Publications (9)22.34 Total impact
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Article: Dexamethasone Intravitreal Implant for Treatment of Patients with Recalcitrant Macular Edema Resulting from Irvine-Gass Syndrome.
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ABSTRACT: Purpose. To evaluate the effectiveness of a single intra-vitreal injection of dexamethasone implant (Ozurdex®, Allergan, Inc., Irvine, CA), over 6 months in patients with recalcitrant cystoid macular edema (CME) due to Irvine-Gass Syndrome. Methods. Retrospective review of the medical records of 9 patients with refractory macular edema (ME) due to Irvine-Gass syndrome, who underwent a single injection of Ozurdex between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. All patients underwent a complete ophthalmic evaluation, including best-corrected visual acuity (BCVA) using standardized ETDRS charts, tonometry, fluorescein angiography and SD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Inc., Dublin, California, USA) with foveal thickness (FT) measurement. Results. The mean duration of CME before treatment with Ozurdex was 9,1 months (range 6 to 9 months). At baseline, the mean FT was 542.22 ±134,78 μm. Mean (SD) values of FT did decrease to 350.88 ± 98.71 μm (P = 0.001) at Month 1 and 319.22 ± 60.96 μm (P = 0.002) at Month 3. Data on the 6-month follow-up, showed a mild increase 398.33 ± 127.89 μm (P = 0.031). The mean (SD) change from baseline FT was 191.33 μm (a decrease value of 35%) at Month 1, 223.00 μm (decrease value of 41%) and 143.89 μm (decrease value of 26%) at Month 3 and Month 6, respectively. The baseline BCVA data was 0.62±0.15 logMAR. The mean BCVA improved to 0.47±0.21 logMAR (P = 0.008), 0.37±0.24 logMAR (P = 0.001) after 1, and 3 months, respectively. At the last visit (6-month follow-up), the mean BCVA was 0.37±0.26 logMAR (P = 0.002). Conclusions. In this study, both mean FT and mean BCVA had improved from baseline by 1 month after treatment with a dexamethasone implant, and the improvement remained statistically significant throughout the 6-month study.Investigative ophthalmology & visual science 04/2013; · 3.43 Impact Factor -
Article: Macular holes after rhegmatogenous retinal detachment repair: surgical management and functional outcome.
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ABSTRACT: To review the surgical management and functional outcome of macular holes (MHs) developing after rhegmatogenous retinal detachment repair. Retrospective, interventional, noncomparative case series. Twenty patients with MH developing after rhegmatogenous retinal detachment repair were included. Pars plana vitrectomy with internal limiting membrane peeling and gas tamponade was performed. Macular attachment status and number of best-corrected visual acuity lines of improvement after MH repair were evaluated. The fovea had been detached in all eyes at the time of rhegmatogenous retinal detachment repair. Six MHs developed after scleral buckling surgery and 14 MHs after vitrectomy with an encircling band. In 5 of the 20 patients, ≥ 2 operations had been required to achieve retinal reapplication. The mean time to MH diagnosis was 38 weeks. Preoperative best-corrected visual acuity was ≤ 20/100 in all but one case. Single-operation MH closure rate was 100%, with a mean of 4 Early Treatment Diabetic Retinopathy Study lines of visual improvement (P < 0.001). Mean postoperative Snellen best-corrected visual acuity was 20/70 (± 0.15) (P < 0.001). In this small retrospective study, standard surgical treatment for idiopathic MH was effective in achieving anatomical closure of these secondary MHs, but visual acuity gain was limited by the previous macula-involving rhegmatogenous retinal detachment status.Retina (Philadelphia, Pa.) 05/2011; 31(9):1777-82. · 2.93 Impact Factor -
Article: Tuberculous uveitis after treatment with etanercept.
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ABSTRACT: Etanercept is a tumor necrosis factor (TNF) inhibitor that has been licensed in the United States for the treatment of adult and juvenile rheumatoid arthritis as well as psoriatic arthritis. Reactivation of tuberculosis is a complication of its use. We report the first case of tuberculous uveitis due to etanercept. We performed a clinical chart review. A 58-year-old Caucasian woman was referred to our hospital for chronic unilateral granulomatous panuveitis of the right eye (RE). She was on etanercept and methotrexate for rheumatoid arthritis. Since the patient was immunosuppressed with etanercept and since the uveitis was granulomatous we considered tuberculosis as a possible etiology. An aqueous humor tap was performed and sent for polymerase chain reaction analyses of Herpes simplex, Herpes zoster, and Mycobacterium tuberculosis (MT). This last test was positive. Another aqueous humor sample was taken and sent for microscopic examination of sputum for acid-fast bacilli and culture, both of which were positive for MT. A diagnosis of tuberculous uveitis was established; the patient was treated with rifampin, isoniazid pyrazinamide, and ethambutol and etanercept was stopped. Four months later there were no cells in the anterior chamber and the vitreous was clear. To our knowledge this is the first reported case of tuberculous uveitis following treatment with etanercept. This etiology has to be considered in patients taking this drug who present with intraocular inflammation.Albrecht von Graæes Archiv für Ophthalmologie 10/2007; 245(9):1397-9. · 2.17 Impact Factor -
Article: Topical anesthesia: possible risk factor for endophthalmitis after cataract extraction.
