Comparison of two methods for obtaining and transporting corneal samples in suspected infectious keratitis.

BACKGROUND AND PURPOSE: The purpose of this study is to compare two alternative methods of collecting and transporting media for the diagnosis of corneal ulcers, as not all clinical settings have conventional culture materials and transport media available. METHODS: In this open-label, prospective, comparative, and randomized study, patients with clinical suspicion of infectious keratitis with high risk of loss of vision had corneal specimens collected using two methods and transport media: Eswab scraping with Amies transport medium and 23-gauge needle scraping in BACTEC Peds broth. The order of each collection method was randomized. The samples were processed by standard methods, comparing the positivity frequencies for both by parametric and nonparametric tests, according to normality criteria. RESULTS: Corneal infiltrates from 40 eyes of 40 patients were analyzed. Culture positivity rate was 50% for Eswab and 35% for 23-gauge needle (P=0.258). The overall growth rate of the two methods combined was not higher than with the swab alone. The results obtained with a swab were not influenced by the collection sequence (P=0.112); however, the positivity rate was significantly higher when the sample taken with the needle was performed first (P=0.046). CONCLUSIONS: The single sample Eswab method of collection and transportation for the diagnosis of high risk corneal ulcers is a valid alternative and can be used in cases in which, for various reasons, there is no access to the full set of traditional culture materials.

Osteoma frontoetmoidal con extensión intraorbitaria. A propósito de un caso / Frontoethmoidal osteoma with orbital extension. A case report

CASO CLÍNICO: Presentamos el caso de un osteoma frontoetmoidal derecho con invasión intraorbitaria en un varón de 43 años que comenzó como un cuadro de dolor retroocular con proptosis, inflamación peripalpebral y diplopía binocular por limitación del recorrido muscular. Se realizó cirugía abierta mediante abordaje subcraneal anterior, con extirpación de varios fragmentos de osteoma, cuyo análisis histológico confirmó el diagnóstico. DISCUSIÓN: Los osteomas son tumores benignos formadores de hueso de crecimiento lento. Habitualmente son asintomáticos, hasta que producen complicaciones por efecto masa en el cerebro o en la órbita, o a nivel local, hasta que obstruyen el drenaje del seno donde asientan, generando mucoceles

CASE REPORT: A case is presented of a right frontoethmoidal osteoma with intraorbital invasion in a 43-year-old male, who was seen in the clinic with a proptosis, retro-orbital pain, peri-palpebral inflammation, and binocular diplopia due to muscular route limitation. Open surgery was performed using a subcranial approach, with removal of several fragments of osteoma. Histological analysis confirmed the diagnosis. DISCUSSION: Osteomas are benign bone-forming tumours with slow growth. They are usually asymptomatic until mass effect complications occur in the brain or in the orbit, or locally, generating mucoceles due to sinus drainage obstruction

Frontoethmoidal osteoma with orbital extension. A case report. / Osteoma frontoetmoidal con extensión intraorbitaria. A propósito de un caso.

CASE REPORT: A case is presented of a right frontoethmoidal osteoma with intraorbital invasion in a 43-year-old male, who was seen in the clinic with a proptosis, retro-orbital pain, peri-palpebral inflammation, and binocular diplopia due to muscular route limitation. Open surgery was performed using a subcranial approach, with removal of several fragments of osteoma. Histological analysis confirmed the diagnosis. DISCUSSION: Osteomas are benign bone-forming tumours with slow growth. They are usually asymptomatic until mass effect complications occur in the brain or in the orbit, or locally, generating mucoceles due to sinus drainage obstruction.

Resultados de la cirugía de estrabismo mínimamente invasiva en las desviaciones horizontales / Outcomes of minimally invasive strabismus surgery for horizontal deviation

OBJETIVO: Estudiar los resultados de la cirugía de estrabismo mínimamente invasiva (MISS) en desviaciones horizontales (DH). MÉTODO: Serie de los primeros 26 casos consecutivos operados de estrabismo horizontal en nuestro hospital mediante MISS desde febrero de 2010 a marzo de 2014. RESULTADOS: Se incluyeron 40 ojos: 26 pacientes (edad media: 7,7 años [DS: 4,9]; 34,61%: hombres). Se operaron 43 músculos: 20 rectos medios y 23 rectos laterales; 28 recesiones (rango: 3-7,5 mm), 6 resecciones (rango: 6-7 mm) y 9 plegamientos (rango: 6,5-7,5 mm). Se encontraron diferencias estadísticamente significativas (p < 0,001) en la desviación horizontal en dioptrías prismáticas pre y poscirugía, con un 88,46% de buenos resultados (desviaciones finales ≤ 10 dioptrías prismáticas). No se hallaron diferencias estadísticamente significativas (p > 0,05) en la AV al día siguiente de la cirugía y a los 6 meses. Un 29,27% de los ojos presentó hiperemia leve, 48,78% moderada y 21,95% severa al primer día postoperatorio, pasando al cuarto día al 63,41%, 31,70% y 4,87% respectivamente. Las complicaciones fueron 4 casos de sangrado conjuntival intraoperatorio, una perforación escleral y 2 prolapsos de Tenon. En un caso hubo que reconvertir a incisión fornix por mala visualización. El rango del tiempo quirúrgico disminuyó desde 30 a 15 min por músculo. CONCLUSIONES: La MISS ha obtenido buenos resultados en la cirugía del estrabismo horizontal. La inflamación conjuntival es leve en la mayoría de los casos a los 4 días de la cirugía. La AV se mantiene estable y el tiempo quirúrgico va disminuyendo una vez superada la curva de aprendizaje de 4 años

