RESUMO
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3 logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1â¯g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2â¯g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1â¯g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100â¯mg per day), subtenon triamcinolone (40â¯mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs.
Assuntos
Ácido Micofenólico , Síndrome Uveomeningoencefálica , Corticosteroides/uso terapêutico , Feminino , Angiofluoresceinografia , Humanos , Ácido Micofenólico/uso terapêutico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Acuidade VisualRESUMO
Presentamos el caso de una mujer hondureña de 27 años sin antecedentes médicos de interés que presentó múltiples áreas de desprendimientos de retina (DR) exudativos y una mejor agudeza visual corregida de 1,3logMAR en ambos ojos. Fue diagnosticada de síndrome de Vogt-Koyanagi-Harada incompleto y tratada con prednisolona intravenosa (1g/24h) durante 3 días, tal y como recomienda la evidencia publicada, junto con micofenolato de mofetilo (2g/24h). Durante el descenso paulatino de corticoesteroides, los DR recidivaron, por lo que se reintrodujeron las megadosis de 1g/24h de corticoesteroides intravenosos durante 6 días hasta la resolución completa de los DR y se añadieron ciclosporina (100mg/24h), triamcinolona subtenoniana (40mg/mL) e inyecciones intravítreas mensuales de ranibizumab en ambos ojos, con un adecuado control de la inflamación coroidea que se tradujo en la remisión de los síntomas y signos (AU)
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100mg per day), subtenon triamcinolone (40mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs (AU)
Assuntos
Humanos , Feminino , Adulto , Síndrome Uveomeningoencefálica/tratamento farmacológico , Ácido Micofenólico/uso terapêutico , Corticosteroides/administração & dosagem , Ácido Micofenólico/administração & dosagem , Resultado do Tratamento , Angiofluoresceinografia , Acuidade VisualRESUMO
The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100mg per day), subtenon triamcinolone (40mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs.
RESUMO
Un varón caucásico de 44 años con antecedentes de psoriasis en placa en tratamiento actualmente con ustekinumab se presentó con una pérdida brusca de visión en su ojo izquierdo. El examen de fondo de ojo mostró una oclusión de la vena central de la retina que coexistía con una oclusión de la arteria central de la retina. Estudios posteriores revelaron una leve policitemia, siendo la causa subyacente desconocida
A 44 year-old Caucasian male with a history of plaque psoriasis currently being treated with ustekinumab presented with sudden loss of vision in his left eye. Fundus examination showed central retinal vein occlusion coexisting with central retinal artery occlusion. Posterior examination revealed mild polycythemia, being the underlying cause unknown
Assuntos
Humanos , Masculino , Adulto , Psoríase/complicações , Oclusão da Artéria Retiniana/etiologia , Oclusão da Veia Retiniana/etiologia , Fármacos Dermatológicos/uso terapêutico , Psoríase/tratamento farmacológico , Ustekinumab/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Miopia/reabilitação , Miopia/prevenção & controle , Atropina/administração & dosagem , Lentes de Contato/efeitos adversosRESUMO
No disponible
Assuntos
Humanos , Criança , Adolescente , Atropina/uso terapêutico , Miopia/tratamento farmacológico , Óculos , Lentes de Contato , Prescrições , Miopia/prevenção & controle , Acuidade Visual , Luz SolarRESUMO
No disponible
Assuntos
Humanos , Criança , Atropina/uso terapêutico , Resultado do Tratamento , Seguimentos , Progressão da Doença , Refração Ocular , Grupos Controle , Soluções Oftálmicas/análise , Soluções Oftálmicas/uso terapêuticoRESUMO
