Utilidad del injerto de membrana amniótica en el manejo de la exposición del implante XEN® / Usefulness of the amniotic membrane graft in the management of the exposure of the XEN® implant

Se presenta el caso de una mujer de 79 años con glaucoma severo y falta de adherencia al tratamiento, que es sometida a cirugía de catarata e implante XEN® en su ojo izquierdo. Dos semanas después de la intervención se objetiva una erosión conjuntival con exposición del extremo distal del implante, por lo que se realiza una reparación quirúrgica mediante la combinación de una sutura aposicional del tubo, adaptando su trayectoria a la curvatura escleral, y el recubrimiento con injerto de membrana amniótica. Tras 6 meses de seguimiento, presenta una presión intraocular controlada, sin necesidad de tratamiento adicional, y sin mostrar progresión de su enfermedad (AU)

We report a case of a 79-year-old woman with severe glaucoma and absence of therapeutic adherence, who underwent cataract surgery and XEN® implant in her left eye. Two weeks after the intervention, conjunctival erosion was observed with exposure of the distal end of the implant, so a surgical repair was performed by combining an appositional suture of the tube, adapting its trajectory to the scleral curvature, and an amniotic membrane graft. After 6 months of follow-up, the intraocular pressure was controlled, without additional treatment needed, and no disease progression (AU)

Usefulness of the amniotic membrane graft in the management of xen® implant exposure.

We report a case of a 79-year-old woman with severe glaucoma and absence of therapeutic adherence, who undergone cataract surgery and XEN® implant in her left eye. Two weeks after the intervention, conjunctival erosion was observed with exposure of the distal end of the implant, so a surgical repair was performed by combining an appositional suture of the tube, adapting its trajectory to the scleral curvature, and an amniotic membrane graft. After 6 months of follow-up, the intraocular pressure is controlled, without additional treatment needed, and no disease progression.

Edema macular asociado a taxanos: presentación de un caso y revisión de la literatura / Macular oedema associated with taxanes: A case report and literature review

ANTECEDENTES Y OBJETIVO: Los taxanos son un grupo de quimioterápicos frecuentemente utilizados que, aunque rara vez, pueden dar lugar a un edema macular. El objetivo de este artículo es revisar y comunicar, de forma integrada, los datos de los casos previamente comunicados en la literatura, así como presentar un nuevo caso. MATERIAL Y MÉTODOS: Revisión narrativa de publicaciones de casos de edemas maculares en relación con taxanos, y presentación del caso clínico de una mujer de 73 años que, tras el tratamiento con paclitaxel por un cáncer de mama metastásico, desarrolla un edema macular que cede tras suspenderse el fármaco. RESULTADOS: Se incluyeron 57 casos que contienen los datos de 109 ojos recogidos en 52 artículos. El 76,79% de los casos fueron mujeres y la edad media fue de 58,75 años. El cáncer que más frecuentemente motivó el tratamiento fue el de mama (60,72%) y el 92,5% de los casos presentaba metástasis. El fármaco asociado con mayor frecuencia fue el paclitaxel (52,63%). La mediana del tiempo transcurrido hasta el desarrollo de síntomas fue de 4,25 meses. En la exploración inicial, el 92,86% de los casos presentó un edema bilateral y la agudeza visual media fue 0,4 (escala decimal), el grosor macular medio 509,63 micras, y el 97,83% de los ojos no presentaron hallazgos angiográficos o fueron mínimos. En el 90,57% de los casos el tratamiento con taxanos fue interrumpido, y algún otro tratamiento fue empleado en un 43,86% de los casos, siendo el más usado la acetazolamida. La evolución fue favorable, en mayor o menor medida, en el 96,23% de los casos. CONCLUSIONES: A pesar de ser una entidad rara, el edema macular asociado al uso de taxanos es una patología que todo oncólogo y oftalmólogo debiera conocer, teniendo en cuenta la buena evolución del cuadro que suele suceder a la suspensión del tratamiento

BACKGROUND AND PURPOSE: Although taxanes are a frequently used group of chemotherapy agents, they can, rarely, lead to macular oedema. The purpose of this article is to review and communicate, in an integrated way, the data of the cases previously reported in the literature, as well as to present a new case. MATERIAL AND METHODS: Narrative review of reports of cases of macular oedema associated with taxanes, and communication of the clinical case of a 73-year-old woman who, after treatment with paclitaxel for metastatic breast cancer, developed macular oedema that disappeared after discontinuing the drug. RESULTS: The review included 57 cases with data from 109 eyes collected in 52 articles. The large majority (76.79%) of the cases were women, and the mean age was 58.75 years. The cancer that most frequently motivated the treatment was breast cancer (60.72%), and 92.5% of cases had metastases. The most frequently associated drug was paclitaxel (52.63%). The median time to symptom development was 4.25 months. At the initial examination, 92.86% of the cases had bilateral oedema and the mean visual acuity was 0.4 (decimal scale). The mean macular thickness was 509.63 microns, and 97.83% of the eyes had no or minimal angiographic findings. In 90.57% of the cases, the treatment with taxanes was interrupted, and some other treatment was used in 43.86% of the cases, with the most widely used being acetazolamide. The outcome was favourable, to a greater or lesser extent, in 96.23% of cases. CONCLUSIONS: Despite being a rare entity, macular oedema associated with the use of taxanes is a disorder that every oncologist and ophthalmologist should be aware of, taking into account the good outcome of the condition that usually occurs when treatment is suspended

Macular oedema associated with taxanes: A case report and literature review. / Edema macular asociado a taxanos: presentación de un caso y revisión de la literatura.

