[Post-traumatic cyclodialysis cleft treated with transscleral diode laser]. / Ciclodiálisis postraumática tratada con láser diodo transescleral.

CASE REPORT: A 28-year-old man who received a blunt trauma in his left eye, presented with persistent ocular hypotony (intraocular pressure: 4 mmHg) as well as loss of visual acuity (0.4), optic disc edema and chorioretinal folds in the macula. The foveal thickness, measured by optic coherence tomography, was 326 microns. Using ultrasound biomicroscopy, a desinsertion of the nasal iris and a 360 degrees choroidal detachment was observed. The hypotony did not respond to conservative treatment and 10 months after the trauma he underwent a transscleral cyclopexy with contact diode laser. One year after the laser treatment the visual acuity was 1.0, the intraocular pressure 14 mmHg and the foveal thickness 240 microns. DISCUSSION: Transscleral cyclopexy with diode laser may be an effective alternative treatment to resolve post-traumatic cyclodialysis that does not respond to medical treatment.

[Frequency doubling perimetry in terminal visual field defects]. / Perimetría de duplicación de frecuencias en defectos campimétricos terminales.

PURPOSE: To evaluate the Frequency Doubling Technology (FDT) in end-stage glaucomatous visual field defects. METHODS: FDT (C-20 threshold test) was performed in 22 consecutive patients presenting an end-stage visual field defect with 24-2 SITA (0 dB in more than 75% and less than 100% of the visual field). Comparisons of the percentage of non-abolished points, topographic correlation, test duration and global indexes were performed between C-20 and 24-2 SITA test. RESULTS: FDT sensitivity was 100%. C-20 test showed 13.7% more points with sensitivity greater than 0 dB compared to 24-2 test (P = 0.002). Two and a half less minutes were required for C-20 test performing (P<0.001). The mean value of Mean Defect was 11.48 dB better in FDT (P = 0,000). The mean value of the Pattern Standard Deviation was 5.37 dB (SD: 1.92) and 6.35 dB (SD: 3.61) for 24-2 and C-20 test respectively (P = 0.258). The inferotemporal quadrant was the best conserved in both perimetric strategies (Kappa agreement test value = 0.911; P<0.001). CONCLUSIONS: FDT showed greater ability than 24-2 test for end-stage visual field defects evaluation, with the advantage of being less time-consuming. Very good topographic correlation between both strategies was found. Further studies evaluating FDT reproducibility in severe glaucomatous visual field damage are necessary.

[Frequency-doubling perimetry in retrochiasmatic disorders]. / Perimetría de duplicación de frecuencias en lesiones retroquiasmáticas.

OBJECTIVE: To determine the ability of frequency doubling technology (FDT) to evaluate retrochiasmatic lesions. METHODS: 21 patients with characteristic retrochiasmatic visual field defects in automated perimetry (Humphrey field analyzer, 24-2 SITA) underwent FDT using C-20 screening and threshold tests. Two independent observers described the visual field defects, the degree of congruence and macular sparing of the three explorations. RESULTS: The visual field defect found in the 24-2 test was inferred in 63.2% and 70% of the eyes from the C-20 screening and C-20 threshold test respectively. The retrochiasmatic lesions were congruent in 45% of the cases in automated perimetry, 5.6% in C-20 screening and 15% in C-20 threshold test. Macular sparing was present in 45% of cases with automated perimetry, 89% with C-20 screening and 82% with C-20 threshold test. CONCLUSIONS: The FDT allows us to suspect retrochiasmatic lesions in more than one-half of patients, but it tends to underestimate the defects. It is not useful for detecting macular sparing or the evaluation of visual field congruence. Both FDT strategies offer similar results, so the C-20 screening test could be more advisable because of its speed (mean: 70 seconds). However, in retrochiasmatic lesions the FDT accuracy is considerably lower than the 24-2 SITA strategy.

Perimetría de duplicación de frecuencias en defectos campimétricos terminales / Frequency doubling perimetry in terminal visual field defects

Objetivo: Evaluar la utilidad de la perimetría de duplicación de frecuencias (PDF) en defectos campimétricos glaucomatosos terminales. Material y métodos: Se realizó PDF (test C-20 umbral) a 22 pacientes consecutivos con campo visual terminal en la estrategia 24-2 SITA [sensibilidad igual a 0 decibelios (dB) en más del 75 por ciento y menos del 100 por ciento del campo visual]. Se comparó entre ambas estrategias el porcentaje de puntos no abolidos, tiempo de realización de la prueba, índices globales y concordancia topográfica. Resultados: La sensibilidad de la PDF fue del 100 por ciento. En el test C-20 había 13.7 por ciento más puntos con sensibilidad mayor de 0 dB que en el test 24-2 (P = 0,002). El test C-20 requirió como media 2 minutos y medio menos para su realización (P < 0,001). El valor medio del Defecto Medio (DM) fue 11,48 dB mejor en la PDF (P = 0,000). El valor medio de la Desviación estándar modelo fue 5,37 (D.E.: 1,92) y 6,35 (D.E.: 3,61) en el test 24-2 y C-20 respectivamente (P = 0,258). El cuadrante inferotemporal fue el más respetado en ambas estrategias perimétricas (test de acuerdo Kappa = 0,911; P < 0,001).Conclusiones: La PDF muestra mayor rentabilidad que el test 24-2 en la evaluación de defectos campimétricos terminales respecto al porcentaje de puntos respetados, con la ventaja de realizarse en un tiempo más corto. Existió una elevada concordancia topográfica entre ambos test. Para conocer su utilidad real es necesario evaluar la reproducibilidad del test C-20 en defectos glaucomatosos severos (AU)

