Hallazgos de angio-OCT en la retinosquisis juvenil ligada al X / Angio-OCT findings in juvenile X-linked retinoschisis

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Monitorización de la escleritis posterior mediante tomografía de coherencia óptica Swept-Source / Posterior scleritis follow-up by Swept-Source optical coherence tomography

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Rabdomiosarcoma alveolar orbitario enmascarado por sinusitis etmoidal en un adulto de 25 años / Orbital alveolar rhabdomyosarcoma masked by ethmoid sinusitis in a 25-year-old

CASO CLÍNICO: Mujer de 25 años con sinusitis subaguda derecha acudió por molestias en ojo derecho. Ante clínica y tomografía urgente sugestiva de absceso subperióstico orbitario etmoidal, se realizó un drenaje urgente, hallándose una tumoración sólida con biopsia positiva para rabdomiosarcoma alveolar. Se inició tratamiento con quimioterapia y radioterapia con remisión completa y resolución del cuadro clínico. DISCUSIÓN: El rabdomiosarcoma orbitario alveolar en adultos es infrecuente. Presenta un alto riesgo de diseminación y puede debutar simulando una sinusitis, como en este caso, por lo que un diagnóstico y tratamiento precoces son de especial importancia en estos pacientes

CASE REPORT: A 25-year-old woman with right subacute sinusitis, complained about discomfort in her right eye. Clinical manifestations and computed tomography were suggestive of sub-periosteal orbital ethmoid wall abscess, for which the patient underwent urgent drainage. A solid tumor was found, with a positive biopsy for alveolar rhabdomyosarcoma. Complete remission and resolution of orbital symptoms were achieved with chemotherapy and radiation therapy. DISCUSSION: Alveolar orbital rhabdomyosarcoma in adults is uncommon. Rhabdomyosarcoma has a high risk of spreading. It can simulate a sinusitis, as in our patient, early diagnosis and early treatment being especially important in these patients

Xantogranuloma necrobiótico. Diagnóstico diferencial, tratamiento e implicaciones sistémicas. A propósito de un caso / Necrobiotic xanthogranuloma. Differential diagnosis, treatment and systemic involvement. Case report

CASO CLÍNICO: Varón de 48 años remitido por edema palpebral con nódulos ulcerados amarillentos en ambos párpados superiores. Las técnicas de imagen demostraron infiltración en ambas órbitas anteriores que fueron biopsiadas con el resultado de xantogranuloma necrobiótico. En el estudio sistémico se halló una gammapatía monoclonal IgG no conocida. Se inició tratamiento con corticoides y ciclosporina orales sin éxito, por lo que se pautaron inyecciones intralesionales de triamcinolona que controlaron la enfermedad orbitaria. Discusión: El xantogranuloma necrobiótico es una rara entidad que suele afectar a párpados y órbita anterior. Su diagnóstico es importante porque se asocia a procesos linfoproliferativos malignos. Los corticoides intralesionales fueron efectivos en su manejo

CASE REPORT: A 48-year-old male was referred to our hospital for further evaluation of eyelid edema with bilateral yellowish ulcerated nodules. Suspecting a xanthogranulomatosis, imaging tests and biopsy were performed with diagnosis of necrobiotic xanthogranuloma. IgG monoclonal gammapathy was diagnosed in a systemic study. Systemic corticosteroids and cyclosporine were initiated unsuccessfully; therefore intra-lesional injections of triamcinolone were started, which controlled the orbital disease. Discussion: Necrobiotic xanthogranuloma is a rare condition that usually affects the eyelids and anterior orbit. Its diagnosis is important as it is associated with malignant lymphoproliferative processes. Intra-lesional corticosteroids were effective in our patient

[Necrobiotic xanthogranuloma. Differential diagnosis, treatment and systemic involvement. Case report]. / Xantogranuloma necrobiótico. Diagnóstico diferencial, tratamiento e implicaciones sistémicas. A propósito de un caso.

CASE REPORT: A 48-year-old male was referred to our hospital for further evaluation of eyelid edema with bilateral yellowish ulcerated nodules. Suspecting a xanthogranulomatosis, imaging tests and biopsy were performed with diagnosis of necrobiotic xanthogranuloma. IgG monoclonal gammapathy was diagnosed in a systemic study. Systemic corticosteroids and cyclosporine were initiated unsuccessfully; therefore intra-lesional injections of triamcinolone were started, which controlled the orbital disease. DISCUSSION: Necrobiotic xanthogranuloma is a rare condition that usually affects the eyelids and anterior orbit. Its diagnosis is important as it is associated with malignant lymphoproliferative processes. Intra-lesional corticosteroids were effective in our patient.

[Orbital alveolar rhabdomyosarcoma masked by ethmoid sinusitis in a 25-year-old]. / Rabdomiosarcoma alveolar orbitario enmascarado por sinusitis etmoidal en un adulto de 25 años.

CASE REPORT: A 25-year-old woman with right subacute sinusitis, complained about discomfort in her right eye. Clinical manifestations and computed tomography were suggestive of sub-periosteal orbital ethmoid wall abscess, for which the patient underwent urgent drainage. A solid tumor was found, with a positive biopsy for alveolar rhabdomyosarcoma. Complete remission and resolution of orbital symptoms were achieved with chemotherapy and radiation therapy. DISCUSSION: Alveolar orbital rhabdomyosarcoma in adults is uncommon. Rhabdomyosarcoma has a high risk of spreading. It can simulate a sinusitis, as in our patient, early diagnosis and early treatment being especially important in these patients.

