Evaluación del músculo ciliar y del grosor escleral anterior en miopes altos mediante tomografía de coherencia óptica / Assessment of the ciliary muscle and scleral anterior thickness in high myopia by optical coherence tomography

Propósito: Evaluar las dimensiones del músculo ciliar (MC) y del grosor escleral anterior (AST) in vivo en miopes altos mediante tomografía de coherencia óptica de fuente de barrido (SS-OCT) y comparar con sujetos emétropes e hipermétropes.MétodosEstudio transversal en el que se incluyeron 34 miopes altos (≥−6dioptrías [D]), 90 emétropes (−1 a +1D) y 38 hipermétropes (≥+3,5D). Se midieron el grosor del MC (CMT) y el AST en los cuadrantes temporal y nasal a 1, 2 y 3mm del espolón escleral utilizando la SS-OCT. Además, se evaluó la longitud del MC (CML).ResultadosLas dimensiones tanto del CML como del CMT en cualquiera de sus puntos de medida fueron mayores en miopes altos y en emétropes que en hipermétropes, tanto en el cuadrante nasal como en el temporal (p<0,001). Sin embargo, no existieron diferencias entre miopes magnos y emétropes para ninguno de los parámetros (p≥0,076), salvo para el CMT a 3mm en temporal (p<0,001). No existieron diferencias en el AST entre miopes altos, emétropes e hipermétropes, en ninguno de los puntos de medida ni cuadrantes estudiados (p>0,05).ConclusionesLa SS-OCT permite medir el MC in vivo, no observándose diferencias en sus dimensiones entre miopes altos y emétropes, pero sí que fueron menores en hipermétropes. En la medida de la esclera anterior no se observaron diferencias entre los tres grupos analizados según la refracción. (AU)

Purpose: To assess ciliary muscle (CM) and anterior scleral thickness (AST) dimensions in vivo in high myopia using swept-source optical coherence tomography (SS-OCT) and to compare with emmetropic and hyperopic subjects.MethodsCross-sectional study that included 34 high myopic patients (≥−6 diopters [D]), 90 emmetropes (−1 to +1D) and 38 hyperopic patients (≥+3.5D). CM thickness (CMT) and AST were measured in the temporal and nasal quadrants at 1, 2, and 3mm from the scleral spur using SS-OCT. In addition, the length of the CM (CML) was evaluated.ResultsThe dimensions of the CML and the CMT at any of their measurement points were greater in high myopes and emmetropes than in hyperopes, both in the nasal and temporal quadrants (P<.001). However, there were no differences between high myopes and emmetropes for any of the parameters (P≥.076) except for the CMT at 3mm in the temporal quadrant (P<.001). There were no differences in the AST between high myopes, emmetropes and hyperopes, in any of the measurement points or quadrants studied (P>.05).ConclusionsThe SS-OCT allows to measure the CM in vivo, not observing differences in its dimensions between high myopes and emmetropes, but they were smaller in hyperopes. In the measurement of the anterior sclera, no differences were observed between the three groups analyzed according to refraction. (AU)

Actualización clínica en nanoftalmos: características, enfermedades y complicaciones asociadas / Clinical update in nanophthalmos: Features, diseases and complications associated

El nanoftalmos es una condición congénita infrecuente del globo ocular que se caracteriza por un menor tamaño de los segmentos anterior y posterior en ausencia de una malformación ocular definida. Tradicionalmente se han descrito alteraciones anatómicas asociadas como una longitud axial corta, esclera engrosada, córnea con menor diámetro, cámara anterior estrecha y aumento de la relación entre el volumen del cristalino y el globo ocular. La causa se desconoce, aunque se han descrito múltiples mutaciones que podrían estar asociadas. En la actualidad, falta todavía una definición y una clasificación consensuada. Su relevancia clínica deriva de la asociación con múltiples afecciones oculares que pueden limitar la función visual como son hipermetropía elevada, ambliopía, glaucoma de ángulo cerrado, desprendimiento de retina y catarata. Asimismo, tanto la cirugía de catarata como la de glaucoma siguen constituyendo un desafío en estos ojos en los que el riesgo de numerosas complicaciones tanto intraoperatorias como postoperatorias es significativamente más elevado. El tratamiento del nanoftalmos tiene una doble orientación. Es preciso tratar las enfermedades asociadas y, además, reducir y controlar las complicaciones quirúrgicas. Esta revisión pretende realizar una actualización de lo publicado en los últimos años en relación con esta enfermedad. (AU)

