Share
array:24 [ "pii" => "S2173579421000736" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.11.005" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1890" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Soc Esp Oftalmol. 2021;96:377-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S036566912100006X" "issn" => "03656691" "doi" => "10.1016/j.oftal.2020.11.024" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1890" "copyright" => "Sociedad Española de Oftalmología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Soc Esp Oftalmol. 2021;96:377-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Afectación metastásica del nervio óptico en paciente con neoplasia de mama y pulmón" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "379" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Metastatic involvement of optic nerve in patient with breast and lung neoplasia" ] ] "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" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1007 "Ancho" => 1007 "Tamanyo" => 80674 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La retinografía de campo amplio con Optomap® muestra un edema del nervio óptico global con una masa amarillenta difusa e irregular y hemorragias peripapilares.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.J. Valentín-Bravo, C. García-Álvarez, M. Para-Prieto, M.A. Sánchez-Ronco, M.A. Saornil-Álvarez" "autores" => array:5 [ 0 => array:2 [ "nombre" => "F.J." "apellidos" => "Valentín-Bravo" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "García-Álvarez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Para-Prieto" ] 3 => array:2 [ "nombre" => "M.A." "apellidos" => "Sánchez-Ronco" ] 4 => array:2 [ "nombre" => "M.A." "apellidos" => "Saornil-Álvarez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579421000736" "doi" => "10.1016/j.oftale.2020.11.005" "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/S2173579421000736?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566912100006X?idApp=UINPBA00004N" "url" => "/03656691/0000009600000007/v1_202107011359/S036566912100006X/v1_202107011359/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579420301766" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.06.010" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1765" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Soc Esp Oftalmol. 2021;96:380-3" "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" => "Retinal arterial and venous obstruction as the first manifestation of an antiphospholipid antibody syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "380" "paginaFinal" => "383" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Obstrucción arterial y venosa retiniana como primera manifestación de un síndrome de anticuerpos antifosfolípidos" ] ] "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" => 426 "Ancho" => 750 "Tamanyo" => 31203 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Image of the fundus of the right eye at 12 months of follow-up.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Pérez-Crespo, C. Gutiérrez-Ortiz" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Pérez-Crespo" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Gutiérrez-Ortiz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120302513" "doi" => "10.1016/j.oftal.2020.06.016" "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/S0365669120302513?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420301766?idApp=UINPBA00004N" "url" => "/21735794/0000009600000007/v1_202107011321/S2173579420301766/v1_202107011321/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579421000293" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.09.018" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1844" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Arch Soc Esp Oftalmol. 2021;96:366-76" "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">Review</span>" "titulo" => "Eye oscilations with neurological implications in pediatric age" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "376" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oscilaciones oculares con implicaciones neurológicas en la edad infantil" ] ] "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" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 676 "Ancho" => 750 "Tamanyo" => 57360 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Joubert’s Syndrome. Brain stem malformation in a Joubert’s syndrome (sign of the molar by cerebellar vermis agenesis and mesencephalic dysgenesis).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Celdrán-Vivancos, S. Noval-Martín, M. González-Manrique, A. Negoita, S. Porto-Castro" "autores" => array:5 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Celdrán-Vivancos" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Noval-Martín" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "González-Manrique" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Negoita" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Porto-Castro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120304160" "doi" => "10.1016/j.oftal.2020.09.015" "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/S0365669120304160?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421000293?idApp=UINPBA00004N" "url" => "/21735794/0000009600000007/v1_202107011321/S2173579421000293/v1_202107011321/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Metastatic involvement of optic nerve in patient with breast and lung neoplasia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "379" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F.J. Valentín-Bravo, C. García-Álvarez, M. Para-Prieto, M.A. Sánchez-Ronco, M.A. Saornil-Álvarez" "autores" => array:5 [ 0 => array:4 [ "nombre" => "F.J." "apellidos" => "Valentín-Bravo" "email" => array:1 [ 0 => "fjvb90@icloud.