Evaluación de los signos de la pseudoexfoliación en el segmento anterior mediante tomografía de coherencia óptica y cámara de Scheimpflug

Objective

To evaluate different anterior segment parameters in eyes with pseudoexfoliation (PSX), fellow eyes, and controls using optical coherence tomography and a Scheimpflug imaging system.

Evaluación del grosor de los músculos extraoculares y estudio de correlación mediante tomografía de coherencia óptica

Objective

To report reference values for the horizontal rectus muscles thickness using Spectral Domain optical coherence tomography (SD-OCT), and to evaluate whether there are any correlations between the muscle thickness and gender, age, or axial length (AL).

Reproducibilidad de la medición manual del grosor coroideo utilizando la tomografía de coherencia óptica

PurposeSpectral-domain optical coherence tomography (SD-OCT) is the most useful tool to measure choroidal thickness (CT). CT may be increased in ocular and systemic diseases. However, there are concerns relating reproducibility and external validity of OCT.The aim of this study was to assess the inter-observer and intra-observer variability of manual OCT measurements.MethodsCT was manually measured in the central choroid of 40 eyes from 21 subjects (11 healthy and 10 with ankylosing spondylitis) using RTVue-100 OCT (Optovue Inc., Fremont, CA, EE. UU.). Measurements were performed by 9 independent ophthalmologists from 6 different centers. To assess the inter-observer variability, the intra-class correlation coefficient (ICC) method was calculated. Also, intra-observer variability was assessed in 2 of the ophthalmologists.ResultsThe mean subfoveal CT was 364.9 ± 85.1 μm (range, 170 to 572). The inter-observer ICC was 0.823 (CI 95%, 0.749 to 0.888, p < 0.001). The intra-observer ICCs were 0.885 (CI 95%, 0.783 to 0.939, p < 0.001) and 0.925 (CI 95%, 0.859 to 0.960. p < 0.001).ConclusionsIn this study, manual measurements of CT with OCT showed a good concordance. These results suggest that manual OCT is a valid tool for multicenter studies.     

Grosor epitelial corneal un año después de la cirugía de LASIK miópico,medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido

ObjectiveTo compare corneal epithelial thickness (CET) between patients who underwent LASIK surgery for the correction of myopia at least one year ago and healthy subjects.MethodsA retrospective observational study was conducted that included 93 healthy subjects (186 eyes) and 26 subjects (52 eyes) that underwent myopic LASIK surgery. OCT-SA, combined with Placido disk, was performed on all subjects, and CET maps were measured. Statistical analysis was performed to analyse differences between groups. Multivariate analysis was also performed to look for possible predictors of final CET.ResultsThere was no statistically significant differences between the groups in the demographic (age, sex) or anterior segment parameters (spherical equivalent, pachymetry) (all P > .05). Statistically significant differences (P < .05) were obtained between both groups when comparing CET, including central, internal, and external rings (higher in patients that underwent LASIK surgery ≥ 1 year). With the exception of the time elapsed since surgery (P = .00), no correlation was found between the CET and age, sex, ablated dioptres, or other variables studied (P < .05).ConclusionsCET values measured by the OCT-SA were higher in patients that underwent LASIK surgery ≥ 1 year. The only variable that correlated with the CET after LASIK was the time elapsed since surgery. CET changes should be taken into consideration when planning refractive surgery due to its implications on the final outcome.     

Síndrome de Sjögren-Larsson: tomografía de coherencia óptica y una nueva mutación

Case reportA case is presented of a thirty year-old male with ichthyosis, mental retardation, epilepsy and spasticity. Ocular examination showed a best-corrected visual acuity of 0.5 and bilateral crystalline maculopathy. Optical coherence tomography (OCT) revealed focal hyperreflective spots and intrafoveal microcystoid spaces. The diagnosis of Sjögren-Larsson syndrome (SLS) was made, and confirmed by genetic analysis.DiscussionSLS is caused by mutations in the ALDH3A2 gene. A previously unreported novel mutation was identified, c.681-14T>G. Macular OCT makes it possible to find even funduscopy invisible changes. Its use is important because the OCT features of SLS are specific and, therefore, it can help to diagnose this rare systemic disease.     

Utilidad de la tomografía de coherencia óptica en la evaluación de los pacientes con trastorno bipolar

Bipolar disorder (BD) is a mental disorder characterised by episodes of extremal mood changes. In recent years, some researchers found neurodegeneration in patients with BD using Magnetic Resonance Imaging. Evaluation of the optic nerve and the retinal layers using optical coherence tomography (OCT) has proved to be a useful, non-invasive tool for diagnosis and monitoring of neurodegenerative diseases. Accordingly, a decrease in the retinal nerve fibre layer and the ganglion cell complex measured by OCT was found in patients with BD in different studies, suggesting that BD is a neurodegenerative process in addition to a psychiatric disorder. Therefore, the neuro-ophthalmological evaluation of these patients could be used as a marker for diagnosis of this disease.This work analyses literature on retinal degeneration in bipolar disorder patients, and evaluates the ability of OCT devices in the detection of neuronal degeneration affecting the different retinal layers in these patients, and its possible role in the diagnosis and monitoring of the disease.     

Valor predictivo de la tomografía de coherencia óptica en la evolución del adenocarcinoma pulmonar con metástasis coroideas

Clinical caseA 59 year-old male, with the diagnosis of lung adenocarcinoma stage iv, following palliative systemic chemotherapy treatment. He was referred to our department due to bilateral blurred vision. In the eye-fundus we observed: bilateral choroidal metastases with macular involvement, and in optical coherence tomography (OCT): neurosensory detachment in both eyes. This neurosensory detachment showed improvement with chemotherapy before the clinical and radiologic improvement.DiscussionOCT could be a great tool in order to predict the response to systemic treatment in cases of lung adenocarcinoma associated with choroidal metastases.     

Albinismo ocular con mutación en GPR143: hallazgos en autofluorescencia de campo amplio y tomografía de coherencia óptica

A 12 year-old boy who consulted due to nystagmus and low vision from birth. His mother also consulted for low vision of the right eye since she was a child, which worsened recently. The physical examination revealed no alterations in skin and hair pigmentation. In the examination of the anterior segment of the child, areas of slight circumferential hypopigmentation were observed in the iris in both eyes. The fundus examination revealed a choroidal fundus due to the absence of melanin in the retinal pigment epithelium. In the autofluorescence, an absence of physiological macular hypo-autofluorescence was observed and, in optical coherence tomography, foveal hypoplasia was observed in both eyes. In the ocular fundus examination of the mother, slight macular pigmentary changes were observed in the right eye, with hyperpigmented radiated spots in the retinal periphery of both eyes, which were hypo-autofluorescent in the wide-field autofluorescence. In the optical coherence tomography of the right eye, a cavitation of the outer retinal layers was observed in the fovea. The genetic study by nucleotide sequencing was performed on the mother and the child. In the mutation found in the GPR143 gene, the son was hemizygous and the mother was heterozygous. X-linked ocular albinism was diagnosed and the genetic counselling was carried out.Ocular albinism linked to X is the most frequent genetic variant of this disease. Peripheral pigment alterations in heterozygous mothers have been previously described in the literature, but there are no reports of cavitations in the external retinal layers using optical coherence tomography.     

Espesor macular medido con tomografía de coherencia óptica en ojos pseudoafáquicos con implante amarillo vs. transparente

ObjectiveTo study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye.MethodsMacular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference.ResultsAfter 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 μm (P=.02), and foveal thickness reduction was 10 ± 17 μm (P=.02).ConclusionsThe macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.