Angiografía por tomografía de coherencia óptica en el estudio de hemorragias secundarias a macroaneurismas arteriales retinianos / Optical coherence tomography angiography in the study of haemorrage secondary to arterial retinal macroaneurysm

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Rotura de macroaneurisma retiniano / Retinal macroaneurysm ruptura

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Angiografía con verde indocianina en escleritis anterior / Indocyanine green angiography in anterior scleritis

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Maculopatía en torpedo: presentación de 2 casos clínicos y revisión de la literatura / Torpedo maculopathy: Two case reports and a literature review

CASOS CLÍNICOS: Varón de 4 años y mujer de 25 años, con agudeza visual de 1, que presentaban una lesión macular unilateral, temporal a la fóvea, hipopigmentada, en forma de torpedo. La tomografía óptica de coherencia mostraba atenuación de la señal del epitelio pigmentario (EPR), y en la mujer un desprendimiento neurosensorial, atrofia del EPR y adelgazamiento de las capas retinianas. La lesión era hipoautofluorescente e hiperfluorescente con la angiografía fluoresceínica. DISCUSIÓN: La maculopatía en torpedo es una lesión asintomática característica, a considerar en el diagnóstico diferencial de las lesiones maculares en niños o pacientes jóvenes

CASE REPORTS: The cases concern a 4 year-old boy and 25 year-old female with 20/20 visual acuity, who presented with a unilateral non-pigmented macular lesion, temporal to the fovea, a torpedo shaped defect in the retinal pigment epithelium (RPE). Optical coherence tomography showed attenuation of the RPE signal, and in the second patient there proved to be a neurosensory detachment, RPE atrophy, and thinning of the retinal layers. The lesion was hypoautofluorescent and hyperfluorescent on fluorescein angiography. DISCUSSION: Torpedo maculopathy is an asymptomatic characteristic lesion which should be considered in the differential diagnosis of macular lesions in children and young patients

Torpedo maculopathy: Two case reports and a literature review. / Maculopatía en torpedo: presentación de 2 casos clínicos y revisión de la literatura.

CASE REPORTS: The cases concern a 4 year-old boy and 25 year-old female with 20/20 visual acuity, who presented with a unilateral non-pigmented macular lesion, temporal to the fovea, a torpedo shaped defect in the retinal pigment epithelium (RPE). Optical coherence tomography showed attenuation of the RPE signal, and in the second patient there proved to be a neurosensory detachment, RPE atrophy, and thinning of the retinal layers. The lesion was hypoautofluorescent and hyperfluorescent on fluorescein angiography. DISCUSSION: Torpedo maculopathy is an asymptomatic characteristic lesion which should be considered in the differential diagnosis of macular lesions in children and young patients.

[Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis]. / Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica.

PURPOSE: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. METHODS: A cross-sectional descriptive study was conducted on patients who underwent cataract surgery in a public hospital over an 11-year period. An ocular infection database was used to report endophthalmitis occurrences and to collect the clinical features. Qualitative variables are described with their frequency distribution and qualitative variables, with the mean and the standard deviation. RESULTS: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. A total of 43 patients suffered from postoperative endophthalmitis, giving an overall infection rate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 women with a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% were diabetic, 44.18% had some degree of immunosuppression and there were complications with posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered: the first one did not receive intracameral antibiotic (8,099 patients) and the second group received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis in the first group with an infection incidence of 0.48% and 4 endophthalmitis in the second group with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroxime was 0.12 (0.04-0.33) with P<0.05. CONCLUSIONS: The incidence of endophthalmitis after cataract surgery in an 11-year period was lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameral cefuroxime resulted in nearly a 9-fold reduction in the rate of infection.

Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica / Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis

