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Evaluación de las secuelas clínicas y funcionales de la coriorretinopatía serosa central. Un análisis de serie de casos
Evaluation of clinical and functional sequels of central serous chorioretinopathy. A case series analysis
A.M. Cerón Enríqueza,
Autor para correspondencia
amceronenriquez@gmail.com

Autor para correspondencia.
, O.L. Teherán Forerob, C. Atencia Niñoc, R. Almanza Benito Revollod, E.C. Ramos Clasone, M.M. Ochoa Díaze
a Universidad del Sinú, Clínica Oftalmológica de Cartagena, Cartagena, Colombia
b Departamento de Glaucoma, Clínica Oftalmológica de Cartagena, Cartagena, Colombia
c Departamento de Retina y Vítreo, Clínica Ebenezer, Cartagena, Colombia
d Departamento de Retina y Vítreo, Clínica Oftalmológica de Cartagena, Cartagena, Colombia
e Grupo de investigación GIBACUS, Escuela de Medicina, Universidad del Sinú, Seccional Cartagena, Cartagena, Colombia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La coriorretinopat&#237;a serosa central &#40;CSC&#41; es una enfermedad coriorretiniana caracterizada por un desprendimiento seroso de la retina neurosensorial en la m&#225;cula<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">1</span></a>&#46; Se considera la cuarta retinopat&#237;a no quir&#250;rgica&#46; Se presenta con mayor frecuencia en varones&#44; entre la tercera y la quinta d&#233;cadas de la vida&#46; Se han descrito factores de riesgo&#44; como estr&#233;s emocional&#44; personalidad tipo<span class="elsevierStyleHsp" style=""></span>A&#44; embarazo&#44; uso de corticoides&#44; trastornos endocrinos como el s&#237;ndrome de Cushing&#44; tumores productores de esteroides&#44; entre otros<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">2-4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La enfermedad ocurre en dos formas b&#225;sicas&#58; aguda y cr&#243;nica&#46; Tanto la forma aguda como la cr&#243;nica se presentan morfol&#243;gicamente de la misma manera&#44; como un l&#237;quido seroso subretiniano con desprendimiento del epitelio pigmentario de la retina &#40;EPR&#41;&#59; la diferencia radica en que la forma aguda debuta como &#250;nico episodio menor a 4<span class="elsevierStyleHsp" style=""></span>meses sin ninguna secuela aparente&#44; y la forma cr&#243;nica se da mayor a 6<span class="elsevierStyleHsp" style=""></span>meses y puede durar hasta varios a&#241;os<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Puede manifestarse unilateralmente con visi&#243;n borrosa&#44; micropsia&#44; metamorfopsia&#44; hiperopizaci&#243;n&#44; alteraci&#243;n de la percepci&#243;n del color y&#44; en algunos casos&#44; escotoma relativo central o paracentral<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">2&#44;6&#44;7</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">La angiotomograf&#237;a &#40;OCT-A&#41; permite la evaluaci&#243;n y la cuantificaci&#243;n del flujo sangu&#237;neo coriocapilar<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">8</span></a>&#44; convirti&#233;ndose en el <span class="elsevierStyleItalic">gold standard</span> diagn&#243;stico&#59; sin embargo&#44; conlleva limitaciones considerables&#44; como artefactos causados por opacidad de medios<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">9&#44;10</span></a> o vasos sangu&#237;neos superficiales que bloquean la detecci&#243;n de vasos profundos<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">11&#44;12</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Debido a una alteraci&#243;n sutil en la agudeza visual&#44; algunos estudios han sugerido otros medios para evaluar la funci&#243;n visual&#44; incluida la sensibilidad al contraste &#40;CS&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a> y el campo visual de 