Nanophthalmos is a rare congenital condition of the eyeball that is characterized by a smaller size of the anterior and posterior segments without associated ocular malformations. Typical features that have traditionally been described in these eyes are short axial length, thickened sclera, cornea with a smaller diameter, narrow anterior chamber, and an increased lens to globe volume ratio. However, at present, there is still a lack of recognized diagnostic criteria for nanophthalmos and a classification of its severity. Its clinical relevance stems from the increased risk of multiple ocular conditions, such as high hyperopia, amblyopia, angle-closure glaucoma, retinal detachment, and cataracts. Likewise, in relation to surgery in these eyes, there are particularities in cataract and glaucoma surgery and with a greater risk of associated intra- and postoperative complications. In this way, the treatment of nanophthalmos focuses on controlling the associated eye conditions and reducing and controlling surgical complications. This review aims to update what has been published in recent years regarding nanophthalmos. (AU)

Prevalence of refractive error within a Portuguese sample of optometric records

Purpose: Considering the burden of refractive error, clinical-based research methods are often used as epidemiological tools. This study aimed to generate evidence on the prevalence and distribution of refractive error in Portugal. Methods A cross-sectional retrospective study was designed to review optometric records from Portuguese practices during July 2021. Results 348 optometric records were analysed. Subjects had a mean age of 44.2 ± 19.2 years (range 6–81) and 58.4% were female. The mean spherical equivalent was myopic, −0.65 ± 2.38 Diopters (D), varying from a minimum of −13.63 to a maximum of 6.25 D. According to sex, the mean spherical equivalent was −0.76 ± 2.29 D for female and −0.49 ± 2.49 D for male, with no significant difference between them (p = .307). The distribution of the spherical equivalent mean across the age groups, linearly varies from a myopic −1.62 ± 1.74 D in the age group of [6 – 29]; −1.58 ± 2.80 D in [30 – 44]; −0.09 ± 2.40 in [45 – 59] to a hyperopic 0.67 ± 1.61 D in the group of [60 – 81]. High myopia had a prevalence of 2.7% in the sample. Myopia was the most prevalent refractive error in the sample representing 41.3%. In the age group [6–29], myopia had a prevalence of 69.3%. Hyperopia had a prevalence in the sample of 29.7%. Conclusions Myopia represents the most prevalent refractive error within the sample and is the prevalence is higher in the younger age groups, demonstrating a shift towards an increase of myopia in the next years. (AU)

Accuracy and precision of automated subjective refraction in young hyperopes under cycloplegia

Purpose: To assess the agreement between the Eye Refract, an instrument to perform subjective automated refraction, and the traditional subjective refraction, as the gold standard, in young hyperopes under noncycloplegic and cycloplegic conditions. Methods: A cross-section and randomized study was carried out, involving 42 participants (18.2 ± 7.7 years, range 6 to 31 years). Only one eye was chosen for the analysis, randomly. An optometrist conducted the refraction with the Eye Refract, while another different optometrist conducted the traditional subjective refraction. Spherical equivalent (M), cylindrical components (J0 and J45), and corrected distance visual acuity (CDVA) were compared between both refraction methods under noncycloplegic and cycloplegic conditions. A Bland-Altman analysis was performed to assess the agreement (accuracy and precision) between both refraction methods. Results: Without cycloplegia, the Eye Refract showed significantly lower values of hyperopia than the traditional subjective refraction (p < 0.009), the mean difference (accuracy) and its 95% limits of agreement (precision) being -0.31 (+0.85, -1.47) D. Conversely, there were no statistical differences between both refraction methods under cycloplegic conditions (p ≥ 0.05). Regarding J0 and J45, both refraction methods manifested no significant differences between them under noncycloplegic and cycloplegic conditions (p ≥ 0.05). Finally, the Eye Refract significantly improved CDVA (0.04 ± 0.01 logMAR) compared with the traditional subjective refraction without cycloplegia (p = 0.01). Conclusions: The Eye Refract is presented as a useful instrument to determine the refractive error in young hyperopes, the use of cycloplegia being necessary to obtain accurate and precise spherical refraction. (AU)

Comparison of an open view autorefractor with an open view aberrometer in determining peripheral refraction in children

