Nuevos hallazgos tomográficos maculares en el síndrome de Alport / New macular tomography findings in Alport syndrome

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Optic nerve alterations in P27(Kip1) knockout mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the P27(Kip1) gene, mainly involved in cell cycle arrest, apoptosis control, and retinoblastoma protein phosphorylation. METHODS: Eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) wild type mice as the control group (n=15), 2) homozygous knockout mice (-/-) for the P27(Kip1) gene as the knockout group (n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. RESULTS: The ON cross-sectional area was significantly larger in the P27(Kip1) knockout mice group than in the control group (p<0.001). The axon sizes in knockout animals were much larger than in wild-type mice (p<0.001). Higher number of axons forming the ON, intra-axonal degeneration, myelin sheath, and axoplasm density alterations were found in P27(Kip1) knockout mice when compared with control group (p<0.001). Analysis of lysates of optic nerves by Western blot showed less expression of myelin basic protein and GFAP in P27(Kip1) knockout mice as compared to wild type mice (p<0.005, p<0.01, respectively). CONCLUSIONS: The morphologic and morphometric results suggest that homozygous P27(Kip1) knock-out mice had hypertrophic, hyperplastic, and dystrophic ON.

Optic nerve alterations in PTEN +/- mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the PTEN gene, mainly involved in cell cycle arrest, apoptosis control, and cell size regulation. METHODS: The eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) 'wild type' mice as the control group (C-G; n=15), 2) heterozygous knockout mice (+/-) for the PTEN gene (PTEN-G; n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. RESULTS: The ON cross-sectional area was significantly higher in the PTEN-G than in the C-G (p<0.001). The axon sizes in mutant animals were much larger than in wild-type mice (p<0.001). No significant differences were noticed between those groups regarding the number of axons forming the ON and the presence of intra-axonal degeneration, myelin sheath alterations, or axoplasm density. No differences were detected in developmental marker protein expression. CONCLUSIONS: The morphologic and morphometric results suggest that heterozygous PTEN knockout mice had hypertrophic ON without ultrastructural alterations.

[Treatment of conjunctival intraepithelial neoplasia with topical mitomycin C 0.02%]. / Tratamiento de las neoplasias conjuntivales intraepiteliales con colirio de mitomicina C al 0,02%

PURPOSE: To evaluate the efficacy of topical mitomycin C (MMC) 0.02% in treating conjunctival intraepithelial neoplasia (CIN). METHODS: Three patients with CIN were treated with topical MMC 0.02%. Our follow-up period was twelve months (range 8-18 months). RESULTS: CIN was resolved in all three cases without modifying the normal corneal and conjunctival architecture. CONCLUSIONS: Topical MMC 0.02% four times daily during two weeks is a useful alternative tool for the surgical management of CIN.

Optic nerve alterations in apolipoprotein E deficient mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for expression of the ApoE gene. METHODS: Eyeballs with the retrobulbar ON attached were obtained from 24-week-old mice. Using morphologic and morphometric techniques and light and transmission electron microscopy, the ON characteristics were determined in three groups of mice: 1) wild type mice as the controls (CG; n = 15), 2) knockout mice for the ApoE gene (ApoE-G; n = 15), and 3) knockout mice for the ApoE gene that were fed a cholesterol-supplemented diet (ApoED-G; n = 15). RESULTS: The ON cross-sectional area was significantly higher in the ApoE-G than in the CG (p < 0.001) mice, whereas no significant changes were noticed between the ApoE-G and ApoED-G mice. Significant differences were noticed between those groups regarding the myelination index. Higher density of intra-axonal degeneration and myelin sheath alterations were found in both ApoE groups in respect to the CG. CONCLUSIONS: These results suggest that ApoE knockout mice have changes in ON morphology and myelination.

[Estimation of the efficacy of deep sclerectomy in glaucoma surgery. One-year follow-up]. / Estimación de la eficacia de la esclerectomía profunda no perforante en el tratamiento quirúrgico del glaucoma al año de la cirugía.

PURPOSE: To evaluate the efficacy of deep sclerectomy in the surgical treatment of glaucoma one year after surgery. METHODS: 53 eyes of 43 patients (26 male, 27 female) with medically uncontrolled glaucoma of various types, were treated with deep sclerectomy surgery. RESULTS: The mean postoperative intraocular pressure (IOP) was 18.19 S.D. 5.22 mmHg., and the mean preoperative IOP was 26.66 S.D. 5.93 mmHg. We observed a statistically significant reduction in the IOP (p<0.05). Our success criteria were IOP lower than 21 mmHg with or without associated hypotensive medications, no advance in glaucomatous visual field defects and no advance in optic nerve cupping. This was achieved in 88.68% of the cases at 12 months follow-up. CONCLUSIONS: Deep sclerectomy is an efficient technique to control IOP, with few early post-operative complications.

