Macro and microangiopathy related to retinopathy and choroidopathy in type 2 diabetes.

PURPOSE: To describe the relationship between diabetic retinopathy (DR) and choroidal thickness (CT), and systemic macro and microangiopathy in patients with type 2 diabetes (T2D). METHODS: Cross-sectional study enrolling 200 eyes (100 T2D naïve patients) without macular edema. DR was graded and swept-source optical coherence tomography Triton DRI (Topcon) was used to measure CT, which gave automatic measurements in ETDRS grid. An endocrinologist examined all the patients and searched in their medical records for data about macro and microangiopathy: ischemic cardiopathy (IC), cerebrovascular accident (CVA), peripheral artery disease (PAD), nephropathy, and peripheral polyneuropathy (PPN). RESULTS: Mean age was 67.38 ± 8.15 years, mean axial length was 23.26 ± 0.09 mm, and mean IOP was 16.75 ± 3.06 mmHg. Sixty eyes had no DR, 46 had mild, 64 had moderate, 20 had severe, and 10 had proliferative DR. IC was correlated with horizontal choroidal zones (p < 0.05 and η between 0.16 and 0.21) but not with DR (p = 0.16). CVA was neither correlated with CT (p > 0.05) nor with DR (p = 0.39). PAD was not correlated with CT (p > 0.05) but it was with DR (p = 0.03). The type of nephropathy was correlated both with CT in vertical sectors (p < 0.05 and η between 0.15 and 0.27) and DR (p = 0.01, τ = 0.24). PPN was not correlated with CT (p > 0.05) but it was with DR (p = 0.03). CONCLUSIONS: DR is correlated with microangiopathy (nephropathy and PPN) but not with macroangiopathy (IC, CVA, and PAD). CT is mildly correlated with nephropathy and IC. Some choroidal regions are more sensitive than others to each diabetic macro and microvascular manifestation.

Non-Mydriatic Ultra-Wide Field Imaging Versus Dilated Fundus Exam and Intraoperative Findings for Assessment of Rhegmatogenous Retinal Detachment.

BACKGROUND: to compare the extent of the detached retina and retinal tears location in rhegmatogenous retinal detachment (RRD) among non-mydriatic ultra-wide field (UWF) imaging, dilated fundus exam (DFE), and intraoperative evaluation. METHODS: this retrospective chart review comprised 123 patients undergoing surgery for RRD. A masked retina specialist analyzed the UWF fundus images for RRD area, status of the macula, and presence and location of retinal breaks. The same variables were collected from a database including DFE and intraoperative recordings. Evaluation methods were compared. RESULTS: mean age was 59.8 ± 14.9 years. Best-corrected visual acuity improved from 0.25 ± 0.3 (Snellen) to 0.67 ± 0.3 at 12 months (p = 0.009). The RRD description and assessment of macula status (34.5% macula-on) did not differ between UWF, DFE, and intraoperative examination. The inferior quadrant was involved most frequently (41.5%), followed by the superior (38.9%), temporal (27.8%) and nasal quadrant (14.8%). Intraoperative exam detected 96.7% of retinal tears compared with DFE (73.2%, p = 0.008) and UWF imaging (65%, p=0.003). UWF imaging and DFE did not differ significantly. CONCLUSION: RRD extent on DFE and UWF images was consistent with intraoperative findings. UWF and DFE detection of peripheral retinal tears was similar, but 25% of retinal breaks were missed until intraoperative evaluation.

Mapping choroidal thickness in patients with type 2 diabetes.