Objetivo: Estimar la incidencia de endoftalmitis tras cirugía de cataratas, la clínica y el papelde los antibióticos intracamerales.Métodos: Se realizó un estudio descriptivo transversal en pacientes operados de cataratas enun hospital público durante 11 años. Se diseñó una base de datos de infecciones ocularespara analizar los aspectos clínico-quirúrgicos. Las variables cualitativas se describen con sudistribución de frecuencias y las cuantitativas con la media y la desviación estándar.Resultados: Desde enero de 1999 hasta diciembre de 2009, 15.173 pacientes se operaron decataratas. Hubo 43 endoftalmitis postquirúrgicas con una incidencia global de 0,28% (IC95%: 0,20-0,36%). Había 19 varones y 24 mujeres, con una edad media de 78,5 an˜ os. Se evaluarondistintos parámetros clínicos: un 25,58% eran diabéticos, un 44,18% tenían algúngrado de inmunosupresión y hubo complicaciones con vitreorragia en el 18,6%. En cuanto aprofilaxis antibiótica, se consideraron 2 grupos: el primer grupo no recibió antibiótico intracameral(8.099 pacientes) y el segundo grupo sí recibió cefuroxima (7.074 pacientes). De las43 endoftalmitis, 39 pertenecieron al primer grupo y 4 al segundo, con lo que la incidenciade infección fue de 0,48% en el primer grupo y 0,056% en el segundo. El riesgo relativo (RR)tras la evaluación después-antes de cefuroxima fue de 0,12 (0,04-0,33) con una p < 0,05.Conclusiones: La incidencia de endoftalmitis tras cirugía de cataratas en 11 años fue inferioral 0,3%. Casi la mitad de los pacientes tenían un riesgo sistémico mayor. Con la cefuroximaintracameral la tasa de infección se redujo casi nueve veces más(AU)

Purpose: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. Methods: A cross-sectional descriptive study was conducted on patients who underwentcataract surgery in a public hospital over an 11-year period. An ocular infection databasewasused to report endophthalmitis occurrences and to collect the clinical features. Qualitativevariables are described with their frequency distribution and qualitative variables, with themean and the standard deviation.Results: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. Atotal of 43 patients suffered from postoperative endophthalmitis, giving an overall infectionrate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 womenwith a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% werediabetic, 44.18% had some degree of immunosuppression and there were complicationswith posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered:the first one did not receive intracameral antibiotic (8,099 patients) and the secondgroup received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis inthe first group with an infection incidence of 0.48% and 4 endophthalmitis in the secondgroup with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroximewas 0.12 (0.04-0.33) with P < 0.05.Conclusions: The incidence of endophthalmitis after cataract surgery in an 11-year periodwas lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameralcefuroxime resulted in nearly a 9-fold reduction in the rate of infection(AU)

Pérdida de agudeza visual en varón exfumador / Loss of visual acuity in male who is ex-smoker

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[Indocyanine green angiography in chorioretinal inflammatory diseases]. / Valoración de enfermedades inflamatorias coriorretinianas con angiografía verde indocianina.

PURPOSE: To determine the role of indocyanine green angiography (ICG) in handling chorioretinal inflammatory disorders. METHOD: We present several posterior uveitis whose diagnosis and therapeutic approach was facilitated with ICG. RESULTS: ICG is useful in the differential diagnosis of <>. In serpiginous choroiditis, the edges and the progression of the inflammatory areas are clearly delineated. In infectious uveitis such as toxoplasmosis, ICG determines the presence or absence of active lesions. There are granulomatous diseases such as sarcoidosis where some areas of choroidal inflammation that cannot be detected with other methods are shown by ICG. Moreover, ICG can detect areas of subretinal neovascularization in some choroidal pathologies such as polypoidal choroidal vasculopathy. CONCLUSIONS: ICG appears to be a useful and complementary tool in the clinical interpretation of posterior uveitis.

Valoración de enfermedades inflamatorias coriorretinianas con angiografía verde indocianina / Indocyanine green angiography in chorioretinal inflammatory diseases

Objetivo: Determinar el papel de la angiografía con verde indocianina (ICG) en el manejo de inflamaciones coriorretinianas. Métodos: Se presentan uveítis posteriores cuyo diagnóstico y actitud terapéutica se facilitó con la ICG. Resultados: La ICG contribuye al diagnóstico diferencial de las "enfermedades de puntos blancos". En coroiditis serpiginosa ayuda a delimitar la extensión y progresión de los bordes activos de la enfermedad. En uveítis infecciosas como la toxoplasmosis, la ICG determina la presencia o ausencia de lesiones activas. Hay enfermedades granulomatosas, como la sarcoidosis, donde se detectan zonas de inflamación coroideas no objetivables con otros métodos. La ICG permite además detectar zonas de neovascularización subretiniana en algunas coroidopatías como en la vasculopatía coroidea polipoidal. Conclusiones: La ICG resulta una herramienta útil y complementaria en la interpretación clínica de las uveítis posteriores (AU)