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Dongil-Moreno FJ, Ortiz M, Pueyo A, Boquete L, Sánchez-Morla EM, Jimeno-Huete D, Miguel JM, Barea R, Vilades E, Garcia-Martin E. Diagnosis of multiple sclerosis using optical coherence tomography supported by explainable artificial intelligence. Eye (Lond) 2024:10.1038/s41433-024-02933-5. [PMID: 38297153 DOI: 10.1038/s41433-024-02933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/10/2023] [Accepted: 01/12/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND/OBJECTIVES Study of retinal structure based on optical coherence tomography (OCT) data can facilitate early diagnosis of relapsing-remitting multiple sclerosis (RRMS). Although artificial intelligence can provide highly reliable diagnoses, the results obtained must be explainable. SUBJECTS/METHODS The study included 79 recently diagnosed RRMS patients and 69 age matched healthy control subjects. Thickness (Avg) and inter-eye difference (Diff) features are obtained in 4 retinal layers using the posterior pole protocol. Each layer is divided into six analysis zones. The Support Vector Machine plus Recursive Feature Elimination with Leave-One-Out Cross Validation (SVM-RFE-LOOCV) approach is used to find the subset of features that reduces dimensionality and optimises the performance of the classifier. RESULTS SVM-RFE-LOOCV was used to identify OCT features with greatest capacity for early diagnosis, determining the area of the papillomacular bundle to be the most influential. A correlation was observed between loss of layer thickness and increase in functional disability. There was also greater functional deterioration in patients with greater asymmetry between left and right eyes. The classifier based on the top-ranked features obtained sensitivity = 0.86 and specificity = 0.90. CONCLUSIONS There was consistency between the features identified as relevant by the SVM-RFE-LOOCV approach and the retinotopic distribution of the retinal nerve fibres and the optic nerve head. This simple method contributes to implementation of an assisted diagnosis system and its accuracy exceeds that achieved with magnetic resonance imaging of the central nervous system, the current gold standard. This paper provides novel insights into RRMS affectation of the neuroretina.
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Affiliation(s)
- F J Dongil-Moreno
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - M Ortiz
- School of Physics, University of Melbourne, Melbourne, 3010, VIC, Australia
| | - A Pueyo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), Biotech Vision SLP, spin-off Company, University of Zaragoza, Zaragoza, Spain
| | - L Boquete
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E M Sánchez-Morla
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain
- School of Medicine, Universidad Complutense, 28040, Madrid, Spain
| | - D Jimeno-Huete
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - J M Miguel
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - R Barea
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E Vilades
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), Biotech Vision SLP, spin-off Company, University of Zaragoza, Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
- Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), Biotech Vision SLP, spin-off Company, University of Zaragoza, Zaragoza, Spain.
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Rodrigo MJ, Martinez-Rincon T, Subias M, Mendez-Martinez S, Garcia-Herranz D, Garcia-Feijoo J, Herrero-Vanrell R, Pablo L, Bravo-Osuna I, Munuera I, Garcia-Martin E. Influence of sex on chronic steroid-induced glaucoma: 24-Weeks follow-up study in rats. Exp Eye Res 2024; 238:109736. [PMID: 38036216 DOI: 10.1016/j.exer.2023.109736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
The objective was to evaluate ocular changes based on sex in steroid-induced glaucoma models in rats comparing healthy controls, over 24 weeks follow-up. Eighty-nine Long-Evans rats (38 males and 51 females) with steroid-induced glaucoma were analysed. Two steroid-induced glaucoma models were generated by injecting poly-co-lactic-glycolic acid microspheres loaded with dexamethasone (MMDEX model) and dexamethasone-fibronectin (MMDEXAFIBRO model) into the ocular anterior chamber. Intraocular pressure was measured by rebound tonometer Tonolab®. Neuroretinal function was analysed using dark- and light-adapted electroretinography (Roland consult® RETIanimal ERG), and structure was analysed using optical coherence tomography (OCT Spectralis, Heidelberg® Engineering) using Retina Posterior Pole, Retinal Nerve Fibre Layer and Ganglion Cell Layer protocols over 24 weeks. Males showed statistically (p < 0.05) higher intraocular pressure measurements. In both sexes and models neuroretinal thickness tended to decrease over time. In the MMDEX model, males showed higher IOP values and greatest percentage thickness loss in the Ganglion Cell Layer (p = 0.015). Females receiving MMDEXAFIBRO experienced large fluctuations in thickness, a higher percentage loss (on average) in Retina Posterior Pole (p = 0.035), Retinal Nerve Fibre Layer and Ganglion Cell Layer than aged-matched males, and the highest thickness loss rate by mmHg. Although no difference was found by sex in dark- and light-adapted electroretinography, increased amplitude in photopic negative response was found in MMDEX males and MMDEXAFIBRO females at 12 weeks. Although both glaucoma models used dexamethasone, different intraocular pressure and neuroretinal changes were observed depending on sex and other influential cofactors (fibronectin). Both sex and the induced glaucoma model influenced neuroretinal degeneration.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain
| | - T Martinez-Rincon
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - M Subias
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - S Mendez-Martinez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - D Garcia-Herranz
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain
| | - J Garcia-Feijoo
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; Department of Ophthalmology, San Carlos Clinical Hospital, Complutense University of Madrid, Spain
| | - R Herrero-Vanrell
- National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, Spain
| | - L Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain; Biotech Vision, Instituto Oftalmologico Quiron, Zaragoza, Spain
| | - I Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, Spain
| | - I Munuera
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain.
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3
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Ciprés M, Satue M, Melchor I, Gil-Arribas L, Vilades E, Garcia-Martin E. Retinal neurodegeneration in patients with type 2 diabetes mellitus without diabetic retinopathy. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:205-218. [PMID: 35523467 DOI: 10.1016/j.oftale.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/06/2021] [Indexed: 06/14/2023]
Abstract
In diabetes mellitus (DM) patients retinal complications were typically considered part of a vascular process. Recent research suggests that retinal degeneration in DM might also be caused by a neuropathy that could precede microvascular alterations. The present work reviews the currently available bibliography about neurodegeneration in patients with type 2 DM (DM2) without diabetic retinopathy (DR). In patients with non-severe, early DM2 without DR and good metabolic control visual function parameters show early abnormalities that precede clinical DR (in which we diagnose with a conventional ophthalmological examination). Using optical coherence tomography (OCT) technology, a reduction in macular and peripapillary thickness has been observed in different studies. Recent researches suggest that systemic complications (especially ischaemia) and a possible microvascular alteration eventually contributes to retinal neurodegeneration, which opens the door to new studies that include new techniques for evaluating the microvascularization of the retinal layers.