Estimación de la eficacia de la esclerectomía profunda no perforante en el tratamiento quirúrgico del glaucoma al año de la cirugía / Estimation of te efficacy of deep sclerectomy in glaucoma surgery. One-year follow-up

Objetivo: Estimar la eficacia del tratamiento quirurgico del glaucoma mediante la técnica de esclerectomia protunda no perborante (E.P.N.P.) al año de la cirugía.Material y métodos: 53 ojos de 43 pacientes (26 varones, 27 mujeres), con diferentes tipos de glaucomas mal controlados médicamente, fueron sometidos a una esclerectomia protunda no perborante.Resultados: La presión intraocular (P.I.O.) media f¦nal fue de 18,19 D.E. 5,22 mmHg., comparada con la P.I.O. media preoperatoria de 26,66 D.E. 5,93 mmHg. Se observa una reducción de la P.I.O. estadisticamente significativa (p<0,05). Consideramos éxito cuando la P.I.O. era menor de 21 mmHg. Con o sin tratamiento médico hipotensor postoperatorio, y no avanzaban los defectos glaucomatosos en el campo visual y no avanzaba la excavación papilar; consiguiéndolo en el 88,68 por ciento de los casos a los 12 meses.Conclusiones: La esclerectomia profunda no perforante es una técnica eficaz para el control de la P.l.O., con pocas complicaciones. (AU)

[A case of loss of retinal myelinated nerve fibers in a chronic glaucoma]. / Desaparición de fibras nerviosas mielinizadas retinianas en una paciente con glaucoma crónico.

PURPOSE/METHOD: A female patient underwent retinographic control and presented a pattern of myelinated nerve fibers in both eyes. Two years later, patient underwent a second retinographic control showing 10/10 glaucomatous cupping in her right eye. This was associated to loss of myelinated nerve fibers. RESULTS/CONCLUSIONS: Etiology, characteristics, associations and other causes of loss of myelinated retinal nerve fibers in chronic glaucoma are reviewed. This is the second of two photograph documented cases where loss of myelinated nerve fibers is associated to an open angle primary glaucoma.

Desaparición de fibras nerviosas mielinizadas retinianas en una paciente con glaucoma crónico / A case of loss of retinal myelinated nerve fibers in a chronic glaucoma

Objetivo/método: Presentamos el caso de una paciente con glaucoma crónico simple que fue sometida a un control retinográfico con el fin de documentar la existencia de fibras nerviosas retinianas mielinizadas peripapilares en ambos ojos. Al cabo de años, acudió de nuevo a nuestra consulta apreciándose una atrofia óptica glaucomatosa con excavación 10/10 en su ojo derecho, asociado a la desaparición de las fibras de mielina. Resultado/conclusiones: Revisamos la etiología, características y asociaciones de las fibras retinianas mielinizadas, así como otras causas asociadas a su desaparición. Aportamos las retinografías de la desaparición de estas fibras de mielina en nuestra paciente. Éste es el segundo caso documentado fotográficamente de la desaparición de fibras de mielina asociado a glaucoma primario de ángulo abierto (AU)

[Conjunctival microbiological study in corneo-schleral prosthesis users]. / Estudio microbiológico de la conjuntiva en portadores de prótesis esclero-corneales.

PURPOSE: To evaluate conjunctival bacterial flora in carrier patients of corneo-schleral prosthesis, both in the affected and fellow eye. MATERIAL AND METHOD: Samples were obtained from twenty-six corneo-schleral prosthesis carriers and smear from both eyes were cultured. Samples were taken from 24 patients as controls. RESULTS: Significant growth of potentially pathogen bacteria was observed in the corneo-schleral prosthesis and fellow eyes compared to controls. CONCLUSION: Conjunctival bacterial flora showed variations in the eyes of controls, corneo-schleral prosthesis and fellow eyes groups.

