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array:24 [ "pii" => "S2173579417301500" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.07.004" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1150" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:447-50" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669117300254" "issn" => "03656691" "doi" => "10.1016/j.oftal.2016.12.014" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1150" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:447-50" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 18 "formatos" => array:2 [ "HTML" => 14 "PDF" => 4 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Queratopatía neurotrófica corneal bilateral en paciente con amiloidosis familiar bilateral" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "447" "paginaFinal" => "450" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neurotrophic keratopathy in a patient with familial amyloidosis" ] ] "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" => 418 "Ancho" => 1350 "Tamanyo" => 136506 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Úlceras corneales neurotróficas antes del tratamiento. A) En el ojo derecho. B) En el ojo izquierdo. Se puede observar la mayor profundidad de la lesión en el ojo izquierdo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.M. de Carvalho Mendes Castenheira, P. Pujol Vives, M. Asaad Ammaar" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A.M." "apellidos" => "de Carvalho Mendes Castenheira" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Pujol Vives" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Asaad Ammaar" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417301500" "doi" => "10.1016/j.oftale.2017.07.004" "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/S2173579417301500?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300254?idApp=UINPBA00004N" "url" => "/03656691/0000009200000009/v1_201708280004/S0365669117300254/v1_201708280004/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579417301299" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.06.002" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1155" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:451-4" "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" => "Sterile infiltrates after cross-linking" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "451" "paginaFinal" => "454" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infiltrados estériles tras <span class="elsevierStyleItalic">cross-linking</span>" ] ] "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" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 676 "Ancho" => 1575 "Tamanyo" => 139556 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Result 3 days after the cross-linking, showing whitish infiltrates occupying superficial layers as well as the absence of conjunctival hyperemia: (A) anterior pole photograph and (B) Cleft photograph.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. García de Oteyza, J. Álvarez de Toledo" "autores" => array:2 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "García de Oteyza" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Álvarez de Toledo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300308" "doi" => "10.1016/j.oftal.2017.01.006" "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/S0365669117300308?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301299?idApp=UINPBA00004N" "url" => "/21735794/0000009200000009/v2_201708291316/S2173579417301299/v2_201708291316/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417300798" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.019" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1164" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:442-6" "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" => "Topical interferon alpha-2B topic as the first therapeutic option in a clinical case of conjunctival intraepithelial neoplasia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "442" "paginaFinal" => "446" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Interferón alfa-2B tópico como primera opción terapéutica en un caso clínico de neoplasia intraepitelial córneo-conjuntival" ] ] "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. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 742 "Ancho" => 990 "Tamanyo" => 82350 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Biomicroscopy one-week after treatment, showing discrete corneal opacification reduction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Pagán Carrasco, D. Arranz Maestro" "autores" => array:2 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Pagán Carrasco" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Arranz Maestro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300588" "doi" => "10.1016/j.oftal.2017.01.013" "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/S0365669117300588?