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Ciclodestrucción y ciclofotocoagulacion ¿dónde estamos ahora? 环形切除术和环形光凝术现在进展如何?
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.06.005
Cyclodestruction is a technique reserved for glaucomas not controlled with medical and surgical treatment and poor visual potential. During the last century, new cyclodestructive techniques were developed, including cyclophotocoagulation, and the use of continuous-wave diode laser transescleral cyclophotocoagulation (CW-TS-CPC) has become widespread. In recent decades, micropulse diode laser transescleral cyclophotocoagulation (MP-TS-CPC) was introduced. We review the cyclodestruction techniques since their origins and these two techniques of cyclophotocoagulation, which are currently the most widely used: how they are performed, their mechanisms of action and their effectiveness and efficacy. We also review the comparison between them and with other techniques.
青光眼环形光凝术是一种专门针对药物和手术治疗无法控制且视觉潜能差的青光眼的技术。在上个世纪,包括环形光凝术在内的新的环形破坏技术得到了发展,连续波二极管激光经巩膜环形光凝术(CW-TS-CPC)已得到广泛应用。近几十年来,微脉冲二极管激光经巩膜环形光凝术(MP-TS-CPC)被引入。我们回顾了自其起源以来的环形光凝技术,以及目前应用最广泛的这两种环形光凝技术:它们是如何进行的、它们的作用机制以及它们的有效性和疗效。我们还回顾了这两种技术之间以及与其他技术之间的比较。
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引用次数: 0
Metotrexato intralesional y nuevos abordajes para la neoadyuvancia en el carcinoma escamoso cutaneo periocular 眼周皮肤鳞状细胞癌新辅助治疗的点内甲氨蝶呤和新方法
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.05.006
This study arises from the need to understand the different therapies for cutaneous squamous cell carcinoma (SCC), especially in challenging clinical situations where conventional therapeutic options may not be optimal.
The purpose of the study is to assess the efficacy and safety of intralesional methotrexate (MTX) as neoadjuvant therapy in the treatment of periocular SCC.
The outcome of a patient after two separate intralesional MTX infiltrations 2 weeks apart is described. Therapeutic response was evaluated, achieving a significant reduction in tumor size and subsequently performing surgical excision of the residual lesion. The procedure was well tolerated, with no local or distant recurrences in the follow up.
Intralesional MTX may be an effective and safe option in the neoadjuvant treatment of periocular SCC. Furthermore, we highlight the growing importance of immunotherapy in the approach to SCC and the need to familiarize specialists with these new treatments.
这项研究的目的是评估鞘内注射甲氨蝶呤(MTX)作为新辅助疗法治疗眼周鳞状细胞癌(SCC)的疗效和安全性。研究描述了一名患者在两次间隔两周的鞘内注射MTX后的疗效。对患者的治疗反应进行了评估,结果显示肿瘤明显缩小,随后对残余病灶进行了手术切除。MTX在眼周SCC的新辅助治疗中可能是一种有效而安全的选择。此外,我们还强调了免疫疗法在SCC治疗中日益增长的重要性,以及让专科医生熟悉这些新疗法的必要性。
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引用次数: 0
Dehiscencia de suturas en pacientes con enfermedad del tejido conectivo: síndromes de Marfan y Weill-Marchesani 结缔组织病患者缝线开裂:马凡综合征和魏尔-马切萨尼综合征。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.06.010
Marfan and Weill-Marchesani syndromes have a mutation of the fibrillin gene (FBN1), producing alteration of connective tissue, within ophthalmology, it is important to take into consideration this type of diseases in cogenetic alterations in this system will produce modifications at the level of the ocular structures generating problems of various types, Most of the literature refers to ectopia lentis and the complications derived from it, as secondary glaucoma.
We present two patients, one with Marfan syndrome and the other with Weill-Marchesani syndrome, who developed lens dislocation, typical of their pathologies, which led them to undergo different surgeries. Both developed suture dehiscence after these surgeries, as a complication derived from their connective tissue involvement. We thus highlight the need for vigilance and extreme caution in the postoperative period of patients affected by this type of syndromes.
马凡综合征和魏尔-马切萨尼综合征的纤维蛋白基因(FBN1)发生突变,导致结缔组织发生改变,在眼科领域,必须考虑到这类疾病,因为该系统的遗传改变会导致眼部结构发生改变,从而引发各种问题。我们介绍了两名患者,一名患有马凡氏综合征,另一名患有魏尔-马切萨尼综合征,他们都出现了晶状体脱位,这是他们的典型病症,导致他们接受了不同的手术。两人在手术后都出现了缝线开裂,这是结缔组织受累引起的并发症。因此,我们强调在此类综合征患者的术后阶段需要保持警惕和格外小心。
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引用次数: 0
Foseta macular miópica con dehiscencia escleral en paciente con miopía magna 一名近视患者的近视黄斑窝伴有巩膜开裂。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.05.013
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引用次数: 0
Resultados a largo plazo del tratamiento de los pacientes con degeneración macular asociada a la edad exudativa durante la pandemia por COVID-19 在 COVID-19 大流行期间治疗渗出性老年性黄斑变性患者的长期疗效
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.06.001

Purpose

To quantify the long-term impact (24 months) on the visual results and activity of neovascular lesions of COVID-19 confinement in patients with nAMD in our population.