Estudio microbiológico de la conjuntiva en portadores de prótesis esclero-corneales / Conjunctival microbiological study in carriers of corneo-schleral prosthesis

Objetivo: Evaluar la flora bacteriana conjuntival en pacientes portadores de prótesis esclero-corneales, tanto en el ojo portador como en el contralateral. Métodos: Obtuvimos muestras de frotis conjuntivales para cultivo en veintiséis pacientes portadores de prótesis esclerocorneales, en sus ojos contralaterales y en veintiséis pacientes de una población control. Resultados: Tanto en el grupo de los ojos portadores de prótesis esclero-corneales como en el grupo formado por los ojos contralaterales existió un crecimiento significativo de gérmenes potencialmente patógenos, con respecto a los ojos del grupo control. Conclusiones: La flora bacteriana conjuntival varía entre los ojos control, los portadores de prótesis y los contralaterales a éstos (AU)

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[CT scan efficiency in emergency room diagnosis for optic neuropathy due to trauma]. / Eficacia de la tomografía computerizada (T.A.C.) en el diagnóstico urgente de la neuropatía óptica traumática.

PURPOSE: To define radiological patterns for Traumatic Optic Neuropathy (TON), which is of special concern for patients suffering of poor awareness when exploration of visual function is needed. We also studied final visual acuity in connection with the early radiological findings. METHOD: 14 optic neuropathies due to trauma, with their emergency requested CT Scan and evolution of visual acuity are reported. RESULTS: 76.9% of the patients showed radiological findings suggesting a TON, 23% consisted in intraorbitary hematic collections, 15% comprised avulsions of optic disc, 15% showed intraorbitary bony fragments and only 15% showed optic canal fractures. CONCLUSIONS: We report the radiological findings suggesting a TON which concerns the polytraumatized patients. Together with the clinical exploration, CT Scan becomes the most important method for the assessment of TON in emergency settings. In cases of avulsion of the optic nerve, visual acuity was regarded as no light perception by the patients, while in others this perception varied.

Eficacia de la tomografía computerizada (T.A.C.) En el diagnóstico urgente de la neuropatía óptica traumática / CT Scan efficiency in emergency room diagnosis for optic neuropathy due to trauma

Objetivo: Establecer los patrones radiológicos sugestivos de neuropatía óptica traumática (N.O.T.) directa, y que pudieran tener especial interés para el clínico en aquellos pacientes con bajo nivel de conciencia, en los que está dificultada la exploración de su función visual. Estudiamos asimismo la agudeza visual (A.V.) final de cada paciente, en relación a sus hallazgos radiológicos iniciales. Métodos: Presentamos una serie de 14 N.O.T., a las que se les realizó T.A.C. orbitario de urgencia, evaluaciones continuadas de su A.V. así como una completa exploración oftalmológica. Resultados: En el 76,9 por ciento de los pacientes de nuestra serie fueron detectados hallazgos radiológicos sugerentes de N.O.T. El 23 por ciento correspondían a hematomas intraorbitarios con proptosis y angulación escleral en algunos casos. El 15 por ciento correspondió a avulsiones o transecciones del nervio óptico (N.O.). En el 15 por ciento el N.O. se afectó por esquirlas óseas intraorbitarias. En otro 15 por ciento se detectaron fracturas del canal óptico. Conclusiones: Aportamos documentación fotográfica de los signos radiológicos que deben dar la alarma sobre una posible N.O.T. subyacente en un paciente politraumatizado. Junto a la exploración clínica el T.A.C. es el método de elección para el diagnóstico y evaluación urgente de la N.O.T. en los casos en que éste confirmó la existencia de una transección o avulsión del nervio óptico, la A.V. fue de amaurosis, siendo variable en el resto de los casos. El T.A.C. no es eficaz para la detección de las N.O.T. de mecanismo indirecto (AU)

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Isquemia del polo anterior y estenosis de carótida / Anterior pole ischemia and carotid stenosis

Objetivo/método: Presentamos el caso de un varón de 69 años de edad que debutó con un síndrome de isquemia del polo anterior en su ojo derecho. No tenía antecedentes de Diabetes Mellitus ni patología oftalmológica previa, el fondo de ojo fue normal. Resultado/conclusiones: La Eco-Duplex y la R.M.N. revelaron la existencia de una marcada estenosis de carótida de ese lado que explicó el cuadro. Revisamos las diferentes formas de manifestación de la retinopatía por éstasis venoso y la oculopatía isquémica en el contexto de la estenosis de carótida y presentamos este poco habitual caso de isquemia del polo anterior sin afectación del segmento posterior (AU)