Vascular iris lesions are rare and can sometimes be associated to systemic vascular lesions. They usually cause spontaneous recurrent hyphema. The differential diagnosis should be considered primarily with iris rubeosis and with highly vascular tumors as iris melanoma. Generally, vascular lesions of hemangioma type are located in the iris without extension to iridocorneal angle. We present a case of a 77-year-old male with an iris vascular lesion suggestive of racemose hemangioma, who is asymptomatic, and with 360-degree iridocorneal angle affectation showing no lesions at any other location.
RESUMENCaso clínico: Paciente epiléptico de 63 años en tratamiento con vigabatrina que refería déficit de agudeza visual. Presentaba una retinopatía tóxica con palidez papilar e importante retracción del campo visual. Tras un año de suspensión del tratamiento persistía la retracción campimétrica. Discusión: Neurólogos y oftalmólogos debemos concienciarnos del potencial efecto retinotóxico de la vigabatrina. No hay consenso en cuanto a la estrategia de screening a utilizar. Una evaluación campimétrica hasta los 60º y una tomografía óptica de coherencia (OCT) parecen ser test diagnósticos sensibles en el screening de pacientes que toman vigabatrina.Palabras clave: Vigabatrina, retinopatía tóxica.
COMUNICACIÓN CORTA
ABSTRACTCase report: We report a case of a 63-year-old patient with epilepsy treated with vigabatrin, who was seen because of diminished visual acuity. Examination showed a toxic retinopathy with optic nerve pallor and severely constricted visual fields. One year after cessation of the vigabatrin, no change in the perimetric constriction had occurred. Discussion: Ophthalmologists and neurologists need to be aware of the possibility of retinal toxicity due to the use of vigabatrin. It is still unclear as to which ophthalmogic assessment is of the most diagnostic value; however visual field examination covering the peripheral 60º and optical coherence tomography could be most useful for the screening of patients using this agent (Arch Soc Esp Oftalmol 2007; 82: 711-714).
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