Changes in the Epidemiology of Diabetic Retinopathy in Spain: A Systematic Review and Meta-Analysis.

Background: The aim of the present study was to determine the prevalence and incidence of diabetic retinopathy (DR) and its changes in the last 20 years in type 2 diabetes mellitus (T2DM) patients in Spain.

Methods: A systematic review with a meta-analysis was carried out on the studies published between 2001-2020 on the prevalence and incidence of DR and sight-threatening diabetic retinopathy (STDR) in Spain. The articles included were selected from four databases and publications of the Spanish Ministry of Health and Regional Health Care System (RHCS).

Randomised controlled trial on vitreoretinal surgery with and without oral anticoagulants: surgical complications, visual results and perioperative thromboembolic events.

Background: Vitreoretinal surgery in anticoagulated patients is a challenging situation for vitreoretinal surgeons, who have to choose between being faced with the systemic thromboembolic risks that the interruption of anticoagulation involves, or the intra- and postoperative haemorrhagic risks associated with maintenance of this therapy. So far, no trial has compared, in a prospective and randomized manner, perioperative complications and the visual results associated with continuation or interruption of oral anticoagulant therapy before pars plana vitrectomy (PPV) under retrobulbar anaesthesia. The main objective of this trial is to compare haemostasis-related perioperative complications of PPV in patients maintaining anticoagulant therapy before surgery compared to patients with an interruption in this therapy before surgery.

Vitrectomy for bilateral macular schisis without apparent optic disc anomalies.

A 78-year-old man complained of bilateral visual acuity loss. Optical coherence tomography examination showed bilateral macular schisis with fluid accumulation in the external retinal layers without vitreous traction. Fundus examination and fluorescein angiography were normal in both eyes.

EVALUATION OF A TELEMEDICINE MODEL TO FOLLOW UP PATIENTS WITH EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

Purpose: To evaluate a telemedicine model to follow up patients with exudative age-related macular degeneration and compare the time spent using this model with the time spent conducting office examinations.

Methods: Results of office and telemedicine evaluations were compared to determine whether patients with exudative age-related macular degeneration previously treated with intravitreal injections needed additional treatment. The office examinations included visual acuity measurement, fundus examination, and optical coherence tomography.

Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy.

Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services.

[Use of ocular drugs in pregnancy].

The information available on the safety of medicines in pregnant women is limited and must be suitably channeled. Medication that is applied topically or as eye drops can present relevant systemic absorption and cross the placenta barrier or enter maternal milk. We have reviewed ophthalmic medicines according to the fetal risk categories proposed by the classification of the Food and Drug Administration (FDA).

Diabetic retinopathy screening by general practitioners using non-mydriatic retinography.

Diabetic retinopathy (DR) is the leading cause of visual loss in people aged 30 to 69 years. Most authorities recommend screening of the ocular fundus to prevent severe visual loss. The increasing incidence of diabetes mellitus and fewer ophthalmologists in many countries is leading to inadequate screening.

[Topical interferon alfa-2b for primary treatment of conjunctiva-cornea intraepithelial neoplasia].

We describe two cases of conjunctival-cornea intraepithelial neoplasia (CIN), treated with topical IFN alfa 2b. The traditional treatment for CIN is surgical excision usually with adjunctive cryotherapy. However, residual tumour may remain, which can lead to recurrence rates of more than 50%.

Diabetic retinopathy screening with non-mydriatic retinography by general practitioners: 2-year results.

Aims: To ascertain in real practice the diagnosis rate of diabetic retinopathy (DR) in patients considered to have positive screening test by general practitioners (GPs) and what are the reasons for the false positive diagnosis.

Methods: Four GPs previously instructed in the interpretation of retinal photographs evaluated the digital retinography images of patients with diabetes obtained during a 2-year period. When the images were considered normal, a new appointment was scheduled for 1 year later and a report was emailed to the referring physician.

Traumatic expulsive iridodialysis with vitreous prolapse.

