Anticoagulantes y cirugía vitreorretiniana / Anticoagulants And Vitreoretinal Surgery

No disponible

Inyección accidental de Ozurdex(R) intracristaliniano / Accidental intralenticular injection of Ozurdex(R)

No disponible

Uso de fármacos oculares en el embarazo / Use of ocular drugs in pregnancy

La información disponible sobre la seguridad de los fármacos en mujeres embarazadas es limitada y debe ser adecuadamente canalizada. Los fármacos de aplicación tópica o en colirio pueden presentar una absorción sistémica relevante y atravesar la barrera placentaria o pasar a la leche materna. Se realiza una revisión de los fármacos oculares según las categorías de riesgo fetal propuestas por la clasificación de la Food and Drug Administration (FDA).Se evalúan los fármacos de elección en las patologías oculares más frecuentes, así como los fármacos que deben evitarse (AU)

The information available on the safety of medicines in pregnant women is limited and must be suitably channeled. Medication that is applied topically or as eye drops can present relevant systemic absorption and cross the placenta barrier or enter maternal milk. We have reviewed ophthalmic medicines according to the fetal risk categories proposed by the classification of the Food and Drug Administration (FDA). We evaluate the medicines of choice in the most frequent ophthalmic pathologies, as well as the medicines that must be avoided (AU)

[Use of ocular drugs in pregnancy]. / Uso de fármacos oculares en el embarazo.

The information available on the safety of medicines in pregnant women is limited and must be suitably channeled. Medication that is applied topically or as eye drops can present relevant systemic absorption and cross the placenta barrier or enter maternal milk. We have reviewed ophthalmic medicines according to the fetal risk categories proposed by the classification of the Food and Drug Administration (FDA). We evaluate the medicines of choice in the most frequent ophthalmic pathologies, as well as the medicines that must be avoided.

[Topical interferon alfa-2b for primary treatment of conjunctiva-cornea intraepithelial neoplasia]. / Interferón alfa-2b tópico como primera opción en las neoplasias intraepiteliales corneoconjuntivales.

We describe two cases of conjunctival-cornea intraepithelial neoplasia (CIN), treated with topical IFN alfa 2b. The traditional treatment for CIN is surgical excision usually with adjunctive cryotherapy. However, residual tumour may remain, which can lead to recurrence rates of more than 50%. 5-Fluorouracil, mitomicyn C and interferon α 2b are new pharmacological agents that have proved their efficacy in the treatment of CIN. As side effects are common, we present IFN α 2b as a single therapeutic agent as an effective and optimal treatment for presumed recurrent corneal and conjunctival intraepithelial neoplasia. It offers the benefits of topical therapy and avoids the risks of surgical or other interventions - specifically, ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cell deficiency.

[Bilateral posterior scleritis]. / Escleritis posterior bilateral.

Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

Escleritis posterior bilateral / Bilateral posterior scleritis

La escleritis posterior es un proceso inflamatoriode la parte posterior de la esclera. Su prevalencia esmuy baja y el diagnóstico puede resultar complicadopor la ausencia de signos oculares externos. Es más frecuenteen mujeres. Cuando aparece en pacientes jóvenesno suele tener otras patologías asociadas, pero enmayores de 55 años hasta un tercio de los casos tienenrelación con alguna enfermedad sistémica, sobre todola artritis reumatoide. El diagnóstico de esta patologíapuede requerir un abordaje multidisciplinar y la colaboraciónde oftalmólogos con neurólogos, internistas oreumatólogos. En este artículo se describe un caso deescleritis posterior bilateral idiopática (AU)

Posterior scleritis is an inflammatory process ofthe posterior part of the sclera. Its prevalence is verylow and its diagnosis can be complicated due to theabsence of external ocular signs. It is more frequentin women. In young patients it does not usually haveother associated pathologies, but in those over 55 yearsnearly one-third of the cases have a relation with somesystemic disease, above all rheumatoid arthritis. Thediagnosis of this pathology can require a multidisciplinaryapproach and the collaboration of ophthalmologistswith neurologists, internists or rheumatologists.This article describes a case of idiopathic bilateral posteriorscleritis (AU)

[Treatment with photodynamic therapy of circumscribed choroidal hemangioma]. / Tratamiento mediante terapia fotodinámica del hemangioma coroideo circunscrito.

CASE REPORTS: The clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy. DISCUSSION: Photodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation. Some questions such as whether attempts should be made to obtain a complete tumour regression, laser settings or the way the spots must be applied remain unresolved.

