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.

Intravitreal injections: what do patients prefer? Analysis of patient's satisfaction and preferences about where to perform intravitreal injections.

OBJECTIVE: To analyse satisfaction and patient preferences on the location where they receive an intravitreal injection. METHOD: A survey was conducted with the intention of analysing these patients who attended the macula clinic and have been intervened using an intravitreal injection at least once in the day hospital or in the theatre setting, comparing both locations. RESULTS: The majority of the interviewed patients preferred the day hospital (50.0 versus 37.5%), mostly because of the comfort and the quick service. In patients with severe age-related macular degeneration (AMD) the option is reversed. The overall satisfaction level was positive in both cases (with 87.5% of patients satisfied or very satisfied in the day hospital and 91.1% in the theatre setting). Through the analysis of different aspects of clinical care the assessment was the same or superior for 75.0% of these patients, except in the waiting time. There were no cases of endophthalmitis. CONCLUSION: In general, patients prefer the clinical intervention in the consulting room than in the theatre setting because of the quicker service. There are several characteristics that can influence this choice and should be taken into account.

[Vitreous luxated PC-IOLs: complications].

PURPOSE: To determine pre-, intra- and postoperative complications of posterior chamber intraocular lenses (PC-IOL) posteriorly luxated in the vitreous. METHODS: We retrospectively reviewed reports of all patients with luxated PC-IOLs at our institution (1989-1999) with a minimum follow-up of 6 months. We identified 41 eyes; 4 were excluded because of short follow-up. Thirty-seven eyes were finally considered. Twenty-one eyes had "in situ" repositioning with vitrectomy, in 9 of them perfluorocarbon liquids (Perfluoro-DK-line) (PFCL) were used to refloat the luxated lenses. Sixteen eyes had IOL exchange, in 7 of them PFCL was used to refloat the IOL. RESULTS: The average age of the patients was 67.5 years. Preoperatively, 15 eyes (40%) had ocular hypertension, 9 eyes (24%) showed epithelial corneal edema (CE), 6 eyes (16%) had light vitreous hemorrhage (VH) and 4 eyes (11%) retinal detachment (RD). Intraoperatively, 9 eyes (24%) had VH related to sulcus fixation. Postoperatively, visual acuity improved in 32 (86%) eyes. In 3 cases (8%) we found a postsurgical RD that could be iatrogenic; one eye developed glaucoma and 1 developed, epiretinal membrane. Two patients were PFCL drops. CONCLUSION: Vitrectomy normalizes IOP and CE, PFCL simplifies the surgical technique for RD, and sulcus fixated IOL allows visual restoration. The combined technique generally offers good results.

[Myopia: frequency of lattice degeneration and axial length]. / Miopía: frecuencia de degeneración en empalizada y longitud axial.

OBJECTIVE: To evaluate the relationship between lattice retinal degeneration and axial length of the eye in different grades of myopia. MATERIAL AND METHODS: A sample of 200 eyes from 124 myopic patients was collected by chance. The average age was 34.8 years (20-50 years) and the myopia was between 0.5 and 20 diopters (D). The eyes were grouped according to the degree of refraction defect, the mean axial length of each group (Scan A) and the frequency of lattice retinal degeneration and the relationship between these variables was studied. The possible influence of age on our results was also considered. For the statistical analysis, the SAS 6.07 program with the variance analysis for quantitative variables, and chi(2) test for qualitative variables with a 5% significance were used. A multivariable linear regression model was also adjusted. RESULTS: The highest frequency of lattice retinal degeneration occurred in those myopia patients having more than 15 D, and also in the group of myopia patients between 3 and 6 D, but this did not show statistical significance when compared with the other myopic groups. If the axial length is assessed, a greater frequency of lattice retinal degeneration is also found when the axial length is 25-27 mm and 29-30 mm, which correspond, respectively, to myopias between 3-10 D and more than 15 D. When the multivariable linear regression model was adjusted, the axial length showed the existence of lattice retinal degeneration (beta 0.41 mm; p=0.08) adjusted by the number of diopters (beta 0.38 mm; p<0.001). The determination coefficient (r(2)) was also 0.86. CONCLUSIONS: The highest number of cases of lattice retinal degeneration was found for myopias with axial eye length between 29-30 mm (more than 15 D), and 25-27 mm (between 3-10 D).

