Resultados de un cribado de retinopatía diabética. Análisis de marcadores de riesgo / Results of a diabetic retinopathy screening. Risk markers analysis

OBJETIVO: Identificar marcadores de riesgo de presentar retinopatía en los pacientes de nuestro medio y compararlos con los identificados en otros estudios. Con esa información diseñar nuestra estrategia de intervalos de seguimiento contrastándolos con intervalos de seguimiento sugeridos en estudios publicados. MATERIAL Y MÉTODOS: Estudio observacional transversal sobre 383 pacientes diabéticos sin diagnóstico de retinopatía previa a los que se realizó cribado de retinopatía diabética. Se analizaron la posible asociación entre factores de los pacientes y la presencia de retinopatía. RESULTADOS: En nuestro estudio el tratamiento con insulina se asoció con una mayor probabilidad de encontrar retinopatía en cribado de pacientes diabéticos sin retinopatía previa, con una significación estadística del 95%. En pacientes con menos de 10 años de evolución únicamente se encontraron retinopatías de fondo leves sin edema macular. CONCLUSIONES: El tratamiento con insulina y el tiempo de evolución de la diabetes deben tenerse en cuenta a la hora de diseñar estrategias eficientes de cribado de retinopatía diabética

OBJECTIVE: To identify risk markers for retinopathy in patients from our geographic area, and to compare them with those published in other studies. To design a screening interval strategy, taking into account these results, and compare it with intervals suggested in published studies. MATERIAL AND METHODS: Cross-sectional observational study on 383 diabetic patients with no previous retinopathy diagnosis, who were screened for diabetic retinopathy. An analysis was made on the possible association between patient factors and presence of retinopathy. RESULTS: A greater probability for finding retinopathy in diabetic patients was associated to insulin treatment in our study, with a statistical significance level of 95%. In patients with less than 10 year onset of their diabetes, only mild retinopathy without macular oedema was found. CONCLUSIONS: Insulin treatment and time of onset of diabetes should be taken into account when designing efficient screening strategies for diabetic retinopathy

Results of a diabetic retinopathy screening. Risk markers analysis.

OBJECTIVE: To identify risk markers for retinopathy in patients from our geographic area, and to compare them with those published in other studies. To design a screening interval strategy, taking into account these results, and compare it with intervals suggested in published studies. MATERIAL AND METHODS: Cross-sectional observational study on 383 diabetic patients with no previous retinopathy diagnosis, who were screened for diabetic retinopathy. An analysis was made on the possible association between patient factors and presence of retinopathy. RESULTS: A greater probability for finding retinopathy in diabetic patients was associated to insulin treatment in our study, with a statistical significance level of 95%. In patients with less than 10year onset of their diabetes, only mild retinopathy without macular oedema was found. CONCLUSIONS: Insulin treatment and time of onset of diabetes should be taken into account when designing efficient screening strategies for diabetic retinopathy.

[Intracranial hypertension and cranial sinus stenosis]. / Hipertensión intracraneal y estenosis de los senos craneales.

CLINICAL CASE: Craneal sinuses stenosis can appear in patients with idiopathic intracranial hypertension. Neuroimaging techniques revealed a right transverse sinus stenosis. As the pressure gradient between both sides of the stenosis was small and response to conservative treatment good, angioplasty was not indicated. DISCUSSION: Lateral sinus stenosis in patients with idiopathic intracranial hypertension is prevalent. It is not clear whether these stenoses are the origin of, or secondary to, cerebrospinal fluid pressure increases. Some cases refractory to conservative treatment may respond to angioplasty with stent placement.

Hipertensión intracraneal y estenosis de los senos craneales / Intracranial hypertension and cranial sinus stenosis

Caso clínico: Varón diagnosticado de hipertensión intracraneal idiopática (HII) que en el estudio diagnóstico presentaba una estenosis del seno transverso derecho. Debido al pequeño gradiente de presión a ambos lados de la estenosis, medido por manometría y a la buena evolución con tratamiento conservador se decide no dilatar la estenosis. Discusión: Las estenosis en los senos laterales aparecen en pacientes con HII, sin que todavía este claro si son la causa del cuadro o secundarias al aumento de la presión del líquido cefalorraquídeo (LCR). En determinados casos la dilatación porangioplastia y colocación de stent han mejorado cuadros que habían sido refractarios a otros tratamientos

Clinical case: Craneal sinuses stenosis can appear in patients with idiopathic intracranial hypertension. Neuroimaging techniques revealed a right transverse sinus stenosis. As the pressure gradient between both sides of the stenosis was small and response to conservative treatment good, angioplasty was not indicated. Discussion: Lateral sinus stenosis in patients with idiopathic intracranial hypertension is prevalent. Itis not clear whether these stenoses are the origin of, or secondary to, cerebrospinal fluid pressure increases. Some cases refractory to conservative treatment may respond to angioplasty with stent placement