Publications by authors named "Lucia Martinez Costa"
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.
View Article and Find Full Text PDFIntroduction: 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.
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.
View Article and Find Full Text PDFArticle 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.
Introduction: Ocular involvement due to varicella-zoster virus (VZV) infection includes conjunctivitis, scleritis, keratitis, uveitis, and necrotizing retinitis. Non-necrotizing chorioretinopathy as a late manifestation has been described.
Case Report: A 50-year-old immunocompetent man developed herpes zoster ophthalmicus (HZO) in the right V1 dermatome with acute anterior uveitis (AAU) treated with oral valaciclovir and topical steroid and a chalazion in the upper eyelid with associated madarosis.
Purpose: To report a case of infectious necrotizing scleritis secondary to Aspergillus terreus after intravitreal injection therapy.
Methods: This is a case report with literature review.
Results: A 98-year-old woman receiving intravitreal aflibercept injections for neovascular age-related macular degeneration in the left eye presented with severe pain, redness, and purulent discharge at the injection site.
Article Synopsis
- - The study investigates clinical and epidemiological features of Vogt-Koyanagi-Harada (VKH) disease in Spain, analyzing data from 112 patients over a minimum of six months.
- - The majority of participants were women (83.9%) with an average age of 37.5 years; the disease was often classified as incomplete acute, with corticosteroids being the most common treatment.
- - Findings indicate that VKH patients generally experience good visual outcomes, though complications like cataracts and ocular hypertension are prevalent.
Article Synopsis
- Anti-IL6R tocilizumab (TCZ) therapy shows promise for treating severe ocular and neurological symptoms in Behçet's disease (BD), but its effectiveness for other manifestations is uncertain.
- A study involved 16 patients, primarily with ocular and neurological issues, who were previously unresponsive to standard treatments, and they experienced significant improvement in their symptoms after TCZ therapy.
- While TCZ proved effective in addressing neurological and ocular domains, it was less successful for oral/genital ulcers and skin lesions, suggesting a selective efficacy depending on the specific manifestations of BD.
Purpose: To describe a case of inflammatory chorioretinopathy and Adie's syndrome possibly associated with COVID-19.
Methods: Observational case report.
Results: A 51-year-old woman developed fever, cough, and headache followed by retro-ocular pain and reading impairment.
: To assess the efficacy and safety of adalimumab in elderly patients with noninfectious uveitis (NIU).: An observational, retrospective, multicenter study was done. Changes in best-corrected visual acuity (BCVA), inflammatory activity parameters, central retinal thickness (CRT), and the occurrence of adverse events (AE) developed during follow-up were recorded.
View Article and Find Full Text PDFPurpose: We assessed the efficacy and safety of biologic therapy in severe and refractory Peripheral Ulcerative Keratitis (PUK).
Design: Open-label multicenter study of biologic-treated patients with severe PUK refractory to conventional immunosuppressive drugs.
Subjects: We studied 34 patients (44 affected eyes) (24 women/10 men; mean age, 55.
Purpose: To report a case of primary choroidal lymphoma that was confirmed by polymerase chain reaction-based clonality testing.
Case Report: A 50-year-old woman presented with unilateral progressive vision loss. Fundus examination and B-ultrasonography demonstrated diffuse choroidal thickening without vitritis.
Objective: To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD).
Methods: We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement.
Purpose: Cystoid macular edema (CME) is a leading cause of blindness. This study assessed the efficacy and safety of tocilizumab (TCZ) in refractory CME.
Design: Retrospective case series.
Purpose: To assess efficacy, safety, and cost-effectiveness of adalimumab (ADA) therapy optimization in a large series of patients with uveitis due to Behçet disease (BD) who achieved remission after the use of this biologic agent.
Design: Open-label multicenter study of ADA-treated patients with BD uveitis refractory to conventional immunosuppressants.
Subjects: Sixty-five of 74 patients with uveitis due to BD, who achieved remission after a median ADA duration of 6 (range, 3-12) months.
Objective: To assess the efficacy of tocilizumab (TCZ) in refractory uveitis of Behçet's disease (BD).
Methods: Multicentre study of patients with BD-associated uveitis. Patients were refractory to conventional and biologic immunosuppressive drugs.
Article Synopsis
- The early development of lens opacities and lens subluxation significantly contribute to vision loss in patients with anterior megalophthalmos (AM), making cataract surgery more complex due to anatomical challenges.
- Postoperative complications commonly include intraocular lens dislocation, and patients with AM are also prone to a specific vitreoretinopathy that increases the risk of retinal detachment.
- The case study discusses a 36-year-old man with bilateral AM, previously misdiagnosed, who experienced vision loss due to lens subluxation and required both lens removal and vitrectomy to prevent retinal detachment, followed by implantation of an iris-claw lens.
To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct "uveitis inflammatory activity" was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea.
View Article and Find Full Text PDFThe effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behçet's disease: results of a multicentre open-label study.
Clin Exp Rheumatol
February 2017
Objectives: To assess the efficacy of other biologic therapies, different from infliximab (IFX) and adalimumab (ADA), in patients with Behçet's disease uveitis (BU).
Methods: Multicenter study of 124 patients with BU refractory to at least one standard immunosuppressive agent that required IFX or ADA therapy. Patients who had to be switched to another biologic agent due to inefficacy or intolerance to IFX or ADA or patient's decision were assessed.
Introduction: Anterior uveitis is the most common type of intraocular inflammation. Those associated to HLA-B27 represent 18 to 32% of all anterior uveitis cases.
Objectives: To describe clinical characteristics, systemic treatment need, and frequency and type of ocular complications in a cohort of patients diagnosed with HLAB27-related anterior uveitis and in a cohort of patients diagnosed with HLA-B27 non-related anterior uveitis.
Central serous chorioretinopathy and systemic corticosteroids in rheumatic diseases: report of three cases.
BMC Musculoskelet Disord
December 2015
Background: Central serous chorioretinopathy is a disorder often related to systemic corticosteroids, drugs commonly used in rheumatologists' clinical practice. Central serous chorioretinopathy prognosis is generally good but in some cases, it may lead to substantial loss of vision resulting in an important functional limitation for patients. It is very important to distinguish this pathology from other diseases involving retinal detachment.
View Article and Find Full Text PDFObjectives: To evaluate the clinical response to Tocilizumab (TCZ) in three patients with non-infectious uveitis refractory to anti-TNF-α drugs.
Methods: Assessment of TCZ-treated patients with immune-mediated uveitis from two Spanish medical referral centers. Uveitis had been refractory to previous standard synthetic immunosuppressive drugs and at least one TNF-α inhibitor.
Objective: The aim of this study was to assess the efficacy of anti-TNF-α therapy in refractory uveitis due to Behçet's disease (BD).
Methods: We performed a multicentre study of 124 patients with BD uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. Patients were treated for at least 12 months with infliximab (IFX) (3-5 mg/kg at 0, 2 and 6 weeks and then every 4-8 weeks) or adalimumab (ADA) (usually 40 mg every 2 weeks).