Person: Méndez Hernández, Carmen Dora
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First Name
Carmen Dora
Last Name
Méndez Hernández
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Inmunología, Oftalmología y ORL
Area
Oftalmología
Identifiers
14 results
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Now showing 1 - 10 of 14
Item Effect of Hypercholesterolemia, Systemic Arterial Hypertension and Diabetes Mellitus on Peripapillary and Macular Vessel Density on Superficial Vascular Plexus in Glaucoma(Journal of Clinical Medicine, 2023) Sanz Gomez, María; Zeng, Ni; Catagna Catagna, Gloria Estefania; Arribas Pardo, Paula; García Feijoo, Julián; Méndez Hernández, Carmen DoraBackground/Aims: Vascular factors are involved in the development of glaucoma, including diseases such as hypercholesterolemia (HC), systemic arterial hypertension (SAH), and diabetes mellitus (DM). The aim of this study was to determine the effect of glaucoma disease on peripapillary vessel density (sPVD) and macular vessel density (sMVD) on the superficial vascular plexus, controlling differences on comorbidities such as SAH, DM and HC between glaucoma patients and normal subjects. Methods: In this prospective, unicenter, observational cross-sectional study, sPVD and sMVD were measured in 155 glaucoma patients and 162 normal subjects. Differences between normal subjects and glaucoma patients’ groups were analyzed. A linear regression model with 95% confidence and 80% statistical power was performed. Results: Parameters with greater effect on sPVD were glaucoma diagnosis, gender, pseudophakia and DM. Glaucoma patients had a sPVD 1.2% lower than healthy subjects (Beta slope 1.228; 95%CI 0.798–1.659, p < 0.0001). Women presented 1.19% more sPVD than men (Beta slope 1.190; 95%CI 0.750–1.631, p < 0.0001), and phakic patients presented 1.7% more sPVD than men (Beta slope 1.795; 95%CI 1.311–2.280, p < 0.0001). Furthermore, DM patients had 0.9% lower sPVD than non-diabetic patients (Beta slope 0.925; 95%CI 0.293–1.558, p = 0.004). SAH and HC did not affect most of the sPVD parameters. Patients with SAH and HC showed 1.5% lower sMVD in the outer circle than subjects without those comorbidities (Beta slope 1.513; 95%CI 0.216–2.858, p = 0.021 and 1.549; 95%CI 0.240–2.858, p = 0.022 respectively. Conclusions: Glaucoma diagnosis, previous cataract surgery, age and gender seem to have greater influence than the presence of SAH, DM and HC on sPVD and sMVD, particularly sPVD.Item Peripapillary Vascular Density in Childhood Glaucoma: A Pilot Comparative Study with Age and Sex Matched Healthy Subjects(Journal of Clinical Medicine, 2023) Xydaki, Flora; Arribas Pardo, Paula; Burgos Blasco, Barbara; García Feijoo, Julián; Méndez Hernández, Carmen DoraPurpose: The aim of this study concerns the evaluation of peripapillary vessel indices in childhood glaucoma (CG) and healthy subjects. Material and Methods: In this prospective, unicenter, observational cross-sectional study, patients with CG and age and sex-matched healthy subjects were included. We compared retinal nerve fiber layer (RNFL) measurements in optical coherence tomography (OCT), peripapillary vessel density (PVD), and the flux index (FI) of the superficial vascular plexus from OCT angiography (OCT-A) between CG patients and control groups. Results: We included 39 patients (68 eyes) with CG and 50 (95 eyes) healthy subjects. The peripapillary RNFL thickness, vessel density, and flux index were significantly lower in the CG group than in the control group. The mean PVD of CG patients was 0.52 ± 0.043%, compared with 0.55 ± 0.014%, p < 0.0001 in healthy subjects. The mean FI was 0.32 ± 0.054 versus 0.37 ± 0.028, p < 0.0001, in CG patients and healthy subjects, respectively. PVD and FI in the superior, inferior, and temporal sectors were significantly lower in CG. The peripapillary RNFL thickness showed a higher area under the ROC curve (AUROC) for discriminating healthy and CG eyes and was significantly different than the PVD (0.797, 95%CI 0.726–0.869; p < 0.0001 vs. 0.664, 95%CI 0.574–0.752; p 0.00037), p 0.012.Conclusions: PVD and FI show lower values in CG and correlate with RNFL thickness measurement but have lower diagnostic ability than RNFL thickness measurement. Our results reveal possible differences in the pathogenesis of microvascular compromise in childhood glaucoma patients.Item Ultrasound biomicroscopy examination of posterior chamber phakic intraocular lens position(Ophthalmology, 2003) García Feijoo, Julián; Jiménez Alfaro, Iñigo; Cuiña Sardiña, Ricardo; Méndez Hernández, Carmen Dora; Benítez Del Castillo Sánchez, José Manuel; García Sánchez, JuliánObjective: To