Estudio comparativo entre tonómetros Goldmann y ORA en pacientes recién diagnosticados de GPAA o HTO, sin tratamiento / Comparison of Goldmann and ORA tonometers in newly diagnosed, untreated, POAG and OHT eyes

Antecedentes y objetivo Las propiedades biomecánicas corneales en ojos de pacientes recién diagnosticados de glaucoma e hipertensión oculares (HTO) y que no han recibido tratamiento previo son de gran interés, porque pueden suponer una fuente de error en la medida de la presión intraocular (PIO) medida mediante tonometría de aplanación Goldmann (TAG) y Ocular Response Analyzer® (ORA). El principal objetivo de este estudio es evaluar los valores de la PIO obtenidos con la TAG y el ORA, en pacientes con glaucoma primario de ángulo abierto (GPAA) e HTO que no han recibido tratamiento antiglaucomatoso previo. Materiales y métodos Estudio transversal, observacional con observador enmascarado. Se incluyeron pacientes recién diagnosticados de GPAA e HTO, que no habían recibido tratamiento tópico hipotensor previo. Resultados Se incluyeron 51 pacientes con GPAA y 34 pacientes con HTO. Se encontró un valor de la PIO corneo compensada (PIOcc) significativamente mayor que el de la PIO TAG en el grupo de GPAA (p=0,0002), mientras que no se encontraron diferencias significativas entre ambos tonómetros en el grupo de HTO (p=0,1). Conclusiones La TAG parece infraestimar la PIO «real» en pacientes con GPAA sin tratamiento hipotensor previo, mientras que parece ser más exacta en pacientes con HTO (AU)

Background and objective The corneal biomechanical properties in naïve, untreated glaucoma and ocular hypertension (OHT) eyes is interesting, because it may be a source of error in intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT) and ocular response analyzer (ORA). The main objective of this study was to evaluate the IOP values obtained using GAT and the ORA, in primary open angle glaucoma (POAG) and in OHT untreated eyes. Material and methods Observational, masked, cross sectional observational study. Newly diagnosed, untreated POAG and OHT eyes were included. Results Fifty-one POAG and 34 OHT eyes were analyzed. We found that IOPcc (IOP corneal-compensated) was significantly higher than GAT IOP in POAG (P=.0002) while we did not find any significant difference between both tonometers in OHT (P=.1). Conclusions GAT seems to underestimate the real IOP in untreated POAG eyes and it seems to be quite accurate in OHT eyes (AU)

Comparison of Goldmann and ORA tonometers in newly diagnosed, untreated, POAG and OHT eyes.

BACKGROUND AND OBJECTIVE: The corneal biomechanical properties in naïve, untreated glaucoma and ocular hypertension (OHT) eyes is interesting, because it may be a source of error in intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT) and Ocular Response Analyzer (ORA) The main objective of this study was to evaluate the IOP values obtained using GAT and the ORA, in primary open angle glaucoma (POAG) and in OHT untreated eyes. MATERIAL AND METHODS: Observational, masked, cross sectional observational study. Newly diagnosed, untreated POAG and OHT eyes were included. RESULTS: 51 POAG and 34 OHT eyes were analyzed. We found that IOPcc (IOP corneal-compensated) was significantly higher than GAT IOP in POAG (p = 0.0002) while we did not find any significant difference between both tonometers in OHT (p = 0.1). CONCLUSIONS: GAT seems to underestimate the real IOP in untreated POAG eyes and it seems to be quite accurate in OHT eyes.

Ex-PRESS® implant as the first surgical option in the iridocorneal endothelial syndrome.

Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome.

Implante Ex-PRESS® como primera opción quirúrgica en el síndrome iridocorneo-endotelial / Ex-PRESS® implant as the first surgical option in the iridocorneal endothelial syndrome

Se plantea como objetivo dar a conocer los resultados a mediano plazo del implante Ex-PRESS® como primera opción quirúrgica en pacientes con síndrome iridocorneo-endotelial (ICE). Se incluye la descripción de dos mujeres con diagnóstico de síndrome ICE y glaucoma no controlado por medicación, tratadas con el implante Ex-PRESS® y con cirugía de catarata asociada en una de ellas. La presión intraocular se mantiene estable tres años después de la intervención sin necesidad de tratamiento médico adicional anti-glaucoma, con un implante bien colocado y rodeado por una ampolla de filtración difusa, sin eventos adversos documentados que pudieran suponer una amenaza para la vista, y sin un progreso registrado en el curso de la patología. El presente informe propone considerar los implantes Ex-PRESS® como primera opción quirúrgica, al posibilitar la existencia de un ostium permeable, a pesar del cierre progresivo del ángulo sinequial típico del síndrome ICE (AU)

Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome (AU)

Discovery of a novel accessory structure of the pitviper infrared receptor organ (serpentes: viperidae).

