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Note the sequential resolution of the macular detachment related to monthly intervals.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D.R. Cruzado-Sánchez, H. Luglio Valdivieso, S.M. Lujan Nájar" "autores" => array:3 [ 0 => array:2 [ "nombre" => "D.R." "apellidos" => "Cruzado-Sánchez" ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Luglio Valdivieso" ] 2 => array:2 [ "nombre" => "S.M." 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Santos-Bueso, J. García-Sánchez" "autores" => array:2 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Santos-Bueso" "email" => array:1 [ 0 => "esbueso@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "García-Sánchez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Neurooftalmología, Hospital Clínico San Carlos, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Simulación en oftalmología (<span class="elsevierStyleSmallCaps">ii</span>)" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In relation to the letter titled <span class="elsevierStyleItalic">Simulation in Ophthalmology</span> and following the publication of our paper<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> we would like to emphasize a few points.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Non-organic visual loss (NOVL) or simulation in ophthalmology is entirely different in children than in adults. While the latter simulates to obtain a benefit or as the result of a psychiatric disorder, in children the etiology and prognosis are different and generally more favorable.</p><p id="par0015" class="elsevierStylePara elsevierViewall">NOVL in adults is not only due to the deceitful intention of patients, but it can also be secondary to a psychiatric disorder described in CIE<span class="elsevierStyleHsp" style=""></span>10 (F44 Dissociation Conversion Disorder) and in DSM<span class="elsevierStyleHsp" style=""></span>IVR (Fictitious Disorders).</p><p id="par0020" class="elsevierStylePara elsevierViewall">In what concerns campimetric alterations, it is exceptional for children to debut with NOVL and a campimetric alteration because they are not aware of said alterations. Usually what makes them aware of any eyesight alteration is diminished bilateral vision which prevents them from doing their school homework. If a child refers campimetric alterations, we must suspect the presence of an urgent organic disease.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Due to professional ethics, we do not include the results of our experience in childhood NOVL<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> which was being published simultaneously in the <span class="elsevierStyleItalic">European Journal of Ophthalmology</span> (EJO) and the <span class="elsevierStyleItalic">Simulation in Ophthalmology</span> paper.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The summary of our work titled <span class="elsevierStyleItalic">Nonorganic visual loss and associated psychopathology in children</span><a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> which is the result of 3 years study in the Neuro-Ophthalmology Unit of the San Carlos Clinic Hospital of Madrid is:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0035" class="elsevierStylePara elsevierViewall">973 children included in the study.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0040" class="elsevierStylePara elsevierViewall">30 children diagnosed with NOVL.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">Prevalence of NOVL: 3.08%.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">70% were girls between 8 and 9 years of age, with a mean age of 8.93 (SD 2.61<span class="elsevierStyleHsp" style=""></span>years).</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall">The month in which the highest number of patients was diagnosed (26.7%) was September, when the academic courses begin.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">The main form of NOVL presentation was diminished bilateral vision (86.6%) followed by diplopia (6.7%).</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">In what concerns associated psychopathologies, the results were:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Prevalence of associated psychopathology: 20%</p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall">The most frequent psychopathological disorders were:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Hyperactivity disorder: 6.6%</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">anxiety: 6.6%</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">attention deficit: 3.3%</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">depression with attempted suicide: 3.3%</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">it is peculiar that 40% of children with NOVL wanted to wear only spectacles, in accordance with a school friend who had been prescribed optic correction.</p></li></ul></p><p id="par0105" class="elsevierStylePara elsevierViewall">In several forms we have outlined the importance of developing multidisciplinary units between Ophthalmology, Primary Care and Pediatric Psychiatry (similar to the unit we have in our center) for following up and treating these patients due to the high prevalence of associated psychopathology. We have stated the significance of said units in the <span class="elsevierStyleItalic">10th European Neuro-Ophthalmology Society Meeting</span> (Barcelona, June 18–21, 2011), in the Ramón Castroviejo Ophthalmology Seminar of the Complutense University of Madrid (April 24, 2008; December 17, 2009; February 16, 2012) or in <span class="elsevierStyleItalic">Acta Estrabológica</span>.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Finally, by way of conclusion, we would also like to point out that suspected NOVL should be considered in the presence of visual deficit or disproportionate symptoms in a patient with strictly normal basic exploration results.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Sánchez J. and Simulación en oftalmología (<span class="elsevierStyleSmallCaps">ii</span>). Arch Soc Esp Oftalmol. 2013;88:203–4.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simulación en oftalmología" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Muñoz-Hernández" 1 => "R. García-Catalán" 2 => "E. Santo-Bueso" 3 => "C. López-Abad" 4 => "J. Gil-de-Bernabé" 5 => "D. Díaz-Valle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftal.2011.04.007" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2011" "volumen" => "86" "paginaInicial" => "320" "paginaFinal" => "326" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22004577" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonorganic visual loss and associated psychopathology in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Muñoz-Hernández" 1 => "E. Santos-Bueso" 2 => "F. Sáenz-Francés" 3 => "C.D. Méndez-Hernández" 4 => "J. García-Feijoó" 5 => "J.A. Gegúndez-Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5301/EJO.2011.8378" "Revista" => array:6 [ "tituloSerie" => "Eur J Ophthalmol" "fecha" => "2011" "volumen" => "22" "paginaInicial" => "269" "paginaFinal" => "273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21623588" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simulación infantil y psicopatología asociada. Equipos multidisciplinares de tratamiento" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Santos-Bueso" 1 => "J. García-Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Estrabol" "fecha" => "2010" "volumen" => "2" "paginaInicial" => "341" "paginaFinal" => "344" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000008800000005/v1_201307100543/S2173579413000844/v1_201307100543/en/main.assets" "Apartado" => array:4 [ "identificador" => "8723" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000008800000005/v1_201307100543/S2173579413000844/v1_201307100543/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579413000844?idApp=UINPBA00004N" ]
Journal Information
Vol. 88. Issue 5.
Pages 203-204 (May 2013)
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Vol. 88. Issue 5.
Pages 203-204 (May 2013)
Letter to the Editor
Simulation in ophthalmology (ii)
Simulación en oftalmología (ii)
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Unidad de Neurooftalmología, Hospital Clínico San Carlos, Madrid, Spain
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