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Congenital stromal corneal dystrophy in a Spanish family: Clinical, genetic and histological analysis. J Fr Ophtalmol 2024; 47:104138. [PMID: 38484481 DOI: 10.1016/j.jfo.2024.104138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 04/08/2024]
Abstract
PURPOSE To present the clinical, genetic, and histopathological features of the ninth family affected by congenital stromal corneal dystrophy (CSCD) to date. METHODS Twelve cases of a Spanish family affected by CSCD were analyzed regarding history, visual acuity (VA, decimal scale), an ophthalmologic exam and specular microscopy. Five eyes were treated by deep anterior lamellar keratoplasty (DALK), and thirteen eyes by penetrating keratoplasty (PK). In the two last generations, a genetic study was performed. RESULTS Most of the patients affected were born with opaque corneas except for three, whose corneas were clear at birth. Biomicroscopy showed a whitish diffuse stromal opacity with an unaltered epithelium, causing poor VA (from hand motions to 0.4). Patients treated with PK presented mean postoperative VA of 0.19±0.20 over a follow-up time of 235.3±101.4months with 38% recurrences. Patients who underwent DALK experienced VA improvement to 0.17±0.11 over a follow-up time of 10.8±2.6months without signs of recurrence. In the latter, the big bubble technique was not achieved, so a manual technique was performed. The genetic study showed heterozygosis for a 1-bp deletion at nucleotide 962 in exon 8 of the decorin gene. CONCLUSIONS CSCD is a rare entity, which should be treated by DALK whenever possible, obtaining better results than PK. Close monitoring of children of affected individuals is important, because CSCD can progress during the early years of life.
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Severe epithelial ingrowth after pars plana vitrectomy ten years after LASIK relifting. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00051-3. [PMID: 38521346 DOI: 10.1016/j.oftale.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/04/2024] [Indexed: 03/25/2024]
Abstract
Epithelial ingrowth is one of the most significant complications of Laser in Situ Keratomileusis (LASIK) refractive surgery. We present the case of a 72-year-old male with a history of myopic LASIK (1999), who underwent cataract surgery and a second thin LASIK sub-Bowman flap to correct refractive error. Then, three months after pars plana vitrectomy for an epiretinal membrane, the patient complained of progressive vision loss. A diffuse haze of the corneal stroma that did not exist before surgery was observed. As the main suspicion was epithelial ingrowth, the flap was lifted and meticulous de-epithelialization of the stromal bed was performed. Mitomycin C 0.02% was applied, the flap was sutured with 10-0 Nylon, and a bandage contact lens was placed. The epithelialization of the interface after vitrectomy in a patient with LASIK could occur even when it is a rare complication and without obvious flap traumatism.
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Corneal endothelial validation in the eye bank: differences in automated methods and repeatability. J Fr Ophtalmol 2024; 47:104022. [PMID: 37951743 DOI: 10.1016/j.jfo.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To evaluate reproducibility of endothelial cell density (ECD) measurements using the Konan Cell Check D in donor corneas by two different ophthalmologists and to compare the two automated cell count methods (center and flex-center) available in the software of this specular microscope. METHODS ECD values were quantified in 54 donor corneas by two independent investigators using the Cell Check D (Konan Medical USA Inc) with both automated cell count methods. In the center method, at least 30 contiguous cells are marked. For the flex-center method, an area is delineated and only the cells within the designated area are counted. RESULTS The mean ECD was 2473.81±378.22 cells/mm2. Good ECD intergrader reproducibility for the center (ICC=0.821) and the flex-center method (ICC=0.784) were noted. Poor reliability was observed for coefficient of variation and hexagonality (ICC≤0.265). When both methods for ECD analysis were compared, a moderate correlation for the two independent graders using the two manual (center and flex-center) methods was detected (correlation coefficient of 0.678 and 0.745 for each of the investigators). Comparison between methods yielded significantly higher ECD with the flex-center method (P=0.013). When corneas were divided by ECD, those under 2200 cells/mm2 and those between 2200 and 2700 cells/mm2 also had significantly higher ECD with the flex-center method (P<0.022). CONCLUSIONS ECD values are reproducible with both methods, although the flex-center method ECDs tend to be higher, particularly in cases of low ECD. Eye banks and surgeons should exercise caution in making decisions based only on small differences in ECD.