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ABSTRACT: To assess the relationship between the risk for acute endophthalmitis after cataract extraction and whether certain factors, such as surgeon qualification, numerical order, duration of surgery, operating theater, and type of anesthesia (topical or retrobulbar), could be modified to decrease the risk. Single-center academic practice. Two epidemiological studies were performed: a case-control study and a retrospective cohort study. The surgical records of all patients with clinically diagnosed endophthalmitis within 30 days after cataract surgery performed between February 2002 and September 2003 were reviewed. The endophthalmitis cases were compared with 108 randomly selected controls (4 controls per case). The global incidence of endophthalmitis and the incidence according to type of anesthesia were calculated. Of 5011 cataract extractions performed, 27 cases of endophthalmitis occurred. The incidence was 5.39 per 1000 procedures. An independent statistically significant relationship was found between endophthalmitis and the use of topical anesthesia (odds ratio [OR], 11.8; 95% confidence interval [CI], 2.4-58.7) and surgery longer than 45 minutes (OR, 7.2; 95% CI, 1.7-29.7) but not between the other variables. The incidence of endophthalmitis was 1.8 per 1000 cataract extractions with retrobulbar anesthesia and 6.76 per 1000 with topical anesthesia (relative risk [RR], 3.76; 95% CI, 0.89-15.85). After the start of the study period was extended to May 2001, the incidence of endophthalmitis was 1.3 per 1000 cataract extractions with retrobulbar anesthesia and 8.7 per 1000 with topical anesthesia (RR, 6.72; 95% CI, 1.63-27.63). Results suggest that there may be an association between topical anesthesia and endophthalmitis after cataract extraction.Journal of Cataract [?] Refractive Surgery 07/2007; 33(6):989-92. · 2.26 Impact Factor -
Article: Radial optic neurotomy in central retinal vein occlusion: comparison of outcome in younger vs older patients.
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ABSTRACT: To evaluate the effectiveness of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) in patients < or =50 years of age (group 1) vs those >50 (group 2). Prospective, interventional, comparative case series. The study included 43 consecutive patients with CRVO and preoperative visual acuity (VA) < or =0.70 logarithm of minimal angle of resolution (logMAR). All patients underwent pars plana vitrectomy and RON at the nasal border of the optic disk. VA and optical coherence tomography (OCT) findings were recorded preoperatively and at one, six, and 12 months postoperatively. Systemic hypertension, diabetes, and open-angle glaucoma were statistically significantly more prevalent in group 2 (P < .05). One patient in group 1 had hyperhomocysteinemia, and had another antiphospholipid syndrome. Fifty percent of patients in group 1 gained > or =3 lines of Early Treatment Diabetic Retinopathy Study (ETDRS) vision, vs 33% in group 2. Mean final VA was 0.5 logMAR VA in group 1 vs 0.8 in group 2 (P = .04). Foveal thickness decreased significantly in both groups (P < .001). Ten patients (55.6%) in group 1 and 13 (54.2%) in group 2 developed retinochoroidal collaterals. Underlying systemic disease does not seem to be an important factor in the pathogenesis of CRVO in younger patients, and thrombophilia was present in only 11% of patients in this age group. RON yielded better functional results in younger patients, although functional improvement remained limited in those with low baseline VA.American Journal of Ophthalmology 01/2007; 143(1):134-140. · 4.22 Impact Factor -
Article: Sympathetic ophthalmia after surgical resection of iridociliary melanoma. A case report.
