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Biomedical subjects

J García Sánchez

Publications and source records attributed to J García Sánchez.

At least 19 recordsLinked to original sources
PubMed2004

[Correlations between retinal thickness analyzer (RTA) and confocal scanning laser tomography (HRT) in optic disc analysis].

OBJECTIVES: To determine if the measures obtained in an optic disc study using the retinal thickness analyzer (RTA) can be adequately correlated with values provided by the confocal scanning laser Heidelberg Retina Tomograph (HRT). METHODS: We analyzed 20 eyes of 20 normal subjects. The contours of the optic disc were drawn by a single operator using both instruments. The data compared were the values of 10 variables denoted in the same way by each instrument and these provided information on disc and cup morphology. RESULTS: Of the 10 variables, only the following three showed clear correlation between the two instruments: maximum cup depth (r=0.926, p=0.001), mean cup depth (r=0.857, p=0.001) and cup shape measure (CSM, r=0.672, p=0.002). The correlation shown by the remaining variables ranged from 0.001 (cup area) and 0.488 (cup volume). CONCLUSIONS: The variables showing best correlation between instruments were those providing information on cup morphology. Operator subjectivity when drawing the disc contour using each device could account for the lower incidence of correlation of the other variables examined.

Adult↗
PubMed2004

[Tear function index validation for dry eye diagnosis].

PURPOSE: To develop a simple method for the clinical evaluation of tear dynamics and evaluate its usefulness in the diagnosis of dry eye syndrome. METHODS: The study includes 170 eyes from 85 adults. 102 eyes had a Schirmer's test value of less than 10 mm and subjective symptoms of dry eye. Tear function index (TFI) was calculated in all the cases using prepared drops with 0.5% fluorescein and 0.4% oxibuprocaína. Five minutes later a Schirmer strip was placed on the conjunctival fornix. Schirmer's test and tear clearance were calculated after a further five minutes. Tear clearance was measured using a table of fluorescein concentrations. TFI is the quotient between the value of the Schirmer's test and TCR. RESULTS: The cut-off value of TFI in dry eye is 74. At this point the sensitivity of this method is 74% and the specificity is 63%. The Schirmer's test results did not correlate with the tear clearance results. CONCLUSION: TFI is a rapid and sensitive method of identification of subjects with dry eye. The lack of correlation between TFI and TCR is because these methods evaluate different aspects of tear dynamics.

Adult↗
PubMed2004

[Cystoid macular edema induced by travoprost].

CASE REPORT: A 72 year old man with open-angle glaucoma was treated with trabeculectomy and cataract surgery. Two years later, intraocular pressure increased making it necessary to add travoprost 0.004%. Two weeks later, visual acuity decreased. The diagnosis of cystoid macular edema and post-treatment observation were carried out using optical coherence tomography. DISCUSSION: Cystoid macular edema is one of the most important effects of hypotensive lipids. Optical coherence tomography is a non-invasive method useful for the diagnosis and evolution of this complication.

Aged↗
PubMed2004

[Modification of the conjuntival flora with cleaning palpebral solutions].

OBJECTIVE: The aim of the present study is to evaluate the effectiveness of a solution of palpebral hygiene during the preoperative stage of cataract surgery. MATERIALS AND METHODS: We studied 286 patients divided in 5 groups. One control group that did not use the product, and the remaining 4, that used the product during 3, 4, 5 and 6 days. The design of the study was prospective, randomize and masked. We took a sample of the conjunctival fundus in the morning of the day of the surgery, before commencing treatment with eye drops. This sample was sown according to microbiological techniques and analyzed by the microbiology department. RESULTS: The best time for using palpebral hygiene solutions prior to cataract surgery is four to five days. If it is used at less than three days, it does not decrease the rate of positive cultures and if the solution is applied more than six days, microorganisms that are not part of the common conjunctival flora may appear. CONCLUSIONS: Palpebral hygiene products should not be used more than five consecutive days previous to surgery.

Adult↗
PubMed2003

Confocal microscopy in ocular chrysiasis.

PURPOSE: To describe the presence of gold salt deposits in the corneal tissue of a patient treated with gold sodium thiomalate through confocal microscopy and to relate our findings to temporary corneal dynamics. METHODS: A patient who had been treated with gold sodium thiomalate for 6 years was referred from the Rheumatology Unit of our center for an ophthalmologic examination. At the time of examination she had been treatment-free for 9 years. Besides visual acuity, the examination included slit-lamp biomicroscopy, intraocular pressure, and fundoscopy. Confocal microscopy performed using a Confoscan P4 instrument with a 40x lens to obtain 15 images per second on an S-VHS video system (Panasonic) for subsequent analysis. RESULTS: The basic layered structure of the cornea was unaffected, but the presence of highly reflective particles was noted. These particles were interpreted as gold deposits in the corneal stroma, especially in the anterior and middle stroma. CONCLUSION: Confocal microscopy is a useful method of evaluating the deposition of gold salts in tissues, particularly the cornea. Its future use will help gain a deeper understanding of corneal metabolism.

