BACKGROUND AND OBJECTIVE: Study the correlation between pupillary diameter and intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification. MATERIAL AND METHODS: Prospective, observatio...BACKGROUND AND OBJECTIVE: Study the correlation between pupillary diameter and intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification. MATERIAL AND METHODS: Prospective, observational, and descriptive study. Data were collected from May 2024 to May 2025. RESULTS: Preoperative pupillary diameter <5.5 mm post dilation was significantly associated with the development of intraoperative complications (P = .002). Among patients with complications, the median pupil dilation was 4.99 mm, whereas in those without complications the median was 5.94 mm. Most complications occurred during the phacoemulsification phase (6; 66.7%), followed by capsulorhexis (2; 22.2%). Additionally, the presence of zonular weakness was significantly associated with the development of complications (P < .001). CONCLUSIONS: Preoperative identification of a pupil diameter <5.5 mm post dilation may alert the surgeon to potential intraoperative findings such as zonular weakness and iris instability, which may lead to better surgical planning.
BACKGROUND: Residual esotropia (RE) is a postoperative complication with a prevalence of 20% after surgery for childhood esotropia. OBJECTIVE: To study the characteristics and efficacy of different surgical techniques in...BACKGROUND: Residual esotropia (RE) is a postoperative complication with a prevalence of 20% after surgery for childhood esotropia. OBJECTIVE: To study the characteristics and efficacy of different surgical techniques in reoperations on subjects with residual esotropia. MATERIALS AND METHODS: Retrospective study of 34 cases with residual esotropia between 2017-2024. The mean age was 33.12 years, 52.94% women. The mean time between initial surgery and reoperation was 16.3 years. Data were collected from the alternating prism cover test, TNO and Worth tests, limitations in ductions, and alphabetical pattern. Success was considered a residual deviation <10 prism diopters without diplopia. The mean follow-up time was the period from the first surgery to data collection: 18.26 years. RESULTS: A total of 46 surgeries were performed: re-recession of the medial rectus (19.15%), lateral rectus resection (44.68%), or both techniques combined (36.17%), uni- or bilaterally. The mean number of reoperations was 1.38 (range,1-3), with one case requiring three surgeries. The surgical technique with the best outcome was the re-recession of the medial rectus muscles (87.5%), followed by combined surgery (64.7%) and resection of the lateral rectus muscles (52.4%). No statistically significant differences were found between the surgical techniques analyzed. CONCLUSIONS: Medial rectus re-recession was the most effective technique for correcting residual esotropia compared to lateral rectus resection or a combination of both. No predictors of surgical success were found.
BACKGROUND AND OBJECTIVE: Intravitreal Ziv-Aflibercept (ZA-IV) is a recombinant fusion protein used to treat macular diseases. Several studies have demonstrated its efficacy and safety. The objective was to evaluate the...BACKGROUND AND OBJECTIVE: Intravitreal Ziv-Aflibercept (ZA-IV) is a recombinant fusion protein used to treat macular diseases. Several studies have demonstrated its efficacy and safety. The objective was to evaluate the efficacy and safety of ZA-IV in the treatment of diabetic macular edema (DME) and macular edema secondary to retinal vein occlusion (RVO). MATERIALS AND METHODS: Systematic review with meta-analysis (PROSPERO: CRD42024542788), with searches in PubMed, EMBASE, and Web of Science up to April 2024. Observational studies and randomized controlled trials (RCTs) were included. Efficacy was determined by best-corrected visual acuity (BCVA) and central macular thickness (CMT). Safety was assessed based on the reports in the studies. Risk of bias was assessed using the Robins-I and Cochrane RoB 2.0 tools. RESULTS: Of 503 studies, 8 observational studies and 5 RCTs were included. In DME, RCTs showed a reduction in CMT (-105 μm; 95% CI: -129.8 to -80.3; I: 0%) and in BCVA a LogMAR reduction (-0.29; 95% CI: -0.36 to -0.21; I: 0%). Observational studies in DME showed a reduction in CMT (-108 μm; 95% CI: -133 to -83.1; I: 34%) and in BCVA a LogMAR reduction (-0.2; 95% CI: -0.26 a -0.14; I: 0%). In RVO, RCTs showed a reduction in CMT (-230 μm; 95% CI: -367 to -94; I: 46%). Observational studies in EMSOV showed a reduction in GMC (-160 μm; 95% CI: -257 to -64; I: 74%) and in BCVA (best corrected visual acuity) a reduction in LogMAR (-0.2; 95% CI: -0.26 to -0.14; I: 50%). No serious ocular or systemic adverse effects were reported. CONCLUSION: ZA-IV demonstrated efficacy and is potentially safe for the treatment of EMD and EMSOV.
