Quality of life and visual function in children with glaucoma in Spain

Objetivo: Evaluar el efecto del glaucoma en la función visual, la calidad de vida en los niños y la calidad de vida percibida por los cuidadores en niños de hasta 16 años. Material y métodos: Se diseñó un estudio observacional y prospectivo. Se aplicó el cuestionario GQL-15 (Glaucoma Quality of Life) a los niños y a los cuidadores, y el cuestionario VFQ-25 (Visual Functioning Questionnarie) a los niños. Se registraron diferentes variables de la historia clínica que podrían influir en la calidad de vida y la función visual. Resultados: Se incluyó a un total de 24 pacientes con una edad media de 9,13 ± 3,08 años, de los cuales 3 tenían afectación unilateral y 20 presentaban glaucoma congénito primario. Los padres reportaron una peor calidad de vida que los niños: el resultado de la encuesta GQL-15 fue de 32,30 ± 11,56 puntos en los niños y de 37,52 ± 14,59 puntos en los cuidadores (p = 0,001). El parámetro que más se relacionó con la calidad de vida y la función visual fue el defecto medio del campo visual en el mejor ojo. Se encontró una correlación estadísticamente significativa entre el resultado de GQL-15 y el defecto medio del campo visual (niños: R = 0,63; p < 0,01 y cuidadores: R = 0,81; p < 0,001). Conclusiones: El daño funcional visual producido por el glaucoma tiene un impacto importante en la calidad de vida y en la función visual de los niños con glaucoma, si bien la calidad de vida percibida por los cuidadores es peor que la percibida por el niño. Objective: To evaluate the effect of glaucoma on visual function, as well as quality of life in children and quality of life perceived by caregivers in children up to 16 years of age. Material and methods: An observational and prospective study was designed using the questionnaire GQL-15 (Glaucoma Quality of Life) and conducted on children and caregivers. The questionnaire VFQ-25 (Visual Functioning Questionnaire) was conducted on children. Different variables of the clinical history that could influence the quality of life and visual function were recorded. Results: The study included 24 patients with a mean age of 9.13 ± 3.08 years, and included 3 with unilateral involvement, and 20 diagnosed with primary congenital glaucoma. Parents reported a worse quality of life than children. The result of the GQL-15 survey was 32.3 ± 11.56 points in children and 37.52 ± 14.59 points in caregivers (P = .001). The parameter most related to quality of life and visual function was the mean deviation (MD) of the visual field in the best eye. A statistically significant correlation was found between the result of GQL-15 and the mean deviation of the visual field (children: R = 0.63, P < .01, caregivers: R = 0.81, P< .001). Conclusions: Functional loss has an impact on the quality of life and visual function in children with glaucoma, although the quality of life perceived by the caregivers is worse than that perceived by the child

PhDAY 2020 -FOO (Facultad de Óptica y Optometría)

Por cuarto año consecutivo los doctorandos de la Facultad de Óptica y Optometría de la Universidad Complutense de Madrid cuentan con un congreso propio organizado por y para ellos, el 4º PhDAY- FOO. Se trata de un congreso gratuito abierto en la que estos jóvenes científicos podrán presentar sus investigaciones al resto de sus compañeros predoctorales y a toda la comunidad universitaria que quiera disfrutar de este evento. Apunta en tu agenda: el 15 de octubre de 2020. En esta ocasión será un Congreso On-line para evitar que la incertidumbre asociada a la pandemia Covid-19 pudiera condicionar su celebración

Response to tocilizumab treatment in Graves’ ophthalmopathy by measuring rectus muscle thickness and chemosis using optical coherence tomography

Purpose: To assess the extraocular muscle thickness and chemosis after treatment with tocilizumab in patients with active Graves’ ophthalmopathy by optical coherence tomography. Methods: Case series of five patients with active Graves’ ophthalmopathy (clinical activity score ≥4/10) treated with 4 doses of tocilizumab. These patients had been previously treated with corticosteroids with no response. Spectral-domain optical coherence tomography was employed to determine lateral and medial rectus muscle thickness and chemosis before and after 4 doses of tocilizumab given monthly. Scanning was performed at 3 and 9 o’clock (nasal and temporal). Results: The study included four women and one man with a median age of 52 years (range: 38-73). Median Graves’ ophthalmopathy activity duration was 17 months (12-18). Median medial rectus and determine lateral thicknesses pre-treatment were 249 μm (174-366) and 337 μm (142-443), respectively. Median chemosis was 409 μm (290-610). After tocilizumab treatment, median muscle thicknesses reduced to 157 μm (88-187) and 197 μm (99-290), respectively (P = .043; Wilcoxon) and chemosis to 59 μm (0-78). Median clinical activity score decreased from 5 (4-8) to 1 (0-3). Conclusions: A reduction in extraocular muscle thickness and chemosis was observed after treatment with tocilizumab in Graves’ ophthalmopathy patients using an optical coherence tomography, so this technique could be a useful complementary technique to assess the therapeutic responses

Mejora de las habilidades de sutura después de entrenamiento. Presentación de un modelo de simulación y de evaluación.

