¿Melanoma o glaucoma? A propósito de un caso / Melanoma or glaucoma? A case report

CASO CLÍNICO: Presentamos a un paciente remitido con sospecha de melanoma de cuerpo ciliar debido a una lesión pigmentada en la raíz del iris del ojo izquierdo, asociada con presión intraocular alta a pesar de tratamiento máximo con medicación tópica y sistémica. El estudio sistemático reveló cambios unilaterales en el endotelio corneal, compatibles con el síndrome iridocorneal. Se implantó una válvula de Ahmed(R), logrando un control sostenido de la presión intraocular y de los defectos del campo visual. Discusión: Los síndromes iridocorneales son un amplio y heterogéneo grupo de enfermedades donde las células endoteliales crecen sobre el trabéculo, lo que lleva a un aumento en la presión intraocular. Debido a la naturaleza de la enfermedad, la cirugía de implante valvular puede ser la mejor opción terapéutica de entrada. El estudio clínico sistemático es crucial, ya que el diagnóstico diferencial puede incluir entidades potencialmente cegadoras e incluso mortales

CASE REPORT: The case is presented of a patient referred to us with suspicion of a ciliary body melanoma due to a pigmented lesion in iris root of left eye, associated with high intraocular pressure, despite maximal topical and systemic medication. The systematic workup revealed unilateral changes in the corneal endothelium, compatible with an iridocorneal syndrome. An Ahmed(R) valve was inserted, achieving sustained control of intraocular pressure and visual field defects. DISCUSSION: Iridocorneal syndromes are a wide and heterogeneous group of diseases, in which endothelial cells grow over the trabeculum, leading to an increase in intraocular pressure. Due to the nature of the disease, tube shunt surgery may be the best option in its treatment. Systematic workup is crucial, since the differential diagnosis may include potentially blinding and even life threatening conditions

Melanoma or glaucoma? A case report. / ¿Melanoma o glaucoma? A propósito de un caso.

CASE REPORT: The case is presented of a patient referred to us with suspicion of a ciliary body melanoma due to a pigmented lesion in iris root of left eye, associated with high intraocular pressure, despite maximal topical and systemic medication. The systematic workup revealed unilateral changes in the corneal endothelium, compatible with an iridocorneal syndrome. An Ahmed® valve was inserted, achieving sustained control of intraocular pressure and visual field defects. DISCUSSION: Iridocorneal syndromes are a wide and heterogeneous group of diseases, in which endothelial cells grow over the trabeculum, leading to an increase in intraocular pressure. Due to the nature of the disease, tube shunt surgery may be the best option in its treatment. Systematic workup is crucial, since the differential diagnosis may include potentially blinding and even life threatening conditions.

Photoprotection and photoreception of intraocular lenses under xenon and white LED illumination.

OBJECTIVE: To analyze the photoprotection and phototransmission that various intraocular lenses (IOLs) provide under the illumination of a xenon (Xe) lamp and white LEDs (light emitting diode). METHODS: The spectral transmission curves of six representative IOLs were measured using a Perkin-Elmer Lambda 35 UV/VIS spectrometer. Various filtering simulations were performed using a Xe lamp and white LEDs. The spectral emissions of these lamps were measured with an ILT-950 spectroradiometer. RESULTS: The IOLs analyzed primarily show transmission of nearly 100% in the visible spectrum. In the ultraviolet (UV) region, the filters incorporated in the various IOLs did not filter equally, and some of them let an appreciable amount of UV through. The Xe lamp presented a strong emission of ultraviolet A (UVA), and its emission under 300nm was not negligible. The white LED did not present an appreciable emission under 380nm. CONCLUSIONS: The cut-off wavelength of most filters is between 380 and 400nm (Physiol Hydriol60C(®), IOLTECH E4T(®), Alcon SA60AT(®), Alcon IQ SN60WF(®)), so that their UV protection is very effective. Nonetheless, the IOL OPHTEC Oculaid(®) contains a filter that, when a Xe lamp is used, lets through up to 20% for 350nm and up to 15% for 300nm, which at this point is ultraviolet B (UVB). The OPHTEC(®) Artisan IOL has a transmission peak below 300nm, which must be taken into account under Xe illumination. White LEDs do not emit energy below 380nm, so no special protection is required in the UV region.

Anorexia elicited by different catecholamines in rats.

Adrenaline (A) produces a strong anorexic effect, possibly by acting on hepatic receptors (nerve endings on hepatocytes). To study whether this is mediated by alpha- or beta-adrenergic mechanisms, or both, the anorexigenic effects of intraperitoneal injections of A, noradrenaline (NA) and isoproterenol (I) were studied under four different experimental conditions: (I) at the beginning of the dark period in rats fed ad libitum, or (II) on a 24 h-feeding/24 h-fasting schedule; (III) during the light period, under the same feeding schedule; (IV) after an acute 24 h fast. In condition I, the three catecholamines produced a marked decrease in feeding, slightly larger for A. In condition II (dark), they elicited a decrease in food intake about double that in condition III (light), their relative potencies also differed: A greater than I greater than NA in II and A greater than I = NA in III. In IV, the same relative potencies were obtained as in III. A mixture of half-doses of NA and I had the same effect in III and IV as either NA or I alone, suggesting that the alpha and beta effects are additive. However, even a mixture of the full doses of NA and I was not as effective as A in condition IV. This suggests that A is more potent than NA or I at stimulating hepatic adrenergic receptors that cannot be classified as either alpha or beta.