GLAUCOMA TENSION NORMAL Y SINDROME …...GLAUCOMA TENSION NORMAL Y SINDROME ANTIFOSFOLIPIDO Author:...
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GLAUCOMA TENSION NORMAL Y SINDROME
ANTIFOSFOLIPIDO
SANTIAGO ARANGO, MD
Hospital Universitario
San Vicente de Paúl
Medellín
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Sindrome Antifosfolípido
Anticuerpos: Anticardiolipina
Anticoagulante Lúpico
VDRL Falso +
B2 Glicoproteina
Fosfolípidos: Plaquetas
Endotelio
Eritrocito
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CLINICA
Sindrome Antifosfolípido Primario
Sindrome Antifosfolípido Secundario
Oclusiones vasculares
Pérdida fetal repetida
Trombocitopenia
Anemia Hemolítica
Trastornos Neurológicos
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Manifestaciones Oculares
Oclusiones Retinales
GNV
Neuritis Optica - NAION
Escleritis -Epiescleritis
Queratitis
Iritis
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CASO CLINICO
Mujer 44 años 1/00
MC y EA: Glaucoma?
AP: neg
AF: neg
EF: AV 20/25 cc AO TA: 12/13
Bio: Normal Gonio: Abierto
Fde Ojo: c/d .8 AO
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Estudios
LAB:
Anti Anticardiolipina IgG 28 vn:0-15
Anti Anticardiolipina IgM 9.8 vn:0-5
VDRL 1 dil FTA Neg
ANA: Neg
Glicemia, Perfil Lipídico, F Renal
Hemograma y Sed, Plaquetas: Normal
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Doppler: OD: Ciliar Temporal
OS: Arteria Central
IDx: GTN -SAF
TTO: Betaxolol
ASA 100mg dia
PIO 15/13 7/00
c/d: .9 AO
Agrego Dorzolamida
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Trabeculectomía con MMC AO 8/00
1/02: AV 20/25 cc AO
PIO 6 AO sin droga
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DISCUSION
SAP:Frecuente Asociación Enf. Ocular
GTN Y SAP: 3 reportes
23% GTN, 22% GPAA, 12% Control 1
Aumento Anticuerpos GTN>GPAA>Control 2
Vasoespasmo Secundario 3
1 Tsakiris et al “ Blood Coagulation Fibrinolysis” 10/92
2 Kremmer et al “ Clinical Exp Inmunnology” 8/01
3 Flammer”Prog Retinal Eye Research” 5/01
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CONCLUSIONES
Insuficiencia Vascular
Enfermedad Microvascular Oclusiva
Vasoespasmo
Estudiar GTN jovenes
Anticuerpos Antifosfolípido:Riesgo