Person:
Méndez Hernández, Carmen Dora

First Name

Carmen Dora

Last Name

Méndez Hernández

URI

https://hdl.handle.net/20.500.14352/79612

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Inmunología, Oftalmología y ORL

Area

Oftalmología

Identifiers

Full item page

Search Results

Now showing 1 - 8 of 8

Comparision of intraocular pressure measured using the new icare 200™ rebound tonometer and the Perkins™ applanation tonometer in healthy subjects and in patients with primary congenital glaucoma
(Archivos de la Sociedad Española de Oftalmología (English Edition), 2021) Pérez García, Pilar; Morales Fernández, Laura; Sáenz Francés, Federico; Méndez Hernández, Carmen Dora; García Feijoo, Julián; Santos Bueso, Enrique; Martínez De La Casa Fernández-Borrella, José María
Objective: To compare intraocular pressure (IOP) measurements obtained using the Icare 200™ (IC200) rebound tonometer and the hand-held version of the Goldmann Applanation Tonometer (Perkins™ tonometer, GAT) in patients with primary congenital glaucoma (PCG) and in healthy subjects. Material and methods: A total of 42 eyes of healthy subjects (G1) and 40 patients with PCG (G2) were analysed. The following clinical data were collected: gender, age, Cup/Disc ratio, central corneal thickness (CCT). IOP was determined in the examination room using the IC200 and GAT tonometers, in the same order. Agreement between both tonometers was determined using the intraclass correlation coefficient (ICC) and Bland-Altman plot. A linear regression analysis was used to establish the IOP was affected by the studied variables. Results: Mean IOP between both tonometers (IC200 minus GAT) was: G1 = 15.91 (2.57) mmHg vs. 15.06 (2.12) mmHg (mean difference, MD = 0.84 (0.50) mmHg; P < .101) and G2=20.10 (6.37) vs.19.12 (5.62) (MD = 0.98 (1.36); P = 0.474). Excellent agreement was found between IC200 and GAT in both groups (ICC = G1: 0.875 (95% CI; 0.768−0.933; P < .001); G2: 0.924 (95% CI; 0.852−0.961; P < .001), and there was a statistically significant correlation between the IOP difference measured with IC200 and GAT and CCT in G1 (B=0.021; 95% CI; 0.005–0.037; P = .008), but was not statistically significant in G2. Conclusions: There was excellent agreement between the IC200 and GAT tonometers, both in healthy subjects and PCG, with a trend to overestimate IOP when measured with IC200. There was no influence by CCT on IOP measurements in patients with PGC.
Agreement between rebound (Icare ic200) and applanation tonometry (Perkins) in patients with primary congenital glaucoma
(Acta Ophthalmologica, 2020) Morales Fernández, Laura; Pérez García, Pilar; Sáenz Francés, Federico; Molero Senosiain, Mercedes; García Sáenz, Sofía; Méndez Hernández, Carmen Dora; Santos Bueso, Enrique; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María
Purpose: To examine agreement between intraocular pressure (IOP) measurements made using the rebound tonometer Icare ic200 (RT200) and the Perkins handheld applanation tonometer (PAT) in patients with primary congenital glaucoma (PCG). The impacts of several covariables on measurements using the two devices were also assessed. Materials and Methods: Intraocular pressure measurements were made in a single session in 86 eyes of 86 patients with PCG (46 under anaesthesia, 40 in the office). The order was RT200 then PAT. The variables age, central corneal thickness (CCT), corneal state and anaesthesia were recorded in each patient. Data were compared by determining interclass correlation coefficients (ICC) for each tonometer and representing the differences detected as Bland–Altman plots. Effects of covariables were assessed through univariate and multivariate regression. Results: Mean IOP difference between tonometers (RT200 minus PAT) was 1.26 mmHg (95%: 0.22–2.31). Absolute agreement (ICC) was 0.73 (95% CI: 0.62–0.82). Lower and upper limits of agreement (95%) were −8.06 mmHg (95% CI: −9.87 to −6.25) and 10.59 mmHg (95% CI: 8.77–12.40), respectively. The tonometers showed systematic differences (a = −4.63 mmHg; 95% CI: −9.11 to −1.44) and proportional differences; for each mmHg increase in PAT‐IOP, the RT200 reading increased by 1.28 mmHg (b = 1.28; 95% CI: 1.12–1.53). None of the variables tested as predictors were able to explain differences between the tonometers. Conclusions: Despite the good overall agreement between both tonometers, caution should be taken in high values of IOP, considering the interchangeability of its readings as systematic and proportional differences appear to exist between both methods.
Efficacy and safety of the PreserFlo implant with mitomycin C in childhood glaucoma after previous failed glaucoma surgeries
