[Central serous chorioretinopathy as an extradigestive manifestation of Helicobacter pylori gastric infection]. / Coriorretinopatía serosa central como manifestación extradigestiva de infección gástrica por helicobacter pylori.

OBJECTIVE: Helicobacter pylori (HP) gastric infection has been implicated as an important factor in occlusive arterial pathology. Nowadays, it is suspected that central serous chorioretinopathy (CSC) is due to a multifocal vascular occlusive disease of the choriocapillaris. The aim of this study was to determine the relation between gastric HP infection and CSC. MATERIALS AND METHODS: We evaluated a group of 16 patients with CSC and 20 controls. HP infection was assessed by the 13C-urea breath test (UBT). Clinical CSC diagnosis was confirmed by fundus biomicroscopy and fluorescein angiography. RESULTS: Out of 16 patients with CSC, 11 (68.75%) were males and 5 (31.25%) females, with a mean age of 46.3 years. HP infection was positive in 11 patients (68.75%) and negative in 5 (31.25%). Men were HP-positive (HP+) in 72.7% of cases, compared to women who were HP+ in 60% of cases. The difference in prevalence of HP between the CSC-group (68.75%) and the control-group (30%) was found to be statistically significant (p< 0.05). HP+ patients had more gastric pain than HP negative (HP-) patients (72.73% vs 20%). CONCLUSIONS: These results indicate a possible statistical association between Helicobacter pylori gastric infection and CSC. HP should thus be considered a risk factor in CSC patients.

Coriorretinopatía serosa central como manifestación extradigestiva de infección gástrica por helicobacteri pylori / Central serous chorioretinopathy as an extradigestive manifestation of Helicobacter pyloru gastric infection

Objetivo: Determinar los niveles de eritropoyetina (Epo) en el vítreo de pacientes con retinopatía diabética proliferante (RDP). Material y método: Mediante vitrectomía vía pars plana, se recogieron muestras no diluidas de vítreo de 44 pacientes sin antecedentes de cirugía vítrea o intraocular previa, que fueron divididos en dos grupos: A (n=24) pacientes con RDP y B (n=20) pacientes con desprendimiento de retina, membrana premacular y agujero macular. La concentración de Epo se determinó mediante radioinmunoensayo. Resultados: La concentración vítrea de Epo en el grupo A fue 512 mU/mL (rango 120-880) y en el grupo B fue 25,1 mU/ml (rango 5,2-201) (p< 0,001). Conclusiones: Estos resultados demuestran que la concentración vítrea de Epo está más elevada en los pacientes con RDP en comparación con el grupo control

Objective: To measure erythropoietin (Epo) levels in the vitreous body from patients with proliferative diabetic retinopathy (PDR). Patients and methods: Undiluted vitreous samples were obtained from 44 patients who had not undergone prior vitreous or intraocular surgery. Patients were divided into two groups: A (n= 24) patients with PDR and B (n= 20) patients with retinal detachment, preretinal macular membranes and macular holes. Epo was determined using radioimmunoassay. Results: Epo vitreous concentration in group A was 512 mU/mL (range 120-880) and in group B was 25.1 mU/mL (range 5.2-201) (p< 0.001). Conclusions: These results show that the concentration of Epo in the vitreous body was significantly higher in patients with PDR than in the control group (Arch Soc Esp Oftalmol 2008; 83: 169-172)

[Microalbuminuria and diabetic retinopathy]. / Microalbuminuria y retinopatía diabética.

OBJECTIVE: To study the prevalence of microalbuminuria and its association with more severe diabetic retinopathy in a group of insulin-dependent diabetic patients. MATERIALS AND METHODS: During the period of January 1998 to December 2005 we examined 360 insulin-dependent diabetic patients with at least five years of evolution. We evaluated the presence of microalbuminuria by immunoanalysis. Patients were evaluated by direct and indirect ophthalmoscopy and classified as non-retinopathy, non-proliferative, severe non-proliferative/proliferative, or macular edema. RESULTS: In this study, 24.1% of patients had microalbuminuria. Most of the patients with microalbuminuria and macroalbuminuria were male and had a longer history of diabetes. Microalbuminuria was associated with more severe diabetic retinopathy. CONCLUSIONS: All patients with insulin-dependent diabetes of at least five years' evolution should undergo an evaluation of renal function including tests for microalbuminuria. In the presence of microalbuminuria an ophthalmologic follow-up may be particularly important.

