Estudio de densidad vascular en pacientes con retinitis pigmentosa por medio de angiografía por tomografía de coherencia óptica / Microvascular quantitative metrics in retinitis pigmentosa using optical coherence tomography angiography

Propósito Evaluar cambios en la densidad vascular (VD) mediante la angiografía por tomografía de coherencia óptica (OCTA) en los diferentes sectores maculares de pacientes con retinitis pigmentosa (RP) y controles. Métodos Estudio observacional de 22 casos y 21 controles. Se reclutan 22 pacientes con RP y 21 controles. Se obtienen imágenes de tamaño 6×6 del área macular mediante Angio-OCT SS-DRI-Triton 1.22 (Topcon, Japón), desechando las imágenes con mala calidad. Se recoge agudeza visual, biomicroscopía, campo visual y tomografía de coherencia óptica (OCT) estructural. El área macular se divide en 4 sectores (nasal, superior, inferior y temporal), y se comparan los valores de VD entre ambos grupos en los plexos superficial (SVP) y profundo (DVP). Se estudia también la correlación entre la VD y el grosor macular. Resultados Diez pacientes con RP se desecharon por mala calidad de imagen. Se analizan 12 pacientes con RP y 21 controles sanos. El índice de campo visual (VFI) medio en el grupo RP fue del 26,11% (±17,29). La VD fue significativamente inferior en el grupo RP comparado con los controles en todos los sectores maculares del DVP (Superior 43,48±3,79 vs. 48,86±2,62; p<0,0001; Nasal 40,52±4,30 vs. 46,01±3,23; p=0,0002; Inferior 42,76±5,26 vs. 50,10±3,36; p<0,0001; Temporal 40,42±4,46 vs. 46,09±2,91; p=0,0001) y en todos menos en el sector nasal en el SVP (Superior 39,86±4,46 vs. 46,47±2,61; p<0,0001; Nasal 40,35±4,56 vs. 44,09±2,87; p=0,0067; Inferior 40,74±4,61 vs. 46,58±3,26; p=0,0002; Temporal 39,98±5,07 vs. 44,78±3,28; p=0,0024). La correlación entre la VD y el grosor macular se mostró positiva y significativa (RP: r=0,59; p=0,043; controles r=0,51; p=0,018). Conclusiones Los pacientes con formas avanzadas de RP muestran menor VD en el área macular que los controles sanos. Estas diferencias están presentes en todos los cuadrantes del DVP y en 3 de ellos en el SVP (AU)

Aims To describe the changes in vessel density (VD) using optical coherence tomography angiography (OCTA) of the different sectors in the macular area between retinitis pigmentosa (RP) patients and controls. Methods Observational case-control study. We initially included 22 patients with RP and 21 controls. We obtained 6x6 OCTA images of the macular area using Angio-OCT SS-DRI-Triton 1.22 (Topcon, Japan), together with visual acuity, biomicroscopy, visual field and optical coherence tomography examination. We compared the VD values in both groups for both superficial (SVP) and deep vascular plexus (DVP). Correlation between VD and macular thickness was also calculated. Results The mean visual field index (VFI) in the RP group was 26.11% (±17.29). VD was significantly lower in the RP group compared with healthy controls in all sectors of the DVP (Superior 43.48±3.79 vs 48.86±2.62, P<.0001; Nasal 40,52±4.30 vs 46,01±3.23, P=.0002; Inferior 42.76±5.26 vs 50.10±3.36, P<.0001; Temporal 40.42±4.46 vs 46.09±2.91, P=.0001) and in all but nasal sector in the SVP (Superior 39.86±4.46 vs 46.47±2.61, P<.0001; Nasal 40.35±4.56 vs 44.09±2.87, P=.0067; Inferior 40.74±4.61 vs 46.58±3.26, P=.0002; Temporal 39.98±5.07 vs 44.78±3.28, P=.0024). Correlation between VD and macular thickness was positive and significant (RP: r=.59, P=.043; controls r=.51, P=.018). Conclusions Patients with advanced forms of RP have less vessel density in the macular area than healthy subjects. These differences are present in all four quadrants in the DVP and three in the SVP (AU)

Microvascular quantitative metrics in retinitis pigmentosa using optical coherence tomography angiography.

