G Rebolleda

University of Alcalá, Cómpluto, Madrid, Spain

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Publications (121)187.12 Total impact

  • Ophthalmology 07/2015; 122(7):e43-4. DOI:10.1016/j.ophtha.2014.12.039 · 6.17 Impact Factor
  • G. Rebolleda, F.J. Muñoz-Negrete
  • Investigative ophthalmology & visual science 04/2015; 56(4):2568-2569. DOI:10.1167/iovs.15-16656 · 3.66 Impact Factor
  • G. Rebolleda, F.J. Muñoz-Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 03/2015; 90(5). DOI:10.1016/j.oftal.2015.02.007
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    ABSTRACT: The purpose of this study was to evaluate the efficacy and safety of nonpenetrating deep sclerectomy (NPDS) in 3 consecutive eyes with preexisting and uncontrolled glaucoma after Descemet stripping with automated endothelial keratoplasty (DSAEK).NPDS with intrascleral implant and topical adjunctive intraoperative mitomycin C (0.2 mg/mL 1 minute) was performed.Intraocular pressure (IOP) and number of glaucoma medication were registered before and after NPDS with at least 1-year follow-up. Intraoperative and postoperative complications were also registered.Before NPDS, IOP was 18 mm Hg in 1 patient and 32 mm Hg in the other 2 patients. Four antiglaucoma drugs were used in 2 cases and 3 in the other one. At 1 year after NPDS, all the patients had an IOP ≤18 mm Hg. Two patients required postoperative antiglaucoma medications (1 drug in 1 case and 2 drugs in the other one). Neodymium-doped yttrium aluminum garnet laser goniopuncture was needed in 2 patients and it had to be repeated in 1 of them. No complications related to NPDS were observed. A corneal graft rejection was observed 5 months after NPDS in 1 case that resolved without sequelae with intensive corticosteroid eye-drop therapy.NPDS could be a safe and successful alternative to conventional filtration surgery after DSAEK in eyes with uncontrolled glaucoma. Larger series and a longer follow-up would be necessary to set the actual role of surgery in DSAEK patients.
    Medicine 02/2015; 94(6):e543. DOI:10.1097/MD.0000000000000543 · 4.87 Impact Factor
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    ABSTRACT: Purpose: To evaluate the ability of the papillomacular bundle (PMB) retinal nerve fiber layer and macular inner retinal layers thickness measurements with Spectralis Optical Coherence Tomography (OCT) to differentiate eyes with non-arteritic anterior ischemic optic neuropathy (NAION) from uninvolved eyes and to evaluate whether their thicknesses correlate with visual acuity. Methods: An observational, cross-sectional study was performed, including 29 eyes with NAION and 29 uninvolved eyes from 29 patients. Eyes underwent scanning with Cirrus OCT (peripapillary and macular scanning) and Spectralis OCT (N-site axonal peripapillary scan and a new automated segmentation macular scan to measure individual retinal layers) in both eyes. Results: NAION eyes showed significant thinning versus uninvolved eyes in the macular retinal nerve fiber (P<0.05), ganglion cell (P<0.001) and inner plexiform layers (P<0.01) by Spectralis and in the GCIPL by Cirrus (P<0.02). Average and sectors of peripapillary retinal nerve fiber layer (pRNFL) and total macular thickness (TMT) were significantly thinner in NAION eyes using both Spectralis and Cirrus OCT (P<0.05). Spectralis temporal (ρSpearman=-0.768;P<0.001) and PMB pRNFL thickness (ρSpearman=-0.675;P<0.001), as well as central macular inner plexiform layer (IPL) thickness (ρSpearman=-0.735;P<0.001), correlated strongly with BCVA. Quadratic regression using outer nasal TMT by Cirrus OCT and temporal pRNFL thickness by Spectralis were the best models to predict BCVA. Conclusions: Macular segmentation by Spectralis and Cirrus OCT reveal inner retinal layer atrophy in NAION eyes. The temporal and PMB pRNFL thicknesses and central macular IPL thickness by Spectralis-OCT and outer nasal TMT by Cirrus were strongly correlated with BCVA in NAION eyes. Copyright © 2015 by Association for Research in Vision and Ophthalmology.
    Investigative Ophthalmology &amp Visual Science 01/2015; 56(2). DOI:10.1167/iovs.14-15314 · 3.66 Impact Factor