The facial pits of rattlesnakes, copperheads, lanceheads, bushmasters and other American and Asian pitvipers (Crotalinae) are highly innervated and densely vascularized infrared (IR) receptor organs. For over a century, studies have focused on a small sample of model species from North America and Asia. Based on an expanded survey of Central and South American crotalines, we report a conspicuous accessory structure composed of well-defined papillae that project from the anterior orbital adnexa. The papillae are continuous with the inner chamber of the IR receptor organ and our histological and ultrastructural data suggest that they possess a well-developed nervous network and extensive vascularization; however, they lack the characteristic IR-sensitive terminal nerve masses found in the IR-receptive pit membrane. The function of the IR receptor organ papillae is unknown.

The impact of conservation on the status of the world's vertebrates.

Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world's vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.

[Band atrophy of the optic disc secondary to ventricular subependymoma compression]. / Atrofia de disco óptico en banda secundaria a compresión por subependimoma ventricular.

CASE REPORT: A 42-year-old man was diagnosed with band or "bow tie" optic atrophy with a right homonymous hemianopia. Computerized tomography (CT) revealed a calcified lesion in the left hippocampus. Craniotomy and tumor resection were performed. The biopsy revealed a subependymoma of the temporal horn of the left ventricular system. DISCUSSION: Optic tract lesions are uncommon clinical entities, in which homonymous hemianopia and contralateral band optic atrophy are characteristic. Subependymomas are infrequent and benign tumors that are typically associated with the ventricular system.

[Acute retinal necrosis syndrome following chickenpox]. / Síndrome de necrosis retiniana aguda tras primoinfección por varicela.

CASE REPORT: A 34-year-old male patient developed acute retinal necrosis in his left eye about three weeks after the onset of chickenpox. Systemic antiviral treatment with intravenous acyclovir (10 mg/kg/8 hours) and systemic corticosteroids (1 mg/kg/day) controlled the retinitis and the patient suffered no loss of visual acuity. DISCUSSION: Acute retinal necrosis is an unusual complication of chickenpox. A mild form of this entity has been described during the course of primary varicella-zoster infection. Adequate and early therapy during the acute phase of the disease with intravenous acyclovir and systemic corticosteroids is recommended to achieve a satisfactory visual acuity and prevent complications.

Atrofia de disco óptico en banda secundaria a compresión por subependimoma ventricular / Band atrophy of the optic disc secondary to ventricular subependyoma compression

Caso clínico: Varón de 42 años con atrofia óptica en banda o en «pajarita» derecha con hemianopsia homónima derecha. En la tomografía computerizada (TC) se observa una lesión calcificada a nivel de hipocampo izquierdo. Se realizó craneotomía y resección tumoral con diagnóstico definitivo de subependimoma de asta temporal de ventrículo lateral izquierdo. Discusión: Las lesiones de la cintilla óptica son entidades clínicas poco frecuentes que cursan con hemianopsia homónima y atrofia óptica en banda o en «pajarita» contralateral. El subependimoma es un tumor infrecuente y benigno, que se asocia típicamente con el sistema ventricular

Case report: A 42-year-old man was diagnosed with band or «bow tie» optic atrophy with a right homonymous hemianopia. Computerized tomography (CT) revealed a calcified lesion in the left hippocampus. Craniotomy and tumor resection were performed. The biopsy revealed a subependymoma of the temporal horn of the left ventricular system. Discussion: Optic tract lesions are uncommon clinical entities, in which homonymous hemianopia and contralateral band optic atrophy are characteristic. Subependymomas are infrequent and benign tumors that are typically associated with the ventricular system

Síndrome de necrosis retiniana aguda tras primoinfección por varicela / Acute retinal necrosis syndrome following chickenpox

Caso clínico: Varón de 34 años que desarrolló una necrosis retiniana aguda en su ojo izquierdo tres semanas después de padecer varicela. Con tratamiento sistémico precoz con aciclovir intravenoso (10 mg/kg/8 horas) y corticoides sistémicos (1 mg/kg/día) la retinitis fue controlada y el paciente no sufrió pérdida de agudeza visual. Discusión: La necrosis retiniana aguda es una complicación inusual de la varicela que necesita atención. Se ha descrito una forma leve durante el curso de la primoinfección por varicela zoster. Se recomienda un tratamiento adecuado y precoz durante la fase aguda de la enfermedad con aciclovir intravenoso para conseguir una buena agudeza visual y prevenir complicaciones

