Aportes de la tomografía de coherencia óptica Visante(R) y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroideo bilateral secundario a topiramato / Contribution of the Visante(R) OCT and B-scan ultrasound in the diagnosis and follow up of a topiramate-induced bilateral ciliochoroidal effusion syndrome

Se trata de un hombre de 45 años con cierre angular y miopía aguda bilateral tras inicio de tratamiento con topiramato por dependencia al alcohol y la heroína. La tomografía de coherencia óptica Visante(R) y la ecografía ocular muestran efusión ciliocoroidea bilateral como mecanismo fisiopatológico. El tratamiento consistió en la retirada del topiramato, y la utilización de hipotensores oculares, ciclopléjico y corticoides tópicos, con lo cual se resolvió el síndrome de efusión ciliocoroidea. La tomografía de coherencia óptica Visante(R) y la ecografía ocular son herramientas útiles en el diagnóstico y seguimiento de los pacientes con cierre angular y miopía en el contexto del síndrome de efusión ciliocoroidea secundario a topiramato. Debido al amplio espectro de indicaciones de esta medicación, tanto el personal sanitario que lo indica como los oftalmólogos, deben conocer las posibles manifestaciones oculares atribuidas a este medicamento

A 45 year-old man with bilateral acute angle-closure and myopia after starting treatment with topiramate, secondary to alcohol and heroin dependence. Using Visante(R) OCT (Optical Coherence Tomography) and B-scan Ultrasound he was diagnosed with bilateral ciliochoroidal effusion as the pathophysiological mechanism. Topiramate was stopped and ocular hypotensive therapy with a topical cycloplegic and corticosteroids were started, resolving ciliochoroidal effusion syndrome. Visante(R) OCT and B-scan Ultrasound are useful tools for the diagnosis and follow-up of patients with acute angle-closure and myopia due to topiramate. As a result of broad spectrum of indications for topiramate, physicians and ophthalmologists should be aware of the possible ophthalmological manifestations attributable to this drug

Contribution of the Visante® OCT and B-scan ultrasound in the diagnosis and follow up of a topiramate-induced bilateral ciliochoroidal effusion syndrome. / Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroideo bilateral secundario a topiramato.

A 45 year-old man with bilateral acute angle-closure and myopia after starting treatment with topiramate, secondary to alcohol and heroin dependence. Using Visante® OCT (Optical Coherence Tomography) and B-scan Ultrasound he was diagnosed with bilateral ciliochoroidal effusion as the pathophysiological mechanism. Topiramate was stopped and ocular hypotensive therapy with a topical cycloplegic and corticosteroids were started, resolving ciliochoroidal effusion syndrome. Visante® OCT and B-scan Ultrasound are useful tools for the diagnosis and follow-up of patients with acute angle-closure and myopia due to topiramate. As a result of broad spectrum of indications for topiramate, physicians and ophthalmologists should be aware of the possible ophthalmological manifestations attributable to this drug.

Estudio comparativo de la modificación de la osmolaridad en enfermedad injerto contra huésped / Comparative study of modification of the osmolarity in graft versus host disease

No disponible

Retinopatía hipertensiva bilateral diagnóstica de feocromocitoma / Bilateral hypertensive retinopathy diagnostic of pheochromocytoma

No disponible

Angiofibroma nasofaríngeo juvenil con extensión orbitaria / Juvenile nasopharyngeal angiofibroma with orbital extension

CASO CLÍNICO: Varón de 21 años con historia de exoftalmos izquierdo y diplopía de 2 semanas de evolución. La resonancia magnética mostró una lesión muy vascularizada etmoido-orbitaria con invasión de base del cráneo anterior y extensión orbitaria. La biopsia etmoidal confirmó un tejido fibrovascular compatible con angiofibroma. DISCUSIÓN: El angiofibroma nasofaríngeo juvenil (ANJ) es un tumor benigno con características locales de malignidad debido a su capacidad de invadir áreas adyacentes. En nuestro caso, el comienzo se presenta con manifestaciones de extensión orbitaria. Consideramos necesario un conocimiento amplio y un abordaje multidisciplinario con el fin de mejorar el pronóstico

CLINICAL CASE: The case is presented of a 21 year-old male with a history of left proptosis and diplopia of two weeks of onset. The MRI showed an ethmoid-orbital vascular lesion with anterior skull base invasion and orbital extension. Biopsy of the ethmoid confirmed fibrovascular tissue, which supported the diagnosis of angiofibroma. DISCUSSION: It is a benign neoplasm with local characteristics of malignancy due to its ability to invade adjacent areas. In this case, the debut presented with manifestations of orbital extension. A broad and multidisciplinary approach is needed in order to improve prognosis

[Juvenile nasopharyngeal angiofibroma with orbital extension]. / Angiofibroma nasofaríngeo juvenil con extensión orbitaria.

