Could the thick of retinal nerve fiber layer be a potential measure of axonal loss in hearing loss?

OBJECTIVE: The objective of the study is to compare the optic coherence tomography (OCT) parameters of the healthy and affected sides of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to investigate the relationships between these and the improvement in hearing levels. METHODS: A bilateral eye evaluation of patients diagnosed with ISSNHL was performed with OCT. The ganglion cell complex (GCC) and retina nerve fiber layer (RNFL) thickness values were recorded and the differences between the two eyes were examined. RESULTS: An evaluation was made of 39 patients with a mean age of 44.82 ± 14.90 years. The RNFL thickness of the eyes was determined to be mean 89.87 ± 3.65 µm on the affected side and 103.87 ± 3.98 µm on the healthy control side (p = 0.0001). The mean GCC was determined to be mean 90.46 ± 3.49 µm on the affected side and 103.77 ± 3.96 µm on the healthy control side (p = 0.0001). CONCLUSIONS: A statistically significant difference was observed between the healthy and affected eyes of patients with ISSNHL with respect to mean GCC and mean RNFL thickness. OCT could be a useful technique for measuring this neural degeneration.

OBJETIVO: Comparar e investigar los parámetros de la tomografía de coherencia óptica (OCT) de los lados sanos y afectados de pacientes con pérdida auditiva neurosensorial súbita idiopática (PANSI). MÉTODO: La evaluación ocular bilateral de los pacientes diagnosticados con PANSI se realizó con OCT. Se registraron los valores de espesor del complejo de células ganglionares (CCG) y de la capa de fibras nerviosas de la retina (CFNR), y se examinaron las diferencias entre los dos ojos. RESULTADOS: Se evaluaron 39 pacientes, con una edad media de 44.82 ± 14.90 años. Se determinó que el grosor de la CFNR de los ojos era una media de 89.87 ± 3.65 µm en el lado afectado y 103.87 ± 3.98 µm en el lado de control sano (p = 0.0001). Se determinó que el CCG medio era 90.46 ± 3.49 µm en el lado afectado y 103.77 ± 3.96 µm en el lado de control sano (p = 0.0001). CONCLUSIONES: Se encontró una diferencia estadísticamente significativa entre los ojos sanos y afectados de pacientes con PANSI con respecto al CCG medio y al espesor medio de la CFNR. La OCT podría ser una técnica útil para medir esta degeneración neuronal.

Un caso inusual de oclusión de rama arterial retiniana: posible variante del síndrome de Sneddon / Unusual case of retinal arterial branch occlusion: Possible variant of Sneddon syndrome

El síndrome de Sneddon (SS) se manifiesta por múltiples accidentes cerebrovasculares y livedo reticularis. La vasculopatía livedoide (VL) se caracteriza por una larga historia de ulceración de pies y piernas y una histopatología que indica un proceso trombótico. Se describe una oclusión de rama arterial retiniana en un varón de 52años con VL. No presentó anomalías de laboratorio perceptibles, como anticuerpos antifosfolípidos, ni antecedentes de accidentes cerebrovasculares. La oclusión de arteria retiniana acompañada de VL podría ser una variante del síndrome de Sneddon. Con angiografía por tomografía de coherencia óptica se observó en la mácula en el ojo asintomático una reducción de las capas vasculares, lo que indica cambios microvasculares localizados como marcador evolutivo en la patogénesis del SS.(AU)

Sneddon's syndrome (SS) manifests through multiple strokes and livedo reticularis. Livedoid vasculopathy (LV) is characterized by a long history of foot and leg ulceration and histopathology indicating a thrombotic process. Arterial retinal branch occlusion is described in a 52-year-old male with LV. He did not present noticeable laboratory abnormalities, such as antiphospholipid antibodies, or a history of strokes. Retinal artery occlusion accompanied by LV could be a variant of Sneddon's syndrome. Optical coherence tomography angiography revealed a reduction in the macula's vascular layers in the asymptomatic eye, indicating localized microvascular changes as an evolving marker in the pathogenesis of SS.(AU)

Presence of subfoveal hyperreflective dots as an anatomic and functional prognostic biomarker in macular holes.

