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OBJECTIVE: The objective of the study is to compare the optic coherence tomography (OCT) parameters of the healthy and affected sides of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to investigate the relationships between these and the improvement in hearing levels. METHODS: A bilateral eye evaluation of patients diagnosed with ISSNHL was performed with OCT. The ganglion cell complex (GCC) and retina nerve fiber layer (RNFL) thickness values were recorded and the differences between the two eyes were examined. RESULTS: An evaluation was made of 39 patients with a mean age of 44.82 ± 14.90 years. The RNFL thickness of the eyes was determined to be mean 89.87 ± 3.65 µm on the affected side and 103.87 ± 3.98 µm on the healthy control side (p = 0.0001). The mean GCC was determined to be mean 90.46 ± 3.49 µm on the affected side and 103.77 ± 3.96 µm on the healthy control side (p = 0.0001). CONCLUSIONS: A statistically significant difference was observed between the healthy and affected eyes of patients with ISSNHL with respect to mean GCC and mean RNFL thickness. OCT could be a useful technique for measuring this neural degeneration.

OBJETIVO: Comparar e investigar los parámetros de la tomografía de coherencia óptica (OCT) de los lados sanos y afectados de pacientes con pérdida auditiva neurosensorial súbita idiopática (PANSI). MÉTODO: La evaluación ocular bilateral de los pacientes diagnosticados con PANSI se realizó con OCT. Se registraron los valores de espesor del complejo de células ganglionares (CCG) y de la capa de fibras nerviosas de la retina (CFNR), y se examinaron las diferencias entre los dos ojos. RESULTADOS: Se evaluaron 39 pacientes, con una edad media de 44.82 ± 14.90 años. Se determinó que el grosor de la CFNR de los ojos era una media de 89.87 ± 3.65 µm en el lado afectado y 103.87 ± 3.98 µm en el lado de control sano (p = 0.0001). Se determinó que el CCG medio era 90.46 ± 3.49 µm en el lado afectado y 103.77 ± 3.96 µm en el lado de control sano (p = 0.0001). CONCLUSIONES: Se encontró una diferencia estadísticamente significativa entre los ojos sanos y afectados de pacientes con PANSI con respecto al CCG medio y al espesor medio de la CFNR. La OCT podría ser una técnica útil para medir esta degeneración neuronal.

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RESUMEN Se hace una revisión bibliográfica acerca del tratamiento que se utiliza en el edema macular clínicamente significativo. Esta es la primera causa de mala visión en los pacientes con diabetes mellitus. Entre las líneas de tratamiento tenemos los antiangiogénicos con sus variantes, los esteroides y la cirugía por medio de la vitrectomía pars plana con pelado de la membrana limitante interna. No existe hasta el momento el tratamiento ideal. La tomografía de coherencia óptica ayuda a predecir la visión final(AU)

ABSTRACT Treatment of clinically significant diabetic macular edema is the topic of our review. This condition is the first cause of vision loss in diabetic patients. Treatment options include anti-VEFG drugs, steroids and surgery (vitrectomy with internal limiting membrane peeling). There is no an ideal treatment at present. Optic coherence tomography is a useful tool to predict final vision in these patients(AU)

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Abstract Background Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. Objective The aim of this study was to compare the retinal nerve fiber layer thickness (RNFLT) and the ganglion cell layer (GCL) volume in patients with type 1 bipolar disorder (BPD1, diagnosed according to DSM 5) to the values in healthy controls. Methods Eighty consecutive outpatients with a diagnosis of euthymic BPD1 and 80 healthy controls were enrolled in the study. Following assessment with the Sociodemographic Data Form, Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Depression Scale and Young Mania Evaluation Scale, both groups underwent Optical coherence tomography (OCT). Results The mean RNFL thickness and mean GCL volume were significantly lower in the BPD1 group than in the controls (p < 0.05). The GCL global value had a significant and independent effect in distinguishing the BPD1 patients from the controls. A cut-off value of 101 mm3 for global GCL volume was proposed to distinguish BPD1 patients from controls with a sensitivity of 87.5%. Discussion Lower values of GCL volume and RNFLT in patients suffering from BPD1 suggest that neurodegeneration may occur during the course of BPD and that this degeneration can be characterized in particular by a thinning of the GCL volume.

