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Biomedical subjects

José M Ruiz-Moreno

Publications and source records attributed to José M Ruiz-Moreno.

13 recordsLinked to original sources
PubMed2006

Evidence for delayed presbyopia after photorefractive keratectomy for myopia.

PURPOSE: To evaluate uncorrected near visual acuity (NVA), accommodation, corneal aberrations, and the optical quality of the retinal image in presbyopic eyes after photorefractive keratectomy (PRK). DESIGN: Nonrandomized comparative retrospective study. PARTICIPANTS: Ten post-PRK patients and 10 normal patients. METHODS: Twenty eyes (10 right and 10 left after PRK for myopia, minimum of 10 years after the operation; group A) were compared with 20 eyes (10 right and 10 left age- and gender-matched normal controls; group B). All subjects were over 40 years of age. MAIN OUTCOME MEASURES: With best distance correction, NVA was measured at 40 cm (Jaeger, J series), and the range of accommodation (diopters [D]) was measured subjectively (negative relative amplitude and positive relative amplitude). The modulation transfer function (MTF) and corneal aberrations such as comalike, spherical (SAs), and higher order (HOAs) were measured with a Hartmann-Shack aberrometer. From the MTF curves, the spatial frequencies corresponding to contrast values of 0.1 and 0.5 were noted. RESULTS: Mean ages (+/- standard deviations [SDs]) were 46.3 years (4.7) for group A and 47.6 years (4.9) for group B (P>0.05). Near acuity was J1 or better in 12 of 20 post-PRK and 4 of 20 control eyes. Mean accommodations (+/- SDs) were 3.2 D (1.14) for right group A eyes and 2.1 D (0.94) for right group B eyes (P = 0.0152), and 3.4 D (0.99) for left A eyes and 2.3 D (1.02) for left B eyes (P = 0.0168). Total HOA indexes (+/- SDs) were 1.449 (0.409) for right group A eyes and 0.824 (0.241) for right group B eyes (P = 0.008), and 1.464 (0.388) for left A eyes and 1.067 (0.542) for left B eyes (P = 0.0752). Pooling the data from post-PRK and control eyes, a significant correlation was found between near acuity and SA (right eyes, r = -0.535, P = 0.015; left eyes, r = -0.493, P = 0.027). Significant associations were found between accommodation, near acuity, HOA, and comalike aberration for right eyes only. Mean spatial frequencies (+/- SDs) corresponding to contrast values of 0.1 for right and left eyes were 14.96 (5.71) for right group A eyes and 22.02 (6.85) for right group B eyes (P = 0.074), and 15.11 (7.80) for left A eyes and 21.41 (9.00) for left B eyes (P = 0.271). Mean spatial frequencies (+/- SDs) corresponding to contrast values of 0.5 for right and left eyes were 2.86 (0.63) for right group A eyes and 3.21 (0.35) for right group B eyes (P = 0.596), and 2.76 (0.98) for left A eyes and 3.22 (0.27) for left B eyes (P = 0.194). CONCLUSIONS: Compared with normal eyes, in previously myopic eyes treated with first-generation PRK lasers there is a tendency for (1) the optical quality of the retinal image to be reduced at low contrast, (2) the aberrations attributed to the corneal surface to increase, and (3) both measured subjective accommodation and near acuity to be greater than expected. We postulate that the corneal aberrations induced by PRK for myopia may reduce the quality of the retinal image for distance but enhance near acuity by way of a multifocal effect that can delay the onset of age-related near vision symptoms.

Accommodation, Ocular↗
PubMed2006

Verteporfin photodynamic therapy for choroidal neovascularization associated with toxoplasmic retinochoroiditis.