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    ABSTRACT: : Optical coherence tomography is a valuable tool for evaluating patients with neuro-ophthalmic disorders. In the acute phase of anterior optic neuritis (ON), peripapillary retinal nerve fiber layer (pRNFL) measurements can underestimate the amount of damage as axonal swelling could mask the true degree of RNFL loss. Contrary to pRNFL evaluation, we hypothesize that macular ganglion cell layer analysis could detect true neuronal loss before swelling resolution in anterior ON. We describe 4 patients with anterior ON in whom ganglion cell layer and inner plexiform layer (GCIPL) thinning was detected earlier than pRNFL loss. GCIPL analysis may provide more accurate information than pRNFL thickness and serve as an early structural indicator of irreversible neuronal loss.
    Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society 12/2014; DOI:10.1097/WNO.0000000000000204 · 1.81 Impact Factor
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    ABSTRACT: To present a clinical practice guideline update on the medical, laser, and surgical treatment of primary angle closure glaucoma (PACG) in adults. Following the formulation of key questions using the PICO scheme (Patient/Problem, Intervention, Comparison, Outcome), a systematic review was performed on the literature published to date, including international clinical practice guidelines. The AMSTAR and Risk of Bias tools were used for evaluating the quality of the information. The level of evidence and grade of recommendation was established following the Scottish Intercollegiate Guidelines Network (SIGN) system. Following the above methodology, recommendations of medical, laser and surgical treatment in adult PACG and levels of evidence are presented. Although the level of scientific evidence for many of the questions raised is not very high, a review is presented on updated treatment recommendations for adult PACG. Among the limitations for the implementation of these recommendations is that most studies have been conducted in Asian populations, and that the effectiveness is measured almost exclusively in terms of reducing intraocular pressure, and does not include visual function, quality of life or cost-effectiveness parameters. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.
    Archivos de la Sociedad Espanola de Oftalmologia 11/2014; 90(3). DOI:10.1016/j.oftale.2015.03.013
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    ABSTRACT: Realización de una guía de práctica clínica actualizada sobre el tratamiento médico, láser y quirúrgico del glaucoma por cierre angular primario (GCAP) en el adulto.
    Archivos de la Sociedad Espanola de Oftalmologia 11/2014; 90(3). DOI:10.1016/j.oftal.2014.09.014
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    ABSTRACT: Optical coherence tomography (OCT) has become essential to evaluate axonal/ neuronal integrity, to assess disease progression in the afferent visual pathway and to predict visual recovery after surgery in compressive optic neuropathies. Besides that OCT testing is considered a powerful biomarker of neurodegeneration and a promising outcome measure for neuroprotective trials in multiple sclerosis (MS). Currently, spectral-domain OCT (SD-OCT) technology allows quantification of retinal individual layers. The Ganglion Cell layer (GCL) investigation has become one of the most useful tools from a neuro-ophthalmic perspective. It has a high correlation with perimetry, is predictive of future progression and is a highly sensitive, specific of several neuro-ophthalmic pathologies. Moreover the superior correlation with clinical measures compared to peripapillary retinal nerve fiber layer (pRNFL) suggests that GCL analysis might be a better approach to examine MS neurodegeneration. In disorders with optic disc edema, such as ischemic optic neuropathy, papillitis and papilledema, reduction in RNFL thickness caused by axonal atrophy is difficult to distinguish from a swelling resolution. In this setting, and in buried optic nerve head drusen (ONHD), GCL analysis may provide more accurate information than RNFL analysis and it might be an early structural indicator of irreversible neuronal loss. Enhanced depth imaging OCT (EDI-OCT) provides in vivo detail of ONHD, allowing to evaluate and quantify drusen dimensions. OCT is improving our knowledge in hereditary optic neuropathies. Furthermore, there is growing evidence about the role of OCT as an adjunctive biomarker of disorders such as Alzheimer and Parkinsońs disease.
    Saudi Journal of Ophthalmology 10/2014; 29(1). DOI:10.1016/j.sjopt.2014.09.016
  • European Journal of Internal Medicine 10/2014; 25(8). DOI:10.1016/j.ejim.2014.07.010 · 2.30 Impact Factor