BACKGROUND AND PURPOSE: Although taxanes are a frequently used group of chemotherapy agents, they can, rarely, lead to macular oedema. The purpose of this article is to review and communicate, in an integrated way, the data of the cases previously reported in the literature, as well as to present a new case. MATERIAL AND METHODS: Narrative review of reports of cases of macular oedema associated with taxanes, and communication of the clinical case of a 73-year-old woman who, after treatment with paclitaxel for metastatic breast cancer, developed macular oedema that disappeared after discontinuing the drug. RESULTS: The review included 57 cases with data from 109 eyes collected in 52 articles. The large majority (76.79%) of the cases were women, and the mean age was 58.75 years. The cancer that most frequently motivated the treatment was breast cancer (60.72%), and 92.5% of cases had metastases. The most frequently associated drug was paclitaxel (52.63%). The median time to symptom development was 4.25 months. At the initial examination, 92.86% of the cases had bilateral oedema and the mean visual acuity was 0.4 (decimal scale). The mean macular thickness was 509.63 microns, and 97.83% of the eyes had no or minimal angiographic findings. In 90.57% of the cases, the treatment with taxanes was interrupted, and some other treatment was used in 43.86% of the cases, with the most widely used being acetazolamide. The outcome was favourable, to a greater or lesser extent, in 96.23% of cases. CONCLUSIONS: Despite being a rare entity, macular oedema associated with the use of taxanes is a disorder that every oncologist and ophthalmologist should be aware of, taking into account the good outcome of the condition that usually occurs when treatment is suspended.

Escotoma juncional. A propósito de un caso / Junctional scotoma. A case report

Mujer de 55 años que refiere pérdida visual progresiva en el ojo derecho presenta un escotoma juncional en un estudio campimétrico. Se practica resonancia magnética, que muestra un aneurisma de la arteria cerebral media derecha con compromiso quiasmático ipsolateral

The case concerns a 55 year-old female patient with progressive visual decrease in her right eye that showed a junctional scotoma in the visual field study. A magnetic resonance scan was performed, which showed a right middle cerebral artery aneurysm with ipsolateral chiasmatic involvement

Junctional scotoma. A case report. / Escotoma juncional. A propósito de un caso.

The case concerns a 55 year-old female patient with progressive visual decrease in her right eye that showed a junctional scotoma in the visual field study. A magnetic resonance scan was performed, which showed a right middle cerebral artery aneurysm with ipsolateral chiasmatic involvement.

Suturas transconjuntivales del tapete escleral en maculopatía hipotónica tardía tras esclerectomía profunda no perforante / Transconjunctival suturing of the scleral flap in late hypotony maculopathy after non-penetrating deep sclerectomy

CASO CLÍNICO: Un hombre de 63 años desarrolla una maculopatía hipotónica tardía tras una esclerectomía profunda no perforante. La sutura transconjuntival del tapete escleral permite resolver la hipotonía y la normalización de la agudeza visual. DISCUSIÓN: La maculopatía hipotónica puede presentarse de forma diferida tras una cirugía de glaucoma. Las suturas transconjuntivales del tapete escleral son una alternativa en el tratamiento de la hipotonía cuando las medidas conservadoras han fracasado

CLINICAL CASE: A 63-year-old man presents with late hypotony maculopathy after non-penetrating deep sclerectomy. Hypotonia and visual acuity are improved after transconjunctival suturing of the scleral flap. DISCUSSION: Hypotony maculopathy may occur as a late complication after glaucoma surgery. Transconjunctival suturing of the scleral flap can be useful when conservative measures have failed

Transconjunctival suturing of the scleral flap in late hypotony maculopathy after non-penetrating deep sclerectomy. / Suturas transconjuntivales del tapete escleral en maculopatía hipotónica tardía tras esclerectomía profunda no perforante.

CLINICAL CASE: A 63-year-old man presents with late hypotony maculopathy after non-penetrating deep sclerectomy. Hypotonia and visual acuity are improved after transconjunctival suturing of the scleral flap. DISCUSSION: Hypotony maculopathy may occur as a late complication after glaucoma surgery. Transconjunctival suturing of the scleral flap can be useful when conservative measures have failed.