la oftalmoscopíaindirecta con indentación escleral encontramosen 11 pacientes al menos un desgarro retiniano.El HRA-II combinado con la lente de campoamplio fue capaz de detectar el 100% de dichaslesiones. Además, mediante esta técnica, se pudolocalizar en 6 pacientes áreas de tracción vítreo retiniana,mostradas como zonas oscuras en la imageninfrarroja de fondo de ojo. Ninguno de los 65pacientes refirió dolor ni fotofobia durante la exploracióncon esta lente de contacto. Los desgarrosretinianos y las áreas de tracción fueron tratadoscon fotocoagulación con láser argón creando una adhesión coriorretiniana. En 2 pacientes se encontraronnuevos desgarros retinianos durante el seguimiento,siendo detectados tanto por oftalmoscopiaindirecta como por el HRA-II con la lente panfunduscópica.Conclusión: El HRA-II con la lente de campoamplio SLO 230 puede complementar la exploraciónde pacientes con desprendimiento agudo devítreo posterior y ayudar a la detección de zonastraccionadas de la retina que podrían dar lugar a undesgarro retiniano (AU)

Purpose: To report a new technique to explore peripheralvitreous-retinal tractions in patients withacute posterior vitreous detachment.Material and methods: A population of 65patients with acute posterior vitreous detachmentwas studied by panfunduscopic SLO 230 lens andHRA-II to detect peripheral retinal tears and vitreous-retinal tractions.Results: In our study, using indirect ophthalmoscopicexploration, we identified eleven patients with atleast one retinal tear. HRA-II combined with theStaurenghi SLO 230 lens was capable of detecting100% of these lesions. In addition, by means of thistechnology, we identified dark retinal zones thatcorresponded to peripheral retinal traction in sixpatients. None of the 65 patients complained of painor photophobia during the exploration with this contactlens. Retinal tears and peripheral vitreous-retinaltraction were treated by argon laser photocoagulationto create a firm chorioretinal adhesion. In twopatients we found new retinal tears in the follow-up,with these new lesions detected by indirect ophthalmoscopyand HRA-II with SLO 230 lens. Conclusion: HRA-II with the panfunduscopicStaurenghi SLO 230 lens can complement theexploration of patients with acute posterior vitreousdetachment and can help to detect tractional zonesthat could develop into retinal tears(AU)

[Peripheral vitreoretinal traction exploration by Staurenghi 230 lens and HRA-II]. / Estudio de la tracción vitreorretiniana periférica mediante HRA-II con lente de Staurenghi 230.

PURPOSE: To report a new technique to explore peripheral vitreous-retinal tractions in patients with acute posterior vitreous detachment. MATERIAL AND METHODS: A population of 65 patients with acute posterior vitreous detachment was studied by panfunduscopic SLO 230 lens and HRA-II to detect peripheral retinal tears and vitreous-retinal tractions. RESULTS: In our study, using indirect ophthalmoscopic exploration, we identified eleven patients with at least one retinal tear. HRA-II combined with the Staurenghi SLO 230 lens was capable of detecting 100% of these lesions. In addition, by means of this technology, we identified dark retinal zones that corresponded to peripheral retinal traction in six patients. None of the 65 patients complained of pain or photophobia during the exploration with this contact lens. Retinal tears and peripheral vitreous-retinal traction were treated by argon laser photocoagulation to create a firm chorioretinal adhesion. In two patients we found new retinal tears in the follow-up, with these new lesions detected by indirect ophthalmoscopy and HRA-II with SLO 230 lens. CONCLUSION: HRA-II with the panfunduscopic Staurenghi SLO 230 lens can complement the exploration of patients with acute posterior vitreous detachment and can help to detect tractional zones that could develop into retinal tears.