Archivos de la Sociedad Espanola de Oftalmologia最新文献

英文中文

Classification of posterior staphyloma in pathologic myopia using 3D wide-field fundus imaging 病理性近视后葡萄肿的三维宽视场眼底成像分类。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.07.001

J.D. Arias Aristizábal , C.M. Cordoba-Ortega , M.A. Gómez Velasco , J.M. Barahona Campos

Introduction and objectives

Pathological myopia is associated with structural changes, including posterior staphylomas, which can be categorized based on their morphology. This study aims to classify posterior staphylomas in patients with pathological myopia using the 3D WIDE SCAN REVIEW Swept-Source optical coherence tomography (OCT) platform and compare the findings with the Ohno-Matsui classification.

Patients and methods

We conducted a retrospective cross-sectional cohort study, including 59 eyes from 31 patients diagnosed with high myopia (axial length ≥ 26 mm and/or spherical equivalent ≥ −6.00 diopters) and pathological myopia, defined as equal to or greater than diffuse chorioretinal atrophy or the presence of a posterior staphyloma, according to the META-PM study group. Posterior staphylomas were categorized based on fundus depression shape and appearance using 3D WIDE SCAN REVIEW analysis and compared using the Ohno-Matsui 2014 classification. Additionally, myopic maculopathy was assessed using the Atrophic-Tractional-Neovascular (ATN) classification, explicitly evaluating atrophic (A), tractional (T), and neovascular (N) components. Image acquisition was performed using the Topcon Triton Swept-Source OCT system, and images were processed and analyzed with the 3D WIDE SCAN REVIEW platform.

Results

The patients’ mean age was 49.56 years (SD ± 18.50; 71.05% women). The distribution of posterior staphylomas varied among the study population. Type I (wide macular) was the most prevalent, observed in 22.0% of cases, followed by Type II (narrow macular) at 10.2%, Type III (peripapillary) at 8.5%, Type IV (nasal) at 3.4%, and Type V (inferior) at 8.5%. This classification highlights the predominance of macular involvement in pathological myopia, with nasal and inferior staphylomas being less common. Regarding myopic maculopathy, A1 was the most common atrophic component (43.5%), T0 was predominant (78.3%), and N0 was the most common neovascular category (83%).

Conclusions

The 3D WIDE SCAN REVIEW Swept-Source OCT platform provides a high-resolution, non-invasive method for detailed visualization and classification of posterior staphylomas. By using Topcon Triton SS-OCT for image acquisition and 3D WIDE SCAN REVIEW software for analysis this study demonstrates a clinically viable alternative to traditional imaging modalities for evaluating posterior staphylomas in pathological myopia.

病理性近视与结构改变有关，包括后葡萄肿，可根据其形态进行分类。本研究旨在使用3D WIDE SCAN REVIEW扫描源光学相干断层扫描（OCT）平台对病理性近视患者的后葡萄肿进行分类，并将结果与Ohno-Matsui分类进行比较。患者和方法：我们进行了一项回顾性横断面队列研究，包括来自31名诊断为高度近视（眼轴长度≥26 mm和/或球面等效≥-6.00屈光度）和病理性近视的患者的59只眼睛，根据META-PM研究组的定义，病理性近视的定义等于或大于弥漫性脉络膜萎缩或存在后葡萄肿。使用3D WIDE SCAN REVIEW分析，根据眼底凹陷的形状和外观对后葡萄瘤进行分类，并与Ohno-Matsui 2014分类进行比较。此外，使用萎缩-牵拉-新生血管（ATN）分类评估近视黄斑病变，明确评估萎缩(A)、牵拉(T)和新生血管(N)成分。使用Topcon Triton SCAN - source OCT系统进行图像采集，并使用3D WIDE SCAN REVIEW平台对图像进行处理和分析。结果：患者平均年龄49.56岁(SD±18.50；71.05%的女性)。后葡萄肿的分布在研究人群中有所不同。I型（宽黄斑）最常见，占22.0%，其次是II型（窄黄斑）10.2%，III型（乳头周围）8.5%，IV型（鼻）3.4%，V型（下）8.5%。这种分类突出了病理性近视中黄斑病变的优势，鼻和下葡萄肿不太常见。在近视黄斑病变中，A1为最常见的萎缩性成分（43.5%），T0为主要成分（78.3%），N0为最常见的新生血管类型（83%）。结论：3D WIDE SCAN REVIEW扫描源OCT平台为后葡萄肿的详细可视化和分类提供了一种高分辨率、无创的方法。通过使用Topcon Triton SS-OCT进行图像采集和3D WIDE SCAN REVIEW软件进行分析，本研究证明了一种临床可行的替代传统成像方式来评估病理性近视的后葡萄肿。

