RESUMO
The main corneal infections reported worldwide are caused by bacteria and viruses but, recently, the number of Acanthamoeba keratitis (AK) cases has increased. Acanthamoeba genus is an opportunistic free living protozoa widely distributed in environmental and clinical sources, with two life-cycle stages: the trophozoite and the cyst. AK presents as primary symptoms eye redness, epithelial defects, photophobia and intense pain. An early diagnosis and an effective treatment are crucial to avoid blindness or eye removal but, so far, there is no established treatment to this corneal infection. Diverse research studies have reported the efficacy of commercialized eye drops and ophthalmic solutions against the two life cycle stages of Acanthamoeba strains, that usually present preservatives such as Propylene Glycol of Benzalkonium chloride (BAK). These compounds present toxic effects in corneal cells, favouring the inflammatory response in the so sensitive eye tissue. In the present work we have evaluated the efficacy of nine proprietary ophthalmic solutions with and without preservatives (ASDA Dry Eyes Eyedrops, Miren®, ODM5®, Ectodol®, Systane® Complete, Ocudox®, Matrix Ocular®, Alins® and Coqun®) against the two life cycle stages of three Acanthamoeba strains. Our work has demonstrated the high anti-Acanthamoeba activity of Matrix Ocular®, which induces the programmed cell death mechanisms in Acanthamoeba spp. trophozoites. The high efficacy and the absence of ocular toxic effects of Matrix Ocular®, evidences the use of the Arabinogalactan derivatives as a new source of anti-AK compounds.
Assuntos
Ceratite por Acanthamoeba , Acanthamoeba , Amebicidas , Ceratite por Acanthamoeba/tratamento farmacológico , Amebicidas/farmacologia , Amebicidas/uso terapêutico , Galactanos , Humanos , Soluções Oftálmicas/uso terapêuticoRESUMO
We present a case of a woman with idiopathic macular telangiectasia type 1, characterized by the presence of a capillary macroanaeurysm associated with macular edema with a macular star pattern. Several differential diagnoses were proposed, in which the study with a multimodal image was key to clarify the diagnosis. In addition, the various treatments used and their effectiveness are discussed.
RESUMO
La intoxicación por ingesta de metanol es una entidad frecuentemente descrita en la literatura, no así la intoxicación vía transdérmica o inhalatoria. Suele cursar con daño multiorgánico variable, entre lo que destaca la afectación visual, neurológica y digestiva, así como las alteraciones metabólicas y electrolíticas que pueden llegar a causar la muerte. El contacto con tolueno por inhalación ocupacional o intencional puede producir también alteraciones neurológicas. En este artículo se expone el caso de una paciente mujer que acude al servicio de urgencias por pérdida visual bilateral secundaria a una intoxicación accidental (inhalatoria-transdérmica) con un disolvente que contenía metanol y tolueno, entre otros compuestos, y que durante el ingreso evoluciona favorablemente tras tratamiento con etanol en perfusión y corticoides
Methanol poisoning is often described in the literature, but not transdermal or inhalational poisoning. It usually involves variable multi-organ damage, among which visual, neurological, and gastrointestinal involvement, as well as the metabolic and electrolyte changes that can lead to death. Contact with toluene by occupational or intentional inhalation may also cause neurological abnormalities. This article describes the case of a female patient who was seen in the Emergency Department due to bilateral visual loss secondary to accidental poisoning (inhalation-transdermal) with a solvent containing methanol and toluene. She had a favourable outcome during admission after treatment with ethanol in perfusion and corticosteroids
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Metanol/envenenamento , Tolueno/envenenamento , Cegueira/induzido quimicamente , Cegueira/diagnóstico por imagem , Cegueira/tratamento farmacológico , Tomografia Computadorizada por Raios X , Oftalmoscopia , Etanol/uso terapêutico , Leucovorina/uso terapêutico , Antídotos/uso terapêutico , Metilprednisolona/uso terapêutico , Glucocorticoides/uso terapêuticoRESUMO
Methanol poisoning is often described in the literature, but not transdermal or inhalational poisoning. It usually involves variable multi-organ damage, among which visual, neurological, and gastrointestinal involvement, as well as the metabolic and electrolyte changes that can lead to death. Contact with toluene by occupational or intentional inhalation may also cause neurological abnormalities. This article describes the case of a female patient who was seen in the Emergency Department due to bilateral visual loss secondary to accidental poisoning (inhalation-transdermal) with a solvent containing methanol and toluene. She had a favourable outcome during admission after treatment with ethanol in perfusion and corticosteroids.