better elucidate the in vivo position of the Collamer posterior chamber phakic intraocular lens (PCPIOL) and its relationship to the iris and the crystalline lens and to analyze possible variations over time. Design: Prospective observational case series. Participants: Eighteen eyes of nine patients were included. Intervention: A Staar Collamer implantable PCPIOL was implanted for the correction of high myopia. Main Outcome Measures: The eyes were studied with a 50-MHz ultrasound biomicroscopy UBM 840. The exact PCPIOL position and the distances between it and the crystalline lens were measured at 3, 6, and 12 months after surgery. Results: There were no intraoperative complications. In 13 eyes (72.22%), contact between the PCPIOL and the crystalline lens was found at some time during follow-up. In 3 eyes (16.6%), central contact could be demonstrated. We also observed that the contact zone and its extension can vary over time. In 2 eyes, rotation of the lens was observed. Conclusions: We found contact between the PCPIOL and the crystalline lens in a high percentage of cases. There was also mobility of the lens in the posterior chamber, especially in the anteroposterior plane, and, as a consequence, both the contact zone and its extension would vary over time. © 2003 by the American Academy of Ophthalmology.Item Effects of corneal thickness on the intraocular penetration of travoprost 0.004%(Eye, 2012) Martínez De La Casa Fernández-Borrella, José María; Rayward, O; Saenz Frances, F; Santos Bueso, Enrique Miguel; Méndez Hernández, Carmen Dora; Herrero Vanrell, María Del Rocío; García Feijoo, Julián; García Sánchez, JuliánPurpose: To determine whether the intraocular penetration of travoprost 0.004% is affected by central corneal thickness. Methods: Sixty-four patients who were scheduled for cataract surgery without any other ophthalmologic pathology of significance were enroled in this study. At 120 min before surgery, one drop of travoprost 0.004% was instilled in the eye to be operated on. At the start of surgery, a sample of aqueous humour was extracted to subsequently determine its AL-5848 concentration. These concentrations were compared among three groups of patients established according to central corneal thickness measurements obtained by ultrasound pachymetry. Results: Mean AL-5848 concentrations were 3.27±2.03 ng/ml in Group I (CCT<511 microns), 3.27±2.44 ng/ml in Group II (CCT≥511 and ≤574 microns), and 2.73±2.15 ng/ml in Group III (CCT>574 microns), indicating no significant differences among the groups. Conclusions: We were unable to demonstrate the greater or lesser penetration of travoprost depending on corneal thickness, which could explain differences in patient responses to this drug. © 2012 Macmillan Publishers Limited All rights reserved.Item Listeria monocytogenes-induced endogenous endophthalmitis: Bioultrasonic findings(American Journal of Ophthalmology, 2004) Méndez Hernández, Carmen Dora; García Feijoo, Julián; García Sánchez, JuliánPurpose To report bioultrasonic findings in Listeria monocytogenes–induced endophthalmitis (LMIE) that have not been described previously. Design Interventional case report. Methods To rule out intraocular tumor, ultrasound biomicroscopy was performed in a patient referred for a 2-day history of uveitis with elevated intraocular pressure, dark hypopyon, and pigment dispersion in the anterior chamber. Results Ultrasound biomicroscopy examination showed increased iris thickness with rarefaction of tissue and irregular echogenicity as well as iris pigment epithelial detachment. A small choroidal detachment was also detected. The anterior chamber and vitreous sample confirmed the LMIE diagnosis. Conclusions The detection of both pigment epithelial detachment and changes in the iris tissue could explain why black hypopyon frequently develops in LMIE with significant pigment dispersion in some cases.Item Comparison of rebound tonometer and goldmann handheld applanation tonometer in congenital glaucoma(Journal of Glaucoma, 2009) Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; Saenz Frances, F.; Vizzeri, G; Fernández Vidal, Ana María; Méndez Hernández, Carmen Dora; García Sánchez, JuliánPURPOSE: To compare intraocular pressure (IOP) measurements obtained using the rebound tonometer (RBT) and the handheld Goldmann applanation tonometer (Perkins) in children with congenital glaucoma. METHODS: Using both tonometers, the IOP was prospectively determined in 68 eyes of 68 patients with congenital glaucoma aged 3 to 13 years. Corneal curvature, central corneal thickness (CCT), and axial length were also measured in each patient. The ease of the use of each