[Retinal detachment associated with morning glory syndrome]. / Desprendimiento de retina asociado a síndrome de morning glory.

CASE REPORT: A twenty three year old woman was diagnosed of a morning glory papillary anomaly, then with normal visual acuity (VA). Nine years later, the VA decreased to 0.4, secondary to a serous macular detachment, confirmed by optical coherence tomography (OCT). After treatment with C2F6 gas injection, positioning, and peripapillary laser, the VA improved to 0.7 and the foveolar area reattached. DISCUSSION: The morning glory Syndrome usually has an early diagnosis due to poor visual acuity. Thirty eight percent of the cases have retinal detachment. We show an unusual case of morning glory syndrome with a serous detachment, successfully treated with gas and laser.

[Decreased visual acuity from optic disc drusen]. / Pérdida de agudeza visual en drusas de papila.

PURPOSE: To evaluate the visual acuity in patients with optic disc drusen and its relationship with the existence of superficial drusen. METHODS: For a six-year period (from 1997 to 2003), fifty-five patients (100 eyes) with optic disc drusen, confirmed with B- echography, were diagnosed. According to their ophthalmoscopic appearance under 20 degrees retinography, the drusen were classified as hidden or visible. We evaluated the best corrected visual acuity. When the visual acuity was less than 0.8, other additional causes of visual impairment were studied. RESULTS: The average visual acute in patients with papillary drusen was 0.82 (maximum 1.2 and minimum 0.05). Lower visual acute was found in those patients with visible drusen. Visual acute was statistically worse (p = 0.016) as the number of drusen increased. The visual acute was normal in 75 cases. The decreased visual acute was exclusively secondary to drusen in 5 cases. In the other 20 patients concomitant causes of visual impairment were found. CONCLUSIONS: A decreased visual acute secondary to drusen is unusual. When present, it is usually moderate and associated with disturbances of the peripheral visual field. There is a significant relationship between the decrease in visual acute and the number of visible drusen. When the central vision is decreased, but not the visual field, other concomitant conditions that could also affect the vision, should be ruled out.

Pérdida de agudeza visual en drusas de papila / Decreased visual acuity from optic disc drusen

Objetivo: Valorar la agudeza visual en los pacientes con drusas de papila y su relación con la presencia de drusas superficiales.Métodos: Durante un periodo de estudio de 6 años (1997-2003) fueron diagnosticados de drusas de papila 55 pacientes (100 ojos), confirmados mediante ecografía B. Clasificamos las drusas según el aspecto oftalmoscópico (retinografía 20°) en drusas visibles y ocultas. Estudiamos la agudeza visual mejor corregida. Cuando existía una agudeza visual inferior a 0,8 se valoró si existían otras causas oculares de disminución visual. Resultados: La agudeza visual media en los pacientes con drusas de papila fue de 0,82 (mínima de 0,05 y máxima de 1,2). Encontramos peor agudeza en los pacientes con drusas visibles, resultando significativamente peor cuanto más abundantes eran las drusas (p = 0,016). La agudeza visual fue normal en el 75% de los casos y anormal solo por drusas en 5 casos; en 20 casos hubo otras causas asociadas de disminución visual.Conclusiones: La disminución de la agudeza visual asociada a drusas es poco frecuente y cuando está presente suele ser moderada y casi siempre asociada a alteraciones del campo periférico. La agudeza visual muestra una relación significativa con la presencia y abundancia de drusas visibles. La pérdida de agudeza visual central sin afectación campimétrica debe hacernos sospechar otras causas asociadas(AU)

Purpose: To evaluate the visual acuity in patients with optic disc drusen and its relationship with the existence of superficial drusen.Methods: For a six-year period (from 1997 to 2003), fifty-five patients (100 eyes) with optic disc drusen, confirmed with B- echography, were diagnosed. According to their ophthalmoscopic appearance under 20° retinography, the drusen were classified as hidden or visible. We evaluated the best corrected visual acuity. When the visual acuity was less than 0.8, other additional causes of visual impairment were studied.Results: The average visual acute in patients with papillary drusen was 0.82 (maximum 1.2 and minimum 0.05). Lower visual acute was found in those patients with visible drusen. Visual acute was statistically worse (p = 0.016) as the number of drusen increased. The visual acute was normal in 75 cases. The decreased visual acute was exclusively secondary to drusen in 5 cases. In the other 20 patients concomitant causes of visual impairment were found.Conclusions: A decreased visual acute secondary to drusen is unusual. When present, it is usually moderate and associated with disturbances of the peripheral visual field. There is a significant relationship between the decrease in visual acute and the number of visible drusen. When the central vision is decreased, but not the visual field, other concomitant conditions that could also affect the vision, should be ruled out(AU)

[Digital analysis of the optic disc with fundus camera: a study of variability]. / Análisis digital de la papila con cámara de fondo convencional: estudio de variabilidad.

PURPOSE: To determine the variability of the measurements of the optic discs applying digital analysis techniques and working with a digital camera available for clinical use. METHOD: We used a fundus camera with telecentric optic system (Zeiss FF 450 IR plus) and a 3 CCD high resolution colour video camera. We used a digital analysis system (Visupac 3.2.1) equipped with measurement systems. The images were studied by three observers with different degrees of experience who analysed the optic disc diameters (horizontal and vertical) and the total optic disc area. 180 measurements were made. RESULTS: The coefficient of total variability for the studied parameters presented a range from 1.04 to 2.08%. The variability attributable to the observer was found to be lower in the case of the observer with a higher imaging analysis experience, with a range from 0.42 to 1.17% for the lineal measurements (vertical and horizontal diameters) and from 0.60 to 2.11% for measurements of the area (total optic disc area). CONCLUSIONS: The digital analysis of optic disc images obtained with conventional fundus cameras, equipped with telecentric optic systems, allows reproducible measures and can be easily employed in clinical practice.