Documento descargado de http://www.elsevier.es el 19/11/2016. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. 450 a r c h s o c e s p o f t a l m o l . 2 0 1 5;9 0(9):448–454 We report the case of a 23-year-old male patient who was diagnosed with severe anterior uveitis and mild vitritis at an emergency department. He did not have synechia, iris atrophy or corneal sensitivity alterations. The fundoscopic eye examination was normal. Ocular pressure was normal. An anamnesis of organs and devices only reported lumbago, for which he was referred to the rheumatology unit. Clinical symptoms corresponding to sarcoidosis, tuberculosis, Behçet’s disease or other autoimmune systemic disease were dismissed. His chronic lumbago had an inflammatory rhythm. He denied having had arthritis, dactylitis or episodes of enthesitis. He had no personal or family history of psoriasis, uveitis or inflammatory bowel disease. Routine blood tests were required, with HLA B27 and LUES serology, and chest and sacroiliac X-rays. Since he did not show any symptoms of alarm he was called for a check-up and an assessment of the complementary tests the following month. During his check-up, he reported having being diagnosed with an acute cytomegalovirus (CMV) infection in a study performed by his primary care physician (PCP) with profound asthenia, coupled with an increase of transaminase levels that were triple the normal levels, which had started 15 days prior to the onset of the uveitis. The rest of the tests that were required had normal results, HLA B27 (−), LUES (−) and chest and sacroiliac X-rays were normal. The CMV serology conducted by the PCP evidenced positive IgM and IgG, and negative HIV serology. A new ophthalmological check-up was performed to verify if there had been a complete healing of the uveitis, which did not occur. This was, then, an immunocompetent patient who 15 days after developing a bilateral anterior uveitis, developed a condition compatible with an acute CMV infection, due to the existence of anti-CMV IgM and IgG in the initial analysis. Given the predominance of the CMV infection, we contemplated if the presence of both diseases was a temporary coincidence or if there was a causal association. No molecular biology techniques were performed due to the benign evolution of the case. Among the several series of anterior uveitis in immunocompetent individuals, the cases involved unilateral uveitis with ocular hypertension and sometimes with other symptoms, such as iris atrophia or keratic precipitates. It is true that in all these cases, research into the CMV caused by a PCR in the aqueous humor was performed where there was ocular inflammation with ocular hypertension in those cases of uveitis that were usually recurring or chronic.2,3 Just as prior to the use of this technique, a lot of cases were diagnosed as PS syndrome and considered idiopathic; immunocompetent individuals could be suffering from a mild self-limiting anterior uveitis due to the CMV infection, which given its favorable evolution, was not researched in more depth. We propose that in cases of acute uveitis with symptoms that point to a systemic viral infection, even where these do not exhibit the usual clinical features of a viral uveitis, the CMV serological blood count should be examined, in order to diagnose the viral infection at an early stage, since its evolution can be torpid with a risk of developing ocular hypertension and glaucoma.1 references 1. Jap A, Chee SP. Viral anterior uveitis. Curr Opin Ophthalmol. 2011;22:483–8. 2. Chee SP, Bacsal K, Jap A, Se-Thoe SY, Cheng CL, Tan BH. Clinical features of cytomegalovirus anterior uveitis inimmunocompetent patients. Am J Ophthalmol. 2008;145:834–40. 3. van Boxtel LA, van der Lelij A, van der Meer J, Los LI. Cytomegalovirus as a cause of anterior uveitis inimmunocompetent patients. Ophtalmology. 2007;114:1358–62. R. Sánchez Parera a,∗ , F.J. Auriguiberry González b , L. Muñoz Medina c , E. Raya Alvarez a a Unidad de Gestión Clínica Reumatología, Hospital Universitario San Cecilio, Granada, Spain b Unidad de Gestión Clínica Oftalmología, Hospital Universitario San Cecilio, Granada, Spain c Unidad de Gestión Clínica Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain ∗ Corresponding author. E-mail address: ribesm@ono.com (R. Sánchez Parera). 2173-5794/© 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved. What color do we see when get angry?夽 ¿De qué color vemos cuando nos enfadamos? Dear Editor: Humans enjoy trichromatic vision allowing us to differentiate about 3,000,000 colors, which we use very much like what we observe in animals, i.e., to communicate with each other. The ability of the eye to perceive colors is because the retina comprises 3 types of cones: one type perceives red, another type green and the third type perceives blue.1 Depending 夽 Please cite this article as: Asensio-Sánchez VM, Ramoa-Osorio R. ¿De qué color vemos cuando nos enfadamos? Arch Soc Esp Oftalmol. 