Animal studies have brought new expectations in the development of local chemotherapy for the treatment of patients with ocular cancer. To know the intermediate and mediate adverse reactions of some of the citostatics will open the breach in the treatment of malignant tumours with no need of radical surgery. At the National Institute of Oncology (INOR), a study performed on rabbits to determine the complications related to the administration of cisplatinum by subconjunctival location as an cistostatic agent for the treatment of epithelial tumours. As results of this, some oedema was observed and the moderated congestion of blood vessels in those eyes which received the trial product. RESUMEN Estudios en animales han abierto expectativas en el desarrollo de la quimioterapia local para el tratamiento de los pacientes con cáncer de presentación ocular. Conocer las reacciones adversas inmediatas y mediatas de algunos citostaticos, abre una brecha en el tratamiento de los tumores malignos sin tener que llegar a la realización de cirugías mutilantes. En el INOR realizamos un estudio en conejos para determinar las complicaciones inherentes a la administración de cisplatino por vía subconjuntival como agente citostático de primera línea para el tratamiento de los tumores epiteliales. Como resultado observamos algo de edema y congestión moderada de vasos sanguíneos en los ojos que le fueron administrados el producto prueba a las dosis referidas.

OBJECTIVE To compare the results with publications of other authors on the subject. METHOD All the diagnosed cases of Osteoma of coroides in this center from their inauguration in 1941 to II of 2002 are reviewed that altogether add 17, but of 8, 1 because finally it was arrived at the diagnosis of Melanoma, 1 by coroiditis, 1 by Haemangioma and 5 doubtful ones are discarded there to consider that they did not have all the tests necessary to be considered like such; therefore the studied cases are 9, such that were diagnosed by oftalmoscopía and confirmed by ECHO, TAC or RMN and AGF. RESULTS In our study was the following thing: - 67% go by visual alterations. - The diagnosis between 2° and 3° is more frequent decades of life 67%. - More frequent in women 67%. - More frequent in an eye 78% (OI = 56%). - 89% are of location to peripapilar. - Only in 10% a diminution of the size is reported. - Diminution of AV. In 40% with respect to the first visit, 56% stay equal. - Average time of pursuit 3.30 years. RESUMEN El Osteoma coroideo es una tumoración benigna en la que el Tejido óseo sustituye a la coroides. OBJETIVO Comparar los resultados con las publicaciones de otros autores sobre el tema. MÉTODO Son revisados todos los casos diagnosticados de Osteoma de coroides en este centro desde su inauguración en el año 1941 hasta II de 2002 que en total suman 17, pero de ahí son descartados 8, 1 porque finalmente se llegó al diagnóstico de Melanoma, 1 por coroiditis, 1 por Haemangioma y 5 dudosos por considerar que no tenían todas las pruebas necesarias para ser considerados como tales; por lo tanto los casos estudiados son 9, los mismos que fueron diagnosticados por oftalmoscopía y confirmados por ECO, TAC o RMN y AGF. RESULTADOS En nuestro estudio se encontró lo siguiente: - El 67% acude por alteraciones visuales. - Es más frecuente el diagnóstico entre la 2° y 3° décadas de la vida 67%. - Más frecuente en mujeres 67%. - Más frecuente en un ojo 78% (OI= 56%). - El 89% es de localización peripapilar. - Sólo en el 10% se reporta una disminución del tamaño. - Disminución de AV. En el 40% respecto a la primera visita, el 56% se mantiene igual. - Tiempo medio de seguimiento 3,30 años. THEY SUMMARIZE The coroideo Osteoma is a benign tumoración in which the bony Weave replaces the coroides.

