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Esteban O, Marcuello C, Martinez M, Lavilla L, Marco S, Ascaso FJ. Macular and choroidal thickness in Down syndrome by swept-source optical coherence tomography (SS-OCT). Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:618-622. [PMID: 34756287 DOI: 10.1016/j.oftale.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 01/05/2021] [Indexed: 06/13/2023]
Abstract
Down syndrome (DS) is associated with certain structural and functional disorders in the whole visual system. The purpose was to compare retinal and choroidal thickness using swept-source optical coherence tomography (SS-OCT) in DS subjects with controls. This cross-sectional study included 100 eyes of 52 DS subjects and 78 eyes of 39 matching age and axial length controls. Our results showed that inner or outer retinal and ganglionar thickness showed no significant differences between DS and control group (p > 0.05). However, retinal foveal thickness (rFT), ganglion foveal thickness (gFT) were significantly higher in DS group than in controls, whereas choroidal foveal thickness (cFT) and some choroidal quadrants of inner and outer rings were significantly lower (p < 0.05). This the first pilot study to provide information about macular and choroidal thicknesses in SD using SS-OCT compared to controls. Further analyses with larger numbers of subjects are needed to confirm our results.
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Affiliation(s)
- O Esteban
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - C Marcuello
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain
| | | | - L Lavilla
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - S Marco
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - F J Ascaso
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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Esteban O, Marcuello C, Martinez M, Lavilla L, Marco S, Ascaso FJ. Macular and choroidal thickness in Down syndrome by swept-source optical coherence tomography (SS-OCT). Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(21)00054-X. [PMID: 33715915 DOI: 10.1016/j.oftal.2021.01.011] [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] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
Down syndrome (DS) is associated with certain structural and functional disorders in the whole visual system. The purpose was to compare retinal and choroidal thickness using swept-source optical coherence tomography (SS-OCT) in DS subjects with controls. This cross-sectional study included 100 eyes of 52 DS subjects and 78 eyes of 39 matching age and axial length controls. Our results showed that inner or outer retinal and ganglionar thickness showed no significant differences between DS and control group (p>0.05). However, retinal foveal thickness (rFT), ganglion foveal thickness (gFT) were significantly higher in DS group than in controls, whereas choroidal foveal thickness (cFT) and some choroidal quadrants of inner and outer rings were significantly lower (p<0.05). This the first pilot study to provide information about macular and choroidal thicknesses in SD using SS-OCT compared to controls. Further analyses with larger numbers of subjects are needed to confirm our results.
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Affiliation(s)
- O Esteban
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.
| | - C Marcuello
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, España
| | | | - L Lavilla
- Hospital Universitario Miguel Servet, Zaragoza, España
| | - S Marco
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - F J Ascaso
- Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
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3
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Pont C, Ascaso FJ, Grzybowski A, Huerva V. Corneal endothelial cell density during diabetes mellitus and ocular diabetes complications treatment. J Fr Ophtalmol 2020; 43:794-798. [PMID: 32616318 DOI: 10.1016/j.jfo.2019.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 12/17/2022]
Abstract
Diabetes mellitus may affect the cornea at various levels. Ocular surface changes and dry eye had been studied. Researchers are concerned that medical treatment of diabetes or retinal complications may result in endothelial damage and cell loss. This report summarizes the possibility of endothelial cell loss in diabetic patients. A decrease in endothelial cell density (ECD) in diabetic patients has been reported. In addition, corneal thickness may increase in diabetic patients. Significant endothelial cell loss has been demonstrated in long-term disease and in cases of poor metabolic control. No association between the use of oral hypoglycemics and ECD has been reported. There is also no evidence of an association between the use of insulin and corneal endothelial damage. No difference in ECD among the various degrees of retinopathy or with a history of photocoagulation has been shown. Regarding the studies comparing diabetic and non-diabetic patients undergoing cataract surgery, in all cases, the decrease in ECD is higher in diabetic patients than that seen in non-diabetic patients. However, there is no evidence of increased endothelial damage in diabetics compared to non-diabetics during vitreo-retinal surgery in phakic eyes. No significant changes in corneal endothelium after intravitreal anti-VEGF injections have been referenced.
