Choroidal haemangioma and photodynamic therapy. Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy | Archivos de la Sociedad Española de Oftalmología (English Edition)

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Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1265 "Ancho" => 1712 "Tamanyo" => 327992 ] ] "descripcion" => array:1 [ "es" => "Evolución en imágenes del paciente número 5. A) Retinografía. Se visualiza lesión anaranjada peripapilar bajo arcada temporal inferior. B) Autofluorescencia. Se observa lesión con hipoautofluorescencia central e hiperautofluorescencia en los márgenes. C) Ecografía modo B: masa sólida de 3,65mm de altura y 7,83mm de base, hiperintensa y homogénea, sin sombra acústica posterior, próxima al nervio óptico. D) ssOCT sobre el tumor: tumor con patrón esponjoso multilobular que se corresponde con los septos vasculares. E) OCT macular antes del tratamiento: presencia de EMQ macular (*), respetando área macular temporal. Observamos que antes del tratamiento ya se objetivaba una disrupción de las capas externas de la retina a nivel foveal (flecha). F) Retinografía con gráfica de grosores retinianos antes del tratamiento: grosor foveal central de 233μm. G) OCT macular 19 meses después de 2 sesiones de TFD: desaparición completa del EMQ, con persistencia de la disrupción de las capas externas de la retina a nivel foveal (flecha). H) Retinografía con gráfica de grosores retinianos después del tratamiento: observamos un grosor foveal central de 144μm." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O. Subirà, H. Brosa, D. 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(b) Wide angiogram and SS-OCT 7 days after the first injection. (c) Wide angiogram and SS-OCT one month after the first injection. (d) Wide angiogram and SS-OCT 7 days after the 2nd injection. (e) Wide angiogram and SS-OCT one month after the 2nd injection. (f) Wide angiogram and SS-OCT one week after the last injection. The structural OCT shows complete SRF reabsorption with uneven RPE." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Torrecillas-Picazo, M. Cerdà-Ibáñez, I. Almor Palacios, J.M. Hervás Hernandis, R. Ramón-Cosín, N. Ruiz del Rio, A. Duch-Samper" "autores" => array:7 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Torrecillas-Picazo" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Almor Palacios" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Hervás Hernandis" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Ramón-Cosín" ] 5 => array:2 [ "nombre" => "N." 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(a) Primary retina detachment (PRD). (b) Repeated retina detachment (ReRD). (c) Vitreomacular interface pathology (VMP). (d) Vitreous hemorrhage (VH)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Martín-Avià, P. Romero-Aroca" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Martín-Avià" ] 1 => array:2 [ "nombre" => "P." 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Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "257" "paginaFinal" => "264" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "O. Subirà, H. Brosa, D. Lorenzo-Parra, L. Arias-Barquet, J. Català-Mora, E. Cobos, P. Garcia-Bru, M.J. Rubio-Caso, J.M. Caminal-Mitjana" "autores" => array:9 [ 0 => array:4 [ "nombre" => "O." "apellidos" => "Subirà" "email" => array:1 [ 0 => "olaiasubira@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Brosa" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Lorenzo-Parra" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Arias-Barquet" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Català-Mora" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Cobos" ] 6 => array:2 [ "nombre" => "P." "apellidos" => "Garcia-Bru" ] 7 => array:2 [ "nombre" => "M.J." "apellidos" => "Rubio-Caso" ] 8 => array:2 [ "nombre" => "J.M." "apellidos" => "Caminal-Mitjana" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemangioma coroideo y terapia fotodinámica. Respuesta anatómica y funcional de los pacientes con hemangioma coroideo tratados con terapia fotodinámica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2646 "Ancho" => 1211 "Tamanyo" => 414052 ] ] "descripcion" => array:1 [ "en" => "Evolution of patient number 7 in images. (A) retinography, showing orange lesion in upper temporal arch. (B) Autofluorescence, showing enhancement of lesion with hyper-and hypo-autofluorescent granulated pattern. (C) Mode B echography, showing hyperintense and homogeneous solid mass 1.6mm height and 10.31mm base, without posterior acoustic shadow. (D) ssOCT over the tumor, showing slightly over-elevated lesion that produces undulations of Bruch's membrane and retina pigment epithelium (arrow). Typical choroidal vasculature pattern loss can be observed (*). (E) macular OCT before treatment, showing subfoveal NSD (*). (F) retinography with retinal thicknesses graph prior to treatment: central foveal thickness 475μm. (G) Macular OCT 20 months after a single PDT session, showing complete absence of NSD. (H) Retinography with retinal thicknesses chart after treatment, showing central foveal thickness of 249μm." ] ] ] "textoCompleto" => "IntroductionChoroidal hemangioma is a benign choroidal vascular lesion. Two subtypes are differentiated: the most frequent circumscribed type, and the diffuse type. The latter is usually associated to the Sturge–Weber syndrome.Circumscribed choroidal hemangioma (CCH) presents as a solitary and slightly elevated lesion with orange-reddish pigmentation, typically located in the posterior pole close to the macular or peripapillary area.<a class="elsevierStyleCrossRef" href="#bib0090">1</a> It is generally diagnosed as from the 3rd decade of life either in a routine exploration or due to the onset of symptoms secondary to the lesion. The most frequently associated symptom of CCH is diminished visual acuity (VA) secondary to the presence of neurosensory detachment (NSD) or microcystic edema (MCE). When the tumor is located in the macular area, VA loss is generally greater and expresses at an earlier age. As CCH is a benign tumor there is no risk of metastasis or vital danger for the patient. However, until a few years ago there was no effective treatment and therefore the majority of cases were related to poor visual prognostic.<a class="elsevierStyleCrossRef" href="#bib0095">2</a> As a general rule, CCH must be treated only when it compromises the vision of a patient.In the last 3 decades the therapeutic approach to CCH has changed with the appearance of new evidence about alternative treatments. In the 90s, argon laser photocoagulation was the treatment of choice. The majority of published studies reported rather discouraging results, particularly when the tumor compromised the foveal area.<a class="elsevierStyleCrossRefs" href="#bib0095">2–4</a> Subsequently, other treatments emerged, such as cryotherapy,<a class="elsevierStyleCrossRef" href="#bib0110">5</a> external radiotherapy or application of a scleral plate<a class="elsevierStyleCrossRef" href="#bib0115">6</a> as well as trans-pupil therapy.<a class="elsevierStyleCrossRefs" href="#bib0120">7,8</a> At this date, these techniques have been gradually discarded despite demonstrating VA increases of varied degree due to local side effects, above all at the retina level. At present, photodynamic therapy (PDT) has consolidated as treatment of choice for CCH because it is a directed and fast treatment with very few side effects. The photochemical effect of PDT achieves tumor regression without retinal or nerve fiber damage.