[Vitreous cyst: a case presentation]. / Quiste vítreo: a propósito de un caso.

CASE REPORT: We report a case of a 12-year-old patient who complained about visual disturbances in left eye for 6 months. His visual acuity was 1/0.9, funduscopy in left eye revealed a free-floating cyst in the anterior vitreous. Magnetic resonance showed a low intense image in T1, and B-scan ultrasound confirmed a hypoechogenic cyst of 3.2 × 4.3 mm; ultrasound biomicroscopy revealed a normal ciliary body. CONCLUSION: Given the good VA the patient will be monitored periodically. If the cyst interferes with visual axis, management with Nd:YAG or Argon laser photocystotomy or remove it by pars plana vitrectomy has been advocated.

Quiste vítreo: a propósito de un caso / Vitreous cyst: a case presentation

Caso clínico: Presentamos el caso de un paciente de 12 años que refiere miodesopsias en ojo izquierdo (OI) de 6 meses de evolución. Presenta una agudeza visual (AV) de 1/0,9, en fondo de ojo izquierdo un quiste vítreo anterior. En la resonancia magnética se observa una imagen hipointensa en T1 y en la ecografía en modo B una lesión hipoecoica de 3,2×4,3 mm; la biomicroscopia ultrasónica puso de manifiesto un cuerpo ciliar normal. Conclusión: Dada la buena AV del paciente se observará periódicamente. Si interfiriese con el eje visual es posible fragmentarlo con láser Nd:YAG o argón, o bien su extracción vía pars plana(AU)

Case report: We report a case of a 12-year-old patient who complained about visual disturbances in left eye for 6 months. His visual acuity was 1/0.9, funduscopy in left eye revealed a free-floating cyst in the anterior vitreous. Magnetic resonance showed a low intense image in T1, and B-scan ultrasound confirmed a hypoechogenic cyst of 3.2×4.3 mm; ultrasound biomicroscopy revealed a normal ciliary body. Conclusion: Given the good VA the patient will be monitored periodically. If the cyst interferes with visual axis, management with Nd:YAG or Argon laser photocystotomy or remove it by pars plana vitrectomy has been advocated(AU)

[Sterile non-traumatic corneal perforation treated with Tachosil®]. / Perforación corneal no traumática estéril tratada con Tachosil®.

CASE REPORT: An 83 year-old male reported to the emergency room with red eye and ocular pain. The slit-lamp examination showed a central corneal perforation of 1mm in diameter, with no associated infection or inflammatory process. The patient had no history of trauma. It was decided to apply a patch of Tachosil(®) at the site of corneal perforation. After 36 hours of occlusion, a layer of fibrin covered the perforation, closing the defect. Successful healing of the corneal perforation was observed in the follow-up, with no recurrences of the process. CONCLUSIONS: Tachosil(®) is collagen sponge with human fibrin and human thrombin used in cardiological and neurosurgical surgery for haemostasis and the occlusion of vessels and meninges. We present the first indication in ophthalmology of Tachosil(®) as an effective alternative in the treatment of sterile non-traumatic corneal perforations less than 1.5 mm in size.

Perforación corneal no traumática estéril tratada con Tachosil® / Sterile non-traumatic corneal perforation treated with Tachosil®

Caso clínico: Varón de 83 años que acude a urgencias por dolor ocular en ojo derecho y enrojecimiento.En la exploración se objetivó una lesión perforante corneal central de 1mm dediámetro sin proceso infeccioso o inflamatorio concomitante ni antecedentes traumáticos.Procedimos al cierre urgente del defecto, aplicando un parche de Tachosil® sobre la zonaperforada. Tras 36 horas de oclusión un material fibrinoide ocluía la perforación cerrandoel defecto. En el posterior seguimiento no se presentaron recurrencias ni efectos adversospersistiendo el sellado completo del defecto.Conclusiones: Tachosil® es una esponja colágena de fibrinógeno y trombina humanos utilizadapara favorecer la hemostasia y la reparación tisular en cirugías cardíacas, urológicasy neuroquirúrgicas. Presentamos la primera indicación oftalmológica de Tachosil® comouna posible alternativa efectiva y de fácil uso en las perforaciones corneales no traumáticasestériles menores de 1,5mm(AU)