OBJECTIVE: To evaluate the presence of subfoveal hyperreflective dots (SfHD) using optical coherence tomography (OCT) in macular holes (MH) and establish whether there is a relationship with postoperative anatomical and functional outcomes. METHODS: An observational cross-sectional study was conducted at the Dr. Elías Santana Hospital. Sixty-eight eyes of 67 patients with a tomographic diagnosis of full-thickness MH who underwent pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling were included. Preoperative and postoperative measurements were obtained using radial macular scans and HD raster scans with Optovue and Cirrus 5000 (Zeiss) OCT machines. The main outcome measures were anatomical closure by OCT and functional outcome through best-corrected visual acuity (BCVA). RESULTS: The anatomical closure rate in our study was 63%. MHs that failed to achieve anatomical closure exhibited a higher number of hyperreflective dots and worse postoperative BCVA. A statistically significant association was found between exposed retinal pigment epithelium (RPE) in microns and the number of SfHD (P = .001). CONCLUSION: SfHD is a common tomographic finding in MH, and the presence of a higher number of these points is associated with poorer anatomical and functional outcomes. This imaging finding is a potential prognostic biomarker in this pathology.

Utilidad del estudio del complejo de células ganglionares de la mácula mediante tomografía de coherencia óptica en el diagnóstico de progresión del glaucoma / Study of the ganglion cell complex of the macula by optical coherence tomography in the diagnosis of glaucoma progression

Introducción: El objetivo de este trabajo es valorar la utilidad del estudio del complejo de células ganglionares de la mácula mediante tomografía de coherencia óptica (OCT) para estimar la progresión del glaucoma según su severidad.Material y métodosSe trata de un estudio transversal retrospectivo. Incluye 205 ojos de 131 pacientes con glaucoma o hipertensión ocular seguidos durante una media de 5,7años. Se han analizado los parámetros y las tasas de tres pruebas mediante el software de progresión de cada instrumento: campo visual, OCT en el complejo de células ganglionares de la mácula y en la capa de fibras nerviosas del nervio óptico. Se han evaluado los resultados de cada prueba, la concordancia entre ellas y cómo difieren según el estadio de gravedad.ResultadosEl campo visual clasifica más casos de progresión en el glaucoma moderado-avanzado, mientras que en el glaucoma leve su capacidad está limitada. El OCT de capa de fibras nerviosas del nervio óptico clasifica más casos de progresión en el glaucoma leve que en el moderado-avanzado, ya que se ve artefactado por el efecto suelo. El OCT del complejo de células ganglionares de la mácula es la prueba que más casos clasifica de progresión y que tiene mayor acuerdo con el campo visual, independientemente de la severidad.ConclusiónEl estudio del complejo de células ganglionares de la mácula mediante OCT podría ser mejor biomarcador de progresión que el estudio de la capa de fibras del nervio óptico, en cualquier estadio de glaucoma. (AU)

Introduction: The aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using optical coherence tomography (OCT) to estimate the progression of glaucoma according to its severity.Material and methodsThis is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, OCT in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated.ResultsVisual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity.ConclusionThe study of the macula ganglion cell complex using OCT could be a better biomarker of progression than the study of the optic nerve fiber layer, at any stage of glaucoma. (AU)

Computational Model Based on Optical Coherence Tomography (OCT) Skin Scanning to Identify and Quantify Acute Radiation Dermatitis (ARD): A Prospective Diagnostic Study.

BACKGROUND: Acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD. OBJECTIVE: Our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies. METHODS: We conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT). RESULTS: A total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P<.05) and a decrease after 3 months (P=.032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime. CONCLUSION: An OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved.

Unusual case of retinal arterial branch occlusion: possible variant of Sneddon syndrome.

Sneddon's syndrome (SS) manifests through multiple strokes and livedo reticularis. Livedoid vasculopathy (VL) is characterized by a long history of foot and leg ulceration and histopathology indicating a thrombotic process. Arterial retinal branch occlusion is described in a 52-year-old male with VL. He did not present noticeable laboratory abnormalities, such as antiphospholipid antibodies, or a history of strokes. Retinal artery occlusion accompanied by VL could be a variant of Sneddon's syndrome. Optical coherence tomography angiography revealed a reduction in the macula's vascular layers in the asymptomatic eye, indicating localized microvascular changes as an evolving marker in the pathogenesis of SS.

Study of the ganglion cell complex of the macula by optical coherence tomography in the diagnosis of glaucoma progression.

INTRODUCTION: The aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using the OCT technique to estimate the progression of glaucoma according to its severity. MATERIAL AND METHODS: This is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7 years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, optical coherence tomography (OCT) in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated. RESULTS: Visual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity. CONCLUSION: In both mild and moderate-advanced glaucoma, OCT of the macula ganglion cell complex may be a better biomarker of progression than OCT of the macula ganglion cell complex.