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Sub-Bowman LASIK retreatment by second flap complicated by deep folds: Repositioning and suturing. J Fr Ophtalmol 2024; 47:104040. [PMID: 38185600 DOI: 10.1016/j.jfo.2023.104040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 01/09/2024]
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Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:680-686. [PMID: 37788756 DOI: 10.1016/j.oftale.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/02/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). METHODS Cross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. RESULTS RNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, p<0.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (p<0.001). CONCLUSIONS The diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.
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Clinical update in nanophthalmos: Features, diseases and complications associated. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:687-702. [PMID: 37813187 DOI: 10.1016/j.oftale.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023]
Abstract
Nanophthalmos is a rare congenital condition of the eyeball that is characterised by a smaller size of the anterior and posterior segments without associated ocular malformations. Typical features that have traditionally been described in these eyes are short axial length, thickened sclera, cornea with a smaller diameter, narrow anterior chamber, and an increased lens to globe volume ratio. However, at present, there is still a lack of recognised diagnostic criteria for nanophthalmos and a classification of its severity. Its clinical relevance stems from the increased risk of multiple ocular conditions, such as high hyperopia, amblyopia, angle-closure glaucoma, retinal detachment, and cataracts. Likewise, in relation to surgery in these eyes, there are particularities in cataract and glaucoma surgery and with a greater risk of associated intra- and postoperative complications. In this way, the treatment of nanophthalmos focuses on controlling the associated eye conditions and reducing and controlling surgical complications. This review aims to update what has been published in recent years regarding nanophthalmos.
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Comparative analysis of the quality of life among different retinal diseases. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:633-639. [PMID: 37748684 DOI: 10.1016/j.oftale.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/26/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To assess the impact on the quality of life (QoL) among different retinal diseases such as diabetic macular edema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC). METHODS A cross-sectional study was carried out in 241 patients, affected by DME (n=44), RVO (n=41), PM (n=34) and nAMD (n=85) receiving intravitreal injections due to the presence of macular edema or choroidal neovascularization. The CSC patients included (n=37) were candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning-25 (NEI VFQ-25). Best eye visual acuity (BEVA) was recorded using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. RESULTS There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (P=.436), despite the difference in BEVA (CSC: 86.3±11.9; RVO: 78.5±15.5, DME: 73.3±15.2, nAMD: 72.9±12.6 and PM: 68.5±18.1 letters respectively; P<.001). The lowest VFQ-25 total score was observed in the PM patients (52.1±20.9), followed by nAMD (55.3±20.8), RVO (65.0±22.3), DME (68.6±21.0) and CSC (70.9±16.2). The DME group reported the worst score for general health (38.9±21.4). Mental health and role difficulties were lowest for PM (48.2±28.8 and 48.2±31.9, P<.007). CONCLUSIONS This study reveals the differences in the QoL among DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing a higher impact in PM and nAMD.
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The importance of ophthalmological check-ups in Spain: Prevalence of undiagnosed ophthalmologic diseases in the Congress of Deputies. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:551-552. [PMID: 37257652 DOI: 10.1016/j.oftale.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 06/02/2023]
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Assessment of the biometric modifications of the eye in LASIK during suction. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00106-8. [PMID: 37364677 DOI: 10.1016/j.oftale.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/05/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE To study the biometric modifications of the eyeball during suction in Laser assisted in Situ Keratomileusis (LASIK). METHODS Observational and cross-sectional study. We studied 43 patients who underwent surgery for myopia and myopic astigmatism. Mean age was 38.3 ± 11.5 years, and 19 were female (44.2%). Conventional LASIK surgery with a manual microkeratome was performed. Before and during the suction maneuvre the following parameters were measured using an 11 Mhz biometric probe: aqueous depth (AQD), lens thickness (LT), vitreous cavity length (VCL) and axial length (AXL). Paired t-test was used to compare the biometric measurements before and during suction. RESULTS The mean spherical equivalent refractive error was -4.5 ± 2.3 diopters. During suction, the AQD did not change significantly (p = 0.231). However, AXL and VCL increased by 0.12 mm and 0.22 mm respectively (p = 0.039 and <0.01) and LT decreased by 0.20 mm (p < 0.01). AXL increased in 42% of the eyes and decreased in 16%, VCL increased in 70% of the eyes and decreased in 9%, and the LT was reduced in 67% of the eyes. CONCLUSIONS Suction maneuvres during LASIK surgery produce changes of little magnitude in the eye globe, mainly a decrease in LT and an increase in VCL and AXL. Therefore, these modifications are expected to produce minimal anatomic alterations.
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Ophthalmoparesis and bilateral orbital mass in an HIV patient: A diagnostic dilemma. J Fr Ophtalmol 2023; 46:e174-e176. [PMID: 36849289 DOI: 10.1016/j.jfo.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 02/27/2023]
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Detection of anti-SARS-CoV-2 antibodies in tears: Ocular surface immunity to COVID-19. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00083-X. [PMID: 37247663 DOI: 10.1016/j.oftale.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE To evaluate the presence of SARS-CoV-2 specific IgA and IgG antibodies in tears of unvaccinated and anti-COVID-19 vaccinated subjects with previous history of SARS-CoV-2 infection. To compare results in tears with those in saliva and serum and correlate with clinical data and vaccination regimens. METHODS Cross-sectional study including subjects with a previous history of SARS-CoV-2 infection, both unvaccinated and vaccinated against COVID-19. Three samples were collected: tears, saliva and serum. IgA and IgG antibodies against S-1 protein of SARS-CoV-2 were analyzed with a semi-quantitative ELISA. RESULTS 30 subjects, mean age 36.4 ± 10, males 13/30 (43.3%) with history of mild SARS-CoV-2 infection were included. 13/30 (43.3%) subjects had received a 2-dose regimen and 13/30 (43.3%) a 3-dose regimen of anti-COVID-19 vaccine, 4/30 (13.3%) subjects were unvaccinated. All the participants with full anti-COVID-19 vaccination (2-or 3-doses) presented detectable anti-S1 specific IgA in all three biofluids, tears, saliva and serum. Among unvaccinated subjects, specific IgA was detected in 3/4 subjects in tears and saliva, whereas IgG was not detected. Considering IgA and IgG antibodies titers, no differences were observed between the 2- and 3-dose vaccination regimen. CONCLUSIONS SARS-CoV-2-specific IgA and IgG antibodies were detected in tears after mild COVID-19, highlighting the role of the ocular surface as a first line of defense against infection. Most naturally infected unvaccinated individuals exhibit long-term specific IgA in tears and saliva. Hybrid immunization (natural infection plus vaccination) appears to enhance mucosal and systemic IgG responses. However, no differences were observed between the 2- and 3-dose vaccination schedule.
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[Detection of anti-SARS-CoV-2 antibodies in tears: Ocular surface immunity to COVID-19]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S0365-6691(23)00091-6. [PMID: 37360534 PMCID: PMC10150186 DOI: 10.1016/j.oftal.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/29/2023] [Indexed: 06/28/2023]
Abstract
Purpose To evaluate the presence of SARS-CoV-2 specific IgA and IgG antibodies in tears of unvaccinated and anti-COVID-19 vaccinated subjects with previous history of SARS-CoV-2 infection. To compare results in tears with those in saliva and serum and correlate with clinical data and vaccination regimens. Methods Cross-sectional study including subjects with a previous history of SARS-CoV-2 infection, both unvaccinated and vaccinated against COVID-19. Three samples were collected: tears, saliva and serum. IgA and IgG antibodies against S-1 protein of SARS-CoV-2 were analyzed with a semi-quantitative ELISA. Results Thirty subjects, mean age 36.4 ± 10, males 13/30 (43.3%) with history of mild SARS-CoV-2 infection were included. 13/30 (43.3%) subjects had received a 2-dose regimen and 13/30 (43.3%) a 3-dose regimen of anti-COVID-19 vaccine, 4/30 (13.3%) subjects were unvaccinated. All the participants with full anti-COVID-19 vaccination (2-or 3-doses) presented detectable anti-S1 specific IgA in all 3 biofluids, tears, saliva and serum. Among unvaccinated subjects, specific IgA was detected in 3/4 subjects in tears and saliva, whereas IgG was not detected. Considering IgA and IgG antibodies titers, no differences were observed between the 2- and 3-dose vaccination regimen. Conclusions SARS-CoV-2-specific IgA and IgG antibodies were detected in tears after mild COVID-19, highlighting the role of the ocular surface as a first line of defense against infection. Most naturally infected unvaccinated individuals exhibit long-term specific IgA in tears and saliva. Hybrid immunization (natural infection plus vaccination) appears to enhance mucosal and systemic IgG responses. However, no differences were observed between the 2- and 3-dose vaccination schedule.
