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Parálisis recurrente del VI nervio craneal secundaria a paquimeningitis idiopática del seno cavernoso: comunicación de un caso 第6次脑神经麻痹复发至特发性海绵状脑膜炎:1例报告
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.07.005
L. Picasso Simón , M. Castro-Rebollo , B. Sastre Borregón , J. González-Martín-Moro
A 56-year-old woman with a history of severe endometriosis, followed at our center for 16 years due to multiple episodes of horizontal binocular diplopia, was diagnosed with recurrent paresis of the VI cranial nerve of her right eye. Magnetic resonance imaging revealed localized pachymeningitis in her right cavernous sinus. Initial episodes were treated with botulinum toxin. Subsequently, she declined treatment during inter-crisis periods because she remains asymptomatic. Idiopathic hypertrophic pachymeningitis is a rare condition of unknown cause, characterized by chronic inflammation of the meninges resulting in localized or diffuse dural thickening. Clinical manifestations vary widely, from generalized processes with complex neurological symptoms to localized processes with monosymptomatic expression, as presented in this case.
一名56岁女性,因多次发作的水平双眼复视,有严重子宫内膜异位症病史,在我中心随访16年,诊断为右眼第六脑神经复发性轻瘫。磁共振成像显示她的右侧海绵窦有局限性的厚脑膜炎。初始发作用肉毒杆菌毒素治疗。随后,她在危机期间拒绝治疗,因为她仍然无症状。特发性肥厚性厚性脑膜炎是一种病因不明的罕见疾病,其特征是脑膜的慢性炎症导致局部或弥漫性硬脑膜增厚。临床表现差异很大,从具有复杂神经症状的全身性病变到具有单一症状表达的局部病变,如本病例所示。
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引用次数: 0
PHOMS: estructuras ovoides que habitualmente no tienen forma de huevo PHOMS:通常不呈蛋形的卵形结构
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.08.003
J. González Martín-Moro
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引用次数: 0
Metástasis no osteoblástica rinosinusal y orbitaria por adenocarcinoma de próstata 前列腺腺癌引起的鼻鼻窦和眼眶非成骨细胞转移
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.08.005
N.C. Pereyra , L.G. Otonelli , M.A. Arriaga , L.L. Iacono , M.L. Braccia Gancedo , L. Sarotto

Background

Bone metastases due to prostate adenocarcinoma usually present osteoblastic characteristics on the imaging modalities.

Method

Case report.

Results

A 77-year-old patient diagnosed with prostate adenocarcinoma with osteoblastic metastases in the dorsal spine and ribs, empirically treated with decongestants for symptoms associated with nasal polyposis, presented with binocular diplopia and ptosis of the right eyelid. Painful ophthalmoplegia and ipsilateral frozen orbit were observed. The CT confirmed the presence of a soft tissue density neoformation infiltrating the paranasal sinuses spreading towards to the base of the skull and extraocular muscles. Biopsy by endoscopic sinus surgery triggered the diagnosis of metastasis.

Conclusions

Regardless of the characteristics seen on the imaging modalities, onset in other organs and systems in patients with a history of prostate adenocarcinoma should prompt the histopathological study of the lesions.
背景:前列腺癌引起的骨转移在影像学上通常表现为成骨细胞特征。MethodCase报告。结果患者77岁,诊断为前列腺腺癌伴脊柱背侧及肋骨成骨细胞转移,经减充血剂治疗鼻息肉病相关症状,表现为双眼复视及右眼睑上睑下垂。观察到疼痛性眼麻痹和同侧眼眶冻结。CT证实软组织密度瘤浸润鼻窦,向颅底及眼外肌扩散。内窥镜鼻窦手术活检触发转移的诊断。结论:无论影像学表现如何,有前列腺癌病史的患者在其他器官和系统的发病应提示对病变进行组织病理学研究。
{"title":"Metástasis no osteoblástica rinosinusal y orbitaria por adenocarcinoma de próstata","authors":"N.C. Pereyra ,&nbsp;L.G. Otonelli ,&nbsp;M.A. Arriaga ,&nbsp;L.L. Iacono ,&nbsp;M.L. Braccia Gancedo ,&nbsp;L. Sarotto","doi":"10.1016/j.oftal.2024.08.005","DOIUrl":"10.1016/j.oftal.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Bone metastases due to prostate adenocarcinoma usually present osteoblastic characteristics on the imaging modalities.</div></div><div><h3>Method</h3><div>Case report.</div></div><div><h3>Results</h3><div>A 77-year-old patient diagnosed with prostate adenocarcinoma with osteoblastic metastases in the dorsal spine and ribs, empirically treated with decongestants for symptoms associated with nasal polyposis, presented with binocular diplopia and ptosis of the right eyelid. Painful ophthalmoplegia and ipsilateral frozen orbit were observed. The CT confirmed the presence of a soft tissue density neoformation infiltrating the paranasal sinuses spreading towards to the base of the skull and extraocular muscles. Biopsy by endoscopic sinus surgery triggered the diagnosis of metastasis.</div></div><div><h3>Conclusions</h3><div>Regardless of the characteristics seen on the imaging modalities, onset in other organs and systems in patients with a history of prostate adenocarcinoma should prompt the histopathological study of the lesions.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"99 12","pages":"Pages 570-573"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tomografía de coherencia óptica de segmento anterior para el diagnóstico diferencial de quiste de iris 用于虹膜囊肿鉴别诊断的前段光学相干断层扫描技术
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.06.009
E. Gracia-Rovira, V.T. Pérez-Torregrosa, A.M. Duch-Samper
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引用次数: 0
Prevalencia y factores de riesgo para padecer una uveítis inmunomediada con mal pronóstico ocular: experiencia en un hospital de tercer nivel 眼部预后不良的免疫介导葡萄膜炎的发病率和风险因素:一家三级医院的经验。
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.06.008
P. Luque-Linero , A. Espejo-González , N. Navarrete-Navarrete

