Guía itinerario formativo tipo (GIFT) Oftalmología

Guía del itinerario formativo de los residentes en el servicio de Oftalmología del Complejo Hospitalario Universitario de FerrolGuía do itinerario formativo dos residentes no servizo de Oftalmoloxía do Complexo Hospitalario Universitario de Ferro

Innovaci?n en oftalmolog?a

Ponencia: "Innovaci?n en oftalmolog?a" presentada por Nuria Olivier Pascual en la Mesa Redonda 2 sobre "Proyectos innovadores en el ?rea Sanitaria de Ferrol", en la 1? Jornada de Innovaci?n en Salud del ?rea Sanitaria de Ferrol, celebrada en Ferrol el 22 de septiembre de 2022.Ponencia: "Innovaci?n en oftalmolox?a" presentada por Nuria Olivier Pascual na Mesa Redonda 2 sobre "Proxectos innovadores na ?rea Sanitaria de Ferrol", na 1? Xornada de Innovaci?n en Sa?de da ?rea Sanitaria de Ferrol, celebrada en Ferrol o 22 de setembro de 2022

Enhancing Pathological Detection and Monitoring in OCT Volumes with Limited Slices using Convolutional Neural Networks and 3D Visualization Techniques

Cursos e Congresos, C-155[Abstract] Optical Coherence Tomography (OCT) is a non-invasive imaging technique with a crucial role in the monitoring of a wide range of diseases. In order to make a good diagnosis it is essential that clinicians can observe any subtle changes that appear in the multiple ocular structures, so it is imperative that the 3D OCT volumes have good resolution in each axis. Unfortunately, there is a trade-off between image quality and the number of volume slices. In this work, we use a convolutional neural network to generate the intermediate synthetic slices of the OTC volumes and we propose a few variants of a 3D reconstruction algorithm to create visualizations that emphasize the changes present in multiple retinal structures to aid clinicians in the diagnostic processXunta de Galicia; ED431C 2020/24This research was funded by Government of Spain, Ministerio de Ciencia e Innovación y Universidades, Government of Spain, RTI2018-095894-B-I00 research project; Ministerio de Ciencia e Innovación, Government of Spain through the research projects with reference PID2019-108435RB-I00, PDC2022-133132-I00 and TED2021-131201B-I00; Consellería de Cultura, Educación e Universidade, Xunta de Galicia through the Grupos de Referencia Competitiva, grant ref. ED431C 2020/24; CITIC, as Research Center accredited by Galician University System, is funded by ”Consellería de Cultura, Educación e Universidade from Xunta de Galicia”, supported in an 80% through ERDF Funds, ERDF Operational Programme Galicia 2014-2020, and the remaining 20% by ”Secretaría Xeral de Universidades”, grant ref. ED431G 2019/01. Emilio López Varela acknowledges its support under FPI Grant Program through PID2019-108435RB-I00 project

Fully automatic segmentation of the choroid in non-EDI OCT images of patients with multiple sclerosis

Emilio López Varela acknowledges its support under FPI Grant Program through PID2019-108435RB-I00 project.[Abstract]: Multiple Sclerosis (MS) is a chronic neurological disease, in which immune-mediated mechanisms lead to pathological processes of neurodegeneration. Optical coherence tomography (OCT) has recently begun to be used to diagnose and monitor patients with MS. Morphological changes in the choroid have been linked to the onset of MS, so an accurate segmentation of this layer is critical. Conventional OCT has several limitations in obtaining accurate images of the choroid, which has been improved through the use of systems such as Enhanced Depth Imaging (EDI) OCT. Unfortunately, many longitudinal studies that have collected samples over the years in the past have been performed using highly variable settings and without the use of the EDI protocol (or similar variants). For these reasons, in this work we propose a series of fully automatic approaches, based on convolutional neural networks, capable of robustly segmenting the choroid in OCT images without using the EDI protocol. To test the robustness and efficiency of our method, we performed experiments on a public dataset and a collected one. The Dice score obtained by the best proposed architecture is 89.7 for the public dataset, and 93.7 for the collected dataset.Instituto de Salud Carlos III; DTS18/00136Ministerio de Ciencia e Innovación y Universidades; RTI2018-095894-B-I00Xunta de Galicia; ED431C 2020/24Ministerio de Ciencia e Innovación; PID2019-108435RB-I00Axencia Galega de Innovación (GAIN); IN845D 2020/38Xunta de Galicia; ED431G 2019/0

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Macroaneurisma retiniano tratado con laser e Implante intravítreo de Dexametadona (Ozurdex®)

