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Alba-Arbalat S, Solana E, Lopez-Soley E, Camos-Carreras A, Martinez-Heras E, Vivó F, Pulido-Valdeolivas I, Andorra M, Sepulveda M, Cabrera JM, Fonseca E, Calvi A, Alcubierre R, Dotti-Boada M, Saiz A, Martinez-Lapiscina EH, Villoslada P, Blanco Y, Sanchez-Dalmau B, Llufriu S. Predictive value of retinal atrophy for cognitive decline across disease duration in multiple sclerosis. J Neurol Neurosurg Psychiatry 2024; 95:419-425. [PMID: 37989566 DOI: 10.1136/jnnp-2023-332332] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND We investigated the association between changes in retinal thickness and cognition in people with MS (PwMS), exploring the predictive value of optical coherence tomography (OCT) markers of neuroaxonal damage for global cognitive decline at different periods of disease. METHOD We quantified the peripapillary retinal nerve fibre (pRFNL) and ganglion cell-inner plexiform (GCIPL) layers thicknesses of 207 PwMS and performed neuropsychological evaluations. The cohort was divided based on disease duration (≤5 years or >5 years). We studied associations between changes in OCT and cognition over time, and assessed the risk of cognitive decline of a pRFNL≤88 µm or GCIPL≤77 µm and its predictive value. RESULTS Changes in pRFNL and GCIPL thickness over 3.2 years were associated with evolution of cognitive scores, in the entire cohort and in patients with more than 5 years of disease (p<0.01). Changes in cognition were related to less use of disease-modifying drugs, but not OCT metrics in PwMS within 5 years of onset. A pRFNL≤88 µm was associated with earlier cognitive disability (3.7 vs 9.9 years) and higher risk of cognitive deterioration (HR=1.64, p=0.022). A GCIPL≤77 µm was not associated with a higher risk of cognitive decline, but a trend was observed at ≤91.5 µm in PwMS with longer disease (HR=1.81, p=0.061). CONCLUSIONS The progressive retinal thinning is related to cognitive decline, indicating that cognitive dysfunction is a late manifestation of accumulated neuroaxonal damage. Quantifying the pRFNL aids in identifying individuals at risk of cognitive dysfunction.
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Affiliation(s)
- Salut Alba-Arbalat
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Elisabeth Solana
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Elisabet Lopez-Soley
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | | | - Eloy Martinez-Heras
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Francesc Vivó
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Irene Pulido-Valdeolivas
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Magi Andorra
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Maria Sepulveda
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Jose María Cabrera
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Elianet Fonseca
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
- Neurology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alberto Calvi
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Rafel Alcubierre
- Ophthalmology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Marina Dotti-Boada
- Ophthalmology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Albert Saiz
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Elena H Martinez-Lapiscina
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | - Pablo Villoslada
- Department of Neurosciences, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Yolanda Blanco
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
| | | | - Sara Llufriu
- Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Fundacio Recerca Clinic Barcelona -IDIBAPS, Barcelona, Spain
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Ferres A, Tercero-Uribe AI, Matas J, Alcubierre R, Codes M, Tafuto R, Camós-Carreras A, Muñoz-Lopetegi A, Tercero J, Alobid I, Sanchez-Dalmau B, Di Somma A, Enseñat J. Neurophysiologic Monitoring of Oculomotor Nerves During Transorbital Surgery: Proof of Concept and Anatomic Demonstration. Oper Neurosurg (Hagerstown) 2024:01787389-990000000-01109. [PMID: 38578710 DOI: 10.1227/ons.0000000000001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/25/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Transorbital neuroendoscopic surgery (TONES) is continuously evolving and gaining terrain in approaching different skull base pathologies. The objective of this study was to present our methodology for introducing recording electrodes, which includes a new transconjunctival pathway, to monitor the extraocular muscle function during TONES. METHODS A translational observational study was performed from an anatomic demonstration focused on the transconjunctival electrode placement technique to a descriptive analysis in our series of 6 patients operated using TONES in association with intraoperative neurophysiologic monitoring of the oculomotor nerves from 2017 to 2023. The stepwise anatomic demonstration for the electrode placement and correct positioning in the target muscle was realized through cadaveric dissection. The descriptive analysis evaluated viability (obtention of the electromyography in each cranial nerve [CN] monitored), security (complications), and compatibility (interference with TONES). RESULTS In our series of 6 patients, 16 CNs were correctly monitored: 6 (100%) CNs III, 5 (83.3%) CNs VI, and 5 (83.3%) CNs IV. Spontaneous electromyography was registered correctly, and compound muscle action potential using triggered electromyography was obtained for anatomic confirmation of structures (1 CN III and VI). No complications nor interference with the surgical procedure were detected. CONCLUSION The methodology for introducing the recording electrodes was viable, secure, and compatible with TONES.