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    ABSTRACT: Objective. To estimate sensitivity and specificity of several optical coherence tomography (OCT) measurements for detecting retinal thickness changes in patients with relapsing-remitting multiple sclerosis (RRMS), such as macular ganglion cell-inner plexiform layer (GCIPL) thickness measured with Cirrus (OCT) and peripapillary retinal nerve fiber layer (pRNFL) thickness measured with Cirrus and Spectralis OCT. Methods. Seventy patients (140 eyes) with RRMS and seventy matched healthy subjects underwent pRNFL and GCIPL thickness analysis using Cirrus OCT and pRNFL using Spectralis OCT. A prospective, cross-sectional evaluation of sensitivities and specificities was performed using latent class analysis due to the absence of a gold standard. Results. GCIPL measures had higher sensitivity and specificity than temporal pRNFL measures obtained with both OCT devices. Average GCIPL thickness was significantly more sensitive than temporal pRNFL by Cirrus (96.34% versus 58.41%) and minimum GCIPL thickness was significantly more sensitive than temporal pRNFL by Spectralis (96.41% versus 69.69%). Generalised estimating equation analysis revealed that age (P = 0.030), optic neuritis antecedent (P = 0.001), and disease duration (P = 0.002) were significantly associated with abnormal results in average GCIPL thickness. Conclusion. Average and minimum GCIPL measurements had significantly better sensitivity to detect retinal thickness changes in RRMS than temporal pRNFL thickness measured by Cirrus and Spectralis OCT, respectively.
    BioMed Research International 09/2014; 2014:128517. DOI:10.1155/2014/128517 · 2.71 Impact Factor
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    ABSTRACT: Purpose 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). Methods Fifty-seven eyes of thirty patients with ONHD and thirty-eight eyes of twenty age-matched and sex-matched control subjects underwent circumpapillary and macular scanning using Cirrus OCT. The percentages of eyes with abnormal GCIPL and RNFL values according to the Cirrus normative data were analysed and compared. Results Overall, eyes with ONHD showed abnormally reduced values for average and minimum GCIPL thicknesses in 35 % and 45 % of cases compared to 2 % for both values in control eyes (P < 0.001). Average RNFL thickness comparison between eyes with ONHD and normal eyes revealed abnormal thinning in 33 % vs. 0 %, respectively (p = 0.002). The percentage of abnormal thinning increased with higher grades of ONHD for all the parameters evaluated, so that in grade III drusen, values were abnormally reduced in 80% of eyes in all three analyses. Regarding buried ONHD, 30 % and 4 % of eyes had an abnormally reduced minimum GCIPL and average RNFL thickness, respectively. Furthermore, 26% of these eyes had abnormal GCIPL exams with a normal or increased RNFL thickness. Conclusions Both RNFL and GCIPL analysis reveal significant thinning in eyes with ONHD directly correlated with drusen severity. In buried ONHD, the abnormality rate was significantly higher with GCIPL compared to RNFL evaluation, suggesting that GCIPL analysis might be an early structural indicator of neuronal loss in the setting of thickened RNFL.
    Albrecht von Graæes Archiv für Ophthalmologie 08/2014; 252(10). DOI:10.1007/s00417-014-2773-5 · 2.33 Impact Factor
  • G. Rebolleda, F.J. Muñoz Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 04/2014; 89(4):133–135. DOI:10.1016/j.oftal.2014.03.028
  • 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). DOI:10.1586/eop.13.4
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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; 252(2). DOI:10.1007/s00417-013-2529-7 · 2.33 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; 28(1). DOI:10.1038/eye.2013.238 · 1.90 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; 89(1). DOI:10.1016/j.oftale.2014.03.002
  • G Rebolleda, F J Muñoz Negrete
    Archivos de la Sociedad Espanola de Oftalmologia 08/2013; 88(8):289-290. DOI:10.1016/j.oftal.2013.03.002

Publication Stats

651 Citations
187.12 Total Impact Points

Institutions

  • 2003–2015
    • University of Alcalá
      Cómpluto, Madrid, Spain
  • 2000–2015
    • Hospital Universitario Ramón y Cajal
      • Departamento de Oftalmología
      Madrid, Madrid, Spain
  • 2006
    • Thomas Jefferson University
      Filadelfia, Pennsylvania, United States
  • 2004
    • Texas A&M University - Galveston
      Galveston, Texas, United States