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Affiliation(s)
- M Ciprés
- Servicio de Oftalmologia, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
| | - M Satue
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Grupo de investigación Miguel Servet Oftalmología (GIMSO), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
| | - I Melchor
- Departamento de Endocrinología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - L Gil-Arribas
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Grupo de investigación Miguel Servet Oftalmología (GIMSO), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
| | - E Vilades
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Grupo de investigación Miguel Servet Oftalmología (GIMSO), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
| | - E Garcia-Martin
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Grupo de investigación Miguel Servet Oftalmología (GIMSO), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
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4
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López-Dorado A, Pérez J, Rodrigo M, Miguel-Jiménez J, Ortiz M, de Santiago L, López-Guillén E, Blanco R, Cavalliere C, Morla EMS, Boquete L, Garcia-Martin E. Diagnosis of multiple sclerosis using multifocal ERG data feature fusion. Inf Fusion 2021; 76:157-167. [PMID: 34867127 PMCID: PMC8475498 DOI: 10.1016/j.inffus.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 11/15/2020] [Accepted: 05/17/2021] [Indexed: 05/16/2023]
Abstract
The purpose of this paper is to implement a computer-aided diagnosis (CAD) system for multiple sclerosis (MS) based on analysing the outer retina as assessed by multifocal electroretinograms (mfERGs). MfERG recordings taken with the RETI-port/scan 21 (Roland Consult) device from 15 eyes of patients diagnosed with incipient relapsing-remitting MS and without prior optic neuritis, and from 6 eyes of control subjects, are selected. The mfERG recordings are grouped (whole macular visual field, five rings, and four quadrants). For each group, the correlation with a normative database of adaptively filtered signals, based on empirical model decomposition (EMD) and three features from the continuous wavelet transform (CWT) domain, are obtained. Of the initial 40 features, the 4 most relevant are selected in two stages: a) using a filter method and b) using a wrapper-feature selection method. The Support Vector Machine (SVM) is used as a classifier. With the optimal CAD configuration, a Matthews correlation coefficient value of 0.89 (accuracy = 0.95, specificity = 1.0 and sensitivity = 0.93) is obtained. This study identified an outer retina dysfunction in patients with recent MS by analysing the outer retina responses in the mfERG and employing an SVM as a classifier. In conclusion, a promising new electrophysiological-biomarker method based on feature fusion for MS diagnosis was identified.
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Affiliation(s)
- A. López-Dorado
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - J. Pérez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
| | - M.J. Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - J.M. Miguel-Jiménez
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - M. Ortiz
- School of Physics, University of Melbourne, VIC 3010, Australia
| | - L. de Santiago
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E. López-Guillén
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - R. Blanco
- Department of Surgery, Medical and Social Sciences, University of Alcalá, Alcalá de Henares, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - C. Cavalliere
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E. Mª Sánchez Morla
- Department of Psychiatry, Hospital 12 de Octubre Research Institute (i+12), 28041 Madrid, Spain
- Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- CIBERSAM: Biomedical Research Networking Centre in Mental Health, 28029 Madrid, Spain
| | - L. Boquete
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - E. Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
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5
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Rodrigo MJ, Garcia-Herranz D, Aragón-Navas A, Subias M, Martinez-Rincón T, Mendez-Martínez S, Cardiel MJ, García-Feijoo J, Ruberte J, Herrero-Vanrell R, Pablo L, Garcia-Martin E, Bravo-Osuna I. Long-term corticosteroid-induced chronic glaucoma model produced by intracameral injection of dexamethasone-loaded PLGA microspheres. Drug Deliv 2021; 28:2427-2446. [PMID: 34763590 PMCID: PMC8592597 DOI: 10.1080/10717544.2021.1998245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
PURPOSE To evaluate a new chronic glaucoma model produced by intracameral injection of dexamethasone-loaded poly lactic-co-glycolic acid microspheres (Dex-PLGA-Ms) over six months. METHODS Healthy rats received two injections (at baseline and Week 4) of Dex-PLGA-Ms into the anterior chamber of the right eye. Clinical signs and intraocular pressure (IOP) were weekly recorded. The structure of the retina and optic nerve was in vivo evaluated using optical coherence tomography (OCT) every two weeks and functionally using dark- and light-adapted electroretinography at 0-12-24 weeks. Histological studies were also performed. RESULTS IOP progressively increased up to hypertension (23.22 ± 3.63 mmHg) in both eyes but did so later in left eyes. OCT quantified a decrease in full-thickness retina posterior pole (R), retinal-nerve-fiber layer (RNFL), and ganglion-cell layer (GCL) thickness up to 24 weeks. Right eyes showed higher neuroretinal thickness loss up to week 8. RNFL experienced the highest percentage thickness loss at the inferior-superior axis, while in GCL the inner sectors of the horizontal axis (Nasal-Temporal) suffered the greatest decrease in thickness. Retinal ganglion cell, photoreceptor, and intermediate cell functionality decreased over time. Increased deposition of collagen IV was also found in zonular fibers and the ciliary body. CONCLUSIONS This work shows the usefulness of drug delivery systems, not to treat pathology but to induce it. Only two injections of Dex-PLGA-Ms in the anterior chamber of rat eyes were enough to progressively create ocular hypertension and subsequent functional and structural neuroretinal degeneration, at least over 6 months.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain
| | - D Garcia-Herranz
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - A Aragón-Navas
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - M Subias
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - T Martinez-Rincón
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - S Mendez-Martínez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - M J Cardiel
- Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain.,Department of Pathology, Lozano Blesa University Hospital, Zaragoza, Spain
| | - J García-Feijoo
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415. National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain.,Servicio de Oftalmología, Hospital Clínico San Carlos, Madrid, Spain.,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - J Ruberte
- Animal Biotechnology and Gene Therapy Centre (CBATEG), Universitat Autònoma de Barcelona, Bellaterra, Spain.,Networked Biomedical Research Centre for Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain.,Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - R Herrero-Vanrell
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - L Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - I Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
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Cordón B, Orduna-Hospital E, Viladés E, Garcia-Martin E, Garcia-Campayo J, Puebla-Guedea M, Polo V, Larrosa JM, Pablo LE, Vicente MJ, Satue M. Analysis of Retinal Layers in Fibromyalgia Patients with Premium Protocol in Optical Tomography Coherence and Quality of Life. Curr Eye Res 2021; 47:143-153. [PMID: 34213409 DOI: 10.1080/02713683.2021.1951301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the inner retinal layers in fibromyalgia (FM) patients compared to control subjects using posterior pole protocol (PPole) analysis in optical coherence tomography (OCT) and to correlate structural retinal changes with subjective quality of life. METHODS Seventy-four eyes of healthy subjects and 55 eyes of those with FM were analyzed. All subjects underwent retinal evaluation using the PPole protocol for Spectralis OCT (Heidelberg Engineering) to obtain measurements of the retinal nerve fiber layer (RNFL) and the ganglion cell layer (GCL) in the macular area. The EuroQol (EQ-5D) questionnaire and Fibromyalgia Impact Questionnaire (FIQ) were performed to analyze health-related quality of life. Additionally, the FM group was divided into three groups depending on the disease phenotype (atypical, depressive and biological). RESULTS : Patients with FM presented with a reduction of the RNFL thickness compared to controls in 17/64 cells of the PPole area, and a reduction of the GCL thickness in 47/64 cells. Depressive FM phenotype showed the greatest number of cells with significant reduction compared with the control group in both RNFL and GCL layers. A correlation between temporal-inferior cells of the GCL and the EuroQol 5D questionnaire results was observed. CONCLUSIONS Patients with FM present with a reduction of the inner retinal layers in the macular area. This degeneration correlates with disease severity/reduced quality of life in these patients. The PPole protocol for OCT is a non-invasive and fast tool that might help clinicians diagnose and monitor neurodegeneration in FM patients.
