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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
Y. Cifre Fabra , I. Gil Hernández , R. Martínez Belda , A. Duch Samper

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
M. Parrilla Vallejo , J.A. Aguiar Caro , M. Girón Ortega , C.J. Cortés Laborda , M.J. Cano Gómez , P. Molina Solana , E. Rodríguez de la Rúa Franch

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。
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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. Ortiz , M. Garcés , J. Toala , E. Vázquez , J. Ortiz
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。
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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
B. Alamar Pérez, J. Montero Hernández, E. Cervera Taulet
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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
R. Bouchikh-El Jarroudi , L. Broc Iturralde , F.J. Valentín-Bravo
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引用次数: 0
Síndrome de isquemia ocular tras tratamiento estético con ácido hialurónico 透明质酸美容治疗后的眼部缺血综合征
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.oftal.2024.05.009
A 49-year-old female with no pre-morbidities comes in with sudden, painless loss of vision in the left eye (OS) after a facial hyaluronic acid (HA) injection for aesthetic purposes one hour ago. Visual acuity was no light perception (NLP). OS examination revealed a mid-non-reactive mydriasis and complete ophthalmoplegia. Fundus examination of the OS suggested central retinal artery occlusion (CRAO). Systemic evaluation was normal. Given this diagnosis, ocular massage, anterior chamber paracentesis, anticoagulation, systemic antibiotherapy, and subcutaneous hyaluronidase around the injection sites and peribulbar region were performed. Despite these interventions, the patient did not regain vision, exhibiting signs of anterior and posterior ocular ischemia. Subsequently, she developed phthisis bulbi, necessitating evisceration. The management of this complication should be prompt, if possible, to mitigate its dire consequences.
一名 49 岁女性,无任何先心病,一小时前为美容目的注射玻尿酸(HA)后,左眼(OS)突然出现无痛性视力下降。视力为无光感(NLP)。眼底检查显示中度无反应性眼球震颤和完全性眼瘫。眼底检查显示视网膜中央动脉闭塞(CRAO)。全身评估结果正常。鉴于这一诊断结果,医生对患者进行了眼部按摩、前房旁抽脂、抗凝、全身抗生素治疗,并在注射部位周围和眼周皮下注射透明质酸酶。尽管采取了这些干预措施,但患者仍未恢复视力,表现出眼球前后缺血的症状。随后,她患上了鼓室脓肿,不得不切除眼球。如果可能,应及时处理这种并发症,以减轻其严重后果。
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引用次数: 0
Trocleítis orbitaria. Revisión bibliográfica 眼眶套管炎文献综述
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.oftal.2024.04.010
Trochleitis is clinically and/or radiologically evidenced inflammation of the trochlea or orbital pulley.
Clinically it is characterized by pain and hypersensitivity in the superomedial orbital angle, which is increased or triggered by direct palpation of the area and/or eye movements. During the REM (rapid eye movements) phase of sleep, patients with trochleitis suffer from nocturnal micro-awakenings that impede their rest, and pain is often associated with visual symptoms (diplopia or Brown's syndrome).
The lack of common guidelines for diagnosis and treatment of this disease, its low prevalence and the lack of knowledge of the different entities associated with trochlear pain, leads to underdiagnosis or misdiagnosis. It is essential to know the characteristics of this pathology and to diagnose it correctly, differentiating it from other trochlear pain entities, in order to be able to carry out an adequate therapeutic and prognostic approach. The lack of consensus on the therapeutic protocol means that various treatments are used, in different order and often with a combination of several without a firm scientific basis.
This comprehensive review of previous studies concludes that nonsteroidal anti-inflammatory drugs (NSAIDs) achieve an overall complete cure rate of 77%, although this rate decreases to 30% in case of motility restriction or diplopia. Intratrochlear corticosteroid injection achieves an overall complete cure rate of 86%, even in the worst prognosis trochleitis, being the only effective option in NSAID-refractory trochleitis and currently being questioned as the first treatment option.
蝶窦炎在临床上和/或放射学上表现为蝶窦或眼眶滑轮的炎症。在临床上,蝶窦炎的特点是眶上内角疼痛和过敏,直接触诊该区域和/或眼球运动时疼痛加剧或诱发疼痛。在快速眼动(REM)睡眠阶段,蝶窦炎患者会出现夜间微觉醒,这妨碍了他们的休息,而且疼痛往往与视觉症状(复视或布朗综合征)有关。由于缺乏诊断和治疗这种疾病的通用指南、发病率低以及缺乏与蝶窦疼痛相关的不同实体的知识,导致诊断不足或误诊。必须了解这种病症的特征并正确诊断,将其与其他蹄叶疼痛实体区分开来,才能采取适当的治疗和预后方法。由于对治疗方案缺乏共识,因此在没有坚实科学依据的情况下,各种治疗方法的使用顺序各不相同,而且往往是几种方法的综合使用。本研究对以往研究进行了全面回顾,得出结论认为,非甾体类抗炎药(NSAIDs)的总体完全治愈率为 77%,但在运动受限或复视的情况下,完全治愈率降至 30%。即使是预后最差的套管炎,蜗管内注射皮质类固醇的总体完全治愈率也达到了86%,是非甾体抗炎药难治性套管炎的唯一有效选择,目前作为第一治疗方案受到质疑。
