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array:24 [ "pii" => "S2173579419301987" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.10.003" "estado" => "S300" "fechaPublicacion" => "2020-02-01" "aid" => "1582" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:98-102" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669119303028" "issn" => "03656691" "doi" => "10.1016/j.oftal.2019.10.002" "estado" => "S300" "fechaPublicacion" => "2020-02-01" "aid" => "1582" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:98-102" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 37 "formatos" => array:2 [ "HTML" => 30 "PDF" => 7 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Linfoma y proliferación melanocítica uveal difusa unilateral: cuando ambas entidades coexisten en el ojo" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "98" "paginaFinal" => "102" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lymphoma and unilateral diffuse uveal melanocytic proliferation: when both conditions co-exist in the eye" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1842 "Ancho" => 1842 "Tamanyo" => 344795 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(a) Alteraciones pigmentarias asociadas a placas anaranjadas subretinianas (OI). (b) Alteraciones del EPR con pérdida de fotorreceptores en esas zonas (OI). (c) Puntos hipoautofluorescentes en el polo posterior y alguno hiperautofluorescente en la zona temporal (OI). (d) Patrón moteado en modo «en-face» (OI). (e) Fondo de ojo del OD que no presenta alteraciones. (f) Imagen de autofluorescencia compatible con la normalidad (OD). (g) Pequeña membrana epirretiniana (OD).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Campos Polo, D. García Guisado, C. Rubio Sánchez, P. Bueno García, N.T. Márquez Ivacevich" "autores" => array:5 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Campos Polo" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "García Guisado" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Rubio Sánchez" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Bueno García" ] 4 => array:2 [ "nombre" => "N.T." "apellidos" => "Márquez Ivacevich" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579419301987" "doi" => "10.1016/j.oftale.2019.10.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301987?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119303028?idApp=UINPBA00004N" "url" => "/03656691/0000009500000002/v2_202108160545/S0365669119303028/v2_202108160545/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579420300153" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.11.006" "estado" => "S300" "fechaPublicacion" => "2020-02-01" "aid" => "1606" "copyright" => "Sociedad Española de Oftalmología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Soc Esp Oftalmol. 2020;95:103-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Comment on: Diagnostic vitrectomy: A case series in a single referral center" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "103" "paginaFinal" => "104" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario al artículo «Vitrectomía diagnóstica: serie de casos en un centro de referencia»" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Fau, S. Nabzo, V. Nasabun" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Fau" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Nabzo" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Nasabun" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119303582" "doi" => "10.1016/j.oftal.2019.11.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119303582?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420300153?idApp=UINPBA00004N" "url" => "/21735794/0000009500000002/v1_202002061534/S2173579420300153/v1_202002061534/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579419302099" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.10.006" "estado" => "S300" "fechaPublicacion" => "2020-02-01" "aid" => "1584" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:94-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Choroidal metastases as initial manifestation of a papillary thyroid carcinoma: A case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "97" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis coroidea como primera manifestación de carcinoma papilar de tiroides: a propósito de un caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 311 "Ancho" => 1255 "Tamanyo" => 155344 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Cytology corresponding to PAAF of the mediastinic adenopathy. Cytological extension with Papanicolaou staining showing papillary groups of cells with poorly defined cytoplasm, rounded or oval-shaped nuclei with slight nucleus size variability. (B) Histological section with 20X increase stained with hematoxylin-eosin of the total thyroidectomy. The upper part of the image shows the columnar cell variant of the thyroid papillary carcinoma and the lower part shows normal thyroid tissue. (C) This image shows the vascular invasion by the papillary carcinoma.