Enrique España-Gregori España - Academia.edu (original) (raw)

Papers by Enrique España-Gregori España

Research paper thumbnail of Zeus, la mirada a través de la cavidad anoftálmica

Archivos de la Sociedad Española de Oftalmología, Apr 1, 2019

discusión se centró en los siguientes subtemas: implantes orbitarios en la cavidad anoftálmica, m... more discusión se centró en los siguientes subtemas: implantes orbitarios en la cavidad anoftálmica, manejo quirúrgico de anoftalmos y criptoftalmos, alternativas a implantes orbitarios. Conclusiones: Los implantes orbitarios que se colocan con mayor frecuencia entre miembros de la SIAO son de acrílico, estos han demostrado buenos resultados a largo plazo, y su principal desventaja es la migración, que, en caso de presentarse, resulta en una rehabilitación secundaria compleja. El injerto dermograso en niños y el lipomicroinjerto en adultos representan también buenas alternativas en el manejo del déficit volumétrico orbitario.

Research paper thumbnail of Does hyaluronidase injected in periocular area change skin ultrastructure?: Standardized in vitro analysis

Journal of Cosmetic Dermatology, May 10, 2022

BackgroundTreatment with hyaluronic acid (HA) fillers as a strategy for rejuvenation has experien... more BackgroundTreatment with hyaluronic acid (HA) fillers as a strategy for rejuvenation has experienced a significant growth in recent years, accompanied by a parallel increase in its complications, the treatment of which, such as hyaluronidase, we must be aware of.Patients/Methods14 patients (28 eyes) had indication for upper blepharoplasty surgery in the Hospital Universitario y Politécnico La Fe. After surgery, periocular skin of one eye of each patient was infiltrated with 300 U of hyaluronidase (14 cases) while the skin of the fellow eye was preserved untreated (14 controls). All samples were studied by the Pathology department, and finally, 6 variables (skin structure alteration, degeneration of elastic fibers, deposits, collagen fibers destructuring, inflammation, and other findings) were analyzed.ResultsNo differences in skin structure, elastic fibers, and collagen dermal fibers were found between hyaluronidase‐treated skin and controls. A significant association between ex vivo application of hyaluronidase in periocular skin and the presence of amorphous extracellular deposits within the dermis was found.ConclusionsHyaluronidase applied ex vivo to periocular skin led to presence of deposits within the extracellular matrix compared to control eyelid skin but elastin and collagen dermis structure remained unaltered.

Research paper thumbnail of Tocilizumab as first treatment option in optic neuropathy secondary to Graves’ orbitopathy

Orbit, Feb 8, 2018

Dysthyroid optic neuropathy (DON) is one of the complications that can affect Graves' orbitopathy... more Dysthyroid optic neuropathy (DON) is one of the complications that can affect Graves' orbitopathy (GO) patients. Its prevalence is estimated at less than 5%. It is usually treated with intravenous steroids, radiotherapy or orbital decompression. Tocilizumab has been proposed as a treatment option in cases of GO refractory to steroid treatment, with good clinical results. Our aim is to report the case of a patient with optic neuropathy secondary to GO treated with tocilizumab as primary treatment option.

Research paper thumbnail of Orbital abscess after peribulbar anesthesia in a frontoethmoidal mucocele

Archivos De La Sociedad Española De Oftalmología (english Edition), Jun 1, 2014

Clinic case: Peribulbar anesthesia is used in daily practice during cataract surgery. It is a saf... more Clinic case: Peribulbar anesthesia is used in daily practice during cataract surgery. It is a safe technique, but not without complications. We present the case of a man who had an orbital abscess secondary to peribulbar anesthesia that led to the perforation of an unknown frontoethmoidal mucocele. Discussion: Orbital abscess secondary to an iatrogenic mucocele perforation after anesthesia is a periorbital complication not described. The detection of the orbital process, intensive medical treatment and monitoring for signs of deterioration are vital in preventing serious complications.