OBJECTIVE: To determine and compare topographic features of the choroidal thickness (CT) between patients with type 2 diabetes (T2D) and age-matched healthy controls based on swept source-optical coherence tomography (SS-OCT). DESIGN: Cross-sectional study. PARTICIPANTS: 96 T2D patients and 33 healthy individuals aged above 18 years and with an axial length (AL) lower than 26 mm were included. METHODS: A macular 6 × 6 mm cube, comprising 900 200 × 200 µm cubes, was scanned with SS-OCT. The choroid was automatically segmented using the segmentation algorithm. Three-dimensional maps were created to represent the choroid. The scanned area was divided into different zones based on CT, and equivalent zones were compared between groups. RESULTS: Mean age (standard deviation) in the control group was 66.83 (7.3) years, and that of the T2D group was 67.94 (7.9) years (p = 0.48). Both groups were similar regarding AL and spherical equivalent. Overall, CT was significantly thinner in the T2D group; it was 203.78 (53.40) in healthy individuals and 169.98 (63.22) in T2D patients (p = 0.01). Outside the fovea, the mean CT was thicker in the superior hemiretina and decreased inferiorly, temporally, and nasally, with minimum thickness in the most distant points from the fovea. CONCLUSIONS: Choroidal thickness follows an ellipsoid pattern in both nondiabetic and diabetic eyes, with diabetic eyes showing thinner measurements diffusely. Understanding these differences is important for future studies aimed at understanding the pathophysiological underpinnings of diabetic retinopathy.

Distribution of Choroidal Thinning in High Myopia, Diabetes Mellitus, and Aging: A Swept-Source OCT Study.

PURPOSE: To compare the macular choroidal thinning between young healthy, aged healthy, young high myopic, and aged type 2 diabetic (T2D) patients using the Early Treatment Diabetic Retinopathy Study (ETDRS) grid and three-dimensional (3D) maps. METHODS: A prospective study including 102 eyes of 51 healthy young subjects, 60 eyes of 30 healthy aged subjects, 24 eyes of 12 high myopic patients, and 110 eyes of 55 T2D patients. Choroidal thickness (CT) was examined with swept-source optical coherence tomography Triton DRI (Topcon Corporation, Tokyo, Japan). The choroid was automatically segmented using the software algorithm, and mean CT values of a 6 × 6 mm macular cube were exported. 3D maps were created to represent CT, and its values were compared using the ETDRS grid. RESULTS: Mean age was 27.31 ± 3.95, 66.41 ± 7.54, 27.69 ± 3.89, and 66.48 ± 7.59 years in young healthy, aged healthy, young high myopic, and T2D patients, respectively. CT was not shown to be uniform, as superior and central zones were thicker. All ETDRS sectors were always thicker (p < 0.05) in young healthy individuals than in the others. It was found that the choroidal sector which got thinner was inferior in case of age (103.28 µm decrease), inferior-nasal in high myopia (86.19 µm decrease), and temporal in T2D (55.57 µm decrease). In addition, the choroid got thinner in those regions where it was thicker in healthy subjects. CONCLUSIONS: 3D maps allow a further comprehension of choroidal changes. The choroidal pattern in young healthy individuals resembles a mountain range; with age, a mountain peak; in high myopia, an inverted gorge; and in aged T2D, gathered hills. Not all choroidal regions are affected in a similar way, as it depends on the pathology. The thicker the zone is in healthy subjects, the thinner it becomes with any pathology.

REPEATABILITY OF CHOROIDAL THICKNESS MEASUREMENTS ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY IN HEALTHY AND DIABETIC INDIVIDUALS.

PURPOSE: To assess the intrasession repeatability of choroidal thickness measurements obtained using swept-source optical coherence tomography in Type 2 diabetic (T2D) patients and healthy controls. METHODS: This was a single-center, prospective, observational, cross-sectional study with consecutive inclusion of 33 healthy subjects and 43 T2D patients. Subjects underwent three consecutive swept-source optical coherence tomography scans in a single session. After automatic delineation of the choroid, subfoveal choroidal thickness, and thickness at 500-µm intervals up to 2,500 µm nasal and temporal from the fovea were measured using the software caliper by the same operator. Intraclass correlation coefficients (ICCs), coefficients of variation, and test-retest variability were calculated. RESULTS: Mean subfoveal choroidal thickness in healthy subjects and in T2D patients was 229.97 ± 79.9 and 192.67 ± 74.3 µm, respectively (P = 0.013). All intrasession intraclass correlation coefficients were higher than 0.95 and 0.99, respectively. Coefficients of variations were less than 4.4% and 1.8%, respectively. Test-retest variability ranged from 0.76 µm to 11.12 µm and 0.64 µm to 6.29 µm, respectively. No significant differences were found in the intrasession repeatability of any choroidal measurement between healthy subjects and T2D patients. CONCLUSION: Swept-source optical coherence tomography provided excellent intrasession repeatability of choroidal thickness measurements in healthy subjects and T2D patients.