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Introducción: El edema macular es la causa más frecuente de deterioro visual en pacientes con retinopatía diabética no proliferativa, la separación de los fotorreceptores, inducida por permeabilidad vascular anormal, reduce el poder de resolución del ojo y la capacidad visual, lo que lleva al paciente a la baja visión. Objetivo: Caracterizar el comportamiento del edema macular diabético y su clasificación según la tomografía de coherencia óptica. Material y métodos: Se realizó un estudio descriptivo, prospectivo, de corte transversal no controlado, en 40 diabéticos (80 ojos) con diagnóstico clínico de edema macular diabético, quienes acudieron a la consulta de Retina del Hospital Docente Dr. Salvador Allende y el Centro de Atención al Diabético entre enero 2014 y diciembre 2016. La evaluación única fue realizada mediante la biomicroscopía posterior y la tomografía de coherencia óptica (OCT Stratus 3000), basada en la clasificación propuesta por Panozzo y colaboradores. Resultados: Se constataron variaciones del grosor macular por encima de las 250 micras, predominó el engrosamiento cistoide y según la clasificación aplicada y el grado de tracción epirretiniana, se incluyeron más pacientes en los grupos T1 y T2. Finalmente, se clasificó el edema en no traccional (T0 y T1, 69 por ciento) y en traccional (T2yT3, 31 por ciento). Conclusiones: La tomografía de coherencia óptica y la clasificación de Panozzo son de gran utilidad para caracterizar el tipo de edema macular traccional o no traccional y orienta sobre el adecuado tratamiento a seguir en cada paciente. El edema macular diabético no traccional sobresalió en la muestra estudiada(AU)

Introduction: Macular edema is the most frequent cause of visual loss in patients suffering from non-proliferative diabetic retinopathy. In this condition, the detachment of photoreceptors induced by an abnormal vascular permeability reduces the resolving power of the eye and visual capacity, causing low vision in the patient. Objective: To characterize the behavior of diabetic macular edema and its classification according to the main changes in the optical coherence tomography. Material and methods: A descriptive, prospective, cross-sectional and non-controlled study was carried out in 40 diabetic patients, (80 eyes), with the clinical diagnosis of diabetic macular edema in the Department of Retina of Salvador Allende University Hospital and the Diabetes Care Center from January 2014 to December 2016. A single evaluation was carried out with a subsequent biomicroscopy and optical coherence tomography (Stratus OCT; model 3000), based on the classification suggested by Panozzo and collaborators. Results: Variations in retinal volume over 250 microns were found in the tomography. The cystoid thickening predominated; and according to the classification used and the degree of epiretinal traction, more patients were included in T1 and T2 groups. Finally, edema was classified as non-tractional (T0 and T1, 69 percent), and tractional (T2 and T3, 31 percent). Conclusions: Optical coherence tomography and the classification suggested by Panozzo are highly useful to characterize the type of the macular edema into tractional or non-tractional, and allows to follow the adequate treatment in each patient. Non-tractional diabetic macular edema was highly noticeable in the sample studied(AU)

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Objetivo: Realizar una revisión de la literatura sobre angiografía por tomografía de coherencia óptica (OCT-A), sus principales características y potenciales usos como herramienta diagnostica en oftalmología. Diseño del estudio: Revisión de la literatura. Método: Búsqueda de la literatura electrónica en PUBMED, Scopus y Google Scholar. Conclusión: La tomografía de coherencia óptica (OCT) ha revolucionado el manejo tanto de la patología retiniana como el diagnóstico del glaucoma. La angiografía por OCT (OCT-A), es una técnica de no contacto, no invasiva que utiliza múltiples algoritmos para la detección del flujo sanguíneo permitiendo la visualización en alta resolución de imágenes angiográficas volumétricas de la retina. Esta revisión, resalta las características diferenciales existentes entre los distintos métodos de angiografía disponibles en la actualidad y realiza una revisión de la literatura disponible sobre sus aplicaciones como: retinopatía diabética (RD), degeneración macular relacionada con la edad (DMRE), oclusiones vasculares retinianas (OVR) y glaucoma.

