Choroidal hemangioma (CH) is a benign vascular tumor dependent on the choroid. Two types of lesions are distinguished: circumscribed (CCH), the most frequent variant, and diffuse (DCH), normally ...associated with Sturge-Weber syndrome.
HCC appears as an orange mass that can present asymptomatically, however, when it produces symptoms, the most frequent is decreased visual acuity due to neurosensory retinal detachment. Due to its benign nature, only those that produce symptoms should be eligible for treatment. Knowledge of this pathology and its correct differential diagnosis is very relevant to establish the appropriate diagnosis and treatment, avoiding unnecessary treatments. There is currently a wide variety of multimodal diagnostic imaging tests that allow us to identify and adequately monitor this tumor. In addition, in recent years, there has been a change in the paradigm of the treatment of these tumors thanks to the use of photodinamic therapy, which has led to a significant improvement in the visual prognosis of these patients. This has been due to the use of photodynamic therapy as the treatment of choice for HCC.
El hemangioma coroideo (HC) es un tumor vascular benigno dependiente de la circulación coroidea. Se distinguen dos tipos de lesiones: circunscrito (HCC), variante más frecuente y difuso (HCD), asociado normalmente al síndrome de Sturge-Weber.
El HCC se presenta como una masa anaranjada que puede presentarse de manera asintomática, sin embargo, cuando produce síntomas lo más frecuente es la disminución de la agudeza visual debido a un desprendimiento de retina neurosensorial. Debido a su carácter benigno sólo deberían ser subsidiarios de tratamiento aquellos que produzcan síntomas. El conocimiento de esta patología y su correcto diagnóstico diferencial es muy relevante para establecer el diagnóstico y tratamiento adecuado, evitando tratamientos innecesarios. En la actualidad existen una gran variedad de pruebas de imagen de diagnóstico multimodal que nos permiten identificar y realizar un seguimiento adecuado de este tumor. Además, en los últimos años, gracias al empleo de la terapia fotodinámica, se ha producido un cambio en el paradigma del tratamiento de estas lesiones, lo cual ha supuesto, una mejora significativa en el pronóstico visual de estos pacientes. Esto se ha debido al empleo de la terapia fotodinámica, como tratamiento de elección para el HCC.
To perform a retrospective analysis on patients with HLA-B27 negative hypertensive acute anterior uveitis. Aqueous humor samples were obtained on which a polymerase chain reaction (PCR) test was ...performed. The patients were then classified into 3 groups depending on whether they were positive for cytomegalovirus (CMV) or herpesvirus (HSV-VZV) or negative for both.
Different variables were collected in successive visits (baseline, 3, 6, and 12 months). The variables were age, sex, visual acuity, intraocular pressure (IOP), cells in the anterior chamber, retro-keratic precipitates, hypotensive treatment, glaucoma or retina surgery, corneal transplantation, and central thickness of the retinal nerve fiber layer.
The sample was 36 patients, with a mean age of 59.78 ± 15.26 years. The mean baseline IOP value was 40 ± 10.42 mmHg in the CMV group compared to 23.8 ± 10.4 mmHg in the HSV-VZV, and 22.65 ± 9.9 mmHg in the negative group. The baseline frequency of retro-keratic precipitates, hypotensive treatment, glaucoma surgery, and corneal transplantation was higher in CMV positives. At one year, the loss of retinal nerve fiber layer and glaucoma surgery was greater in the negative group. In the 3 groups, there was a direct and positive correlation between IOP and inflammation in the anterior chamber. Being 0.94 (P = .05) for the positive for CMV, 0.24 (P = .75) in that of HSV-VZV, and 0.98 (P = .17) in the negative group.
HLA-B27 negative hypertensive acute anterior uveitis with CMV positive has a more aggressive initial presentation. However, after one year, the glaucomatous damage is less than in the negative group. In hypertensive acute anterior uveitis, when inflammation in anterior chamber is controlled then IOP is also controlled.
Analizar los datos clínicos de pacientes con uveítis anteriores agudas hipertensivas HLA-B27 negativas. Se obtuvieron muestras de humor acuoso, en las que se realizó reacción en cadena de la polimerasa (PCR), y se clasificaron los pacientes en 3 grupos según las muestras fueran positivas para citomegalovirus (CMV), virus herpes (VHS-VVZ) o negativas para ambos.