Choroidal thickness measured using swept-source optical coherence tomography is reduced in patients with type 2 diabetes.

OBJECTIVE: To compare choroidal thickness between patients with type 2 diabetes (T2D) and healthy controls measured using swept-source optical coherence tomography (SS-OCT). METHODS: The sample comprised 157 eyes of 94 T2D patients, 48 eyes of which had diabetic macular edema (DME), and 71 normal eyes of 38 healthy patients. Subfoveal (SF) choroidal thickness, and choroidal thickness at 500-µm intervals up to 2500 µm nasal and temporal from the fovea were measured using the SS-OCT. Choroidal thicknesses were compared between groups using Student's t-test. Additionally, Pearson correlations were calculated between diabetes duration, glycosylated hemoglobin (HbA1c) levels, and choroidal thickness. RESULTS: Mean diabetes duration was 16.6±9.5 years, while mean glycosylated hemoglobin was 7.7±1.3%. Overall, the choroid was significantly thinner in T2D patients. Individuals with DME had reduced choroidal thickness in all measurements, except at 2000 and 2500-µm nasal positions, compared to healthy controls. There was a moderate correlation between choroidal thickness and HbA1c levels in DME patients (SF: r = 0.342; p = 0.017). Diabetes duration did not correlate significantly with choroidal thickness. CONCLUSION: SS-OCT measurements revealed that the choroid was significantly thinner in T2D patients, moderate non-proliferative diabetic retinopathy patients, and DME patients than in healthy individuals. Further studies are needed to clarify the effect of diabetes on this layer and the relationship between choroidal thickness and DME.

Effect of the Eye Tracking System on the Reproducibility of Measurements Obtained With Spectral-domain Optical Coherence Tomography in Glaucoma.

PURPOSE: The purpose of this study was to evaluate whether the eye tracking system (ETS) improved the reproducibility of a single circle peripapillary retinal nerve fiber layer (RNFL) measurement acquired with spectral-domain optical coherence tomography (OCT). MATERIALS AND METHODS: The sample comprised 205 individuals divided into 2 groups according to intraocular pressure and visual field outcomes. A total of 100 healthy individuals and 105 patients with open-angle glaucoma underwent imaging of the optic nerve head with OCT 3 times during the same session and 2 additional times in subsequent sessions (30 days apart). Intraclass correlation coefficient (ICC), coefficient of variation, and test-retest variability were calculated for the RNFL thickness acquired with and without the ETS enabled, and compared. RESULTS: The glaucoma group mainly comprised patients with moderate glaucoma (mean deviation of standard automated perimetry, -6.73±6.2 dB). The RNFL thicknesses did not differ between acquisitions with or without the ETS activated and disabled. All ICCs were >0.9 in the control and glaucoma groups with or without the ETS activated. The best parameter in the intersession analysis (with ETS activated) was global RNFL thickness (ICC, 0.95; coefficient of variation, 2.7%; and test-retest variability, 2.87 µm). The reproducibility and repeatability of RNFL measurements did not differ significantly between acquisitions with or without the ETS in either group. CONCLUSIONS: The reproducibility of peripapillary RNFL thicknesses acquired with OCT was excellent. The variability between OCT measurements did not decrease with the ETS activated.

Clinical Applications of Dexamethasone for Aged Eyes.