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引用次数: 0

Bilateral and simultaneous retinal artery occlusion in a woman with systemic lupus erythematosus 女性系统性红斑狼疮患者双侧及同时视网膜动脉闭塞。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.04.012

V.M. Asensio-Sánchez

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost every organ. This article describes a middle-aged woman, previously diagnosed with untreated SLE, who during a severe SLE flare simultaneously presented with a superior nasal artery occlusion in the right eye and a central retinal artery occlusion (CRAO) in the left eye. Severe ocular complications, such as CRAO, can occur during an acute flare of the disease in previously asymptomatic SLE.

系统性红斑狼疮（SLE）是一种可以影响几乎所有器官的自身免疫性疾病。这篇文章描述了一位中年妇女，先前诊断为未经治疗的SLE，在严重的SLE发作期间同时出现右眼鼻上动脉闭塞和左眼视网膜中央动脉闭塞（CRAO）。严重的眼部并发症，如CRAO，可发生在疾病的急性发作期间，以前无症状的SLE。

引用次数: 0

Surgical Safety Checklist in ophthalmology: A tertiary hospital proposal 眼科手术安全检查表：三级医院的建议。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.05.014

N. Lorenzana-Blanco, A. Escudero-Villanueva, N. Alejandre-Alba, I. Jiménez-Alfaro Morote

Adverse events due to unsafe healthcare practices constitute a serious global problem. The World Health Organization (WHO) has recognized healthcare insecurity as a public health issue and has undertaken various initiatives to safeguard patient safety. The Surgical Safety Checklist (SSC) is one of the tools implemented that has proven to be most effective in reducing morbidity and mortality associated with surgeries. Its impact is tied to implementation policies. Although the SSC is universal, the WHO has encouraged adaptations for different specialties. The purpose of our work is to present the SSC used in our hospital for major and minor ophthalmic surgery. Regarding cataract surgery, it is noteworthy to consider special ocular conditions and the correct choice of intraocular lens.

由于不安全的卫生保健做法造成的不良事件构成了一个严重的全球性问题。世界卫生组织（世卫组织）已认识到保健不安全是一个公共卫生问题，并采取了各种举措来保障患者的安全。手术安全检查表（SSC）是已被证明在降低手术相关发病率和死亡率方面最有效的工具之一。其影响与实施政策有关。虽然SSC是通用的，但世界卫生组织鼓励针对不同的专业进行调整。我们的工作目的是介绍我院在大、小眼科手术中使用的SSC。对于白内障手术，需要考虑特殊的眼部情况和人工晶状体的正确选择。

引用次数: 0

Congenital microcoria: Description of 3 cases in a family 先天性小喙病：一个家庭3例报告。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.05.013

P. Merino, A. Fuentes, P. Gómez de Liaño, J. Ruiz

Congenital microcoria (MCOR) is a rare ocular anomaly characterized by pupil smaller than 2 mm with no response to mydriatic agents. It can present in two forms: autosomal recessive associated with Pierson syndrome and autosomal dominant isolated (associated with a high incidence of myopia and glaucoma). Studies have identified deletions in the 13q32.1 region of chromosome 13 that include the GPR180 gene, involved in smooth muscle cell growth, as the underlying cause. We describe 3 members of a family with deletion of the GPR180 gene on chromosome 13. In all, IOP was normal and gonioscopy showed iridocorneal angle dysgenesis with prominent ciliary processes. MCOR is due to poor development of the iris dilator muscle of genetic cause. Early diagnosis and continuous follow-up for possible complications such as amblyopia, progressive myopia and juvenile glaucoma is essential.