Purpose: The aim of this study was to compare central and peripheral refraction using an open view Shin-Nippon NVision-K 5001 autorefractor and an open view COAS-HD VR aberrometer in young children.MethodsCycloplegic central and peripheral autorefraction was measured in the right eye of 123 children aged 8 to 16 years. Three measurements each were obtained with both Shin-Nippon NVision-K 5001 autorefractor and COAS-HD VR aberrometer along the horizontal visual field up to 30° (nasal and temporal) in 10° steps. The refraction from the autorefractor was compared with aberrometer refraction for pupil analysis diameters of 2.5-mm and 5.0-mm.ResultsThe Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. For both pupil sizes, the 95% limits of agreement were approximately 0.50 D for central refraction, and limits were wider in the nasal visual field compared to the temporal visual field. The mean difference for both J0 and J45 were within 0.15 D and the 95% limits of agreement within 0.90 D across the horizontal visual field.ConclusionDefocus components were similar between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 2.5-mm pupil for most visual field angles. However, there was a significant difference in defocus component between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 5.0-mm pupil, wherein the autorefractor measured more hyperopia. The astigmatic components J0 and J45 were similar between instruments for both central and peripheral refraction. (AU)

The effect of intrinsically photosensitive retinal ganglion cell (ipRGC) stimulation on axial length changes to imposed optical defocus in young adults

Purpose: The intrinsically photosensitive retinal ganglion cells (ipRGCs) regulate pupil size and circadian rhythms. Stimulation of the ipRGCs using short-wavelength blue light causes a sustained pupil constriction known as the post-illumination pupil response (PIPR). Here we examined the effects of ipRGC stimulation on axial length changes to imposed optical defocus in young adults.Materials and methodsNearly emmetropic young participants were given either myopic (+3 D, n = 16) or hyperopic (-3 D, n = 17) defocus in their right eye for 2 h. Before and after defocus, a series of axial length measurements for up to 180 s were performed in the right eye using the IOL Master following exposure to 5 s red (625 nm, 3.74 × 1014 photons/cm2/s) and blue (470 nm, 3.29 × 1014 photons/cm2/s) stimuli. The pupil measurements were collected from the left eye to track the ipRGC activity. The 6 s and 30 s PIPR, early and late area under the curve (AUC), and time to return to baseline were calculated.ResultsThe PIPR with blue light was significantly stronger after 2 h of hyperopic defocus as indicated by a lower 6 and 30 s PIPR and a larger early and late AUC (all p<0.05). Short-wavelength ipRGC stimulation also significantly exaggerated the ocular response to hyperopic defocus, causing a significantly greater increase in axial length than that resulting from the hyperopic defocus alone (p = 0.017). Neither wavelength had any effect on axial length with myopic defocus.ConclusionsThese findings suggest an interaction between myopiagenic hyperopic defocus and ipRGC signaling. (AU)

The prevalence of refractive errors in college students in Israel

PurposeTo determine the prevalence of refractive errors in Jewish and Arab college students in Israel and associations with ethnicity and sex.MethodsIn this retrospective cross-sectional study, first-year college students underwent non-cycloplegic autorefraction and answered a questionnaire to assess age, sex, and self-identified ethnicity. Spherical equivalent refractive error (SER) was calculated, and the prevalence of hyperopia (>+0.50 Diopter, D), emmetropia (>-0.50 to +0.50 D), myopia (≤-0.50D, low ≤-0.50 to >-3.0D, moderate <-3.0 to >-6.0D, high ≤-6.0D), and astigmatism (>0.50D) were determined. Groups were compared using Chi-square or Fisher test. Univariate and multivariate analyses were conducted to identify factors associated with refractive errors.ResultsParticipants (n = 807) had a mean age of 22.1 ± 2.6 years (range: 17–30 years) and SER of -1.7 ± 2.2D (range: -13.3 to +5.7D). The prevalence and 95% confidence internal of myopia was 66.3% (63.0–69.6). Jewish students had a higher prevalence than Arab students for myopia (69.2% vs 60.3%), moderate (18.5% vs 12.2%) and high myopia (5.9% vs 1.9%) and astigmatism (51.4% vs 43.9%, p<0.05 for all), but not low myopia or hyperopia. Females had a higher prevalence of myopia than males (68.1% vs 58.7%, p<0.03). Jewish ethnicity was associated with myopia (OR=1.48, p = 0.01) and moderate myopia (OR=1.72, p = 0.01), and studying optometry was associated with moderate myopia (OR=1.63, p = 0.02). Sex and age were not associated with myopia.ConclusionMyopia prevalence in Israeli college students is high, showing associations with Jewish, but not Arab, ethnicity, suggesting that ethnic factors may play a role in the refractive differences between Arabs and Jews. (AU)

