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Martín Juan, R. Madrigal, J. Porta Etessam, F. Sáenz-Francés San Baldomero, E. Santos Bueso" "autores" => array:5 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Martín Juan" "email" => array:1 [ 0 => "albert_mj89@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Madrigal" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Porta Etessam" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Sáenz-Francés San Baldomero" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Santos Bueso" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ceguera de Anton–Babinski, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1121 "Ancho" => 1867 "Tamanyo" => 113653 ] ] "descripcion" => array:1 [ "en" => "OCT Images showing structured macula and retinal nerve fiber layer thickness within normal ranges." ] ] ] "textoCompleto" => "IntroductionAnton–Babinski disease is a clinical condition consisting in bilateral vision loss of encephalic origin associated to lack of awareness of the impairment by the patient (visual anosognosia) caused by a legion in both occipital lobes compromising the primary visual cortex and related association areas, generally due to ischemia. The case of a patient exhibiting said condition after an episode of cardiorespiratory arrest (CRA) is described.Clinical Case ReportFemale, 22, in dialysis due to terminal chronic renal insufficiency without relevant ophthalmological history, who exhibited a CRA episode. After recovery, she began to refer blurred vision.Ophthalmological examination produced a visual acuity (VA) of “finger counting” in both eyes (BE) about which the patient was apparently not aware (she referred watching TV normally and recognizing persons). The ophthalmological examination also revealed biomicroscopy within normal ranges, intraocular pressure of 16mmHg in BE, extrinsic ocular motility and eye fundus normal, with intrinsic ocular motility showing pupils in mean midriasis reactive to light in BE and optical coherence tomography (OCT, Heidelberg Engineering Inc, Heidelberg, Germany) normal both in retinal and macular nerve fiber layers (Fig. 1).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Neurological examination determined anosognosia, left-side hemiasomatognosia and visual agnosia, together with left hemiparesis and hemi-hypoesthesia. Cerebral magnetic resonance showed cortical hyper-intensity in both occipital lobes in T2 sequence, in precentral right turn and corpus callosus splenius, compatible with subacute ischemia in said areas (Fig. 2). Accordingly, anoxic encephalopathy after CRA was diagnosed with associated visual impairment, compatible with Anton–Babinski blindness.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Since then, the patient was regularly followed up by Neuro-Ophthalmology, exhibiting VA improvement (at present 0.6 monocular in BE), without ophthalmological alterations and chronic changes in cerebral magnetic resonance, including persistent hyper-intensity in the areas described above as well as parietal lobe atrophy.DiscussionAnton–Babinski blindness or syndrome is caused by bilateral lesions in associative visual brain areas (Brodman areas 18 and 19 or secondary visual cortex), giving rise to visual anosognosia involving patient inability to identify said vision impairment.<a class="elsevierStyleCrossRefs" href="#bib0045">1–3</a>The most frequent etiology is ischemia or parenchyma hemorrhage as well as other less frequently described causes of such as radiation leukoencephalopathy and adrenoleukodystrophy.<a class="elsevierStyleCrossRefs" href="#bib0045">1,3–5</a>Clinical expressions comprise objective poor vision (usually “perception of light” or “bulk movement” VA) involving visual confabulation of the patient who refers normal vision and attends to describe the environment and to move about without help although with continuous errors.<a class="elsevierStyleCrossRef" href="#bib0070">6</a> Examination of these patients identifies associated neurologic sensitive-motor impairment (but, by definition, without dementia or memory disorders) and without ophthalmological findings. Neuroimaging tests produce evidence of lesions in both occipital lobes.<a class="elsevierStyleCrossRefs" href="#bib0070">6,7</a> Additional tests and examinations are required for the etiological diagnostic.Said clinic is infrequent but must be suspected in patients with strange or inconsistent vision impairment. Evidence of occipital encephalic damage in neuroimaging tests is necessary, excluding any alteration in the proximal visual pathways.<a class="elsevierStyleCrossRefs" href="#bib0070">6,7</a> Prognostic is variable and several rehabilitation treatments has been described consisting in improving mobility and daily life activities and regularly reminding the patient about said impairment.<a class="elsevierStyleCrossRef" href="#bib0080">8</a> In the present case, vision gradually improved during hospital stay probably due to the partial functional recovery of ischemic areas.By way of conclusion, Anton–Babinski blindness must be considered in patients with CRA or hypoxia where ophthalmological examination is not consistent with the VA referred by the patient.Conflict of InterestNo conflict of interests was declared by the authors." "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1099739" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1040921" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1099738" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1040920" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical Case Report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of Interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-01-21" "fechaAceptado" => "2018-04-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1040921" "palabras" => array:4 [ 0 => "Blindness" 1 => "Neurology" 2 => "Ophthalmology" 3 => "Visual acuity" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1040920" "palabras" => array:4 [ 0 => "Ceguera" 1 => "Neurología" 2 => "Oftalmología" 3 => "Agudeza visual" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Clinical caseA 22 year-old woman complained about blurred vision after an episode of recovered cardiorespiratory arrest. She had bilateral low visual acuity (“count fingers”) and no ophthalmological or visual pathways changes. She also had an apparent lack of awareness of the deficit. The magnetic resonance imaging (MRI) showed ischaemic changes in both occipital lobes. As a result, she was diagnosed with Anton–Babinski syndrome. DiscussionThis is a rare disease that should be suspected in strange or poorly congruent visual loss. It is usually due to an ischemic injury in this region of brain, manifesting itself with low vision not perceived by the patient (visual confabulation). It can simulate a non-organic visual loss or psychiatric disease." "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Caso clínicoMujer de 22 años que presentó visión borrosa después de un episodio de parada cardiorrespiratoria recuperada, objetivándose en la exploración una AV de «cuenta dedos» en AO sin alteración oftalmológica ni de vía visual y asociada a aparente falta de conciencia del déficit, junto con una resonancia magnética que mostró cambios isquémicos en ambos lóbulos occipitales, diagnosticándose de ceguera de Anton-Babinski. DiscusiónLa ceguera de Anton-Babinski es un cuadro poco frecuente que debe sospecharse en pérdidas visuales poco congruentes y se debe a lesión habitualmente isquémica en el territorio cerebral descrito, manifestándose con baja visión no percibida por el paciente («confabulación visual»), pudiendo ser diagnosticada como pérdida visual no orgánica, o incluso patología psiquiátrica." "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Martín Juan A, Madrigal R, Porta Etessam J, Sáenz-Francés San Baldomero F, Santos Bueso E. Ceguera de Anton-Babinski, a propósito de un caso. Arch Soc Esp Oftalmol. 2018;93:555–557." ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1121 "Ancho" => 1867 "Tamanyo" => 113653 ] ] "descripcion" => array:1 [ "en" => "OCT Images showing structured macula and retinal nerve fiber layer thickness within normal ranges." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 793 "Ancho" => 1400 "Tamanyo" => 52268 ] ] "descripcion" => array:1 [ "en" => "Cerebral magnetic resonance with hyper-intensity in both occipital lobes, compatible with ischemia (anoxic encephalopathy)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recurrent bilateral occipital infarct with cortical blindness and Anton syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. 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ISSN: 2173-5794
e-ISSN: 1989-7286

Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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