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J M Benítez del Castillo

Publications and source records attributed to J M Benítez del Castillo.

18 recordsLinked to original sources
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↗
PubMed2003

Frosted branch angiitis and late peripheral retinochoroidal scar in a patient with acquired toxoplasmosis.

PURPOSE: To report a case of acute frosted branch angiitis associated with acquired toxoplasmosis in which a late peripheral chorioretinal scar developed. RESULTS: A 32-year-old man without systemic symptoms presented with sudden visual loss in his left eye. Examination demonstrated frosted branch angiitis without necrotizing chorioretinitis. Serologic tests showed elevated Toxoplasma gondii-specific immunoglobulin M antibody titers. Antitoxoplasmic therapy and oral steroids healed the ocular inflammation. In a follow-up visit one year later, a peripheral chorioretinal scar was noted. CONCLUSIONS: Acute frosted branch angiitis without focal necrotizing chorioretinitis can be a manifestation of acquired toxoplasmosis. This could be an important, and sometimes forgotten, sign of the disease.

Adult↗
PubMed2003

[A new device for measuring contrast sensitivity with and without glare].

PURPOSE/METHOD: To measure the photopic contrast sensitivity, with and without glare, by means of a new instrument. Seventy eight right eyes of 49 young adults and of 29 adults subjects between 35 and 55 years were studied. Contrast sensitivity was measured with the Contrast Glaretester CGT-1000 (Takagi, Japan) that determines the contrast threshold by means of an automated strategy for 6 spatial frecuencies. RESULTS/CONCLUSIONS: The values of contrast sensitivity were similar to those obtained with other clinical tests. Contrast sensitivity, without and with glare, decreased significantly with the age. However, glare did not modify the contrast sensitivity under photopic conditions.

Adolescent↗
PubMed2003

The Madrid triple classification of dry eye.

From the clinical point of view, there are many etiologic causes, several combinations of anatomo-pathologic manifestations, and different grades of severity of Dry Eye diseases in the dysfunctional tear film syndrome. The dacryologist doctor must recognize these three parameters, quantify them, and establish the most appropriate treatment. The present triple classification has been elaborated for this purpose. First, there is an etiologic distribution in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenetic, inflammatory, traumatic, neurodeprivative, and tantalic. Each of these groups comprise many variants. Second, there is an anatomo-pathologic classification named ALMEN classification from the acronym of aquodeficiency, lipodeficiency, mucodeficiency, epitheliopathy, and non-ocular exocrine affectations. Finally, there is a severity classification in five grades: subclinical (symptoms only when overexposure), mild (habitual symptoms), moderate (symptoms plus reversible signs), severe (symptoms plus permanent signs), and disabling (all the above, plus visual discapacity).

Dry Eye Syndromes↗
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↗
PubMed2001

Safety of posterior chamber phakic intraocular lenses for the correction of high myopia: anterior segment changes after posterior chamber phakic intraocular lens implantation.