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "García-Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Para-Prieto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Sánchez-Ronco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "M.A." "apellidos" => "Saornil-Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Afectación metastásica del nervio óptico en paciente con neoplasia de mama y pulmón" ] ] "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" => 1340 "Ancho" => 1340 "Tamanyo" => 194086 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Part A shows optical coherence tomography centered on the optic nerve. There is a diffuse papilla elevation with posterior vitritis. In part B, B-mode ultrasound shows optic nerve elevation without posterior acoustic shadowing, ruling out calcifications.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Metastases are the most frequent intraocular tumor in adults, usually located in the uvea due to its high vascularization. In contrast, metastases found in the optic nerve are extremely rare and, in most cases, are associated to choroid, orbit or central nervous system involvement. In a publication with 660 intraocular metastasis patients, Shields et al., reported that prevalence of optic nerve involvement accounts for 4.5% of the total.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Primary origin differs depending on the age it appears, the most frequent in adults being breast and lung neoplasms. However, in children it is usually a hematological process such as leukemia or lymphoma.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The following is a rare case of unilateral optic nerve metastasis of a patient with 2 known neoplastic processes: breast and lung.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical case</span><p id="par0015" class="elsevierStylePara elsevierViewall">The case of a 67-year-old woman that visited the emergency room with subacute vision loss symptoms in the right eye (RE) of 15 days of evolution is described. It initially started with myodesopsia, but 3 days later a superior altitude loss that progressively affected the entire visual field evolved. The patient denied smoking or any toxic habit and did not present headaches or other arteritic symptoms at any time. Patient history includes breast cancer previously treated with radical mastectomy, external radiotherapy (60 Co) and 6 adjuvant chemotherapy cycles of cyclophosphamide + methotrexate + fluorouracil, with complete remission 30 years ago. Currently a positive thyroid transcription factor 1 lung adenocarcinoma was being treated with bevacizumab + carboplatin + paclitaxel, diagnosed 9 months prior due to a pleural effusion from which a positive cytology was obtained. Five months after the diagnosis, it metastasized in the axial skeleton, complicating further with a vertebral fracture (D9) treated with palliative radiotherapy. Likewise, a mechanical aortic prosthesis (Carbomedics® n.<span class="elsevierStyleSup">o</span> 21, LivaNova Laboratory, London, United Kingdom) was attached as a consequence of severe stenosis in said valve, and suffered from atrial fibrillation; therefore being treated with acenocoumarol (Sintrom, Cinfa laboratory, Olloki [Navarra], Spain) and bisoprolol (Bisoprolol Cor Alter 2.5 mg, Alter SA Laboratories, Madrid, Spain).</p><p id="par0020" class="elsevierStylePara elsevierViewall">In ophthalmological examination, visual acuity was of finger count in the RE and 0.8 in the left eye. Intraocular pressure was 12 mmHg in both eyes. Pupils were isochoric, with significant hyporesponsiveness and relative afferent pupillary defect in RE, with preserved extrinsic ocular motility. Anterior pole biomicroscopy was normal in both eyes, without proptosis, exhibiting a slight phacosclerosis in accordance with age. An applied retina was observed at the bottom of the RE and the papilla showed significant edema with peripapillary splinter hemorrhages along the vascular arches, associated to posterior vitritis. Optical coherence tomography showed a papilla pseudoedema, as seen in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A. In addition, wide-field retinography was performed with Optomap® (Quantel Medical, Cournon d’Auvergne, France), revealing a diffuse and irregular yellow mass on the papilla associated with hemorrhages, as it can be observed in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>. Ultrasound allowed the observation of a nonspecific optic nerve elevation in B-mode without calcifications and elevated internal hyperreflectivity in A-mode (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">No relevant data was observed in the analyses carried out, except for a C-reactive protein of 70.7 mg/l (normal values = 5.0–7.0). In addition, a cerebral computed tomography scan was requested, reported as non-pathological. Given the high suspicion of tumor as the condition’s origin due to the patient’s history, the symptoms and the ophthalmological examination, a request for a brain and orbital MRI was decided.</p><p id="par0030" class="elsevierStylePara elsevierViewall">While waiting for the new neuroimaging study, and after ruling out any contraindicating active infection and immunosuppression, a consensus was reached with the Internal Medicine service to initiate empirical treatment with intravenous boluses of methylprednisolone 1 mg iv for 3 days, without significant improvement in the condition.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Magnetic resonance imaging was performed the following days, revealing multiple cortical hyper-uptake foci, compatible with tumor dissemination foci. A bilateral perioptic subarachnoid space ectasia was described, showing a small hyper-uptake imprint of pseudonodular morphology in the right eyeball’s optic disc of approximately 2.5 mm, indicative of metastasis. After a complete patient study, a multidisciplinary team made up of ophthalmologists, clinical oncologists and their corresponding radiotherapists decided to treat with palliative brain stereotaxic radiotherapy (30 Gy). Despite the good tolerance and initial response, the patient passed away from the disease 3 months later.