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Chacón González, A. Ibáñez Muñoz, L. Rodríguez Vicente, I. Ortega Renedo, M. Rozanova Klecheva, A. Yagüe Hernando, M.E. Lizuaín Abadia, B. Jiménez del Rio" "autores" => array:8 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Chacón González" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Ibáñez Muñoz" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Rodríguez Vicente" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Ortega Renedo" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Rozanova Klecheva" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Yagüe Hernando" ] 6 => array:2 [ "nombre" => "M.E." "apellidos" => "Lizuaín Abadia" ] 7 => array:2 [ "nombre" => "B." "apellidos" => "Jiménez del Rio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119303041" "doi" => "10.1016/j.oftal.2019.10.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119303041?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419302099?idApp=UINPBA00004N" "url" => "/21735794/0000009500000002/v1_202002061534/S2173579419302099/v1_202002061534/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Lymphoma and unilateral diffuse uveal melanocytic proliferation: when both conditions co-exist in the eye" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "98" "paginaFinal" => "102" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Campos Polo, D. García Guisado, C. Rubio Sánchez, P. Bueno García, N.T. Márquez Ivacevich" "autores" => array:5 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Campos Polo" "email" => array:1 [ 0 => "rafacampospolo@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "García Guisado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Rubio Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Bueno García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "N.T." "apellidos" => "Márquez Ivacevich" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Hospital Virgen del Puerto, Plasencia, Cáceres, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Perpetuo Socorro, Badajoz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Campo Arañuelo, Navalmoral de la Mata, Cáceres, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfoma y proliferación melanocítica uveal difusa unilateral: cuando ambas entidades coexisten en el ojo" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1842 "Ancho" => 1842 "Tamanyo" => 344795 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) pigment alterations associated to subretinal orange plaques (LE). (b) RPE alterations with photoreceptor loss in those areas (LE). (c) hypo-autofluorescent dots in posterior pole and some hyper-autofluorescent dots in the temporal zone (LE). (d) dotted pattern in the «in-face» mode (LE). (e) RE alteration-free ocular fundus. (f) autofluorescence image compatible with normality (RE). (g) small epiretinal membrane (RE).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Bilateral diffuse uveal melanocytic proliferation (DUMP) bilateral is an infrequent paraneoplastic disorder associated to systemic cancer. Most frequently associated cancer types are ovary, uterus and lung cancer. However, DUMP has also been described in other types of tumors.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Unilateral DUMP secondary to central nervous system lymphoma with ocular involvement is presented.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinic case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">Male, 60, who visited the Emergencies Dept. due to diminished visual acuity (VA) in the left eye (LE) with one week evolution. No remarkable antecedents were referred with the exception of allergy to iodine contrast.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Patient VA was 1 in right eye (RE) and 0.4 in the left eye (LE). Anterior segment was normal and tonometry was 15 mmHg in both eyes (BE). LE ocular fundus (OF) showed pigment alterations in posterior pole associated to subretinal orange plaques, while autofluorescence (TRC-50IX, Topcon Medical Systems, Oakland, NJ, USA) showed multiple hypoautofluorescent points distributed on the posterior pole exceeding the arcades, although some hyperautofluorescent points were also found in the temporal zone. Structural optical coherence tomography (SS-OCT, DRI OCT Triton, Topcon Europe Medical BV, Capelle aan den Ijssel, The Netherlands) showed alterations in the retina pigment epithelium (RPE) with los of outer layers at the photoreceptor level, while the «in-face» examination mode evidenced a dotted pattern similar to that observed in autofluorescence. Examination of the RE produced entirely normal results with the exception of a small incipient epiretinal membrane (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The results of the examination gave rise to suspected unilateral DUMP due to the absence of characteristic lesions in the RE. Complete blood and urine analysis was requested, including antibodies for toxoplasmosis, herpes, tuberculosis, syphilis, Lyme’s disease, HIV, HBV and HCV. Chest x-ray and HLA B51 and A29 were also requested. However, the patient declined all tests and did not return for checkup.