先天性小眼珠（MCOR）是一种罕见的眼部异常，其特征是瞳孔小于2mm，对瞳孔抑制剂无反应。它可以表现为两种形式：常染色体隐性遗传与皮尔逊综合征相关和常染色体显性分离（与近视和青光眼的高发相关）。研究已经确定了13号染色体13q32.1区域的缺失，其中包括GPR180基因，参与平滑肌细胞的生长，这是潜在的原因。我们描述了13号染色体上GPR180基因缺失的3个家族成员。总的来说，IOP正常，角镜显示虹膜角膜角发育不良，睫状突突出。MCOR是由于虹膜扩张肌发育不良所致的遗传性原因。弱视、进行性近视、青光眼等并发症的早期诊断和持续随访至关重要。

引用次数: 0

Management of bilateral oculomotor paralysis after traumatic head injury: a case report 外伤性颅脑损伤后双侧动眼肌麻痹1例。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.06.004

P. Talavero González, J. García Bella, E. Hernández García, E. Vico Ruiz, Á. Romo López, R. Gómez de Liaño Sánchez

A 73-year-old male with disabling torticollis. He suffered a severe traumatic head injury when he had 36 years old, affecting multiple cranial nerves, including III, IV and VI bilaterally. On actual examination he presented a large torticollis left head turn that compensates the diplopía. In the right eye, −4 limitation of adduction, −1 limitation of elevation and horizontal nystagmus on abduction. In the left eye, −6 limitation of abduction, −2 limitation of adduction, −1 limitation of elevation and −2 limitation of depression (0–8 scale). The right eye underwent Nasal Nishida procedure and the left eye underwent a Temporal Nishida. One year after the surgery the patient was no longer maintaining a head turn but had a mild tilt to the right and inttermitent diplopía.

Nishida procedure can be a good option in cases of complex bilateral oculomotor paralysis.

73岁男性，患有致残性斜颈。他在36岁时遭受严重的颅脑外伤，累及多根脑神经，包括双侧III、IV、VI。在实际检查中，他提出了一个大的斜颈左头转动补偿diplopía。右眼内收-4限制，外展时抬高和水平眼震-1限制。左眼外展受限-6，内收受限-2，抬高受限-1，凹陷受限-2（0-8分）。右眼行鼻西田手术，左眼行颞西田手术。手术一年后，患者不再保持头部转动，但有轻微的向右倾斜和间歇性diplopía。对于复杂的双侧动眼肌麻痹，西田手术是一个很好的选择。

引用次数: 0

Peripapillary intrachoroidal cavitation 乳头周围脉络膜内空化。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.04.011

J.C. Escribano Villafruela, A. Fuentes Zamora, L. Gómez Fernández, J.R. Ruiz Batrés, J.L. Urcelay Segura

Peripapillary Intrachoroidal Cavitation (PICC) can be appeared as an orangish lesion located at the outer lower edge of the myopic cone and confined to the intrachoroidal space. It is more common in patients with high myopia, older age, and greater axial length. The most accepted pathophysiological mechanism involves traction over a vulnerable sclera tissue at the myopic cone. PICC may present with visual field defects like mild glaucomatous neuropathy. Differential diagnosis with other choroidal pathologies is essential, and OCT-HD shows distinctive features in PICC. Additionally, OCT-A plays a crucial role in the diagnosis.

We present 3 patients with PICC from our center, all of whom share advanced age, increased axial length, and myopia. All cases exhibit characteristic imaging alterations and visual field defects likely associated with the pathology.