The risk of severe eye problems has been found to increase significantly with age, particularly between the fifth and sixth decades of life. Cataracts, dry eye, neovascular age-related macular degeneration, diabetic retinopathy and retinal vein occlusion (RVO) are very common and very different age-related ocular diseases that reduce the patient's quality of life. The rationale for using corticosteroids to treat anterior and posterior ocular segment diseases is driven by inflammation. Dexamethasone, one of the most powerful corticosteroids available, is widely used for topical or intravitreal administration. Topical dexamethasone has proven efficacy for the management of postoperative inflammation in the anterior segment after cataract surgery and symptom relief in dry-eye disease. A new sustained-release 700 µg dexamethasone intravitreal implant (DEX) was recently approved for the treatment of macular edema following RVO, diabetic macular edema, or non-infectious uveitis, and its use is increasing, especially when other therapeutic agents have failed. The most common side effects are increased intraocular pressure and cataract formation. The potency of DEX, alone or in combination with other agents, makes DEX a promising option for treating several retinal diseases.

Macular Retinal Ganglion Cell Layer Thickness Is Not Reduced in Patients with Obstructive Sleep Apnea.

PURPOSE: To evaluate macular ganglion cell layer (GCL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses in patients with obstructive sleep apnea (OSA) syndrome. METHODS: 73 OSA patients and 67 age-matched controls were consecutively and prospectively enrolled. All participants underwent at least one reliable standard automated perimetry (SAP) and were imaged with spectral-domain optical coherence tomography (OCT) using two different devices. The OCT parameters were compared between groups, and Pearson correlations between main indices of SAP and OCT parameters were calculated. RESULTS: The pattern standard deviation of SAP was higher in the OSA group (p = 0.001). Mean GCIPL thickness was 82.99 ± 10.30 and 80.78 ± 12.15 µm in the control and OSA groups, respectively (p = 0.25), and GCL thickness was 44.93 ± 11.42 µm in the control group and 48.81 ± 10.85 µm in OSA individuals (p = 0.47). Pearson correlations between the GCIPL-GCL measurements and the main indices of SAP were not significant. CONCLUSIONS: Neither GCIPL nor GCL thickness were reduced in OSA subjects compared with healthy individuals. Retinal sensitivity evaluated with SAP was however decreased in OSA patients.

Assessment of the retinal nerve fiber layer in individuals with obstructive sleep apnea.

BACKGROUND: The effect of obstructive sleep apnea (OSA) syndrome in the peripapillary retinal nerve fiber layer (RNFL) thicknesses remains unclear. The purpose of this study was to assess RNFL measurements acquired using scanning laser polarimetry (SLP) and optical coherence tomography (OCT) in patients with OSA. METHODS: The sample of this cross-sectional study included 40 OSA patients and 45 age-matched controls, consecutively and prospectively selected. All participants underwent at least one reliable standard automated perimetry (SAP) test, while RNFL measurements were obtained using the SLP and OCT. The OSA group was divided into 3 sub-groups based on the apnea/hypopnea index (AHI): mild, moderate, or severe OSA. SAP, SLP, and OCT outcomes were compared between the control and OSA groups. The relationship between AHI and RNFL parameters was also evaluated. RESULTS: Age was not different between both groups. Mean deviation of SAP was -0.47 ± 0.9 dB and -1.43 ± 2.3 dB in the control and OSA groups, respectively (p = 0.01). RNFL thickness measured with OCT was similar between groups. OSA patients showed increased nerve fiber indicator (NFI; 20.9 ± 7.9 versus 16.42 ± 7.82; p = 0.01) and decreased superior average (59.74 ± 10.35 versus 63.73 ± 6.58; p = 0.03) obtained with SLP compared with healthy individuals. In the total sample, NFI and AHI were moderately correlated (r = 0.358; p = 0.001). In severe OSA subjects (n = 22), NFI and AHI had a Spearman correlation coefficient of 0.44 (p = 0.04). CONCLUSION: RNFL thickness measured with OCT did not differ significantly between groups. Severe OSA was related to a reduction of the RNFL thickness assessed by SLP.