tonometer was scored using a visual analog scale. RESULTS: IOP readings obtained using the RBT and Perkins tonometer showed good correlation (r=0.869, P<0.001) although RBT readings were consistently higher (mean difference: 3.1 ±4.0'mm Hg). According to the Bland-Altman plot, the 95% limits of agreement between the 2 methods were -4.8 to 10.9'mm Hg (slope=0.589, P<0.001). When estimating CCT, the 2 tonometers behaved similarly and correlation was observed between IOP measurements and CCT, with higher IOPs obtained as the CCT increased. In contrast, no correlation was detected between corneal curvature or axial length and the IOPs recorded using either tonometer. Ease of use scores awarded by the examiner was higher for the RBT. CONCLUSIONS: The RBT overestimates the IOP compared with the Perkins tonometer in patients with congenital glaucoma. Differences in readings between the 2 tonometers become larger as the CCT increases. © 2009 by Lippincott Williams & Wilkins.Item Measuring hemoglobin levels in the optic nerve head: Comparisons with other structural and functional parameters of glaucoma(Investigative Ophthalmology and Visual Science, 2013) de la Rosa, M.G; Gonzalez Hernandez, M; Sigut, J; Alayon, S; Radcliffe, N; Mendez Hernandez, C; Méndez Hernández, Carmen Dora; García Feijoo, Julián; Fuertes Lazaro, I; Perez Olivan, S; Ferreras, APURPOSE. We evaluated and compared the ability of a new method for measuring hemoglobin (Hb) levels at the optic nerve head (ONH) to that of visual field evaluation, scanning laser ophthalmoscopy (HRT), scanning laser polarimetry (GDx), and optical coherence tomography (OCT) for diagnosing glaucoma. METHODS. Healthy eyes (n = 102) and glaucomatous eyes (n = 101) underwent reliable Oculus Spark perimetry, and imaging with the HRT, GDx, and Cirrus OCT. In addition, ONH color images were acquired with a non-mydriatic fundus camera. The Laguna ONhE program then was used to calculate the Hb amount in each of 24 sectors of the ONH. Sensitivities at 95% fixed specificity, diagnostic agreement, and linear correlations between parameters with the best diagnostic ability were calculated. RESULTS. The glaucoma discriminant function (GDF) of the Laguna program, evaluating Hb in the vertical intermediate sectors and center/periphery Hb amount slope, yielded an 89.1% sensitivity and 95.1% specificity, which was superior or similar to the other tests. The best GDF diagnostic agreement was for the OCT-vertical cup-to-disc (C/D) ratio (kappa = 0.772) and the final phase Spark pattern SD (kappa = 0.672). Hb levels correlated strongly with the Spark mean sensitivity (first phase 0.70, final phase 0.71). Hb also correlated well with the Reinhard OW Burk discriminant function of the HRT (0.56), nerve fiber indicator of GDx (-0.64), and vertical C/D ratio of OCT (0.71). CONCLUSIONS. Hb levels evaluated by color analysis of ONH photographs had high reproducibility, a high sensitivity- specificity balance, and moderate to strong agreement with other structural and functional tests. Copyright 2013 The Association for Research in Vision and Ophthalmology, Inc.Item Circadian IOP-lowering efficacy of travoprost 0.004% ophthalmic solution compared to latanoprost 0.005%(Current Medical Research and Opinion, 2006) García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María; Castillo, A; Méndez Hernández, Carmen Dora; Fernández Vidal, Ana María; García Sánchez, JuliánPurpose: The primary objective of this study was to determine the intraocular pressure- (IOP) lowering efficacy over two consecutive 24-h periods of travoprost 0.004% ophthalmic solution (Travatan†) compared to latanoprost 0.005% (Xalatan‡) dosed once daily in patients with primary open-angle glaucoma or ocular hypertension. Methods: This was a double-masked trial conducted at the Hospital Clinico San Carlos, Madrid, Spain. The primary objective of this study was to determine the IOP lowering efficacy of travoprost and latanoprost. During the eligibility visit, patients' IOP was measured throughout two consecutive 24-h periods every 4 h. Patients were then randomized to travoprost or latanoprost (one drop at 8 p.m. daily for 2 weeks). Sixty-two patients were randomized (travoprost n = 32; latanoprost n = 30). IOP was measured at week 2 every 4 h throughout two 24-h periods. All measurements were taken in both supine and sitting positions with the aid of Perkins applanation tonometry. Limitations of the study include a small sample size (due to the difficulty in recruiting patients in a study of this type) which enrolled only Caucasian patients and a short study duration. However, with 25 subjects per group, there was at least 90% power