Influencia del embarazo sobre los parámetros refractivos tras cirugía laser in situ keratomileusis / Influence of pregnancy on refractive parameters after LASIK surgery

Objetivos: Diversos cambios oculares y complicaciones de la cirugía refractiva corneal del tipo queratectomía fotorrefractiva (PRK) asociados al embarazo han sido estudiados en los últimos años. Sin embargo, no se han descrito en gestantes las posibles complicaciones derivadas de la realización de cirugía tipo laser in situ keratomileusis (LASIK). Nuestro objetivo fue valorar cómo los cambios fisiológicos oculares secundarios a la gestación pueden alterar el estado refractivo en gestantes sometidas a cirugía tipo LASIK. Presentamos los resultados correspondientes a las modificaciones observadas entre los dos primeros trimestres de embarazo. Métodos: Estudio observacional prospectivo en el que se comparó un grupo de estudio formado por nueve gestantes sometidas a cirugía refractiva LASIK previamente al embarazo y un grupo control con nueve gestantes con alteraciones refractivas no corregidas quirúrgicamente. Se realizó en los dos primeros trimestres de gestación un estudio de agudeza visual, máxima agudeza visual corregida, tonometría, características anatómicas oculares mediante biometría y estudio corneal y refractivo mediante Pentacam®. Resultados: Fueron observados cambios significativos en el cilindro y el EE entre los dos primeros trimestres en ambos grupos. La agudeza visual y el componente esférico mostraron una clara tendencia al empeoramiento, mayor en el grupo de estudio. Las pacientes de este grupo con un defecto prequirúrgico mayor presentaron menores modificaciones en el curso de los dos primeros trimestres(AU)

Conclusiones: Las mujeres con una mayor demanda de cirugía refractiva mediante láser se encuentran entre los 20 y los 30 años, con lo que en muchos casos la práctica de la cirugía corneal se sigue de, al menos, una gestación, con los efectos que ello puede conllevar a nivel ocular. Las conclusiones que se pueden derivar de este proyecto suponen la valoración de los cambios refractivos que sufrirían las córneas operadas y por tanto biomecánicamente debilitadas, al ser sometidas a estímulos hormonales fisiológicos como los propios de la gestación(AU)

Objectives: Different ocular changes and complications of refractive surgery such as photorefractive keratectomy (PRK) due to pregnancy have been described in the last few years. However there is no information about the possible problems of laser in situ keratomileusis (LASIK) in pregnant women. Our objective was to study how physiological changes secondary to pregnancy could alter the refractive situation in pregnant women who have undergone LASIK surgery. We show the results obtained due to the changes between the first two trimesters of the pregnancy. Methods: A prospective and observational study was conducted in which one study group, made up of 9 patients who had undergone LASIK surgery before becoming pregnant, was compared with a control group of 9 patients with non-surgically corrected refractive problems. The following measurements were made in both groups in the first and second trimesters of the pregnancy; visual acuity, the best corrected visual acuity, tonometry, ocular anatomical characteristics by biometry, and refractive and corneal study by Pentacam®. Results: Signicant changes were observed in the cylinder and spherical equivalent between the two trimesters in both groups. Visual acuity and spherical equivalent show a strong trend towards worsening, which was more significant in the study group. The patients of this group who had a larger pre-surgical defect showed lower modifications during the six first months of pregnancy. Conclusions: The majority of women who require laser refractive surgery are are between 20-30 years old, thus in many cases corneal surgery is followed by at least one pregnancy, with different possible ophthalmological effects. The conclusions that may be derived from this study are that the assessment of the refractive changes in surgically operated corneas may be biomechanically weakened on being subjected to physiological hormone stimulation as happens during gestation(AU)

[Influence of pregnancy on refractive parameters after LASIK surgery]. / Influencia del embarazo sobre los parámetros refractivos tras cirugía laser in situ keratomileusis.

OBJECTIVES: Different ocular changes and complications of refractive surgery such as photorefractive keratectomy (PRK) due to pregnancy have been described in the last few years. However there is no information about the possible problems of laser in situ keratomileusis (LASIK) in pregnant women. Our objective was to study how physiological changes secondary to pregnancy could alter the refractive situation in pregnant women who have undergone LASIK surgery. We show the results obtained due to the changes between the first two trimesters of the pregnancy. METHODS: A prospective and observational study was conducted in which one study group, made up of 9 patients who had undergone LASIK surgery before becoming pregnant, was compared with a control group of 9 patients with non-surgically corrected refractive problems. The following measurements were made in both groups in the first and second trimesters of the pregnancy; visual acuity, the best corrected visual acuity, tonometry, ocular anatomical characteristics by biometry, and refractive and corneal study by Pentacam(®). RESULTS: Signicant changes were observed in the cylinder and spherical equivalent between the two trimesters in both groups. Visual acuity and spherical equivalent show a strong trend towards worsening, which was more significant in the study group. The patients of this group who had a larger pre-surgical defect showed lower modifications during the six first months of pregnancy. CONCLUSIONS: The majority of women who require laser refractive surgery are are between 20-30 years old, thus in many cases corneal surgery is followed by at least one pregnancy, with different possible ophthalmological effects. The conclusions that may be derived from this study are that the assessment of the refractive changes in surgically operated corneas may be biomechanically weakened on being subjected to physiological hormone stimulation as happens during gestation.