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Affiliation(s)
- C Pont
- Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Avda. Alcade Rovira Roure 80, 25198 Lleida, Spain
| | - F J Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain; Aragón Health Research Institute (IIS Aragon), Zaragoza, Spain; Aragon Institute of Engineering Research (13A), University of Zaragoza, Zaragoza, Spain
| | - A Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - V Huerva
- Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Avda. Alcade Rovira Roure 80, 25198 Lleida, Spain; University of Lleida (UdL), Lleida, Spain; IRB Lleida, Lleida, Spain.
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Abstract
Sinonasal undifferentiated carcinoma (SNUC) is an infrequent tumor described by Frierson et al. in 1986. Since its initial description, fewer than 100 patients have been reported. We present a case of a SNUC invading the orbit in a 57-year-old woman, for which the findings are documented by CT scan, light and electron microscopy.
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Affiliation(s)
- F J Ascaso
- Department of Opthalmology, University Hospital, Zaragoza, Spain
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Abstract
A case of bilateral primary choroidal melanoma is described. To our knowledge, this is the first reported case in Spain. On admission of a 70-year-old man for a choroidal melanoma in the right eye, an asymptomatic tumor was detected in the periphery of his left eye. A-scan ultrasonography, fluorescein angiography and diascleral transillumination supported the diagnosis of choroidal melanoma in both eyes. The right eye was enucleated. Histology confirmed a choroidal melanoma of the mixed type. The left eye was treated with laser photocoagulation and an episcleral plaque of ruthenium-106. Careful systemic evaluation produced no evidence of a primary tumor or metastatic disease elsewhere in the body. Because of the impossibility, in most cases, of obtaining histological confirmation in both eyes, and the tendency of choroidal melanomas to metastatize late, we suggest that the criteria of independent origin (two separate cell types and tumors separated in time) are not necessary in cases of presumed bilateral choroidal melanoma.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain
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Abstract
We report the case of a 14-year-old girl with multiple findings characteristic of Noonan's syndrome, including short stature, mild mental retardation, facial, skeletal and renal abnormalities. In addition, ophthalmic examination revealed a keratoconus in the left eye and a right optic disc coloboma. To date, only two cases of Noonan's syndrome with keratoconus have been reported, and this is the second case of this syndrome with optic disc coloboma. To our knowledge, this is the first report of Noonan's syndrome associated with unilateral keratoconus and contralateral optic disc coloboma. In view of the large number of patients with Noonan's syndrome reported to date and the rarity of these ocular abnormalities, it is most likely that this association is fortuitous. Ocular findings reported in patients with Noonan's syndrome are reviewed.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain
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Rodríguez-Marco NA, Solanas-Alava S, Ascaso FJ, Martínez-Martínez L, Rubio-Obanos MT, Andonegui-Navarro J. [Severe and reversible optic neuropathy by ethambutol and isoniazid]. An Sist Sanit Navar 2016; 37:287-91. [PMID: 25189987 DOI: 10.4321/s1137-66272014000200012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ethambutol and isoniazid are antimicrobial agents used to treat multi-drug-resistant tuberculosis. The most commonly recognized toxic effect of these drugs is optic neuropathy, usually manifesting as a decrease in visual acuity, deficits in colour vision and cecocentral scotomas. This study presents the case of a 59-year-old Nigerian woman diagnosed of multi-drug-resistant tuberculosis who developed a severe bilateral optic neuropathy induced by ethambutol and isoniazid. Ophthalmologic examination revealed normal intraocular pressure, normal funduscopic examination and normal biomicroscopy. Automated visual field revealed 360º peripheral constriction and central scotoma. Magnetic resonance images of the brain and orbits were normal. Ten months after suspending treatment, the patient recovered complete visual function. Visual loss is a rare complication that can be related to ethambutol and isoniazid toxicity. Both eyes are usually symmetrically affected with deficits in colour vision and cecocentral scotoma. For successful treatment of visual loss, it is important to make a differential diagnosis between infection and adverse effects of anti-TB drugs. Ophthalmological examination is thus important before and after treatment.
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Affiliation(s)
- N A Rodríguez-Marco
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, 31008, Spain.