OBJECTIVE: To assess the safety of posterior chamber phakic intraocular lens (PCPIOL) implantation in patients with high myopia. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Twenty eyes of 10 patients were included. INTERVENTION: Staar Collamer Implantable Contact Lens PCPIOLs were implanted for the correction of high myopia. MAIN OUTCOME MEASURES: Intra- and postoperative complications were recorded. Specular microscopy, lens fluorophotometry, laser flare-meter, and ultrasound biomicroscopy were performed before surgery and at different stages of the follow-up period to evaluate endothelial cell density, crystalline lens transmittance, aqueous flare, and anatomic relations of the implanted lenses with the other structures of the anterior segment. RESULTS: There were no intraoperative complications. One patient experienced pupillary entrapment by the lens in the immediate postoperative period, which was resolved without incident. Pigmentary dispersion or cataracts did not appear during the postoperative period. All the lenses remained correctly centered, and no patient reported night halos or glare. Anterior chamber depth showed a statistically significant reduction, between 9% and 12%. Central endothelial density was significantly decreased after surgery. The percentages of cell loss after 3, 6, 12, 18, and 24 months were 4.41%, 4.83%, 5.17%, 5.46%, and 6.57%, respectively. Aqueous flare increased by 49.19% in the first postoperative month in relation to preoperative values. Afterward, it decreased and then remained above preoperative values for the entire follow-up period (33.76% at month 3, 27.81% at month 6, 27.65% at month 12, 23.39% at month 18, and 27.27% at month 24). Crystalline lens transmittance decreased by 0.72% at month 3, by 1.44% at month 6, by 1.95% at month 12, by 2.25% at month 18, and by 2.24% at month 24. Finally, by ultrasound biomicroscopy it was observed that the PCPIOL and the crystalline lens were in contact on the peripheral level in 12 patients (60%) and in the center in another three patients (15%) during at least one checkup. In all the patients, contact between the PCPIOL and the posterior iris surface could be observed. CONCLUSIONS: Posterior chamber phakic IOL implantation for the surgical correction of high myopia is a safe procedure with regard to immediate visual and refractive results. The short-term clinical benefit and lack of immediate surgical complications are impressive. However, the increase in flare, the endothelial cell loss, the decrease in crystalline lens transmittance, and the iris-PCPIOL and crystalline lens-PCPIOL contact are findings that suggest caution regarding the long-term safety of this lens implant.

Adult↗
PubMed1998

Immunologic and clinical evaluation of postsurgical necrotizing sclerocorneal ulceration.

PURPOSE: To perform a clinical, laboratory and pathologic evaluation in patients who had developed a postsurgical necrotizing sclerocorneal ulceration to detect a serious associated autoimmune disorder and to treat the ocular disease early. METHODS: Nine patients with postsurgical necrotizing sclerocorneal ulceration after uneventful cataract extraction were studied by means of immunohistochemical techniques on conjunctival resections, immunologic serologic studies, and rheumatologic evaluation. Nine healthy subjects who underwent uneventful cataract surgery were used as controls. RESULTS: The pathologic studies showed a local immunoglobulin M (IgM) and IgG deposition, increased human leukocyte antigen (HLA-DR) expression, and a significant T-helper cell participation in conjunctival biopsies in the most severe ulcerations, which were detected in four patients with underlying autoimmune systemic disorder (rheumatoid arthritis, 45%) and only a macrophagic infiltration in the mildest ulcers in patients (55%) without immune disorders. Serologic features included high titers of rheumatoid factor in the four (45%) patients with rheumatoid arthritis, nonspecific serologic immune alteration in three (33%) patients, and were unremarkable in two (22%) patients. The medical and immunologic evaluations were negative in the control cases. Topically administered cyclosporin A healed the ocular disease. CONCLUSION: A surgically induced local autoimmune reaction could occur in the incision area in patients with systemic vasculitic disease. There was no underlying systemic disorder in the mildest ulcers, and these ulcers could be due to a defect in the surgical technique. Our results suggest the need for a detailed systemic evaluation in patients with severe postsurgical necrotizing ulceration. Early diagnosis and aggressive medical treatment of the ocular disorder improves the visual outcome.

Aged↗
PubMed1997

Patterns of uveitis as a guide in making rheumatologic and immunologic diagnoses.

OBJECTIVE: To describe the patterns of clinical presentation in a series of 407 patients with uveitis and to establish the relationship between these patterns and the final diagnosis. METHODS: Patients were referred to the Uveitis Clinic of a tertiary hospital from January 1992 to January 1996. All patients received a complete ophthalmologic examination, and a general clinical history was obtained. The current International Uveitis Study Group classification system was used for anatomic classification. To establish the final diagnosis of the most common entities causing uveitis, current diagnostic criteria were used. A discriminant analysis, with diagnostic grouping as the outcome variable and the clinical presentation features as discriminating variables, was performed. RESULTS: With our classification system, 66.5% of the cases could be correctly classified according to the clinical pattern and morphologic findings. By diagnostic groups, discriminant analysis showed that 75% of patients with Behçet's disease, 77.1% of those with spondylarthropathy (including inflammatory bowel disease), 33.3% of those with sarcoidosis, 97.9% of those with toxoplasmosis, 85.7% of those with Vogt-Koyanagi-Harada syndrome, 100% of those with herpes, and 50.4% of those with idiopathic uveitis were correctly classified. In the miscellaneous group, which included disease entities with fewer than 5 cases, 42.9% were correctly classified. CONCLUSION: Rheumatologic evaluation of the patient with uveitis can be more cost-effective if the referring ophthalmologist follows the classification system described herein, allowing a tailored approach in which only specific and necessary diagnostic tests are used.

