Carlos Neves - Academia.edu (original) (raw)

Papers by Carlos Neves

Research paper thumbnail of Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes

Ophthalmology, 2010

Large macular holes usually have an increased risk of surgical failure. Up to 44% of large macula... more Large macular holes usually have an increased risk of surgical failure. Up to 44% of large macular holes remain open after 1 surgery. Another 19% to 39% of macular holes are flat-open after surgery. Flat-open macular holes are associated with limited visual acuity. This article presents a modification of the standard macular hole surgery to improve functional and anatomic outcomes in patients with large macular holes. A prospective, randomized clinical trial. Patients with macular holes larger than 400 μm were included. In group 1, 51 eyes of 40 patients underwent standard 3-port pars plana vitrectomy with air. In group 2, 50 eyes of 46 patients underwent a modification of the standard technique, called the inverted internal limiting membrane (ILM) flap technique. In the inverted ILM flap technique, instead of completely removing the ILM after trypan blue staining, a remnant attached to the margins of the macular hole was left in place. This ILM remnant was then inverted upside-down to cover the macular hole. Fluid-air exchange was then performed. Spectral optical coherence tomography and clinical examination were performed before surgery and postoperatively at 1 week and 1, 3, 6, and 12 months. Visual acuity and postoperative macular hole closure. Preoperative mean visual acuity was 0.12 in group 1 and 0.078 in group 2. Macular hole closure was observed in 88% of patients in group 1 and in 98% of patients in group 2. A flat-hole roof with bare retinal pigment epithelium (flat-open) was observed in 19% of patients in group 1 and 2% of patients in group 2. Mean (or median) postoperative visual acuity 12 months after surgery was 0.17 (range, 0.1-0.6) in group 1 and 0.28 (range, 0.02-0.8) in group 2 (P = 0.001). The inverted ILM flap technique prevents the postoperative flat-open appearance of a macular hole and improves both the functional and anatomic outcomes of vitrectomy for macular holes with a diameter greater than 400 μm. Spectral optical coherence tomography after vitrectomy with the inverted ILM flap technique suggests improved foveal anatomy compared with the standard surgery.

Research paper thumbnail of One-year safety outcomes of intravitreal implant of fluocinolone acetonide 0.19 mg in clinical practice assessed by intraocular pressure measurement

Investigative Ophthalmology & Visual Science, Jun 23, 2017

Research paper thumbnail of Retinopathy of prematurity: contribution of inflammatory and genetic factors

Molecular and Cellular Biochemistry

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder that represents an impor... more Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder that represents an important cause of childhood visual impairment and blindness. Although oxidative stress has long been implicated in ROP etiology, other prenatal and perinatal factors are also involved. This review focuses on current research involving inflammation and genetic factors in the pathogenesis of ROP. Increasing evidence suggests that perinatal inflammation or infection contributes to ROP pathogenesis. Cytokines and chemokines with a fundamental role in inflammatory responses and that significantly contributing to angiogenesis are analyzed. Microglia cells, the retinal-resident macrophages, are crucial for retinal homeostasis, however, under sustained pathological stimuli release exaggerated amounts of inflammatory mediators and can promote pathological neovascularization. Current modulation of angiogenic cytokines, such as treatment with antibodies to vascular endothelial growth factor (anti-VEGF), has shown efficacy in the treatment of ocular neovascularization; however, some patients are refractory to anti-VEGF agents, suggesting that other angiogenic or anti-angiogenic cytokines need to be identified. Much evidence suggests that genetic factors contribute to the phenotypic variability of ROP. Several studies have implicated the involvement of candidate genes from different signaling pathways in the development of ROP. However, a genetic component with a major impact on ROP has not yet been discovered. Most studies have limitations and did not replicate results. Future research involving bioinformatics, genomics, and proteomics may contribute to finding more genes associated with ROP and may allow discovering better solutions in the management and treatment of ROP.