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Dexamethasone implant prior to anti-VEGF therapy in pigment epithelium detachments with high-risk rupture characteristics secondary to neovascular age-related macular degeneration. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:676-683. [PMID: 35879177 DOI: 10.1016/j.oftale.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Evaluate the incidence of pigment epithelial tear when intravitreal delayed-release dexamethasone implant is administered (off-label use) prior to antiangiogenic treatment in pigment epithelium detachments (PED) secondary to neovascular age-related macular degeneration (nAMD) with high-risk rupture characteristics and investigate if it causes a decrease in the PED size. METHODS Patients with nAMD, PED height >500 microns and Ozurdex implant prior to the antiangiogenic therapy were included. The presence of pigment epithelium rupture in optical coherence tomography scans, best-corrected visual acuity (BCVA) and PED measurements (maximum height and diameter) were registered. RESULTS The study included 14 eyes of 14 patients: mean age 77 ± 7 years, 11 (79%) females. 25 ± 13 days after the Ozurdex, patients started with at least 3 anti-VEGF monthly injections. BCVA improved from 64 ± 14-69 ± 11 letters after anti-VEGF therapy (p > 0.05). Mean baseline PED height was 817 ± 269 µm, being 639 ± 268 µm after Ozurdex and 370 ± 260 µm after anti-VEGF injections (p = 0.035 and p = 0.009). One retinal pigment epithelium tear occurred (7%). No other adverse effects were reported. CONCLUSIONS Dexamethasone implant prior to anti-VEGF therapy may represent a promising therapeutic modality for large PED in nAMD, reducing PED dimensions and the risk of pigment epithelium tears prior to anti VEGF therapy.
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Bilateral retinal vein occlusion after two doses of SARS-CoV-2 adenovirus vector-based vaccine. J Fr Ophtalmol 2022; 45:e397-e399. [PMID: 36150989 PMCID: PMC9257142 DOI: 10.1016/j.jfo.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 12/01/2022]
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Scleritis as first manifestation of granulomatosis (Wegener's) with polyangiitis. J Fr Ophtalmol 2022; 45:1093-1094. [DOI: 10.1016/j.jfo.2022.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 10/14/2022]
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Efficacy and safety of adjustable suture in horizontal strabismus: Comparative study of children versus adults. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:483-489. [PMID: 35872000 DOI: 10.1016/j.oftale.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Adjustable suture procedures allow addressing the unpredictability of some postoperative results in strabismus surgery. The purpose of the study was to compare the effectiveness of adjustable and non-adjustable suture in the treatment of horizontal strabismus in children and adults. METHODS Prospective study including patients undergoing strabismus surgery to correct horizontal strabismus with fixed hanging suture (non-adjustable suture group) and adjustable suture. Visual acuity, amblyopia, deviation, oblique muscle involvement, previous surgeries, nystagmus, need for adjustment, and complications were recorded. The variables were recorded in the immediate postoperative period, at one week and at 3 and 6 months. RESULTS 186 patients were included: 157 (84.4%) with adjustable suture and 29 (15.6%) with non-adjustable suture, of which 119 were children and 67 were adults. Postoperatively, 19 children (16.0%) and 19 adults (28.4%) required adjustment (p = 0.044). Of 157 patients with adjustable suture, it was adjusted in 20% (32/157). Success after adjustment was higher for adjustable suture (91.72% vs 79.31%; p = 0.043) and remained for 6 months (p < 0.05). Previous surgery (p = 0.004) and exotropia (p = 0.018) correlated with the need for adjustment. CONCLUSIONS 20% of patients with horizontal strabismus can benefit from a postoperative adjustment to improve the surgical result. The adjustable suture was shown to be superior to the fixed hanging suture and is an excellent surgical option, both in children and adults.
