RESUMEN
OBJECTIVE: To prepare a protocol for the treatment of retinopathy of prematurity (ROP) agreed by the majority of Spanish ophthalmologists dedicated to this topic. MATERIAL AND METHOD: A draft of the protocol was produced taking into account the experience of the participants and up to date publications. This draft was corrected by all the ophthalmologists participating in the project, and the final document was agreed by all of them. RESULTS: We present general guidelines as an aid for the treatment of ROP, including treatment criteria, treatment methods, a calendar of action, and follow-up. CONCLUSIONS: It is important to have a common working protocol for the treatment of ROP to improve care and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.
Asunto(s)
Retinopatía de la Prematuridad/terapia , Protocolos Clínicos , Humanos , Guías de Práctica Clínica como Asunto , EspañaRESUMEN
OBJECTIVE: To prepare a retinopathy of prematurity (ROP) screening program as agreed by most of Spanish ophthalmologists dedicated to this topic. MATERIALS AND METHODS: A draft of the protocol was produced taking into account the experience of the participants and current publications. This draft was corrected by all the ophthalmologists participating in the project and the final document produced was agreed by all of them. RESULTS: We present general guidelines to help in the screening of ROP, including treatment criteria, treatment methods, and a calendar of action. CONCLUSIONS: It is important to have a common working protocol in the screening of ROP to improve the action and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.
Asunto(s)
Tamizaje Neonatal/normas , Retinopatía de la Prematuridad/diagnóstico , Protocolos Clínicos , Humanos , Recién Nacido , Guías de Práctica Clínica como Asunto , EspañaRESUMEN
PURPOSE: The uveal melanoma is the most common primary intraocular tumour in adults. The objective of this work is to show how a computerised database has been formed with specific applications, for clinical and research use, to an extensive group of patients diagnosed with uveal melanoma. METHOD: For the design of the database a selection of categories, attributes and values was created based on the classifications and parameters given by various authors of articles which have had great relevance in the field of uveal melanoma in recent years. RESULTS: The database has over 250 patient entries with specific information on their clinical history, diagnosis, treatment and progress. It enables us to search any parameter of the entry and make quick and simple statistical studies of them. CONCLUSION: The database models have been transformed into a basic tool for clinical practice, as they are an efficient way of storing, compiling and selective searching of information. When creating a database it is very important to define a common strategy and the use of a standard language.
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Bases de Datos Factuales , Melanoma/terapia , Neoplasias de la Úvea , Adulto , Técnicas de Diagnóstico Oftalmológico , Manejo de la Enfermedad , Control de Formularios y Registros , Hospitales Universitarios , Humanos , Sistemas de Registros Médicos Computarizados , Servicio de Oncología en Hospital , Programas Informáticos , España/epidemiología , Interfaz Usuario-Computador , Neoplasias de la Úvea/diagnóstico , Neoplasias de la Úvea/epidemiología , Neoplasias de la Úvea/patología , Neoplasias de la Úvea/terapiaRESUMEN
OBJECTIVE: The aim of this work is to describe the ultrasound features in vasoproliferative tumours of the ocular fundus (VPTOF). METHODS: The medical records corresponding to eight patients were retrospectively studied. Clinical data from the complete ophthalmologic examination and ultrasonographic findings were analysed. RESULTS: Nodular masses affecting either the retina or both the retina and the choroid were found. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In terms of dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 and the height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularity signs were detected. CONCLUSION: According to the results it is suggested that when a differential diagnosis of VPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasound examination should also be done.