Objective

To describe the characteristics of patients with uveitis and ocular complications in a tertiary hospital. As well as to determine the risk factors for the development of an ocular complication.

Methods

Retrospective study of patients with uveitis evaluated in a Uveitis Unit of the Virgen de las Nieves Hospital from January 2018 to October 2022. A descriptive and analytical study was carried out using logistic regression to know the predictive factors of a poor ocular prognosis.

Results

A total of 127 patients were studied, of which 63% were women and 83.5% were Caucasian. The median age was 51 years IQR (15-88) years. Following the SUN classification, uveitis was predominantly bilateral (55.1%) and anterior (52%), had a recurrent evolution in 51,2% and only 12,6% were granulomatous. Of the total uveitis, 74,2% of the sample turned out to have an immune-mediated profile, although a final diagnosis was only reached in 46,1% of the patients. A total of 17,3% patients suffer from loss of vision. Visual complications in decreasing order were: posterior synechiae (15,6%), cystic macular edema (14.8%), cataracts (13,1%), glaucoma (8,2%), epiretinal membranes (4,9%) and neovascular membranes (1,7%) and retinal detachment (4%). In the bivariate analysis, ethnicity other than Caucasian was significant, p = 0,024, and a number of outbreaks greater than 2, p = 0,045. The rest of the variables analyzed were not significant. In the multivariate analysis, they were significant outbreaks OR: 1,2 CI (1,051- 1,426) and ethnicity OR: 0,11 CI (0,014- 0,938).

Conclusions

The number of outbreaks and non-Caucasian race were related to a greater probability of presenting an ocular complication. An earlier and more specific diagnosis of the etiology, especially in these patients, would allow earlier treatment and improve their prognosis.
目的了解某三级医院葡萄膜炎及眼部并发症的特点。以及确定眼部并发症发生的危险因素。方法回顾性研究2018年1月至2022年10月在维尔京德拉斯尼夫斯医院葡萄膜炎科评估的葡萄膜炎患者。采用逻辑回归进行描述性和分析性研究,以了解眼部预后不良的预测因素。结果共纳入127例患者,其中女性占63%,白种人占83.5%。中位年龄51岁(15-88岁)。根据SUN分类,葡萄膜炎主要是双侧(55.1%)和前部(52%),51.2%复发,只有12.6%为肉芽肿性。在所有葡萄膜炎病例中,74.2%的样本具有免疫介导的特征,尽管最终诊断的患者仅占46.1%。共有17.3%的患者视力丧失。视力并发症由大到小依次为:后粘液病(15.6%)、囊性黄斑水肿(14.8%)、白内障(13.1%)、青光眼(8.2%)、视网膜前膜(4.9%)和新生血管膜(1.7%)、视网膜脱离(4%)。在双变量分析中,除白种人以外的种族具有显著性,p = 0.024,并且一些暴发大于2,p = 0.045。其余的分析变量都不显著。在多变量分析中,它们是显著的暴发OR: 1,2 CI(1,051- 1,426)和种族OR: 0,11 CI(0,014- 0,938)。结论爆发次数和非白种人与出现眼部并发症的可能性相关。早期和更具体的病因诊断,特别是对这些患者,将允许早期治疗和改善他们的预后。
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引用次数: 0
Neovascularización coroidea en niños: etiología, características clínicas y resultados del tratamiento 儿童脉络膜新生血管:病因、临床特征和治疗效果
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.06.007
D. Rego-Lorca, J. Català-Mora, A. López-de-Eguileta, J. Díaz-Cascajosa

Purpose

To provide data on the most frequent causes, main characteristics, management, and outcomes of pediatric choroidal neovascularization (CNV) in a major tertiary referral hospital for children, together with a review of the current literature.

