Person:
López Cuenca, Inés

First Name

Inés

Last Name

López Cuenca

URI

https://hdl.handle.net/20.500.14352/85492

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Inmunología, Oftalmología y ORL

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Now showing 1 - 10 of 38

Project number: 51
Enseñanza virtual de la asignatura Técnicas de diagnóstico ocular para el Óptico-Optometrista en el Grado de Óptica y Optometría (temario teórico y práctico), para hacer frente a pandemias tipo COVID-19
(2022) Ramírez Sebastián, Ana Isabel; Ramírez Sebastián, José Manuel; García Martín, Elena Salobrar; Hoz Montañana, María Rosa de; Salazar Corral, Juan José; López Cuenca, Inés; Fernández Albarral, José Antonio; Sánchez-Puebla Fernández, Lidia; Elvira Hurtado, María Lorena
Memoria final del Proyecto de Innovación Docente diseñado para permitir a los alumnos que cursan la asignatura de Técnicas de Diagnóstico Ocular para Ópticos-Optometristas, impartida en el 4º curso del Grado de Óptica y Optometría la posibilidad de obtener los conocimientos de manera telemática, para poder realizar las prácticas hospitalarias sin problemas.
Foveal Avascular Zone and Choroidal Thickness Are Decreased in Subjects with Hard Drusen and without High Genetic Risk of Developing Alzheimer’s Disease
(Biomedicines, 2021) López Cuenca, Inés; Hoz Montañana, María Rosa de; Alcántara Rey, Celia; García Martín, Elena Salobrar; Elvira Hurtado, Lorena; Fernández Albarral, José Antonio; Barabash, Ana; Ramírez Toraño, Federico; Frutos Lucas, Jaisalmer de; Salazar Corral, Juan José; Ramírez Sebastián, Ana Isabel; Ramirez Sebastian, Jose Manuel
A family history (FH+) of Alzheimer’s disease (AD) and ε4 allele of the ApoE gene are the main genetic risk factors for developing AD, whereas ε4 allele plays a protective role in age-related macular degeneration. Ocular vascular changes have been reported in both pathologies. We analyzed the choroidal thickness using optical coherence tomography (OCT) and the foveal avascular zone (FAZ) using OCT-angiography and compared the results with ApoE gene expression, AD FH+, and the presence or absence of hard drusen (HD) in 184 cognitively healthy subjects. Choroidal thickness was statistically significantly different in the (FH−, ε4−, HD+) group compared with (i) both the (FH−, ε4−, HD−) and the (FH+, ε4+, HD+) groups in the superior and inferior points at 1500 µm, and (ii) the (FH+, ε4−, HD+) group in the superior point at 1500 µm. There were statistically significant differences in the superficial FAZ between the (FH+, ε4−, HD+) group and (i) the (FH+, ε4−, HD−) group and (ii) the (FH+, ε4+, HD−) group. In conclusion, ocular vascular changes are not yet evident in participants with a genetic risk of developing AD.
Retinal Disorders in Humans and Experimental ALS Models
(Animal Models and Experimental Research in Medicine, 2022) Rojas Lozano, Pilar; Ramírez Sebastián, Ana Isabel; Hoz Montañana, María Rosa de; Cadena Santoyo, Manuel; García Martín, Elena Salobrar; López Cuenca, Inés; Fernández Albarral, José Antonio; Sánchez Puebla, Lídia; Matamoros, José A.; Salazar Corral, Juan José; Ramirez Sebastian, Jose Manuel
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease that severely impairs the patient’s mobility, as it mainly affects the upper and lower motor neurons in the spinal cord. In addition, alterations have also been demonstrated in different parts of the central nervous system (CNS), such as the brain and brainstem. The retina is a projection to the brain and is considered as a “window” to the CNS. Moreover, it is possible to use the retina as a biomarker in several neurodegenerative diseases, even in the absence of major visual impairment. Classically, it was thought that the eyes were not affected in ALS, with respect to extraocular muscles, whereas the remainder of the muscles of the body were distressed. Nevertheless, retinal changes have recently been found in this pathology and could help in diagnosis, follow-up, and even monitoring therapies in this disease.
Situs inversus del nervio óptico. A propósito de un caso
(Revista de Neurología, 2017) López Cuenca, Inés; Hoz Montañana, Rosa de; García Martín, Elena Salobrar; Rojas López, Blanca; Ramírez Sebastián, Ana Isabel; Salazar Corral, Juan José; Triviño Casado, Alberto; Ramirez Sebastian, Jose Manuel
