Cambios precoces en la tomografía de coherencia óptica en un niño con maculopatía inducida por puntero láser.

Niño de 9 años de edad, que refiere pérdida visual en su ojo derecho, después de jugar con un puntero láser. En la primera exploración (12h después) la agudeza visual (AV) era 0,15, la fóvea presentaba una lesión hipopigmentada, y la tomografía de coherencia óptica (OCT) demuestra la presencia de bandas hiperreflectivas verticales. Al cabo de 6 meses, la AV había mejorado a 0,5 y se aprecia en la OCT un área bien definida de interrupción de la retina externa. Discusión Un inadecuado uso de los punteros láser, puede producir pérdida visual severa e irreversible.pre-print671 K

Ciclodiálisis traumática tratada con láser ciclodiodo transescleral: evolución de la exploración del segmento anterior y posterior

Caso clínico Paciente varón de 35 años de edad, que presentó un cuadro severo de maculopatía por hipotensión tras recibir una patada en el ojo izquierdo. Presentaba una zona amplia de iridodiálisis. La gonioscopia, biomicroscopia ultrasónica y tomografía de coherencia óptica no permitieron localizar la ciclodiálisis. Cinco meses después, ante la falta de respuesta al tratamiento médico, el paciente fue tratado con ciclofotocoagulación transescleral con láser de diodo, que produjo la resolución del cuadro clínico. Discusión La ciclofotocoagulación transescleral con láser diodo constituye un tratamiento eficaz, produce poca iatrogenia y permite incluso resolver cuadros de hipotensión ocular producidos por ciclodiálisis que no han podido ser localizadas.pre-print290 K

A systematic review and meta-analysis on the efficacy of topical povidone iodine in adenoviral conjunctivitis.

Purpose: To evaluate if topical povidone iodine (alone (PI) or combined with dexamethasone (PI-DXM)) is superior to placebo for treating adenoviral conjunctivitis (AC). Methods: A systematic review was performed according to Preferred Reporting Items for the Systematic Review and Meta-Analyses (PRISMA) Statement. An electronic search was made of PubMed, Embase and Cochrane Library. Randomized control studies that compared PI or PI-DXM with placebo were included. At least three researchers were involved in all phases. Primary outcomes were AC duration and the number of clinical resolutions during the first week. Secondary outcomes were conjunctival redness and serous discharge one week after starting treatment and the rate of AC complications. Results: Only five studies met the inclusion criteria. PI-DXM reduced the duration of the disease by 2.4 days (IC95% 4.09–0.71), however this result was based only in one study. PI and PI-DXM did not modify the probability of clinical resolution during the first week; relative risk (RR) = 1.77 (IC95% 0.63–4.96) and 1.70 (IC95% 0.67–4.36). The impact of PI on the probability of pseudomembranes could not be estimated. PI-DXM did not influence the risk of developing subepithelial infiltrates RR = 0.73 (IC95% 0.02–3.38). Conclusions: At this time there is great uncertainty about the usefulness of PI on the course of adenoviral conjunctivitis. PI-DXM may have a small effect on AC duration. To make future reviews possible, it is important to standardize the way in which these results are reported. Futures studies should include etiological confirmation, unit of study (eyes vs patients) and report on those aspects that are more relevant for patient quality of life (duration of the disease, development of complications: pseudomembranes and subepithelial infiltrates).pre-print1092 K

Impact of tamsulosin exposure on late complications following cataract surgery: retrospective cohort study

The purpose of this study is to measure the impact of tamsulosin intake on five postoperative cataract surgery complications (toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema, and postoperative endophthalmitis). This retrospective cohort study was conducted at University Hospital of Henares. The study included 660-eyes of 660 patients submitted to cataract surgery at the ophthalmology unit of Hospital del Henares (Madrid) between 2 March 2009 and 28 February 2010. Extracapsular cataract extraction, combined glaucoma and cataract surgery phacovitrectomy, posterior capsule rupture and zonular damage were considered exclusion criteria. Clinical charts were reviewed during July 2012. Patients were divided in two groups (exposed and non-exposed to tamsulosin). Cumulative incidence of toxic anterior segment syndrome, rebound uveitis, retinal detachment, macular edema and postoperative endophthalmitis were compared in both groups. Rebound uveitis (relative risk [RR] 3.39; confidence interval [CI] 1.63–7.08) and macular edema (RR 4.15; CI 1.06–16.22) were more common in the tamsulosin-exposed group. Retinal detachment had a similar incidence in both groups. We observed no cases of endophthalmitis or toxic anterior segment syndrome in either of the two groups. Tamsulosin exposure in this cohort was associated with a higher risk of rebound uveitis and macular edema but the other three studied postoperative complications had a similar incidence in both groups