Assuntos
Cegueira/induzido quimicamente , Metanol/envenenamento , Solventes/envenenamento , Tolueno/envenenamento , Administração Cutânea , Administração por Inalação , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
CASO CLÍNICO: Varón de 45 años de edad, acude diagnosticado de paludismo con afectación neurológica. Dos meses más tarde refiere metamorfopsia en el ojo izquierdo. En el fondo de ojo se aprecia retinopatía palúdica bilateral, observándose en la tomografía de coherencia óptica (OCT) macular un desprendimiento del epitelio pigmentario (DEP) parafoveal en el ojo izquierdo. Se inicia tratamiento específico antipalúdico, evidenciándose desaparición de la retinopatía. DISCUSIÓN: El Plasmodium falciparum es responsable de la retinopatía en el paludismo neurológico. Debiéndose realizar en estos pacientes una exploración fundoscópica y OCT macular porque está asociado a una mortalidad mayor cuando existe afectación retiniana
CASE REPORT: A 45-year-old man was diagnosed with malaria with neurological involvement. Two months later he referred metamorphopsia in the left eye. Malarial retinopathy was observed in the fundus examination. The Optic Coherence Tomography (OCT) of the macula showed parafoveal pigment epithelium detachment (DEP). Specific anti-malarial treatment was initiated, with the disappearance of the retinopathy being observed. DISCUSSION: Plasmodium falciparum is responsible for the retinopathy in neurological malaria. A funduscopic examination and macular OCT should be performed in these patients, as it is associated with a higher mortality when there is a retinal involvement
Assuntos
Humanos , Masculino , Adulto , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Malária/diagnóstico , Doenças Retinianas/tratamento farmacológico , Doenças Retinianas/parasitologia , Antimaláricos/uso terapêutico , Plasmodium falciparum/isolamento & purificaçãoRESUMO
CASE REPORT: A 45-year-old man was diagnosed with malaria with neurological involvement. Two months later he referred metamorphopsia in the left eye. Malarial retinopathy was observed in the fundus examination. The Optic Coherence Tomography (OCT) of the macula showed parafoveal pigment epithelium detachment (DEP). Specific anti-malarial treatment was initiated, with the disappearance of the retinopathy being observed. DISCUSSION: Plasmodium falciparum is responsible for the retinopathy in neurological malaria. A funduscopic examination and macular OCT should be performed in these patients, as it is associated with a higher mortality when there is a retinal involvement.
Assuntos
Malária Cerebral/complicações , Malária Falciparum/complicações , Descolamento Retiniano/etiologia , Epitélio Pigmentado da Retina/patologia , Antimaláricos/uso terapêutico , Chade , Doxiciclina/uso terapêutico , Eritrócitos/parasitologia , Angiofluoresceinografia , Humanos , Malária Cerebral/tratamento farmacológico , Malária Falciparum/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Quinidina/análogos & derivados , Quinidina/uso terapêutico , Quinina/uso terapêutico , Descolamento Retiniano/diagnóstico por imagem , Descolamento Retiniano/tratamento farmacológico , Descolamento Retiniano/patologia , Hemorragia Retiniana/etiologia , Epitélio Pigmentado da Retina/diagnóstico por imagem , Tomografia de Coerência Óptica , Doença Relacionada a ViagensRESUMO
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