Maculopatía paracentral aguda media y neurorretinopatía macular aguda / Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy

La neurorretinopatía macular aguda es una condición rara con patogenia microvascular. Se presenta con un inicio agudo con escotomas paracentrales correspondientes a lesiones paramaculares evidentes. Los avances en las imágenes multimodales permitieron caracterizar este trastorno de retina y crear nuevos conceptos. Serraf, en el 2013, identificó dos formas por medio de la tomografía de coherencia óptica dominio espectral: el tipo 1 conocido como maculopatía paracentral aguda media en la cual se observa una banda hiperreflectiva en la capa nuclear interna, y el tipo 2 en el cual la banda hiperreflectiva se ubica en la capa nuclear externa, que involucra la zona elipsoide y la zona de interdigitación con el epitelio pigmentario de la retina. Hasta el momento no existe cura; pero se puede actuar sobre los factores de riesgo. Por ser una condición rara y por no existir reportes hasta el momento en Cuba es que se presentan a continuación dos pacientes con cuadros clínicos similares de estas dos variantes; concluyendo la importancia que presentan las imágenes multimodales como medio auxiliar diagnóstico(AU)

Acute macular neuroretinopathy is a rare condition with complex pathogenesis and microvascular cause. It appears with acute onset, with paracentral scotomas corresponding to obvious paramacular lesions. Advances in multimodal imaging made it possible to characterize this retinal disorder and to create new concepts. Serraf, in 2013, identified two forms by spectral domain optical coherence tomography: type 1, known as paracentral acute middle maculopathy, in which a hyperreflective band is observed in the inner nuclear layer; and type 2, in which the hyperreflective band is located in the outer nuclear layer, involving the ellipsoid zone and the zone of interdigitation with the retinal pigment epithelium. Up to this moment, there is no cure; but it is possible to act on the risk factors. Because it is a rare condition and because there are no reports so far in Cuba, two patients with similar clinical pictures of these two variants are presented; concluding the importance of multimodal images as an auxiliary diagnostic tool(AU)

Caracterización de las lesiones compresivas de la vía visualanterior / Characterization of Compressive Lesions of the Anterior VisualPathway

Objetivo: Determinar las características clínico-epidemiológicas de los pacientes diagnosticados con lesiones compresivas de la vía visual anterior. Métodos: Se realizó un estudio descriptivo transversal durante el período comprendido entre mayo de 2018 y marzo de 2020 con 41 pacientes con diagnóstico de síndrome compresivo de la vía visual anterior atendidos en el Servicio de Neuroftalmología del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Resultados: La mayor frecuencia en cuanto a síntomas fue la disminución progresiva de la visión central. Se encontraron lesiones de tipo tumoral en 39 pacientes para el 95,1 por ciento. Los defectos hemianópticos se detectaron en el campo visual del 45 por ciento de la muestra y el 33 por ciento presentó disminución difusa de la sensibilidad retiniana. Conclusiones: La mayoría de los pacientes fueron del sexo femenino en edades medias de la vida. Predominaron las lesiones tumorales sobre las vasculares. Los macroadenomas de hipófisis y los meningiomas fueron las etiologías más frecuentes y el sitio de compresión más encontrado fue el quiasma óptico. Se detectó disminución del grosor del complejo de células ganglionares maculares en la tomografía de coherencia óptica de la mayoría de los enfermos(AU)

Objective: To determine the clinical-epidemiological characteristics of patients diagnosed with compressive lesions of the anterior visual pathway. Methods: A cross-sectional descriptive study was conducted during the period from May 2018 to March 2020 with 41 patients diagnosed with compressive syndrome of the anterior visual pathway attended at the Neurophthalmology Service of the Cuban Institute of Ophthalmology "Ramón Pando Ferrer". Results: The most frequent symptom was the progressive decrease of central vision. Tumor type lesions were found in 39 patients for 95.1 percent. Hemianoptic defects were detected in the visual field of 45 percent of the sample and 33 percent presented diffuse decrease of retinal sensitivity. Conclusions: The majority of patients were female at middle ages of life. Tumor lesions predominated over vascular lesions. Pituitary macroadenomas and meningiomas were the most frequent etiologies and the most frequent site of compression was the optic chiasm. Decreased thickness of the macular ganglion cell complex was detected in the optical coherence tomography of most of the patients(AU)

Tamaño del nervio óptico detectado por tomografía coherencia óptica en pacientes sanos atendidos en un centro oftalmológico del Paraguay / Size of the optic nerve detected by optic coherencetomography in healthy patients in an ophthalmologicalcenter of Paraguay

