Archivos de la Sociedad Espanola de Oftalmologia最新文献

{"title":"Simultaneous bilateral NAION following initiation of high-dose semaglutide: a case report","authors":"V.M. Asensio-Sánchez,&nbsp;J. Rodríguez-Espinosa,&nbsp;S. Silva-Schultz,&nbsp;G. González-Fernández,&nbsp;S. Lallana-Serrano","doi":"10.1016/j.oftale.2026.502490","DOIUrl":"10.1016/j.oftale.2026.502490","url":null,"abstract":"<div><div>We report a case of simultaneous bilateral non-arteritic anterior ischemic optic neuropathy (NAION) in a 68-year-old man with poorly controlled type 2 diabetes mellitus and significant hyperopia (+5 diopters). Visual loss began 14 days after initiating semaglutide at a relatively high dose (0.5<!--> <!-->mg/week), progressing to functional blindness within four weeks. Ophthalmologic examination revealed bilateral optic disc edema with hemorrhages, exudates, and subretinal fluid. Infectious and autoimmune causes were ruled out, and cerebrospinal fluid analysis was normal. Following the high dose of semaglutide, glycated hemoglobin decreased, although the magnitude and speed of this decline should be interpreted with caution, and the association between the drug and the optic nerve event must be considered purely temporal, with no evidence of direct causality. Despite drug discontinuation and corticosteroid treatment, visual loss persisted. The simultaneous bilateral presentation, rapid progression, and predisposing anatomical factors—crowded optic discs and possible scleral rigidity—highlight extreme vulnerability. This case illustrates a possible temporal association, representing one of the few such cases reported to date, and underscores the importance of baseline ophthalmic evaluation, close monitoring, and careful consideration of initial dosing in patients treated with GLP-1 receptor agonists.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502490"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluocinolone acetonide implant in non-infectious uveitis: Interpreting long-term outcomes","authors":"A. Maduri,&nbsp;R. Saxena,&nbsp;V. Vadhithala,&nbsp;S. Kumar","doi":"10.1016/j.oftale.2026.502565","DOIUrl":"10.1016/j.oftale.2026.502565","url":null,"abstract":"","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502565"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical outcome and visual recovery after pneumatic retinopexy: Analysis of predictive factors in a cohort including non-standard criteria","authors":"A. Márquez Falcón,&nbsp;L. Cabanes Goy,&nbsp;Y. Ramos Ravelo,&nbsp;G. Castillo Bermúdez","doi":"10.1016/j.oftale.2026.502551","DOIUrl":"10.1016/j.oftale.2026.502551","url":null,"abstract":"<div><h3>Background and objective</h3><div>Pneumatic retinopexy is a treatment for rhegmatogenous retinal detachment with standard selection criteria. There is growing interest in evaluating its outcomes in broader clinical profiles. This study aimed to evaluate anatomical outcomes and visual recovery after pneumatic retinopexy in a cohort including non-standard criteria, and to identify independent predictive factors for anatomical failure and reduced visual recovery.</div></div><div><h3>Materials and methods</h3><div>A prospective cohort study of 92 eyes (92 patients), stratified into standard (<em>n</em> = 57) and non-standard (<em>n</em> = 35) criteria. Over 12 months of follow-up, primary reattachment survival was assessed using Kaplan–Meier curves and predictive factors were analyzed with multivariate regression models.</div></div><div><h3>Results</h3><div>The primary anatomical success rate was 82.5% in the standard criteria group and 85.7% in the non-standard group (<em>P</em> = .777), with a cumulative survival at 12 months &gt;95% in both groups (log-rank, <em>P</em> = .754). Final anatomical success exceeded 97%. Final best-corrected visual acuity improved significantly (<em>P</em> &lt; .001) with no differences between groups (<em>P</em> = .343). Greater detachment extent was an independent predictor of anatomical failure in multivariate model (OR = 3.23 per additional quadrant; <em>P</em> = .044). Longer detachment duration (β = 0.021 logMAR/day; <em>P</em> &lt; .001) and older age (β = 0.006 logMAR/year; <em>P</em> &lt; .001) were independent predictors of reduced visual recovery.</div></div><div><h3>Conclusions</h3><div>Pneumatic retinopexy suggests a high survival rate of primary retinal reattachment and provides significant visual improvement in patients meeting both standard and non-standard criteria. Detachment extent, symptom duration, and age are key independent predictive factors for optimizing candidate selection and anticipating functional outcomes.