Person:
García Feijoo, Julián

First Name

Julián

Last Name

García Feijoo

URI

https://hdl.handle.net/20.500.14352/79607

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Inmunología, Oftalmología y ORL

Area

Oftalmología

Identifiers

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Search Results

Now showing 1 - 10 of 115

Targeting the Schlemm’s canal in the medical therapy of glaucoma: Current and future considerations.
(Advances in Therapy, 2017) Andrés Guerrero, Vanesa; García Feijoo, Julián; Konstas, Anastasios Georgios; Springer
Schlemm’s canal (SC) is a unique, complex vascular structure responsible for maintaining fluid homeostasis within the anterior segment of the eye by draining the excess of aqueous humour. In glaucoma, a heterogeneous group of eye disorders afflicting approximately 60 million individuals worldwide, the normal outflow of aqueous humour into SC is progressively hindered, leading to a gradual increase in outflow resistance, which gradually results in elevated intraocular pressure (IOP). By and large available antiglaucoma therapies do not target the site of the pathology (SC), but rather aim to decrease IOP by other mechanisms, either reducing aqueous production or by diverting aqueous flow through the unconventional outflow system. The present review first outlines our current understanding on the functional anatomy of SC. It then summarizes existing research on SC cell properties; first in the context of their role in glaucoma development/progression and then as a target of novel and emerging antiglaucoma therapies. Evidence from ongoing research efforts to develop effective antiglaucoma therapies targeting SC suggests that this could become a promising site of future therapeutic interventions.
Visual and Refractive Outcomes after Bilateral Implantation of an Enhanced Monofocal IOL: a Prospective study.
(Journal of Cataract & Refractive Surgery, 2024) García Bella, Javier; Burgos Blasco, Bárbara; Vidal Villegas, Beatriz; Garzón Jiménez, Nuria; Villanueva Gómez-Chacón, Celia; García Feijoo, Julián
Purpose: To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction. Setting: San Carlos Hospital, Madrid, Spain. Design: Prospective, monocentric, non-comparative study. Methods: Adults 21 years or older suitable for cataract surgery and with corneal astigmatism < 1.50D were bilaterally implanted with the RayOne EMV IOL and followed up for 3-months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire. Results: 50 eyes of 25 patients were included. At Month-3, the mean manifest spherical equivalent was -0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤ 0.0 logMAR and 95% ≤ 0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤ 0.2 logMAR. Mean monocular CDVA was -0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤ 0.2 logMAR over a 2 D range from +1.00 D to -1.25 D. Satisfaction was good in 96% of patients. Conclusion: Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction.
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.
Ocular Vascular Changes in Mild Alzheimer’s Disease Patients: Foveal Avascular Zone, Choroidal Thickness, and ONH Hemoglobin Analysis
(Journal of personalized medicine, 2020) García Martín, Elena Salobrar; Méndez Hernández, Carmen D.; Hoz Montañana, Rosa de; Ramírez Sebastián, Ana Isabel; López Cuenca, Inés; Fernández Arrabal, José A.; Rojas Lozano, Pilar; Wang, Surina; García Feijoo, Julián; Gil, Pedro; Salazar Corral, Juan José; Ramírez Sebastián, José Manuel
In Alzheimer’s disease (AD), vascular changes could be caused by amyloid beta (Aβ) aggregates replacing the contractile smooth musculature of the arteriole walls. These changes happen in the brain vascular network, but also in the eye, and are related to decreased vascular density and low blood flow. In patients with Alzheimer’s disease, thinning of the choroid and the retina has been shown. The aim of this prospective study was to assess the retinal and choroidal vascular systems, analyzing the choroidal thickness with optical coherence tomography (OCT), the foveal avascular zone (FAZ) with OCT-angiography (OCTA), and the optic nerve head (ONH) hemoglobin with the Laguna ONhE program, to evaluate which of the two ocular vascular systems shows earlier changes in mild AD patients. These patients, compared to controls, showed a significantly thinner choroid at all the analyzed points, with the exception of the temporal macula (at 1000 and 1500 µm from the fovea). On the other hand, the FAZ and ONH hemoglobin did not show significant differences. In conclusion, a thinner choroid was the main ocular vascular change observed in mild AD patients, while the retinal vessels were not yet affected. Therefore, choroidal thickness could be used an early biomarker in AD.
Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma
(Archivos de la Sociedad Española de Oftalmología (English Edition), 2023) Guemes Villahoz, Noemí; Burgos Blasco, B.; Morales-Fernández, L.; Perez García, P.; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María
Purpose: To evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). Methods: Cross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. Results: RNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, p < 0.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (p < 0.001). Conclusions: The diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.
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 Dora
Background/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.
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 Dora
Purpose: 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.
Corneal aberrations in primary congenital glaucoma and its visual correlation
(International Ophthalmology, 2024) Ly-Yang, Fernando; Morales Fernández, Laura; García Bella, Javier; Garcia Caride, Sara; Santos Bueso, Enrique Miguel; Saenz Frances, Federico; Fernández-Vigo López, José; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María
Primary congenital glaucoma (PCG) can cause permanent vision loss, and its prognosis is related to early detection and treatment. The main pathological defect consists of resistance to aqueous outflow through the trabecular meshwork due to abnormal development of tissue derived from the neural crest in the anterior chamber angle. Even after successful intraocular pressure (IOP) management in PCG poor visual outcomes still present a lifelong challenge. Vision loss in PCG is multifactorial, resulting from optic nerve damage, corneal scarring, and myopic astigmatism associated with anisometropic amblyopia. Although it is already known that children with PCG present with an altered corneal configuration, the knowledge of irregular astigmatism due to high-order aberrations (HOA) and due to the unequal expansion of the anterior segment, and its impact on visual outcomes, is not yet fully understood, to the best of our knowledge. Quality vision is influenced by the presence of aberrations in the eye's optical system, which can degrade the quality of the image projected onto the retina. Low-order aberrations (LOA), including myopia, hyperopia, and regular astigmatism, can be corrected by spectacles, while HOA cannot be corrected by ordinary means. Coma and spherical aberrations are the most visually significant HOAs, while trefoil and other HOAs have a lower impact on visual quality. The purpose of this article is to establish a quantitative correlation between HOA and visual acuity (VA) to measure the magnitude of the impact of the altered cornea on visual outcomes in PCG.
Letter in response to article in journal of infection: “High SARS-CoV-2 antibody prevalence among healthcare workers exposed to COVID-19 patients”
(Journal of infection, 2020) Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Ariño Gutiérrez, Mayte; Fernández Vigo, José Ignacio; Benito Pascual, Blanca; Cabello Clotet, Noemí; Mayol Martínez, Julio; Gegúndez Fernández, José Antonio; Díaz Valle, David; Benítez del Castillo, José Manuel; García Feijoo, Julián