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Bouchikh-El Jarroudi R, Valentín-Bravo FJ, Calatayud-Riera M, Ruiz-Bilbao S. Retinal stroke: A call to action for awareness and treatment of ocular vascular emergencies. Arch Soc Esp Oftalmol (Engl Ed) 2024:S2173-5794(24)00074-4. [PMID: 38670259 DOI: 10.1016/j.oftale.2024.03.006] [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] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024]
Affiliation(s)
- R Bouchikh-El Jarroudi
- Servicio de Oftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Unidad de Oftalmología Basada en Evidencias (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru.
| | - F J Valentín-Bravo
- Servicio de Oftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Català de la Retina (ICR), Barcelona, Spain
| | - M Calatayud-Riera
- Servicio de Oftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - S Ruiz-Bilbao
- Servicio de Oftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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Bustamante A, Balboa M, Ezcurra G, Sánchez-Fortún A, Ruiz J, Castellví J, Castillo-Acedo S, Matas È, Bouchikh R, Martínez-Sánchez M, Castaño C, Remollo S, Werner M, Salgado MC, Villodres S, Gea M, Millán M, Pérez de la Ossa N, Ruiz-Bilbao S. Implementation of a retinal stroke-code protocol results in visual recovery in patients receiving reperfusion therapies. Eur Stroke J 2024:23969873231221366. [PMID: 38189284 DOI: 10.1177/23969873231221366] [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: 01/09/2024] Open
Abstract
INTRODUCTION Reperfusion therapies represent promising treatments for patients with Central Retinal Artery Occlusion (CRAO), but access is limited due to low incidence and lack of protocols. We aimed to describe the benefit of implementing a Retinal Stroke-Code protocol regarding access to reperfusion, visual acuity and aetiological assessment. PATIENTS AND METHODS Prospective cohort study performed at a Comprehensive Stroke Centre. Criteria for activation were sudden monocular, painless vision loss within 6 h from onset. Eligible patients received IAT when immediately available and IVT otherwise. All patients were followed by ophthalmologists to assess best-corrected visual acuity (BCVA) and visual complications, and by neurologists for aetiological workup. Visual amelioration was defined as improvement of at least one Early Treatment Diabetic Retinopathy Study (ETDRS) letter from baseline to 1 week. RESULTS Of 49 patients with CRAO, 15 (30.6%) received reperfusion therapies (12 IVT, 3 IAT). Presentation beyond 6 h was the main contraindication. Patients receiving reperfusion therapies had better rates of visual improvement (33.3% vs 5.9%, p = 0.022). There were no complications related to reperfusion therapies. Rates of neovascular glaucoma were non-significantly lower in patients receiving reperfusion therapies (13.3% vs 20.6%, p = 0.701). Similar rates of atherosclerotic, cardioembolic and undetermined aetiologies were observed, leading to 10 new diagnosed atrial fibrillation and five carotid revascularizations. CONCLUSION A comprehensive acute management of CRAO is feasible despite low incidence. In our study, reperfusion therapies were safe and associated with higher rates of visual recovery. A similar etiological workup than ischemic stroke led to of high proportion of underlying aetiologies.
