Distrofia foveomacular viteliforme del adulto

Four cases of adult-onset foveomacular vitelliform dystrophy are shown. In two cases we were able to complete the exploration under optical coherence tomography. One of the patients developed spontaneous disappearance of the subfoveal deposit in her right eye along with an important decrease in her visual acuity. Discussion: Adult-onset foveomacular vitelliform dystrophy is characterized by yellowish round-shaped bilateral, lesions in the subfoveal area. Optical coherence tomography reveal the presence of a slightly elevated lesion wich affects the retinal pigment epithelium and the external layers of neurosensory retin

Fibropapilomatosis oral múltiple como manifestación inicial de Síndrome de Cowden: caso clínico

El síndrome de Cowden es una infrecuente enfermedad hereditaria englobada dentro de las poliposis gastrointestinales de tipo hamartomatoso. Se caracteriza por asociar anomalías cutaneomucosas y por la extraordinaria tendencia a desarrollar neoplasias malignas, principalmente de mama y tiroides. La importancia de un diagnóstico precoz del síndrome y de un adecuado screening tumoral en pacientes con lesiones papilomatosas cutaneomucosas, nos va a permitir adelantarnos en el diagnóstico de patologías con enorme morbimortalidad asociada en caso de una detección tardía. Presentamos el caso de una paciente diagnosticada de síndrome de Cowden tras consultar por lesiones papilomatosas labiales de largo tiempo de evolución y tratada posteriormente de cáncer de mama y riñón en estadios iniciales. El correcto diagnóstico de una patología banal de mucosa oral, nos ha permitido actuar de manera muy precoz frente a la patología neoplásica asociada a dicha enfermedad.Cowden syndrome is a rare hereditary disease included within hamartoma-type gastrointestinal polyposis. It is characterised by associated mucocutaneous anomalies and by the extraordinary tendency to develop malignant neoplasia, mainly in the breast and thyroid. Early diagnosis of the syndrome and adequate tumoral screening in patients with mucocutaneous papillomatosis make it possible to make an earlier diagnosis of associated pathologies which have great morbidity when detected late. We present the case of a patient diagnosed with Cowden syndrome after consultation for labial papillomatous lesions of long evolution who was subsequently treated for breast and kidney cancer in initial stages. The correct diagnosis of a banal pathology of oral mucosa made it possible for us to take early action against the neoplastic pathology associated with this disease

La escritura de la historia de la Iglesia en Paraguay: algunos progresos recientes

This article examines the recent historiography of the Paraguayan Church –contexts of produc- tion, historical discourse and conceptual coordinates that underpin the main research in the area– in order to respond to particular questions: What are the issues that, in the last fifty years have been the main source of interest among scholars? Who were the writers and what approaches did they adopt? And to what extent is the practice of the history of the Church in Paraguay part of the current historiographical trends?Este artículo pretende revisar la historio- grafía reciente sobre la Iglesia paraguaya –contextos de producción, discursos históricos y coordenadas conceptuales que han sustentado principales investigaciones– con el propósito de responder a determinados interrogantes ¿Cuáles son los temas que, en los últimos cincuenta años, han despertado mayor interés entre los estudiosos? ¿Quiénes han escrito y cuáles han sido los enfoques que han adoptado? Y ¿Hasta qué punto la práctica de la historia de la Iglesia en Paraguay participa de las tendencias historiográficas actuales

Triamcinolona intravítrea en el tratamiento de la oclusión de rama venosa retiniana

Clinical cases: Five eyes with branch retinal vein occlusion (BRVO) were treated with intravitreal injection of 4 mg of triamcinolone. Four cases showed good visual acuity and macular thickness evolution after one dose. The remaining one case suffered a relapse three months later. Therefore a second injection was performed in that case. Discussion: Several treatments have been suggested to manage macular edema in BRVO. Intravitreal triamcinolone may be a therapeutic option to increase visual acuity and decrease macular thickness in patients with macular edema secondary to BRV

Distrofia macular anular benigna

Clinical cases: Two cases of benign concentric macular dystrophy are described. In one case, ophthalmologic examination, fluorescein angiogram and visual field measurement were performed. The presence of a juxtafoveal fibrosis in the other patient, indicate that choroidal neovascularization may be associated with this type of macular dystrophy. Discussion: Benign concentric macular dystrophy is an entity with well-defined ophthalmoscopic and angiographic characteristics. Usually the prognosis is good. Rarely, choroidal neovascularization can be associated with this macular dystroph