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Affiliation(s)
- B Cordón
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - E Orduna-Hospital
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - E Viladés
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - E Garcia-Martin
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - J Garcia-Campayo
- Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain).,Psychiatry Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - M Puebla-Guedea
- Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain)
| | - V Polo
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - J M Larrosa
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - L E Pablo
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - M J Vicente
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
| | - M Satue
- Miguel Servet Ophthalmology Research and Innovative Group (GIMSO). Aragon Institute for Health Research (IIS Aragón). University of Zaragoza. Zaragoza (Spain).,Ophthalmology Department, Miguel Servet University Hospital. Zaragoza (Spain)
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7
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Garcia-Martin E, Ortiz M, Boquete L, Sánchez-Morla EM, Barea R, Cavaliere C, Vilades E, Orduna E, Rodrigo MJ. Early diagnosis of multiple sclerosis by OCT analysis using Cohen's d method and a neural network as classifier. Comput Biol Med 2020; 129:104165. [PMID: 33302162 DOI: 10.1016/j.compbiomed.2020.104165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The consequences of inflammation, demyelination, axonal degeneration and neuronal loss in the central nervous system, typical of the development of multiple sclerosis (MS), are manifested in thinning of the retina and optic nerve. The purpose of this work is to diagnose early-stage MS patients based on analysis of retinal layer thickness obtained by swept-source optical coherence tomography (SS-OCT). METHOD OCT (Triton® SS-OCT device -Topcon, Tokyo, Japan-) recordings were obtained from 48 control subjects and 48 recently diagnosed MS patients. The following thicknesses were measured on a 45 × 60 grid: retinal nerve fibre layer (RNFL), ganglion cell layer (GCL+), GCL++, retinal thickness and choroid. Using Cohen's d effect size, it was determined the regions and layers with greatest capacity to discriminate between control subjects and patients. Points exceeding the threshold set were used as inputs for an automatic classifier: support vector machine and feed-forward neural network. RESULTS In MS at clinical onset the layer with greatest discriminant capacity is GCL++ [AUC = 0.83] which exhibits a horseshoe-like macular topographic distribution. It is followed by retina, GCL+ and RNFL; choroidal thicknesses do not provide discriminatory capacity. Using a neural network as a classifier between controls and MS patients, obtains sensitivity of 0.98 and specificity of 0.98. CONCLUSIONS This work suggest that OCT may serve as an important complementary role to other clinical tests, particularly regarding neurodegeneration. It is possible to characterise structural alterations in retina and diagnose early-stage MS with high degree of accuracy using OCT and artificial neural networks.
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Affiliation(s)
- E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - M Ortiz
- School of Physics, University of Melbourne, VIC, 3010, Australia
| | - L Boquete
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain; Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E M Sánchez-Morla
- Department of Psychiatry, Hospital 12 de Octubre Research Institute (i+12), 28041, Madrid, Spain; Faculty of Medicine, Complutense University of Madrid, 28040, Madrid, Spain; CIBERSAM: Biomedical Research Networking Centre in Mental Health, 28029, Madrid, Spain
| | - R Barea
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - C Cavaliere
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E Vilades
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
| | - E Orduna
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
| | - M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain.
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8
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Rodrigo MJ, Cardiel MJ, Fraile JM, Mendez-Martinez S, Martinez-Rincon T, Subias M, Polo V, Ruberte J, Ramirez T, Vispe E, Luna C, Mayoral JA, Garcia-Martin E. Brimonidine-LAPONITE® intravitreal formulation has an ocular hypotensive and neuroprotective effect throughout 6 months of follow-up in a glaucoma animal model. Biomater Sci 2020; 8:6246-6260. [PMID: 33016285 DOI: 10.1039/d0bm01013h] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intravitreal administration is widely used in ophthalmological practice to maintain therapeutic drug levels near the neuroretina and because drug delivery systems are necessary to avoid reinjections and sight-threatening side effects. However, currently there is no intravitreal treatment for glaucoma. The brimonidine-LAPONITE® formulation was created with the aim of treating glaucoma for extended periods with a single intravitreal injection. Glaucoma was induced by producing ocular hypertension in two rat cohorts: [BRI-LAP] and [non-bri], with and without treatment, respectively. Eyes treated with brimonidine-LAPONITE® showed lower ocular pressure levels up to week 8 (p < 0.001), functional neuroprotection explored by scotopic and photopic negative response electroretinography (p = 0.042), and structural protection of the retina, retinal nerve fibre layer and ganglion cell layer (p = 0.038), especially on the superior-inferior axis explored by optical coherence tomography, which was corroborated by a higher retinal ganglion cell count (p = 0.040) using immunohistochemistry (Brn3a antibody) up to the end of the study (week 24). Furthermore, delayed neuroprotection was detected in the contralateral eye. Brimonidine was detected in treated rat eyes for up to 6 months. Brimonidine-LAPONITE® seems to be a potential sustained-delivery intravitreal drug for glaucoma treatment.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
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9
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Gavín A, Garcia-Martin E, Garcia-Campayo J, Viladés E, Orduna E, Satué M. The use of optical coherence tomography in the evaluation of patients with bipolar disorder. ACTA ACUST UNITED AC 2020; 96:141-151. [PMID: 32912807 DOI: 10.1016/j.oftal.2020.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/12/2020] [Indexed: 11/16/2022]
Abstract
Bipolar disorder (BD) is a mental disorder characterised by episodes of extremal mood changes. In recent years, some researchers found neurodegeneration in patients with BD using Magnetic Resonance Imaging. Evaluation of the optic nerve and the retinal layers using optical coherence tomography (OCT) has proved to be a useful, non-invasive tool for diagnosis and monitoring of neurodegenerative diseases. Accordingly, a decrease in the retinal nerve fibre layer and the ganglion cell complex measured by OCT was found in patients with BD in different studies, suggesting that BD is a neurodegenerative process in addition to a psychiatric disorder. Therefore, the neuro-ophthalmological evaluation of these patients could be used as a marker for diagnosis of this disease. This work analyses literature on retinal degeneration in bipolar disorder patients, and evaluates the ability of OCT devices in the detection of neuronal degeneration affecting the different retinal layers in these patients, and its possible role in the diagnosis and monitoring of the disease.
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Affiliation(s)
- A Gavín
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO), Zaragoza, España.
| | - E Garcia-Martin
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO), Zaragoza, España
| | - J Garcia-Campayo
- Servicio de Psiquiatría, Hospital Universitario Miguel Servet, Zaragoza, España; Departamento de Psicología y Sociología, facultad de ciencias sociales y humanas, Universidad de Zaragoza, Zaragoza, España
| | - E Viladés
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO), Zaragoza, España
| | - E Orduna
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO), Zaragoza, España
| | - M Satué
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Grupo de Investigación e Innovación Miguel Servet Oftalmología (GIMSO), Zaragoza, España
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10
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Boquete L, López-Guillén E, Vilades E, Miguel-Jiménez JM, Pablo LE, De Santiago L, Ortiz del Castillo M, Alonso-Rodríguez MC, Morla EMS, López-Dorado A, Garcia-Martin E. Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method. PLoS One 2019; 14:e0224500. [PMID: 31703082 PMCID: PMC6839873 DOI: 10.1371/journal.pone.0224500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/15/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine if a novel analysis method will increase the diagnostic value of the multifocal electroretinogram (mfERG) in diagnosing early-stage multiple sclerosis (MS). METHODS We studied the mfERG signals of OD (Oculus Dexter) eyes of fifteen patients diagnosed with early-stage MS (in all cases < 12 months) and without a history of optic neuritis (ON) (F:M = 11:4), and those of six controls (F:M = 3:3). We obtained values of amplitude and latency of N1 and P1 waves, and a method to assess normalized root-mean-square error (FNRMSE) between model signals and mfERG recordings was used. Responses of each eye were analysed at a global level, and by rings, quadrants and hemispheres. AUC (area under the ROC curve) is used as discriminant factor. RESULTS The standard method of analysis obtains further discrimination between controls and MS in ring R3 (AUC = 0.82), analysing N1 waves amplitudes. In all of the retina analysis regions, FNRMSE value shows a greater discriminating power than the standard method. The highest AUC value (AUC = 0.91) was in the superior temporal quadrant. CONCLUSION By analysing mfERG recordings and contrasting them with those of healthy controls it is possible to detect early-stage MS in patients without a previous history of ON.
