Interior 1_2006.qxd - Oftalmologia.ro
Interior 1_2006.qxd - Oftalmologia.ro
Interior 1_2006.qxd - Oftalmologia.ro
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OFTALMOLOGIA 1 - 2006<br />
MODIFIC|RI<br />
OCULO-ORBITARE<br />
ÎN OSTEOPETROZ|<br />
A. CSISZÁR*, M.D. BAGHIU**, A. HORVÁTH**, A. NEGHIRLA***, M. RUSU*, C. MAKI*,<br />
E. ELEKES****<br />
* UNIVERSITATEA DE MEDICIN~ }I FARMACIE TG. MURE}, CLINICA DE OFTALMOLOGIE<br />
** UNIVERSITATEA DE MEDICIN~ }I FARMACIE TG. MURE}, CLINICA DE PEDIATRIE I<br />
*** SPITALUL CLINIC JUDE|EAN DE URGEN|~ TG.MURE}, DISPENSAR }COLAR<br />
**** OPTICA OPTOFARM<br />
REZUMAT<br />
Osteopet<strong>ro</strong>za, forma precoce, este o afec\iune ereditar`, autozomal recesiv`, cu<br />
evolu\ie sever` (osteopet<strong>ro</strong>za infantil` malign` - MIOP). Prezent`m cazul unei feti\e cu<br />
MIOP în vârst` de 5 ani ]i 6 luni, cunoscut` de la vârsta de 3 luni, când s-a pus diagnosticul<br />
de DSA-ostium secundum ]i anemie hipoplastic` cu erit<strong>ro</strong>poiez` extramedular`, pentru<br />
care s-a instituit corticoterapie de lung` durat`. La vârsta de 18 luni, se precizeaz`<br />
diagnosticul de osteopet<strong>ro</strong>z` form` precoce. Prezen\a tarelor neu<strong>ro</strong>logice ]i neu<strong>ro</strong>senzoriale<br />
contraindic` transplantul medular. Evolu\ia este nefavorabil` ]i din punct de vedere<br />
oftalmologic prin instalarea at<strong>ro</strong>fiei optice bilaterale resp. a cecit`\ii, a exoftalmiei extreme<br />
cu glaucom secundar ]i keratite prin expunere. În prezent se administreaz` tratament<br />
paliativ (corticoterapie, anticonvulsivante, morfin`, <strong>ro</strong>borante resp. tratament local oftalmologic).<br />
P<strong>ro</strong>gnosticul este nefavorabil, speran\a de via\` fiind de 6 ani în 70% din cazuri<br />
]i 10 ani pentru 30% din cazuri.<br />
CUVINTE CHEIE:<br />
• osteopet<strong>ro</strong>za,<br />
• craniostenoze,<br />
• hipoplazie medular`.<br />
ABSTRACT<br />
Osteopet<strong>ro</strong>sis means a low fuction of osteoclasts, that induce a bone resorbtion<br />
p<strong>ro</strong>cess with a bone density g<strong>ro</strong>wth. He has two genetical forms: a benign form with autosomal<br />
dominant inheritance (AD) and a malign form with autosomal recessive inheritance<br />
(AR). The most succesfull therapy is bone mar<strong>ro</strong>w transplantation (rate of succes 80%).<br />
We will present a case of malign osteopet<strong>ro</strong>sis of a five years old child. The tardiv diagnosis<br />
(at 18 month) and the malign evolution has made possible only the palleative<br />
treatment, without surgical or ophthalmo-neu<strong>ro</strong>surgical implication. The p<strong>ro</strong>gnosis is unfavorable<br />
with 70% survival to six years and 30% to ten years.<br />
KEY WORDS:<br />
• osteopet<strong>ro</strong>sis,<br />
• craniostenosis,<br />
• medular hypoplesia.<br />
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