We present an unusual clinical case of odontogenic orbital cellulitis (OOC) complicated by a serous macular detachment (SMD), an extremely rare association. A 61-year-old patient presented with blurred vision, severe ocu...We present an unusual clinical case of odontogenic orbital cellulitis (OOC) complicated by a serous macular detachment (SMD), an extremely rare association. A 61-year-old patient presented with blurred vision, severe ocular pain, and proptosis. Imaging studies revealed orbital cellulitis secondary to an apical abscess of an upper molar. Although retinal involvement is uncommon in OOC, in this case the SMD represented an atypical and striking manifestation, highlighting the importance of considering unusual retinal complications in orbital infections. Combined treatment with intravenous antibiotics and corticosteroids, along with dental extraction of the infectious focus, led to resolution of both the orbital inflammation and the SMD. A multidisciplinary approach between ophthalmology and dentistry was crucial, with complete visual and anatomical recovery observed at 18 months of follow-up.
We report a case of simultaneous bilateral non-arteritic anterior ischemic optic neuropathy (NAION) in a 68-year-old man with poorly controlled type 2 diabetes mellitus and significant hyperopia (+5 diopters). Visual los...We report a case of simultaneous bilateral non-arteritic anterior ischemic optic neuropathy (NAION) in a 68-year-old man with poorly controlled type 2 diabetes mellitus and significant hyperopia (+5 diopters). Visual loss began 14 days after initiating semaglutide at a relatively high dose (0.5mg/week), progressing to functional blindness within four weeks. Ophthalmologic examination revealed bilateral optic disc edema with hemorrhages, exudates, and subretinal fluid. Infectious and autoimmune causes were ruled out, and cerebrospinal fluid analysis was normal. Following the high dose of semaglutide, glycated hemoglobin decreased, although the magnitude and speed of this decline should be interpreted with caution, and the association between the drug and the optic nerve event must be considered purely temporal, with no evidence of direct causality. Despite drug discontinuation and corticosteroid treatment, visual loss persisted. The simultaneous bilateral presentation, rapid progression, and predisposing anatomical factors-crowded optic discs and possible scleral rigidity-highlight extreme vulnerability. This case illustrates a possible temporal association, representing one of the few such cases reported to date, and underscores the importance of baseline ophthalmic evaluation, close monitoring, and careful consideration of initial dosing in patients treated with GLP-1 receptor agonists.
Central Serous Chorioretinopathy (CSC) is a pachychoroidopathy characterized by the accumulation of subretinal fluid due to alterations in the retinal pigment epithelium, affecting mainly to 30-50 years old men and being...Central Serous Chorioretinopathy (CSC) is a pachychoroidopathy characterized by the accumulation of subretinal fluid due to alterations in the retinal pigment epithelium, affecting mainly to 30-50 years old men and being an extremely infrequent pathology in the pediatric age. In this article we present the case of a 7-year-old patient with recent personal record of trip to Mauricio Islands who attends to the Emergency Room with serious loss of vision in an insidious way during the last week. A complete ophthalmologic examination was performed along with imaging tests (ocular ultrasound, OCTm, and optomap) revealing a large neurosensory retinal detachment (NSD) in the macular area associated with underlying choroidal thickening. Systemic workup, including a head CT, 18-FDG PET-CT, and serological marker analysis, was normal. The NSD resolved completely within 6 weeks with topical anti-inflammatory treatment. Despite the sudden beginning of the clinical case and the wide variety of possible diagnosis, the self-limited and self-solving characteristics of the process, drives us to the diagnostic possibility of Central Serous Chorioretinopathy.
Amyloidosis is characterized by the extracellular deposition of abnormal amyloid protein fibrils in tissues. Amyloidosis of the eyelid and conjunctiva (AEC) is a rare clinical finding. We present the case of a 48-year-ol...Amyloidosis is characterized by the extracellular deposition of abnormal amyloid protein fibrils in tissues. Amyloidosis of the eyelid and conjunctiva (AEC) is a rare clinical finding. We present the case of a 48-year-old female patient with pinkish-yellow infiltration in the upper and lower bulbar conjunctiva, along with a firm, well-circumscribed nodular lesion on the lower eyelid of the right eye. Biopsies of the eyelid and conjunctiva were performed, and histological examination confirmed amyloid deposition with Congo red staining. AEC is a rare entity that is often underdiagnosed. Although it most frequently manifests as a localized process, systemic involvement must always be ruled out.
