Metastatic Intraocular Tumor Due to Colorectal Adenocarcinoma: Case Report and Literature Review.

PURPOSE: To describe the clinical and histopathological findings of a case of intraocular metastasis due to colorectal adenocarcinoma and to carry out a literature review. CASE REPORT: A 64-year-old man with a history of tumor resection due to infiltrating colorectal adenocarcinoma three years previously sought ophthalmological care because of severe ocular pain without response to medical treatment and progressive vision loss in the left eye. On ultrasonographic examination, there was a heterogeneous intraocular choroidal tumor, which occupied approximately 40% of the vitreous cavity, as well as peritumoral serous retinal detachment. The patient underwent left eyeball enucleation. The histopathological diagnosis was metastatic tubular adenocarcinoma involving the retina and choroid that partially infiltrated the sclera and the proximal optic nerve. CONCLUSION: The present case highlights a rare pathological entity associated with variable therapeutic schemes and survival times and poor prognosis in patients with metastatic intraocular tumors due to colorectal adenocarcinoma.

Wide-field angiography for diagnosis and follow-up of Eales disease: a case series / Angiografia de amplo campo para diagnóstico e monitoramento da doença de Eales: série de casos

ABSTRACT Wide-field angiography enables assessing peripheral areas with better quality and gives greater deep focus, which improves the image periphery. Some studies have proposed the usefulness of these angiographic systems in inflammatory diseases of the retina. However, few studies have evaluated this technique in Eales disease. We present a case series in which 5 eyes of 3 patients with Eales disease were evaluated by using retinal fluorescein angiography with 30º, 50º, and 150º lenses in a laser-scanning ophthalmoscope. These cases highlight the usefulness of wide-field fluorescein angiography in the diagnosis and follow-up of peripheral ischemic retinal areas in Eales disease, which enables better follow-up than possible with conventional fluorescein angiography images.

RESUMO A angiografia de campo amplo permite avaliar áreas periféricas com melhor qualidade e proporciona maior foco profundo, melhorando a imagem da periferia. Alguns estudos têm proposto a utilidade desses sistemas angiográficos nas doenças inflamatórias da retina. No entanto, poucos estudos avaliaram esta técnica na doença de Eales. Apresentamos uma série de casos em que 5 olhos de 3 pacientes com doença de Eales foram avaliados usando angiografia de fluoresceína da retina com lentes de 30º, 50º e 150º em um oftalmoscópio de varredura a laser. Esses casos destacam a utilidade da angiografia com fluoresceína de campo amplo no diagnóstico e no acompanhamento das áreas isquêmicas periféricas da retina na doença de Eales, permitindo um melhor acompanhamento do o possível com imagens por angiofluoresceinografia convencional.

Wide-field angiography for diagnosis and follow-up of Eales disease: a case series.

Wide-field angiography enables assessing peripheral areas with better quality and gives greater deep focus, which improves the image periphery. Some studies have proposed the usefulness of these angiographic systems in inflammatory diseases of the retina. However, few studies have evaluated this technique in Eales disease. We present a case series in which 5 eyes of 3 patients with Eales disease were evaluated by using retinal fluorescein angiography with 30º, 50º, and 150º lenses in a laser-scanning ophthalmoscope. These cases highlight the usefulness of wide-field fluorescein angiography in the diagnosis and follow-up of peripheral ischemic retinal areas in Eales disease, which enables better follow-up than possible with conventional fluorescein angiography images.

Recurrent vitreous hemorrhage secondary to retinal vessel avulsion.

Spontaneous vitreous hemorrhage is a rare entity, present in 7 out of 100,000 inhabitants. It is associated with different pathologies; however, it is rarely reported to be caused by retinal vessel avulsion syndrome. In the present manuscript, we report a case of avulsion of retinal vessels associated with recurrent vitreous hemorrhage managed, at first, by photocoagulation, but due to the several recurrence of bleeding, the patient went into surgical management.

Velocidad de marcha y desarrollo de trastornos neurocognitivos en adultos mayores: resultados de una cohorte peruana / Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort

