RESUMENCaso clínico: Varón de 35 años con antecedentes familiares de enfermedad de von Hippel-Lindau (VHL) diagnosticado de dos hemangiomas retinianos en ojo derecho (OD) y uno en ojo izquierdo. Las lesiones se trataron con crioterapia en OD y láserterapia en OI. A pesar de una aparente buena evolución de las lesiones retinianas hubo una progresiva disminución de la AV. Se realizó RM donde se evidenció lesiones tumorales del nervio óptico (NO) bilaterales compatibles con glioma, meningioma o hemangioblastoma. Actualmente: AV (OD): movimiento de manos y AV(OI): 0,6. Discusión: La presencia de los hemangiomas retinianos en este paciente hizo retrasar el diagnóstico de un tumor en el NO, infrecuente en esta entidad.Palabras clave: Enfermedad de von Hippel-Lindau, hemangioma retiniano, tumor del nervio ópti-co, hemangioblastoma del nervio óptico.
COMUNICACIÓN CORTA
ABSTRACTClinical case: A 35-year-old man with a family history of von Hippel-Lindau disease was diagnosed to have two retinal hemangiomas in the right eye and another in the left eye. The hemangiomas were treated with cryotherapy and laser photocoagulation respectively. Despite apparent good resolution of the retinal lesions, progressive visual loss was observed. An MRI was then performed and showed bilateral tumoral lesions of the optic nerve compatible with a glioma, meningioma or hemangioblastoma. Currently the visual acuity in his right eye is hand movement, and is 0.6 in the left eye. Discussion: The presence of the retinal hemangiomas delayed the diagnosis of an optic nerve tumor in this patient (Arch Soc Esp Oftalmol 2006; 81: 293-296).
To compare surgical results after phacoemulsifi cation using two different techniques for removal of Ophthalmic Viscoelastic Device (OVD). Methods: A randomized prospective study was conducted on 77 patients who underwent cataract surgery. In the fi rst group, OVD was removed over the optic by small abrupt horizontal and vertical displacements of the IOL. In the second group OVD was removed by placing the I/A probe behind the IOL. Intraocular Pressure (IOP), Intraocular Lens Position (IOLP) and refraction were analyzed over the fi rst six weeks. Results: Results in both groups were similar in axial length, keratometry, intraocular lens, age, sex, spherical equivalent and anterior chamber depth. IOP, refraction and IOLP were similar after surgery, and no statistically signifi cant differences were found. The mean refractive change along the fi rst six weeks was 0.33 diopters for the fi rst group (removal only over the IOL) and 0.28 diopters in the second group (P= 0.38). IOL shifting along the fi rsts six weeks was of 0.18 mm for the fi rst group and 0.11 mm for the second group. The difference between groups for this parameter, nearly reached statistical signifi cancy (P= 0.057). No complications were reported with this maneuver. Conclusions: The aspiration of retrolental OVD (behind the IOL) appears to be a safe maneuver, but it has not proved to offer any advantages. According to our results, displacing the retrolental OVD by subtle taps on the IOL has been enough to avoid secondary postoperative intraocular pressure spikes and IOL shifting in fi rst 6 weeks.
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