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array:24 [ "pii" => "S2173579417300774" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.017" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1079" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:379-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "HTML" => 5 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669116301605" "issn" => "03656691" "doi" => "10.1016/j.oftal.2016.08.007" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1079" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:379-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 42 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 30 "PDF" => 10 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Glaucoma melanomalítico secundario a melanoma de iris" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "379" "paginaFinal" => "381" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Melanomalytic glaucoma secondary to iris melanoma" ] ] "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" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 650 "Ancho" => 900 "Tamanyo" => 79548 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Iridoresección (posquirúrgico). A) Biomicroscopía de polo anterior. B) Gonioscopia.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Ajamil Rodanés, C. García-Álvarez, M.A. Saornil Alvarez, F. López-Lara, J.M. Frutos Baraja, M. Quiñones" "autores" => array:6 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Ajamil Rodanés" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "García-Álvarez" ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Saornil Alvarez" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "López-Lara" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Frutos Baraja" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Quiñones" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417300774" "doi" => "10.1016/j.oftale.2017.03.017" "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/S2173579417300774?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116301605?idApp=UINPBA00004N" "url" => "/03656691/0000009200000008/v1_201707250054/S0365669116301605/v1_201707250054/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579417300750" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.015" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1127" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:382-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6 "HTML" => 6 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Canthotomy and cantholysis prior to ultrasound circular cyclocoagulation (UC3<span class="elsevierStyleSup">®</span> Eye Tech Care) in refractory glaucoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "382" "paginaFinal" => "385" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ciclocoagulación circular mediada por ultrasonidos (UC3<span class="elsevierStyleSup">®</span> Eye Tech Care) en glaucoma refractario tras cantotomía y cantólisis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 750 "Ancho" => 1000 "Tamanyo" => 132173 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">application of ultrasound (UC3<span class="elsevierStyleSup">®</span>) after cantholysis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Fernández, J. Raez-Balbastre, V. Elipe, F. Poyales" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Fernández" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Raez-Balbastre" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Elipe" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Poyales" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300023" "doi" => "10.1016/j.oftal.2016.11.014" "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/S0365669117300023?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300750?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417300750/v1_201707250047/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417301287" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.04.003" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1193" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:372-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 16 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 9 "PDF" => 6 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Efficacy of the SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> in the postoperative follow-up of PHACO-ExPRESS combined surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "372" "paginaFinal" => "378" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia del SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> para el seguimiento postoperatorio de la cirugía combinada FACO-ExPRESS" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1368 "Ancho" => 1645 "Tamanyo" => 95725 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Mean IOP-S amplitude (measurement unit: millivolt equivalent/mVeq) during the diurnal (left) and nocturnal periods (right), recorded before (black) and after (green) FACO-ExPRESS surgery with the SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> system. Diminished amplitude curves after surgery can be appreciated (both for the diurnal and nocturnal period), representing a directly proportional reduction of IOP-G in these patients.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Osorio-Alayo, V.T. Pérez-Torregrosa, R. Clemente-Tomás, Á. Olate-Pérez, M. Cerdà-Ibáñez, A. Gargallo-Benedicto, A. Barreiro-Rego, A. Duch-Samper" "autores" => array:8 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Osorio-Alayo" ] 1 => array:2 [ "nombre" => "V.T." "apellidos" => "Pérez-Torregrosa" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Clemente-Tomás" ] 3 => array:2 [ "nombre" => "Á." "apellidos" => "Olate-Pérez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Gargallo-Benedicto" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Barreiro-Rego" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Duch-Samper" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S036566911730134X" "doi" => "10.1016/j.oftal.2017.04.003" "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/S036566911730134X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301287?