Linfoma ocular primario / Primary intraocular lymphoma

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Rotura de macroaneurisma retiniano / Retinal macroaneurysm ruptura

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Imagen multimodal en uveítis tuberculosa / Multimodal imaging in tubercular uveitis

No disponible

Maculopatía petaloide por Valsalva / Valsalva petaloid maculopathy

No disponible

Estrabismo y diplopías tras la cirugía refractiva / Strabismus and diplopia after refractive surgery

Objetivo: Analizar los factores que pueden incidir en la descompensación del estrabismo o aparición de diplopía en pacientes sometidos a cirugía refractiva. Métodos: Estudio retrospectivo de 19 pacientes remitidos por presentar descompensación de la motilidad ocular y/o de la visión binocular tras cirugía refractiva. La edad media era 38,89 DS±10,26 años (rango 27 a 63). Catorce pacientes eran miopes, cinco hipermétropes. Cinco de ellos presentaban anisometropía intensa. En tres casos la técnica refractiva fue fotoqueratectomía refractiva, en trece de tipo Lasik, en uno LIO+Lasik y en dos LIO bilateral. Resultados: La prevalencia de diplopía poscirugía refractiva fue 0,12% (5 de los 19 procedían de nuestro centro, sobre una base de datos de 4.135 pacientes sometidos a cirugia refractiva, al realizar el estudio). Todos tenían patología binocular previa a la cirugía. Tras esta, once presentaban endoforia o endotropía, tres exoforia o exotropía, dos desviaciones verticales y tres horizontal y vertical. Las causas de descompensación fueron: factor acomodativo residual, hipercorrección refractiva en sentido hipermetrópico, inestabilidad visual, anisoagudeza, descompensación de una foria en el estrabismo del miope magno, pérdida de supresión, cambio de dominancia y presbicia. Frecuentemente varios factores actuaron simultáneamente. Conclusiones: La aparición de diplopía o estrabismo poscirugía refractiva es poco frecuente. Varios factores pueden incidir en la descompensación, fundamentalmente la hipercorrección miópica y los factores acomodativos y visuales, especialmente en edad présbita, en fuertes anisométropes y miopes magnos(AU)

Objective: To evaluate factors that may decompensate a strabismus or lead to diplopia after refractive surgery. Methods: Retrospective study of 19 patients, who presented with binocular decompensation after refractive surgery. Mean age at surgery was 38.89 SD 10.26 (27-63) years. Fourteen patients were myopic, 5 hyperopic, and 5 of them had a marked anisometropia. The photo-refractive keratectomy procedure was used in 3 cases, laser-assisted in situ keratomileusis (LASIK) in 13, posterior chamber-IOL)+LASIK in one of them, and bilateral IOL in 2 cases. Results: There was a prevalence of strabismus of 0.12%. All of our patients had a binocular pathology previous to the refractive surgery. After surgery, 11 patients had an esophoria or esotropia, 3 exophoria or exotropia, 2 vertical deviations, and 3 horizontal and vertical deviations. Several factors often worked simultaneously in the same patient, such as: residual accommodation, refractive overcorrection (hyperopia), visual instability or anisoacuity, high myopia and phoria decompensation, elimination of suppression, dominance change, and a presbyopic age. Conclusions: All of our patients had a previous binocular pathology. Binocularity may decompensate by several factors but mostly by myopic overcorrection, accommodation and visual factors, particularly in patients close to or in presbyopic age, in anisometropia and high myopia(AU)

[Strabismus and diplopia after refractive surgery]. / Estrabismo y diplopías tras la cirugía refractiva.

OBJECTIVE: To evaluate factors that may decompensate a strabismus or lead to diplopia after refractive surgery. METHODS: Retrospective study of 19 patients, who presented with binocular decompensation after refractive surgery. Mean age at surgery was 38.89 SD 10.26 (27-63) years. Fourteen patients were myopic, 5 hyperopic, and 5 of them had a marked anisometropia. The photo-refractive keratectomy procedure was used in 3 cases, laser-assisted in situ keratomileusis (LASIK) in 13, posterior chamber-IOL)+LASIK in one of them, and bilateral IOL in 2 cases. RESULTS: There was a prevalence of strabismus of 0.12%. All of our patients had a binocular pathology previous to the refractive surgery. After surgery, 11 patients had an esophoria or esotropia, 3 exophoria or exotropia, 2 vertical deviations, and 3 horizontal and vertical deviations. Several factors often worked simultaneously in the same patient, such as: residual accommodation, refractive overcorrection (hyperopia), visual instability or anisoacuity, high myopia and phoria decompensation, elimination of suppression, dominance change, and a presbyopic age. CONCLUSIONS: All of our patients had a previous binocular pathology. Binocularity may decompensate by several factors but mostly by myopic overcorrection, accommodation and visual factors, particularly in patients close to or in presbyopic age, in anisometropia and high myopia.

[Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis]. / Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica.

PURPOSE: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. METHODS: A cross-sectional descriptive study was conducted on patients who underwent cataract surgery in a public hospital over an 11-year period. An ocular infection database was used to report endophthalmitis occurrences and to collect the clinical features. Qualitative variables are described with their frequency distribution and qualitative variables, with the mean and the standard deviation. RESULTS: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. A total of 43 patients suffered from postoperative endophthalmitis, giving an overall infection rate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 women with a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% were diabetic, 44.18% had some degree of immunosuppression and there were complications with posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered: the first one did not receive intracameral antibiotic (8,099 patients) and the second group received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis in the first group with an infection incidence of 0.48% and 4 endophthalmitis in the second group with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroxime was 0.12 (0.04-0.33) with P<0.05. CONCLUSIONS: The incidence of endophthalmitis after cataract surgery in an 11-year period was lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameral cefuroxime resulted in nearly a 9-fold reduction in the rate of infection.

Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica / Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis

Objetivo: Estimar la incidencia de endoftalmitis tras cirugía de cataratas, la clínica y el papelde los antibióticos intracamerales.Métodos: Se realizó un estudio descriptivo transversal en pacientes operados de cataratas enun hospital público durante 11 años. Se diseñó una base de datos de infecciones ocularespara analizar los aspectos clínico-quirúrgicos. Las variables cualitativas se describen con sudistribución de frecuencias y las cuantitativas con la media y la desviación estándar.Resultados: Desde enero de 1999 hasta diciembre de 2009, 15.173 pacientes se operaron decataratas. Hubo 43 endoftalmitis postquirúrgicas con una incidencia global de 0,28% (IC95%: 0,20-0,36%). Había 19 varones y 24 mujeres, con una edad media de 78,5 an˜ os. Se evaluarondistintos parámetros clínicos: un 25,58% eran diabéticos, un 44,18% tenían algúngrado de inmunosupresión y hubo complicaciones con vitreorragia en el 18,6%. En cuanto aprofilaxis antibiótica, se consideraron 2 grupos: el primer grupo no recibió antibiótico intracameral(8.099 pacientes) y el segundo grupo sí recibió cefuroxima (7.074 pacientes). De las43 endoftalmitis, 39 pertenecieron al primer grupo y 4 al segundo, con lo que la incidenciade infección fue de 0,48% en el primer grupo y 0,056% en el segundo. El riesgo relativo (RR)tras la evaluación después-antes de cefuroxima fue de 0,12 (0,04-0,33) con una p < 0,05.Conclusiones: La incidencia de endoftalmitis tras cirugía de cataratas en 11 años fue inferioral 0,3%. Casi la mitad de los pacientes tenían un riesgo sistémico mayor. Con la cefuroximaintracameral la tasa de infección se redujo casi nueve veces más(AU)

Purpose: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. Methods: A cross-sectional descriptive study was conducted on patients who underwentcataract surgery in a public hospital over an 11-year period. An ocular infection databasewasused to report endophthalmitis occurrences and to collect the clinical features. Qualitativevariables are described with their frequency distribution and qualitative variables, with themean and the standard deviation.Results: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. Atotal of 43 patients suffered from postoperative endophthalmitis, giving an overall infectionrate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 womenwith a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% werediabetic, 44.18% had some degree of immunosuppression and there were complicationswith posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered:the first one did not receive intracameral antibiotic (8,099 patients) and the secondgroup received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis inthe first group with an infection incidence of 0.48% and 4 endophthalmitis in the secondgroup with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroximewas 0.12 (0.04-0.33) with P < 0.05.Conclusions: The incidence of endophthalmitis after cataract surgery in an 11-year periodwas lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameralcefuroxime resulted in nearly a 9-fold reduction in the rate of infection(AU)

[Decreased visual acuity from optic disc drusen]. / Pérdida de agudeza visual en drusas de papila.

