Retinocoroidopatía birdshot, reporte de un caso en Colombia / Birdshot retinochoroidopathy, case report in Colombia

Introducción: La retinocoroidopatía birdshot (RCB) es una uveítis posterior crónica, bilateral de origen autoinmune, con fuerte asociación al antígeno leucocitario humano HLA-A29. Objetivo: Describir un caso de RCB en Colombia. Material y métodos: Mujer caucásica de 57 años, con hallazgos clínicos y exámenes complementarios compatibles con RCB. Recibió terapia biológica durante 15 meses, con mejoría clínica significativa. Resultados y conclusiones: El tratamiento depende del estadio de la enfermedad y consiste en el uso solo de corticoesteroides o combinación con agentes inmunosupresores y biológicos, que han demostrado preservar la función visual y minimizar efectos adversos de los esteroides

Background: Birdshot Retinocoroidopathy (BRC) is a chronic, bilateral posterior uveitis of autoimmune origin, with a strong association with the human leukocyte antigen HLA-A29. Objective: To describe a BRC case in Colombia. Material and methods: A 57-year-old Caucasian woman with clinical findings and complementary tests compatible with BRC. She received biologic therapy for 15 months, with significant clinical improvement. Results and conclusions: Treatment depends on stage of disease and is about corticosteroid use, alone or combination with immunosuppressive and biological agents, which have been shown to preserve visual function and minimize adverse effects of steroids

Spontaneous microscopic hyphema secondary to iris vascular tufts: Case report with video documentation.

A 71-year-old woman presented with spontaneous microhyphema in her left eye, causing blurry vision. Bleeding stopped spontaneously shortly after several cycles of digital compression on the upper eyelid, (which were documented in video), and therefore, did not require laser photocoagulation, a possible approach previously explained to the patient. A microhemangioma at the edge of the iris was identified to be the cause of the condition. The hemorrhage did not recur during the follow-up period (9 months).

Traumatic corneal flap avulsion and loss 13 years after LASIK.

Postoperative flap displacements after Laser In Situ Keratomileusis (LASIK) are uncommon complications, and flap losses are even less frequent, occurring most commonly within 24 hours after the procedure. Although cases of late subluxation have been reported up to 14 years after the surgery, the longest reported time after surgery for late flap loss is four years after LASIK. We report a case of a 54-year-old man that presented a traumatic total flap avulsion and loss 13 years after LASIK. According to our knowledge, this is the longest time reported in such a case in the literature. Medical treatment yielded an acceptable visual result. This case reinforces the concept that there could be a lifelong potential risk of traumatic corneal flap loss after LASIK.

Massive Hyphaema Following Laser Iridotomy in a Patient on Dual Antiplatelet Therapy (Aspirin plus Ticagrelor): Case report and literature review.

Massive hyphaema presentation after a laser iridotomy is very rare. We report a 63-year-old man with ischaemic heart disease on dual antiplatelet therapy (aspirin plus ticagrelor) who was diagnosed as a primary angle-closure suspect and was to undergo a neodymium-doped yttrium aluminium garnet laser iridotomy at Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia in 2016. While performing the iridotomy in the left eye, active bleeding occurred that finally filled approximately 75% of the anterior chamber. Intraocular pressure (IOP) increased to 62 mmHg. Mannitol and a topical dorzolamide/timolol were used to control the increase in IOP. The hyphaema slowly resolved over the following week without sequelae. This case revealed that massive hyphaema can complicate laser iridotomy in patients on dual antiplatelet therapy, although this is rare. Therefore, if patients are taking aspirin and ticagrelor, it would be advisable to stop the second medication if possible. In addition, sequential application of photocoagulation and photodisruption lasers might diminish the risk of significant bleeding.