Quemosis conjuntival bilateral como síntoma de adenocarcinoma suprarrenal / Bilateral conjunctival oedema as a symptom of adrenal adenocarcinoma

Caso clínicoSe presenta el caso de una paciente de 67 años que acude por edema conjuntival bilateral resistente a tratamiento tópico con antibióticos antiinflamatorios. Tras un completo examen sistémico llegamos al diagnóstico de adenocarcinoma suprarrenal que fue tratado mediante cirugía y quimioterapia, tras los cuales la quemosis mejoró. Desafortunadamente, la paciente falleció por insuficiencia respiratoria debido a metástasis.ConclusiónSe destaca la necesidad de realizar un examen exhaustivo y completo por el oftalmólogo en casos de pacientes con edema conjuntival bilateral no respondedores a tratamiento tópico con antibióticos y antiinflamatorios, para descartar enfermedades sistémicas potencialmente graves(AU)

Clinical caseWe present a case of a 67-year-old female suffering for bilateral conjunctival oedema that did not improve with antibiotic and antiinflammatory treatment. After a complete systemic examination she was diagnosed with an adrenal adenocarcinoma and treated by surgery and chemotherapy. The conjunctival chemosis subsequently improved. Unfortunately the patient died of respiratory failure due to metastasis.ConclusionWe emphasise the need of an exhaustive and complete examination by the ophthalmologist in cases of non-responders to topical antibiotic and antiinflammatory treatment in patients with bilateral conjunctival oedema, in order to make a correct diagnosis of systemic potentially lethal diseases(AU)

[HIV retinal vasculitis]. / Vasculitis retiniana por VIH.

CASE REPORT: We present a case of a 47 year-old woman, infected with human immunodeficiency virus (HIV) diagnosed 5 years ago without receiving any treatment, who had floaters in her left eye. A peripheral retinal vasculitis was discovered and confirmed by an angiography. No source of infection was found, antiretroviral and corticosteroid treatment was given, with a complete resolution of the vasculitis. DISCUSSION: From 70-80% of positive untreated HIV patients develop ocular complications, with intraocular inflammation in more than half of them. Intraocular inflammation can be associated with opportunistic infections, tumours and as in our case, secondary to the HIV. Antiretroviral therapy is the proper treatment in these patients.

Vasculitis retiniana por VIH / HIV retinal vasculitis

Caso clínico: Mujer de 47 años con infección por el virus de la inmunodeficiencia humana(VIH) de 5 años de evolución sin tratamiento que acude por miodesopsias. Se le halla unfoco de vasculitis retiniana periférica en el ojo izquierdo (OI) confirmado angiográficamente.Se descarta otra patología infecciosa por parte de Medicina Interna y se inicia tratamientoantirretroviral y corticoideo sistémico, con resolución del foco de vasculitis.Discusión: Entre un 70 y un 80% de los pacientes positivos para VIH sin tratamiento desarrollancomplicaciones oculares, con inflamación intraocular en más de la mitad de ellos.La inflamación intraocular puede ser debida a infecciones oportunistas, neoplasias y, comoen nuestro caso, secundarias al propio virus. En estos pacientes el tratamiento antirretroviralconsigue la resolución del cuadro(AU)

Case report: We present a case of a 47 year-old woman, infected with humanimmunodeficiency virus (HIV) diagnosed 5 years ago without receiving any treatment, whohad floaters in her left eye. A peripheral retinal vasculitis was discovered and confirmed byan angiography. No source of infection was found, antiretroviral and corticosteroidtreatment was given, with a complete resolution of the vasculitis.Discussion: From 70-80% of positive untreated HIV patients develop ocular complications,with intraocular inflammation in more than half of them. Intraocular inflammation can beassociated with opportunistic infections, tumours and as in our case, secondary to the HIV.Antiretroviral therapy is the proper treatment in these patients(AU)