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Affiliation(s)
- L. Boquete
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
| | - E. López-Guillén
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - E. Vilades
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
| | - J. M. Miguel-Jiménez
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - L. E. Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
| | - L. De Santiago
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - M. Ortiz del Castillo
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - M. C. Alonso-Rodríguez
- Physics and Mathematics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | | | - A. López-Dorado
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - E. Garcia-Martin
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
- * E-mail:
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11
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Del Castillo MO, Cordón B, Sánchez Morla EM, Vilades E, Rodrigo MJ, Cavaliere C, Boquete L, Garcia-Martin E. Identification of clusters in multifocal electrophysiology recordings to maximize discriminant capacity (patients vs. control subjects). Doc Ophthalmol 2019; 140:43-53. [PMID: 31538293 DOI: 10.1007/s10633-019-09720-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To propose a new method of identifying clusters in multifocal electrophysiology (multifocal electroretinogram: mfERG; multifocal visual-evoked potential: mfVEP) that conserve the maximum capacity to discriminate between patients and control subjects. METHODS The theoretical framework proposed creates arbitrary N-size clusters of sectors. The capacity to discriminate between patients and control subjects is assessed by analysing the area under the receiver operator characteristic curve (AUC). As proof of concept, the method is validated using mfERG recordings taken from both eyes of control subjects (n = 6) and from patients with multiple sclerosis (n = 15). RESULTS Considering the amplitude of wave P1 as the analysis parameter, the maximum value of AUC = 0.7042 is obtained with N = 9 sectors. Taking into account the AUC of the amplitudes and latencies of waves N1 and P1, the maximum value of the AUC = 0.6917 with N = 8 clustered sectors. The greatest discriminant capacity is obtained by analysing the latency of wave P1: AUC = 0.8854 with a cluster of N = 12 sectors. CONCLUSION This paper demonstrates the effectiveness of a method able to determine the arbitrary clustering of multifocal responses that possesses the greatest capacity to discriminate between control subjects and patients when applied to the visual field of mfERG or mfVEP recordings. The method may prove helpful in diagnosing any disease that is identifiable in patients' mfERG or mfVEP recordings and is extensible to other clinical tests, such as optical coherence tomography.
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Affiliation(s)
- M Ortiz Del Castillo
- Biomedical Engineering Group, Electronics Department, University of Alcalá, Alcalá de Henares, Spain.,School of Physics, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - B Cordón
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, 50009, Zaragoza, Spain
| | - E M Sánchez Morla
- 12 de Octubre University Hospital Research Institute (i + 12), Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - E Vilades
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, 50009, Zaragoza, Spain
| | - M J Rodrigo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain. .,Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, 50009, Zaragoza, Spain.
| | - C Cavaliere
- Biomedical Engineering Group, Electronics Department, University of Alcalá, Alcalá de Henares, Spain
| | - L Boquete
- Biomedical Engineering Group, Electronics Department, University of Alcalá, Alcalá de Henares, Spain.,RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Barcelona, Spain
| | - E Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, 50009, Zaragoza, Spain.,RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Barcelona, Spain
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12
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Obis J, Satue M, Alarcia R, Pablo LE, Garcia-Martin E. Update on visual function and choroidal-retinal thickness alterations in Parkinson's disease. ACTA ACUST UNITED AC 2018; 93:231-238. [PMID: 29454631 DOI: 10.1016/j.oftal.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 01/06/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative process that affects 7.5 million people around the world. Since 2004, several studies have demonstrated changes in various retinal layers in PD using optical coherence tomography (OCT). However, there are some discrepancies in the results of those studies. Some of them have correlated retinal thickness with the severity or duration of the disease, demonstrating that OCT measurements may be an innocuous and easy biomarker for PD progression. Other studies have demonstrated visual dysfunctions since early phases of the disease. Lastly, the most recent studies that use Swept Source OCT technology, have found choroidal thickness increase in PD patients and provide new information related to the retinal degenerative process in this disease. The aim of this paper is to review the literature on OCT and PD, in order to determine the altered retinal and choroidal parameters in PD and their possible clinical usefulness, and also the visual dysfunctions with higher impact in these patients.
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Affiliation(s)
- J Obis
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - M Satue
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - R Alarcia
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - L E Pablo
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Garcia-Martin
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
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13
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Rodrigo M, Garcia-Martin E, Orduna E, Obis J, Cipres M, Vilades E, Satue M. Choroidal changes in patients with multiple sclerosis. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M.J. Rodrigo
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | | | - E. Orduna
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - J. Obis
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - M. Cipres
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - E. Vilades
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - M. Satue
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
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14
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Vilades Palomar E, Orduna Hospital E, Ciprés M, Obis J, Rodrigo SanJuan M, Satué M, Garcia-Martin E. Multifocal electroretinogram and optical coherence tomography to evaluate parafoveal fixation. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. Vilades Palomar
- Neurophthalmology; Miguel Servet University Hospital; Zaragoza Spain
- IIS-Aragón; Aragón Health Research Institute; Zaragoza Spain
| | | | - M. Ciprés
- Neurophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - J. Obis
- Neurophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | | | - M. Satué
- Neurophthalmology; Miguel Servet University Hospital; Zaragoza Spain
- IIS-Aragón; Aragón Health Research Institute; Zaragoza Spain
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15
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Obis J, Garcia-Martin E, Orduna E, Vilades E, Cipres M, Rodrigo M, Satue M. Relation between cardiovascular conditions and macular and retinal nerve fiber layer thickness evaluated with Spectral-Domain OCT. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J. Obis
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Garcia-Martin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Orduna
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Vilades
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Cipres
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.J. Rodrigo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Satue
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
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16
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Gavin Sancho A, Romero Sanz M, Idoipe Corta M, Mateo Orobia A, Sanchez Perez A, Garcia-Martin E, Satue Palacian M. Evaluation of visual quality parameters after Descemet membrane endotelial keratoplasty (DMEK). Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Vildades Palomar E, Orduna Hospital E, Ciprés M, Obis J, Rodrigo SanJuan M, Satué Palacian M, Garcia-Martin E. Correlation between electrophysiological test and visual dysfunction in multiple sclerosis patients. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E. Vildades Palomar
- Miguel Servet University Hospital, Neurophthalmology; Zaragoza Spain
- Aragón Health Research Institute, IIS-Aragón; Zaragoza Spain
| | | | - M. Ciprés
- Miguel Servet University Hospital, Neurophthalmology; Zaragoza Spain
| | - J. Obis
- Miguel Servet University Hospital, Neurophthalmology; Zaragoza Spain
| | | | - M. Satué Palacian
- Miguel Servet University Hospital, Neurophthalmology; Zaragoza Spain
- Aragón Health Research Institute, IIS-Aragón; Zaragoza Spain
| | - E. Garcia-Martin
- Miguel Servet University Hospital, Neurophthalmology; Zaragoza Spain
- Aragón Health Research Institute, IIS-Aragón; Zaragoza Spain
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18
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Vilades Palomar E, Cipres M, Obis J, Rodrigo M, Satue M, Garcia-Martin E. Changes in visual function and retinal structure in patients with manic-depressive illness or bipolar disorder. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - M. Cipres
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - J. Obis
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.J. Rodrigo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Satue
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Garcia-Martin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
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19
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Vilades Palomar E, Cipres M, Obis J, Rodrigo M, Satue M, Garcia-Martin E. Reproducibility of the measurements taken with swept source optical coherence tomography. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - M. Cipres