Case report: An 83 year-old male reported to the emergency room with red eye and ocularpain. The slit-lamp examination showed a central corneal perforation of 1mm in diameter,with no associated infection or inflammatory process. The patient had no history of trauma.It was decided to apply a patch of Tachosil® at the site of corneal perforation. After 36 hoursof occlusion, a layer of fibrin covered the perforation, closing the defect. Successful healingof the corneal perforationwas observed in the follow-up, with no recurrences of the process.Conclusions: Tachosil® is collagen sponge with human fibrin and human thrombin used incardiological and neurosurgical surgery for haemostasis and the occlusion of vessels andmeninges. We present the first indication in ophthalmology of Tachosil® as an effectivealternative in the treatment of sterile non-traumatic corneal perforations less than 1.5mmin size(AU)

[Choroidal folds. A presentation of two cases]. / Pliegues coroideos. A propósito de dos casos.

CLINICAL CASE: We report two patients of 29 and 50 years old presenting with unilateral choroidal folds in posterior segment in which, after a complete ophthalmic examination, we suspected an acquired hyperopic shift syndrome. Fluorescein angiography and magnetic resonance imaging revealed a flattening of posterior globes and distended perineural subarachnoid spaces. DISCUSSION: Acquired hyperopia with choroidal folds is a benign condition characterised by the acute development of a unilateral or bilateral hyperopic shift in refractive error. We emphasise the importance of a differential diagnosis from a wide variety of disorders that can mimic this syndrome.

Pliegues coroideos. A propósito de dos casos / Choroidal folds. A presentation of two cases

Caso clínico: Presentamos dos pacientes de 29 y 50 años con pliegues coroideos en el poloposterior en los cuales, tras un examen oftalmológico completo, sospechamos un síndromede hipermetropía adquirida. Tras realizar la angiofluoresceingrafía y la resonanciamagnética diagnosticamos un aplanamiento del polo posterior de ambos ojos y un ensanchamientodel espacio subaracnoideo del nervio óptico.Discusión: La hipermetropía adquirida con pliegues coroideos es una entidad benigna caracterizadapor un cambio refractivo agudo hacia la hipermetropía unilateral o bilateral.Enfatizamos la importancia del diagnóstico diferencial con otras enfermedades que puedenmimetizar este cuadro clínico(AU)

Clinical case: We report two patients of 29 and 50 years old presenting with unilateralchoroidal folds in posterior segment in which, after a complete ophthalmic examination,we suspected an acquired hyperopic shift syndrome. Fluorescein angiography andmagnetic resonance imaging revealed a flattening of posterior globes and distendedperineural subarachnoid spaces.Discussion: Acquired hyperopia with choroidal folds is a benign condition characterised bythe acute development of a unilateral or bilateral hyperopic shift in refractive error. Weemphasise the importance of a differential diagnosis from a wide variety of disorders thatcan mimic this syndrome(AU)

[Brown-McLean syndrome after insertion of an anterior chamber intraocular lens: description of one case]. / Síndrome de Brown-McLean con lente intraocular de cámara anterior: descripción de un caso.

CASE REPORT: We report one case of Brown-McLean syndrome. DISCUSSION: In this case, a 71-year-old male developed a Brown-McLean syndrome after implantation of an anterior chamber lens in one aphakic eye. A phacoemulsification procedure was performed in the other eye without development of corneal clearance alterations in the next 7 years. The cause of Brown-McLean syndrome is still unexplained. It is possible that it could develop in eyes with a genetic predisposition when these eyes are exposed to certain conditions, such as insertion of an anterior chamber lens.