Purpose: To report the epidemiology of retinoblastoma (RB) in Guatemala. Design: Retrospective case series. Methods: All medical files of patients from the pediatric division of our center who were diagnosed with retinoblastoma (RB) in the past ten years (1995-2005) were reviewed. From each file, the gender, age of diagnosis, clinical manifestations, staging based on the Reese-Ellseworth classification, and the geographical origin of the patients were recorded in a data sheet. Main Outcome Measures: Incidence of retinoblastoma in Guatemala. Results: From January 1997 to March of 2005, sixty-eight (68) patients were diagnosed with RB. Thirty-five (52%) were male and thirty-three (48%) female. Mean age of diagnosis was 31 months. Forty-nine (72%) cases were unilateral and 19 (28%) had bilateral involvement. Sixty-seven percent of the cases were at advanced stages at the diagnosis. Conclusion: RB in Guatemala is diagnosed at advanced stages and the mean age of diagnosis is greater than the developed countries.

The indication of the enucleation for choroidal melanoma, has abruptly reduce in the recent decades, due to a replacement for less aggressive treatments. All actual therapeutic alternatives are revised in relation to different publications which are focused in current treatment alternatives, this contains within its most important options Transpupillary Thermotherapy (TTT) for small melanomas, for medium melanomas braquitherapy (BT) or radiotherapy turns out to be very effective without differences as to the patient survival with regard to the enucleation. The local resections are an interesting indication for melanomas of anterior localization or with invasion to the ciliary body. It is important the combination of therapies to reduce tumor recurrences or to treat big sized melanomas with BT and TTT, local resection and TTT or BT. The enucleation is limited to big sized melanomas without visual possibilities or associated with complications such as neovascular glaucoma. We must also consider, some of the new concepts in the phato biology and genetic of the melanomas which will allow us to determine in the short run, a part of the treatment, the prognosis and the regular control in these patients. Resumen: La indicación de la enucleación para melanomas coroideos disminuyó radicalmente en las últimas décadas, debido al reemplazo por tratamientos conservadores. Todas las alternativas terapéuticas actuales son revisadas en relación a diversas publicaciones, que tiene dentro de sus opciones más importantes, Termoterapia Trans Pupilar (TTT) para melanomas pequeños, en los melanomas medianos la braquiterapia (BT) o radioterapia resulta altamente efectiva, sin diferencias en la sobrevida del paciente en relación a la enucleación. Las resecciones locales son una interesante indicación para melanomas de ubicación anterior o con compromiso del cuerpo ciliar. Es importante la combinación de terapéuticas para disminuir las recurrencias o para tratar melanomas de gran tamaño como la BT con TTT, resecciones locales con TTT o BT. La enucleación esta limitada a melanomas de gran tamaño, sin posibilidades visuales o asociados a complicaciones como el glaucoma neovascular. Consideraremos, algunos de los nuevos conceptos en la pato biología y genética de los melanomas que pensamos permitirá a corto plazo determinará en parte el tratamiento, el pronóstico y el seguimiento de estos pacientes.

The authors report two cases of cicatricial pemphigoid and describe the nature of the cutaneous, oral and ocular lesions, emphasizing the devastating effects of the latter. With regard to the diagnosis, they stress the importance of adequate sampling for direct immunofluorescence reactions. The therapeutic approach is discussed focusing the available tools for the ophthalmologist.

Purpose. To report an unusual case of a retained intra-orbital wooden foreign body in a 6-year-old child. Methods. Case Report. Results. A fragment of wood stick was removed from the left orbit of a 6-year-old with history of proptosis and vision diminishment after probable penetrating eyelid trauma 45 days before the consult. Discussion. Intra-orbital foreign body (IOF) has to be managed with thorough clinical history and ophthalmic examination complemented with broad spectrum systemic antibiotics and adequate imaging studies for a guided surgical intervention. More importantly, organic IOF has to be highly suspected by the clinician when managing pediatric ocular trauma.

