Archivos de la Sociedad Española de Oftalmología
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Arch Soc Esp Oftalmol · Sep 2009
Case Reports[Uveitis masquerade syndrome as a presenting form of diffuse retinoblastoma].
A 3-year-old boy presented with an intermediate uveitis. Complete ophthalmic exam, ocular ultrasonography, magnetic resonance imaging and computerized tomography of the orbit were inconclusive. Determination of the aqueous humor/serum rate of Lactate dehydrogenase (LDH) was the key for the diagnosis of a diffuse retinoblastoma. ⋯ A masquerade syndrome is the initial presentation in 1-3% of retinoblastomas. Aqueous humor punction is contraindicated in patients with retinoblastoma but it might be the only way to achieve a correct diagnosis in these difficult and very unusual cases: enzymatic assays such as LDH offer a good sensitivity and specificity for the diagnosis of these patients.
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Arch Soc Esp Oftalmol · Jul 2008
Case Reports[Visual acuity loss, the initial sympton of a spinal cord neoplasm].
A 46-year-old woman, who presented with right visual acuity loss, was found to have papilledema, and subsequently shown to have ventricular dilatation in a cerebral Magnetic Resonance Imaging (MRI) assessment. Elevated protein levels were found in the cerebrospinal fluid. Spinal MRI revealed the presence of a spinal cord neoplasm. After surgical removal of the tumor, which turned out to be a neurilemmoma, the patient's visual acuity was restored. ⋯ The ocular presentation and the relationship between intracranial hypertension and spinal tumors are discussed. Likewise, the importance of considering the various causes of papilledema is emphasized.