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Affiliation(s)
- Abel Ferres
- Department of Neurological Surgery, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Ana Isabel Tercero-Uribe
- Department of Neurology, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Jessica Matas
- Institut Clinic Oftalmologia (ICOF), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Rafel Alcubierre
- Institut Clinic Oftalmologia (ICOF), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Marta Codes
- Department of Neurological Surgery, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Roberto Tafuto
- Department of Neurological Surgery, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Anna Camós-Carreras
- Institut Clinic Oftalmologia (ICOF), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Amaia Muñoz-Lopetegi
- Department of Neurology, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Javier Tercero
- Department of Anesthesiology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Isam Alobid
- Department of Otorhinolaryngology, Institut Clinic d'Especialitats Mèdiques i Quirúrgiques (ICEMEQ), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Bernardo Sanchez-Dalmau
- Institut Clinic Oftalmologia (ICOF), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Alberto Di Somma
- Department of Neurological Surgery, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Joaquim Enseñat
- Department of Neurological Surgery, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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Camós-Carreras A, Figueras-Roca M, Dotti-Boada M, Alcubierre R, Casaroli-Marano RP, Muñoz E, Sánchez-Dalmau B. Progression of Retinal Ganglion Cell and Nerve Fiber Layer Loss in Spinocerebellar Ataxia 3 Patients. Cerebellum 2023:10.1007/s12311-023-01634-1. [PMID: 38030858 DOI: 10.1007/s12311-023-01634-1] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/01/2023]
Abstract
Spectral domain optical coherence tomography (SD-OCT) allows noninvasive measurements of retinal neuron layers. Here, we evaluate the relationship between clinical features and anatomical SD-OCT measurements in patients with spinocerebellar ataxia type 3 (SCA3) and how they change with time. A retrospective review was conducted on SCA3 patients. Clinical variables such as disease duration, number of CAG repeats, and the Scale for the Assessment and Rating of Ataxia (SARA) score were correlated with SD-OCT measurements, including retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, macular volume (MV), and central macular thickness (CMT). Seventeen SCA3 patients with an average follow-up of 44.9 months were recruited. Clinical features with significant baseline correlations with SD-OCT measurements included disease duration (CMT r = - 0.590; GCC r = - 0.585), SARA score (CMT r = - 0.560; RNFL r = - 0.390), and number of CAG repeats (MV r = - 0.552; RNFL r = - 0.503; GCC r = - 0.493). The annual rate of change of the SARA score during follow-up was associated with that of both the MV (r = - 0.494; p = 0.005) and GCC thickness (r = - 0.454; p = 0.012). High disability (stages 2 and 3) was independently inversely associated with the annual change in MV (ß coefficient - 17.09; p = 0.025). This study provides evidence of an association between clinical features and objective anatomical measurements obtained by SD-OCT in SCA3 patients. MV and GCC thickness could serve as potential biomarkers of disease severity, as their rates of decrease seem to be related to a worsening in the SARA score. These findings highlight the potential of SD-OCT as a noninvasive tool for assessing disease severity and progression in SCA3 patients.
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Affiliation(s)
- Anna Camós-Carreras
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain.
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain.
