Felix Armadá

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Karim N'Diaye

Centre National de la Recherche Scientifique / French National Centre for Scientific Research

Alistair Welchman

University of Texas at San Antonio

David Seamon

Kansas State University

Michael Chase

Centre National de la Recherche Scientifique / French National Centre for Scientific Research

Jason Hassenstab

Washington University in St. Louis

Paul S . Loeb

University of Puget Sound

Rice University

Stanford University

Stockholm University

Universidade Federal de São Paulo (UNIFESP)

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Papers by Felix Armadá

[Treatment of two cases of diffuse retinal pigment epitheliopathy with photodynamic therapy]

Archivos de la Sociedad Espanola de Oftalmologia

We present two patients with Diffuse Retinal Pigment Epitheliopathy (DRPE) treated with verteporf... more We present two patients with Diffuse Retinal Pigment Epitheliopathy (DRPE) treated with verteporfin photodynamic therapy (PDT). The first patient was treated with PDT because there was foveal involvement. The second patient received PDT because he had multiple recurrences of DRPE with poor resolution following previous argon-laser photocoagulation. Resolution of the lesions occurred in both cases with improvement in visual acuity. No recurrences have been documented at eleven months of follow-up. The outcomes in our patients were satisfactory. We consider PDT is a safe and effective option, but further randomized studies are necessary to confirm this.

PATOLOGÍA Y CIRUGIA MACULAR

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[Epidemiology of age-related macular degeneration. Situation in Spain]

Atención Primaria

Damián J et al.

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Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration

by Luis Arias, Francisco Gomez-ulla, and Felix Armadá

Journal of Ophthalmology, 2015

Individualized treatment regimens may reduce patient burden with satisfactory patient outcomes in... more Individualized treatment regimens may reduce patient burden with satisfactory patient outcomes in neovascular age-related macular degeneration. Intravitreal anti-VEGF drugs are the current gold standard. Fixed monthly injections offer the best visual outcome but this regimen is not commonly followed outside clinical trials. A PRN regimen requires monthly visits where the patient is treated in the presence of signs of lesion activity. Therefore, an early detection of reactivation of the disease with immediate retreatment is crucial to prevent visual acuity loss. Several trials suggest that &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;treat and extend&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and other proactive regimens provide a reasonable approach. The rationale of the proactive regimens is to perform treatment anticipating relapses or recurrences and therefore avoid drops in vision while individualizing patient followup. Treat and extend study results in significant direct medical cost savings from fewer treatments and office visits compared to monthly treatment. Current data suggest that, for one year, PRN is less expensive, but treat and extend regimen would likely be less expensive for subsequent years. Once a patient is not a candidate to continue with treatment, he/she should be sent to an outpatient unit with adequate resources to follow nAMD patients in order to reduce the burden of specialized ophthalmologist services.

[Guidelines of clinical practice of the SERV: treatment of exudative age-related macular degeneration (AMD)]

Archivos de la Sociedad Española de Oftalmología, 2009

Age related macular degeneration (ARMD) in its neovascular form is a serious disease which produc... more Age related macular degeneration (ARMD) in its neovascular form is a serious disease which produces legal blindness in many patients with poor prognosis if left untreated. We intend to establish a clinical guide with the different therapeutic options that exist nowadays, which may help the ophthalmologists in their clinical practice. A group of medical retina experts selected by SERV have evaluated the results of different published studies with the drugs currently available, obtaining an evidence-based consensus. Some recommendations have been established for diagnosis, treatment and monitoring of patients with neovascular ARMD. The intravitreal injection of ranibizumab at a dosage of 0.5 mg produces significant improvement of visual acuity in subfoveal lesions, according to data obtained from studies with the highest level of evidence. It should be considered as a first choice drug. The use of bevacizumab, a drug with not approved indication for intraocular use, nor for the treatm...

La calidad en la atención de pacientes con degeneración macular asociada a la edad, edema macular y retinopatía diabética y oclusión vascular venosa de la retina

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Espesor macular medido con tomografía de coherencia óptica en ojos pseudoafáquicos con implante amarillo vs. transparente

Archivos de la Sociedad Española de Oftalmología, 2014

ABSTRACT Objective To study the use of optical coherence tomography (OCT), for measuring the macu... more ABSTRACT Objective To study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. Methods Macular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. Results After 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 μm (P=.02), and foveal thickness reduction was 10 ± 17 μm (P=.02). Conclusions The macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.

Accidental injections of dexamethasone intravitreal implant (Ozurdex®) into the crystalline lens

European Journal of Ophthalmology, 2014

To describe the side effects and management after inadvertent injection of a dexamethasone implan... more To describe the side effects and management after inadvertent injection of a dexamethasone implant (Ozurdex) into the crystalline lens. Two case reports. Two patients with macular edema due to unilateral retinal vein occlusion were scheduled for an intravitreal injection of Ozurdex. During the procedure, the implant was accidentally injected into the crystalline lens. Both patients developed cataracts during the course of several weeks and in both there was an intraocular pressure (IOP) increase, which required treatment with topical hypotensives. Macular edema improved only slightly. Cataract surgery with uneventful removal of the implant was performed 3 (case 1) and 6 months (case 2) after the injection. After inadvertent injection of Ozurdex into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.

