[How far reaches earliness of optical coherence tomography in cognitive impairment]. / Hasta donde llega la precocidad de la tomografia de coherencia optica en el deterioro cognitivo?

INTRODUCTION: Alzheimer's disease (AD) is the leading cause of dementia in the world today. Increasingly greater efforts are being made to be able to detect cognitive impairment in earlier stages, and diagnostic entities such as mild cognitive impairment (MCI) and subjective memory complaints (SMC) are appearing. The number of biomarkers studied with the aim of reaching this goal continues to rise, and include optical coherence tomography. SUBJECTS AND METHODS: The study conducted employed optical coherence tomography to measure the macular thickness and the retinal nerve fibre layer in patients diagnosed with AD (n = 36), in patients with MCI (n = 33), in individuals with SMC (n = 24) and in control subjects (n = 45). RESULTS: Statistically significant differences have been found in terms of the macular thickness among all the groups studied (SMC: 261.8 ± 25.88 µm; MCI: 259.19 ± 22.582 µm; mild AD: 258.53 ± 14.804 µm; moderate AD: 249.32 ± 18.467 µm) and control subjects (271.96 ± 15.57 µm). The same occurs as regards the retinal nerve fibre layer and the difference is statistically significant compared with the control group (94.51 ± 9.203 µm) of all the groups (SMC: 90.44 ± 9.059 µm; MCI: 89.4 ± 10.421 µm; mild AD: 87.12 ± 10.279 µm; moderate AD: 82.25 ± 10.636 µm). CONCLUSION: Optical coherence tomography could be a future biomarker and support tool to facilitate the early diagnosis of cognitive impairment and AD.

TITLE: Hasta donde llega la precocidad de la tomografia de coherencia optica en el deterioro cognitivo?Introduccion. La enfermedad de Alzheimer (EA) es la primera causa de demencia mundial. Cada vez son mas los esfuerzos para lograr una deteccion temprana del deterioro cognitivo y surgen en el panorama cientifico entidades diagnosticas como el deterioro cognitivo leve (DCL) y las quejas subjetivas de memoria (QSM). Debido a ello, aparecen numerosos biomarcadores estudiados para conseguir dicho objetivo, entre ellos la tomografia de coherencia optica. Sujetos y metodos. Se ha realizado un estudio que utiliza la tomografia de coherencia optica para medir el grosor macular y la capa de fibras nerviosas de la retina en pacientes diagnosticados de EA (n = 36), pacientes con DCL (n = 33), en individuos con QSM (n = 24) y en sujetos control (n = 45). Resultados. Se han encontrado diferencias estadisticamente significativas en cuanto al grosor macular entre todos los grupos estudiados (QSM: 261,8 ± 25,88 µm; DCL: 259,19 ± 22,582 µm; EA leve: 258,53 ± 14,804 µm; EA moderada: 249,32 ± 18,467 µm) y sujetos control (271,96 ± 15,57 µm). Respecto a la capa de fibras nerviosas de la retina, ocurre de igual manera, y la diferencia es estadisticamente significativa frente al grupo control (94,51 ± 9,203 µm) de todos los grupos (QSM: 90,44 ± 9,059 µm; DCL: 89,4 ± 10,421 µm; EA leve: 87,12 ± 10,279 µm; EA moderada: 82,25 ± 10,636 µm). Conclusion. La tomografia de coherencia optica podria situarse como un futuro biomarcador y una herramienta de apoyo para facilitar el diagnostico precoz del deterioro cognitivo y de la EA.

[Trans-scleral sutureless vitrectomy with a 25-G system for rhegmatogenous retinal detachment treatment]. / Cirugía del desprendimiento de retina regmatógeno mediante vitrectomía transescleral sin sutura con sistema 25-G.

PURPOSE: The evaluation of the trans-scleral sutureless vitrectomy (TSV) efficiency using a 25G system as an alternative in rhegmatogenous retinal detachment (RRD) treatment. METHODS: Patients treated for RRD with TSV have been reviewed taking into account their age, phakic or pseudophakic state, RRD localization and extension, surgical technique and post-operative resolution. RESULTS: Twenty two eyes of 22 patients have been treated for RRD with TSV. The average age was 54.3 years. 50% of the eyes were phakic. Eight of the detachments were "macula-off" at the time of diagnosis. SF6 was used in 5 cases and air in the remainder. Retinopexia of the breaks was done with trans-scleral cryocoagulation in 13 cases, with laser endophotocoagulation in 6 cases, and with both methods in 3 cases. The average follow-up time was 6.8 months, and the main complications were cataracts in 7 of 11 phakic eyes (63.6%) and a new retinal detachment in 4 eyes (18.2%). The intraocular pressures were similar to those before surgery and in 18 cases (81.8%) the visual acuity was better. CONCLUSION: TSV is effective in the treatment of RRD but with some limitations like the need for a learning period and a high incidence of cataracts.

IgG, albumin and total IgG index in the aqueous humour of eyes with pseudoexfoliation syndrome.

IgG and albumin in the aqueous humour and serum were studied using kinetic nephelometry, carried out on 34 eyes with pseudoexfoliation and 31 normal eyes (control group). The results show a rupture in the hemato-aqueous barrier for IgG and albumin in the group of eyes with pseudoexfoliation and glaucoma, and only for albumin in the group of eyes with pseudoexfoliation without glaucoma. The calculation of the total IgG index rules out the existence of a primary or associated immunological mechanism in eyes with this syndrome.

Comparative study of three non-contact tonometers and the Goldmann tonometer.

The main objective of this study was to find out how well three non-contact tonometers (Pulsair, Xpert-NCT and CT-20) compare with the Goldmann tonometer (GT). Sensitivity, specificity, positive and negative predictive values were all evaluated for an intraocular pressure (IOP) > or = 21 mm Hg. We also calculated the mean IOP, the correlation and the dispersion of the results. The difficulty in using the instruments, the patient's attitude and subjective comfort of IOP measuring were also evaluated. We describe the advantages and shortcomings of non-contact tonometers as screening tools to detect elevated IOP in the general population.