Archivos De La Sociedad Espanola De Oftalmologia最新文献

英文中文

Disfunción visual progresiva y neurodegeneración retiniana en pacientes con fibromialgia 纤维肌痛患者的进行性视力障碍和视网膜神经退行性变

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-10-01 Epub Date: 2025-08-07 DOI: 10.1016/j.oftal.2025.06.015

E. Garcia-Martin , M.J. Vicente Altabás , E. Vilades Palomar , E. Orduna Hospital , B. Cordon Ciordia , J. Garcia-Campayo , M. Puebla-Guedea , M. Satue Palacian

Background

Pathophysiology of fibromyalgia is still not well known. There are certain theories than point out a possible neurodegeneration component.

Objectives

To evaluate variations in visual function parameters and in the macular ganglion cell layer (CGR) of patients with Fibromyalgia (FM) over a period of 5 years, and compare these results with controls.

Method

85 patients with FM and 41 healthy subjects underwent a complete ophthalmic evaluation, including assessment of visual acuity (VA) with ETDRS, contrast sensitivity vision (CSV) with Pelli Robson, color vision with Farnsworth and Lanthony D15 tests and retinal evaluation using Cirrus HD-OCT 3000 (Carl Zeiss, California). All subjects were re-evaluated after 5 years. It was also analysed the association between progressive structural, functional and disease severity changes. Furthermore, patients were classified into three groups (1, atypical; 2, depressive; 3, biologic).

Results

Progressive changes were detected in visual function parameters and CGR thickness in FM patients after 5 years. Patients with FM presented worse low contrast VA (p = 0.022), color discrimination (Lanthony's C index, p = 0.006) and decreased CGR thickness (nasal inferior, p < 0.001) over the follow up time, compared with controls. Changes in color vision were associated with CGR thinning, but no correlations with disease severity were observed.

Conclusions

It has been noticed progressive visual dysfunction and CGR loss in patients suffering from FM. The analysis of visual function parameters and CGR thickness using Cirrus OCT could be of value to control FM disease.

背景纤维肌痛的病理生理机制尚不清楚。有一些理论指出了可能的神经变性成分。目的评价纤维肌痛（FM）患者5年内视觉功能参数和黄斑神经节细胞层（CGR）的变化，并与对照组进行比较。方法对85例FM患者和41名健康受试者进行全面的眼科检查，包括ETDRS视力评估（VA）、Pelli Robson对比敏感度评估（CSV）、Farnsworth和Lanthony D15色差评估和Cirrus HD-OCT 3000 （Carl Zeiss, California）视网膜评估。所有受试者在5年后重新评估。还分析了进行性结构、功能和疾病严重程度变化之间的关系。此外，将患者分为三组（1，非典型；2，抑郁；3，生物学）。结果FM患者5年后视功能参数及CGR厚度呈进行性变化。与对照组相比，FM患者的低对比度VA （p = 0.022）、颜色辨别（Lanthony's C指数，p = 0.006）和CGR厚度（鼻下区，p < 0.001）随随访时间变差。色觉变化与CGR变薄有关，但与疾病严重程度无相关性。结论FM患者存在进行性视觉功能障碍和CGR下降。利用卷云OCT分析视觉功能参数和CGR厚度，对FM病的防治有一定的参考价值。

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引用次数: 0

El rol de la OCT de segmento anterior en queratitis ulcerativa periférica 前段OCT在周围溃疡性角膜炎中的作用

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-10-01 Epub Date: 2025-06-17 DOI: 10.1016/j.oftal.2025.03.004

C. Parés-Alfonso, D. Oliver-Gutiérrez, E. Ros-Sanchez

引用次数: 0

Reconstrucción de párpado superior tras mordedura de perro mediante el uso de injerto compuesto en edad pediátrica 在狗咬伤后使用儿科复合移植重建上眼睑

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-10-01 Epub Date: 2025-06-12 DOI: 10.1016/j.oftal.2025.05.004

C.A. Gómez Lanz , B. Palmero Sánchez , M.V. Carmona Pérez , E. Nevado Sánchez

Eyelid lesions in children are always a surgical challenge. We present the case of a 2-year-old girl with subtotal amputation of the upper eyelid due to a dog bite. Immediate surgical reimplantation with a composite graft was performed, achieving complete functional recovery without affecting ocular closure. At 6 years of follow-up, the only sequel was the absence of eyelashes in the affected area. The use of composite grafts seems to be an effective option in this type of injuries, allowing good functional and aesthetic results without limiting future reconstructions.

