Evolución clínica de la uveítis intermedia asociada a infección por el virus linfotrópico de células T humano tipo 1 (HTLV-1) / Clinical course of HTLV-1 infection associated intermediate uveitis

Objetivo: Describir las características asociadas a la presentación, tratamiento y seguimiento de una serie de casos de uveítis intermedia asociada al virus linfotrópico de células T humano de tipo 1 (HTLV-1).Pacientes y métodosEstudio retrospectivo, descriptivo y longitudinal. Se incluyó a pacientes con uveítis intermedia asociada a infección por HTLV-1 atendidos en una clínica oftalmológica de referencia de Lima (Perú), durante 2012-2018.ResultadosSe incluyó a 18 pacientes (28 ojos). La edad promedio a la presentación fue de 57,3 años; el 66,6% fueron mujeres. El tiempo de seguimiento promedio fue de 1.280 días. Los síntomas más frecuentes fueron visión borrosa o disminuida (78,6%) y visión de cuerpos flotantes (57,1%). La agudeza visual mejor corregida fue de 20/40 o mejor en el 53,6%. La presión intraocular inicial promedio fue de 14,95mmHg. Se observaron precipitados retroqueráticos en el 50% de ojos, siendo el tipo más frecuente el espiculado (17,9% de los ojos). El tratamiento más frecuente fue la inyección periocular de corticoides (en el 53,6% de los ojos). Se presentaron complicaciones como membrana epimacular (50%), catarata (21,4%) y glaucoma (7,1%). Al final del seguimiento, solo 2 ojos perdieron una línea de visión; la agudeza visual mejor corregida final fue de 20/40 o mejor en el 85,7%, y de 20/70 o mejor en el 96,4%. Los pacientes afectados en ambos ojos aumentaron de 33% a la presentación a 55,5%. El curso de la enfermedad fue crónico en el 60,7%.ConclusiónLa uveítis intermedia asociada a infección por HTLV-1 se presentó principalmente en la segunda mitad de la vida, con curso crónico y buen pronóstico visual. (AU)

Objective: To describe the clinical features at presentation, delivered treatment and follow-up of a case series of human T-cell lymphotropic virus type 1 (HTLV-1) associated intermediate uveitis.Patients and methodsRetrospective, descriptive and longitudinal study of patients with HTLV-1 associated intermediate uveitis treated at a reference ophthalmology facility in Lima, Peru, during the years 2012 to 2018.ResultsA total of 18 patients (28 eyes) were included, the average age at presentation was 57.3 years, 66.6% were women, and the average follow-up time was 1,280 days. The most frequent symptoms were blurred or diminished vision (78.6%) and floaters (57.1%). Best corrected visual acuity was 20/40 or better in 53.6%. The mean initial intraocular pressure was 14.95mmHg. Keratic precipitates were observed in 50% of eyes, 17.9% were of the stellate type. The most frequent treatment was periocular corticosteroid injections (53.6%). Complications such as epimacular membrane (50%), cataract (21.4%) and glaucoma (7.1%) occurred. At the end of follow-up, only 2 eyes lost one line of vision; the final best corrected visual acuity was 20/40 or better in 85.7%, and 20/70 or better in 96.4%. Patients with both eyes affected increased from 33% at presentation to 55.5%. The course of the disease was chronic in 60.7%.ConclusionHTLV-1 associated intermediate uveitis mainly occurred in patients in the second half of life, developing a chronic course and with good visual prognosis. (AU)

Clinical course of HTLV-1 infection associated intermediate uveitis.

OBJECTIVE: To describe the clinical features at presentation, delivered treatment and follow-up of a case series of human T-cell lymphotropic virus type 1 (HTLV-1) associated intermediate uveitis. PATIENTS AND METHODS: Retrospective, descriptive and longitudinal study of patients with HTLV-1 associated intermediate uveitis treated at a reference ophthalmology facility in Lima, Peru, during the years 2012 to 2018. RESULTS: A total of 18 patients (28 eyes) were included, the average age at presentation was 57.3 years, 66.6% were women, and the average follow-up time was 1,280 days. The most frequent symptoms were blurred or diminished vision (78.6%) and floaters (57.1%). Best corrected visual acuity was 20/40 or better in 53.6%. The mean initial intraocular pressure was 14.95 mmHg. Keratic precipitates were observed in 50% of eyes, 17.9% were of the stellate type. The most frequent treatment was periocular corticosteroid injections (53.6%). Complications such as epimacular membrane (50%), cataract (21.4%) and glaucoma (7.1%) occurred. At the end of follow-up, only 2 eyes lost one line of vision; the final best corrected visual acuity was 20/40 or better in 85.7%, and 20/70 or better in 96.4%. Patients with both eyes affected increased from 33% at presentation to 55.5%. The course of the disease was chronic in 60.7%. CONCLUSION: HTLV-1 associated intermediate uveitis mainly occurred in patients in the second half of life, developing a chronic course and with good visual prognosis.

Coristoma óseo epibulbar: caso clínico y revisión de literatura / Epibulbar osseous choristoma: A clinical case and review of the literatura

Presentamos el caso de un preescolar varón de 3 años con un coristoma óseo epibulbar. El paciente presentaba una masa subconjuntival de consistencia dura de 8×10 mm en el cuadrante superotemporal del ojo derecho con vascularización y presencia de cilios largos de aproximadamente 8 a 10 mm que tocaban la superficie corneal. El estudio histopatológico evidenció la presencia de trabéculas de hueso compacto maduro rodeado de tejido fibroso, canales de Havers con anillos concéntricos de hueso laminar sin médula ósea y con osteocitos normales, lo cual definió el diagnóstico de coristoma óseo epibulbar. El coristoma óseo es el tipo más raro de coristomas oculares y debe considerar en el diagnóstico diferencial de los tumores epibulbares pediátricos

We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8 × 10 mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10 mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumour

Epibulbar osseous choristoma: A clinical case and review of the literature. / Coristoma óseo epibulbar: caso clínico y revisión de literatura.

We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8×10mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumours.