Ivermectina para Demodex y condiciones oculares asociadas: revisión de la literatura / Ivermectin for Demodex and related ocular conditions: Review of the literature

Introducción: Existe creciente interés en Demodex y su asociación con condiciones como rosácea, blefaritis, chalazión, meibomitis y queratoconjuntivitis. El manejo con ivermectina ha sido ampliamente reportado tanto en dermatología como en oftalmología. Objetivo: Revisar la literatura para determinar el papel de Demodex en la inflamación de la superficie ocular y el uso de ivermectina en su tratamiento. Diseño del estudio: Revisión de la literatura. Método: Búsqueda de artículos en PubMed con los siguientes términos: Demodex, rosácea ocular, chalazión, rosácea pediátrica, meibomitis, queratoconjuntivitis e ivermectina. Resultados: Se presenta una revisión de generalidades, epidemiología y fisiopatología de la inflamación ocular asociada a Demodex. Se resume el conocimiento actual sobre rosácea y Demodex, y el papel de este como disparador de procesos inflamatorios como chalazión, blefaritis, meibomitis, queratoconjuntivitis y rosácea ocular. Se citan estudios relevantes sobre el manejo de ivermectina en las condiciones mencionadas. Conclusiones: La evidencia reciente otorga a Demodex el papel de un agente disparador de varias condiciones inflamatorias de la superficie ocular. Si bien se requieren más estudios para determinar la efectividad de la ivermectina tópica, el conocimiento actual permite pensar que puede ser útil contra Demodex por su capacidad acaricida

Background: There has been increasing interest in Demodex and its association with conditions such as rosacea, blepharitis, chalazion, meibomitis and keratoconjunctivitis; and ivermectin as a treatment has been reported both in dermatology and ophthalmology. Objective: To review the literature in order to determine the role of Demodex in ocular surface inflammation and the use of ivermectin for its treatment. Study design: Review of the literature. Methods: An article search was done in PubMed with the following terms: Demodex, ocular rosacea, chalazion, pediatric rosacea, meibomitis, keratoconjunctivitis and ivermectin. Results: A review including the epidemiology and pathophysiology of ocular inflammation associated with Demodex is presented. Current knowledge on Demodex and rosacea, chalazion, blepharitis, meibomitis, keratoconjunctivitis and ocular rosacea is summarized. Relevant articles on the use of ivermectin for these conditions are listed. Conclusions: Recent evidence suggests Demodex is a trigger for a number of ocular surface inflammatory conditions. Although more studies are necessary to determine the effectiveness of topical ivermectin, current knowledge supports its acaricidal action against Demodex

Eyelash hair transplantation with strip composite eyebrow graft: an enhancing technique in tarsoconjunctival flap eyelid reconstruction procedure.

Purpose: To describe and evaluate the eyelash transplantation with strip composite eyebrow graft to improve eyelid anatomy in tarsoconjunctival flap eyelid reconstruction procedure. Methods: Twenty two patients with eyelid tumors managed by local excision and reconstruction using tarsoconjunctival flap reconstruction procedure were included. Eyelash graft was performed during flap division by harvesting a graft from the eyebrow and creating a recipient pocket in the receptor eyelid. Patients had a 1-year follow up. Eyelash orientation and follicle survival rate were recorded. Demographic variables were analyzed with descriptive statistics. For eyelash follicles survival rate assessment, we evaluated the number of follicles found in the first postoperative day with the follicles found at the end of the study using the Wilcoxon signed rank test. P < 0.05 was considered statistically significant. Results: All eyelash grafts showed a good follicle orientation and no cases of eyelashes misdirection toward the eyeball were reported. No statistical differences (p > 0.05) were found in Wilcoxon signed rank test when comparing the number of follicles present at the first postoperative day and the number of follicles present at the 12th postoperative month, meaning that the vast majority of follicles survived at the end of the study. Graft ischemia, necrosis or infection were not observed. Conclusions: Tarsoconjunctival flap is an outstanding option for eyelid reconstruction and eyelash transplantation with an eyebrow composite graft is an excellent procedure to enhance and recreate a normal eyelid.

Crisis convulsiva como primera manifestación clínica de esclerosis múltiple / Convulsive crisis how first clinical manifestation of multiple sclerosis

La esclerosis múltiple es una enfermedad desmielinizante del sistema nervioso central cuyos hallazgos patológicos se encuentran principalmente en la sustancia blanca. Sin embargo, es paradójico que quienes padecen esta enfermedad tienen una probabilidad mayor que la población general de presentar crisis epilépticas. Citamos a continuación el caso de un paciente joven con esclerosis múltiple tipo recaída remisión, que presentó una crisis como primera manifestación de su enfermedad. Los hallazgos imagenológicos de las lesiones corticales y yuxtacorticales encontrados se relacionan topográficamente con las manifestaciones clínicas de las convulsiones. Se analizan la epidemiología, clínica, fisiopatología, aproximación diagnóstica y terapéutica, así como el pronóstico a largo plazo de estos pacientes.