Antirheumatic Agents↗
PubMed2003

[Hypotony maculopathy diagnosed by optical coherence tomography].

CASE REPORT: A 40 year-old man with advanced pigmentary glaucoma in the left eye underwent trabeculectomy. In the immediate postoperative period, visual acuity decreased with no alterations noted on examination of the fundus or on angiofluoresceingraphy. Through optical coherence tomography, we were able to make a diagnosis of hypotonic maculopathy and treatment was immediately started. DISCUSSION: Hypotony maculopathy is one of the most feared complications of filtering eye surgery. In some cases, optical coherence tomography can be useful to confirm its diagnosis non invasively.

Adult↗
PubMed2002

[Follow-up of macrotrabeculectomy in glaucoma].

PURPOSE: In this study we report the preliminary results of macrotrabeculectomy in our hospital. METHOD: Fifty-nine eyes of 41 patients with open-angle glaucoma underwent macrotrabeculectomy from Sept. 1994 through Sept. 1995 and were retrospectively analysed. Intraocular pressure control was defined as a decrease of postoperative IOP lower than 21 mm Hg or a decrease of at least 20% of initial IOP if this was lower than 21 mm Hg. Disc/cup ratio control was assumed when the progression was under 0.2. Disease control was defined when IOP, disc/cup ratio and visual field were controlled. RESULTS: IOP control was obtained in 93.22% of patients at 2 years and in 91.19% at 3 and 4 years. Disease control was achieved in 88.14% at 2 years and 84.3% at 3 and 4 years (Kapplan-Meier survival analysis). CONCLUSION: Macrotrabeculectomy is a safe and effective technique to control IOP and glaucomatous disease.

Aged↗
PubMed2002

[Initial findings with pulsar perimetry in patients with ocular hypertension].

PURPOSE: To evaluate our first results with Pulsar perimetry in patients with ocular hypertension and compare them with normal individuals. METHODS: We studied 34 eyes of patients with ocular hypertension and normal G1 Octopus perimetry (mean age: 57.29 S.D. 10.55) and 41 eyes of normal individuals (mean age: 48.34 S.D. 13.71). A complete ophthalmologic examination, including Dr. González de la Rosa's Pulsar perimetry with TOP strategy, was performed for all patients. EXCLUSION CRITERIA: visual acuity <0.8, refractive defect 3 spheric dp or 1.5 astigmatic dp, pupil size <3 mm, ocular surgery or pathologies, non-controlled diabetes or neurological diseases. They all had previous perimetric experience. Results were analyzed with student t - test. RESULTS: For normal individuals, mean sensitivity (MS) for Pulsar perimetry was 21,25 src (spatial resolution and contrast units) with an S.D. of 2,70. Mean defect (MD) was 0,93 src S.D. 1,80 and loss variance (LV) was 6,11 src S.D. 4,30. For patients with ocular hypertension: MS was 18,65 src S.D. 2,79; MD was 2,73 src S.D. 2,30 and LV was 8,46 src S.D. 5,01. LV differences between the two groups were statistically significant (p<0.05) with 95% confidence limits of (-4.49; -0.20), and MS and MD differences, highly significant (p<0.01), with 99% confidence limits of (+0.92; +4.28;) and (-3.05; -0.54) respectively. CONCLUSIONS: Pulsar perimetry may have greater sensibility for the detection of early defects in patients with ocular hypertension than conventional perimetry.

Adolescent↗
PubMed2002

[Validation of a questionnaire for the diagnosis of dry eye].

PURPOSE: To develop and evaluate a questionnaire for diagnosis and follow-up of patients with symptoms suggestive of eye surface pathology. To evaluate the efficacy of dry eye treatment. METHODS: Samples were chosen among dry eye patients (n=44). A control group was chosen among the healthy population. The questionnaire was filled in at the beginning and end of the treatment with carbopol + polyvinyl alcohol (Siccafluid, Thea, Spain) four times a day. Initial and final punctuation was established and confronted with other classic diagnostic tests; fluorescein tear break up time, Schirmer test and Rose Bengal staining. RESULTS: Red eyes, lid inflammation, discharge, dry eye, sandy and foreign body sensations, burning, itching, discomfort, pricking, tearing and photophobia got significantly better after treatment (p<0.05). Lid reddening, lid inflammation, flakes in lashes, sticky eyes in the morning, teary eyes, transitory blurring vision and heavy sensation didn't improve (p>0.05). Total punctuation was significantly reduced at one month of treatment (p<0.01). Validation of the test was done against other standard tests (Schirmer test and Rose Bengal). We found a sensitivity of 76% and specificity of 71.5% for Schirmer test and a sensibility of 77% and specificity of 65% if gold standard was Rose Bengal. Predictive value (positive and negative), global value of the test and likelihood ratios were also assessed. CONCLUSION: This questionnaire is useful for diagnosis and follow-up of patients with dry eyes and other ocular surface symptoms. Carbopol + polyvinyl alcohol is useful for the treatment of patients with secretor tear insufficiency.