El espacio supracoroideo en pacientes afectados por retinosis pigmentaria / The suprachoroidal space in patients affected by retinitis pigmentosa

Antecedentes y objetivo: El espacio supracoroideo (SCS) es una estructura teórica que se sitúa entre el borde interno de la esclera y el límite externo del coroides. El SCS está siendo estudiado por sus posibles usos como vía para la administración de medicamentos y por técnicas quirúrgicas innovadoras para el tratamiento de muchas enfermedades retinianas. La retinitis pigmentosa (RP) es un grupo de trastornos hereditarios y progresivos caracterizados por el detrimento gradual de fotorreceptores que conduce a una discapacidad visual que se manifiesta típicamente como hemeralopía y pérdida progresiva del campo visual. El objetivo del estudio fue definir la morfología de los márgenes coroideos externos mediante el uso de tomografía de coherencia óptica de barrido (SS-OCT) en la RP.Materiales y métodosEstudio observacional retrospectivo diseñado para evaluar la presencia del ESC en la RP. Realizamos SS-OCT en un grupo de 55 pacientes afectados por RP (26 hombres y 29 mujeres, 110 ojos) con una edad media de 51,8±13,7 años. En el grupo de control incluimos a 28 sujetos sanos (6 hombres y 22 mujeres, 56 ojos) con una edad media de 48,8±16,6 años.ResultadosLas imágenes OCT permitieron delinear de manera precisa el margen coroideo externo y el margen escleral interno en los 110 ojos. En el grupo RP se detectó el ESC en 47 de los 110 ojos (42,7%), en el grupo de control se detectó el ESC en 11 ojos (19,6%).Los sujetos del grupo RP con SCS visibles presentaron un menor grosor retiniano (168,4 micrones) en comparación con aquellos con SCS visibles (211,2 micrones, p=0,007). (AU)

Background and objective: The suprachoroidal space (SCS) is a theoretical structure which can be demonstrated between the inner border of the sclera and the outer boundary of the choroid. SCS is being studied for its potential uses as a route for drug delivery and innovative surgical techniques for the treatment of many retinal diseases. Retinitis pigmentosa (RP) is a group of inherited eye disorders characterized by a gradual loss of photoreceptors, resulting in vision impairment, which typically presents as night blindness and progressive visual field loss. The purpose of the study is to define the morphology of outer choroidal margins by means of SS-OCT in RP.Material and methodThis is a retrospective observational study designed to evaluate the presence of SCS in RP. We performed swept source optical coherence tomography (SS-OCT) in a group of 55 patients affected by RP (26 males and 29 females, 110 eyes) with a mean age of 51.8±13.7 years. In the control group, we included 28 healthy subjects (6 males and 22 females, 56 eyes) with a mean age of 48.8±16.6 years.ResultsOCT scans allowed the outer choroidal margin and inner scleral margin to be delineated with certainty in all 110 eyes. In the RP group SCS was detected in 47 of 110 eyes (42.7%), in the control group SCS was detected in 11 eyes (19.6%).Subjects with SCS visible (RP group) had reduced retinal thickness (168.4μm) compared to those with not visible SCS (211.2μm, p=0.007). (AU)

Evaluación del músculo ciliar y del grosor escleral anterior en miopes altos mediante tomografía de coherencia óptica / Assessment of the ciliary muscle and scleral anterior thickness in high myopia by optical coherence tomography

Propósito: Evaluar las dimensiones del músculo ciliar (MC) y del grosor escleral anterior (AST) in vivo en miopes altos mediante tomografía de coherencia óptica de fuente de barrido (SS-OCT) y comparar con sujetos emétropes e hipermétropes.MétodosEstudio transversal en el que se incluyeron 34 miopes altos (≥−6dioptrías [D]), 90 emétropes (−1 a +1D) y 38 hipermétropes (≥+3,5D). Se midieron el grosor del MC (CMT) y el AST en los cuadrantes temporal y nasal a 1, 2 y 3mm del espolón escleral utilizando la SS-OCT. Además, se evaluó la longitud del MC (CML).ResultadosLas dimensiones tanto del CML como del CMT en cualquiera de sus puntos de medida fueron mayores en miopes altos y en emétropes que en hipermétropes, tanto en el cuadrante nasal como en el temporal (p<0,001). Sin embargo, no existieron diferencias entre miopes magnos y emétropes para ninguno de los parámetros (p≥0,076), salvo para el CMT a 3mm en temporal (p<0,001). No existieron diferencias en el AST entre miopes altos, emétropes e hipermétropes, en ninguno de los puntos de medida ni cuadrantes estudiados (p>0,05).ConclusionesLa SS-OCT permite medir el MC in vivo, no observándose diferencias en sus dimensiones entre miopes altos y emétropes, pero sí que fueron menores en hipermétropes. En la medida de la esclera anterior no se observaron diferencias entre los tres grupos analizados según la refracción. (AU)