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300798?idApp=UINPBA00004N" "url" => "/21735794/0000009200000009/v2_201708291316/S2173579417300798/v2_201708291316/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Neurotrophic keratopathy in a patient with familial amyloidosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "447" "paginaFinal" => "450" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.M. de Carvalho Mendes Castenheira, P. Pujol Vives, M. Asaad Ammaar" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A.M." "apellidos" => "de Carvalho Mendes Castenheira" "email" => array:1 [ 0 => "amelia_cast@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Pujol Vives" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Asaad Ammaar" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Consorci Sanitari de Terrassa, Tarrasa (Barcelona), 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" => "Queratopatía neurotrófica corneal bilateral en paciente con amiloidosis familiar bilateral" ] ] "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" => 489 "Ancho" => 1350 "Tamanyo" => 149156 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Post-treatment corneal neurotrophic ulcers. (A) Right eye. (B) Left eye. The right eye ulcer healed adequately with topical treatment, whereas the LE ulcer required tarsorrhaphy, similarly with good clinic evolution.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Amyloidosis is a disease of unknown etiology,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> characterized by the extracellular sedimentation of a fibrillary substance of proteic origin in various tissues and organs, giving rise to functional and structural alterations therein.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Familial amyloidotic polyneuropathy is related to deposits of the protein that fixes retinol, transthyretin, produced in the liver. This accumulates mainly in the peripheral nerves, producing polyneuropathies or myocardiopathies. It is a dominant autosomal disease, the most common mutation of which is the substitution of valine by methionine in position 30.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> At present, the treatment yielding the best results is liver transplant<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>; however, severe ocular compromise is a long-term risk, with frequent vitreous opacities and glaucoma.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> The literature contains few reports on neurotrophic keratopathy secondary to amyloidosis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Clinic case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">Male, 33, who visited the Emergency Dept. with conjunctival hyperemia and itching in both eyes (BE) with one month evolution, without associating ocular pain. The patient had been treated with tobramycin cream during 15 days without clinic improvement. Pathological antecedents included celiac disease, psoriasis and familial amyloidosis requiring liver transplant and pacemaker implantation. Ophthalmological examination revealed visual acuity (VA) of 20/100 in the right eye (RE) and 20/50 in the left eye (LE). Biomicroscopy produced in both eyes marked ciliary hyperemia, with 1<span class="elsevierStyleHsp" style=""></span>mm diameter inferior paracentral corneal ulcer, with corneal thinning up to the deep stroma, predominantly in LE. Ulcer edges were well defined, without signs of acute infection (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No cells were evidenced in the anterior chamber, or hypopyon. Intraocular pressure was 14<span class="elsevierStyleHsp" style=""></span>mmHg in BE. Corneal sensitivity was assessed with a cotton swab, observing total anesthesia in BE. Optical coherence tomography (Cirrus HD-OCT 4.0, Carl Zeiss Meditec, Dublin, CA) demonstrated significant thinning in the ulcerated area, with a residual thickness of 360<span class="elsevierStyleHsp" style=""></span>μm in RE and 290<span class="elsevierStyleHsp" style=""></span>μm in LE. Treatment was initiated with cycloplegic eyedrops every 8<span class="elsevierStyleHsp" style=""></span>h, ofloxacin eyedrops every 2<span class="elsevierStyleHsp" style=""></span>h, erythromycin cream during the night and artificial tears every hour in BE. Due to the significant corneal thinning, 4 days later a lateral tarsoconjunctival bridge was made in the LE. At day 15, the patient exhibited partial cicatrization of the neurotrophic ulcers with diminished corneal thinning. VA was 20/160 in BE. During the follow-up, OCT images were taken. At month 3, corneal thickness was 400<span class="elsevierStyleHsp" style=""></span>μm in LE (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). At month 9, the tarsoconjunctival bridge was submitted to excision, when the ulcer was in the residual corneal leukoma phase (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Anatomopathological analysis of the bridge conjunctiva evidenced the presence of amyloid substance, both in hematoxylin eosin (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>) as well as apple green bi-refringence, characteristic of the substance after Congo red staining (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>), which confirmed the diagnostic.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">The present case is an infrequent occurrence of neurotrophic keratopathy due to corneal innervation compromise caused by familial amyloidotic polyneuropathy in which conjunctival compromise was additionally confirmed through anatomopathological study. Corneal-conjunctival amyloid deposits constitute an infrequent finding in the literature.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7–9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Neurotrophic keratopathy is the result of trigeminal nerve compromise, which accounts for corneal innervation. The dysfunction of said nerve could produce corneal hypoesthesia or total anesthesia. This involves diminished corneal protection that could evolve to neurotrophic ulcers and consequently to corneal perforation. Accordingly, early diagnostic is crucial, including complete anamnesis of patient antecedents.