Archivos de la Sociedad Espanola de Oftalmologia最新文献

Background and objective: Conducting a national visual health survey and comparing results after 5 years.

Materials and methods: Cross-sectional study using a computer-assisted telephone interview with a representative sample of Spaniards over 18 years of age (except Ceuta and Melilla). The survey was designed by ophthalmologists, the selection of the sample and the conduct of the interviews (April 2017 and May 2023) was carried out through the company Metroscopia and the analysis of the anonymous data was carried out by researchers. Demographic data, knowledge about glaucoma, use of glasses, perceived visual quality, ophthalmological pathology and ocular treatments were collected.

Results: 1209 and 600 people were interviewed in 2017 and 2023 respectively. The level of glaucoma awareness went from 80% to 87%. The perceived visual quality was reduced (8.2 ± 1.6 to 6.9 ± 1.8) and the frequency of access to the ophthalmologist. The prevalence of glasses use increased (50%-62%), dry eye (13%-28%), cataract (9.7%-12.4%), glaucoma (1.9%-4.6%), age-related macular degeneration (7%-11.3%), and diabetic retinopathy (1.2%-1.7%). The use of artificial tears and glaucoma drops also increased (16.9%-32.9% and 1.6%-6%, respectively).

Conclusions: The study shows that there has been an increase in self-reporting of eye diseases in recent years in Spain. These types of population surveys can serve to encourage the development of visual health programs aimed at the needs of our country.

Background and objective: To determine the prevalence of DEMODEX in patients with blepharitis, its clinical characteristics, as well as its association with systemic conditions, and the type and severity of dry eye disease (DED).

Materials and methods: A cross-sectional, observational, and analytical study was conducted. 302 patients with signs of blepharitis were evaluated from December 2024 to April 2025 at a Mexican ophthalmology referral center.

Results: The prevalence of DEMODEX was 49.3%, with significant differences between age groups, observing a higher prevalence with advanced ages: 39.7% in <60 years, and 49.3% in ≥60 years (χ² = 0.009). Type 2 diabetes (T2D) was associated with a significant risk of developing demodicosis (OR 2.456 (CI 1.457-4.141), p = <0.001). Regarding clinical characteristics, patients with DEMODEX had a higher presence of collarettes, a higher prevalence of mixed blepharitis (58.4%), and mixed dry eye disease (DED). Regarding tests for dry eye type and severity, there were only differences in the Van Bijsterveld score (χ² = 0.009), but not for the TBUT, Schirmer, or OSDI scores.

Conclusion: Ocular demodicosis has a high prevalence in our population; its presence is associated with age, with no differences by gender. T2D increases the likelihood of developing DEMODEX. The anatomical and functional alterations caused by this ocular infection can promote or worsen the symptoms and severity of DED.

Background and objectives: To evaluate intraocular pressure (IOP) and the number of hypotensive medications in patients with mild-to-moderate appositional primary angle-closure glaucoma (PACG) after phacoemulsification surgery (phaco-only group) versus phacoemulsification combined with the implantation of two iStent® W inject trabecular stents (Glaukos Corporation, CA, USA) (phaco-iStent group).

Materials and methods: A retrospective cohort study including 28 eyes from 28 patients with appositional PACG, divided into two groups (phaco-only and phaco-iStent). The number of medications and IOP values were recorded, at baseline, as well as, at one month, six months, and twelve months postoperatively.

Results: Baseline and one-month postoperative mean IOP were similar in both groups (P > .05). The phaco-iStent group exhibited significantly lower IOP at six and twelve months postoperatively compared to the phaco-only group (P = .024 at six months and P = .018 at twelve months). The number of active agents was significantly lower at twelve months in the phaco-iStent group (P = ,01).

Conclusions: There is greater efficacy in lowering intraocular pressure over time in patients with appositional PACG if phacoemulsification is accompanied by trabecular surgery. This could be useful in patients in whom we suspect that lowering IOP with phacoemulsification alone will not be sufficient to control the disease.

A case is presented of a 77-year-old woman with recurrent cystoid macular edema treated with intravitreal dexamethasone implants (Ozurdex®), who developed an acute and severe intraocular inflammatory reaction after the last administration. Clinical and imaging findings, together with negative microbiological cultures and favorable evolution under conservative medical treatment, were consistent with sterile endophthalmitis or implant-induced panuveitis. The implant showed an abnormal appearance-swollen and surrounded by vitreous condensations-suggesting possible structural alterations of the device or inadvertent contamination during injection, which could have triggered an immunologic or irritative reaction, among other mechanisms described in the literature. This case highlights the importance of recognizing atypical presentations of intraocular inflammation following Ozurdex®, differentiating them from infectious processes, and reporting such events to pharmacovigilance systems, given that this is an exceptional reaction with very few cases reported in the literature.

