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Sun MT, Cotton RM, Charoenkijkajorn C, Garcia-Sanchez J, Dalal R, Xia X, Lin JH, Singh K, Goldberg JL, Liu WW. Evaluation of Verteporfin as a Novel Antifibrotic Agent in a Rabbit Model of Glaucoma Filtration Surgery: A Pilot Study. Ophthalmol Sci 2024; 4:100448. [PMID: 38261964 PMCID: PMC10797546 DOI: 10.1016/j.xops.2023.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024]
Abstract
Purpose Verteporfin is a benzoporphyrin derivative which is Food and Drug Administration-approved for treatment of choroidal neovascularization in conjunction with photodynamic therapy. It has been shown to prevent fibrosis and scar formation in several organs and represents a promising novel antifibrotic agent for glaucoma surgery. The goal of this study is to determine the effect of verteporfin on wound healing after glaucoma filtration surgery. Design Preclinical study using a rabbit model of glaucoma filtration surgery. Subjects Eight New Zealand white rabbits underwent glaucoma filtration surgery in both eyes. Methods Eyes were randomized into 4 study groups to receive a postoperative subconjunctival injection of 1 mg/mL verteporfin (n = 4), 0.4 mg/mL mitomycin C (MMC; n = 4), 0.4 mg/mL MMC + 1 mg/mL verteporfin (n = 4), or balanced salt solution (BSS) control (n = 4). Bleb survival, vascularity, and morphology were graded using a standard scale over a 30-day period, and intraocular pressure (IOP) was monitored. At 30 days postoperative or surgical failure, histology was performed to evaluate for inflammation, local toxicity, and scarring. Main Outcome Measures The primary outcome measure was bleb survival. Secondary outcome measures were IOP, bleb morphology, and bleb histology. Results Compared to BSS control blebs, verteporfin-treated blebs demonstrated a trend toward increased surgical survival (mean 9.8 vs. 7.3 days, log rank P = 0.08). Mitomycin C-treated blebs survived significantly longer than verteporfin-treated blebs (log rank P = 0.009), with all but 1 MMC-treated bleb still surviving at postoperative day 30. There were no significant differences in survival between blebs treated with combination verteporfin + MMC and MMC alone. Mitomycin C-treated blebs were less vascular than verteporfin-treated blebs (mean vascularity score 0.3 ± 0.5 for MMC vs. 1.0 ± 0.0 for verteporfin, P < 0.01). Bleb histology did not reveal any significant toxicity in verteporfin-treated eyes. There were no significant differences in inflammation or scarring across groups. Conclusions Although verteporfin remained inferior to MMC with regard to surgical survival, there was a trend toward increased survival compared with BSS control and it had an excellent safety profile. Further studies with variations in verteporfin dosage and/or application frequency are needed to assess whether this may be a useful adjunct to glaucoma surgery. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Michelle T. Sun
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Renee M. Cotton
- Department of Comparative Medicine, Stanford University, Palo Alto, California
| | - Chaow Charoenkijkajorn
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Julian Garcia-Sanchez
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Roopa Dalal
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Xin Xia
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Jonathan H. Lin
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Kuldev Singh
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Jeffrey L. Goldberg
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
| | - Wendy W. Liu
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
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Zhu Y, Garcia-Sanchez J, Dalal R, Sun Y, Kapiloff MS, Goldberg JL, Liu WW. Differential expression of PIEZO1 and PIEZO2 mechanosensitive channels in ocular tissues implicates diverse functional roles. Exp Eye Res 2023; 236:109675. [PMID: 37820892 PMCID: PMC10843266 DOI: 10.1016/j.exer.2023.109675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/08/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
PIEZO1 and PIEZO2 are mechanosensitive ion channels that regulate many important physiological processes including vascular blood flow, touch, and proprioception. As the eye is subject to mechanical stress and is highly perfused, these channels may play important roles in ocular function and intraocular pressure regulation. PIEZO channel expression in the eye has not been well defined, in part due to difficulties in validating available antibodies against PIEZO1 and PIEZO2 in ocular tissues. It is also unclear if PIEZO1 and PIEZO2 are differentially expressed. To address these questions, we used single-molecule fluorescence in situ hybridization (smFISH) together with transgenic reporter mice expressing PIEZO fusion proteins under the control of their endogenous promoters to compare the expression and localization of PIEZO1 and PIEZO2 in mouse ocular tissues relevant to glaucoma. We detected both PIEZO1 and PIEZO2 expression in the trabecular meshwork, ciliary body, and in the ganglion cell layer (GCL) of the retina. Piezo1 mRNA was more abundantly expressed than Piezo2 mRNA in these ocular tissues. Piezo1 but not Piezo2 mRNA was detected in the inner nuclear layer and outer nuclear layer of the retina. Our results suggest that PIEZO1 and PIEZO2 are differentially expressed and may have distinct roles as mechanosensors in glaucoma-relevant ocular tissues.
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Affiliation(s)
- Ying Zhu
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Julian Garcia-Sanchez
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Roopa Dalal
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Yang Sun
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michael S Kapiloff
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jeffrey L Goldberg
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Wendy W Liu
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
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Soo RA, Han JY, Dafni U, Cho BC, Yeo CM, Nadal E, Carcereny E, de Castro J, Sala MA, Bernabé R, Coate L, Provencio Pulla M, Garcia Campelo R, Cuffe S, Hashemi SMS, Früh M, Massuti B, Garcia-Sanchez J, Dómine M, Majem M, Sanchez-Torres JM, Britschgi C, Pless M, Dimopoulou G, Roschitzki-Voser H, Ruepp B, Rosell R, Stahel RA, Peters S. A randomised phase II study of osimertinib and bevacizumab versus osimertinib alone as second-line targeted treatment in advanced NSCLC with confirmed EGFR and acquired T790M mutations: the European Thoracic Oncology Platform (ETOP 10-16) BOOSTER trial. Ann Oncol 2021; 33:181-192. [PMID: 34839016 DOI: 10.1016/j.annonc.2021.11.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND While osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is the standard treatment in patients with advanced non-small-cell lung cancer (NSCLC) with sensitising EGFR and acquired T790M mutations, progression inevitably occurs. The angiogenic pathway is implicated in EGFR TKI resistance. PATIENTS AND METHODS BOOSTER is an open-label randomised phase II trial investigating the efficacy and safety of combined osimertinib 80 mg daily and bevacizumab 15 mg/kg every 3 weeks, versus osimertinib alone, in patients with EGFR-mutant advanced NSCLC and acquired T790M mutations after failure on previous EGFR TKI therapy. Primary endpoint was investigator-assessed progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR) and adverse events (AEs). RESULTS Between May 2017 and February 2019, 155 patients were randomised (combination: 78; osimertinib: 77). At data cut-off of 22 February 2021, median follow-up was 33.8 months [interquartile range (IQR): 26.5-37.6 months] and 129 (83.2%) PFS events were reported in the intention-to-treat population. There was no difference in median PFS between the combination [15.4 months; 95% confidence interval (CI) 9.2-18.0 months] and osimertinib arm (12.3 months; 95% CI 6.2-17.2 months; stratified log-rank P = 0.83), [hazard ratio (HR) = 0.96; 95% CI 0.68-1.37]. Median OS was 24.0 months (95% CI 17.8-32.1 months) in the combination arm and 24.3 months (95% CI 16.9-37.0 months) in the osimertinib arm (stratified log-rank P = 0.91), (HR = 1.03; 95% CI 0.67-1.56). Exploratory analysis revealed a significant interaction of smoking history with treatment for PFS (adjusted P = 0.0052) with a HR of 0.52 (95% CI 0.30-0.90) for smokers, and 1.47 (95% CI 0.92-2.33) for never smokers. ORR was 55% in both arms and the median time to treatment failure was significantly shorter in the combination than in the osimertinib arm, 8.2 months versus 10.8 months, respectively (P = 0.0074). Safety of osimertinib and bevacizumab was consistent with previous reports with grade ≥3 treatment-related AEs (TRAEs) reported in 47% and 18% of patients on combination and osimertinib alone, respectively. CONCLUSIONS No difference in PFS was observed between osimertinib plus bevacizumab and osimertinib alone. Grade ≥3 TRAEs were more common in patients on combination.