Research paper thumbnail of Vision‐related quality of life in spondyloarthritis patients with history of acute anterior uveitis under treatment with golimumab: preliminary results of the GO‐VISION observational study

Acta Ophthalmologica, 2022

Research paper thumbnail of Cardiovascular, Ocular And Autonomic Characterization Of The Water Drinking Test In The Anesthetized Rat

Investigative Ophthalmology & Visual Science, 2011

Research paper thumbnail of Effects of Amlodipine in an Experimental Model of Isolated Rabbit Eye

Investigative Ophthalmology & Visual Science, 2007

Research paper thumbnail of O-008. Influence of Hypertension in Pregnancy on Hematological Phenotypes of Preterm Infants with Gestational Age Inferior to 32 Weeks

Pregnancy Hypertension, 2021

Research paper thumbnail of Trabeculectomy with mitomycin C alone or with mitomycin C plus intracameral bevacizumab—A comparative study

Acta Ophthalmologica, 2021

Research paper thumbnail of Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

The Lancet Neurology, 2020

Background Hereditary transthyretin (ATTRv) amyloidosis is a rare, inherited, progressive disease... more Background Hereditary transthyretin (ATTRv) amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We aimed to assess the efficacy and safety of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with ATTRv amyloidosis with polyneuropathy. Methods This multi-country, multi-centre, open-label extension (OLE) trial enrolled patients at 43 sites in 19 countries as of 24 September 2018. Patients were eligible if they had completed the phase 3 APOLLO (randomised, double-blind, placebo-controlled [2:1], 18-month study) or phase 2 OLE (single-arm, 24-month study) parent studies and tolerated the study drug. Eligible patients from APOLLO (APOLLO-patisiran [received patisiran during APOLLO] and APOLLO-placebo [received placebo during APOLLO] groups) and the phase 2 OLE (phase 2 OLE patisiran group) studies enrolled in this Global OLE trial and receive patisiran 0•3 mg/kg by intravenous infusion every 3 weeks for up to 5 years. Efficacy assessments include measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress. Patients included in the current efficacy analyses are those who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received ≥1 dose of patisiran up to the data cutoff. The Global OLE is ongoing with no new enrolment, and current findings are based on the 12-month interim analysis. The study is registered with ClinicalTrials.gov, NCT02510261.

Research paper thumbnail of Spontaneous retrobulbar haemorrhage in idiopathic thrombocytopenic purpura

BMJ case reports, Jan 13, 2017

Research paper thumbnail of Pupilloplasty to prevent dexamethasone intravitreal implant migration to anterior chamber

Research paper thumbnail of Glaucoma assessment tools used by clinicians: old or gold?

Acta Ophthalmologica, 2017

PurposeGlaucoma is the main cause of irreversible blindness worldwide. Early detection and person... more PurposeGlaucoma is the main cause of irreversible blindness worldwide. Early detection and personalized management is the key to prevent or slow disease progression. Our group previously evaluated the quality of within‐hospital referral to a glaucoma subspecialty department (GSD), raising awareness to the importance of doing applanation tonometry (AT), gonioscopy and visual fields (VF) before referral. The aim of this work was to perform an audit cycle, one year after the awareness training session in December 2015.MethodsRetrospective analysis of a random sample of within‐hospital referrals to the GSD, in Lisbon Academic Medical Center (January 2016 to May 2017). Electronic records were screened for clinical data, exams, medical and surgical treatments prior to referral. Descriptive statistics were performed with SPSS.ResultsA total of 150 patients (69 males) were included in this analysis, with a mean age of 65 years [range 10–93]. Mean intraocular pressure (IOP) was 19.8 mmHg. Al...

Research paper thumbnail of Prevalence of silent breast cancer in autopsy specimens, as studied by the disease being held by image-guided biopsies: The pilot study and literature review

Molecular and clinical oncology, 2017

Breast cancer epidemiological patterns vary in European countries, which present different incide... more Breast cancer epidemiological patterns vary in European countries, which present different incidence rates. Data have suggested that the reduction in breast cancer mortality is not only due to the early detection of the disease, but is, in almost equal part, due to screening and to the advances that have been made in molecular medicine and the development of novel therapies. The aim of the present study is to quantify the actual number of cases of breast cancer present in both of the sexes by calculating the prevalence of silent breast cancer in corpses. To achieve this quantification, bilateral subcutaneous radical mastectomies are performed in corpses of either sex above 40 years of age that lacked any clinical manifestation of the disease, and where the breast cancer or its complications was not the cause of death. Only five publications exist in the international literature based on medico-legal autopsies that were designed to define the 'natural reservoir' of the diseas...

