RESUMO
PURPOSE: To report a case of spontaneous closure of a full-thickness macular hole after a posterior subtenon injection of triamcinolone in a patient with Irvine-Gass syndrome. METHODS: Case report and literature review. RESULTS: A 70-year-old man presented to the retina clinic with visual disturbance in his right eye after an uneventful cataract surgery. Patient was found to have macular edema associated with a full-thickness macular hole, treated with a posterior subtenon injection of triamcinolone with subsequent spontaneous closure of the hole and excellent visual acuity. CONCLUSION: This case demonstrates possible resolution of a condition which traditionally requires surgical intervention, with a nonsurgical approach.
Assuntos
Macula Lutea/patologia , Edema Macular/tratamento farmacológico , Perfurações Retinianas/induzido quimicamente , Triancinolona/efeitos adversos , Idoso , Seguimentos , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Humanos , Injeções Intraoculares , Edema Macular/diagnóstico , Masculino , Remissão Espontânea , Perfurações Retinianas/diagnóstico , Cápsula de Tenon , Fatores de Tempo , Tomografia de Coerência Óptica , Triancinolona/administração & dosagem , Acuidade VisualRESUMO
Objetivo: determinar la utilidad de la microperimetría y la tomografía óptica coherente en la detección de daño retinal subclínico por cloroquina. Métodos: estudio prospectivo, observacional y analítico en pacientes consumidores de cloroquina, atendidos en la consulta de Neuroftalmología del Instituto Cubano de Oftalmología Ramón Pando Ferrer, entre septiembre 2010 y octubre 2011. Fueron incluidos 44 ojos. Se realizaron exámenes para evaluar función (psicofísica visual y microperimetría) y estructura (biomicroscopia y tomografía óptica coherente). Resultados: la edad promedio fue de 43 años con una dosis acumulada de cloroquina de 182 g y un tiempo de consumo inferior a cinco años. Existió relación significativa entre la dosis acumulada y las variables siguientes: visión del color (-0,495; p= 0,001), grosor retinal peripapilar temporal (-0,353; p= 0,019) e inferior (-0,336; p= 0,026), macular central (-0,652; p= 0,000) y sensibilidad retinal por microperimetría (-0,436; p= 0,003) con alteraciones funcionales y estructurales en relación con el incremento de la dosis acumulada. Conclusiones: se demostró que es posible detectar daño retinal funcional temprano mediante microperimetría y tomografía óptica coherente en pacientes consumidores de cloroquina, en presencia de otros estudios funcionales y biomicroscopia normales. Unido a la tomografía óptica coherente el microperímetro puede constituir una útil herramienta para pesquisa de toxicidad retiniana
Objective: to determine the usefulness of microperimetry and of the optical coherence tomography in the detection of subclinical retinal damage due to chloroquine. Methods: prospective, observational and analytical study in patients taking chloroquine, who were seen at the Neuro-ophthalmology service of "Ramón Pando Ferrer" Institute of Ophthalmology from September 2010 through October 2011. Forty four eyes were included. Tests were performed to assess function (visual psychophysics and microperimetry) and structure (biomicroscopy and optical coherence tomography). Results: mean age was 43 years with a cumulative dose of 182 g and less than 5 years taking this drug. There was significant correlation between the cumulative dose of chloroquine and the following variables: color vision (-0.495, p = 0.001), temporal peripapillary retinal thickness (-0.353, p= 0.019) and lower (-0.336, p = 0.026), central macular (-0.652, p = 0.000) and retinal sensitivity by microperimetry (-0.436, p= 0.003) with functional and structural changes related to the increase in cumulative dose. Conclusions: it was demonstrated that it is possible to detect early functional retinal damage by using microperimetry and optical coherence tomography in patients taking chloroquine, despite normal results of other functional studies and of biomicroscopy. The combination of microperimetry and optical coherence tomography may be a useful screening tool for retinal toxicity