Vasculitis retiniana y del disco óptico en el síndrome de Susac / Retinal and optic disc vasculitis in Susac's syndrome

Mujer de 42 años, sin antecedentes de interés que acude con cefalea severa, náuseas, vómitos, pérdida de la audición y alteraciones mentales con desorientación y confusión. El examen oftalmológico reveló la presencia de hiperemia del disco óptico derecho y de áreas focales de oclusión arteriolar en ambos ojos. La audiometría puso de manifiesto una hipoacusia bilateral neurosensorial. En la resonancia magnética cerebral se detectaron múltiples lesiones de pequeño tamaño hiperintensas localizadas en el esplenio, cuerpo calloso, ganglios basales y sustancia blanca

The case is presented of 42 year-old woman with no significant medical history, with severe headaches, nausea and vomiting, hearing loss, and alteration of mental status with disorientation and confusion. Ophthalmic examination showed optic disc hyperaemia in right eye, and focal areas of arteriolar occlusion in both eyes. Audiometry demonstrated bilateral neurosensory hypoacusis. Magnetic Resonance Imaging showed multiple small round hyperintense lesions located in the splenium, corpus callosum, basal ganglia, and white matter

Excavación focal coroidea asociada a membrana neovascular coroidea idiopática / Focal choroidal excavaction associated with idiopathic choroidal neovascularization

CASO CLÍNICO: Presentamos el caso de una mujer de 61 años, con una retinopatía de tipo Purtscher asociada a un fallo renal agudo. La exploración oftalmológica, angiografía fluoresceínica y tomografía de coherencia óptica fueron compatibles con una retinopatía de Purtscher-like. Las manifestaciones oculares precedieron al fracaso renal. El estudio sistémico y de laboratorio descartó su asociación con pancreatitis y otras enfermedades sistémicas. Finalmente se complicó con un glaucoma neovascular. DISCUSIÓN: La retinopatía de Purtscher-like rara vez precede a la enfermedad sistémica asociada. El diagnóstico precoz basado en las manifestaciones oftálmicas, podría contribuir al diagnóstico y tratamiento de la enfermedad de base y a la prevención de las posibles complicaciones

CASE REPORT: The case is reported of a 61 year-old woman with Purtscher-like retinopathy associated with acute renal failure. Ophthalmic examination, fluorescein-angiography, and optical coherence tomography were consistent with Purtscher-like retinopathy. Ophthalmic symptoms and signs preceded renal failure. Pancreatitis and other systemic diseases were ruled out. The patient developed a neovascular glaucoma. DISCUSSION: Purtscher-like retinopathy rarely precedes the associated systemic illness. Early diagnosis based on ophthalmic symptoms may help in the recognition and treatment of the disease, and prevent later complications

Retinal and optic disc vasculitis in Susac's syndrome. / Vasculitis retiniana y del disco óptico en el síndrome de Susac.

CASE REPORT: The case is presented of 42 year-old woman with no significant medical history, with severe headaches, nausea and vomiting, hearing loss, and alteration of mental status with disorientation and confusion. Ophthalmic examination showed optic disc hyperaemia in right eye, and focal areas of arteriolar occlusion in both eyes. Audiometry demonstrated bilateral neurosensory hypoacusis. Magnetic Resonance Imaging showed multiple small round hyperintense lesions located in the splenium, corpus callosum, basal ganglia, and white matter. DISCUSSION: Besides branch retinal arteriolar occlusion, the angiopathy in Susac's syndrome may affect the optic disc vessels.

Focal choroidal excavaction associated with idiopathic choroidal neovascularization. / Excavación focal coroidea asociada a membrana neovascular coroidea idiopática.

CASE REPORT: The case is presented of a 45 year-old man with a focal choroidal excavation associated with choroidal neovascularisation not included in the area of excavation. Clinical features were analysed using retinography, fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography. The patient was treated with 3 intravitreal injections of bevacizumab, with a good response. DISCUSSION: Focal choroidal excavation can be associated with choroidal neovascularization not included in the area of excavation. Multimodal imaging provides a complete description of clinical features, before and after treatment.

Uveítis unilateral asociada a nefropatía IgA / Unilateral uveitis associated with IgA nephropathy

Caso clínico: Presentamos el caso de un varón de 42 años de edad con varios episodios de uveítis unilateral en su ojo derecho. El examen oftalmológico mostró una uveítis anterior granulomatosa con vitritis. El estudio sistémico puso de manifiesto una proteinuria de rango no nefrótico y microhematuria. La biopsia renal reveló una nefropatía IgA. Discusión: Las uveítis y las glomerulonefritis podrían tener mecanismos inmunológicos comunes. En el diagnóstico diferencial de los pacientes con uveítis y nefropatías debería incluirse la nefropatía IgA (AU)