Introduction. Acquiring surgical skills through simulation is a growing need nowadays. Every day more, patient safety is valued, and therefore it isunacceptable that surgeons without previous training attend patients. Our objective is to develop a low-cost simulation system, and a score, which allowsevaluating the acquisition of knowledge. Methods. 6 first-year ophthalmology residents were chosen to perform two recorded sessions, where they performed different suture techniques. Between them, the residents were allowed to complete a 4-session training. After completing the training, the initial and final sessions were evaluated by 3 blind expert surgeons. Mann–Whitney tests wereused to compare scores. And the agreement between the three evaluators was checked using the Fleiss´ kappa concordance test. Results. The concordance inthe evaluation between the three examiners was substantial, κ= 0,71 (IC 95%, 0,33 a 0,82), p &lt; .0005. Residents improved their median performance scores after completion of training (6,52 vs 7,81) however, no significant differences were found due to the small number of participants. Conclusion. We developed a low-cost, portable training system with acquisition of skills in a group of residents.We have also developed an evaluation scale that allows to objectively assessprogression.Introducción. Adquirir habilidades quirúrgicas a través de la simulación es una necesidad creciente en la actualidad. Cada día se valora más la seguridad delpaciente, y por ello es inaceptable que cirujanos sin la formación adecuada previa atiendan a los pacientes. Nuestro objetivo es desarrollar un sistema de simulación de bajo coste, y una escala de medida, que permita evaluar la adquisición de conocimientos. Métodos. Se eligieron 12 residentes de primer año de oftalmología para realizar dos sesiones grabadas, donde realizaron diferentes técnicas de sutura.Entre ellas, a los residentes se les permitió completar un entrenamiento de 4 sesiones. Después de completar el entrenamiento, las sesiones inicial y final fueron evaluadas por 3 cirujanos expertos. Se utilizó la prueba de Mann-Whitney para comparar puntuaciones. Y se comprobó la concordancia entre los tres evaluadores mediante la prueba de concordancia kappa de Fleiss. Resultados. La concordancia en la evaluación entre los tres examinadores fue sustancial, κ= 0,71 (IC 95%, 0,33 a0,82), p &lt; .0005. Los residentes mejoraron su desempeño promedio después de completar el entrenamiento (6,52 vs 7,81); sin embargo, no se encontraron diferencias significativas debido al pequeño número de participantes. Conclusión.Desarrollamos un sistema de entrenamiento portátil de bajo coste para la adquisición de habilidades quirúrgicas en un grupo de residentes. Asimismo,hemos desarrollado una escala de evaluación que permite evaluar objetivamente la progresión

Changes in ocular motility in Kabuki syndrome

Kabuki syndrome is a rare genetic disorder, caused by mutation in the KMT2D or KDM6A genes, which affects several organs in the majority of patients, among which are the eyes. The most typical clinical characteristics are mental retardation, postnatal growth retardation, skeletal anomalies, and characteristic facial features. As the eyes are affected in most of the cases, ophthalmological examination is recommended for the early detection of ocular anomalies, in order to prevent visual impairment. The most frequent ocular signs are strabismus, ptosis, and refractive anomalies. A series of cases of Kabuki Syndrome is described in five children, four of whom exhibited strabismus with esotropia, over action of inferior oblique muscles, and under action of superior oblique muscles associated with a V pattern. Most published papers do not report or might underestimate the ocular problems. It may be appropriate to perform orbital resonances in order to detect changes in the muscle paths that are related to the pathology of the eye movements found

Improvement of suturing skills after training. Presentation of a simulation and evaluation model.

