G Rebolleda

University of Alcalá, Cómpluto, Madrid, Spain

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Publications (109)148.59 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the effect of optic nerve head drusen (ONHD) on the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) using Cirrus optical coherence tomography (OCT).
    08/2014;
  • G Rebolleda, F J Muñoz Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 04/2014; 89(4):133-135.
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    ABSTRACT: Thyroid orbitopathy is a complex disease that can produce severe functional and cosmetic complications. Prompt diagnosis and treatment during the active inflammatory phase is essential to decrease late sequels. Corticosteroids remain the main pillar in the treatment of the active phase. Other possibilities when steroids fail are radiotherapy, cyclosporine or new biological agents such as rituximab. Rehabilitative surgery can be performed to treat the functional and disfiguring sequels in the inactive phase. A review of the clinical manifestations, classifications and treatment, both medical and surgical, is presented.
    Expert Review of Ophthalmology 01/2014; 8(2).
  • G. Rebolleda, F.J. Muñoz Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 01/2014; 89(4):133–135.
  • European Journal of Internal Medicine 01/2014; · 2.05 Impact Factor
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    ABSTRACT: The incidence of false positive (FP) results of optic coherence tomography (OCT) retinal nerve fiber layer (RNFL) color code in healthy subjects can be very high with Cirrus OCT. Recent evidence has shown that OCT parameters derived from macular ganglion cell-inner plexiform layer (GCIPL) have excellent ability to discriminate between normal eyes and eyes with early glaucoma. This was a prospective, cross-sectional study. One hundred eyes from 50 healthy volunteers underwent circumpapillary scanning by Cirrus and Spectralis OCT and macular scanning using Cirrus OCT. FP rates for each of the OCT parameters, using predefined criteria for an abnormal test were calculated. Comparative analysis was performed using the McNemar test. A generalized estimating equations model (GEE) was used to compare demographic and clinical factors between the eyes with normal findings and eyes with abnormal results. The overall RNFL color-code FP rate was significantly higher for Cirrus (39 %) than for Spectralis (18 %) (P = 0.000). The Spectralis RNFL FP rate showed no significant difference when compared to the FP rate by Cirrus GCIPL (13 %) and ONH (11 %) analysis. Axial length, mean spherical equivalent, presence of peripapillary atrophy, and tilted disc were significantly related to the RNFL FP occurrence displayed by both devices. Spectralis might be more specific than Cirrus when evaluating the RNFL thickness for Caucasians and moderate myopic population. GCIPL and ONH analysis might be more useful than RNFL thickness to evaluate this population using Cirrus OCT.
    Albrecht von Graæes Archiv für Ophthalmologie 12/2013; · 1.93 Impact Factor
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    ABSTRACT: AimTo determine the response of the lamina cribrosa (LC) and prelaminar tissue to a reduction of intraocular pressure (IOP) after nonpenetrating deep sclerectomy (NPDS) using enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT).MethodsA total of 28 eyes from 28 patients presenting with primary open angle glaucoma who underwent NPDS were studied. SD-OCT scans using EDI technology were obtained before surgery and 1 week, 1 month, and 3 months postoperatively. The OCT device was set to image a 15 × 10° vertical rectangle centred on the optic disc. The scan closest to the optic nerve head (ONH) centre was selected for analysis. The vertical distances from three equidistant points on the reference line (Bruch's membrane opening) to the anterior prelaminar tissue surface and the anterior and posterior surfaces of the LC were measured.ResultsThe IOP decreased from 18.7±4.3 to 9.1±4.0 at the first week, 11.4±3.7 at 1 month, and 13.1±3.6 mm Hg at 3 months postoperatively (P<0.001). There was a significant reduction of the ONH cupping at 1 week (22.3%, P<0.001), 1 month (13.7%, P<0.001), and 3 months (9.8%, P=0.001) after surgery. Anterior displacement of the LC was slight but statistically significant at 1 week (4.5%, P=0.003), 1 month (3.8%, P=0.014), and 3 months postoperatively (3.3%, P=0.010). IOP reduction was significantly correlated with a reduction of ONH cupping and anterior displacement of LC at the first week and first month (P<0.05).Conclusions Cupping reversal after NPDS is mainly due to changes in prelaminar tissue thickness, whereas the LC changes in position are less pronounced.Eye advance online publication, 15 November 2013; doi:10.1038/eye.2013.238.