Case report: The case is presented of a 42 year-old man with episodes of unilateral uveitis in his right eye. Ophthalmic examination showed a granulomatous anterior uveitis with vitritis. Systemic investigations revealed non-nephrotic proteinuria and microhaematuria. A renal biopsy showed IgA nephropathy. Discussion: Uveitis and glomerulonephritis may have common immunological pathogenesis. IgA nephropathy should be a differential diagnosis in patients with uveitis and nephropathy (AU)

Ecografía ocular en paciente con hemovítreo por desgarro retiniano / Ocular ultrasound in a patient with vitreous haemorrhage caused by a retinal tear

No disponible

Desprendimiento de retina exudativo bilateral asociado con coriorretinopatía serosa central en una paciente tratada con corticoesteroides / Bilateral exudative retinal detachment associated with central serous chorioretinopathy in a patient treated with corticosteroids

Caso clínico: Presentamos el caso de una mujer de 54 años con una coriorretinopatía serosa central diagnosticada erróneamente de enfermedad de Vogt-Koyanagi-Harada y tratada con corticoides sistémicos. La paciente desarrolló un desprendimiento de retina exudativo bulloso en ambos ojos. Discusión: La interrupción del tratamiento con corticoides junto con el drenaje quirúrgico del líquido subretiniano y la aplicación de terapia fotodinámica consiguió la mejoría anatómica y funcional. El correcto diagnóstico de las formas atípicas de la enfermedad podría evitar las complicaciones del uso inadecuado de los corticoides (AU)

Case report: The case is presented on a 54-year-old woman with a central serous chorioretinopathy, misdiagnosed as Vogt-Koyanagi-Harada disease, and treated with systemic corticosteroids. The patient presented with a bilateral bullous exudative retinal detachment. Discussion: Discontinuation of corticosteroid therapy, surgical drainage of subretinal fluid, and photodynamic therapy, led to anatomical and functional improvement. The recognition of an atypical presentation of central serous chorioretinopathy may avoid complications of the inappropriate treatment with corticosteroids (AU)

Coriorretinitis placoide posterior sifilítica como presentación inicial de neurosífilis temprana / Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis

Caso clínico: Varón de 36 años con diagnóstico reciente de VIH con pérdida de visión de ojo izquierdo. En fundoscopia se observó placa amarillenta en mácula. Tras angiografía con fluoresceína, tomografía de coherencia óptica, angiotomografía de coherencia óptica, pruebas serológicas y examen de LCR se llegó al diagnóstico de neurosífilis y coriorretinitis placoide posterior sifilítica. Discusión: La coriorretinitis placoide posterior es una manifestación clínica poco frecuente de sífilis ocular. En todos los pacientes con coriorretinitis placoide posterior sifilítica debe descartarse la posibilidad de neurosífilis y coinfección con el VIH. El tratamiento temprano con penicilina intravenosa suele ser efectivo, con un buen resultado visual (AU)

Case report: A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. Discussion: Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results (AU)

Inserción intracristaliniana accidental como complicación de implante intravítreo de dexametasona / Accidental intralenticular insertion as a complication of intravitreal dexamethasone implant

No disponible

Macrovaso retiniano asociado a telangiectasias periféricas retinianas e isquemia retiniana / Congenital retinal macrovessel associated with retinal peripheral telangiectasia and retinal ischaemia

Caso clínico: Presentamos el caso de una paciente de 16 años con un macrovaso retiniano congénito unilateral, con telangiectasias retinianas periféricas asociadas a zonas de isquemia. Discusión: Los macrovasos retinianos congénitos constituyen un hallazgo raro, no habiéndose descrito casos asociados a telangiectasias retinianas e isquemia periférica. Tras 21 meses de seguimiento, la paciente se mantiene estable, conservando la visión inicial y sin complicaciones adicionales (AU)

Clinical case: The case is presented of a 16 year-old girl with unilateral congenital retinal macrovessel associated with peripheral telangiectasia and retinal ischaemia. Discussion: Congenital retinal macrovessel is a rare finding. To the best of our knowledge this is the first report of this unusual presentation of congenital retinal macrovessel. After 21 months of follow up, visual acuity remained stable, and no complications developed (AU)

Unilateral uveitis associated with IgA nephropathy. / Uveítis unilateral asociada a nefropatía IgA.

CASE REPORT: The case is presented of a 42 year-old man with episodes of unilateral uveitis in his right eye. Ophthalmic examination showed a granulomatous anterior uveitis with vitritis. Systemic investigations revealed non-nephrotic proteinuria and microhaematuria. A renal biopsy showed IgA nephropathy. DISCUSSION: Uveitis and glomerulonephritis may have common immunological pathogenesis. IgA nephropathy should be a differential diagnosis in patients with uveitis and nephropathy.

Bilateral exudative retinal detachment associated with central serous chorioretinopathy in a patient treated with corticosteroids. / Desprendimiento de retina exudativo bilateral asociado con coriorretinopatía serosa central en una paciente tratada con corticoesteroides.

