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Biomedical subjects

E Ferrer Novella

Publications and source records attributed to E Ferrer Novella.

13 recordsLinked to original sources

[Idiopathic polypoidal choroidal vasculopathy].

PURPOSE: To evaluate the incidence, clinical features and evolution of polypoidal choroidal vasculopathy (PCV) in our population. METHODS: Retrospective study of patients diagnosed with exudative and/or hemorrhagic maculopathy including age-related macular degeneration in the last two years and who have undergone a complete ophthalmologic exploration and videoangiography with fluorescein and indocyanine green. RESULTS: 250 patients were included in the study, 8 patients (3.2%) had clinical and angiographic criteria of PCV. The mean age was 68 years-old, 62.5% were men and 85.7% were caucasian. Ninety percent of cases presented clinically as a predominantly hemorrhagic macular detachment. The initial clinical diagnosis before indocyanine green angiography was exudative age-related macular degeneration in 90% of cases. The mean visual acuity was 0.2 at baseline and after follow-up. Laser treatment was performed in 4 eyes, achieving good anatomic and visual acuity results in 2 of them; both eyes of one patient were treated by photodynamic therapy with poor angiographic and functional outcome. CONCLUSIONS: Polypoidal choroidal vasculopathy is a clinical entity which is relatively frequent among patients previously diagnosed with exudative maculopathy. Indocyanine green angiography increases the number of correct diagnoses. Treatment must be individualized depending on the location of the lesions and the severity of the disease.

Aged↗

[Serpiginous choroiditis: clinical course and treatment].

PURPOSE: To evaluate the clinical evolution and treatment of serpiginous choroiditis in 11 diagnosed patients. METHODS: Retrospective study of 11 cases diagnosed with serpiginous choroiditis in our area, from 1980 to the present. We analyzed age at onset of symptoms, systemic diseases, ophthalmological symptoms at presentation, the location of lesions, initial and final visual acuity, recurrences, treatment régime and development of subretinal neovascularization. A complete ophthalmological examination and fluorescein angiograms were performed in all of them. RESULTS: The mean period of follow-up was 4 years. Average age was 56 years, predominantly in men (10/1). Five patients had known ischemic cardiopathy and systemic hypertension, one patient underwent a kidney transplant. All of them were treated with oral prednisone (1-1.5 mg/kg/daily) in the active stages. Three patients received triple therapy (prednisone, cyclosporine and azathioprine) that did not prevent the recurrences. Five patients developed a subretinal neovascularization, bilateral in three of them. CONCLUSIONS: The serpiginous choroiditis is a rare entity and the visual outcome prognosis is determined by the macular involvement. Men are predominantly affected in our series and corticosteroid treatment is effective in acute inflammatory episodes. Recurrences could not be prevented by triple therapy with immunosuppressive agents in our three patients.

Aged↗

[Photodynamic therapy for treatment of choroidal neovascularization].

PURPOSE: To evaluate the efficacy of photodynamic therapy with photodynamic therapy (PDT) in the management of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) and myopia. METHODS: 102 eyes with subfoveal or yuxtafoveal CNV underwent visual acuity (VA) testing, ophthalmic examination, and fluorescein angiography. Retreatment of persistent CNV was done after three months. RESULTS: CNV was caused by AMD in 75.5% of patients, pathologic myopia in 24.5%. Follow up ranged from 9 to 33 months (mean: 15.94 months). 88% of CNV caused by pathologic myopia was classic and 40% was in lesions caused by AMD. CNV survival was shorter in lesions caused by pathologic myopia with a significant difference (p=0.0018). VA improved in 48% of lesions caused by pathologic myopia and in 28.6% of lesions caused by AMD. We did not observe any severe complication caused by PDT. CONCLUSION: PDT is a moderately effective treatment without complications in treating subfoveal CNV.

Aged↗

[Photodynamic therapy for choroidal neovascularization not caused by age related macular degeneration or pathologic myopia].

