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Biomedical subjects

V Huerva

Publications and source records attributed to V Huerva.

11 recordsLinked to original sources

Primary diffuse large B-cell lymphoma of the lower eyelid.

An 80-year-old woman presented with a palpable mass in the central right lower eyelid, with no visible alterations of the overlying skin or eyelid margin, and no signs of inflammation. Eversion of the eyelid revealed an ulcerating lesion approximately 8 mm in diameter, suggesting malignant lesion. Excision with eyelid reconstruction using the Hughes technique was performed. Histopathological analysis revealed a diffuse infiltrate with large atypical lymphocytes. Borders of the surgical resection were free from infiltration. Histochemical staining of the proliferating cells with monoclonal antibodies was positive for CD20 and CD79a, and polyclonal antibodies were positive for Lambda chains, confirming a diffuse large B-cell lymphoma. After 24 months' follow-up there has been no local or systemic recurrence of the disease. Lymphoma may present as an ulcerating lesion of the tarsal conjunctiva. Complete surgical excision, with no evidence of systemic disease, may be considered to carry a good prognosis and survival.

Aged↗

[Onset of Behçet's disease as meningoencephalitis and sudden blindness].

CASE REPORT: A 41-year-old man presented a clinical picture characterized by lymphocytic meningoencephalitis, visual loss in both eyes and transverse sinus thrombosis. This picture was treated with prednisone and anticoagulation. Fundus examination showed complete occlusive arteritis, periphlebitis, peripheral ischemia and perfusion macular defects affecting both eyes. The picture was suggestive of Behçet's disease. Azathioprine was added to the treatment without improvement in visual acuity. Four months later oral aphthous ulcers developed, confirming the suspected diagnosis. DISCUSSION: Behçet's disease may appear with the sudden onset of visual loss secondary to massive occlusive retinal vasculitis. The critical state of neuro-Behçet disease may delay the diagnosis. This combination of visual and neurological symptoms is associated with a poor visual prognosis (Arch Soc Esp Oftalmol 2002; 77: 275-278).

Adult↗

Apoprotein A and A-I profiles in subretinal fluid.

Previous reports have described the presence of apoproteins A in subretinal fluid (SRF). We studied the presence of total apoprotein A (apo A) and apoprotein A-I (apo A-I), using the method described by Laurel in SRF and its levels in serum in 20 patients with retinal detachment. By this method we can quantify the concentrations of apoproteins in SRF. All cases showed the presence of these apoproteins in SRF. The mean +/- standard deviation obtained was 78.7 +/- 26.94 mg/dl and 173.35 +/- 30.08 mg/dl for total apo A in SRF and serum respectively. For apo A-I these values were 32.62 +/- 14.36 mg/dl in SRF and 123.4 +/- 24.11 mg/dl in serum. We found no correlation between levels of total apo A and apo A-I in SRF and its levels in serum. Statistical differences were found between apo A-I content in SRF from detachments with the size of 3 quadrants and that of 1 and 2 quadrants but not between 3 and 4 quadrants. When the detachment affected 1 and 2 quadrants the concentrations of apo A-I were statistically lower. No statistical differences were found between concentrations of total apo A and apo A-I in SRF and the duration or presence of PVR in the detachments. These findings suggest that the outer blood retinal barrier is preserved during rhegmatogenous retinal detachment.

Adult↗

Levels of vancomycin in aqueous humor after topical eye drops administration.

Vancomycin is an antibiotic which is especially active against Gram positive bacteria. At present, numerous infections of the anterior segment of the eye are caused by the Staphilococcus aureus and epidermis. Strains which are resistant to methicilin are more and more frequent and for this reason Vancomycin is becoming the antibiotic of choice to combat these infections since no resistance of the Staphilococcus to it has been demonstrated. The authors evaluated the levels of Vancomycin in aqueous humor after the administration of topical eye-drops. For the first two hours after the last administration, levels of 0.52 micrograms/ml were detected. These inhibit the growth of the majority of bacteria sensitive to Vancomycin. Between two and four hours, the levels decreased to 0.15 micrograms/ml; these are therapeutic levels for a large number of Gram positive bacteria. From four hours after the last administration, these levels are undetectable. Due to the success of its penetration, topical administration of Vancomycin should be considered as a therapeutic modality against infections by gram positive bacteria of the anterior segment. The ideal guideline for administration would be one drop every two hours, especially if the infection is severe. In this way, subconjunctival injection could be avoided.

Anterior Eye Segment↗

[Usher syndrome. Two case reports].

Usher's syndrome is an autosomal, recessively inherited trait that combines a congenital hearing impairment with retinitis pigmentosa. The AA. present the cases of two brothers affected. The actual classification and the last etiopathogenic theories are revised.

Adolescent↗

[Size of incision and induced astigmatism in cataract surgery].