儿童眼睑病变一直是一个手术挑战。我们提出的情况下，一个2岁的女孩与上眼睑次全截肢，由于狗咬。在不影响闭眼的情况下，立即进行复合移植手术，实现了完全的功能恢复。在6年的随访中，唯一的后遗症是患处没有睫毛。复合移植物的使用似乎是这类损伤的有效选择，可以获得良好的功能和美观效果，而不会限制未来的重建。

引用次数: 0

Osteoma primario gigante en la órbita: reporte de caso y revisión de la literatura 在轨的巨大原发性骨瘤：病例报告和文献综述

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-10-01 Epub Date: 2025-07-14 DOI: 10.1016/j.oftal.2025.06.011

M. Dorronsoro, C. Pagano Boza

Osteoma is a benign, slow-growing bone tumor that primarily affects the jaw and paranasal sinuses. Intraorbital location, whether primary or secondary, is rare. Although it is generally asymptomatic, it can become symptomatic. As it grows, orbital osteoma can cause symptoms due to displacement and compression of the orbital contents posing a risk to vision.

This article is a literature review and case report of a large primary orbital osteoma in a 36-year-old woman, initially asymptomatic and later exhibiting a few symptoms despite significant displacement of the orbital structures that the tumor causes. Its handling was controversial for us because we did not have references on the approach we should be taking. To this date, no cases of asymptomatic intraorbital osteomas of this size have ever been published.

骨瘤是一种生长缓慢的良性骨肿瘤，主要影响下颌和鼻窦。眶内定位，无论是原发性还是继发性，都很少见。虽然它通常是无症状的，但它可以成为症状。随着眼眶骨瘤的生长，眼眶内容物的移位和压迫会引起症状，对视力构成威胁。这篇文章是一篇文献回顾和病例报告，一名36岁的女性，最初无症状，后来表现出一些症状，尽管肿瘤引起的眶结构明显移位。它的处理对我们来说是有争议的，因为我们没有关于我们应该采取的方法的参考资料。到目前为止，没有这种大小的无症状眶内骨瘤的病例被发表过。

引用次数: 0

Evaluación de la efectividad del implante de válvula de Ahmed adicionando mitomicina C en pacientes con glaucoma refractario a un año de seguimiento 对Ahmed添加肌霉素C瓣膜植入物对难治性青光眼患者一年随访的有效性的评价

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-07-28 DOI: 10.1016/j.oftal.2025.06.003

O. Teherán , C. Parra , E. Ramos , M. Ochoa , W. Escobar

Introduction

The Ahmed valve is indicated for glaucoma refractory to maximal pharmacologic therapy and properly performed filtering surgeries. Surgical success can be compromised by the formation of fibrotic tissue around the valve body; various strategies have been employed to prevent this, including the use of antimetabolites such as mitomycin C (MMC).

Aim

To evaluate the effectiveness and safety of mitomycin C (MMC) use when implanting Ahmed valve in patients with refractory glaucoma.

Methods

Cohort study involving 34 patients divided into 2 groups of 17 patients each: group 1 (MMC use) and group 2 (no MMC use), with a one-year follow-up. Complete success was defined as intraocular pressure (IOP) between 6-18 mmHg without the use of antiglaucoma medications; qualified success referred to the same IOP range but associated with antiglaucoma medications, while failure was characterized by IOP outside this range, severe complications or reintervention.

Results

The overall success rate in group 1 was 88.2%, and in group 2, 94.2%. There was an average reduction in IOP of 18.0 ± 11.5 mmHg in group 1 and 11.3 ± 5.0 mmHg in group 2 (p = 0.0352). The hypertensive phase occurred in 17.6% of the participants in the first group and the second, 70.6% (p = 0.0048).

Conclusions

The use of MMC decreases the hypertensive phase observed in Ahmed valve implant surgery, thereby achieving better IOP control.

Ahmed瓣膜适用于最大药物治疗难治性青光眼和适当的滤过手术。瓣膜周围纤维化组织的形成会影响手术的成功；已经采用了各种策略来预防这种情况，包括使用抗代谢物，如丝裂霉素C （MMC）。目的评价丝裂霉素C （MMC）在难治性青光眼患者艾哈迈德瓣膜植入术中的有效性和安全性。方法将34例患者分为2组，每组17例：1组（使用MMC）和2组（未使用MMC），随访1年。在没有使用抗青光眼药物的情况下，眼内压（IOP）在6-18 mmHg之间是完全成功的定义；合格的成功是指相同的IOP范围，但与抗青光眼药物相关，而失败的特征是IOP超出该范围，严重的并发症或再干预。结果1组总成功率为88.2%，2组总成功率为94.2%。组1平均眼压降低18.0±11.5 mmHg，组2平均眼压降低11.3±5.0 mmHg （p = 0.0352）。第一组患者高血压期发生率为17.6%，第二组为70.6% （p = 0.0048）。结论MMC的使用减少了Ahmed瓣膜置换术中观察到的高血压期，从而达到更好的IOP控制。

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引用次数: 0

Un estudio ambispectivo sobre la progresión fenotípica de los pacientes con enfermedad de Stargardt por mutación en el gen ABCA4 ABCA4基因突变引起的Stargardt病患者表型进展的双目研究

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1016/j.oftal.2025.06.005

V.A. Martel Ramirez, C.R. Pérez Montaño, A.Y. Hernández Vázquez, S. Rojas Juárez, J.A. Ramírez Estudillo

Objective

This study aims to describe the phenotypic progression of patients with Stargardt disease caused by mutations in the ABCA4 gene and reports on the mutated allelic variants.

