Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido / Corneal epithelial thickness one year after myopic LASIK surgery, measured by anterior segment optical coherence tomography combined with Placido disk

OBJETIVO: Comparar el grosor epitelial corneal (GEC) en pacientes intervenidos de LASIK miópico de más de un año respecto a sujetos no operados. MÉTODOS: En este estudio retrospectivo observacional se incluyeron 93 sujetos no operados (186 ojos) y 26 sujetos (52 ojos) operados de LASIK miópico. Se realizó una tomografía óptica de segmento anterior (OCT-SA) combinada con anillo de Plácido en todos los sujetos y se midió el GEC por sectores. Se hizo análisis estadístico para determinar diferencias entre las variables medidas en ambos grupos, así como análisis multivariante para buscar predictores de GEC. RESULTADOS: No hubo diferencias significativas entre los grupos en términos demográficos (edad, sexo) ni de segmento anterior (equivalente esférico, paquimetría) (todas las p > 0,05). Se obtuvieron diferencias estadísticamente significativas (p < 0,05) entre los dos grupos en todos los sectores estudiados, central, anillos interno y externo, siendo mayores todos los valores de GEC en los pacientes intervenidos de LASIK ≥ 1 año. A excepción del tiempo transcurrido desde la cirugía (p = 0,00), no se encontró correlación entre el GEC y la edad, el sexo, las dioptrías ablacionadas ni otra variable estudiada (p > 0,05). CONCLUSIONES: El GEC medio y por sectores medido mediante la OCT-SA es mayor en pacientes intervenidos de LASIK hace más de un año. La única variable correlacionada con el GEC tras el LASIK es el tiempo desde la cirugía. Las modificaciones del GEC deben ser tenidas en cuenta al planear la cirugía refractiva por sus implicaciones en el resultado final

OBJECTIVE: To compare corneal epithelial thickness (CET) between patients who underwent LASIK surgery for the correction of myopia at least one year ago and healthy subjects. METHODS: A retrospective observational study was conducted that included 93 healthy subjects (186 eyes) and 26 subjects (52 eyes) that underwent myopic LASIK surgery. OCT-SA, combined with Placido disk, was performed on all subjects, and CET maps were measured. Statistical analysis was performed to analyse differences between groups. Multivariate analysis was also performed to look for possible predictors of final CET. RESULTS: There was no statistically significant differences between the groups in the demographic (age, sex) or anterior segment parameters (spherical equivalent, pachymetry) (all P > .05). Statistically significant differences (P < .05) were obtained between both groups when comparing CET, including central, internal, and external rings (higher in patients that underwent LASIK surgery ≥1 year). With the exception of the time elapsed since surgery (P = .00), no correlation was found between the CET and age, sex, ablated dioptres, or other variables studied (P < .05). CONCLUSIONS: CET values measured by the OCT-SA were higher in patients that underwent LASIK surgery ≥ 1 year. The only variable that correlated with the CET after LASIK was the time elapsed since surgery. CET changes should be taken into consideration when planning refractive surgery due to its implications on the final outcome

Factores asociados con el desprendimiento neurosensorial macular en pacientes miopes magnos con estafiloma inferior / Factors associated with serous retinal detachment in highly myopic eyes with inferior posterior staphyloma

OBJETIVO: Investigar los factores clínicos asociados con el desprendimiento neurosensorial macular en ojos de pacientes miopes magnos con estafiloma inferior. MATERIAL Y MÉTODO: Estudio transversal de 27 pacientes miopes magnos (44 ojos) con estafiloma inferior. Todos los pacientes fueron sometidos a un examen oftalmológico completo, incluyendo angiografía fluoresceína. El grosor coroideo, la interfaz vitreorretiniana y la altura del envainamiento macular se analizaron mediante el dispositivo DRI OCT Triton Swept-Source (Topcon Corp., Tokio, Japón). RESULTADOS: De los 44 ojos, 13 presentaron un desprendimiento de la retina neurosensorial y 31 carecían del mismo. No observamos diferencias estadísticamente significativas en ninguna de las variables estudiadas (edad, sexo, equivalente esférico, longitud axial, agudeza visual, tracción vitreomacular, membrana epirretiniana o desprendimiento de membrana limitante interna). Los ojos con desprendimiento de la retina neurosensorial presentaron una mayor altura del envainamiento macular (p = 0,01) y una reducción del espesor coroideo (p = 0,02). El desprendimiento neurosensorial macular siempre se produjo en el borde superior del estafiloma inferior y se caracterizó por una hiperfluorescencia granular en la angiografía fluoresceínica. CONCLUSIONES: Una mayor altura del envainamiento macular y un menor grosor coroideo podrían ser factores importantes en el desarrollo del desprendimiento neurosensorial macular en pacientes miopes magnos con estafiloma inferior