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Evaluation of the perception of physical and emotional health of ophthalmologists in Spain and the influence of the COVID-19 pandemic. J Fr Ophtalmol 2022; 45:689-699. [PMID: 35760600 PMCID: PMC9212495 DOI: 10.1016/j.jfo.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/03/2022]
Abstract
Objective The main objective was to study the perception of physical and emotional health of Spanish ophthalmologists and their health habits, as well as the possible influence of the COVID-19 pandemic. Methods An observational, cross-sectional, non-randomized and uncontrolled study was carried out among at Spanish ophthalmologists through an online survey of 47 questions on eating habits, tobacco, alcohol, physical exercise, workload, and perception of physical and emotional state. Results Of a total of 2,179 ophthalmologists, 260 (11.9%) of whom 55% were men responded to the survey, with a mean age of 52.9 ± 11.4 years. 5.8% were smokers. In total, 51.5% reported good physical health, with a mean Body Mass Index of 24.4 kg/m2. Overall, 53.5% reported depression, 66.9% tiredness, 34.6% difficulty sleeping, and 57.3% considered their work hard. Up to 28.5% of those surveyed had thought about leaving their job and 60.8% about reorganizing their workload. In total, 91.9% would continue to choose Ophthalmology as a specialty. In total, 36.2% reported an increase in workload, 42.3% worsening of physical state and 63.8% worsening of emotional state as a consequence of the COVID-19 pandemic. Conclusions Spanish ophthalmologists have a positive perception of their physical and emotional health, despite having life habits that are not always healthy and feeling mostly down. The COVID-19 pandemic has had a negative influence on the physical and emotional health of ophthalmologists.
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Reliability and agreement analysis among 5 subjective methods of ocular torsion measurement. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:450-456. [PMID: 35660357 DOI: 10.1016/j.oftale.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/31/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the reliability in the measurement of ocular torsion and the agreement of the following subjective methods: double Maddox test, synoptophore, Gracis torsionometer, Harms screen and Awaya cyclodeviation test. METHOD Patients with vertical strabismus acquired in adulthood were recruited and ocular torsion was measured with the 5 methods described on three occasions. As a gold standard test does not exist, the one that obtained the best repeatability data was chosen as the reference test. RESULTS 25 patients were included in the study. The repeatability of each test was studied: double Maddox test (ICC = 0.783, CV = 29.33%), synoptophore (ICC = 0.976, CV = 6.71%), Gracis torsionometer (ICC = 0.937, CV = 20.10%), Harms screen (ICC = 0.962, CV = 11.86%) and Awaya test (ICC = 0.987, CV = 52.58%). The reference test to compare the agreement was the synoptophore. Statistically significant differences were found when comparing the ocular torsion ranges between the synoptophore and the Gracis torsionometer (p = 0.008) and between the synoptophore and the Awaya test (p = 0.02). CONCLUSIONS The double Maddox test, the synoptophore, the Gracis torsionometer, and the Harms screen are reliable methods with good reproducibility indices. Among them, the synoptophore is the most consistent method. The Awaya test did not show good reliability. The bilateral Maddox test, the Gracis torsionometer, and the Harms screen were methods with good agreement with the synoptophore, which was determined as the reference test. The Awaya test did not show good agreement with the synoptophore.
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Assessment of the perception of healthcare barriers and the impact of intravitreal injections on neovascular age-related macular degeneration. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:198-204. [PMID: 35523466 DOI: 10.1016/j.oftale.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/09/2021] [Indexed: 06/14/2023]
Abstract
AIM To evaluate the perception of barriers in healthcare and the impact of intravitreal injections in patients with neovascular age-related macular degeneration (nAMD). METHODS Cross-sectional study including 108 patients with nAMD in treatment with intravitreal injections. The patients answered a questionnaire with 26 questions (score from 1 to 5) divided in three sections: 1) the disease and its treatment with injections, 2) healthcare barriers and 3) new technologies. RESULTS The mean age was 80.4 ± 7.0 years and visual acuity (VA) was 75.2 ± 12.4 letters. The main barriers in healthcare were long waiting times (72%), followed by other comorbidities (10%). Some 63% of patients have to wait between 3 and 5 h to attend their clinical visit. Significant anxiety due to the injections (2.8 ± 1.3) was observed, being present in 71% of the cases the day before. A great fear of blindness and losing independence was observed (4.4 ± 0.9 and 4.3 ± 1.1), with no differences in relation to VA, age or sex (p ≥ 0.135). Moreover, 28% of the patients reported that it was quite or very difficult for them to attend the clinical visit, with 69% of the total showing great interest in having a diagnostic device at home. CONCLUSION The nAMD and its treatment represent a significant burden on patients, among whom there is a great fear of blindness and of losing their independence, the main barrier being the long waiting time for the clinical visit.