En los 3 grupos de pacientes se recogieron las variables edad, sexo, agudeza visual, presión intraocular (PIO), células en cámara anterior, precipitados retroqueráticos, tratamiento hipotensor, cirugía de glaucoma, retina o trasplante corneal y grosor central de la capa de fibras nerviosas de la retina. Todas las variables fueron recogidas en la visita basal y a los 3, 6 y 12 meses.
Se incluyeron 36 pacientes, con una edad media de 59,78 ± 15,26 años. El valor medio basal de PIO fue 40 ± 10,42 mmHg en el grupo CMV frente a 23,8 ± 10,4 mmHg en el VHS-VVZ y 22,65 ± 9,9 mmHg en el grupo PCR negativo. La frecuencia basal de precipitados retroqueráticos, tratamiento hipotensor, cirugía de glaucoma y trasplante corneal fue mayor en los positivos para CMV. Sin embargo, al año la pérdida de capa de fibras nerviosas de la retina y la tasa de cirugía de glaucoma fue mayor en el grupo PCR negativo. Durante el seguimiento, en los 3 grupos hubo correlación directa y positiva entre la PIO y la inflamación en cámara anterior. Esta correlación fue de 0,94 (p = 0,05) para el positivo para CMV, de 0,24 (p = 0,75) en el de VHS-VVZ y de 0,98 (p = 0,17) en el negativo.
Las uveítis anteriores agudas hipertensivas HLA-B27 negativas con PCR de humor acuoso positiva para CMV tienen una presentación más agresiva inicialmente; sin embargo, al año de seguimiento el daño glaucomatoso es menor que en aquellas con PCR negativa. En las uveítis anteriores agudas hipertensivas, cuando, con el tratamiento oportuno, se controla la inflamación en cámara anterior, se controla la PIO.
The case is reported of a 59-year-old woman, who reported decreased visual acuity (VA) in the left eye (LE). On examination, a corrected VA of finger count/30cm was observed in LE. Corneal edema and ...folds in the Descemet's membrane were observed using the slit lamp. Anterior synechiae, iris atrophy, and corectopia were also found. Iridocorneal endothelial syndrome (ICE) was diagnosed. The treatment option was a combination of cataract surgery and automated endothelial keratoplasty with Descemet's membrane dissection (DSAEK). There were no complications during the operation, with a successful anatomical and functional recovery, with a VA of 0.8 being observed after one year. This result supports the efficacy of DSAEK in ICE syndrome, encouraging more studies to be carried out that should also support its efficacy in this syndrome.
Reportamos el caso de una mujer de 59años, que refería disminución de agudeza visual (AV) en el ojo izquierdo (OI). Mediante la exploración, se objetivó en dicho ojo una AV corregida de cuenta dedos a 30cm, y en la lámpara de hendidura se observó la presencia de edema corneal moderado, con pliegues en la membrana de Descemet. También se apreciaron sinequias iridianas anteriores, atrofia de iris y corectopia. Se diagnosticó de síndrome iridocórneo endotelial (ICE). Se decidió un abordaje terapéutico quirúrgico mediante una cirugía combinada de catarata y queratoplastia endotelial automatizada con disección de la membrana de Descemet (DSAEK).
No se reportaron complicaciones intraoperatorias. La recuperación anatómica y funcional fue exitosa, presentando una AV corregida al año de 0,8. Este resultado apoya la eficacia de la DSAEK en el síndrome ICE animando a la realización de más estudios que soporten igualmente su eficacia en este síndrome.
PURPOSETo analyse the association between the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the thickness of the inner macular layers with the mean deviation of the visual ...field (MD) in children with primary congenital glaucoma (PCG). MATERIAL AND METHODSA total of 41 children with PGC were included in the study. They all had a complete ophthalmological examination, including visual acuity, intraocular pressure, funduscopy, Octopus™ visual field, as well as circumpapillar and macular spectral domain optical coherence tomography (SD-OCT). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fibre layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer. RESULTSThe mean age was 11.2±3.86 years, and the mean MD was 8.85±6.76dB. The visual field was classified as normal in 46% of the patients, and 20% of the patients had a concentrical restriction of the visual field. A positive correlation was found between between the cup-to-disc ratio and the MD, r=0.51 (P=.004). The correlation between the MD and the cpRNFL was r=-0.63 (P<.001), and r=-0.69 (P<.001) with the GCL. CONCLUSIONSInner macular layers thickness and cpRNFL thickness show a good correlation with the mean deviation of the visual field in children with primary congenital glaucoma.