We present the case of a woman with metastatic BRAF-mutated melanoma and a history of type 1 diabetes mellitus, who developed ocular toxicity secondary to Binimetinib treatment. She was initially treated with Vemurafenib...We present the case of a woman with metastatic BRAF-mutated melanoma and a history of type 1 diabetes mellitus, who developed ocular toxicity secondary to Binimetinib treatment. She was initially treated with Vemurafenib and Cobimetinib, achieving complete remission. However, due to cumulative toxicities, therapy was switched to Encorafenib and Binimetinib in February 2023. After three months, she developed cystoid macular edema (CME), confirmed by optical coherence tomography (OCT). Management included Binimetinib dose reduction and topical ketorolac, resulting in initial improvement, although the CME recurred several months later. The rapid progression of metastatic melanoma in January 2024, with peritoneal carcinomatosis, massive ascites, and a left adrenal metastasis, limited further treatment options such as intravitreal anti-VEGF or dexamethasone. The patient ultimately began immunotherapy with Nivolumab and Ipilimumab, but died in February 2024 due to refractory abdominal septic shock. This case highlights the importance of early ophthalmologic monitoring and interdisciplinary collaboration in patients receiving MEK inhibitors.
Granulomatosis with polyangiitis is a systemic autoimmune disease characterized by the presence of granulomatous necrotizing vasculitis with kidney, respiratory, and vascular involvement, whose peak incidence is in the f...Granulomatosis with polyangiitis is a systemic autoimmune disease characterized by the presence of granulomatous necrotizing vasculitis with kidney, respiratory, and vascular involvement, whose peak incidence is in the fifth and sixth decades of life. Its localized presentation without systemic involvement is infrequent. We present the case of a 10-year-old patient with recurrent eyelid edema as the initial symptom in the setting of granulomatosis with systemic polyangiitis. Although rare, this disease can affect children, as in the case we present, and given its low incidence and atypical presentation it is sometimes a diagnostic challenge.
BACKGROUND AND OBJECTIVE: Pterygium is a wing-shaped degenerative growth of the bulbar conjunctiva that extends onto the cornea. Its treatment can be medical, surgical, or a combination of both. Argon laser therapy has b...BACKGROUND AND OBJECTIVE: Pterygium is a wing-shaped degenerative growth of the bulbar conjunctiva that extends onto the cornea. Its treatment can be medical, surgical, or a combination of both. Argon laser therapy has been reported as an initial treatment option. The effectiveness of argon laser use as a first-line treatment for primary T1 or grade 1 pterygium was evaluated in comparison with a control group. MATERIALS AND METHODS: Randomized, double-blind, single-center trial. Subjects were divided into two groups using a randomized block design. Group 1 received argon laser treatment along the vessels of the head and body of the pterygium, and group 2 received placebo treatment. Symptoms of dry eye, signs of conjunctivitis, best corrected visual acuity, and pterygium size were evaluated at one week, one month, three months, and six months after treatment. RESULTS: Thirty-two subjects were included. There was a statistically significant reduction in the length of the pterygium between the first and third month after laser treatment. All symptoms, except for itching, improved after the third month of argon laser treatment and continued to improve until the end of the follow-up period. CONCLUSIONS: Argon laser therapy can be a safe and effective method for the treatment of T1 or grade 1 pterygium, significantly reducing the size of the pterygium and improving the signs and symptoms of the ocular surface.
BACKGROUND AND OBJECTIVE: Conducting a national visual health survey and comparing results after 5 years. MATERIALS AND METHODS: Cross-sectional study using a computer-assisted telephone interview with a representative s...BACKGROUND AND OBJECTIVE: Conducting a national visual health survey and comparing results after 5 years. MATERIALS AND METHODS: Cross-sectional study using a computer-assisted telephone interview with a representative sample of Spaniards over 18 years of age (except Ceuta and Melilla). The survey was designed by ophthalmologists, the selection of the sample and the conduct of the interviews (April 2017 and May 2023) was carried out through the company Metroscopia and the analysis of the anonymous data was carried out by researchers. Demographic data, knowledge about glaucoma, use of glasses, perceived visual quality, ophthalmological pathology and ocular treatments were collected. RESULTS: 1209 and 600 people were interviewed in 2017 and 2023 respectively. The level of glaucoma awareness went from 80% to 87%. The perceived visual quality was reduced (8.2 ± 1.6 to 6.9 ± 1.8) and the frequency of access to the ophthalmologist. The prevalence of glasses use increased (50%-62%), dry eye (13%-28%), cataract (9.7%-12.4%), glaucoma (1.9%-4.6%), age-related macular degeneration (7%-11.3%), and diabetic retinopathy (1.2%-1.7%). The use of artificial tears and glaucoma drops also increased (16.9%-32.9% and 1.6%-6%, respectively). CONCLUSIONS: The study shows that there has been an increase in self-reporting of eye diseases in recent years in Spain. These types of population surveys can serve to encourage the development of visual health programs aimed at the needs of our country.
