RESUMEN
Leber congenital amaurosis is a retinal dystrophy with several forms of presentation due to its genetic variability. Case of a female girl followed up from 4 to 11 years old is presented, with positive clinical data of nyctalopia, myopia and choroid ocular fundus. Electroretinogram was not measurable in all phases but diagnostic was confirmed by RPE65 mutation genetic study. RPE65 Leber congenital amaurosis is particularly important as it has been researched for a gene therapy treatment with good functional outcomes up to now, awaiting to offer hope and a better quality of life to people with this disease.
Asunto(s)
Amaurosis Congénita de Leber/diagnóstico , Niño , Preescolar , Electrorretinografía , Femenino , Estudios de Seguimiento , Fondo de Ojo , Humanos , Amaurosis Congénita de Leber/genética , Mutación , Calidad de Vida , Factores de TiempoRESUMEN
BACKGROUND: Optical coherence tomography is a useful tool in several diseases. Its intraoperative use with the intention of improving anatomical results has recently been described. PURPOSE: To determine the usefulness and safety of optical coherence tomography during pars plana vitrectomy for several vitreo-retinal diseases. MATERIAL AND METHODS: A prospective case series is reported, in which the decision that influenced the use of the optical coherence tomography imaging during pars plana vitrectomy is evaluated. A RESCAN 700 microscope that includes a spectral domain tomography was used to obtain the images. At the end of each procedure the surgeons completed a questionnaire to determine if the tomographic image had an influence when making decisions during the surgery, or change the decision during the procedure. RESULTS: Thirteen patients with pars plana vitrectomy were included, with cataract surgery also performed in 6 patients. The surgeon considered that the intraoperative image influenced the decision during the procedure in 8 cases. CONCLUSION: Intraoperative optical coherence tomography is helpful for a safe patient diagnosis. It does not affect the surgery time, and in some cases it is useful for optimising the procedure in vitreous-retinal surgery.
Asunto(s)
Extracción de Catarata/métodos , Cirugía Asistida por Computador/métodos , Tomografía de Coherencia Óptica , Vitrectomía/métodos , Cirugía Vitreorretiniana/métodos , Adolescente , Adulto , Anciano , Toma de Decisiones Clínicas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Facoemulsificación/métodos , Estudios Prospectivos , Enfermedades de la Retina/cirugía , Cirujanos/psicología , Cirugía Asistida por Computador/instrumentación , Tomografía de Coherencia Óptica/instrumentación , Cuerpo Vítreo/cirugía , Adulto JovenRESUMEN
OBJECTIVE: To determine the risk factors associated with recurrent retinal detachment in patients vitrectomized. METHODS: Case-control study nested in a cohort. We included patients with a diagnosis of rhegmatogenous retinal detachment treated with vitrectomy for one year, with a six months follow-up. We monitored the presence of incident event in the emergency department, and the examination room. Statistical analysis was performed by descriptive statistics (median, minimum and maximum) and inferential statistics (chi-squared test, Cox regression, Kaplan-Meier). RESULTS: A population of 94 patients with a median age of 55 years (21-83) was analyzed. The silicone was the most widely used type of tamponade in 62 patients (66 %) and recurrent retinal detachment occurred in 19 cases (20 %). In the relation between the non-relapse group and the relapse group, the statistically significant variable was the use of silicone (p = 0.05, OR = 0.03, 0.013-0.98), wich had a lower probability of recurrent detachment compared with the use of sulfur hexafluoride (SF6 gas) (p = 0.012). CONCLUSIONS: The use of silicone compared with the use of SF6 gas has shown to be a protective factor for recurrent retinal detachment; however, the choice of method of tamponade should be individualized for each patient.
OBJETIVO: determinar los factores de riesgo quirúrgico relacionados con el desprendimiento de retina recidivante en pacientes que habían sido tratados con vitrectomía. MÉTODOS: estudio de casos y controles anidado en una cohorte recolectada durante un año. Se incluyeron pacientes con diagnóstico de desprendimiento regmatógeno de retina tratados con vitrectomía, con un seguimiento de seis meses. Se monitorizó la presencia del evento incidente en el servicio de urgencias y en la consulta. El análisis de los datos se realizó mediante estadística descriptiva (medianas, mínimos y máximos) e inferencial (chi-squared, regresión de Cox y método de Kaplan-Meier). RESULTADOS: se analizaron 94 pacientes con mediana de edad de 55 años (rango de 21 a 83 años). La silicona fue el material de taponamiento utilizado en 62 pacientes (66 %) y la recidiva se presentó en 19 (20 %). En la relación entre el grupo sin recidiva y el grupo con recidiva, la variable estadísticamente significativa fue el uso de silicona (p = 0.05, OR = 0.03, 0.013-0.98), el cual tuvo menor probabilidad de redesprendimiento comparado con el del hexafluoruro de azufre (p = 0.012). CONCLUSIONES: el uso de silicona comparado con el del gas SF6 mostró ser un factor protector para el desarrollo de redesprendimiento de retina, sin embargo, la decisión de que elemento emplear para el taponamiento debe individualizarse.