Introducción. El situs inversus del nervio óptico es una anomalía congénita caracterizada por la emergencia de los vasos de la retina en dirección nasal en lugar de temporal. Es causado por una anómala inserción del tallo óptico en la vesícula óptica que da lugar a la variación de disposición de la cabeza del nervio óptico. No es una condición aislada y suele aparecer junto con el síndrome del disco inclinado y en pacientes con miopía. Se caracteriza por la presencia de un cono de atrofia inferior, defectos en el campo visual temporal, defectos de refracción y ambliopía. Caso clínico. Mujer de 22 años, que acude a revisión oftalmológica por presentar fuertes cefaleas frontales acompañadas de halos y pérdida de nitidez en la visión. Tras un examen optométrico y oftalmológico se llega al juicio clínico de que padece un cuadro compatible con esta anomalía anatómica congénita. Conclusiones. El situs inversus del nervio óptico es una condición rara que puede aparecer aislada o acompañada de otras patologías. La aplicación de la campimetría y de nuevas técnicas diagnósticas, como la tomografía de coherencia óptica, facilita el diagnóstico diferencial de esta situación. No se conoce su prevalencia, pues no se encuentra en el registro de las enfermedades raras. Además, el escaso número de pacientes estudiados y la exigua bibliografía existente sobre esta anomalía no permiten conocer si los defectos causados progresan en el tiempo, por lo que sería importante realizar un seguimiento oftalmológico de los pacientes con situs inversus del nervio óptico.
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.
Microglial Activation in the Retina of a Triple-Transgenic Alzheimer’s Disease Mouse Model (3xTg-AD)
(International Journal of Molecular Sciences, 2020) García Martín, Elena Salobrar; Rodríguez Neves, Ana C.; Ramírez Sebastián, Ana Isabel; Hoz Montañana, María Rosa de; Fernández Albarral, José Antonio; López Cuenca, Inés; Ramirez Sebastian, Jose Manuel; Ambrósio, Antonio Francisco; Salazar Corral, Juan José
Alzheimer’s disease (AD) is the most common type of dementia in the world. The main biomarkers associated with AD are protein amyloid-β (Aβ) plaques and protein tau neurofibrillary tangles, which are responsible for brain neuroinflammation mediated by microglial cells. Increasing evidence has shown that the retina can also be affected in AD, presenting some molecular and cellular changes in the brain, such as microglia activation. However, there are only a few studies assessing such changes in the retinal microglia in animal models of AD. These studies use retinal sections, which have some limitations. In this study, we performed, for the first time in a triple-transgenic AD mouse model (3xTg-AD), a quantitative morphometric analysis of microglia activation (using the anti-Iba-1 antibody) in retinal whole-mounts, allowing visualization of the entire microglial cell, as well as its localization along the extension of the retina in different layers. Compared to age-matched animals, the retina of 3xTg-AD mice presents a higher number of microglial cells and a thicker microglial cell body area. Moreover, the microglia migrate, reorient, and retract their processes, changing their localization from a parallel to a perpendicular position relative to the retinal surface. These findings demonstrate clear microglia remodeling in the retina of 3xTg-AD mice.
Characterization of Retinal Drusen in Subjects at High Genetic Risk of Developing Sporadic Alzheimer’s Disease: An Exploratory Analysis
(Journal of Personalized Medicine, 2022) López Cuenca, Inés; García Martín, Elena Salobrar; Gil Salgado, Inés; Sánchez Puebla, Lídia; Elvira Hurtado, Lorena; Fernández Albarral, José Antonio; Ramírez Toraño, Federico; Barabash, Ana; Frutos Lucas, Jaisalmer de; Salazar Corral, Juan José; Ramirez Sebastian, Jose Manuel; Ramírez Sebastián, Ana Isabel; Hoz Montañana, María Rosa de
Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence of drusen. Subjects with drusen show choroidal thinning compared to patients without drusen, and thinning could trigger changes in choroidal perfusion that may give rise to the deposits that generate drusen
Retinal Thickness Changes Over Time in a Murine AD Model APPNL-F/NL-F
(Frontiers in aging neuroscience, 2021) García Martín, Elena Salobrar; López Cuenca, Inés; Sánchez Puebla, Lídia; Hoz Montañana, María Rosa de; Fernández Arrabal, José A.; Ramírez Sebastián, Ana Isabel; Bravo Ferrer, Isbel; Medina Alonso, Violeta; Moro Sánchez, María Ángeles; Saido, Takaomi C.; Saito, Takashi; Salazar Corral, Juan José; Ramirez Sebastian, Jose Manuel