PURPOSE: To evaluate the visual acuity in patients with optic disc drusen and its relationship with the existence of superficial drusen. METHODS: For a six-year period (from 1997 to 2003), fifty-five patients (100 eyes) with optic disc drusen, confirmed with B- echography, were diagnosed. According to their ophthalmoscopic appearance under 20 degrees retinography, the drusen were classified as hidden or visible. We evaluated the best corrected visual acuity. When the visual acuity was less than 0.8, other additional causes of visual impairment were studied. RESULTS: The average visual acute in patients with papillary drusen was 0.82 (maximum 1.2 and minimum 0.05). Lower visual acute was found in those patients with visible drusen. Visual acute was statistically worse (p = 0.016) as the number of drusen increased. The visual acute was normal in 75 cases. The decreased visual acute was exclusively secondary to drusen in 5 cases. In the other 20 patients concomitant causes of visual impairment were found. CONCLUSIONS: A decreased visual acute secondary to drusen is unusual. When present, it is usually moderate and associated with disturbances of the peripheral visual field. There is a significant relationship between the decrease in visual acute and the number of visible drusen. When the central vision is decreased, but not the visual field, other concomitant conditions that could also affect the vision, should be ruled out.

Pérdida de agudeza visual en drusas de papila / Decreased visual acuity from optic disc drusen

Objetivo: Valorar la agudeza visual en los pacientes con drusas de papila y su relación con la presencia de drusas superficiales.Métodos: Durante un periodo de estudio de 6 años (1997-2003) fueron diagnosticados de drusas de papila 55 pacientes (100 ojos), confirmados mediante ecografía B. Clasificamos las drusas según el aspecto oftalmoscópico (retinografía 20°) en drusas visibles y ocultas. Estudiamos la agudeza visual mejor corregida. Cuando existía una agudeza visual inferior a 0,8 se valoró si existían otras causas oculares de disminución visual. Resultados: La agudeza visual media en los pacientes con drusas de papila fue de 0,82 (mínima de 0,05 y máxima de 1,2). Encontramos peor agudeza en los pacientes con drusas visibles, resultando significativamente peor cuanto más abundantes eran las drusas (p = 0,016). La agudeza visual fue normal en el 75% de los casos y anormal solo por drusas en 5 casos; en 20 casos hubo otras causas asociadas de disminución visual.Conclusiones: La disminución de la agudeza visual asociada a drusas es poco frecuente y cuando está presente suele ser moderada y casi siempre asociada a alteraciones del campo periférico. La agudeza visual muestra una relación significativa con la presencia y abundancia de drusas visibles. La pérdida de agudeza visual central sin afectación campimétrica debe hacernos sospechar otras causas asociadas(AU)

Purpose: To evaluate the visual acuity in patients with optic disc drusen and its relationship with the existence of superficial drusen.Methods: For a six-year period (from 1997 to 2003), fifty-five patients (100 eyes) with optic disc drusen, confirmed with B- echography, were diagnosed. According to their ophthalmoscopic appearance under 20° retinography, the drusen were classified as hidden or visible. We evaluated the best corrected visual acuity. When the visual acuity was less than 0.8, other additional causes of visual impairment were studied.Results: The average visual acute in patients with papillary drusen was 0.82 (maximum 1.2 and minimum 0.05). Lower visual acute was found in those patients with visible drusen. Visual acute was statistically worse (p = 0.016) as the number of drusen increased. The visual acute was normal in 75 cases. The decreased visual acute was exclusively secondary to drusen in 5 cases. In the other 20 patients concomitant causes of visual impairment were found.Conclusions: A decreased visual acute secondary to drusen is unusual. When present, it is usually moderate and associated with disturbances of the peripheral visual field. There is a significant relationship between the decrease in visual acute and the number of visible drusen. When the central vision is decreased, but not the visual field, other concomitant conditions that could also affect the vision, should be ruled out(AU)

[Influence of visual function on quality of life in patients with glaucoma]. / Influencia de la función visual en la calidad de vida de los pacientes con glaucoma.

OBJECTIVE: To determine the relationship between visual function objective measures and the perceived quality of life in patients with glaucoma and ocular hypertension. METHOD: This was a cross-sectional study of quality of life. Patients required knowledge to understand the questionnaire. PERIOD OF STUDY: April-May 2006. SETTING: third level hospital in Madrid. INSTRUMENT: Visual Function Index (VF-14). Visual acuity, computerized perimetry and ophthalmological examination were all performed. RESULTS: 120 questionnaires were distributed, 89.1% were returned completed. Cronbach's alpha was used for data validity and reliability (0.88). 49 patients had ocular hypertension (HTO) and 71 had glaucoma (52.1% men and 47.9% women). The mean health status was 73.9 (SD 24.13; range: 0-100); HTO: 81.4 (SD: 16.3) and glaucoma: 68.69 (SD:22) (p=0.001). These results were significantly correlated with the quality of life and visual acuity (r=0.51), mean deviation (MD) r=0.35, education level (p=0.024), and sex (p=0.031). No significant differences were found in the older groups or for evolution time. CONCLUSIONS: Quality of life measures can be useful in the management of patients with glaucoma, as a moderate relationship was found between quality of life, visual acuity and visual field loss in such patients. The VF-14 seems to discriminate between glaucoma and ocular hypertensive patients.