AIMS: To describe the changes in vessel density (VD) using optical coherence tomography angiography (OCTA) of the different sectors in the macular area between retinitis pigmentosa (RP) patients and controls. METHODS: Observational case-control study. We initially included 22 patients with RP and 21 controls. We obtained 6 × 6 OCTA images of the macular area using Angio-OCT SS-DRI-Triton 1.22 (Topcon, Japan), together with visual acuity, biomicroscopy, visual field and optical coherence tomography examination. We compared the VD values in both groups for both superficial (SVP) and deep vascular plexus (DVP). Correlation between VD and macular thickness was also calculated. RESULTS: The mean visual field index (VFI) in the RP group was 26.11% (±17.29). VD was significantly lower in the RP group compared with healthy controls in all sectors of the DVP (Superior 43.48 ±â€¯3.79 vs 48.86 ±â€¯2.62, P < .0001; Nasal 40,52 ±â€¯4.30 vs 46,01 ±â€¯3.23, P = .0002; Inferior 42.76 ±â€¯5.26 vs 50.10 ±â€¯3.36, P < .0001; Temporal 40.42 ±â€¯4.46 vs 46.09 ±â€¯2.91, P = .0001) and in all but nasal sector in the SVP (Superior 39.86 ±â€¯4.46 vs 46.47 ±â€¯2.61, P < .0001; Nasal 40.35 ±â€¯4.56 vs 44.09 ±â€¯2.87, P = .0067; Inferior 40.74 ±â€¯4.61 vs 46.58 ±â€¯3.26, P = .0002; Temporal 39.98 ±â€¯5.07 vs 44.78 ±â€¯3.28, P = .0024). Correlation between VD and macular thickness was positive and significant (RP: r = 0.59, P = .043; controls r = 0.51, P = .018). CONCLUSIONS: Patients with advanced forms of RP have less vessel density in the macular area than healthy subjects. These differences are present in all four quadrants in the DVP and three in the SVP.

[Spontaneous resolution of idiopathic macular hole type IV: optical coherence tomography follow-up]. / Cierre espontáneo de un agujero macular idiopático tipo IV: seguimiento mediante tomografía de coherencia óptica.

CASE REPORT: A fifty-five year old patient with visual loss in the left eye was diagnosed to have a complete idiopathic macular hole. After a three-week observational period, spontaneous resolution of the macular hole was observed with vision recovery, all of this clearly demonstrated by optical coherence tomography (OCT). DISCUSSION: Spontaneous resolution of the idiopathic macular hole is infrequent (3-6%). OCT follow-up enabled monitoring of the closure mechanisms. Complex surgery was avoided by a short observational period.

Cierre espontáneo de un agujero macular idiopático tipo IV: seguimiento mediante tomografía de coherencia óptica / Spontaneous resolution of idiopathic macular hole type IV: optical coherence tomography follow-up

Caso clínico: Paciente varón de 55 años que acudepor pérdida de visión en ojo izquierdo, diagnosticándosede agujero macular idiopático estadio IV.Tras un período de observación de 3 semanas seproduce el cierre espontáneo del agujero macularcon recuperación de la visión, todo ello bien documentadomediante tomografía de coherencia óptica(OCT).Discusión: El cierre espontáneo de un agujeromacular idiopático es poco frecuente (3-6%). Elseguimiento mediante OCT permite visualizar losmecanismos de reparación a nivel retiniano. Unperíodo corto de observación nos puede evitar unaintervención quirúrgica compleja y laboriosa