    Eye (London, England) 11/2013; · 1.97 Impact Factor
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    ABSTRACT: To evaluate primary cultures from human conjunctiva supplemented with fetal bovine serum, autologous serum, and platelet-rich autologous serum, over human amniotic membrane and lens anterior capsules. One-hundred and forty-eight human conjunctiva explants were cultured in CnT50(®) supplemented with 1, 2.5, 5 and 10% fetal bovine serum, autologous serum and platelet-rich autologous serum. Conjunctival samples were incubated at 37°C, 5% CO2 and 95% HR, for 3 weeks. The typical phenotype corresponding to conjunctival epithelial cells was present in all primary cultures. Conjunctival cultures had MUC5AC-positive secretory cells, K19-positive conjunctival cells, and MUC4-positive non-secretory conjunctival cells, but were not corneal phenotype (cytokeratin K3-negative) and fibroblasts (CD90-negative). Conjunctiva epithelial progenitor cells were preserved in all cultures; thus, a cell culture in CnT50(®) supplemented with 1 to 5% autologous serum over human amniotic membrane can provide better information of epithelial cell differentiation for the conjunctival surface reconstruction.
    Archivos de la Sociedad Espanola de Oftalmologia 10/2013;
  • G Rebolleda, F J Muñoz Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 08/2013; 88(8):289-290.
  • Ophthalmology 04/2013; 120(4):875-875.e1. · 5.56 Impact Factor
  • F J Muñoz Negrete, G Rebolleda
    Archivos de la Sociedad Espanola de Oftalmologia 04/2013; 88(4):125-126.
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    ABSTRACT: PURPOSE: To evaluate the agreement of retinal nerve fiber layer (RNFL) color codes among Stratus, Cirrus, and Spectralis optical coherence tomography (OCT) in patients with relapsing-remitting multiple sclerosis. DESIGN: Prospective cohort study. METHODS: In 140 eyes from 70 patients having relapsing-remitting multiple sclerosis from January 2011 to September 2011, peripapillary RNFL thickness was measured using the fast RNFL program by Stratus, the optic disc cube protocol by Cirrus, and the N-site axonal analysis by Spectralis. RESULTS: Overall, a moderate to good RNFL color code agreement was found (0.435-0.884), except for the nasal quadrant. The temporal quadrant was the most abnormal color coding by both Cirrus (64.7%) and Spectralis (61.7%) in both the optic neuritis (ON) and non-ON group and by Stratus (58.8%) in the ON group. Abnormal temporal RNFL color-code rate was significantly higher in ON eyes than non-ON eyes by Cirrus (P < .001), Stratus (P < .001), and Spectralis (P = .030). Overall, Cirrus significantly displayed abnormal findings while both Stratus and Spectralis displayed normal results for the inferior quadrant (P < .05). On the other hand, Spectralis OCT showed a significantly higher rate of abnormal findings while Cirrus displayed normal results for the temporal quadrant in non-ON eyes (P < .001). CONCLUSIONS: We found a substantial color-code disagreement among devices in patients with relapsing-remitting multiple sclerosis regarding the ON antecedent. In non-ON eyes, Spectralis yielded a significantly higher thinning for temporal quadrant than Cirrus, suggesting that N-site axonal analysis could define axonal damage in relapsing-remitting multiple sclerosis patients earlier than conventional RNFL analysis.