Caso clínico. Presentamos un caso de una mujer que tras sufrir un macroaneurisma (MA) retiniano complicado con hemorragia y exudación retiniana, recibió tratamiento con láser argón y un implante intravítreo de dexametasona (Ozurdex, Allegan). Se reabsorve la exudación retiniana y se recupera rápidamente la agudeza visual. Discusión. Los macroaneurismas arteriales retinianos son dilataciones aneurismáticas adquiridas de las ramas arteriales retinianas que ocurren en el polo posterior. Cuando la mácula se ve amenazada con edema o exudación, se debe realizar un diagnóstico y tratamiento precoz con fotocoagulaicón láser. El implante intravítreo de dexametasona (Ozurdex) podría ser útil para reducir la exudación macular y permitir una pronta recuperación visual

Neuroretinitis in Epstein Barr virus primary infection

Caso Clínico. Mujer de 36 años que acude a Urgencias por disminución de visión aguda en el OD. Se evidencia edema de papila bilateral con alteraciones significativas en los campos visuales realizados. El estudio sistémico demostró una seroconversión de Ig M para el Virus Epstein Barr. El cuadro se resolvió de forma espontánea con recuperación de la AV inicial. Discusión. La neurorretinitis es una enfermedad que puede ser de origen infeccioso, inflamatorio, autoinmune o vascular, pero a pesar de su etiología variada, suele presentarse con unos signos característicos, que facilitan su diagnóstico. El tratamiento variará dependiendo de la causa de la enfermedad.Case Report. We present the case of a 36 year-old woman who came to the Emergency Department due to loss visual acuity in the right eye. There was demostrate a bilateral papilledema with significative changes in visual fields. The systematic study was positive to Epstein Barr Virus with a seroconversion IgM. The case had a sponteneus resolution and the VA initial was recuperated. Conclusión. The neuroretinitis had multiple ethiology: infection, inflamatory, autoinmune or vascular, but there are some tipical signs which help the diagnosis. The treatment will change in function the disease's ethilogy

Pliegues coroideos. Diagnóstico diferencial a propósito de un caso

Caso clínico: presentamos un caso clínico de una paciente con pliegues coroideos unilaterales en el polo posterior en los cuales, tras un completo examen oftalmológico encontramos la causa subyacente. Discusión: los pliegues coroideos están presentes en una gran variedad de procesos oculares. Pese a que se han descrito frecuentemente asociados a un síndrome benigno consistente en hipermetropía adquirida, existen una gran variedad de procesos oculares y orbitarios que hay que tener en cuenta. Por ello, es muy importante realizar un correcto diagnóstico diferencial

Orbital rhabdomyosarcoma: difficulties with european treatment protocol

Objetivo, material y método: Presentar la experiencia en el manejo del rabdomiosarcoma orbitario en nuestro centro a lo largo de 21 años. Se revisan 12 casos de rabdomiosarcoma orbitario pediátrico y los resultados del tratamiento en términos de mortalidad y morbilidad, comparándolos con otros estudios publicados. Resultados/Conclusiones: El manejo del rabdomiosarcoma orbitario siguiendo el protocolo europeo conlleva unos resultados pobres comparados con los del protocolo americano. La radioterapia precoz y la cirugía excisional completa podrían jugar papel en el manejo de estos tumores.Purpose, Material and methods: To present the experience in management of orbital rhabdomyosarcoma over 21 years in our centre. Review of the 12 cases of pediatric rhabdomyosarcoma and results of treatament in terms of mortality and morbidity comparing our results with other studies. Results/Conclusión: Management of orbital rhabdomyosarcoma following th European Protocol leads to poor results compared with the American protocol. Early radiotherapy and complete tumoral excision could play a role in management of this tumor (Arch Soc Esp Oftalmol 2005; 80: 331-338)

Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole

Purpose To analyze the recovery course of foveal microstructures in eyes with nonsurgical healing of full-thickness macular hole (FTMH). Methods By serial OCT scans, the temporal healing sequences were analyzed in ocular trauma, vitreomacular traction (VMT), cystoid macular edema (CME), and the remaining group. We evaluated correlations between the final best-corrected spectacle visual acuity and reconstruction time of external limiting membrane (ELM), and inner segment/outer segment (IS/OS). Results The healing (mean +/- standard deviation in months) most involved fusion at the level of the outer nuclear layer (ONL) (6.3 +/- 10.5) followed by restoration of ELM (9.1 +/- 13.8), and lastly, by IS/OS regeneration (13.1 +/- 19.5). In severe blunt ocular trauma, healing was fast and involved subretinal zipper glue-like reapposition with resulting outer retinal atrophy. Best spectacle-corrected visual acuity correlated with normalization of the clivus (p=0.012), faster ELM (p=0.006), and IS/OS reconstitution (p=0.024). Recurrence of FTMH occurred when the healing was halted (3 eyes) or was aberrant by lamellar hole epiretinal proliferation (LHEP) (3 eyes) or by the persistence of VMT (1 eye). Conclusion Recovery sequences proceeded from the ONL to the deeper layers with BCVA correlating absolutely and temporally with the restoration of outer retinal layer integrity