{"title":"Unveiling the Enigma: Gigantic primary de novo poorly-differentiated ductal adenocarcinoma of the lacrimal gland with aggressive features. A case report and literature review.","authors":"S Malik, C Ahluwalia, A Aziz Khan","doi":"10.1016/j.oftale.2025.03.018","DOIUrl":"10.1016/j.oftale.2025.03.018","url":null,"abstract":"<p><p>Primary ductal adenocarcinoma (PDA) of the lacrimal gland is a rare and aggressive malignancy originating from ductal epithelial cells. Its rarity and diverse clinical presentations pose significant diagnostic challenges, emphasizing the need for accurate diagnosis and appropriate management strategies. The study presents an intriguing case of a 50-year-old man with a large de novo primary ductal adenocarcinoma of the lacrimal gland, initially misdiagnosed as a meningeal solitary fibrous tumor due to its atypical clinical presentation of \"down and out\" proptosis. The case underscores the importance of histopathology to achieve a correct diagnosis and guide management decisions. Despite aggressive treatment approaches, the prognosis of primary ductal adenocarcinoma patients remains grim due to its aggressive behavior and tendency for recurrence and metastasis. The present case study emphasizes that a differential of primary ductal adenocarcinoma should be considered despite the presence of anomalous clinical and radiological presentation.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Gallardo Martin, B Burgos-Blasco, B Vidal-Villegas, J I Fernandez-Vigo, J Garcia-Feijoo, J M Martinez-de-la-Casa
{"title":"Cytokine analysis to evaluate severity in primary open-angle glaucoma and exfoliative glaucoma.","authors":"L Gallardo Martin, B Burgos-Blasco, B Vidal-Villegas, J I Fernandez-Vigo, J Garcia-Feijoo, J M Martinez-de-la-Casa","doi":"10.1016/j.oftale.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.oftale.2025.03.019","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze cytokines in tear and aqueous humour as biomarkers for evaluation of severity of glaucoma.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects and methods: </strong>Tear and aqueous humour samples were collected from 15 exfoliative glaucoma (XFG) patients, 43 primary open-angle glaucoma (POAG) patients and 33 controls (eligible for cataract surgery). A total of 27 inflammatory cytokines were analyzed in the tear and aqueous humor samples by the Bio-Plex Pro Human Cytokine 27-Plex Immunoassay kit: interleukin (IL)-1b, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL9, IL-10, IL-12, IL-13, IL-15, IL-17, eotaxin, fibroblast growth factor (FGF) basic, granulocyte colony-stimulating factor, granulocyte-monocyte colony-stimulating factor, interferon-γ, interferon gamma-induced protein, monocyte chemo-attractant protein-1, macrophage inflammatory protein (MIP)-1a, MIP-1b, platelet-derived growth factor, regulated on activation normal T cell expressed and secreted, tumor necrosis factor-α and vascular endothelial growth factor.</p><p><strong>Results: </strong>In the tear samples a statistically significant difference in Il-2, IL-4, IL-9, IL-12, IL-15 and FGF-basic between study groups was observed. In aqueous humor, a statistically significant difference of the following cytokines was observed: IL-5, IL-6, IL-12 and MCP-1. Il-4 and IL-15 differences correlate with the number of topical drugs, while IL-9 and IL-15 are associated with the visual field mean defect.</p><p><strong>Conclusion: </strong>Inflammation is strongly associated with glaucoma and some cytokines may be related to glaucoma severity.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Navarro, E Ballesteros-Zamalloa, R Hualpa-Vicente, P Minami, M A Rodriguez-Cuba
{"title":"Microbiological profile of bacterial and fungal corneal ulcers at a national institute of ophthalmology in Perú.","authors":"R Navarro, E Ballesteros-Zamalloa, R Hualpa-Vicente, P Minami, M A Rodriguez-Cuba","doi":"10.1016/j.oftale.2025.03.017","DOIUrl":"10.1016/j.oftale.2025.03.017","url":null,"abstract":"<p><strong>Objective: </strong>To describe the microbiological profile of bacterial and fungal corneal ulcers, as well as the antibiotic susceptibility profile of the most frequent pathogenic species.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted using the recorded data of corneal ulcer scrapings from the ocular microbiology laboratory of the National Institute of Ophthalmology. Laboratory data from 2015 to 2022 were collected and included for all corneal ulcer scrapings.