Queratitis secundaria a Fusarium spp. en España 2012-2014 / Keratitis secondary to Fusarium spp. in Spain 2012-2014

OBJETIVO: Describir las características clinicoepidemiológicas de una serie de casos de queratitis fúngica asociada con Fusarium spp., en España durante los años 2012 a 2014. MÉTODOS: Estudio retrospectivo de una serie de casos. Se identificaron los centros sanitarios que se encontraban en las capitales provinciales (n = 250), obteniéndose una muestra aleatoria sistemática del 10%. Se les preguntó si habían presentado casos de queratitis por Fusarium spp. caracterizados mediante métodos microbiológicos, 23 centros respondieron, detectando casos en 14 de ellos, aceptando participar 13, completando el estudio 11 instituciones, a los que se les envió el cuestionario previamente validado. Las variables analizadas fueron: edad, sexo, residencia habitual, profesión, antecedentes patológicos y médicos (enfermedades sistémicas y oculares previas, cirugías oculares previas) y su evolución. RESULTADOS: La tasa de respuesta fue del 92%, identificando 23 casos de Fusarium spp.; 21 casos (91,3%) vivían en zonas urbanas. Los profesionales fueron los más afectados por la enfermedad (chef, administrativo, técnico) con 13 casos (56,5%). Las pautas de tratamiento establecidas antes de la confirmación de la infección evidenciaron el uso combinado de antibióticos tópicos asociados a agentes antivirales y/o antifúngicos, siendo el principal factor de riesgo el uso de lentes de contacto (86,9%). DISCUSIÓN: Es una enfermedad poco frecuente en nuestro medio, un gran porcentaje de las personas residían en áreas urbanas y su trabajo se realizaba en entornos cerrados, enfocando la atención en los microtraumas causados por el uso de lentes de contacto

OBJECTIVE: To describe the clinical-epidemiological characteristics of a case series of fungal keratitis associated with Fusarium spp.., in Spain during the years 2012 to 2014. METHODS: A retrospective study of a case series was conducted on a systematic random sample of 10% of patients identified in Health Centres of provincial capitals (n = 250). The centres were asked whether they had been presented with cases of Fusarium spp. keratitis characterised by microbiological methods. Of the 23 centres that responded, 14 had detected cases, with 13 of them accepting to participate, and 11 of them completing the study. The latter being sent a previously validated questionnaire. The variables analysed were: age, gender, habitual residence, profession, disease and medical history (previous systemic and ocular diseases, previous eye surgeries), and their outcomes. RESULTS: The response rate was 92%, identifying 23 cases of Fusarium spp.. of which 21 (91.3%) of them lived in urban areas. The professions most affected by the disease included chefs, administrative, and technical, with 13 cases (56.5%). The treatment guidelines established to confirm the infection showed the combined use of topical antibiotics associated with antiviral and/or antifungal agents. The use of contact lenses (86.9%) was the main risk factor. DISCUSSION: This study showed that this is a rare disease in Spain, but that a large percentage of people who present with the disease are resident in urban areas, and they work in closed environments, focusing attention on microtraumas caused by use of contact lenses

Keratitis secondary to Fusarium spp. in Spain 2012-2014. / Queratitis secundaria a Fusarium spp. en España 2012-2014.

OBJECTIVE: To describe the clinical-epidemiological characteristics of a case series of fungal keratitis associated with Fusarium spp.., in Spain during the years 2012 to 2014. METHODS: A retrospective study of a case series was conducted on a systematic random sample of 10% of patients identified in Health Centres of provincial capitals (n=250). The centres were asked whether they had been presented with cases of Fusarium spp. keratitis characterised by microbiological methods. Of the 23 centres that responded, 14 had detected cases, with 13 of them accepting to participate, and 11 of them completing the study. The latter being sent a previously validated questionnaire. The variables analysed were: age, gender, habitual residence, profession, disease and medical history (previous systemic and ocular diseases, previous eye surgeries), and their outcomes. RESULTS: The response rate was 92%, identifying 23 cases of Fusarium spp.. of which 21 (91.3%) of them lived in urban areas. The professions most affected by the disease included chefs, administrative, and technical, with 13 cases (56.5%). The treatment guidelines established to confirm the infection showed the combined use of topical antibiotics associated with antiviral and/or antifungal agents. The use of contact lenses (86.9%) was the main risk factor. DISCUSSION: This study showed that this is a rare disease in Spain, but that a large percentage of people who present with the disease are resident in urban areas, and they work in closed environments, focusing attention on microtraumas caused by use of contact lenses.

Tomografía de coherencia óptica de dominio espectral en la toxicidad retiniana por Celestone® / Spectral domain optical coherence tomography in Celestone® retinal toxicity

CASO CLÍNICO: Tras la administración intravítrea inadvertida de Celestone® (betametasona acetato y fosfato sódico, cloruro de benzalconio) en una paciente, la tomografía de coherencia óptica de dominio espectral (OCT-SD) mostraba hiperreflectividad, adelgazamiento e irregularidad en espículas en las capas internas de la mácula. Estos hallazgos tempranos serían el resultado del efecto tóxico directo del fármaco o sus excipientes. La alteración en la línea de los elipsoides y la aparición de espacios quísticos tabicados fueron hallazgos tardíos. DISCUSIÓN: La OCT-SD puede ayudar a conocer mejor la fisiopatología del daño retiniano y a diagnosticar las complicaciones asociadas, aportando información con valor pronóstico

CASE REPORT: After inadvertent intravitreal injection of Celestone® (betamethasone sodium phosphate and acetate, benzalkonium chloride) in a patient, the macular spectral domain optical coherence tomography (SD-OCT) images showed hyper-reflectivity, thinning, and irregular spikes in the inner retinal layers. These early findings could explain the toxic secondary anatomical changes due to the drug itself and/or to its excipients. Late and permanent SD-OCT findings included changes in the ellipsoid zone and cystic-like spaces. DISCUSSION: In this case, SD-OCT images can help to better understand the pathophysiology of the retinal damage and to diagnose the associated complications, providing information with prognostic value

Spectral domain optical coherence tomography in Celestone® retinal toxicity.

CASE REPORT: After inadvertent intravitreal injection of Celestone® (betamethasone sodium phosphate and acetate, benzalkonium chloride) in a patient, the macular spectral domain optical coherence tomography (SD-OCT) images showed hyper-reflectivity, thinning, and irregular spikes in the inner retinal layers. These early findings could explain the toxic secondary anatomical changes due to the drug itself and/or to its excipients. Late and permanent SD-OCT findings included changes in the ellipsoid zone and cystic-like spaces. DISCUSSION: In this case, SD-OCT images can help to better understand the pathophysiology of the retinal damage and to diagnose the associated complications, providing information with prognostic value.

Estudio de la relación entre miopía y personalidad / Study of the relationship between myopia and personality

Objetivo: Estudiar la correlación entre el error refractivo miópico y determinados rasgos de personalidad. Igualmente, se pretende determinar si existe correlación entre el grado de miopía y una mayor frecuencia de trastornos de la personalidad. Métodos: Estudio transversal observacional multicéntrico. La muestra la formaron 82 sujetos (26 hombres, 56 mujeres) mayores de 18 años con miopía (defecto esférico ≤ −0,5 D); 30 eran miopes magnos (<−6 D). Datos recogidos: edad y sexo, nivel de formación, resultado en el inventario de personalidad Neo PI-R, autorrefractometría, enfermedad miópica, tratamiento oftalmológico. Resultados: No se encontró correlación (rho de Spearman) estadísticamente significativa entre el defecto esférico y los rasgos de personalidad estudiados en el total de la muestra: neuroticismo (−0,057; p = 0,610), extraversión (−0,020; p = 0,857), apertura (−0,032; p = 0,774), amabilidad (−0,060; p = 0,592), responsabilidad (−0,034; p = 0,765). Al agruparlos por subgrupos de alta y baja significación (t-test), se halló una tendencia al aumento del defecto miópico con la extraversión, que resultó significativa (p = 0,002). Al comparar miopes magnos y el resto, se vio que existían diferencias significativas entre ambos grupos en cuanto a la enfermedad asociada (p < 0,001), el tratamiento recibido (p < 0,001) y el nivel de estudios ((p = 0,013), no así en las variables de personalidad: neuroticismo (p = 0,852), extraversión (p = 0,199), apertura (p = 0,560), amabilidad (p = 0,584), responsabilidad (p = 0,722). Conclusiones: Se encontró baja correlación entre miopía y personalidad. El grado de miopía no resultó diferente entre los grupos con diversos niveles de estudios. Los sujetos con enfermedad oftalmológica más grave asociada a la miopía presentaban puntuaciones más altas en neuroticismo, sin asociación significativa