El objetivo de este trabajo fue determinar el tamaño del disco óptico por tomografía de coherencia óptica (TCO), en una población mayor de 40 años, que asistió a control rutinario oftalmológico desde noviembre el 2015 a febrero del 2016 y que no tenían antecedentes conocidos de glaucoma ni de enfermedades sistémicas. Fueron incluidos en el estudio 52 pacientes que asistieron a la consulta externa de oftalmología de la Fundación Visión, por un examen de rutina. Se le diligenció una historia clínica completa, donde se indagaron los antecedentes patológicos tanto sistémicos como oculares. Se realizó la toma de la agudeza visual utilizando la cartilla de Snellen en cada ojo por separado a 6 metros del paciente, refracción automatizada, prueba refractiva, biomicroscopía en lámpara de hendidura con énfasis en la profundidad de la cámara anterior. Se excluyeron pacientes con cámaras anteriores pandas o estrechas (utilización de gonioscopio mirrow 4 mini) y presión intraocular elevada. Luego de la instilación de Tropicamida 0,5%/Fenilefrina HCL 5% en cada ojo y evaluación del polo posterior en lámpara de hendidura con lente de 90D Superfield, se realizó la Tomografía de coherencia óptica con el equipo The ZEISS Cirrus(tm) HD-TCO Model 4000 (Cirrus HD-TCO).

The objective of this study was to determine the size of the optic nerve by opticalcoherence tomography (TCO) in a population older than 40 years old who attendedroutine ophthalmological control from November 2015 to February 2016 and did not haveknown records of glaucoma or systemic. Fifty two patients were included in the study whoatended the external consulting room of ophthalmology of the Foundation Vision for aroutine control. A full medical history was completed, where the systemic and ocularpathologic records were investigated. Visual acuity test was performed using Snellen chartin each patient separately at 6 meters from the patinet. Automatic refraction, retractiontest, slit lamp biomicroscopy with emphasis in the anterior chamber depth were alsoperformed. Patients with narrow or panda anterior chambers (using the mini 4 mirrorgonioscope and high intraocular pressure were excluded. After instillation of tropicamide0.5%/phenylephrine HCL 5% in each eye and evaluation of the posterior pole in slit lampwith 90D Superfield lens, the optic coherence tomography was made using a ZEISSCirrus™ HD-TCO Model 4000 (Cirrus HD-TCO).

Meaning of TCO2 in the Diabetic and Non-diabetic Patients Undergoing Long-term Hemodialysis / 대한신장학회잡지

OBJECTIVE: Various degrees of metabolic acidosis are accompanied by the decrease in the kidney function. It is known that dialysis patients' long-term convalescences and complications are related to metabolic acidosis. It is generally known that the extreme acidosis of the dialysis patients should be corrected but on the contrary, there are reports on hemodialysis patients with slight acidosis have better nutritional condition. However, the research results are rare compared to the ratio of diabetic patients among dialysis patients. Therefore, in this paper we tried to reach a conclusion by comparing and analyzing the total carbon dioxide of the serum and other nutrition parameters of the diabetic patients among long-term hemodialysis patients with the non-diabetic patients. METHODS: We divided 50 patients, who have been hemodialysis for longer than three months, into 21 patients with diabetes and 29 patients with non-diabetes. And we compared and analyzed the TCO2 in addition to measuring other parameters based on the blood tests carried out on the beginning of every month from January of 1999 to December of 2000. RESULTS: TCO2 showed a inverse correlation with nPCR, serum albumin, blood urea nitrogen, and creatinine on the correlation analysis of the total target patients. And blood urea nitrogen and age were the independent factors in the independent factor analysis using multiple regression analysis. When we divided and compared the total target patients into diabetic patients and non-diabetic patients, there were no significant differences between various kinds of nutrition parameters and dialysis parameters. And TCO2 showed a inverse correlation with nPCR, nPCR being the independent factor in the diabetic patients. In addition, TCO2 showed a inverse correlation with serum creatinine, serum creatinine being the independent factor in the non-diabetic patients. CONCLUSION: Increase of ingestion of protein was one of the important factors in inducing metabolic acidosis, but the TCO2 and improved nutritional condition resulting from ingesting sufficient protein could be preserved in the diabetic patients. Therefore we think that the diabetic patients' nutritional condition and supervision of their ingestion of protein is more needed as sufficient ingestion of protein is a major factor in balancing acid-base for diabetic patients than non-diabetic patients.

Experimental Study on Monitoring Extremital Blood Circulation in Rabbits with Replanted Limb by Na~(99m)TcO_4 Trace Imaging / 中国医师杂志

Objective To explore feasibility of monitoring the extremital arterial blood supply and venous blood circulation in rabbits with replanted limb by Na~(99m)TcO_4 trace imaging(TTI). Methods TTI was performed on 6 normal control rabbits and 30 rabbits with replanted limb at 24～36h after replantation. The radioactivity uptake ratio of replanted limb/normal limb(T/NT) was analyzed. Imaging was classified into ?,Ⅰ,Ⅱand Ⅲ scales according to the accumulation amount of extremital radionuclide. Then an exploratory operation was performed on each rabbit. Results Rabbits with ?,Ⅰ,Ⅱand Ⅳ scales had 8,6,15(including 6 normal control rabbits),and 7 animals, respectively, and their T/NT were 0.178?0.072, 0.461?0.046, 0.816?0.074, 1.14?0.086(P1.05) may serve as a qualitative and semiquantitative diagnostic standard for venous blood circulation block. Conclusion TTI was feasible in monitoring the extremital arterial blood supply and venous blood circulation in patients with replanted limb(finger).