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - J. Obis
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.J. Rodrigo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Satue
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Garcia-Martin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
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20
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Rodrigo M, Garcia-Martin E, Orduna E, Vilades E, Satue M, Cipres M, Obis J. Neuro-retinal changes evaluation in multiple sclerosis patients: 10 years follow-up. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M.J. Rodrigo
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | | | - E. Orduna
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - E. Vilades
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - M. Satue
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - M. Cipres
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
| | - J. Obis
- Oftalmología; Hospital Miguel Servet; Zaragoza Spain
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21
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Obis J, Garcia-Martin E, Satue M, Rodrigo M, Cipres M, Vilades E, Orduna E. Swept-Source OCT
utilised to compare the choroidal thickness of the peripapillary area between patients with Parkinson′s disease and healthy subjects. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J. Obis
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Garcia-Martin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Satue
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.J. Rodrigo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M. Cipres
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Vilades
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Orduna
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
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Vilades E, Garcia-Martin E, Satue M, Rodrigo M, Obis J, Cipres Alastuey M. Visual dysfunction and its correlation with retinal changes in patients with Parkinson disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Obis J, Cipres Alastuey M, Villades E, Garcia-Martin E, Satue M, Rodrigo M. Analysis of the peripapillary retinal nerve fiber layer and choroidal thickness in patients with Parkinson's disease using swept-source optical coherence tomography. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Obis J, Cipres Alastuey M, Villades E, Garcia-Martin E, Satue M, Rodrigo M. Analysis of retinal and choroidal thickness in the macular area in patients with Parkinson's disease using swept-source optical coherence tomography. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vilades E, Garcia-Martin E, Satue M, Rodrigo M, Obis J, Cipres Alastuey M. Visual dysfunction and its correlation with retinal changes in patients with Alzheimer's disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Satue M, Rodrigo M, Obis J, Cipres Alastuey M, Vilades E, Garcia-Martin E. Evaluation of progressive visual dysfunction and degeneration of the retinal nerve fiber layer and macular thickness in patients with Parkinson disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Satue M, Rodrigo M, Obis J, Cipres Alastuey M, Vilades E, Garcia-Martin E. Effects of current treatments in progressive retinal nerve fiber layer loss in multiple sclerosis patients. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Polo V, Satue M, Rodrigo MJ, Otin S, Alarcia R, Bambo MP, Fuertes MI, Larrosa JM, Pablo LE, Garcia-Martin E. Visual dysfunction and its correlation with retinal changes in patients with Parkinson's disease: an observational cross-sectional study. BMJ Open 2016; 6:e009658. [PMID: 27154474 PMCID: PMC4861131 DOI: 10.1136/bmjopen-2015-009658] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson's disease (PD). METHODS Patients with PD (n=37) and controls (n=37) were included in an observational cross-sectional study, and underwent visual acuity (VA), colour vision (using the Farnsworth and Lanthony desaturated D15 colour tests) and contrast sensitivity vision (CSV; using the Pelli-Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fibre layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses, were obtained using spectral domain optical coherence tomography (SD-OCT). Comparison of obtained data, and correlation analysis between functional and structural results were performed. RESULTS VA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in patients with PD than in controls. Colour vision was significantly affected based on the Lanthony colour test. Significant GCL loss was observed in the minimum GCL+inner plexiform layer. A clear tendency towards a reduction in several macular sectors (central, outer inferior, outer temporal and superior (inner and outer)) and in the temporal quadrant of the RNFL thickness was observed, although the difference was not significant. CSV was the functional parameter most strongly correlated with structural measurements in PD. Colour vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r>0.70, p<0.05). CONCLUSIONS Patients with PD had visual dysfunction that correlated with structural changes evaluated by SD-OCT. GCL measurements may be reliable indicators of visual impairment in patients with PD.
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Affiliation(s)
- V Polo
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - M Satue
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - M J Rodrigo
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
| | - S Otin
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - R Alarcia
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - M P Bambo
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - M I Fuertes
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - J M Larrosa
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - L E Pablo
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - E Garcia-Martin
- IIS Aragon, Institute for Health Sciences of Aragon, Zaragoza, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
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Vallés-Torres J, Garcia-Martin E, Fernández-Tirado FJ, Gil-Arribas LM, Pablo LE, Peña-Calvo P. Contact topical anesthesia versus general anaesthesia in strabismus surgery. ACTA ACUST UNITED AC 2015; 91:108-13. [PMID: 26743186 DOI: 10.1016/j.oftal.2015.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/11/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). METHODOLOGY Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation<10 prism diopters, was evaluated. RESULTS Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17±2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13±2.39 vs. 2.77±2.18, respectively; P=.510) and during the first postoperative day (3.22±2.84 vs. 3.17±2.73; P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CONCLUSIONS CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome.
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Affiliation(s)
- J Vallés-Torres
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - E Garcia-Martin
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, España
| | - F J Fernández-Tirado
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, España
| | - L M Gil-Arribas
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, España
| | - L E Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, España
| | - P Peña-Calvo
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Miguel Servet, Zaragoza, España
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Satue M, Rodrigo M, Mateo A, Otin S, Bambo M, Fuertes I, Pablo L, Garcia-Martin E. Visual dysfunction and its correlation with retinal changes in patients with Parkinson disease. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Satue
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.J. Rodrigo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - A. Mateo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - S. Otin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - M.P. Bambo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - I. Fuertes
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - L. Pablo
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
| | - E. Garcia-Martin
- Ophthalmology; Miguel Servet University Hospital; Zaragoza Spain
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Pilar Bambo M, Garcia-Martin E, Gutierrez-Ruiz F, Magallon R, Roca M, Garcia-Campayo J, Perez-Olivan S, Polo V, Larrosa JM, Pablo LE. Study of perfusion changes in the optic disc of patients with fibromyalgia syndrome using new colorimetric analysis software. J Fr Ophtalmol 2015; 38:580-7. [PMID: 25976129 DOI: 10.1016/j.jfo.2015.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 12/19/2014] [Accepted: 01/05/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE We measured the amount of hemoglobin at the optic nerve head of fibromyalgia (FM) patients using new colorimetric analysis software. We also investigated whether perfusion defects of the optic nerve head in patients with FM lead to tissue atrophy and corresponding retinal nerve fiber layer (RNFL) thinning measured by optical coherence tomography (OCT). METHODS We recruited for this cross-sectional study 118 FM patients and 76 sex- and age-matched healthy controls. All subjects underwent a complete neuro-ophthalmologic examination, which also included visual field testing using the Spark strategy in an Easyfield perimeter, and OCT examinations using the Spectralis. One photograph of the optic disc was obtained using a Cirrus™ Photo 800 multi-modality imager. We analyzed fundus photographs using Laguna ONhE software, a new method that allows hemoglobin levels to be measured at the optic nerve head. We compared hemoglobin percentages in different sectors of the nerve head and RNFL thicknesses between the two groups. RESULTS Mean hemoglobin percentages and hemoglobin content in all optic nerve head sectors calculated by the Laguna ONhE program were significantly lower in FM patients than in healthy controls, and the main differences were detected in the outer ring, which corresponds with the neuroretinal rim. However, only the differences in the superotemporal RNFL were statistically significant. Correlations between the RNFL thickness and the percentage of hemoglobin in the different sectors were weak. CONCLUSION Optic disc perfusion was decreased in patients with FM, especially within the neuroretinal rim, without clear involvement in the RNFL.