乳头周围脉络膜腔内空化（PICC）可表现为位于近视眼锥体外下缘的橙色病变，局限于脉络膜内间隙。在高度近视、年龄较大、眼轴长度较大的患者中更为常见。最被接受的病理生理机制涉及牵拉在一个脆弱的巩膜组织在近视锥。PICC可表现为视野缺损，如轻度青光眼神经病。与其他脉络膜病变的鉴别诊断是必要的，OCT-HD在PICC中显示出独特的特征。此外，OCT-A在诊断中起着至关重要的作用。我们报告了本中心的3例PICC患者，均为高龄、眼轴长度增加和近视。所有病例均表现出与病理相关的特征性影像学改变和视野缺陷。

引用次数: 0

Update on ophthalmic biotechnology: Techniques for identifying molecular and genetic biomarkers 眼科生物技术的更新。分子和遗传生物标志物的鉴定技术。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.06.001

E. Marín-Payá , L. Zanón-Moreno , I. Andrés-Blasco , J. Marín-Montiel , M.D. Pinazo-Durán , V. Zanón-Moreno

引用次数: 0

New OCT sign in X-linked retinoschisis without macular schisis: "Inverted roof fovea" 无黄斑裂片的x联性视网膜裂片的OCT新征象：“倒顶中央凹”。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.05.003

P.B. Blasco Palacio, A. Aramburu-Gonzalez, I. Rodríguez García

We present the case of a 52-year-old man with a stable ophthalmological follow-up for the last 10 years. Clinically asymptomatic, except for floaters in both eyes. In the fundus, bilateral peripheral retinoschisis was observed without associated macular schisis. The electroretinogram (ERG) is electronegative and shows a genetic confirmation of the pathogenic variant c.461A > G; p.(Gln154Arg) of the RS1 gene compatible with the diagnosis of juvenile X-linked retinoschisis (RSLX). The foveal architecture in Optical Coherence Tomography (OCT) presents "inverted roof fovea" not previously described, having found two similar cases in the literature. In males in whom we find the sign of "inverted roof fovea", we should check the fundus, and if we find peripheral retinoschisis, we recommend insisting on the family history, and increase its study with an ERG and molecular genetic analysis, ruling out RSLX.

我们提出的情况下，52岁的男子稳定的眼科随访了过去的10年。临床无症状，双眼有飞蚊症。眼底观察到双侧外周视网膜裂，无黄斑裂。视网膜电图（ERG）呈电负性，遗传上证实了致病变异c.461A >g；与少年x连锁视网膜裂（RSLX）诊断相容的RS1基因p.（Gln154Arg）。光学相干断层扫描（OCT）的中央凹结构表现为“倒置屋顶中央凹”，以前没有描述过，在文献中发现了两个类似的病例。男性如发现“顶凹内翻”征，应检查眼底，如发现外周性视网膜裂，建议坚持家族史，并加强对其ERG和分子遗传分析的研究，排除RSLX。

引用次数: 0

Cultural adaptation and validation of the Ocular Surface Disease Index Questionnaire (OSDI) to the Mexican population 墨西哥人口眼表疾病指数问卷（OSDI）的文化适应和验证。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.06.006

N. Kahuam-López , J.G. Serrano-Robles , G.R. Vera-Duarte , J.R. Bermeo-Escalona , C.A. Müller-Morales , A. Ramirez-Miranda , A. Navas , E.O. Graue-Hernandez

Objective

Translate, culturally adapt, and validate the Ocular Surface Disease Index into Spanish for the Mexican population.

Methods

To ensure fluency and comprehensibility, we employed the Crawford and INFLEZS indexes. The Content Validity Coefficient was used to assess coherence, relevance, clarity, and sufficiency. Internal consistency was evaluated using Cronbach’s Alpha Coefficient.

