RESUMEN
Objetivos: Describir los resultados anatómicos y refractivos en un grupo de pacientes tratados por retinopatía del prematuro (ROP) con bevacizumab intravítreo o láser. Métodos: Estudio multicéntrico, prospectivo y observacional. Se incluyó a pacientes tratados por ROP en el Hospital Roberto del Río. Los pacientes con menos de 6 meses de seguimiento fueron excluidos. Los pacientes con zona II posterior, zona I o retinopatía agresiva posterior (AP-ROP) fueron tratados con bevacizumab intravítreo. El resto fueron tratados con láser. El seguimiento fue hecho cada 3 meses, e incluyó fondo de ojo, refracción y test de Teller. Resultados: Se incluyeron 144 ojos de 72 pacientes. Un total de 49 fueron tratados con láser y 23 con bevacizumab. Un caso (1,4%) tratado con láser progresó a un desprendimiento de retina etapa 4 b y requirió vitrectomía bilateral. Otros 45 casos tuvieron ROP de tipo 1; 16 enfermedad umbral y 11 AP-ROP. La mediana de edad gestacional fue de 26 semanas (rango 23-30) y la mediana de peso de nacimiento fue de 800 g (rango 405-1.350). La mediana de seguimiento fue de 10 meses (rango 6-28). La mediana del Teller fue de 3,2 ciclos/cm (rango 0,32-13). Del total, 16 casos (22%) presentaron miopía de -6 D o más. La mediana de la esfera fue de -1,75 D (rango -16,00 a +3,50 D) y la mediana del cilindro fue de 0,00 (rango -4,5 a +1,5 D). El éxito anatómico se logró en 71 pacientes (98,6%). Conclusión: El tratamiento con láser o bevacizumab intravítreo como tratamiento primario en ROP es altamente eficaz. El éxito anatómico se alcanzó en la mayoría de los pacientes. Los resultados visuales obtenidos por test de Teller muestran buenos resultados (AU)
Objective: To describe the anatomical and refractive outcomes after treatment with intravitreal bevacizumab or laser in a patient cohort with retinopathy of prematurity (ROP). Methods: A multicentre, prospective, and observational study was performed on patients with ROP treated at Hospital Roberto del Río. Those patients with less than 6 months of follow-up were excluded. Cases with posterior zone II, zone I ROP, and aggressive posterior ROP (AP-ROP) were treated with intravitreal bevacizumab. All other patients were treated with laser. Follow-up was performed every 3 months, and included fondo evaluation, refraction, and Teller tests. Results: The treated group included 144 eyes of 72 patients, of whom 49 were treated with laser and 23 with intravitreal bevacizumab. One (1.4%) patient from the laser group progressed to stage 4 b retinal detachment and required bilateral vitrectomy. Of the remainder, 45 cases had type 1 ROP, 16 had threshold disease, and 11 had AP-ROP. The median of gestational age was 26 weeks (range 23-30), and median of birth weight was 800 g (range 405-1350). Median follow-up was 10 months (range 6-8). The Teller test median was 3.2 cycles/cm (range 0.32-13). There were 16 (22%) cases with a myopic refraction of -6 D or more. The sphere median was -1.75 D (range -16.00 to +3.50 D) and the cylindrical median was 0.00 (range -4.5 to +1.5 D). Anatomical success was achieved in 71 (98.6%) of patients. Conclusion: Treatment with laser or intravitreal bevacizumab is a highly successful primary treatment for ROP. Anatomical success can be achieved in most cases. Treated patients develop frequent and severe refractive defects, which should be corrected. Vision outcome, measured using the Teller preferential test, shows good results (AU)
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Retinopatía de la Prematuridad/terapia , Bevacizumab/uso terapéutico , Terapia por Láser , Resultado del Tratamiento , Inyecciones Intravítreas , Agudeza Visual , Refracción OcularRESUMEN
Objetivos: Mostrar la importancia de la histopatología en el diagnóstico del quiste folicular inflamatorio para un correcto tratamiento y la relevancia de una nomenclatura precisa. Material y Métodos: Búsqueda en Pubmed, ScienceDirect, EBSCO-host de «odontogenic-cysts¼, «dentigerous cyst of inflammatory origin¼ y "follicular inflammatory-cyst¼ como key-words, full-text en inglés o español de los últimos 10 años. Resultados: Paciente 10 años de edad, presenta tumoración vestibular de zona de diente 5.3, de consistencia dura, asintomático y cubierto por mucosa normal. Diente asociado sin lesiones cariosas. La radiografía evidenció una extensa área radiolúcida bien definida, rodeando la corona del diente 1.3, desplazando y reteniéndolo. Tras evaluación radiográfica, los diagnósticos diferenciales fueron tumor-odontogénico-adenomatoide, queratoquiste y QD. La histopatología confirmó QFI. Originándose la lesión a partir de la pieza 5.4 con tratamiento pulpar. Conclusiones: Se debe considerar al QFI como una lesión similar a otros quistes inflamatorios (paradentales o radiculares). Se sugiere considerar en dentición mixta, que QFI y quiste radicular del diente temporal son la misma lesión y las diferencias en su aspecto clínico dependerán del tiempo de evolución y la relación de proximidad entre folículo y proceso inflamatorio del diente temporal.