Introducción. La prevención y el manejo de los trastornos neurocognitivos (TNC) en adultos mayores puede mejorar si se identifica tempranamente sus factores de riesgo, como la velocidad de marcha. El objetivo del estudio es evaluar la asociación entre velocidad de la marcha y el desarrollo de TNC en una población de adultos mayores del Perú. Material y métodos. Cohorte realizada en adultos mayores que acudieron al servicio de geriatría del Centro Médico Naval (Callao, Perú). Se registró la velocidad de la marcha de los participantes durante la evaluación basal, sometiéndoles a seguimiento anualmente hasta 60 meses, con un promedio de 21 meses. El desarrollo de TNC fue definido como la ocurrencia de una puntuación≤24 puntos en el Mini Mental State Examination (test de cribado) durante el seguimiento. Se hallaron hazard ratio (HR) y sus intervalos de confianza al 95% (IC 95%) usando regresiones de Cox. Resultados. Se incluyeron 657 adultos mayores, con edad promedio de 73,4±9,2 (DE) años, de los cuales el 47,0% fueron varones. El 47,8% reportaron una velocidad de marcha <0,8 m/s, y el 20,1% desarrollaron TNC durante el seguimiento. Se encontró que los adultos mayores con una velocidad de marcha <0,8 m/s en la evaluación basal tuvieron más probabilidades de desarrollar TNC que aquellos con una velocidad de marcha ≥0,8 m/s (HR ajustada=1,41; IC 95%=1,34-1,47). Conclusión. Encontramos asociación entre la velocidad de marcha disminuida y el desarrollo de TNC, lo cual sugeriría que la velocidad de marcha podría ser útil para identificar pacientes en riesgo para tal trastorno (AU)

Introduction. The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. Material and methods. Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants’ gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. Results. The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). Conclusion. A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset (AU)

[Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort]. / Velocidad de marcha y desarrollo de trastornos neurocognitivos en adultos mayores: resultados de una cohorte peruana.

INTRODUCTION: The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. MATERIAL AND METHODS: Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants' gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. RESULTS: The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). CONCLUSION: A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset.

[Primary orbital cystic tumor: A case of hydatidosis in a child]. / Tumor primario quístico de la órbita: A propósito de un caso de hidatidosis infantil.

Primary orbital cystic tumors caused by Echinococcus granulosus are rare. As this parasite is endemic in Peru, we report the case of a 10-year-old girl from a rural area of Huancavelica, who presented with progressive and irreducible axial proptosis of the right eye and loss of vision. Orbital tomographic images demonstrated a tumor mass with a cystic appearance. Serologic tests were negative. The patient underwent surgical resection, and histopathologic analysis revealed anhistic membranes, corresponding to hydatid cysts. During one year of follow-up, no evidence of local or systemic recurrence was observed. In conclusion, orbital hydatidosis should be considered in the differential diagnosis of a cystic orbital tumor in pediatric patients, especially if the patient is from an endemic area.

Los tumores quísticos primarios de la órbita, causados por infestaciones parasitarias como el Equinococcus granulosus son raros. Al ser el Perú zona endémica para este parásito, presentamos el caso de una niña de 10 años de edad, proveniente de una zona rural de Huancavelica, con proptosis axial irreductible del globo ocular derecho, de curso progresivo, con pérdida de la agudeza visual e imágenes tomográficas de la órbita en relación a masa tumoral de apariencia quística. Los exámenes serológicos fueron negativos, la paciente fue sometida a resección quirúrgica con resultado histopatológico de membranas anhistas correspondientes a quiste hidatídico. Al año de seguimiento no se evidencia recurrencia local ni sistémica. En conclusión, ante una tumoración orbitaria quística en pacientes pediátricos, se debe de considerar como diagnóstico diferencial la hidatidosis orbitaria, sobre todo si proceden de zonas endémicas.

Tumor primario quístico de la órbita: A propósito de un caso de hidatidosis infantil / Primary orbital cystic tumor: A case of hydatidosis in a child

RESUMEN Los tumores quísticos primarios de la órbita, causados por infestaciones parasitarias como el Equinococcus granulosus son raros. Al ser el Perú zona endémica para este parásito, presentamos el caso de una niña de 10 años de edad, proveniente de una zona rural de Huancavelica, con proptosis axial irreductible del globo ocular derecho, de curso progresivo, con pérdida de la agudeza visual e imágenes tomográficas de la órbita en relación a masa tumoral de apariencia quística. Los exámenes serológicos fueron negativos, la paciente fue sometida a resección quirúrgica con resultado histopatológico de membranas anhistas correspondientes a quiste hidatídico. Al año de seguimiento no se evidencia recurrencia local ni sistémica. En conclusión, ante una tumoración orbitaria quística en pacientes pediátricos, se debe de considerar como diagnóstico diferencial la hidatidosis orbitaria, sobre todo si proceden de zonas endémicas.

ABSTRACT Primary orbital cystic tumors caused by Echinococcus granulosus are rare. As this parasite is endemic in Peru, we report the case of a 10-year-old girl from a rural area of Huancavelica, who presented with progressive and irreducible axial proptosis of the right eye and loss of vision. Orbital tomographic images demonstrated a tumor mass with a cystic appearance. Serologic tests were negative. The patient underwent surgical resection, and histopathologic analysis revealed anhistic membranes, corresponding to hydatid cysts. During one year of follow-up, no evidence of local or systemic recurrence was observed. In conclusion, orbital hydatidosis should be considered in the differential diagnosis of a cystic orbital tumor in pediatric patients, especially if the patient is from an endemic area.