A Delphi Study to Detect Deficiencies and Propose Actions in Real Life Treatment of Neovascular Age-Related Macular Degeneration

by Luis Arias, Enrique JAUREGUIZAR-Cervera, and Felix Armadá

Journal of Ophthalmology, 2014

Purpose. Spanish retina specialists were surveyed in order to propose actions to decrease deficie... more Purpose. Spanish retina specialists were surveyed in order to propose actions to decrease deficiencies in real-life neovascular age macular degeneration treatment (nv-AMD). Methods. One hundred experts, members of the Spanish Vitreoretinal Society (SERV), were invited to complete an online survey of 52 statements about nv-AMD management with a modified Delphi methodology. Four rounds were performed using a 5-point Linkert scale. Recommendations were developed after analyzing the differences between the results and the SERV guidelines recommendations. Results. Eighty-seven specialists completed all the Delphi rounds. Once major potential deficiencies in real-life nv-AMD treatment were identified, 15 recommendations were developed with a high level of agreement. Consensus statements to reduce the burden of the disease included the use of treat and extend regimen and to reduce the amount of diagnostic tests during the loading phase and training technical staff to perform these tests and reduce the time between relapse detection and reinjection, as well as establishing patient referral protocols to outside general ophthalmology clinics. Conclusion. The level of agreement with the final recommendations for nv-AMD treatment among Spanish retinal specialist was high indicating that some actions could be applied in order to reduce the deficiencies in real-life nv-AMD treatment.

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Combined External Drainage and 25-Gauge Vitrectomy for Severe X-Linked Congenital Retinoschisis

Retina, 2011

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home &gt; Current ...

Double-Fluence Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioblastoma in a Pediatric Patient

Journal of Pediatric Ophthalmology & Strabismus, 2012

Epidemiología de la degeneración macular asociada con la edad. Situación en España

Atención Primaria, 2006

Damián J et al.

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Guías de práctica clínica de la SERV: Tratamiento de la degeneración macular asociada a la edad (DMAE) exudativa

Archivos de la Sociedad Española de Oftalmología, 2009

... use, nor for the treatment of neovascular ARMD can reach a result which is closer to the ones... more

Siderosis bulbi. Presentación clínica de un caso de tres años de evolución

Archivos de la Sociedad Española de Oftalmología, 2012

The clinical and functional characteristics of a 30 years-old patient with three years-evolution ... more The clinical and functional characteristics of a 30 years-old patient with three years-evolution siderosis bulbi are described in this paper, as well as the treatment using phacoemulsification and vitrectomy for the elimination of the metallic remains. In spite of the fact that the majority of the intraocular foreign bodies (IOFB) have a dangerous immediate effect, in cases of small, local bodies and with little visual deterioration, observation is possible. Nevertheless, with time, the iron settles on the pigmented epithelium of the retina, producing changes at macula and peripheral level, which are responsible for the gradual loss of vision. The surgical removal of the IOFB can stop the progression of this pathology.

Tratamiento con terapia fotodinámica de dos casos de epiteliopatía pigmentaria retiniana difusa

Archivos de la Sociedad Española de Oftalmología, 2006

ABSTRACT

Photodynamic therapy for chronic central serous chorioretinopathy

Acta Ophthalmologica, 2009

Purpose: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chro... more

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Prevalence of age-related macular degeneration in the AGES - Reykjavik Study

Acta Ophthalmologica, 2008

Diabetic retinopathy and pregnancy

Acta Ophthalmologica Scandinavica, 2004

The problem concerning the influence of pregnancy on diabetic retinopathy is still a matter for d... more The problem concerning the influence of pregnancy on diabetic retinopathy is still a matter for discussion. The questions are: can the pregnancy itself influence the onset of a retinopathy? and can a pregnancy worsen the prognosis of a retinopathy and if it is the case is there any difference regarding the type of the retinopathy: background or proliferative? Despite controversies in the literature, it seems that: If no retinopathy is present at the onset of the pregnancy, the risk for developing retinal complications is very low. A background retinopathy can worsens and may become proliferative. But improvement is often observed in post-partum. A proliferative retinopathy worsen very frequently and the proper management of patients with this type of retinopathy is of extreme importance regarding to the risk of complications and loss of vision. Before the advent of photocoagulation, the alternative to therapeutic abortion was pituitary ablation. Now, the photocoagulation became the treatment of choice for proliferative retinopathy with the same results in pregnant or non pregnant woman. But the proliferative retinopathy is associated with a high incidence of foetal morbidity. Some studies provide evidence that changes in background retinopathy may be related to the degree of diabetic control achieved during pregnancy. The rapidity of improvement in diabetic control may be critical. Diabetic women who are wishing pregnancies may undergo ocular examination with angiography. During pregnancy strict ocular examination is necessary through dilated pupils. Angiography does not seem to induce any side effect on pregnant women.