A study was carried out of postoperative astigmatism in three groups of 50 eyes which had had cataracts removed by phacoemulsification or by planned extracapsular removal through incisions of 3.5-4 mm, 7-7.5 mm, and 10-11 mm respectively. No statistically significant differences were observed in the average number of cases of astigmatism found 100 days after the operation in the patients in whom incisions of 10-11 mm (1.82 +/- 0.95 Dp) and 7-7.5 mm (1.78 +/- 0.90 Dp) were made. Appreciable differences were discovered when these two groups were compared with cases in which small incisions had been used and who presented a lower degree of astigmatism (1.02 +/- 0.59 Dp). To ensure less postoperative astigmatism after phacoemulsification, the size of the incision should be modified as little as possible during the insertion of the intraocular lens.

Adult↗

Posttraumatic reaction in a case of fundus flavimaculatus with atrophic macular degeneration.

We report the case of a 13-year-old girl who had fundus flavimaculatus with atrophic macular degeneration. At the age of 14 years, she suffered mild trauma OD, subsequently developing a fibroglial reaction of the retina and pigmentary migration. The coexistence of both phenomena could be explained by the liberation of growth factors by the damaged retinal pigment epithelial (RPE) cells as a reaction to the injury and/or by the passage of chemoattractants from the serum through the damaged RPE cell barrier.

Adolescent↗

[Möbius syndrome and bilateral chorioretinal coloboma].

A child with palsy of the right facial nerve and bilateral palsy of the VIth, IXth and XIIth cranial nerves, dysfunction of the VIIIth cranial nerve, facial malformations and bilateral equinovarus was diagnosed on the basis of these features as having Moebius syndrome. Ocular studies disclosed congenital cataract and chorioretinal coloboma in both eyes. These ocular abnormalities have not previously been described in Moebius syndrome. This paper discusses whether the coexistence of these two types of anomalies may be due to occurrence of a break in the primitive internal carotid and trigeminal arteries between the fourth and fifth postconceptional weeks, causing maldevelopment of the choriocapillary and impairing neuron differentiation in cranial nerve nuclei.

Choroid↗

Apoprotein B in subretinal fluid.

We studied the presence of apolipoprotein B (apo B) by immunoelectrophoresis in subretinal fluid (SRF) and serum from 15 rhegmatogenous retinal detachments and 5 retinal detachments with proliferative vitreoretinopathy (PVR). Apo B concentration +/- standard deviation was 1.49 +/- 1.06 mg/dl in SRF and 108.41 +/- 40.22 mg/dl in serum. Only in four cases was apo B not detected in SRF. We found no significant correlation between apo B concentrations in SRF and apo B levels in serum. We did not find a positive correlation between apo B concentrations in SRF and the duration and size of the detachments. There was no statistical relationship between the presence of PVR and apo B levels. This phenomenon suggests the preservation of the outer blood retinal barrier during rhegmatogenous retinal detachment.

Adult↗

A new case of acute idiopathic frosted branch angiitis in Europe.

CASE REPORT: A 20-year-old male with no history of any systemic or eye disease developed loss of visual acuity in both eyes. White exudates surrounding the retinal veins from the posterior pole to the periphery, retinal edema and hemorrhages in both eyes were evident on ophthalmoscopy. Fluorescein angiography showed leakage of the dye from the veins and extensive staining of the vein walls. A diagnosis of acute frosted branch angiitis was made. Systemic examination revealed axillary, submandibular and inguinal lymphadenopathies. VCA IgM antibody for Epstein-Barr virus was negative and IgG positive. Biopsy was taken of an axillary lymph node; a non-specific inflammatory reaction was found on anatomopathologic study. The patient was started on 90 mg prednisolone daily. After two weeks retinal vasculitis had improved and the lymphadenopathies soon resolved. Small, hard exudates were present in the posterior pole during absorption of the retinal edema and resolution of the vascular inflammation. Systemic prednisolone were reduced progressively and definitively withdrawn two months later. The patient's visual acuity was 20/25 in both eyes. No fibrotic scar tissue or atrophic lesions were noted in either fundus. CONCLUSIONS: We report a new case of acute frosted branch angiitis with an onset and favorable clinical course similar to previous reports. We found the additional presence of lymphadenopathies but have been unable to establish a possible causal agent. To our knowledge, apart from a recent case of frosted branch angiitis-like response in Greece, the present case is the first reported in western Europe.

Acute Disease↗

Noonan's syndrome with keratoconus and optic disc coloboma.

We report the case of a 14-year-old girl with multiple findings characteristic of Noonan's syndrome, including short stature, mild mental retardation, facial, skeletal and renal abnormalities. In addition, ophthalmic examination revealed a keratoconus in the left eye and a right optic disc coloboma. To date, only two cases of Noonan's syndrome with keratoconus have been reported, and this is the second case of this syndrome with optic disc coloboma. To our knowledge, this is the first report of Noonan's syndrome associated with unilateral keratoconus and contralateral optic disc coloboma. In view of the large number of patients with Noonan's syndrome reported to date and the rarity of these ocular abnormalities, it is most likely that this association is fortuitous. Ocular findings reported in patients with Noonan's syndrome are reviewed.

Adolescent↗