Difficulties in the management of retinal capillary haemangiomas associated with von Hippel Lindau disease. / Dificultades en el manejo de los hemangiomas capilares retinianos asociados a enfermedad de von Hippel-Lindau.

CLINICAL CASE: A 29-year-old female with bilateral retinal capillary haemangiomas (RCH). A genetic analysis was carried out due to the suspicion of von Hippel-Lindau (VHL) disease, with negative results on 2occasions. There was progression of the RCH in the left eye, leading to a macular epiretinal membrane. The patient was treated with laser, intravitreal ranibizumab, and vitrectomy. Finally, a third genetic test detected a de novo mutation in the VHL gene, and led to the genetic diagnosis. DISCUSSION: VHL syndrome causes a complex ocular disease with a difficult diagnosis that requires early treatment of the RCH in order to modify its visual prognosis.

[Fungal keratitis caused by Colletotrichum spp. A presentation of case]. / Queratitis fúngica por Colletotrichum spp. A propósito de un caso.

CASE REPORT: A 23 years old male with an unremarkable past medical history suffered an injury with a branch of a lemon tree in the right eye two days prior to presentation. The slit-lamp examination showed a central corneal erosion with a white tree-shaped stromal infiltrate and Tyndall +/++ in anterior chamber. Cultivation of corneal scraping was positive for Colletotrichum spp. The patient responded favourably to topical amphotericin. DISCUSSION: Colletotrichum spp. is an uncommon cause of keratitis, usually secondary to corneal erosion caused by plant material and should be included in the differential diagnosis of fungal keratitis.

[Papilledema secondary to cerebral venous sinus thrombosis]. / Papiledema secundario a trombosis cerebral de los senos venosos.

CASE REPORT: A 14 year old patient showing bilateral frontal headache during the previous four months was studied. Ophtalmoscopic examination revealed presence of bilateral papilledema. Magnetic resonance angiography showed presence of thrombosis in upper sagital and transverse sinuses. Patient was treated with oral acetazolamide (500 mg a day), one month later, headhache had disappeared and papilledema decreased. DISCUSSION: Aseptic cerebral venus thrombosis is an infrecuent condition that often is cause of neurologic complications that may become severe. Treatment should aim at decreasing intracranial pressure in order to avoid optic nerve atrophy and visual loss.

Papiledema secundario a trombosis cerebral de los senos venosos / Papilledema associated to cerebral venous sinus thrombosis

Caso clínico: Presentamos el caso de un varón de 14 años con cefalea frontal bilateral de 4 meses de evolución, siendo diagnosticado de papiledema bilateral. La angiorresonancia magnética reveló la existencia de una trombosis de los senos sagital superior y transversos. El paciente fue tratado con 500 mg/día de acetazolamida por vía oral. Un mes después de iniciar el tratamiento, la cefalea había desaparecido y el papiledema había disminuido de tamaño. Discusión: La trombosis venosa cerebral aséptica es un proceso infrecuente, que suele causar complicaciones neurológicas que pueden ser muy graves. El objetivo del tratamiento es disminuir la hipertensión intracraneal (HIC) causada por el proceso (AU)