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502551"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomicroscopic, gonioscopic and tomographic analysis of a Kayser-Fleischer ring: Case report","authors":"V.J. Altares-Mateos,&nbsp;M. Castro Rebollo,&nbsp;J. González Martín-Moro","doi":"10.1016/j.oftale.2026.502535","DOIUrl":"10.1016/j.oftale.2026.502535","url":null,"abstract":"<div><div>The Kayser- Fleischer Ring (KFR) is a characteristic, though not pathognomonic, feature of Wilson’s disease (WD). It arises from copper deposition in Descemet’s membrane and may exhibit a range of hues, including yellow-green, dull red, bright green, or blue. We report the case of a 58-year-old female patient in whom, in addition to copper deposition, optical coherence tomography (OCT) revealed leucomatous alterations in the corneal stroma adjacent to the deposit.</div><div>Early recognition of this clinical sign plays a crucial role in the diagnosis of WD, in which timely identification is essential to reducing morbidity. In this study, we discuss the value of different diagnostic modalities for the detection and monitoring of this clinical sign and propose that copper toxicity may induce irreversible changes in the peripheral corneal stroma.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502535"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White crescent sign in iStent inject® W implantation using the Swan-Jacob gonioscopy lens","authors":"J.E. Muñoz de Escalona Rojas","doi":"10.1016/j.oftale.2026.502533","DOIUrl":"10.1016/j.oftale.2026.502533","url":null,"abstract":"<div><div>To describe the value of the “white crescent sign” as a gonioscopic reference for accurate implantation of the iStent W device. The ab interno surgical technique using the Swan-Jacob direct gonioscopy lens is described. Optical principles of coaxial visualization and the effects of peripheral aberrations and parallax in minimally invasive glaucoma surgery are analyzed. Central and coaxial visualization with the Swan-Jacob lens produces a bright reflection over the trabecular meshwork, termed the “white crescent sign.” This sign confirms appropriate alignment, minimizes distortion, and enables identification of the optimal anatomical implantation zone (the thickest portion of the crescent), thereby reducing parallax error. The white crescent sign is a reliable intraoperative marker that enhances anatomical precision during iStent W implantation and may reduce surgical error.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502533"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of the current state of intravitreal therapy in Spain","authors":"G. Garay-Aramburu,&nbsp;J. Zarranz-Ventura,&nbsp;J.J. Escobar-Barranco,&nbsp;A. García-Layana,&nbsp;E. Rodríguez Neila,&nbsp;J. Donate-López,&nbsp;E. Cervera-Taulet,&nbsp;P. Calvo-Pérez,&nbsp;M. Gómez-Resa,&nbsp;M. López-Gálvez,&nbsp;F. Gómez-Ulla,&nbsp;M.J. Abraldes","doi":"10.1016/j.oftale.2026.502532","DOIUrl":"10.1016/j.oftale.2026.502532","url":null,"abstract":"<div><h3>Background and objective</h3><div>Intravitreal injections are the most frequently performed intraocular procedure in ophthalmology; however, limited data exist regarding their organizational implementation in Spain. This study evaluated the current status of intravitreal therapy in Spanish hospitals and clinics.</div></div><div><h3>Methods</h3><div>A structured national survey comprising 46 questions grouped into nine thematic sections was conducted. The survey was voluntarily distributed using a nonprobability sampling strategy through professional networks across Spain. Duplicate responses were excluded.</div></div><div><h3>Results</h3><div>A total of 172 responses were received, of which 129 unique responses were analyzed. Most centers (89.84%) lacked formal agreements with primary care. However, 64.34% reported having referral protocols from outpatient clinics, and 66% had written protocols for managing macular diseases. Only 39.53% had a dedicated intravitreal therapy unit, whereas an additional 33% reported nursing or administrative coordination specifically assigned to intravitreal therapy. Only 27.81% had an efficient system for reviewing clinical outcomes of intravitreal injections, and 6% used artificial intelligence systems for optical coherence tomography analysis. Patient safety was a shared concern, and most centers reported safety incidents.</div></div><div><h3>Conclusions</h3><div>Intravitreal therapy delivery in Spain demonstrates substantial organizational variability. No relevant differences were observed between public and private sectors. Areas for improvement include coordination with primary care, implementation of standardized protocols, and equitable access to resources.