Research paper thumbnail of Normobaric hypoxia induces changes in mean ocular perfusion pressure

Acta Ophthalmologica, 2016

PurposeIt is still unclear how a normobaric hypoxic stimulus affects mean ocular perfusion pressu... more PurposeIt is still unclear how a normobaric hypoxic stimulus affects mean ocular perfusion pressure (MOPP) in healthy subjects. The Hypoxia Challenge Test (HCT), performed according to the British Thoracic Society (BTS) protocol, mimics the hypoxia levels in medium/long‐haul flights, in which cabins are pressurized to a value of around 565 mmHg, equivalent to breathing 15.1% oxygen at sea level. We aimed to study the relationship between hypoxia and MOPP.MethodsProspective cohort study. All volunteers answered a health questionnaire and HCT was performed, according to the BTS protocol. Oxygen desaturation index (ODI) was assessed using the built‐in software. Intraocular pressure was measured in three timepoints (baseline, hypoxia, post‐hypoxia) using iCare® tonometer. The MOPP was calculated as MOPP = 2/3(mean arterial pressure) − IOP. To guarantee data independence, right and left eyes were compared separately. Statistical analyses were performed using STATA 13.0.ResultsStudied pop...

Research paper thumbnail of Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Associated With Focal Choroidal Excavation

Ophthalmic Surgery, Lasers and Imaging Retina, 2016

The authors report the use of optical coherence tomography angiography (OCTA) (DRI OCT Triton; To... more The authors report the use of optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) to localize, characterize, and confirm the presence of a choroidal neovascular membrane in a patient of focal choroidal excavation (FCE) with recent-onset metamorphopsia and visual blurring. En face OCTA images just above the level of the retinal pigment epithelium-Bruch's membrane complex typically showed the presence of a glomerulus-like neovascular network with an adjacent dark area suggestive of a Type 2 choroidal neovascularization (CNV). OCTA was found to be a very useful, noninvasive, and quick imaging modality to detect secondary CNV formation in a case of FCE. [ Ophthalmic Surg Lasers Imaging Retina . 2016;47:969–971.]

Research paper thumbnail of High‐intensity focused ultrasound cyclocoagulation: a 6‐month study

Acta Ophthalmologica, 2016

PurposeTo evaluate the safety and efficacy of high‐intensity focused ultrasound (HIFU) cyclocoagu... more PurposeTo evaluate the safety and efficacy of high‐intensity focused ultrasound (HIFU) cyclocoagulation in reducing intraocular pressure (IOP) in patients with glaucoma by using a novel miniaturized delivery device (EyeOP1) after 6 months of follow up.MethodsThis was an interventional study of 61 eyes of 61 patients with glaucoma. The first series of 39 patients did not receive Pilocarpine before intervention and the second series of 22 patients received Pilocarpine before intervention. All eyes were treated with 6 activated transducers operating at 21 MHz with a duration of 8 sec. A complete ophthalmic examination was performed before the procedure and at day 1, week 3, month 3 and 6 after the procedure. Primary outcome was to evaluate intraocular pressure (IOP) at 3 and 6 months. Secondary outcomes were to assess intra‐ and postoperative tolerance, visual acuity, medication use, complication rates and re‐interventions.ResultsIOP results of months 3 and 6 will be available at Novem...

Research paper thumbnail of Glaucoma patients have a significant decrease in retrobulbar blood flow velocities during general anesthesia

Acta Ophthalmologica, 2015

Research paper thumbnail of Intra and inter‐rater agreement of anterior lamina cribrosa depth measurements using enhanced‐depth imaging optical coherence tomography

Acta Ophthalmologica, 2015

PurposeTo determine intra and inter‐rater agreement of anterior lamina cribrosa depth (ALCD) manu... more PurposeTo determine intra and inter‐rater agreement of anterior lamina cribrosa depth (ALCD) manual measurements using enhanced depth imaging spectral‐domain optical coherence tomography (EDI‐OCT).MethodsDouble blind prospective observational study between December 14 and May 15. EDI‐OCT of optic nerve head was performed in subjects with an irrelevant ophthalmologic history (2 cross scans: vertical and horizontal). ALCD was defined as the perpendicular distance between the line connecting both edges of Bruch's membrane and the anterior border of the lamina cribrosa, at the maximum depth point. Two double‐blinded experienced operators manually measured ALCD twice, with a one‐month interval. Intra and inter‐rater agreement was evaluated using intraclass correlation coefficients (ICC), concordance correlation coefficients (CCC) and Bland‐Altman (BA) plots for the right eye vertical (RV) and horizontal (RH) scans and left eye vertical (LV) and horizontal (LH) scans. Statistical anal...