Manifestaciones oftalmológicas en 6 pacientes con síndrome de Williams-Beuren y revisión de la literatura / Ophthalmological manifestations in 6 patients diagnosed with Williams-Beuren syndrome and literature review

Se revisó la historia clínica de 6 pacientes diagnosticados de síndrome de Williams-Beuren en la edad pediátrica. Todos los pacientes presentaron la facies de elfo característica y anomalías cardiovasculares. Todos presentaron buena agudeza visual, excepto un caso de ambliopía unilateral. El error refractivo más frecuente fue la hipermetropía (n=6; 100%) y el astigmatismo (n=5; 83,3%). En 2 pacientes se encontraron alteraciones de la motilidad ocular (un caso de exoforia con hiperfunción de oblicuo inferior derecho y otro de endotropía congénita con hiperfunción del oblicuo inferior bilateral). Cognitivamente un 66,7% (n=4) tenía alteraciones visoperceptivas. Otros hallazgos fueron epicantus (n=6; 100%) y obstrucción congénita del conducto nasolagrimal con epífora unilateral (n=1; 16,7%). El síndrome de Williams-Beuren es un trastorno poco frecuente con manifestaciones oftalmológicas y sistémicas complejas. Por ello, es recomendable realizar un seguimiento oftalmológico a estos niños (AU)

Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (n=6; 100%) and astigmatism (n=5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (n=4) had visoperceptive disorders. Other findings were epicanthus (n=6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (n=1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended (AU)

Relationship between peripheral refraction, axial lengths and parental myopia of young adult myopes

Purpose: To determine the relationship between peripheral refraction at the horizontal retina, axial length and parental history of myopia between myopic adults who have positive parental myopia and those with negative parental myopia.Methods: 69 males and 44 females in the age range of 18–25 years were assigned either a negative parental myopia (NPM) or positive parental myopia (PPM) group. In the corrected and uncorrected states, peripheral refractive error was measured up to 30° horizontally in 10° steps using an open field autorefractor. Axial length was measured using an Opto US1000 Fine A-Scan Ultrasonography (model US1000).Results: Relative peripheral refractive error showed more hyperopic defocus that was statistically significantly more increased in the positive parental myopia group than in the negative parental myopia group (P ≥ 0.02). The overall mean ± SD axial length of all subjects was 23.38 ± 0.32 mm (range 23.01–25.01 mm). The study showed a statistically significant difference (P = 0.005) in axial lengths of young adult myopes (23.45 ± 0.36 mm) with parental myopia compared to those with similar spherical equivalent refraction who have non-myopic parents (23.28 ± 0.19 mm).Conclusion: There was significantly more hyperopic defocus at 30° N and 30° T retina in the corrected states of young adult myopes who had myopic parents compared to their counterparts with non-myopic parents. (AU)

Refractive status of patients attending eye clinics of the Public Health System from Aguascalientes, Mexico

Purpose: This paper aims to evaluate the prevalence of REs in a clinic from Aguascalientes, Mexico by analysing clinical records from the local public health system. Refractive errors (REs) are quite common globally, but no data have been published regarding their frequency in clinics from Mexico. A priori, the frequency of ametropias should be high as admixture ancestry from this region is mainly European and Amerindian, the regions with high prevalence worldwide.MethodsThis cross-sectional study was conducted on 2195 subjects from records of public optometry services during the year 2018. Information obtained included age, gender, sphere, cylinder and axis. The prevalence of myopia, hyperopia and astigmatism was determined by gender and age groups in paediatric and adult patients. Chi-square testing was applied to determine significant differences in prevalence across age groups and gender. A p-value <0.05 was considered significant.ResultsIn subjects under 18 years of age, the prevalence of emmetropia, astigmatism, myopia and hyperopia was 20.1%, 51.1%, 7.0% and 11.8%, respectively. In adults, emmetropia was present at a frequency of 20.1%, while 57.1% presented astigmatism, 12.4% hyperopia and 8.6% presented myopia. A significant association was observed between the presence of REs and age and gender.ConclusionsIn this first report of prevalence of REs from western Mexico, astigmatism was the most prevalent RE in children, adolescents and adults while the least common was myopia. Important differences were found in prevalence in comparison to national and international reports. (AU)

La hipermetropía del conde István Tisza / The hypermetropia of count István Tisza

No disponible

The relationship between clinical measures of aniseikonia and stereoacuity before and after LASIK / Relación entre las mediciones clínicas de aniseiconía y estereoagudeza antes y después de la cirugía LASIK