Purpose: To perform a review of the available literature on angiography by optical coherence tomography (OCT-A) its main characteristics and potential uses as a diagnostic tool in ophthalmology. Study Design: Literature Review. Method: A literature search was made in PUBMED, Scopus and Google Scholar. Conclusion: Optical coherence tomography (OCT) has transformed the approach to diagnosis and management of retinal pathology and glaucoma. Recently this technology has also been the object of constant improvement, therefore OCT (OCT-A) angiography can now be performed, which is a noninvasive technique that uses multiple algorithms of fl ow detection allowing the visualization of volumetric images of the retina. The differential characteristics existing between the angiographic methods currently available are denoted below. A review of the available literature on the subject and its applications in ophthalmic pathologies of the retina such as: diabetic retinopathy (RD), age-related macular degeneration (AMD), retinal vascular occlusions (OVR), and glaucoma.

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SCA3 presents with a CAG expansion at 14q24.3-q32 while SCA10 shows an ATTCT expansion at 22q13-qter. SCA10 seems to be less aggressive than SCA3. For an in vivo, noninvasive approach of the correlation between central nervous system and clinical evolution, we can use optic coherence tomography (OCT) to measure retinal nerve fiber (RNFL) and ganglion cell layer (GCL) thickness. To describe OCT findings in SCA10, correlate it with expansion size and disease severity and compare with those of SCA3. We analyzed ten individuals with SCA3 and nine with SCA10 recruited from the neurology service of Hospital de Clínicas of Paraná-Brazil. They were submitted to OCT and clinical evaluation using SARA score. Expansion size, demographic data, time from disease onset, and age of onset were collected. We found no correlation between size of expansion, SARA, and RNFL or GCL thickness in SCA10. RNFL seemed to be thicker in SCA10 (p > 0.05). GCL thickness, SARA, median age, and time from disease onset did not differ between groups. SCA10 individuals had an earlier disease onset. In SCA3, there was a negative correlation between SARA and RNFL thickness in nasal area. To the best of our knowledge, this is the first paper assessing retinal changes by OCT in individuals with SCA10. The lack of correlation between disease progression, age, and time since onset supports the anatomopathological findings which suggest SCA10 is less aggressive than other SCAs. The findings in SCA3 are in accordance with the literature.

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Se realizó un estudio descriptivo y transversal de 53 pacientes, atendidos en el Servicio de Oftalmología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde enero hasta diciembre del 2011, con vistas a describir la correlación entre la estructura hística retinal de los afectados y la imagen obtenida por el tomógrafo de coherencia óptica. La información obtenida se procesó mediante el programa estadístico SPSS versión 11.5. Predominaron los pacientes mayores de 70 años; la hipertensión arterial y la diabetes mellitus como antecedentes patológicos personales y no hubo diferencias significativas entre ambos sexos. Los patrones tomográficos más frecuentes encontrados fueron desprendimiento seroso neuroepitelial y edema macular quístico. La comparación y evaluación de las líneas de hiporreflectividad e hiperreflectividad del tomógrafo y las diferentes capas de la arquitectura hística retinal evidenciaron la posibilidad de correlacionar ambas y lograr una comprensión más integral de la afectación macular.

A descriptive and cross-sectional study of 53 patients, assisted in the Ophthalmology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba, was carried out from January to December, 2011, aimed at describing the correlation between the retinal tissular structure of those affected and the image obtained by the optic coherence tomograph. The obtained information was processed by means of the SPSS statistical program version 11.5. The patients older than 70 years; hypertension and diabetes mellitus prevailed as personal pathological history and there were not significant differences between both sexes. The most frequent found tomographic patterns were serum neuroepitelial detachment and cystic macular edema. The comparison and evaluation of the hiporreflectivity and hiperreflectivity lines of the tomograph and the different layers of the retinal tissular architecture evidenced the possibility to correlate both of them and achieve a more comprehensive understanding of the macular damage.

