0000000000129425
AUTHOR
Roberto Gallego-pinazo
Tratamiento Focal Macular guiado por el mapa de grosor retiniano del HD-OCT Cirrus® versus Angiografía Fluoresceínica en las Oclusiones Venosas de la Retina
Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema.
Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Rosa Dolz-Marco1, J Fernando Arevalo3, Salvador García-Delpech1, J Luis Mullor4, Manuel Díaz-Llopis1,2,51Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Retina and Vitreous Service, Clinical Ophthalmology Center, Caracas, Venezuela; 4Unit of Experimental Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 5University of Valencia, Faculty of Medicine, Valencia, SpainBackground: The aim of this study was to compare the efficacy of spectral-domain optical coherence tomography…
Crystallization After Intravitreous Foscarnet Injections
Need to consensus for novel findings by optical coherence tomography in patients with age-related macular degeneration
Oral propranolol and intravitreal ranibizumab for refractory serous macular detachment secondary to retinal capillary hemangioblastoma
Rituximab in refractory Vogt-Koyanagi-Harada disease.
Introduction Vogt–Koyanagi–Harada (VKH) prognosis depends on early recognition and treatment; chronic disease may be developed when either delayed or inadequate treatment is performed, whereas other cases despite correct treatment are refractory to different drugs and also become chronic. We report a case of refractory VKH controlled with rituximab treatment. Case report A 41-year-old female with painful visual loss and headache was examined. (VA 0.4 in RE and hand movements (HM) in LE). Retinal examination demonstrated multiple serous retinal detachments in both eyes. High-dose oral steroids were started, followed by progressive tapering of prednisone. New acute anterior and posterior rela…
Local safety of repeated intravitreal Ozurdex
Sir, The article entitled ‘Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion'1 highlights the significant cataract progression in eyes receiving more than one Ozurdex implant. We retrospectively reviewed the charts of all patients with macular edema secondary to retinal vein occlusion (RVO) refractory to current therapies and treated with Ozurdex from April 2010 until March 2012. The mean age of patients with branch RVO (n=33) was 72.4. In eyes receiving a second Ozurdex implant, four out of the five phakic eyes showed progression of cataract requiring surgery. We registered one case of anterior chamber migration resulting in a bu…
Beals–Hecht syndrome and choroidal neovascularization
PURPOSE To describe a case of choroidal neovascularization (CNV) in a female diagnosed with Beals-Hecht syndrome. METHODS A retrospective, interventional case is described in a 26-year-old female complaining of metamorphopsia and visual loss in her left eye (counting fingers). The fluorescein angiogram and the optical coherence tomography supported the diagnosis of CNV. Intravitreal ranibizumab was administered. RESULTS After the third intravitreal ranibizumab, her visual acuity improved to 0.8 and the morphology of the macular area was restored. CONCLUSIONS To our knowledge this is the first report of CNV in Beals-Hecht syndrome treated with ranibizumab. Self-monitoring by periodically per…
Kyrieleis´ vasculitis in acute retinal necrosis
Ester Francés-Muñoz1, Roberto Gallego-Pinazo1, Ruth López-Lizcano1, Salvador García-Delpech1, J Luis Mullor3, Manuel Díaz-Llopis1,21Department of Ophthalmology, Hospital La Fe, Valencia, Spain; 2University of Valencia, Valencia, Spain; 3Unit of Experimental Ophthalmology. Fundación para la Investigación del Hospital Universitario La Fe. Valencia, Valencia, SpainAbstract: We report the first case in the literature of Kyrieleis´ vasculitis related to acute retinal necrosis by Varicella zoster virus in a 76-year-old woman with bilateral involvement. In our patient the arterial lesions appeared 15 days after …
Oxidative stress and mitochondrial failure in the pathogenesis of glaucoma neurodegeneration
This review focuses on oxidative stress and mitochondrial failure for understanding mechanisms of optic nerve damage in primary open-angle glaucoma. The chapter shows scientific evidence for the role of mitochondrial disbalance and reactive oxygen species in glaucoma neurodegeneration. Mitochondria regulate important cellular functions including reactive oxygen species generation and apoptosis. Mitochondrial alterations result from a wide variety of damaging sources. Reactive oxygen species formed by the mitochondria can act as signaling molecules, inducing lipid peroxidation and/or excitotoxicity with the result of cell lesion and death. Antioxidants may help to counteract oxidative stress…
Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration
Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Ester Francés-Muñoz1, J María Millán2,3, J Fernando Arevalo4, J Luis Mullor5, Manuel Díaz-Llopis1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 5Unit of Experimental Ophthalmology, Fundación para la Investigación del Hospital Universitario La Fe…
Serous Macular Detachment Associated with Dome-Shaped Macula and Tilted Disc
Introduction: An entirely new type of staphyloma has been recently described as dome-shaped macula (DSM). It is characterized by an abnormal convex macular contour within the concavity of a posterior staphyloma. We found DSM associated with serous macular detachment (SMD) and tilted disc in two consecutive cases. Case Reports: Case 1: A 37-year-old female presented to our department because of sudden onset blurred vision in her right eye (OD). The best-corrected visual acuity (BCVA) was 0.5 in both eyes. Funduscopy evidenced bilateral tilted disc associated with posterior staphyloma. Optical coherence tomography (OCT) demonstrated a DSM with SMD in her OD. After 15 months of follow-up, BCVA…
Prophylaxis of Pseudophakic Cystoid Macular Edema with Intraoperative Pegaptanib
The purpose of this study was to determine the efficacy of an intraoperative intravitreal pegaptanib injection during phacoemulsification in preventing the development of pseudophakic cystoid macular edema (CME) following cataract surgery.This prospective, controlled pilot study was carried out at the Department of Ophthalmology, Nuevo Hospital Universitario y Politécnico La Fe, Valencia (Spain). Five hundred patients with cataract and healthy retina were included in the study. Patients were assigned in a 1:1 ratio to receive an intraoperative intravitreal pegaptanib injection (n=250) or not (control group, n=250) associated with standardized phacoemulsification surgery and postoperative tr…
Oxidative stress and its downstream signaling in aging eyes
María Dolores Pinazo-Durán,1,* Roberto Gallego-Pinazo,2,* Jose Javier García-Medina,1,3,* Vicente Zanón-Moreno,1,4 Carlo Nucci,5 Rosa Dolz-Marco,2 Sebastián Martínez-Castillo,2 Carmen Galbis-Estrada,1 Carla Marco-Ramírez,1 Maria Isabel López-Gálvez,6,* David J Galarreta,6,* Manuel Díaz-Llópis4,*1Ophthalmic Research Unit "Santiago Grisolía", Valencia, Spain; 2Department of Ophthalmology, Macula Section, The University and Polytechnic Hospital La Fe, Valencia, Spain; 3Department of Ophthalmology, University Hospital Reina Sofia, Murcia, Spain; 4Faculty of Medicine, University of Valencia, Spain; 5Uni…
Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?
The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality a…
Evaluation of the improvement of sensibility with the new IOL Master software version 5.4.3
Purpose To evaluate the improvement of sensibility of the new IOL-Master version 5.4.3 compared with the version 4.08. Methods 214 eyes of 115 patients were examined in a cataract preoperative evaluation making use of both IOL-Master software versions 5.4.3 and 4.08. The type and severity of the lens opacification was assessed by slitlamp biomicroscopy. Results In 182 of the eyes examined both versions were capable to determine the AL; in 29 the version 4.01 could not determine AL whereas the version 5.4.3 was able to measure it; these cases showed posterior capsular cataract (16), dense nuclear cataract (11), posterior synechiae (1) and asteroid hyalosis (1). Finally, the AL of 3 eyes coul…
Enhanced Oxidative Stress and Other Potential Biomarkers for Retinopathy in Type 2 Diabetics: Beneficial Effects of the Nutraceutic Supplements
We have studied the global risk of retinopathy in a Mediterranean population of type 2 diabetes mellitus (T2DM) patients, according to clinical, biochemical, and lifestyle biomarkers. The effects of the oral supplementation containing antioxidants/omega 3 fatty acids (A/ω3) were also evaluated. Suitable participants were distributed into two main groups: (1) T2DMG (with retinopathy (+DR) or without retinopathy (−DR)) and (2) controls (CG). Participants were randomly assigned (+A/ω3) or not (−A/ω3) to the oral supplementation with a daily pill of Nutrof Omega (R) for 18 months. Data collected including demographics, anthropometrics, characteristics/lifestyle, ophthalmic examination (best cor…
Beals–Hecht syndrome and choroidal neovascularization
Roberto Gallego-Pinazo1, Ruth López-Lizcano1, José María Millán2,3, J Fernando Arevalo5, J Luis Mullor6, Manuel Díaz-Llopis1,3,41Department of Ophthalmology, 2Department of Genetics, Unit of Experimental Opthalmology, Hospital Universitario La Fe, Valencia, Spain; 3Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain; 4Faculty of Medicine, University of Valencia, Valencia, Spain; 5Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 6Unit of Experimental Opthalmology, Fundación Parala Investigación del…
Antioxidant Supplements and Diabetic Retinopathy