Research paper thumbnail of Differences in optical coherence tomography findings in early intervention vs late intervention surgically treated submacular hemorrhages

Acta Ophthalmologica, 2014

ABSTRACT Purpose The purpose of this retrospective observational study is to compare Spectral-Dom... more ABSTRACT Purpose The purpose of this retrospective observational study is to compare Spectral-Domain OCT findings in early-intervention vs late-intervention submacular hemorrages treated surgically with vitrectomy, recombinant tissue Plasminogen Activator (rtPA) subretinal injection and gas injection.Methods Retrospective analysis of pre and post operative OCT findings of 4 patients with submacular hemorrhages treated with 23G vitrectomy, rtPA subretinal injection and gas (SF6, C3F8) injection. 2 patients were treated after 6 and 10 days of diagnosis establishment and the other 2 were treated after 21 and 28 days of diagnosis establishment. Subfoveal thickness was measured in both pre and post operative exams. Analysis of the retinal structure and submacular hemorrhage characteristics were performed.Results The early intervention group presented with higher pre-operative subfoveal thickness (716 and 973 microns compared with 405 and 554 microns). Post operative OCT showed an important decrease in subfoveal thickness in the early intervention group (716 to 260 microns and 973 to 433 microns), not seen in the late intervention group (405 to 593 and 554 to 548 microns). Images analysis shows recent submacular hemorrhages as low density, thick, homogeneous, subretinal tumefactions that do not severely distort retina internal anatomy. Older submacular hemorrhages appear as more dense, thinner, heterogeneous masses, with retinal distortion, cysts formation and separation of the inner and outer layers of the retina.Conclusion OCT is an important exam in the evaluation of submacular hemorrhage, which may differentiate recent and late hemorrhages. Early intervention is crucial for good post operative anatomical result.

Research paper thumbnail of P 104 Pterygium post-operative irradiation results and complications

Vision Research, 1995

Backarcund: Merkel cell carcinoma is a highly malignant cutaneous neoplasm with a high rate of lo... more Backarcund: Merkel cell carcinoma is a highly malignant cutaneous neoplasm with a high rate of local recurrence and systemic metastasis. Ten percent of all Merkel cell carcinomas involve the periocular region. We present three pStiSfltS.

Research paper thumbnail of Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes

Ophthalmology, 2010

Large macular holes usually have an increased risk of surgical failure. Up to 44% of large macula... more Large macular holes usually have an increased risk of surgical failure. Up to 44% of large macular holes remain open after 1 surgery. Another 19% to 39% of macular holes are flat-open after surgery. Flat-open macular holes are associated with limited visual acuity. This article presents a modification of the standard macular hole surgery to improve functional and anatomic outcomes in patients with large macular holes. A prospective, randomized clinical trial. Patients with macular holes larger than 400 μm were included. In group 1, 51 eyes of 40 patients underwent standard 3-port pars plana vitrectomy with air. In group 2, 50 eyes of 46 patients underwent a modification of the standard technique, called the inverted internal limiting membrane (ILM) flap technique. In the inverted ILM flap technique, instead of completely removing the ILM after trypan blue staining, a remnant attached to the margins of the macular hole was left in place. This ILM remnant was then inverted upside-down to cover the macular hole. Fluid-air exchange was then performed. Spectral optical coherence tomography and clinical examination were performed before surgery and postoperatively at 1 week and 1, 3, 6, and 12 months. Visual acuity and postoperative macular hole closure. Preoperative mean visual acuity was 0.12 in group 1 and 0.078 in group 2. Macular hole closure was observed in 88% of patients in group 1 and in 98% of patients in group 2. A flat-hole roof with bare retinal pigment epithelium (flat-open) was observed in 19% of patients in group 1 and 2% of patients in group 2. Mean (or median) postoperative visual acuity 12 months after surgery was 0.17 (range, 0.1-0.6) in group 1 and 0.28 (range, 0.02-0.8) in group 2 (P = 0.001). The inverted ILM flap technique prevents the postoperative flat-open appearance of a macular hole and improves both the functional and anatomic outcomes of vitrectomy for macular holes with a diameter greater than 400 μm. Spectral optical coherence tomography after vitrectomy with the inverted ILM flap technique suggests improved foveal anatomy compared with the standard surgery.