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Three months later the patient returned due to worsening VA in LE. He referred consulting in another clinic where he was prescribed systemic corticoids treatment. VA was hand movements at that time, while the RE gave a VA of 1. Anterior segment exhibits nuclear cataract in LE. The OF of RE remains normal although the LE exhibits significant vitritis through which large white-yellowish subretinal plaques can be seen in the posterior pole (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>a and b). The same battery of diagnostic tests was requested again, including nuclear magnetic resonance (NMR) of the central nervous system. In addition and considering the characteristics of the condition at the time, it was decided to perform diagnostic and exploratory phacovitrectomy with vitreous samples for cytologic and immunohistochemical study, as well as flow cytometry and molecular and cytokin analysis due to suspected lymphoma diagnostic. Vitrectomy enabled a clear view of subretinal plaques and the confirmation that the aggregate hypo-autofluorescent lesions remained unchanged (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>c and d). Vitreous biopsy found an IL-10/IL-6 coefficient of 0.87, although NMR showed a lesion in the front lobe suggesting lymphoma. Due to said findings, the patient was diagnosed with primary central nervous system lymphoma with LE ocular involvement and associated unilateral DUMP in said eye. Treatment was initiated with systemic methotrexate and 2 intravitreal injections of rituximab at 2-week intervals until the condition stabilized and remitted. The large subretinal yellowish plaques diminished and were limited to a small atrophic lesion in the upper nasal area. The hypo-autofluorescent dotted areas diminished in number and density together with the RPE irregularities present in the structural OCT. Meanwhile, examination of RE continued to yield normal results (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). After 6 months follow-up, the ocular condition remains unchanged.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">To the best of the knowledge of the authors, this is the first unilateral DUMP associated to central nervous system primary lymphoma with ocular involvement to be described.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">DUMP is an ocular paraneoplastic syndrome that generally arises in patients with carcinoma, although it has also been described in other non-carcinomatous tumors such as lymphoma.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The main characteristics of DUMP was described by Gass: presence of multiple roundish subretinal reddish lesions at the RPE level (in giraffe or leopard pattern) exhibiting early hyperfluorescence in angiography, associated to uveal tract melanocytic tumors, exudative retina detachments and rapid cataract progression.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The present case does not comprise all of said characteristics perhaps due to being an early DUMP stage. In addition, fluorescein angiography was not taken because the patient declined the test considering his allergy history.</p><p id="par0040" class="elsevierStylePara elsevierViewall">DUMP associated to lymphoma has been described as a bilateral disease although it can exhibit asymmetric expressions.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Only one case of unilateral DUMP has been described in the literature by Spaide, which was secondary to mammary carcinoma.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Accordingly, in the knowledge of the authors, this is the first case of unilateral DUMP secondary to brain lymphoma with ocular compromise.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Miles et al. published that patients with DUMP exhibit a factor in IgG fraction that could account for the right lateral proliferation of melanocytes.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> However, Spaide suggests that other factors account for this process due to the unilateral compromise described in his article, such as gain in chromosomes 6 and X, deletion of chromosome 19 or 8q polysomy.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In order to confirm the diagnostic of vitreoretinal lymphomas, it is necessary to demonstrate the existence of malign cells in the vitreal or chorioretinal samples. It must be borne in mind that false negatives are frequent and this could be due to several circumstances, including the fact that malign cells attract healthy lymphocytes and that the samples could contain polyclonal B-cells. They could also be due to poor preservation of material to be studied or that it could contain low malign cell counts. It must be noted that, prior to being diagnosed with ocular lymphoma, patients are frequently diagnosed with uveitis and treated with systemic corticoids which are tumoricidal.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> For all the above reasons, cytology as a single diagnostic test has a vitreoretinal lymphoma confirmation rate between 45 and 60% of cases. IL-10 is a growth and differentiation factor for malign B-lymphocytes whereas IL-6 is increased in inflammatory diseases. Therefore, the IL-10/IL-6 coefficient has been utilized to differentiate between uveitis and vitreoretinal lymphomas, but not as a single diagnostic test because, in addition to the errors mentioned above, in some exceptional cases said coefficient is increased in uveitis or diminished in the vitreoretinal lymphomas, involving the necessity of combining it with other tests.