Hipertensión ocular como causa de obstrucción de arteria ciliorretiniana en el paciente joven, a propósito de un caso / Ocular hypertension as a cause of cilioretinal artery obstruction in the young patient, about a case

CASO CLÍNICO: Mujer de 16 años que acude a urgencias por pérdida de la agudeza visual (AV) en el ojo izquierdo (OI) y cefalea opresiva de un día de evolución, en tratamiento con corticoide tópico por conjuntivitis vírica. La AV fue de 1,00 en el ojo derecho y 0,05 en el OI, la presión intraocular fue de 42 mmHg en ambos ojos. En el OI la funduscopía se objetivó edema isquémico retiniano en haz papilomacular, con angiografía por tomografía de coherencia óptica (OCT-A) se observó obstrucción de la arteria ciliorretiniana. El estudio sistémico fue anodino, las ecografías cardiacas y de los troncos supraaórticos fueron normales, siendo la hipertensión ocular secundaria a corticoides el único agente causal identificado. Como conclusión, ante una obstrucción de arteria ciliorretiniana debe indicarse un estudio sistémico amplio para identificar posibles fenómenos embólicos. La hipertensión ocular es una de las causas que puede ser responsable de este cuadro

CLINICAL CASE: A 16-year-old patient seen in the Emergency Department due to loss of visual acuity (VA) in the left eye (LE), and oppressive headache of 1 day onset. The patient was on treatment with topical corticosteroids for viral conjunctivitis. The VA was 1.00 in the right eye and 0.05 in LE. The intraocular pressure was 42mmHg in both eyes. In the LE, the funduscopy revealed retinal ischaemic oedema in the papillomacular bundle. The optical coherence tomography angiography (OCT-A) showed an obstruction of the cilioretinal artery. The systemic study was normal, the cardiac and supra-aortic trunks ultrasound was normal, with ocular hypertension secondary to corticosteroids being the only causative agent identified. This case shows that in the event of an obstruction of the cilioretinal artery, a systemic study should be performed in order to identify possible embolic phenomena. Ocular hypertension is one of the possible causes that may be responsible for this condition

Ocular hypertension as a cause of cilioretinal artery obstruction in the young patient, about a case. / Hipertensión ocular como causa de obstrucción de arteria ciliorretiniana en el paciente joven, a propósito de un caso.

CLINICAL CASE: A 16-year-old patient seen in the Emergency Department due to loss of visual acuity (VA) in the left eye (LE), and oppressive headache of 1 day onset. The patient was on treatment with topical corticosteroids for viral conjunctivitis. The VA was 1.00 in the right eye and 0.05 in LE. The intraocular pressure was 42mmHg in both eyes. In the LE, the funduscopy revealed retinal ischaemic oedema in the papillomacular bundle. The optical coherence tomography angiography (OCT-A) showed an obstruction of the cilioretinal artery. The systemic study was normal, the cardiac and supra-aortic trunks ultrasound was normal, with ocular hypertension secondary to corticosteroids being the only causative agent identified. This case shows that in the event of an obstruction of the cilioretinal artery, a systemic study should be performed in order to identify possible embolic phenomena. Ocular hypertension is one of the possible causes that may be responsible for this condition.

Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico / Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report

Introducción: El hamartoma astrocítico retiniano es un tumor benigno generalmente asintomático, asociado o no al complejo de esclerosis tuberosa. La hemorragia vítrea es una rara presentación. Caso clínico: Paciente de 12 años acude por visión de "una mancha negra" en el hemicampo temporal superior del ojo derecho. Refiere un episodio similar hace 2 años. En lámpara de hendidura el polo anterior es normal. En la funduscopia se evidencia una masa de aspecto translúcido blanco-amarillenta peripapilar y hemorragia vítrea peripapilar. Las características de la autofluorescencia, angiografía fluoresceínica y la tomografía de coherencia óptica son compatibles con un hamartoma astrocítico retiniano. Los estudios complementarios (serología y radiografías) y examen clínico completo descartan afectación sistémica asociada. Se procedió a un seguimiento estrecho del paciente hasta reabsorción de la hemorragía vítrea. Conclusión: La hemorragia vítrea es una rara complicación de hamartoma astrocítico retiniano y dificulta la exploración fundoscópica. Debería descartarse afectación sistémica

Introduction: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. Case report: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. Conclusion: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out

Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report. / Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico.

INTRODUCTION: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. CASE REPORT: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. CONCLUSION: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out.