Research paper thumbnail of One-year safety outcomes of intravitreal implant of fluocinolone acetonide 0.19 mg in clinical practice assessed by intraocular pressure measurement

Investigative Ophthalmology & Visual Science, Jun 23, 2017

Research paper thumbnail of Retinopathy of prematurity: contribution of inflammatory and genetic factors

Molecular and Cellular Biochemistry

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder that represents an impor... more Retinopathy of prematurity (ROP) is a retinal vasoproliferative disorder that represents an important cause of childhood visual impairment and blindness. Although oxidative stress has long been implicated in ROP etiology, other prenatal and perinatal factors are also involved. This review focuses on current research involving inflammation and genetic factors in the pathogenesis of ROP. Increasing evidence suggests that perinatal inflammation or infection contributes to ROP pathogenesis. Cytokines and chemokines with a fundamental role in inflammatory responses and that significantly contributing to angiogenesis are analyzed. Microglia cells, the retinal-resident macrophages, are crucial for retinal homeostasis, however, under sustained pathological stimuli release exaggerated amounts of inflammatory mediators and can promote pathological neovascularization. Current modulation of angiogenic cytokines, such as treatment with antibodies to vascular endothelial growth factor (anti-VEGF), has shown efficacy in the treatment of ocular neovascularization; however, some patients are refractory to anti-VEGF agents, suggesting that other angiogenic or anti-angiogenic cytokines need to be identified. Much evidence suggests that genetic factors contribute to the phenotypic variability of ROP. Several studies have implicated the involvement of candidate genes from different signaling pathways in the development of ROP. However, a genetic component with a major impact on ROP has not yet been discovered. Most studies have limitations and did not replicate results. Future research involving bioinformatics, genomics, and proteomics may contribute to finding more genes associated with ROP and may allow discovering better solutions in the management and treatment of ROP.

Research paper thumbnail of Vision‐related quality of life in spondyloarthritis patients with history of acute anterior uveitis under treatment with golimumab: preliminary results of the GO‐VISION observational study

Acta Ophthalmologica, 2022

Research paper thumbnail of Cardiovascular, Ocular And Autonomic Characterization Of The Water Drinking Test In The Anesthetized Rat

Investigative Ophthalmology & Visual Science, 2011

Research paper thumbnail of Effects of Amlodipine in an Experimental Model of Isolated Rabbit Eye

Investigative Ophthalmology & Visual Science, 2007

Research paper thumbnail of O-008. Influence of Hypertension in Pregnancy on Hematological Phenotypes of Preterm Infants with Gestational Age Inferior to 32 Weeks

Pregnancy Hypertension, 2021

Research paper thumbnail of Trabeculectomy with mitomycin C alone or with mitomycin C plus intracameral bevacizumab—A comparative study

Acta Ophthalmologica, 2021

Research paper thumbnail of Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

The Lancet Neurology, 2020

Background Hereditary transthyretin (ATTRv) amyloidosis is a rare, inherited, progressive disease... more Background Hereditary transthyretin (ATTRv) amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We aimed to assess the efficacy and safety of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with ATTRv amyloidosis with polyneuropathy. Methods This multi-country, multi-centre, open-label extension (OLE) trial enrolled patients at 43 sites in 19 countries as of 24 September 2018. Patients were eligible if they had completed the phase 3 APOLLO (randomised, double-blind, placebo-controlled [2:1], 18-month study) or phase 2 OLE (single-arm, 24-month study) parent studies and tolerated the study drug. Eligible patients from APOLLO (APOLLO-patisiran [received patisiran during APOLLO] and APOLLO-placebo [received placebo during APOLLO] groups) and the phase 2 OLE (phase 2 OLE patisiran group) studies enrolled in this Global OLE trial and receive patisiran 0•3 mg/kg by intravenous infusion every 3 weeks for up to 5 years. Efficacy assessments include measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress. Patients included in the current efficacy analyses are those who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received ≥1 dose of patisiran up to the data cutoff. The Global OLE is ongoing with no new enrolment, and current findings are based on the 12-month interim analysis. The study is registered with ClinicalTrials.gov, NCT02510261.

Research paper thumbnail of Spontaneous retrobulbar haemorrhage in idiopathic thrombocytopenic purpura

BMJ case reports, Jan 13, 2017

Research paper thumbnail of Pupilloplasty to prevent dexamethasone intravitreal implant migration to anterior chamber

Research paper thumbnail of Glaucoma assessment tools used by clinicians: old or gold?