Method

We conducted an observational, ambispective, and descriptive study. Patients who had Stargardt disease by the ABCA4 gene mutation were included. The study used the genetic report and the baseline examinations appearing on health records. To evaluate the phenotypic variation, a new ophthalmological evaluation was conducted using macular OCT, retinography, autofluorescence, and electroretinogram.

Results

The study identified a total of 32 cases with a mean follow-up of 6 years. The mean age of onset was 16 years. The mean initial and final VA were 0.79 and 0.95 logMAR, respectively. The mean initial and final CMT were 142.5 and 135 microns, respectively. The predominant degree of fundus involvement and autofluorescence pattern at the beginning and end was macular atrophy with flecks and the low signal of macular autofluorescence surrounded by a heterogeneous background, respectively. Initial electroretinography showed predominantly preserved function of rods and cones, while in the end most cases presented rod and cone system dysfunction. A total of 9 cases were homozygous, and 31 different mutant allelic variants were identified. The most common variant was p.Trp1618Cys, followed by p.Ala1773Val. Two new allelic variants, p.Leu634Pro, and p.Tyr665Serfs*5, were also discovered.

Conclusions

The study found that patients experienced structural and functional deterioration at the follow-up. The study also identified 2 predominant variants and 2 new variants. Homozygotes had an earlier onset of the disease.

目的研究ABCA4基因突变引起的Stargardt病患者的表型进展，并报道突变的等位基因变异。方法采用观察性、双视角、描述性研究。包括因ABCA4基因突变而患有Stargardt病的患者。这项研究使用了遗传报告和出现在健康记录上的基线检查。为了评估表型变异，使用黄斑OCT、视网膜造影、自身荧光和视网膜电图进行了新的眼科评估。结果本研究共发现32例，平均随访6年。平均发病年龄为16岁。平均初始和最终VA分别为0.79和0.95 logMAR。平均初始和最终CMT分别为142.5微米和135微米。黄斑萎缩伴斑点，黄斑自身荧光低信号被异质背景包围。初始视网膜电图显示视杆和视锥细胞的功能主要保留，而最终大多数病例表现为视杆和视锥系统功能障碍。共9例为纯合子，共鉴定出31种不同的突变等位变异。最常见的变体是p.Trp1618Cys，其次是p.Ala1773Val。此外，还发现了两个新的等位基因变异p.Leu634Pro和p.Tyr665Serfs*5。结论研究发现患者在随访中出现结构和功能恶化。该研究还确定了2个主要变体和2个新变体。纯合子的发病时间较早。

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引用次数: 0

Nuevos sistemas biotecnológicos de administración de fármacos para la degeneración macular asociada a la edad 为老年性黄斑变性提供药物的新生物技术系统

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-07-25 DOI: 10.1016/j.oftal.2025.03.009

S. Amatha , R. Das , M.K. Gautam , S. Mondal

Recent years have witnessed remarkable advancements in biotechnological ocular drug delivery systems, introducing novel strategies such as gene therapy, cell-based systems, and targeted carriers. This article focuses specifically on age-related macular degeneration, the most prevalent ocular condition. While gene therapy holds promise for age-related macular degeneration treatment, it also presents significant challenges, leading to the exploration of cell-based therapy as a complementary or alternative approach. To address these hurdles and ensure successful market translation, new companies often form collaborative expert teams encompassing all relevant fields, including regulatory affairs. As medical science continues to evolve, a comprehensive understanding of gene therapy, cell-based delivery, biocompatibility, safety considerations, regulatory aspects, and ongoing clinical trials is essential to fully grasp the safety and effectiveness of these novel ocular therapies. Consequently, this paper primarily explores these key areas. The successful evolution of biotechnological ocular delivery signals a positive shift towards personalized medicine, which is expected to significantly improve the quality of life for age-related macular degeneration patients in the near future.

