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Biomedical subjects

D Díaz-Valle

Publications and source records attributed to D Díaz-Valle.

15 recordsLinked to original sources
PubMed2006

[Amaurosis secondary to frontal traumatism].

CASE REPORT: We present the case of a patient diagnosed with amaurosis of the right eye secondary to a right frontal contusion. The energy of the impact was projected from the orbital ceiling to the minor wing of the sphenoid bone. This bone was fractured, thus reducing the optic canal diameter and damaging the optic nerve. DISCUSSION: In our case, we describe a mixed mechanism of injury, that is to say, a frontal contusion indirectly transmitted to the optic canal and a direct lesion of the optic nerve secondary to the movement of the minor wing of the sphenoid bone into the optic canal.

Aged↗
PubMed2006

[Eyelid tick bite].

CASE REPORT: We describe a patient who was bitten on his right upper eyelid by a common canine tick. The tick was impregnated with gasoline prior to being removed. DISCUSSION: Tick bites are uncommon in ophthalmologic practice. They occur more frequently in rural areas, especially in spring and summer. Correct identification of the problem and treatment is essential. The tick needs to be completely removed in order to avoid the embedding of different parts of the insect. Zoonoses, such as rickettsiosis, arbovirus and paralysis due to ticks must be ruled out.

Adult↗
PubMed2006

[Optic nerve drusen and deep visual fields defects].

PURPOSE: Optic nerve drusen needs to be included in the differential diagnosis of pseudopapilledema. As the identification of this entity by funduscopy may be difficult, ultrasonography has thus become the gold standard for its diagnosis. Severe optic nerve drusen has been correlated with a reduction of the nerve fiber layer measured by optic coherence tomography and with the presence of serious visual field defects. To demonstrate the relationship between extensive optic nerve drusen and visual field defects. METHOD: A prospective observational study of the visual fields of a series of 5 patients with severe optic nerve drusen diagnosed by ultrasonography. RESULTS: Visual field defects of widely differing severity, from inferior nasal quadrant to severe hemivisual field defects, were described in each patient studied. CONCLUSIONS: Visual field defects of diverse severity are common in patients with deep optic nerve drusen. For that reason ultrasonography and/or optical coherence tomography is highly recommended where such visual field defects exist.

Adult↗
PubMed2006

[Optical coherence tomography in solar eclipse retinopathy].

CASE REPORT: We describe the case of a patient suffering from acute visual loss soon after watching a solar eclipse. Optical coherence tomography was the main diagnostic tool used. DISCUSSION: Solar retinopathy is now an unusual cause of visual loss, although there are still some cases diagnosed, especially after viewing solar eclipses. Optical coherence tomography is suitable for detecting permanent retinal injuries related to solar exposure, with the outer retinal layers being typically affected.

Adult↗
PubMed2005

[Ocular infiltration in a patient with Multiple Myeloma].

CASE REPORT: We report the case of a patient with Multiple Myeloma Ig G Kappa stage IIIA and hepatic infiltration, who presented with ocular infiltration. The initial sign was a rapidly growing sub-conjunctival mass that caused ophthalmoplegia and increased intraocular pressure secondary to progressive infiltration of the orbit. DISCUSSION: Multiple Myeloma is a malignant tumor of plasma cells that can affect the eye and orbit, not only as an infiltration secondary to the disease but also primary as an isolated tissue proliferation (extramedullary plasmacytoma). Chemotherapy is the usual treatment given. Radiotherapy with or without excisional surgery is the first option for plasmacytomas.

Antineoplastic Agents↗
PubMed2005

[Treatment with topical interferon alone in severe conjunctivo-corneal neoplasia].

CASE REPORT: A 78-year-old man was referred for evaluation of a limbic lesion in his left eye. This had a gelatinous appearance and an extension of 240 degrees . The lesion was clinically diagnosed to be a conjunctival and corneal intraepithelial neoplasia (CIN). Topical treatment with interferon alpha2b (INFalpha2b) four times daily was started and continued until the lesion had completely resolved at 4 months. DISCUSSION: Topical INFalpha2b alone may be a safe and effective treatment of CIN instead of the other classic alternatives such as surgical excision with cryotherapy, which could induce the development of severe limbic deficiency in cases with extensive disease.