Introducción. Adquirir habilidades quirúrgicas a través de la simulación es una necesidad creciente en la actualidad. Cada día se valora más la seguridad del paciente, y por ello es inaceptable que cirujanos sin la formación adecuada previa atiendan a los pacientes. Nuestro objetivo es desarrollar un sistema de simulación de bajo coste, y una escala de medida, que permita evaluar la adquisición de conocimientos. Métodos. Se eligieron 12 residentes de primeraño de oftalmología para realizar dos sesiones grabadas, donde realizaron diferentes técnicas de sutura. Entre ellas, a los residentes se les permitió completar un entrenamiento de 4 sesiones. Después de completar el entrenamiento, las sesiones inicial y final fueron evaluadas por 3cirujanos expertos. Se utilizó la prueba de Mann-Whitney para comparar puntuaciones. Y se comprobó la concordancia entre los tres evaluadores mediante la prueba de concordancia kappade Fleiss. Resultados. La concordancia en la evaluación entre los tres examinadores fue sustancial,κ= 0,71 (IC 95%, 0,33 a 0,82), p < .0005. Los residentes mejoraron su desempeño promedio despuésde completar el entrenamiento (6,52 vs 7,81); sin embargo, no se encontraron diferencias significativas debido al pequeño número de participantes. Conclusión. Desarrollamos un sistema de entrenamiento portátil de bajo coste para la adquisición de habilidades quirúrgicas en un grupo de residentes. Asimismo, hemos desarrollado una escala de evaluación que permite evaluar objetivamente la progresión.Introduction. Acquiring surgical skills through simulation is a growing need nowadays.Every day more, patient safety is valued, and therefore it is unacceptable that surgeons withoutprevious training attend patients. Our objective is to develop a low-cost simulation system, and ascore, which allows evaluating the acquisition of knowledge. Methods. 6 first-year ophthalmologyresidents were chosen to perform two recorded sessions, where they performed different suturetechniques. Between them, the residents were allowed to complete a 4-session training. Aftercompleting the training, the initial and final sessions were evaluated by 3 blind expert surgeons.Mann–Whitney tests were used to compare scores. And the agreement between the threeevaluators was checked using the Fleiss ́ kappa concordance test. Results. The concordance in theevaluation between the three examiners was substantial, κ= 0,71 (IC 95%, 0,33 a 0,82), p < .0005.Residents improved their median performance scores after completion of training (6,52 vs 7,81)however, no significant differences were found due to the small number of participants.Conclusion. We developed a low-cost, portable training system with acquisition of skills in agroup of residents. We have also developed an evaluation scale that allows to objectively assessprogression

Lower tear meniscus height measured by optical coherence tomography in children

Introduction: While optical coherence tomography (OCT) measurements of the lower tear meniscus height (LTMH) have been reported in adults, here we obtained LTMH measurements through Fourier Domain OCT in healthy children and compared these with values obtained in healthy adults. Methods: Participants were children 7–17 years of age and a control group of adults 20–40 years of age. Inclusion criteria were no abnormal eye conditions or the use of contact lenses. Candidates who fulfilled the TFOS DEWS II criteria for dry eye disease (DED) were excluded. All subjects underwent LTMH measurement (OCT Spectralis) and tests for non-invasive tear break-up time and ocular surface staining. Participants also completed the ocular surface disease index questionnaire. Results: A total of 86 children and 27 adults were included. Mean LTMH values in the children and adult groups were 217.40 ± 71.40 μm and 225.0 ± 54.86 μm, respectively; p = 0.53. However, 59.3% of the children had an LTMH ≤210 μm suggestive of DED, compared with only 33.3% of adults (p = 0.02). For the children, no significant differences in LTMH were observed with sex or for those more or less than 12 years of age. Conclusions: Optical coherence tomography-derived LTMH measurements were obtained in healthy children. While values were similar in children and adults, a greater proportion of children had an LTMH compatible with a diagnosis of DED. More studies in different paediatric populations are required to establish a complete set of normative LTMH measurements.Depto. de Optometría y VisiónDepto. de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaFac. de MedicinaTRUEinpres

Effects of corneal biomechanical properties on rebound tonometry (Icare200) and applanation tonometry (Perkins) readings in patients with primary congenital glaucoma

Objective: To assess the influence of corneal biomechanics on intraocular pressure (IOP) measurements made with the Icare200 (IC200) rebound tonometer and the Perkins hand-held applanation tonometer in patients with primary congenital glaucoma (PCG). Materials and methods: 40 PCG patients and 40 healthy controls, age and gender-matched, were recruited. IOP was measured with the Ocular Response Analyzer (IOPc, IOPg), Icare200 and Perkins. The variables age, IOP, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), best corrected visual acuity, spherical equivalent, medications and glaucoma surgeries were recorded for each subject. Uni and multivariate analysis were used to detect effects of variables on IOP measurements. Results: Mean CCT was 545.65±71.88 μm in PCG vs. 558.78±27.58 μm in controls (p=0.284). CH and CRF were significantly lower in PCG group than in control group: mean CH 8.11±1.69 mmHg vs. 11.15±1.63 mmHg (p<0.001), and mean CRF 9.27 ± 2.35 mmHg vs. 10.71 ± 1.75 mmHg (p=0.002). Mean differences between IOP IC200-Perkins were 0.79 ± 0.53 mmHg in PCG vs. 0.80 ± 0.23 mmHg in controls (p<0.001) and mean differences IC200-IOPc were -0.89 ± 5.15 mmHg in PCG (p<0.001) vs. 1.60 ± 3.03 mmHg in controls (all p<0.009). Through multivariate analysis, CRF showed positive association and CH negative association with IOP measured with Perkins or IC200 in both subject groups. No association was detected for CCT, age or gender. Conclusion: CH and CRF were identified as the main factors interfering with IOP measurements made with both tonometers in patients with PCG and healthy controls