--- a
+++ b/data/text/es-S0365-66912010000300005-1.txt
@@ -0,0 +1,17 @@
+An 80-year-old man came to the emergency department with a decrease in visual acuity (VA) in the right eye (OD) of 2 days' evolution.
+His medical history included: hypertension and dyslipidaemia under treatment, chronic bronchitis and a transient ischaemic accident requiring antiplatelet therapy with aspirin.
+The ophthalmological examination in the emergency department was as follows. VA by OD: light perception (LP); by left eye (LO): 1; afferent pupillary defect of the LO 3+/4+; intraocular pressure of the LO: 16; LO: 17; biomicroscopy was normal and funduscopy showed a subretinal haemorrhage of 6 × 10 papillary diameters at the level of the posterior pole, including the macular area.
+
+An angiofluoresceingraphy (AFG) was performed, confirming the subretinal location of this haemorrhage, together with an inferior juxtafoveolar hyperfluorescent area at late times, indicating the presence of a neovascular membrane (NVM) at that level.
+
+Two days later, 25 μg of r-TPA in a volume of 0.1 ml was injected intravitreally, followed by a 0.3 ml injection of pure sulphur hexafluoride (SF6) and a 0.2 ml anterior chamber evacuation paracentesis.
+After 3 days, he came for a check-up and it was observed that the blood had partially shifted from the posterior pole, together with areas of fibrin.
+
+One month after this procedure, the patient was seen again with a VA of 0.05 and the funduscopy showed a decrease in the haemorrhage, although the blood persisted in the macular area and fibrin in the lower area.
+
+One month later, the patient came for a check-up and funduscopy revealed a subretinal haemorrhage of similar extent to that seen at diagnosis, so he was diagnosed with haemorrhagic AMD and a course of 3 doses of intravitreal ranibizumab was prescribed.
+
+After the ranibizumab cycle, he came to the hospital for a check-up and showed a VA of PL in the OD and 1 in the OI. Funduscopy revealed the presence of haemolithiasis that prevented adequate visualisation of the posterior pole structures.
+At the present time, the patient is still under study to assess the next therapeutic step.
+
+