PURPOSE: To investigate the factors associated with persistent serous retinal detachment in highly myopic eyes with inferior posterior staphyloma. METHODS: A total of 27 highly myopic patients (44 eyes) with an inferior posterior staphyloma were recruited. Serous retinal detachment was investigated; 13 eyes had persistent sub-macular fluid (study group), and 31 eyes lacked sub-macular fluid (control group). All patients underwent complete ophthalmologic examinations, including axial length measurement and fluorescein angiography (FA). Triton Deep Range Imaging (DRI) optical coherence tomography (OCT) (Topcon Corp., Tokyo, Japan) scans through the fovea measured choroidal thicknesses, macular bend height, and vitreoretinal interface factors. RESULTS: Of the 44 eyes, 13 had neurosensory retinal detachment and 31 did not. No significant differences were found in any of the studied variables (age, gender, spherical equivalence, axial length, vitreomacular traction, epiretinal membrane, internal limiting membrane detachment), except a higher macular bend height (p = 0.01), and a reduced macular choroidal thickness (p = 0.02), which were associated with the risk of serous retinal detachment. No statistically significant differences in best-corrected visual acuity (BCVA) were observed between the study and control groups. Serous retinal detachment always occurred at the bisected retinal pigment epithelium of the macula corresponding to the upper edge of the staphyloma, and was characterised by multiple hyperfluorescent granular patches on fluorescein angiography. CONCLUSIONS: A higher macular bend height and a reduced macular choroidal thickness may be important factors in the development of serous retinal detachment in patients with inferior posterior staphyloma

Factors associated with serous retinal detachment in highly myopic eyes with inferior posterior staphyloma. / Factores asociados con el desprendimiento neurosensorial macular en pacientes miopes magnos con estafiloma inferior.

PURPOSE: To investigate the factors associated with persistent serous retinal detachment in highly myopic eyes with inferior posterior staphyloma. METHODS: A total of 27 highly myopic patients (44 eyes) with an inferior posterior staphyloma were recruited. Serous retinal detachment was investigated; 13 eyes had persistent sub-macular fluid (study group), and 31 eyes lacked sub-macular fluid (control group). All patients underwent complete ophthalmologic examinations, including axial length measurement and fluorescein angiography (FA). Triton Deep Range Imaging (DRI) optical coherence tomography (OCT) (Topcon Corp., Tokyo, Japan) scans through the fovea measured choroidal thicknesses, macular bend height, and vitreoretinal interface factors. RESULTS: Of the 44 eyes, 13 had neurosensory retinal detachment and 31 did not. No significant differences were found in any of the studied variables (age, gender, spherical equivalence, axial length, vitreomacular traction, epiretinal membrane, internal limiting membrane detachment), except a higher macular bend height (p = 0.01), and a reduced macular choroidal thickness (p = 0.02), which were associated with the risk of serous retinal detachment. No statistically significant differences in best-corrected visual acuity (BCVA) were observed between the study and control groups. Serous retinal detachment always occurred at the bisected retinal pigment epithelium of the macula corresponding to the upper edge of the staphyloma, and was characterised by multiple hyperfluorescent granular patches on fluorescein angiography. CONCLUSIONS: A higher macular bend height and a reduced macular choroidal thickness may be important factors in the development of serous retinal detachment in patients with inferior posterior staphyloma.