PURPOSE: To assess the effects of photodynamic therapy (PDT) with verteporfin on visual acuity (VA) and fluorescein angiography, in patients with subfoveal choroidal neovascularization (CNV) not secondary to age related macular degeneration (AMD) or pathologic myopia. METHODS: 113 eyes from 104 patients underwent PDT due to subfoveal CNV from July 2001 to June 2002. In this study only those patients with CNV not related to AMD or pathologic myopia were included. Fluorescein angiography and visual acuity were evaluated. RESULTS: 9 eyes from 8 patients (8.03%) showed distinct causes of CNV: 3 were idiopathic cases, 1 suffered angioid streaks, 1 was secondary to laser photocoagulation due to diabetic retinopathy, 2 had polypoidal choroidal vasculopathy and 2 central serous choroiditis. Regarding VA results, 77.7% improved or mantained the previous VA. Angiography resolution was observed in 55.5% of the cases (80% with just one PDT session). Average follow up was 10.5 months. Systemic or local complications were not observed. CONCLUSION: PDT may be useful in the treatment of different types of CNV due to causes other than AMD or high myopia.

Aged↗

[Ocular cyanoacrylate injury].

UNLABELLED: PURPOSE/MATERIAL AND METHOD: Cyanoacrylate tissue adhesive is indicated when a small corneal perforation is present. We report the case of a 23 year-old man who was attacked being thrown cyanoacrylate to both of his eyes. RESULTS/CONCLUSION: Wound healing has been laborious, however performed with low morbidity. This case is reported for being a bilateral injury and after finding no precedented cases in the literature.

Adult↗

[A case of primary toxoplasmosis in an immunocompetent patient].

CASE REPORT: A case of an immunocompetent patient presenting primary systemic toxoplasma infection involving the eye (condition seen in less than 3% of primary infections). The patient showed reactivation of this primary focus two years later. DISCUSSION: Diagnosis of toxoplasm retinitis is based on a typical lesion consisting in an area of active retinitis adjacent to an inactive corioretinal scar. Differential diagnosis must consider other causes of retinal coroiditis in primary infection cases: sarcoidosis, tuberculosis, syphilis as well as viral and fungal infections. Ocular toxoplasmosis was confirmed by serum tests.

Adult↗

[Dynamic angiography in age related macular degeneration].

PURPOSE: To evaluate the utility of dynamic angiography with fluorescein and indocyanine green with scanning laser ophthalmoscope (SLO) in exudative age-related macular degeneration. METHOD: We retrospectively studied 95 patients with exudative age-related macular degeneration (ARMD) between April 98 and April 01. RESULTS: We studied 102 eyes of 95 patients with ARMD. Mean age was 75.3 years with a mean follow-up time of 16.8 months. We found an occult or mixed angiographic membrane pattern with fluorescein angiography in 85 eyes (83.3%). Angiography with indocyanine green showed choroidal neovascular membranes in 94 of 102 eyes (92.1%). The most frequent location found was sub-foveal (53.2%). Laser photocoagulation was used in 55 eyes and photodynamic therapy in 5 eyes. In 17 eyes laser treatment failed to close the membrane. CONCLUSION: Dynamic angiography with fluorescein or indocyanine green allowed neovascular membrane identification in more than 90% of the cases of ARMD. Successful treatment was achieved in 42% of cases.

Aged↗

[Exudative idiopathic juxtafoveolar retinal telangiectasis].

PURPOSE: To study the different clinical presentation of the idiopathic juxtafoveolar retinal telangiectasis and its treatment with argon laser. MATERIAL AND METHOD: We studied retrospectively nine eyes of eight patients, seen from 1990 to 1997, with diagnosis of idiopathic juxtafoveolar retinal telangiectasis. They have been studied with fluorescein angiography and treated with argon laser. RESULT: The most frequent clinical presentation was large areas of retinal telangiectasis affecting the horizontal rafe temporal to the macula. The diagnosis was stabilised as regards clinical manifestation and after ruling out other causes. Six out of eight patient with visual disfunction for macular edema and exudation improved considerably after laser photocoagulation. In 3 patients the vascular abnormalities were progressive after the treatment. CONCLUSIONS: The idiopathic juxtafoveolar retinal telangiectasis with exudation is an uncommon disease, that causes visual disturbance, but may be treated with laser photocoagulation.