Long-Term Visual Outcome in Wet Age-Related Macular Degeneration Patients Depending on the Number of Ranibizumab Injections.

Purpose. To analyse the visual outcome in wet age-related macular degeneration (AMD) patients depending on the number of ranibizumab injections. Methods. 51 naïve wet AMD patients were retrospectively recorded. Visual acuity (VA), central retinal thickness (CRT) measured with spectral domain (SD) optical coherence tomography (OCT), and number of intravitreal injections were compared at 6, 12, 18, 24, 30, and 36 months of follow-up. Kaplan-Meier survival rates (SRs) based on VA outcomes were calculated depending on the number of ranibizumab injections performed. Results. VA improved compared with baseline at 6 and 12 months (P < 0.005). No differences were found at 18, 24, 30, and 36 months (P > 0.05). CRT measured with Cirrus OCT decreased (P < 0.001) at all time points analysed. The mean number of injections received was 6.98 ± 3.69. At 36 months, Kaplan-Meier SR was 76.5% (the proportion of patients without a decrease in vision of more than 0.3 logMAR units). VA remained stable (≤0.01 logMAR units) or improved in 62.7%. Within this group, SR was 92.9% in those who received 7 or more injections versus 51.4% receiving <7 treatments (P = 0.008; log-rank test). Conclusion. Better VA outcomes were found in stable wet AMD patients after 3 years of follow-up if they received ≥7 ranibizumab injections.

Diabetic Macular Edema: Options for Adjunct Therapy.

Diabetes mellitus (DM) is a chronic disease that affects 387 million people worldwide. Diabetic retinopathy (DR), a common complication of DM, is the main cause of blindness in the active population. Diabetic macular edema (DME) may occur at any stage of DR, and is characterized by vascular hyperpermeability accompanied by hard exudates within the macula. Medical and surgical therapies have dramatically reduced the progression of DR, and timely intervention can reduce the risk of severe vision loss by more than 90 %. In 2012, intravitreal ranibizumab became the first antivascular endothelial growth factor (anti-VEGF) agent approved for DME and, since then, many reports of the use of ranibizumab for DME have been promising. Randomized, prospective, multicenter clinical trials-most notably, RESOLVE, READ-2, RISE/RIDE, RESTORE, DRCR.net protocol I, and RETAIN-reported improvements in best-corrected visual acuity and decreased central retinal thickness as measured with optical coherence tomography in patients with DME. Similar treatment benefits have also been noted in clinical trials evaluating intravitreal aflibercept and bevacizumab (DAVINCI, VISTA/VIVID, and BOLT) and more recently DRCR.net protocol T. Intravitreal steroids (dexamethasone intravitreal implant and fluocinolone acetonide), particularly in refractory cases, also play a significant role in the management of DME (MEAD/CHAMPLAIN and FAMOUS/FAME studies). In summary, over the last 5 years, blocking VEGF and inflammation has been shown to improve visual outcomes in patients with macular edema due to DM, revolutionizing the treatment of center-involved DME and establishing a new standard of care.

Treatment of Acanthamoeba neurotrophic corneal ulcer with topical matrix therapy.

