[Pigmentary epitheliopathy multifocal acute placoid associated with paralysis of VI cranial par]. / Epiteliopatía pigmentaria placoide multifocal aguda asociada a parálisis del VI par craneal.

CLINICAL CASE: We report the case of a 24-year-old patient who attended our hospital with an acute posterior multifocal placoid pigment epitheliopathy (APMPPE) which was later confirmed by fluorescein angiography. One month after presentation the patient developed a right VI nerve palsy. DISCUSSION: APMPPE is an acute-onset bilateral inflammatory disease causing impaired vision. Although it is thought to be benign, neurologic manifestations have been described even months after presentation. There is no previous report of APMPPE associated with VI nerve palsy.

[Surgical arteriovenous decompression (sheathotomy) in branch retinal vein occlusion: retrospective study]. / Descompresión venosa quirúrgica en las oclusiones de rama venosa retinianas: estudio retrospectivo.

PURPOSE: To evaluate best-corrected visual acuity (BCVA), incidence of neovascularization and angiographic changes in patients with branch retinal vein occlusion (BRVO) treated with surgical decompression by sheathotomy. METHODS: Retrospective study including 17 cases of temporal BRVO with macular edema treated with surgical decompression. Results of BCVA, incidence of neovascularization and vitreous hemorrhage 6 months following surgery are included. Angiographic changes in the first 8 cases a month after decompression are also evaluated. RESULTS: The mean postoperatory BCVA was 0.40 with a mean improvement of 0.26. Seventy one percent of patients (12/17) improved 2 or more visual acuity lines and 53% of patients (9/17) improved 4 or more lines. Only in one case the vision worsened. There was no evidence of retinal neovascularization or rubeosis iridis six months after surgery. CONCLUSIONS: Surgical decompression is a therapeutical option for those patients suffering BRVO with macular edema. Our initial results are encouraging, not only regarding visual acuity improvement, but also because of a decreased risk of neovascularization. No patient included in our study developed neovascularization.

Topical cyclosporin A 2% in the treatment of vernal keratoconjunctivitis.

Topical cyclosporin A at a 2% concentration was used for 6 months in the management of 2 patients with vernal keratoconjunctivitis who had failed to respond to conventional therapy. We used one drop every 6 hours in both eyes during the first month and every 12 hours during the remaining 5 months. Clinical controls were carried out weekly during the first month, monthly during the 6 month period and every 2 months thereafter. Cyclosporin A blood levels and serum creatinine were regularly monitored in both patients. Within the first month, both the symptoms and signs of the condition, in particular papillary proliferations, improved significantly and these results were maintained throughout the entire period of treatment and during 2 years of follow-up with conservative management (artificial tears).

The use of collagen shields impregnated with amphotericin B to treat Aspergillus keratomycosis.

We treated three patients with Aspergillus keratomycosis with collagen shields soaked in amphotericin B (0.50%) for 2 hours at 25 degrees C before application. These shields, replaced daily, were used in conjunction with amphotericin B (0.25%) eye drops, which were applied every 2 hours. Cultures from the eyes of all patients became negative within 15 days of treatment. Subsequently, two patients required keratoplasty. The results suggest that collagen shields prepared this way deliver an adequate concentration of amphotericin B to the cornea, aid its tolerance, and improve the prognosis of Aspergillus keratomycosis. Further studies are needed to define the minimum therapeutic concentrations necessary to inhibit the growth of the fungus and to avoid a toxic effect on the cornea.