{"title":"Trocleítis orbitaria. Revisión bibliográfica","authors":"","doi":"10.1016/j.oftal.2024.04.010","DOIUrl":"10.1016/j.oftal.2024.04.010","url":null,"abstract":"<div><div>Trochleitis is clinically and/or radiologically evidenced inflammation of the trochlea or orbital pulley.</div><div>Clinically it is characterized by pain and hypersensitivity in the superomedial orbital angle, which is increased or triggered by direct palpation of the area and/or eye movements. During the REM (rapid eye movements) phase of sleep, patients with trochleitis suffer from nocturnal micro-awakenings that impede their rest, and pain is often associated with visual symptoms (diplopia or Brown's syndrome).</div><div>The lack of common guidelines for diagnosis and treatment of this disease, its low prevalence and the lack of knowledge of the different entities associated with trochlear pain, leads to underdiagnosis or misdiagnosis. It is essential to know the characteristics of this pathology and to diagnose it correctly, differentiating it from other trochlear pain entities, in order to be able to carry out an adequate therapeutic and prognostic approach. The lack of consensus on the therapeutic protocol means that various treatments are used, in different order and often with a combination of several without a firm scientific basis.</div><div>This comprehensive review of previous studies concludes that nonsteroidal anti-inflammatory drugs (NSAIDs) achieve an overall complete cure rate of 77%, although this rate decreases to 30% in case of motility restriction or diplopia. Intratrochlear corticosteroid injection achieves an overall complete cure rate of 86%, even in the worst prognosis trochleitis, being the only effective option in NSAID-refractory trochleitis and currently being questioned as the first treatment option.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"99 10","pages":"Pages 436-449"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130848","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
Papel de la vitrectomía en uveítis sifilítica en un hospital terciario de España 西班牙一家三级医院的玻璃体切除术在梅毒性葡萄膜炎中的作用。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.oftal.2024.04.014
Diagnosis and treatment of ocular syphilis can be challenging due to the wide spectrum of clinical presentations of this sexually transmitted disease. In some cases of syphilitic panuveitis, pars plana vitrectomy (PPV) can be useful in management since it plays an important role in improving fundus examination allowing treatment of possible retinal associated lesions when vitreous inflammation is intense. We present 3 cases of patients with ocular syphilis that underwent a therapeutic PPV, vitreous sample was taken and analyzed in two of them.
由于这种性传播疾病的临床表现多种多样,因此眼梅毒的诊断和治疗具有挑战性。在某些梅毒性泛葡萄膜炎病例中,玻璃体旁切除术(PPV)在治疗中非常有用,因为它在改善眼底检查方面发挥着重要作用,当玻璃体炎症严重时,可以治疗可能的视网膜相关病变。我们介绍了3例接受治疗性玻璃体切割术的眼梅毒患者,其中两例患者的玻璃体样本已采集并进行了分析。
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引用次数: 0
Reporte de un caso: Raro caso de ciclodiálisis después de una cirugía de catarata manejado exclusivamente con terapia médica 病例报告:罕见的白内障手术后循环透析病例,完全采用药物治疗
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.oftal.2024.04.013
A. Romero-Titos , P. Álvarez-Sánchez , F.M. Hermoso Fernández , J.E. Muñoz de Escalona Rojas , M.C. González Gallardo , R. Martínez Castillo
We present the case of a 68-year-old female who presented with a substantial cyclodialysis after phacoemulsification identified by anterior segment optical coherence tomography and ultrasound biomicroscopy. Gonioscopy is challenging because of its shallow anterior chamber. Due to lack of response to topical steroids and refusal by the patient for surgical treatment, topical steroids were tapered, and cycloplegic was initiated. After 2 weeks, the cyclodialysis cleft was closed on optical coherence tomography persisting residual subchoroidal fluid, topical treatment was mantained. Despite of this, visual acuity and hypotony were restored. Finally at 2 months visit subchoroidal fluid was reabsorbed and patient was discharged.
Clinics should consider the possibility of cyclodialysis in cases of unjustified hypotony during postoperative period. In addition, we recommend performing anterior segment imaging which includes ultrasound biomicroscopy and optical coherence tomography, when the evaluation of angular structures is unfeasible. Finally, we propose medical management for severe cyclodialysis as the first option considering anti-inflammatory drugs could perpetrate the separation between scleral spur and ciliary muscle.
我们介绍了一例 68 岁女性的病例,她在接受超声乳化术后出现了大量的环状渗出,经前节光学相干断层扫描和超声生物显微镜检查发现了这一情况。由于前房较浅,巩膜镜检查具有挑战性。由于对局部类固醇缺乏反应,患者又拒绝手术治疗,因此局部类固醇逐渐减少,并开始使用环磷酰胺。2 周后,光学相干断层扫描显示环形透析裂隙闭合,但仍有残留的脉络膜下积液,患者继续接受局部治疗。尽管如此,患者的视力和眼底仍得到了恢复。最后,在 2 个月的回访中,脉络膜下积液被重新吸收,患者康复出院。此外,如果无法评估角膜结构,我们建议进行眼前节成像,包括超声生物显微镜和光学相干断层扫描。最后,考虑到抗炎药物可能会导致巩膜骨刺和睫状肌之间的分离,我们建议首选药物治疗严重的环状渗出。
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引用次数: 0
Coriorretinopatía serosa central ampollosa fibrinosa con desprendimiento de retina exudativo 伴有渗出性视网膜脱离的纤维素性中央浆液性大泡纤维素性脉络膜视网膜病变
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.oftal.2024.05.014
K. Arun, B. Demir, A. Makuloluwa
{"title":"Coriorretinopatía serosa central ampollosa fibrinosa con desprendimiento de retina exudativo","authors":"K. Arun,&nbsp;B. Demir,&nbsp;A. Makuloluwa","doi":"10.1016/j.oftal.2024.05.014","DOIUrl":"10.1016/j.oftal.2024.05.014","url":null,"abstract":"","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"99 10","pages":"Pages 467-468"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358291","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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