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"apellidos" => "Flores-Suárez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417300671" "doi" => "10.1016/j.oftale.2016.10.006" "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/S2173579417300671?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116302192?idApp=UINPBA00004N" "url" => "/03656691/0000009200000007/v1_201706240027/S0365669116302192/v1_201706240027/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S217357941730066X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.009" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1099" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:338-42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 32 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 28 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Congenital retinal macrovessel associated with retinal peripheral telangiectasia and retinal ischaemia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "338" "paginaFinal" => "342" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Macrovaso retiniano asociado a telangiectasias periféricas retinianas e isquemia retiniana" ] ] "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" => 1575 "Ancho" => 1500 "Tamanyo" => 279544 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">LE angiofluorescence, showing increased telangiectasiae associated to ischaemia areas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Medina-Tapia, F.E. Molina-Sócola, L. Llerena-Manzorro, F. López-Herrero, M. Castilla-Martino, A. Martínez-Borrego, J.L. Sánchez-Vicente" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Medina-Tapia" ] 1 => array:2 [ "nombre" => "F.E." "apellidos" => "Molina-Sócola" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Llerena-Manzorro" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "López-Herrero" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Castilla-Martino" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Martínez-Borrego" ] 6 => array:2 [ "nombre" => "J.L." "apellidos" => "Sánchez-Vicente" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669116302155" "doi" => "10.1016/j.oftal.2016.10.012" "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/S0365669116302155?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941730066X?idApp=UINPBA00004N" "url" => "/21735794/0000009200000007/v1_201706250033/S217357941730066X/v1_201706250033/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417300658" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.008" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1121" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:330-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 20 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 14 "PDF" => 5 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Coats’ disease with macular oedema responsive to aflibercept and argon laser" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "330" "paginaFinal" => "333" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad de Coats con edema macular sensible al aflibercept y láser argón" ] ] "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" => 787 "Ancho" => 960 "Tamanyo" => 93079 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Broad field right eye FAG, showing hyperfluorescence corresponding to posterior pole vascular alterations and temporal periphery, with exudation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.C. Guixeres Esteve, A.O. Pardo Saiz" "autores" => array:2 [ 0 => array:2 [ "nombre" => "M.C." "apellidos" => "Guixeres Esteve" ] 1 => array:2 [ "nombre" => "A.O." "apellidos" => "Pardo Saiz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669116302386" "doi" => "10.1016/j.oftal.2016.11.009" "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/S0365669116302386?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300658?idApp=UINPBA00004N" "url" => "/21735794/0000009200000007/v1_201706250033/S2173579417300658/v1_201706250033/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Sclerodermatomyositis, ocular manifestations" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "334" "paginaFinal" => "337" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Pedroza-Seres, J.C. Serna-Ojeda, L.F. Flores-Suárez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Pedroza-Seres" "email" => array:1 [ 0 => "mpedrozaseres@gmail.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" => "J.C." "apellidos" => "Serna-Ojeda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L.F." "apellidos" => "Flores-Suárez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Instituto de Oftalmología «Conde de Valenciana», Mexico City, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Clínica de Vasculitis Sistémicas Primarias, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico" "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" => "Esclerodermatomiositis con manifestaciones oculares predominantes" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2009 "Ancho" => 2667 "Tamanyo" => 638393 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Clinic images of the right eye, showing scleral thinning.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sclerodermatomyositis is an “overlap” syndrome, defined as having the concurrent presence of diseases that fulfill defined clinical data and diagnostic criteria independently, occasionally accompanied by specific serological tests.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–4</span></a> The etiopathogeny of dermatomyositis has been linked to the deposit of immune complexes in vessels and is regarded as a supplement-regulated vasculopathy.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Clinical expressions include symmetric proximal weakness, myalgia, myositis, Gottron sign (erythematous or purple plates appearing in the dorsal area of the inter-phalanx, metacarpian-phalanx, elbows and knee joints) and calcinosis.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Some ocular expressions have been described including heliotrope erythema (hyperpigmentation, scaling and palpebral edema), avascular areas in the conjunctiva, uveitis, scleritis and glaucoma, as well as retinopathy with cotton-like lesions, retinal hemorrhages, retinal edema and optic nerve paleness.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5–8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Diagnostic is based on clinical findings, data compatible with inflammatory myopathy and antibody pattern. The auto-antibodies reported in this conditions include anti-ribonucleoprotein (anti-RNP) which are associated with this overlap in variable percentages (generally under 30%) whereas nearly 90% of patients with scleroderma are positive to antinuclear antibodies (AAN), and 35% are positive for rheumatoid factor.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,9,10</span></a> Treatment includes systemic glycocorticoids although generally an immunosuppressant agent is also required.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Clinic case report</span><p id="par0025" class="elsevierStylePara elsevierViewall">Female, 57, who consulted due to poor vision and intermittent episodes of throbbing pain in both eyes during 20 years. She was diagnosed in another institution with idiopathic panuveitis and treated with topical steroids and midriatics with apparent clinical improvement. Two years prior to consulting at the authors’ practice, the patient debuted with pain in proximal and distal inter-phalanx, metacarpo-phalanx and shoulder joints without morning stiffness and with proximal myalgia in thoracic limbs. In addition, she exhibited dyspnea with median effort and dysphagia against solids as well as lesions in the forehead which increased with exposure to the sun. Pathological personal history included hypertension with 7 years evolution.