<a class="elsevierStyleCrossRefs" href="#bib0130">9–13</a>The objective of this study is to determine the efficacy and limitations of PDT as a treatment for symptomatic CCH, assessing the results obtained in a tertiary center in the past 7 years.Subjects, material and methodsA retrospective study of 16 patients with CCH who visited at the authors’ hospital and treated with PDT in the past 7 years (from July 2010 to September 2015). All patients completed a minimum follow-up of 7 months after treatment.CCH diagnostic was based on the results obtained by slitlamp examination, fluorescein angiography, B-mode echography, autofluorescence and optical coherence tomography (OCT). After diagnostic, response to treatment and evolution were assessed by means of OCT.Swept-Source OCT (ssOCT) was utilized in the cases included in the study in the past 3 years in order to define with greater precision the characteristics and internal structure of the tumor.All patients exhibited CCH that caused symptoms secondary to the presence of MCE or NSD, visualized through OCT (Topcon 2000; DRI-1; Atlantis OCT, Tokyo, Japan).The study excluded patients who underwent previous ocular surgery in the past 4 months (cataract surgery), those who exhibited a disease that could involve diminished VA (such as age-related macular degeneration and macular disk-shaped scar) as well as patients with CCH who had either received previous treatment for the lesion (radiotherapy, transpupilar therapy, photocoagulation, etc.), or were undergoing some type of photosensitive treatment.PDT was performed with a Zeiss laser (Visulas 6905, Carl Zeiss-Meditec AG, Jena, Germany), together with the administration of verteporfin at a dose of 6mg/m2 (Visudyne®; Oftalmología, Novartis AG, basil, Switzerland). Standard fluency dose (50J/cm2 during 83s) was applied to 14 patients, whereas double fluency PDT (100J/cm2 during 166s) was applied to 2 patients. The power applied was 600mW/cm2 and one or 2 spots were utilized depending on tumor diameter (with a maximum spots diameter between 4000–8000μm).Study parameters were age, gender, tumor location, associated symptoms, VA (measured in the decimal scale) pre-and post-treatment, qualitative and quantitative alterations shown in OCT pre-and post-treatment, the number of PDT sessions and rescue treatment needed.The checkup visit after the first PDT treatment was at 3 months. Subsequently, follow-up was customized to the evolution of each patient. No additional PDT sessions were made when the exudate had resolved completely, regardless of the presence of residual tumor. The indication for a change in treatment was the persistence of MCE and/or NSD (or incomplete resolution thereof) after 3 PDT sessions.The statistical study was made with the SPSS application (V20, SPSS, Chicago, Illinois, USA). Sample normality was analyzed with normality graphs and the Kolmogorov–Smirnov test. The effectiveness of the treatment was estimated analyzing the following items: disappearance of MCE and/or NSD and the need for rescue treatment (calculated with the McNemar test). On the other hand, the Wilcoxon test was applied for assessing VA changes and foveal retinal thickness variations (observed by means of ssOCT), and Pearson's correlation test for measuring the association between the results obtained after measuring tumor height with echography and ssOCT.ResultsThe mean age of the 16 patients (13 males and 3 females) was 54.88±16.09 years and the mean follow-up time was 22.75±13.25 months. All patients exhibited symptoms secondary to the presence of MC and/or subretinal fluid (SRF) associated to CCH: diminished VA (81.25%), metamorphopsia (6.25%), visualization of scotoma (18.75%), myodesopsiae and photopsiae (12.5%) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>All the tumors were located in the posterior pole. The most frequent anatomic location was peripapillary (37.5%), followed by temporal (25%), under vascular arches (18.75%) and macular (parafoveal or subfoveal, with 12.5 and 6.25%, respectively) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).Seven patients (43.75%) only required a single PDT session. The remaining 9 patients required 2 or 3 sessions (25 and 31.25%, respectively). All patients requiring one or 2 sessions exhibited complete resolution of intraretinal fluid (IRF) or SRF (with one exception, with only partial reabsorption). All patients that required 3 PDT sessions exhibited relatively poor evolution (3 maintained clinical stability without improvement and 2 worsened). For this reason, the indication for treatment change was the persistence of NSD or MCE (or incomplete resolution thereof) together with lack of VA improvement after 3 PDT sessions. The prevalence of NSD and MCE at the first visit was 81.25 and 50%, respectively (31.25% exhibited both alterations concurrently) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). After carrying out PDT, the presence of both variables was 31.25% for NSD (p=0.08) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and 25% for MCE (p=0.219) (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>The mean pretreatment foveal thickness (measured through OCT) was 374.93μm, while the post-treatment foveal thickness was 323.13μm, with a non-significant mean foveal thickness reduction.Mean VA increased from 0.23 to 0.38 (p=0.055). Overall, 56.25% of patients exhibited VA improvement, 25% remained stable and only 18.75% worsened. No positive correlation was observed between tumor height measured with echography and ssOCT (correlation 0.42, p>0.05).The treatment was well tolerated (no allergic or hypersensitivity reactions were observed) by all patients, and no side effects were detected. In addition, no damages were observed on retinal structures, although an evolution toward retinal atrophy was identified with external layer disruption at the foveal level in 3 patients (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). It must be noted that a review of pretreatment OCT images already showed said alterations secondary to the presence of SRF or IRF. This entailed low VA despite the complete reabsorption of IRF or SRF.DiscussionCCH is a benign tumor and does not involve vital compromise. Therefore treatment is indicated only for patients who exhibit symptoms, particularly visual loss. In the present study, the majority of patients with CCH treated with PDT achieved VA improvements (baseline mean VA of 0.23 and mean post-PDT VA of 0.38), with a mean of 1.69 PDT sessions. Overall, 62.5% of patients evolved to anatomic and functional resolution (increased or stabilized VA). None of the patients exhibited PDT-related toxicity.Treatment before photodynamic therapy has demonstrated varying degrees of efficacy. However, frequent recurrences and mainly the high number of side effects have caused the obsolescence of said techniques. Tumor photocoagulation with argon or xenon laser involves only the tumor surface and causes significant retinal scarring that cause irreversible VA losses. Madreperla et al.<a class="elsevierStyleCrossRef" href="#bib0105">4</a> described complete SRF resolution in only 46 of patients treated with photocoagulation. In addition, Anand et al.<a class="elsevierStyleCrossRef" href="#bib0100">3</a> reported that 20% of patients exhibited VA improvement, 53% maintained stable VA and 27% exhibited worsened VA, also after laser photocoagulation. Also, 40% of treated cases exhibited SRF reappearance.In contrast, external radiotherapy and brachytherapy penetrate deeper tumor layers, inducing complete regression and SRF reabsorption in the majority of cases. Aizman et al.<a class="elsevierStyleCrossRef" href="#bib0155">14</a> observed complete subretinal fluid resolution in all patients, together with diminished mean height of tumors in 50% of cases treated with radiotherapy. However, these techniques involve greater complexity and high costs, in addition to a large number of reported side effects, both locally (cataracts, retinal ischemia and secondary neovascularization, etc.) and systemically.<a class="elsevierStyleCrossRef" href="#bib0160">15</a>Trans-pupil thermotherapy is a therapeutic option that still maintains its validity for cases that are refractory to treatment with PDT. The series of 26 patients treated with trans-pupil effect published by Gündüz<a class="elsevierStyleCrossRef" href="#bib0165">16</a> reported VA increases in 20 cases (77%) and VA stability in the remaining 6 (23%). However, preretinal fibrosis was observed in 2 eyes, focal iris atrophy in 3 and retinal vascular occlusion in one eye. Possible side effects diminish the validity of this technique for tumors located in the macula.