Adult↗

[Indocyanine green angiography and subretinal neovascularization. Patterns in age related macular degeneration].

PURPOSE: To determine the different angiographic patterns of neovascular membranes with indocyanine green in age-related macular degeneration (ARMD) and to establish the phase in which neovascularizations can be visualized most frequently. MATERIAL AND METHOD: We studied 56 eyes from 55 patients with a diagnosis of ARMD between April 98 and April 99. All patients underwent indocyanine green (ICG) and fluorescein digital videoangiography. We evaluated the pattern and the moment of identification of the neovascular membrane with both procedures. RESULTS: We found that 13 out of 56 eyes (23.2%) presented well-defined subretinal neovascularization in fluorescein videoangiography while 43 (76.8%) showed an occult pattern. ICG videoangiography was able to identify choroidal neovascularization in 89.3% of cases. The following patterns were found: Type I: visible neovascularization (17.9%), Type II: well-defined membranes with hypofluorescent margin (33.9%), Type III: high fluorescent focal membranes (hot-spots) (8.9%), Type IV: hyperfluorescent plaques that appeared only in late phases (10.7%), Type V: mixed types (17.9%). A high percentage of choroidal neovascularization was observed in early or medium phases of the angiogram (85.4%). CONCLUSIONS: Choroidal neovascularization in ARMD can appear with different patterns in the ICG videoangiographic study. The most frequently found pattern was that of well-defined membranes with a hypofluorescent margin. A high percentage of cases can be already visualized in the early phases of the angiogram.

Aged↗

[Clinical course of cytomegalovirus retinitis with the different antiretroviral therapies in our hospital].

PURPOSE: A study of protease inhibitors on CMV retinitis in HIV infected hospital patients. METHOD: A retrospective study was performed in 485 diagnosed of AIDS, between January, 1990 and December 1998. Among those, 81 patients who were diagnosed of CMV retinitis, the following was studied: anti-retroviral treatment, anti CMV treatment, survival time and CD4 lymphocyte count. RESULTS: Treatment with protease inhibitors in HIV patients showed an increase in life expectancy, reduced the incidence of CMV retinitis and a reduction in CMV retinitis prevention treatment was observed. CONCLUSIONS: Treatment with protease inhibitors has reduced the rate of CMV retinitis in HIV patients.

Acquired Immunodeficiency Syndrome↗

[Ophthalmological exploration of children with Down's syndrome. Main results and comparison with a control group].

BACKGROUND: Down's Syndrome is the most frequent chromosomal aberration. There is a wide variety of symptoms. From an ophthalmological point of view, numerous alterations associated with Down's Syndrome have been described. MATERIAL AND METHODS: We have carried out a complete ophthalmic exploration on 60 children with Down's Syndrome and 60 control children. RESULTS: The first group showed a high percentage of refraction errors (90%), nystagmus (28%), strabismus (48%) and cataracts (13%). If we compare these results with those of the control group we find that the Down's group has a frequency significantly higher both in refraction errors as a whole (p < 0.001) and myopia (p < 0.01), hypermetropia (p < 0.02) and stigmatism (p < 0.001). They have also shown a frequency significantly higher of strabismus (p < 0.001). CONCLUSION: All of the observed alterations can have a negative influence on the appropriate educational development of these children. An early ophthalmological exploration would be advisable in children with Down's Syndrome.

Cataract↗

Hemorrhagic retinopathy in newborns: frequency, form of presentation, associated factors and significance.

During the first 72 hours of their lives, 420 neonates were checked for retinal hemorrhages and macular affection. The neonate's gestational age, birth weight, and Apgar scores and maternal data (nulliparty, fetal presentation, duration of labor and delivery, induction of labor and obstetric technique) were all recorded. In 81 cases (19.2%), retinal hemorrhages were found. No significant relation was established with any of the associated factors, except for a significantly lower frequency of hemorrhages in cases of cesarean delivery (p < 0.01) and a significantly longer expulsive phase in the group with hemorrhages (p < 0.05). In follow-up examination 3 to 4 months later, neither the infants with hemorrhages nor the control group presented alterations.

Cesarean Section↗