2015;90:450–451. Documento descargado de http://www.elsevier.es el 19/11/2016. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. a r c h s o c e s p o f t a l m o l . 2 0 1 5;9 0(9):448–454 on the type of cones being excited, we perceive the corresponding color. Different cone types can become excited at the same time and in varying degrees, thus producing the perception of color and its shades. The retina ganglion cells encode information about the relative amount of light in the center and periphery of their receptive fields and in many cases on its wavelength. Sequentially, the striated cortex and the visual association cortex additionally process this information. The energy of each color stimulates the pineal and pituitary glands, influencing the production of hormones that have effects on a range of physiological processes. This explains why color has a direct influence on thoughts, moods and behavior patterns. Red light stimulates the sympathetic nervous system whereas white and blue light stimulates the parasympathetic nervous system. When our mood is of anger, we tend to change the perception of the color in our environment. Accordingly, when people become irritated of furious they tend to see everything red. This is due to the amount of testosterone in circulation which enhances red tones. Testosterone is a hormone related to superiority and category. In a recent study, Fetterman et al.2 asked several subjects to view mostly reddish or bluish images. The subjects who were angry tended to choose the images with reddish hues and discarded the blue ones. In nature, poisonous plants and some insects have reddish tones because red is associated to supremacy and mating selection in multiple species. Red is deeply rooted in the human mind and it brings up contradictory emotions such as danger, alarm, passion, heat, violence, intensity. It is the color we associate with feelings of energy, anger and upset. 451 In addition, red has other associations related to hostility: when we are angry, our cheeks get red. When something turns red, our senses become alert, like a red traffic light. The conclusions of this study2,3 have demonstrated that our brain is programmed for alerting the body the instant it becomes convenient to flee from danger. The association of red with anger matches the association of our ancestors with danger. references 1. Hofer H, Carroll J, Neitz J, Neitz M, Williams DR. Organization of the human trichromatic cone mosaic. J Neurosci. 2005;25:9669–79. 2. Fetterman AK, Robinson MD, Gordon RD, Elliot AJ. Anger as seeing red: perceptual sources of evidence. Soc Psychol Personal Sci. 2011;2:311–6. 3. Fetterman AK, Robinson MD, Meier BP. Anger as seeing red: evidence for a perceptual association. Cogn Emot. 2012;26:1445–58. V.M. Asensio-Sánchez ∗ , R. Ramoa-Osorio Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, Spain ∗ Corresponding author. E-mail address: victor asensio@orangemail.es (V.M. Asensio-Sánchez). 2173-5794/© 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved. Retinal folds as a non-reported secondary effect of darunavir in a 20 year-old HIV patient夽 Pliegues retinianos como efecto adverso no descrito del darunavir en paciente con VIH de 20 años de edad Dear Editor: The rapid appearance of new medications and their generalised use on the population fosters the appearance of a low incidence of adverse effects that have not been described in the drug data sheet but which the ophthalmologist should be aware of. Darunavir (Prezista, Janssen-Cilag SpA, Italy) is a relatively recent introduced antiretroviral, as it was approved in Europe in February 2007. It is used for the treatment of the human immunodeficiency virus infection (HIV-1), in combination with other antiretroviral drugs, and co-administered with 100 mg of Ritonavir as a pharmacokinetic enhancer. It is a non-peptidic HIV-1 protease inhibitor of the sulphonamide type, developed to overcome the commonest resistances to the protease inhibitors.1 In the Ophthalmology Department her at the General Valencia Hospital, we saw a 20-year-old HIV+ patient infected by vertical transmission, who was admitted into pneumology due to pneumococcal pneumonia. The patient was under highly active anti-retroviral therapy (HAART) with therapeutic non-compliance; therefore, on her admission, treatment was re-established with tenofovir + emtricitabine, etravirine, 夽 Please cite this article as: Hernández Bel L, Cabrera A, Domenech N, Moratal B, Cervera E. Pliegues retinianos como efecto adverso no descrito del darunavir en paciente con VIH de 20 años de edad. Arch Soc Esp Oftalmol. 2015;90:451–453.