Corneal epithelial thickness one year after myopic LASIK surgery, measured by anterior segment optical coherence tomography combined with Placido disk. / Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido.

OBJECTIVE: To compare corneal epithelial thickness (CET) between patients who underwent LASIK surgery for the correction of myopia at least one year ago and healthy subjects. METHODS: A retrospective observational study was conducted that included 93 healthy subjects (186eyes) and 26 subjects (52eyes) that underwent myopic LASIK surgery. OCT-SA, combined with Placido disk, was performed on all subjects, and CET maps were measured. Statistical analysis was performed to analyse differences between groups. Multivariate analysis was also performed to look for possible predictors of final CET. RESULTS: There was no statistically significant differences between the groups in the demographic (age, sex) or anterior segment parameters (spherical equivalent, pachymetry) (all P>.05). Statistically significant differences (P<.05) were obtained between both groups when comparing CET, including central, internal, and external rings (higher in patients that underwent LASIK surgery ≥1year). With the exception of the time elapsed since surgery (P=.00), no correlation was found between the CET and age, sex, ablated dioptres, or other variables studied (P<.05). CONCLUSIONS: CET values measured by the OCT-SA were higher in patients that underwent LASIK surgery ≥1year. The only variable that correlated with the CET after LASIK was the time elapsed since surgery. CET changes should be taken into consideration when planning refractive surgery due to its implications on the final outcome.

Prospective analysis of macular and optic disc changes after non-arteritic anterior ischemic optic neuropathy.

PURPOSE: To prospectively analyse macular and optic disc changes after the occurrence of non-arteritic anterior ischemic optic neuropathy (NAION) and study possible predictors of final visual outcome. METHODS: Patients with NAION underwent a complete ophthalmic examination, including spectral-domain optical coherence tomography of the macula and optic nerve head. The examination was repeated 1, 3, 6, 9 and 12 months after onset. Final visual prognosis was evaluated by visual field (VF) and best-corrected visual acuity (BCVA) at the final visit. Data within the NAION group were analysed over the course of the disease and compared to a disease-free control group at each visit. RESULTS: Twenty-two eyes with NAION and 43 eyes from a control group were included. The retinal nerve fiber layer (RNFL) was significantly thicker in NAION eyes than controls at presentation (P=0.00), and significantly decreased during the next 3 months after presentation (P=0.02). The ganglion cell+inner plexiform layer (GCIPL) was thinner in the NAION group throughout the course of the disease (all P<0.05). Although the acute NAION eyes had significantly lower cup/disc ratios and higher neuroretinal and disc sizes (all P=0.00), there were no significant differences between groups from the third month onwards (all P>0.05). The best predictors of BCVA and VF were GCIPL at 3 months of follow-up (r2=0.32; P=0.03) and RNFL at 6 months of follow-up (r2=0.41; P=0.01) respectively. CONCLUSIONS: RNFL and optic disc changes occur during the first 3 months after the onset of NAION, whereas GCIPL is affected soon after the onset of symptoms. GCIPL and RNFL are useful predictors of final visual outcome.

Estudio longitudinal de la función visual en pacientes con esclerosis múltiple remitente-recurrente con y sin antecedentes de neuritis óptica / Longitudinal study of visual function in patients with relapsing-remitting multiple sclerosis with and without a history of optic neuritis

