Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration

Luis Arias1,2, Jordi Monés11Institut de la Màcula i de la Retina, Centro Médico Teknon, Barcelona; 2Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, BarcelonaPurpose: To determine the efficacy and safety of treating predominantly hemorrhagic age-related macular degeneration (AMD) with transconjunctival sutureless vitrectomy (TSV), tissue plasminogen activator (tPA), sulphur hexafluoride (SF6), and intravitreal bevacizumab.Methods: Retrospective study, consecutive case series. Patients with acute hemorrhagic AMD treated with 25- or 23-gauge TSV, subretinal or intravitreal tPA, fluid-air-SF6 exchange and intravitreal injection of bevacizumab. All operations were performed within the first 5 days after the start of symptoms, which consisted of visual acuity (VA) loss and central scotoma.Results: Fifteen eyes from 15 patients were included. The patients’ mean age was 79.6 years, and the mean follow-up was 11.8 months. Five patients (33%) were receiving oral anticoagulant treatment. At baseline, the mean VA (logMAR values) was 1.5 (20/640 Snellen equivalent). At the last follow-up visit, the mean VA was 1.1 (20/250) (P < 0.0001; paired t-test). The submacular hemorrhage was successfully displaced in all the cases. Complications consisted of three cases of vitreous hemorrhage and a tear or the retinal pigment epithelium. Twelve cases (80%) did not require further treatment during the follow-up period.Conclusion: A surgical approach with 25- or 23-gauge TSV, tPA, SF6 and intravitreal bevacizumab is an efficacious and safe procedure in patients with hemorrhagic AMD. Early treatment is advisable for obtaining the optimal outcome.Keywords: Hemorrhagic age-related macular degeneration, tissue plasminogen activator, intravitreal bevacizumab; transconjunctival sutureless vitrectom

Ranibizumab in the treatment of choroidal neovascularization on the border of an inferior staphyloma associated with tilted disc syndrome

Luis Arias1,2, Jordi Monés21Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona; 2Institut de la Màcula i de la Retina, Centro Médico Teknon, BarcelonaPurpose: To describe a case of choroidal neovascularization (CNV) on the border of an inferior staphyloma associated with tilted disc syndrome treated with intravitreal ranibizumab.Patients: Observational case report.Methods: A patient with CNV on the border of an inferior staphyloma associated with tilted disc syndrome was imaged using fluorescein angiography, autofluorescence and spectral domain optical coherence tomography, and treated with intravitreal injections of ranibizumab. Results: The patient received 3 ranibizumab injections during the 9-month follow-up. The visual acuity improved from 20/40 to 20/32 and the foveal thickness reduced from 470 microns to 248 microns. The angiograms showed resolution of leakage associated with CNV. There were no adverse events.Conclusion: Intravitreal ranibizumab is an efficacious and safe treatment in the management of choroidal neovascularization on the border of an inferior staphyloma associated with tilted disc syndrome.Keywords: intravitreal ranibizumab, choroidal neovascularization, tilted disc syndrome, inferior staphylom

L'ensenyament i la qüestió nacional als Països Catalans

Abstract not availabl

L'Institut Obrer de Barcelona (desembre 1937-gener 1939) = The Institut Obrer [The Workers' Institute of Barcelona (December 1937-January 1939)

En aquest article es revisa la trajectòria de l'Institut Obrer de Barcelona, durant el breu període de la seva història, entre el desembre de 1937 i el gener de 1939. Aquest institut va seguir l'exemple dels que s'havien establert anteriorment a València i Sabadell i tenia com a objectiu contribuir a la preparació tècnica i professional dels alumnes, sense perdre de vista la seva formació intel·lectual. Es pot dir que en aquest establiment es va reunir un excel·lent planter de professors i un alumnat certament remarcable que van posar en marxa —tot i les dificultats d'aquells moments de Guerra Civil— una experiència pedagògica de gran valor polític i ideològic, per bé que va seguir la tradició unitària i centralista de l'ensenyament espanyol sense tenir en compte el context català en què havia d'arrelar.This article reviews the evolution of the Institut Obrer [Workers’ Institute] of Barcelona, during its brief history, between December 1937 and January 1939. This institute followed the example of those previously established in Valencia and Sabadell, geared towards contributing to the technical and professional preparation of pupils, without losing sight of their intellectual training. This establishment assembled an excellent team of teachers and a remarkable body of pupils that started up —despite the hardships of the Civil War— a pedagogical experience of great political and ideological value, even though it followed the unitary and centralist tradition of Spanish teaching, disregarding the Catalan context in which it was to be rooted