Carrillo Martinez JM, Ramos Soto O, Carrillo Hernandez JM
… +5 more, Hernández Núñez F, Serrano Ramirez DL, Blanco D' Mendieta JA, Ordaz Espino A, Vega García AD
BACKGROUND AND OBJECTIVES: To assess the usefulness of clinical, and structural biomarkers obtained by Spectral-Domain Optical Coherence Tomography (SD-OCT), as predictors of visual outcome after idiopathic epiretinal me...BACKGROUND AND OBJECTIVES: To assess the usefulness of clinical, and structural biomarkers obtained by Spectral-Domain Optical Coherence Tomography (SD-OCT), as predictors of visual outcome after idiopathic epiretinal membrane (iERM) surgery. MATERIALS AND METHODS: This was a retrospective, observational, and analytical study of 50 eyes from 50 patients who underwent iERM surgery. We studied preoperative best-corrected visual acuity (BCVA) as a clinical biomarker, and the following structural SD-OCT biomarkers: preoperative (Pre) and postoperative (Post) central macular thickness (CMT); Pre Govetto stage; and the presence of Pre ectopic inner foveal layers (EIFL), disorganization of retinal inner layers (DRIL), outer layer disruption (OLD), and interdigitation zone disruption (IZD). RESULTS: Ten eyes were included in stage 2, 27 in stage 3, and 13 in stage 4. Pre BCVA was 0.96 ± 0.36 LogMAR, Post was 0.65 ± 0.43 LogMAR. Preoperative CMT was 425.4 ± 91.5 µm, Post was 338.5 ± 73.6 µm. Significant differences were found in Post BCVA between stages, with a trend toward worse BCVA in more advanced stages. A moderate-to-strong positive correlation was found between Pre BCVA and Post BCVA. Post BCVA did not correlate with Post CMT, but it did with Pre CMT. Patients with one or more of the EIFL, DRIL, DCE, and DZI biomarkers tended to have a worse visual outcome. CONCLUSIONS: A worse initial BCVA, greater Pre CMT, and the presence of EIFL, DRIL, DCE, and/or DZI (associated with more advanced stages) translate to poorer postoperative vision. Early surgery could confer a higher probability of a better visual outcome.
BACKGROUND AND OBJECTIVE: To determine the prevalence of DEMODEX in patients with blepharitis, its clinical characteristics, as well as its association with systemic conditions, and the type and severity of dry eye disea...BACKGROUND AND OBJECTIVE: To determine the prevalence of DEMODEX in patients with blepharitis, its clinical characteristics, as well as its association with systemic conditions, and the type and severity of dry eye disease (DED). MATERIALS AND METHODS: A cross-sectional, observational, and analytical study was conducted. 302 patients with signs of blepharitis were evaluated from December 2024 to April 2025 at a Mexican ophthalmology referral center. RESULTS: The prevalence of DEMODEX was 49.3%, with significant differences between age groups, observing a higher prevalence with advanced ages: 39.7% in <60 years, and 49.3% in ≥60 years (χ = 0.009). Type 2 diabetes (T2D) was associated with a significant risk of developing demodicosis (OR 2.456 (CI 1.457-4.141), p = <0.001). Regarding clinical characteristics, patients with DEMODEX had a higher presence of collarettes, a higher prevalence of mixed blepharitis (58.4%), and mixed dry eye disease (DED). Regarding tests for dry eye type and severity, there were only differences in the Van Bijsterveld score (χ = 0.009), but not for the TBUT, Schirmer, or OSDI scores. CONCLUSION: Ocular demodicosis has a high prevalence in our population; its presence is associated with age, with no differences by gender. T2D increases the likelihood of developing DEMODEX. The anatomical and functional alterations caused by this ocular infection can promote or worsen the symptoms and severity of DED.