Neurorretinopatía macular aguda: a propósito de un caso / Acute macular neuroretinopathy: a case report

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Maculopatía en torpedo con desprendimiento seroso del epitelio pigmentario de la retina / Torpedo maculopathy with serous detachment of retinal pigment epithelium

No disponible

Actualización en técnicas de imagen coroidea: pasado, presente y futuro / Update of choroidal imaging techniques: past, present and future

La coroides es la capa media del ojo, un tejido muy vascularizado y pigmentado, cuyo papel ya ha sido probado en numerosas enfermedades oftálmicas. Pero no ha sido hasta los últimos años cuando hemos sido capaces de cuantificar y medir de una forma fiable, precisa y reproducible su grosor y su forma. Las técnicas de imagen basadas en ultrasonidos y la angiografía con verde de indocianina fueron las primeras en ser utilizadas para el estudio de la coroides, y aún mantienen su uso y sus indicaciones clínicas para el diagnóstico y manejo de algunas enfermedades oculares. Pero fue la llegada de la tomografía de coherencia óptica la que supuso el mayor avance en cuanto a la visualización de la coroides se refiere. En esta revisión se discutirán modalidades de imagen coroidea pasadas, presentes y futuras, con una especial atención sobre la tomografía de coherencia óptica y su más reciente desarrollo

The choroid is the middle layer of the eye, a very vascular and pigmented tissue, with its role in several ophthalmological pathologies already having been clearly established. But it was not until the last few years that we have been able to reliably and precisely measure and quantify its shape and thickness. Ultrasound technology and indocyanine green angiography were the first techniques used for the study of the choroid, and they still maintain their use and clinical indications for the diagnosis and management of several pathologies. But it was the advent of optical coherence tomography that was the greatest breakthrough in choroidal imaging. In this chapter, the past, current and future image modalities for the study of the choroid will be discussed, with special focus on optical coherence tomography and its latest developments

Update of choroidal imaging techniques: Past, present and future. / Actualización en técnicas de imagen coroidea: pasado, presente y futuro.

The choroid is the middle layer of the eye, a very vascular and pigmented tissue, with its role in several ophthalmological pathologies already having been clearly established. But it was not until the last few years that we have been able to reliably and precisely measure and quantify its shape and thickness. Ultrasound technology and indocyanine green angiography were the first techniques used for the study of the choroid, and they still maintain their use and clinical indications for the diagnosis and management of several pathologies. But it was the advent of optical coherence tomography that was the greatest breakthrough in choroidal imaging. In this chapter, the past, current and future image modalities for the study of the choroid will be discussed, with special focus on optical coherence tomography and its latest developments.

[Antiangiogenic therapy in Sorsby's fundus dystrophy without a mutation in the TIMP-3 gene]. / Tratamiento antiangiogénico en fondo de distrofia de Sorsby sin mutación en gen de TIMP-3.

CASE REPORT: The case is presented of a 32-year-old man referring to metamorphopsia and blurred vision in both eyes for 3 days. Best corrected visual acuity of 20/32 in the right eye and 20/25 in the left eye. Fundus examination revealed the presence of drusen-like deposits, suggestive of Sorsby's fundus dystrophy (SFD) and choroidal neovascularization (CNV) bilaterally. The patient received intravitreal ranibizumab. Visual acuity improved to 20/20 in both eyes at 6-months follow-up, and results of fundus examination showed complete regression of neovascularization. No mutations were found in the TIMP-3 gene. DISCUSSION: The known mutations in TIMP-3 may not be extended to all patients with SFD. The use of intravitreal ranibizumab may be considered as a therapeutic option in CNV secondary to SFD.

Tratamiento antiangiogénico en fondo de distrofia de Sorsby sin mutación en gen de TIMP-3 / Antiangiogenic therapy in Sorsby's fundus dystrophy without a mutation in the TIMP-3 gene

Caso clínico: Varón de 32 años, con metamorfopsias y visión borrosa bilateral de tres días de evolución. Mejor agudeza visual corregida de 20/32 en OD y 20/25 en OI. La funduscopia presenta lesiones amarillentas difusas sugerentes de distrofia de Sorsby y membranas neovasculares (MNV). Recibió tratamiento con ranibizumab intravítreo, mejorando la agudeza visual a 20/20 en ambos ojos y remitiendo las MNV. No se hallaron mutaciones conocidas de TIMP-3. Discusión: Las mutaciones conocidas en TIMP-3 pueden no estar extendidas a todos los pacientes con fondo de distrofia de Sorsby. El ranibizumab intravítreo debe considerarse para el tratamiento de MNV secundaria a esta enfermedad (AU)

Case report: The case is presented of a 32-year-old man referring to metamorphopsia and blurred vision in both eyes for 3 days. Best corrected visual acuity of 20/32 in the right eye and 20/25 in the left eye. Fundus examination revealed the presence of drusen-like deposits, suggestive of Sorsby's fundus dystrophy (SFD) and choroidal neovascularization (CNV) bilaterally. The patient received intravitreal ranibizumab. Visual acuity improved to 20/20 in both eyes at 6-months follow-up, and results of fundus examination showed complete regression of neovascularization. No mutations were found in the TIMP-3 gene. Discussion: The known mutations in TIMP-3 may not be extended to all patients with SFD. The use of intravitreal ranibizumab may be considered as a therapeutic option in CNV secondary to SFD (AU)