Características clínico-epidemiológicas del queratocono en Asturia / Clinical-epidemiological characteristics of keratoconus in Asturias

Introducción El queratocono es la ectasia corneal más frecuente y la segunda causa de queratoplastia en el mundo. Las características clínicas y epidemiológicas del queratocono no han sido apenas estudiadas en España y, hasta la fecha, no se ha hecho ningún trabajo en Asturias. Material y métodos Se realizó un estudio transversal analizando todos los casos de queratocono diagnosticado en las primeras consultas de la sección de Córnea y Superficie de los centros Hospital Universitario Central de Asturias (Oviedo) y Hospital Universitario de Cabueñes (Gijón) entre 2017 y 2020. A todos los pacientes se les recogieron datos demográficos, agudeza visual y se les realizó una topografía corneal. Resultados Se incluyeron un total de 112 pacientes (42,0% mujeres y 58,0% hombres). La edad media era de 36,84±15,59, teniendo un 39,3% una edad superior a 40 años. Un 31,8; 28,0; 15,0 y 25,2% se encontraban en los estadios i, ii, iii y iv, respectivamente, en la escala Amsler-Krumeich. En un 7,5% se implantaron segmentos corneales, en un 4,7% se realizó cross-linking y en un 13,2% se realizó queratoplastia. Conclusión Aproximadamente un 40% de los queratoconos se detectan en estadios avanzados y otro 40% a una edad superior a los 40 años. Un 13% de los mismos requieren queratoplastia, por lo que sigue siendo una indicación frecuente en nuestro medio. Es necesario, por tanto, realizar un diagnóstico precoz para actuar antes de que exista una pérdida visual irreversible. (AU)

Introduction Keratoconus is the most frequent corneal ectasia and second most common cause of keratoplasty worldwide. The clinical and epidemiological characteristics of keratoconus have rarely been studied in Spain, and to date, no study has been done in Asturias. Material and methods A cross-sectional study was conducted to analyze all cases of keratoconus diagnosed in the first consultations of the cornea and surface section of the Hospital Universitario Central de Asturias (Oviedo) and Hospital Universitario de Cabueñes (Gijón) between 2017 and 2020. Demographic data, visual acuity and corneal topography were collected. Results A total of 112 patients (42.0% women and 58.0% men) were included. The mean age was 36.84±15.59, with 39.3% being older than 40 years. 31.8%, 28.0%, 15.0%, and 25.2% were in stages i, ii, iii and iv, Amsler–Krumeich scale, respectively. Corneal segments were implanted in 7.5% of patients, cross-linking was performed in 4.7%, and keratoplasty was performed in 13.2%. Conclusion Approximately 40% of keratoconus cases are detected at advanced stages and another 40% are detected at an age over 40 years. 13% of these patients require keratoplasty, which is why it is frequently performed in our setting. Therefore, early diagnosis before irreversible visual loss is necessary. (AU)

Clinical-epidemiological characteristics of keratoconus in Asturias.

INTRODUCTION: Keratoconus is the most frequent corneal ectasia and second most common cause of keratoplasty worldwide. The clinical and epidemiological characteristics of keratoconus have rarely been studied in Spain, and to date, no study has been done in Asturias. MATERIAL AND METHODS: A cross-sectional study was conducted to analyze all cases of keratoconus diagnosed in the first consultations of the Cornea and Surface section of the Hospital Universitario Central de Asturias (Oviedo) and Hospital Universitario de Cabueñes (Gijón) between 2017 and 2020. Demographic data, visual acuity and corneal topography were collected. RESULTS: A total of 112 patients (42.0% women and 58.0% men) were included. The mean age was 36.84 ±â€¯15.59, with 39.3% being older than 40 years. 31.8%, 28.0%, 15.0%, and 25.2% were in stages I, II, III and IV, Amsler-Krumeich scale, respectively. Corneal segments were implanted in 7.5% of patients, cross-linking was performed in 4.7%, and keratoplasty was performed in 13.2%. CONCLUSION: Approximately 40% of keratoconus cases are detected at advanced stages and another 40% are detected at an age over 40 years. 13% of these patients require keratoplasty, which is why it is frequently performed in our setting. Therefore, early diagnosis before irreversible visual loss is necessary.

Queratitis por Absidia corymbifera en paciente inmunocompetente sin traumatismo corneal previo / Keratitis caused by Absidia corymbifera in an immunocompetent male with no corneal injuries

CASO CLÍNICO: Varón sano de 55 años sin antecedente de traumatismo corneal acude a urgencias por un infiltrado en el ojo izquierdo que responde parcialmente a tratamiento antibiótico tópico. Tras la introducción de corticoterapia tópica presenta un importante empeoramiento de la úlcera. El examen directo y la tinción de Gram permiten un rápido diagnóstico de las hifas de Absidia. Presenta buena respuesta al tratamiento combinado de anfotericina y posaconazol. DISCUSIÓN: Las queratitis por Zygomycetes son raras. Es rara la afectación de pacientes sanos sin antecedentes de traumatismo corneal. El tratamiento combinado de anfotericina y posaconazol ejerce un efecto sinergico contra hongos filamentosos

CASE REPORT: A healthy 55-years-old male went to emergency due to a white infiltrate in the left eye without corneal trauma which partially responds to antibiotic treatment. The infiltrate worsened by the use of topical steroids. Direct microscopic evaluation and Gram stain are a valuable diagnostic tool for the detection of Absidia filaments. There is a successful treatment with anphotericin and posaconazole. DISCUSSION: Keratitis caused by Zygomicetes are unusual. This is a rare condition in healthy patients with no corneal trauma. The treatment with amphotericin and posaconazole are synergistic against filamentous fungi

Keratitis caused by Absidia corymbifera in an immunocompetent male with no corneal injuries.

Case Report A healthy 55-years-old male went to emergency due to a white infiltrate in the left eye without corneal trauma which partially responds to antibiotic treatment. The infiltrate worsened by the use of topical steroids. Direct microscopic evaluation and Gram stain are a valuable diagnostic tool for the detection of Absidia filaments. There is a successful treatment with anphotericin and posaconazole. Discussion Keratitis caused by Zygomicetes are unusual. This is a rare condition in healthy patients with no corneal trauma. The treatment with amphotericin and posaconazole are synergistic against filamentous fungi.