Results

A total of 372 participants were included in the study (63.4%, women; age ranged from 17 to 86 years). According to the INFLEZS readability index, symptom-related items achieved scores of 82.56, 72.69, 85.81, 73.24, and 74.24. Lifestyle-related items obtained scores of 71.39, 76.90, 58.27, and 72.56, while in the environmental domain, scores of 83.61, 74.03, and 58.93 were recorded. Using the Crawford index, symptom scores were 3.6, 4.6, 3.5, 4.1, and 3.8, lifestyle scores were 4.7, 4.1, 5.1, and 4.6, and environmental scores were 3.7, 4.4, and 5.7. The Cronbach's alpha coefficient was 0.868. Based on the scores from the OSDI questionnaire, patients were categorized as having no dry eye (n = 129), mild dry eye (n = 99), moderate (n = 45), and severe dry eye (n = 99).

Conclusions

This study developed and validated the Mexican version of the Ocular Surface Disease Index, while assessing its reliability and internal consistency. With this tool, ophthalmologists and researchers alike will be able to assess and monitor Mexican-Spanish-speaking patients with dry eye in their routine clinical practice and future research.

目的：翻译，文化适应，并验证眼表疾病指数成西班牙语的墨西哥人口。方法采用Crawford指数和INFLEZS指数，以保证词汇的流畅性和可理解性。内容效度系数用于评估连贯性、相关性、清晰度和充分性。采用Cronbach’s Alpha系数评价内部一致性。结果：共有372名参与者被纳入研究(63.4%，女性；年龄从17岁到86岁不等)。根据INFLEZS可读性指数，症状相关项目得分分别为82.56、72.69、85.81、73.24和74.24。生活方式方面的得分分别为71.39、76.90、58.27、72.56，环境方面的得分分别为83.61、74.03、58.93。使用克劳福德指数，症状评分为3.6、4.6、3.5、4.1和3.8，生活方式评分为4.7、4.1、5.1和4.6，环境评分为3.7、4.4和5.7。Cronbach’s alpha系数为0.868。根据OSDI问卷得分，将患者分为无干眼（n = 129）、轻度干眼（n = 99）、中度干眼（n = 45）和重度干眼（n = 99）。结论：本研究开发并验证了墨西哥版眼表疾病指数，同时评估了其可靠性和内部一致性。有了这个工具，眼科医生和研究人员将能够在他们的常规临床实践和未来的研究中评估和监测墨西哥-西班牙语干眼症患者。

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引用次数: 0

Pigmentary chorioretinopathy due to long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD): a case report with long-term follow-up 长链3-羟基酰基辅酶a脱氢酶缺乏症（LCHAD）所致色素性脉络膜视网膜病变1例并长期随访。

Archivos de la Sociedad Espanola de Oftalmologia

Pub Date : 2025-08-01 DOI: 10.1016/j.oftale.2025.06.003

N. Castro Casal, N. Olivier Pascual, R. Arroyo Castillo

Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) is a rare but severe genetic disorder that causes pigmentary chorioretinopathy. We present the case of a 20-year-old female patient diagnosed with LCHAD by neonatal screening with alteration of the retinal pigment epithelium (RPE) since the age of 3 years. Fundus examination showed a salt-and-pepper speckled granular pattern and diffuse peripheral chorioretinal atrophy. The patient is stable, visually asymptomatic and with good systemic control after more than 15 years of follow-up with retinography, optical coherence tomography (OCT), autofluorescence (FAF) and electroretinogram (ERG), essential for control. This case highlights the importance of early diagnosis and treatment to prevent decompensation and improve survival and progression.

长链3-羟基酰基辅酶a脱氢酶缺乏症（LCHAD）是一种罕见但严重的遗传性疾病，可引起色素脉络膜视网膜病变。我们提出的情况下，20岁的女性患者诊断为LCHAD新生儿筛查与改变视网膜色素上皮（RPE）自3岁。眼底检查显示椒盐斑状颗粒状，弥漫性周围绒毛膜视网膜萎缩。患者病情稳定，视力无症状，经过超过15年的视网膜造影，光学相干断层扫描（OCT），自体荧光（FAF）和视网膜电图（ERG）的随访，系统控制良好，这是控制的必要条件。这个病例强调了早期诊断和治疗的重要性，以防止失代偿和改善生存和进展。

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