Archivos De La Sociedad Espanola De Oftalmologia最新文献

英文中文

Maculopatía fótica: características en la angiografía OCT de ocho ojos 光性大疱病：八眼近距离血管造影的特征

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502432

Amine Zahaf , Atf Ben Abderrazek , Houda Lajmi , Wassim Hmaied , Besma Ben Achour

Introduction and objectives

Photic maculopathy is a retinal condition caused by exposure to intense light sources, resulting in varying degrees of visual impairment. Optical coherence tomography angiography (OCT-A) offers high-resolution, non-invasive imaging of the retinal microvasculature, facilitating detailed assessment of vascular alterations linked to this pathology. This study aims to characterize the OCT-A features of photic maculopathy and to emphasize the utility of OCT-A in evaluating retinal damage and microvascular changes.

Materials and methods

This retrospective descriptive study included patients diagnosed with PM between September 2021 and September 2023. Inclusion required a history of intense or prolonged light exposure temporally related to visual symptoms, characteristic fundus and clinical findings, and multimodal imaging confirming focal outer retinal damage at the fovea. Patients with alternative diagnoses, poor-quality imaging, or incomplete records were excluded. Clinical evaluation included structural optical coherence tomography (OCT), OCT-A, fluorescein angiography, and visual function tests. Demographic and ophthalmic data were collected, and a literature review was conducted to support interpretation.

Results

Eight eyes from six patients were analyzed: two bilateral cases of solar maculopathy, one unilateral welder's maculopathy, and three unilateral laser-induced maculopathies. All patients presented with reduced visual acuity. Fundus examination revealed a yellowish foveal lesion in seven eyes and retinal pigment epithelium changes in one. OCT showed consistent disruption of the outer retinal layers. OCT-A demonstrated an irregular foveal avascular zone in six eyes and reduced vessel density in the superficial capillary plexus in four eyes.

Conclusions

OCT-A plays a critical role in detecting structural retinal damage and associated microvascular alterations, offering key insights into the underlying pathophysiology. This study emphasizes the added value of OCT-A in assessing retinal integrity and vascular changes, which may enhance diagnostic accuracy and guide the clinical management of photic maculopathy.

介绍和目的光性黄斑病变是由于暴露在强光源下引起的一种视网膜疾病，导致不同程度的视力损害。光学相干断层扫描血管造影（OCT-A）提供视网膜微血管的高分辨率、非侵入性成像，有助于详细评估与该病理相关的血管改变。本研究旨在描述光性黄斑病变的OCT-A特征，并强调OCT-A在评估视网膜损伤和微血管变化中的应用。材料和方法本回顾性描述性研究纳入了2021年9月至2023年9月诊断为PM的患者。纳入要求有与视觉症状、特征性眼底和临床表现相关的强烈或长时间光照史，以及确认视网膜中央凹局灶性外视网膜损伤的多模态成像。排除其他诊断、影像质量差或记录不完整的患者。临床评价包括结构光学相干断层扫描（OCT）、OCT- a、荧光素血管造影和视觉功能检查。收集了人口统计学和眼科数据，并进行了文献回顾以支持解释。结果对6例8眼患者进行分析，其中2例为双侧太阳斑病变，1例为单侧焊工斑病变，3例为单侧激光黄斑病变。所有患者均表现为视力下降。眼底检查显示7只眼中央凹病变呈淡黄色，1只眼视网膜色素上皮改变。OCT显示视网膜外层持续破坏。OCT-A显示6眼不规则中央凹无血管带，4眼毛细血管浅丛血管密度降低。结论soct - a在检测视网膜结构性损伤和相关微血管改变中起着关键作用，为潜在的病理生理提供了重要的见解。本研究强调OCT-A在评估视网膜完整性和血管变化方面的附加价值，可提高诊断准确性，指导光性黄斑病变的临床治疗。

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引用次数: 0

Trastornos respiratorios del sueño en pacientes con ceguera bilateral total: estudio prospectivo a 10 años 双侧完全失明患者的呼吸睡眠障碍：10年前瞻性研究

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502453

V.M. Asensio-Sánchez , A. Prieto , V. Roig

Background and Objective

Obstructive sleep apnea (OSA) is common in the general population and is associated with major cardiovascular consequences and impaired quality of life. The absence of light perception in patients with total bilateral blindness (TBB) promotes circadian desynchronization, which may increase the risk of OSA. The aim of this study was to assess the prevalence of OSA and other sleep-disordered breathing conditions in patients with TBB.

Patients and Methods

This was a prospective observational study conducted over a 10-year period, including 19 patients with TBB of various etiologies. Clinical interviews, validated questionnaires (STOP-BANG, ESS), and in-laboratory overnight polysomnography were performed.