Síndrome de Brown-McLean con lente intraocular de cámara anterior: descripción de un caso / Brown-McLean syndrome after insertion of an anterior chamber intraocular lens: description of one case

Caso clínico: Se presenta un caso de síndrome de Brown-McLean. Discusión: Un varón de 71 años de edad desarrolló un síndrome de Brown-McLean tras el implante de una lente de cámara anterior en un ojo afáquico. Se realizó facoemulsificación en el ojo contralateral sin desarrollo de alteraciones en la transparencia corneal. El síndrome de Brown-McLean tiene un origen incierto todavía. Probablemente, se desarrolle en ojos con predisposición genética expuestos a ciertas condiciones, como por ejemplo lentes de cámara anterior

Case report: We report one case of Brown-McLean syndrome. Discussion: In this case, a 71-year-old male developed a Brown-McLean syndrome after implantation of an anterior chamber lens in one aphakic eye. A phacoemulsification procedure was performed in the other eye without development of corneal clearance alterations in the next 7 years. The cause of Brown-McLean syndrome is still unexplained. It is possible that it could develop in eyes with a genetic predisposition when these eyes are exposed to certain conditions, such as insertion of an anterior chamber lens

[Juxtapapillary capillary hemangioma and central serous retinopathy: description of a case with spontaneous resolution]. / Hemangioma capilar yuxtapapilar y retinopatía central serosa: descripción de un caso con resolución espontánea.

CASE REPORT: A patient presented with a unilateral decrease of visual acuity and was found to have a juxtapapillary capillary hemangioma by ophthalmoscopy (confirmed by fluorescein angiography) and atrophy in the retinal pigmentary epithelium with leakage points suggesting bilateral central serous retinopathy. Spontaneous resolution of the hemangioma, as well as the central serous retinopathy, subsequently occurred. DISCUSSION: The decrease of visual acuity in a patient with a juxtapapillary capillary hemangioma has been associated with complications from the lesion itself, but an association of central serous retinopathy, as a possible predisposing factor, has not been previously described.

Hemangioma capilar yuxtapapilar y retinopatía central serosa: descripción de un caso con resolución espontánea / Juxtapapillary capillary hemangioma and central serous retinopathy: description of a case with spontaneous resolution

Caso clínico: Paciente con pérdida de agudezavisual unilateral. Funduscópicamente se observóuna masa compatible con hemangioma capilar yuxtapapilar(confirmada mediante angiofluoresceingrafía)y alteración del epitelio pigmentario y puntosde exudación en polo posterior compatibles conretinopatía central serosa bilateral.En la evolución se produjo regresión espontáneatanto del hemangioma como de la retinopatía centralserosa.Discusión: La pérdida de visión en un paciente conhemangioma capilar yuxtapapilar se ha relacionadocon complicaciones derivados del mismo, nohabiendo sido descrita la asociación con retinopatíacentral serosa, como factor contribuyente

Case report: A patient presented with a unilateral ;;decrease of visual acuity and was found to have a ;;juxtapapillary capillary hemangioma by ophthalmoscopy ;;(confirmed by fluorescein angiography) ;;and atrophy in the retinal pigmentary epithelium ;;with leakage points suggesting bilateral central ;;serous retinopathy. Spontaneous resolution of the ;;hemangioma, as well as the central serous retinopathy, ;;subsequently occurred. ;;Discussion: The decrease of visual acuity in a ;;patient with a juxtapapillary capillary hemangioma ;;has been associated with complications from the ;;lesion itself, but an association of central serous ;;retinopathy, as a possible predisposing factor, has ;;not been previously described

Pliegues coroideos en retinopatía diabética / Choroidal folds in diabetic retinopathy