    American journal of ophthalmology 02/2013; · 3.83 Impact Factor
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    ABSTRACT: Objective To evaluate primary cultures from human conjunctiva supplemented with fetal bovine serum, autologous serum, and platelet-rich autologous serum, over human amniotic membrane and lens anterior capsules. Methods One-hundred and forty-eight human conjunctiva explants were cultured in CnT50® supplemented with 1, 2.5, 5 and 10% fetal bovine serum, autologous serum and platelet-rich autologous serum. Conjunctival samples were incubated at 37 °C, 5% CO2 and 95% HR, for 3 weeks. Results The typical phenotype corresponding to conjunctival epithelial cells was present in all primary cultures. Conjunctival cultures had MUC5AC-positive secretory cells, K19-positive conjunctival cells, and MUC4-positive non-secretory conjunctival cells, but were not corneal phenotype (cytokeratin K3-negative) and fibroblasts (CD90-negative). Conclusions Conjunctiva epithelial progenitor cells were preserved in all cultures; thus, a cell culture in CnT50® supplemented with 1 to 5% autologous serum over human amniotic membrane can provide better information of epithelial cell differentiation for the conjunctival surface reconstruction.
    Archivos de la Sociedad Espanola de Oftalmologia 01/2013;
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    ABSTRACT: Purpose:  To evaluate the positivity rate of temporal artery biopsies (TAB) performed in suspects of giant cell arteritis (GCA) and to study the epidemiological and clinical factors associated to the biopsy result. Methods:  A retrospective, multicenter, case-control study was performed, including three hundred and thirty-five patients who underwent TAB for a suspicion of GCA from 2001 to 2010. Clinical, epidemiological and pathology data were recovered from the patients' clinical records. Histologic diagnosis of GCA was made when active inflammation or giant cells were found in the arterial wall. Results:  Eighty-one biopsies (24.2%) were considered positive for GCA. Clinical factors independently associated to TAB result in a logistic regression analysis were temporal cutaneous hyperalgesia (OR = 10.8; p < 0.001), jaw claudication (OR = 4.6; p = 0.001), recent-onset headache (OR = 4.4; p = 0.001), decreased temporal pulse (OR = 2.8; p = 0.02), pain and stiffness in neck and shoulders (OR = 2.3; p = 0.05), unintentional weight loss (OR = 1.33; p = 0.003) and age (OR = 1.085; p = 0.004). Other factors such as length of the surgical specimen (OR = 1.079; p = 0.028) and erythrocyte sedimentation rate (OR = 1.042; p < 0.001) were also statistically significant. The model was accurate (C-index = 0.921), reliable (p(Hosmer-Lemeshow)  = 0.733) and consistent in the bootstrap sensitivity analysis. No significant association was detected between TAB result and number of days of previous systemic corticosteroid treatment (p = 0.146). However, an association was observed between TAB result and the total accumulated dose of previous systemic corticotherapy (p = 0.043). Conclusions:  Exhaustive anamnesis and clinical examination remain of paramount importance in the diagnosis of GCA. To improve the yield of TAB, it should be performed specially in older patients with GCA-compatible clinic. TAB could be avoided in patients with an isolated elevation of acute phase reactants, without GCA-compatible clinic.
    Acta ophthalmologica 08/2012; · 2.44 Impact Factor
  • Albrecht von Graæes Archiv für Ophthalmologie 05/2012; · 1.93 Impact Factor
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    ABSTRACT: BACKGROUND: To evaluate the visual and anatomic outcomes after systemic steroid treatment in non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: Ten eyes from ten patients diagnosed with NAION and treated during the acute phase with 80 mg daily, tapering-down dose of corticosteroids were compared with a non-contemporary cohort of 27 patients that received no treatment. The visual outcomes of treated and untreated group were compared. Patients underwent complete ophthalmic examination including determination of Snellen visual acuity (VA), visual fields (VFs) (standard automated perimetry, Swedish Interactive Testing Algorithm 24-2 strategy), and optical coherence tomography (OCT) scanning of the optic nerve head at diagnosis, 6-8 weeks and 6 months after presentation. RESULTS: No statistical differences were found between steroid-treated and untreated NAION for the median change in VA (Mann-Whitney P = 0.28), median change in VF mean deviation (MD) and median change in VF pattern standard deviation (PSD) (Mann-Whitney P = 0.213 and P = 0.07 respectively). Statistical analysis showed no differences when comparing average RNFL loss (P = 0.871) and RNFL loss for superior, nasal, inferior and temporal optic disc quadrants between both groups. Complications occurred in three of the ten treated patients (30%); in one of them, steroid therapy had to be discontinued. Another two patients developed a NAION in their fellow eye after 2 and 3 months while on low-dose prednisone. No complications developed in the control group. The study was interrupted early due to a significantly higher rate of complications observed in the treated group (P = 0.002) CONCLUSION: High-dose systemic steroid treatment did not show any beneficial effect in visual and anatomic outcomes when given during the acute phase of NAION. Furthermore, it caused serious complications in a third of the patients treated.