Results

Moderate to severe OSA was present in 63.2% (12/19) of patients, with a predominance among males. Significant alterations in sleep architecture were observed, along with a high frequency of circadian desynchronization (non-24-hour sleep–wake disorder).

Conclusions

Patients with TBB show a significantly higher prevalence of OSA compared with the general population, probably related to circadian desynchronization secondary to the absence of light perception. These findings support the need for systematic screening for sleep-disordered breathing in this population, given its impact on quality of life and cardiovascular risk.

背景与目的阻塞性睡眠呼吸暂停（OSA）在普通人群中很常见，与主要心血管后果和生活质量受损有关。全双侧失明（TBB）患者的光感知缺失促进昼夜节律不同步，这可能增加OSA的风险。本研究的目的是评估阻塞性睡眠呼吸暂停和其他睡眠呼吸障碍在TBB患者中的患病率。患者和方法这是一项为期10年的前瞻性观察研究，包括19例不同病因的TBB患者。临床访谈，验证问卷（STOP-BANG， ESS）和实验室夜间多导睡眠图进行。结果63.2%（12/19）的患者存在中度至重度OSA，以男性为主。观察到睡眠结构的显著改变，以及高频率的昼夜节律不同步（非24小时睡眠-觉醒障碍）。结论TBB患者的OSA患病率明显高于一般人群，可能与继发于光感知缺失的昼夜节律不同步有关。鉴于睡眠呼吸障碍对生活质量和心血管风险的影响，这些发现支持了对这一人群进行系统筛查的必要性。

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引用次数: 0

Siembra subconjuntival de melanoma del cuerpo ciliar después de una trabeculectomía: una complicación quirúrgica 小脑切除术后纤毛下结膜黑色素瘤：手术并发症

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502434

Y.S. Atlıhan

A rare case of ciliary body melanoma (CBM) with subconjunctival extension following prior trabeculectomy is presented. The 66-year-old female patient experienced recurrent ocular discomfort and subconjunctival pigmentation in the left eye. Clinical evaluation identified a pigmented subconjunctival mass, secondary glaucoma, and evidence of previous filtration surgery. Imaging and histopathology confirmed CBM with extraocular extension, and the patient subsequently underwent enucleation; the postoperative recovery was uneventful.

This case underscores the importance of considering intraocular tumors such as CBM in patients presenting with unilateral secondary glaucoma, especially prior to filtration surgery. Surgical manipulation in undiagnosed CBM may facilitate tumor dissemination beyond the eye, emphasizing the necessity of comprehensive preoperative evaluation.

本文报告一例罕见的睫状体黑色素瘤（CBM）在小梁切除术后出现结膜下延伸。66岁女性患者反复眼部不适，左眼结膜下色素沉着。临床评估发现结膜下有色素性肿块，继发性青光眼和既往滤过手术的证据。影像学和组织病理学证实CBM伴眼外扩张，患者随后行去核术；术后恢复顺利。本病例强调了单侧继发性青光眼患者考虑眼内肿瘤如CBM的重要性，特别是在滤过手术之前。未确诊CBM的手术操作可能促进肿瘤向眼外扩散，强调术前综合评估的必要性。

引用次数: 0

Stellate Multiform Amelanotic Choroidopaty y la importancia de su diagnóstico para prevenir el sobretratamiento 星形多形性淀粉样结肠炎及其诊断对预防过度治疗的重要性

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502451

E. Gracia-Rovira , V. Miralles Pechuán , D. Hernandez Pérez , E. Cervera Taulet , A.-M. Duch Samper , J. Montero Hernández

SMACH (Stellate Multiform Amelanotic Choroidopathy) is a rare entity that should be considered for differential diagnosis of choroidal lesions with subretinal fluid, particularly in young patients. We present the case of a 15-year-old male with a yellow-orange choroidal lesion in the right eye, initially misinterpreted as an infection process due to the presence of a cutaneous erythema and environmental exposure. Multimodal imaging — including OCT, en-face OCT, and ICG — was essential in identifying the hallmark features of SMACH: dendriform projections, choroidal hyperreflectivity in absence of pachyvessels or deep vascular alteration, and a stellate hypofluorescent pattern. The self-limited nature of the subretinal fluid and the absence of inflammatory signs supported the diagnosis. Recognizing SMACH avoided unnecessary treatments such as anti-VEGF therapy or corticosteroids. This is Spain's first case, it underscores the importance of early diagnosis through multimodal imaging to prevent overtreatment and to improve both visual and emotional outcomes for the patient.