Case report: A fifty-five year old patient with visual loss in the left eye was diagnosed to have a complete idiopathic macular hole. After a threeweek observational period, spontaneous resolution of the macular hole was observed with vision recovery, all of this clearly demonstrated by optical coherence tomography (OCT). Discussion: Spontaneous resolution of the idiopathic macular hole is infrequent (3-6%). OCT followup enabled monitoring of the closure mechanisms. Complex surgery was avoided by a short observational period

Uveítis recurrentes y tratamiento con anticuerpos monoclonales (Daclizumab) / Recurrent uveitis and therapy with monoclonal antibody (DACLIZUMAB)

Objetivo: Evaluar la eficacia de la administración de un anticuerpo monoclonal (Daclizumab) como alternativa de tratamiento en pacientes con uveítis no infecciosas recurrentes que no responden a otros inmunosupresores. Métodos: Se seleccionaron diez pacientes con uveítis no infecciosas intermedias o posteriores recurrentes, y se trataron mediante la administración de daclizumab intravenoso (anticuerpo monoclonal humanizado anti-receptor de IL-2) durante un período de dos años, con un intervalo de un mes entre cada dosis. Resultados: En un 70% de los casos se objetivó una mejoría de la actividad inflamatoria manteniéndose los pacientes sin recurrencias. Un 10% de los casos tuvieron un incremento en su agudeza visual de 2 líneas, mejorando el edema macular quístico. Un 20% de los casos siguieron con sus recurrencias, aunque sin producirse empeoramiento respecto al año anterior. En un 40% de casos se consiguió eliminar el tratamiento con corticoides y un 30% se mantuvieron con dosis mínimas (5 mg). No aparecieron efectos secundarios durante el período de tratamiento. Conclusiones: Daclizumab es eficaz y seguro como tratamiento a largo plazo en este tipo de uveítis, las cuales no son controladas con otros tratamientos, permitiendo con el tiempo disminuir las dosis de corticoides o incluso eliminarlos(AU)

Purpose: Assess the efficacy of monoclonal antibody (daclizumab) therapy in the treatment of patients with non-infectious uveitis who do not respond to other immunosuppressive agents. Material and method: Ten patients with non-infectious intermediate and posterior uveitis were treated with intravenous daclizumab (humanized anti-IL-2 receptor monoclonal antibody) monthly for two years. Results: 70% of the patients have had some improvement in their inflammatory activity being maintained without recurrence. 10% of the patients improved their visual acuity in two lines and the macular edema decreased. 20% of the patients continued to have recurrences, but not worse than the year before. 40% of the patients gave up having the treatment with corticosteroids and 30% with minimum dose (5 mg). No secondary effects were noted during the treatment. Conclusions: Daclizumab is effective and safe for long-term use in the treatment of uveitis which cannot be kept under control by other treatments. In time, it allows the dose of corticosteroids to be decreased or even discontinued(AU)

[Recurrent uveitis and therapy with monoclonal antibody (daclizumab)]. / Uveítis recurrentes y tratamiento con anticuerpos monoclonales (Daclizumab).

PURPOSE: Assess the efficacy of monoclonal antibody (daclizumab) therapy in the treatment of patients with non-infectious uveitis who do not respond to other immunosuppressive agents. MATERIAL AND METHOD: Ten patients with non-infectious intermediate and posterior uveitis were treated with intravenous daclizumab (humanized anti-IL-2 receptor monoclonal antibody) monthly for two years. RESULTS: 70% of the patients have had some improvement in their inflammatory activity being maintained without recurrence. 10% of the patients improved their visual acuity in two lines and the macular edema decreased. 20% of the patients continued to have recurrences, but not worse than the year before. 40% of the patients gave up having the treatment with corticosteroids and 30% with minimum dose (5 mg). No secondary effects were noted during the treatment. CONCLUSIONS: Daclizumab is effective and safe for long-term use in the treatment of uveitis which cannot be kept under control by other treatments. In time, it allows the dose of corticosteroids to be decreased or even discontinued.