    Albrecht von Graæes Archiv für Ophthalmologie 03/2012; · 1.93 Impact Factor
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    ABSTRACT: To evaluate the accuracy of 3 spectral-domain (SD) optical coherence tomography (OCT) devices (Topcon 3D-1000 [Topcon]; Cirrus HD [Carl Zeiss Meditec, Inc], and Spectralis OCT [Heidelberg Engineering]) before and after mydriasis for the diagnosis of diabetic macular edema. Cross-sectional study. Sixty-two eyes of 62 consecutive patients with diabetes without recent loss of vision referred for retinal control were assessed. Two scans were performed for each SD OCT instrument. Central retinal thickness was measured before and after pupil dilation. Pupil dynamic was studied using pMetrics pupillometer (iVIS Technologies), and lens opacity was measured by Pentacam densitometry (Oculus). The diagnostic accuracy of SD OCT devices was assessed by sensitivity, specificity, and area under the receiver operating characteristic curve. Logistic regression analysis was used to assess the effect of pupil size and lens opacity on the reliability of SD OCT in the acquisition of adequate images. The area under the receiver operating characteristic curve for the Topcon 3D OCT device was 0.84, that for the Cirrus HD OCT device was 0.93, and that for the Spectralis OCT device was 0.91. Significant differences in area under the receiver operating characteristic curve before and after pupillary dilatation were not found. Sensitivity and specificity associated with the cutoff value for the best performance were 82% and 74% for the Topcon 3D OCT device, 90% and 87% for the Cirrus HD OCT device, and 90% and 84% for the Spectralis OCT device, respectively. The Topcon 3D OCT device had an 11.3% segmentation algorithm failure rate for the central millimeter of the fovea, and the nuclear lens density was significantly greater in these eyes than in those without failure (17.1 ± 1.1 mm vs 10.4 ± 0.2 mm; P < .05). SD OCT is a useful tool to detect and to measure diabetic macular edema without the need for pupil dilatation.
    American journal of ophthalmology 03/2012; 153(3):536-543.e1. · 3.83 Impact Factor
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    ABSTRACT: To compare intrascleral blebs characteristics after deep sclerectomy (DS) with three intrascleral implants using the Visante anterior segment optical coherence tomography. This is a cross-sectional study including 60 eyes of 51 patients that underwent DS with Sk-Gel, Esnoper, and Aquaflow implant. Intraocular pressure (IOP) measurement, slit-lamp examination, and Visante scans were performed the same day in all the patients. Visante scans were done through the intrascleral bleb at 45°, 90°, and 135° and the bleb height was measured. Sk-Gel was used in 19 eyes (31.66%), Esnoper in 22 eyes (36.66%), and Aquaflow in 19 eyes (31.66%). The median time lapsed from the surgery was 15.50 months 25th and 75th percentiles (p(25) 8.25; p(75) 20). The median IOP was 13 mm Hg (p(25) 10; p(75) 15), with no significant differences among implants (P = 0.232). Overall, the correlation between the scleral bleb height and the IOP was statistically significant at 45° (r=-0.359; P = 0.004), 90° (r = -0.410; P = 0.001), and 135° (r = -0.417; P = 0.001). However, Sk-Gel did not show any statistically significant correlation between the scleral height and IOP whereas the other two groups (Esnoper and Aquaflow) showed a significant correlation. There were no differences in the bleb height among implants. There was a moderate inverse correlation between the scleral bleb height and the IOP measurement after DS with Esnoper and Aquaflow implants. There were no differences in bleb height among the three implants.