CLINICAL CASE: The case is presented of a 21 year-old male with a history of left proptosis and diplopia of two weeks of onset. The MRI showed an ethmoid-orbital vascular lesion with anterior skull base invasion and orbital extension. Biopsy of the ethmoid confirmed fibrovascular tissue, which supported the diagnosis of angiofibroma. DISCUSSION: It is a benign neoplasm with local characteristics of malignancy due to its ability to invade adjacent areas. In this case, the debut presented with manifestations of orbital extension. A broad and multidisciplinary approach is needed in order to improve prognosis.

Metotrexato como tratamiento en el penfigoide ocular cicatricial moderado / Methotrexate as a treatment in ocular cicatricial moderate pemphigoid

CASO CLÍNICO: Una mujer de 73 años se presenta con historia de molestias inespecíficas y fotofobia en ambos ojos (AO) de un año de evolución. A la exploración se observa un simbléfaron bilateral y acortamiento de fondos de saco. El análisis inmunohistoquímico (IHQ) confirma la presencia de un depósito lineal de Ig G, Ig M y C3 a lo largo de la membrana basal conjuntival. Ante el diagnóstico de penfigoide ocular cicatricial (POC) se pauta tratamiento sistémico mediante metotrexato (MTX) subcutáneo. DISCUSIÓN: Consideramos dicho tratamiento una alternativa inmunosupresora inicial muy eficaz en pacientes con inflamación conjuntival moderada y en casos de rápida progresión

CLINICAL CASE: A 73 year-old woman presented with a history of non-specific symptoms and photophobia in both eyes of 1 year progression. The examination revealed a bilateral symblepharon and fornix shortening. Immunohistochemical analysis confirmed the presence of linear deposits of IgG, IgM and C3 along the conjunctival basement membrane. With the diagnosis of Ocular Cicatricial Pemphigoid, systemic treatment with subcutaneous methotrexate was prescribed. DISCUSSION: We consider such treatment a very effective initial immunosuppressive alternative in patients with moderate conjunctival inflammation and in cases of rapid progression

Afectación orbitaria por linfoma no Hodgkin de células T NK / Orbital involvement by non-Hodgkin lymphoma NK T cells

CASO CLÍNICO: Un varón de 37 años se presenta por una historia de obstrucción nasal con rinorrea derecha, cefalea, hipoacusia y exoftalmos derecho de 4 meses de evolución. La RM revela la ocupación de senos etmoidales y maxilares por tejido inflamatorio con extensión hacia la región orbitaria. La biopsia confirma un linfoma no Hodgkin de células T natural killer (NK). DISCUSIÓN: El linfoma no Hodgkin T NK es un tumor infrecuente en el área orbitaria que precisa de una precoz detección así como de una atención multidisciplinaria para asegurar un seguimiento y tratamiento adecuados

CLINICAL CASE: The case is presented of 37 year-old male with a history of nasal obstruction with right rhinorrhea, headache, hearing loss and right exophthalmos of 4 months progression. The MRI revealed that the ethmoidal and maxillary sinuses contained inflammatory tissue extending into the orbital region. The biopsy confirmed a non-Hodgkin lymphoma of natural killer (NK) T cells. DISCUSSION: Non-Hodgkin's T NK lymphoma is a rare tumor in the orbital area that requires an early detection and multi-disciplinary care to ensure appropriate monitoring and treatment

Éter etílico: un viejo aliado contra la blefaritis por Demodex resistente a ivermectina oral / Ethyl ether: an old ally against oral ivermectin resistant demodex blepharitis

No disponible

Methotrexate as a treatment in ocular cicatricial moderate pemphigoid.

CLINICAL CASE: A 73 year-old woman presented with a history of non-specific symptoms and photophobia in both eyes of 1 year progression. The examination revealed a bilateral symblepharon and fornix shortening. Immunohistochemical analysis confirmed the presence of linear deposits of IgG, IgM and C3 along the conjunctival basement membrane. With the diagnosis of Ocular Cicatricial Pemphigoid, systemic treatment with subcutaneous methotrexate was prescribed. DISCUSSION: We consider such treatment a very effective initial immunosuppressive alternative in patients with moderate conjunctival inflammation and in cases of rapid progression.

Orbital involvement by non-Hodgkin lymphoma NK T cells.

CLINICAL CASE: The case is presented of 37 year-old male with a history of nasal obstruction with right rhinorrhea, headache, hearing loss and right exophthalmos of 4 months progression. The MRI revealed that the ethmoidal and maxillary sinuses contained inflammatory tissue extending into the orbital region. The biopsy confirmed a non-Hodgkin lymphoma of natural killer (NK) T cells. DISCUSSION: Non-Hodgkin's T NK lymphoma is a rare tumor in the orbital area that requires an early detection and multi-disciplinary care to ensure appropriate monitoring and treatment.

Sensimed Triggerfish ® como nuevo sistema para el registro continuo de tensión intraocular durante 24 horas en pacientes con glaucoma / Sensimed Triggerfish ® as a new system for continuous recording of 24-hour intraocular pressure in glaucoma patients

No disponible