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Affiliation(s)
- M Pilar Bambo
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
| | - E Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain.
| | - F Gutierrez-Ruiz
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
| | - R Magallon
- Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain; Centro Salud Arrabal, Red de Investigación en Atención primaria (REDIAPP), Zaragoza, Spain
| | - M Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Mallorca, Spain
| | - J Garcia-Campayo
- Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain; Department of Psychiatry, Miguel Servet Hospital, University of Zaragoza, Red de Investigación en Atención primaria (REDIAPP), Zaragoza, Spain
| | - S Perez-Olivan
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
| | - V Polo
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
| | - J M Larrosa
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
| | - L E Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Isabel la Catolica 1-3, 50009 Zaragoza, Spain; Aragones Institute of Health Sciences, Service, Lozano Blesa University Hospital Clinic, Avenida San Juan Bosco, C/Domingo Miral, s/n. 15, 50009 Zaragoza, Spain
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Bambo MP, Garcia-Martin E, Larrosa JM, Polo V, Pablo LE, González-de la Rosa M. [Evaluation of optic nerve perfusion in optic neuropathies and neurodegenerative diseases]. Arch Soc Esp Oftalmol 2015; 90:153-155. [PMID: 25728649 DOI: 10.1016/j.oftal.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/23/2015] [Indexed: 06/04/2023]
Affiliation(s)
- M P Bambo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
| | - E Garcia-Martin
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
| | - J M Larrosa
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
| | - V Polo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
| | - L E Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
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Garcia-Martin E. Author response: Retinal segmentation to demonstrate hyperplasia in ataxia of Charlevoix-Saguenay: critique on study methodology and results. Invest Ophthalmol Vis Sci 2014; 55:4729-30. [PMID: 25091413 DOI: 10.1167/iovs.14-14991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Garcia-Martin E, Bambo MP, Gazulla J, Larrosa JM, Polo V, Fuertes MI, Fuentes JL, Ferreras A, Pablo LE. [Finding of retinal nerve fiber layer hypertrophy in ataxia of Charlevoix-Saguenay patients]. ACTA ACUST UNITED AC 2013; 89:207-11. [PMID: 24269465 DOI: 10.1016/j.oftal.2012.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 10/31/2012] [Accepted: 11/19/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE/METHODS To present the neuro-ophthalmology examination in 5 spastic ataxia of Charlevoix-Saguenay (ARSACS) patients showing significant increases in retinal nerve fiber layer (RNFL) thickness. RESULTS/CONCLUSIONS All patients showed abnormal visual fields, normal optic discs with increased visibility of RNFL in color stereo-photographs, normal examination with Heidelberg Retina Tomography instrument, and moderate to markedly increased RNFL thickness in Cirrus Optical Coherence Tomography evaluation (average thickness: 119 to 220 microns). We found evidence that RNFL hypertrophy may be an alternative funduscopic finding to the hypermyelinated retinal fibers in previous reports. A revision of ARSACS diagnostic criteria, particularly with regard to retinal alterations, is necessary.
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Affiliation(s)
- E Garcia-Martin
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España.
| | - M P Bambo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
| | - J Gazulla
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - J M Larrosa
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
| | - V Polo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
| | - M I Fuertes
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
| | - J L Fuentes
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A Ferreras
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
| | - L E Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
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Satue M, Seral M, Otin S, Alarcia R, Herrero R, Bambo MP, Fuertes MI, Pablo LE, Garcia-Martin E. Retinal thinning and correlation with functional disability in patients with Parkinson's disease. Br J Ophthalmol 2013; 98:350-5. [PMID: 24276697 DOI: 10.1136/bjophthalmol-2013-304152] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To determine whether there is an association between retinal thinning and functional rating scales in patients with Parkinson's disease (PD). MATERIALS AND METHODS Patients with PD (n=153) and controls (n=242) underwent evaluations of the macula and retinal nerve fibre layer (RNFL) using two new-generation Fourier domain optical coherence tomography (OCT) devices (Cirrus, Carl Zeiss Meditec, Dublin, California, USA; Spectralis, Heidelberg Engineering, Heidelberg, Germany). PD severity was assessed using the Schwab-England Activities of Daily Living scale, the Unified Parkinson Disease Rating Scale, the Hoehn and Yahr (HY) scale. Retinal and RNFL thicknesses were compared between patients and controls. Correlations between structural parameters and the scores of the neurologic scales were evaluated. RESULTS RNFL parameters were significantly reduced in patients with PD, especially when using the Spectralis OCT device. All macular parameters, except for foveal thickness, differed significantly between controls and patients with PD (p<0.001). HY scores were significantly and inversely correlated with all macular parameters when measured with the Spectralis OCT device (p<0.05) and with RNFL thickness when measured with the Cirrus OCT device (nasal quadrant, sectors 2 and 5). CONCLUSIONS The neurodegeneration caused by PD can be detected using Fourier domain OCT. RNFL and macular thicknesses correlate with PD severity.
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Affiliation(s)
- M Satue
- Ophthalmology Department, Miguel Servet University Hospital, , Zaragoza, Spain
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Vallés-Torres J, Garcia-Martin E, Gil-Arribas LM, Fernández Tirado FJ, Pablo Júlvez LE. [Local and regional anesthetic techniques in strabismus surgery: advantages and disadvantages]. ACTA ACUST UNITED AC 2013; 88:331-3. [PMID: 23988038 DOI: 10.1016/j.oftal.2013.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 10/26/2022]
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Satué Palacián M, Garcia-Martin E, Fernández Tirado FJ, Pablo Júlvez LE. [Update and review of conjunctival melanoma treatment]. Arch Soc Esp Oftalmol 2013; 88:247-249. [PMID: 23768470 DOI: 10.1016/j.oftal.2013.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 06/02/2023]
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Garcia-Martin E, Calvo B, Malvè M, Herrero R, Fuertes I, Ferreras A, Larrosa JM, Polo V, Pablo LE. Three-dimensional geometries representing the retinal nerve fiber layer in multiple sclerosis, optic neuritis, and healthy eyes. Ophthalmic Res 2013; 50:72-81. [PMID: 23774269 DOI: 10.1159/000350413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 01/24/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND To represent and interpret the three-dimensional (3D) geometry and the distribution of the axonal damage to the retinal nerve fiber layer (RNFL) in patients with multiple sclerosis (MS) compared with healthy subjects. To analyze alterations in RNFL morphology in eyes of MS patients with or without previous episodes of optic neuritis (ON). METHODS MS patients (n = 122) and age-matched healthy subjects (n = 108) were enrolled. The Spectralis optical coherence tomography system was used to determine the circumpapillary RNFL thickness. The 768 RNFL thickness measurements were used to evaluate thickness measurements in patients with or without antecedent ON and to design a 3D reconstruction of the RNFL thickness representing the mechanobiologic tissue response to neurodegeneration caused by MS and ON episodes. RESULTS RNFL thickness was decreased in MS patients, and was higher in the MS group with previous ON. Statistical analysis and 3D RNFL reconstruction revealed greater damage to the ganglionar cells in the superonasal RNFL area (101.77 µm in MS vs. 125.47 µm in healthy subjects) and in the inferotemporal RNFL (119.05 µm in MS eyes and 149.26 µm in healthy eyes). CONCLUSIONS The 3D representation of RNFL thickness based on measurements allows physicians to better observe damage in the temporal areas, especially in patients with previous ON.