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ABSTRACT: We report a case of sympathetic ophthalmia with systemic findings following resection of a malignant melanoma of the iris and ciliary body, and describe the treatment and clinical outcome. A 49-year-old man underwent sector iridocyclectomy of a malignant iridociliary melanoma of the right eye. Five weeks later, he was diagnosed with sympathetic ophthalmia. Snellen's best-corrected visual acuity, fluorescein angiography, electroretinography, cerebrospinal fluid analysis and audiometry were performed. High-dose systemic steroid and immunosuppressive (cyclosporine and azathioprine) therapy was prescribed. Two months later chorioretinitis and macular edema persisted, and intravitreous triamcinolone was injected into the right eye. Five weeks after resection of an iridociliary melanoma, our patient had reported acute bilateral vision loss. Visual acuity was hand motion in both eyes. Examination showed bilateral granulomatous uveitis, diffuse choroiditis with Dalen-Fuchs nodules, papillitis and vitritis. On fluorescein angiography multiple hyperfluorescent dots, which coalesced in areas of exudative retinal detachment, were evident. The patient presented meningismus with pleocytosis on cerebrospinal fluid analysis, and sensorineural deafness. Sympathetic ophthalmia was diagnosed. High-dose intravenous steroids followed by oral prednisone at a tapering dose and immunosuppressive agents (cyclosporine and azathioprine), topical steroids in both eyes and intravitreal steroids in the right eye were administered. Phacoemulsification and intraocular lens implantation were performed to treat a dense cataract of the right eye. After 24 months of follow-up, best-corrected visual acuity was 20/200 in the right eye and 20/25 in the left; no signs of intraocular inflammation were observed and neurological signs had resolved. Low maintenance doses of systemic steroids and immunosuppressive agents were administered up to month 18 of follow-up to avoid recurrence. Sympathetic ophthalmia is a rare, but severe disease that can occur after resection of iridociliary melanoma. High-dose steroid therapy and supplementation with immunosuppressive agents early in the course of the disease was effective in resolving the condition.Albrecht von Graæes Archiv für Ophthalmologie 11/2006; 244(10):1353-6. · 2.17 Impact Factor -
Article: Radial optic neurotomy for management of hemicentral retinal vein occlusion.
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ABSTRACT: To evaluate the effect of radial optic neurotomy on visual acuity (VA) and foveal thickness in patients with hemicentral retinal vein occlusion. A prospective noncomparative case series of 13 eyes in 13 patients with hemicentral retinal vein occlusion and a preoperative VA of 20/60 or less from a total of 232 retinal vein occlusions diagnosed. All patients underwent pars plana vitrectomy, posterior hyaloid dissection, and radial optic neurotomy at the nasal border of the optic disc. Visual acuity and macular thickness were measured with optical coherence tomography. Nine patients (69.2%) gained 2 or more Snellen lines of vision, and in 4 patients (30.8%) VA improved by 4 or more Snellen lines (median visual acuity, 20/50; mean VA, 20/45; P<.01) (average gain, 2.7 Snellen lines). The decrease in foveal thickness was statistically significant (P<.01) (median decrease, 297 microm). Final VA was statistically related to decreased macular thickness at optical coherence tomography (P = .03; rho = -0.62). Retinochoroidal shunts developed in 6 patients (46.1%) at the radial optic neurotomy site. No surgical complications were observed. Radial optic neurotomy seems to be a potential treatment in selected patients with hemicentral retinal vein occlusion, probably because of the more rapid appearance of retinochorioretinal collateral vessels, which promote faster resolution of macular edema.Archives of Ophthalmology 06/2006; 124(5):690-5. · 3.71 Impact Factor -
Article: Frosted branch angiitis associated with Epstein-Barr virus systemic infection.
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ABSTRACT: To describe the first case that the authors are aware of frosted branch angiitis associated with Epstein-Barr virus infection. Case report. A 7-year-old boy presented with bilateral decreased visual acuity. Funduscopy showed a typical image of frosted branch angiitis. He was started on treatment with intravenous steroids and acyclovir. Serological testing was positive for anti-Epstein-Barr virus IgM antibodies. Anti-Epstein-Barr virus IgG antibodies tested positive later. During follow-up, the venous sheathing decreased. Three months later funduscopy showed no abnormalities. Epstein-Barr virus infection should be considered in patients presenting with the typical clinical manifestations of this syndrome.Ocular immunology and inflammation 16(1):41-3. · 0.72 Impact Factor -
Article: An unusual case of fungal chorioretinitis in an immunocompetent individual.
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ABSTRACT: To describe a case of fungal chorioretinitis in a healthy individual. Case report. A 74-year-old immunocompetent man presented with peripheral chorioretinitis with hemorrhage in the superonasal quadrant. A retinal biopsy was performed. PAS and Gomori methenamine silver stain disclosed fungal structures identified as broad nonseptate hyphae with right-angle branches, probably belonging to the Zygomycete class. A systemic workup was initiated to seek the source of the infection with normal findings. The patient was successfully treated with intravitreous and intravenous amphotericine B. Nontraumatic fungal chorioretinitis can present in immunocompetent patients.Ocular immunology and inflammation 16(5):242-3. · 0.72 Impact Factor
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Institutions
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2007
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Hospital Universitari Vall d'Hebron
Barcelona, Catalonia, Spain
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2006–2007
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University of Barcelona
Barcelona, Catalonia, Spain
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