Research paper thumbnail of Dyschromatopsia in multiple sclerosis reflects diffuse chronic neurodegeneration beyond anatomical landmarks

Acta Ophthalmologica, Dec 1, 2022

To formulate and validate a dyschromatopsia linear regression model in patients with multiple scl... more To formulate and validate a dyschromatopsia linear regression model in patients with multiple sclerosis (MS). 64 MS patients (50 to formulate the model and 14 for its validation) underwent neurological (Expanded Disability Status Scale, EDSS), color vision (Farnsworth D15 test), and peripapillary retinal nerve fiber layer (pRNFL) and retinal evaluation with spectral-domain optical coherence tomography (SD-OCT). Neuroradiological examination permitted to obtain brain parenchymal fraction (BPF) and cervical spinal cord volume (SC). Ophthalmic parameters were calculated as the average of both non-optic neuritis (ON) eyes, and in case the patient had previous ON, the value of the fellow non-ON eye was taken. The influence of sex, age, disease duration, and history of disease-modifying treatment (first-or second-line DMT) was tested as covariables that could influence color perception. Color confusion index (log CCI) correlated with pRNFL (r = − 0.322, p = 0.009), ganglion cell layer (GCL, r = − 0.321, p = 0.01), BPF (r = − 0.287, p = 0.021), SC volume (r = − 0.33, p = 0.008), patients' age (r = 0.417, p = 0.001), disease duration (r = 0.371, p = 0.003), and EDSS (r = 0.44, p = 0.001). The following CCI equation was obtained: log (CCI) = 0.316-0.224 BPF − 0.187 SC volume (mm 3) + 0.226 age (years) + 0.012 disease duration (years) − 0.372 GCL (µm). CCI correlates with MS clinical and paraclinical established biomarkers suggesting chronic diffuse neurodegeneration in MS operates at brain, SC, and retina linking all three compartments. Color vision outcome can be calculated through the aforementioned variables for clinical and research purposes.

Research paper thumbnail of Optical Coherence Tomography Characterization of Macular Changes Secondary to Arteriovenous Fistula

Neuro-Ophthalmology, Sep 14, 2017

Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular system... more Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Our purpose is to illustrate different retinal manifestations of AVF. We report the multimodal imaging study of three cases with retinal changes due to AVF, showing neurosensory retinal detachment, macular oedema, and macular ischemia. In conclusion, AVF may appear with different ophthalmic alterations. While usually increased IOP and diplopia are our main concerns, retinal study is mandatory, since a myriad of morphologic abnormalities might be present.

Research paper thumbnail of Functional and biomechanical changes in keratoconic corneas after implantation of intracorneal ring segments 5 and 6mm in diameter

Acta Ophthalmologica, Aug 6, 2012

Purpose To determinate biomechanical and functional changes in human keratoconic corneas after tr... more Purpose To determinate biomechanical and functional changes in human keratoconic corneas after triangular section ring implantation in two designs.

Research paper thumbnail of Periorbital necrotising fasciitis secondary to scratching

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2019

An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral... more An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral itching and pain after an insect bite. Her eyelids had areas of laceration due to scratching, which rapidly progressed to fibrinoid necrosis over the first 24 h. Lesions were cultivated, revealing Streptococcus pyogenes and Staphylococcus aureus. The patient was admitted to hospital with the diagnosis of periorbital necrotising fasciitis, in order to receive treatment with intravenous ceftriaxone, linezolid, and immediate surgical debridement. She remained in hospital for 17 days. Daily wound management consisted of debridement of necrotic remains, disinfection with chlorhexidine, and wound dressing with mupirocin, sulfadiazine, and miconazole ointments. The patient suffered streptococcal toxic shock syndrome, but she recovered over the first week. Palpebral reconstruction was performed on day 15, consisting of a preauricular total thickness skin graft for the superior eyelid, and lateral malar advancement to cover the lower eyelid. Adequate cosmetic and functional results were obtained.