Methods

Case series including children diagnosed with CNV between 2008 and 2023. Age, sex, date of diagnosis, CNV etiology, CNV localization, treatment with anti-vascular endothelial growth factor (VEGF), and ophthalmological examination data at diagnosis and after one year of follow-up were recorded.

Results

42 eyes (31 patients) were included. Best's disease (35.5%) was the most frequent etiology, followed by intraocular inflammation (25.8%). Most neovascular membranes (78.6%) were located within 1 disc diameter of the fovea centre. 78.6% of eyes received anti-VEGF treatment. Mean visual acuity (VA) significantly improved from logMAR 0.57 to 0.31 after one year of follow-up.

Conclusion

CNV in children is a serious condition with severe ophthalmological consequences. Although certain patients may spontaneously improve or maintain good VA without treatment, in many others anti-VEGF treatment may lead to significant visual improvement. VA impairment, signs of exudative CNV on OCT images and the location of CNV seem to be the most important features in the decision to treat or not to treat these patients.
目的:提供一家大型三级转诊医院儿童脉络膜新生血管(CNV)最常见的原因、主要特征、处理和结局的数据,并对现有文献进行综述。方法纳入2008年至2023年间诊断为CNV的儿童的病例系列。记录患者的年龄、性别、诊断日期、CNV病因、CNV定位、抗血管内皮生长因子(VEGF)治疗以及诊断时和随访1年后的眼科检查资料。结果纳入42只眼(31例)。最常见的病因是贝斯特病(35.5%),其次是眼内炎症(25.8%)。大多数新生血管膜(78.6%)位于中央凹中心1个椎间盘直径内。78.6%的眼睛接受了抗vegf治疗。随访1年后,平均视力(VA)由logMAR 0.57显著改善至0.31。结论儿童cnv是一种严重的眼科疾病。尽管某些患者无需治疗即可自发改善或维持良好的VA,但在许多其他患者中,抗vegf治疗可能导致显著的视力改善。VA损伤、OCT图像上渗出性CNV的征象和CNV的位置似乎是决定治疗或不治疗这些患者的最重要特征。
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引用次数: 0
Presentación atípica de neovascularización tipo 1 con dilataciones aneurismáticas en una mujer joven 1型新血管化伴动脉瘤扩张的年轻女性非典型发病
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.07.009
M. Zamorano , B. Puerto , J. Carceller , J.J. González-López , M.S. Figueroa , F.J. Muñoz-Negrete
Type 1 neovascularization with aneurysmal dilations (N1a), is a retinal disorder characterized by choroidal vascular abnormalities. Clinically, it is characterized by an exudative maculopathy with multiple recurrent serosanguineous pigment epithelial detachments. This disease is more common in women aged 55-65 years. However, we present an exceptional case of N1a in a 26-year-old woman, who responded favorably to aflibercept. As far as we know, this is the first case ever reported of a young woman under 30 with N1a. The patient has responded very favourably to anti-VEGF therapy with three intravitreal injections of aflibercept. Moreover, we provide an update on anti-VEGF therapeutic options for N1a.
1型新生血管伴动脉瘤样扩张(N1a),是一种以脉络膜血管异常为特征的视网膜疾病。临床表现为渗出性黄斑病变,伴有多发性复发性血清液色素上皮脱落。这种疾病在55-65岁的女性中更为常见。然而,我们提出了一个例外的情况下,N1a在一个26岁的妇女,谁对阿伯西普反应良好。据我们所知,这是第一例30岁以下的年轻女性感染N1a的病例。患者对三次玻璃体内注射阿伯西普的抗vegf治疗反应良好。此外,我们还提供了N1a抗vegf治疗方案的最新进展。
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引用次数: 0
Termoqueratoplastia y trasplante de membrana amniótica como tratamiento del hidrops corneal refractario en un paciente con degeneración marginal pelúcida 热角成形术和羊膜移植,用于治疗边缘毛囊变性患者的难治性角膜积液
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.07.010
C. Klein-Burgos , L. Sanjuán-Riera , M. Larrañaga-Cores , E. Fernández-Gutiérrez , A. Boto-de los Bueis
A 57-year-old male presented to our clinic with acute corneal hydrops. He had been diagnosed with pellucid marginal degeneration (PMD) three years before. Since conservative treatment and intracameral air injections failed to resolve the corneal edema, we decided to perform a thermokeratoplasty (TKP) plus an amniotic membrane transplantation (AMT). Two weeks after the procedure the patient did not have any pain, corneal edema resolved, and best corrected visual acuity (BCVA) improved from counting fingers to 1 logMAR. During the two-year follow-up the patient has remained asymptomatic, at the 2-year follow-up, BCVA is 0.2 logMAR, corneal steepness has reduced in inferior perifery from 71.3 diopters (D) down to 56.7 D and just a mild leukoma remains at the original hydrops presentation site.