SMACH（星状多形态无色变性脉络膜病）是一种罕见的疾病，在视网膜下积液脉络膜病变的鉴别诊断中应予以考虑，特别是在年轻患者中。我们报告一例15岁男性右眼黄橙色脉络膜病变，由于皮肤红斑和环境暴露，最初被误解为感染过程。多模式成像（包括OCT、正面OCT和ICG）对于识别SMACH的标志性特征至关重要：树突状突出、脉络膜高反射率（无厚血管或深部血管改变）和星状低荧光模式。视网膜下液的自限性和无炎症体征支持诊断。识别SMACH避免了不必要的治疗，如抗vegf治疗或皮质类固醇。这是西班牙的第一例病例，它强调了通过多模态成像进行早期诊断的重要性，以防止过度治疗，并改善患者的视觉和情感结果。

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引用次数: 0

Membrana neovascular asociada a un nevus coroideo: composición de imagen multimodal 与冠状动脉痣相关的新血管膜：多模态成像

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502435

B. Alamar Pérez, A. Díaz Barrón, M. Barba Beltrán

引用次数: 0

Tratamiento simultáneo de la afaquia postraumática, aniridia y astigmatismo 同时治疗创伤后失语症、心律失常和散光

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502444

I. Jürgens, A. Dyrda

To present a case of a 20-year-old female who underwent a novel surgical technique for post-traumatic aphakia, aniridia, and astigmatism. Prior to surgery, the artificial iris (AI) (CustomFlex® Artificial Iris, HumanOptics) was sutured to a toric intraocular lens (IOL) (Carlevale™, Soleko), folded, and then implanted in the sulcus through a small corneal incision. The procedure was complication-free and resulted in favorable functional and cosmetic outcomes. The Carlevale™ IOL provides stable support for the AI, effectively addressing post-traumatic aphakia, aniridia, and astigmatism. This technique ensures excellent centration, six-point fixation in the sulcus, and improved visual and aesthetic results.

报告一位20岁的女性，她接受了一种新的手术技术来治疗创伤后失光、无虹膜和散光。手术前，人工虹膜（AI）（CustomFlex®人工虹膜，HumanOptics）被缝合到环形人工晶状体（IOL）（Carlevale™，Soleko）上，折叠，然后通过一个小的角膜切口植入角膜沟。该手术无并发症，结果良好的功能和美容效果。Carlevale™IOL为人工智能提供稳定的支持，有效解决创伤后无晶状体、无虹膜和散光问题。该技术确保了良好的定位，在沟内的六点固定，并改善了视觉和美学效果。

引用次数: 0

Nuevos horizontes en el tratamiento de las uveítis no infecciosas 非传染性卵母细胞病治疗的新视野

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502430

A. Fonollosa , A. Adán

引用次数: 0

Características de la telemedicina en oftalmología vía WhatsApp® 通过WhatsApp®实现眼科远程医疗功能

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502431

C. Sevillano , V. Rodríguez López

Background and objective

Telemedicine allows for shorter diagnostic times and is cost-effective. One of the most widely used instant messaging applications in our field is WhatsApp™. We analyze the use of this application in our specialty, to determine whether it is useful for everyday use in our clinical practice.

Material and methods

All teleconsultations from 2024 carried out through this application to the same mobile phone were collected. The origin, the reason for consultation and the most frequent diagnoses, as well as the characteristics of the applicants, were analyzed.

Results

Of the 206 teleconsultations, 65% became from the patient himself. The average age of the applicants was 42.66 years, with 38% being men. Eighty-one percent were seeking a diagnosis, whose most frequent pathologies were conjunctivitis and ametropias. WhatsApp™ allows for fast and effective communication, although they are young patients due to a probable digital divide. In our experience, it has allowed us to avoid face-to-face consultations (77%) and, more importantly, to bring forward some potentially serious ones quickly.

Conclusions

It is a cost-effective, fast tool that adds advantages to our daily clinical practice.

背景和目的远程医疗可以缩短诊断时间，并且具有成本效益。在我们的领域最广泛使用的即时通讯应用程序之一是WhatsApp™。我们分析这个应用程序在我们专业的使用情况，以确定在我们的临床实践中是否对日常使用有用。材料与方法收集自2024年以来通过该应用程序对同一手机进行的所有远程咨询。分析了本病的发病原因、就诊原因和最常见的诊断，以及患者的特点。结果206次远程问诊中，65%来自患者本人。申请者的平均年龄为42.66岁，其中男性占38%。81%的人寻求诊断，其最常见的病理是结膜炎和屈光不正。WhatsApp™允许快速有效的沟通，尽管他们是年轻的病人，因为可能存在数字鸿沟。根据我们的经验，它使我们能够避免面对面的磋商（77%），更重要的是，能够迅速提出一些潜在的严重问题。结论该方法成本低、速度快，为我们的临床实践增添了优势。

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引用次数: 0

Potenciales evocados visuales y desarrollo en niños con catarata congénita y cirugía después de los cuatro meses de edad 患有先天性白内障并在4个月后接受手术的儿童的视觉潜力和发育

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2026-01-01 DOI: 10.1016/j.oftal.2025.502436

C. Sánchez , G. Romero , E. Ontiveros , I. Martínez , L.L. Arroyo Muñoz , M. Mandujano , K.M. Soler-Limón

Introduction and objectives

Congenital cataract (CC) is a pediatric eye condition that causes low vision and blindness. Despite the possible surgical treatment to avoid disability, it produces a fifth of the world's blind children. Visual Evoked Cortical Potentials (VEP) is an essential procedure for clinical practice to evaluate the visual pathway and cortex; however, there are no reports of VEP in CC cases. The objective was to explore visual function in CC cases treated by surgical removal and lens implantation older than four months of age and their effect on their postoperative development.