</p><p><strong>Results: </strong>After excluding repeated, non-cultured, and duplicate results, a total of 3,470 corneal samples were analyzed. Positive samples accounted for 88.1% of all scraps. Of these, 2,816 (81.2%), 904 (26.2%), and 662 (19.1%) showed bacterial, fungal, and mixed growth, respectively. Coagulase-negative Staphylococci (2,257; 69.8%) were the most frequent bacteria, with Staphylococcus epidermidis (1,677; 51.9%) being the most isolated organism, followed by Pseudomonas aeruginosa (275; 8.5%) and Staphylococcus aureus (274; 8.5%). Fusarium spp. was the most common fungus. Less than 60% of S. epidermidis isolates showed susceptibility to Oxacillin, Cefazolin, Moxifloxacin, and Gentamicin, while more than 90% of isolates were susceptible to Gatifloxacin. P. aeruginosa showed less than 80% susceptibility only to Imipenem.</p><p><strong>Conclusion: </strong>Gram-positive bacteria were the most isolated, with S. epidermidis being the most frequent pathogen, followed by P. aeruginosa. S. epidermidis exhibited alarmingly low susceptibility to commonly used antibiotics.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L A Oseguera Chávez, L E Salas Medina, C Palacio Pastrana, W Cedillo Suárez
{"title":"Endothelial changes in patients with and without diabetes after manual small-incision cataract surgery.","authors":"L A Oseguera Chávez, L E Salas Medina, C Palacio Pastrana, W Cedillo Suárez","doi":"10.1016/j.oftale.2025.03.016","DOIUrl":"10.1016/j.oftale.2025.03.016","url":null,"abstract":"<p><strong>Background and objective: </strong>In Mexico there is a high prevalence of diabetes, which is one of the most frequent etiologies of cataract. The impact of diabetes on postoperative corneal decompensation associated with MSICS has not been studied in our country. The objective of the study was to determine the difference in corneal endothelial changes between diabetic and non-diabetic patients by preoperative specular microscopy and at one month and 3 months after MSICS.</p><p><strong>Patients and methods: </strong>Prospective, longitudinal, paired, non-randomized study with two groups; Group 1: diabetic patients and Group 2: non-diabetic patients. All patients had a complete ophthalmologic evaluation and preoperative and postoperative specular microscopy at one month and 3 months.</p><p><strong>Results: </strong>119 eyes were included. The percentage of CD loss at 1 month was 11.1% in diabetic patients and 6.3% in non-diabetic patients. At 3 months the percentage of loss was 9.9% in diabetic patients and 5.4% in non-diabetic patients. The CV was higher in patients with diabetes and was significant at 1 month; however, at 3 months the values were comparable. The percentage of HEX decreased significantly in the first month in patients with diabetes.</p><p><strong>Conclusions: </strong>There was a significant difference with greater CD loss, greater CV and less HEX in patients with diabetes vs. without diabetes at 1 month after the M-SICS procedure, however, it was not statistically significant at 3 months. This suggests greater endothelial stress, longer recovery time and remodeling of the corneal endothelium in patients with diabetes.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Robles García, Y Fernández Barrientos, J L Ramos Navarro, J Díaz Bernal, J Mora Castilla, J Ortega Usobiaga
{"title":"Central toxic keratopathy after refractive surgery: Diagnosis, treatment and challenges in the routine clinical practice.","authors":"A Robles García, Y Fernández Barrientos, J L Ramos Navarro, J Díaz Bernal, J Mora Castilla, J Ortega Usobiaga","doi":"10.1016/j.oftale.2025.03.015","DOIUrl":"10.1016/j.oftale.2025.03.015","url":null,"abstract":"<p><p>Central toxic keratopathy (CTK) is a rare, non-inflammatory complication that can arise after LASIK surgery. It typically presents between days3 and 9 postoperatively, characterized by central corneal opacification, stromal thinning, and a hyperopic shift. In this clinical case, a 34-year-old patient with a history of cutaneous B-cell lymphoma developed CTK in the right eye after undergoing excimer laser refractive surgery. The diagnostic process and clinical evolution of the condition under conservative treatment are detailed. Different theories regarding the pathophysiology of CTK are also presented, highlighting the importance of differential diagnosis with diffuse lamellar keratitis (DLK) and its therapeutic implications to minimize visual sequelae.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M M Valentín-Pastrana Aguilar, B Sandoval Cortés, S Durán Poveda, L Guerrero Altares, B García Sandoval