Una paciente caucásica de 17 años de edad acudió a nuestro servicio con disminución de la visión; no asociaba otros síntomas en aquel momento. La exploración oftalmológica reveló hallazgos típicos de coroidopatía hipertensiva: manchas de Elschnig y estrías de Siegrist. El examen médico posterior reveló una tensión arterial de 220/155 mm Hg y se determinó que la causa subyacente de dicho trastorno era un carcinoma adrenal metastásico secretor. Este caso representa el primero descrito en el que se asocia la coroidopatía hipertensiva al carcinoma adrenal
A 17 year-old Caucasian female presented with decreased vision, with no other symptoms reported at that time. Ophthalmological examination revealed typical signs of hypertensive choroidopathy, Elschnig spots, and Siegrist streaks. Further medical examination found high blood pressure (220/155 mmHg), with a metastatic hormone-secreting adrenal carcinoma being the underlying cause of these alterations. To our knowledge, this is the first reported case of hypertensive choroidopathy associated with adrenal carcinoma
Assuntos
Humanos , Feminino , Adolescente , Retinopatia Hipertensiva/diagnóstico por imagem , Retinopatia Hipertensiva/etiologia , Doenças da Coroide/etiologia , Doenças da Coroide/diagnóstico por imagem , Neoplasias do Córtex Suprarrenal/complicações , Carcinoma Adrenocortical/complicações , Tomografia Computadorizada por Raios X , Angiofluoresceinografia , Evolução FatalRESUMO
A 44 year-old Caucasian male with a history of plaque psoriasis currently being treated with ustekinumab presented with sudden loss of vision in his left eye. Fundus examination showed central retinal vein occlusion coexisting with central retinal artery occlusion. Posterior examination revealed mild polycythemia, being the underlying cause unknown.
Assuntos
Psoríase/complicações , Oclusão da Artéria Retiniana/etiologia , Oclusão da Veia Retiniana/etiologia , Adulto , Fármacos Dermatológicos/uso terapêutico , Humanos , Masculino , Psoríase/tratamento farmacológico , Oclusão da Artéria Retiniana/complicações , Oclusão da Veia Retiniana/complicações , Ustekinumab/uso terapêuticoRESUMO
A 17 year-old Caucasian female presented with decreased vision, with no other symptoms reported at that time. Ophthalmological examination revealed typical signs of hypertensive choroidopathy, Elschnig spots, and Siegrist streaks. Further medical examination found high blood pressure (220/155mmHg), with a metastatic hormone-secreting adrenal carcinoma being the underlying cause of these alterations. To our knowledge, this is the first reported case of hypertensive choroidopathy associated with adrenal carcinoma.
Assuntos
Neoplasias das Glândulas Suprarrenais/complicações , Carcinoma/complicações , Doenças da Coroide/etiologia , Hipertensão/complicações , Adolescente , Neoplasias das Glândulas Suprarrenais/metabolismo , Carcinoma/metabolismo , Doenças da Coroide/diagnóstico por imagem , Evolução Fatal , Feminino , Humanos , Papiledema/diagnóstico por imagem , Papiledema/etiologiaRESUMO
No disponible
Assuntos
Humanos , Miopia/epidemiologia , Acuidade Visual , Descolamento Retiniano/complicações , Fatores de Risco , Óculos/tendências , Hiperopia/epidemiologia , Miopia/complicações , Miopia/economia , Degeneração Macular/complicações , Progressão da DoençaAssuntos
Miopia/terapia , Adolescente , Adulto , Idade de Início , Atropina/uso terapêutico , Criança , Lentes de Contato , Progressão da Doença , Óculos , Humanos , Incidência , Estilo de Vida , Iluminação , Morbidade/tendências , Miopia/epidemiologia , Miopia/etiologia , Miopia/prevenção & controle , Soluções Oftálmicas , Fatores de Risco , Luz SolarRESUMO
OBJETIVO: Confirmar la seguridad y eficacia de la aplicación diaria nocturna de atropina superdiluida al 0,01% en colirio para frenar la progresión de la miopía en los niños. MATERIAL Y MÉTODOS: Un total de 200 niños de 9-12 años randomizados en el grupo tratado y control sin tratamiento. Se realizó refracción bajo cicloplejia. RESULTADOS: La progresión miópica del grupo tratado fue de -0,14 ± 0,35 frente a -0,65 ± 0,54 en el grupo control, sin tratamiento. La obligación de suspender el tratamiento por efectos secundarios fue solo del 2% de los casos. CONCLUSIÓN: La atropina superdiluida (0,01%) en colirio es eficaz y bien tolerada, reduciendo a la cuarta parte la progresión de la miopía