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Affiliation(s)
- R A Soo
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - J-Y Han
- National Cancer Center, Center for Lung Cancer, Goyang, Republic of Korea
| | - U Dafni
- National and Kapodistrian University of Athens, Athens, Greece; Frontier Science Foundation Hellas, Athens, Greece
| | - B C Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Division of Medical Oncology, Seoul, Republic of Korea
| | - C M Yeo
- Medical Oncology Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - E Nadal
- Medical Oncology Department, ICO L'Hospitalet, Barcelona, Spain
| | - E Carcereny
- Medical Oncology Department, Institut Català d'Oncologia Badalona Hospital Germans Trias i Pujol, B-ARGO Group, Badalona, Spain
| | - J de Castro
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M A Sala
- Medical Oncology Department, Hospital Universitario Basurto, Bilbao, Spain
| | - R Bernabé
- Medical Oncology Department, Hospital Virgen del Rocio, Sevilla, Spain
| | - L Coate
- Mid-Western Cancer Centre and University Hospital Limerick, Limerick, Ireland
| | - M Provencio Pulla
- Hospital Puerta de Hierro, Majadahonda Medical Oncology Service, Madrid, Spain
| | - R Garcia Campelo
- Medical Oncology Department, Hospital Teresa Herrera, La Coruña, Spain
| | - S Cuffe
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - S M S Hashemi
- Department of Pulmonary Diseases, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | - M Früh
- Cantonal Hospital St. Gallen, Oncology and Hematology, St. Gallen, Switzerland; Department of Oncology, Inselspital Bern, Bern, Switzerland
| | - B Massuti
- Medical Oncology Department, Hospital General Universitario Alicante, Alicante, Spain
| | - J Garcia-Sanchez
- Medical Oncology Service, Hospital Arnau Vilanova, Valencia, Spain
| | - M Dómine
- Department of Oncology, Hospital Universitario Fundacion Jimenez Díaz (IIS-FJD), Madrid, Spain
| | - M Majem
- Medical Oncology Department, Hospital De La Santa Creu I Sant Pau, Barcelona, Spain
| | - J-M Sanchez-Torres
- Medical Oncology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - C Britschgi
- Department of Medical Oncology and Hematology, University Hospital Zurich, Comprehensive Cancer Center Zurich, Zurich, Switzerland
| | - M Pless
- Cantonal Hospital Winterthur, Oncology and Haematology, Winterthur, Switzerland
| | - G Dimopoulou
- Frontier Science Foundation Hellas, Athens, Greece
| | - H Roschitzki-Voser
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland
| | - B Ruepp
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland
| | - R Rosell
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain; Catalan Institute of Oncology (ICO), Honorary Consultant, Barcelona, Spain
| | - R A Stahel
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland.
| | - S Peters
- Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
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MCEWAN P, Darlington O, Garcia-Sanchez J, Rao N, Wheeler D, Heerspink H. POS-336 THE IMPACT OF CHRONIC KIDNEY DISEASE AND CLINICAL EVENTS ON PATIENT HEALTH RELATED QUALITY OF LIFE IN DAPA-CKD. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Garcia-Sanchez J, Benet M, Cordon L, Piqueras M, Garde-Noguera J, de Julian M, Gonzalez-Castillo L, Lorente D, Piera N, Gomez-Soler M, Ruiz V, Carretero J, Sanchez-Hernandez A, Juan-Vidal O, Lahoz A. 165P Baseline circulating myeloid-derived suppressor cells correlate with neutrophil-to-lymphocyte ratio and overall survival in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee JY, Castelli V, Bonsack B, Coats AB, Navarro-Torres L, Garcia-Sanchez J, Kingsbury C, Nguyen H, Vandenbark AA, Meza-Romero R, Offner H, Borlongan CV. A Novel Partial MHC Class II Construct, DRmQ, Inhibits Central and Peripheral Inflammatory Responses to Promote Neuroprotection in Experimental Stroke. Transl Stroke Res 2020; 11:831-836. [PMID: 31797249 PMCID: PMC10166182 DOI: 10.1007/s12975-019-00756-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 12/23/2022]
Abstract
Recognizing that the pathologic progression of stroke is closely associated with aberrant immune responses, in particular the activation of peripheral leukocytes, namely T cells, we hypothesized that finding a treatment designed to inhibit neuroantigen-specific T cells and block cytotoxic monocytes and macrophages may render therapeutic effects in stroke. We previously reported that subcutaneous administration of partial MHC class II constructs promote behavioral and histological effects in stroke mice by centrally promoting a protective M2 macrophage/microglia phenotype in the CNS and peripherally reversing stroke-associated splenic atrophy. Here, we employed a second species using adult Sprague-Dawley rats exposed to the middle cerebral artery occlusion stroke model and observed similar therapeutic effects with a mouse partial MHC class II construct called DRmQ, as evidenced by reductions in stroke-induced motor deficits, infarcts, and peri-infarct cell loss and neuroinflammation. More importantly, we offered further evidence of peripheral sequestration of inflammation at the level of the spleen, which was characterized by attenuation of stroke-induced spleen weight reduction and TNF-ɑ and IL-6 upregulation. Collectively, these results satisfy the Stroke Therapy Academic Industry Roundtable criteria of testing a novel therapeutic in a second species and support the use of partial MHC class II constructs as a stroke therapeutic designed to sequester both central and peripheral inflammation responses in an effort to retard, or even halt, the neuroinflammation that exacerbates the secondary cell death in stroke.
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Affiliation(s)
- Jea-Young Lee
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Vanessa Castelli
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Brooke Bonsack
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Alexandreya B Coats
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Lisset Navarro-Torres
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Julian Garcia-Sanchez
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Chase Kingsbury
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Hung Nguyen
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Arthur A Vandenbark
- Neuroimmunology Research, R&D-31, VA Portland Health Care System, 3710, SW U.S. Veterans Hospital Rd., Portland, OR, 97239, USA
- Department of Neurology and Molecular Microbiology & Immunology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Roberto Meza-Romero
- Neuroimmunology Research, R&D-31, VA Portland Health Care System, 3710, SW U.S. Veterans Hospital Rd., Portland, OR, 97239, USA
- Department of Neurology and Molecular Microbiology & Immunology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Halina Offner
- Neuroimmunology Research, R&D-31, VA Portland Health Care System, 3710, SW U.S. Veterans Hospital Rd., Portland, OR, 97239, USA
- Department of Neurology and Molecular Microbiology & Immunology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Cesar V Borlongan
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
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Lazaro C, Garcia-Feijoo J, Castillo A, Perea J, Martinez-Casa JM, Garcia-Sanchez J. Impact of Intraocular Pressure after Filtration Surgery on Visual Field Progression in Primary Open-Angle Glaucoma. Eur J Ophthalmol 2018; 17:357-62. [PMID: 17534816 DOI: 10.1177/112067210701700313] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare visual field progression after trabeculectomy in eyes showing a postoperative intraocular pressure (IOP) less than or equal to 16 mmHg and eyes with an IOP of 17 to 21 mmHg. METHODS A retrospective cohort study design was used. A total of 101 eyes of 101 consecutive patients undergoing trabeculectomy for primary open-angle glaucoma (POAG) with a postoperative IOP less than or equal to 21 mmHg were divided into two groups: Group 1 included eyes showing a postoperative IOP less than or equal to 16 mmHg at all visits and Group 2 included eyes with a postoperative IOP between 17 and 21 mmHg. In turn, each of these groups was divided into two subgroups according to whether treatment was required for IOP control. Glaucomatous visual field control during follow-up was compared between the subject groups. RESULTS Kaplan-Meier analysis revealed glaucomatous visual field control in 98.53% of the eyes in Group 1 and 89.06% of those in Group 2 at 5 years, the difference between the groups being significant. CONCLUSIONS Glaucomatous disease progression is less frequent when IOP is less than or equal to 16 mmHg in all the follow-up visits after trabeculectomy. The results indicate a definite benefit of low IOP in visual field control.
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Affiliation(s)
- C Lazaro
- Hospital Provincial, Toledo, Spain.
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Reche-Frutos J, Calvo-Gonzalez C, Donate-Lopez J, Garcia-Feijoo J, Leila M, Garcia-Sanchez J. Short-Term Anatomic Effect of Ranibizumab for Polypoidal Choroidal Vasculopathy. Eur J Ophthalmol 2018; 18:645-8. [DOI: 10.1177/112067210801800427] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - M. Leila
- Hospital Clínico Universitario San Carlos, Madrid - Spain
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Reche-Frutos J, Calvo-Gonzalez C, Donate-Lopez J, Garcia-Feijoo J, Saenz-Frances F, Fernandez-Perez C, Garcia-Sanchez J. Retinal Angiomatous Proliferation Reactivation 6 Months after High-Dose Intravitreal Acetonide Triamcinolone and Photodynamic Therapy. Eur J Ophthalmol 2018; 17:979-82. [DOI: 10.1177/112067210701700619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To describe the incidence of retinal angiomatous proliferation (RAP) reactivation after combined treatment with a high-dose intravitreal triamcinolone acetonide (IVTA) and photodynamic therapy (PDT) at 1-year follow-up. Methods All patients had undergone a full ophthalmic examination. High-dose IVTA (20 mg) was injected via pars plana. Four to 7 days later, PDT was delivered. Results Fourteen eyes of 13 patients were included. Eight lesions (57%) reopened and needed retreatment with combined therapy at 6 months follow-up. At 1-year follow up, the lesion was obliterated in nine cases (64.2%) and best-corrected visual acuity improved from 0.87 logMar (range, 0.7–1) to 0.79 logMar (range, 0.5–1). Conclusions Combined therapy using high-dose IVTA and PDT is beneficial in stabilizing RAP. However, a high incidence of RAP reactivation has been observed at 6 months, even with a high-dose IVTA injection.