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Grzybowski A, Ascaso FJ. Migration of Intraocular Silicone Oil to CNS: The Role of Elevated Intraocular Pressure and Congenital Optic Nerve Abnormalities. Clin Neuroradiol 2016; 26:127. [PMID: 26346584 PMCID: PMC4833792 DOI: 10.1007/s00062-015-0460-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A Grzybowski
- Department of Ophthalmology, Poznan City Hospital, 3 Szwajcarska St, 361-285, Poznań, Poland.
- Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.
| | - F J Ascaso
- Medical and Surgical Retina Unit, Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- School of Medicine, University of Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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Huerva V, Traveset AE, Ascaso FJ, Sánchez MC. Spontaneous resolution of a rare case of circumferential lymphangiectasia haemorrhagica conjunctivae. Eye (Lond) 2014; 28:912-4. [PMID: 24699167 PMCID: PMC4094813 DOI: 10.1038/eye.2014.73] [Citation(s) in RCA: 4] [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: 11/09/2022] Open
Affiliation(s)
- V Huerva
- Ophthalmology Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - A E Traveset
- Ophthalmology Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - F J Ascaso
- Department of Ophthalmology, ‘Lozano Blesa' University Clinic Hospital, Zaragoza, Spain
| | - M C Sánchez
- Ophthalmology Department, University Hospital Arnau de Vilanova, Lleida, Spain
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Ascaso FJ. [«Eyeball licking» or the pleasure of licking the eyes]. Arch Soc Esp Oftalmol 2014; 89:212. [PMID: 24332690 DOI: 10.1016/j.oftal.2013.09.010] [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: 08/28/2013] [Accepted: 09/24/2013] [Indexed: 06/03/2023]
Affiliation(s)
- F J Ascaso
- Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
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Ascaso FJ. [Vodka eyeballing: Give me another drink … in the eye, please!]. Arch Soc Esp Oftalmol 2013; 88:411-412. [PMID: 24060308 DOI: 10.1016/j.oftal.2013.02.007] [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: 02/02/2013] [Accepted: 02/06/2013] [Indexed: 06/02/2023]
Affiliation(s)
- F J Ascaso
- Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Departamento de Cirugía, Facultad de Medicina, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España.
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Grzybowski A, Ascaso FJ. Vitreomacular traction syndrome: the role of intravitreal plasmin injection is still not clear. Eye (Lond) 2013; 27:776. [PMID: 23579411 DOI: 10.1038/eye.2013.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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13
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Grzybowski A, Ascaso FJ. More on a patient-centric approach in the anti-VEGF therapy. Eye (Lond) 2012; 26:1388. [PMID: 22814805 PMCID: PMC3470047 DOI: 10.1038/eye.2012.148] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- A Grzybowski
- Department of Ophthalmology, Poznan City Hospital, Poznań, Poland
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
| | - F J Ascaso
- Department of Ophthalmology, ‘Lozano Blesa' University Clinic Hospital, Zaragoza, Spain
- Aragon Health Sciences Institute, Zaragoza, Spain
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Ascaso FJ, Lizana J. [An enigmatic eye in an enigmatic bust]. Arch Soc Esp Oftalmol 2012; 87:125-126. [PMID: 22482897 DOI: 10.1016/j.oftal.2011.07.014] [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: 06/21/2011] [Accepted: 07/07/2011] [Indexed: 05/31/2023]
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Ruiz-De-Gopegui E, Ascaso FJ, Del Buey MA, Cristóbal JA. [Effects of encircling scleral buckling on the morphology and biomechanical properties of the cornea]. ACTA ACUST UNITED AC 2011; 86:363-7. [PMID: 22040643 DOI: 10.1016/j.oftal.2011.05.