OBJECTIVE: To confirm the clinical security and effectiveness of the daily application of 0.01% superdiluted atropine eyedrops in the progression of myopia in children. MATERIAL AND METHODS: A total of 200 children 9-12 years of age were randomised into a treated group and a control without treatment. Refraction under cycloplegia was performed. RESULTS: Myopia progression of the treated group was -0.14 ± 0.35 versus -0.65 ± 0.54 in the control group without treatment. Only 2% of patients were forced to stop treatment due to side effects. CONCLUSION: Atropine superdiluted atropine 0.01% eyedrops is effective and well tolerated, and reduced myopia progression by 25%
Assuntos
Humanos , Masculino , Feminino , Criança , Miopia/tratamento farmacológico , Atropina/uso terapêutico , Resultado do Tratamento , Soluções Oftálmicas/uso terapêutico , Assistência de Longa Duração/tendências , Refração Ocular , Estudos Prospectivos , Análise de VariânciaRESUMO
OBJECTIVE: To confirm the clinical security and effectiveness of the daily application of 0.01% superdiluted atropine eyedrops in the progression of myopia in children. MATERIAL AND METHODS: A total of 200 children 9-12 years of age were randomised into a treated group and a control without treatment. Refraction under cycloplegia was performed. RESULTS: Myopia progression of the treated group was -0.14±0.35 versus -0.65±0.54 in the control group without treatment. Only 2% of patients were forced to stop treatment due to side effects. CONCLUSION: Atropine superdiluted atropine 0.01% eyedrops is effective and well tolerated, and reduced myopia progression by 25%.
Assuntos
Atropina/administração & dosagem , Antagonistas Muscarínicos/administração & dosagem , Miopia/prevenção & controle , Adolescente , Atropina/efeitos adversos , Criança , Progressão da Doença , Feminino , Humanos , Masculino , Antagonistas Muscarínicos/efeitos adversos , Soluções Oftálmicas , Estudos Prospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJETIVO: Evaluar la eficacia de las terapias intravítreas en casos de degeneración macular asociada a la edad (DMAE) atrófica con fluido intra- o subretiniano. MÉTODOS: Revisamos, de forma retrospectiva, las características de pacientes diagnosticados de DMAE atrófica con fluido intra- o subretiniano. Examinamos las retinografías y las imágenes de tomografía de coherencia óptica de dominio espectral analizando en ellas la presencia de fluido y su densidad. Descartamos la existencia de neovascularización coroidea mediante angiografía con fluoresceína o con verde de indocianina. RESULTADOS: Se incluyeron 14 ojos de 13 pacientes con una edad media de 72,64 años y un seguimiento medio de 80,5 semanas. Se observó fluido intrarretiniano en 6 ojos (42,9%) y fluido subretiniano en 8 ojos (57,1%). Este fluido era de alta densidad en 4 de ellos (28,5%) y de baja densidad en los otros 4 ojos (28,5%). La mejor agudeza visual corregida evaluada mediante la escala de Snellen mejoró de 0,37 inicialmente a 0,56 en la visita final (p = 0,002). El grosor macular central (en micras) disminuyó de forma significativa de 291,0 μm al inicio a 228,9μm en la visita final (p≤0,001). Del total, 8 ojos recibieron ranibizumab, 5 ojos recibieron bevacizumab y un ojo recibió triamcinolona intravítrea. CONCLUSIONES: La DMAE atrófica puede presentarse con fluido intra- o subretiniano en ausencia de neovascularización coroidea. Son necesarios estudios adicionales para analizar el valor de estos hallazgos como factor de riesgo en el desarrollo de formas avanzadas de DMAE, así como la eficacia de las terapias intravítreas