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Sáenz-Francés F, Elías-De-Tejada M, Martínez-De-La-Casa J, Calvo-González C, Fernández-Vidal A, Méndez-Hernández C, Pato E, López-Abad C, Benítez-Del-Castillo J, Garcia-Sanchez J, Garcia-Feijoo J. Ocular Inflammatory Signs Observed in a Cohort of Spanish Patients with Behçet Disease and Ocular Inflammation. Eur J Ophthalmol 2018; 18:563-6. [DOI: 10.1177/112067210801800410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- F Sáenz-Francés
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - M. Elías-De-Tejada
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - J.M. Martínez-De-La-Casa
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - C. Calvo-González
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - A. Fernández-Vidal
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - C. Méndez-Hernández
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - E. Pato
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - C. López-Abad
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - J.M. Benítez-Del-Castillo
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - J. Garcia-Sanchez
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
| | - J. Garcia-Feijoo
- Department of Ophthalmology, Hospital Clinico universitario San Carlos-Universidad Complutense, Madrid -Spain
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Saenz-Frances F, Sanz-Pozo C, Borrego-Sanz L, Jañez L, Morales-Fernandez L, Martinez-de-la-Casa JM, Garcia-Sanchez J, Garcia-Feijoo J, Santos-Bueso E. Dependence of dynamic contour and Goldmann applanation tonometries on peripheral corneal thickness. Int J Ophthalmol 2017; 10:1521-1527. [PMID: 29062770 DOI: 10.18240/ijo.2017.10.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/11/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the effects of peripheral corneal thickness (PCT) on dynamic contour tonometry(DCT) and Goldmann applanation tonometry (GAT). METHODS A cross-sectional study. We created a software which calculates the corneal contour (CC) as a function of the radius from the corneal apex to each pixel of the contour. The software generates a central circumference with a radius of 1 mm and the remainder of the cornea is segmented in 5 rings concentric with corneal apex being its diameter not constant around the corneal circumference as a consequence of the irregular CC but keeping constant the diameter of each ring in each direction of the contour. PCT was determined as the mean thickness of the most eccentric ring. Locally weighted scatterplot smoothing (LOWESS) regression was used to determine the pattern of the relationship between PCT and both DCT and GAT respectively. Thereafter, two multivariable linear regression models were constructed. In each of them, the dependant variable was intraocular pressure (IOP) as determined using GAT and DCT respectively. In both of the models the predictive variable was PCT though LOWESS regression pattern was used to model the relationship between the dependant variables and the predictor one. Age and sex were also introduced control variables along with their first-degree interactions with PCT. Main outcome measures include amount of IOP variation explained through regression models (R2) and regression coefficients (B). RESULTS Subjects included 109 eyes of 109 healthy individuals. LOWESS regression suggested that a 2nd-degree polynomial would be suitable to model the relationship between both DCT and GAT with PCT. Hence PCT was introduced in both models as a linear and quadratic term. Neither age nor sex nor interactions were statistically significant in both models. For GAT model, R2 was 17.14% (F=9.02; P=0.0002), PCT linear term B was -1.163 (95% CI: -1.163, -0.617). PCT quadratic term B was 0.00081 (95% CI: 0.00043, 0.00118). For DCT model R2 was 14.28% (F=9.29; P=0.0002), PCT linear term B was -0.712 (95% CI: -1.052, -0.372), PCT quadratic term was B=0.0005 (95% CI: 0.0003, 0.0007). CONCLUSION DCT and GAT measurements are conditioned by PCT though this effect, rather than linear, follows a 2nd-degree polynomial pattern.
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Affiliation(s)
- Federico Saenz-Frances
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | - Claudia Sanz-Pozo
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | - Lara Borrego-Sanz
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | - Luis Jañez
- Institute of Knowledge Technology, Complutense University, Madrid 28003, Spain
| | - Laura Morales-Fernandez
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | | | - Julian Garcia-Sanchez
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | - Julian Garcia-Feijoo
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
| | - Enrique Santos-Bueso
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid 28040, Spain
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Saenz-Frances F, Jañez L, Borrego-Sanz L, Berrozpe-Villabona C, Martinez-de-la-Casa JM, Morales-Fernandez L, Garcia-Sanchez J, Santos-Bueso E, Garcia-Feijoo J. Correlations between corneal and optic nerve head variables in healthy subjects and patients with primary open angle glaucoma. Int J Ophthalmol 2015; 8:1156-61. [PMID: 26682165 DOI: 10.3980/j.issn.2222-3959.2015.06.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 03/03/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To correlate corneal variables (determined using the Pentacam) with optic nerve head (ONH) variables determined using the Heidelberg retina tomograph (HRT) in healthy subjects and patients diagnosed with primary open angle glaucoma (POAG). METHODS Measurements were made in 75 healthy eyes and 73 eyes with POAG and correlations examined through Pearson correlation coefficients between the two sets of variables in the two subject groups. The corneal variables determined were corneal volume (CVol), central corneal thickness (CCT), overall corneal thickness (OvCT), the mean thickness of a circular zone centered at the corneal apex of 1 mm radius (zone I) and the mean thickness of several concentric rings, also centered at the apex until the limbus, each of 1 mm width (zones II to VI respectively). The ONH variables were determined using the HRT. RESULTS The following pairs of variables were correlated in the control group: CCT-disc area (DAr) (-0.48; P<0.0001), Zone I-DAr (-0.503; P<0.0001) and Zone II-DAr (-0.443; P<0.0001); and in the POAG group: CCT-cup-to-disc area ratio (CDRa) (-0.402; P<0.0001), Zone I-CDRa (-0.418; P<0.0001), Zone II-CDRa (-0.405; P=0.006), Zone I-cup shape measure (CSM) (-0.415; P=0.002), Zone II-CSM (-0.405; P=0.001), Zone IV-height variation contour (HVC) (0.378; P=0.002); Zone V-HVC (0.388, P<0.0001). CONCLUSIONS In the healthy subjects, significant negative correlation was detected between central and paracentral corneal thickness and optic disc area. In contrast, the POAG patients showed significant negative correlation between central and paracentral corneal thickness and the cup-disc ratio and CSM, and positive correlation between peripheral corneal thickness and HVC.
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Affiliation(s)
- Federico Saenz-Frances
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | - Luis Jañez
- Technology of Knowledge Institute, Complutense University of Madrid, Madrid 28223, Spain
| | - Lara Borrego-Sanz
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | - Clara Berrozpe-Villabona
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | | | - Laura Morales-Fernandez
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | - Julian Garcia-Sanchez
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | - Enrique Santos-Bueso
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
| | - Julian Garcia-Feijoo
- Department of Ophthalmology, Clinico San Carlos Hospital, Complutense University of Madrid, Madrid 28040, Spain
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Mendez-Hernandez C, Arcos-Villegas G, Garcia-Sanchez J, Garcia-Feijoo J. Clinical classification and medical treatment options in childhood glaucoma. Arch Soc Esp Oftalmol 2015; 90:557-561. [PMID: 26358844 DOI: 10.1016/j.oftal.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/10/2015] [Accepted: 07/01/2015] [Indexed: 06/05/2023]
Affiliation(s)
- C Mendez-Hernandez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España.