Abstract Conventional treatments for diabetic retinopathy (DR) includes glycemic control, laser photocoagulation, vitrectomy, intravitreal triamcinolone, and intravitreal anti-vascular endothelial growth factor agents. However these strategies have not proved capable of halting the progression of this disease in all cases. The mechanisms leading to DR are not fully understood, but there is a growing body of evidence showing that oxidative stress plays a pivotal role in the development of this diabetic complication. In fact it has been proposed that oxidative stress is the initial and maintaining event that triggers and provides feedback to the other pathophysiological pathways related to DR…
Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group
PurposeTo compare the functional and anatomical outcomes of eyes with chronic central serous chorioretinopathy treated with yellow micropulse (MP) laser versus half-dose verteporfin photodynamic therapy (PDT).MethodsThis is a multicentre, retrospective comparative study of 92 eyes treated with yellow MP laser (duty cycle of 5%, zero spacing between spots, spot size varied from 100 to 200 µm, power varied from 320 to 660 mW, and the pulse burst duration was 200 ms) and 67 eyes treated with PDT (half-dose verteporfin (3 mg/m2) infused over 10 min), followed by laser activation for 83 s. Spot sizes varied from 400 to 2000 µm.ResultsIn the MP group, at 12 months of follow-up, the mean best corr…
“Super p53” Mice Display Retinal Astroglial Changes
Tumour-suppressor genes, such as the p53 gene, produce proteins that inhibit cell division under adverse conditions, as in the case of DNA damage, radiation, hypoxia, or oxidative stress (OS). The p53 gene can arrest proliferation and trigger death by apoptosis subsequent to several factors. In astrocytes, p53 promotes cell-cycle arrest and is involved in oxidative stress-mediated astrocyte cell death. Increasingly, astrocytic p53 is proving fundamental in orchestrating neurodegenerative disease pathogenesis. In terms of ocular disease, p53 may play a role in hypoxia due to ischaemia and may be involved in the retinal response to oxidative stress (OS). We studied the influence of the p53 ge…
Macular toxoplasmosis and intravitreal clindamycin: An alternative to oral treatment
<p>Multimodal Evaluation of Visual Function in Geographic Atrophy versus Normal Eyes</p>
Purpose To comprehensively evaluate visual function in eyes with geographic atrophy (GA) as compared to normal eyes. Patients and Methods Sixty-three eyes from 63 patients ≥50 years old were recruited for this observational study; 31 were identified as normal macular health eyes and 32 with GA. Visual function was tested with best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), low luminance deficit (LLD), reading speed, macular integrity microperimetry, fixation stability, and contrast sensitivity function (CSF). Anatomic function was evaluated with spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF). Quality of life and vision were a…
Thyroid hormone deficiency disrupts rat eye neurodevelopment
Clinical and experimental studies have highlighted the role played by thyroid hormones (TH) in neural and neuro-sensorial development. However, knowledge on TH mechanisms on the developing visual system is still incomplete. To uncover TH actions on the eyes and vision we carried out a microscopical study on the role of TH in the developing retina and optic nerve, in a rat model of controlled TH deficiency (THD). Morphometric and stereological analyses of the retina and optic nerve showed a reduction in the volume of the eye (p<0.001) and optic nerve cross-sectional area (p<0.001), and thinning of the retinal layers (p<0.001). Glial development and myelination was significantly delayed in th…
Ocular Comorbidities and the Relationship between Eye Diseases and Systemic Disorders
Patients with ocular disorders may have additional ophthalmic problems that can have an impact on both morbidity and vision. Ocular comorbidities are commonly associated with vision-related disability and decreased quality of life related to visual impairment. The majority of studies on this topic deal with cataracts, glaucoma, uveitis, and/or retinopathies. It is important to summarize the available evidence to date on the association of one or several ocular diseases and the implications these comorbidities have on prognosis and therapy. The relationship between eye disorders and systemic diseases has recently drawn special interest. The increasing prevalence of neurodegenerative disorder…
Optical Coherence Tomography Characterization of Macular Changes Secondary to Arteriovenous Fistula
Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Our purpose is to illustrate different retinal manifestations of AVF. We report the multimodal imaging study of three cases with retinal changes due to AVF, showing neurosensory retinal detachment, macular oedema, and macular ischemia. In conclusion, AVF may appear with different ophthalmic alterations. While usually increased IOP and diplopia are our main concerns, retinal study is mandatory, since a myriad of morphologic abnormalities…
Update on intravitreal anti-tumor necrosis factor alpha therapies for ocular disorders
Abstract Tumor necrosis factor alpha (TNF-?) is an important pro-inflammatory cytokine associated with a variety of ocular diseases. The currently available TNF-? inhibitors are etanercept, infliximab, adalimumab, golimumab, and certolizumab. Experimental and clinical studies on the intravitreal use of these agents have been reported with etanercept, infliximab, and adalimumab: etanercept has shown limited efficacy in scarce reports; infliximab has been associated with local safety concerns but appears to benefit certain cases; adalimumab has shown no efficacy in cases of age-related macular degeneration (AMD) or diabetic macular edema (DME), but the combination with bevacizumab may be effe…
Rapid Regression of Exudative Maculopathy in Idiopathic Retinitis, Vasculitis, Aneurysms and Neuroretinitis Syndrome after Intravitreal Ranibizumab
The idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome is a rare retinal vascular disorder characterized by multiple leaking aneurysmal dilations, retinal vasculitis, neuroretinitis and peripheral vascular ischemia. Visual loss mainly occurs due to the development of retinal neovascularization and/or exudative maculopathy. Although the treatment of choice has not yet been established, retinal photocoagulation seems to be the best option to control the disease and to prevent its progression. Herein, we report a case of idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome with both retinal neovascularization and macular exudation successfully managed wi…
Glutathione-dependent formaldehyde dehydrogenase (ADH3) and low km mitochondrial aldehyde dehydrogenase (ALDH2). New evidence for differential expression in the rat retina in response to oxidative stress.
Epidemiological and experimental studies support the involvement of lipid peroxidation (LPO) in retinal diseases. In addition to other pathogenic mechanisms not fully understood, the possibility remains that peroxidic aldehydes, acting as cytotoxic chemicals, mediate in the progression of chronic ocular disorders.To test proper mechanisms involved in removing peroxidic aldehydes from the retina, in an attempt to understand long-lasting changes induced by LPO, the oxidative and antioxidant enzymatic activities, as well as the retinal distribution and activity of glutathione-dependent formaldehyde dehydrogenase (ADH3) and low km mitochondrial aldehyde dehydrogenase (ALDH2), were studied and c…
Pattern Dystrophy of the Macula in a Case of Steinert Disease
<b><i>Introduction:</i></b> Myotonic dystrophies are typically associated with ocular complications like ptosis, weakness of the ocular muscle and cataracts, but also with less recognized retinal changes. <b><i>Case Report:</i></b> A 41-year-old female with type 1 myotonic dystrophy complained of progressive vision loss. Slit lamp examination revealed the presence of typical bilateral polychromatic cataract with posterior subcapsular component. Dilated fundus examination was remarkable for bilateral macular depigmented changes. Multimodal imaging analysis of the macula suggested the presence of a butterfly-shaped pattern dystrophy. <b>&l…
Do nutritional supplements have a role in age macular degeneration prevention?
Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD), as well as the role of antioxidants (AOX) and omega-3 fatty acids (ω-3) supplements in AMD prevention.Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX andω-3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain).Results. High dietary intakes ofω-3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS) showed a benefic…
Hacia la nueva clasificación de la degeneración macular asociada a la edad basada en la tomografía de coherencia óptica de dominio espectral
Resumen Introduccion La degeneracion macular asociada a la edad (DMAE) es un problema sociosanitario de primer orden en las sociedades industrializadas. La aportacion de las nuevas tecnicas diagnosticas, fundamentalmente la tomografia de coherencia optica de dominio espectral (SD-OCT), ha ayudado a comprender mejor esta enfermedad. Objetivo Recordar la clasificacion clinica vigente de la DMAE, exponer la nueva clasificacion tomografica de la DMAE exudativa, y revisar los nuevos nuevos hallazgos tomograficos de la degeneracion macular seca. Desarrollo Clasicamente se distinguen dos formas de DMAE: seca y exudativa; asimismo existen tres estadios progresivos de severidad: precoz, intermedio y…
Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?