<a class="elsevierStyleCrossRefs" href="#bib0165">16,17</a>PDT consists in selective photochemical lesion of vascular endothelial cells, preserving other retinal structures and optic nerve fibers, thus avoiding the side effects of the above-described treatments.Blasi et al.<a class="elsevierStyleCrossRef" href="#bib0135">10</a> carried out a prospective study with 22 patients that were administered either a single PDT session (100J/cm2) or 2 sessions (the first having 50J/cm2 and the second 100J/cm2) with a follow-up of 60 months. In this series, the mean VA improvement was 18.5 ETDRS, whereas foveal thickness diminished from 386.20 to 179.2μm, observing complete resolution of macular exudation in all cases.Boixadera et al.<a class="elsevierStyleCrossRef" href="#bib0140">11</a> described a series of 31 cases treated with PDT (between 1 and 3 sessions at 50J/cm2) with 12 months follow-up. Mean VA increased from 20/60 to 20/35. Overall, 69% exhibited VA improvements. MCE disappeared in all cases whereas NSD also disappeared in all but 2 cases.Elizalde et al.<a class="elsevierStyleCrossRef" href="#bib0150">13</a> carried out a retrospective study of 13 patients with a mean follow-up of 26 months. Of these, 7 patients (54%) had a single PDT session, 5 (38%) had 2 sessions and one had 5 sessions, finally requiring external beam radiotherapy treatment. VA improved at least one line in 11 patients and remained stable in the remaining 2. SRF results completely in 92% of cases.In the present study, the majority of patients exhibited positive response to PDT treatment, all requiring one or 2 sessions. In general, the patients that required more treatment sessions responded poorly to PDT as well as to the rest of treatments. In the present series, significant reductions in MCE as well as NSD were achieved after PDT (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In addition, a non-significant mean foveal thickness reduction was observed. As regards VA, 56.25% of patients exhibited improvements, 25% remained stable and only 18.75% worsened. For this reason, the results of the present study are excellent as regards study parameters, as well as being similar to the results of other studies. Even so, it is difficult to compare different studies due to variable follow-up times and use of different treatment parameters. The treatment protocol, light intensity, number of impact and exposure time are different in each series.<a class="elsevierStyleCrossRefs" href="#bib0130">9–13</a> For this reason, there is no clear consensus on this issue, and it would be necessary to carry out studies comparing the obtained results with the various PDT parameters in order to draw conclusions. The fact of utilizing standard fluency treatments in the majority of cases, together with longer observation times in comparison with other results, could justify a discreet higher prevalence of MCE or NSD at the end of the follow-up period. Accordingly, in the most recent cases the authors have systematically applied dual fluency PDT as a standard technique.The limitations of the present study include its retrospective nature and the use of different treatment parameters in all patients. Even so, the authors consider that PDT is a directed, fast and highly effective procedure on the basis of IRF or SRF reabsorption as well as visual improvements, and free of significant evidences of side effects. Accordingly, PDT is considered by the authors as a first choice treatment for symptomatic CCH on the basis of its anatomic and functional results as well as a minimum amount of re-treatments and complications (chorioretinal atrophy) in the course of a prolonged ophthalmological follow-up period.Conflict of interestsNo conflict of interests was declared by the authors." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres845212" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec840095" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres845213" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec840094" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Subjects, material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-08-02" "fechaAceptado" => "2016-11-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec840095" "palabras" => array:3 [ 0 => "Circumscribed choroidal hemangioma" 1 => "Choroidal tumor" 2 => "Photodynamic therapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec840094" "palabras" => array:3 [ 0 => "Hemangioma coroideo circunscrito" 1 => "Tumor coroideo" 2 => "Terapia fotodinámica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo study the effectiveness and limitations of photodynamic therapy (PDT) as treatment of choice in patients with symptomatic circumscribed choroidal hemangioma. MethodsA retrospective study was conducted on 16 patients (13 men and 3 women, with mean age of 54.88 years) with circumscribed choroidal hemangioma, who attended our center and were treated with PDT in the last 7 years. ResultsAll patients had circumscribed choroidal hemangioma, which caused a decrease in visual acuity (VA) secondary to the presence of intraretinal microcystic edema or neurosensory detachment. The mean initial VA was 0.23, and the final mean VA after performing PDT was 0.38 (all the VA were measured in decimal scale). It should be noted that patients needed a mean of 1.69 PDT sessions. Three of the patients needed rescue treatment with trans-pupillary thermotherapy, intravitreal injection of anti-vascular endothelial growth factor (ranibizumab, aflibercept) or a dexamethasone intravitreal implant (Ozurdex®). The indication for a change of treatment was the persistence of intraretinal microcystic edema and/or neurosensory detachment (or incomplete resolution) after 3 PDT sessions. As overall results, 62.5% of patients evolved into anatomical and functional (increase in AV or stability) resolution. ConclusionsPDT is a straight forward and fast procedure, with a good anatomical and functional response, causing minimal damage to adjacent vessels." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoEstudiar la eficacia y las limitaciones de la terapia fotodinámica (TFD) como tratamiento de primera elección en pacientes con hemangioma coroideo circunscrito sintomático. MétodosSe realizó un estudio retrospectivo de 16 pacientes (13 varones y 3 mujeres, con una media de edad de 54,88 años) con hemangioma coroideo circunscrito visitados en nuestro centro y tratados con TFD en los últimos 7 años. ResultadosTodos los pacientes presentaban hemangioma coroideo circunscrito, que ocasionaba sintomatología secundaria a la presencia de edema microquístico intrarretiniano o desprendimiento neurosensorial. La agudeza visual (AV) media inicial del grupo era de 0,23 y la AV media posterior a la realización de TFD fue de 0,38 (todas las AV fueron medidas en escala decimal). Cabe destacar que los pacientes necesitaron una media de 1,69 sesiones de TFD. Tres de los pacientes necesitaron un tratamiento de rescate con termoterapia transpupilar, inyección intravítrea de antifactor de crecimiento endotelial vascular (ranibizumab, aflibercept) o implante intravítreo de dexametasona (Ozurdex®). La indicación de cambio de tratamiento fue la persistencia de edema microquístico intrarretiniano y/o desprendimiento neurosensorial (o su resolución incompleta) tras 3 sesiones de TFD. Como resultados generales, destacamos que un 62,5% de los pacientes evolucionó hacia la resolución anatómica y funcional (incremento de AV o estabilidad). ConclusionesLa TFD es un procedimiento dirigido y rápido, con buena respuesta anatómica y funcional, que ocasiona un mínimo daño a los vasos adyacentes a la lesión." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Subirà O, Brosa H, Lorenzo-Parra D, Arias-Barquet L, Català-Mora J, Cobos E., et al. Hemangioma coroideo y terapia fotodinámica. Respuesta anatómica y funcional de los pacientes con hemangioma coroideo tratados con terapia fotodinámica. Arch Soc Esp Oftalmol. 2017;92:257–264." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2646 "Ancho" => 1211 "Tamanyo" => 414052 ] ] "descripcion" => array:1 [ "en" => "Evolution of patient number 7 in images. (A) retinography, showing orange lesion in upper temporal arch. (B) Autofluorescence, showing enhancement of lesion with hyper-and hypo-autofluorescent granulated pattern. (C) Mode B echography, showing hyperintense and homogeneous solid mass 1.6mm height and 10.31mm base, without posterior acoustic shadow. (D) ssOCT over the tumor, showing slightly over-elevated lesion that produces undulations of Bruch's membrane and retina pigment epithelium (arrow). Typical choroidal vasculature pattern loss can be observed (*). (E) macular OCT before treatment, showing subfoveal NSD (*). (F) retinography with retinal thicknesses graph prior to treatment: central foveal thickness 475μm. (G) Macular OCT 20 months after a single PDT session, showing complete absence of NSD. (H) Retinography with retinal thicknesses chart after treatment, showing central foveal thickness of 249μm." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1026 "Ancho" => 1731 "Tamanyo" => 223711 ] ] "descripcion" => array:1 [ "en" => "Evolution of patient number 4 in images. (A) Retinography showing superior juxtapapillary orange lesion. (B) Angiography showing vascular filling in early angiogram phases. (C) Mode B echography, showing hyperintense and homogeneous solid mass having 3.10mm height and 8.63mm base, without posterior acoustic shadow. (D) ssOCT over the tumor, showing juxtapapillary tumor with multi-lobular spongelike pattern at the choroidal level with associated MCE. (E) macular OCT prior to treatment, showing diffuse MCE (*) foveal profile loss. (F) Macular OCT 14 months after a single PDT session, showing complete absence of MCE." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1265 "Ancho" => 1712 "Tamanyo" => 327992 ] ] "descripcion" => array:1 [ "en" => "Evolution of patient number 5 in images. (A) Retinography showing peripapillary orange lesion under inferior temporal arch. (B) Autofluorescence showing lesion with central hypo-autofluorescence and hyper-autofluorescence in margins. (C) Mode B echography showing hyperintense and homogeneous solid mass having 3.65mm height and 7.83mm base without posterior acoustic shadow, close to the optic nerve. (D) ssOCT over the tumor, showing multi-lobular spongelike pattern corresponding to vascular septum. (E) Macular OCT prior to treatment, showing macular MCE (*), respecting temporal macular area. It can be seen that prior to treatment a disruption of external retina layers could be observed at the foveal level (arrow). (F) Retinography retinal thickness graph prior to treatment, with central foveal thickness of 233μm. (G) Macular OCT taken 19 months after 2 PDT sessions, showing complete absence of MCE, persistence of external retina layers disruption at the foveal level (arrow). (H) Retinography retinal thickness graph after treatment, showing central foveal thickness of 144μm." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Age (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Symptoms expressing in first visit \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VA at first visit (decimal scale) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VA at last visit (decimal scale) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up time (months) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Tumor location \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of PDT sessions \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Rescue treatment \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Alterations in OCT at first visit \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Scotoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vascular arches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Macular parafoveal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA and scotoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE and NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Myodesopsia and photopsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vascular arches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anti-VEGF and IV dexamethasone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Macular subfoveal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anti-VEGF and IV dexamethasone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE and NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE and NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Metamorphopsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">TTT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE and NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA and scotoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Peripapillary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">TTT and IV dexamethasone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE and NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA and myodesopsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vascular arches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diminished VA and myodesopsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Macular parafoveal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NSD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Casual finding, asymptomatic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MCE \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1427460.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Summary of cases." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MCE at first visit \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MCE at last visit \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NSD at first visit \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NSD at last visit \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Foveal thickness at first visit (μm) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Foveal thickness at last visit (μm) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">882 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">421 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">122 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">383 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">322 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">529 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">206 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">228 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">144 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">380 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">771 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">475 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">264 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">484 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">586 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">318 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">182 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">346 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">498 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">207 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">166 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">363 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">472 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">999 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">329 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">185 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">305 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">385 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">273 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">194 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1427461.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Qualitative and quantitative alterations of optical coherence tomography." ] ] ] "bibliografia" => array:2 [ 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Choroidal haemangioma and photodynamic therapy. Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy

Hemangioma coroideo y terapia fotodinámica. Respuesta anatómica y funcional de los pacientes con hemangioma coroideo tratados con terapia fotodinámica

O. Subirà

Corresponding author

olaiasubira@gmail.com

Corresponding author.