| | - G Arcos-Villegas
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España
| | - J Garcia-Sanchez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España
| | - J Garcia-Feijoo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España
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Saenz-Frances F, Jañez L, Borrego-Sanz L, Martinez-de-la-Casa JM, Morales-Fernandez L, Santos-Bueso E, Garcia-Sanchez J, Garcia-Feijoo J. Characterization of the thickness of different corneal zones in glaucoma: effect on dynamic contour, Goldmann and rebound tonometries. Acta Ophthalmol 2013; 91:e620-7. [PMID: 23764044 DOI: 10.1111/aos.12154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To characterize five models of corneal thickness circular zoning in a sample of healthy controls and a sample of patients with primary open-angle glaucoma (POAG) and to determine their effect on Goldmann (GAT), dynamic contour (DCT) and rebound tonometers (RT). METHODS The study participants were 122 controls and 129 cases. Five corneal thickness zoning models (A, B, C, D and E) were constructed. The partitioning pattern consisted of a circle centred at the corneal apex and several concentric rings, until the limbus; the contours of each ring followed the geometry of the corneal contour of each participant. In Model A, the central circle was 1 mm in diameter and five concentric rings were established. Mean was obtained for each zone for both samples and compared between them using a t-test. The effect on the tonometers of central cornel thickness (CCT) and mean thickness of the zones generated was determined through several linear regression models (one per tonometer and per sample). RESULTS According to a t-test, cases and controls differ in zones I [mean difference (MD): 17.93 μm], V (MD: 25.52 μm) and VI (MD: 31.78 μm) of model A (higher values in the cases sample). RT was affected by CCT (controls: B = 0.089; cases: B = 0.081). DCT was affected by zone IV of model A (controls: B = -0.029; cases: B = -0.012). GAT was affected by CCT (controls: B = 0.043; cases: B = 0.025) and zone III of model A (controls: B = -0.045; cases: B = -0.033). CONCLUSION Our results highlight the importance of the thickness of other regions of the cornea different from its main centre in discriminating between healthy controls and patients with POAG and in IOP measurements made using DCT, GAT and RT.
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Affiliation(s)
- Federico Saenz-Frances
- Department of Ophthalmology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, SpainInstiuto de Tecnología del Conocimiento, Universidad Complutense de Madrid, Madrid, Spain
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Mendez-Hernandez C, Garcia-Feijoo J, Saenz-Frances F, Santos-Bueso E, Martinez-de-la-Casa JM, Megias AV, Fernández-Vidal AM, Garcia-Sanchez J. Topical intraocular pressure therapy effects on pregnancy. Clin Ophthalmol 2012; 6:1629-32. [PMID: 23109799 PMCID: PMC3474270 DOI: 10.2147/opth.s36712] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the course of intraocular pressure (IOP), visual field progression, and adverse effects of antiglaucoma medication used during pregnancy. Methods Thirteen eyes of eight patients with glaucoma were examined. Their clinical records were reviewed to compare IOP, number of medications, and visual field indices (VFI) before, during, and after pregnancy using a two-tailed paired t-test. Results In seven (87.5%) of the eight patients, no disease progression was observed. IOP (mmHg) remained stable (baseline 17.3 ± 3.6; first trimester 17.4 ± 5.2, P = 0.930; second trimester 18.1 ± 4.7, P = 0.519; third trimester 20.2 ± 8.7, P = 0.344; and postpartum 21.5 ± 7.6, P = 0.136). The mean number of glaucoma treatments fell from 1.7 ± 0.52 before pregnancy to 0.83 ± 0.75 (P = 0.04) in the second and third trimesters. In one patient, IOP increased during pregnancy and there was further visual field loss. In the only patient kept on fixed combination timolol–dorzolamide therapy throughout pregnancy, labor was induced because of delayed intrauterine growth. Conclusions No changes in IOP and VFI were detected in most patients despite a reduction in the number of hypotensive agents required. Delayed intrauterine growth in one patient under fixed combination timolol–dorzolamide treatment was observed whereas no other adverse effects were detected.
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Saenz-Frances F, Gonzalez-Pastor E, Borrego-Sanz L, Jerez-Fidalgo M, Martinez-de-la-Casa J, Mendez-Hernandez C, Santos-Bueso E, Fernandez-Vidal A, Garcia-Sanchez J, Garcia-Feijoo J. Comparaison de l’épaisseur cornéenne centrale mesurée par pachymétrie ultrasonore et par Pentacam chez les patients sains et les patients avec glaucome primaire à angle ouvert. J Fr Ophtalmol 2012; 35:333-7. [DOI: 10.1016/j.jfo.2011.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 06/24/2011] [Accepted: 07/19/2011] [Indexed: 11/30/2022]
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Morales-Fernandez L, Martinez-de-la-Casa JM, Garcia-Feijoo J, Saenz-Frances F, Santos E, Garcia-Sanchez J. Reproducibility of the New Goldmann AT900D Digital Tonometer. J Glaucoma 2012; 21:186-8. [DOI: 10.1097/ijg.0b013e31820bd1e9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cohen S, Bourgeois H, Chaine G, Corbe C, Espinasse-Berrod M, Garcia-Sanchez J, Gaudric A, Hullo A, Leys A, Sahel J, Soubrane G. 288 Résultats de l’étude FRANCE DMLA 2. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Reche-Frutos J, Calvo-González C, Donate-López J, García-Feijoó J, Wasfy M, Saenz-Frances F, Fernandez-Perez C, Garcia-Sanchez J. Photodynamic therapy in non-subfoveal choroidal neovascularization secondary to pathological myopia: 1-year outcome. Br J Ophthalmol 2007; 91:1722-3. [PMID: 18024827 DOI: 10.1136/bjo.2006.112045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Diaz-Valle D, Benitez del Castillo JM, Fernandez Acenero MJ, Santos-Bueso E, Martinez de la Casa JM, Garcia-Sanchez J. Endogenous Pseudomonas endophthalmitis in an immunocompetent patient. Eur J Ophthalmol 2007; 17:461-3. [PMID: 17534838 DOI: 10.1177/112067210701700336] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report an unusual case of community-acquired Pseudomonas aeruginosa pneumonia in an immunocompetent host complicated by orbital cellulitis, panophthalmitis, and subcutaneous nodules. METHODS An otherwise healthy 47-year-old woman presented with a 24-hour history of fever, cutaneous nodules, right sided pleuritic chest pain, and eyelid edema with severe vision loss in her right eye. A chest X-ray demonstrated a homogeneous infiltrate in the right upper lobe. Ophthalmic examination revealed signs of metastatic orbital cellulitis and panophthalmitis. Culture specimens from blood, sputum, skin, and vitreous showed a significant growth of P. aeruginosa species. RESULTS Intravenous antibiotic therapy led to resolution of the pneumonia, cutaneous nodules, and orbital cellulitis. Despite intravitreal and topical antibiotics, the patient finally required enucleation. CONCLUSION This case represents a rare combination of manifestations in an immunocompetent patient with P. aeruginosa infection. It highlights the accelerated course that may result from P. aeruginosa infection, the difficulties of treatment, and the poor prognosis in the case of eye involvement.
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Affiliation(s)
- D Diaz-Valle
- Department of Ophthalmology, Hospital Clinico San Carlos, Madrid, Spain.
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Corbe C, Bourgeois H, Chaine G, Cohen S, Espinasse-Berrod M, Garcia-Sanchez J, Gaudric A, Hullo A, Leys A, Sahel J, Soubrane G. 258 Étude FRANCE DMLA 2. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martinez-de-la-Casa JM, Garcia-Feijoo J, Vico E, Fernandez-Vidal A, Benitez del Castillo JM, Wasfi M, Garcia-Sanchez J. Effect of Corneal Thickness on Dynamic Contour, Rebound, and Goldmann Tonometry. Ophthalmology 2006; 113:2156-62. [PMID: 16996599 DOI: 10.1016/j.ophtha.2006.06.016] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Revised: 06/07/2006] [Accepted: 06/19/2006] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To identify correlations among intraocular pressure (IOP) measurements obtained using the rebound tonometer (RBT), the dynamic contour tonometer (DCT), and the Goldmann applanation tonometer (GAT). The effects of corneal thickness on the measures obtained using each of the 3 tonometers also were examined. DESIGN Cross-sectional study. PARTICIPANTS One hundred forty-six eyes of 90 patients with ocular hypertension or glaucoma. METHODS Intraocular pressure measurements were obtained in all patients using RBT, DCT, and GAT. Central corneal thickness was determined by ultrasound pachymetry. Patients were divided randomly into 6 groups to vary the order in which the tonometers were used. All IOP measurements were made by the same examiner, who was masked to the readings obtained. MAIN OUTCOME MEASURES Intraocular pressure and central corneal thickness. RESULTS There was good correlation between IOP readings obtained using the RBT and GAT (r = 0.864; P<0.0001), between DCT and GAT (r = 0.871; P<0.0001), and between RBT and DCT (r = 0.804; P<0.0001). Rebound tonometer and DCT readings consistently were higher than GAT measurements (RBT-GAT median difference, 1.4+/-2.7 mmHg; DCT-GAT median difference, 4.4+/-2.6 mmHg). A Bland-Altman plot indicated that the 95% limits of agreement between RBT and GAT were -4.3 to 6.4 mmHg (slope = 0.056; P = 0.218), those between DCT and GAT were -0.7 to 9.5 mmHg (slope = 0.016; P = 0.717), and those between RBT and DCT were -3.1 to 9.8 mmHg (slope = -0.041; P = 0.457). Using RBT, the point that best discriminated between patients with an IOP 21 mmHg or less and more than 21 mmHg as determined by GAT was >23.3 mmHg (sensitivity, 66.7%; specificity, 92.1%); using DCT, this point was >22.7 mmHg (sensitivity, 95.6%; specificity, 71.3%). In terms of pachymetry, GAT and RBT behaved similarly. Using these instruments, differences of approximately 3 mmHg were detected between the groups of patients with the thinnest (<531 mum) and thickest (>565 mum) corneas, whereas a significantly lower difference (0.5 mmHg) was noted for the DCT. CONCLUSIONS Measurements obtained both with the RBT and DCT show excellent correlation with those provided by applanation tonometry. Both tonometers tend to overestimate the IOP measured with the GAT, particularly the DCT. This last tonometer seems to be less affected by the corneal thickness.