10&#176; centrales<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; Este &#250;ltimo permite el examen de la sensibilidad macular y la fijaci&#243;n retiniana<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a> y permite cuantificar el defecto funcional&#44; aunque la agudeza visual est&#233; preservada<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">16</span></a>&#46; El desprendimiento seroso puede conducir a una p&#233;rdida variable de fotorreceptores&#44; atrofia y acortamiento de los segmentos externos&#44; cambios que inducen una disminuci&#243;n de la sensibilidad macular incluso despu&#233;s de la resoluci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La discriminaci&#243;n de tonos se mide com&#250;nmente mediante la prueba Farnsworth-Munsell 100 Hue &#40;FM100&#41;&#44; que permite visualizar los defectos de visi&#243;n del color con diferentes tonos y la misma saturaci&#243;n&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">El tratamiento de la enfermedad puede incluir la observaci&#243;n y la modificaci&#243;n del factor de riesgo sin medidas terap&#233;uticas adicionales&#44; hasta el uso de f&#225;rmacos inhibidores de la anhidrasa carb&#243;nica&#44; espironolactona&#44; AINE&#44; adem&#225;s de l&#225;ser micropulsado&#44; antiangiog&#233;nicos intrav&#237;treos y terapia fotodin&#225;mica de baja fluencia&#44; considerada como terapia de primera l&#237;nea para el tratamiento de la CSC<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Aunque la CSC puede autorresolverse en la mayor&#237;a de los casos sin dejar ning&#250;n tipo de secuela cl&#237;nica evidente&#44; otros pueden experimentar una discapacidad visual permanente&#44; debido al desprendimiento seroso cr&#243;nico&#44; que conduce a atrofia foveal&#44; degeneraci&#243;n del EPR&#44; degeneraci&#243;n cistoide o neovascularizaci&#243;n coroidea<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">19&#44;20</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Ante el escenario de este posible desenlace&#44; el presente estudio tiene como objetivo caracterizar las secuelas cl&#237;nicas y funcionales de la CSC utilizando t&#233;cnicas complementarias como prueba de sensibilidad al contraste&#44; campo visual 10-2 y prueba de color Farnsworth D-15 en pacientes con enfermedad resuelta&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se trata de un estudio con un dise&#241;o observacional descriptivo transversal realizado en pacientes con diagn&#243;stico de CSC atendidos en la Cl&#237;nica de Oftalmol&#243;gica de Cartagena &#40;Cartagena&#44; Colombia&#41; en el periodo 2015-2021 con enfermedad resuelta por OCT macular&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para ello&#44; se filtraron historias cl&#237;nicas de la base de datos de la instituci&#243;n con c&#243;digos CIE-10 H353&#44; H357 y H358 utilizados en el departamento de Retina&#46; Se revis&#243; la historia cl&#237;nica de cada paciente con enfermedad resuelta en la &#250;ltima consulta y se contact&#243; para la toma de los estudios&#44; previa firma del consentimiento informado&#44; cumpliendo con los principios de la declaraci&#243;n de Helsinki y la aprobaci&#243;n por el comit&#233; de &#233;tica m&#233;dica&#46; Se cit&#243; a cada paciente en dos oportunidades&#44; en la primera se realiz&#243; OCT macular por Avanti&#8482; TVue XR Optovue para confirmar la resoluci&#243;n de la enfermedad&#44; una vez confirmada&#44; se cita en una segunda ocasi&#243;n para realizar los estudios restantes &#40;campo visual 10-2 mediante Octopus 900&#174; Haag- Streit&#44; prueba de sensibilidad al contraste mediante Optec 6500&#174; Stereo Optical y test de Farnsworth D-15 de Pantone&#174;&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se incluyeron individuos diagnosticados