PURPOSE: To evaluate the efficacy and safety of verteporfin photodynamic therapy (V-PDT) for young adults and children with subfoveal choroidal neovascularization (CNV) associated with toxoplasmic retinochoroiditis. METHODS: Patients with subfoveal CNV associated with toxoplasmic retinochoroiditis were treated with V-PDT and prospectively followed up. Before V-PDT and during follow-up, patients underwent visual acuity testing, complete ophthalmic examination including color photography, angiography with fluorescein and/or indocyanine green, and optical coherence tomography. The decision to retreat CNV was based on the criteria used in the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy investigation. RESULTS: Eight patients (5 males and 3 females) were treated at a mean age of 15.3 years (range, 5-31 years). CNV was 100% classic or predominantly classic in all study patients. Mean visual acuity increased from 20/225 (range, 20/400 to 20/50) to 20/123 (range, 20/200 to 20/25) during a mean follow-up period of 25 months (range, 5-49 months). Persistent closure of CNV was achieved in all eight patients (mean number of treatments, 1.75). Vascular anastomosis developed in the treated area in two patients, but there was no additional visual loss. No significant adverse effects of V-PDT were observed. CONCLUSION: V-PDT for subfoveal CNV associated with toxoplasmic retinochoroiditis appears to be effective and safe even in young adults and children. However, a longer follow-up is recommended to confirm our observations.

Adolescent↗
PubMed2006

Photodynamic therapy in subfoveal and juxtafoveal idiopathic and postinflammatory choroidal neovascularization.

PURPOSE: To evaluate the efficacy of photodynamic therapy (PDT) in the treatment of idiopathic and inflammatory choroidal neovascularization (CNV). METHODS: This study represents a non-randomized, multicentre, interventional case series. Sixteen eyes of 16 patients with classic or predominantly classic sub- and juxtafoveal idiopathic CNV and 26 eyes of 24 patients with classic or predominantly classic sub- and juxtafoveal CNV secondary to inflammatory conditions were treated with PDT with verteporfin. Best corrected visual acuity (BCVA) before and after PDT, the number of lines gained or lost and the number of PDT sessions were analysed. RESULTS: The mean follow-up periods were 20 months (SD 11) and 16 months (SD 9) for the idiopathic and inflammatory groups, respectively. The mean BCVA in idiopathic CNV changed from 0.63 logMAR (SD 0.37) before treatment to 0.82 logMAR (SD 0.43) after treatment (p = 0.16; Student's t-test paired data). The number of treatments performed averaged 2.1 (range 1-4, SD 0.9). The mean BCVA in postinflammatory CNV changed from 0.60 logMAR (SD 0.4) before treatment to 0.57 logMAR (SD 0.6) after treatment (p = 0.79; Student's t-test paired data). The mean number of treatments was 2.6 (range 1-6, SD 1.2). CONCLUSIONS: Photodynamic therapy with verteporfin may be useful in stabilizing BCVA in patients with sub- and juxtafoveal postinflammatory CNV and subfoveal idiopathic CNV.

Adolescent↗
PubMed2005

Full-thickness macular hole after LASIK for the correction of myopia.

PURPOSE: To describe 19 patients (20 eyes) who developed a macular hole (MH) after undergoing bilateral LASIK for the correction of myopia. DESIGN: Noncomparative, interventional, retrospective, multicenter case series. PARTICIPANTS: Nineteen patients (20 eyes) who developed an MH after bilateral LASIK for the correction of myopia at 10 institutions in Venezuela, Colombia, Puerto Rico, Spain, and the United States. METHODS: Chart review. MAIN OUTCOME MEASURE: Macular hole development. RESULTS: The MH formed between 1 to 83 months after LASIK (mean, 12.1). In 60% of cases, the MH developed < or =6 months after LASIK, and in 30% of cases it developed > or =1 year after LASIK. Eighteen of 19 (94.7%) patients were female. Mean age was 46 years (range, 25-65). All eyes were myopic (range, -0.50 to -19.75 diopters [mean, -8.9]). Posterior vitreous detachment was not present before and was documented after LASIK in 55% of eyes. A vitrectomy closed the MH on the 14 eyes that underwent surgical management, with an improvement of final best-corrected visual acuity in 13 of 14 (92.8%) patients. Our 20 eyes with a full-thickness MH after LASIK reflect an incidence of approximately 0.02% (20/83938). CONCLUSION: An MH may infrequently develop after LASIK for the correction of myopia. Our study shows that vitreoretinal surgery can be successful in restoring vision for most myopic eyes with an MH after LASIK. Vitreoretinal interface changes may play a role in MH formation after LASIK for the correction of myopia.