Acta Ophthalmologica, 2017

PurposeGlaucoma is the main cause of irreversible blindness worldwide. Early detection and person... more PurposeGlaucoma is the main cause of irreversible blindness worldwide. Early detection and personalized management is the key to prevent or slow disease progression. Our group previously evaluated the quality of within‐hospital referral to a glaucoma subspecialty department (GSD), raising awareness to the importance of doing applanation tonometry (AT), gonioscopy and visual fields (VF) before referral. The aim of this work was to perform an audit cycle, one year after the awareness training session in December 2015.MethodsRetrospective analysis of a random sample of within‐hospital referrals to the GSD, in Lisbon Academic Medical Center (January 2016 to May 2017). Electronic records were screened for clinical data, exams, medical and surgical treatments prior to referral. Descriptive statistics were performed with SPSS.ResultsA total of 150 patients (69 males) were included in this analysis, with a mean age of 65 years [range 10–93]. Mean intraocular pressure (IOP) was 19.8 mmHg. Al...

Research paper thumbnail of Prevalence of silent breast cancer in autopsy specimens, as studied by the disease being held by image-guided biopsies: The pilot study and literature review

Molecular and clinical oncology, 2017

Breast cancer epidemiological patterns vary in European countries, which present different incide... more Breast cancer epidemiological patterns vary in European countries, which present different incidence rates. Data have suggested that the reduction in breast cancer mortality is not only due to the early detection of the disease, but is, in almost equal part, due to screening and to the advances that have been made in molecular medicine and the development of novel therapies. The aim of the present study is to quantify the actual number of cases of breast cancer present in both of the sexes by calculating the prevalence of silent breast cancer in corpses. To achieve this quantification, bilateral subcutaneous radical mastectomies are performed in corpses of either sex above 40 years of age that lacked any clinical manifestation of the disease, and where the breast cancer or its complications was not the cause of death. Only five publications exist in the international literature based on medico-legal autopsies that were designed to define the 'natural reservoir' of the diseas...

Research paper thumbnail of Normobaric hypoxia induces changes in mean ocular perfusion pressure

Acta Ophthalmologica, 2016

PurposeIt is still unclear how a normobaric hypoxic stimulus affects mean ocular perfusion pressu... more PurposeIt is still unclear how a normobaric hypoxic stimulus affects mean ocular perfusion pressure (MOPP) in healthy subjects. The Hypoxia Challenge Test (HCT), performed according to the British Thoracic Society (BTS) protocol, mimics the hypoxia levels in medium/long‐haul flights, in which cabins are pressurized to a value of around 565 mmHg, equivalent to breathing 15.1% oxygen at sea level. We aimed to study the relationship between hypoxia and MOPP.MethodsProspective cohort study. All volunteers answered a health questionnaire and HCT was performed, according to the BTS protocol. Oxygen desaturation index (ODI) was assessed using the built‐in software. Intraocular pressure was measured in three timepoints (baseline, hypoxia, post‐hypoxia) using iCare® tonometer. The MOPP was calculated as MOPP = 2/3(mean arterial pressure) − IOP. To guarantee data independence, right and left eyes were compared separately. Statistical analyses were performed using STATA 13.0.ResultsStudied pop...

Research paper thumbnail of Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Associated With Focal Choroidal Excavation

Ophthalmic Surgery, Lasers and Imaging Retina, 2016

The authors report the use of optical coherence tomography angiography (OCTA) (DRI OCT Triton; To... more The authors report the use of optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) to localize, characterize, and confirm the presence of a choroidal neovascular membrane in a patient of focal choroidal excavation (FCE) with recent-onset metamorphopsia and visual blurring. En face OCTA images just above the level of the retinal pigment epithelium-Bruch's membrane complex typically showed the presence of a glomerulus-like neovascular network with an adjacent dark area suggestive of a Type 2 choroidal neovascularization (CNV). OCTA was found to be a very useful, noninvasive, and quick imaging modality to detect secondary CNV formation in a case of FCE. [ Ophthalmic Surg Lasers Imaging Retina . 2016;47:969–971.]