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Background: A 43 year old woman presented with chest pain followed by cardiac arrest recovered after defibrillation. Coronary angiography revealed a narrowed anterior descending coronary artery but no intraluminal thrombi. Optic coherence tomography showed intramural hematoma and the patient was treated medically with aspirin, clopidogrel and atorvastatin. Two weeks later the pain recurred and coronary angiography revealed similar findings. After medical treatment with heparin followed by aspirin and clopidogrel she has remained stable.

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Se realizó una búsqueda de información actualizada relacionada con el uso y los principios de funcionamiento de la tomografía de coherencia óptica del segmento anterior. Se hizo referencia a los distintos tomógrafos que hoy existen en el mundo, enfatizando en el SL-OCT HEIDELBERG ENGINEERING, con la intención de demostrar su importancia y utilidad en el manejo del glaucoma. Se compara con la biomicroscopia ultrasónica en cuanto a las principales ventajas y desventajas de estos equipos

Updated information on the use and the principles of the optic coherence tomography of the anterior segment was searched for. Reference was made to several tomographs used worldwide, making emphasis on the SL-OCT HEIDELBERG ENGINEERING to demonstrate its significance and usefulness in managing glaucoma. This equipment was compared with the ultrasonic biomicroscopy in terms of main advantages and disadvantages

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OBJECTIVE: To assess the visual quality of life in patients with multiple sclerosis (MS), and to observe whether this parameter could be correlated to the findings of the ophthalmologic examination. METHOD: The translated and validated 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was used to assess the visual quality of life. Clinical data on MS, visual acuity, visual fields, optic coherence tomography (OCT) and disc cupping were used for assessing correlation with VFQ-25. RESULTS: The mean VFQ-25 value was 78.6±18.2 percent in 27 patients. VFQ-25 did not correlate with patients' ages, with disability (EDSS), disease duration or medication use. Visual acuity showed a relatively poor (<60 percent) correlation to VFQ-25, while no correlation could be established between visual fields, OCT and disc cupping with VFQ-25. CONCLUSION: MS patients present several alterations in their eyes and sight that cannot be assessed by isolated measures. Ophthalmological examination of these patients must include many parameters not usually used in standard ophthalmologic consultations.

OBJETIVO: Avaliar a qualidade de vida visual de pacientes com esclerose múltipla (EM) e observar se este parâmetro pode ser relacionado aos achados do exame oftalmológico. MÉTODO: O questionário traduzido e validado 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) foi utilizado para avaliar a qualidade de vida visual. Dados clínicos da EM, acuidade visual, campo visual, tomografia de coerência óptica (OCT) e escavação do disco foram utilizados para correlação com VFQ-25. RESULTADOS: A média do VFQ-25 foi 78,6±18,2 por cento em 27 pacientes. VFQ-25 não se correlacionou com a idade dos pacientes, com a incapacidade (EDSS), duração da doença ou medicação em uso. A acuidade visual mostrou uma correlação relativamente pobre (<60 por cento) com VFQ-25, enquanto não foi observada nenhuma correlação entre campo visual, OCT e escavação de disco com VFQ-25. CONCLUSÃO: Pacientes com EM apresentam diversas alterações oculares e na visão que não podem ser avaliadas por medidas isoladas. O exame oftalmológico destes pacientes deve incluir parâmetros que não são habitualmente utilizados em consultas oftalmológicas padronizadas.