Adult↗
PubMed2004

Postoperative Corynebacterium macginleyi endophthalmitis.

A 72-year-old man with chronic endophthalmitis who received steroid treatment for 3 months came to our center. Sterile endophthalmitis after cataract extraction had been diagnosed. Aqueous samples including smears, classic cultures, and polymerase chain reaction were taken for microbiological study. Amplified DNA was sequenced to identify the pathogen. Polymerase chain reaction amplification was positive for bacteria. Sequence analysis showed Corynebacterium macginleyi as the causal agent in 48 hours. The culture and smear stains from the ocular samples were negative. The patient was successfully treated with vancomycin. Polymerase chain reaction and subsequent DNA-typing were useful in detecting the microorganisms that caused the chronic endophthalmitis.

Aged↗
PubMed2004

Changes in keratoconic corneas after intracorneal ring segment explantation and reimplantation.

PURPOSE: To evaluate the outcome and potential reversibility of the changes induced in keratoconic eyes after intracorneal ring segment explantation. DESIGN: Retrospective, interventional case series. PARTICIPANTS: Five eyes of 4 patients who underwent uneventful implantation of one or two intracorneal ring segment segments for the correction of clear corneal keratoconus and who required explantation of one segment due to complications. MAIN OUTCOME MEASURES: Visual acuity, refraction, keratometric readings, and corneal topography. The follow-up was up to 1 year from the primary implantation procedure in all cases. RESULTS: Explantation was performed easily in all cases without intraoperative or postoperative complications. The segments were extracted due to migration and local melting. The visual, refractive, and topographic map findings regressed to approximate the original clinical situation before segment implantation. CONCLUSIONS: Intracorneal ring segments are safely and easily explanted from keratoconic eyes. Most of the visual, refractive, and topographic findings return to near the preimplantation levels.

Adult↗
PubMed2003

Follow-up of age-related macular degeneration patients treated by photodynamic therapy with optical coherence tomography 3.

BACKGROUND: Photodynamic therapy (PDT) has been described to effectively reduce or delay severe vision loss in eyes with predominantly classic form of choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Optical coherence tomography 3 (OCT3) is a non-invasive diagnostic procedure which provides information about retinal thickness and volume at the posterior pole, as well as about the presence of certain structures under the retina. METHODS: Prospective interventional study. Eleven eyes (9 patients) with AMD and CNV were treated with Verteporfin PDT. A complete ophthalmologic examination was performed. Fluorescein angiography (FA) and OCT3 scans were performed before treatment and 1, 2, 4, and 12 weeks after it. RESULTS: Two different patterns of changes were observed. One group (7 eyes) showed changes in the amount of subretinal fluid (decrease, increase, and finally stable decrease), with a reduction in the CNV and the appearance of a subretinal band of hyperreflective tissue. The second group (4 eyes) showed little or no changes in retinal thickness, fluid, or reflectivity. CONCLUSION: Changes observed in OCT3 scans represent variations in retinal thickness, fluid, and CNV after PDT. OCT3 provides a useful tool in the follow-up and measurement of changes appeared in eyes with CNV associated to AMD after treatment with PDT.

Aged↗
PubMed2003

Choroidal neovascularization in phakic eyes with anterior chamber intraocular lenses to correct high myopia.