Research paper thumbnail of Fascitis necrosante periorbitaria secundaria a rascado

Archivos de la Sociedad Española de Oftalmología, May 1, 2019

Mujer de 80 años sin antecedentes médicos que consulta por empeoramiento de picor y dolor palpebr... more Mujer de 80 años sin antecedentes médicos que consulta por empeoramiento de picor y dolor palpebral derecho tras la picadura de un insecto. Presenta zonas de laceración por rascado en los párpados, que evolucionan a placas de necrosis fibrinoide durante las primeras 24 horas. Se cultivan las lesiones, demostrando Streptococcus pyogenes y Staphylococcus aureus. Se ingresa a la paciente con diagnóstico de fascitis necrosante periorbitaria para tratamiento intravenoso con ceftriaxona, linezolid y desbridamiento quirúrgico urgente. Permanece ingresada durante 17 días; se le realizan curas diarias consistentes en desbridamiento de restos necróticos, limpieza con clorhexidina y curas con pomadas de mupirocina, sulfadiazina y miconazol. Sufre síndrome de shock tóxico estreptocócico, del que se recupera durante la primera semana de ingreso. A las 2 semanas se le realiza reconstrucción plapebral con autoinjerto de piel de espesor total preauricular en el párpado superior y avance malar lateral en el párpado inferior, con adecuado resultado cosmético y funcional.

Research paper thumbnail of Necrosis retiniana aguda por virus de Epstein-Barr en un niño de cinco años

Revista De Enfermedades Infecciosas En Pediatria, 2004

Research paper thumbnail of Post-LASIK Visual Quality With a Corneoscleral Contact Lens to Treat Irregular Corneas

Eye & Contact Lens: Science & Clinical Practice, 2017

To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric... more To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery. Methods: From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL. Results: Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean6SD, 32.663.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean6SD, 0.1460.03 logMAR and 0.0160.06 logMAR, respectively; P,0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P,0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting. Conclusions: Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.

Research paper thumbnail of C0118: Thrombophilic Mutations in Ocular Behçet’s Disease with Posterior Segment Involvement

Thrombosis Research, 2014

Research paper thumbnail of Pourfour du Petit Syndrome Associated With a Cervical Vertebral Anomaly

Journal of Neuro-Ophthalmology, 2012

Pourfour du Petit syndrome is a rare dysautonomic disorder characterized by mydriasis, eyelid ret... more Pourfour du Petit syndrome is a rare dysautonomic disorder characterized by mydriasis, eyelid retraction, and hyperhidrosis and is caused by irritative stimulation of the sympathetic cervical chain. The authors describe a 45-year-old woman with iris heterochromia, who presented with episodes of ipsilateral mydriasis and hyperhidrosis and was found to have a cervical vertebral anomaly, probably present since birth, as the cause of Pourfour du Petit syndrome.

Research paper thumbnail of Cytomegalovirus Infection of the Caruncle in the Acquired Immunodeficiency Syndrome

American Journal of Ophthalmology, Mar 1, 1994

Research paper thumbnail of High dose intravitreal foscarnet in the treatment of cytomegalovirus retinitis in AIDS

British Journal of Ophthalmology, Feb 1, 1994

The efficacy and tolerance of high dose intravitreal foscarnet for cytomegalovirus retinitis in p... more The efficacy and tolerance of high dose intravitreal foscarnet for cytomegalovirus retinitis in patients with AIDS was studied. Foscarnet in a dose of 2400 [tg was injected directly into

Research paper thumbnail of Necrobiotic xanthogranuloma. Differential diagnosis, treatment and systemic involvement. Case report

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2014

Case report: A 48-year-old male was referred to our hospital for further evaluation of eyelid ede... more Case report: A 48-year-old male was referred to our hospital for further evaluation of eyelid edema with bilateral yellowish ulcerated nodules. Suspecting a xanthogranulomatosis, imaging tests and biopsy were performed with diagnosis of necrobiotic xanthogranuloma. IgG monoclonal gammapathy was diagnosed in a systemic study. Systemic corticosteroids and cyclosporine were initiated unsuccessfully; therefore, intra-lesional injections of triamcinolone were started, which controlled the orbital disease. Discussion: Necrobiotic xanthogranuloma is a rare condition that usually affects the eyelids and anterior orbit. Its diagnosis is important as it is associated with malignant lymphoproliferative processes. Intra-lesional corticosteroids were effective in our patient.