近年来，生物技术眼科药物输送系统取得了显著进展，引入了基因治疗、细胞系统和靶向载体等新策略。这篇文章特别关注年龄相关性黄斑变性，最常见的眼部疾病。虽然基因疗法有望治疗与年龄相关的黄斑变性，但它也提出了重大挑战，导致以细胞为基础的治疗作为补充或替代方法的探索。为了解决这些障碍并确保成功的市场翻译，新公司通常会组建包括监管事务在内的所有相关领域的协作专家团队。随着医学科学的不断发展，全面了解基因治疗、细胞传递、生物相容性、安全性考虑、监管方面以及正在进行的临床试验对于充分掌握这些新型眼科疗法的安全性和有效性至关重要。因此，本文主要探讨这些关键领域。生物技术眼部移植的成功发展标志着个性化医疗的积极转变，有望在不久的将来显著改善年龄相关性黄斑变性患者的生活质量。

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引用次数: 0

Endoftalmitis atípica por Streptococcus pneumoniae

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-05-12 DOI: 10.1016/j.oftal.2025.04.004

M. Moro-Muniz , J. Raga Cervera , G. Genovés , A. Adloff-Alonso , A. Janicka-Caulineau , D. Salom

Endogenous endophthalmitis is a serious intraocular infection resulting from hematogenous spread of microorganisms. Although Streptococcus pneumoniae is an uncommon cause, its aggressiveness can lead to severe complications.

We present the case of a 48-year-old male who presented to the emergency department with blurred vision and periorbital pain in the right eye. Examination revealed hypertensive panuveitis with vitreous hemorrhage. Broad-spectrum topical and systemic antibiotics were initiated.

Imaging studies showed signs of orbital cellulitis without venous thrombosis, and aqueous humor culture confirmed the presence of S. pneumoniae, prompting hospital admission. Despite treatment, clinical progression led to the development of an intraorbital abscess requiring evisceration, after which the patient evolved favorably, allowing for later prosthesis placement.

This case highlights the aggressiveness of pneumococcal endogenous endophthalmitis and the importance of early, multidisciplinary management.

内源性眼内炎是一种由微生物血液传播引起的严重眼内感染。虽然肺炎链球菌是一种罕见的病因，但其侵袭性可导致严重的并发症。我们提出的情况下，一个48岁的男性谁提出了急诊科视力模糊和眶周疼痛在右眼。检查发现高血压性全葡萄膜炎伴玻璃体出血。开始使用广谱局部和全身抗生素。影像学检查显示眼眶蜂窝织炎的征象，无静脉血栓形成，房水培养证实肺炎链球菌的存在，促使住院。尽管进行了治疗，但临床进展导致眼眶内脓肿的发展，需要切除，之后患者进化良好，允许以后放置假体。这个病例强调了肺炎球菌内源性眼内炎的侵袭性和早期多学科治疗的重要性。

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引用次数: 0

Papilitis parainfecciosa bilateral superpuesta a seudoedema de papila por drusas del nervio óptico 双侧副脓疱性乳头炎，再加上视神经上的眼睑伪水肿

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-06-17 DOI: 10.1016/j.oftal.2025.04.005

Javier Garulo Nicolás , Laura Manfreda Domínguez , Patricia Bayo Calduch , Sergio Obiol Ferrando , Andrea Català Nadal , Antonio Miguel Duch Samper

Papillary drusen are deposits of calcified hyaline material at the level of the optic nerve head. They are considered the most frequent cause of pseudopapilledema, so in clinical practice it is essential to identify and differentiate them from true optic disc oedema.

Parainfectious optic neuritis is an inflammatory optic neuropathy, usually bilateral and acute, which occurs between 1 and 3 weeks after an infectious disease. It usually occurs as a papillitis, since it is usually located in the head of the optic nerve causing optic disc oedema.

In this article we present an unusual case of bilateral papillitis superimposed on papillary drusen in a young male with Chlamydia trachomatis prostatitis. After an exhaustive etiological study, it was concluded that, in this patie

nt, papillitis was associated with his sexually transmitted disease.

乳头状结节是视神经头水平的钙化透明物质沉积。它们被认为是假性视盘水肿最常见的原因，因此在临床实践中，必须将其与真正的视盘水肿进行鉴别和区分。副感染性视神经炎是一种炎性视神经病变，通常为双侧急性，发生于感染性疾病后1 - 3周。它通常以乳头炎的形式出现，因为它通常位于视神经的头部，引起视盘水肿。在这篇文章中，我们提出了一个不寻常的病例双侧乳头炎叠加乳头状囊肿在年轻男性与沙眼衣原体前列腺炎。经过详尽的病因学研究，得出结论，在这个病人中，乳头炎与他的性传播疾病有关。

引用次数: 0

Éxito quirúrgico en el desprendimiento de retina regmatógeno: nuevas consideraciones en 2025 手术成功切除regmatorgenos视网膜：2025年的新考虑因素

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia

Pub Date : 2025-09-01 Epub Date: 2025-07-25 DOI: 10.1016/j.oftal.2025.06.001

L. López Guajardo , P. Carnota Méndez , F. González del Valle

引用次数: 0

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