, H. Brosa, D. Lorenzo-Parra, L. Arias-Barquet, J. Català-Mora, E. Cobos, P. Garcia-Bru, M.J. Rubio-Caso, J.M. Caminal-Mitjana

Departamento de Oftalmología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evolution of patient number 7 in images&#46; &#40;A&#41; retinography&#44; showing orange lesion in upper temporal arch&#46; &#40;B&#41; Autofluorescence&#44; showing enhancement of lesion with hyper-and hypo-autofluorescent granulated pattern&#46; &#40;C&#41; Mode B echography&#44; showing hyperintense and homogeneous solid mass 1&#46;6<span class="elsevierStyleHsp" style=""></span>mm height and 10&#46;31<span class="elsevierStyleHsp" style=""></span>mm base&#44; without posterior acoustic shadow&#46; &#40;D&#41; ssOCT over the tumor&#44; showing slightly over-elevated lesion that produces undulations of Bruch&#39;s membrane and retina pigment epithelium &#40;arrow&#41;&#46; Typical choroidal vasculature pattern loss can be observed &#40;&#42;&#41;&#46; &#40;E&#41; macular OCT before treatment&#44; showing subfoveal NSD &#40;&#42;&#41;&#46; &#40;F&#41; retinography with retinal thicknesses graph prior to treatment&#58; central foveal thickness 475<span class="elsevierStyleHsp" style=""></span>&#956;m&#46; &#40;G&#41; Macular OCT 20 months after a single PDT session&#44; showing complete absence of NSD&#46; &#40;H&#41; Retinography with retinal thicknesses chart after treatment&#44; showing central foveal thickness of 249<span class="elsevierStyleHsp" style=""></span>&#956;m&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Choroidal hemangioma is a benign choroidal vascular lesion&#46; Two subtypes are differentiated&#58; the most frequent circumscribed type&#44; and the diffuse type&#46; The latter is usually associated to the Sturge&#8211;Weber syndrome&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Circumscribed choroidal hemangioma &#40;CCH&#41; presents as a solitary and slightly elevated lesion with orange-reddish pigmentation&#44; typically located in the posterior pole close to the macular or peripapillary area&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">1</span></a> It is generally diagnosed as from the 3rd decade of life either in a routine exploration or due to the onset of symptoms secondary to the lesion&#46; The most frequently associated symptom of CCH is diminished visual acuity &#40;VA&#41; secondary to the presence of neurosensory detachment &#40;NSD&#41; or microcystic edema &#40;MCE&#41;&#46; When the tumor is located in the macular area&#44; VA loss is generally greater and expresses at an earlier age&#46; As CCH is a benign tumor there is no risk of metastasis or vital danger for the patient&#46; However&#44; until a few years ago there was no effective treatment and therefore the majority of cases were related to poor visual prognostic&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> As a general rule&#44; CCH must be treated only when it compromises the vision of a patient&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the last 3 decades the therapeutic approach to CCH has changed with the appearance of new evidence about alternative treatments&#46; In the 90s&#44; argon laser photocoagulation was the treatment of choice&#46; The majority of published studies reported rather discouraging results&#44; particularly when the tumor compromised the foveal area&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">2&#8211;4</span></a> Subsequently&#44; other treatments emerged&#44; such as cryotherapy&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a> external radiotherapy or application of a scleral plate<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> as well as trans-pupil therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">7&#44;8</span></a> At this date&#44; these techniques have been gradually discarded despite demonstrating VA increases of varied degree due to local side effects&#44; above all at the retina level&#46; At present&#44; photodynamic therapy &#40;PDT&#41; has consolidated as treatment of choice for CCH because it is a directed and fast treatment with very few side effects&#46; The photochemical effect of PDT achieves tumor regression without retinal or nerve fiber damage&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">9&#8211;13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The objective of this study is to determine the efficacy and limitations of PDT as a treatment for symptomatic CCH&#44; assessing the results obtained in a tertiary center in the past 7 years&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Subjects&#44; material and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A retrospective study of 16 patients with CCH who visited at the authors&#8217; hospital and treated with PDT in the past 7 years &#40;from July 2010 to September 2015&#41;&#46; All patients completed a minimum follow-up of 7 months after treatment&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">CCH diagnostic was based on the results obtained by slitlamp examination&#44; fluorescein angiography&#44; B-mode echography&#44; autofluorescence and optical coherence tomography &#40;OCT&#41;&#46; After diagnostic&#44; response to treatment and evolution were assessed by means of OCT&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Swept-Source</span> OCT &#40;ssOCT&#41; was utilized in the cases included in the study in the past 3 years in order to define with greater precision the characteristics and internal structure of the tumor&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All patients exhibited CCH that caused symptoms secondary to the presence of MCE or NSD&#44; visualized through OCT &#40;Topcon 2000&#59; DRI-1&#59; Atlantis OCT&#44; Tokyo&#44; Japan&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The study excluded patients who underwent previous ocular surgery in the past 4 months &#40;cataract surgery&#41;&#44; those who exhibited a disease that could involve diminished VA &#40;such as age-related macular degeneration and macular disk-shaped scar&#41; as well as patients with CCH who had either received previous treatment for the lesion &#40;radiotherapy&#44; transpupilar therapy&#44; photocoagulation&#44; etc&#46;&#41;&#44; or were undergoing some type of photosensitive treatment&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">PDT was performed with a Zeiss laser &#40;Visulas 6905&#44; Carl Zeiss-Meditec AG&#44; Jena&#44; Germany&#41;&#44; together with the administration of verteporfin at a dose of 6<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> &#40;Visudyne<span class="elsevierStyleSup">&#174;</span>&#59; Oftalmolog&#237;a&#44; Novartis AG&#44; basil&#44; Switzerland&#41;&#46; Standard fluency dose &#40;50<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> during 83<span class="elsevierStyleHsp" style=""></span>s&#41; was applied to 14 patients&#44; whereas double fluency PDT &#40;100<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> during 166<span class="elsevierStyleHsp" style=""></span>s&#41; was applied to 2 patients&#46; The power applied was 600<span class="elsevierStyleHsp" style=""></span>mW&#47;cm<span class="elsevierStyleSup">2</span> and one or 2 spots were utilized depending on tumor diameter &#40;with a maximum spots diameter between 4000&#8211;8000<span class="elsevierStyleHsp" style=""></span>&#956;m&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Study parameters were age&#44; gender&#44; tumor location&#44; associated symptoms&#44; VA &#40;measured in the decimal scale&#41; pre-and post-treatment&#44; qualitative and quantitative alterations shown in OCT pre-and post-treatment&#44; the number of PDT sessions and rescue treatment needed&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The checkup visit after the first PDT treatment was at 3 months&#46; Subsequently&#44; follow-up was customized to the evolution of each patient&#46; No additional PDT sessions were made when the exudate had resolved completely&#44; regardless of the presence of residual tumor&#46; The indication for a change in treatment was the persistence of MCE and&#47;or NSD &#40;or incomplete resolution thereof&#41; after 3 PDT sessions&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The statistical study was made with the SPSS application &#40;V20&#44; SPSS&#44; Chicago&#44; Illinois&#44; USA&#41;&#46; Sample normality was analyzed with normality graphs and the Kolmogorov&#8211;Smirnov test&#46; The effectiveness of the treatment was estimated analyzing the following items&#58; disappearance of MCE and&#47;or NSD and the need for rescue treatment &#40;calculated with the McNemar test&#41;&#46; On the other hand&#44; the Wilcoxon test was applied for assessing VA changes and foveal retinal thickness