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">Uveal metastases are the most common intraocular tumor in adults, with an estimated incidence of 20,000 cases/year, and more than 80% of cases located in the choroid, probably a consequence of its great vascularization.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, settlement in the optic nerve is infrequent and usually associated to a contiguous choroidal involvement, its isolated presentation being very rare. On the one hand, these can occur directly hematogenously, usually settling in the retrobulbar portion of the nerve. On the other hand, the spread is able to develop through the meninges (meningeal carcinomatosis), entailing an even darker prognosis. Optic nerve metastases pose a great clinical challenge due to their rarity and their similar presentation to other optic neuropathies. For this reason, a good clinical history detailing evolution time and its presentation form enables guidance for the differential diagnosis. Contrary to the development of the present case, optic neuropathies of purely ischemic origin tend to appear abruptly, typically upon waking up and in most cases in absence of vitritis. Characteristically, optic disc metastases are usually unilateral, and a creamy looking infiltrate can be seen along peripapillary hemorrhages (42%) and cotton wool exudates upon fundus inspection.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Alternatively, the fundus may be normal if the involvement is retrobulbar. Based on their origin, the most frequently involved primary tumors are located in breast (47%) and lung (25%),<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> but it is important to note that in up to 15–20% of cases the tumor origin is not identified.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5</span></a> In the present case, the presence of 2 neoplastic processes made diagnosis and systemic treatment difficult, since without a biopsy allowing a correct histopathological analysis it is not possible to properly confirm the origin. However, the lack of response to treatment and the tendency to associated bone and neural metastases can signal a cause of breast carcinoma recurrence.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Ocular presentation form can be very variable, but it tends to clinically manifest with vision loss, as in this case.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Prognosis of patients with optic nerve metastases is poor and in the series by Shields et al., mean survival after diagnosis was 13 months.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Despite the data and lack of consensus in clinical guidelines,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> treatments such as systemic chemotherapy, corticosteroids or radiotherapy have been shown to decrease tumor size in a large group of patients, regardless of survival.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In eyes with low visual potential and significant pain, enucleation may be an option.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0060" class="elsevierStylePara elsevierViewall">In summary, optic nerve metastases are a rare presentation of metastatic carcinoma and can pose a diagnostic challenge. Regardless, every ophthalmologist should suspect it in a patient with a history of cancer and subacute visual impairment with papillary alterations. Due to the increase in recent years of therapeutic possibilities for metastatic carcinomas, an early diagnosis can contribute to diminish vision loss and improve survival.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1541332" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1394320" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1541333" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1394321" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusion" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-08-05" "fechaAceptado" => "2020-11-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1394320" "palabras" => array:3 [ 0 => "Optic nerve metastasis" 1 => "Breast carcinoma" 2 => "Lung carcinoma" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1394321" "palabras" => array:3 [ 0 => "Metástasis del nervio óptico" 1 => "Carcinoma de mama" 2 => "Carcinoma de pulmón" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Metastases are the most common adult intraocular tumors. However, those located in the optic nerve are very uncommon and are usually associated with spread to other locations such as the central nervous system, which darkens the prognosis.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">There is a case of a 67-year-old woman who reports progressive vision loss in the right eye of 15 days of evolution. The ophthalmological examination shows a relative afferent pupil defect in this eye and a pseudoedema of the papilla with retinal hemorrhages in the fundus. Personal history and characteristics of the optic nerve suggest the diagnosis of metastatic infiltration.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las metástasis son los tumores intraoculares más frecuentes del adulto. Sin embargo, aquellas localizadas en el nervio óptico son muy infrecuentes y suelen asociarse a diseminación en otras localizaciones como el sistema nervioso central, lo que ensombrece el pronóstico.