Traumatic expulsive iridodialysis is a rare complication after trauma by a blunt object in eyes with previous small-incision cataract surgery. The presence of an intact lens capsule with an intraocular lens was thought to protect against damage beyond the posterior capsule. We report a case of dehiscence of the cataract wound and traumatic expulsive iridodialysis that also exhibited vitreous prolapse.

[Bilateral posterior scleritis].

Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women.

[Treatment with photodynamic therapy of circumscribed choroidal hemangioma].

Case Reports: The clinical characteristics of three patients with circumscribed choroidal haemangioma and subfoveal exudation detected by optical coherence tomography are described in this paper. The three patients were successfully treated with photodynamic therapy.

Discussion: Photodynamic therapy is the most adequate therapeutic option for circumscribed choroidal hemangioma associated with subfoveal exudation.

Diabetic retinopathy screening using tele-ophthalmology in a primary care setting.

We evaluated tele-ophthalmology for diabetic retinopathy screening in a primary care setting. Four general practitioners (GPs) were taught to assess non-mydriatic retinography images of patients with diabetes. After training, a total of 1223 patients were screened using this method: 926 (76%) did not have diabetic retinopathy and 297 (24%) were referred for an ophthalmologic assessment.

[eOphthalmology: current state and future tendencies].

eOphthalmology can be defined as the use of information and telecommunications technologies to provide or support a group of activities related to ophthalmic care. The same concept applied to ophthalmic care would be eOphthalmology. This paper describes the current state of eOphthalmology-based models in diabetic retinopathy screening and in the diagnosis and follow-up of chronic glaucoma and age-related macular degeneration.

[Outbreak of toxic anterior segment syndrome after vitreous surgery].

Case Report: An outbreak of Toxic Anterior Segment Syndrome after vitreoretinal surgery is reported. Two patients underwent exclusively vitrectomy while the other three patients were operated of vitrectomy and some other anterior segment procedure.

Discussion: Toxic Anterior Segment Syndrome is a sterile postoperative inflammation due to any non infectious substance that reaches the anterior segment during surgery.

[Agreement between ophthalmologist and nurse in the first postoperative exploration following cataract extraction].

Introduction: Nursing activity in the cataract extraction process extends from carrying out biometry in the preoperative stage and collaboration in surgery, to providing the initial care in the postoperative stage and keeping the patient and family informed throughout the whole process. This article analyses agreement between ophthalmologists and nurses in the findings of the first post-surgical exploration of patients of cataract extraction using facoemulsification and without complications in surgery.

Methods: The study was carried out between May and June of 2005 on 129 patients who had been operated on for cataracts, 78 women and 51 men with an average age of 73.

[Leber's miliary aneurysm].

Case Report: A 45-year-old man was referred to us with a scotoma sensation in his right visual field. Funduscopic examination showed aneurysmal dilatations with lipid exudation in the superior and inferior temporal retinal arcades in his right eye. Angiofluorography showed vascular dilatations and late dye leakage.

[Agreement among ophthalmologists and primary care physicians in the evaluation of retinographies of diabetic patients].

Purpose: To assess the extent of agreement in the evaluation of non-mydriatic retinographies of diabetic patients among ophthalmologists and a group of primary care physicians with previous training.

Methods: The study was divided in two phases. In the first phase, the four participants were instructed in the interpretation of retinographies.

[Coats disease of adult onset].

Case Report: We report a 66-year-old male who exhibited an exudative retinal vasculopathy, diagnosed as Coats disease of adult onset, treated with laser photocoagulation.

Discussion: Most cases of Coats disease are diagnosed in childhood. When this entity appears in adults it usually exhibits a more benign clinical course.

[Hereditary syndrome of hyperferritinemia and cataract].

This report describes a family with hereditary hyperferritinemia cataract syndrome. Inheritance is autosomal dominant and clinical characteristics of this syndrome are familial cataracts of early development and elevated serum ferritin levels but otherwise normal iron studies and haematological parameters. It is important to increase awareness of this entity in order to diagnose new cases and avoid unnecessary diagnostic tests and inadequate treatments.