Acrylic Resins↗
PubMed2002

[Development of an automatic discrimination system for glaucomatous visual fields based on neuro-fuzzy nets].

PURPOSE: To provide a useful tool in the diagnosis of glaucoma by developing an automatic system for visual field classification based on neuro-fuzzy rules. METHOD: A total of 212 visual fields (OCTOPUS 123 program G1X), from 198 patients, were analysed: 61 normal (controls) and 151 with glaucomatous damage (49% with incipient damage, 29.1% with moderate damage, and 21.9% advanced). Inclusion criteria for glaucomatous patients were: Visual acuity >0.5, IOP < 20 mm Hg (with treatment), refraction <5 Dp and previous perimetric experience. EXCLUSION CRITERIA: miotics, other ocular pathologies which could interfere with visual field examination, and for control subjects: visual acuity >0.5, no ocular pathologies and refraction < 5 Dp. A neuro-fuzzy classifier (NEFCLASS) is a system consisting in a series of fuzzy rules, obtained after a learning process, which attempts to assign to each piece of data input its corresponding output. Initially, the characteristics of each data input are established (input units). Then, based on previous knowledge, a set of rules are defined, and finally, the learning process allows the optimisation of the classifier parameters to generate an output. RESULTS: Input units were defined by using the mean defects calculated at specific areas of the visual field; five rules were then created which generated sensitivity and specificity values of 96.0% and 93.4% respectively. CONCLUSIONS: The use of neuro-fuzzy rules for visual field classification in normal vs glaucomatous can provide results which can match the quality of those obtained with other techniques such as discriminatory analysis or neural networks.

Aged↗
PubMed2001

[Ocular complications after treatment with intravenous cidofovir for cytomegalovirus retinitis].

PURPOSE: To describe the ocular changes observed in six patients treated with intravenous cidofovir for cytomegalovirus retinitis. METHODS: We have studied six patients (12 eyes) treated with intravenous cidofovir. A complete ophthalmologic examination was performed before and after each dose during the follow-up period, paying special attention to intraocular pressure changes. RESULTS: Three cases of non-granulomatous anterior uveitis with good response to conventional treatment were detected. The intraocular pressure decreased after the administration of the two first doses of the drug (p<0.01), and was followed by stabilization of the intraocular pressure with the next doses. In two of the eyes (16.7%), the decrease in the intraocular pressure was more than 50% in comparison to the measurements at the onset of treatment. In three eyes (18.7%), we detected acute anterior uveitis, which responded well to conventional treatment. CONCLUSIONS: The intravenous administration of cidofovir for the treatment of cytomegalovirus retinitis is associated with important ocular changes that must be carefully observed in the follow-up of these patients.

AIDS-Related Opportunistic Infections↗
PubMed2001

[Analysis of aged-related nerve fiber layer thickness changes with laser polarimetry].

PURPOSE: Scanning laser polarimetry allows a quantitative study of the retinal nerve fiber layer thickness. It was used to evaluate the effects of aging on thickness of nerve fiber layer in the retinal of normal subjects. METHODS: The retinal nerve fiber layer thickness of 48 eyes of 48 normal subjects was studied. Three consecutive polarimetric images were acquired for each eye and the mean image was calculated, the nerve fiber layer thickness measurements was obtained in this image using the standard 10 pixels and 1.75 disc diameter band centered on the optic nerve head. The standard GDx quadrants were used. Linear regression analysis was used to evaluate the effects of aging on the nerve fiber layer thickness. RESULTS: The mean nerve fiber layer thickness was 78.59 SD 9.81 microm. A significant reduction with age was found in the mean nerve fiber layer thickness (r2: 0.19, p=0.002), the mean superior-inferior quadrant thickness (r2: 0.239, p<0.001), the superior (r2: 0.212; p=0.001) and inferior quadrant thickness (r2: 0.196, p= 0.002), and the maximal superior quadrant (r2: 0.111, p= 0.019) and inferior quadrant thickness (r2: 0.081, p=0,048). CONCLUSIONS: The nerve fiber layer thickness decreases with increasing age in normal subjects.

Adolescent↗
PubMed2001

[First results after implanting 125 acrylic lenses (Acrysof MA60BM)].