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se presenta un caso de una mujer de 67 años que refiere pérdida de visión progresiva en el ojo derecho de 15 días de evolución. En la exploración oftalmológica se observa un defecto pupilar aferente relativo en dicho ojo y un pseudoedema de papila con hemorragias retinianas en el fondo de ojo. Los antecedentes personales y las características del nervio óptico apuntan al diagnóstico de infiltración metastásica.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Valentín-Bravo FJ, García-Álvarez C, Para-Prieto M, Sánchez-Ronco MA, Saornil-Álvarez MA. Afectación metastásica del nervio óptico en paciente con neoplasia de mama y pulmón. Arch Soc Esp Oftalmol. 2021;96:377–379.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1340 "Ancho" => 1340 "Tamanyo" => 194086 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Part A shows optical coherence tomography centered on the optic nerve. There is a diffuse papilla elevation with posterior vitritis. In part B, B-mode ultrasound shows optic nerve elevation without posterior acoustic shadowing, ruling out calcifications.</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" => 1007 "Ancho" => 1007 "Tamanyo" => 80674 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Wide-field retinography with Optomap® shows a global optic nerve edema with a diffuse and irregular yellow mass and peripapillary hemorrhages.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic neoplasms in the optic disc: the Bjerrum Lecture: Part 2" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Shiedls" 1 => "C.L. Shields" 2 => "A.D. Singh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archopht.118.2.217" "Revista" => array:6 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "2000" "volumen" => "118" "paginaInicial" => "217" "paginaFinal" => "224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10676787" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Survey of 1,264 patients with orbital tumors and simulating lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Shields" 1 => "C.L. Shields" 2 => "R. Scartozzi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ophtha.2003.01.002" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "2004" "volumen" => "111" "paginaInicial" => "997" "paginaFinal" => "1008" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15121380" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic tumors of the orbit andocular adnexa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.M. Ahmad" 1 => "B. Esmaeli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICU.0b013e3282c5077c" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Ophthalmol" "fecha" => "2007" "volumen" => "18" "paginaInicial" => "405" "paginaFinal" => "413" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17700235" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optic nerve metastasis caused by lung adenocarcinoma. Metástasis de nervio óptico secundaria a adenocarcinoma de pulmón" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Hernández Pardines" 1 => "J.C. Molina Martín" 2 => "L. Fernández Montalvo" 3 => "A. Juárez Marroquí" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftal.2017.01.007" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2017" "volumen" => "92" "paginaInicial" => "552" "paginaFinal" => "554" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28647309" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carcinoma metastatic to the eye and orbit. A clinicopathologic study of 227 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.P. Ferry" 1 => "R.L. Font" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archopht.1974.01010010286003" "Revista" => array:6 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "1974" "volumen" => "92" "paginaInicial" => "276" "paginaFinal" => "286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4412321" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rectal adenocarcinoma: rare metástasis to the optic nerve" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "O. Jamall" 1 => "K. Theodoraki" 2 => "S. Amin" 3 => "D. Verity" 4 => "A. Bates" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "BMJ Case Rep" "fecha" => "2019" "volumen" => "12" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated metastases to the retina or optic nerve" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.G. Mack" 1 => "F.A. Jakobiec" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00004397-199703740-00020" "Revista" => array:6 [ "tituloSerie" => "Int Ophthalmol Clin" "fecha" => "1997" "volumen" => "37" "paginaInicial" => "251" "paginaFinal" => "260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9429945" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optic disc metástasis as the presenting sign of lung adenocarcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.A. Micieli" 1 => "E.A. Margolin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/WNO.0000000000000428" "Revista" => array:6 [ "tituloSerie" => "J Neuroophthalmol" "fecha" => "2016" "volumen" => "36" "paginaInicial" => "399" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27468119" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumors metastatic to the orbit: a changing picture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.A. Goldberg" 1 => "J. Rootman" 2 => "R.A. Cline" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0039-6257(90)90045-w" "Revista" => array:6 [ "tituloSerie" => "Surv Ophthalmol" "fecha" => "1990" "volumen" => "35" "paginaInicial" => "1" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2204127" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009600000007/v1_202107011321/S2173579421000736/v1_202107011321/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009600000007/v1_202107011321/S2173579421000736/v1_202107011321/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421000736?idApp=UINPBA00004N" ]