Research paper thumbnail of Orbital alveolar rhabdomyosarcoma masked by ethmoid sinusitis in a 25-year-old

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2014

Case report: A 25-year-old woman with right subacute sinusitis complained about discomfort in her... more Case report: A 25-year-old woman with right subacute sinusitis complained about discomfort in her right eye. Clinical manifestations and computed tomography were suggestive of subperiosteal orbital ethmoid wall abscess, for which the patient underwent urgent drainage. A solid tumor was found, with a positive biopsy for alveolar rhabdomyosarcoma. Complete remission and resolution of orbital symptoms were achieved with chemotherapy and radiation therapy. Discussion: Alveolar orbital rhabdomyosarcoma in adults is uncommon. Rhabdomyosarcoma has a high risk of spreading. It can simulate a sinusitis, as in our patient, early diagnosis and early treatment being especially important in these patients.

Research paper thumbnail of Síndrome de Horner como manifestación de disección carotídea

Archivos de la Sociedad Española de Oftalmología, Nov 1, 2011

Un varón de 42 años se presenta con ptosis y miosis izquierda después de una historia de cefalea ... more Un varón de 42 años se presenta con ptosis y miosis izquierda después de una historia de cefalea homolateral de 20 días de evolución, que empeora progresivamente durante los últimos días. Una angioresonancia revela disección de la arteria carótida interna. Discusión: El «síndrome de Horner doloroso» destaca como una urgencia médica por posible manifestación de una disección carotídea. Consideramos que el perfecto conocimiento de las urgencias neurooftalmológicas es de gran necesidad para el médico oftalmólogo y que estas requieren una atención multidisciplinaria para asegurar un seguimiento y tratamiento adecuado.

Research paper thumbnail of Intravitreal Foscarnet for Cytomegalovirus Retinitis in a Patient With Acquired Immunodeficiency Syndrome

American Journal of Ophthalmology, Dec 1, 1992

Research paper thumbnail of Posterior scleral perforation due to endogenous endophthalmitis in a pregnant with selective IgA deficiency

Romanian Journal of Ophtalmology, Mar 31, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Zeus, la mirada a través de la cavidad anoftálmica

Archivos de la Sociedad Española de Oftalmología, Apr 1, 2019

discusión se centró en los siguientes subtemas: implantes orbitarios en la cavidad anoftálmica, m... more discusión se centró en los siguientes subtemas: implantes orbitarios en la cavidad anoftálmica, manejo quirúrgico de anoftalmos y criptoftalmos, alternativas a implantes orbitarios. Conclusiones: Los implantes orbitarios que se colocan con mayor frecuencia entre miembros de la SIAO son de acrílico, estos han demostrado buenos resultados a largo plazo, y su principal desventaja es la migración, que, en caso de presentarse, resulta en una rehabilitación secundaria compleja. El injerto dermograso en niños y el lipomicroinjerto en adultos representan también buenas alternativas en el manejo del déficit volumétrico orbitario.

Research paper thumbnail of Does hyaluronidase injected in periocular area change skin ultrastructure?: Standardized in vitro analysis

Journal of Cosmetic Dermatology, May 10, 2022

BackgroundTreatment with hyaluronic acid (HA) fillers as a strategy for rejuvenation has experien... more BackgroundTreatment with hyaluronic acid (HA) fillers as a strategy for rejuvenation has experienced a significant growth in recent years, accompanied by a parallel increase in its complications, the treatment of which, such as hyaluronidase, we must be aware of.Patients/Methods14 patients (28 eyes) had indication for upper blepharoplasty surgery in the Hospital Universitario y Politécnico La Fe. After surgery, periocular skin of one eye of each patient was infiltrated with 300 U of hyaluronidase (14 cases) while the skin of the fellow eye was preserved untreated (14 controls). All samples were studied by the Pathology department, and finally, 6 variables (skin structure alteration, degeneration of elastic fibers, deposits, collagen fibers destructuring, inflammation, and other findings) were analyzed.ResultsNo differences in skin structure, elastic fibers, and collagen dermal fibers were found between hyaluronidase‐treated skin and controls. A significant association between ex vivo application of hyaluronidase in periocular skin and the presence of amorphous extracellular deposits within the dermis was found.ConclusionsHyaluronidase applied ex vivo to periocular skin led to presence of deposits within the extracellular matrix compared to control eyelid skin but elastin and collagen dermis structure remained unaltered.