con CSC resuelta&#44; es decir&#44; pacientes en los que no se evidenci&#243; l&#237;quido subretiniano por tomograf&#237;a&#44; despu&#233;s de un episodio agudo&#44; independientemente de la edad o sexo&#44; con o sin antecedente de enfermedad sist&#233;mica&#44; siempre y cuando no presentaran alteraciones retinianas secundarias a su patolog&#237;a de base&#46; Se excluyeron pacientes con CSC cr&#243;nica o recurrente &#40;2 o m&#225;s episodios agudos&#41;&#44; as&#237; como pacientes que presentaban alteraciones retinianas de origen sist&#233;mico de cualquier &#237;ndole&#44; vasculopat&#237;as&#44; oclusiones vasculares&#44; traumas y&#47;o trastornos inflamatorios&#46; Para disminuir el riesgo de alteraciones en el campo visual y en el test de sensibilidad al contraste&#44; fueron excluidos todos los pacientes que tuviesen diagn&#243;stico de glaucoma en cualquiera de sus tipos y los pacientes con opacidades de medios &#40;leucomas y cataratas&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">El tiempo de evoluci&#243;n se defini&#243; como el tiempo transcurrido desde el inicio de los s&#237;ntomas hasta la realizaci&#243;n de los ex&#225;menes pertinentes para evaluar las secuelas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Las secuelas representadas por OCT macular fueron catalogadas como irregularidad&#44; disrupci&#243;n&#44; fibrosis o elevaci&#243;n del EPR&#46; Se denominaron &#171;normales&#187; las tomograf&#237;as que no presentaban alteraciones evidentes&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Dentro de la evaluaci&#243;n del campo visual 10-2&#44; se clasificaron como normales aquellos que no presentaban escotomas o disminuci&#243;n de la sensibilidad retiniana dentro de los 10&#176; centrales&#44; y como anormales aquellos que presentaban sensibilidad foveal inferior a 30<span class="elsevierStyleHsp" style=""></span>dB o escotomas que compromet&#237;an los 5&#176; centrales&#44; paracentrales o ambos&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los resultados en la prueba de sensibilidad al contraste se clasificaron como defecto tipo<span class="elsevierStyleHsp" style=""></span>1 si la alteraci&#243;n correspond&#237;a a frecuencias espaciales altas &#40;12 y 18&#41;&#59; tipo<span class="elsevierStyleHsp" style=""></span>2 si todas las frecuencias estaban alteradas &#40;1&#44;5&#44; 3&#44; 6&#44; 12 y 18&#41;&#59; tipo<span class="elsevierStyleHsp" style=""></span>3 para frecuencias espaciales bajas &#40;1&#44;5 y 3&#41;&#44; y tipo<span class="elsevierStyleHsp" style=""></span>4 cuando la alteraci&#243;n no pod&#237;a ser clasificada como otro tipo&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Seg&#250;n los resultados de la prueba de color Farnsworth D-15&#44; se clasific&#243; como normal si correspond&#237;a a un paciente tricr&#243;mata &#40;visi&#243;n conservada para los ejes rojo&#44; verde y azul&#41;&#46; Los individuos con d&#233;ficit total en la percepci&#243;n del rojo se denominaron protanopes&#59; si el d&#233;ficit fue parcial&#44; protan&#243;malos&#46; Los individuos con un d&#233;ficit total en la percepci&#243;n del verde se denominaron deuteranopes&#59; si el d&#233;ficit fue parcial&#44; deuteran&#243;malos&#46; Finalmente&#44; aquellos que presentaban un d&#233;ficit total en la percepci&#243;n del color azul fueron clasificados como tritanopes&#44; y si fue parcial&#44; tritan&#243;malos&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Se realiz&#243; estad&#237;stica descriptiva&#44; calculando frecuencias y porcentajes para variables cualitativas&#46; Para variables cuantitativas se utilizaron medidas de centralizaci&#243;n tipo mediana &#40;Me&#41; con medidas de dispersi&#243;n y rango intercuart&#237;lico &#40;RIC&#41;&#44; dado el