PURPOSE: Analysis of the results obtained after the implantation of 125 AcrySof IOLs. METHODS: A retrospective study in 125 patients with cataracts was performed; 98 without previous eye diseases and 27 with previous eye disease (diabetic retinopathy, traumatic cataract, central corneal leucoma and glaucoma). The phacoemulsification technique chosen depended on the type of cataract (< >, < >). Patients were followed up for an average of 9 months. RESULTS: Functional results (best corrected visual acuity in patients suffering from pre-operative eye diseases were 0.5 or higher in 22.22% of cases, whereas in the group without any disease was higher in 100%. AcrySof was implanted in sulcus when the posterior capsule was ruptured. CONCLUSIONS: AcrySof is a soft acrylic IOL which can be very safely and effectively implanted, and it did not lead to complications nor to adverse effects in our study. It is a safe, foldable IOL for small incision and phacoemulsification cataract surgery.

Aged↗
PubMed2001

[Intravitreal injection of triamcinolone acetonide in non infectious uveitis].

PURPOSE: Systemic immunosuppressants take more than two weeks before showing activity. Therefore corticosteroids remain the mainstay in the treatment of non infectious uveitis. The goal of this study is to assess results of the use of intravitreal triamcinolone acetonide in acute sight-threatening non-infectious uveitis. METHOD: Ten patients (4 idiopathic retinal vasculitis, 1 idiopathic panuveitis, 1 pars planitis and 4 Behçet disease) were treated. Triamcinolone acetonide 4 mg/0.1 ml was injected through pars plana. RESULTS: Pre-treatment visual acuity<0.1 and post-treatment visual acuity >0.6 after less than a week. Inflammation resolved completely in all cases. The only complications observed were transient ocular hypertension which was successfully treated in two patients with topical betablockers and a catact in one case. CONCLUSIONS: Intravitreal triamcinolone acetonide is effective in rapidly decreasing inflammation in acute sight threatening non infectious uveitis.

Adolescent↗
PubMed2000

[Medical treatment of glaucoma].

PURPOSE: this review aims to establish the easiest possible diagram to aid the ophthalmologist in the management of the numerous antiglaucomatous agents that have been increasing our therapeutic group. METHOD: we have analyzed the indications, advantages and inconveniences of the medical treatment successively and have reviewed the criteria used to choose a specific drug based on glaucoma severity, general clinical history of the patient, tolerance, local and general adverse effects. RESULTS: finally, we have also considered the ease of compliance, validity of associations and influence of these factors in the patient's quality of life. CONCLUSIONS: the final therapeutic outline is really an index that aims to facilitate a correct use standard.

Adrenergic alpha-Agonists↗
PubMed2000

[Study of the corneal endothelium after glaucoma surgery].

PURPOSE: To analyze the changes suffered by corneal endothelium in patients who underwent a macrotrabeculectomy. METHODS: A prospective study was conducted on 35 patients who underwent a macrotrabeculectomy and 21 patients who did not undergo any surgical technique. All the patients suffered chronic open angle-glaucoma and we only studied patients between 65 and 75 years old. Central corneal endothelium was studied with a specular microscope before surgery and three months after it, analyzing endothelial density, coefficient of variation and hexagonal endothelial cells. RESULTS: The initial cellular count in the operated group was 2361.9 SD 400 and the final was 2211.9 SD 380 cells/mm(2). The decrease of cellular density was 150 cells/mm(2) (6.35%). In the not operated group the initial cellular count was 2313.4 SD 241 and the final was 2299.2 SD 241 cells/mm(2). A decrease of 14 cells/mm(2) was observed. This difference was statistically significant (p=0.035). No statistically significant differences were observed in coefficient of variation and hexagonal endothelial cells. CONCLUSIONS: A decrease of cellular count after three months of macrotrabeculectomy was observed and they are similar to previous studies with conventional trabeculectomies, clearly less than observed with mitomycin use. No statistically significant differences were observed in coefficient of variation and hexagonal endothelial cells.

Aged↗
PubMed2000

[Current status of refractive surgery].

RATIONALE: An attempt is made to review the different surgical procedures for the treatment of the ocular refraction defects and their organs. Special emphasis is placed on the advantages and disadvantages of them, their principal indications and present situation in the surgeon's strategy when solving the problems which, in practice, are caused by these defects, as well as the possibilities that are being tested to solve the problems that presently have not satisfactory response. METHODOLOGY: In addition to analyzing the bibliography, the procedures used by the author and his or her opinion on them, an attempt is made to group them based on the objective on which the intervention is centered to obtain the result desired. COMMENTARY: Both the accuracy of the procedures as well as the complications that are presently derived from this surgery are discussed. Reasonable limits of each procedures, the reasons that make it obligatory to discontinue some of them and the problems that must be solved in the future to up-date each one of the techniques presently in use are commented on.

Humans↗