Purpose: To assess ciliary muscle (CM) and anterior scleral thickness (AST) dimensions in vivo in high myopia using swept-source optical coherence tomography (SS-OCT) and to compare with emmetropic and hyperopic subjects.MethodsCross-sectional study that included 34 high myopic patients (≥−6 diopters [D]), 90 emmetropes (−1 to +1D) and 38 hyperopic patients (≥+3.5D). CM thickness (CMT) and AST were measured in the temporal and nasal quadrants at 1, 2, and 3mm from the scleral spur using SS-OCT. In addition, the length of the CM (CML) was evaluated.ResultsThe dimensions of the CML and the CMT at any of their measurement points were greater in high myopes and emmetropes than in hyperopes, both in the nasal and temporal quadrants (P<.001). However, there were no differences between high myopes and emmetropes for any of the parameters (P≥.076) except for the CMT at 3mm in the temporal quadrant (P<.001). There were no differences in the AST between high myopes, emmetropes and hyperopes, in any of the measurement points or quadrants studied (P>.05).ConclusionsThe SS-OCT allows to measure the CM in vivo, not observing differences in its dimensions between high myopes and emmetropes, but they were smaller in hyperopes. In the measurement of the anterior sclera, no differences were observed between the three groups analyzed according to refraction. (AU)

The suprachoroidal space in patients affected by retinitis pigmentosa.

BACKGROUND AND OBJECTIVE: The Suprachoroidal Space (SCS) is a theoretical structure which can be demonstrated between the inner border of the sclera and the outer boundary of the choroid. SCS is being studied for its potential uses as a route for drug delivery and innovative surgical techniques for the treatment of many retinal diseases. Retinitis pigmentosa (RP) is a group of inherited eye disorders characterized by a gradual loss of photoreceptors, resulting in vision impairment, which typically presents as night blindness and progressive visual field loss. The purpose of the study is to define the morphology of outer choroidal margins by means of SS-OCT in RP. MATERIAL AND METHOD: This is a retrospective observational study designed to evaluate the presence of SCS in RP. We performed Swept Source optical coherence tomography (SS-OCT) in a group of 55 patients affected by RP (26 males and 29 females, 110 eyes) with a mean age of 51.8 ±â€¯13.7 years. In the control group, we included 28 healthy subjects (6 males and 22 females, 56 eyes) with a mean age of 48,8 ±â€¯16,6 years. RESULTS: OCT scans allowed the outer choroidal margin and inner scleral margin to be delineated with certainty in all 110 eyes. In the RP group SCS was detected in 47 of 110 eyes (42,7%), in the control group SCS was detected in 11 eyes (19,6%). Subjects with SCS visible (RP group) had reduced retinal thickness (168.4 µm) compared to those with not visible SCL (211.2 µm, P = .007). CONCLUSIONS: SS-OCT can be successfully applied to assess the presence of SCS in RP and the high rate of SCS found in the RP patients is encouraging when considering future innovative therapies.

Assessment of the ciliary muscle and scleral anterior thickness in high myopia by optical coherence tomography.

PURPOSE: To assess ciliary muscle (CM) and anterior scleral thickness (AST) dimensions in vivo in high myopia using swept-source optical coherence tomography (SS-OCT) and to compare with emmetropic and hyperopic subjects. METHODS: Cross-sectional study that included 34 high myopic patients (≥ -6 diopters [D]), 90 emmetropes (-1 to +1 D) and 38 hyperopic patients (≥ +3.5 D). CM thickness (CMT) and AST were measured in the temporal and nasal quadrants at 1, 2, and 3 mm from the scleral spur using SS-OCT. In addition, the length of the CM (CML) was evaluated. RESULTS: The dimensions of the CML and the CMT at any of their measurement points were greater in high myopes and emmetropes than in hyperopes, both in the nasal and temporal quadrants (P < .001). However, there were no differences between high myopes and emmetropes for any of the parameters (P ≥ .076) except for the CMT at 3 mm in the temporal quadrant (P < .001). There were no differences in the AST between high myopes, emmetropes and hyperopes, in any of the measurement points or quadrants studied (P > .05). CONCLUSIONS: The SS-OCT allows to measure the CM in vivo, not observing differences in its dimensions between high myopes and emmetropes, but they were smaller in hyperopes. In the measurement of the anterior sclera, no differences were observed between the three groups analyzed according to refraction.

Capacidad diagnóstica de la densidad vascular papilar y macular frente a parámetros estructurales con tomografía de coherencia óptica en el glaucoma seudoexfoliativo / Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma

Propósito Evaluar la capacidad diagnóstica de la densidad de vasos (DV) papilar y macular mediante angiografía por tomografía de coherencia óptica (OCTA) y el grosor de la capa de fibras nerviosas de la retina (CFNR) y complejo de células ganglionares (CCG) maculares mediante tomografía de coherencia óptica (OCT) en los pacientes con glaucoma seudoexfoliativo (GPX). Métodos Estudio transversal que incluyó GPX y controles sanos. Se realizó OCT y OCTA de la papila y el área macular con el OCT RS-3000 Advance (Nidek Co., Gamagori, Japón). Se registró la DV macular del plexo capilar superficial (SCP) y la DV papilar del plexo capilar peripapilar radial (RPCP). Se empleó el área bajo la curva característica operativa del receptor (AUROC) para determinar el poder discriminatorio de cada parámetro. Resultados El grosor de la CFNR y del CCG, así como la DV a nivel papilar y macular, fueron significativamente menores en los pacientes con GPX que en los controles sanos (todos, p<0,05). El mejor parámetro discriminante fue el grosor medio de la CFNR (AUROC: 0,928). El AUROC de la DV papilar fue mejor que el de la DV macular (AUROC: 0,897 y 0,780, respectivamente). AUROC de la DV papilar fue comparable a la del grosor de la CFNR (p<0,001).Conclusiones La capacidad diagnóstica de la DV papilar en el GPS parece comparable a la de los parámetros estructurales, espesor de la CFNR y CCG, obtenidos mediante OCT, por lo que la OCTA podría ser una herramienta valiosa en el GPX. (AU)

PurposeTo evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). Methods Cross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. Results RNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, P<.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (P<.001).Conclusions The diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice. (AU)

Maculopatía paracentral aguda media y neurorretinopatía macular aguda / Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy

La neurorretinopatía macular aguda es una condición rara con patogenia microvascular. Se presenta con un inicio agudo con escotomas paracentrales correspondientes a lesiones paramaculares evidentes. Los avances en las imágenes multimodales permitieron caracterizar este trastorno de retina y crear nuevos conceptos. Serraf, en el 2013, identificó dos formas por medio de la tomografía de coherencia óptica dominio espectral: el tipo 1 conocido como maculopatía paracentral aguda media en la cual se observa una banda hiperreflectiva en la capa nuclear interna, y el tipo 2 en el cual la banda hiperreflectiva se ubica en la capa nuclear externa, que involucra la zona elipsoide y la zona de interdigitación con el epitelio pigmentario de la retina. Hasta el momento no existe cura; pero se puede actuar sobre los factores de riesgo. Por ser una condición rara y por no existir reportes hasta el momento en Cuba es que se presentan a continuación dos pacientes con cuadros clínicos similares de estas dos variantes; concluyendo la importancia que presentan las imágenes multimodales como medio auxiliar diagnóstico(AU)

Acute macular neuroretinopathy is a rare condition with complex pathogenesis and microvascular cause. It appears with acute onset, with paracentral scotomas corresponding to obvious paramacular lesions. Advances in multimodal imaging made it possible to characterize this retinal disorder and to create new concepts. Serraf, in 2013, identified two forms by spectral domain optical coherence tomography: type 1, known as paracentral acute middle maculopathy, in which a hyperreflective band is observed in the inner nuclear layer; and type 2, in which the hyperreflective band is located in the outer nuclear layer, involving the ellipsoid zone and the zone of interdigitation with the retinal pigment epithelium. Up to this moment, there is no cure; but it is possible to act on the risk factors. Because it is a rare condition and because there are no reports so far in Cuba, two patients with similar clinical pictures of these two variants are presented; concluding the importance of multimodal images as an auxiliary diagnostic tool(AU)

Alta proporción de macrodisco en pacientes de dos centros oftalmológicos en el occidente de Honduras / High proportion of macrodisc in patients from two ophthalmological centers in western Honduras

Antecedentes: Cuando el nervio óptico presenta una superficie mayor a 2.5 mm2 , y sin patologías asociadas, se trata de un macrodisco, cuya excavación es proporcional al tamaño aumentado del mismo. Con base en la distribución bajo la curva de Gauss, se define como "macrodisco" cuando está por encima de 2 desviaciones estándar arriba de la media. Se espera que solo el 2.3% de la población exceda estos límites. Objetivo: Determinar el tamaño promedio del disco óptico y proporción de macrodisco en la población sin glaucoma ni patologías retinianas que acude a dos clínicas oftalmológicas del occidente de Honduras, en el periodo de julio 2021 hasta julio 2022. Métodos: Estudio retrospectivo descriptivo. Se midieron los parámetros morfométricos del disco óptico mediante Tomografía de Coherencia Óptica ZEISS Cirrus HD Model 4000. Se definió macrodisco como: área del disco óptico >2.5 mm 2 y área del disco más 2 o más desviaciones estándar arriba de la media. Resultados: La proporción de macrodisco fue de 31% tomando en cuenta la definición de área de disco >2.5 mm2 , y 3% considerando la definición con base a la distribución bajo la curva de Gauss (>3.17mm2 ). Se obtuvo un promedio de área de disco óptico de 2.28±0.45 mm 2 , ratio copa/disco (C/D) de 0.59±0.13, ratio C/D vertical de 0.56±0.13, área de anillo neuroretiniano de 1.37±0.22 mm 2 , espesor de Capa de Fibras Nerviosas Retinianas (CFNR) de 97.4±10.664µm. Discusión: El área de disco promedio obtenido es mayor que los caucásicos, similar a lo reportado en los hispánicos, y menor que afrodescendientes y asiáticos...(AU)

Optical coherence tomography-guided versus intravascular ultrasound-guided percutaneous coronary intervention in patients with acute myocardial infarction.

INTRODUCTION AND OBJECTIVES: Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) yields clinical outcomes comparable to intravascular ultrasound (IVUS)-guided PCI in patients with stable ischemic heart disease. However, there is a scarcity of data comparing the clinical outcomes of OCT-guided and IVUS-guided PCI in the setting of acute myocardial infarction (AMI). We sought to compare the clinical outcomes of OCT-guided vs IVUS-guided PCI for patients with AMI in the era of second-generation drug-eluting stent (DES). METHODS: We identified 5260 consecutive patients who underwent PCI with a second-generation DES for AMI under IVUS or OCT guidance from pooled data derived from a series of Korean AMI registries between 2011 and 2020. The primary endpoint was the 1-year rate of target lesion failure, defined as a composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization. RESULTS: A total of 535 (10.2%) and 4725 (89.8%) patients were treated under OCT and IVUS guidance, respectively. The 1-year target lesion failure rates were comparable between the OCT and IVUS groups before and after propensity score matching (hazard ratio, 0.92; 95%CI, 0.42-2.05, P=.84). The OCT utilization rate did not exceed 5% of total patients treated with second-generation DES implantation during the study period. The primary factors for the selection of OCT over IVUS were the absence of chronic kidney disease, non-left main vessel disease, single-vessel disease, stent diameter <3mm, and stent length ≤ 25mm. CONCLUSIONS: OCT-guided PCI in patients with AMI treated with a second-generation DES provided comparable clinical outcomes for 1-year target lesion failure compared with IVUS-guided PCI.

Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma.

PURPOSE: To evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). METHODS: Cross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. RESULTS: RNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, p<0.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (p<0.001). CONCLUSIONS: The diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.

Detección de la progresión de la retinopatía externa oculta zonal aguda (AZOOR) con angiografía por tomografía de coherencia óptica: a propósito de un caso / Detecting progression of acute zonal occult outer retinopathy (AZOOR) with optical coherence tomography angiography: A case report

Caso clínico Mujer de 48años con escotomas superotemporales persistentes y fotopsias de 2meses de evolución y zonas despigmentadas en retina de ambos ojos con patrón trizonal en imagen multimodal. La resonancia magnética cerebral, la tomografía por emisión de positrones, los anticuerpos antirretinianos y los marcadores inmunológicos, infecciosos y tumorales fueron negativos, por lo que se diagnosticó retinopatía externa oculta zonal aguda. La paciente fue tratada con adalimumab. Sin embargo, 19meses después los síntomas aumentaron y se detectó progresión en la angiografía por tomografía de coherencia óptica, así como también en la prueba de campo visual Humphrey y el electrorretinograma, por lo que se agregó micofenolato de mofetilo, mostrando mejoría y estabilización de la enfermedad durante un seguimiento de 4años. Discusión La angiografía por tomografía de coherencia óptica puede ser una herramienta potencial para monitorizar la progresión y la respuesta al tratamiento además de otras modalidades de imagen en la retinopatía externa oculta zonal aguda, y la combinación de adalimumab y micofenolato puede ser útil en la enfermedad recurrente (AU)

Clinical case A 48-year-old woman with persistent superotemporal scotomas and photopsias for 2months, and depigmented zones in the retina of both eyes with a trizonal pattern on multimodal imaging. Brain magnetic resonance imaging, positron emission tomography, antiretinal antibodies and immunological, infectious and tumor markers tests were negative, thus acute zonal occult outer retinopathy was diagnosed. Patient was treated with adalimumab. Nevertheless, 19months later symptoms increased, and progression was detected on optic coherence tomography angiography, as well as in Humphrey visual field test and electroretinogram, thus, mycophenolate mofetil was added showing improvement and stabilization of the disease in a 4-year follow-up. Discussion Optic coherence tomography angiography may be a potential tool to monitor progression and response to treatment in addition to other imaging modalities in acute zonal occult outer retinopathy, and the combination of adalimumab and mycophenolate may be useful in recurrent disease (AU)

El glistening de las lentes intraoculares: revisión de la literatura / Glistening on intraocular lenses: a review

El glistening en las lentes intraoculares (LIO) es un fenómeno en el que se forman diminutas microvacuolas llenas de agua dentro del material de la LIO, lo que hace que la luz se disperse y cree un efecto centelleante o reluciente. La presencia del glistening es frecuente en muchos tipos de materiales y modelos de LIO, y se ha estudiado ampliamente en los últimos años para conocer su incidencia, factores de riesgo, evolución y posible relevancia clínica. Clásicamente se ha estudiado in vitro en laboratorio o mediante fotografía obtenida con lámpara de hendidura. Sin embargo, son técnicas que requieren de un explorador experto, además de requerir mucho tiempo y un complejo procesado de las imágenes. En los últimos años, han surgido propuestas basadas en la cámara de Scheimpflug y en la tomografía de coherencia óptica como forma de simplificar el análisis del glistening en las LIO. Se ha descrito que tanto el proceso de fabricación, como el propio material acrílico hidrofóbico, y el tiempo desde la cirugía son factores de riesgo relacionados con la aparición de glistening. Además, aún se desconocen numerosas cuestiones relacionadas con este fenómeno, como la cantidad de puntos o el tamaño de los mismos necesarios para causar afectación de la función visual, ya que se han descrito diferentes fenómenos ópticos relacionados con el glistening de las LIO (AU)

The glistening in intraocular lenses (IOLs) is a phenomenon in which tiny water-filled microvacuoles form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. The presence of glistening is common in many types of IOL materials and models and has been extensively studied in recent years to determine its incidence, risk factors, evolution, and possible clinical relevance. Classically, it has been studied in vitro in the laboratory or by means of photography obtained with a slit lamp, but these were techniques that required either specific technology or an expert explorer, complex image processing, and required a lot of time. In recent years, proposals based on the Scheimpflug camera and optical coherence tomography have emerged to try to simplify the analysis of glistening in IOLs. It has been described that the manufacturing process, the hydrophobic acrylic material, or the time since surgery are risk factors for the appearance of glistening. In addition, many issues related to this phenomenon are still unknown, such as not knowing from what number of points or their size they may have relevance to visual function since different optical phenomena related to glistening have been described on the IOLs (AU)

Influencia de la longitud axial ocular en el grosor de la capa de fibras nerviosas peripapilar medido con tomografía de coherencia óptica / Ocular axial length influence on peripapillary retinal nerve fiber layer thickness measurement with optical coherence tomography

Antecedentes La tomografía de coherencia óptica (OCT) permite la medición del grosor de la capa de fibras del nervio óptico (CFNR) peripapilar. El efecto de la longitud axial ocular (LA) sobre el grosor de la CFNR puede ser relevante en la interpretación de los resultados de OCT en el diagnóstico de enfermedades del nervio óptico. Objetivos Evaluar la influencia de la longitud axial ocular en el grosor de la CFNR y en los parámetros topográficos del disco óptico (área del disco óptico, área del anillo neurorretiniano y volumen de la excavación papilar) medidos por OCT en individuos sanos. Método Se estudió una muestra de 109 ojos sanos clasificados en 3 grupos según la LA (A: LA<22mm; B: LA 22-24,5mm; C: LA>24,5mm). La medición del grosor de la CFNR y de los parámetros topográficos del disco óptico se realizó mediante Swept-Source OCT Triton (Topcon Corporation, Tokio, Japón), y se compararon entre grupos mediante análisis de la varianza. La correlación entre la longitud axial y las variables de estudio se realizó mediante correlación de Pearson. Resultados El grosor de la CFNR fue menor en ojos con longitud axial más alta en el cuadrante superior (r=−0,41; p<0,001), inferior (r=−0,58; p<0,001) y nasal (r=−0,43; p<0,001), en el valor medio de la CFNR (r=−0,49; p<0,001), área del disco óptico (r=−0,40;p<0,001) y área del anillo neurorretiniano (r=−0,25; p=0,01). Conclusión La LA se correlaciona negativamente con el grosor de la CFNR y los parámetros topográficos del disco óptico medidos mediante Swept-Source OCT Triton (Topcon) (AU)

Background Optical coherence tomography (OCT) allows the measurement of the peripapillary optic nerve fiber layer (RNFL) thickness. The effect of ocular axial length (AL) on RNFL thickness measurement may be relevant in the interpretation of OCT results in diagnosing optic nerve diseases. Purposes To assess the influence of ocular AL on RNFL thickness and on optic disc topographic parameters (optic disc area, rim area and cup volume) measured by OCT, in healthy individuals. Method A sample of 109 healthy eyes classified into three groups according to AL (A: AL <22mm; B: AL 22–24.5mm; C: AL >24.5mm) was studied. RNFL thickness and optic disc topographic parameters were measured using Swept-Source OCT Triton (Topcon Corporation, Tokyo, Japan) and were compared between groups using a variance analysis. Correlation between the AL and the study variables was performed using a Pearson's correlation coefficient test. Results The RNFL thickness was lower in eyes with higher AL in the superior (r=−0.41; p<0.001), inferior (r=0.58; p<0.001) and nasal (r=−0.43; p<0.001) quadrants, in the mean value of the RNFL (r=−0.49; p<0.001), optic disc area (r=−0.40; p<0.001) and rim area (r=−0.25; p=0.01). Conclusion AL is negatively correlated with RNFL thickness and optic disc topographic parameters measured by Swept-Source OCT Triton (Topcon) (AU)

Correlación entre la sensibilidad al contraste y las características morfológicas obtenidas por OCT en pacientes con degeneración macular relacionada con la edad avanzada tratados con dosis de carga de inhibidores del factor de crecimiento endotelial vascular / Correlation between contrast sensitivity and morphological features obtained by OCT in patients with age-related macular degeneration treated with a loading dose of vascular endothelial growth factor inhibitors

Objetivo Determinar la correlación entre la sensibilidad al contraste y las características morfológicas obtenidas por tomografía de coherencia óptica en pacientes con degeneración macular relacionada con la edad avanzada tratados con dosis de carga de inhibidores del factor de crecimiento endotelial vascular (anti-VEGF). Diseño Se trata de un estudio ambispectivo (prospectivo+retrospectivo) observacional y analítico. Participantes Todos los pacientes de 55 años o más con degeneración macular relacionada con la edad que acudieron al departamento de Retina del servicio de Oftalmología y cumplieron con los criterios de inclusión entre marzo-mayo de 2022. Métodos Se recolectaron los datos por medio de la revisión de expedientes. Se analizaron los estudios de tomografía de coherencia óptica previa a la aplicación de inyecciones intravítreas de los pacientes que se encontraban en el mes posterior a la última dosis. Se incluyeron un total de 33 sujetos y un total de 30 continuaron seguimiento. Se realizaron pruebas de normalidad (Shapiro y Bartlett) entre los grupos de estudio, dando como resultado grupos no normales no homocedásticos. Los sujetos fueron sometidos a una nueva evaluación oftalmológica y nueva toma de mediciones retinianas. Resultados Se realizó un análisis de regresión lineal comparando los valores logarítmicos de la agudeza visual y la sensibilidad al contraste, obteniendo una relación significativa entre ambos valores posterior a la aplicación del tratamiento (p<0,0001). Asimismo, se demostró una correlación entre la disminución de los valores de la sensibilidad al contraste y todas las características evaluadas en el tomografía de coherencia óptica. Conclusiones Las estrategias de antiangiogénesis pueden conducir a mejores resultados en la función visual global, impactando positivamente en la sensibilidad al contraste (AU)

Objective To determine the correlation between contrast sensitivity and morphological characteristics obtained by optical coherence tomography in patients with age-related macular degeneration treated with a loading dose of vascular endothelial growth factor inhibitors (anti-VEGF). Design This is an ambispective (prospective+retrospective) observational, cross-sectional, and analytical study. Participants All patients over 55 years of age with age-related macular degeneration who attended the Retina service of the Ophthalmology department and met the inclusion criteria between March-May 2022. Methods Data collection was carried out by reviewing the records of patients.Optical coherence tomography studies prior to the application of intravitreal injections of patients who were currently in the first month after the last dose of anti-VEGF were analyzed. A total of 33 subjects were included, of which 30 continued follow-ups. Normality tests (Shapiro and Bartlett) were performed where a nonparametric data distribution was demonstrated. The subjects underwent a new ophthalmological evaluation and new retinal measurements of the affected eye. Results A linear regression analysis was performed comparing the logarithmic values of both visual acuity and contrast sensitivity, obtaining a significant relationship between both values after the application of treatment (P<.0001). Likewise, correlation was demonstrated between the decrease in contrast sensitivity values and all the characteristics evaluated in the patients’ optical coherence tomography. Conclusions Antiangiogenesis strategies can lead to better results in global visual function, positively impacting contrast sensitivity (AU)