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417301287/v1_201707250047/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Melanomalytic glaucoma secondary to iris melanoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "379" "paginaFinal" => "381" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Ajamil Rodanés, C. García-Álvarez, M.A. Saornil Alvarez, F. López-Lara, J.M. Frutos Baraja, M. Quiñones" "autores" => array:6 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Ajamil Rodanés" "email" => array:1 [ 0 => "sofiajamilrod@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C." "apellidos" => "García-Álvarez" ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Saornil Alvarez" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "López-Lara" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Frutos Baraja" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Quiñones" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Tumores Intraoculares, Servicio de Oftalmología y Radioterapia, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Glaucoma melanomalítico secundario a melanoma de iris" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1127 "Ancho" => 1500 "Tamanyo" => 559047 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Excisional biopsy showing increased cellularity at the expense of nevic cells forming nests together with pleomorphic cells pigmented with marked nucleoles replacing the normal iris stroma. Immunohistochemistry with HMB45 was positive. (A) Stain with H&E ×40. (B) HMB45 ×40. (C) Melan-A ×10. (D) Melan-A ×40.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Iris melanoma accounts for approximately 4% of uvea melanomas.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> In 14–30% of cases it can associate glaucoma,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> which could be the result of various mechanisms depending on tumor size, type and location. It could also arise due to diminished aqueous humor exit, compression or infiltration of the tumor mass in the anterior chamber angle or dispersion of pigment and inflammatory cells.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The case of a patient with iris melanoma and unusual presentation in the form of melanomalytic glaucoma is presented.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinic case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">Male, 35, without relevant personal history, referred to the intraocular tumor unit for assessing a pigmented lesion in the iris associated to intraocular hypertension and visual acuity (VA) loss in the right eye (RE) with 4 months evolution. Ophthalmological examination showed VA of 0.4 in the RE and of 1 in the LE. Anterior pole biomicroscopy revealed melanotic mass in the periphery of the iris between 7 and 8 o’clock (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Intraocular pressure (IOP) in the RE was 40<span class="elsevierStyleHsp" style=""></span>mmHg and 10<span class="elsevierStyleHsp" style=""></span>mmHg in the LE. Gonioscopy showed that the mass invaded the chamber angle and that the trabecular mesh was highly pigmented at 360° (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Ultrasound biomicroscopy confirmed the presence of the iris mass, its location in the iris periphery and the absence of invasion of adjacent structures. The mass measured 5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm at its base and 2<span class="elsevierStyleHsp" style=""></span>mm height. RE fundus showed that the papilla was completely worn and pale, revealing the <span class="elsevierStyleItalic">lamina cribosa</span> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">By way of treatment and to confirm the diagnostic, excisional biopsy of the mass was performed (irido-resection)<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The anatomopathological study showed proliferation of pleomorphic nevic cells that replaced the normal stroma of the iris. The immunohistochemical HMB45 and Melan-A markers that mark melanocytic and melanoma cells were positive, thus confirming the iris melanoma diagnostic (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Extension tests were performed which gave negative results for systemic disease. Due to the malign nature of the lesion it was decided to complete treatment with adjuvant episcleral brachytherapy with iodine-125. Insulin hypertension was controlled with pharmacological treatment. Six years after the treatment, neither local relapse nor metastatic extension of the disease could be identified. Ocular pressure is maintained stable with pharmacological treatment.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Uvea melanoma has an incidence of 4–6 cases per million inhabitants per year in North America and the Nordic countries. Of all uvea melanoma types, the iris melanoma accounts for 3–10%. Uvea melanoma can present with ocular hypertension between 3 and 7% of cases,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> but in the case of iris melanoma association with glaucoma increases up to 40%.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Glaucoma could be the result of various mechanisms, e.g., diminished accuracy humor exit due to compression or infiltration of the tumor mass at the anterior chamber angle or due to dispersion of pigment or deposit of inflammatory cells that obstruct the trabeculum.