The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality a…
Intravitreal Docosahexaenoic Acid in a Rabbit Model: Preclinical Safety Assessment
PurposeThe purpose of the present study was to evaluate the retinal toxicity of a single dose of intravitreal docosahexaenoic acid (DHA) in rabbit eyes over a short-term period.MethodsSixteen New Zealand albino rabbits were selected for this pre-clinical study. Six concentrations of DHA (Brudy Laboratories, Barcelona, Spain) were prepared: 10 mg/50 µl, 5 mg/50 µl, 2'5 mg/50 µl, 50 µg/50 µl, 25 µg/50 µl, and 5 µg/50 µl. Each concentration was injected intravitreally in the right eye of two rabbits. As a control, the vehicle solution was injected in one eye of four animals. Retinal safety was studied by slit-lamp examination, and electroretinography. All the rabbits were euthanized one week a…
<p>A randomized multicenter study comparing seawater washes and carmellose artificial tears eyedrops in the treatment of dry eye syndrome</p>
Purpose To investigate the safety and efficacy of sterile isotonic seawater washes vs standard treatment with carmellose artificial tears in dry eye syndrome (DES). Patients and methods This is a randomized multicenter prospective study with 12 weeks of follow-up. A group of patients with DES (N=60) were treated with seawater spray (Quinton®) five times daily, and another similar group (N=60) were treated with carmellose artificial tears eyedrops (Viscofresh® 0.5%) five times a day. The parameters studied and measured were as follows: Ocular Surface Disease Index questionnaire score, Schirmer I test (without anesthesia) score, tear osmolarity (TearLab®), tear breakup time, tear meniscus hei…
Automated macular choroidal thickness measurement by swept-source optical coherence tomography in pseudoxanthoma elasticum
Introduction Pseudoxanthoma elasticum (PXE) typically involves elastic fibers in blood vessels and Bruch membrane. Our purpose was to analyze retinal and choroidal macular thickness in patients with angioid streaks due PXE compared with a control group. Methods Best-corrected visual acuity (BCVA), axial length (AL), and macular swept-source optical coherence tomography were obtained. Automated segmentations of the retina and the choroid were used to obtain the corresponding thickness values. An age, gender and AL matched control group was used to compare the thickness values. Results Twelve eyes of 6 patients were included. The mean BCVA was 0.68 ± 0.29 versus 1.0 in controls (p < 0.001). T…
Beals–Hecht syndrome and choroidal neovascularization
Purpose: To describe a case of choroidal neovascularization (CNV) in a female diagnosed with Beals–Hecht syndrome. Methods: A retrospective, interventional case is described in a 26-year-old female complaining of metamorphopsia and visual loss in her left eye (counting fingers). The fluorescein angiogram and the optical coherence tomography supported the diagnosis of CNV. Intravitreal ranibizumab was administered. Results: After the third intravitreal ranibizumab, her visual acuity improved to 0.8 and the morphology of the macular area was restored. Conclusions: To our knowledge this is the first report of CNV in Beals–Hecht syndrome treated with ranibizumab. Self-monitoring by periodically…
Rediscovering the macula of high myopia in the xxi century
Update on the principles and novel local and systemic therapies for the treatment of non-infectious uveitis.
Ocular inflammatory disorders constitute a sight-threatening group of diseases that might be managed according to their severity. Their treatment guidelines experience constant changes with new agents that improve the results obtained with former drugs. Nowadays we can make use of a five step protocol in which topical, periocular and systemic corticosteroids remain as the main therapy for non-infectious uveitis. In addition, immunosuppresive drugs can be added in order to enhance the anti-inflammatory effects and to play the role of corticosteroid-sparing agents. These can be organized in four other steps: cyclosporine and methotrexate in a second one; azathioprine, mycophenolate and tacrol…
Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration
Roberto Gallego-Pinazo,1,2 Ana Marina Suelves-Cogollos1, Ester Franc&eacute;s-Mu&ntilde;oz,1 J Mar&iacute;a Mill&aacute;n,2,3 J Fernando Arevalo,4 J Luis Mullor,5 Manuel D&iacute;az-Llopis,1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigaci&oacute;n Biom&eacute;dica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, Cl&iacute;nica Oftalmol&oacute;gica Centro Caracas, Caracas, Venezuela; 5Unit of Experimental Ophthalmology, Fundaci&oacute;n para la Investigaci&oacute;n del Hospital Universitario La F…
Intravitreal therapies for non-neovascular age-related macular degeneration with intraretinal or subretinal fluid
OBJECTIVE: To evaluate the efficacy of intravitreal therapies in cases of atrophic age-related macular degeneration (AMD) with subretinal or intraretinal fluid. METHODS: A retrospective review was made of the clinical charts of patients diagnosed with atrophic AMD with subretinal or intraretinal fluid. Fundus photographs and spectral-domain optical coherence tomography images were examined, and an analysis was made on the presence of fluid and its density. Neovascularisation was ruled out by fluorescein and/or indocyanine green angiography. RESULTS: The study included 14 eyes from 13 patients with a mean age of 72.64 years and a mean follow-up of 80.5 weeks. Intraretinal fluid was observed …
Evaluation of presumptive biomarkers of oxidative stress, immune response and apoptosis in primary open-angle glaucoma.