(Graefe's Archive for Clinical and Experimental Ophthalmology, 2023) Burgos Blasco, Bárbara; García Feijoo, Julián; Ginés Gallego, Cristina; Perucho González, Lucía; Fernández Vigo, José Ignacio; Martínez De La Casa Fernández-Borrella, José María; Sáenz Francés, Federico; Morales Fernández, Laura; Méndez Hernández, Carmen Dora
Purpose: This study aims to evaluate the efficacy and safety of the PreserFlo MicroShunt (Santen, Osaka, Japan) in lowering intraocular pressure (IOP) in childhood glaucoma patients with previous failed glaucoma surgeries. Methods: This is a prospective case review of consecutive PreserFlo procedures performed in childhood glaucoma patients after failed surgeries. Age, sex, diagnosis, and previous glaucoma surgeries, as well as visual acuity, IOP, and treatment in the preoperative visit and all follow-up visits were collected. Outcome measures included IOP reduction from baseline, mean IOP change from baseline at month 6, medication use at 6 months, complications, adverse events, and need for further procedures. Results: Fourteen patients were included, 8 (57%) males and 6 (43%) females; the mean age was 27.5 ± 13.5 years. Nine patients (64%) had at least two trabeculectomies, and 6 patients (43%) had at least one trabeculectomy and a glaucoma drainage implant. The mean IOP change from baseline was 11.3 ± 4.9 mmHg at 12 months. At 12 months, 12 patients (86%) presented ≥ 20% IOP lowering from baseline, and 11 patients (79%) presented ≥ 30%. The mean medication count decreased from 3.9 ± 0.7 (baseline) to 0.7 ± 1.3 (12 months). No intraoperative complications were reported. No adverse events were noted. No secondary filtration surgery was required, although bleb needling was required in one case, 1 month after the surgery. Conclusions: PreserFlo with MMC can be used successfully to treat uncontrolled IOP in childhood glaucoma cases with previous failed surgeries. Larger studies with longer follow-up are needed to further explore the role of the device in resistant childhood glaucoma cases.
Cese paradójico de un caso de síndrome de Charles Bonnet
(Archivos de la Sociedad Española de Oftalmología, 2014) Santos Bueso, Enrique Miguel; Serrador García, Mercedes; Sáenz Francés, Federico; Méndez Hernández, Carmen Dora; Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; García Sánchez, Julián
Caso clínico: paciente varón de 78 años diagnosticado de síndrome de Charles Bonnet (SCB) por déficit visual secundario a glaucoma terminal. Evolucionó a amaurosis, presentando desaparición brusca de las alucinaciones de forma paralela a la pérdida del resto visual. Discusión: el cese paradójico del SCB se produce cuando el paciente pierde el resto visual, evolucionando a amaurosis. La falta de estimulación en la retina y el córtex correspondiente hacen desaparecer las alucinaciones debido a que las neuronas desaferentadas e hiperexcitadas pierden el estímulo que desencadena el SCB.
Clinical outcomes of combined Preserflo Microshunt implantation and cataract surgery in open-angle glaucoma patients
(Scientific reports, 2021) Martínez De La Casa Fernández-Borrella, José María; Sáenz Francés, Federico; Morales Fernández, Laura; Perucho González, Lucía; Méndez Hernández, Carmen Dora; Fernández Vidal, Ana M.; García Sáenz, Sofía; Sánchez Jean, Rubén; García Feijoo, Julián
To assess the effectiveness and safety of the Preserflo Microshunt (PMS) implantation combined with cataract surgery in open-angle glaucoma (OAG) patients. Retrospective, open-label study conducted on insufficiently controlled OAG patients, who underwent a PMS implant procedure with mitomycin-C 0.2%, either alone or in combination with cataract surgery, and were followed for at least 12 months. Success was defined as an intraocular pressure (IOP) ≤ 18 mmHg and a reduction of at least 20% without (complete) or with (qualified) hypotensive medication. Fifty-eight eyes were included in the study, 35 eyes underwent PMS alone and 23 underwent PMS + Phaco. In the overall study sample, mean IOP was significantly lowered from 21.5 ± 3.3 mmHg at baseline to 14.6 ± 3.5 mmHg at month 12 (p < 0.0001). The IOP was significantly reduced in both groups; p < 0.0001 each, respectively. Ocular hypotensive medication was significantly reduced (p < 0.0001) in both groups. No significant differences were observed in IOP lowering or medication reduction between groups. At month 12, 62.1% eyes were considered as complete success and 82.8% eyes as qualified success. The most common adverse events were device close-to-endothelium, conjunctival fibrosis, and wound leakage. PMS, either alone or in combination with phacoemulsification, may be considered as a valuable option for treating OAG patients.
