Neoplasia intraepitelial conjuntival. Interferón como terapia de rescate tras fracaso de la mitomicina C / Conjunctival intraepithelial neoplasia. Interferon as a rescue therapy after failure of mitomycin C

CASO CLÍNICO: Varón de 60 años con lesión conjuntival diagnosticada de neoplasia intraepitelial corneal conjuntival (NICC), iniciándose tratamiento con mitomicina C. Tras 3 semanas y mínima mejoría, se reemplaza por interferón alfa 2B. Seis meses después, con completa remisión, se suspende el tratamiento sin signos de recidiva. DISCUSIÓN: Actualmente, el tratamiento de estas lesiones se realiza con agentes quimioterapéuticos o inmunomoduladores como la mitomicina C, el 5-fluorouracilo y el interferón alfa 2B. Este último, a pesar de ser menos utilizado, presenta excelentes resultados con efectos secundarios menores que la mitomicina C, resultando una alternativa óptima para el tratamiento no invasivo de las NICC

CLINICAL CASE: The case of a 60 year-old male with a conjunctival lesion diagnosed as conjunctival intraepithelial neoplasia (CIN), who was treated with mitomycin-C for 3 weeks with minimal improvement. The therapy was change to interferon 2B. Six month later, and after a complete remission of the lesion, the treatment was suspended, with no signs of relapse. DISCUSSION: The treatment of these lesions is currently made with chemotherapy and immunotherapy agents, such as mitomycin-C, 5-fluorouracil, and interferon alfa 2B. The latter, even although is the least used, gives excellent results with fewer secondary effects than mitomycin-C, resulting in an optimal therapy for the non-invasive treatment of CIN lesions

Conjunctival intraepithelial neoplasia. Interferon as a rescue therapy after failure of mitomycin C.

CLINICAL CASE: The case of a 60 year-old male with a conjunctival lesion diagnosed as conjunctival intraepithelial neoplasia (CIN), who was treated with mitomycin-C for 3 weeks with minimal improvement. The therapy was change to interferon 2B. Six month later, and after a complete remission of the lesion, the treatment was suspended, with no signs of relapse. DISCUSSION: The treatment of these lesions is currently made with chemotherapy and immunotherapy agents, such as mitomycin-C, 5-fluorouracil, and interferon alfa 2B. The latter, even although is the least used, gives excellent results with fewer secondary effects than mitomycin-C, resulting in an optimal therapy for the non-invasive treatment of CIN lesions.

Choroidal metastases from lung adenocarcinoma

A 32-year-old woman presented with an unknown visual deficit. Fundus examination revealed a lesion compatible with a metastatic focus. Diagnostic workup revealed a lung mass and the biopsy was compatible with lung adenocarcinoma. The intraocular lesion was the only metastatic site at the time of diagnosis. She received local choroidal treatment and further systemic therapy. A pneumonectomy was performed. Five months later she progressed systemically and has since then received several lines of chemotherapy. Choroidal metastases are an infrequent site of systemic dissemination and associated with a poor prognosis, with a median survival of around 2 months if it is the first manifestation of a lung neoplasm. Here we review the literature on choroidal metastases, their treatment options and epidemiology (AU)

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[Experimental study of the suture of the intraocular lens sutured to the ciliary sulcus. Needle passage and distance from the limbus]. / Estudio experimental de la sutura de las lentes intraoculares suturadas al sulcus ciliar. Paso de la aguja y distancia al limbo.

OBJECTIVE: To discover which technique is best to scleral suture fixation of the lens in the ciliary sulcus, based on two needle direction options: passing the needle from the outer part of the eyeball inwards or from the inner part outwards and to know at what distance the needle must be passed from the sclerocorneal limbus. MATERIAL AND METHODS: We used 40 cadaver eyes conserved in 10% formaldehyde. The needle was passed from the interior to the exterior of the eye, observing whether if it had crossed through the ciliary sulcus and the distance of the needle from the limbus. Stitches were also made, going from the exterior to the interior of the eyeball at a known distance from the limbus, either parallel to the iris or perpendicular to the sclera. RESULTS: When the needle was passed from the interior toward the exterior of the eye, it passed through the ciliary sulcus, exiting the eye at 1.50+/-0.16 mm from the limbus, in 80% of the cases. When the needle was passed from the exterior toward the interior of the globe perpendicularly to the sclera only 32.5% passed through the sulcus and when it was parallel to the iris only, only 40%. There is greater statistical probability that the needle will pass through the sulcus from the interior of the eyeball, exiting the limbus at approximately 1.5 mm. CONCLUSION: Since it is necessary to pass the suture through the sulcus in order to be able to place the lens haptics in the ciliary sulcus when suturing a posterior chamber lens to the sclera, it is best to pass the needle from the interior to the exterior of the eyeball and for the needle to exit at approximately 1.5 mm from the limbus.

Estudio experimental de la sutura de las lentes intraoculares suturadas al sulcus ciliar. Paso de la aguja y distancia al limbo / Experimental study of the suture of the intraocular lens sutured at the ciliary sulcus

Objetivo: Encontrar la mejor técnica para suturar una lente a la esclera a nivel del sulcus ciliar entre la opción de pasar la aguja desde el exterior hacia el interior del globo ocular o a la inversa y conocer cuál es la distancia a la que debe pasar la aguja respecto al limbo esclerocorneal. Material y métodos: Hemos utilizado 40 ojos de cadáver conservados en formaldehido al 10 per cent. Pasamos por un lado la aguja desde el interior hacia el exterior del ojo y consideramos si ha atravesado el sulcus ciliar y a qué distancia del limbo ha salido y por otro lado pasamos agujas desde el exterior hacia el interior del globo a una distancia del limbo conocida, bien paralelas al iris o bien perpendiculares a la esclera. Resultados: Cuando pasamos la aguja desde el interior hacia el exterior del ojo, en el 80 per cent de los casos atraviesa el sulcus ciliar, saliendo entonces a 1,50ñ0,16 mm del limbo. Cuando pasamos la aguja desde el exterior hacia el interior del globo perpendicularmente a la esclera sólo el 32,5 per cent atraviesa el sulcus ciliar y paralelamente al iris sólo el 40 per cent lo atraviesa. Es más probable pasar la aguja por el sulcus ciliar de forma estadísticamente significativa cuando lo hacemos desde el interior del globo ocular y sale aproximadamente 1,5 mm del limbo. Conclusión: Puesto que para conseguir situar los hápticos de la lente en el sulcus ciliar al suturar una lente de cámara posterior a la esclera hay que pasar previamente la sutura por el mismo, la mejor manera de conseguirlo es pasando la aguja desde el interior hacia el exterior del globo ocular y que ésta salga aproximadamente a 1,5 mm del limbo (AU)