Introducción: El examen de la sensibilidad al contraste permite determinar la calidad de la función visual en pacientes con esclerosis múltiple (EM). El objetivo de este estudio es analizar las modificaciones evolutivas de la función visual en pacientes con EM remitente-recurrente. Métodos: Estudio longitudinal de 61 pacientes clasificados en 3 grupos: a) pacientes libres de enfermedad (grupo control); b) pacientes con EM y sin antecedentes de neuritis óptica (NO), y c) pacientes con EM y antecedentes de NO unilateral. A todos los pacientes se les realizó una exploración oftalmológica que incluía agudeza visual y test de sensibilidad al contraste tipo Pelli-Robson mono y binocularmente, tanto al inicio como a los 6 años de seguimiento. Resultados: La sensibilidad al contraste monocular en pacientes con EM con y sin antecedentes de NO fue significativamente inferior al grupo control tanto al inicio (p=0,00 y p=0,01) como a los 6 años (p = 0,01 y p = 0,02), manteniéndose estable a lo largo del seguimiento excepto en el grupo de pacientes con NO en el cual existe una pérdida significativa de sensibilidad al contraste (p = 0,01). La agudeza visual y la sensibilidad al contraste binocular al inicio y a los 6 años de seguimiento fueron significativamente inferiores en el grupo de pacientes con antecedentes de NO que en el grupo control (p = 0,003 y p = 0,002; p = 0,006 y p = 0,005) y con EM sin NO (p = 0,04 y p = 0,038; p = 0,008 y p = 0,01); sin embargo, no encontramos diferencias significativas en el seguimiento (p = 0,1 y p = 0,5). Conclusiones: El test de Pelli-Robson monocular podría servir como marcador evolutivo del deterioro de la función visual en ojos con NO

Introduction: The contrast sensitivity test determines the quality of visual function in patients with multiple sclerosis (MS). The purpose of this study is to analyse changes in visual function in patients with relapsing-remitting MS with and without a history of optic neuritis (ON). Methods: We conducted a longitudinal study including 61 patients classified into 3 groups as follows: a) disease-free patients (control group); b) patients with MS and no history of ON; and c) patients with MS and a history of unilateral ON. All patients underwent baseline and 6-year follow-up ophthalmologic examinations, which included visual acuity and monocular and binocular Pelli-Robson contrast sensitivity tests. Results: Monocular contrast sensitivity was significantly lower in MS patients with and without a history of ON than in controls both at baseline (P=.00 and P=.01, respectively) and at 6 years (P=.01 and P=.02). Patients with MS and no history of ON remained stable throughout follow-up whereas those with a history of ON displayed a significant loss of contrast sensitivity (P=.01). Visual acuity and binocular contrast sensitivity at baseline and at 6 years was significantly lower in the group of patients with a history of ON than in the control group (P=.003 and P=.002 vs P=.006 and P=.005) and the group with no history of ON (P=.04 and P=.038 vs P=.008 and P=.01). However, no significant differences were found in follow-up results (P=.1 and P=.5). Conclusions: Monocular Pelli-Robson contrast sensitivity test may be used to detect changes in visual function in patients with ON

Longitudinal study of visual function in patients with relapsing-remitting multiple sclerosis with and without a history of optic neuritis. / Estudio longitudinal de la función visual en pacientes con esclerosis múltiple remitente-recurrente con y sin antecedentes de neuritis óptica.

INTRODUCTION: The contrast sensitivity test determines the quality of visual function in patients with multiple sclerosis (MS). The purpose of this study is to analyse changes in visual function in patients with relapsing-remitting MS with and without a history of optic neuritis (ON). METHODS: We conducted a longitudinal study including 61 patients classified into 3 groups as follows: a) disease-free patients (control group); b) patients with MS and no history of ON; and c) patients with MS and a history of unilateral ON. All patients underwent baseline and 6-year follow-up ophthalmologic examinations, which included visual acuity and monocular and binocular Pelli-Robson contrast sensitivity tests. RESULTS: Monocular contrast sensitivity was significantly lower in MS patients with and without a history of ON than in controls both at baseline (P=.00 and P=.01, respectively) and at 6 years (P=.01 and P=.02). Patients with MS and no history of ON remained stable throughout follow-up whereas those with a history of ON displayed a significant loss of contrast sensitivity (P=.01). Visual acuity and binocular contrast sensitivity at baseline and at 6 years was significantly lower in the group of patients with a history of ON than in the control group (P=.003 and P=.002 vs P=.006 and P=.005) and the group with no history of ON (P=.04 and P=.038 vs P=.008 and P=.01). However, no significant differences were found in follow-up results (P=.1 and P=.5). CONCLUSIONS: Monocular Pelli-Robson contrast sensitivity test may be used to detect changes in visual function in patients with ON.

