Usefulness of liquid biopsy biomarkers from aqueous humor in predicting anti-VEGF response in diabetic macular edema : results of a pilot study

The objective was to investigate the usefulness of the "liquid biopsy" of aqueous humor (AH) to predict the clinical response after intravitreal injections (IVT) of anti-VEGF agents for treating diabetic macular edema (DME). For this purpose, AH samples obtained during the first anti-VEGF IVT from 31 type two diabetic patients were analyzed. Patients were classified into three groups according to their anti-VEGF response: rapid responders (n = 11), slow responders (n = 11), and non-responders (n = 9). In addition, patients (n = 7) who showed good response to corticosteroids but a delayed or no response to anti-VEGF therapy were analyzed. Levels of 17 different cytokines, chemokines, and growth factors in AH were measured using a multiplex immunoassay. We found higher concentrations of VEGF in rapid responders to anti-VEGF therapy compared to non-responders. In addition, slow responders to anti-VEGF treatment showed higher levels of inflammatory markers than rapid responders, but did not reach statistical significance. Finally, those patients who responded to corticosteroids but not to anti-VEGF therapy showed significantly lower levels of VEGF than patients with rapid response (p = 0.01). In conclusion, "liquid biopsy" of AH could be useful to determine whether the predominant pathogenic event is primarily angiogenic or inflammatory in nature. This approach would allow physicians to select a more rational and cost-effective treatment. Further studies to validate these preliminary results are warranted

Optical performance of a new design of trifocal intraocular lens based on the Devil's diffractive lens

In this work, we propose a new diffractive trifocal intraocular lens design with focus extension, conceived to provide a high visual performance at intermediate distances. This design is based on a fractal structure known as the "Devil's staircase". To assess its optical performance, numerical simulations have been performed with a ray tracing program using the Liou-Brennan model eye under polychromatic illumination. The simulated through the focus visual acuity was the merit function employed to test its pupil-dependence and its behavior against decentering. A qualitative assessment of the multifocal intraocular lens (MIOL) was also performed experimentally with an adaptive optics visual simulator. The experimental results confirm our numerical predictions. We found that our MIOL design has a trifocal profile, which is very robust to decentration and has low degree of pupil dependence. It performs better at intermediate distances than at near distances and, for a pupil diameter of 3 mm, it works like an EDoF lens over almost the entire defocus range

Recommendations for ophthalmologic practice during the easing of COVID-19 control measures

In the context of the COVID-19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID-19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS-CoV-2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow-up of the ophthalmic diseases. With this update (5th) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID-19 pandemic

La trabeculoplastia en el tratamiento del glaucoma

Purpose: Revise the last contributions in the treatment of the glaucoma with argon laser trabeculoplasty (ALT) and contribute our experience. Methods: A retrospective study of 60 eyes is carried out of 37 patients who suffered a chronic simple glaucoma of open angle, to that which it made them a ALT. Results: The intraocular pressure (IOP) descent a mean of 21.58 % after the ALT (p< 0.01), the descent is high vhen the IOP initial is more elevated, so in the cases with IOP initial comprehended between 16-19 descend a 9.65 %, and in those in that which their IOP initial is situate between 24-34 the descent is a 33.50 %, and he is maintained, in similar figures, to the year. Conclusions: The ALT is effective in order to decrease the IOP, that descends in a mean 0f 21.5 %, in the eyes with chronic simple glaucoma. The pressure-lowering effect is high when the initial IOP is rather elevated. The favorable effect persists to the year.Objetivo: Revisar las últimas aportaciones en el tratamiento del glaucoma por medio de la trabeculoplastia con láser de argón (TBLA) y aportar nuestra experiencia. Métodos: Se realiza un estudio retrospectivo de 60 ojos de 37 pacientes, que padecían un glaucoma crónico simple de ángulo abierto, a los que se les hizo una (TBLA). Resultados: La PIO desciende una media de 21.58 % tras la TBLA (p < 0.01), el descenso es mayor cuando la PIO inicial es mas elevada, así en los casos con PIO inicial comprendida entre 16-19 desciende un 9.65 % y en aquellos en los que su PIO inicial se sitúa entre 24-34 el descenso es un 33.50 % y se mantiene, en cifras parecidas, al año. Conclusiones: La TBLA es efectiva para disminuir la PIO, que desciende en una media de 21.5 %, en los ojos con glaucoma crónico simple. La acción hipotensora es mayor cuando la PIO inicial es mas elevada. El efecto favorable persiste al año

Portadores de lentes de contacto en la Red. Primeros resultados

In previous projects we studied the applications that Internet offers to the contact lenses. In this communication we present the use of the Net for the study of the distribution of contact lens wearers. For this, we designed a survey in the Web, structured in order to save the answers automatically in a data base. We present the preliminary results of this survey.En trabajos previos hemos estudiado las aplicaciones que Internet ofrece a la Contactología. En este artículo presentamos el uso de la Red para el estudio de la distribución de portadores de lentes de contacto. Para ello hemos diseñado una encuesta en una página Web a la cual se puede acceder a través de la red Internet, estructurada de tal forma que las respuestas son recogidas automáticamente en una base de datos. Presentamos los primeros resultados de dicha encuesta