Publications by authors named "David Diaz Valle"

The leading cause of blindness due to non-infectious uveitis is cystoid macular edema (CME). Behçet's disease (BD) is one of the most commonly conditions related to CME. To compare the effectiveness and safety of adalimumab (ADA), infliximab (IFX) and certolizumab (CZP) in refractory CME due to BD.

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Objective: To assess keratoconus (KC) progression following the implant of intrastromal corneal ring segments (ICRSs) in young patients.

Materials And Methods: Retrospective, longitudinal, observational, controlled nonrandomized case series study. Keratoconus patients aged 25 years or younger who underwent uneventful ICRS surgery and completed at least 3 years of follow-up were enrolled.

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Compounded insulin eye drops were prepared at 1 IU/mL from commercially available subcutaneous insulin by dilution in saline solution or artificial tears. Physicochemical characterization and in vitro tolerance testing in human and conjunctival cells were followed by a 28-day short-term stability study under various conditions. The formulations were isotonic (280-300 mOsm/L), had a pH close to neutral (7-8), medium surface-tension values (<56 MN/m), and low (≈1 mPa·s) and medium (≈5 mPa·s) viscosities (compounded normal saline solution and artificial tear-based preparation, respectively).

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Introduction: This was a multicenter, prospective, longitudinal, observational study involving eight Spanish tertiary hospitals to determine the interobserver reliability of an uveitis disease activity index, (UVEDAI) and assess its sensitivity to change in patients with receiving pharmacologic treatment.

Methods: Patients aged ≥ 18 years diagnosed with active noninfectious uveitis were included. A complete baseline assessment was performed by two ophthalmologists who determined ocular inflammatory activity using the UVEDAI index independently of each other.

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Purpose: To determine the safety and feasibility of human autologous adipose tissue-derived adult mesenchymal stem cells (ASCs) for ocular surface regeneration in patients with bilateral limbal stem-cell deficiency (LSCD).

Methods: A phase IIa clinical trial was designed (https://Clinicaltrials.gov, NCT01808378) with 8 patients, 3 of whom had aniridia, 2 meibomian glands diseases, 2 multiple surgeries and 1 chronic chemical injury.

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Objective: To develop evidence-based expert-consensus recommendations for the management of non-infectious, non-neoplastic, non-demyelinating disease associated uveitis.

Methods: Clinical research questions relevant to the objective of the document were identified, and reformulated into PICO format (patient, intervention, comparison, outcome) by a panel of experts selected based on their experience in the field. A systematic review of the available evidence was conducted, and evidence was graded according to GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria.

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Objective: To evaluate the efficacy of insulin eye drops for dry eye disease in reducing corneal staining and improving symptoms.

Methods: In this retrospective case series, patients with dry eye disease treated with off-label use of insulin eye drops were collected. The main inclusion criterion was diagnosis of dry eye disease with epithelial damage and acceptance of the off-label use of topical insulin.

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Prcis: Childhood glaucoma produces alterations in the postnatal development and function of various ocular structures, including the cornea. Childhood glaucoma patients present lower corneal transplant survival rates. Our series shows outcomes of corneal transplant in childhood glaucoma with survival rates of 29% at 2 years.

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We report the case of a 14-year-old girl with ocular toxoplasmosis presenting with severe panuveitis with anterior segment involvement, moderate vitreous haze, focal retinochoroiditis, extensive retinal periphlebitis, and macular bacillary layer detachment. Toxoplasmosis treatment was complicated by Stevens-Johnson syndrome, which developed 8 days after starting trimethoprim-sulfamethoxazole.

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Purpose: The aim of this study was to describe a case of spontaneous Descemet layer dissection without pneumodissection in femtosecond laser-assisted mushroom-type deep anterior lamellar keratoplasty.

Methods: This study is a case report.

Results: A 46-year-old woman diagnosed with reticular dystrophy underwent, in her left eye, mushroom configuration femtosecond laser-assisted DALK (F-DALK).

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Introduction: Uveitis is the inflammation of the middle layer of the eye, the uvea, and is a major cause of blindness. None of the instruments used in clinical practice are, in themselves, sufficient to evaluate the course of uveitis. Therefore, it is necessary to develop instruments enabling standardized measurement of inflammatory activity.