PURPOSE: To determine the significance of changes and and inter-relationships between three markers of binocular function (aniseikonia, distance and near stereoacuity) following unremarkable LASIK at 3 and 6 months postoperatively. METHODS: All patients underwent LASIK using the Schwind Amaris 750S and the flaps were created using Intralase 150 kHz. Patients were I, monocular myopes II, binocular myopes III, binocular hyperopes IV, binocular astigmats V, anisometropes and VI, matched age and gender control (n = 20 in each group except III where n = 18). Aniseikonia (Awaya test), distance and near stereoacuity (Randot tests) were measured before surgery, and at 3 and 6 months after surgery. At all times data were collected under constant conditions and analyzed using appropriate non-parametric statistical tests. RESULTS: The following statistically significant changes were found after applying the Bonferroni correction (p ≤ 0.001); aniseikonia reduced (groups I, III, IV, V), stereoacuity improved at distance (groups I, III-V) and near (groups I, V). Inter-group differences in aniseikonia distance and near stereoacuity were significant preoperatively, but not postoperatively. In groups I, IV and V, the changes in aniseikonia and stereoacuity (near and distance) were significantly correlated with the preoperative value. Aniseikonia was significantly correlated with distance and near stereoacuity preoperatively but not postoperatively. CONCLUSION: Binocular function improved in all groups after LASIK except in binocular myopes. In general, binocular function was still low compared with the control group at six months postoperatively. It is unclear why binocular function improved in the binocular astigmats

OBJETIVO: Determinar la significancia de cualquier cambio, así como las interrelaciones entre tres marcadores de la función binocular (aniseiconía, estereoagudeza de lejos y de cerca) tras LASIK sin complicaciones a los 3 y 6 meses postoperatorios. MÉTODOS: A todos los pacientes se les realizó cirugía LASIK con el laser Schwind Amaris 750S, creándose los flaps con Intralase 150 kHz. Los grupos de pacientes fueron: I miopes monoculares, II miopes binoculares, III hipermétropes binoculares, IV astígmatas binoculares, V anisométropes y VI controles equivalentes en edad y género (n = 20 en cada grupo, exceptuando III donde n = 18). Se midió la aniseiconía (prueba de Awaya), la estereoagudeza de lejos y de cerca (pruebas Randot) durante el preoperatorio, y a los 3 y 6 meses posteriores a la cirugía. En todo momento se recabaron los datos en condiciones constantes, analizándose los mismos con pruebas estadísticas no paramétricas adecuadas. RESULTADOS: Se encontraron los siguientes cambios estadísticamente significativos tras aplicar la corrección de Bonferroni (p ≤ 0,001); se redujo la aniseiconía (grupos I, III, IV, V), y mejoró la estereoagudeza de lejos (grupos I, III-V) y de cerca (grupos I, V). Las diferencias inter-grupo en cuanto a aniseiconía de lejos y de cerca y la estereoagudeza de cerca fueron significativas en el preoperatorio, pero no en el postoperatorio. En los grupos I, IV y V, los cambios en cuanto a aniseiconía y estereoagudeza (de cerca y de lejos) guardaron una correlación significativa con el valor preoperatorio. La aniseiconía guardó una correlación significativa con la estereoagudeza de lejos y de cerca en el preoperatorio, pero no el postoperatorio. CONCLUSIÓN: La función binocular mejoró en todos los grupos tras la cirugía LASIK, excepto en la miopía binocular. En general, la función binocular fue aún baja al compararse con el grupo control a los seis meses postoperatorios. No queda claro por qué la función binocular mejoró en el astigmatismo binocular

Alteraciones de la motilidad ocular en el síndrome de Kabuki / Changes in ocular motility in Kabuki síndrome

El síndrome de Kabuki es una enfermedad genética rara debida a una mutación genética en los genes KMT2D y KDM6A, que afecta a múltiples órganos, entre ellos los ojos, en la mayoría de los pacientes. Las características clínicas más típicas son: facies peculiar, baja estatura, anormalidades esqueléticas y bajo coeficiente intelectual. Las manifestaciones oculares más frecuentes son el estrabismo, la ptosis y los defectos refractivos. Presentamos una serie de casos de 5 pacientes (3 mujeres), 4 de ellos con estrabismo en forma de esotropía, hiperacción de oblicuos inferiores e hipofunción de oblicuos superiores asociado a un síndrome V. Son pocos los casos publicados de síndrome de Kabuki que describan las afectaciones oftalmológicas y las estrabológicas. Podría ser conveniente la realización de resonancias magnéticas orbitarias para detectar cambios en los trayectos musculares que estén relacionados con la patología de los movimientos oculares encontrados