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Affiliation(s)
- Jose M Martinez-de-la-Casa
- Hospital Clínico San Carlos and Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain.
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Martinez-de-la-Casa JM, Garcia-Feijoo J, Fernandez-Vidal A, Mendez-Hernandez C, Garcia-Sanchez J. Ocular Response Analyzer versus Goldmann Applanation Tonometry for Intraocular Pressure Measurements. ACTA ACUST UNITED AC 2006; 47:4410-4. [PMID: 17003433 DOI: 10.1167/iovs.06-0158] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To establish correlations between intraocular pressure (IOP) measurements obtained with the ocular response analyzer (ORA) and the Goldmann applanation tonometer (GAT). The effects of central corneal thickness on the measures obtained were also examined. METHODS This was a cross-sectional study. IOP was determined in 48 eyes of 48 patients with glaucoma In all patients, central corneal thickness (CCT) was measured by ultrasound pachymetry. RESULTS ORA readings were consistently higher than GAT measurements (Goldmann-correlated IOP - IOP GAT mean difference, 7.2 +/- 3.5 mm Hg; corneal-compensated IOP - IOP GAT mean difference, 8.3 +/- 4.0 mm Hg) However, differences were not constant and increased with increasing IOP GAT readings, both with respect to Goldmann-correlated IOP (slope = 0.623, P < 0.0001) and corneal-compensated IOP (slope = 0.538, P < 0.0001). Both pressure measurements provided by the ORA showed significant correlation with CCT (CCT versus Goldmann-correlated IOP: r = 0.460, P = 0.001; CCT versus corneal-compensated IOP: r = 0.442, P = 0.001). No significant effects of corneal curvature or refraction on any of the pressures were observed. CONCLUSIONS The ORA significantly overestimates IOP compared with the GAT. Differences between both sets of measures increase as the GAT-determined IOP increases. ORA readings seem to be affected by central corneal thickness.
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Affiliation(s)
- Jose M Martinez-de-la-Casa
- Hospital Clínico San Carlos, and Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain
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Abstract
PURPOSE To establish the reproducibility of a rebound tonometer in humans and the effect of corneal thickness on measurements, comparing it with Goldmann applanation tonometer. METHODS In a first study designed to examine the reliability of the RBT, three experienced ophthalmologists undertook three consecutive intraocular pressure (IOP) measurements in 12 eyes of 12 normal subjects. A cross-sectional study was then performed to compare measurements obtained using the two tonometers in 147 eyes of 85 patients with ocular hypertension or glaucoma. RESULTS Intraobserver coefficients of correlation obtained in the reproducibility study were 0.82, 0.73, and 0.87. Interobserver correlation was 0.82. There was a good correlation between IOP readings obtained by the RBT and the GAT (r = 0.865, P < 0.0001). RBT readings were consistently higher than GAT measurements (median difference, 1.8 +/- 2.8 mm Hg). A Bland-Altman plot indicated the 95% limits of agreement between the two methods were -3.7 to 7.3 mm Hg (slope = -0.022, P = 0.618). Using RBT, the point that best discriminated between patients with an IOP < or = 21 mm Hg and those with >21 mm Hg, as determined by the GAT was >23 mm Hg (sensitivity, 70.5%; specificity, 95.1%). In terms of pachymetry, the two tonometers behaved in a similar way, with correlation observed between IOP measurements and central corneal thickness. CONCLUSIONS Rebound tonometry is a reproducible method of determining IOP in humans. In general, it tends to overestimate IOP compared with Goldmann applanation tonometry. The tonometers used in both methods are similarly affected by pachymetry.
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Affiliation(s)
- Jose M Martinez-de-la-Casa
- Hospital Clinico San Carlos, Madrid, Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain.
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Martin E, Martinez-de-la-Casa JM, Garcia-Feijoo J, Troyano J, Larrosa JM, Garcia-Sanchez J. A 6-month assessment of bimatoprost 0.03% vs timolol maleate 0.5%: hypotensive efficacy, macular thickness and flare in ocular-hypertensive and glaucoma patients. Eye (Lond) 2005; 21:164-8. [PMID: 16254590 DOI: 10.1038/sj.eye.6702149] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIM To compare 6 months of treatment with bimatoprost and timolol in terms of their hypotensive efficacy and secondary effects, including changes in macular thickness and the inflammatory reaction induced in the anterior chamber. METHODS A prospective, randomized, parallel-group trial performed on 30 eyes of 30 patients per group. The main outcome measure was the difference between the IOP value taken between the baseline visit and the 6-month-visit. Macular thickness determined through optical coherence tomography and anterior chamber inflammation estimated using the laser flare meter was also evaluated. Adverse events were recorded during the study period. RESULTS Bimatoprost treatment gave rise to a significantly lower mean IOP than timolol in all follow-up visits as from the first month (P<0.05). Bimatoprost achieved high percentage IOP reductions from baseline in a significantly higher proportion of patients (P<0.05). Macular thickness and anterior chamber flare failed to vary significantly both between the two groups and within each group during the 6-month evaluation (P>0.05). CONCLUSIONS Bimatoprost 0.03% once daily showed a greater efficacy then timolol 0.05% twice daily in patients with elevated IOP. No significant differences were detected in macular thickness or anterior uveitis using optical coherence tomography and laser flare photometry.
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Affiliation(s)
- E Martin
- Hospital Clinico San Carlos, Madrid, Spain
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Benitez-Del-Castillo JM, Rodríguez-Bayo S, Fontan-Rivas E, Martinez-de-la-Casa JM, Garcia-Sanchez J. Treatment of Recurrent Corneal Erosion With Substance P–Derived Peptide and Insulin-like Growth Factor I. ACTA ACUST UNITED AC 2005; 123:1445-7. [PMID: 16219742 DOI: 10.1001/archopht.123.10.1445] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jose M Benitez-Del-Castillo
- Unidad de Superficie e Inflamacion Ocular, Hospital Clinico San Carlos, Martin Lagos s/n, 28040 Madrid, Spain.
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Benitez-del-Castillo JM, Martinez-de-la-Casa JM, Pato-Cour E, Méndez-Fernández R, López-Abad C, Matilla M, Garcia-Sanchez J. Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab). Eye (Lond) 2004; 19:841-5. [PMID: 15389273 DOI: 10.1038/sj.eye.6701689] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the long-term efficacy and safety of infliximab as treatment for noninfectious posterior uveitis. METHODS An open-label clinical trial including seven patients (12 eyes) with posterior uveitis refractory to conventional treatment regimens with corticosteroids and at least one immunosuppressive agent. Three intravenous doses of 5 mg/kg of infliximab were administered at weeks 0, 2, and 6. Infliximab infusion was repeated in patients undergoing a relapse of uveitis after initial remission. Improvement was defined as amelioration of visual acuity or disappearance of retinal exudates and/or haemorrhages, decreased macular oedema and/or vitreous opacities. All patients were followed up for at least 36 months. RESULTS Six of the seven patients (five diagnosed with Behçet's disease and one diagnosed with sarcoidosis) showed a significant improvement after the first infliximab dose. Only in one patient diagnosed with chronic idiopathic multifocal choroiditis did the drug have no effect, and this patient was withdrawn from the study. At the end of follow-up, one eye had lost one line of vision and three eyes showed improved vision. All eyes had improved in terms of signs of inflammation. No adverse effects of treatment were observed. CONCLUSION Infliximab is efficient and safe for the long-term management of refractory posterior uveitis, especially in patients with predominant retinal vasculitis and vitritis.