BACKGROUND: This study was done to evaluate the visual and anatomical outcomes of topical regenerating agents as a novel therapy for neutrophic corneal ulcer (NCU) secondary to acanthamoeba infection. FINDINGS: A 20-year-old woman with a history of contact lens wear was referred to our hospital for keratitis after responding poorly to conventional treatment. In vivo confocal microscopy images suggested acanthamoeba keratitis with double-walled cysts in the anterior corneal stroma. Acanthamoeba infection was confirmed by laboratory findings. She was started on 0.1 % propamidine and 0.02 % chlorhexidine drops every hour. The antibiotic and antifungal drops were stopped when bacterial and fungal cultures proved negative. A central neurotrophic corneal ulcers (NCU) appeared, and despite treatment with artificial tears, bandage contact lens, and autologous serum, the ulcer worsened and she was treated with topical CACICOL20 (1 drop every 2 days) for 8 weeks. The corneal defect was completely repaired in 3 weeks. The treatment was well tolerated, and no local or systemic side effects were noted. Visual acuity remained 20/400. Two months later, the defect was still closed and the patient continued with 0.1 % propamidine and 0.02 % chlorhexidine drops, bandage contact lens, artificial tears, and autologous serum. CONCLUSIONS: Topical regenerating agents interact with components of the extracellular matrix, binding matrix proteins and protecting them from proteolysis, restoring the matrix environment, and improving tissue healing. In this case, CALCICOL20 was effective for vision stabilization, wound healing, and was well tolerated for NCU secondary to acanthamoeba infection.

Structure-Function Relationship between Frequency-Doubling Technology Perimetry and Optical Coherence Tomography in Glaucoma.

Purpose: To assess the relationship between the retinal nerve fibre layer (RNFL) thickness and the frequency-doubling technology perimetry (FDT) outcome. Methods: Sixty-two healthy individuals and 72 glaucoma patients were prospectively selected. All participants underwent a reliable FDT and optical coherence tomography (OCT). Pearson correlations were calculated between the unlogged threshold values of FDT and RNFL thicknesses measured by OCT. Results: Mild to moderate correlations were found between a few points from FDT and RNFL thicknesses in the vertical axis. The nasal superior area of FDT and the RNFL thickness at the 7-o'clock position had the strongest correlation (0.434, p < 0.001). Conclusions: The poor agreement between FDT and OCT parameters suggests that both instruments assess different characteristics of glaucomatous optic neuropathy. The map obtained validates previously reported clinical findings and contributes to a better understanding of the structure-function relationship in glaucoma. © 2014 S. Karger AG, Basel.

Retinal sensitivity is reduced in patients with obstructive sleep apnea.

PURPOSE: To evaluate the outcomes of standard automated perimetry (SAP) in patients with obstructive sleep apnea (OSA). METHODS: Eighty OSA patients and 111 age-matched controls were consecutively and prospectively enrolled. One eye per subject was randomly selected. All participants underwent at least one reliable SAP (24-2 SITA Standard algorithm). The peripapillary retinal nerve fiber layer thickness (RNFL) was measured with spectral-domain optical coherence tomography (OCT). Patients with OSA were classified into three groups according to the apnea/hypopnea index: mild, moderate, or severe OSA. Parameters of SAP and OCT were compared between healthy controls and OSA patients. Correlation of apnea/hypopnea index with OCT and SAP measurements were calculated. RESULTS: Mean age, best-corrected visual acuity, and central corneal thickness were similar between groups. Intraocular pressure, however, was lower in the OSA group. Mean deviation of SAP was -0.23 ± 0.8 dB in the control group and -1.74 ± 2.8 dB in the OSA group (P < 0.001). Thickness of RNFL measured with OCT did not differ significantly between groups. Patients with OSA showed reduced sensitivity at most points tested by white-on-white perimetry compared with healthy individuals. The threshold values were more depressed in the peripheral visual field. The apnea/hypopnea index was related to the SAP indices: Pearson correlations were -0.432 with mean deviation, 0.467 with pattern standard deviation, and -0.416 with the visual field index (P < 0.001). CONCLUSIONS: Patients with OSA exhibited reduced retinal sensitivity measured with SAP compared with healthy controls.

Assessment of the optic disc morphology using spectral-domain optical coherence tomography and scanning laser ophthalmoscopy.