Adolescent↗
PubMed1996

Chronic subclinical inflammation in phakic eyes with intraocular lenses to correct myopia.

PURPOSE: To evaluate whether either of two anterior chamber intraocular lenses (IOLs) implanted in myopic, phakic eyes induced an inflammatory response that was measurable with a laser flare-cell meter but that could not be measured by other methods. SETTING: Jiménez-Díaz Foundation and San Carlos University Hospital, Madrid, Spain. METHODS: Thirty eyes with a Worst-Fechner IOL and 30 eyes with a Baikoff ZB5M IOL were evaluated using the flare mode of a laser flare-cell meter. Patients in each group were divided into three subgroups of 10 eyes each according to when the postoperative flare measurements were done: 12 months, 18 months, and 24 months. Thirteen phakic eyes with myopia greater than -6.00 diopters were used as controls. RESULTS: Postoperative flare in the Worst-Fechner group was 27.05 +/- 19 photons per millisecond (photons/ms) (mean +/- SD) at 12 months, 18.09 +/- 17.38 photons/ms at 18 months, and 31.03 +/- 28.8 photons/ms at 24 months. Postoperative flare in the Baikoff group was 21.1 +/- 5.9 photons/ms at 12 months, 16.13 +/- 8.3 photons/ms at 18 months, and 21.05 +/- 23.5 photons/ms at 24 months. Flare in the control group was 4.24 +/- 2.8 photons/ms. Postoperative flare values were significantly higher in both IOL groups than in the control group at all follow-ups (Mann-Whitney test, P < .05). Postoperative flare values in the Worst-Fechner group were higher than in the Baikoff group at 12, 18, and 24 months, although the difference was not significant (Mann-Whitney test, P > .05). CONCLUSIONS: Our study shows chronic subclinical inflammation between 1 and 2 years after implantation of both IOL types.

Adult↗
PubMed1995

Influence of topical cyclosporine A and dissolvent on corneal epithelium permeability of fluorescein.

The corneal stroma is the major barrier to penetration for the lipophilic Cyclosporine A (CsA) molecule and prevents the use of the common ophthalmic solvents. At present, corn oil, castor oil and olive oil are the three most commonly used vehicles. The aim of this study was to determine the effect that topically applied CsA dissolved in different oils has on corneal epithelial permeability measured by fluorophotometry. Forty healthy volunteers, with absence of ocular or systemic disease and not receiving topical or systemic drugs were enrolled. Measurements were taken before and 45 min after the instillation of 40 microliters of a 2% aqueous solution of sodium fluorescein without preservatives. Basal corneal permeability and the permeability 24 h after the instillation of 2% CsA-olive oil, olive oil alone, 2% CsA-castor oil, castor oil alone, 2% CsA-corn oil and corn oil alone, were calculated. To prepare the topical 2% CsA, a Sandimmun oral solution (Sandoz, Basel, Switzerland) was employed under sterile conditions. We found that epithelial permeability 24 h after the instillation of any CsA formulations or solvents increased more than 6.62 times (p <0.001). No differences in corneal permeability values were found between any of the CsA formulations and the vehicles. We conclude that oils used to dissolve CsA are mainly responsible for the increased corneal epithelial permeability. No differences were found in the effects of the tested solvents on corneal epithelial permeability.

Administration, Topical↗
PubMed1995

Bowel inflammation in anterior uveitis and spondyloarthropathy.

OBJECTIVE: To assess the possible involvement of the bowel in the spectrum of anterior uveitis (AU). METHODS: Ileocolonoscopy and histology studies were performed on 27 patients with AU. RESULTS: Patients with AU had a higher incidence of chronic intestinal inflammation (CII) than controls. CII was present in AU regardless of HLA-B27 status, sacroiliitis or NSAID intake, and was more prevalent in uveitis with high recurrence. CONCLUSION: Bowl inflammation ia a component of the spectrum of AU. This finding supports a HIL-B27 independent common pathogenic link between AU and spondyloarthropathy.