variations &#40;observed by means of ssOCT&#41;&#44; and Pearson&#39;s correlation test for measuring the association between the results obtained after measuring tumor height with echography and ssOCT&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">The mean age of the 16 patients &#40;13 males and 3 females&#41; was 54&#46;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;09 years and the mean follow-up time was 22&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;25 months&#46; All patients exhibited symptoms secondary to the presence of MC and&#47;or subretinal fluid &#40;SRF&#41; associated to CCH&#58; diminished VA &#40;81&#46;25&#37;&#41;&#44; metamorphopsia &#40;6&#46;25&#37;&#41;&#44; visualization of scotoma &#40;18&#46;75&#37;&#41;&#44; myodesopsiae and photopsiae &#40;12&#46;5&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">All the tumors were located in the posterior pole&#46; The most frequent anatomic location was peripapillary &#40;37&#46;5&#37;&#41;&#44; followed by temporal &#40;25&#37;&#41;&#44; under vascular arches &#40;18&#46;75&#37;&#41; and macular &#40;parafoveal or subfoveal&#44; with 12&#46;5 and 6&#46;25&#37;&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Seven patients &#40;43&#46;75&#37;&#41; only required a single PDT session&#46; The remaining 9 patients required 2 or 3 sessions &#40;25 and 31&#46;25&#37;&#44; respectively&#41;&#46; All patients requiring one or 2 sessions exhibited complete resolution of intraretinal fluid &#40;IRF&#41; or SRF &#40;with one exception&#44; with only partial reabsorption&#41;&#46; All patients that required 3 PDT sessions exhibited relatively poor evolution &#40;3 maintained clinical stability without improvement and 2 worsened&#41;&#46; For this reason&#44; the indication for treatment change was the persistence of NSD or MCE &#40;or incomplete resolution thereof&#41; together with lack of VA improvement after 3 PDT sessions&#46; The prevalence of NSD and MCE at the first visit was 81&#46;25 and 50&#37;&#44; respectively &#40;31&#46;25&#37; exhibited both alterations concurrently&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; After carrying out PDT&#44; the presence of both variables was 31&#46;25&#37; for NSD &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and 25&#37; for MCE &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;219&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">The mean pretreatment foveal thickness &#40;measured through OCT&#41; was 374&#46;93<span class="elsevierStyleHsp" style=""></span>&#956;m&#44; while the post-treatment foveal thickness was 323&#46;13<span class="elsevierStyleHsp" style=""></span>&#956;m&#44; with a non-significant mean foveal thickness reduction&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mean VA increased from 0&#46;23 to 0&#46;38 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;055&#41;&#46; Overall&#44; 56&#46;25&#37; of patients exhibited VA improvement&#44; 25&#37; remained stable and only 18&#46;75&#37; worsened&#46; No positive correlation was observed between tumor height measured with echography and ssOCT &#40;correlation 0&#46;42&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The treatment was well tolerated &#40;no allergic or hypersensitivity reactions were observed&#41; by all patients&#44; and no side effects were detected&#46; In addition&#44; no damages were observed on retinal structures&#44; although an evolution toward retinal atrophy was identified with external layer disruption at the foveal level in 3 patients &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; It must be noted that a review of pretreatment OCT images already showed said alterations secondary to the presence of SRF or IRF&#46; This entailed low VA despite the complete reabsorption of IRF or SRF&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">CCH is a benign tumor and does not involve vital compromise&#46; Therefore treatment is indicated only for patients who exhibit symptoms&#44; particularly visual loss&#46; In the present study&#44; the majority of patients with CCH treated with PDT achieved VA improvements &#40;baseline mean VA of 0&#46;23 and mean post-PDT VA of 0&#46;38&#41;&#44; with a mean of 1&#46;69 PDT sessions&#46; Overall&#44; 62&#46;5&#37; of patients evolved to anatomic and functional resolution &#40;increased or stabilized VA&#41;&#46; None of the patients exhibited PDT-related toxicity&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Treatment before photodynamic therapy has demonstrated varying degrees of efficacy&#46; However&#44; frequent recurrences and mainly the high number of side effects have caused the obsolescence of said techniques&#46; Tumor photocoagulation with argon or xenon laser involves only the tumor surface and causes significant retinal scarring that cause irreversible VA losses&#46; Madreperla et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> described complete SRF resolution in only 46 of patients treated with photocoagulation&#46; In addition&#44; Anand et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> reported that 20&#37; of patients exhibited VA improvement&#44; 53&#37; maintained stable VA and 27&#37; exhibited worsened VA&#44; also after laser photocoagulation&#46; Also&#44; 40&#37; of treated cases exhibited SRF reappearance&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In contrast&#44; external radiotherapy and brachytherapy penetrate deeper tumor layers&#44; inducing complete regression and SRF reabsorption in the majority of cases&#46; Aizman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> observed complete subretinal fluid resolution in all patients&#44; together with diminished mean height of tumors in 50&#37; of cases treated with radiotherapy&#46; However&#44; these techniques involve greater complexity and high costs&#44; in addition to a large number of reported side effects&#44; both locally &#40;cataracts&#44; retinal ischemia and secondary neovascularization&#44; etc&#46;&#41; and systemically&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Trans-pupil thermotherapy is a therapeutic option that still maintains its validity for cases that are refractory to treatment with PDT&#46; The series of 26 patients treated with trans-pupil effect published by G&#252;nd&#252;z<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> reported VA increases in 20 cases &#40;77&#37;&#41; and VA stability in the remaining 6 &#40;23&#37;&#41;&#46; However&#44; preretinal fibrosis was observed in 2 eyes&#44; focal iris atrophy in 3 and retinal vascular occlusion in one eye&#46; Possible side effects diminish the validity of this technique for tumors located in the macula&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">16&#44;17</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">PDT consists in selective photochemical lesion of vascular endothelial cells&#44; preserving other retinal structures and optic nerve fibers&#44; thus avoiding the side effects of the above-described treatments&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Blasi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> carried out a prospective study with 22 patients that were administered either a single PDT session &#40;100<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; or 2 sessions &#40;the first having 50<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> and the second 100<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; with a follow-up of 60 months&#46; In this series&#44; the mean VA improvement was 18&#46;5 ETDRS&#44; whereas foveal thickness diminished from 386&#46;20 to 179&#46;2<span class="elsevierStyleHsp" style=""></span>&#956;m&#44; observing complete resolution of macular exudation in all cases&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Boixadera et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a> described a series of 31 cases treated with PDT &#40;between 1 and 3 sessions at 50<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; with 12 months follow-up&#46; Mean VA increased from 20&#47;60 to 20&#47;35&#46; Overall&#44; 69&#37; exhibited VA improvements&#46; MCE disappeared in all cases whereas NSD also disappeared in all but 2 cases&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Elizalde et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a> carried out a retrospective study of 13 patients with a mean follow-up of 26 months&#46; Of these&#44; 7 patients &#40;54&#37;&#41; had a single PDT session&#44; 5 &#40;38&#37;&#41; had 2 sessions and one had 5 sessions&#44; finally requiring external beam radiotherapy treatment&#46; VA improved at least one line in 11 patients and remained stable in the remaining 2&#46; SRF results completely in 92&#37; of