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Revised: 03/20/2011] [Accepted: 05/25/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of encircling scleral buckle (SB) on corneal biomechanical properties of the cornea and its morphological parameters. METHODS We prospectively examined twelve eyes diagnosed with vitreous haemorrhage undergoing pars plana vitrectomy (PPV), and fifteen eyes undergoing combined PPV and scleral buckle (PPV/SB) for repair of rhegmatogenous retinal detachment (RRD). Corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF), were measured with an Ocular Response Analyser (ORA) before and 1-month postoperatively. The ORA also determined the values of intraocular pressure (IOPg) and corneal compensated IOP (IOPcc). Finally, four morphological parameters of the cornea were measured with the Orbscan II topographer (Orbtek, Inc.): mean corneal power, thinnest corneal point (μm), and anterior chamber depth (ACD). RESULTS CH decreased significantly from 10.2+/-1.7mmHg to 7.6+/-1.1mmHg after PPV/SB (p=0.003), but not after PPV alone (9.8+/-3.2mmHg vs 11.6+/-2.7mmHg, P=.465). CRF did not change significantly after surgery in both groups. IOPg and IOPcc increased significantly in the PPV/SB group (P=.019 and P=.010, respectively) but not in PPV group (P=.715 and P=.273, respectively). Unlike the PPV group, values were significantly higher than IOPg values before (P=.001) and after surgery (P=.003) in the PPV/SB group IOPcc. Neither the PPV/SB group nor the PPV group showed any significant changes in the corneal morphological parameters after surgery (P>.05). CONCLUSIONS SB surgery leads to a change in the corneal biomechanical properties without altering corneal morphological parameters. It may cause an underestimation error in IOP measurement. PPV may be a less invasive surgical approach for the repair of noncomplex RRD than PPV/SB.
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Huerva V, Sánchez MC, Ascaso FJ, Craver L, Fernández E. Calciphylaxis and bilateral optic neuropathy. J Fr Ophtalmol 2011; 34:651.e1-4. [PMID: 21680055 DOI: 10.1016/j.jfo.2011.02.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Revised: 02/16/2011] [Accepted: 02/18/2011] [Indexed: 11/28/2022]
Abstract
A 51-year-old woman on hemodialysis for chronic renal failure complained of visual loss in her right eye. Right optic disc edema was observed on fundus examination. An arteritic optic neuropathy was suspected. However, a first biopsy did not reveal any inflammatory cells. Two months later, the patient experienced sudden visual loss in her left eye and presented with necrotic cutaneous lesions at the distal phalanges of several fingers of the right hand. Necrotic lesions also appeared on the inner aspect of the thighs. Biopsy of the cutaneous lesions revealed calcification in the wall of a small artery. A new biopsy of the temporal artery showed large calcium deposits in the artery's tunica media. The diagnosis of optic neuropathy secondary to calciphylaxis was made. A temporal artery biopsy should be repeated if the first one is inconclusive. An early diagnosis leading to appropriate treatment may help to prevent an irreversible loss of vision in these patients.
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Affiliation(s)
- V Huerva
- Department of ophthalmology, university hospital Arnau-de-Vilanova, 80, avenida Rovira Roure, 25198 Lleida, Spain.
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Ascaso FJ, Peiro C, Cristóbal JA. [The country of the blind, by H.G. Wells (1866-1946)]. Arch Soc Esp Oftalmol 2010; 85:313-314. [PMID: 21167438 DOI: 10.1016/j.oftal.2010.11.002] [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: 10/17/2010] [Accepted: 11/03/2010] [Indexed: 05/30/2023]
Affiliation(s)
- F J Ascaso
- Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
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Affiliation(s)
- F J Ascaso
- Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
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Abstract
Behçet's disease (BD) is a chronic, multisystem and relapsing vasculitis of unknown etiology. Central nervous system (CNS) involvement is reported in 30% of cases, but it is the first symptom of the disease in only 5% of subjects. Neurological manifestations may appear as a parenchymal CNS pattern (the commonest), an intracranial hypertension-like pattern, or a meningitis-like pattern. We describe a 30-year-old Algerian man with BD who developed, as first symptom, a typical intracranial hypertension picture with headaches, bilateral papilledema and raised cerebrospinal fluid (CSF) pressure. Magnetic resonance angiography (MRA) revealed a cerebral venous sinus thrombosis (VST). After 1 month of treatment with anticoagulants, prednisone, colchicine and chlorambucil, MRA showed complete recanalization of the cerebral venous sinus and the patient made a full recovery. BD should be routinely looked for in adult patients, especially males in their third and fourth decades, who present with intracranial hypertension syndrome. We therefore advocate the use of MRA for unexplained neurological symptoms in BD, since without it cerebral VST may easily be missed.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain.