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In the COVID-19 period, face masks increased exponentially. Several studies suggest that the rise in ocular discomfort symptoms during the pandemic is mostly part of dry eye disease and that these are due to the effect of face masks, resulting in the newly described term MADE, for "mask-associated dry eye". The most commonly proposed mechanism states that wearing a face mask creates an unnatural upward airflow towards the ocular surface during expiration, although the increased temperature, humidity and levels of carbon dioxide of the exhaled air, stress, increased use of video display terminals, as well as changes in the ocular microbiota may contribute.

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Article Synopsis
  • The study aimed to compare the effectiveness of TNF inhibitors (adalimumab and infliximab) versus tocilizumab in treating refractory cystoid macular edema associated with Behçet’s disease.
  • A multicenter analysis included 49 patients with cystoid macular edema who had already undergone other treatments; they were tracked for changes in macular thickness, visual acuity, and inflammation over four years.
  • Results showed that all treatment options led to improvements in macular thickness and visual acuity, with tocilizumab still being effective for patients who did not respond to TNF inhibitors.
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Introduction: To identify factors affecting the response rate to immunosuppressive drugs (ISDs) in patients with non-infectious uveitis (NIU).

Methods: This longitudinal retrospective cohort study included patients from the Hospital Clinico San Carlos Uveitis Clinic diagnosed with NIU from 1992 to 2016. Subjects were followed up from ISD prescription until the achievement of good therapeutic response (GTR), ISD treatment change, or up to 12 months.

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Purpose: To report the efficacy and safety of 5-fluorouracil as the second line of treatment for two cases of conjunctival intraepithelial neoplasia refractive to topical interferon alpha-2b.

Case Report: In the first case, a 77-year-old woman was evaluated because of a fleshy vascularized lesion in the temporal conjunctiva on her right eye with leukoplakia of the corneal epithelium from 10- to 5-o'clock limbus. In the second case, an 81-year-old man, a nodular lesion in the temporal conjunctiva on his RE, with corneal adjacent opalescence, one millimeter in extent, was observed.

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To report the clinical results on the use of corneas frozen in Eusol-C as tectonic corneal grafts.Retrospective review of medical records of patients who received frozen corneas as emergency tectonic grafts from 2013 to 2020. Corneas had been stored in Eusol-C preservation media at - 78 °C for a mean time of 6.

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Purpose: To assess differences between corneal biomechanical properties in patients with non-infectious uveitis and healthy subjects using CorVis.

Methods: 77 patients with non-infectious uveitis and 47 control subjects were recruited. Biomechanical parameters were measured: deformation amplitude (DA), A-1 length and A-2 length (L1, L2), A-1 velocity and A-2 velocity (V1, V2), peak distance (PD) and HC radius (highest concavity radius).

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Article Synopsis
  • Non-infectious uveitis is a complex condition that can be debilitating, often treated with immunosuppressive drugs, either alone or in combination, though the effectiveness of these strategies has not been directly compared.
  • The CoTHEIA study is a significant research project designed to evaluate the safety, efficacy, and cost-effectiveness of methotrexate, adalimumab, and their combination in treating non-infectious non-anterior uveitis, involving 192 participants over a 52-week period.
  • Ethical approvals are in place for the study, which will also employ machine learning to identify patient subgroups based on treatment response, and there are plans to widely disseminate the findings to various stakeholders.
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Purpose: The purpose of this study was to report the clinical outcomes of postoperative repositioning of 2 inverted Descemet membrane endothelial keratoplasty (DMEK) grafts in 2 patients with endothelial dysfunction.

Methods: Two patients underwent DMEK surgery in a tertiary referral corneal clinic. Initial surgery was performed by 2 different corneal surgeons, and a third surgeon repositioned both cases.

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Microscopic polyangiitis is a rare autoimmune disease of unknown etiology, characterized by inflammation and necrosis of blood vessels. It forms a part of the antineutrophil cytoplasmic antibody-associated vasculitides-a heterogeneous group of disorders characterized by vasculitis. It is a systemic disease affecting multiple organs.

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