OBJECTIVE: To compare the equivalent optic nerve head (OHN) parameters obtained with confocal scanning laser ophthalmoscopy (HRT3) and spectral-domain optical coherence tomography (OCT) in healthy and glaucoma patients. METHODS: One hundred and eighty-two consecutive healthy subjects and 156 patients with open-angle glaucoma were divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent imaging of the ONH with the HRT3 and the Cirrus OCT. The ONH parameters and the receiver operating characteristic (ROC) curves were compared between both groups. RESULTS: Mean age did not differ between the normal and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P = 0.15). Rim area, average cup-to-disc (C/D) ratio, vertical C/D ratio, and cup volume were different between both instruments (P < 0.001). All equivalent ONH parameters, except disc area, were different between both groups (P < 0.001). The best areas under the ROC curve were observed for vertical C/D ratio (0.980 for OCT and 0.942 for HRT3; P = 0.11). Sensitivities at 95% fixed-specificities of OCT parameters were higher than those of HRT3. CONCLUSIONS: Equivalent ONH parameters of Cirrus OCT and HRT3 are different and cannot be used interchangeably. ONH parameters measured with OCT yielded a slightly better diagnostic performance.

Relationship between spectral-domain optical coherence tomography and standard automated perimetry in healthy and glaucoma patients.

OBJECTIVE: To evaluate the relationship between spectral-domain optical coherence tomography (OCT) and standard automated perimetry (SAP) in healthy and glaucoma individuals. METHODS: The sample comprised 338 individuals divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent a reliable SAP and imaging of the optic nerve head with the Cirrus OCT. Pearson correlations were calculated between threshold sensitivity values of SAP (converted to linear scale) and OCT parameters. RESULTS: Mean age did not differ between the control and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P = 0.15). Significant differences were found for the threshold sensitivities at each of the 52 points evaluated with SAP (P < 0.001) and the peripapillary retinal nerve fiber layer (RNFL) thicknesses, except at 3 and 9 clock-hour positions between both groups. Mild to moderate correlations (ranging between 0.286 and 0.593; P < 0.001) were observed between SAP and most OCT parameters in the glaucoma group. The strongest correlations were found between the inferior RNFL thickness and the superior hemifield points. The healthy group showed lower and weaker correlations than the glaucoma group. CONCLUSIONS: Peripapillary RNFL thickness measured with Cirrus OCT showed mild to moderate correlations with SAP in glaucoma patients.

Caracterización fitoquímica de factores antinutricionales en las hojas de uvito (cordia dentata poir) / Phytochemical characterization of the antinutritional factors in the uvito leaves (cordia dentata poir)

Objetivo. Establecer factores antinutricionales en la biomasa de uvito (Cordia dentata Poir), y su valor nutricional e impacto en el bienestar animal, mediante experimentos de producción de gas. Materiales y Métodos. La recolección de hojas de C. dentata se llevó a cabo en dos épocas del año, correspondientes al periodo de verano (marzo) y lluvioso (septiembre), en el municipio de Codazzi (Cesar). Adicionalmente se realizó un muestreo de pasto Colosuana (Bothriochloa pertusa) que fue utilizado como forraje control. En las diferentes muestras se determinó la concentración de taninos, saponinas, alcaloides, nitratos y nitritos. Posteriormente, en ensayos de producción de gas in vitro, se cuantificó el impacto nutricional de diferentes concentraciones de los componentes antinutricionales mayoritarios identificados en la primera fase. Resultados. Los análisis realizados en este estudio indicaron que el uvito es un forraje degradable y una buena fuente de proteína aprovechable (16.8%) y que los contenidos de saponinas, alcaloides y taninos no deben ser considerados factores antinutricionales en esta especie. Sin embargo, la concentración de nitratos fue catalogada como potencialmente tóxica, condición que debe ser un factor a tener en cuenta al momento de incluir esta especie en la dieta de rumiantes. La cantidad de gas producido en los experimentos se vio afectada negativamente por la presencia de los nitratos contenidos en las hojas de C. dentata. Conclusiones. El uvito () puede ser incluido en la dieta de bovinos, teniendo muy en cuenta el control de los nitratos en el total de la dieta.