OBJECTIVE: To evaluate the efficacy of intravitreal therapies in cases of atrophic age-related macular degeneration (AMD) with subretinal or intraretinal fluid. METHODS: A retrospective review was made of the clinical charts of patients diagnosed with atrophic AMD with subretinal or intraretinal fluid. Fundus photographs and spectral-domain optical coherence tomography images were examined, and an analysis was made on the presence of fluid and its density. Neovascularisation was ruled out by fluorescein and/or indocyanine green angiography. RESULTS: The study included 14 eyes from 13 patients with a mean age of 72.64 years and a mean follow-up of 80.5 weeks. Intraretinal fluid was observed in 6 eyes (42.9%), while subretinal fluid was shown in 8 eyes (57.1%), with high density in 4 eyes (28.5%), and low density in 4 eyes (28.5%). Snellen best-corrected visual acuity improved from 0.37 at baseline to 0.56 at the final visit (P=.002). Central subfield thickness (microns) significantly decreased (P<.001) from 291.0 at baseline to 228.9 at the final visit. Eight eyes received ranibizumab, 5 eyes received bevacizumab, and one case received triamcinolone. CONCLUSIONS: Cases of atrophic AMD may present with subretinal or intraretinal fluid in the absence Neovascularisation. Further studies are required to analyse the value of this finding as a risk factor of developing advanced forms of AMD, as well as the efficacy of intravitreal therapies
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Degeneração Macular/tratamento farmacológico , Degeneração Macular/cirurgia , Degeneração Macular , Ranibizumab/uso terapêutico , Bevacizumab/uso terapêutico , Triancinolona/uso terapêutico , Tomografia de Coerência Óptica/instrumentação , Angiofluoresceinografia/instrumentação , Tomografia de Coerência Óptica/normas , Tomografia de Coerência Óptica , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia , Injeções Intravítreas/instrumentação , Injeções Intravítreas/métodos , Tomografia de Coerência Óptica/métodosRESUMO
OBJECTIVE: To evaluate the efficacy of intravitreal therapies in cases of atrophic age-related macular degeneration (AMD) with subretinal or intraretinal fluid. METHODS: A retrospective review was made of the clinical charts of patients diagnosed with atrophic AMD with subretinal or intraretinal fluid. Fundus photographs and spectral-domain optical coherence tomography images were examined, and an analysis was made on the presence of fluid and its density. Neovascularisation was ruled out by fluorescein and/or indocyanine green angiography. RESULTS: The study included 14 eyes from 13 patients with a mean age of 72.64 years and a mean follow-up of 80.5 weeks. Intraretinal fluid was observed in 6 eyes (42.9%), while subretinal fluid was shown in 8 eyes (57.1%), with high density in 4 eyes (28.5%), and low density in 4 eyes (28.5%). Snellen best-corrected visual acuity improved from 0.37 at baseline to 0.56 at the final visit (P=.002). Central subfield thickness (microns) significantly decreased (P<.001) from 291.0 at baseline to 228.9 at the final visit. Eight eyes received ranibizumab, 5eyes received bevacizumab, and one case received triamcinolone. CONCLUSIONS: Cases of atrophic AMD may present with subretinal or intraretinal fluid in the absence Neovascularisation. Further studies are required to analyse the value of this finding as a risk factor of developing advanced forms of AMD, as well as the efficacy of intravitreal therapies.
Assuntos
Bevacizumab/administração & dosagem , Ranibizumab/administração & dosagem , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Exsudatos e Transudatos , Feminino , Angiofluoresceinografia , Humanos , Injeções Intravítreas , Masculino , Ranibizumab/uso terapêutico , Retina/patologia , Drusas Retinianas/etiologia , Líquido Sub-Retiniano/efeitos dos fármacos , Tomografia de Coerência Óptica , Resultado do Tratamento , Triancinolona/administração & dosagem , Triancinolona/uso terapêutico , Degeneração Macular Exsudativa/patologiaRESUMO
No disponible