[Analysis of the quantitative differences in the thickness of the retinal nerve fibre layer between time-domain and spectral-domain optical coherence tomography in patients with relapsing-remitting multiple sclerosis]. / Analisis de las diferencias cuantitativas en el grosor de la capa de fibras nerviosas retiniana entre la tomografia de coherencia optica de dominio-tiempo y de dominio-espectral en pacientes con esclerosis multiple remitente recurrente.

INTRODUCTION: Optical coherence tomography (OCT) is a tool that is increasingly more commonly used in the study of neuro-degenerative diseases. AIMS: To analyse and correlate the thickness of the retinal nerve fibre layer (RNFL) by means of time-domain and spectral-domain OCT in patients with relapsing-remitting multiple sclerosis (MS), with and without a history of optic neuritis (ON). SUBJECTS AND METHODS: We conducted a cross-sectional study of the thickness (mean and by quadrants) of the RNFL of 15 disease-free subjects, 28 with MS with no prior history of ON and 18 with a history of ON. The full ophthalmologic examination included measurement of the RNFL by means of time-domain and spectral-domain tomography. RESULTS: Statistically significant differences are found between the two tomography scans on comparing the mean thickness of the RNFL of the control group (p = 0.000), the group with a history of ON (p = 0.000) and the group without ON (p = 0.000). We obtained a strong, statistically significant and directly proportional correlation between the mean thickness of the RNFL measured with the two types of tomography in the control group (rho = 0.842; p = 0.000), and the groups of eyes without ON (rho = 0.91; p = 0.000) and with ON (rho = 0.902; p = 0.000). CONCLUSIONS: There is a strong correlation between the two tomography scans in the measurement of the thickness of the RNFL in patients with MS, with and without a history of ON. Time-domain OCT quantifies greater thicknesses, and therefore both types of tomography have proven to be effective in the study of MS, although the results cannot be interchanged or extrapolated.

TITLE: Analisis de las diferencias cuantitativas en el grosor de la capa de fibras nerviosas retiniana entre la tomografia de coherencia optica de dominio-tiempo y de dominio-espectral en pacientes con esclerosis multiple remitente recurrente.Introduccion. La tomografia de coherencia optica (OCT) es una herramienta cada vez mas extendida en el estudio de las enfermedades neurodegenerativas. Objetivos. Analizar y correlacionar el grosor de la capa de fibras nerviosas retiniana (CFNR) mediante OCT de dominio-tiempo y dominio-espectral en pacientes con esclerosis multiple (EM) remitente recurrente, con y sin antecedente de neuritis optica (NO). Sujetos y metodos. Estudio transversal del grosor medio y por cuadrantes de la CFNR en 15 sujetos libres de enfermedad, 28 con EM sin historia previa de NO y 18 con antecedentes de NO. La exploracion oftalmologica completa incluia la medicion de la CFNR mediante tomografos de dominio-tiempo y dominio-espectral. Resultados. Existen diferencias estadisticamente significativas entre ambos tomografos al comparar el grosor medio de la CFNR en el grupo control (p = 0,000), el grupo con antecedentes de NO (p = 0,000) y el grupo sin NO (p = 0,000). Hemos obtenido una fuerte correlacion, estadisticamente significativa y directamente proporcional entre el grosor medio de la CFNR medido con ambos tomografos en el grupo control (rho = 0,842; p = 0,000), y los grupos de ojos sin NO (rho = 0,91; p = 0,000) y con NO (rho = 0,902; p = 0,000). Conclusiones. Existe una fuerte correlacion en la medicion del grosor de la CFNR entre ambos tomografos en pacientes con EM, con y sin antecedente de NO. La OCT de dominio-tiempo cuantifica grosores mayores, por lo que ambos tomografos se demuestran eficaces en el estudio de la EM, aunque los resultados no son intercambiables ni extrapolables.