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Affiliation(s)
- J M Benitez-del-Castillo
- Department of Ophthalmology, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain
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Benítez del Castillo JM, Wasfy MAS, Fernandez C, Garcia-Sanchez J. An In Vivo Confocal Masked Study on Corneal Epithelium and Subbasal Nerves in Patients with Dry Eye. ACTA ACUST UNITED AC 2004; 45:3030-5. [PMID: 15326117 DOI: 10.1167/iovs.04-0251] [Citation(s) in RCA: 213] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE The objective of the present study was to determine whether dry eye (DE) associated with primary Sjögren's syndrome (PSDE) and DE not associated with Sjögren's syndrome (NSDE) are related to an alteration of corneal innervation. METHODS Eleven healthy volunteers younger than 60 years (normal [N] < 60 group), 10 healthy volunteers 60 years of age or older (N > or = 60 group), 11 patients with PSDE, and 10 patients with NSDE were studied. Epithelial and stromal density and subbasal and stromal nerves were investigated by confocal microscopy. RESULTS The density of the superficial epithelial cells was 741 +/- 306 cells/mm2 in the PSDE group; 1022 +/- 331 cells/mm2 in the NSDE group; 1523 +/- 294 cells/mm2 in the N > or = 60 group, and 1529 +/- 341 cells/mm2 in the N < 60 group (P < 0.0001, ANOVA). The number of subbasal nerves was 2.8 +/- 1.2 in the PSDE group, 3.3 +/- 0.7 in the NSDE group, 3.1 +/- 0.9 in the N > or = 60 group, and 4.6 +/- 0.8 in the N < 60 group (P < 0.0001, ANOVA). The number of beadlike formations observed in the different groups was 387 +/- 62/mm in the PSDE group, 323 +/- 64/mm in the NSDE group, 182 +/- 63/mm in the N > or = 60 group, and 198 +/- 66/mm in the N < 60 group (P < 0.0001, ANOVA). A correlation was found between the number of subbasal nerves and age (P < 0.01) and between the number of subbasal nerves and Schirmer's test (P < 0.001, Spearman rho). CONCLUSIONS Patients with DE show alteration in the corneal innervations. The demonstration of such alterations introduces new strategies for treatment of this frequent disease.
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Martinez-de-la-Casa JM, Castillo A, Garcia-Feijoo J, Mendez-Hernandez C, Fernandez-Vidal A, Garcia-Sanchez J. Concomitant administration of travoprost and brinzolamide versus fixed latanoprost/timolol combined therapy: three-month comparison of efficacy and safety. Curr Med Res Opin 2004; 20:1333-9. [PMID: 15383180 DOI: 10.1185/030079904125004529] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare the efficacy and safety of the concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily with those of a fixed combination of latanoprost 0.005%/timolol 0.5% once daily. RESEARCH, DESIGN AND METHODS Forty-four patients with primary open-angle glaucoma or ocular hypertension with elevated IOP insufficiently responsive to monotherapy were randomly assigned to one of the two treatment groups: concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily (TB group: 22 patients) or latanoprost 0.005% plus timolol 0.5% once daily (LT group: 22 patients). Visits were undertaken at screening (current ocular hypotensive therapy was discontinued), baseline (randomization), and after 2 weeks, 1 month, 2 months and 3 months of therapy. MAIN OUTCOME MEASURES IOP was determined at 9 a.m., 12 p.m. and 4 p.m. at each study visit, and diurnal IOP was calculated as the mean of these recordings. Adverse events were recorded at each visit. RESULTS IOP at the baseline visit was similar in both groups. Overall mean IOP was significantly lower in the TB as compared to the LT group after 1 month, 2 month and 3 month follow-up; only 9 a.m. measurements were significantly different, reaching a maximum difference (16.9 +/- 0.9 mmHg vs 18.4 +/- 1.8 mmHg, p < 0.001) at the 3 month check. The percentage of responders (IOP decrease > or = 30%) was higher in the TB group. Both treatments were well tolerated and there were no cases of withdrawal from treatment. CONCLUSIONS Travoprost 0.004% and brinzolamide 0.1% concomitant therapy showed a greater efficacy than the fixed latanoprost 0.005%/timolol 0.5% combination in terms of absolute IOP decreases. Travoprost/brinzolamide therapy also offered the advantages of a greater percentage of responders.
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Affiliation(s)
- J M Martinez-de-la-Casa
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain.
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Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, Matilla M, Macias JM, Benitez-del-Castillo JM, Garcia-Sanchez J. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye (Lond) 2004; 18:498-502. [PMID: 15131681 DOI: 10.1038/sj.eye.6700695] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To compare selective laser trabeculoplasty (SLT) with conventional argon laser trabeculoplasty (ALT) in terms of hypotensive efficacy, anterior chamber inflammation, and pain reported by the patients treated. METHODS A prospective study performed on 40 consecutive patients. Group I (n = 20): SLT 180 degrees. Group II (n = 20): ALT 180 degrees. Intraocular pressure, flare (Laser-Flare-Meter, Kowa FM-500, Japan), and pain (Visual Analogue Scale) were measured before treatment and 1 h, 24 h,1 week, and 1, 3 and 6 months after treatment. Statistically significant differences were determined by an independent-sample Student's t-test. RESULTS At 6 months after treatment, pressure reduction was similar in both groups: SLT 22.2% (range 0-36.3%) and ALT 19.5% (range 0-30.2%), P= 0.741. The energy released during treatment was significantly lower in SLT (48.3 SD 7.4 mJ) than in ALT (4321 SD 241.7 mJ), P < 0.001. At 1 h after treatment,anterior chamber flare was also lower in SLT(13.3 SD 6.3 vs 20.7 SD 7.4 photons/ms),P = 0.003. Pain reported by the patients during the treatment was significantly lower in SLT(2.0 SD 0.7 vs 4.3 SD 1.3), P<0.001. CONCLUSIONS The hypotensive efficacy of both lasers at the end of follow-up was similar. The energy released during treatment and inflammation produced in the anterior chamber in the immediate postoperative period were significantly lower for SLT. The SLT procedure was better tolerated, producing less discomfort during treatment than conventional trabeculoplasty with argon.
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Affiliation(s)
- J M Martinez-de-la-Casa
- Instituto de Investigaciones, Oftalmológicas Ramón, Castroviejo Hospital Clínico, San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
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Mendez-Hernandez C, Garcia-Feijoo J, Garcia-Sanchez J. Listeria monocytogenes-induced endogenous endophthalmitis: bioultrasonic findings. Am J Ophthalmol 2004; 137:579-81. [PMID: 15013893 DOI: 10.1016/j.ajo.2003.08.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2003] [Indexed: 11/16/2022]
Abstract
PURPOSE To report bioultrasonic findings in Listeria monocytogenes-induced endophthalmitis (LMIE) that have not been described previously. DESIGN Interventional case report. METHODS To rule out intraocular tumor, ultrasound biomicroscopy was performed in a patient referred for a 2-day history of uveitis with elevated intraocular pressure, dark hypopyon, and pigment dispersion in the anterior chamber. RESULTS Ultrasound biomicroscopy examination showed increased iris thickness with rarefaction of tissue and irregular echogenicity as well as iris pigment epithelial detachment. A small choroidal detachment was also detected. The anterior chamber and vitreous sample confirmed the LMIE diagnosis. CONCLUSIONS The detection of both pigment epithelial detachment and changes in the iris tissue could explain why black hypopyon frequently develops in LMIE with significant pigment dispersion in some cases.
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Affiliation(s)
- Carmen Mendez-Hernandez
- Instituto de Investigaciones Oftalmologicas Ramón Castro viejo, Glaucoma Department, Hospital Clinico San Carlos, Guadalajara, Spain.