To analyse the association between the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the thickness of the inner macular layers with the mean deviation of the visual field ...(MD) in children with primary congenital glaucoma (PCG).
A total of 41 children with PGC were included in the study. They all had a complete ophthalmological examination, including visual acuity, intraocular pressure, funduscopy, Octopus™ visual field, as well as circumpapillar and macular spectral domain optical coherence tomography (SD-OCT). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fibre layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer.
The mean age was 11.2 ± 3.86 years, and the mean MD was 8.85 ± 6.76 dB. The visual field was classified as normal in 46% of the patients, and 20% of the patients had a concentrical restriction of the visual field. A positive correlation was found between between the cup-to-disc ratio and the MD, r = 0.51 (P = 0.004). The correlation between the MD and the cpRNFL was r = −0.63 (P < .001), and r = −0.69 (P < .001) with the GCL.
Inner macular layers thickness and cpRNFL thickness show a good correlation with the mean deviation of the visual field in children with primary congenital glaucoma.
Analizar la correlación entre el grosor de la capa de fibras nerviosas peripapilar (cpRNFL) y el grosor de las capas internas de la retina con el defecto medio del campo visual (DM) en pacientes con glaucoma congénito primario (GCP).
En este estudio transversal se incluyeron 41 pacientes diagnosticados de GCP. A todos los pacientes se les realizó una exploración oftalmológica completa incluyendo agudeza visual, presión intraocular, fondo de ojo, campo visual y tomografía de coherencia óptica (OCT) macular y peripapilar. Se utilizo la segmentación automática del OCT Spectralis para medir el grosor de la capa de fibras nerviosas macular (mRNFL), capa de células ganglionares (GCL) y plexiforme interna.
La edad media fue de 11,2 ± 3,86 años y el DM medio fue de 8,85 ± 6,76 dB. En un 46% de los pacientes el campo visual fue clasificado como normal, y un 20% de los pacientes presentaba una restricción concéntrica del campo visual. Se encontró una correlación positiva entre la relación anillo/excavación y el DM (p = 0.004). La correlación ente el DM y el cRNFL fue de r = −0,63 (p < 0.001) y de r = −0,69 con la GCL.
El grosor de las capas internas de la retina y el cpRNFL tiene una buena correlación con el defecto medio del campo visual en pacientes con glaucoma congénito primario.
The second-generation of gravitational-wave detectors are just starting operation, and have already yielding their first detections. Research is now concentrated on how to maximize the scientific ...potential of gravitational-wave astronomy. To support this effort, we present here design targets for a new generation of detectors, which will be capable of observing compact binary sources with high signal-to-noise ratio throughout the Universe.
Advanced LIGO Abbott, R; Addesso, P; Aggarwal, N ...
Classical and quantum gravity,
04/2015, Letnik:
32, Številka:
7
Journal Article, Web Resource
Recenzirano
Odprti dostop
The Advanced LIGO gravitational wave detectors are second-generation instruments designed and built for the two LIGO observatories in Hanford, WA and Livingston, LA, USA. The two instruments are ...identical in design, and are specialized versions of a Michelson interferometer with 4 km long arms. As in Initial LIGO, Fabry-Perot cavities are used in the arms to increase the interaction time with a gravitational wave, and power recycling is used to increase the effective laser power. Signal recycling has been added in Advanced LIGO to improve the frequency response. In the most sensitive frequency region around 100 Hz, the design strain sensitivity is a factor of 10 better than Initial LIGO. In addition, the low frequency end of the sensitivity band is moved from 40 Hz down to 10 Hz. All interferometer components have been replaced with improved technologies to achieve this sensitivity gain. Much better seismic isolation and test mass suspensions are responsible for the gains at lower frequencies. Higher laser power, larger test masses and improved mirror coatings lead to the improved sensitivity at mid and high frequencies. Data collecting runs with these new instruments are planned to begin in mid-2015.
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