TKP combined with AMT should be considered as a treatment option in acute corneal hydrops, especially in patients with peripheral location as PMD, uncompliant patients, and refractory cases.
一名57岁男性因急性角膜积液就诊。三年前,他被诊断为透明边缘变性(PMD)。由于保守治疗和腔内空气注射未能解决角膜水肿,我们决定进行热角膜移植术(TKP)加羊膜移植(AMT)。手术后两周,患者无任何疼痛,角膜水肿消退,最佳矫正视力(BCVA)从数指提高到1 logMAR。在2年随访期间,患者无症状,2年随访时,BCVA为0.2 logMAR,下周角膜斜度从71.3屈光度(D)降至56.7 D,仅在原始积液表现部位保留轻度白血病。TKP联合AMT是急性角膜积液的一种治疗选择,特别是外周位置为PMD的患者、不顺应性患者和难治性患者。
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引用次数: 0
Abordaje multidisciplinar para el manejo del glaucoma: papel de la biomecánica corneal 青光眼管理的多学科方法:角膜生物力学的作用
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.09.001
R. Bouchikh-El Jarroudi , P. Romera-Romero , J. Botella-Garcia , J. Loscos-Arenas
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引用次数: 0
Propuesta de incidentes graves en productos sanitarios utilizados en la cirugía del segmento anterior. Proponiendo ideas (II) 关于前段手术中使用的医疗器械发生严重事故的建议。建议意见(II)
Q3 Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.oftal.2024.06.004
R. Lorente-Moore , J. Mendicute del Barrio , M.V. Rojas Silva , A. Macarro-Merino , E. Larra Mateos , J.C. Pastor
La entrada en vigor del reglamento sobre productos sanitarios obliga a los oftalmólogos a identificar y reportar los posibles incidentes graves derivados de su utilización. Ante las dudas que pueden suscitarse sobre qué puede o no considerarse un incidente grave, un grupo de trabajo de miembros de la Sociedad Española de Cirugía Ocular Implanto Refractiva (SECOIR) y el clúster de oftalmología y ciencias de la visión (Cluster4Eye), han elaborado un documento que pretende orientar a los oftalmólogos sobre algunos de los incidentes que, en la experiencia del equipo de trabajo, no son habituales o pueden causar un serio daño a la función del paciente en relación con el uso de productos sanitarios. Se han abordado incidentes relacionados con el uso de viscoelásticos, colorantes de cápsula anterior, lentes intraoculares y otros elementos utilizados en la cirugía del segmento anterior.
The entry into force of the regulation on medical devices obliges ophthalmologists to identify and report possible serious incidents arising from their use. Faced with the doubts that may arise about what can or cannot be considered a serious incident, a working group of members of the Spanish Society of Refractive and Implant Eye Surgery (SECOIR) and the ophthalmology and vision sciences cluster (Cluster4Eye), have prepared a consensus document that aims to guide ophthalmologists on some of the incidents that, in the experience of the work team, are not common or can cause serious damage to the patient's function in relation to the use of medical devices. Incidents related to the use of viscoelastics, anterior capsule dyes, intraocular lenses, and other items used in anterior segment surgery have been addressed.
《卫生产品条例》的生效要求眼科医生识别和报告因使用卫生产品而可能发生的严重事故。怀疑可能发生哪些可被视为一个严重的事件,一个工作组成员的西班牙社会Implanto眼科手术矫正(SECOIR)和眼科及视觉科学集群(Cluster4Eye),拟订了一份旨在指导对心脏病的一些事件,工作经验的团队,不常见或可能对患者使用卫生用品的功能造成严重损害。与粘胶弹性剂、前囊色素、眼内晶状体和其他在前节段手术中使用的物品有关的事件已经得到解决。《医疗器械条例》生效后,眼科医生有义务识别和报告因使用医疗器械而可能发生的严重事故。Faced with the法律that may arise about what can or不能被视为严重事件,工作组成员[Society of Refractive and Implant Eye Surgery (SECOIR) and the (ophthalmology and vision sciences集群Cluster4Eye),有一份共识文件,编写区域to guide ophthalmologists on some of the》that, in the experience of the work team,在使用医疗器械时,不常见或可能对患者的功能造成严重损害。与使用粘胶弹性剂、前囊状物、眼内晶状体和其他在前段手术中使用的物品有关的事件已经得到解决。
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引用次数: 0
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Archivos De La Sociedad Espanola De Oftalmologia
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