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Biomedical subjects

P Romero Aroca

Publications and source records attributed to P Romero Aroca.

10 recordsLinked to original sources

[Tuberculous retinitis with associated periphlebitis].

CASE REPORT: A female 23 years old, from Equador, was referred to us because of a vision decrease in her left eye. Fundus exploration demonstrated an inflammatory chorioretinal lesion with associated periphlebitis. Serology results showed positive for PPD. A vitreous biopsy was carried out together with tuberculosis prophylactic treatment with isoniacide (300 mg/day); the clinical findings improved. Finally, PCR test was positive for mycobacterium tuberculosis. In consequence, therapeutic treatment for tuberculosis was initiated. DISCUSSION: Due to the current increase in prevalence of tuberculosis, we should always take this into account as a possible etiology when dealing with cases of chorioretinitis.

Adult↗

[Study of the relationship between retinal and renal microangiopathy in patients with diabetes mellitus type 1].

The similarities in the vascularization of the retina and the kidney give rise to the complications of diabetes mellitus in the small vessels (microangiopathy) that appear in both organs. The present study presents the prospectively obtained results along 10 years in 104 diabetic type 1 patients, with the characteristics not to present microalbuminuria nor diabetic retinopathy at the beginning of the study; the results bear as objective the establishment of the relation between the presence of proliferative diabetic retinopathy and microalbuminuria, taking into account different factors of epidemiological risk: gender, duration of diabetes, presence of diastolic hypertension, levels of HbAlc, and blood lipids. The results obtained indicate a 10 years of follow-up incidence of diabetic retinopathy of 37.50% (being the proliferative form 13.46%) and the incidence of microalbuminuria is of 20.19%. The appearance of proliferative diabetic retinopathy is associated to the presence of diastolic hypertension, while the appearance of microalbuminuria is related to the elevation of levels of HbAlc. The results obtained in the proliferative diabetic retinopathy and microalbuminuria incidence are similar to those of other authors. At the end of the study four groups of patients are configured depending on whether they present proliferative diabetic retinopathy and/or microalbuminuria. The results obtained in the present study suggest the possible existence of two populations of diabetic patients, one that would develop proliferative diabetic retinopathy and renal injury, and a second population in which only would appear proliferative diabetic retinopathy.

Adult↗

[Chronic endophthalmitis in pseudophakic patients caused by bacillus subtilis].

OBJECTIVE/METHODS: We present two cases of patients with chronic endophthalmitis. The treatment included intraocular lens exchange, total capsulectomy and posterior vitrectomy through the limbus. In both cases, samples of the vitreous were taken and sent to the laboratory together with the intraocular lens and remmants of posterior capsule for culture and antibiogram. RESULTS/CONCLUSIONS: Microbiologic examination and culture were positive in two cases for Bacillus subtilis, which is not actually identified in literature as an etiologic agent for chronic endophthalmitis.

Aged↗

[Suprachoroidal bleeding: review and description of eight cases].

INTRODUCTION: Suprachoroidal hemorrhage (SCH) is a dramatic complication of intraocular surgery that can result in total loss of vision. METHODS: The records of eight cases of SCH during cataract surgery were reviewed. Six of eight patients were treated by combined radial sclerotomies for suprachoroidal drainage and vitrectomy. Risk factors, therapeutic strategies, and functional and anatomical results were analyzed. RESULTS: The incidence of SCH was 0.45%. Preoperative visual acuity of all eyes suffering from SCH was limited to the perception of light. Postoperatively, six patients showed an increase in visual acuity greater than 0.1; one patient achieved 0.5. Ocular and general risk factors (ocular hypotony, myopia, Valsalva-type maneuvers, intraoperative systemic hypertension) and surgery complications were analyzed. CONCLUSIONS: In spite of using state-of-the-art surgical techniques, the prognosis of SCH remains serious, with a poorer outcome associated with increasing complications due to hemorrhage. Secondary treatment combining radial sclerotomies and vitrectomy should be performed to minimize the damaging effect of choroidal hemorrhage.

Aged↗

[Is microalbuminuria a risk factor for diabetic retinopathy?].

