Highlights of Ophthalmology

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2021 | June | Volume 49 | Issue 3ENG

María Fernanda Delgado Morales

The Importance of Optimizing the Follow-Up of the Progression of Primary Open Angle Glaucoma in Clinical Practice

[Year:2021] [Month:June] [Volume:49] [Number:3ENG] [Pages:13] [Pages No:4 - 16]

Keywords: Glaucoma, optical coherent tomography, visual field, progression, optic nerve

PDF  |  DOI: 10.5005/hoe-10101-49301  |  (Buy Now)  |  How to cite  | 

Abstract

Objective: To describe how to optimize the follow-up (F/U) for patients with primary open angle glaucoma (POAG), its early diagnosis and the timely detection. Monitoring functional and structural change, will protect quality of life and avoid risk of blindness. Background: Glaucoma definition has evolved to, a multifactorial neuro-degenerative disease, where despite research developments, intraocular pressure reduction remains as mainstay for treatment and stability of the disease. Close monitoring of POAG patients is crucial for early change detection and advancing treatment to improve results. Results: Current evidence shows the benefit of the correlation between structure and function to detect glaucomatous change, favoring the use of optical coherence tomography (OCT) of the optic disc and macula, as well as perimetry studies, within the F/U scheme of patients with POAG. Numerous publications stand out the ability of OCT of the optic disc to early detect damage and change before functional changes are detectable in the visual field. The frequency of tests, as well as patient visits, are determined by the severity of damage, rate of progression and individual risk factors. Knowing the different examination strategies and applying recommendations to the clinical practice, will contribute to a better treatment of the POAG patient. Understanding the different types of exams and their advantages according to the severity of the disease, will improve rational use of resources and a better chance to detect progression and define therapeutic actions. Conclusion: Progression analysis by event and trend can be performed in structure and function tests. Progression analysis improve glaucoma F/U of POAG patients and optimize results of treatment. Clinical Relevance: Visual loss secondary to glaucoma is irreversible, and the main objective of treatment is to preserve quality of life in the patient who suffers from it. Knowing and applying change analysis in clinical practice is the key to achieve that objective.

Luis J. Cárdenas-Lamas, Sandra E. Partida-Calderón, Marisol Iñiguez-Soto, Juan C. Juárez Echenique

Primary Iris Cyst. Case Report

[Year:2021] [Month:June] [Volume:49] [Number:3ENG] [Pages:5] [Pages No:17 - 21]

Keywords: Primary iris cyst, recurrence of iris cyst, ultrabiomicroscopy

PDF  |  DOI: 10.5005/hoe-10101-49302  |  (Buy Now)  |  How to cite  | 

Abstract

We present a case of stromal cyst of the iris, which is a rare pathology whose treatment has a wide range of possibilities and results. This is a 5-year-old female patient, who is taken to an ophthalmological evaluation for presenting photophobia and a dark mass in the left eye growing for one year. Through diagnostic studies of the anterior segment, the diagnosis of primary iris cyst is confirmed, which, given its characteristics, meets surgical criteria and presents a favorable evolution after the procedure in subsequent appointments during the last 4 months. The treatment used was mixed in order to offer the patient a lower risk of recurrence, as reported in the literature. We can conclude that iridian cysts despite their stable nature and that conservative management is still preferred by consensus, may represent a risk of complications that put visual function at risk, so close monitoring is important in these cases and makes timely decisions in your treatment to preserve it.

María Angélica Moussalli, Catalina Gigena Zito

Papillary Drusen and Glaucoma: About a Case

[Year:2021] [Month:June] [Volume:49] [Number:3ENG] [Pages:6] [Pages No:22 - 27]

Keywords: Drusen, optic nerve head, glaucoma, eye hypertension

PDF  |  DOI: 10.5005/hoe-10101-49303  |  (Buy Now)  |  How to cite  | 

Abstract

Objectives: Clinical case report of bilateral papilla drusen in an adult patient in which glaucoma was also detected. Understand the importance of optic nerve head analysis by using complementary studies to establish early treatment.

Gabriel Merchán-De Mendoza, María Victoria Baez

Determining a Suitable Compensation in LASIK Surgery for Hyperopic Patients Older than 45 Years

[Year:2021] [Month:June] [Volume:49] [Number:3ENG] [Pages:6] [Pages No:28 - 33]

Keywords: LASIK, hypocorrection, hyperopia, accommodation, presbyopia. clinical emmetropia

PDF  |  DOI: 10.5005/hoe-10101-49304  |  (Buy Now)  |  How to cite  | 

Abstract

Objective: To determine an adequate compensation to achieve a refractive state of clinical emmetropia for hyperopic patients older than 45 years of age. Methods: A Proportional analysis was performed by comparing samples of cases that successfully achieved clinical emmetropia intervened with and without a compensation of +0.50 or +0.75 Dpts. for hyperopic patients older than 45 years of age at OPTILASER, Refractive Surgery Center in Bogotá, Colombia. Results: The result of the analysis with a Confidence Level of 95% is: Z Value = 4.35, Cumulative Probability = 0.9998 and p-Value = 0.0002, therefore, the Null Hypothesis Ho is rejected in favor of Ha which states that “hyperopic patients of 45 years of age and older, operated with compensation +0.50 or +0.75 Dpts., show a proportion of successes of clinical emmetropia significantly greater than those operated without any compensation.” Conclusions: For hyperopic patients of 45 years of age and older, it is recommended to introduce a compensation of +0.50 or +0.75 Dpts. over the patient\'s degree of hyperopia, into the LASIK prior to surgery, to significantly increase the probabilities of achieving a refractive state of clinical emmetropia. Clinical Importance: The compensation proposed in this investigation achieves in a large proportion of hyperopes a satisfactory state of clinical emmetropia in far vision, avoiding accommodative efforts in patients over 45 years of age with a low amplitude of accommodation.

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