Neuropatía óptica autoinmune recidivante bilateral en la infancia

Clinical case: A ten year-old girl, after a Yersinia gastroenteritis, developed an optic neuritis in the left eye. She was not treated and resulted ultimately in optic atrophy on the affected side. Six months later a similar episode occurred in the contralateral eye. On this occasion corticosteroid therapy was given. During this therapy the neuritis diminished; however the patient had three relapses, so it was decided to give her immunosuppressive treatment with azathioprine and continue this indefinitely. Discussion: After considering the differential diagnoses of bilateral recurrent optical neuritis in childhood, we concluded that it was most likely to have an autoimmune basis. After considering the benefits and risks of the long-term treatment, we believe immunosuppressive therapy is most useful in controlling the disease allowing corticosteroid therapy to be reduced (Arch Soc Esp Oftalmol 2006; 81: 607-610)

Hemorragia submacular traumática tratada con rt-PA y SF6

This patient was afflicted by a traumatic submacular hemorrhage. A posterior vitrectomy was performed and intravitreal rt-PA and SF6 were administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8. No complications due to the treatment with rt-PA were reported. DISCUSSION: It is known that waiting for the spontaneous blood removal in such cases results in a poor visual acuity recovery due to a toxic effect of the blood products. Both rt-PA and the SF6 are useful for the treatment of submacular hemorrhages secondary to age-related macular degeneration, and this case report has shown they are also useful to lyse traumatic blood clots, thus contributing to a better recovery of visual acuity

Multiple oral fibropapillomatosis as an initial manifestation of Cowden Syndrome : case report

El síndrome de Cowden es una infrecuente enfermedad hereditaria englobada dentro de las poliposis gastrointestinales de tipo hamartomatoso. Se caracteriza por asociar anomalías cutaneomucosas y por la extraordinaria tendencia a desarrollar neoplasias malignas, principalmente de mama y tiroides. La importancia de un diagnóstico precoz del síndrome y de un adecuado screening tumoral en pacientes con lesiones papilomatosas cutaneomucosas, nos va a permitir adelantarnos en el diagnóstico de patologías con enorme morbimortalidad asociada en caso de una detección tardía. Presentamos el caso de una paciente diagnosticada de síndrome de Cowden tras consultar por lesiones papilomatosas labiales de largo tiempo de evolución y tratada posteriormente de cáncer de mama y riñón en estadios iniciales. El correcto diagnóstico de una patología banal de mucosa oral, nos ha permitido actuar de manera muy precoz frente a la patología neoplásica asociada a dicha enfermedad

Termoterapia transpupilar en neovascularización subretiniana oculta secundaria a degeneración macular asociada a la edad. Primeros resultados

To determine the efficacy of transpupillary thermotherapy (TTT) to treat choroidal neovascularization (CNV) in patients with age-related macular degeneration (ARMD). Patients and Methods: Eight patients (ten eyes) with occult CNV were treated by TTT. A 810 nm diode laser was used to perform TTT. The diode laser was delivered through a panfunduscopic contact lens. Results: Three eyes showed a visual acuity improvement and a decrease in exudation on fluorescein angiography. Four eyes remained stable. Nevertheless, lesions worsened after treatment in three cases. One of these cases suffered an overtreatment. Conclusions: TTT may be a useful therapy in some cases of CNV in patients with age-related macular degeneration. Randomized and multicentric studies are necessary to stablish precise indications of this therap

Intravitreal bevacizumab associated with grid laser photocoagulation in macular edema secondary to branch retinal vein occlusion

To evaluate intravitreal bevacizumab (IVB) combined with grid laser photocoagulation in macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Eight eyes (8 patients) with ME associated with BRVO with at least 3 months of evolution since symptom onset were included. All subjects underwent measurement of best-corrected visual acuity (BCVA) and imaging with spectral domain optical coherence tomography (SD-OCT) at baseline and 1, 3, 6, and 12 months. Intravitreal bevacizumab was administered at baseline and macular grid laser photocoagulation 1 month later. During follow-up, additional IVB was administered based on physician discretion if persistent or recurrent intraretinal fluid (cysts) was observed on SD-OCT. The mean BCVA and SD-OCT central subfield thickness (CST) values were determined at each time point. Fisher exact test was performed to assess differences between baseline and post-treatment BCVA and SD-OCT measurements. RESULTS: The mean baseline BCVA was 0.28+/-0.14 (mean+/-SD), and the mean CST was 479+/-137 microm. The mean BCVAs at 1, 3, 6, and 12 months were 0.47+/-0.18 (p=0.031), 0.56+/-0.50 (p=0.031), 0.65+/-0.60 (p=0.008), and 0.66+/-0.65 (p=0.016), respectively. The mean CST values at 1, 3, 6, and 12 months were 295+/-60 microm (p=0.008), 333+/-114 microm (p=0.070), 339+/-80 microm (p=0.008), and 335+/-109 microm (p=0.008). A mean 2.13 injections were administered; the second injection was administered a mean of 2.71 months after baseline. CONCLUSIONS: Combined treatment with IVB and macular grid photocoagulation provided good results and may be considered as an alternative therapy for ME in BRVO. Further studies are needed to assess these preliminary results