Objetivos: Los pliegues coroideos son unas ondulaciones de la parte interna de la coroides, membrana de Bruch, epitelio pigmentario retiniano y capas externas de la retina que producen líneas alternas amarillentas y oscuras. Hemos hecho una revisión bibliográfica de todas las causas y no encontramos una clara relación con la retinopatía diabética. Nos proponemos estudiar un grupo de casos que encontramos con pliegues coroideos y retinopatía diabética. Métodos: Revisamos 1.019 angiografías de pacientes diabéticos, encontrando 16 con pliegues coroideos. Se analizó su historia médica y oftalmológica el estado de la retinopatía y la morfología y patrones de los pliegues. Resultados: Todos los casos presentaban un patrón similar, circunferenciales u horizontales, concéntricos, por fuera del área macular y de longitud variable. Han sido demostrados cambios en la apariencia de los pliegues con el tiempo. 88 por ciento fueron mujeres; en un 54 por ciento existía una baja hipermetropía (no mayor de 2,5 dioptrías); el 100 por ciento eran diabéticos tipo II y 85 por ciento eran insulin-dependientes. El estado de la retinopatía era: 44 por ciento de fondo moderada, 12 por ciento de fondo severa y 44 por ciento proliferativa. La hipertensión arterial fue la enfermedad sistémica más frecuentemente asociada(50 por ciento).Conclusiones: Encontramos pliegues coroideos en pacientes con retinopatía diabética de características muy similares. Los cambios observados con el tiempo y objetivados con AFG indican que, con alta probabilidad, son adquiridos. El engrosamiento de la coroides que se produce en los diabéticos, junto con la retinopatía hipertensiva, podría ser la causa de estos pliegues (AU)

Periflebitis retiniana como signo precoz de endoftalmitis / Retinal periphlebitis as early sign of endophthalmitis

Caso clínico: Una mujer de 75 años de edad es operada de cataratas mediante facoemulsificación sin complicaciones. Cuatro días después acude por visión borrosa y miodesopsias de instauración brusca; en la exploración ocular presentaba una periflebitis retiniana en el fondo. Al día siguiente presentaba una endoftalmitis evidente con signos y síntomas típicos.Discusión: La endoftalmitis es una de las complicaciones más graves de la cirugía, por lo que precisa un diagnóstico e instauración de tratamiento precoz para conservar una adecuada función visual. Uno de los signos más precoces de endoftalmitis bacteriana y muy raramente hallado es la periflebitis retiniana ante lo que el oftalmólogo debe conocer y actuar con prontitud (AU)

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[Retinal periphlebitis as early sign of endophthalmitis]. / Periflebitis retiniana como signo precoz de endoftalmitis.

CASE REPORT: 75 year-old woman was operated for cataract by means of phacoemulsification without complications. Four days after she came for suddenly blurred vision and floaters; on ocular examination there was a periphlebitis in the fundus. On the following day, an endophthalmitis with typical signs and symptoms was evident. DISCUSSION: Endophthalmitis is one of the most serious complications of the cataract surgery; therefore, an early diagnosis and treatment is necessary to preserve an adequate visual function. One of the earliest sings of bacterial endophthalmitis, seldom found, is a retinal periphlebitis, which the ophthalmologist must know and make a prompt decision.

[Choroidal folds in diabetic retinopathy]. / Pliegues coroideos en retinopatía diabética.

PURPOSE: Choroidal folds are wrinkles of the inner part of the choroid, Bruch's membrane, retinal pigment epithelium and the outer retinal layers that produce alternate yellow and dark streaks. We have made a bibliographic checking of all of the causes and we have not found a clear relationship with diabetic retinopathy. Our purpose is to study a group of cases that we found with choroidal folds and diabetic retinopathy. METHODS: We have checked 1,019 angiographies of diabetic patients and we have found 16 cases with choroidal folds. Medical and ocular history have been analysed, as well as the state of the retinopathy and the morphology and pattern of the folds. RESULTS: All the cases had a similar pattern, bend shaped and horizontal, concentric, outside the macula and variable length. Changes of the appearance in the time have been demonstrated. 88% were women; 54% had a mild hyperopia (less than 2.5 diopters); 100% were diabetic type II and 85% insulin-dependent. The clinical appearance of the retinopathy was in 44% of moderate background, in 12% of severe background and in 44% of proliferative retinopathy. Arterial hypertension was the systemic disease more frequently associated (50%). CONCLUSIONS: We have found choroidal folds in patients with diabetic retinopathy of similar appearance. Changes observed in the time in angiographies reveal that, with high probability, they are acquired. The thick choroid that is developed in diabetics, together with the hypertensive retinopathy could be the cause of these folds.