Person:
Valverde Megías, Alicia

First Name

Alicia

Last Name

Valverde Megías

URI

https://hdl.handle.net/20.500.14352/79982

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Óptica y Optometría

Department

Optometría y Visión

Area

Optica

Identifiers

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Search Results

Now showing 1 - 8 of 8

Rotation of retinal vascular arcades and comparison with disc-fovea angle in the assessment of cycloposition
(British Journal of Ophthalmology, 2014) Piedrahita Alonso, María Elena; Valverde Megías, Alicia; Gómez De Liaño Sánchez, María Rosario
Background/aims: To assess the agreement between disc-fovea angle (DFA) and the retinal vascular arcades rotation to measure cycloposition. Device repeatability and reproducibility between observers were also evaluated. Methods: Cycloplegic retinography was taken in 321 eyes of 165 normal patients and repeated in 18 eyes at least 24 h later. Two independent observers used software to determine DFA, vein-related angle (VRA) and artery-related angle (ARA) in every retinography. Mean value of related angle (MRA) (mean value of VRA and ARA) was calculated. Results: Camera repeatability was good (Intra-class Correlation Coefficient, ICC 0.89). In Bland-Altman analysis, mean VRA, ARA and MRA were 4° to 5° different from DFA (p<0.01). There was poor correlation between DFA and other methods (ICC): DFA versus VRA 0.3, versus ARA 0.4, versus MRA 0.5. Reliability between observers was good in all methods. The multivariate analysis showed no interaction between each method and eye side, sex or observer (p>0.05). Conclusions: The rotation of retinal vascular arcades using a first-order approximation technique is no substitute to DFA when assessing torsion in fundus photographs. Of the methods tested, MRA correlated most closely, but DFA remains the gold standard for cycloposition. The rotation of vascular arcades provides a qualitative assessment, particularly in uncertain macular location.
Oct parameters as predictive factors for the visual outcome after ranibizumab therapy in neovascular age related macular degeneration
(Archivos de la Sociedad Española de Oftalmología, 2015) Valverde Megías, Alicia; Donate López, J.; García Gil de Bernabé, J.; Megías Fresno, Alicia; García Feijoo, Julián
Objective: To evaluate macular morphological parameters measured by spectral domain optical coherence tomography (SD-OCT) as predictive factors of visual outcome in patients with exudative age-related macular degeneration (AMD) treated with ranibizumab. Methods: A retrospective study was conducted on 47 patients diagnosed with exudative AMD and treated with intravitreal ranibizumab for 12 months. Central retinal thickness (CRT), extension and thickness of modifications secondary to neovascular process, and status of the bands corresponding to the external limiting membrane (ELM) and to the ellipsoid region of the photoreceptors (ISe) were evaluated by means of SD-OCT. The relationship between these variables and visual acuity was analyzed by statistical methods. Results: At the time of the diagnosis, preservation of ELM and ISe bands, and CRT were correlated with initial visual acuity. Twelve months later, CRT and visual acuity were independent parameters. Bivariate relationship analysis showed a correlation between final visual acuity and the following parameters: initial CRT, initial ISe and ELM status, and ISe and ELM integrity after loading dose. Multiple regression analysis indicated that initial visual acuity and ISe band status after loading dose have a predictive value for final visual acuity. Conclusions: The status of ISe and ELM bands after 12 months of treatment with ranibizumab was associated with visual outcome. Initial visual acuity and status of the ISe band after loading dose are prognostic factors of final visual acuity.
Effect of COVID-19 lockdown in Spain on structural and functional outcomes of Neovascular AMD patients
(Journal of Clinical Medicine, 2021) Valverde Megías, Alicia; Rego Lorca, Daniela; Fernández Vigo, José Ignacio; Murciano Cespedosa, Antonio; Megías Fresno, Alicia; García Feijoo, Julián
This is a retrospective single-center study of patients with neovascular age-related macular degeneration whose follow-up was delayed due to COVID-19 pandemic with at least three months between visits in Madrid, Spain. The purpose of the study was to evaluate best corrected visual acuity (BCVA) changes and try to identify features in optical coherence tomography (OCT) that could be related to more profound visual loss. It included 270 eyes. The two last visits before lockdown were used for comparison with the visit after lockdown. BCVA changed from 60.2 ± 18.2 to 55.9 ± 20.5 ETDRS letters. 29% of the eyes lost more than 5 letters. OCT was active in 67% of eyes before lockdown and in 80.4% after lockdown. Multiple lineal analysis showed that patients whose OCT before lockdown presented with a combination of intra and subretinal fluid were more likely to suffer a greater visual loss (p = 0.002). These patients should be encouraged to not miss any visits in case a new lockdown is imposed.
Systemic effects of repeated intraocular dexamethasone Intravitreal implant in diabetic patients: a retrospective study
(Diabetes Therapy, 2017) Valverde Megías, Alicia; Cifuentes Canorea, Pilar; Ruiz Medrano, Jorge; Peña-García, Pablo; Megías Fresno, Alicia; Donate-López, Juan; García Feijoo, Julián
