Retinopatía por puntero láser: presentación de dos casos / Handheld laser maculopathy: two case reports

El uso indebido de los punteros láser, especialmente el recreativo en los niños, puede causar lesiones retinianas que amenazan la visión. El daño retiniano que producen no está bien caracterizado, debido a que la mayoría de las publicaciones son casos aislados o series pequeñas. El tratamiento y el pronóstico visual es variable según la morfología del daño macular que presenten. En algunos casos, no existe tratamiento, y pueden evolucionar a la curación espontánea; sin embargo, otros precisan cirugía. En una serie de 13 casos, uno requirió cirugía, mientras que el resto necesitó solo observación. De estos 13 casos, 3 pacientes se curaron en forma espontánea, con agudeza visual de 10/10.Se describen dos pacientes de 16 y 12 años con disminución de agudeza visual tras el uso indebido de punteros láser. En el fondo de ojo, presentaron alteraciones maculares. La agudeza visual de ambos se recuperó completamente sin tratamiento.

The improper use of laser pointers, especially for recreational use in children, may cause sight-threatening retinal injuries. The retinal damage it is not well characterized because most publications are isolated cases or small series.The treatment and visual prognosis are variable according to the morphology of the macular damage. In some cases, there is no treatment, and spontaneous healing can be developed; however, others require surgery. In a series of 13 cases, 1 required surgery and the rest observation; 3 patients obtained a spontaneous healing with visual acuity of 10/10.We describe two patients aged 16 and 12 years with decreased visual acuity. Macular alterations appear in the fundus of the eye. The visual acuity of both recovered completely without treatment

Management of traumatic macular holes: case report.

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.

Management of traumatic macular holes: case report / Tratamento do buraco macular traumático: relato de caso

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.

O buraco macular traumático é doença cuja patogênese não é totalmente esclarecida e a melhor conduta terapêutica ainda é controversa. Relatamos 2 casos de buraco macular traumático para os quais adotamos condutas diferentes. No primeiro caso, um menino de 9 anos apresentou buraco macular traumático secundário a trauma ocular contuso com uma pedra, com visão inicial de 20/300. Foi submetido a tratamento cirúrgico e obteve visão final igual a 20/70 com buraco fechado após 1 ano de seguimento. No segundo caso, mulher de 20 anos sofreu traumatismo penetrante por projétil de arma de fogo na fronte, do lado esquerdo. O trauma causou avulsão do nervo óptico no olho esquerdo com perda de percepção luminososa neste olho. No olho direito apresentou buraco macular traumático e sinais sugestivos de coriorretinite esclopetária, com acuidade visual igual a 20/60. O caso foi inicialmente observado e a visão melhorou para 20/30 com diminuição do diâmetro do buraco. A visão e o diâmetro do buraco mantiveram-se estáveis por 8 meses.

Parafoveal arteriolar obstruction after ocular trauma in a patient with systemic lupus erithematosus.

BACKGROUND: Retinal arterial obstruction after ocular trauma is a rarely described entity which presents a still controversial pathogenesis. However, intravascular leucoembolization in response to activation of complement factor 5 (C5a) has now been hypothesized as a possible cause of arterial embolization after severe trauma. Coincidentally, the pathogenesis of vascular lesions seen in active systemic lupus erithematosus is also related to the activation of the same complement factor. METHODS: We present the case of a 32-year-old man with active systemic lupus erithematosus who received a blunt trauma in his right eye and immediate developed severe visual loss. RESULTS: Ophthalmoscopy of the affected eye revealed a cherry-red spot macula, small hemorrhages and edema of the posterior pole. Fluorescein-angiography showed obstructions and staining of small branches of arterioles in the parafoveal region. After 2 months of follow-up, the ophthalmoscopic picture evolved to optic atrophy and the visual acuity remained severely reduced. CONCLUSION: We hypothesize that patients with complement-mediated diseases are predisposed to retinal arteriolar obstruction after ocular trauma.

Uveíte esquistossomótica: alteraçöes fundoscópicas; achados histológicos do ovo do S. mansoni, abordagem da etiologia e tratamento / Uveitis caused by schistosomiasis: fundus changes, histopathological finding of S. mansoni's egg and clinical boarding and treatment

Este trabalho vem acrescentar mais uma entidade etiológica ao capítulo das Uveites - a Coroidite Esquistossomótica - fato inédito na literatura mundial. Apresentamos 6 casos clínicos, os quais säo descritos através de estudo laboratorial, anamnéstico, biomicroscópico, fundoscópico e angioretinográfico. O aspecto morfológico em 5 dos casoselhante e bilateral, caracterizado por nódulos branco-amarelados, de tamanhos variados, distribuidos pela coroide, e 1 caso foi unilateral, com nódulos e papilite. Além desses casos, descrevemos 1 caso no qual tivemos a felicidade de constatar, pela histologia de 100 cortes, a presença de S. mansoni na coroide. Também fazemos uma discussäo sobre os diagnósticos diferenciais e as possíveis vías pelas quais o parasita alcança a coroide, e outras formas de uveite