Research paper thumbnail of High‐intensity focused ultrasound cyclocoagulation: a 6‐month study

Acta Ophthalmologica, 2016

PurposeTo evaluate the safety and efficacy of high‐intensity focused ultrasound (HIFU) cyclocoagu... more PurposeTo evaluate the safety and efficacy of high‐intensity focused ultrasound (HIFU) cyclocoagulation in reducing intraocular pressure (IOP) in patients with glaucoma by using a novel miniaturized delivery device (EyeOP1) after 6 months of follow up.MethodsThis was an interventional study of 61 eyes of 61 patients with glaucoma. The first series of 39 patients did not receive Pilocarpine before intervention and the second series of 22 patients received Pilocarpine before intervention. All eyes were treated with 6 activated transducers operating at 21 MHz with a duration of 8 sec. A complete ophthalmic examination was performed before the procedure and at day 1, week 3, month 3 and 6 after the procedure. Primary outcome was to evaluate intraocular pressure (IOP) at 3 and 6 months. Secondary outcomes were to assess intra‐ and postoperative tolerance, visual acuity, medication use, complication rates and re‐interventions.ResultsIOP results of months 3 and 6 will be available at Novem...

Research paper thumbnail of Glaucoma patients have a significant decrease in retrobulbar blood flow velocities during general anesthesia

Acta Ophthalmologica, 2015

Research paper thumbnail of Intra and inter‐rater agreement of anterior lamina cribrosa depth measurements using enhanced‐depth imaging optical coherence tomography

Acta Ophthalmologica, 2015

PurposeTo determine intra and inter‐rater agreement of anterior lamina cribrosa depth (ALCD) manu... more PurposeTo determine intra and inter‐rater agreement of anterior lamina cribrosa depth (ALCD) manual measurements using enhanced depth imaging spectral‐domain optical coherence tomography (EDI‐OCT).MethodsDouble blind prospective observational study between December 14 and May 15. EDI‐OCT of optic nerve head was performed in subjects with an irrelevant ophthalmologic history (2 cross scans: vertical and horizontal). ALCD was defined as the perpendicular distance between the line connecting both edges of Bruch's membrane and the anterior border of the lamina cribrosa, at the maximum depth point. Two double‐blinded experienced operators manually measured ALCD twice, with a one‐month interval. Intra and inter‐rater agreement was evaluated using intraclass correlation coefficients (ICC), concordance correlation coefficients (CCC) and Bland‐Altman (BA) plots for the right eye vertical (RV) and horizontal (RH) scans and left eye vertical (LV) and horizontal (LH) scans. Statistical anal...

Research paper thumbnail of Differences in optical coherence tomography findings in early intervention vs late intervention surgically treated submacular hemorrhages

Acta Ophthalmologica, 2014

ABSTRACT Purpose The purpose of this retrospective observational study is to compare Spectral-Dom... more ABSTRACT Purpose The purpose of this retrospective observational study is to compare Spectral-Domain OCT findings in early-intervention vs late-intervention submacular hemorrages treated surgically with vitrectomy, recombinant tissue Plasminogen Activator (rtPA) subretinal injection and gas injection.Methods Retrospective analysis of pre and post operative OCT findings of 4 patients with submacular hemorrhages treated with 23G vitrectomy, rtPA subretinal injection and gas (SF6, C3F8) injection. 2 patients were treated after 6 and 10 days of diagnosis establishment and the other 2 were treated after 21 and 28 days of diagnosis establishment. Subfoveal thickness was measured in both pre and post operative exams. Analysis of the retinal structure and submacular hemorrhage characteristics were performed.Results The early intervention group presented with higher pre-operative subfoveal thickness (716 and 973 microns compared with 405 and 554 microns). Post operative OCT showed an important decrease in subfoveal thickness in the early intervention group (716 to 260 microns and 973 to 433 microns), not seen in the late intervention group (405 to 593 and 554 to 548 microns). Images analysis shows recent submacular hemorrhages as low density, thick, homogeneous, subretinal tumefactions that do not severely distort retina internal anatomy. Older submacular hemorrhages appear as more dense, thinner, heterogeneous masses, with retinal distortion, cysts formation and separation of the inner and outer layers of the retina.Conclusion OCT is an important exam in the evaluation of submacular hemorrhage, which may differentiate recent and late hemorrhages. Early intervention is crucial for good post operative anatomical result.

Research paper thumbnail of P 104 Pterygium post-operative irradiation results and complications

Vision Research, 1995

Backarcund: Merkel cell carcinoma is a highly malignant cutaneous neoplasm with a high rate of lo... more Backarcund: Merkel cell carcinoma is a highly malignant cutaneous neoplasm with a high rate of local recurrence and systemic metastasis. Ten percent of all Merkel cell carcinomas involve the periocular region. We present three pStiSfltS.