CASE REPORT: The case is presented on a 54-year-old woman with a central serous chorioretinopathy, misdiagnosed as Vogt-Koyanagi-Harada disease, and treated with systemic corticosteroids. The patient presented with a bilateral bullous exudative retinal detachment. DISCUSSION: Discontinuation of corticosteroid therapy, surgical drainage of subretinal fluid, and photodynamic therapy, led to anatomical and functional improvement. The recognition of an atypical presentation of central serous chorioretinopathy may avoid complications of the inappropriate treatment with corticosteroids.

Congenital retinal macrovessel associated with retinal peripheral telangiectasia and retinal ischaemia. / Macrovaso retiniano asociado a telangiectasias periféricas retinianas e isquemia retiniana.

CLINICAL CASE: The case is presented of a 16 year-old girl with unilateral congenital retinal macrovessel associated with peripheral telangiectasia and retinal ischaemia. DISCUSSION: Congenital retinal macrovessel is a rare finding. To the best of our knowledge this is the first report of this unusual presentation of congenital retinal macrovessel. After 21 months of follow up, visual acuity remained stable, and no complications developed.

Tratamiento quirúrgico en un hamartoma combinado de retina y epitelio pigmentario / Surgical treatment in combined hamartoma of the retina and retinal pigment epithelium

CASO CLÍNICO: Presentamos el caso de un paciente varón de 39 años, con un hamartoma combinado de retina y epitelio pigmentario de retina. El paciente refería disminución progresiva de la visión y empeoramiento de la metamorfopsia. Se realizó una vitrectomía con pelado de la membrana epirretiniana, consiguiendo una mejoría de la agudeza visual y de la metamorfopsia, así como de la arquitectura retiniana en la tomografía de coherencia óptica. DISCUSIÓN: Algunos pacientes seleccionados con hamartomas combinados de retina y epitelio pigmentario podrían beneficiarse de la realización de una vitrectomía

CASE REPORT: The case is presented of a 39 year-old man with a combined hamartoma of the retina and retinal pigment epithelium, who experienced progressive visual loss and worsening of metamorphopsia. The patient underwent vitrectomy and epiretinal component peeling, with improvement in visual acuity, metamorphopsia, and retinal architecture, assessed by optical coherence tomography. DISCUSSION: Selected patients with combined hamartomas of the retina and retinal pigment epithelium may benefit from surgical management

Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis. / Coriorretinitis placoide posterior sifilítica como presentación inicial de neurosífilis temprana.

CASE REPORT: A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. DISCUSSION: Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results.

Surgical treatment in combined hamartoma of the retina and retinal pigment epithelium. / Tratamiento quirúrgico en un hamartoma combinado de retina y epitelio pigmentario.

CASE REPORT: The case is presented of a 39 year-old man with a combined hamartoma of the retina and retinal pigment epithelium, who experienced progressive visual loss and worsening of metamorphopsia. The patient underwent vitrectomy and epiretinal component peeling, with improvement in visual acuity, metamorphopsia, and retinal architecture, assessed by optical coherence tomography. DISCUSSION: Selected patients with combined hamartomas of the retina and retinal pigment epithelium may benefit from surgical management.

Síndrome de Churg-Strauss asociado con anticuerpos antifosfolipídicos en un paciente con vasculitis retiniana / Churg-Strauss syndrome associated with antiphospholipid antibodies in a patient with retinal vasculitis

CASO CLINICO: Presentamos el caso clínico de una mujer de 69 años, con una vasculitis retiniana unilateral. El estudio del caso mostró la presencia de asma, sinusitis con pólipos nasales, eosinofilia en sangre periférica, aumento de la velocidad de sedimentación, proteinuria y anticuerpos antifosfolipídicos. Los anticuerpos antineutrófilos citoplasmáticos fueron negativos. DISCUSIÓN: A pesar de la ausencia de anticuerpos antineutrófilos citoplasmáticos, se consideró el diagnóstico de un síndrome de Churg-Strauss, dadas las otras manifestaciones clínicas y de laboratorio, iniciándose un tratamiento con altas dosis de corticoides y anticoagulantes

CASE REPORT: We present the case of a 69-year-old woman with unilateral retinal vasculitis. Investigations showed asthma, rhinosinusitis, nasal polyposis, peripheral blood eosinophilia, increased sedimentation rate, proteinuria, and antiphospholipid antibodies. Anti-neutrophil cytoplasmic antibodies (ANCA) were negative. DISCUSSION: Although her anti-neutrophil cytoplasmatic antibody (ANCA) status was negative, taking into account the other clinical and laboratory features, retinal vasculitis was thought to be an ocular manifestation of Churg-Strauss syndrome. Treatment was started with high-dose corticosteroids and anticoagulant therapy