Microalbuminuria y retinopatía diabética / Microalbuminuria and diabetic retinopathy

Objetivo: Estudiar la prevalencia de microalbuminuria y su asociación con las formas más severas de retinopatía diabética en una población de diabéticos insulinodependientes. Material y método: Se estudiaron 360 pacientes con diabetes insulinodependiente con al menos cinco años de evolución en un periodo comprendido entre enero de 1998 y diciembre de 2005. Se evaluó la presencia de microalbuminuria por inmunoanálisis. Los pacientes fueron estudiados con oftalmoscopía directa e indirecta y clasificados como no retinopatía, retinopatía no proliferante, retinopatía no proliferante severa / proliferante y edema macular. Resultados: En este estudio el 24,1% de los pacientes tenían microalbuminuria. La mayoría de los pacientes con microalbuminuria y macroalbuminuria eran varones con mayor tiempo de evolución de la diabetes. La microalbuminuria se asoció con las formas más severas de retinopatía diabética. Conclusiones: Todos los pacientes diabéticos insulinodependiente con al menos cinco años de evolución deberían ser evaluados en su función renal incluida la microalbuminuria y los pacientes con microalbuminuria deberían ser revisados más frecuentemente

Objective: To study the prevalence of microalbuminuria and its association with more severe diabetic retinopathy in a group of insulin-dependent diabetic patients. Materials and methods: During the period of January 1998 to December 2005 we examined 360 insulin-dependent diabetic patients with at least five years of evolution. We evaluated the presence of microalbuminuria by immunoanalysis. Patients were evaluated by direct and indirect ophthalmoscopy and classified as non-retinopathy, non-proliferative, severe non-proliferative/proliferative, or macular edema. Results: In this study, 24.1% of patients had microalbuminuria. Most of the patients with microalbuminuria and macroalbuminuria were male and had a longer history of diabetes. Microalbuminuria was associated with more severe diabetic retinopathy. Conclusions: All patients with insulin-dependent diabetes of at least five years’ evolution should undergo an evaluation of renal function including tests for microalbuminuria. In the presence of microalbuminuria an ophthalmologic follow-up may be particularly important

HLA-A24: factor de riesgo en retinopatía diabética proliferante / HLA-A24: risk factor in proliferante diabetic retinopathy

Objetivo: La retinopatía diabética proliferante (RDP) se caracteriza por pérdida de la visión en la población joven. Está bien establecido que el antígeno leucocitario humano (HLA)-A24 es un factor de riesgo para la pérdida total de las células‚ del páncreas. Nuestro objetivo es estudiar la asociación del HLA-A24 con la RDP. Material y método: Se estudió un grupo de pacientes con RDP (n= 95) y un grupo control (n= 60). A todos se les determinó el HLA-A24 mediante técnicas hibridación molecular. Resultados: El grupo control mostró menos frecuencia de HLA-A24 que el grupo con RDP (p= 0,043). El HLA-A24 se asoció a retinopatía diabética proliferante (OR = 5,4; 95% CI= 3,2-7,6; p< 0,001). Conclusiones: El HLA-A24 no es un factor de protección para la retinopatía diabética proliferante, es un factor de riesgo para desarrollarla

Objective: Proliferative diabetic retinopathy (PDR) is characterized by a progressive visual impairment in young people. Human leucocyte antigen (HLA)- A24 is a well-established factor associated with the pancreatic islets of Langerhans lost in this process. Our aim was to study further the relationship of the HLA-A24 associated with PDR. Materials and methods: We evaluated a group of patients with PDR (n=95) and a healthy control group (n= 60). HLA-A24 for each participant in the study was determined by molecular hybridization techniques. Results: The control group showed a lower frequency of HLA-A24 compared with the PDR group (p = 0.043). HLA-A24 was associated with PDR (OR = 5.4; 95% CI= 3.2-7.6; p< 0.001). Conclusions: HLA-A24 is not a protective factor for PDR, but is a risk factor of its development

[HLA-A24: risk factor in proliferante diabetic retinopathy]. / HLA-A24: factor de riesgo en retinopatía diabética proliferante.

OBJECTIVE: Proliferative diabetic retinopathy (PDR) is characterized by a progressive visual impairment in young people. Human leucocyte antigen (HLA)-A24 is a well-established factor associated with the pancreatic islets of Langerhans lost in this process. Our aim was to study further the relationship of the HLA-A24 associated with PDR. MATERIALS AND METHODS: We evaluated a group of patients with PDR (n=95) and a healthy control group (n= 60). HLA-A24 for each participant in the study was determined by molecular hybridization techniques. RESULTS: The control group showed a lower frequency of HLA-A24 compared with the PDR group (p = 0.043). HLA-A24 was associated with PDR (OR = 5.4; 95% CI= 3.2-7.6; p< 0.001). CONCLUSIONS: HLA-A24 is not a protective factor for PDR, but is a risk factor of its development.