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Assessment of vision-related quality of life and depression and anxiety rates in patients with neovascular age-related macular degeneration. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:470-475. [PMID: 34479703 DOI: 10.1016/j.oftale.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/12/2020] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). METHODS A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. RESULTS Fifty-five patients with nAMD participated with a mean age of 80.9 ± 6.6 years-old (range 67-93) and a mean VA in the best eye of 73.5 ± 12.7 letters (range 44-95). The global VFQ-25 mean score was 57.4 ± 21.9 being 38.9 ± 13.2 for the general vision and 42.0 ± 19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R = 0.608; P < .001), but no correlation was observed with general health (P = .936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R = -0.438). CONCLUSION This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.
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Giant pachyvessel. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(21)00016-2. [PMID: 33627239 DOI: 10.1016/j.oftal.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/27/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
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AS-OCT and anterior segment negative image in the study of acanthamoeba keratitis. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(21)00025-3. [PMID: 33612367 DOI: 10.1016/j.oftal.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/01/2020] [Accepted: 12/26/2020] [Indexed: 06/12/2023]
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Adult phlebectasia of the internal jugular vein: A rare cause of Horner's syndrome. J Fr Ophtalmol 2021; 44:e369-e371. [PMID: 33558025 DOI: 10.1016/j.jfo.2020.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 12/09/2022]
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Biometry data and prevalence of corneal astigmatism in caucasian spanish candidates for cataract surgery. J Fr Ophtalmol 2020; 44:76-83. [PMID: 33162179 DOI: 10.1016/j.jfo.2020.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/12/2020] [Accepted: 03/25/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe ocular biometric parameters and the prevalence of corneal astigmatism as well as age and gender correlations in a population of cataract surgery candidates and to estimate the number of eyes that would be candidates for a toric intraocular lens (IOL). METHODS In consecutive patients requiring cataract surgery over a one-year period (June 2016 to June 2017), the following optical biometry measurements were performed on an IOLMaster 700 or Lenstar 900: axial length (AL), anterior chamber depth (ACD), lens thickness (LT), mean keratometry (K), flat keratometry (K1), steep keratometry (K2), corneal astigmatism (Cyl) and white-to-white diameter (WTW). Descriptive statistics for the demographic and biometric data were analyzed. RESULTS The study sample included 6111 eyes of 3332 patients (59.3% women), with a mean age of 74.78±9.7years. The means of the compiled data are as follows: AL 23.58±1.55mm, ACD 3.08±0.41mm, LT 4.55±0.52mm,K 44.15±1.54 diopters (D), K1 43.64±1.57 D, K2 44.69±1.61 D, Cyl 1.0±0.81. D and WTW 11.88±0.46mm. The male patients had significantly larger eyes (higher AL, ACD and WTW) and flatter corneas (lower flat and steep K). Older patients had significantly lower AL, ACD and WTW, while their LT values were higher. Corneas became significantly steeper with age. 60.5% of eyes had less than 1 D of corneal astigmatism, while 3.1% had ≥3.0 D. CONCLUSIONS Less than 1 D of corneal astigmatism was present in the majority of cataract surgery candidates. 3.1% of eyes were candidates for a toric IOL. This study provides useful information on inventory requirements for planning hospital resources.
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Intracorneal hemorrhage secondary to acute viral conjunctivitis. J Fr Ophtalmol 2020; 43:e321-e323. [DOI: 10.1016/j.jfo.2019.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
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Multimodal imaging in optic nerve melanocytoma: Optical coherence tomography angiography and other findings. J Fr Ophtalmol 2020; 43:1039-1046. [PMID: 32948356 DOI: 10.1016/j.jfo.2020.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate optical coherence tomography (OCT), fundus autofluorescence (FAF) imaging and optical coherence tomography angiography (OCTA) as diagnostic tools in optic disc melanocytoma (ODM) and study the differences in peripapillary and macular vascular density in eyes with ODM using OCTA. METHODS Patients with ODM were enrolled in this case series. Each patient underwent evaluation of best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination, fundus photography, standard visual field testing, spectral domain OCT, ultrasound B-scan examination, FAF, fluorescein angiography and OCTA. RESULTS Eight patients (three males and five females) with ODM (9 eyes) were enrolled. The largest ODM presented a nodular appearance with a hyper-reflective tumor surface and a posterior optical shadow on OCT. FAF images showed hypoautofluorescence of the tumor with well-defined outlines. Analysis of optic nerve vascular area showed decreased values in the radial peripapillary capillary plexus (3 of 5) and the outer retinal plexus (4 of 5) in the eyes with ODM. In contrast, the ODM eyes had a higher macular vascular area in the deep capillary plexus in 4 of 6 patients. CONCLUSIONS ODM may be associated with changes in peripapillary and macular perfusion, with an increase in peripapillary vascularization being a possible risk factor for growth. OCTA might be a helpful objective method in the analysis of changes in flow in patients with ODM.