| | - Marc Figueras-Roca
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain
- Fundació Per La Recerca Biomèdica-IDIBAPS, Villarroel 170, 08036, Barcelona, Spain
| | - Marina Dotti-Boada
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - Rafel Alcubierre
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain
| | - Ricardo Pedro Casaroli-Marano
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Fundació Per La Recerca Biomèdica-IDIBAPS, Villarroel 170, 08036, Barcelona, Spain
| | - Esteban Muñoz
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Fundació Per La Recerca Biomèdica-IDIBAPS, Villarroel 170, 08036, Barcelona, Spain
- Neurology Department, Seu Villarroel, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Bernardo Sánchez-Dalmau
- Ophthalmology Department, Seu Maternitat, Hospital Clínic de Barcelona, Universitat de Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Fundació Per La Recerca Biomèdica-IDIBAPS, Villarroel 170, 08036, Barcelona, Spain
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Herranz-Cabarcos A, Alcubierre R, Van der Veen RLP. Paraneoplastic orbital myositis as a first manifestation of renal cell carcinoma. Orbit 2023:1-5. [PMID: 37837294 DOI: 10.1080/01676830.2023.2264916] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023]
Abstract
Paraneoplastic syndromes (PNSs) are remote effects of the primary tumor on tissues and organs, not related to direct invasion or metastasis. Ophthalmological involvement has been reported in 0.01-0.1% cases of PNSs. It may present as retinopathy, optic neuritis, myasthenia-like syndromes, or orbital myositis (OM), among others. An 89-year-old male with bilateral ocular pain and chemosis, was given an initial diagnosis of bilateral acute conjunctivitis. After 5 days, the patient presented worsening of the pain and bilateral complete ophthalmoplegia. Cranial CT scan showed diffuse bilateral thickening of the four rectus muscles. Inflammatory markers, thyroid hormones, and thyroid antibodies were normal. An abdominal ultrasound test was performed, observing a mass in the right kidney. After confirmation of the lesion with a CT scan, the radiological characteristics of the lesion were highly suggestive of renal cell carcinoma. Treatment with intravenous corticosteroids was ensued with complete resolution of all ophthalmological symptoms. Paraneoplastic orbital panmyositis was first described in 1994. Since then it has been reported scarcely, remaining an extremely rare entity. To our knowledge, this is the first report of its association with renal cell carcinoma. In the absence of inflammatory or dysthyroid blood markers, bilateral orbital panmyositis warrants further investigation for a possible underlying oncological pathology.
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Affiliation(s)
- A Herranz-Cabarcos
- Ophthalmology Department, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | | | - R L P Van der Veen
- Ophthalmology Department, Barraquer Ophthalmology Center, Barcelona, Spain
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Parrado-Carrillo A, Alcubierre R, Camós-Carreras A, Sanchez-Dalmau BF. Paraneoplastic syndromes in ophthalmology. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:350-357. [PMID: 35292226 DOI: 10.1016/j.oftale.2022.03.006] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/03/2021] [Indexed: 06/14/2023]
Abstract
Paraneoplastic syndromes consist on systemic manifestations associated with certain cancers which are not a direct consequence of tumor invasion or its metastases. It is known that autoimmunity and autoantibody synthesis play an important role in its pathophysiology due to a process of molecular mimicry. Paraneoplastic syndromes in ophthalmology are rare, but it is important to recognize them clinically because in some cases symptoms preceded the diagnosis of an underlying neoplasia. Most frequently involved cancer is small cell lung carcinoma, but there is also a relationship with other tumor etiologies such as thymoma, gynecological tumors or neuroblastoma in children. Paraneoplastic syndromes with ocular involvement can be divided into those that affect the afferent visual pathway, such as cancer-associated retinopathy, melanoma-associated retinopathy, or paraneoplastic optic neuropathy; and the ones that affect the efferent visual pathway, such as bilateral tonic pupils, Myasthenia Gravis, Lambert-Eaton syndrome or paraneoplastic cerebellar degeneration. The presence of autoantibodies is helpful in clinical practice but negativity does not exclude this diagnosis. Although evolution and prognosis is linked to primary disease, in some cases specific treatment, usually immunosuppressive therapy, can help improving patients quality of life.
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Affiliation(s)
- A Parrado-Carrillo
- Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - R Alcubierre
- Complex Hospitalari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - A Camós-Carreras
- Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain
| | - B F Sanchez-Dalmau
- Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Abstract
Ocular neuromyotonia is a rare disorder of the oculomotor nerves caused by chronic damage to the nerve, usually secondary to previous irradiation or longstanding compression. We present the case of a 40-year-old man who had received proton beam therapy for a right cavernous sinus chondrosarcoma 15 years earlier. He developed intermittent episodes of self-limited horizontal diplopia, which occurred over the course of 1 year. At its peak, the deviation reached 20Δ in primary gaze and 25Δ in right gaze. Signs included right upper lid retraction and right medial rectus muscle absence of relaxation after sustained left gaze, with mild deficit of elevation and depression but no pupillary involvement. Full recovery occurred after he closed his eyes. Ocular neuromyotonia of the right oculomotor nerve was diagnosed after recurrence of primary disease relapse was ruled out. Symptoms remitted completely under oxcarbazepine.