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22
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Ascaso FJ, Loras E, Cristobal JA. Combination of Nd:Yag laser-induced subconjunctival bleeding and intracameral viscoelastic injection to treat hypotony maculopathy. Ophthalmic Surg Lasers 2002; 33:504-7. [PMID: 12449229] [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: 02/27/2023]
Abstract
A 38-year-old man with primary open-angle glaucoma who had undergone trabeculectomy with mitomycin-C developed macular folds consistent with hypotony maculopathy. The patient was successfully treated with a combination of Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-induced subconjunctival bleeding and injection of a viscoelastic substance into the anterior chamber. The combination of Nd:YAG laser-induced subconjunctival bleeding with intracameral viscoelastic injection appears to be a reasonable alternative to autologous blood injection and may be tried as first-line treatment for hypotony maculopathy caused by overfiltration.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, San Juan, Bosco 15, 50009 Zaragoza, Spain
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Abstract
PURPOSE Paraneoplastic neurological syndromes are well-known sequelae of some malignancies. To our knowledge, a syndrome mimicking progressive external ophthalmoplegia had never been reported preceding the diagnosis of a lymphoma. CASE REPORT A 63-year-old man developed progressive external ophthalmoplegia, without any other neurological symptoms, as the initial manifestation of a follicular lymphoma grade III. The ophthalmoplegia resolved after two cycles of combination chemotherapy. CONCLUSIONS The ophthalmologist, when confronted with a progressive external ophthalmoplegia, should consider a neurological paraneoplastic syndrome associated with a tumor as a possible diagnosis.
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25
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Perena MF, Ascaso FJ, Barrio J, Martínez J, Cascante M, Iturbe F. [Primary retinal vasculitis]. Arch Soc Esp Oftalmol 2000; 75:417-20. [PMID: 11151187] [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: 02/18/2023]
Abstract
CASE REPORT We present the case of a 22-year-old Caucasian female who consulted because of a brief episode of blurred vision in her right eye. Funduscopic findings in right eye included marked venous tortuousness and roundish paramacular haemorrhages. A slight venous tortuousness in left eye. Fluorescein angiography showed a segmentary retinal vasculitis affecting medium calibre vessels of the posterior pole. Complementary examinations ruled out any systemic involvement. After therapy with oral corticoesteroids the case evolves to remission. DISCUSSION The diagnosis of retinal vasculitis is achieved by the performance of ophthalmoscopy and fluorescein angiography. Prior studies have ruled out the need for complementary examinations to find any systemic involvement in patients.
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Affiliation(s)
- M F Perena
- Servicio de Oftalmología del H.C.U. de Zaragoza, España
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Abstract
Occlusion of the retinal artery is a rare complication after therapeutic embolization. We present a case of a partial retinal artery obstruction following coil embolization of an intracerebral aneurysm. To our knowledge, only six cases of acute occlusion of the choroidal and/or retinal arteries after therapeutic embolization have been reported so far. The case presented here, however, is the first in which platinum microcoils were the material used. In addition the retinal ischemia was reversible, visual acuity returning to normal and cutten-wool spot and retinal hemorrhages resolving spontaneously.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hopsital, Zaragoza, Spain
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Ascaso FJ, Ayala I, Carbonell P, Castro FJ, Palomar A. Prophylactic intravenous ondansetron in patients undergoing cataract extraction under general anesthesia. Ophthalmologica 1997; 211:292-5. [PMID: 9286804 DOI: 10.1159/000310811] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 02/05/2023]
Abstract
During the past decade the demand for outpatient surgery has grown rapidly. Postoperative nausea and vomiting is one of the more common undesirable consequences of surgery, which may significantly delay the patient's discharge from the ambulatory surgery center. None of the currently used antiemetic drugs is considered totally effective in abolishing nausea or vomiting. The purpose of this study was to compare the efficacy of ondansetron, a highly selective 5-hydroxytryptamine subtype-3 receptor antagonist, with that of metoclopramide for the prevention of postoperative emesis in patients undergoing cataract surgery. The incidence of postoperative nausea was significantly less in the ondansetron group than that in the metoclopramide group (p = 0.046). Although the incidence of vomiting was clinically less frequent in the ondansetron group, there were no significant differences between both treatment groups. To our knowledge, this is the first study to demonstrate that ondansetron is effective to prevent postoperative emesis after extracapsular cataract extraction.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain
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28
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Abstract
Previous reports have described the presence of apoproteins A in subretinal fluid (SRF). We studied the presence of total apoprotein A (apo A) and apoprotein A-I (apo A-I), using the method described by Laurel in SRF and its levels in serum in 20 patients with retinal detachment. By this method we can quantify the concentrations of apoproteins in SRF. All cases showed the presence of these apoproteins in SRF. The mean +/- standard deviation obtained was 78.7 +/- 26.94 mg/dl and 173.35 +/- 30.08 mg/dl for total apo A in SRF and serum respectively. For apo A-I these values were 32.62 +/- 14.36 mg/dl in SRF and 123.4 +/- 24.11 mg/dl in serum. We found no correlation between levels of total apo A and apo A-I in SRF and its levels in serum. Statistical differences were found between apo A-I content in SRF from detachments with the size of 3 quadrants and that of 1 and 2 quadrants but not between 3 and 4 quadrants. When the detachment affected 1 and 2 quadrants the concentrations of apo A-I were statistically lower. No statistical differences were found between concentrations of total apo A and apo A-I in SRF and the duration or presence of PVR in the detachments. These findings suggest that the outer blood retinal barrier is preserved during rhegmatogenous retinal detachment.
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Affiliation(s)
- V Huerva
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain
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29
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Abstract
Since its introduction, fluorescein angiography has been widely used to investigate diseases of the ocular fundus. A case of fatal acute myocardial infarction after intravenous fluorescein angiography is presented. This appears to be the first case documented by autopsy in which the findings are compatible with myocardial infarction as the cause of death. Although there are no known contraindications for fluorescein angiography in patients with a history of cardiovascular disease, the indications for this elective procedure should be carefully reviewed in such patients. Adequate emergency resuscitation equipment should be available in the fluorescein angiography suite.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, Clinic Hospital, University of Zaragoza, Spain
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30
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Huerva V, Ascaso FJ, Palomar MT, Garcia J, Olivares JL, Gabas M, Palomar A. [Möbius syndrome and bilateral chorioretinal coloboma]. Ann Pediatr (Paris) 1992; 39:313-6. [PMID: 1616250] [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: 12/27/2022]
Abstract
A child with palsy of the right facial nerve and bilateral palsy of the VIth, IXth and XIIth cranial nerves, dysfunction of the VIIIth cranial nerve, facial malformations and bilateral equinovarus was diagnosed on the basis of these features as having Moebius syndrome. Ocular studies disclosed congenital cataract and chorioretinal coloboma in both eyes. These ocular abnormalities have not previously been described in Moebius syndrome. This paper discusses whether the coexistence of these two types of anomalies may be due to occurrence of a break in the primitive internal carotid and trigeminal arteries between the fourth and fifth postconceptional weeks, causing maldevelopment of the choriocapillary and impairing neuron differentiation in cranial nerve nuclei.
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Affiliation(s)
- V Huerva
- Service d'Ophtalmologie, Hôpital Clinique Universitaire, Zaragoza, Espagne
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31
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Abstract
A retrospective study of 183 eyes that had undergone extracapsular cataract extraction and posterior chamber intraocular lens (IOL) implantation was undertaken to compare the accuracy of eight IOL power calculation formulas (modified Binkhorst, Colenbrander, Gullstrand, Fyodorov-Galin-Linksz, Gill, Axt, Donzis-Kastle-Gordon and SRK regression). We found that the regression formulas were more accurate than the theoretical formulas, giving enough approximation to the ideal IOL as to assure its clinical use. We prefer the SRK formula because it is easier and it has a constant A that can be adapted in a personalized way to each surgical team.
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Affiliation(s)
- F J Ascaso
- Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain
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