Methods

A retrospective observational study of patients with nAMD who attended consultation or were treated during the 3 months before confinement was carried out.

Results

144 patients (168 eyes) with nAMD were included, 51 of them (35.42%) came during confinement, and at 24 months the final cohort was 118 patients (133 eyes).
The previous VA of 57.99 ± 23.68 letters decreased, clinically relevant and statistically significant, by an average of 6.87 (±16.84) and 7.89 (±19.58) at 12- and 24-months follow-up. This change differs significantly from the two-year vision change observed in the national database of pretreated patients.
The median number of injections and consultations is lower in our group at 12 months, compared to the pre-pandemic national database, and tends to equalize at 24 months.
We did not find differences in vision when we compared patients who attended consultations during confinement or in treatment intervals greater than 8 weeks (Tq8w).

Conclusions

The VA of patients with nAMD decreased significantly after confinement, probably due to the lower number of antiangiogenic injections and consultations during the first year, and did not recover during the second year despite the increase in the number of injections and visits close to those reported before confinement.
目的 对我国 nAMD 患者进行 COVID-19 封闭治疗对视觉效果和新生血管病变活动性的长期影响(24 个月)进行量化研究。结果 纳入了 144 名 nAMD 患者(168 只眼),其中 51 名(35.42%)是在禁闭期间就诊的,24 个月时最终纳入的患者总数为 118 名(133 只眼)。在 12 个月和 24 个月的随访中,之前的视力值为 57.99 ± 23.68 个字母,平均下降了 6.87 个字母(±16.84)和 7.89 个字母(±19.58),具有临床相关性和统计学意义。与大流行前的国家数据库相比,本组患者在 12 个月时的注射和就诊次数中位数较低,在 24 个月时趋于相等。我们比较了在禁闭期间或治疗间隔超过 8 周(Tq8w)时就诊的患者,没有发现视力方面的差异。结论nAMD 患者的视力在禁闭后显著下降,这可能是由于第一年的抗血管生成注射和就诊次数较少,尽管第二年的注射和就诊次数增加,接近禁闭前报告的次数,但视力并未恢复。
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引用次数: 0
Percepción de los riesgos laborales de las oftalmólogas durante la gestación 眼科医生对孕期职业危害的看法
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.05.012

Background and objective

Woman ophthalmologists of childbearing age are exposed to different types of occupational risks which can be harmful to pregnancy and to the development of the fetus. The objective of this paper is to analyze the perception of these risks during pregnancy.

Material and methods

We designed a survey which was answered by 42 ophthalmologists who had been working during pregnancy. We report the perception of global and specific risk according to the type of agent.

Results

The 38.1% of the ophthalmologists perceive that the overall risk of working during pregnancy is high, and 35.7% consider it moderate. Regarding specific risk, the most relevant agents are the ergonomic and psychosocial ones. Physical agents are considered the least important.

Conclusions

Although most of the surveyed ophthalmologists perceived the occupational risk as high or moderate, only 19% of them took time off work due to this reason. The most important agents were ergonomic and psychosocial.
背景和目的育龄期的女眼科医生面临着不同类型的职业风险,这些风险可能对妊娠和胎儿的发育有害。材料和方法 我们设计了一项调查,由 42 名在孕期工作的眼科医生回答。结果38.1%的眼科医生认为孕期工作的总体风险较高,35.7%的眼科医生认为风险适中。在具体风险方面,最相关的因素是人体工程学因素和社会心理因素。结论虽然大多数接受调查的眼科医生认为职业风险很高或中等,但只有 19% 的人因此而请假。最重要的因素是人体工程学和社会心理因素。
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引用次数: 0
Análisis a tres años de resultados, seguridad y progresión en pacientes con glaucoma de ángulo abierto o hipertensión ocular, intervenidos de microcirugía trabecular 对接受小梁显微手术的开角型青光眼或眼压过高患者的疗效、安全性和病情进展进行为期三年的分析。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.06.002

Aim

To evaluate the efficacy, safety, structural and functional progression following the insertion of iStent inject ® implants in patients with open-angle glaucoma or ocular hypertension at a tertiary-level hospital.