Research paper thumbnail of Tocilizumab as first treatment option in optic neuropathy secondary to Graves’ orbitopathy

Orbit, Feb 8, 2018

Dysthyroid optic neuropathy (DON) is one of the complications that can affect Graves' orbitopathy... more Dysthyroid optic neuropathy (DON) is one of the complications that can affect Graves' orbitopathy (GO) patients. Its prevalence is estimated at less than 5%. It is usually treated with intravenous steroids, radiotherapy or orbital decompression. Tocilizumab has been proposed as a treatment option in cases of GO refractory to steroid treatment, with good clinical results. Our aim is to report the case of a patient with optic neuropathy secondary to GO treated with tocilizumab as primary treatment option.

Research paper thumbnail of Orbital abscess after peribulbar anesthesia in a frontoethmoidal mucocele

Archivos De La Sociedad Española De Oftalmología (english Edition), Jun 1, 2014

Clinic case: Peribulbar anesthesia is used in daily practice during cataract surgery. It is a saf... more Clinic case: Peribulbar anesthesia is used in daily practice during cataract surgery. It is a safe technique, but not without complications. We present the case of a man who had an orbital abscess secondary to peribulbar anesthesia that led to the perforation of an unknown frontoethmoidal mucocele. Discussion: Orbital abscess secondary to an iatrogenic mucocele perforation after anesthesia is a periorbital complication not described. The detection of the orbital process, intensive medical treatment and monitoring for signs of deterioration are vital in preventing serious complications.

Research paper thumbnail of Dyschromatopsia in multiple sclerosis reflects diffuse chronic neurodegeneration beyond anatomical landmarks

Acta Ophthalmologica, Dec 1, 2022

To formulate and validate a dyschromatopsia linear regression model in patients with multiple scl... more To formulate and validate a dyschromatopsia linear regression model in patients with multiple sclerosis (MS). 64 MS patients (50 to formulate the model and 14 for its validation) underwent neurological (Expanded Disability Status Scale, EDSS), color vision (Farnsworth D15 test), and peripapillary retinal nerve fiber layer (pRNFL) and retinal evaluation with spectral-domain optical coherence tomography (SD-OCT). Neuroradiological examination permitted to obtain brain parenchymal fraction (BPF) and cervical spinal cord volume (SC). Ophthalmic parameters were calculated as the average of both non-optic neuritis (ON) eyes, and in case the patient had previous ON, the value of the fellow non-ON eye was taken. The influence of sex, age, disease duration, and history of disease-modifying treatment (first-or second-line DMT) was tested as covariables that could influence color perception. Color confusion index (log CCI) correlated with pRNFL (r = − 0.322, p = 0.009), ganglion cell layer (GCL, r = − 0.321, p = 0.01), BPF (r = − 0.287, p = 0.021), SC volume (r = − 0.33, p = 0.008), patients' age (r = 0.417, p = 0.001), disease duration (r = 0.371, p = 0.003), and EDSS (r = 0.44, p = 0.001). The following CCI equation was obtained: log (CCI) = 0.316-0.224 BPF − 0.187 SC volume (mm 3) + 0.226 age (years) + 0.012 disease duration (years) − 0.372 GCL (µm). CCI correlates with MS clinical and paraclinical established biomarkers suggesting chronic diffuse neurodegeneration in MS operates at brain, SC, and retina linking all three compartments. Color vision outcome can be calculated through the aforementioned variables for clinical and research purposes.

Research paper thumbnail of Optical Coherence Tomography Characterization of Macular Changes Secondary to Arteriovenous Fistula

Neuro-Ophthalmology, Sep 14, 2017

Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular system... more Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Our purpose is to illustrate different retinal manifestations of AVF. We report the multimodal imaging study of three cases with retinal changes due to AVF, showing neurosensory retinal detachment, macular oedema, and macular ischemia. In conclusion, AVF may appear with different ophthalmic alterations. While usually increased IOP and diplopia are our main concerns, retinal study is mandatory, since a myriad of morphologic abnormalities might be present.

