76 research outputs found
Manifestaciones retinianas de las enfermedades infecciosas
The retina and the choroids are richly
vascularised structures and can therefore be
colonised by germs via the haematogenous route in
the course of a systemic infectious disease. The
germs responsible for this type of infection can be
fungi, viruses, bacteria and parasites. Ocular
candidiasis is outstanding amongst these
colonisations because of its frequency; it can
manifest itself as an endophthalmitis with a slow and
hidden course. The so-called ocular histoplasmosis
syndrome, although it is infrequent in our setting, is
an important cause of choroidal neovascularisation.
The viruses that most frequently affect the retina are
of the herpes type and can produce devastating
symptoms in immunoincompetent patients, named
acute retinal necrosis syndrome. Retinitis due to
cytomegalovirus is more frequent in
immunodepressed patients, as in the case of AIDS,
but it must also be contemplated in patients with
lymphoma and immunomodulatory treatment. The
most frequent bacterial diseases that affect the retina
are syphilis and tuberculosis. Disease due to cat
scratches, caused by a borrelia, can produce a
neuroretinitis. Toxoplasmosis is the most common of
the infectious diseases caused by a parasite and
gives rise to chorioretinitis. Toxocariasis, also
caused by a parasite, is second in importance, giving
rise to choroidal granulomas and retinal tractions
Optical coherence tomography in central retinal artery occlusion
CLINICAL CASES: Three eyes with central retinal artery occlusion (CRAO) have been
studied. Optical coherence tomography (OCT) was performed in each of them.
Ophthalmoscopic signs of CRAO were equivocal in the three eyes. However, the
presence of a hyporeflective signal in the OCT scan could be seen clearly in each
of them. DISCUSSION: The presence of a hyporeflective band between the
neurosensory retina and the retinal pigment epithelium in OCT images, that
persist for several months after a CRAO episode, is useful in establishing the
diagnosis in these patient
Distrofia foveomacular viteliforme del adulto
Four cases of adult-onset foveomacular vitelliform dystrophy are shown. In two cases we were able to complete the exploration under optical coherence tomography. One of the patients developed spontaneous disappearance of the subfoveal deposit in her right eye along with an important decrease in her visual acuity.
Discussion: Adult-onset foveomacular vitelliform dystrophy is characterized by yellowish round-shaped bilateral, lesions in the subfoveal area. Optical coherence tomography reveal the presence of a slightly elevated lesion wich affects the retinal pigment epithelium and the external layers of neurosensory retin
Triamcinolona intravítrea en el tratamiento de la oclusión de rama venosa retiniana
Clinical cases: Five eyes with branch retinal vein occlusion (BRVO) were treated with intravitreal injection of 4 mg of triamcinolone. Four cases showed good visual acuity and macular thickness evolution after one dose. The remaining one case suffered a relapse three months later. Therefore a second injection was performed in that case.
Discussion: Several treatments have been suggested to manage macular edema in BRVO. Intravitreal triamcinolone may be a therapeutic option to increase visual acuity and decrease macular thickness in patients with macular edema secondary to BRV
Aceite de silicona para el tratamiento de la maculopatía hipotónica
Case report: We report a case of a man who developed hypotonic maculopathy after vitreoretinal surgery for anterior proliferative vitreoretinopathy. After an injection of intravitreal triamcinolone, the ocular pressure did not increase, therefore silicone oil was injected. After this, the visual acuity increased and the choroidal and retinal folds regressed.
Discussion: Hypotonic maculopathy is a frustrating problem, often resulting in poor visual acuity. There are not many effective treatments. The injection of silicone oil could be an alternative to increase the intraocular pressure and re-establish the normal anatomy of the eye, improving the visual acuity in some patient
Hemorragia submacular traumática tratada con rt-PA y SF6
This patient was afflicted by a traumatic submacular hemorrhage. A
posterior vitrectomy was performed and intravitreal rt-PA and SF6 were
administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8.
No complications due to the treatment with rt-PA were reported. DISCUSSION: It is
known that waiting for the spontaneous blood removal in such cases results in a
poor visual acuity recovery due to a toxic effect of the blood products. Both
rt-PA and the SF6 are useful for the treatment of submacular hemorrhages
secondary to age-related macular degeneration, and this case report has shown
they are also useful to lyse traumatic blood clots, thus contributing to a better
recovery of visual acuity
Distrofia macular anular benigna
Clinical cases: Two cases of benign concentric macular dystrophy are described. In one case, ophthalmologic examination, fluorescein angiogram and visual field measurement were performed. The presence of a juxtafoveal fibrosis in the other patient, indicate that choroidal neovascularization may be associated with this type of macular dystrophy.