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Affiliation(s)
- Alejandro Bustamante
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Balboa
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Garbiñe Ezcurra
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Fortún
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judith Ruiz
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Castellví
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Castillo-Acedo
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Èric Matas
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rachid Bouchikh
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marina Martínez-Sánchez
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Castaño
- Neuroradiology Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sebastiá Remollo
- Neuroradiology Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mariano Werner
- Neuroradiology Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Carmen Salgado
- Emergency Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Samuel Villodres
- Emergency Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Gea
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mònica Millán
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natàlia Pérez de la Ossa
- Stroke Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Ruiz-Bilbao
- Retina Unit, Oftalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
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Vilaplana F, Ros A, Garcia B, Blanco I, Castellanos E, Edwards NJ, Valldeperas X, Ruiz-Bilbao S, Sabala A. Clinical characteristics, imaging findings, and genetic results of a patient with CEP290-related cone-rod dystrophy. Ophthalmic Genet 2021; 42:474-479. [PMID: 33886416 DOI: 10.1080/13816810.2021.1916827] [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: 10/21/2022]
Abstract
PURPOSE To describe the clinical characteristics, the imaging findings, and the genetic results of a patient with cone-rod dystrophy (CORD) related to mutations in CEP290. METHODS A case report of atypical CEP290-related CORD. Ophthalmological examination was performed, including best-corrected visual acuity (BCVA), fundus photography, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT), a visual field test, and electroretinography testing. The genetic test was performed by next-generation sequencing (NGS)-based panel test containing 336 genes. RESULTS A 57-year-old female who had reported a visual loss for 5 years. BCVA was 20/100 in both eyes. The fundus examination revealed a hypopigmented halo around the fovea, showing a paracentral hyperautofluorescent ring on FAF. OCT demonstrated the presence of atrophy in the outer retinal layers. The genetic test identified the probably pathogenic variants c.4028delA and c.5254C>T in compound heterozygosis in CEP290. CONCLUSIONS This is the first report to present the clinical characteristics, imaging findings, and genetic test results of a patient with CEP290-related CORD. Our case contributes to expanding the clinical involvement of CEP290 pathogenic variants. This study indicates that CEP290-related CORD may have a mild phenotype with late-onset dystrophy, making these patients interesting candidates for innovative treatments such as genetic therapeutic approaches.
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Affiliation(s)
- Ferran Vilaplana
- Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Ros
- Genetic Counseling Unit, Genetics Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Belen Garcia
- Genetic Counseling Unit, Genetics Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Ignacio Blanco
- Genetic Counseling Unit, Genetics Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Elisabeth Castellanos
- Clinical Genomics Unit, Genetics Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Hereditary Cancer Group, Germans Trias Research Institute, IGTP, Barcelona, Spain
| | | | - Xavier Valldeperas
- Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Ruiz-Bilbao
- Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Sabala
- Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
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Fernández-Rivas G, Diaz-Aljaro P, Ávila M, Ruiz-Bilbao S. An unusual presentation of uveitis in a HIV-infected late presenter patient. Enferm Infecc Microbiol Clin 2019; 38:135-137. [PMID: 31500878 DOI: 10.1016/j.eimc.2019.07.005] [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] [Received: 05/15/2019] [Revised: 07/05/2019] [Accepted: 07/12/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Gema Fernández-Rivas
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Hospital Universitari Germans Trias i Pujol, "Department of Genetics and Microbiology", Universitat Autònoma de Barcelona, Badalona, Spain.
| | - Pablo Diaz-Aljaro
- Ophthalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marta Ávila
- Pathology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Susana Ruiz-Bilbao
- Ophthalmology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Ruiz-Bilbao S, Hernández À, Gómez-Sánchez S, Romeu J, Llobera L L, Carrato C, Anglada R, Sabala A, Matas L. [AIDS-related primary CNS non-Hodgkin's lymphoma in a patient with previous Epstein-Barr virus panuveitis. A clinico-pathological report]. ACTA ACUST UNITED AC 2014; 90:241-3. [PMID: 25443210 DOI: 10.1016/j.oftal.2014.07.005] [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: 02/27/2014] [Accepted: 07/16/2014] [Indexed: 10/24/2022]
Abstract
CLINICAL CASE Patient with AIDS and Epstein-Barr virus (EBV) uveitis. The PCR of the aqueous and vitreous humor was positive for EBV, and DNA quantification was 56.602×10(6) copies/ml in the vitreous humor, 173,400 copies/ml in the peripheral blood, and negative in the cerebrospinal fluid (CSF). The patient developed a non-Hodgkin's lymphoma (NHL), diagnosed in the autopsy. CONCLUSION The EBV is a rare cause of uveitis and it may be necessary to perform a quantitative PCR to reach the diagnosis. High amounts of EBV DNA are associated with a greater incidence of NHL.
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Affiliation(s)
- S Ruiz-Bilbao
- Departamento de Oftalmología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - À Hernández
- Departamento de Microbiología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - S Gómez-Sánchez
- Departamento de Oftalmología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - J Romeu
- Departamento de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - L Llobera L
- Departamento de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - C Carrato
- Departamento de Patología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - R Anglada
- Departamento de Oftalmología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - A Sabala
- Departamento de Oftalmología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - L Matas
- Departamento de Microbiología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), España
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