Purpose: To evaluate the Frequency Doubling Technology (FDT) in end-stage glaucomatous visual field defects. Methods: FDT (C-20 threshold test) was performed in 22 consecutive patients presenting an end-stage visual field defect with 24-2 SITA (0 dB in more than 75% and less than 100% of the visual field). Comparisons of the percentage of non-abolished points, topographic correlation, test duration and global indexes were performed between C-20 and 24-2 SITA test. Results: FDT sensitivity was 100%. C-20 test showed 13.7% more points with sensitivity greater than 0 dB compared to 24-2 test (P = 0.002). Two and a half less minutes were required for C-20 test performing (P < 0.001). The mean value of Mean Defect was 11.48 dB better in FDT (P = 0,000). The mean value of the Pattern Standard Deviation was 5.37 dB (SD: 1.92) and 6.35 dB (SD: 3.61) for 24-2 and C-20 test respectively (P = 0.258). The inferotemporal quadrant was the best conserved in both perimetric strategies (Kappa agreement test value = 0.911; P < 0.001). Conclusions: FDT showed greater ability than 24-2 test for end-stage visual field defects evaluation, with the advantage of being less time-consuming. Very good topographic correlation between both strategies was found. Further studies evaluating FDT reproducibility in severe glaucomatous visual field damage are necessary (AU)

Perimetría de duplicación de frecuencias en lesiones retroquiasmáticas / Frequency doubling perimetry in retrochiasmatic disorders

Objetivo: Determinar la utilidad de la perimetría de doble frecuencia (PDF) en la evaluación de lesiones retroquiasmáticas. Método: 21 pacientes con patrón campimétrico característico de lesiones retroquiasmáticas en perimetría automática (analizador de campos Humphrey, estrategia 24-2 SITA) fueron evaluados con PDF, realizándose test C-20 screening y umbral. Dos observadores independientes describieron el patrón de defecto campimétrico, congruencia y grado de respeto macular en las tres exploraciones. Resultados: El patrón de lesión hallado con el test 24-2 es deducido en el 63,2 por ciento y en el 70 por ciento de los ojos con las estrategias C-20 screening y umbral respectivamente. Las lesiones retroquiasmáticas fueron congruentes en el 45 por ciento de los casos en perimetría convencional y en el 5,6 por ciento y 15 por ciento con C-20 screening y umbral respectivamente. El respeto macular estuvo presente en el 45 por ciento de los casos con perimetría blanco-blanco y en el 89 por ciento y el 82 por ciento con C-20 screening y umbral respectivamente. Conclusiones: La PDF permite sospechar lesiones retroquiasmáticas en algo más de la mitad de los pacientes, tendiendo a infraestimar los defectos. No es útil para detectar respeto macular ni grado de congruencia perimétrica. Ambas estrategias de PDF ofrecen resultados similares, por lo que el uso del test screening C-20 podría ser más recomendable, dada su rapidez (media: 70 segundos). Sin embargo, en lesiones retroquiasmáticas la precisión de la PDF es considerablemente inferior que la estrategia 24-2 SITA (AU)

Objective: To determine the ability of frequency doubling technology (FDT) to evaluate retrochiasmatic lesions. Methods: 21 patients with characteristic retrochiasmatic visual field defects in automated perimetry (Humphrey field analyzer, 24-2 SITA) underwent FDT using C-20 screening and threshold tests. Two independent observers described the visual field defects, the degree of congruence and macular sparing of the three explorations. Results: The visual field defect found in the 24-2 test was inferred in 63.2% and 70% of the eyes from the C-20 screening and C-20 threshold test respectively. The retrochiasmatic lesions were congruent in 45% of the cases in automated perimetry, 5.6% in C-20 screening and 15% in C-20 threshold test. Macular sparing was present in 45% of cases with automated perimetry, 89% with C-20 screening and 82% with C-20 threshold test. Conclusions: The FDT allows us to suspect retrochiasmatic lesions in more than one-half of patients, but it tends to underestimate the defects. It is not useful for detecting macular sparing or the evaluation of visual field congruence. Both FDT strategies offer similar results, so the C-20 screening test could be more advisable because of its speed (mean: 70 seconds). However, in retrochiasmatic lesions the FDT accuracy is considerably lower than the 24-2 SITA strategy (AU)