Kabuki syndrome is a rare genetic disorder, caused by mutation in the KMT2D or KDM6A genes, which affects several organs in the majority of patients, among which are the eyes. The most typical clinical characteristics are mental retardation, postnatal growth retardation, skeletal anomalies, and characteristic facial features. As the eyes are affected in most of the cases, ophthalmological examination is recommended for the early detection of ocular anomalies, in order to prevent visual impairment. The most frequent ocular signs are strabismus, ptosis, and refractive anomalies. A series of cases of Kabuki syndrome is described in five children, four of whom exhibited strabismus with esotropia, over action of inferior oblique muscles, and under action of superior oblique muscles associated with a V pattern. Most published papers do not report or might underestimate the ocular problems. It may be appropriate to perform orbital magnetic resonances in order to detect changes in the muscle paths that are related to the pathology of the eye movements found

Agreement between Pentacam and handheld Auto-Refractor/Keratometer for keratometry measurement / Concordancia entre el sistema Pentacam y un auto-refractómetro/queratómetro portátil para la medición de queratometría

OBJECTIVE: This study was conducted to evaluate the level of agreement in keratometry measurements between a rotating Scheimpflug imaging-based system (Pentacam) and a handheld auto-refractokeratometer (handheld NIDEK ARK-30). METHOD: This analytical cross-sectional study was conducted in the right eyes of 579 subjects. Keratometry measurements were conducted with the Pentacam and the handheld NIDEK ARK-30 systems. The SPSS Software version 22 and MedCalc V3 were applied to estimate descriptive statistics using paired t-test, Pearson correlation coefficient, 95% limits of agreement (LoA), and Bland-Altman plot. RESULTS: In the total sample, the inter-device difference in the mean flat and steep keratometry values was -0.266 diopter (D) (P-value < 0.001) and 0.052 D (P-value = 0.093), respectively. There was a significant difference in mean flat keratometry between the two devices in all groups of refractive errors (paired difference < 0.5 D and P-value < 0.001). The difference in mean steep keratometry was significant only in myopic subjects (P-value = 0.046). The 95% LoA between the two devices measurements was 2.51 D, 3.98 D, and 6.37 D for flat keratometry and 2.6 D, 3.2 D, and 3.9 D for steep keratometry in emmetropic, myopic, and hyperopic subjects, respectively. CONCLUSION: Our study showed relatively wide limits of agreement between handheld NIDEK ARK-30 and Pentacam; therefore, these devices cannot be used interchangeably for measuring corneal curvature

OBJETIVO: Se realizó este estudio para evaluar el nivel de concordancia de las mediciones queratométricas obtenidas mediante un sistema de cámara rotatoria Scheimpflug (Pentacam) y un auto-refractoqueratómetro portátil (NIDEK ARK-30 portátil). MÉTODO: Este estudio analítico transversal fue realizado en los ojos derechos de 579 sujetos. Las mediciones queratométricas se obtuvieron con Pentacam y NIDEK ARK-30 portátil. Se aplicó el software SPSS versión 22 y MedCalc V3 para calcular las estadísticas descriptivas utilizando la prueba t pareada, el coeficiente de correlación de Pearson, los límites de concordancia (LoA) al 95%, y el análisis gráfico de Bland-Altman. RESULTADOS: En la muestra total, la diferencia inter-dispositivo en cuanto a valores queratométricos planos y curvos medios fue de -0,266 dioptrías (D) (valor P < 0,001) y 0,052 D (valor P = 0,093), respectivamente. Se produjo una diferencia significativa en términos de queratometría plana media entre los dos dispositivos para todos los grupos de errores refractivos (diferencia pareada < 0,5 D y valor P < 0,001). La diferencia en cuanto a queratometría curva media fue significativa únicamente en sujetos miopes (valor P = 0,046). Los LoA al 95% entre las mediciones de los dos dispositivos fue de 2,51 D, 3,98 D, y 6,37 D para la queratometría plana, y de 2,6 D, 3,2 D, y 3,9 D para la curva, en los sujetos con emetropía, miopía e hipermetropía, respectivamente. CONCLUSIÓN: Nuestro estudio reflejó unos límites de concordancia relativamente amplios entre NIDEK ARK-30 portátil y Pentacam; por tanto, estos dispositivos no pueden utilizarse indistintamente para medir la curvatura de la córnea