Materials and methods

Prospective longitudinal study of 53 CC cases. VEP were done under standard techniques, exploring mono and binocular responses, obtaining waves N1, P1 y N2, and the amplitude of P1. The possible impact on child development was evaluated using Gesell scales.

Results

All CC cases, except 6 with associated morbidities, had VEP responses. Before 12 months, they had moderate delays but followed the expected ontogenic reductions during postoperative periods. CC cases with more significant initial alteration obtained higher development quotients.

Conclusions

CC cases had VEP responses and had postoperative reductions according to age. Their preoperative developmental delays improved on postoperative period. VEP is useful for assessing the effect of surgery on child development. Although cases were diagnosed and treated late, considering the positive impact in cases younger than 12 months demonstrated that the recovery critical period window is remarkably more extended than the accepted on academic reports. These findings could modify the surgical criterion for treating CC cases, especially in less developed countries.

简介和目的先天性白内障（CC）是一种导致视力低下和失明的儿童眼病。尽管可以通过手术治疗来避免残疾，但世界上有五分之一的失明儿童是由失明造成的。视觉诱发皮层电位（VEP）是临床评价视觉通路和皮层的重要手段；然而，在CC病例中没有VEP的报道。目的是探讨年龄大于4个月的CC患者手术摘除和晶状体植入术后的视觉功能及其对术后发育的影响。材料与方法对53例CC病例进行前瞻性纵向研究。在标准技术下进行VEP，探索单眼和双眼反应，获得波N1， P1 y N2和P1振幅。使用格塞尔量表评估对儿童发展可能产生的影响。结果除6例有相关并发症外，所有CC患者均有VEP反应。在12个月前，他们有中度延迟，但在术后期间遵循预期的本体减少。初始改变越显著的CC病例发育商越高。结论scc患者有VEP反应，术后随年龄减少。术前发育迟缓在术后有所改善。VEP可用于评估手术对儿童发育的影响。虽然病例的诊断和治疗较晚，但考虑到年龄小于12个月的病例的积极影响，表明恢复关键期窗口明显比学术报告所接受的更长。这些发现可以修改治疗CC病例的手术标准，特别是在欠发达国家。

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引用次数: 0

Membrana de Descemet retenida tras queratoplastia penetrante con queratoplastia endotelial de la membrana de Descemet previa 穿透性角成形术后保留的Descemet膜与前Descemet膜的内皮角成形术

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-12-01 DOI: 10.1016/j.oftal.2025.07.007

L. Domínguez García , P. Vázquez Colomo , P. Spang-Valencia , S. Quiñones Garrido , E. Ruiz Bravo-Burguillos

Although keratoplasties are key surgical procedures for treating corneal diseases, they may present late complications such as retrocorneal membranes. We present an unusual case following a penetrating keratoplasty (PKP) in a patient with a history of DMEK. This is the case of an 85-year-old woman with a past medical history of DMEK and 2 PKPs due to previous graft failures, who developed a retrocorneal membrane 6 months after the last PKP. A membranectomy was performed. Histological analysis confirmed the presence of retained Descemet's membrane and decreased endothelial cell density. Visual acuity remained stable (0.4–0.63) with no signs of edema. No recurrence was observed. Late retention of Descemet's membrane may result from incomplete descemetorhexis, among other causes. Although asymptomatic, it may require surgery. Close postoperative follow-up is essential.

虽然角膜成形术是治疗角膜疾病的关键外科手术，但它们可能出现晚期并发症，如角膜后膜。我们提出一个不寻常的情况下，穿透性角膜移植术（PKP）后，患者的历史的DMEK。这是一名85岁的女性，既往有DMEK病史和2次因移植物失败导致的PKP，在最后一次PKP发生6个月后出现角膜后膜。行膜切除术。组织学分析证实存在保留的Descemet膜和内皮细胞密度降低。视力保持稳定（0.4-0.63），无水肿迹象。未见复发。除其他原因外，Descemet膜的延迟保留可能是由于Descemet不完全变形造成的。虽然无症状，但可能需要手术。术后密切随访至关重要。

引用次数: 0

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