OBJECTIVE: To study the outcomes of minimally invasive strabismus surgery (MISS) for treating horizontal deviation. METHOD: Case Series of the first 26 consecutive patients operated on using the MISS technique in our hospital from February 2010 to March 2014. RESULTS: A total of 40 eyes were included: 26 patients (mean age: 7.7 years old ± 4.9); 34.61%: male. A total of 43 muscles were operated on: 20 medial, and 23 lateral recti; 28 recessions (range: 3-7.5 mm), 6 resections (6-7 mm), and 9 plications (6.5-7.5 mm) were performed. No significant difference was found (P > 0 .05) for visual acuity at postoperative day 1, and 6 months after surgery. A mild hyperaemia was observed in 29.27%, moderate in 48.78%, and severe in 21.95% at postoperative day 1 and in 63.41%, 31.70% and 4.87%, respectively, at 4 days after surgery. The complications observed were 4 intraoperative conjunctival haemorrhages, 1 scleral perforation, and 2 Tenon's prolapses. A conversion from MISS to a fornix approach was necessary in 1 patient because of bad visualization. The operating time range decreased from 30 to 15 minutes. CONCLUSIONS: The MISS technique has obtained good results in horizontal strabismus surgery. The conjunctival inflammation was mild in most of the cases at postoperative day 4. The visual acuity was stable during follow-up, and operating time decreased after a 4-year learning curve

Outcomes of minimally invasive strabismus surgery for horizontal deviation.

OBJECTIVE: To study the outcomes of minimally invasive strabismus surgery (MISS) for treating horizontal deviation METHOD: Case Series of the first 26 consecutive patients operated on using the MISS technique in our hospital from February 2010 to March 2014. RESULTS: A total of 40 eyes were included: 26 patients (mean age: 7.7 years old ± 4.9); 34.61%: male. A total of 43 muscles were operated on: 20 medial, and 23 lateral recti; 28 recessions (range: 3-7.5mm), 6 resections (6-7 mm), and 9 plications (6.5-7.5 mm) were performed. No significant difference was found (P>0.05) for visual acuity at postoperative day 1, and 6 months after surgery. A mild hyperaemia was observed in 29.27%, moderate in 48.78%, and severe in 21.95% at postoperative day 1 and in 63.41%, 31.70% and 4.87%, respectively, at 4 days after surgery. The complications observed were 4 intraoperative conjunctival haemorrhages, 1 scleral perforation, and 2 Tenon's prolapses. A conversion from MISS to a fornix approach was necessary in 1 patient because of bad visualization. The operating time range decreased from 30 to 15 minutes. CONCLUSIONS: The MISS technique has obtained good results in horizontal strabismus surgery. The conjunctival inflammation was mild in most of the cases at postoperative day 4. The visual acuity was stable during follow-up, and operating time decreased after a 4-year learning curve.

Macrovaso congénito retiniano: presentación atípica con baja visión y engrosamiento macular / Congenital retinal macrovessel: An atypical presentation with low vision and macular thickening

CASO CLÍNICO: Se presenta el caso de un varón de 35 años sin antecedentes de interés que consulta por mala visión del ojo izquierdo objetivada de forma fortuita, en el cual tras un completo estudio se llega al diagnóstico de macrovaso congénito retiniano con engrosamiento macular. DISCUSIÓN: Los macrovasos congénitos retinianos son una rara anomalía vascular cuyo diagnóstico suele ser casual ya que la repercusión visual es mínima. En los pocos casos en que se produce afectación visual importante, esta se debe a hemorragias maculares, quistes foveales, desprendimiento seroso macular o al propio transcurso del vaso por la zona avascular foveal

CASE REPORT: We report a case of a 35 year old male patient with no medical history, who experienced decreased vision in his left eye that he noticed by chance. After a complete ophthalmic examination, he was diagnosed with congenital retinal macrovessel with macular thickening. DISCUSSION: Congenital retinal macrovessels are rare vascular anomalies, in which the diagnosis is usually incidental as their visual impact is minimal. In the rare cases where there is a significant visual impairment, this is due to macular hemorrhages, foveal cysts, serous macular detachment, or the course of the vessel itself through the foveal avascular zone

[Congenital retinal macrovessel: an atypical presentation with low vision and macular thickening]. / Macrovaso congénito retiniano: presentación atípica con baja visión y engrosamiento macular.

CASE REPORT: We report a case of a 35 year old male patient with no medical history, who experienced decreased vision in his left eye that he noticed by chance. After a complete ophthalmic examination, he was diagnosed with congenital retinal macrovessel with macular thickening. DISCUSSION: Congenital retinal macrovessels are rare vascular anomalies, in which the diagnosis is usually incidental as their visual impact is minimal. In the rare cases where there is a significant visual impairment, this is due to macular hemorrhages, foveal cysts, serous macular detachment, or the course of the vessel itself through the foveal avascular zone.

[Utility of systematically determining serum HBsAg in the 3d trimester of pregnancy]. / Utilidad de la determinación sistemática del HBsAg sérico en el tercer trimestre de la gestación.

A group of pregnant women living in the south of the province of Pontevedra (Spain) have been studied in order to determine the prevalence of hepatitis B virus biological markers. For that respect we have prospectively studied HBsAg and other markers in 535 pregnant women from June 1987 to March 1988. The prevalence of HBsAg was 0.75%, and in 6.12% certain biological markers were detected. Only one carrier fulfilled the current criteria recommended by the Advisory Committee on Immunization Practices (ACIP) for selective screening of pregnant women. Although the prevalence and costs of the detection are similar to those for voluntary blood donors of the same region (1%), the frequency with which infected neonates develop chronic antigenemia along with the low sensitivity of the selective screening justifies the systematized serological study of the pregnant women.