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Affiliation(s)
- E Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.
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Garcia-Martin E, Rodriguez-Mena D, Herrero R, Almarcegui C, Dolz I, Martin J, Ara JR, Larrosa JM, Polo V, Fernandez J, Pablo LE. Neuro-ophthalmologic evaluation, quality of life, and functional disability in patients with MS. Neurology 2013; 81:76-83. [DOI: 10.1212/wnl.0b013e318299ccd9] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Satue M, Garcia-Martin E, Fuertes I, Otin S, Alarcia R, Herrero R, Bambo MP, Pablo LE, Fernandez FJ. Use of Fourier-domain OCT to detect retinal nerve fiber layer degeneration in Parkinson's disease patients. Eye (Lond) 2013; 27:507-14. [PMID: 23429414 PMCID: PMC3626016 DOI: 10.1038/eye.2013.4] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 12/26/2012] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To demonstrate axonal loss in the retinal nerve fiber layer (RNFL) of patients with Parkinson's disease (PD) and to evaluate the ability of Fourier-domain optical coherence tomography (OCT) to detect RNFL degeneration and retinal thinning in these patients. METHODS PD patients (n=100) and healthy subjects (n=100) were included in the study and underwent visual acuity, color vision, and OCT examinations using two next-generation Fourier-domain devices (Spectralis and Cirrus). Differences in the RNFL thicknesses were compared between patients and controls. RESULTS RNFL thicknesses were significantly reduced in PD patients compared with healthy subjects, especially those obtained using the Spectralis OCT, in the inferotemporal quadrant (155.6±16.5 μm in healthy eyes vs 142.1±24.9 μm in patients, P=0.040) and in the superotemporal quadrant (142.6±20.9 μm in healthy eyes vs 132.77±18.6 μm in PD patients, P=0.046). Significant differences were observed between controls and patients in relation to mean macular thickness (P=0.031), foveal thickness (P=0.030), and inferior outer thickness (P=0.019). CONCLUSION PD is associated with RNFL loss and retinal thinning, which is detectable by Fourier-domain OCT measurements.
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Affiliation(s)
- M Satue
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - I Fuertes
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - S Otin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
| | - R Alarcia
- Department of Neurology, Miguel Servet University Hospital, Zaragoza, Spain
| | - R Herrero
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - M P Bambo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - L E Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
| | - F J Fernandez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
- Aragones Institute of Health Sciences, Research Department, Zaragoza, Spain
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Bambó Rubio MP, Garcia-Martin E, Gil-Arribas LM, Fernández Tirado FJ, Pablo Júlvez LE. Anterior ischaemic optic neuropathy: what do we know and what do we still need to know? Arch Soc Esp Oftalmol 2013; 88:85-87. [PMID: 23473083 DOI: 10.1016/j.oftal.2013.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 02/13/2013] [Indexed: 06/01/2023]
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Rodriguez-Mena D, Almarcegui C, Dolz I, Pablo LE, Garcia-Martin E. Application of electrophysiological tests in the study of neurological diseases with visual involvement. ACTA ACUST UNITED AC 2012; 87:311-4. [PMID: 23021227 DOI: 10.1016/j.oftal.2012.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 08/15/2012] [Indexed: 11/29/2022]
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Garcia-Martin E, Pueyo V, Ara JR, Almarcegui C, Martin J, Pablo L, Dolz I, Sancho E, Fernandez FJ. Effect of optic neuritis on progressive axonal damage in multiple sclerosis patients. Mult Scler 2011; 17:830-7. [DOI: 10.1177/1352458510397414] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this research was to study the effect of optic neuritis (ON) on axonal damage in multiple sclerosis (MS) patients. Specifically, we compared changes over 2 years in the retinal nerve fibre layer (RNFL) between affected and contralateral eyes in MS patients with a prior history of ON. Methods: Thirty-four patients with one unilateral definitive episode of ON were included and underwent a complete ophthalmic examination, optical coherence tomography (OCT), scanning laser polarimetry, visual evoked potentials (VEP) and pattern electroretinogram (pERG). All patients were re-evaluated at 12 and 24 months. Parameters were compared between ON-affected and contralateral eyes in an initial exploration and over the course of the follow-up. Correlations between parameter changes were analysed. Results: RNFL thickness and functional parameters showed more affection in ON eyes ( p ≤ 0.05), but changes in measurements during the study were similar between both groups of eyes. Conclusions: Progressive axonal loss can be detected in the optic nerve, but ON is not a risk factor for increased chronic damage in MS patients without ophthalmic relapses. Loss of the RNFL is caused by progressive degeneration associated with the disease.
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Affiliation(s)
- E Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
| | - V Pueyo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
| | - JR Ara
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - C Almarcegui
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
- Neurophysiology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - J Martin
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - L Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
| | - I Dolz
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
- Neurophysiology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - E Sancho
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - FJ Fernandez
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
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Garcia-Martin E, Gil-Arribas LM, Idoipe M, Alfaro J, Pueyo V, Pablo LE, Fernandez FJ. Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma. Br J Ophthalmol 2011; 95:1393-6. [PMID: 21242584 DOI: 10.1136/bjo.2010.193078] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND To compare the efficacy, cosmesis and tolerance of two non-surgical treatments-imiquimod (IMQ) 5% cream and radiotherapy (RT)-to combat periocular nodular basal cell carcinoma (BCC). METHODS Twenty-seven patients with clinical and histopathological diagnosis of nodular BCC on the eyelid were included and randomly selected: 15 patients were treated with IMQ 5% cream once daily, 5 days/week for 6 weeks, and 12 patients were treated with RT. RESULTS All tumours showed histopathological remission within 3 months of the treatment, and sustained clinical remission was documented in each patient after 24 months' follow-up. Treatment tolerability was rated as moderate with IMQ and good with RT. Functional results were better in patients treated with IMQ. Loss of eyelashes was reported for most of the patients treated with RT. CONCLUSIONS IMQ and RT therapies are effective for treating eyelid nodular BCCs. Cosmesis and functional results were better with IMQ, while tolerability was higher with RT.
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Affiliation(s)
- E Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.
