Consecutive strabismus after infantile nystagmus syndrome surgery and potential risk factors.

PURPOSE: The aim of this study is to evaluate the incidence of consecutive strabismus after infantile nystagmus surgery and its potential risk factors. METHODS: A retrospective study including 89 patients was conducted. Patients presented infantile nystagmus (idiopathic or ocular disease-associated nystagmus) without previous or coincidental strabismus. Sex, age at surgery, amblyopia, botulinum toxin (BT) injection before surgery, spherical equivalent, anisometropia, surgery procedure (Anderson's or retroequatorial recessions of four horizontal recti), and follow-up were analyzed. Kaplan-Meier and univariate Cox regression were performed. RESULTS: The median age at surgery was 5 years. The median follow-up was 36 months. The incidence of consecutive strabismus was 11.2%. There were eight patients with exotropia and two patients with esotropia. Consecutive strabismus was associated with severe bilateral amblyopia (p = 0.036), previous treatment with BT injection (p = 0.025), and large recessions of the four horizontal muscles (p = 0.001). The hazard ratio for patients with severe bilateral amblyopia was 5.4 (95% CI 1.1-25.8), and for patients previously treated with BT was 6.1 (1.3-29.3). The survival rate was 95.4% at 6 months and 88.5% at 3 years. CONCLUSION: Severe bilateral amblyopia, previous BT treatment, and type of surgery seem to be associated with consecutive strabismus after infantile nystagmus surgery. Most cases appear within the first months after surgery.

Nuevas dianas terapéuticas en el tratamiento de la degeneración macular asociada a la edad / New therapeutic targets in the treatment of age-related macular degeneration

La degeneración macular asociada a la edad (DMAE), y en especial su forma neovascular, supone la principal causa de baja visión en países desarrollados. Aunque en años recientes la introducción de los fármacos conocidos como anti-VEGF ha supuesto una revolución en el manejo de esta enfermedad, su precio, la necesidad de inyecciones intravítreas repetidas y la pérdida de efectividad a largo plazo en una importante proporción de pacientes son problemas aún por resolver. En la actualidad existen en desarrollo una serie de nuevas estrategias que tratan de ofrecer soluciones a las limitaciones que presentan los fármacos intravítreos actuales. Entre ellos destacan nuevos anti-VEGF como brolucizumab o abicipar, fármacos contra el receptor de angiopoyetina-2 como faricimab, sistemas de liberación sostenida de macromoléculas o inhibidores de la tirosina cinasa. Respecto a la DMAE seca, la neuroprotección, la modulación de la vía del complemento y, en última instancia, la terapia con células madre son las líneas de investigación más prometedoras en la actualidad

Age-related macular degeneration and especially neovascular age-related macular degeneration is the leading cause of low vision in developed countries. Even though the introduction of anti-VEGF drugs in recent years completely changed the management of this condition, its cost, the need for repeated intravitreal injections, and loss of efficacy in the long term are still issues to deal with. Currently, a new generation of novel therapies under development is attempting to address some of these limitations. Some of the most prominent among them are new anti-VEGFs such as brolucizumab or abicipar, drugs against angiopoietin-2 receptor such as faricimab, sustained-release systems, or tyrosine kinase inhibitors. As regards dry age-related macular degeneration, neuroprotection, the complement pathway, and stem cell therapy are the most promising targets currently under investigation

New therapeutic targets in the treatment of age-related macular degeneration. / Nuevas dianas terapéuticas en el tratamiento de la degeneración macular asociada a la edad.

Age-related macular degeneration and especially neovascular age-related macular degeneration is the leading cause of low vision in developed countries. Even though the introduction of anti-VEGF drugs in recent years completely changed the management of this condition, its cost, the need for repeated intravitreal injections, and loss of efficacy in the long term are still issues to deal with. Currently, a new generation of novel therapies under development is attempting to address some of these limitations. Some of the most prominent among them are new anti-VEGFs such as brolucizumab or abicipar, drugs against angiopoietin-2 receptor such as faricimab, sustained-release systems, or tyrosine kinase inhibitors. As regards dry age-related macular degeneration, neuroprotection, the complement pathway, and stem cell therapy are the most promising targets currently under investigation.