Case report: A 34-year-old male patient developed acute retinal necrosis in his left eye about three weeks after the onset of chickenpox. Systemic antiviral treatment with intravenous acyclovir (10 mg/kg/8hours) and systemic corticosteroids (1 mg/kg/day) controlled the retinitis and the patient suffered no loss of visual acuity. Discussion: Acute retinal necrosis is an unusual complication of chickenpox. A mild form of this entity has been described during the course of primary varicella-zoster infection. Adequate and early therapy during the acute phase of the disease with intravenous acyclovir and systemic corticosteroids is recommended to achieve a satisfactory visual acuity and prevent complications

[Combined topical plus subconjunctival anesthesia versus retrobulbar anesthesia in non-penetrating sclerectomy]. / Anestesia tópica más subconjuntival versus retrobulbar en la esclerectomía profunda no penetrante.

PURPOSE: To compare the safety and efficacy of topical plus subconjunctival versus retrobulbar anesthesia for primary non-penetrating sclerectomy supplemented with adjuntive 5-FU. METHODS: A prospective study of 30 consecutive patients who were randomized to receive subconjunctival (n = 14) or retrobulbar (n = 16) anesthesia was performed. Operating conditions, patient comfort, postoperative pain, total pain and surgical outcomes were evaluated. RESULTS: There were no differences in the operating conditions. The retrobulbar group reported significantly more pain during administration of the anesthetic agent than the subconjunctival group (P= 0.00). The subconjunctival group reported more discomfort during surgery than the retrobulbar group (P= 0.00); however, this feature was not a problem for the surgeon. No statistically significant differences were found in regard to the total pain experienced, the postoperative pain, nor the success rates of the operative procedure in either group. CONCLUSION: Topical/subconjunctival anesthesia is a safe and effective alternative to retrobulbar anesthesia for non penetrating sclerectomy supplemented with 5-FU.

[Brown-McLean syndrome after insertion of an anterior chamber intraocular lens: description of one case]. / Síndrome de Brown-McLean con lente intraocular de cámara anterior: descripción de un caso.

CASE REPORT: We report one case of Brown-McLean syndrome. DISCUSSION: In this case, a 71-year-old male developed a Brown-McLean syndrome after implantation of an anterior chamber lens in one aphakic eye. A phacoemulsification procedure was performed in the other eye without development of corneal clearance alterations in the next 7 years. The cause of Brown-McLean syndrome is still unexplained. It is possible that it could develop in eyes with a genetic predisposition when these eyes are exposed to certain conditions, such as insertion of an anterior chamber lens.

Anestesia tópica más subconjuntival versus retrobulbar en la esclerectomía profunda no penetrante / Combined topical plus subconjunctival anesthesia versus retrobulbar anesthesia in non-penetrating sclerectomy

Objetivo: Comparar la eficacia y seguridad de la anestesia tópica-subconjuntival con la retrobulbar en la escleroctomía profunda no penetrante suplementada con 5-FU. Método: Se realizó un estudio prospectivo y aleatorizado de 30 pacientes consecutivos a los que se les practicó anestesia tópica-subconjuntival (n=14) o retrobulbar (n=16). Se evaluaron las condiciones operatorias, el confort del paciente, el dolor postoperatorio, el dolor total y el resultado quirúrgico en cuanto a bajada de presión intraocular. Resultados: No hubo diferencias en las condiciones quirúrgicas entre ambos grupos. El grupo con anestesia retrobulbar refirió más dolor durante la aplicación del anestésico (P= 0,00). El grupo con anestesia tópica-subconjuntival refirió más disconfort intraoperatoriamente (P=0,00). Sin embargo, esto no representó un problema para el cirujano. No hubo diferencias en el dolor postoperatorio entre ambos grupos. No hubo diferencias estadísticamente significativas en cuanto al dolor total. No hubo diferencia en cuanto al éxito quirúrgico entre ambos grupos. Conclusiones: La anestesia tópica-subconjuntival es una alternativa segura y efectiva para la escleroctomía no penetrante suplementada con 5-FU