Research paper thumbnail of Functional and biomechanical changes in keratoconic corneas after implantation of intracorneal ring segments 5 and 6mm in diameter

Acta Ophthalmologica, Aug 6, 2012

Purpose To determinate biomechanical and functional changes in human keratoconic corneas after tr... more Purpose To determinate biomechanical and functional changes in human keratoconic corneas after triangular section ring implantation in two designs.

Research paper thumbnail of Periorbital necrotising fasciitis secondary to scratching

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2019

An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral... more An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral itching and pain after an insect bite. Her eyelids had areas of laceration due to scratching, which rapidly progressed to fibrinoid necrosis over the first 24 h. Lesions were cultivated, revealing Streptococcus pyogenes and Staphylococcus aureus. The patient was admitted to hospital with the diagnosis of periorbital necrotising fasciitis, in order to receive treatment with intravenous ceftriaxone, linezolid, and immediate surgical debridement. She remained in hospital for 17 days. Daily wound management consisted of debridement of necrotic remains, disinfection with chlorhexidine, and wound dressing with mupirocin, sulfadiazine, and miconazole ointments. The patient suffered streptococcal toxic shock syndrome, but she recovered over the first week. Palpebral reconstruction was performed on day 15, consisting of a preauricular total thickness skin graft for the superior eyelid, and lateral malar advancement to cover the lower eyelid. Adequate cosmetic and functional results were obtained.

Research paper thumbnail of Fascitis necrosante periorbitaria secundaria a rascado

Archivos de la Sociedad Española de Oftalmología, May 1, 2019

Mujer de 80 años sin antecedentes médicos que consulta por empeoramiento de picor y dolor palpebr... more Mujer de 80 años sin antecedentes médicos que consulta por empeoramiento de picor y dolor palpebral derecho tras la picadura de un insecto. Presenta zonas de laceración por rascado en los párpados, que evolucionan a placas de necrosis fibrinoide durante las primeras 24 horas. Se cultivan las lesiones, demostrando Streptococcus pyogenes y Staphylococcus aureus. Se ingresa a la paciente con diagnóstico de fascitis necrosante periorbitaria para tratamiento intravenoso con ceftriaxona, linezolid y desbridamiento quirúrgico urgente. Permanece ingresada durante 17 días; se le realizan curas diarias consistentes en desbridamiento de restos necróticos, limpieza con clorhexidina y curas con pomadas de mupirocina, sulfadiazina y miconazol. Sufre síndrome de shock tóxico estreptocócico, del que se recupera durante la primera semana de ingreso. A las 2 semanas se le realiza reconstrucción plapebral con autoinjerto de piel de espesor total preauricular en el párpado superior y avance malar lateral en el párpado inferior, con adecuado resultado cosmético y funcional.

Research paper thumbnail of Necrosis retiniana aguda por virus de Epstein-Barr en un niño de cinco años

Revista De Enfermedades Infecciosas En Pediatria, 2004

Research paper thumbnail of Post-LASIK Visual Quality With a Corneoscleral Contact Lens to Treat Irregular Corneas

Eye & Contact Lens: Science & Clinical Practice, 2017

To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric... more To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery. Methods: From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL. Results: Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean6SD, 32.663.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean6SD, 0.1460.03 logMAR and 0.0160.06 logMAR, respectively; P,0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P,0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting. Conclusions: Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.

Research paper thumbnail of C0118: Thrombophilic Mutations in Ocular Behçet’s Disease with Posterior Segment Involvement

Thrombosis Research, 2014

Research paper thumbnail of Pourfour du Petit Syndrome Associated With a Cervical Vertebral Anomaly

Journal of Neuro-Ophthalmology, 2012

Pourfour du Petit syndrome is a rare dysautonomic disorder characterized by mydriasis, eyelid ret... more Pourfour du Petit syndrome is a rare dysautonomic disorder characterized by mydriasis, eyelid retraction, and hyperhidrosis and is caused by irritative stimulation of the sympathetic cervical chain. The authors describe a 45-year-old woman with iris heterochromia, who presented with episodes of ipsilateral mydriasis and hyperhidrosis and was found to have a cervical vertebral anomaly, probably present since birth, as the cause of Pourfour du Petit syndrome.