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Affiliation(s)
- Jose M Benitez-del-Castillo
- Unidad de Superficie e Inflamacion Ocular, Hospital Clinico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
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Lazaro C, Benitez-del-Castillo JM, Castillo A, Garcia-Feijoo J, Macias JM, Garcia-Sanchez J. Lens fluorophotometry after trabeculectomy in primary open-angle glaucoma. Ophthalmology 2002; 109:76-9. [PMID: 11772583 DOI: 10.1016/s0161-6420(01)00865-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the loss of lens transparency incurred by patients undergoing trabeculectomy. DESIGN A prospective cohort study. PARTICIPANTS AND CONTROLS Data corresponding to 33 eyes of 33 consecutive patients with primary open-angle glaucoma (POAG) subjected to trabeculectomy (group 1) were compared with those corresponding to 12 eyes of 12 patients with POAG receiving topical antiglaucomatous treatment (group 2). INTERVENTION Lens fluorophotometry was performed on the group 1 patients before and 12 months after surgery. In group 2, fluorophotometry was conducted at the onset of the study and at 12 months of follow-up. MAIN OUTCOME MEASURES Starting and final lens autofluorescence and transmittance values corresponding to each subject group were compared. RESULTS In group 1, starting and final autofluorescence was 556.3 +/- 184.3 and 691.1 +/- 179.3 Eq ng/ml, and starting and final transmittance was 0.78 +/- 0.11 and 0.67 +/- 0.14, respectively. Respective values for group 2 were 574.3 +/- 94.8 and 595.2 +/- 107.0 Eq ng/ml and 0.72 +/- 0.17 and 0.71 +/- 0.16. The mean change between final and initial autofluorescence was statistically different between groups (134.7 +/- 123.7, group 1, 20.9 +/- 25.1 Eq ng/ml, group 2; P < 0.001). Similarly, a significant difference (P < 0.001) in transmittance change was observed between the surgery and control groups (-0.11 +/- 0.072, group 1; 0.02 +/- 0.008, group 2) CONCLUSIONS It was demonstrated by lens fluorophotometry that trabeculectomy in POAG leads to a loss in lens transparency.
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Affiliation(s)
- Carlos Lazaro
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense, 28005 Madrid, Spain
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Lazaro C, Castillo A, Hernandez-Matamoros JL, Iradier MT, Garcia-Feijoo J, Benitez-del-Castillo JM, Perea J, Garcia-Sanchez J. Laser in situ keratomileusis enhancement after photorefractive keratectomy. Ophthalmology 2001; 108:1423-9. [PMID: 11470693 DOI: 10.1016/s0161-6420(01)00635-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To describe the safety, effectiveness, and predictability of laser in situ keratomileusis (LASIK) for correcting residual myopia after primary photorefractive keratectomy (PRK). DESIGN A retrospective, noncomparative case series. PARTICIPANTS AND INTERVENTION Thirty-six consecutive eyes of 30 patients underwent LASIK after primary PRK. A Multiscan Schwind excimer laser was used for LASIK enhancement. MAIN OUTCOME MEASURES Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity, refraction, videokeratography, and complications were determined before and after LASIK retreatment. Follow-up was at least 12 months. RESULTS Before LASIK, 11.11% of eyes showed a UCVA of 20/40 or better. This increased to 94.44% 12 months after LASIK. A UCVA of 20/25 or better was achieved in 0% before and in 72.22% after retreatment. Refraction +/-0.5 diopters (spherical equivalent) represented 0% of eyes before and 77.78% of eyes after enhancement. Before LASIK, two eyes had significant haze. Haze remained in these two eyes and appeared in another eye. CONCLUSIONS Laser in situ keratomileusis proved to be safe and effective for treating residual myopia after PRK. Care must be taken when considering LASIK retreatment in patients with significant haze after primary PRK.
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Affiliation(s)
- C Lazaro
- Centro Oftalmológico Real Vision, Madrid, Spain.
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Benitez-del-Castillo JM, del Rio T, Iradier T, Hernández JL, Castillo A, Garcia-Sanchez J. Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea 2001; 20:30-2. [PMID: 11188999 DOI: 10.1097/00003226-200101000-00005] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate tear secretion and corneal sensitivity after laser in situ keratomileusis (LASIK) for the correction of myopia. METHODS In a prospective study, 48 consecutive eyes (24 patients) underwent LASIK to correct myopia ranging from -3.5 to -12.25 diopters. Tear secretion tested by the tear function index and corneal sensitivity tested using the Cochet-Bonnet esthesiometer were evaluated preoperatively and 1 week and 1, 3, 6, and 9 months postoperatively. RESULTS Tear secretion and corneal sensitivity after LASIK were reduced during the first 3 months after surgery (p<0.001). Tear secretion returned to its preoperative values only after 9 months. Tear secretion and corneal sensitivity were more depressed in long-term contact lens wearers preoperatively and 6 months after surgery (p<0.05). CONCLUSION In the correction of myopia, tear secretion was depressed after LASIK during the first 6 months after surgery.
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Affiliation(s)
- J M Benitez-del-Castillo
- Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Facultad de Medicina, Universidad Complutense, Madrid, Spain
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Benitez-Del-Castillo JM, Garcia-Sanchez J, Iradier T, Bañares A. Sulfasalazine in the prevention of anterior uveitis associated with ankylosing spondylitis. Eye (Lond) 2000; 14 ( Pt 3A):340-3. [PMID: 11026996 DOI: 10.1038/eye.2000.84] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the effects of sulfasalazine in preventing recurrences and reducing the severity of anterior uveitis associated with ankylosing spondylitis and chronic intestinal inflammation. METHODS Twenty-two patients with anterior uveitis associated with ankylosing spondylitis were studied. Ten patients were randomised to receive oral sulfasalazine (group 1) and 12 patients randomised to no treatment (group 2); all were followed for 3 years. Blood-aqueous barrier permeability was determined by fluorophotometry and bowel biopsies were taken. RESULTS A statistically significant difference was observed between the two groups regarding the number of recurrences of uveitis (p = 0.016). The blood-aqueous barrier permeability was significantly higher during acute attacks in group 2 (group 1: 31.3 +/- 26.4 x 10(-4) min-1 vs group 2: 66.2 +/- 28.5 x 10(-4) min-1; p = 0.019) but not during the disease-free period. We observed a higher incidence of chronic intestinal inflammation at the end of the study in group 2 (group 1: 3/8 vs group 2: 7/9, p = 0.153). No relation was observed between blood-aqueous barrier permeability and the number of recurrences. The number of patients with severe persistent posterior synechiae at the end of the study was higher in group 2 (group 1: 4 patients before and 4 patients at the end; group 2: 4 patients before and 8 patients at the end; p = 0.65). CONCLUSION Sulfasalazine may be beneficial in preventing recurrences and reducing the severity of anterior uveitis associated with ankylosing spondylitis.
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Affiliation(s)
- J M Benitez-Del-Castillo
- Instituto Investigaciones Oftalmologicas Ramon Castroviejo, Facultad de Medicina, Universidad Complutense, Madrid, Spain
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Abstract
Thygeson's superficial punctate keratitis (Thygeson's SPK) is a distinct clinical entity, characterized by round conglomerates of discrete, granular, white-gray, fine intraepithelial dots without conjunctival involvement. The only effective treatment with regard to relieving symptoms and diminishing lesions has been topical corticosteroids, but their prolonged use can be associated with severe side-effects. The purpose of this study is to present the long-term results of the use of 2% topical cyclosporin A in olive oil in Thygeson's SPK. Eight patients diagnosed as having Thygeson's SPK were included. All the patients were treated with 2% cyclosporin dissolved in olive oil four times a day for three months, and two times a day for one month before withdrawing therapy. The follow-up period ranged from twelve to twenty-five months. The number of corneal lesions varied between 5 and 15 before treatment. After cyclosporin treatment, no corneal lesion was observed and the cornea remained clear after the follow-up period. In conclusion, 2% cyclosporin in olive oil is a safe alternative to corticosteroids in the treatment of Thygeson's SPK, and resulted in satisfactory control of the condition.
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Affiliation(s)
- J M Del Castillo
- Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Madrid, Spain
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Garcia-Feijoo J, Benitez del Castillo JM, Martin-Carbajo M, Garcia-Sanchez J. Orbital cup. A device to facilitate ultrasound biomicroscopic examination of pars plana and peripheral retina. Arch Ophthalmol 1997; 115:1475-6. [PMID: 9366688 DOI: 10.1001/archopht.1997.01100160645026] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Ultrasound biomicroscopy is a useful technique for anterior segment evaluation; however, examination of the pars plana and the peripheral retina is difficult. We describe a method that facilitates ultrasound biomicroscopic examination of these areas using using a modified swimming goggle(orbital cup) and an eyelid speculum. With this method, not only the pars plana but also structures up to 15 mm from the temporal limbus can be readily imaged.
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Affiliation(s)
- J Garcia-Feijoo
- Instituto de Investigaciones Ramon Castroviejo, Universidad Comlutense de Madrid, Spain
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Castillo A, Benitez del Castillo JM, Toledano N, Diaz-Valle D, Sayagues O, Garcia-Sanchez J. Deposits of topical norfloxacin in the treatment of bacterial keratitis. Cornea 1997; 16:420-3. [PMID: 9220239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Fluoroquinolone solutions are widely used in therapy of bacterial keratitis. These drugs are safe, and their ocular side effects are mild and not serious in nature. The most frequent untoward effect associated with ciprofloxacin therapy has been a white crystalline deposit. This deposit has not been reported after using the other commercially available quinolones, ofloxacin and norfloxacin. METHODS We present three cases of norfloxacin deposits after treatment of bacterial keratitis. RESULTS In the three cases, the norfloxacin was substituted for another antibiotic effective against the bacteria, and the precipitate spontaneously resolved in all cases within a few days with no untoward ocular effect. CONCLUSION Crystalline corneal deposits can develop during topical norfloxacin therapy. The exact factors contributing to the formation are unknown, although the differences in the tear pH/solubility could be involved. Clinicians should be aware of this ocular side effect.