Charles Bonnet syndrome in a child with congenital glaucoma
(Archivos de la Sociedad Española de Oftalmología, 2017) Santos Bueso, Enrique Miguel; Serrador García, Mercedes; Sáenz Francés, Federico; Méndez Hernández, Carmen Dora; Morales Fernández, Laura; Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; Porta-Etessam, Jesús
Case report: The case is presented of a 12 year-old boy with congenital glaucoma and low visual acuity diagnosed with Charles Bonnet syndrome. This consisted of the acute onset of complex, repetitive, persistent, and with visual hallucinations (people, brooms and coffeemakers) of self-limited evolution without treatment. The patient was diagnosed with congenital glaucoma at 3 years of age, and subjected to a trabeculectomy in right eye, and trabeculectomy and keratoplasty in his left eye. Discussion: Charles Bonnet syndrome symptoms have been described in adults, but their presence in children is poorly reflected in literature, with unknown characteristics and prevalence.
Retinal nerve fiber layer thickness in children with primary congenital glaucoma measured by spectral domain optical coherence tomography
(Journal of American Association for Pediatric Ophthalmology and Strabismus, 2019) Perucho González, Lucía; Martínez De La Casa Fernández-Borrella, José María; Sáenz Francés, Federico; Morales Fernández, Laura; Méndez Hernández, Carmen Dora; Sánchez Jean, Rubén; García Feijoo, Julián
Purpose: To evaluate retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in a population of children diagnosed with primary congenital glaucoma (PCG). Methods: In this cross-sectional study, 59 eyes of 59 children diagnosed with PCG and 87 eyes of 87 healthy children were evaluated by SD-OCT to measure the RNFL. The global average peripapillary RNFL thickness and sectional RNFL thickness were evaluated in both groups. Differences in global average and sectional thickness were analyzed. Results: Mean age in the PCG group was 9.61 ± 3.23 years; in the control group, 8.47 ± 2.99 years (P = 0.0516). There were statistically significant differences (P < 0.007) in all sectors between both groups. Conclusions: SD-OCT is a promising tool for evaluating the eyes of children diagnosed with PCG. Future research should examine the test–retest variability of SD-OCT parameters and their ability to diagnose progression in these children.
Structural and biomechanical corneal differences between patients suffering from primary congenital glaucoma and healthy volunteers
(Acta Ophthalmologica, 2017) Perucho González, Lucía; Sáenz Francés, Federico; Morales Fernández, Laura; Martínez De La Casa Fernández-Borrella, José María; Méndez Hernández, Carmen Dora; Santos Bueso, Enrique Miguel; Brookes, John L.; García Feijoo, Julián
Purpose: To determine whether a set of ocular morphometric and biomechanical variables are able to discriminate between healthy volunteers and patients suffering from primary congenital glaucoma (PCG). Methods: Case-control study in which 66 patients with PCG and 94 age-matched healthy subjects were evaluated using ocular response analyser (ORA) to record corneal biomechanical properties. Topographic corneal variables were obtained using the Pentacam in both groups. To determine the ability to discern between both groups, a multivariate binary logistic model was constructed. The outcome was the diagnosis of PCG and the predictors; the corneal variables analysed along with their first-term interactions. Sensitivity and specificity of this model along with the area under the receiver characteristic operating curve (AUC of ROC) were determined. Results: The best model to discriminate between both groups included the following predictors: corneal hysteresis (CH), corneal resistance factor (CRF), posterior maximum elevation (PME), anterior maximum elevation (AME) and central corneal thickness (CCT). This model, for a cut-point of 50%, presents a sensitivity of 86.67%, a specificity of 86.89% and an AUC of the ROC curve of 93.16% [95% confidence interval (CI): 88.97-97.35]. The adjusted odds ratios of those predictors which showed a significant discriminating capacity were as follows: for CH, 0.27 (95% confidence interval: 0.15-0.46); for CRF, 2.13 (95% CI: 1.33-3.40); for PME, 1.06 (95% CI: 1.01-1.12); and for AME, 1.35 (95% CI: 1.10-1.66). Conclusion: Corneal hysteresis (CH), CRF, PME and AME are able to discern between patients with PCG and healthy controls. This fact suggests that there are structural and biomechanical differences between these groups.