Revisión del estrabismo en miopes / Strabismus-associated myopia. Review

Introducción: El tratamiento del estrabismo asociado a la miopía representa, en muchas ocasiones, un reto terapéutico para el oftalmólogo. El estrabismo asociado a la miopía tiene ciertas peculiaridades y existen incluso ciertos tipos de estrabismo que se producen exclusivamente en miopía, como el estrabismo fixus que requiere tratamientos con técnicas quirúrgicas específicas. Material y métodos: Es importante hacer un diagnóstico diferencial correcto, porque hay muchas entidades descritas con esta asociación. Se presenta una revisión del estrabismo asociado a la miopía con su tratamiento ajustado al error refractivo. Resultados: Las medidas del estrabismo pueden ser alteradas por el efecto prismático de las gafas. Los resultados quirúrgicos pueden ser impredecibles si no se considera la miopía. Hemos obtenido mejores resultados con las técnicas de reemplazo anatómico descritas por Yokoyama que con la retroinserción-resección tradicional. Conclusiones: Es importante para un diagnóstico y tratamiento adecuados del estrabismo asociado a miopía hacer una correcta medición del ángulo de desviación, realizar pruebas de imagen previo a la cirugía en determinadas entidades y tener en cuenta las características anatómicas propias del globo ocular miope que requieren una especial atención durante la cirugía (AU)

Introduction: The treatment of strabismus associated with myopia is often a therapeutic challenge for the ophthalmologist. The strabismus associated with myopia has certain peculiarities and there are even certain types of strabismus that occur exclusively in myopia, such as strabismus fixus, requiring treatments with specific surgical techniques. Materials and methods: It is important to make a correct differential diagnosis, because there are many conditions described with this association. A review is presented of strabismus associated with myopia, together with its treatment adjusted to refractive error. Results: Measurements of strabismus may be altered by the prismatic effect of the spectacles. Surgical results may be unpredictable if myopia is not taken into account. Better results were obtained with the techniques of anatomical replacement described by Yokoyama than with traditional retro-insertion-resection. Conclusion: For the diagnosis and appropriate treatment of strabismus, it is important to make a correct measurement of the angle of deviation, and perform image tests prior to surgery in certain cases. The anatomical characteristics of the myopic eye should also be taken into account during surgery (AU)

Strabismus-associated myopia. Review. / Revisión del estrabismo en miopes.

INTRODUCTION: The treatment of strabismus associated with myopia is often a therapeutic challenge for the ophthalmologist. The strabismus associated with myopia has certain peculiarities and there are even certain types of strabismus that occur exclusively in myopia, such as strabismus fixus, requiring treatments with specific surgical techniques. MATERIALS AND METHODS: It is important to make a correct differential diagnosis, because there are many conditions described with this association. A review is presented of strabismus associated with myopia, together with its treatment adjusted to refractive error. RESULTS: Measurements of strabismus may be altered by the prismatic effect of the spectacles. Surgical results may be unpredictable if myopia is not taken into account. Better results were obtained with the techniques of anatomical replacement described by Yokoyama than with traditional retro-insertion-resection. CONCLUSION: For the diagnosis and appropriate treatment of strabismus, it is important to make a correct measurement of the angle of deviation, and perform image tests prior to surgery in certain cases. The anatomical characteristics of the myopic eye should also be taken into account during surgery.

El error médico y la seguridad del paciente en Oftalmología / Medical errors and patient safety in Ophthalmology

No disponible

Oclusión venosa retiniana en pacientes jóvenes y estudio sistémico. Caso clínico y revisión de la literatura / Systematic study of retinal vein occlusion in young patients. Case report and review of the literature

OBJETIVO: Presentar el caso de una mujer joven con oclusión venosa retiniana (OVR) y mutación heterocigota de la protrombina, y revisar la evidencia científica actual acerca del estudio diagnóstico sistémico en casos de OVR en pacientes jóvenes. MÉTODOS: Se realizó una búsqueda exhaustiva de la literatura en PubMed. CONCLUSIÓN: Los factores de riesgo de la OVR pueden tener diferente importancia dependiendo de cada grupo de edad. En el estudio diagnóstico sistémico se recomienda buscar factores de riesgo «emergentes» en los casos de pacientes jóvenes, afectación bilateral o ausencia de factores de riesgo «clásicos»

PURPOSE: To report the case of a young woman with retinal vein occlusion and prothrombin heterozygous mutation, and to review the current evidence on the systematic study in cases of retinal vein occlusion (RVO) in young patients. METHODS: Eligible articles were identified using a comprehensive literature search of PubMed. CONCLUSION: RVO risk factors may have different relevance depending on each age group. In the systematic study of cases in young patients, it is recommended to look for «emerging» risk factors, bilateral involvement, or absence of «classic» risk factors

Systematic study of retinal vein occlusion in young patients. Case report and review of the literature.