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Ophthalmological examination produced visual acuity in the right eye (RE) of 20/200 that improved to 20/80 and 20/100 in the left eye (LE) that improved to 20/80. Biomicroscopy revealed 360° scleral thinning, cornea with discrete peripheral thinning, anterior chamber with cellularity 2+ and clear lens in the RE (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The LE showed sclera without alterations, anterior chamber with cellularity 2+, posterior synechiae and clear lens (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). RE ocular fundus did not show alterations whereas the LE ocular fundus identified 2+ vitreous cellularity (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">General physical examination found Gottron's papules, heliotrope erythema, changes suggesting Raynaud in the distal phalanx of hands, increased skin consistency in those areas, Heberden and Bouchard nodules and abnormal capillaroscopy (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The relevant lab results were: anti-centromere antibodies 1:1.280 (normal: 1:20), AAN positive (59.7<span class="elsevierStyleHsp" style=""></span>U/ml, with normal <10<span class="elsevierStyleHsp" style=""></span>U/ml), PCR 20.7<span class="elsevierStyleHsp" style=""></span>mg/l (normal: <3.8), VSG 38<span class="elsevierStyleHsp" style=""></span>mm/h, CPK 310.7<span class="elsevierStyleHsp" style=""></span>U/l (normal: up to 140), rheumatoid factor, antibodies against Ro and La negative and normal blood biometry.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Considering the clinic and serological findings, the patient was diagnosed with probable sclerodermatomyositis, based on typical dermatological changes, myalgia, high CPK, distal cutaneous induration, abnormal capillaroscopy and esophagic symptoms.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the most recent follow-up, the patient was in treatment with prednisone at a dose of 1<span class="elsevierStyleHsp" style=""></span>mg/kg/day, that was gradually diminished every week, azathioprine 100<span class="elsevierStyleHsp" style=""></span>mg daily, 1% prednisolone drops and reduction dose and midriatics every 12<span class="elsevierStyleHsp" style=""></span>h. The patient remained clinically stable with cellularity diminished to 0+ in anterior chamber and vitreous of authorities, and controls extraocular expressions in one year follow-up.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The importance of the present case is due both to the infrequent appearance of overlap syndromes and to the scarcity of literature about ocular expressions thereof, in contrast with other self immune dermatological diseases. A study by Akikusa et al. reporting the ocular expressions of 108 patients with juvenile dermatomyositis found that 38% had heliotrope erythema, 18.3% had cataracts mainly attributed to the chronic use of glycocorticoids, 7.4% had palpebral atrophic scars and 4.9% had blepharitis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> However, retinopathy associated to dermatomyositis is rare. It was first reported in 1958 by Venkatesh et al., with 2 sclerodermatomyositis cases with proliferative retinopathy. However, to the best of the authors’ knowledge, the case of the present patient is the first to be published with non-necrotizing anterior scleritis and non-granulomatous bilateral anterior uveitis with posterior expressions.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> The long history of ocular symptoms diagnosed 20 years before must be noted.</p><p id="par0060" class="elsevierStylePara elsevierViewall">This paper has described some inflammatory ocular expressions which are not typical in a sclerodermatomyositis case and that have contributed to the differential diagnostic. As said disease is rare, its identification requires significant diagnostic suspicion as well as an extensive clinic and laboratory approach that includes full ophthalmological examinations. The prognostic role of ocular findings is yet to be defined.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflict of interests</span><p id="par0065" 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" => "xres856924" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Clinical case" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec850968" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres856923" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec850969" "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" => "2016-08-25" "fechaAceptado" => "2016-10-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec850968" "palabras" => array:5 [ 0 => "Sclerodermatomyositis" 1 => "Overlap syndrome" 2 => "Antinuclear antibodies" 3 => "Sclera" 4 => "Myositis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec850969" "palabras" => array:5 [ 0 => "Esclerodermatomiositis" 1 => "Síndrome de superposición" 2 => "Anticuerpos antinucleares" 3 => "Esclera" 4 => "Miositis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sclerodermatomyositis is an overlap syndrome of myositis and scleroderma, with dermatological, muscular and joint involvement, but may also present with ocular manifestations.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Clinical case</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A 57 year-old woman presented with ophthalmological manifestations, including scleral thinning 360°, and the presence of cells in the anterior and posterior chamber. Oriented physical examination and laboratory studies led to the diagnosis, with the need for systemic treatment.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sclerodermatomyositis is a rare disease. Its diagnosis needs thorough clinical and laboratory studies, and its management should be multidisciplinary when inflammatory ocular manifestations may be present.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Clinical case" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Antecedentes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La esclerodermatomiositis es un síndrome de superposición que tiene manifestaciones dermatológicas, musculares y articulares, y que puede presentar afección ocular.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Caso clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se presenta el caso de una mujer de 57 años en quien la exploración oftalmológica hizo evidente adelgazamiento escleral 360 grados, celularidad anterior y vítrea. La exploración física orientada y los estudios de laboratorio permitieron sustentar el diagnóstico de esclerodermatomiositis, por lo que se trató de forma sistémica.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusión</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La esclerodermatomiositis es una enfermedad rara, cuyo diagnóstico implica estudio clínico y de laboratorio, y su manejo debe ser multidisciplinario, donde las manifestaciones oculares inflamatorias pueden estar presentes.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pedroza-Seres M, Serna-Ojeda JC, Flores-Suárez LF. Esclerodermatomiositis con manifestaciones oculares predominantes. Arch Soc Esp Oftalmol. 2017;92:334–337.</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" => 2009 "Ancho" => 2667 "Tamanyo" => 638393 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Clinic images of the right eye, showing scleral thinning.</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" => 947 "Ancho" => 1417 "Tamanyo" => 178810 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Clinic image of the left eye, showing posterior synechiae.</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" => 1135 "Ancho" => 1500 "Tamanyo" => 221522 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Clinic images of left eye fundus, showing turbidity due to vitreous cellularity.</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" => 1153 "Ancho" => 1650 "Tamanyo" => 126246 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Gottron's papules.</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" => "Dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.A. 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