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Affiliation(s)
- A Castillo
- Hospital General de Móstoles, Madrid, Spain
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Abstract
OBJECTIVE Lens autofluorescence originates from an accumulation of fluorescent substances that are associated with the process of cataractogenesis and lens aging. The aim of this study was to determine whether postmenopausal estrogen use reduces age-related nuclear sclerosis in women. DESIGN The authors designed a case-controlled study. PARTICIPANTS Nineteen postmenopausal women reporting estrogen use for more than 4 years (group 1), 20 postmenopausal women reporting no estrogen use (group 2), and 23 age-matched men (group 3) were studied. INTERVENTION The authors performed fluorophotometry. MAIN OUTCOME MEASURES Corneal and lens autofluorescence and lens transmittance were measured. RESULTS Lens transmittance values were 0.905 +/- 0.03, 0.839 +/- 0.08, and 0.841 +/- 0.08 in the three groups, respectively. There was a statistically significant difference between group 1 and the other two groups (P < 0.01). CONCLUSIONS These data are suggestive of a protective effect of estrogen use on the lenses of postmenopausal women.
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Castillo A, Benitez del Castillo JM, Diaz D, Sayagues O, Ruibal JL, Garcia-Sanchez J. Analysis of the blood-retinal barrier: its relation to clinical and metabolic factors and progression to retinopathy in juvenile diabetics. A 4-year follow-up study. Graefes Arch Clin Exp Ophthalmol 1996; 234:246-50. [PMID: 8964530 DOI: 10.1007/bf00430417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The study was carried out to evaluate the correlation between blood-retinal barrier (BRB) permeability and the development of diabetic retinopathy (DR) and to assess the metabolic and clinical factors related to DR over a 4-year period by means of vitreous fluorophotometry (VF). METHODS Thirty-five type I diabetics with no retinopathy, age 7-21 years (mean 14.32 +/- 2.1 years) were enrolled in this longitudinal study. Two visits included standard ophthalmological examination, fluorescein angiography and VF were performed, on entry into the study and 4 years later. The following risk factors in DR were analyzed: age, duration of diabetes, blood pressure, cholesterol, triglycerides, fasting blood glucose levels, glycosylated hemoglobin (HbA1c), insulin dose/kg body weight (IDBW), fructosamine and albuminuria. To estimate the BRB permeability we adopted the vitreous penetration ratio transmittance (VPRt) value. RESULTS At 4-year follow-up the mean VPRt had significantly increased. During that time 13 patients developed DR and their final mean VPRt was significantly higher than that in non-DR patients. Additionally, the initial mean VPRt was higher but not significantly so, in patients that later developed DR than in non-DR subjects. A constant linear correlation was found between VPRt and duration of diabetes, HbA1c and microalbuminuria. CONCLUSION VF is a quantitative method that could measure and predict the breakdown of the BRB before angiographic retinopathy in type I diabetics. The major clinical and metabolic factors related to alterations in the BRB are duration of diabetes, HbA1c and microalbuminuria.
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Affiliation(s)
- A Castillo
- Department of Ophthalmology, Hospital de Móstoles, Madrid, Spain
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Abstract
PURPOSE To report the diagnosis of pars planitis on the basis of ultrasound biomicroscopy images. METHODS The Humphrey ultrasound biomicroscope was used for examination of the right eye of a 17-year-old boy, referred to our clinic because of blurred vision. The lens showed a posterior subcapsular cataract precluding fundus visualization. RESULTS Ultrasound biomicroscopy showed a homogeneous mass of medium reflectivity over the pars plana. Lensectomy and vitrectomy confirmed the diagnosis. CONCLUSION This brief case report points out the utility of ultrasound biomicroscopy in diagnosing pars planitis in cases of media opacities.
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Affiliation(s)
- J Garcia-Feijoo
- Instituto de Investigaciones Oftalmologicas Castroviejo, Facultad de Medicina, Universidad Complutense de Madrid, Spain
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Benitez del Castillo JM, Iradier MT, Hernandez JL, Jimenez-Alfaro I, Perez-Santonja JJ, Garcia-Sanchez J. Corneal endothelial permeability after implantation of angle-fitted anterior chamber lenses in myopic phakic eyes. Preliminary results. Doc Ophthalmol 1995; 91:201-6. [PMID: 8886584 DOI: 10.1007/bf01204171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This present study aimed to evaluate the corneal endothelium after implantation of angle-fixed anterior chamber lenses in myopic phakic eyes. Twelve eyes (9 patients) with high myopia (more than-14 diopters) were implanted with ZB5M lenses (Domilens, France). The corneal endothelium was studied by fluorophotometry (endothelial transfer coefficient: kc.ca), specular microscopy and ultrasonic pachimetry. Tests were performed prior to and 3 and 6 months after the surgery. The Wilcoxon rank test was used for the statistical analysis of the data. There was a significant difference (p < 0.05) between the preoperative kc.ca (4.15 +/- 0.72 x 10(-3) min-1) and the kc.ca three months after the implantation (4.43 +/- 0.87 x 10(-3) min-1). A statistically significant difference (p < 0.01) was also found between the three and six months postoperative kc.ca (5.31 +/- 0.81 x 10(-3) min-1). There was a significant difference (p < 0.05) between the preoperative central endothelial cell density (2533 +/- 219 cells/mm2). No significant differences were found in relation to the central corneal thickness. In conclusion, three months after the implantation of ZB5M lenses to correct high myopia in phakic eyes, the corneal endothelial function was altered and continued to be so six months after the operation.
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Benitez del Castillo JM, Jimenez-Alfaro I, Ortega P, Castillo A, Diaz D, Toledano N, Garcia-Sanchez J. Effect of bendazac lysine on lens and retina in diabetics. Doc Ophthalmol 1994; 86:387-93. [PMID: 7835176 DOI: 10.1007/bf01204597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The possible beneficial effects on the lens and retina which Bendazac Lysine may have in the treatment of adult diabetic patients were investigated. Twenty patients, ranging in age from 54.80 +/- 5.86 years old, were studied. The average duration of the diabetes was 11.32 +/- 4.10 years. Thirteen patients had background retinopathy. The metabolic controls carried out during the study were satisfactory (HbA1 < 11%). Bendazac Lysine (500 mg three times a day) was administered for 6 months. Blood-retinal barrier permeability (VPR and VPRt) and lens transmittance (t) were evaluated prior to and 6 months after treatment by fluorophotometry. No statistically significant differences between the pre- and post-treatment values of the retina permeability were observed, however, there was a statistically significant improvement (p < 0.05) (initial value: t = 0.813 +/- 0.040 and final value: t = 0.823 +/- 0.037) in the lens transmittance. The authors conclude that Bendazac Lysine has a beneficial effect on the lens in the diabetic adult although no improvement in the permeability of the blood-retinal barrier has been observed.
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Affiliation(s)
- J M Benitez del Castillo
- San Carlos University Hospital, R. Castroviejo Ophthalmic Research Center Complutense University, Madrid, Spain
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Abstract
Immunocytochemical localization of glial fibrillary acidic protein (GFAP) has been used to study astrocyte distribution and morphology in whole mounted human retinas and vertical sections. Two types of astrocytes can be distinguished: elongated astrocytes are located in the nerve fibre layer (NFL); and star-shaped astrocytes are found in the ganglion cell layer (GCL). Astroglial processes join to form bundles. The bundles formed by the elongated astrocytes lie along and separate the nerve fibre bundles. Processes from star-shaped astrocytes reach towards other star-shaped astrocytes and towards the vessels to form a morphologically honeycombed plexus. These astrocytes also send other processes towards the internal nuclear layer (INL), forming an irregular plexus which accompanies the GCL capillaries that extend into the INL. Often, the cell bodies of the star-shaped GCL astrocytes lie over vessels and form cell clusters. Finally, none of the retinas examined for this study evidenced the "perivascular astrocytes" described by Wolter in the human retina.
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Affiliation(s)
- J M Ramirez
- Instituto de Investigaciones Oftalmológicas, Ramón Castroviejo, Facultad de Medicina, Universidad Complutense, Madrid, Spain
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