OBJECTIVE: To study the correlation between the myopic refractive error and certain personality traits, and to determine whether there is a correlation between the degree of myopia and an increased frequency in personality disorders. METHODS: Cross-sectional observational multicenter study conducted on 82 subjects (26 men, 56 women) age over 18 years with myopia (spherical defect ≤ −0.5 D), with 30 subjects having high myopia (<−6 D). Data collected: age and gender, academic level, result in the Neo PI-R personality test, autorefractometry, myopic pathology, and ophthalmological treatment. RESULTS: Correlation (Spearman's) between the magnitude of the spherical defect and the 5 personality traits studied in the total sample was not statistically significant: neuroticism (−0.057; P=.610), extroversion (−0.020; P=.857), openness (−0.032; P=.774), kindness (−0.060; P=.592), and responsibility (−0.034;P=.765). By dividing them into subgroups of low and high significance (t-test), a significant (P=.002) upward trend of the myopic defect with increasing scores on extraversion was found. When comparing high myopic subjects to the non-high myopic ones, there were significant differences between the 2 groups in terms of the associated pathology (P=.001), received treatment (P=.001) and the level of studies (P=.013). There were no differences in the variables of personality: neuroticism (P=.852), extroversion (P=.199), openness (P=.560), kindness (P=.584), and responsibility (P=.722). CONCLUSIONS: A low correlation was found between myopia and personality. There was no difference in the degree of myopia between the groups with different education levels. Subjects with more severe ocular pathology associated with myopia had higher scores in neuroticism, without finding any significant association

Study of the relationship between myopia and personality.

OBJECTIVE: To study the correlation between the myopic refractive error and certain personality traits, and to determine whether there is a correlation between the degree of myopia and an increased frequency in personality disorders. METHODS: Cross-sectional observational multicenter study conducted on 82 subjects (26 men, 56 women) age over 18 years with myopia (spherical defect ≤ -0.5 D), with 30 subjects having high myopia (<-6 D). DATA COLLECTED: age and gender, academic level, result in the Neo PI-R personality test, autorefractometry, myopic pathology, and ophthalmological treatment. RESULTS: Correlation (Spearman's) between the magnitude of the spherical defect and the 5 personality traits studied in the total sample was not statistically significant: neuroticism (-0.057; P=.610), extroversion (-0.020; P=.857), openness (-0.032; P=.774), kindness (-0.060; P=.592), and responsibility (-0.034; P=.765). By dividing them into subgroups of low and high significance (t-test), a significant (P=.002) upward trend of the myopic defect with increasing scores on extraversion was found. When comparing high myopic subjects to the non-high myopic ones, there were significant differences between the 2 groups in terms of the associated pathology (P=.001), received treatment (P=.001) and the level of studies (P=.013). There were no differences in the variables of personality: neuroticism (P=.852), extroversion (P=.199), openness (P=.560), kindness (P=.584), and responsibility (P=.722). CONCLUSIONS: A low correlation was found between myopia and personality. There was no difference in the degree of myopia between the groups with different education levels. Subjects with more severe ocular pathology associated with myopia had higher scores in neuroticism, without finding any significant association.

Excavación intracoroidea peripapilar en miopía patológica / Peripapillary intrachoroidal cavitation in pathological myopia

CASO CLÍNICO: Mujer de 54 años, miope magna, que presentaba una lesión sobreelevada y blanco-amarillenta en la parte inferior del conus miópico de su ojo izquierdo. La tomografía de coherencia óptica (OCT) mostró un espacio hiporreflectivo intracoroideo. En la angiografía con fluoresceína (AFG) se apreciaba una hipofluorescencia precoz con tinción tardía, sin fuga del contraste. DISCUSIÓN: El reconocimiento de la «excavación intracoroidea peripapilar» como una entidad propia asociada a la miopía patológica es importante para evitar la confusión con otras posibles lesiones retinianas susceptibles de más estudios y tratamiento

CASE REPORT: A 54 year old woman with pathological myopia, presented with an elevated, yellowish-white lesion at the inferior border of the myopic conus in her left eye. The optical coherence tomography (OCT) demonstrated an intrachoroidal hyporeflective space. The fluorescein angiography examination (FA) showed early hypofluorescence with delayed staining, with no leakage of contrast. DISCUSSION: Recognition of «peripapillary intrachoroidal cavitation» as an own entity associated with pathological myopia is important to avoid confusion with other possible retinal lesions which require further investigation and treatment

Peripapillary intrachoroidal cavitation in pathological myopia.

CASE REPORT: A 54 year old woman with pathological myopia, presented with an elevated, yellowish-white lesion at the inferior border of the myopic conus in her left eye. The optical coherence tomography (OCT) demonstrated an intrachoroidal hyporeflective space. The fluorescein angiography examination (FA) showed early hypofluorescence with delayed staining, with no leakage of contrast. DISCUSSION: Recognition of «peripapillary intrachoroidal cavitation¼ as an own entity associated with pathological myopia is important to avoid confusion with other possible retinal lesions which require further investigation and treatment.