Archivos de la Sociedad Espanola de Oftalmologia最新文献

英文中文

Myopic macular pit with scleral dehiscence in highly myopic patient 高度近视患者的近视黄斑凹陷与巩膜开裂[[es]]高度近视患者的近视黄斑凹陷与巩膜开裂。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-11-01 DOI: 10.1016/j.oftale.2024.07.008

M. Comes-Carsí, N. Ruiz-Del Río, A.M. Duch-Samper

引用次数: 0

Long-term results of the treatment of patients with exudative age-related macular degeneration during the COVID-19 pandemic 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效果。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-11-01 DOI: 10.1016/j.oftale.2024.07.004

B. Son-Camey , I. Rosado-Cerro , P. Escámez-Fernández , G. Liaño Sanz Diez de Ulzurrun , R. Montejano-Milner , C. Arruabarrena

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性的长期（24 个月）影响进行量化：方法：对禁闭前 3 个月内就诊或接受治疗的 nAMD 患者进行回顾性观察研究：结果：共纳入 144 名 nAMD 患者（168 只眼睛），其中 51 人（35.42%）是在禁闭期间就诊的。之前的视力为 57.99 ± 23.68 个字母，在 12 个月和 24 个月的随访中分别平均下降了 6.87（±16.84）和 7.89（±19.58）个字母，具有临床相关性和统计学意义。这一变化与全国预处理患者数据库中观察到的两年视力变化明显不同。与大流行前的国家数据库相比，我们小组在 12 个月时的注射和咨询次数中位数较低，在 24 个月时趋于相同。我们对在禁闭期间或治疗间隔超过 8 周（Tq8w）时就诊的患者进行了比较，没有发现视力方面的差异：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到接近禁闭前的水平，但视力仍未恢复。

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引用次数: 0

Implementation of a checklist for intravitreal injections 实施玻璃体内注射检查表。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-11-01 DOI: 10.1016/j.oftale.2024.10.001

R. Bouchikh-El Jarroudi , L. Broc Iturralde , F.J. Valentín-Bravo

引用次数: 0

Ocular ischemia syndrome after aesthetic treatment with hyaluronic acid 玻尿酸美容治疗后的眼部缺血综合征。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-11-01 DOI: 10.1016/j.oftale.2024.07.010

E. Gracia Rovira , S. Natividad Andreu , N. Montalt Barrachina , E. Navarro Hernández , J. Agustí Martínez , A. Lanuza García

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。

引用次数: 0

Cyclodestruction and cyclophotocoagulation: Where are we? 环形破坏和环形光凝：我们在哪里？

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-11-01 DOI: 10.1016/j.oftale.2024.09.001

B. Vidal-Villegas , J.A. Miralles de Imperial-Ollero , M.P. Villegas-Pérez

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。

引用次数: 0

Role of vitrectomy for syphilitic uveitis in a tertiary hospital in Spain 西班牙一家三级医院玻璃体切除术在梅毒葡萄膜炎治疗中的作用。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-10-01 DOI: 10.1016/j.oftale.2024.05.010

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。

引用次数: 0

Non-arteritic anterior ischemic optic neuropathy as the only manifestation of a malignant hypertensive crisis: Report of a case 非动脉炎性前部缺血性视神经病变是恶性高血压危象的唯一表现：病例报告。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-10-01 DOI: 10.1016/j.oftale.2024.06.007

Non-arteritic anterior ischemic optic neuropathy (NAION) is after glaucoma the most common optic neuropathy in patients over 50 years. It is known that high blood pressure (HBP) is an important risk factor for the development of NAION. It is also known that malignant arterial hypertension (MAH) could be accompanied by optic disc edema. However, MAH has not classically been considered a cause of NAION. We report the case of a 32-year-old patient who presented irreversible visual loss with a pattern compatible with NAION as the only manifestation of a hypertensive crisis.

非动脉炎性前部缺血性视神经病变（NAION）是继青光眼之后，50 岁以上患者最常见的视神经病变。众所周知，高血压（HBP）是诱发非动脉炎性前部缺血性视神经病变的重要危险因素。人们还知道，恶性动脉高血压（MAH）可能伴有视盘水肿。然而，恶性动脉高血压并不被认为是NAION的病因。我们报告了一例 32 岁患者的病例，该患者出现了不可逆转的视力下降，其模式与 NAION 相符，是高血压危象的唯一表现。

引用次数: 0

Fibrinous bullous central serous chorioretinopathy with exudative retinal detachment 纤维素性大疱性中心性浆液性脉络膜视网膜病变伴渗出性视网膜脱离。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-10-01 DOI: 10.1016/j.oftale.2024.07.003

K. Arun, B. Demir, A. Makuloluwa

引用次数: 0

Effectiveness of pars plana Ahmed® valve implantation in patients with refractory glaucoma 在难治性青光眼患者中实施 Ahmed® 瓣膜植入术的效果。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-10-01 DOI: 10.1016/j.oftale.2024.07.009

O.L. Teherán Forero , J.V. Rios Moreno , M. Ochoa-Díaz , E. Ramos-Clason

Purpose

To evaluate the success rate and complications of the Ahmed FP7 valve implanted via Pars Plana in a group of vitrectomized patients with refractory glaucoma and anterior segment abnormalities from January 2018 to June 2023.

Methods

Quasi-experimental, prospective study. Eleven eyes with refractory glaucoma were included. Participants underwent a comprehensive ophthalmic examination, including assessment of intraocular pressure (IOP) reduction, visual acuity, characterization of glaucoma type, and number of antiglaucoma medications.

Results

The mean baseline IOP was 37.3 ± 11 mmHg, which decreased to 13.5 ± 3.0 mmHg after one year. The qualified success rate was 63.7%, while the complete success rate was 36.3%. The most common diagnosis was neovascular glaucoma in 36.4% of cases. The most frequent postoperative complications were choroidal detachment and hypotony.

Conclusions

Our data suggest that implantation of the Ahmed FP7 valve via pars plana is an effective and safe option for patients with refractory secondary glaucoma.

目的：评估 2018 年 1 月至 2023 年 6 月期间，在一组经玻璃体切除术治疗的难治性青光眼和眼前节异常患者中，经旁路植入 Ahmed FP7 瓣膜的成功率和并发症：准实验前瞻性研究。共纳入 11 名患有难治性青光眼的患者。参与者接受了全面的眼科检查，包括评估眼压降低情况、视力、青光眼类型特征以及抗青光眼药物的数量：平均基线眼压为 37.3 ± 11 mmHg，一年后降至 13.5 ± 3.0 mmHg。合格成功率为 63.7%，完全成功率为 36.3%。最常见的诊断是新生血管性青光眼，占 36.4%。最常见的术后并发症是脉络膜脱离和眼压过低：我们的数据表明，对于难治性继发性青光眼患者来说，通过眼旁植入 Ahmed FP7 瓣膜是一种有效而安全的选择。

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引用次数: 0

Case report: A rare case of cyclodialysis after cataract surgery managed exclusively with medical therapy 病例报告：一例罕见的白内障术后循环透析病例，完全采用药物治疗。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2024-10-01 DOI: 10.1016/j.oftale.2024.05.008

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 two 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。两周后，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，局部治疗仍在继续。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。对于术后出现不合理低视力的病例，诊所应考虑循环透析的可能性。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

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