[Visual hallucinations secondary to ciprofloxacin treatment]. / Alucinaciones visuales secundarias al tratamiento con ciprofloxacino.

CASE REPORT: We describe a case of a 74-year-old woman who experienced visual hallucinations after ciprofloxacin administration, when she was also taking theophylline, which resolved on cessation of the ciprofloxacin. DISCUSSION: Although uncommon, all ophthalmologists should be aware of this potential problem and be familiar with the adverse visual effects which may occur in patients simultaneously administered quinolones and theophylline.

Alucinaciones visuales secundarias al tratamiento con ciprofloxacino / Visual hallucinations secondary to ciprofloxacin treatment

Caso clínico: Se describe el caso de una mujer de 74 años que tuvo alucinaciones visuales después de la administración de ciprofloxacino cuando estaba tomando una teofilina, resolviéndose el cuadro alucinatorio cuando se suspendió el ciprofloxacino. Discusión: Aunque es poco frecuente, todos los oftalmólogos deberían estar alerta y conocer los posibles efectos adversos visuales en pacientes con tratamiento simultáneo de quinolonas y teofilinas

Case report: We describe a case of a 74-year-old woman who experienced visual hallucinations after ciprofloxacin administration, when she was also taking theophylline, which resolved on cessation of the ciprofloxacin. Discussion: Although uncommon, all ophthalmologists should be aware of this potential problem and be familiar with the adverse visual effects which may occur in patients simultaneously administered quinolones and theophylline

[Mesangiocapillary glomerulonephritis type II and macular degeneration]. / Glomerulonefritis mesangiocapilar tipo II y degeneración macular.

CASE REPORT: We report a 34-year-old woman with biopsy proven type II mesangiocapillary glomerulonephritis (MCG II) who had an ophthalmic fundal appearance similar to that seen in patients with age-related macular degeneration (ARMD). DISCUSSION: All patients with MCG II should be reviewed regularly by an ophthalmologist to assess and treat any retinal complications.

Glomerulonefritis mesangiocapilar tipo II y degeneración macular / Mesangiocapillary glomerulonephritis type II and macular degeneration

Caso clínico: Se describe una mujer de 34 años diagnosticada por biopsia de una glomerulonefritis mesangiocapilar tipo II (GMC II) y con un fondo de ojo similar al que se puede describir en un paciente con degeneración macular asociada a la edad (DMAE). Discusión: Todos los pacientes con GMC II deben ser evaluados periódicamente por un oftalmólogo para controlar las complicaciones retinianas

Case report: We report a 34-year-old woman with biopsy proven type II mesangiocapillary glomerulonephritis (MCG II) who had an ophthalmic fundal appearance similar to that seen in patients with agerelated macular degeneration (ARMD). Discussion: All patients with MCG II should be reviewed regularly by an ophthalmologist to assess and treat any retinal complications

Desprendimiento seroso de mácula como manifestación atípica en la enfermedad del arañazo del gato / Serous macular detachment as an atypical sign in cat scratch disease

Caso clínico: Paciente de 58 años con una agudeza visual de 0,1 en el ojo izquierdo asociada a un desprendimiento seroso de la mácula como única manifestación ocular de la enfermedad del arañazo del gato. El diagnóstico se realizó con estudios serológicos y por la evolución clínica. Discusión: Aunque es poco frecuente, la enfermedad del arañazo del gato debería considerarse en el diagnóstico diferencial del desprendimiento seroso de mácula

Case report: A 58-year-old woman presented with 0.1 visual acuity in the left eye associated with a serous retinal detachment of the macula as the only ocular manifestation of cat scratch disease. This diagnosis was made by serum antibody titers and the clinical course. Discussion: Although uncommon, cat scratch disease should be considered in patients with a serous detachment in the macula region of the retina

[Serous macular detachment as an atypical sign in cat scratch disease]. / Desprendimiento seroso de mácula como manifestación atípica en la enfermedad del arañazo del gato.

CASE REPORT: A 58-year-old woman presented with 0.1 visual acuity in the left eye associated with a serous retinal detachment of the macula as the only ocular manifestation of cat scratch disease. This diagnosis was made by serum antibody titers and the clinical course. DISCUSSION: Although uncommon, cat scratch disease should be considered in patients with a serous detachment in the macula region of the retina.