There is growing interest on the correlation among oxidative stress, inflammation, apoptosis and primary open-angle glaucoma initiation and progression. Reactive oxygen species are formed in the eyes following a wide variety of stressors, and are largely implicated in glaucoma pathogenesis. Immune-inflammatory response mediators have recently become a target of ophthalmologic concern, including glaucoma. Much attention has been derived to the role of specific pro and anti-apoptotic molecules in glaucoma. This article reviews the early evidence suggesting that reactive oxygen species, immune inflammatory response mediators, and apoptogenic molecules are engaged in glaucoma disease. Moreover,…
Towards the new spectral-domain optical coherence tomography based classification of age-related macular degeneration
Abstract Introduction Age-related macular degeneration (AMD) is major social and health problem in industrialised societies. The contribution of the new diagnostic techniques, mainly spectral-domain optical coherence tomography (SD-OCT), has led to a better understanding of this disease. Aim To review the current clinical classification of AMD, to describe the new tomographic classification of wet AMD, and to review the new topographical findings in dry AMD. Development There are two classically described forms of AMD: dry and wet; there are also three progressive stages of severity: early, intermediate and advanced. This purely clinical stratification does not take into account any criteri…
Combined pre- and postnatal ethanol exposure in rats disturbs the myelination of optic axons.
Aims: To analyse myelination and outgrowth of the optic axons in relation to the neuro-ophthalmological manifestations of ethanol (EtOH) abuse during pregnancy. Methods: An experimental model of chronic EtOH exposure was developed in rats and their offspring by subjecting the dams to a liquid diet (35% of the daily total calories as either EtOH or maltose-dextrose nutritional controls (Con). Eyeballs and optic nerves were obtained at key developmental stages and processed for morphologic, immunocytochemical and immunoblotting procedures, using alternatively antibodies against myelin basic protein (MBP) or neurofilament (NF) protein, and image analysing. Results: A significant delay in onset…
Diabetic Retinopathy and Oxidative Stress
Abstract Diabetic retinopathy (DR) is the leading cause of acquired blindness in working age adults worldwide. Biochemical changes in DR contribute to both the microscopic structural and functional changes in the retina. All these alterations result in macroscopic retinal damage that can be assessed by funduscopy. The overproduction of reactive oxygen species (ROS) in the mitochondria is considered a causal link between elevated glucose and biochemical abnormalities in the pathophysiology of DR. Moreover, oxidatively induced pathways also seem to provide positive feedback to ROS production, resulting in a vicious cycle. ROS can directly damage lipids, proteins and DNA, leading to cell death…
Noninfectious uveitis: strategies to optimize treatment compliance and adherence.
Noninfectious uveitis includes a heterogenous group of sight-threatening ocular and systemic disorders. Significant progress has been made in the treatment of noninfectious uveitis in recent years, particularly with regard to the effective use of corticosteroids and non-corticosteroid immunosuppressive drugs, including biologic agents. All of these therapeutic approaches are limited, however, by any given patient's ability to comply with and adhere to their prescribed treatment. In fact, compliance and adherence are among the most important patient-related determinants of treatment success. We discuss strategies to optimize compliance and adherence.
Smoking and age-related macular degeneration: review and update.
Age-related macular degeneration (AMD) is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health.
Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review.
Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairmen…
Propranolol e inyecciones intravítreas de ranibizumab en el desprendimiento seroso macular secundario a hemangioblastoma retiniano capilar
Kyrieleis&acute; vasculitis in acute retinal necrosis
Ester Franc&eacute;s-Mu&ntilde;oz1, Roberto Gallego-Pinazo1, Ruth L&oacute;pez-Lizcano1, Salvador Garc&iacute;a-Delpech1, J Luis Mullor3, Manuel D&iacute;az-Llopis1,21Department of Ophthalmology, Hospital La Fe, Valencia, Spain; 2University of Valencia, Valencia, Spain; 3Unit of Experimental Ophthalmology. Fundaci&oacute;n para la Investigaci&oacute;n del Hospital Universitario La Fe. Valencia, Valencia, SpainAbstract: We report the first case in the literature of Kyrieleis&acute; vasculitis related to acute retinal necrosis by Varicella zoster virus in a 76-year-old woman with bilateral involvement. In our patient the arterial lesions appeared 15 days after …
Terapias intravítreas en degeneración macular asociada a la edad no neovascular con fluido intrarretiniano o subretiniano
Resumen Objetivo Evaluar la eficacia de las terapias intravitreas en casos de degeneracion macular asociada a la edad (DMAE) atrofica con fluido intra- o subretiniano. Metodos Revisamos, de forma retrospectiva, las caracteristicas de pacientes diagnosticados de DMAE atrofica con fluido intra- o subretiniano. Examinamos las retinografias y las imagenes de tomografia de coherencia optica de dominio espectral analizando en ellas la presencia de fluido y su densidad. Descartamos la existencia de neovascularizacion coroidea mediante angiografia con fluoresceina o con verde de indocianina. Resultados Se incluyeron 14 ojos de 13 pacientes con una edad media de 72,64 anos y un seguimiento medio de …
INTRAVITREAL BEVACIZUMAB FOR CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION: 5-Year Results of The Pan-American Collaborative Retina Study Group.
To report the long-term anatomical and functional outcomes of patients with choroidal neovascularization secondary to age-related macular degeneration treated with intravitreal bevacizumab (IVB).Retrospective case series. Patients diagnosed with subfoveal choroidal neovascularization secondary to age-related macular degeneration that were treated with at least 1 intravitreal injection of 1.25 mg of IVB and had a minimum follow-up of 60 months. Patients underwent best-corrected Snellen visual acuity testing, optical coherence tomography, and ophthalmoscopic examination at baseline and follow-up visits.Two hundred and forty-seven consecutive patients (292 eyes) were included. The mean number …
Kyrieleis’ vasculitis in acute retinal necrosis
We report the first case in the literature of Kyrieleis' vasculitis related to acute retinal necrosis by Varicella zoster virus in a 76-year-old woman with bilateral involvement. In our patient the arterial lesions appeared 15 days after the initial presentation.
Adult Coats’ Disease Successfully Managed with the Dexamethasone Intravitreal Implant (Ozurdex®) Combined with Retinal Photocoagulation
Purpose: To report a case of Coats’ disease managed with the dexamethasone intravitreal implant Ozurdex® (Allergan, Inc., Irvine, Calif., USA) combined with retinal photocoagulation. Methods: A 46-year-old female with 20/200 visual acuity was diagnosed with Coats’ disease with secondary retinal vasoproliferative tumor. An initial approach was performed with an intravitreal injection of the sustained-release dexamethasone implant Ozurdex. After reattachment of the retina, the telangiectatic vessels were treated with laser photocoagulation. Results: The patient’s visual acuity improved to 20/25 after the intravitreal Ozurdex. No further recurrences of exudation were evident through the 12-mon…
ANATOMICAL AND FUNCTIONAL OUTCOMES OF SYMPTOMATIC IDIOPATHIC VITREOMACULAR TRACTION
To describe the natural history of eyes with symptomatic idiopathic vitreomacular traction (VMT).Retrospective multicenter study of 168 eyes with spectral-domain optical coherence tomography (SD-OCT) findings consistent with idiopathic VMT. All eyes were graded according to SD-OCT findings. Grade 1 was defined as incomplete cortical vitreous separation with foveal attachment. Grade 2 was defined as Grade 1 plus intraretinal cysts or clefts. Grade 3 was defined as Grade 2 plus a foveal detachment. All patients were followed for at least 6 months.There were 168 patients (51 men) with a mean age of 68.8 ± 10.7 years. Patients were followed for a mean of 22.7 ± 20.1 months. The mean duration of…
Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group
Purpose: This study was designed to evaluate the visual and anatomical outcomes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies. Methods: The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA) and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuva…