[Guidelines of clinical practice of the SERV: treatment of exudative age-related macular degeneration (AMD)]. / Guías de práctica clínica de la SERV: tratamiento de la degeneración macular asociada a la edad (DMAE) exudativa.

OBJECTIVE: Age related macular degeneration (ARMD) in its neovascular form is a serious disease which produces legal blindness in many patients with poor prognosis if left untreated. We intend to establish a clinical guide with the different therapeutic options that exist nowadays, which may help the ophthalmologists in their clinical practice. METHODS: A group of medical retina experts selected by SERV have evaluated the results of different published studies with the drugs currently available, obtaining an evidence-based consensus. Some recommendations have been established for diagnosis, treatment and monitoring of patients with neovascular ARMD. RESULTS: The intravitreal injection of ranibizumab at a dosage of 0.5 mg produces significant improvement of visual acuity in subfoveal lesions, according to data obtained from studies with the highest level of evidence. It should be considered as a first choice drug. The use of bevacizumab, a drug with not approved indication for intraocular use, nor for the treatment of neovascular ARMD can reach a result which is closer to the ones obtained with ranibizumab than to those obtained with photodynamic therapy (PDT) and pegaptanib. The use of intravitreal pegaptanib sodium in intravitreal injection at a dosage of 0.3 mg as a treatment for subfoveal lesions can obtain similar results to the TFD, but with a wider range of injuries. CONCLUSION: The results of the evidence-based studies are a good guide for the treatment of this disease.

Guías de práctica clínica de la SERV: tratamiento de la degeneración macular asociada a la edad (DMAE) exudativa / Guidelines of clinical practice of the SERV: treatment of exudative age-related macular degeneration (AMD)

Objetivo: La Degeneración Macular Asociada a laEdad (DMAE) en su forma húmeda supone unagrave enfermedad que condiciona ceguera legal enmuchos pacientes y con mal pronóstico si no es tratada.Pretendemos establecer una guía de actuaciónclínica con las diferentes opciones terapeúticas queexisten en el momento actual, que puedan ayudar aloftalmólogo en su práctica clínica.Métodos: Un grupo de expertos en retina médicaseleccionados por la SERV han evaluado los resultadosde los diferentes estudios publicados con losfármacos actualmente disponibles, llegando a un consenso basado en la evidencia. Se han establecidounas recomendaciones para el diagnóstico, tratamientoy seguimiento de los enfermos con DMAEhúmeda.Resultados: La inyección intravítrea de ranibizumaba la dosis de 0,5 mg permite obtener mejoríassignificativas de la agudeza visual en lesiones subfoveales,según los datos obtenidos de estudios conmáximo nivel de evidencia. Debe ser consideradocomo el fármaco de primera elección. El empleo debevacizumab, fármaco sin indicación aprobada parauso intraocular, ni para el tratamiento de la DMAEhúmeda, puede aportar un beneficio más próximo alos resultados obtenidos con el ranibizumab que alos obtenidos con la terapia fotodinámica (TFD) yel pegaptanib. El uso de pegaptanib sódico eninyección intravítrea a la dosis de 0,3 mg como tratamientode lesiones subfoveales permite obtenerresultados parecidos a la TFD, pero en un abanicomás amplio de lesionesConclusiones: Los resultados de los estudios basadosen la evidencia constituyen una buena guía deactuación en el tratamiento de esta enfermedad(AU)

Objective: Age related macular degeneration(ARMD) in its neovascular form is a serious diseasewhich produces legal blindness in many patientswith poor prognosis if left untreated. We intend toestablish a clinical guide with the different therapeuticoptions that exist nowadays, which may helpthe ophthalmologists in their clinical practice.Methods: A group of medical retina experts selectedby SERV have evaluated the results of differentpublished studies with the drugs currently available,obtaining an evidence-based consensus. Somerecommendations have been established for diagnosis, treatment and monitoring of patients with neovascularARMD.Results: The intravitreal injection of ranibizumabat a dosage of 0.5 mg produces significant improvementof visual acuity in subfoveal lesions, accordingto data obtained from studies with the highestlevel of evidence. It should be considered as a firstchoice drug. The use of bevacizumab, a drug withnot approved indication for intraocular use, nor forthe treatment of neovascular ARMD can reach aresult which is closer to the ones obtained with ranibizumabthan to those obtained with photodynamictherapy (PDT) and pegaptanib. The use of intravitrealpegaptanib sodium in intravitreal injection at adosage of 0.3 mg as a treatment for subfoveallesions can obtain similar results to the TFD, butwith a wider range of injuries.Conclusion: The results of the evidence-based studiesare a good guide for the treatment of this disease(AU)

Sobre la urgencia del diagnóstico y tratamiento precoz de la DMAE exudativa / The emergency in early diagnosis and treatment of age-related macular degeneration

No disponible

[Indocyanine green angiography in angioid streaks]. / Angiografía verde indocianina en las estrías angioides.

PURPOSE: To define the findings of an indocyanine green angiographic study of angioid streaks and compare them with the ophthalmoscopic and fluorescein angiographic findings. PATIENTS AND METHODS: Twelve eyes of six patients with bilateral angioid streaks were examined by ophthalmoscopy, fluorescein angiography, and indocyanine green angiography. RESULTS: In the ophthalmoscopy, the streak colors ranged from brown in the early phases to orange in severe stages. The streaks already presented a hyperfluorescent pattern from the arterial phases in all of the eyes with the fluorescein angiography. Using the indocyanine green angiography filling of the choroidal veins, a hyperfluorescent pattern was observed in eight eyes with severe lesional changes and a hypofluorescent pattern in four eyes with an early stage of the disease. The angioid streaks were more clearly visualized by indocyanine green angiography. CONCLUSION: The indocyanine green angiography contributes to the diagnosis of angioid streaks. The indocyanine patterns seems to be correlated with the ophthalmoscopic features and degree of evolution of the disease. The indocyanine green angiography allows for the early detection of angioid streaks and diagnosis in young patients.

Angiografía verde indocianina en las estrías angioides / Indocyanine green angiography in angioid streaks

Objetivo: Definir los hallazgos con angiografía verde indocianina en el estudio de las estrías angioides y compararlos con los de la oftalmoscopia y angiografía fluoresceínica. Pacientes y métodos: En doce ojos de seis pacientes con estrías angioides bilaterales se realizan oftalmoscopia, angiografía fluoresceínica y angiografía verde indocianina. Resultados: En la oftalmoscopia la coloración de las estrías varía entre el marrón en fases precoces y el naranja en estadios graves. Con la fluoresceína presentan un patrón hiperfluorescente ya desde fases arteriales en todos los ojos. La angiografía verde indocianina en fases venosas muestra un patrón hiperfluorescente en ocho ojos con lesiones severas y un patrón hipofluorescente en cuatro ojos con estadios tempranos de la enfermedad. Las estrías angioides se visualizan mejor con la angiografía con verde indocianina. Conclusiones: La angiografía con verde indocianina contribuye al diagnóstico de las estrías angioides. Los patrones de indocianina parecen relacionarse con el aspecto oftalmoscópico de las estrías y con el grado de evolución de la enfermedad. La angiografía verde indocianina ayuda a realizar un diagnóstico precoz y en pacientes jóvenes (AU)

Hemispheric retinal branch vein occlusions.

Nine cases of hemispheric retinal branch vein occlusion (HRBVO) are discussed retrospectively after identification from among 94 cases of branch vein occlusion. The high incidence of simple chronic glaucoma (close to that found in central vein occlusion cases), the presence of vein-vein disc collaterals and the visual prognosis make it important to distinguish HRBVO cases from other branch vein occlusions.