Materials and methods

A retrospective study included 98 eyes (57 males and 41 females) with open-angle glaucoma or ocular hypertension, which underwent iStent inject W® implantation (Glaukos, Corporation, CA) between December 2018 and December 2022. Differences in intraocular pressure (IOP), the number of hypotensive eye drops used, and structural and functional tests were assessed between preoperative values and subsequent reviews during a follow-up period of one (n = 98), two (n = 55), and three years (n = 15) after surgery.

Results

Among the 98 eyes studied, 85% were diagnosed with open-angle glaucoma (50% mild, 32% moderate, and 18% severe) and 15% with ocular hypertension. There was a statistically significant reduction in IOP compared to preoperative values for all visits except the 1-month (p = 0.36) and 3-year (p = 0.39) visits. Visual acuity increased from 0.39 ± 0.25 to 0.72 ± 0.24 (p< 0.01), considering that a significant portion of the interventions included cataract surgery. Before surgery, 66% of the sample used 2 or more hypotensive medications. Post-surgery, the number of hypotensive medications decreased (from 1.88 ± 0.84 to 0.21 ± 0.59 at 3 years) (p< 0.01), with an 88.9% reduction in the number of medications over three years. After surgery, 75% of cases did not require any medication.
Regarding structural and functional tests, thickness of retinal nerve fiber layers (RNFL (p = 0.35), excavation / papilla ratio E/P (p = 0.31), visual function index
(VFI (p = 0.06), and deviation mean (MD (p = 0.06) showed no statistically significant differences post-intervention. However, standard deviation of the pattern (DSM) did exhibit differences, decreasing from 5.46 ± 4.03 dB to 5.34 ± 3.48 dB (p = 0.02).