Adolescent↗
PubMed1994

Fluorophotometry in myopic phakic eyes with anterior chamber intraocular lenses to correct severe myopia.

Implanting an anterior chamber intraocular lens in a phakic eye is an effective surgical procedure for the correction of severe myopia. However, the potential risks on the anterior segment structures are scarcely known. We conducted a prospective study to evaluate the permeability of the blood-aqueous barrier and the lens transmittance changes after Worst-Fechner lenses were implanted to correct myopia. Preoperative and serial postoperative fluorophotometry was done in 15 eyes that had a Worst-Fechner lens implanted to correct myopia. Lens transmittance was evaluated by lens autofluorescence, and permeability of the blood-aqueous barrier was estimated by anterior vitreous fluorophotometry, which was carried out before and after intravenous injection of fluorescein. Preoperative lens transmittance was 0.971 +/- 0.002 (mean +/- standard error), and, after the operation, lens transmittance decreased to 0.970 +/- 0.002 at one month, 0.966 +/- 0.001 at three months, 0.964 +/- 0.002 at six months, and 0.962 +/- 0.003 at 14 months. At three, six, and 14 months after the operation, lens transmittance values were significantly lower than preoperative values (P = .038 at three months, P < .001 at six months, and P = .005 at 14 months). Fluorescein concentration in the anterior vitreous was 18.522 +/- 1.797 ng/ml (mean +/- standard error) preoperatively and was 21.328 +/- 1.667 ng/ml at one month, 27.518 +/- 1.412 ng/ml at three months, 27.150 +/- 1.474 ng/ml at six months, and 27.012 +/- 1.980 ng/ml at 14 months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Persistent choroidopathy in systemic lupus erythematosus.

We report a case of a rare entity, choroidopathy in association with systemic lupus erythematosus (SLE), previously described in only twelve patients to our knowledge. It manifested by multiple focal serous elevations of the sensory retina and/or serous detachments of the retinal pigment epithelium bilaterally. No retinal vascular changes were observed. The probable pathogenesis is related to choroidal vascular disease due to systemic hypertension secondary to lupus nephritis, vasculitis, or a combination of these.

Choroid Diseases↗
PubMed1994

Influence of topically applied cyclosporine A in olive oil on corneal epithelium permeability.

The effect that topically administered cyclosporine A (CsA) dissolved in olive oil has on corneal epithelial permeability was determined by fluorophotometry. Twenty-six healthy volunteers, who had no ocular or general disease and were not receiving any topical or systemic treatments, were studied. A Fluorotron Master fluorophotometer was used. Measurements were taken before and 45 min after the instillation of 40 microliters of a 2% aqueous solution of sodium fluorescein without preservatives. Basal corneal epithelial permeability, as well as the permeability 24 h after the instillation of 2% CsA-olive oil and of the solvent alone, were calculated. Under sterile conditions, the Sandimmun oral solution (Sandoz, Basel, Switzerland) was used to prepare the topical 2% CsA. Immediately after the 2% CsA-olive oil or the solvent alone were instilled, the volunteers complained of itching for approximately 1 h and developed punctate keratopathy, which improved the next day. Epithelial permeability 24 h after instillation of 2% CsA-olive oil increased 7.03 times (p < 0.001), and that of the solvent alone increased 6.68 times (p < 0.001). No differences in corneal permeability were found between CsA-olive oil and the vehicle (p = 0.651). We concluded that the olive oil used to dissolve CsA is responsible for the increased corneal epithelial permeability.

Administration, Topical↗
PubMed1993

[Vitreous fluorophotometry and nocturnal GH secretion in young insulin-dependent diabetics treated with oral pirenzepine].