Discussion: Benign concentric macular dystrophy is an entity with well-defined ophthalmoscopic and angiographic characteristics. Usually the prognosis is good. Rarely, choroidal neovascularization can be associated with this macular dystroph
Retinal thickness study with optical coherence tomography in patients with diabetes
To quantitatively assess retinal thickness by optical coherence
tomography (OCT) in normal subjects and patients with diabetes. This study was
intended to determine which retinal thickness value measured with OCT best
discriminates between diabetic eyes, with and without macular edema. METHODS: OCT
retinal thickness was measured by a manual technique in a total of 26 healthy
volunteers (44 control eyes) and 85 patients with diabetes (148 eyes) with the
clinical diagnosis of no diabetic retinopathy (45 eyes), nonproliferative
diabetic retinopathy without clinically significant macular edema (CSME; 54
eyes), proliferative diabetic retinopathy without CSME (21 eyes), and 28 eyes
with diabetic retinopathy with CSME. Independent predictors of the presence of
CSME were quantified by using univariate and multivariate logistic regression
analyses. Receiver operating characteristic (ROC) curves were generated to
evaluate and compare the predictor variables. The correlation of retinal
thickness measurements and visual acuity was calculated. RESULTS: There were
statistically significant differences in foveal thickness between control eyes
and all the other eye groups (P = 0.001). Diabetic eyes with CSME had a
statistically significant greater thickness in each of the areas compared with
the other groups. In a multivariate logistic regression model, foveal thickness
was a strong and independent predictor of CSME (odds ratio [OR], 1.037; 95%
confidence interval [CI] 1.02-1.05). The area under the ROC curve of this
predictor variable was 0.94 (P = 0.001). For a cutoff point of 180 microm, the
sensitivity was 93%, and specificity was 75%. Foveal thickness correlated with
visual acuity in a log minimum angle of resolution (logMAR) scale (Spearman's rho
= 0.9, P = 0.001). CONCLUSIONS: These results suggest that foveal thickening over
180 microm measured by OCT may be useful for the early detection of macular
thickening and may be an indicator for a closer follow-up of the patient with
diabetes
Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis
Studying axonal loss in the retina is a promising biomarker for
multiple sclerosis (MS). Our aim was to compare optical coherence tomography
(OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness
of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the
relationship between changes in the RNFL thickness with physical and cognitive
disability. We studied 52 patients with MS and 18 proportionally matched controls
by performing neurological examination, neuropsychological evaluation using the
Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT
and HRT. RESULTS: We found that both OCT and HRT could define a reduction in the
thickness of the RNFL in patients with MS compared with controls, although both
measurements were weakly correlated, suggesting that they might measure different
aspects of the tissue changes in MS. The degree of RNFL atrophy was correlated
with cognitive disability, mainly with the symbol digit modality test (r=0.754,
P<0.001). Moreover, temporal quadrant RNFL atrophy measured with OCT was
associated with physical disability. CONCLUSION: In summary, both OCT and HRT are
able to detect thinning of the RNFL, but OCT seems to be the most sensitive
technique to identify changes associated with MS evolution
Effects of lutein and docosahexaenoic Acid supplementation on macular pigment optical density in a randomized controlled trial
We studied the macular pigment ocular density (MPOD) in patients with early age macular degeneration (AMD) before and 1 year after nutritional supplementation with lutein and docosahexaenoic acid (DHA). Forty-four patients with AMD were randomly divided into two groups that received placebo (n = 21) or a nutritional supplement (n = 23, 12 mg of lutein and 280 mg of DHA daily). Heterochromatic flicker photometry was used to determine the MPOD. At baseline, the MPOD in AMD patients with placebo was 0.286 ± 0.017 meanwhile in AMD patients with supplementation it was 0.291 ± 0.016. One year later, the mean MPOD had increased by 0.059 in the placebo group and by 0.162 in patients receiving lutein and DHA. This difference between groups was significant (p < 0.05). Lutein and DHA supplementation is effective in increasing the MPOD and may aid in prevention of age related macular degeneration
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