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> It has been recently published that cases associated to severe sub-RPE infiltration exhibit very high IL-6 levels due to ruptured hematoretinal barrier and secretion of reactive cells.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In addition to the utilization of corticoids, the case presented herein exhibited considerable sub-RPE infiltration and both circumstances could be the cause for the IL-10/IL-6 coefficient being under 1.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1300367" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1199747" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1300366" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1199746" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-24" "fechaAceptado" => "2019-10-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1199747" "palabras" => array:5 [ 0 => "Diffuse uveal melanocytic proliferation" 1 => "IL-10/IL-6" 2 => "Ocular lymphoma" 3 => "Central nervous system lymphoma" 4 => "Paraneoplastic ocular syndrome" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1199746" "palabras" => array:5 [ 0 => "Proliferación melanocítica uveal difusa" 1 => "IL-10/IL-6" 2 => "Linfoma ocular" 3 => "Linfoma del sistema nervioso central" 4 => "Síndrome paraneoplásico ocular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The case is presented of a 60 year-old male with decreased visual acuity in his left eye (LE). In the funduscopic examination, pigmentary alterations associated with sub-retinal orange plaques could be observed that, in autofluorescence, manifested as hypoautofluorescent spots. Subsequently, the patient subsequently developed significant vitritis with large white sub-retinal plaques on the posterior pole of his LE, with no alterations in the right eye. The IL-10/IL-6 coefficient was 0.87, and a lesion suggestive of a lymphoma in the frontal lobe could be seen on brain magnetic resonance scan. The patient was diagnosed with primary lymphoma of the central nervous system with ocular involvement of the LE and associated unilateral diffuse uveal melanocytic proliferation (DUMP) of the same eye.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">DUMP is a bilateral para-neoplastic process that occurs as a consequence of carcinomatous tumour processes, although it does not always meet these characteristics.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Varón de 60 años que presenta disminución de agudeza visual rápida y progresiva en su ojo izquierdo (OI). En la exploración funduscópica, se pueden observar alteraciones pigmentarias asociadas a placas anaranjadas sub-retinianas que, mediante autofluorescencia, aparecen como múltiples puntos hipoautofluorescentes en polo posterior. A los 3 meses, el paciente desarrolla una importante vitritis asociada a grandes placas blanco-amarillentas sub-retinianas en el polo posterior del OI; el ojo derecho no presenta alteraciones. El coeficiente intravítreo IL-10/IL-6 fue de 0,87 y la resonancia nuclear magnética cerebral evidenció una lesión densa en el lóbulo frontal, sugestiva de linfoma. Se diagnosticó al paciente de un linfoma primario del sistema nervioso central, con afectación ocular de su OI, que se asoció a una proliferación melanocítica uveal difusa (PMUD) del mismo ojo. La PMUD se trata de un proceso paraneoplásico bilateral que ocurre como consecuencia de procesos tumorales carcinomatosos, aunque no siempre cumple estas características.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Campos Polo R, García Guisado D, Rubio Sánchez C, Bueno García P, Márquez Ivacevich NT. Linfoma y proliferación melanocítica uveal difusa unilateral: cuando ambas entidades coexisten en el ojo. Arch Soc Esp Oftalmol. 2020;95:98–102.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1842 "Ancho" => 1842 "Tamanyo" => 344795 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) pigment alterations associated to subretinal orange plaques (LE). (b) RPE alterations with photoreceptor loss in those areas (LE). (c) hypo-autofluorescent dots in posterior pole and some hyper-autofluorescent dots in the temporal zone (LE). (d) dotted pattern in the «in-face» mode (LE). (e) RE alteration-free ocular fundus. (f) autofluorescence image compatible with normality (RE). (g) small epiretinal membrane (RE).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1842 "Ancho" => 1842 "Tamanyo" => 237511 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(a) intense vitritis (LE). (b) yellowish subretinal plates (LE). (c) subretinal plaques arranged beyond the arcades seen 24 h after performing vitrectomy (LE). (d) aggregate hyper-autofluorescent lesions that did not change appearance (LE).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2175 "Ancho" => 2175 "Tamanyo" => 302241 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(a) atrophic lesion after 2 intravitreal rituximab injections and systemic treatment with methotrexate (LE). (b) dotted hypo-autofluorescent diminished in number and density compared to the previous image at the beginning of chemotherapy treatment (LE). (c) Reduction of irregularities seen at the RPE level (LE). 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