Miller Fisher syndrome (MFS) is an uncommon variant of Guillain-Barré syndrome characterized by the triad of ophthalmoplegia, ataxia, and areflexia. Diagnosis can be particularly challenging when the clinical presentation is incomplete or atypical, especially in early stages. We report the case of a 54-year-old woman who presented to the emergency department with blurred vision and nonspecific dizziness, without diplopia or other relevant neurological findings. Hospital discharge was initially considered. However, ophthalmologic examination revealed severe bilateral ophthalmoplegia with supranuclear involvement and convergence impairment, in the absence of pupillary abnormalities. These findings prompted hospital admission and neurological evaluation, which confirmed the diagnosis of MFS. Treatment with intravenous immunoglobulins led to complete recovery. This case represents an atypical form of MFS, lacking all three classical components at onset and showing no positive findings on serologic or neuroimaging studies. The initial clinical suspicion raised by the ophthalmology team was essential to prevent premature discharge and allowed early diagnosis and treatment. This report underscores the importance of thorough ocular examination in patients with nonspecific visual symptoms and highlights the key role of ophthalmologists in the early recognition of rare neurological disorders with ocular manifestations.

Age-related macular degeneration (AMD) is a multifactorial disease influenced by genetic and environmental factors, yet its pathogenesis remains incompletely understood. DNA methylation, increasingly recognized as a disease indicator, has been linked to AMD and may represent a promising biomarker or therapeutic target. This systematic review, conducted according to PRISMA 2020 guidelines, analyzed 13 studies addressing DNA methylation in AMD populations (2012-2025). Results revealed that 25% reported hypermethylation, 8% hypomethylation, and 41% both patterns, while 15% found no significant differences. Notably, one study described downregulation of DNA methyltransferases in advanced stages compared with early or intermediate AMD. Despite the limited evidence, findings support the relevance of methylation in AMD prognosis and therapy. Further research with robust methodologies is essential to clarify the role of epigenetic mechanisms in disease progression and to explore their potential for guiding targeted therapeutic strategies.

Introduction and objectives: To measure the repeatability of static cyclotorsion registry by the WaveLight EX500 excimer laser platform and its reliability in terms of the percentage of errors during different phases of the surgery.

Material and methods: Experimental, prospective, descriptive study. Candidates for LASIK surgery were evaluated with a Placido-based topographer for iris registration. Once in the operating room and after placing the blepharostat (phase 1), 3 consecutive cyclotorsion measurement attempts were performed using the excimer laser. Valid measurements or the number of errors were noted. Then, after the flap creation (phase 2) and after the flap lifting (phase 3) the first valid cyclotorsion measurement up to a maximum of three attempts was noted. The number and percentage of errors in every phase were calculated. The intraclass correlation coefficient (ICC) for absolute agreement was also calculated.

Results: 135 eyes of 80 subjects were included. Three consecutive measurement errors were found in 2.9%, 20.7%, and 23% of the eyes in phases 1, 2, and 3, respectively. In Phase 1, the mean range of the 3 measurements was 0,7 ° with a maximum difference of 3.5 °. The ICC between the 3 measurements was 0.960. The maximum difference between the measurements of Phases 1, 2, and 3 was calculated as 5.5 °. Twenty percent of patients with a valid measurement in Phases 1 or 2 were unable to achieve a valid measurement in Phase 3.

Conclusions: Static cyclotorsion measurements are highly repeatable. Registry errors are more likely to occur after flap lifting.

Primary open-angle glaucoma (POAG), with a prevalence of 2.6% in people over 40, is the most common form of glaucoma and can cause blindness in up to 9% of cases. The new therapeutic paradigm prioritizes early surgery to preserve vision and quality of life. The objectives of this study were to analyze the diagnosis, treatment, and management of POAG in Andalusia, evaluate the incorporation of innovation, and propose improvements. A review of scientific literature and official databases was conducted, supplemented by a multidisciplinary panel of experts. The results show a high rate of underdiagnosis due to asymptomatic nature, lack of screening, and scarce resources, as well as limitations in adopting an early surgical approach due to waiting lists and restricted capacity. It is concluded that early diagnosis and treatment are key to slowing progression, preventing visual impairment, and reducing the socioeconomic burden.