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In addition, ophthalmological exploration and exhaustive follow-up with slit lamp is essential. Supplementary tests such as anterior pole OCT are useful for following up corneal thickness during the healing process of the ulcer. Corneal sensitivity evaluation is crucial, as this enables the identification of complete bilateral corneal anesthesia that explains the discrepancy between in the absence of pain and the depth of the corneal ulcers exhibited by the patient. Finally, it is important to take into account that the treatment must be based on hourly topical lubrication with artificial tears or concentrated autogenic serum, application of therapeutic contact lenses with antibiotic covering or amniotic membrane, or even tarsorrhaphy in more evolved cases with worse prognosis. At present, new extracellular matrix regenerators are being researched (RGTA<span class="elsevierStyleSup">®</span>: Cacicol<span class="elsevierStyleSup">®</span>, Thea, France), neuropeptides and nerve growth factors such as P substance and insulin growth factor type 1 with promising results.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflict of interests</span><p id="par0035" 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" => "xres888084" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec874029" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres888085" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec874028" "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" => "2016-05-25" "fechaAceptado" => "2016-12-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec874029" "palabras" => array:3 [ 0 => "Familial amyloidosis" 1 => "Polyneuropathy" 2 => "Neurotrophic keratopathy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec874028" "palabras" => array:3 [ 0 => "Amiloidosis familiar" 1 => "Polineuropatía" 2 => "Queratopatía neurotrófica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Familial amyloidotic polyneuropathy is a disease related to amyloid material deposits in the extracellular matrix that can affect many tissues, including the eye.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This case includes clinical data, a full corneal study report, and histopathological findings, as well as the treatment and follow up of bilateral neurotrophic keratopathy in a 33 year-old patient with familial amyloidotic polyneuropathy.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Discussion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Although amyloidotic deposits were also found in the conjunctival tissue, this is not a typical form of ophthalmic amyloidosis. The corneal wound in this case is a result of a corneal anesthesia due to the systemic polyneuropathy.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introducción</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La amiloidosis familiar es una enfermedad caracterizada por el depósito extracelular de un material denominado amiloide que puede afectar a gran variedad de órganos, incluyendo el ojo.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Caso clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se presentan datos clínicos, pruebas complementarias e histológicas, así como el tratamiento y seguimiento de un paciente de 33 años con úlcera neurotrófica corneal bilateral, debida a una polineuropatía amiloidótica familiar.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discusión</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este caso no es la forma típica de presentación de la amiloidosis oftálmica, ya que la úlcera corneal es el resultado de la anestesia causada por la polineuropatía sistémica, aunque se encontraron depósitos de amiloide en el tejido conjuntival.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de Carvalho Mendes Castenheira AM, Pujol Vives P, Asaad Ammaar M. Queratopatía neurotrófica corneal bilateral en paciente con amiloidosis familiar bilateral. Arch Soc Esp Oftalmol. 2017;92:447–450.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 418 "Ancho" => 1350 "Tamanyo" => 136506 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Pre-treatment neurotrophic corneal ulcers. (A) Right eye. (B) Left eye, showing greater depth of lesion.</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" => 999 "Ancho" => 995 "Tamanyo" => 331061 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">(A) Left eye neurotrophic ulcer OCT, 2 months post-diagnostic. (B) Left eye neurotrophic ulcer OCT 3 months post-diagnostic.</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" => 489 "Ancho" => 1350 "Tamanyo" => 149156 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Post-treatment corneal neurotrophic ulcers. (A) Right eye. (B) Left eye. The right eye ulcer healed adequately with topical treatment, whereas the LE ulcer required tarsorrhaphy, similarly with good clinic evolution.</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" => 930 "Ancho" => 975 "Tamanyo" => 130366 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Tarsal conjunctiva sample stained with hematoxylin–eosin, showing amyloidosis deposits surrounding the neurovascular bundle (20×).</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 774 "Ancho" => 975 "Tamanyo" => 108768 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Tarsal conjunctiva sample evidencing apple green birefringence characteristic of amyloid after Congo red staining (20×).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features of patients with the pathological diagnosis of amyloidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. 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