Comment on: “Contribution of the Visante® OCT and B-scan ultrasound in the diagnosis and follow up of a topiramate-induced bilateral ciliochoroidal effusion syndrome”

Lucas, A.N.; Copati, I.; Leiro, J.; Levaggi, N.D.

doi:10.1016/j.oftale.2020.05.037

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Lucas, I. Copati, J. Leiro, N.D. Levaggi" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A.N." "apellidos" => "Lucas" "email" => array:1 [ 0 => "aguslucas@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Copati" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Leiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "N.D." "apellidos" => "Levaggi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Glaucoma, Hospital Oftalmológico Dr. Pedro Lagleyze, Ciudad Autónoma de Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Urgencias, Hospital Oftalmológico Dr. Pedro Lagleyze, Ciudad Autónoma de Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario sobre: «Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroidea bilateral secundario a topiramato»" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 729 "Ancho" => 905 "Tamanyo" => 156254 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "B-scan ultrasound of an eye with topiramate-induced ciliochoroidal effusion syndrome. Choroidal effusion (CE) and ciliary body anterior rotation (CBAR) are observed." ] ] ] "textoCompleto" => "We read with much interest the article by Diaz-Cespedes et al. regarding the use of imaging techniques in a case of topiramate-induced bilateral ciliochoroidal effusion syndrome.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> We agree with the authors that the syndrome has a clinical diagnosis, and complementary imaging procedures can help with confirmation and follow up.Visante® OCT (Carl Zeiss Meditec, Dublin CA, USA) allows, in these cases, visualization of the angular closure and choroidal effusion. Furthermore, in the most peripheral portion of the iris, anterior bowing of the iris root can be observed.The authors report that the Visante® OCT allows visualization of these pathological changes, but they also uphold that it is possible to observe the anterior rotation of the ciliary body, responsible for the anterior bowing of the iris.We argue that, since the light beam of the OCT would be blocked by the iris pigment epithelium, one should not be able to visualize structures located behind the iris, as the ciliary body.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>On the other hand, ultrasound biomicroscopy presents high-definition images of the ciliary body, and it has proved to be useful in these cases.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The authors comment that patients’ cooperation is hard to obtain due to ocular pain. Although this is true when an open-shell technique is performed, the use of sterile bag covers (ClearScan; ESI, Inc., Plymouth, MN) allows the study to be carried out without eyelid manipulation, thus reducing patient´s discomfort and facilitating collaboration. The bag/balloon technology has demonstrated to have the same measurement accuracy with better comfort levels than the open-shell technique.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>Although ocular echography is mostly used to evaluate the posterior segment of the eye, it allows under certain circumstances, visualization of the ciliary body. In the presence of patient’s collaboration and with a proper eye excursion, it is possible to observe the pars plicata, mainly in the nasal quadrant.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> In the case that no other ancillary imaging technique is available, we consider that ocular echography should be sufficient as the only study performed.We present a B-scan ultrasound of a patient with topiramate-induced bilateral ciliochoroidal effusion syndrome in which it is possible to visualize, in addition to uveal effusion, the ciliary body anterior rotation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>In conclusion, all three studies are useful to complement this syndrome’s clinical diagnosis. However, anterior segment optical coherence tomography is not the ideal technique in those conditions in which the ciliary body is involved in the pathogenesis (such as iris plateau syndrome, misdirection syndrome, or the one reported here). In these cases, ultrasound biomicroscopy remains the best option, since it allows direct visualization of the ciliary body in all quadrants, and it can be performed with lesser discomfort for the patient if sterile bag covers are available." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Lucas AN, Copati I, Leiro J, Levaggi ND. Comentario sobre: «Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroidea bilateral secundario a topiramato». Arch Soc Esp Oftalmol. 2021;96:56–57." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 729 "Ancho" => 905 "Tamanyo" => 156254 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "B-scan ultrasound of an eye with topiramate-induced ciliochoroidal effusion syndrome. Choroidal effusion (CE) and ciliary body anterior rotation (CBAR) are observed." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribution of the Visante® OCT and B-scan ultrasound in the diagnosis and follow up of a topiramate-induced bilateral ciliochoroidal effusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.A. Diaz-Cespedes" 1 => "D. Toro-Giraldo" 2 => "A. Olate-Perez" 3 => "A. Hervas-Ontiveros" 4 => "S. Garcia-Delpech" 5 => "P. Udaondo-Mirete" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftal.2019.01.004" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol." 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Green" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "2nd edition" "fecha" => "2010" "editorial" => "Jaypee Brothers Medical Publishers LTD" "editorialLocalizacion" => "New Delhi" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009600000001/v1_202101050734/S2173579420302152/v1_202101050734/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/21735794/0000009600000001/v1_202101050734/S2173579420302152/v1_202101050734/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420302152?idApp=UINPBA00004N"]

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Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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Vol. 96. Issue 1.

Pages 56-57 (January 2021)

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