PURPOSE: To report the case of a young woman with retinal vein occlusion and prothrombin heterozygous mutation, and to review the current evidence on the systematic study in cases of retinal vein occlusion (RVO) in young patients. METHODS: Eligible articles were identified using a comprehensive literature search of PubMed. CONCLUSION: RVO risk factors may have different relevance depending on each age group. In the systematic study of cases in young patients, it is recommended to look for "emerging" risk factors, bilateral involvement, or absence of "classic" risk factors.

Propranolol e inyecciones intravítreas de ranibizumab en el desprendimiento seroso macular secundario a hemangioblastoma retiniano capilar / Oral propranolol and intravitreal ranibizumab for refractory serous macular detachment secondary to retinal capillary hemangioblastoma

No disponible

Goldmann-Witmer, diagnóstico de certeza en coroiditis unifocal helioide / Goldmann-Witmer, definitive diagnosis in unifocal helicoid choroiditis

CASO CLÍNICO: Paciente sano de 20 años con pérdida de visión aguda en el ojo izquierdo. Al examen del fondo de ojo presentó una alteración macular compatible con coroiditis unifocal helioide caracterizada por ser una lesión inflamatoria atípica redondeada, solitaria, blanca-amarillenta, de aproximadamente del tamaño de un disco óptico. En el estudio etiológico se detectó leve positividad serológica de IgG (inmunoglobulinas G) Antitoxoplasma gondii. DISCUSIÓN: Una serología inespecífica y las características atípicas de la lesión limitan el diagnóstico. El coeficiente Goldmann-Witmer puede ser útil en el diagnóstico de lesiones localizadas al relacionar concentraciones entre IgG séricas y humor acuoso

CASE REPORT: A 20 year-old healthy patient consulted due to acute loss vision in his left eye. A fundus examination showed a macular alteration compatible with unifocal helioid choroiditis, characterized by being an atypical inflammatory yellow-white, round, single lesion of approximately an optic disc in diameter. The etiology study detected low Antitoxoplasma gondii Ig G (immunoglobulin) titers. DISCUSSION: The non-specificity of the serology and the atypical characteristics of the lesion is a limitation in the diagnosis. The Goldmann-Witmer coefficient may be useful in the diagnosis of atypical lesions, by comparing the concentration of IgG from the serum and aqueous humor

Láser subumbral para coriorretinopatía serosa central activa / Subthreshold laser for active central serous chorioretinopathy

No disponible

Cambio a eylea en edema macular debido a enfermedades vasculares de la retina / Switching to eylea in macular edema due to retinal vascular diseases

No disponible

[Goldmann-Witmer, definitive diagnosis in unifocal helicoid choroiditis]. / Goldmann-Witmer, diagnóstico de certeza en coroiditis unifocal helioide.

CASE REPORT: A 20 year-old healthy patient consulted due to acute loss vision in his left eye. A fundus examination showed a macular alteration compatible with unifocal helioid choroiditis, characterized by being an atypical inflammatory yellow-white, round, single lesion of approximately an optic disc in diameter. The etiology study detected low Antitoxoplasma gondii Ig G (immunoglobulin) titers. DISCUSSION: The non-specificity of the serology and the atypical characteristics of the lesion is a limitation in the diagnosis. The Goldmann-Witmer coefficient may be useful in the diagnosis of atypical lesions, by comparing the concentration of IgG from the serum and aqueous humor.

Afectación orbitaria por linfoma no Hodgkin de células T NK / Orbital involvement by non-Hodgkin lymphoma NK T cells

CASO CLÍNICO: Un varón de 37 años se presenta por una historia de obstrucción nasal con rinorrea derecha, cefalea, hipoacusia y exoftalmos derecho de 4 meses de evolución. La RM revela la ocupación de senos etmoidales y maxilares por tejido inflamatorio con extensión hacia la región orbitaria. La biopsia confirma un linfoma no Hodgkin de células T natural killer (NK). DISCUSIÓN: El linfoma no Hodgkin T NK es un tumor infrecuente en el área orbitaria que precisa de una precoz detección así como de una atención multidisciplinaria para asegurar un seguimiento y tratamiento adecuados

CLINICAL CASE: The case is presented of 37 year-old male with a history of nasal obstruction with right rhinorrhea, headache, hearing loss and right exophthalmos of 4 months progression. The MRI revealed that the ethmoidal and maxillary sinuses contained inflammatory tissue extending into the orbital region. The biopsy confirmed a non-Hodgkin lymphoma of natural killer (NK) T cells. DISCUSSION: Non-Hodgkin's T NK lymphoma is a rare tumor in the orbital area that requires an early detection and multi-disciplinary care to ensure appropriate monitoring and treatment