PURPOSE: To determine the relationship between microalbuminuria and diabetic retinopathy. METHODS: A prospective 10-year study of 104 younger-onset diabetic patients. The diabetic retinopathy diagnosis was made by fundus retinography, and determination of microalbuminuria was made from urine samples. RESULTS: The incidence of diabetic retinopathy in this group of patients was 39 (37.5%). The epidemiological factors implicated were diabetes duration, higher levels of HbA(1c), male sex, and diastolic arterial hypertension. The incidence of microalbuminuria was 21 patients (20.2%), with high levels of HbA(1c) the epidemiological factor implicated. The association between microalbuminuria and diabetic retinopathy grouped the patients as follows: 56 patients without microalbuminuria or retinopathy, 16 patients who developed microalbuminuria and diabetic retinopathy, 23 patients who developed retinopathy but not microalbuminuria, and nine patients who developed only microalbuminuria. The discriminant analysis showed that the high levels of HbA(1c) were associated with microalbuminuria and diabetes duration and high levels of HbA(1c) were associated with diabetic retinopathy. CONCLUSIONS: In the population studied, microalbuminuria was not a good marker for diabetic retinopathy.

Adult↗

[Is basic the anesthetist presence in cataract surgery?].

PURPOSE: To determine the need for anesthesiology in cataract surgery. METHODS: For the present study a total of 406 consecutive patients who underwent cataract surgery under regional peribulbar anesthesia were selected. RESULTS: In 109 cases (28,5%) the anesthetist was required, the causes of intervention were: high blood pressure in 68 patients (16.74%), perturbation in 20 patients (4.92%), cardiac arrhytmia in 20 patients (4.92%) and one case of myocardial infarction. CONCLUSIONS: Anesthetist intervention was requiered in one third of cataract surgery cases. This is why the anesthetist care seems to be justified in cataract surgery under local anesthesia.

Aged↗

[Anterior optic neuritis do to ulcerative colitis].

PURPOSE/METHODS: We present the case of a 27 year old woman with acute bilateral loss of vision associated with abdominalgia, bloody diarrhea and arthralgia. In the present article, the different forms of ocular complications in relationship to chronic intestinal inflammations and their possible causes are discussed. RESULTS/CONCLUSIONS: On examination, bilateral anterior uveitis associated to a picture of optic nerve lesion compatible with a bilateral anterior optic neuritis was observed. The patient was diagnosed of ulcerative colitis by intestinal biopsy. The ocular affectation resolved after the ulcerative colitis was treated with systemic mesalamine.

Adult↗

[Results in the treatment of acute endophthalmitis by vitrectomy using limbal incision].

PURPOSE: To describe the results obtained in the treatment of acute onset endophthalmitis after cataract surgery in our center using vitrectomy with corneal limbal incisions. METHODS: Study carried out in 12 patients with acute endophthalmitis after cataract surgery in whom a posterior vitrectomy by limbic incisions was performed followed by intravitreal injections of antibiotics (vancomycin + ceftazidime/amikacin) with systemic and topical antibiotic and corticosteroid treatment in the post-operative period. RESULTS: The incidence of endophthalmitis in our center was 0.92%. The most frequently isolated microorganism was Staphylococcus epidermidis (4 cases, 33.33%). Four cases were negative (33.33%). A visual acuity equal to or greater than 0.5 at three months was obtained in 6 patients (50%). Only one case required a second administration of intravitreal injections. One patient suffered vitreal hemorrhaging in the post-operative period, and no other complications were observed in the remaining patients. CONCLUSIONS: We consider that vitrectomy through limbal incisions is a valid alternative for acute onset endophthalmitis treatment.

Acute Disease↗

[Relationship between microalbuminuria and diabetic retinopathy in type 1 diabetes mellitus].

Prospective studies focusing on the relationship between diabetic retinopathy and the presence of microalbuminuria are lacking. The objective of the present study was to determine the potential relationship between both forms of diabetic microangiopathy by means of a five-year long prospective study in which 104 patients with type 1 diabetes mellitus and with no retinal involvement at the beginning of the study were included. At the end of the study four groups of patients emerged: group 1, made up of 63 patients without both retinal involvement and microalbuminuria; group 2, made up of 17 patients with both retinopathy and microalbuminuria; group 3, with 16 patients with retinopathy but without microalbuminuria, and group 4, with eight patients with microalbuminuria only. In the statistical study, a direct significance was observed for both increased levels of HbA1c and total cholesterol; and a reverse significance for increased levels of HDL-cholesterol as well as the presence of diastolic arterial hypertension, for group 2 (patients with both retinopathy and microalbuminuria). For group 3, increased levels of triglycerides and evolution time (patients with retinopathy but without microalbuminuria) were significant. In the present study we conclude that microalbuminuria is not a good marker for diabetic microangiopathy defined as renal and retinal involvement, although its presence prompt us to watch more frequently the ocular fundus in diabetic patients.

Adult↗