Miopía: frecuencia de degeneración en empalizada y longitud axial / Myopia: frequency of lattice degeneration and axial length

Objetivo: Valorar la relación entre la degeneración en empalizada y la longitud axial del globo ocular en los diferentes grados de miopía. Material y métodos: Se ha recogido una muestra de oportunidad de 200 ojos en 124 pacientes miopes, con una edad media de 34,8 años (20-50 años), y con un grado de miopía entre las 0,5 y 20 dioptrías. Hemos agrupado los ojos dependiendo del defecto de refracción, considerando la longitud axial media de cada grupo (Scan A) y la frecuencia de degeneración en empalizada, valorando la relación entre estas variables. También consideramos la posible influencia de la edad en nuestros resultados. Para el análisis estadístico usamos el programa SAS 6.07, con análisis de la varianza para las variables cuantitativas y el test c2 para las cualitativas considerando un nivel de significación del 5 por ciento. Se ajustó un modelo de regresión lineal multivariable. Resultados: La mayor frecuencia de empalizada se ha producido en las miopías mayores de 15 dioptrías (D) y en el grupo de miopía entre 3 y 6 D, pero sin alcanzar significación estadística, en comparación con los otros grupos de miopía. Si valoramos la longitud axial, también aparece una mayor frecuencia de degeneración en empalizada cuando la longitud axial estaba entre 25-27 mm y 29-30 mm, que correspondían, respectivamente, a grupos de miopía entre 3-10 dioptrías y más de 15 D. Al ajustar un modelo de regresión lineal multivariable, la longitud axial se relacionó con la existencia de degeneración en empalizada (beta 0,41 mm; p=0,08) ajustada por el número de dioptrías (beta 0,38 mm; p<0,001). El coeficiente de determinación (r2) fue de 0,86. Conclusiones: El mayor número de casos de degeneración en empalizada se ha producido en las miopías con una longitud axial comprendida entre los 29-30 mm (miopías mayores de 15 D) y entre los 25-27 mm (miopías entre 3-10 dioptrías). (AU)

Manifestaciones oftalmológicas del síndrome antifosfolípido primario / Ofthalmologic manifestations in the primary antiphospholipid syndrome

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Miopía: prevalencia de desgarros y agujeros tróficos / Myopia: prevalence of retinal tears and round throphic holes

Objetivo: Estudiar la prevalencia de desgarros y agujeros tróficos en una población de miopes, así como su prevalencia por grupos de edad en dicha población, y su posible relación con los diferentes tipos de desprendimiento posterior de vítreo. Igualmente establecemos los cuadrantes retinianos más afectados. Material y métodos: Seleccionamos 200 ojos de 124 pacientes miopes, con una edad media de 34,65 años, y divididos en 5 grupos según el defecto de refracción. Asimismo consideramos 3 grupos de edad. A todos los pacientes se les realizó una oftalmoscopia indirecta con indentación bajo midriasis y biomicroscopia con lente de 3 espejos de Goldmann. Resultados: Aparecieron 7 desgarros en 6 ojos de los 200 estudiados, lo que representa el 3 por ciento de la totalidad, y 16 agujeros tróficos en 14 ojos de los 200 (7 por ciento). No encontramos significación estadística en la aparición de desgarros o agujeros para los diferentes grupos de miopía o de edad; tampoco con respecto a su relación con los diferentes tipos de desprendimiento posterior de vítreo. El cuadrante retiniano más afectado fue el temporal superior. Conclusiones: Los desgarros y/o agujeros tróficos que hemos encontrado (respectivamente 3 por ciento y 7 por ciento), no han mostrado relación con el tipo de desprendimiento posterior de vítreo, la edad ni el grado de miopía (AU)

[Myopia: prevalence of retinal tears and throphic holes]. / Miopía: prevalencia de desgarros y agujeros tróficos.

PURPOSE: We study the prevalence of retinal tears and holes in myopia. We consider age distribution, also retinal localization, and its relationship with the different types of posterior vitreous detachment. MATERIAL AND METHODS: 200 eyes from 124 myopic patients were selected. Average age was 34,76 years. Five groups of myopia were considered, and three groups of age. Indirect ophthalmoscopy under cycloplegia, scleral indentation and biomicroscopy with three mirror Goldmann contact lens were performed in all the patients. RESULTS: 7 tears were found in 6 eyes out of the 200 myopic eyes studied (3%), and 16 holes in 14 eyes (7%). No statistical relationship was found for tears or holes between the different groups of myopia or age, neither considering the different types of posterior vitreous detachment. Superotemporal retinal quadrant was more frequently involved by these lesions. CONCLUSIONS: The tears and round trophic holes found (3% and 7% respectively) did not show relationship with posterior vitreous detachment type, age nor myopic grade.

[Consumption of psychotropic drugs by the aged]. / Consumo de fármacos psicotrópicos en los ancianos.

BACKGROUND: The medical prescription increase for psychotropic drugs, and particularly by elderly, are the facts that have motivated this study: 1) elderly psychotropic consumption assessment, 2) identify risk factors consumption. METHODS: Descriptive and cross-sectional survey from individual questionnaires. RESULTS: The prevalence for psychotropic drugs was 24% in our sample, (72.1% women). 53.3% prescription were realized by family practitioners. 54.3% patients used them for more than three years. The biggest group consumed are the long term benzodiazepines (62.3%). CONCLUSIONS: The high prevalence, the long time of consumption, the use of long-term benzodiazepines, and the fact of that family practitioners are the main prescribers, must make us think about the pertinence and accuracy of these medical prescriptions.