Influencia de la función visual en la calidad de vida de los pacientes con glaucoma / Influence of visual function on quality of life in patients with glaucoma

Objetivo: Determinar la relación entre las medidas objetivas de la función visual y la percepción de los pacientes de su calidad de vida relacionada con la salud. Métodos: Estudio transversal de evaluación de la calidad de vida en pacientes con glaucoma o hipertensión ocular y con un nivel intelectual suficiente para comprender el cuestionario. Período de estudio: abril-mayo de 2006. Ambito: hospital de tercer nivel de la Comunidad de Madrid. Instrumento: Índice de Función Visual VF-14. Se registró agudeza visual, perimetría computerizada, y exploración oftalmológica completa. Resultados: Se recogieron 120 cuestionarios, en los que el 89,1% lo cumplimentó el propio paciente. Para el análisis de fiabilidad y validez de los datos se uso el índice de fiabilidad alpha de Cronbach (0,88). Cuarenta y nueve pacientes fueron diagnosticados de hipertensión ocular (HTO) y 71 de glaucoma (52,1% hombres y 47,9% mujeres). La valoración media de su calidad de vida fue de 73,9 (DE: 24,13 R: 0-100); HTO: 81,4 (DE: 16,3) y glaucoma 68,69 (DE: 22) (p=0,001). Se han encontrado diferencias del estado de salud en relación con la agudeza visual (r=0,51), defecto campimétrico (r=0,35), nivel de estudios (p=0,024), y sexo (p=0,031). No se observó peor estado de salud en los grupos de mayor edad ni con el tiempo de evolución de la enfermedad. Conclusiones: Las medidas de calidad de vida pueden resultar útiles en la monitorización de los pacientes con glaucoma. Observamos moderada correlación entre agudeza visual, alteración campimétrica y calidad de vida de los pacientes con glaucoma. El VF-14 permite diferenciar entre pacientes con glaucoma e hipertensión ocular

Objective: To determine the relationship between visual function objective measures and the perceived quality of life in patients with glaucoma and ocular hypertension. Method: This was a cross-sectional study of quality of life. Patients required knowledge to understand the questionnaire. Period of study: April-May 2006. Setting: third level hospital in Madrid. Instrument: Visual Function Index (VF-14). Visual acuity, computerized perimetry and ophthalmological examination were all performed. Results: 120 questionnaires were distributed, 89.1% were returned completed. Cronbach’s alpha was used for data validity and reliability (0.88). 49 patients had ocular hypertension (HTO) and 71 had glaucoma (52.1% men and 47.9% women). The mean health status was 73.9 (SD 24.13; range: 0-100); HTO: 81.4 (SD: 16.3) and glaucoma: 68.69 (SD:22) (p=0.001). These results were significantly correlated with the quality of life and visual acuity (r=0.51), mean deviation (MD) r=0.35, education level (p=0.024), and sex (p=0.031). No significant differences were found in the older groups or for evolution time. Conclusions: Quality of life measures can be useful in the management of patients with glaucoma, as a moderate relationship was found between quality of life, visual acuity and visual field loss in such patients. The VF-14 seems to discriminate between glaucoma and ocular hypertensive patients (Arch Soc Esp Oftalmol 2008; 83: 249-256)

[Binocular vision following refractive surgery in hyperopic patients]. / Visión binocular tras cirugía refractiva en pacientes hipermétropes.

PURPOSE: To evaluate the changes in binocular vision and ocular motility in hyperopic patients undergoing refractive surgery. METHODS: Prospective study of 31 consecutive patients who underwent bilateral refractive surgery for hyperopia between May 1999 and February 2002. The examination included best-corrected visual acuity, cycloplegic refraction, ocular motility, fusion at distance, stereopsis and fusional amplitudes, before and at one month, 3 months, 6 months, one year after surgery and annually thereafter. RESULTS: After refractive surgery, there were changes in visual acuity, residual hyperopic refractive errors, and anisometropic changes that influenced the oculomotor status. The most frequent sensory modifications were suppression at distance, with much less change in stereopsis. From the point of view of ocular motility, we found a significant tendency to esotropia in strabismic patients (p=0.003). In non-strabismic patients, we also found sensorimotor modifications, but of less intensity and with fewer consequences than in strabismic patients. Sensorial and/or motor decompensation appeared in 25% of strabismic patients, and asthenopia symptoms developed in 28.7% in the same group. CONCLUSIONS: Slight binocular modifications with no symptomatic consequences were found in patients with normal binocular vision. However ocular motility was modified towards esotropia in strabismic patients, binocular decompensation appeared in 25%, and 28.7% of them suffered from asthenopia.