La atropina superdiluida al 0.01% frena el aumento de miopía en niños-adolescentes. Un estudio a largo plazo 5 años de evolución: seguridad y eficacia / Superdiluted atropine at 0.01% reduces myopia progression in children and adolescents. A 5-year study of safety and effectiveness

No disponible

Miopía, el reto de la Oftalmología y su "explosiva epidemia" mundial / Myopia, the challenge of Ophthalmology and its worldwide "explosive epidemic"

No disponible

Síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria asociado a puntos blancos. Caso clínico / Posterior microphthalmos, retinitis pigmentosa and optic disc drusen with white dots. A case report

Objetivo: Presentar el caso de un paciente con un síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria asociado por primera vez a puntos blancos en el polo posterior. Material: El síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria fue descrito por primera vez en la literatura en 1991. Posteriormente se asoció a un patrón de engrosamiento foveolar o foveosquisis. Distintas formas de mutaciones en los cromosomas 11 y 14 han sido identificadas como responsables de la aparición de este síndrome, sin que se haya podido esclarecer, hasta el momento, un patrón de herencia determinado. Discusión: Presentamos el caso de un varón de 37 años, sin antecedentes personales ni familiares de interés, con este síndrome asociado a puntos blancos en el polo posterior. Esta asociación morfológica nunca ha sido descrita en la literatura. Conclusión: El síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria es una entidad muy poco común y nunca ha sido descrita asociada a puntos blancos en el polo posterior. Es necesaria más casuística para establecer patrones claros tanto de la enfermedad como en su herencia (AU)

Objective: To present the case of a patient with a posterior microphthalmos-optic disc drusen-retinitis pigmentosa syndrome associated, for the first time, with white dots in the posterior pole. Methodology: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome was described for the first time in literature in 1991. Later, it was associated with a pattern of foveal thickening and/or foveoschisis. Different forms of mutations on chromosomes 11 and 14 have been identified as being responsible for the appearance of this syndrome, but the inheritance pattern is unknown. Discussion: The case is reported of a 37 year-old man, with no personal or family history of interest, diagnosed with this syndrome in association with white dots in the posterior pole. Such a morphological association has never been published before in literature. Conclusion: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome is a very rare entity, and has never been described associated with white dots in the posterior pole. More case reports are needed to establish clear patterns of both the disease and inheritance (AU)

Influence of different types of astigmatism on visual acuity / Influencia de los diferentes tipos de astigmatismo en la agudeza visual

Purpose: To investigate the change in visual acuity (VA) produced by different types of astigmatism (on the basis of the refractive power and position of the principal meridians) on normal accommodating eyes. Methods: The lens induced method was employed to simulate a set of 28 astigmatic blur conditions on different healthy emmetropic eyes. Additionally, 24 values of spherical defocus were also simulated on the same eyes for comparison. VA was measured in each case and the results, expressed in logMAR units, were represented against of the modulus of the dioptric power vector (blur strength). Results: LogMAR VA varies in a linear fashion with increasing astigmatic blur, being the slope of the line dependent on the accommodative demand in each type of astigmatism. However, in each case, we found no statistically significant differences between the three axes investigated (0◦, 45◦, 90◦). Non-statistically significant differences were found either for the VA achieved with spherical myopic defocus (MD) and mixed astigmatism (MA). VA with simple hyperopic astigmatism (SHA) was higher than with simple myopic astigmatism (SMA), however, in this case non conclusive results were obtained in terms of statistical significance. The VA achieved with imposed compound hyperopic astigmatism (CHA) was highly influenced by the eye’s accommodative response. Conclusions: VA is correlated with the blur strength in a different way for each type of astigmatism, depending on the accommodative demand. VA is better when one of the focal lines lie on the retina irrespective of the axis orientation; accommodation favors this situation (AU)