Tratamiento mediante terapia fotodinámica del hemangioma coroideo circunscrito / Treatment with photodynamic therapy of circumscribed choroidal hemangioma

Casos clínicosSe presentan las características clínicas de tres pacientes con hemangioma coroideo circunscrito y exudación subfoveal, detectada mediante tomografía óptica de coherencia, tratados con éxito mediante terapia fotodinámica.DiscusiónLa terapia fotodinámica es actualmente la alternativa terapéutica más efectiva para tratar los hemangiomas coroideos circunscritos asociados a exudación subfoveal. Respecto a la utilización de este tratamiento quedan por definir algunas cuestiones como son si se debe buscar o no la desaparición total de la masa tumoral, los parámetros de láser más adecuados en estos casos o la forma de aplicación de los impactos(AU)

Case reportsThe clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy.DiscussionPhotodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation. Some questions such as whether attempts should be made to obtain a complete tumour regression, laser settings or the way the spots must be applied remain unresolved(AU)

[eOphthalmology: current state and future tendencies]. / eOftalmología: estado actual y tendencias futuras.

eOphthalmology can be defined as the use of information and telecommunications technologies to provide or support a group of activities related to ophthalmic care. The same concept applied to ophthalmic care would be eOphthalmology. This paper describes the current state of eOphthalmology-based models in diabetic retinopathy screening and in the diagnosis and follow-up of chronic glaucoma and age-related macular degeneration. Furthermore, the main advantages of these models and the technological requirements needed for their implementation are described. Finally, a prediction of the impact of eOphthalmology on the future of health care is offered.

eOftalmología: estado actual y tendencias futuras / eOphthalmology: current state and future tendencies

La eSalud se puede definir como el uso de las tecnologíasde la información y las comunicaciones paraproporcionar o apoyar un diverso grupo de actividadesrelacionadas con la atención en salud. Si este conceptose traslada a la atención oftalmológica sería lo quedenominamos como eOftalmología. En este artículose describe el estado actual de los modelos de eOftalmologíaen el cribado de la retinopatía diabética y eldiagnóstico y el seguimiento del glaucoma crónico yla degeneración macular asociada a la edad. Tambiénse definen los requerimientos tecnológicos necesariospara implantar este tipo de modelos de asistencia, sediscuten las ventajas derivadas de los mismos y se haceuna previsión del impacto que la eOftalmología puedetener en el futuro de la asistencia sanitaria(AU)

eOphthalmology can be defined as the use of informationand telecommunications technologies to provideor support a group of activities related to ophthalmiccare. The same concept applied to ophthalmiccare would be eOphthalmology. This paper describesthe current state of eOphthalmology-based models indiabetic retinopathy screening and in the diagnosis andfollow-up of chronic glaucoma and age-related maculardegeneration. Furthermore, the main advantages of thesemodels and the technological requirements neededfor their implementation are described. Finally, a predictionof the impact of eOphthalmology on the futureof health care is offered(AU)

[Outbreak of toxic anterior segment syndrome after vitreous surgery]. / Brote de síndrome tóxico del segmento anterior después de cirugía vítrea.

CASE REPORT: An outbreak of Toxic Anterior Segment Syndrome after vitreoretinal surgery is reported. Two patients underwent exclusively vitrectomy while the other three patients were operated of vitrectomy and some other anterior segment procedure. DISCUSSION: Toxic Anterior Segment Syndrome is a sterile postoperative inflammation due to any non infectious substance that reaches the anterior segment during surgery. It occurs in outbreaks and while most of the cases have been reported after anterior segment procedures, this case demonstrates that development after vitreoretinal surgery is also a possibility.

Brote de síndrome tóxico del segmento anterior después de cirugía vítrea / Outbreak of toxic anterior segment syndrome after vitreous surgery

Caso clínico: Se describe un brote de SíndromeTóxico del Segmento Anterior después de cirugíavítrea. Dos pacientes habían sido intervenidosexclusivamente mediante vitrectomía mientras quelos otros tres fueron sometidos a vitrectomía yalgún otro procedimiento del segmento anterior.Discusión: El Síndrome Tóxico del SegmentoAnterior es una inflamación postoperatoria estérilprovocada por alguna sustancia no infecciosa quealcanza el polo anterior durante la cirugía. Sueleocurrir en brotes y aunque la mayoría de los casoshan sido descritos después de cirugía del segmentoanterior, los casos que presentamos demuestran quees posible su aparición tras cirugía vítrea(AU)

Case report: An outbreak of Toxic Anterior SegmentSyndrome after vitreoretinal surgery is reported.Two patients underwent exclusively vitrectomywhile the other three patients were operated of vitrectomyand some other anterior segment procedure.Discussion: Toxic Anterior Segment Syndrome is asterile postoperative inflammation due to any noninfectious substance that reaches the anterior segmentduring surgery. It occurs in outbreaks and whilemost of the cases have been reported after anteriorsegment procedures, this case demonstrates thatdevelopment after vitreoretinal surgery is also a possibility(AU)

Concordancia oftalmólogo-enfermera en la primera exploración postquirúrgica de la cirugía de cataratas / Agreement between ophthalmologist and nurse in the first postoperative exploration following cataract extraction