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Garcia-Martin E, Pinilla I, Pueyo V, Gil L, Martinez-Morales J, Fernandez J. Bilateral Internuclear Ophthalmoplegia in a Patient with Devic's Neuromyelitis Optica. Case Rep Neurol 2010; 2:139-144. [PMID: 21113284 PMCID: PMC2988848 DOI: 10.1159/000322428] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An unusual presentation of Devic's neuromyelitis optica (NMO) disease associated with bilateral internuclear ophthalmoplegia (INO) is described. A 32-year-old pregnant patient was diagnosed with NMO. First symptoms were headache and sudden visual loss in her right eye (RE). Eighteen months ago, she reported other neurologic symptoms such as paresthesia. Based on her visual field, fundoscopy and Ishihara test, she was diagnosed with retrobulbar neuritis of the RE. After delivery, new neurologic symptoms resembling transverse myelitis appeared. She was treated with methylprednisolone and plasmapheresis, which improved her visual acuity; however, a sudden bilateral INO appeared, with adduction defect and nystagmus with abduction in both eyes. No improvement was obtained after treatment with azathioprine and rituximab. Paresis of the legs and the right arm persisted, but double vision and OIN gradually disappeared. At the end, the patient had a residual exophoria in the RE and nystagmus with abduction in the left eye. Prevalence of NMO is lower than one case per one million inhabitants, and it is not likely to affect the encephalic trunk; furthermore, bilateral INO in NMO is rare. Two major criteria and at least two of the three minor ones are required to confirm a NMO diagnosis, and our patient fulfilled these diagnosis criteria.
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Affiliation(s)
- E Garcia-Martin
- Department of Ophthalmology, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
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Martinez-Oliva C, Garcia-Martin E, Alonso-Navarro H, Benito-Leon J, Puertas I, Garcia-Gamito F, Rubio L, López-Alburquerque T, Garcia-Agundez J, Jiménez-Jiménez F. P3.156 Alcohol dehydrogenase 2 polymorphism is not associated to the risk for essential tremor. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Guerini D, Garcia-Martin E, Zecca A, Guidi F, Carafoli E. The calcium pump of the plasma membrane: membrane targeting, calcium binding sites, tissue-specific isoform expression. Acta Physiol Scand Suppl 1998; 643:265-73. [PMID: 9789569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The two Ca2+ pumps of higher eucaryotes are strictly targeted to different membrane systems: the plasma membrane (PMCA) and the sarco(endo)plasmic reticulum (SERCA). Chimeric constructs of the two pumps expressed in COS-7 cells have revealed a strong signal for endoplasmic reticulum retention in the N-terminal cytosolic portion of the SERCA pump: the signal is contained in a stretch of 28 amino acids that follows the N-terminus. A second, but masked, endoplasmic reticulum retention signal is contained in a cytosolic C-terminal sequence immediately preceding the calmodulin-binding domain of the Ca2+ pump. Selective mutations on the SERCA pump have led to the conclusion that 5 conserved residue membrane domains (TM)4, 5, and 6 form the Ca2+ channel through the pump protein. A comparative sequence inspection has failed to reveal any of these residues in TM5 of the PMCA pump. Mutation of the conserved residue in TM4 and of two in TM6 abolished the ability of the pump to form the Ca(2+)-dependent phosphoenzyme. However, one of the mutations (N979, TM6) also caused retention of the PMCA pump in the reticulum, suggesting structural alterations. Of the four basic isoforms of the pump, two (1, 4) are ubiquitously expressed, two (2, 3) are essentially brain specific. Isoform 2 has the highest calmodulin affinity. Primary cultures of cerebellar granule cells from newborn rats did not express isoforms 2 and 3 at plating time. Incubation of the cells in depolarizing concentrations of KCl, which promote Ca2+ influx, promoted the expression of isoforms 2 and 3, and of a brain specific spliced variant of isoform 1. Incubation of the cells in L-type Ca2+ channel blockers abolished the upregulation of the pump genes.
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Affiliation(s)
- D Guerini
- Institute of Biochemistry, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
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Ricote M, Garcia-Martin E, Sancho J, Gutierrez-Merino C. Hypothalamic hypophyseal inhibitory factor (HHIF) increases intrasynaptosomal free calcium concentration. Hypertension 1997; 29:1337-43. [PMID: 9180638 DOI: 10.1161/01.hyp.29.6.1337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We have isolated from bovine hypothalamic and pituitary tissues a sodium pump inhibitor that is structurally different from ouabain. By mass spectrometric analysis, this purified factor revealed a single unique molecular ion with an accurate mass of 412.277 and a mass spectra different from that of ouabain. It has been previously shown that this factor inhibits the Ca2+, Mg(2+)-ATPase of the plasma membrane of synaptosomes. Because Ca2+ plays a major role in cellular excitability, we carried out a systematic study of the effects of this inhibitor on the Ca2+ transport processes across the plasma membrane of synaptosomes: We measured ATP-dependent calcium uptake, Na(+)-Ca2+ exchange, and passive permeability using 45Ca2+ and Millipore filtration, chlortetracycline fluorescence, and light-scattering, respectively. This factor inhibits the Na+, K(+)-ATPase activity of the synaptosomal plasma membrane vesicles in the same range of concentrations that produced an increase of intrasynaptosomal free calcium, with nearly the same K0.5 value. In addition, in this concentration range, this factor stimulated 10- to 11-fold the passive flux of Ca2+ and 2.5- to 3-fold the Ca2+ influx via the Na(+)-Ca2+ exchange in these membranes with respect to control values. Measurements of fluorescence anisotropy showed that in this concentration range, the inhibitor did not significantly change the order parameter (fluidity) of these membranes. These results suggest that besides its known inhibition of the sodium pump, this factor could play a role in the control of Ca2+ homeostasis by direct modulation of transport systems implicated in the control of intracellular calcium.
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Affiliation(s)
- M Ricote
- Departamento de Bioquímica y Biología Molecular y Genética, Facultad de Ciencias, Universidad de Extremadura, Badajoz, Spain
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Abstract
The Ca2+ pump of the plasma membrane (PMCA) is regulated by a number of agents. The most important is calmodulin (CaM), which binds to a domain located in the C-terminal portion of the pump, removing it from an autoinhibitory site next to the active site. The CaM-binding domain is preceded by an acidic sequence which contains a hidden signal for endoplasmic reticulum (ER) retention. Chimeras of the PMCA and endoplasmic reticulum (SERCA) pumps have revealed the presence of a strong signal for ER retention in the first 45 residues of the SERCA pump. Four gene products of the PMCA pump are known: two of them (1 and 4) are ubiquitously expressed, two (2 and 3) are specific for nerve cells and may be induced by their activation. Mutagenesis work has identified four residues in three of the transmembrane domains of the pump which may be components of the trans-protein Ca2+ path. The mutation of two of these residues alters the membrane targeting of the pump.
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Affiliation(s)
- E Carafoli
- Inst. for Biochemistry III, ETH Zurich, Switzerland
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Gutierrez-Merino C, Centeno F, Garcia-Martin E, Merino JM. Fluorescence energy transfer as a tool to locate functional sites in membrane proteins. Biochem Soc Trans 1994; 22:784-8. [PMID: 7821685 DOI: 10.1042/bst0220784] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- C Gutierrez-Merino
- Departamento de Bioquimica y Biologia Molecular, Facultad de Ciencias, Universidad de Extremadura, Badajoz, Spain
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