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"101 7","pages":"Article 502532"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral ocular hypertension secondary to frontal mucocele with orbital extension.","authors":"M Moro-Muniz, E Sanz Marco, D Salom Alonso","doi":"10.1016/j.oftale.2026.502597","DOIUrl":"10.1016/j.oftale.2026.502597","url":null,"abstract":"<p><p>We report the case of a 35-year-old man with no relevant past medical history who was referred for intermittent left-sided proptosis, self-limited blurred vision, and unilateral ocular hypertension. Examination showed preserved extraocular motility, mild left proptosis, and intraocular pressure of 19mmHg in the right eye and up to 29mmHg in the left eye, without structural glaucomatous damage on optical coherence tomography. Computed tomography demonstrated a large left frontal mucocele with remodeling and bony dehiscence of the orbital roof, causing extraconal mass effect on the left orbit. Topical hypotensive therapy was initiated, followed by endoscopic sinonasal surgery with left Draf IIb and right Draf I frontal sinusotomy technique. After surgery, proptosis resolved and intraocular pressure decreased to 14mmHg in the left eye. This case highlights frontal mucocele with orbital extension as an uncommon and potentially reversible cause of unilateral ocular hypertension.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":"502597"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the anterior hyaloid using intraoperative optical coherence tomography: a key strategy in complex cataract surgery.","authors":"M Cucurull Martí, M Babinska, L Bisbe López","doi":"10.1016/j.oftale.2026.502595","DOIUrl":"10.1016/j.oftale.2026.502595","url":null,"abstract":"<p><p>Cataract surgery in patients with high myopia and a history of multiple intravitreal injections carries an increased risk of complications. We report the case of a 57-year-old highly myopic patient with a phakic intraocular lens and a history of multiple intravitreal injections who experienced posterior capsular rupture during surgery. The use of intraoperative anterior segment optical coherence tomography enabled confirmation of the integrity of the anterior hyaloid, which proved crucial for adapting surgical maneuvers and avoiding anterior vitrectomy. This case underscores the value of intraoperative optical coherence tomography as a real-time diagnostic tool for tailoring surgical strategy and minimizing risk in complex cases. Its use may be particularly beneficial in highly myopic patients with prior intravitreal treatments, in whom careful assessment of the vitreolenticular interface is essential to maintain posterior segment stability.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":"502595"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal occlusive event in a pediatric patient in the context of dengue infection: Case report.","authors":"N L Oliva Castillo","doi":"10.1016/j.oftale.2026.502593","DOIUrl":"10.1016/j.oftale.2026.502593","url":null,"abstract":"<p><p>We report the case of a 3-year-old pediatric patient with serologically confirmed dengue infection who subsequently developed left exotropia and severe visual impairment. Ophthalmologic examination revealed diffuse retinal and optic disc pallor, alterations of the retinal pigment epithelium, and macular fibrosis. B-mode ultrasonography ruled out intraocular malignancy, and optical coherence tomography demonstrated complete macular atrophy. The clinical findings were consistent with a previous retinal vascular occlusive event. However, the absence of angiographic studies and comprehensive systemic evaluation to exclude other etiologies limits the ability to establish a definitive causal relationship with dengue infection. This case highlights the importance of early ophthalmologic assessment in pediatric patients with recent viral infection and underscores the need for further studies to accurately characterize retinal vascular events.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":"502593"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-flow carotid-cavernous fistula associated with cavernous sinus thrombosis: An ophthalmic presentation.","authors":"M Moro-Muniz, E Sanz Marco, D Salom Alonso","doi":"10.1016/j.oftale.2026.502592","DOIUrl":"10.1016/j.oftale.2026.502592","url":null,"abstract":"<p><p>A 70-year-old woman presented with 20 days of painless left-sided proptosis and ocular discomfort, without infectious symptoms. Examination revealed conjunctival chemosis and hyperemia, painless proptosis, ocular hypertension (intraocular pressure, 35mmHg), and mild limitation of abduction and elevation. Contrast-enhanced computed tomography and venous computed tomography angiography demonstrated left cavernous sinus thrombosis with proptosis and dilation of the superior ophthalmic vein. Dynamic magnetic resonance angiography suggested a low-flow carotid-cavernous fistula with partial cavernous sinus thrombosis and orbital venous hypertension. Orbital ultrasonography showed an arterialized superior ophthalmic vein with reversed flow. Conservative management with topical hypotensive agents and oral acetazolamide resulted in progressive clinical improvement. The 4-month follow-up magnetic resonance imaging demonstrated complete spontaneous resolution of the fistula and orbital venous congestion, with full clinical recovery.</p>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":" ","pages":"502592"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}