to detect a mean IOP change from baseline of 2.9 mmHg and 80% power to detect a difference of 2.5 mmHg between treatments. Results: Patients on travoprost therapy showed lower mean IOP levels than those on latanoprost. This difference was statistically significant (p < 0.05) at 12, 16, 20, 24, 36, 40, and 48 h after the last dose for the supine position. The mean IOPs in the supine position throughout the first and the second 24-h period of the week 2 visit as well as for the 48-h visit were statistically lower (p < 0.05) for the travoprost group. Adverse events were mild and included hyperemia and corneal staining. Travoprost and latanoprost were both well tolerated. Conclusion: Mean IOP values were significantly lower for patients on travoprost for the majority of time points in the supine position. © 2006 Librapharm Limited.Item Comparing corneal variables in healthy subjects and patients with primary open-angle glaucoma(Investigative Ophthalmology and Visual Science, 2011) Saenz Frances, F; García Feijoo, Julián; Jáñez Escalada, Luis; Borrego Sanz, L; Martínez De La Casa Fernández-Borrella, José María; Fernández Vidal, Ana María; Méndez Hernández, Carmen Dora; Santos Bueso, Enrique Miguel; Reche-Frutos, J; García Sánchez, JuliánPurpose. This study was designed to identify possible differences between healthy subjects and patients with primary open-angle glaucoma (POAG) in keratometry, central corneal thickness, overall corneal thickness, mean thickness of a circular zone centered at the corneal apex of 1-mm radius (zone I), and mean thickness of several concentric rings also centered at the apex of 1-mm width (zones II to VI, respectively). Methods. These variables were recorded in 126 healthy subjects and 130 patients with POAG. Corneal thicknesses and the power of the flattest and steepest axes were compared between the two populations using a t-test and the position of the flattest axis using a Mann-Whitney U test. A binary logistic regression procedure was used to determine the diagnostic capacity of the corneal variables using the area under the receiver operator characteristic curve (AUC) to select the best regression equation. Results. Significant differences between subjects and patients were detected in mean corneal thickness and in mean thicknesses of zones I to VI. The logistic regression model included as predictors the mean corneal thickness and the mean thicknesses of zones IV and VI; for this model, the AUC was 0.711, sensitivity was 67.7%, and specificity was 65.5%. Conclusions. Healthy subjects and glaucoma patients differ significantly in terms of mean overall corneal thickness and thicknesses of the corneal zones I to VI defined here. The variables mean corneal thickness and mean thicknesses of zones IV and VI are able to discriminate between subjects with or without glaucoma. © 2011 The Association for Research in Vision and Ophthalmology, Inc.Item Ocular response analyzer versus Goldmann applanation tonometry for intraocular pressure measurements(Investigative Ophthalmology and Visual Science, 2006) Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; Fernández Vidal, Ana María; Méndez Hernández, Carmen Dora; García Sánchez, JuliánPURPOSE. To establish correlations between intraocular pressure (IOP) measurements obtained with the ocular response analyzer (ORA) and the Goldmann applanation tonometer (GAT). The effects of central corneal thickness on the measures obtained were also examined. METHODS. This was a cross-sectional study. IOP was determined in 48 eyes of 48 patients with glaucoma In all patients, central corneal thickness (CCT) was measured by ultrasound pachymetry. RESULTS. ORA readings were consistently higher than GAT measurements (Goldmann-correlated IOP -IOP GAT mean difference, 7.2 ± 3.5 mm Hg; corneal-compensated IOP - IOP GAT mean difference, 8.3 ± 4.0 mm Hg) However, differences were not constant and increased with increasing IOP GAT readings, both with respect to Goldmann-correlated IOP (slope = 0.623, P < 0.0001) and corneal-compensated IOP (slope = 0.538, P < 0.0001). Both pressure measurements provided by the ORA showed significant correlation with CCT (CCT versus Goldmann-correlated IOP: r = 0.460, P = 0.001; CCT versus corneal-compensated IOP: r = 0.442, P = 0.001). No significant effects of corneal curvature or refraction on any of the pressures were observed. CONCLUSIONS. The ORA significantly overestimates IOP compared with the GAT. Differences between both sets of measures increase as the GAT-determined IOP increases. ORA readings seem to be affected by central corneal thickness. Copyright © Association for Research in Vision and Ophthalmology.