    Eye (London, England) 01/2012; 26(4):552-6. · 1.97 Impact Factor
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    ABSTRACT: To evaluate if decompression surgery produces changes in retrobulbar blood flow parameters in Graves' ophthalmopathy (GO). Retrobulbar blood vessels of 26 eyes (14 patients) that underwent orbital bone decompression between June 2009 and May 2010 were measured prospectively using color Doppler ultrasound before and after surgery. The disease was inactive in all patients enrolled according to the European Group on Graves' Orbitopathy. Patients were classified with mild, moderate-to-severe, or sight-threatening disease. All patients underwent a full ophthalmic examination including intraocular pressure and Hertel measurement. An age-matched control group included 20 eyes of 20 healthy volunteers. The resistance indexes (RIs) in the central retinal artery (CRA) and ophthalmic artery (OA) were significantly higher in patients with GO preoperatively than in the control group (P < 0.001, P = 0.001 respectively). After decompression surgery, a significant decrease in RIs occurred in the CRA (5%) and OA (6%) (P = 0.002, P < 0.001 respectively). Proptosis was decreased a median of 6 mm (range, 4-7). Three-wall decompression surgery resulted in a significantly greater reduction in exophthalmos (median 7 mm) compared with two-wall surgery (median 5 mm) and one-wall surgery (2.5 mm). Although no significant correlation was found, the RIs decreased more with major reductions in exophthalmos. In inactive moderate-to-severe GO, the RIs of the CRA and OA are higher than in normal subjects. The authors hypothesized that increased RIs of inactive GO may be due to orbital extrinsic compression of vascular structures because decompression surgery leads to decreases in the RIs of both the CRA and OA.
    Investigative ophthalmology & visual science 04/2011; 52(8):5612-7. · 3.43 Impact Factor
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    ABSTRACT: This study was undertaken to compare the ocular haemodynamic effects of Combigan(®) versus placebo in patients with ocular hypertension (OHT). Thirty patients with OHT were included in a controlled, randomised, double blind study in two parallel groups; 15 were randomised to receive Combigan(®) and 15 to receive placebo for a period of 3 months. At baseline and at 3 months retrobulbar blood flowmeasurements of the ophthalmic artery (OA) and central retinal artery (CRA) were taken using colour Doppler imaging(CDI) ultrasound, concurrently with intraocular pressure (IOP). Combigan(®) significantly reduced IOP after 3 months of treatment (P = 0.001), whereas placebo showed no significant change in IOP. The baseline haemodynamic parameters were similar between treatment and placebo groups. Patients treated with Combigan® showed a statistically significant decrease in CRA resistive index (P = 0.007). Patients treated for 3 months with Combigan(®) showed a significant decrease of CRA resistive index that could be explained by the decrease in IOP.
    Archivos de la Sociedad Espanola de Oftalmologia 02/2011; 86(2):42-6.

Publication Stats

444 Citations
148.59 Total Impact Points

Institutions

  • 2003–2014
    • University of Alcalá
      • Department of Geography and Geology
      Cómpluto, Madrid, Spain
  • 2000–2014
    • Hospital Universitario Ramón y Cajal
      • Departamento de Oftalmología
      Madrid, Madrid, Spain
  • 2012
    • Complejo Hospitalario de Toledo
      Toledo, Castille-La Mancha, Spain
  • 2011
    • Hospital Universitario La Paz
      Madrid, Madrid, Spain
  • 2007
    • Universidad de Navarra
      • Oftalmología
      Pamplona, Navarre, Spain
  • 2004
    • Texas A&M University - Galveston
      Galveston, Texas, United States