Reply of the article: Contribution of the Visante® OCT and B-scan ultrasonography in the diagnosis and follow up of a bilateral ciliochoroidal effusion syndrome induced by topiramate

Diaz-Cespedes, R.A.; Olate-Perez, A.; Toro-Giraldo, D.

doi:10.1016/j.oftale.2020.06.016

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Choroidal effusion (CE) and ciliary body anterior rotation (CBAR) are observed." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.N. Lucas, I. Copati, J. Leiro, N.D. Levaggi" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A.N." "apellidos" => "Lucas" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Copati" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Leiro" ] 3 => array:2 [ "nombre" => "N.D." 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Diaz-Cespedes, A. Olate-Perez, D. Toro-Giraldo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R.A." "apellidos" => "Diaz-Cespedes" "email" => array:1 [ 0 => "riediaz@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Olate-Perez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "D." "apellidos" => "Toro-Giraldo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Clínico y Provincial de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Réplica del artículo: Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroideo 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" => 723 "Ancho" => 900 "Tamanyo" => 80714 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Visante® optical coherence tomography. Patient with choroidal effusion secondary to topiramate. (A) Choroidal edema (arrow) at the time of diagnosis. (B) Resolution of choroidal edema." ] ] ] "textoCompleto" => "We sincerely appreciate the comments received in relation to our article,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> and would like to make some considerations in relation to it. Firstly, in view of the possibility of a diagnosis of ciliochoroidal effusion syndrome, it is essential to make an early diagnosis to minimise the complications that may arise from untimely treatment. We believe that the most readily available diagnostic tools should be used, depending on our work environment.Ultrasonic biomicroscopy (UBM) using 35-50 MHz transducers is the diagnostic method that allows the position and possible alterations that may affect the ciliary body to be visualised more accurately and with better resolution.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> In addition, it allows the identification of pars plana conditions, as well as possible edemas, choroidal thickening or cysts that are involved in the anterior portion of the effusion syndrome.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Therefore, if this technique is available, it should be considered as first choice for diagnosis and follow-up of these patients.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>In the case of not having UBM, the Visante® optical coherence tomography (OCT) and the ocular ultrasound (OU) are easily executed and widely spread techniques that allow a first approach as well as enabling an evolutionary control in this type of diseases. In relation to OCT Visante®, although we agree that it does not allow the exact evaluation of the position of the ciliary body due to the mechanical effect of blockage secondary to the iris pigment epithelium,<a class="elsevierStyleCrossRefs" href="#bib0010">2,5</a> it does allow the identification of the accumulation of fluid in the suprachoroidal space, which leads to choroidal detachment, myopic changes and anterior rotation of the ciliary body and the root of the iris.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> These findings can be a guide for both diagnosis and follow-up in these patients (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). On the other hand, OU is a very useful tool that enables the identification of choroidal detachment in a simple and direct manner, as well as assessing its evolution.<a class="elsevierStyleCrossRef" href="#bib0035">7</a><elsevierMultimedia ident="fig0005"></elsevierMultimedia>The Clearscan® is a very thin and acoustically invisible film that provides an image very similar to that obtained using the open-shell<a class="elsevierStyleCrossRef" href="#bib0040">8</a> technique. For some authors, the lack of patient cooperation is a contraindication for performing UBM,<a class="elsevierStyleCrossRef" href="#bib0045">9</a> and although Clearscan® diminishes the discomfort associated with the test, its availability is not widespread in our ophthalmological practices. We agree that the possibility of assessing structures up to 10 mm behind the corneal limbus makes it a useful tool in the diagnostic strategy of these patients,<a class="elsevierStyleCrossRef" href="#bib0040">8</a> but in no case its lack of availability should prevent diagnosis and follow-up with other more accessible techniques.Since the conclusion of our article points out that OCT Visante® and OU are suitable techniques for diagnostic confirmation and evolutionary control of these patients, it should be emphasised that their use becomes more important in view of the impossibility of performing a UBM or having Clearscan® covers available for use." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Diaz-Cespedes RA, Olate-Perez A, Toro-Giraldo D. Réplica del artículo: Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroideo bilateral secundario a topiramato. Arch Soc Esp Oftalmol. 2021;96:58–59." ] ] "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" => 723 "Ancho" => 900 "Tamanyo" => 80714 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Visante® optical coherence tomography. Patient with choroidal effusion secondary to topiramate. (A) Choroidal edema (arrow) at the time of diagnosis. (B) Resolution of choroidal edema." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aportes de la tomografía de coherencia óptica Visante® y la ecografía ocular en el diagnóstico y seguimiento del síndrome de efusión ciliocoroideo bilateral secundario a topiramato" "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. 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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 58-59 (January 2021)

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