Purpose. To evaluate the safety and efficacy of goniotomy as a first-line surgery in cases of open angle pe-diatric glaucoma, other than primary congenital, in which medical therapy had failed or had been judged to be not advisable. Methods. A non-comparative retrospective chart review of a series of gonio-tomies performed in children with refractory secondary glaucoma. Success was defined as an intraocular pressure (IOP) less or equal to 22 mmHg, without need for further surgical intervention with or without additional medical therapy. Results. 12 patients (16 eyes) with underlying diagnoses of Sturge Weber Syndrome, uveitis, infantile and traumatic glaucoma were included. The mean age at the first goniotomy was 5.2-year-old, with a mean follow-up of 35 months. Surgical success was achieved in 9 eyes (56%) with a mean IOP of 16.3 + 4.61mmHg (reduction of 16 mmHg, p<0.001). Complications included different degrees of hyphema and a small iris prolapse. Discussion. Although traditionally limited to management of congenital glaucoma, goniotomy is a relatively gentle and potentially useful first-line surgical procedure for children with refractory glaucoma different than congenital.

The cornea is responsible for the majority of the eye's refringence, this makes it a vital structure an adequate visual function. Diseases affecting the eye are various and have different causes; however the almost always cause damage to this tissue, which, due to it's scarring characteristics, can have dramatic consequences in the affected individual's refraction. The field of tissue engineering offers us now the possibility to obtain functional tissue substitutes in the laboratory, as has been shown by our group for skin, cartilage and oral mucosa; these substitutes are viable alternatives to grafts and transplants due to the fact that they are not associated with the risks and limitations of these procedures. The aim of this work was to standardize the culture conditions for the three types of corneal tissue and, to seed them in collagen scaffolds. We obtained pure, confluent cultures 5 days post-seeding. Cell morphology allowed primary identification of the cultures. Fibroblasts seeded in collagen scaffolds were seen adherent 14 days post-seeding with very little proliferation and cellular infiltration of the scaffold. RESUMEN La córnea es el tejido responsable de la mayoría del poder refractivo del ojo, lo que la convierte en una estructura vital para el adecuado funcionamiento de la visión. Las patologías de la córnea son múltiples y de diferentes etiologías; debido a las características de la cicatrización de este tejido casi todas pueden dañarla, causando alteraciones dramáticas en la refracción del paciente. En estos casos el tratamiento indicado es el transplante de espesor total o parcial. La fuente de córnea son los donantes cadavéricos, lo cual genera riesgo de infección y rechazo. Nuestro grupo ha desarrollado sustitutos de tejido conectivo mucoso y dermis artificiales que en el momento se encuentran en valoración preclínica. En este trabajo nos propusimos aplicar la metodología estandarizada, para establecer cultivos primaros de células de la córnea que luego fueron subcultivados en soportes de colágeno I e incubados. Los resultados indican la obtención de cultivos primarios de células endoteliales, células epiteliales y fibroblastos corneales 5 días post-siembra. Igualmente, que la siembra de fibroblastos en los soportes de colágeno I condujo a su adhesión a las fibras y a la formación de material eosinófilo entre las células.

The results of preclinical and finished clinical trials revealed the efficacy of antivascular endothelial growth factor (anti-VEGF) therapy as antiangiogenic and antipermeability agents. The safety of single-dose intravitreal injections of different dosages has been established. Macugen has been the first approved anti-VEGF drug in the United States since December 2004 for the treatment of neo-vascular AMD. The results of the ongoing ranibizumab (Lucentis) trials that are currently running will need to compare to that observed with pegaptanib in similarly designed phase trials. In addition, the preliminary data from the bevacizumab SANA study and intravitreal bevacizumab (Avastin) are promising. We are looking forward to the results of the Phase III randomized trials. Probably, the combination of anti-VEGF compounds with photodynamic therapy or intravitreal steroids may be the future management of choroidal neovascularization. This article will review the current role of anti-VEGF therapy in the management of choroidal neovascularization.