PURPOSE: To analyze the appearance, incidence, and characteristics of choroidal neovascularization (CNV) in patients with high myopia corrected by implantation of a phakic anterior chamber intraocular lens (PACL). SETTING: University Miguel Hernández, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: The CNV observed in 294 consecutive eyes (181 patients) implanted with a PACL for the correction of high myopia (-7.0 to -38.0 diopters) was studied. The mean follow-up was 50.6 months +/- 32.8 (SD) (range 6 to 120 months). RESULTS: Choroidal neovascularization occurred in 5 eyes (1.70%); 3 eyes were in women, and 2 were in men. The interval between PACL implantation and CNV was 63.2 +/- 27.3 months (range 18 to 87 months). The CNV was subfoveal in 4 eyes and juxtafoveal in 1 case. The mean best spectacle-corrected visual acuity (BSCVA) after PACL implantation and before the appearance of CNV was 0.53 +/- 0.18 (range 0.4 [20/50] to 0.8 [20/25]); after CNV appeared, it was 0.26 +/- 0.18 (range 0.05 [20/400] to 0.5 [20/40]), a statistically significant difference (P =.001, paired Student t test). In 2 cases, the CNV was treated with photodynamic therapy (PDT); in the other 3 cases, PDT was rejected. The cumulative risk for CNV (Kaplan-Meier survival analysis) in highly myopic patients corrected by PACL implantation was 0.43% at 18 months and 5.4% at 87 months. CONCLUSIONS: Implantation of a PACL to correct high myopia was followed by a small incidence of CNV (cumulative risk of 5.4% at 87 months). The appearance of CNV was followed by a significant decrease in BSCVA.

Adolescent↗
PubMed2003

Rapid molecular diagnosis of posttraumatic keratitis and endophthalmitis caused by Alternaria infectoria.

The first case of Alternaria infectoria ocular infection is reported. Keratitis and endophthalmitis developed after eye-perforating trauma from a lemon tree branch. Two months after surgery and empirical steroid and antibiotic treatment, diagnosis by molecular methods was performed. PCR amplification was positive for a fungus after 4 h. Antifungal treatment with amphotericin B and fluconazole was initiated immediately. DNA sequence analysis showed Alternaria infectoria to be the causal agent. After topical and systemic administration of antifungal treatment, ocular inflammation disappeared and visual acuity improved. DNA typing was found to be a useful tool to achieve early identification of the causal agent.

Aged↗
PubMedDate not supplied

Rupture of radial keratotomy incisions by blunt trauma 6 years after combined photorefractive keratectomy/radial keratotomy.

PURPOSE: To report a case of traumatic corneal rupture that occurred 6 years previous, following combined radial keratotomy (RK) and photorefractive keratectomy (PRK). METHODS: A 28-year-old man experienced a severe direct trauma to the right eye. Upon initial examination, a ruptured globe was diagnosed. Four of the eight radial incisions were ruptured with extrusion of intraocular tissues. The patient was also diagnosed with a fracture of the medial wall of the right orbit. The patient received immediate surgery during which the radial incisions that had been torn were stitched with a suture. RESULTS: Following the postoperative period, the patient had visual acuity of light perception. CONCLUSION: PRK, carried out on a cornea already treated with RK, may increase the likelihood of rupture in blunt trauma.

Adult↗
PubMedDate not supplied

Intraretinal hemorrhage associated with leishmaniasis.

A 39-year-old man presented with sudden loss of visual acuity caused by two retinal hemorrhages with no choroidal neovascularization (confirmed by fluorescein angiography). The patient was hospitalized for malaise, progressive pancytopenia, hepatosplenomegaly, progressive anemia, and perianal inflammation. Positive serologies were obtained for toxoplasmosis (IgG) and Leishmania (1/160). A diagnosis of visceral leishmaniasis was made, and the patient was treated with pentavalent antimonials. Two months later, best-corrected visual acuity was 20/25, with no residual scotoma. Indirect ophthalmoscopy showed complete resolution of the hemorrhages. This patient was an otherwise healthy immunocompetent adult who presented frank visceral leishmaniasis and retinal hemorrhages as the only ocular or systemic hemorrhagic findings, with spontaneous resolution after improvement of platelet levels. This rare cause of macular hemorrhage should be considered in areas where Leishmania is endemic.

Adult↗