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> The latter mechanism is known as melanomalytic glaucoma, in which melanine-carrying macrophages physically obstruct the angle trabeculum.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">5,6</span></a> Less frequently, iris melanoma can give rise to secondary glaucoma due to angle neovascularization or hyphema.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The differential diagnostic of an iris mass is established with nevus, melanocytoma and melanoma. In these cases, ultrasound biomicroscopy is important to study the posterior surface of the iris, the ciliary body, and evaluate the location and extension of the lesion. Excisional biopsy enables treatment of the lesion and greater certainty for anatomopathological diagnostic. The difficulty in obtaining broad surgical margins to ensure the absence of recurrences makes the association of episcleral brachytherapy essential as adjuvant treatment.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion, it is important to carry out an exhaustive examination with patients exhibiting unilateral glaucoma resistance to pharmacological treatment together with pigment dispersion, emphasizing the role played by ultrasound biomicroscopy.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In patients with localized iris melanoma without extension signs and associated melanomalytic glaucoma as in the present case, resection through iridectomy or iridocyclectomy together with adjuvant brachytherapy is effective for controlling the disease.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0050" 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" => "xres873563" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec862209" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres873564" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec862208" "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" => "2016-04-13" "fechaAceptado" => "2016-08-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec862209" "palabras" => array:3 [ 0 => "Melanomalytic glaucoma" 1 => "Iris melanoma" 2 => "Episcleral brachytherapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec862208" "palabras" => array:3 [ 0 => "Glaucoma melanomalítico" 1 => "Melanoma de iris" 2 => "Braquiterapia epiescleral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 35-year-old male with unilateral ocular hypertension in the right eye (RE). Anterior segment examination of the RE showed a melanotic lesion. Intraocular pressure (IOP) was 40<span class="elsevierStyleHsp" style=""></span>mmHg in RE. Gonioscopy revealed extension into the anterior chamber angle. Excisional biopsy was performed and consistent with iris melanoma and secondary melanomalytic glaucoma. Brachytherapy was performed as adjuvant therapy.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In patients presenting with unilateral glaucoma and increased pigmentation in the trabecular meshwork, it is crucial to perform imaging studies. Resection by iridectomy with adjuvant episcleral brachytherapy is effective in controlling the disease.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Varón de 35 años con hipertensión ocular en el ojo derecho (OD). En segmento anterior se observó una masa melanótica. La presión intraocular (PIO) fue de 40<span class="elsevierStyleHsp" style=""></span>mmHg en el OD. En la gonioscopia se observó una masa iridiana con extensión camerular. Se realizó biopsia escisional confirmando el diagnóstico de melanoma de iris y glaucoma melanomalítico. Se asoció tratamiento con braquiterapia epiescleral adyuvante.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A los pacientes que presentan glaucoma unilateral, con aumento de pigmentación en malla trabecular, es esencial realizar pruebas de imagen. La resección mediante iridectomía junto con braquiterapia adyuvante es eficaz en el control de la enfermedad.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ajamil Rodanés S, García-Álvarez C, Saornil Alvarez MA, López-Lara F, Frutos Baraja JM, Quiñones M. Glaucoma melanomalítico secundario a melanoma de iris. Arch Soc Esp Oftalmol. 2017;92:379–381.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Presented at the EVER Congress, October 2014 in Nice, France.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 674 "Ancho" => 900 "Tamanyo" => 81993 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Anterior pole biomicroscopy (right eye) showing a concave surface pigmented lesion in the periphery, between 7 and 8 o’clock. Satellite lesions and melanic Tyndall cannot be observed.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 677 "Ancho" => 900 "Tamanyo" => 60070 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Gonioscopy: melanotic mass occupying iris and chamber angle with uneven anterior edges. Hyperpigmentation of the filtration line (filtrating trabeculum) at 360° together with the open angle. In ocular fundus, papilla has complete excavation, showing the <span class="elsevierStyleItalic">lamina cribosa</span>.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 650 "Ancho" => 900 "Tamanyo" => 79548 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Iris resection (after surgery). (A) Anterior pole biomicroscopy. (B) Gonioscopy.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1127 "Ancho" => 1500 "Tamanyo" => 559047 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Excisional biopsy showing increased cellularity at the expense of nevic cells forming nests together with pleomorphic cells pigmented with marked nucleoles replacing the normal iris stroma. Immunohistochemistry with HMB45 was positive. (A) Stain with H&E ×40. (B) HMB45 ×40. (C) Melan-A ×10. 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