Síndrome de isquemia ocular: manifestaciones clínicas, diagnóstico y evolución tras el tratamiento

El síndrome de isquemia ocular es causado por la hipoperfusión ocular crónica debido a estenosis u oclusión de arteria carótida común o interna ipsilateral. Presentamos el caso de un varón de 58 años con episodios de amaurosis fugax unilateral, exploración oftalmológica compatible con isquemia ocular crónica y estenosis severa de arteria carótida interna ipsilateral. Tras la angioplastia y stent de la zona de estenosis carotídea, los hallazgos resolvieron

Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment

Purpose To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD). Methods This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented. Results One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks ( p < 0.001) and with increased myopia ( p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44–7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21–1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29–1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08–0.88]; p = 0.056). SRF resolution time correlated marginally with prone position. Conclusions Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year