cases&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In the present study&#44; the majority of patients exhibited positive response to PDT treatment&#44; all requiring one or 2 sessions&#46; In general&#44; the patients that required more treatment sessions responded poorly to PDT as well as to the rest of treatments&#46; In the present series&#44; significant reductions in MCE as well as NSD were achieved after PDT &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In addition&#44; a non-significant mean foveal thickness reduction was observed&#46; As regards VA&#44; 56&#46;25&#37; of patients exhibited improvements&#44; 25&#37; remained stable and only 18&#46;75&#37; worsened&#46; For this reason&#44; the results of the present study are excellent as regards study parameters&#44; as well as being similar to the results of other studies&#46; Even so&#44; it is difficult to compare different studies due to variable follow-up times and use of different treatment parameters&#46; The treatment protocol&#44; light intensity&#44; number of impact and exposure time are different in each series&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">9&#8211;13</span></a> For this reason&#44; there is no clear consensus on this issue&#44; and it would be necessary to carry out studies comparing the obtained results with the various PDT parameters in order to draw conclusions&#46; The fact of utilizing standard fluency treatments in the majority of cases&#44; together with longer observation times in comparison with other results&#44; could justify a discreet higher prevalence of MCE or NSD at the end of the follow-up period&#46; Accordingly&#44; in the most recent cases the authors have systematically applied dual fluency PDT as a standard technique&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The limitations of the present study include its retrospective nature and the use of different treatment parameters in all patients&#46; Even so&#44; the authors consider that PDT is a directed&#44; fast and highly effective procedure on the basis of IRF or SRF reabsorption as well as visual improvements&#44; and free of significant evidences of side effects&#46; Accordingly&#44; PDT is considered by the authors as a first choice treatment for symptomatic CCH on the basis of its anatomic and functional results as well as a minimum amount of re-treatments and complications &#40;chorioretinal atrophy&#41; in the course of a prolonged ophthalmological follow-up period&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0155" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xres845212"
          "titulo" => "Abstract"
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            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
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              "identificador" => "abst0015"
              "titulo" => "Results"
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              "identificador" => "abst0020"
              "titulo" => "Conclusions"
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        1 => array:2 [
          "identificador" => "xpalclavsec840095"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres845213"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
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            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
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        3 => array:2 [
          "identificador" => "xpalclavsec840094"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Subjects&#44; material and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
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        7 => array:2 [
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          "titulo" => "Discussion"
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          "identificador" => "sec0025"
          "titulo" => "Conflict of interests"
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          "titulo" => "References"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-08-02"
    "fechaAceptado" => "2016-11-20"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec840095"
          "palabras" => array:3 [
            0 => "Circumscribed choroidal hemangioma"
            1 => "Choroidal tumor"
            2 => "Photodynamic therapy"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec840094"
          "palabras" => array:3 [
            0 => "Hemangioma coroideo circunscrito"
            1 => "Tumor coroideo"
            2 => "Terapia fotodin&#225;mica"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To study the effectiveness and limitations of photodynamic therapy &#40;PDT&#41; as treatment of choice in patients with symptomatic circumscribed choroidal hemangioma&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was conducted on 16 patients &#40;13 men and 3 women&#44; with mean age of 54&#46;88 years&#41; with circumscribed choroidal hemangioma&#44; who attended our center and were treated with PDT in the last 7 years&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">All patients had circumscribed choroidal hemangioma&#44; which caused a decrease in visual acuity &#40;VA&#41; secondary to the presence of intraretinal microcystic edema or neurosensory detachment&#46; The mean initial VA was 0&#46;23&#44; and the final mean VA after performing PDT was 0&#46;38 &#40;all the VA were measured in decimal scale&#41;&#46; It should be noted that patients needed a mean of 1&#46;69 PDT sessions&#46; Three of the patients needed rescue treatment with trans-pupillary thermotherapy&#44; intravitreal injection of anti-vascular endothelial growth factor &#40;ranibizumab&#44; aflibercept&#41; or a dexamethasone intravitreal implant &#40;Ozurdex<span class="elsevierStyleSup">&#174;</span>&#41;&#46; The indication for a change of treatment was the persistence of intraretinal microcystic edema and&#47;or neurosensory detachment &#40;or incomplete resolution&#41; after 3 PDT sessions&#46; As overall results&#44; 62&#46;5&#37; of patients evolved into anatomical and functional &#40;increase in AV or stability&#41; resolution&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">PDT is a straight forward and fast procedure&#44; with a good anatomical and functional response&#44; causing minimal damage to adjacent vessels&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "titulo" => "Conclusions"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estudiar la eficacia y las limitaciones de la terapia fotodin&#225;mica &#40;TFD&#41; como tratamiento de primera elecci&#243;n en pacientes con hemangioma coroideo circunscrito sintom&#225;tico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio retrospectivo de 16 pacientes &#40;13 varones y 3 mujeres&#44; con una media de edad de 54&#44;88 a&#241;os&#41; con hemangioma coroideo circunscrito visitados en nuestro centro y tratados con TFD en los &#250;ltimos 7 a&#241;os&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes presentaban hemangioma coroideo circunscrito&#44; que ocasionaba sintomatolog&#237;a secundaria a la presencia de edema microqu&#237;stico intrarretiniano o desprendimiento neurosensorial&#46; La agudeza visual &#40;AV&#41; media inicial del grupo era de 0&#44;23 y la AV media posterior a la realizaci&#243;n de TFD fue de 0&#44;38 &#40;todas las AV fueron medidas en escala decimal&#41;&#46; Cabe destacar que los pacientes necesitaron una media de 1&#44;69 sesiones de TFD&#46; Tres de los pacientes necesitaron un tratamiento de rescate con termoterapia transpupilar&#44; inyecci&#243;n intrav&#237;trea de antifactor de crecimiento endotelial vascular &#40;ranibizumab&#44; aflibercept&#41; o implante intrav&#237;treo de dexametasona &#40;Ozurdex<span class="elsevierStyleSup">&#174;</span>&#41;&#46; La indicaci&#243;n de cambio de tratamiento fue la persistencia de edema microqu&#237;stico intrarretiniano y&#47;o desprendimiento neurosensorial &#40;o su resoluci&#243;n incompleta&#41; tras 3 sesiones de TFD&#46; Como resultados generales&#44; destacamos que un 62&#44;5&#37; de los pacientes evolucion&#243; hacia la resoluci&#243;n anat&#243;mica y funcional &#40;incremento de AV o estabilidad&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La TFD es un procedimiento dirigido y r&#225;pido&#44; con buena respuesta anat&#243;mica y funcional&#44; que ocasiona un m&#237;nimo da&#241;o a los vasos adyacentes a la lesi&#243;n&#46;</p></span>"
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            "identificador" => "abst0035"
            "titulo" => "Resultados"