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Enfermedades de la Coroides/diagnóstico por imagen , Errores Diagnósticos , Gliosis/diagnóstico por imagen , Neovascularización Patológica/diagnóstico por imagen , Enfermedades de la Retina/diagnóstico por imagen , Adulto , Anciano , Carcinoma/diagnóstico , Carcinoma/secundario , Enfermedades de la Coroides/patología , Neoplasias de la Coroides/diagnóstico , Diagnóstico Diferencial , Oftalmopatías/complicaciones , Femenino , Fondo de Ojo , Gliosis/patología , Hemangioma/diagnóstico , Humanos , Masculino , Melanoma/diagnóstico , Persona de Mediana Edad , Neovascularización Patológica/patología , Oftalmoscopía , Enfermedades de la Retina/patología , Neoplasias de la Retina/diagnóstico , Estudios Retrospectivos , Ultrasonografía , Adulto JovenRESUMEN
Objetivo: Describir las características ecográficas en los tumores vasoproliferativos del fondode ojo (TVPFO).Métodos: Se estudiaron retrospectivamente las historias clínicas correspondientes a8 pacientes afectados de TVPFO. Se analizaron los datos correspondientes a la exploraciónoftalmológica completa y a la exploración ecográfica.Resultados: Se encontraron masas nodulares afectando a la retina o bien a la retina y la coroides.La superficie tumoral era regular en 5 casos e irregular en los 3 restantes. La media de lasdimensiones fue (mm/DE): base mayor, 7,14/2,56; base menor, 6,74/2,48 y altura 2,38/1,26. Laestructura interna fue siempre sólida e irregular y la reflectividad era media-alta en 6 casos.No se detectó ni ángulo kappa ni vascularidad interna en ningún caso.Conclusión: De acuerdo con los resultados obtenidos se propone que tanto el diagnósticocomo el diagnóstico diferencial de los TVPFO deben ser llevados a cabo no solo con laoftalmoscopia sino también con la exploración ecográfica(AU)
Objective: The aim of this work is to describe the ultrasound features in vasoproliferativetumours of the ocular fundus (VPTOF).Methods: The medical records corresponding to eight patients were retrospectively studied.Clinical data from the complete ophthalmologic examination and ultrasonographic findingswere analysed.Results: Nodular masses affecting either the retina or both the retina and the choroid werefound. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In termsof dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 andthe height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularitysigns were detected.Conclusion: According to the results it is suggested that when a differential diagnosis ofVPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasoundexamination should also be done(AU)
Asunto(s)
Humanos , Masculino , Femenino , Fondo de Ojo , Neoplasias del Ojo , Melanoma , Neovascularización Patológica , Estudios RetrospectivosRESUMEN
OBJECTIVE: To ascertain whether insulin-like growth factor 1 (IGF1) is associated with retinopathy of prematurity (ROP) and is a useful predictor of the disease. Although its aetiopathogenesis is multifactorial, development of the disease appears to be related to a deficiency in IGF1, a hormone that acts together with vascular endothelial growth factor in the normal angiogenesis in the retina. DESIGN: Prospective study for a 30-month period. PARTICIPANTS: A total of 74 premature newborn babies, of less than 1500 g and/or 32 weeks' gestational age or less. TESTING: To determine the development and severity of ROP. MAIN OUTCOME MEASURES: Serum levels of IGF1 were measured once a week from birth until 40 weeks corrected gestational age in each subject. RESULTS: Of our subjects, 32.4% developed some form of ROP, and all those ROP patients had the following characteristics at birth (median +/- standard deviation scores): low weight (1098 +/- 188 vs. 1393 +/- 285 g), short length (36.74 +/- 1.77 vs. 38.89 +/- 3.08 cm), small cranial perimeter (26.03 +/- 1.74 vs. 27.93 +/- 1.81 cm) and young gestational age (29.7 +/- 1.78 vs. 31.3 +/- 1.79 weeks) (p < 0.05). Other factors previously associated with ROP that were also observed with statistically significant frequency in our ROP patients were bronchopulmonary dysplasia, intracranial haemorrhage, the need for erythrocyte transfusion or treatment with erythropoietin and sepsis (all p < 0.05). Levels of IGF1 at the 3rd week post-partum, independent of gestational age at birth, were clearly lower in the group who developed ROP (29.13 vs. 43.16 ng/mL, p < 0.05). A value of 30 ng/mL of IGF1 in the third week post-partum was found to have a 90% sensitivity in the diagnosis of ROP. A rapid rise in IGF1 levels between the 3rd and 5th weeks appeared to be related to the development of a higher stage of ROP. CONCLUSION: Determination of IGF1 serum levels in the 3rd week post-partum, independent of gestational age at birth, provides a sufficient and reliable prognostic tool and allows the identification of a group of patients at high risk of developing the disease.