Technological advances in the field of molecular biology and especially re-combinant DNA techniques have enabled scientists to develop gene therapy techniques for the treatment of human diseases. The potential therapeutic applications of gene transfer technology are enormous. The cornea is an excellent candidate for gene therapy because of its accessibility and immune-privileged nature. Studies examining the feasibility and optimal methods for vector-mediated gene transfer to the cornea have been performed using histochemical and fluorescent marker genes. These studies have utilized various viral vectors, such as adenovirus, adeno-associated virus, retrovirus, lentivirus, and herpes simplex virus, as well as non-viral methods to transfer heterologous genes into corneal cells in vitro, in vivo and ex vivo. In this review, we will discuss viral and non-viral approaches of gene delivery into the cornea as well as the limitations of these approaches. Additionally, we will discuss some potential applications for gene-based interventions which have been analyzed in specific corneal disorders such as allograft rejection, corneal wound healing, and corneal dystrophies using experimental models.

Purpose: To report a case of unilateral Pneumocistis carinii (Pc) choroiditis as a primary presentation of disseminated pneumocystosis in immunocompetent patient. Materials and Methods: Clinical examination on of a 25-year-old caucasian female with cystic fibrosis and impaired left eye vision. Results: Polimerase Chain Reaction (PCR) of vitreous humor tested positive for Pc. Laboratory investigations proved her immunological competence and excluded other infeccious diseases. Choroiditis regressed after specific therapy with intravenous trimethoprim-sulfamethoxazole. Vitrectomy was performed for residual epiretinal membrane. Conclusions: Ophthalmologic examination is an important tool in the dianosis of disseminated pneumocystosis. In contrast to what is currently accepted, this case suggests that unilateral choroiditis may be caused by Pc, no matter the immunocompetence status of the patient. Resumo Objectivo: Apresentar a coroidite por Pneumocystis carinii (Pc) com as particularidades de contexto de imunocompetência, ausência de história prévia de pneumonia a Pc ou sua profilaxia, apresentação unilateral e o envolvimento do vítreo. Material e Métodos: Descreve-se o caso de um doente com fibrose quística que recorre à consulta de oftalmologia por diminuição da acuidade visual monocular esquerda. Resultados:: A investigação oftalmológica foi compatível com o diagnóstico de coroidite por Pc, identificando-se este parasita através da análise do humor vítreo por PCR do DNA. O estudo sistémico (analítico, bacteriológico, imunológico e imagiológico) não revelou patologia infecciosa concomitante e comprovou a competência imunológica. Instituiu-se terapêutica com trimetoprim-sulfametoxazol endovenoso, obtendo-se uma regressão quase completa das lesões. Procedeu-se a cirurgia vitreo-retiniana para remoção de membrana epi-retiniana residual. Conclusões: A coroidite por Pc pode ser o primeiro e único sinal de doença sistémica. O exame oftalmológico revelou-se um instrumento diagnóstico da pneumocistose disseminada, para a qual não existe teste serológico ou investigação clínica complementar específicos. Este caso sugere que o envolvimento oftalmológico pelo Pc não está limitado ao contexto da SIDA ou outras imunodeficiências. Num contexto de imunocompetência, uma coroidite unilateral com envolvimento do vítreo deverá incluir no seu diagnóstico diferencial o Pneumocystis carinii como agente etiológico responsável.

Purpose: To describe the ophthalmic coherence tomography (OCT) findings of a case of Juvenile X-linked Retinoschisis. Methods: Case report Results: OCT of the posterior pole demonstrated a diffuse cystic degeneration in the outer plexiform layer of the retina. Conclusion: OCT findings in patients with X-linked Juvenile Retinoschisis consistently demonstrate an intraretinal splitting. OCT, therefore may be helpful in the diagnosis of this rare disease.

Rosacea is a skin disease that frequently involves the eye. Chronic inflammation can lead to corneal vascularization with decreased visual acuity. Treatment of ocular rosacea includes lubricants, lid hygiene, and the use of topical and systemic medications to control inflammation. Systemic tetracyclines are the mainstay of treatment.