Background: Alzheimer’s disease (AD) may present retinal changes before brain pathology, suggesting the retina as an accessible biomarker of AD. The present work is a diachronic study using spectral domain optical coherence tomography (SD-OCT) to determine the total retinal thickness and retinal nerve fiber layer (RNFL) thickness in an APPNL−F/NL−F mouse model of AD at 6, 9, 12, 15, 17, and 20 months old compared to wild type (WT) animals. Methods: Total retinal thickness and RNFL thickness were determined. The mean total retinal thickness was analyzed following the Early Treatment Diabetic Retinopathy Study sectors. RNFL was measured in six sectors of axonal ring scans around the optic nerve. Results: In the APPNL−F/NL−F group compared to WT animals, the total retinal thickness changes observed were the following: (i) At 6-months-old, a significant thinning in the outer temporal sector was observed; (ii) at 15-months-old a significant thinning in the inner temporal and in the inner and outer inferior retinal sectors was noticed; (iii) at 17-months-old, a significant thickening in the inferior and nasal sectors was found in both inner and outer rings; and (iv) at 20-months-old, a significant thinning in the inner ring of nasal, temporal, and inferior retina and in the outer ring of superior and temporal retina was seen. In RNFL thickness, there was significant thinning in the global analysis and in nasal and inner-temporal sectors at 6 months old. Thinning was also found in the supero-temporal and nasal sectors and global value at 20 months old. Conclusions: In the APPNL−F/NL−F AD model, the retinal thickness showed thinning, possibly produced by neurodegeneration alternating with thickening caused by deposits and neuroinflammation in some areas of the retina. These changes over time are similar to those observed in the human retina and could be a biomarker for AD. The APPNL−F/NL−F AD model may help us better understand the different retinal changes during the progression of AD. Keywords: Alzheimer, retina, OCT, mouse model of AD, APPNL-F/NL-F
Retinal Vascular Study Using OCTA in Subjects at High Genetic Risk of Developing Alzheimer’s Disease and Cardiovascular Risk Factors
(Journal of Clinical Medicine, 2022) López Cuenca, Inés; García Martín, Elena Salobrar; Sánchez Puebla, Lídia; Espejel Checa, Eva; García del Arco, Lucía; Rojas Lozano, Pilar; Elvira Hurtado, Lorena; Fernández Albarral, José Antonio; Ramírez Toraño, Federico; Barabash, Ana; Salazar Corral, Juan José; Ramirez Sebastian, Jose Manuel; Hoz Montañana, María Rosa de; Ramírez Sebastián, Ana Isabel
In 103 subjects with a high genetic risk of developing Alzheimer’s disease (AD), family history (FH) of AD and ApoE ɛ4 characterization (ApoE ɛ4) were analyzed for changes in the retinal vascular network by OCTA (optical coherence tomography angiography), and AngioTool and Erlangen-Angio-Tool (EA-Tool) as imaging analysis software. Retinal vascularization was analyzed by measuring hypercholesterolemia (HCL) and high blood pressure (HBP). Angio-Tool showed a statistically significant higher percentage of area occupied by vessels in the FH+ ApoE ɛ4- group vs. in the FH+ ApoE ɛ4+ group, and EA-Tool showed statistically significant higher vascular densities in the C3 ring in the FH+ ApoE ɛ4+ group when compared with: i)FH- ApoE ɛ4- in sectors H3, H4, H10 and H11; and ii) FH+ ApoE ɛ4- in sectors H4 and H12. In participants with HCL and HBP, statistically significant changes were found, in particular using EA-Tool, both in the macular area, mainly in the deep plexus, and in the peripapillary area. In conclusion, OCTA in subjects with genetic risk factors for the development of AD showed an apparent increase in vascular density in some sectors of the retina, which was one of the first vascular changes detectable. These changes constitute a promising biomarker for monitoring the progression of pathological neuronal degeneration.
Ocular Exploration in the Diagnosis and Follow-Up of the Alzheimer’s Dementia
(Alzheimer’s Disease, 2019) García Martín, Elena Salobrar; Hoz Montañana, María Rosa de; Ramírez Sebastián, Ana Isabel; Salazar Corral, Juan José; Rojas Lozano, Pilar; López Cuenca, Inés; Fernández Albarral, José Antonio; Ramirez Sebastian, Jose Manuel
The retina is part of the central nervous system (CNS), and therefore, in Alzheimer’s disease (AD), retinal and optic nerve degeneration could take place. This degeneration leads to neurofunctional changes that can be detected early and followed up throughout the evolution of the disease. As opposed to other CNS structures, the eye is easily accessible for in vivo observation. Retinal organization allows for the identification of its different neurons, and in consequence, detection of minimal changes taking place during neurodegeneration is possible. Functional vision studies performed on AD patients in recent years have shown how visual acuity, contrast sensitivity, color vision, and visual integration vary with the progression of neurodegeneration. The development of optical coherence tomography in ophthalmology has meant a breakthrough in retinal exploratory techniques, allowing the obtention of high-resolution images using light. This technique enables retinal analysis in the earliest stages of AD, being considered as a biomarker of neuronal damage. Given AD’s high prevalence and its expected increase, it is important to perform easy tests that cause minimal discomfort to the patients at a low cost while offering abundant information on the stage of the disease.