Research paper thumbnail of Cytomegalovirus Infection of the Caruncle in the Acquired Immunodeficiency Syndrome

American Journal of Ophthalmology, Mar 1, 1994

Research paper thumbnail of High dose intravitreal foscarnet in the treatment of cytomegalovirus retinitis in AIDS

British Journal of Ophthalmology, Feb 1, 1994

The efficacy and tolerance of high dose intravitreal foscarnet for cytomegalovirus retinitis in p... more The efficacy and tolerance of high dose intravitreal foscarnet for cytomegalovirus retinitis in patients with AIDS was studied. Foscarnet in a dose of 2400 [tg was injected directly into

Research paper thumbnail of Necrobiotic xanthogranuloma. Differential diagnosis, treatment and systemic involvement. Case report

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2014

Case report: A 48-year-old male was referred to our hospital for further evaluation of eyelid ede... more Case report: A 48-year-old male was referred to our hospital for further evaluation of eyelid edema with bilateral yellowish ulcerated nodules. Suspecting a xanthogranulomatosis, imaging tests and biopsy were performed with diagnosis of necrobiotic xanthogranuloma. IgG monoclonal gammapathy was diagnosed in a systemic study. Systemic corticosteroids and cyclosporine were initiated unsuccessfully; therefore, intra-lesional injections of triamcinolone were started, which controlled the orbital disease. Discussion: Necrobiotic xanthogranuloma is a rare condition that usually affects the eyelids and anterior orbit. Its diagnosis is important as it is associated with malignant lymphoproliferative processes. Intra-lesional corticosteroids were effective in our patient.

Research paper thumbnail of Orbital alveolar rhabdomyosarcoma masked by ethmoid sinusitis in a 25-year-old

Archivos De La Sociedad Española De Oftalmología (english Edition), May 1, 2014

Case report: A 25-year-old woman with right subacute sinusitis complained about discomfort in her... more Case report: A 25-year-old woman with right subacute sinusitis complained about discomfort in her right eye. Clinical manifestations and computed tomography were suggestive of subperiosteal orbital ethmoid wall abscess, for which the patient underwent urgent drainage. A solid tumor was found, with a positive biopsy for alveolar rhabdomyosarcoma. Complete remission and resolution of orbital symptoms were achieved with chemotherapy and radiation therapy. Discussion: Alveolar orbital rhabdomyosarcoma in adults is uncommon. Rhabdomyosarcoma has a high risk of spreading. It can simulate a sinusitis, as in our patient, early diagnosis and early treatment being especially important in these patients.

Research paper thumbnail of Síndrome de Horner como manifestación de disección carotídea

Archivos de la Sociedad Española de Oftalmología, Nov 1, 2011

Un varón de 42 años se presenta con ptosis y miosis izquierda después de una historia de cefalea ... more Un varón de 42 años se presenta con ptosis y miosis izquierda después de una historia de cefalea homolateral de 20 días de evolución, que empeora progresivamente durante los últimos días. Una angioresonancia revela disección de la arteria carótida interna. Discusión: El «síndrome de Horner doloroso» destaca como una urgencia médica por posible manifestación de una disección carotídea. Consideramos que el perfecto conocimiento de las urgencias neurooftalmológicas es de gran necesidad para el médico oftalmólogo y que estas requieren una atención multidisciplinaria para asegurar un seguimiento y tratamiento adecuado.

Research paper thumbnail of Intravitreal Foscarnet for Cytomegalovirus Retinitis in a Patient With Acquired Immunodeficiency Syndrome

American Journal of Ophthalmology, Dec 1, 1992

Research paper thumbnail of Posterior scleral perforation due to endogenous endophthalmitis in a pregnant with selective IgA deficiency

Romanian Journal of Ophtalmology, Mar 31, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.