Archivos de la Sociedad Espanola de Oftalmologia最新文献

We report the case of a 56-year-old male patient with mixed infectious keratitis who developed a 5 × 5 mm corneal ulcer with irregular borders and positive fluorescein staining. After topical and systemic treatment, the infectious process resolved. Topical losartan was then initiated to reduce residual fibrosis and support visual rehabilitation. During follow-up, a progressive improvement in visual acuity and a reduction in corneal leucoma were observed. This case highlights the potential of losartan as a therapeutic alternative for managing corneal opacities secondary to inflammatory or infectious processes. Its antifibrotic effect is associated with its ability to penetrate the corneal stroma, modulate fibroblast activity, and inhibit scar tissue formation. In the absence of specific treatments for corneal fibrosis, losartan represents a promising option with relevant clinical implications for preventing vision loss and improving patients' quality of life.

Background and objective: Although uncommon, ocular neoplasms represent a significant cause of visual morbidity and, in some cases, mortality. In advanced stages, management may require mutilating procedures such as enucleation or exenteration. Clinical, epidemiological, and histopathological characterization of these cases improves diagnostic suspicion and guides therapeutic decision-making. The objective of this study was to analyze the epidemiological, clinical, and histopathological profile of patients who underwent enucleation or evisceration due to suspected ocular neoplasia at a tertiary care hospital in Mexico.

Materials and methods: Observational, descriptive, cross-sectional, and retrospective study. Patients with suspected ocular neoplasms who underwent enucleation or exenteration were included. Clinical, demographic, and histopathological variables were collected. Descriptive statistical analysis was performed.

Results: A total of 43 patients were included; 31 (72.1%) underwent enucleation and 12 (27.9%) underwent exenteration. The right eye was affected in 58.1% of cases. The mean age was 2 ± 2 years in the pediatric group (n = 21) and 63.4 years in the adult group (n = 22). The most frequent histopathological diagnosis was retinoblastoma (48.8%), followed by melanoma (23.3%) and squamous cell carcinoma (9.3%). Clinical and histopathological diagnostic concordance was observed in 90.7% of cases. The optic nerve was the most commonly infiltrated structure in retinoblastoma, while scleral infiltration predominated in melanoma.

Conclusion: The age distribution and tumor types observed are consistent with those reported in the international literature. The high clinicopathological concordance highlights the importance of clinical judgment in managing these entities. Histopathological analysis is essential for prognostication and the development of early diagnostic strategies.

Orbital fractures are a common cause of facial trauma and may lead to significant functional impairments. Titanium mesh implants are frequently used in orbital reconstruction; however, complications can arise if improperly placed. We report the case of a 40-year-old woman who sustained cranioencephalic trauma in a traffic accident, resulting in fractures of the orbital floor and medial wall. She underwent early maxillofacial surgery without prior ophthalmologic evaluation, and a titanium mesh was implanted. Postoperatively, she developed sudden vision loss. A second surgery replaced the implant with smaller plates, but no improvement occurred. Imaging revealed persistent compression of the optic nerve and extraocular muscles. Surgical removal of the implants and orbital decompression, along with corticosteroid therapy, led to gradual visual recovery, reaching 20/40 best-corrected acuity and restoration of the central visual field. This case underscores the need for timely diagnosis and multidisciplinary management in orbital trauma to prevent permanent visual sequelae.

Background and objective: Plasmacytomas are localized collections of monoclonal plasma cells.

Patient and method: This is a 48-year-old female patient of mixed race, with no significant medical history, with a soft, painless tumor adhered to the sclera, in the bulbar conjunctiva and inferior temporal fornix. The method used was the presentation of a clinical case.

Results: The tumor was excised with pathological analysis and immunohistochemical study confirming the diagnosis of conjunctival plasmacytoma. Postoperative follow-up was uneventful.

Conclusions: Extraosseous plasma cell tumors located in the eye are rare and difficult to diagnose because they present a wide range of clinical differentiation.