Introducción: La actividad de enfermería en el proceso quirúrgico de la catarata engloba, desde la realización de la biometría en el preoperatorio y la colaboración en la cirugía, hasta la administración de los primeros cuidados en el postoperatorio y la información al paciente y a la familia durante todo el proceso. El objetivo del presente trabajo es analizar la concordancia entre oftalmólogo y enfermera en los hallazgos de la primera exploración postquirúrgica de los pacientes intervenidos de cataratas mediante facoemulsificación y sin complicaciones en la cirugía. Metodología: El estudio se realizó entre mayo y junio de 2005 en 129 pacientes intervenidos de cataratas, 78 mujeres y 51 hombres con edad media de 73,1 años. Se definieron las variables a valorar en la primera exploración postquirúrgica y se estudió la concordancia entre oftalmólogos y enfermeras en la identificación de las complicaciones más frecuentes de la cirugía de cataratas. Resultados: La concordancia fue del 100% de los casos en la presión intraocular >22 mm de Hg, la irregularidad pupilar, la reacción inflamatoria de cámara anterior y el prolapso de iris; del 65,9% en la presencia de Seidel, y del 60,5% en el edema corneal severo. Conclusiones: El alto índice de concordancia médico-enfermera encontrado en 4 de las variables, puede ofrecer la posibilidad de que la enfermera realice esta primera exploración postquirúrgica. Sin embargo, una concordancia moderada en el resto hace necesario un mayor periodo de formación del personal de enfermería, para conseguir aumentar estos valores (AU)

Introduction: Nursing activity in the cataract extraction process extends from carrying out biometry in the preoperative stage and collaboration in surgery, to providing the initial care in the postoperative stage and keeping the patient and family informed throughout the whole process. This article analyses agreement between ophthalmologists and nurses in the findings of the first post-surgical exploration of patients of cataract extraction using facoemulsification and without complications in surgery. Methods: The study was carried out between May and June of 2005 on 129 patients who had been operated on for cataracts, 78 women and 51 men with an average age of 73.1 years. The variables to be evaluated in the first post-surgical exploration were defined, and a study was made of the agreement between ophthalmologists and nurses in identification of the most frequent complications in cataract surgery. Results: Agreement was 100% in the cases of intraocular pressure >22 mm Hg, pupil irregularity, inflammatory reaction of the anterior chamber and iris prolapse; it was 65.9% on the presence of Seidel; and 60.5% on severe corneal edema. Conclusions: The high rate of agreement between ophthalmologists and nurses in 4 of the variables might offer the possibility of the nurse carrying out this post-surgical exploration. However, a moderate rate of agreement in the other variables makes a longer training period for nursing personnel necessary in order to obtain higher values (AU)

[Leber's miliary aneurysm]. / Aneurismas miliares de Leber.

CASE REPORT: A 45-year-old man was referred to us with a scotoma sensation in his right visual field. Funduscopic examination showed aneurysmal dilatations with lipid exudation in the superior and inferior temporal retinal arcades in his right eye. Angiofluorography showed vascular dilatations and late dye leakage. DISCUSSION: Leber's disease is a primary retinal vasculopathy characterized by several aneurysms associated with intraretinal lipid exudates. Visual compromise depends on macular involvement by the exudates. Differential diagnosis must be established with other primary retinal vasculopathies and secondary aneurysms. Treatment consists of argon laser photocoagulation of the aneurysms.

Aneurismas miliares de Leber / Leber´s miliary aneurysm

Caso clínico: Varón de 45 años con sensación de escotoma en campo visual derecho. En la imagen del fondo de ojo aparecen dilataciones aneurismáticas con exudación lipídica en arcada temporal superior e inferior. La angiofluoresceingrafía muestra dilatación vascular y extravasación tardía de colorante. Discusión: La enfermedad de Leber es una vasculopatía retiniana primaria caracterizada por múltiples aneurismas asociados a exudados lipídicos intrarretinianos. El compromiso visual depende dela afectación macular por exudados. El diagnóstico diferencial comprende al resto de vasculopatías retinianas primarias y aneurismas secundarios a otras patologías. El tratamiento es la foto coagulación con láser argon de los aneurismas

Case report: A 45-year-old man was referred to us with a scotoma sensation in his right visual field. Funduscopic examination showed aneurysmal dilatations with lipid exudation in the superior and inferior temporal retinal arcades in his right eye. Angiofluorography showed vascular dilatations and late dye leakage. Discussion: Leber’s disease is a primary retinal vasculopathy characterized by several aneurysms associated with intraretinal lipid exudates. Visual compromise depends on macular involvement by the exudates. Differential diagnosis must be established with other primary retinal vasculopathies and secondary aneurysms. Treatment consists of argon laser photocoagulation of the aneurysms