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Affiliation(s)
- Rafel Alcubierre
- Department of Ophthalmology, Hospital Moisès Broggi Sant Joan Despi, Consorci Sanitari Integral, Barcelona, Spain.
| | - Aida Alejaldre
- Department of Neurology, Hospital Moisès Broggi Sant Joan Despi, Consorci Sanitari Integral, Barcelona, Spain
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Alcubierre R, Sanchez-Dalmau BF, Mousavi K. Compressive optic neuropathy secondary to an allergic reaction to hyaluronidase. ACTA ACUST UNITED AC 2019; 94:441-444. [PMID: 31280939 DOI: 10.1016/j.oftal.2019.03.017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/17/2019] [Accepted: 03/23/2019] [Indexed: 10/26/2022]
Abstract
A 58 year-old woman presented with severe chemosis and ophthalmoparesis on her left eye 8hours after uncomplicated cataract surgery under sub-tenon anaesthesia. Recovery of extrinsic motility was observed after corticosteroid and antihistamine treatment, but a non-haemorrhagic papillary oedema and a concentric defect of visual field were found. It progressed to papillary atrophy with preserved central vision, but with a significant visual field constriction. The aetiological study revealed an allergy to hyaluronidase that was used as adjuvant to the anaesthesia. This complication needs to be promptly diagnosed and treated, as the swelling of the orbital tissues can cause damage to the optic nerve.
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Affiliation(s)
- R Alcubierre
- Centre Ocular Quirúrgic de Sant Boi, Sant Boi de Llobregat, Barcelona, España; Departamento de Oftalmología, Hospital General de l'Hospitalet, Hospitalet de Llobregat, Barcelona, España.
| | - B F Sanchez-Dalmau
- Centre Ocular Quirúrgic de Sant Boi, Sant Boi de Llobregat, Barcelona, España; Departamento de Oftalmología, Hospital Clínic, Barcelona, España
| | - K Mousavi
- Centre Ocular Quirúrgic de Sant Boi, Sant Boi de Llobregat, Barcelona, España
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Alcubierre R, Arias L, Lorenzo D, Pujol O, Rubio M. [Low-fluence photodynamic therapy in chronic central serous chorioretinopathy]. ACTA ACUST UNITED AC 2012; 87:3-8. [PMID: 22248651 DOI: 10.1016/j.oftal.2011.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/22/2011] [Accepted: 06/03/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate safety and efficacy of low-fluence photodynamic therapy (LFPDT) with verteporfin in patients affected with chronic central serous chorioretinopathy (CCSC), in terms of visual acuity (VA) and macular morphology measured with optical coherence tomography (OCT). METHODS A retrospective, non-randomized and interventionist analysis was performed on 16 eyes in 15 patients with CCSC treated with LFPDT. Best corrected visual acuity (BCVA) with ETDRS optotypes and central foveal thickness (CFT) in OCT were evaluated as outcome measures. RESULTS The mean follow-up was 10.8 months. The mean BCVA improved from 58.12 to 68.68 ETDRS letters, and CFT decreased from 280.5 to 172.18 microns, with subretinal fluid resolution in 14 eyes (87.5%), two of them after a second LFTPD. No complications related to treatment were recorded. CONCLUSIONS LFPDT with verteporfin can be useful in CCSC to stabilise or improve BCVA, reabsorb subretinal fluid and reduce CFT. Randomised studies with a longer follow-up are required to assure the role of this treatment and to optimise parameters for higher efficacy and safety in CCSC patients.
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Affiliation(s)
- R Alcubierre
- Sección de Retina, Departamento de Oftalmología, Hospital Universitari de Bellvitge, L'Hospitalet De Llobregat, Barcelona, España.
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Arias L, Alcubierre R, Lorenzo D. [Bullous retinal detachment in chronic central serous chorioretinopathy treated with photodynamic therapy]. ACTA ACUST UNITED AC 2011; 86:58-61. [PMID: 21440832 DOI: 10.1016/j.oftal.2010.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 10/29/2010] [Accepted: 11/10/2010] [Indexed: 10/26/2022]
Abstract
CASE REPORT We describe a case of serous retinal detachment as an atypical presentation of bilateral chronic central serous chorioretinopathy, DISCUSSION We present its differential diagnosis and therapeutical management with low-fluence photodynamic therapy, achieving satisfactory anatomical and functional results.
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Affiliation(s)
- L Arias
- Hospital Universitari de Bellvitge, Barcelona, España
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Lorenzo D, Arias L, Alcubierre R, Pujol O, Caminal J, Rubio M, Català J, Garcia-Bru P, Arruga J. Intravitreal Ranibizumab for Choroidal Neovascularization Secondary to Pathological Myopia: 12-Month Follow-Up. Ophthalmologica 2011; 226:103-9. [DOI: 10.1159/000328980] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 04/21/2011] [Indexed: 12/29/2022]
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