Administration, Topical↗
PubMed2004

[Treatment of refractory anterior diffuse scleritis with infliximab].

CASE REPORT: A 48-year old woman diagnosed with rheumatoid arthritis 10 years previously, developed severe anterior scleritis in the right eye (RE) refractory to conventional treatment. The patient was treated with 3 intravenous doses of Infliximab achieving complete remission of the scleral inflammation within four weeks. DISCUSSION: The use of Infliximab, a blocker of tumour necrosis factor (TNFalpha) could be an alternative approach to the management of refractory scleritis, but further long-term investigations would be necessary to evaluate their safety and efficacy.

Antibodies, Monoclonal↗
PubMed2003

Frosted branch angiitis and late peripheral retinochoroidal scar in a patient with acquired toxoplasmosis.

PURPOSE: To report a case of acute frosted branch angiitis associated with acquired toxoplasmosis in which a late peripheral chorioretinal scar developed. RESULTS: A 32-year-old man without systemic symptoms presented with sudden visual loss in his left eye. Examination demonstrated frosted branch angiitis without necrotizing chorioretinitis. Serologic tests showed elevated Toxoplasma gondii-specific immunoglobulin M antibody titers. Antitoxoplasmic therapy and oral steroids healed the ocular inflammation. In a follow-up visit one year later, a peripheral chorioretinal scar was noted. CONCLUSIONS: Acute frosted branch angiitis without focal necrotizing chorioretinitis can be a manifestation of acquired toxoplasmosis. This could be an important, and sometimes forgotten, sign of the disease.

Adult↗
PubMed2003

[Neurotrophic keratopathy management with cyanoacrylate tarsorraphy and autologous serum].

PURPOSE/METHODS: Neurotrophic keratopathy is a degenerative corneal disease with a highly complex treatment caused by an impairment of corneal sensitivity. We report the case of a 47 year-old man with a refractory postherpetic neurotrophic keratopathy in his right eye and we discuss the treatment options. RESULTS/CONCLUSION: The combination of cyanoacrylate with temporary tarsorraphy along with the administration of topical autologous serum eyedrops and systemic tetracycline, allowed to control the progression of the disease and to regenerate the corneal surface. This unpublished therapeutic strategy might be an effective and safe alternative in the management of neurotrophic keratopathy (Arch Soc Esp Oftalmol 2003; 78: 119-122).

Body Fluids↗
PubMed2003

[Severe retinal phlebitis in ocular bartonellosis].

PURPOSE/METHODS: To report the clinical case of a 34-year-old male with atypical ophthalmic manifestations of cat-scratch disease (ocular bartonellosis), including an extensive retinal phlebitis, as well as the evolution of the clinical picture with treatment. RESULTS/CONCLUSIONS: The clinical diagnosis of ocular bartonellosis was serologically confirmed. Oral treatment with ciprofloxacine healed the phlebitis and the neuroretinitis, with a residual optic disk pallor. This case exemplifies the diversitiy of ocular manifestations of this disease. The authors recommend considering this condition in the differential diagnosis of posterior uveitis in young patients.

Adult↗
PubMed2002

[Immunomediate scleritis in a patient with lepromatous leprosy].

CASE REPORT: A 55 year-old Spanish woman with a personal history of lepromatous leprosy treated for 10 years with anti-lepromatous triple therapy was referred to us presenting nodular scleritis in her left eye with no other clinical manifestations. Ophthalmological evaluation disclosed several inflammatory features in both eyes. Complementary tests performed were negative and the clinical picture was diagnosed as an immuno-mediated manifestation of leprosy. A favorable outcome was achieved with steroidal treatment. DISCUSSION: Scleritis and some immunomediated conditions may appear during the evolution of lepromatous patients whose disease may have been declared clinically cured.

Aged↗
PubMed1998

Endothelial damage with cataract surgery techniques.

