Corrigendum

Wang XJ, Wong SH, Givergis R, Chynn EW. Evaluation of analgesic efficacy of bromfenac sodium ophthalmic solution 0.09% versus ketorolac tromethamine ophthalmic solution 0.5% following LASEK or Epi-LASIK. Clin Ophthalmol. 2011;5:1451-1457.On page 1456 the Acknowledgment section details were incomplete. The corrected Acknowledgment section is: ISTA Pharmaceuticals Inc provided ketorolac tromethamine ophthalmic solution 0.5% and bromfenac sodium ophthalmic solution 0.09% free of charge for this study and monetary compensation to the subjects to encourage participation. Dalton and Associates provided medical editing expertise.Original Articl

Síndrome de Cogan: apresentação de caso e diagnóstico diferencial Differential diagnosis between Cogan's syndrome

A síndrome de Cogan é uma doença de difícil diagnóstico pois não apresenta nenhum marcador laboratorial específico, assim como a neuronite vestibular. As características clínicas da síndrome de Cogan são: ceratite intersticial não-luética associada à vertigem, tinnitus e disacusia neurossensorial. Evidências de vasculite sistêmica são encontradas em 50% dos pacientes. As formas atípicas da síndrome de Cogan abrangem doenças oculares inflamatórias mais severas. As características clínicas da Neuronite Vestibular são: vertigem incapacitante de aparecimento abrupto e não responsiva ao tratamento clínico, sem associação com alterações cocleares. Exemplificamos essa dificuldade diagnóstica com o caso de um paciente que iniciou quadro de vertigem súbita incapacitante associada à febre e algia ocular unilateral. O paciente foi hospitalizado, sendo iniciada a terapêutica para síndrome vestibular, não respondendo à medicação. Após uma semana, evoluiu com lesão ocular caracterizada por esclerouveíte anterior. Com quinze dias de evolução o paciente apresentou quadro de disacusia neurossensorial rapidamente progressiva. O exame vestibular evidenciou arreflexia à esquerda, ipsilateral à disacusia neurossensorial. A ressonância magnética evidenciou sinais de microvasculite em sistema nervoso central sendo diagnosticada a síndrome de Cogan. Foi iniciada terapia com corticóide oral e pulsoterapia com ciclofosfamida, havendo melhora total da vertigem, do desequilíbrio e da alteração ocular e com melhora parcial da disacusia.<br>Cogan's syndrome is a disease of difficult diagnosis as there is no specific laboratorial exam and the same occurs with Vestibular Neurinitis. The clinical features of Cogan's syndrome are nonsyphilitic interstitial keratitis and vestibuloauditory dysfunction. Evidences of systemic vasculitis are found in 50% of the patients. The atypical forms of Cogan's syndrome array more severe inflammatory ocular disease. The clinical features of the Vestibular Neuronitis are acute episodes of vertigo that doesn't respond to clinical treatment. We exemplify these diagnostical difficulties with the case study of a patient who initiated a state of acute episodes of vertigo associated with fever and unilateral ocular pain. The patient was hospitalized, and initiated therapy for vestibular symptoms, not responding to medications. A week later, the patient evoluted to an ocular disease characterized by anterior sclerouveitis. With fifteen days of evolution, the patient presented a state of rapidly progressive hearing loss. The otoneurological exam showed unilateral diminished caloric response. Magnetic resonance imaging showed signs of microvasculitis in the central nervous system, being diagnosed Cogan's syndrome. Therapy was initiated with oral prednisone and cyclophosphamide, with total improvement of vertigo, dizziness and eye symptoms and partial improvement of sensorineural hearing loss