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O objetivo desse estudo foi comparar a habilidade da avaliação subjetiva do disco óptico e da camada de fibras nervosas (CFN) por oftalmologistas generalistas e por um glaucomatólogo com medidas objetivas pela tomografia de coerência óptica (Stratus OCT), oftalmoscopia confocal de varredura a laser (HRTIII), e a polarimetria de varredura a laser (GDxECC) para discriminar olhos glaucomatosos de olhos normais. 61 olhos glaucomatosos e 57 olhos normais de 118 indivíduos foram incluídos nesse estudo. Três oftalmologistas generalistas independentes e um glaucomatólogo avaliaram fotografias estereoscópicas do disco óptico. Curvas ROC (Receiver Operator Characteristic) foram construídas para cada técnica de imagem e a sensibilidade a uma especificidade fixa foi determinada. Comparações das áreas sob essas curvas (AROC) e a concordância (k) foram determinadas entre a graduação das fotografias estereoscópicas e o melhor parâmetro de cada exame de imagem computadorizado. O melhor parâmetro de cada técnica de imagem computadorizada (CFN temporal inferior do Stratus OCT = 0,92; área integrada vertical da topografia do disco óptico pelo Stratus OCT = 0,86; espessura macular do setor inferior externo fornecido pelo Stratus OCT = 0,82; NFI do GDxECC = 0,91; razão área E/D do HRT3 = 0,83) mostrou AROC maior do que a graduação das fotografias estereoscópicas por oftalmologistas generalistas (0,80) para separar olhos glaucomatosos de olhos normais. A graduação por glaucomatólogo forneceu AROC igual ou maior (0,92) do que o melhor parâmetro de exame computadorizado de imagem. A avaliação das fotografias estereoscópicas por glaucomatólogo mostrou melhor concordância com o melhor parâmetro de cada técnica de imagem quantitativa na classificação de olhos como glaucomatosos ou normais comparadas à avaliação de fotografias estereoscópicas por oftalmologistas generalistas. A combinação da avaliação subjetiva do disco óptico por oftalmologistas generalistas com parâmetros...

The purpose of this study was to compare the ability of subjective assessment of optic nerve head and retinal nerve fiber layer by general ophthalmologists and by a glaucoma expert with objective measurements by optical coherence tomography (Stratus OCT, Carl Zeiss Meditec, Inc.), confocal scanning laser ophthalmoscope (HRT III; Heidelberg Engineering, Heidelberg, Germany), and scanning laser polarimetry (GDx ECC; Carl Zeiss Meditec, Inc., Dublin, CA) in discriminating glaucomatous and normal eyes. 61 glaucomatous and 57 normal eyes of 118 subjects were included in the study. Three independent general ophthalmologists and one glaucoma expert evaluated ONH stereophotographs. Receiver operating characteristic curves were constructed for each imaging technique and sensitivity at fixed specificity was estimated. Comparisons of areas under these curves (aROC) and agreement (k) were determined between stereophoto grading and best parameter from each technique. Best parameter from each technique showed larger aROC (StratusOCT RNFL = 0.92; StratusOCT ONH vertical integrated area = 0.86; StratusOCT macular thickness = 0.82; GDxECC = 0.91; HRT3 global cup-to-disc area ratio = 0.83) compared to stereophotograph grading by general ophthalmologists (0.80) in separating glaucomatous and normal eyes. Glaucoma expert stereophoto grading provided equal or larger aROC (0.92) than best parameter of each computerized imaging device. Stereophoto evaluated by a glaucoma expert showed better agreement with best parameter of each quantitative imaging technique in classifying eyes either as glaucomatous or normal compared to stereophoto grading by general ophthalmologists. The combination of subjective assessment of the optic disc by general ophthalmologists with RNFL objective parameters improved identification of glaucoma patients in a larger proportion than the combination of these objective parameters with subjective assessment of the optic disc by a glaucoma expert...

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El autor principal hace una exposición sobre los principales métodos imagenológicos en la oftalmología y sus fundamentos, en especial de la tomografía óptica coherente con el equipo Stratus 3000. Con su colectivo de autores presenta una galería de imágenes de la tomografía óptica coherente acompañadas de imágenes de fondo de ojo y los campos visuales, de más de 500 pacientes con diversas enfermedades de retina y nervio óptico, lo que constituye el primer atlas cubano sobre esta entidad.

The main author exposes the main imaging methods used in ophthalmology and their foundations, specially the optic coherence tomography with the Stratus 3000 equipment. Together with the other authors, he presents a gallery of images of the optic coherence tomography accompanied with images of the fundus oculi and the visual fields of more than 500 patients with different diseases of the retina and optic nerve, which constitute the first Cuban athlas on this entity.