Pliegues coroideos. Diagnóstico diferencial a propósito de un caso / Choroidal folds. Differential diagnosis and report of a case

Caso clínico: Presentamos un casos clínico de una paciente con pliegues coroideos unilaterales en el polo posterior en los cuales, tras un completo examen oftalmológico encontramos la causa subyacente. Discusion: Los pliegues coroideos están presentes en una gran variedad de procesos oculares. Pese a que se han descrito frecuentemente asociados a un síndrome benigno consistente en hipermetropía adquirida, existen una gran variedad de procesos oculares y orbitarios que hay que tener en cuenta. Por ello, es muy importante realizar un correcto diagnóstico diferencial (AU)

Case report: We present a cases of a patient withunilateral choroidals folds in the posterior pole in which, after a complete ophthalmic examination, we found a subsequent cause. Discussion: Choroidal folds are present in a variety of ocular disease. Despite there were associated as a benign condition consisted in acquired hyperopia, there are a variety of ocular and orbital disease that have to be considered. For that reason, an exhaustive differential diagnosis is essential (AU)

[Outcomes of inferior access external dacryocystorhinostomy performed by residents]. / Resultados de la dacriocistorrinostomía externa vía inferior realizada por médicos residentes.

PURPOSE: To assess the outcomes of external dacryocystorhinostomy (DCREx) performed by residents at the Hospital Universitari de Bellvitge, comparing the cases operated on by residents and the cases operated on by staff surgeons. METHODS: We performed a retrospective study between January 2006 and December 2007 of all DCREx performed at our hospital. The operations involved 65 cases from 54 patients: 16 operations were performed by residents and 49 by staff surgeons. The cases were divided into two groups: cases operated on by residents and cases operated on by staff surgeons, and the following variables were studied: epidemiologic characteristics of the patients (age, sex), side of intervention, antecedents of lacrimal sac inflammation, type of anesthesia, intrasurgical and postsurgical complications and results. <> was defined as the possibility to pass physiologic serum through the lacrimal pathway and <> if the patient in addition was without symptoms of epiphora. RESULTS: The procedure was successful in 88% of cases: 80% were classified as <> while only 8% were considered <>. The operations performed by residents were successful in 81% of cases (75% <> and 6% <>), whereas staff surgeons achieved success in 90% of cases (82% <> - 8% <>). CONCLUSION: The results show that residents with suitable training and supervision can achieve good success rates approaching those of staff surgeon outcomes, without additional complications (Arch Soc Esp Oftalmol 2009; 84: 501-506).

Resultados de la dacriocistorrinostomía externa vía inferior realizada por médicos residentes / Outcomes of inferior access external dacryocystorhinostomy performed by residents

Objetivo: Analizar los resultados de la dacriocistorrinostomíaexterna (DCREx) realizada por losmédicos residentes del Hospital Universitari deBellvitge, estudiando las diferencias de sus cirugíasrespecto a los médicos adjuntos.Métodos: Realizamos un estudio retrospectivoestudiando todas las DCREx realizadas entre enerode 2006 y diciembre de 2007 en nuestro centro quecorrespondieron a 65 cirugías de 54 pacientes, delas cuales 16 fueron realizadas por médicos residentesy 49 por los médicos adjuntos.Se constituyen dos grupos: casos intervenidos porlos médicos residentes y casos intervenidos por losmédicos adjuntos, y se estudian las siguientes variables:características epidemiológicas de los pacientesintervenidos (edad, sexo), lado de intervención,antecedente de inflamación del saco lagrimal, tipode anestesia empleada, complicaciones intraquirúrgicas,postquirúrgicas y resultados de la cirugía. Sedefine como «éxito anatómico» cuando se compruebala permeabilidad de la vía lagrimal al irrigarsuero, y «éxito funcional» cuando además elpaciente no refiere síntomas de epífora.Resultados: En el 88% de los casos se obtuvieronbuenos resultados: en un 80% de los casos se alcanzó éxito funcional y en un 8% sólo anatómico. En lascirugías realizadas por los médicos residentes se consiguióun éxito global del 81% (75% funcional-6%anatómico), frente al 90% de éxito global alcanzadopor los adjuntos (82% funcional-8% anatómico).Conclusión: Los resultados indican que con el adecuadoentrenamiento y supervisión, en la DCRExlos residentes pueden obtener tasas de éxito satisfactorias,muy próximas a las alcanzadas por losadjuntos, sin que exista un incremento en las complicaciones(AU)

Purpose: To assess the outcomes of external dacryocystorhinostomy(DCREx) performed by residentsat the Hospital Universitari de Bellvitge, comparingthe cases operated on by residents and thecases operated on by staff surgeons.Methods:We performed a retrospective study betweenJanuary 2006 and December 2007 of all DCRExperformed at our hospital. The operations involved 65cases from 54 patients: 16 operations were performedby residents and 49 by staff surgeons.The cases were divided into two groups: cases operatedon by residents and cases operated on by staffsurgeons, and the following variables were studied:epidemiologic characteristics of the patients (age,sex), side of intervention, antecedents of lacrimalsac inflammation, type of anesthesia, intrasurgicaland postsurgical complications and results. «Anatomicsuccess» was defined as the possibility to passphysiologic serum through the lacrimal pathwayand «functional success» if the patient in additionwas without symptoms of epiphora.Results: The procedure was successful in 88% ofcases: 80% were classified as «functional success»while only 8% were considered «anatomic success». The operations performed by residents were successful in 81% of cases (75% «functional success» and 6% «anatomic success»), whereas staffsurgeons achieved success in 90% of cases (82%«functional success» – 8% «anatomic success»).Conclusion: The results show that residents withsuitable training and supervision can achieve goodsuccess rates approaching those of staff surgeonoutcomes, without additional complications(AU)