Angio-OCT en hamartoma astrocíticos retiniano solitario / OCT angiography in solitary astrocitic hamartoma

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Angio-OCT en macroaneurisma arterial retiniano / OCT angiography in retinal arterial macroaneurysm

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[Retinal detachment associated with morning glory syndrome]. / Desprendimiento de retina asociado a síndrome de morning glory.

CASE REPORT: A twenty three year old woman was diagnosed of a morning glory papillary anomaly, then with normal visual acuity (VA). Nine years later, the VA decreased to 0.4, secondary to a serous macular detachment, confirmed by optical coherence tomography (OCT). After treatment with C2F6 gas injection, positioning, and peripapillary laser, the VA improved to 0.7 and the foveolar area reattached. DISCUSSION: The morning glory Syndrome usually has an early diagnosis due to poor visual acuity. Thirty eight percent of the cases have retinal detachment. We show an unusual case of morning glory syndrome with a serous detachment, successfully treated with gas and laser.

Desprendimiento de retina asociado a síndrome de morning glory / Retinal detachment associated with morning glory syndrome

Caso Clínico: Mujer de 23 años con anomalía papilar de morning glory con agudeza visual (AV) de 1. Nueve años después presenta disminución de AV (0,4) por desprendimiento seroso macular confirmado por tomografía de coherencia óptica (OCT). Tratado con inyección de gas intraocular C2F6, posicionamiento y láser, conseguimos la desaparición del líquido subretiniano y una AV final de 0,7.DiscusiónEl síndrome de morning glory suele diagnosticarse precozmente debido a la mala AV. Un 38% de los casos presentan desprendimiento de retina. Mostramos un caso inusual de síndrome de morning glory con desprendimiento seroso tratado con éxito mediante gas y láser (AU)

Case report: A twenty three year old woman was diagnosed of a morning glory papillary anomaly, then with normal visual acuity (VA). Nine years later, the VA decreased to 0.4, secondary to a serous macular detachment, confirmed by optical coherence tomography (OCT). After treatment with C2F6 gas injection, positioning, and peripapillary laser, the VA improved to 0.7 and the foveolar area reattached.DiscussionThe morning glory Syndrome usually has an early diagnosis due to poor visual acuity. Thirty eight percent of the cases have retinal detachment. We show an unusual case of morning glory syndrome with a serous detachment, successfully treated with gas and laser (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)

Pérdida de agudeza visual en varón exfumador / Loss of visual acuity in male who is ex-smoker

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[Digital analysis of the optic disc with fundus camera: a study of variability]. / Análisis digital de la papila con cámara de fondo convencional: estudio de variabilidad.

PURPOSE: To determine the variability of the measurements of the optic discs applying digital analysis techniques and working with a digital camera available for clinical use. METHOD: We used a fundus camera with telecentric optic system (Zeiss FF 450 IR plus) and a 3 CCD high resolution colour video camera. We used a digital analysis system (Visupac 3.2.1) equipped with measurement systems. The images were studied by three observers with different degrees of experience who analysed the optic disc diameters (horizontal and vertical) and the total optic disc area. 180 measurements were made. RESULTS: The coefficient of total variability for the studied parameters presented a range from 1.04 to 2.08%. The variability attributable to the observer was found to be lower in the case of the observer with a higher imaging analysis experience, with a range from 0.42 to 1.17% for the lineal measurements (vertical and horizontal diameters) and from 0.60 to 2.11% for measurements of the area (total optic disc area). CONCLUSIONS: The digital analysis of optic disc images obtained with conventional fundus cameras, equipped with telecentric optic systems, allows reproducible measures and can be easily employed in clinical practice.

[Indocyanine green angiography in chorioretinal inflammatory diseases]. / Valoración de enfermedades inflamatorias coriorretinianas con angiografía verde indocianina.

PURPOSE: To determine the role of indocyanine green angiography (ICG) in handling chorioretinal inflammatory disorders. METHOD: We present several posterior uveitis whose diagnosis and therapeutic approach was facilitated with ICG. RESULTS: ICG is useful in the differential diagnosis of <>. In serpiginous choroiditis, the edges and the progression of the inflammatory areas are clearly delineated. In infectious uveitis such as toxoplasmosis, ICG determines the presence or absence of active lesions. There are granulomatous diseases such as sarcoidosis where some areas of choroidal inflammation that cannot be detected with other methods are shown by ICG. Moreover, ICG can detect areas of subretinal neovascularization in some choroidal pathologies such as polypoidal choroidal vasculopathy. CONCLUSIONS: ICG appears to be a useful and complementary tool in the clinical interpretation of posterior uveitis.

Valoración de enfermedades inflamatorias coriorretinianas con angiografía verde indocianina / Indocyanine green angiography in chorioretinal inflammatory diseases

Objetivo: Determinar el papel de la angiografía con verde indocianina (ICG) en el manejo de inflamaciones coriorretinianas. Métodos: Se presentan uveítis posteriores cuyo diagnóstico y actitud terapéutica se facilitó con la ICG. Resultados: La ICG contribuye al diagnóstico diferencial de las "enfermedades de puntos blancos". En coroiditis serpiginosa ayuda a delimitar la extensión y progresión de los bordes activos de la enfermedad. En uveítis infecciosas como la toxoplasmosis, la ICG determina la presencia o ausencia de lesiones activas. Hay enfermedades granulomatosas, como la sarcoidosis, donde se detectan zonas de inflamación coroideas no objetivables con otros métodos. La ICG permite además detectar zonas de neovascularización subretiniana en algunas coroidopatías como en la vasculopatía coroidea polipoidal. Conclusiones: La ICG resulta una herramienta útil y complementaria en la interpretación clínica de las uveítis posteriores (AU)