PURPOSE: To evaluate intraoperative endothelial damage after planned extracapsular cataract extraction (ECCE) with difference capsulotomy techniques and phacoemulsification. SETTING: San Carlos University Hospital, Castroviejo Institute, Madrid, Spain. METHODS: In this prospective, randomized study, 60 patients with senile cataract scheduled for cataract surgery were divided into three groups of 20 each: Group 1 had phacoemulsification; Group 2, planned ECCE with continuous curvilinear capsulorhexis; and Group 3, ECCE with letter-box capsulotomy. Preoperatively and 3 months postoperatively, endothelial cell density, percentage of hexagonality, and the cell size variation coefficient were determined by contact specular microscopy; endothelial permeability was examined by anterior segment fluorophotometry and central corneal thickness, by ultrasonic pachymetry. Results were analyzed using the two-tailed Student's t-test and analysis of variance. RESULTS: In all three groups, endothelial permeability and cell loss increased significantly from the preoperative values, but there were not significant differences among the postoperative values. Mean cell loss was 11.8% in Group 1, 12.8% in Group 2, and 10.1% in Group 3. There were no differences between the preoperative and postoperative morphometric indexes. Postoperative pachymetric measurements were not significant. CONCLUSIONS: Endothelial response was not statistically significantly different among the surgical techniques, although endothelial damage was lower in Group 3, which could indicate a protective effect of the anterior capsule during cataract extraction. Endothelial barrier function remained disturbed despite the apparent morphological stabilization.

Aged↗
PubMed1998

Immunologic and clinical evaluation of postsurgical necrotizing sclerocorneal ulceration.

PURPOSE: To perform a clinical, laboratory and pathologic evaluation in patients who had developed a postsurgical necrotizing sclerocorneal ulceration to detect a serious associated autoimmune disorder and to treat the ocular disease early. METHODS: Nine patients with postsurgical necrotizing sclerocorneal ulceration after uneventful cataract extraction were studied by means of immunohistochemical techniques on conjunctival resections, immunologic serologic studies, and rheumatologic evaluation. Nine healthy subjects who underwent uneventful cataract surgery were used as controls. RESULTS: The pathologic studies showed a local immunoglobulin M (IgM) and IgG deposition, increased human leukocyte antigen (HLA-DR) expression, and a significant T-helper cell participation in conjunctival biopsies in the most severe ulcerations, which were detected in four patients with underlying autoimmune systemic disorder (rheumatoid arthritis, 45%) and only a macrophagic infiltration in the mildest ulcers in patients (55%) without immune disorders. Serologic features included high titers of rheumatoid factor in the four (45%) patients with rheumatoid arthritis, nonspecific serologic immune alteration in three (33%) patients, and were unremarkable in two (22%) patients. The medical and immunologic evaluations were negative in the control cases. Topically administered cyclosporin A healed the ocular disease. CONCLUSION: A surgically induced local autoimmune reaction could occur in the incision area in patients with systemic vasculitic disease. There was no underlying systemic disorder in the mildest ulcers, and these ulcers could be due to a defect in the surgical technique. Our results suggest the need for a detailed systemic evaluation in patients with severe postsurgical necrotizing ulceration. Early diagnosis and aggressive medical treatment of the ocular disorder improves the visual outcome.

Aged↗
PubMedDate not supplied

Endothelial morphological and functional evaluation after cataract surgery.

PURPOSE: To assess endothelial barrier function, morphological appearance and corneal thickness three months after cataract surgery in order to evaluate intraoperative endothelial damage. METHODS: Endothelial permeability was examined by fluorophotometry, and contact specular microscopy and corneal pachymetry measurements were made in 40 patients (40 eyes) with senile, non-complicated cataracts one month before and three months after cataract surgery. Twenty eyes underwent uneventful phacoemulsification (Group 1) and 20 uneventful extracapsular cataract extraction (ECCE) with continuous curvilinear capsulotomy (Group 2). Results were analyzed using the two-tailed Student's t test, analysis of variance, and multifactorial and regression analysis. RESULTS: There was a significant postoperative increase in endothelial permeability in both groups (p < 0.001), but no real differences between the postoperative values (p = 0.07). Mean cell loss was 15.2% in ECCE and 18.3% in phacoemulsification (p = 0.4). There was a significant linear correlation between ultrasound time, cell loss and functional damage. Postoperative pachymetric measurements were not significant. CONCLUSIONS: Endothelial response showed no differences between the surgical techniques. Endothelial barrier function remained disturbed in spite of the apparent morphological stabilization. Corneal pachymetry is not useful for assessing postoperative endothelial changes.

Aged↗