Introduction: The objective of this study is to evaluate the influence of repeated intraocular dexamethasone implant (Ozurdex) injections on metabolic control in type 2 diabetic patients. Methods: Retrospective study of 165 type 2 diabetic patients starting Ozurdex treatment who received no less than three consecutive injections. Glycated hemoglobin (HbA1c), serum creatinine, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TGs) were evaluated during 15 months of follow-up after Ozurdex treatment onset. Results: Fifty-seven patients met inclusion criteria. Mean baseline values for HbA1c, creatinine, total cholesterol, HDL cholesterol, and TGs before treatment (7.1%, 1.3, 176.7, 51.1, and 125.6 mg/ dl, respectively) were similar to mean values after Ozurdex onset (Wilcoxon test p values were 0.68, 0.41, 0.06, 0.87, and 0.33, respectively) and remained stable during the follow-up period. Mean LDL cholesterol levels increased slightly after Ozurdex treatment onset (90.1 vs 88.2 mg/ dl, p = 0.04) but after 15 months of follow-up they had returned to baseline values. Transient increase in LDL cholesterol was remarkable in the group of 24 bilaterally treated patients (96.8 vs 88.4 mg/dl, p = 0.03). A third of these patients increased their baseline LDL values by more than 20%. Even with continuous injections of Ozurdex, LDL cholesterol levels also declined back to baseline by month 15. Conclusion: Ozurdex injections had no influence on HbA1c or renal function. Lipid profile changes were mild and transient. However, a significant temporary increase has been found in LDL cholesterol levels in patients receiving simultaneous bilateral injections. Lipid levels should be monitored in patients starting with bilateral Ozurdex injections especially in those with recent history of acute myocardial infarction.
Degeneración macular exudativa asociada a la edad. Riesgo inducido por facoemulsificación e impacto en los genes e impacto de los genes "CFH" y "ARMS2" sobre la incidencia, desarrrollo y respuesta al tratamiento con ranibizumab intravítreo
(2013) Valverde Megías, Alicia; García Feijoó, Juan; García Gil de Bernabé, Javier; Megías Fresno, Alicia
Long-term effect of intravitreal ranibizumab therapy on retinal nerve fiber layer in eyes with exudative age-related macular degeneration
(Graefe's Archive for Clinical and Experimental Ophthalmology, 2019) Valverde Megías, Alicia; Ruiz Calvo, Aurora; Murciano Cespedosa, Antonio; Hernández Ruiz, Samuel; Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián
Purpose: To investigate long-term effect (96 months) of intravitreal ranibizumab administered for exudative age-related macular degeneration (AMD) on retinal nerve fiber layer (RNFL) thickness when used following a pro re nata regimen. Methods: In this prospective study, 20 eyes of 20 patients diagnosed with exudative AMD were included. Contralateral non-exudative AMD eyes of nine of these patients were included as controls. Data on intraocular pressure (IOP) and number of injections were recorded. Spectralis optic coherence tomography (OCT) of the circumpapillary RNFL was performed under dilation when diagnosis was made and before the three loading injections. “Follow-up” software was selected to accurately compare baseline with subsequent images through the 8 years of the study. Results: Baseline IOP was 14.1 mmHg both in study (standard deviation, SD: 0.8) and control eyes (SD: 0.9) and remained unchanged during the study. Mean number of injections was 21 (SD: 2.8) at the end of the study. Mean average thickness of RNFL in the study eye group at the end of the study was 96.5 μm (SD: 2.1). Mean loss for the study period was 5.3 μm (SD: 0.7; p < 0.0001). Corresponding RNFL values for controls were 92.9 (SD: 3.2) and 5.8 μm (SD: 1.2; p < 0.001). Superior temporal sector had the greatest loss in both groups, followed by inferior and nasal sectors. No statistically significant differences were found when comparing losses in injected eyes versus control eyes. Conclusions: RNFL thickness decreased both equally in injected eyes and control eyes. Thus, no long-term effects of intravitreal ranibizumab were observed on the retinal nerve fiber layer thickness.
Long-Term Consequences of COVID-19 Lockdown in Neovascular AMD Patients in Spain: Structural and Functional Outcomes after 1 Year of Standard Follow-Up and Treatment
(Journal of Clinical Medicine, 2022) Rego Lorca, Daniela; Valverde Megías, Alicia; Fernández Vigo, José; Oribio Quinto, Carlos; Murciano Cespedosa, Antonio; Sánchez Quirós, Julia; Donate López, Juan; García Feijoo, Julián
Consequences of the COVID-19 pandemic on medical care have been extensively analyzed. Specifically, in ophthalmology practice, patients suffering age-related macular degeneration (AMD) represent one of the most affected subgroups. After reporting the acute consequences of treatment suspension in neovascular AMD, we have now evaluated these same 242 patients (270 eyes) to assess if prior functional and anatomical situations can be restored after twelve months of regular follow-up and treatment. We compared data from visits before COVID-19 outbreak and the first visit after lockdown with data obtained in subsequent visits, until one year of follow-up was achieved. For each patient, rate of visual loss per year before COVID-19 pandemic, considered “natural history of treated AMD”, was calculated. This rate of visual loss significantly increased during the lockdown period and now, after twelve months of regular follow-up, is still higher than before COVID outbreak (3.1 vs. 1.6 ETDRS letters/year, p < 0.01). Percentage of OCT images showing active disease is now lower than before the lockdown period (51% vs. 65.3%, p = 0.0017). Although anatomic deterioration, regarding signs of active disease, can be apparently fully restored, our results suggest that functional consequences of temporary anti-VEGF treatment suspension are not entirely reversible after 12 months of treatment, as BCVA remains lower and visual loss rate is still higher than before the COVID-19 pandemic.
Project number: 260
Creación de material audiovisual para el Campus Virtual y plataformas educativas en aras de que los estudiantes de grado, posgrado y profesionales de la visión dominen el análisis ocular con biomicroscopio
(2022) Carballo Álvarez, Jesús; Bella Gala, Rafael; Cuiña Sardiña, Ricardo; Durán Prieto, Elena; Peral Cerda, María Asunción; Valverde Megías, Alicia; Cedrún Sánchez, Juan Enrique
Edición y publicación de videos explicando los fundamentos y técnicas del biomicroscopio ocular con el análisis de la salud superficial del polo anterior ocular y las imágenes biomicroscópicas y fluoroscópicas para la correcta adaptación de lentes de contacto.