Objectives: To show the importance of histopathology in the diagnosis of follicular inflammatory cyst for a correct treatment and the relevance of a precise nomenclature. Material and Methods: Pubmed search, ScienceDirect, EBSCO-host "odontogenic cysts", "inflammatory dentigerous cyst" and "follicular inflammatory cyst" as keywords, full text in English or Spanish for the last 10 years. Results: A 10-year-old patient presented vestibular tumor of the tooth area 5.3, with a hard consistency, asymptomatic and covered by normal mucosa. Associated tooth without carious lesions. The radiograph evidenced a radiolucent area with well-defined limits, around the crown of the tooth 1.3, displacing and retaining it. After radiographic evaluation, the differential diagnoses were tumor-odontogenic-adenomatoid, keratocyst and QD. Histopathology confirmed QFI. Originating the lesion from piece 5.4 with pulp treatment. Conclusions: The QFI should be considered as an similar to other inflammatory (paradental or root) cysts. It is suggested to consider in mixed dentition, that QFI and radicular cyst of the temporal tooth are the same lesion and the differences in their clinical aspect will depend on the evolution time and the proximity relation between follicle and inflammatory process of temporal temporal.
RESUMEN
OBJECTIVE: To describe the anatomical and refractive outcomes after treatment with intravitreal bevacizumab or laser in a patient cohort with retinopathy of prematurity (ROP). METHODS: A multicentre, prospective, and observational study was performed on patients with ROP treated at Hospital Roberto del Río. Those patients with less than 6months of follow-up were excluded. Cases with posterior zone II, zone I ROP, and aggressive posterior ROP (AP-ROP) were treated with intravitreal bevacizumab. All other patients were treated with laser. Follow-up was performed every 3 months, and included fondo evaluation, refraction, and Teller tests. RESULTS: The treated group included 144 eyes of 72 patients, of whom 49 were treated with laser and 23 with intravitreal bevacizumab. One (1.4%) patient from the laser group progressed to stage 4b retinal detachment and required bilateral vitrectomy. Of the remainder, 45 cases had type 1 ROP, 16 had threshold disease, and 11 had AP-ROP. The median of gestational age was 26 weeks (range 23-30), and median of birth weight was 800g (range 405-1350). Median follow-up was 10 months (range 6-8). The Teller test median was 3.2 cycles/cm (range 0.32-13). There were 16 (22%) cases with a myopic refraction of -6 D or more. The sphere median was -1.75 D (range -16.00 to +3.50 D) and the cylindrical median was 0.00 (range -4.5 to +1.5 D). Anatomical success was achieved in 71 (98.6%) of patients. CONCLUSION: Treatment with laser or intravitreal bevacizumab is a highly successful primary treatment for ROP. Anatomical success can be achieved in most cases. Treated patients develop frequent and severe refractive defects, which should be corrected. Vision outcome, measured using the Teller preferential test, shows good results.