{"title":"Maculopathy due to hypotony: A diagnostic challenge.","authors":"M M Valentín-Pastrana Aguilar, B Sandoval Cortés, S Durán Poveda, L Guerrero Altares, B García Sandoval","doi":"10.1016/j.oftale.2025.03.013","DOIUrl":"10.1016/j.oftale.2025.03.013","url":null,"abstract":"<p><p>Hypotony maculopathy is a potential complication of glaucoma filtering surgery, clinically relevant as it can cause vision loss. Classically, it produces choroidal folds, vascular tortuosity, and optic disc edema. However, in optical coherence tomography (OCT), it may also present as intraretinal cysts (IRC). We present the case of a patient who, 10 years after undergoing glaucoma surgery, developed ocular hypotony, IRC, and decreased visual acuity (VA). Given the patient's history of diabetes mellitus, it was initially diagnosed as diabetic macular edema (DME), which delayed appropriate treatment. This led to worsening corneal decompensation, ultimately requiring a corneal transplant in the form of Descemet membrane endothelial keratoplasty (DMEK).</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surprising complete regression of a choroidal neovascular membrane with faricimab.","authors":"F Garcia Ibor, N Ruiz Del Rio, A M Duch Samper","doi":"10.1016/j.oftale.2025.03.012","DOIUrl":"10.1016/j.oftale.2025.03.012","url":null,"abstract":"","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A B González Escobar, I E Molina Guilabert, R M García Herrera, I M Baquero Aranda, R Luque Aranda, J M Galván Cano
{"title":"Retinopathy associated with facioscapulohumeral muscular dystrophy. A case report treated with intravitreal dexamethasone implant and laser photocoagulation.","authors":"A B González Escobar, I E Molina Guilabert, R M García Herrera, I M Baquero Aranda, R Luque Aranda, J M Galván Cano","doi":"10.1016/j.oftale.2025.03.014","DOIUrl":"10.1016/j.oftale.2025.03.014","url":null,"abstract":"<p><p>Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive muscular dystrophy that affects especially the muscles of the face, shoulder girdle and upper arms. It may present extramuscular manifestations such as hearing loss and retinopathy. Up to 75% of patients may show alterations in the retinal vasculature such as vascular tortuosity, microaneurysms, telangiectasias, retinal ischemia and exudation, and in less than 1% of cases it may present as Coats-like syndrome. We present a 40-year-old male with FSHD who, in an ophthalmologic examination, showed exudative retinopathy in his left eye (LE) with peripheral retinal ischemia treated with laser therapy, and macular edema (ME) treated with intravitreal dexamethasone injection (IDI). We would like to emphasize the importance of performing an ophthalmological examination on all patients with FSHD to rule out associated retinal pathology, and thus prevent loss of visual acuity (VA) with early treatment.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Labay-Tejado, J Laguna, M J Navarro-Angulo, L Muñoz, M Jodar, E Milla
{"title":"XEN 63 in a case of refractory glaucoma secondary to microphthalmia and aphakia.","authors":"S Labay-Tejado, J Laguna, M J Navarro-Angulo, L Muñoz, M Jodar, E Milla","doi":"10.1016/j.oftale.2025.03.010","DOIUrl":"10.1016/j.oftale.2025.03.010","url":null,"abstract":"<p><p>Microphthalmia (MO) predisposes to glaucoma and congenital cataracts (CC). Cataract removal in MO is characterized by several complications such as aphakic glaucoma (AG). We report the case of a 33-year-old male with MO, aphakia, and refractory glaucoma who underwent inferonasal ab-interno XEN 63 implantation, after posterior vitrectomy. Whole Exome Sequencing (WES) analysis was performed identifying the likely pathogenic variant c.197G>A (p.Cys66Tyr) in heterozygosity in the PAX6 gene related to Peters anomaly (PA) and the variant of unclear significance c.353T>C (p.Leu118Pro) in heterozygosity in the CRYBB3 gene, potentially related to CC. Until the 12-month follow-up, the patient maintained intraocular pressure (IOP) between 16 and 18 mmHg without medication or complications. XEN 63, when combined with posterior vitrectomy may be an option in select cases, owing to its versatility. However, further investigation is required. Genetic analysis provides a pre-symptomatic diagnosis and may lead to a more personalised medicine.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retinal vasculitis associated with intravitreal bevacizumab injection: A case report.","authors":"S Murillo-Lopez, S Medina-Medina","doi":"10.1016/j.oftale.2025.03.011","DOIUrl":"10.1016/j.oftale.2025.03.011","url":null,"abstract":"<p><p>Anti-vascular endothelial growth factor drugs are the treatment of choice for macular edema due to venous occlusions. While rare, they have been associated with some uncommon adverse effects. We present a case of retinal vasculitis associated with bevacizumab in a72-year-old woman who presented to our clinic with sudden visual acuity loss in her left eye due to macular edema following central vein occlusion. She was treated with bevacizumab, with a minor inflammatory response that resolved with topical steroids. After 6 weeks, the macular edema recurred and a 2<sup>nd</sup> dose of bevacizumab was indicated, with a severe inflammatory reaction that resolved with periocular steroids and topical NSAIDs. Systemic vasculitis and infectious diseases were ruled out and treatment was switched to aflibercept with no adverse effects being reported.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}