With the aim of finding a correlation between the blocking of G.H. secretion and the irregularities in the permeability of the hematoretinal barrier, we have studied the average nocturnal G.H. levels (NAGHL) and the vitreous penetration rate (VPR) in five young diabetic patients. These patients, 3 males and 2 females, were between the ages of 12 and 17 years with a mean age of 16.0. They were studies both before and after receiving treatment for one month with an oral nocturnal dose of 0.6 mg/kg of pirenzepine (gastrozepin) and 1 mg/kg during the subsequent five months. We also tried to find a relationship between the VPR post-treatment and the evolution time of their illness and with their BA1C. The most important results found in this study were: 1) the nocturnal oral pirenzepine modified the NAGHL in the study population (10.48 +/- 4.94 vs; 4.34 +/- 2.53 ng/ml; p < 0.05). 2) Ingestion of the aforementioned drug did not affect the VPR (4.84 +/- 2.08 vs 4.53 +/- 2.54 x 10(-6)/min; p > 0.05). We have not found a relationship between the VPR after treatment with either the HBA1C levels or with the evolution time of the illness. Therefore, we conclude that the dose of oral pirenzepine used for 6 months, although it definitely decreases G.H. secretion, does not modify the permeability of the B.H.R. within this group of young diabetics. Hence, we can infer that the G.H. hypersecretion does not seem to have a relationship, at least exclusively, with the development of diabetic retinopathy.

Administration, Oral↗
PubMedDate not supplied

Effects of subconjunctival methylprednisolone on the blood aqueous barrier following cataract surgery.

The aim of this double-blind randomized study was to assess the effect of subconjunctival methylprednisolone hemisuccinate (MH) on the recovery of the blood aqueous barrier (BAB) following uncomplicated cataract surgery performed by the same surgeon in normal eyes. Fifty eyes of fifty patients (28 female, 22 male, mean age 72.3 +/- 11.2 years) were randomized into two groups: group 1 received a subconjunctival injection of MH (40 mg in 0.5 cc) at the end of the surgery and group 2 did not. All patients were free of other ocular or systemic diseases known to alter the BAB and were not taking any anti-inflammatory medications. Postoperative treatments were similar in both groups. The patients were submitted to laser flare photometry 30 minutes to one hour after mydriasis with a drop of tropicamide preoperatively and on the first, second and seventh day and then one month and six months following surgery. No difference in aqueous flare was seen between the two groups on any of postoperative visits. These data suggest that subconjunctival MH has no beneficial effect in postoperative BAB permeability following uncomplicated cataract surgery in normal eyes.

Aged↗
PubMedDate not supplied

The triple classification of dry eye for practical clinical use.

PURPOSE: "Dry Eye is a condition produced by the inadequate interrelation between lacrimal film and ocular surface epithelium, and is caused by quantitative and qualitative deficits in one or both of them. It can be produced by one or combined etiologic causes, affecting one or several of the secretions of the glands serving the ocular surface, and producing secondary manifestations of different grades of severity". Clinicians need a practical classification to face diagnosis, prognosis and treatment. Dry eyes have many etiologies and pathogenesis, different affectation of the various dacryoglands and ocular surface epithelium, and diverse grades of severity. The specialists in xero-dacryology must know these three parameters to evaluate any case of dry eye, and to establish an adequate treatment. METHODS: To facilitate this, an open session in the 8th congress of the International Society of Dacryology and Dry Eye (Madrid, April, 2005) proposed modifying the Triple Classification of dry eye approved in the XIV congress of the European Society of Ophthalmology (Madrid, June, 2003). There was consensus of all conclusions. CONCLUSIONS: The following classification has been established: First, a classification of the etio-pathogenesis, distributed in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenic, infectious/inflammatory, traumatic, neurologic and tantalic. Second, a classification of the affected glands and tissues, which under the acronym of ALMEN includes the Aqueo-serousdeficient, Lipodeficient, Mucindeficient and Epitheliopatic dry eyes, and the Non dacryological affected exocrine glands (saliva, nasal secretion, tracheo-pharyngeal secretion, etc). And thirdly, a classification of severity, in three grades: Grade 1 or mild (symptoms without slitlamp signs), grade 2 or moderate (symptoms with reversible signs), and grade 3 or severe (symptoms with permanent signs).

Aging↗