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            "titulo" => "Conclusiones"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Subir&#224; O&#44; Brosa H&#44; Lorenzo-Parra D&#44; Arias-Barquet L&#44; Catal&#224;-Mora J&#44; Cobos E&#46;&#44; et al&#46; Hemangioma coroideo y terapia fotodin&#225;mica&#46; Respuesta anat&#243;mica y funcional de los pacientes con hemangioma coroideo tratados con terapia fotodin&#225;mica&#46; Arch Soc Esp Oftalmol&#46; 2017&#59;92&#58;257&#8211;264&#46;</p>"
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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            "imagen" => "gr1.jpeg"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evolution of patient number 7 in images&#46; &#40;A&#41; retinography&#44; showing orange lesion in upper temporal arch&#46; &#40;B&#41; Autofluorescence&#44; showing enhancement of lesion with hyper-and hypo-autofluorescent granulated pattern&#46; &#40;C&#41; Mode B echography&#44; showing hyperintense and homogeneous solid mass 1&#46;6<span class="elsevierStyleHsp" style=""></span>mm height and 10&#46;31<span class="elsevierStyleHsp" style=""></span>mm base&#44; without posterior acoustic shadow&#46; &#40;D&#41; ssOCT over the tumor&#44; showing slightly over-elevated lesion that produces undulations of Bruch&#39;s membrane and retina pigment epithelium &#40;arrow&#41;&#46; Typical choroidal vasculature pattern loss can be observed &#40;&#42;&#41;&#46; &#40;E&#41; macular OCT before treatment&#44; showing subfoveal NSD &#40;&#42;&#41;&#46; &#40;F&#41; retinography with retinal thicknesses graph prior to treatment&#58; central foveal thickness 475<span class="elsevierStyleHsp" style=""></span>&#956;m&#46; &#40;G&#41; Macular OCT 20 months after a single PDT session&#44; showing complete absence of NSD&#46; &#40;H&#41; Retinography with retinal thicknesses chart after treatment&#44; showing central foveal thickness of 249<span class="elsevierStyleHsp" style=""></span>&#956;m&#46;</p>"
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        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evolution of patient number 4 in images&#46; &#40;A&#41; Retinography showing superior juxtapapillary orange lesion&#46; &#40;B&#41; Angiography showing vascular filling in early angiogram phases&#46; &#40;C&#41; Mode B echography&#44; showing hyperintense and homogeneous solid mass having 3&#46;10<span class="elsevierStyleHsp" style=""></span>mm height and 8&#46;63<span class="elsevierStyleHsp" style=""></span>mm base&#44; without posterior acoustic shadow&#46; &#40;D&#41; ssOCT over the tumor&#44; showing juxtapapillary tumor with multi-lobular spongelike pattern at the choroidal level with associated MCE&#46; &#40;E&#41; macular OCT prior to treatment&#44; showing diffuse MCE &#40;&#42;&#41; foveal profile loss&#46; &#40;F&#41; Macular OCT 14 months after a single PDT session&#44; showing complete absence of MCE&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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            "imagen" => "gr3.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evolution of patient number 5 in images&#46; &#40;A&#41; Retinography showing peripapillary orange lesion under inferior temporal arch&#46; &#40;B&#41; Autofluorescence showing lesion with central hypo-autofluorescence and hyper-autofluorescence in margins&#46; &#40;C&#41; Mode B echography showing hyperintense and homogeneous solid mass having 3&#46;65<span class="elsevierStyleHsp" style=""></span>mm height and 7&#46;83<span class="elsevierStyleHsp" style=""></span>mm base without posterior acoustic shadow&#44; close to the optic nerve&#46; &#40;D&#41; ssOCT over the tumor&#44; showing multi-lobular spongelike pattern corresponding to vascular septum&#46; &#40;E&#41; Macular OCT prior to treatment&#44; showing macular MCE &#40;&#42;&#41;&#44; respecting temporal macular area&#46; It can be seen that prior to treatment a disruption of external retina layers could be observed at the foveal level &#40;arrow&#41;&#46; &#40;F&#41; Retinography retinal thickness graph prior to treatment&#44; with central foveal thickness of 233<span class="elsevierStyleHsp" style=""></span>&#956;m&#46; &#40;G&#41; Macular OCT taken 19 months after 2 PDT sessions&#44; showing complete absence of MCE&#44; persistence of external retina layers disruption at the foveal level &#40;arrow&#41;&#46; &#40;H&#41; Retinography retinal thickness graph after treatment&#44; showing central foveal thickness of 144<span class="elsevierStyleHsp" style=""></span>&#956;m&#46;</p>"
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            "identificador" => "at1"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Symptoms expressing in first visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VA at first visit &#40;decimal scale&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VA at last visit &#40;decimal scale&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up time &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Tumor location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of PDT sessions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Rescue treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Alterations in OCT at first visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Scotoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vascular arches&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macular parafoveal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA and scotoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE and NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Myodesopsia and photopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vascular arches&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Anti-VEGF and IV dexamethasone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macular subfoveal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Anti-VEGF and IV dexamethasone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE and NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE and NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Metamorphopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE and NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA and scotoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peripapillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">TTT and IV dexamethasone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE and NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA and myodesopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vascular arches&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diminished VA and myodesopsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macular parafoveal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Casual finding&#44; asymptomatic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MCE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1427460.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Summary of cases&#46;</p>"
        ]
      ]
      4 => array:8 [
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MCE at first visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MCE at last visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NSD at first visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NSD at last visit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Foveal thickness at first visit &#40;&#956;m&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Foveal thickness at last visit &#40;&#956;m&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">882&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">421&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">322&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">529&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">380&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">484&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">318&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">346&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">498&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">472&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">329&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">305&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">385&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">273&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">194&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1427461.png"
              ]
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Qualitative and quantitative alterations of optical coherence tomography&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:17 [
            0 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circumscribed choroidal hemangioma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Karimi"
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