Conclusion

The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.
材料和方法一项回顾性研究纳入了2018年12月至2022年12月期间接受iStent inject W® 植入术(Glaukos公司,加利福尼亚州)的98例开角型青光眼或眼压过高患者(57例男性,41例女性)。在术后一年(98 例)、两年(55 例)和三年(15 例)的随访期间,对术前值与后续复查值之间的眼压(IOP)差异、降压眼药水使用次数以及结构和功能测试进行了评估。与术前值相比,除1个月(p = 0.36)和3年(p = 0.39)检查外,所有检查的眼压均有统计学意义上的显著降低。考虑到相当一部分干预措施包括白内障手术,视力从 0.39 ± 0.25 提高到 0.72 ± 0.24(p< 0.01)。手术前,66% 的样本使用了 2 种或 2 种以上降压药物。手术后,降压药物的数量有所减少(从 1.88 ± 0.84 降至 3 年后的 0.21 ± 0.59)(p< 0.01),三年内药物数量减少了 88.9%。在结构和功能测试方面,视网膜神经纤维层厚度(RNFL)(p = 0.35)、挖空/乳头比率 E/P(p = 0.31)、视功能指数(VFI)(p = 0.06)和平均偏差(MD)(p = 0.06)在干预后无显著统计学差异。结论本研究结果表明,iStent inject W® 技术是控制眼压和治疗青光眼的有效而安全的选择。
{"title":"Análisis a tres años de resultados, seguridad y progresión en pacientes con glaucoma de ángulo abierto o hipertensión ocular, intervenidos de microcirugía trabecular","authors":"","doi":"10.1016/j.oftal.2024.06.002","DOIUrl":"10.1016/j.oftal.2024.06.002","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the efficacy, safety, structural and functional progression following the insertion of iStent inject ® implants in patients with open-angle glaucoma or ocular hypertension at a tertiary-level hospital.</div></div><div><h3>Materials and methods</h3><div>A retrospective study included 98 eyes (57 males and 41 females) with open-angle glaucoma or ocular hypertension, which underwent iStent inject W® implantation (Glaukos, Corporation, CA) between December 2018 and December 2022. Differences in intraocular pressure (IOP), the number of hypotensive eye drops used, and structural and functional tests were assessed between preoperative values and subsequent reviews during a follow-up period of one (n<!--> <!-->=<!--> <!-->98), two (n<!--> <!-->=<!--> <!-->55), and three years (n<!--> <!-->=<!--> <!-->15) after surgery.</div></div><div><h3>Results</h3><div>Among the 98 eyes studied, 85% were diagnosed with open-angle glaucoma (50% mild, 32% moderate, and 18% severe) and 15% with ocular hypertension. There was a statistically significant reduction in IOP compared to preoperative values for all visits except the 1-month (p<!--> <!-->=<!--> <!-->0.36) and 3-year (p<!--> <!-->=<!--> <!-->0.39) visits. Visual acuity increased from 0.39<!--> <!-->±<!--> <!-->0.25 to 0.72<!--> <!-->±<!--> <!-->0.24 (p&lt;<!--> <!-->0.01), considering that a significant portion of the interventions included cataract surgery. Before surgery, 66% of the sample used 2 or more hypotensive medications. Post-surgery, the number of hypotensive medications decreased (from 1.88<!--> <!-->±<!--> <!-->0.84 to 0.21<!--> <!-->±<!--> <!-->0.59 at 3 years) (p&lt;<!--> <!-->0.01), with an 88.9% reduction in the number of medications over three years. After surgery, 75% of cases did not require any medication.</div><div>Regarding structural and functional tests, thickness of retinal nerve fiber layers (RNFL (p<!--> <!-->=<!--> <!-->0.35), excavation / papilla ratio E/P (p<!--> <!-->=<!--> <!-->0.31), visual function index</div><div>(VFI (p<!--> <!-->=<!--> <!-->0.06), and deviation mean (MD (p<!--> <!-->=<!--> <!-->0.06) showed no statistically significant differences post-intervention. However, standard deviation of the pattern (DSM) did exhibit differences, decreasing from 5.46<!--> <!-->±<!--> <!-->4.03<!--> <!-->dB to 5.34<!--> <!-->±<!--> <!-->3.48<!--> <!-->dB (p<!--> <!-->=<!--> <!-->0.02).</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that the iStent inject W® technique constitutes an effective and safe option for tension control and glaucoma treatment.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Siderosis retiniana postraumática, un reporte de caso 创伤后视网膜巩膜病变,病例报告
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.05.011
A thirty-year-old patient attended a few hours after an ocular trauma while hammering, receiving trauma with a metal splinter at the left eye. Due to an unfavorable clinical picture, surgical management was decided, which was initially rejected by the patient. He returned six months later with a profound decrease in left eye visual acuity, reaching counting finger at one meter despite optical correction. The anterior segment shows a lower scarring leukoma, associated with Tyndall (++), retrokeratic pigment, lower posterior synechiae and a total cataract. Cataract surgery with intraocular lens implantation and a posterior vitrectomy with intraocular foreign body extraction were indicated. At postoperative control it was shown that post-traumatic ocular siderosis did not significantly affect his central vision, which remains until now.
一名 30 岁的患者在锤击时眼部受创几小时后就诊,左眼被金属碎片刺伤。由于临床表现不佳,医生决定进行手术治疗,但患者起初拒绝接受。6 个月后,他再次就诊,左眼视力严重下降,尽管进行了光学矫正,但仍只能在 1 米处数手指。前段显示下部瘢痕性白血病,伴有 Tyndall(+++)、角膜后色素沉着、下后裂和全白内障。白内障手术需要植入眼内晶状体,后玻璃体切除术需要取出眼内异物。术后检查显示,外伤后眼球巩膜病变并没有对他的中心视力造成明显影响,这种情况一直持续到现在。
{"title":"Siderosis retiniana postraumática, un reporte de caso","authors":"","doi":"10.1016/j.oftal.2024.05.011","DOIUrl":"10.1016/j.oftal.2024.05.011","url":null,"abstract":"<div><div>A thirty-year-old patient attended a few hours after an ocular trauma while hammering, receiving trauma with a metal splinter at the left eye. Due to an unfavorable clinical picture, surgical management was decided, which was initially rejected by the patient. He returned six months later with a profound decrease in left eye visual acuity, reaching counting finger at one meter despite optical correction. The anterior segment shows a lower scarring leukoma, associated with Tyndall (++), retrokeratic pigment, lower posterior synechiae and a total cataract. Cataract surgery with intraocular lens implantation and a posterior vitrectomy with intraocular foreign body extraction were indicated. At postoperative control it was shown that post-traumatic ocular siderosis did not significantly affect his central vision, which remains until now.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementación de un checklist en inyecciones intravítreas 实施玻璃体内注射核对表
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.08.012
{"title":"Implementación de un checklist en inyecciones intravítreas","authors":"","doi":"10.1016/j.oftal.2024.08.012","DOIUrl":"10.1016/j.oftal.2024.08.012","url":null,"abstract":"","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Melanoma de cuerpo ciliar: imagen multimodal 睫状体黑色素瘤:多模态成像
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.06.003
{"title":"Melanoma de cuerpo ciliar: imagen multimodal","authors":"","doi":"10.1016/j.oftal.2024.06.003","DOIUrl":"10.1016/j.oftal.2024.06.003","url":null,"abstract":"","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Archivos De La Sociedad Espanola De Oftalmologia
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