Purpose: To compare the safety and efficacy of topical plus subconjunctival versus retrobulbar anesthesia for primary non-penetrating sclerectomy supplemented with adjuntive 5-FU. Methods: A prospective study of 30 consecutive patients who were randomized to receive subconjunctival (n = 14) or retrobulbar (n = 16) anesthesia was performed. Operating conditions, patient comfort, postoperative pain, total pain and surgical outcomes were evaluated. Results: There were no differences in the operating conditions. The retrobulbar group reported significantly more pain during administration of the anesthetic agent than the subconjunctival group (P= 0.00). The subconjunctival group reported more discomfort during surgery than the retrobulbar group (P= 0.00); however, this feature was not a problem for the surgeon. No statistically significant differences were found in regard to the total pain experienced, the postoperative pain, nor the success rates of the operative procedure in either group. Conclusion: Topical/subconjunctival anesthesia is a safe and effective alternative to retrobulbar anesthesia for non penetrating sclerectomy supplemented with 5-FU

Síndrome de Brown-McLean con lente intraocular de cámara anterior: descripción de un caso / Brown-McLean syndrome after insertion of an anterior chamber intraocular lens: description of one case

Caso clínico: Se presenta un caso de síndrome de Brown-McLean. Discusión: Un varón de 71 años de edad desarrolló un síndrome de Brown-McLean tras el implante de una lente de cámara anterior en un ojo afáquico. Se realizó facoemulsificación en el ojo contralateral sin desarrollo de alteraciones en la transparencia corneal. El síndrome de Brown-McLean tiene un origen incierto todavía. Probablemente, se desarrolle en ojos con predisposición genética expuestos a ciertas condiciones, como por ejemplo lentes de cámara anterior

Case report: We report one case of Brown-McLean syndrome. Discussion: In this case, a 71-year-old male developed a Brown-McLean syndrome after implantation of an anterior chamber lens in one aphakic eye. A phacoemulsification procedure was performed in the other eye without development of corneal clearance alterations in the next 7 years. The cause of Brown-McLean syndrome is still unexplained. It is possible that it could develop in eyes with a genetic predisposition when these eyes are exposed to certain conditions, such as insertion of an anterior chamber lens

Iris melanocytoma mimicking the Cogan-Reese syndrome with monocular pigment dissemination.

PURPOSE: To report a case of iris melanocytoma mimicking the Cogan-Reese syndrome. METHODS: A 37-year-old woman presented with pigmentary glaucoma in her left eye. There was diffuse pigmentary dispersion in the anterior segment, pedunculated pigmented nodules on the anterior iris surface, mild iris atrophy, and ectropion iridis. Neither intrinsic vasculature nor a sector cataract was found. The angle was open with marked trabecular pigmentation and no anterior synechiae. The intraocular pressure was 30 mmHg with maximum medical treatment and there was glaucomatous optic atrophy. The differential diagnosis included iris pigmented tumor and iridocorneal endothelial syndrome (Cogan-Reese syndrome). An iris biopsy was performed for diagnostic purposes. RESULTS: Histologic diagnosis after evaluation of the specimen was iris melanocytoma. CONCLUSIONS: This case presents signs considered quasi-pathognomonic of iridocorneal endothelial syndrome (Cogan-Reese syndrome): glaucoma, mild iris atrophy associated with pedunculated iris nodules, and ectropion iridis. Therefore, iris melanocytoma can present with features that mimic the Cogan-Reese syndrome.

Production of interleukin-6 in cultures of peripheral blood mononuclear cells from children with primary protein-calorie malnutrition and from eutrophic controls.

The spontaneous as well as mitogen-induced in vitro production of interleukin-6 (IL-6) was studied in cultures of peripheral blood mononuclear cells (PBMC) from 14 children with marginal protein-energy malnutrition, 43 children with definite protein-energy malnutrition and 38 eutrophic controls of similar age, sex, race and socioeconomical condition. PBMC were cultured without added mitogen or stimulated with either lipopolysaccharide (LPS) or phytohemagglutinin (PHA). After 48 h incubation, cell-free culture supernatants were collected and stored at -70 degrees C. The amount of IL-6 in the supernatants was determined by a specific bioassay based on the proliferation of B9 hybridoma cells using human rIL-6 as standard. The mean level of IL-6 was significantly increased in supernatants from nonstimulated PBMC cultures from definitely malnourished children as compared with that observed in those of the controls. Stimulation with either LPS or PHA induced a rise in cytokine bioactivity in the supernatants of PBMC cultures from the different nutritional groups tested. Interestingly, IL-6 was significantly increased in the supernatants of PHA-stimulated cultures from malnourished children as compared with those of the controls.