Grosor coroideo macular en la neuropatía óptica isquémica anterior no arterítica / Macular choroidal thickness in non-arteritic ischemic optic neuropathy

OBJETIVO: Analizar el grosor coroideo macular (GCM) en la neuropatía óptica isquémica anterior no arterítica (NOIA-NA). MATERIAL Y MÉTODOS: Un total de 22 pacientes diagnosticados de NOIA-NA (22 ojos) y 42 sujetos sanos (42 ojos) fueron estudiados usando tomografía de coherencia óptica con técnica Enhanced Depth Imaging (EDI-OCT). Se realizó un escáner de una línea horizontal centrado en la fóvea 3 meses después del inicio de NOIA-NA. Se tomaron 3 medidas desde la parte posterior del epitelio pigmentario hasta la unión esclerocoroidea a intervalos de 500 μm en las 1.500 μm centrales de la mácula. Los resultados fueron analizados estadísticamente comparando la media de GCM entre grupos y correlacionando el GCM con otros parámetros oculares y sistémicos. RESULTADOS: Excepto en el error refractivo (p = 0,01), no hubo diferencias significativas en longitud axial (p = 0,53), edad (p = 0,88) ni en otros parámetros oculares ni epidemiológicos entre grupos. La media de GCM en la NOIA-NA y en el grupo control fue 236,21 ± 63,29 μm y 269,13 ± 52,28, respectivamente. La media del GCM fue significativamente más delgada en ojos con NOIA-NA que en sanos (p = 0,03). El adelgazamiento del GCM estuvo asociado con el diagnóstico de NOIA-NA después de ajustar por error refractivo (p = 0,04). CONCLUSIONES: Los ojos afectos con NOIA-NA mostraron un GCM significativamente más adelgazado que en sujetos sanos, después de ajustar por error refractivo

OBJECTIVE: To analyse macular choroidal thickness (MCT) in non-arteritic ischaemic optic neuropathy (NAION). MATERIALS AND METHODS: An analysis was made on 22 patients diagnosed with NAION (22 eyes) and 42 healthy controls (42 eyes) using enhanced-depth imaging of spectral-domain optical coherence tomography. A horizontal raster scan centred on the fovea was obtained per eye 3 months after the onset of NAION. Three measurements of MCT were obtained from the posterior edge of the retinal pigment epithelium to the choroid-sclera junction at 500 μm intervals. Statistical analysis was used to compare the mean MCT and to correlate MCT with other ocular and systemic parameters. RESULTS: Except for refractive error (P=.01), there were no statistically significant differences between both groups in axial length (P=.53), age (P=.88) and other epidemiological and ocular parameters. Mean MCT in NAION eyes and control group was 236.21 ± 63.29 μm and 269.13 ± 52.28, respectively. Mean MCT was significantly thinner in NAION eyes than in healthy eyes (P=.03). Thinner MCT, adjusted for refractive error, was associated with the diagnosis of NAION (P=.04). CONCLUSIONS: Eyes affected by NAION showed significantly thinner MCT compared with healthy control eyes after adjusting for refractive error

Macular choroidal thickness in non-arteritic ischemic optic neuropathy. / Grosor coroideo macular en la neuropatía óptica isquémica anterior no arterítica.

OBJECTIVE: To analyse macular choroidal thickness (MCT) in non-arteritic ischaemic optic neuropathy (NAION). MATERIALS AND METHODS: An analysis was made on 22 patients diagnosed with NAION (22 eyes) and 42 healthy controls (42 eyes) using enhanced-depth imaging of spectral-domain optical coherence tomography. A horizontal raster scan centred on the fovea was obtained per eye 3 months after the onset of NAION. Three measurements of MCT were obtained from the posterior edge of the retinal pigment epithelium to the choroid-sclera junction at 500µm intervals. Statistical analysis was used to compare the mean MCT and to correlate MCT with other ocular and systemic parameters. RESULTS: Except for refractive error (P=.01), there were no statistically significant differences between both groups in axial length (P=.53), age (P=.88) and other epidemiological and ocular parameters. Mean MCT in NAION eyes and control group was 236.21±63.29µm and 269.13±52.28, respectively. Mean MCT was significantly thinner in NAION eyes than in healthy eyes (P=.03). Thinner MCT, adjusted for refractive error, was associated with the diagnosis of NAION (P=.04). CONCLUSIONS: Eyes affected by NAION showed significantly thinner MCT compared with healthy control eyes after adjusting for refractive error.