Objetivo: Investigar el cambio en la agudeza visual (AV) producido por los diferentes tipos de astigmatismo (sobre la base del poder refractivo y la posición de los principales meridianos) en ojos con acomodación normal. Métodos: Se utilizó el método de desenfoque inducido con lentes para simular un conjunto de veintiocho situaciones de desenfoque astigmático en diferentes ojos emetrópicos sanos. Además, se simularon veinticuatro valores de defecto esférico en los mismos ojos, a fines comparativos. Se midió la AV en cada caso, representándose los resultados, expresados en unidades logMAR, frente a los módulos del vector de potencia dióptrica (desenfoque). Resultados: La escala LogMAR para AV varía de manera lineal, incrementando la distorsión astigmática, dependiendo la inclinación de la línea de la demanda acomodativa en cada tipo de astigmatismo. Sin embargo, en cada caso, no hallamos diferencias significativas entre los tres ejes analizados (0◦, 45◦, 90◦). No se hallaron diferencias estadísticamente significativas en cuanto a la AV lograda con el defecto miópico esférico (MD) y astigmatismo mixto (MA). La AV con astigmatismo hipermetrópico simple (SHA) fue más elevada que con astigmatismo miópico simple (SMA). Sin embargo, en este caso se obtuvieron resultados no concluyentes en términos de significancia estadística. La AV lograda con astigmatismo hipermetrópico compuesto (CHA) se vio altamente influenciada por la respuesta acomodativa del ojo. Conclusiones: La AV guarda relación con el desenfoque de modo diferente para cada tipo de astigmatismo, dependiendo de la demanda de acomodación. La AV es mejor cuando una de las líneas focales está en la retina con independencia de la orientación del eje; la acomodación favorece esta situación (AU)

Prolactinomas en la población pediátrica / Prolactinomas in a paediatric population

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Efecto de la cirugía de las cataratas congénitas unilaterales sobre el crecimiento ocular axial y el aplanamiento corneal / Effect of unilateral congenital cataract surgery on ocular axial length growth and corneal flattening

OOBJETIVO: Estudiar el efecto de la cirugía de las cataratas congénitas unilaterales sobre el crecimiento ocular y el aplanamiento corneal. MÉTODOS: Realizamos un estudio transversal sobre 59 pacientes intervenidos de cataratas congénitas unilaterales. La mediana de edad de los pacientes en el momento del diagnóstico fue de 17 meses (rango intercuartílico: 5-39 meses), la mediana de edad en el momento de la intervención fue de 28 meses (rango intercuartílico: 8-52 meses) y el tiempo medio de seguimiento fue de 149,7 ± 69,9 meses (rango: 30-319 meses). Se midió la longitud axial y la curvatura corneal de ambos ojos en todos los pacientes, tanto los operados de catarata congénita como los no operados. Estos valores fueron comparados entre sí. RESULTADOS: No se evidencian diferencias estadísticamente significativas entre ambos ojos (operados y no operados) respecto a la longitud axial (p = 0,327, prueba t de Student) ni a la curvatura corneal (p = 0,078, prueba t de Student). Al realizar un subanálisis dependiendo de la agudeza visual y la edad de los pacientes en el momento de la intervención, encontramos diferencias estadísticamente significativas solo respecto a la longitud axial en el grupo de pacientes que no presentan ambliopía profunda (p = 0,007, prueba t de Student), con menor longitud axial en los ojos intervenidos respecto a los ojos sanos. CONCLUSIONES: No encontramos cambios significativos en el crecimiento axial de los ojos intervenidos de catarata congénita unilateral respecto a sus ojos adelfos. Solo encontramos menor longitud axial en los ojos intervenidos con respecto a los ojos sanos en el grupo que no presentaba ambliopía profunda. No se hallaron diferencias respecto al aplanamiento corneal en los ojos operados con respecto a los ojos adelfos tras la cirugía de las cataratas congénitas unilaterales

OBJECTIVE: The aim of this article is to study the effect of unilateral congenital cataract surgery on ocular growth and corneal flattening. METHODS: This is a cross-sectional study of 59 patients operated on due to a unilateral congenital cataract. The median age of the patients at the time of diagnosis was 17 months (interquartile range, 5-39 months). The median age at cataract the time of surgery was 28 months (interquartile range, 8-52 months), and the mean follow-up between cataract surgery and assessments was 149.7 ± 69.9 months (range, 30-319 months). Axial length and corneal curvature were measured in both operated and non-operated eyes, comparing the results between them. RESULTS: There were no statistically significant differences for axial length growth or corneal flattening between operated and non-operated eyes: axial length (P=.327, Student t test) and corneal curvature (P=.078, Student t test). A sub-analysis was performed using the visual acuity and the age of the patient at the time of surgery. The only statistically significant data (P=.007, Student t test) was a lower axial length in operated eyes compared to non-operated eyes, in the non-deep-amblyopia group. CONCLUSIONS: No significant axial length growth modifications were observed between operated and non-operated eyes. Only the non-deep-amblyopia group presented with a lower axial length in the operated eyes compared to non-operated eyes. No significant differences in corneal flattening were found between groups after unilateral congenital cataract surgery