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Update on the management of chronic central serous chorioretinopathy. ACTA ACUST UNITED AC 2020; 96:251-264. [PMID: 32891458 DOI: 10.1016/j.oftal.2020.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
Central serous chorioretinopathy (CSC) is one of the main causes of impaired visual acuity in patients younger than 60 years. Its pathophysiology remains partially unknown, although it has been postulated that choroidal hyper-permeability may be involved. This typically produces a neurosensory retinal detachment and/or a detachment of the retinal pigment epithelium in the posterior pole. Although acute CSC generally does not require treatment, when chronic it must be treated to avoid visual impairment. With the development of new imaging techniques, there has been an improvement in diagnosis, and different therapeutic strategies have been proposed. Various treatments for the management of chronic CSC have currently been shown to be useful to improve or stabilise visual acuity, the resolution of subretinal fluid, and to prevent recurrences. The most commonly used treatments today are photodynamic therapy, micropulse subthreshold laser, mineralocorticoid antagonists, or anti-vascular endothelial growth factor drugs. There are also other proposals and new treatments being developed, with promising results. This review aims to provide the reader with an overview of the current scientific evidence of the different treatment options available for CSC in order to help decision-making in clinical practice.
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Satisfaction with strabismus surgery based on the opinion of expert surgeons. ACTA ACUST UNITED AC 2020; 96:19-25. [PMID: 32709474 DOI: 10.1016/j.oftal.2020.05.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the perception of strabismus surgeons in Spain regarding patient satisfaction after surgery, by analysing the types of strabismus with the most satisfied patients, as well as the causes of dissatisfaction. METHODS A survey was carried out among the members of the Spanish Strabology Society who were over 50 years of age, active in Spain, with more than 20 years of surgical experience, and whose main surgical activity was strabismus. The questionnaire consisted of 18 questions about the perception of patient satisfaction according to the type of strabismus, patient age, as well as the most frequent cause of dissatisfaction after surgery. RESULTS The questionnaires were completed by a total of 29 surgeons, with a mean of 31 years of surgical experience. The most frequent cause of perceived dissatisfaction was residual strabismus. No differences were found in the satisfaction index between children and adults. The surgery that was considered to produce greater satisfaction was endotropia, followed by decompensated 4th nerve palsy, and exotropia, while 3rd nerve palsy was the cause of the most dissatisfaction. CONCLUSIONS According to strabismus surgeons, endotropia is the most satisfactory surgery for the patient, followed by exotropia, vertical strabismus, and traumatic paralysis of the 4th cranial nerve.
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Asymmetric diabetic retinopathy: Takayasu's arteritis. J Fr Ophtalmol 2020; 43:561-563. [PMID: 32362401 DOI: 10.1016/j.jfo.2019.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/19/2022]
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Non invasive methods to diagnose ocular argyrosis. J Fr Ophtalmol 2020; 43:e185-e187. [PMID: 32107027 DOI: 10.1016/j.jfo.2019.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 08/30/2019] [Indexed: 11/29/2022]
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Penetrating keratoplasty with Krumeich ring for corneal leukoma secondary to Acanthamoeba keratitis. J Fr Ophtalmol 2020; 43:e115-e118. [PMID: 31973972 DOI: 10.1016/j.jfo.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/04/2019] [Accepted: 08/19/2019] [Indexed: 11/26/2022]
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Extramedullary plasmacytoma of the eyelid. J Fr Ophtalmol 2020; 43:177-178. [PMID: 31952874 DOI: 10.1016/j.jfo.2019.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
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