comportamiento no param&#233;trico de estas variables estimadas con la prueba de Shapiro Wilk&#46; Para comparar la distribuci&#243;n por las variables cuantitativas seg&#250;n tratamiento u observaci&#243;n&#44; se utiliz&#243; la prueba de Mann Whitney&#46; Las comparaciones de variables cualitativas se realizaron con la prueba de chi cuadrado o el test exacto de Fisher seg&#250;n fuese necesario&#46; Un valor p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 fue considerado como estad&#237;sticamente significativo&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0095" class="elsevierStylePara elsevierViewall">De la base de datos de la instituci&#243;n se obtuvieron 11&#46;939 admisiones con los c&#243;digos CIE-10 H353 &#40;8&#46;921&#41;&#44; H357 &#40;209&#41; y H358 &#40;2&#46;809&#41; correspondientes a diversas patolog&#237;as retinianas&#44; incluida la CSC&#46; Se obtuvieron 4&#46;319 pacientes&#44; de los cuales 295 padec&#237;an CSC&#46; Se excluyeron 163 individuos con enfermedad activa y aquellos que perdieron el seguimiento&#44; obteniendo 134 individuos&#44; de los que 53 aceptaron participar en el estudio&#46; Se realiz&#243; tomograf&#237;a macular en la primera visita&#44; reportando enfermedad activa en 26 pacientes&#44; obteniendo una muestra final de 27 ojos de 26 participantes con CSC resuelta&#44; a los que se tomaron los tres estudios adicionales &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">En la poblaci&#243;n acompa&#241;ada&#44; la mediana de edad fue de 48<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;RIC 42-56&#41;&#46; Un total de 19 pacientes &#40;70&#44;4&#37;&#41; eran hombres&#44; 23 &#40;85&#44;1&#37;&#41; mestizos&#44; y la lateralidad fue derecha en 18 ojos &#40;66&#44;7&#37;&#41;&#46; Entre las comorbilidades referidas destaca la hipertensi&#243;n arterial en 7 pacientes &#40;25&#44;9&#37;&#41;&#44; seguido por diabetes&#44; insomnio y depresi&#243;n&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El 53&#44;8&#37; del total de la muestra ten&#237;an alg&#250;n tratamiento&#44; cuya intervenci&#243;n m&#225;s utilizada fueron los AINE en 13 de ellos &#40;48&#44;2&#37;&#41;&#44; adem&#225;s de espironolactona en 4 &#40;14&#44;8&#37;&#41;&#44; y en porcentajes variables&#44; el uso de l&#225;ser micropulsado o antiangiog&#233;nicos intrav&#237;treos&#46; Doce pacientes &#40;44&#44;4&#37;&#41; correspondieron al grupo de observaci&#243;n&#44; sin intervenci&#243;n terap&#233;utica &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">El tiempo de evoluci&#243;n del total de la muestra fue de 29<span class="elsevierStyleHsp" style=""></span>meses &#40;25-39&#41;&#46; Al evaluar la presencia de secuelas por OCT macular&#44; estas se confirmaron en 20 &#40;74&#44;1&#37;&#41; casos&#44; siendo las m&#225;s prevalentes la disrupci&#243;n y elevaci&#243;n del EPR en 11 &#40;40&#44;7&#37;&#41; y 7 &#40;25&#44;9&#37;&#41;&#44; respectivamente&#44; seguido de irregularidad y fibrosis&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La sensibilidad al contraste se encontr&#243; alterada en 21 ojos &#40;77&#44;8&#37;&#41;&#44; siendo m&#225;s frecuente el defecto tipo<span class="elsevierStyleHsp" style=""></span>2 &#40;12 ojos&#44; 44&#44;4&#37;&#41;&#46; El campo visual se alter&#243; en un 100&#37;&#44; correspondiendo a una disminuci&#243;n de la sensibilidad &#40;sensibilidad foveal media &#91;MS&#93;&#41; de 25&#44;5<span class="elsevierStyleHsp" style=""></span>dB &#40;RIC 22&#44;3-27&#44;7&#41;&#44; identific&#225;ndose adem&#225;s escotomas centrales y paracentrales en 11 casos &#40;40&#44;7&#37;&#41;&#44; solo paracentrales en 3 &#40;11&#44;1&#37;&#41; y solo central en 1 &#40;3&#44;7&#37;&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">El test de Farnsworth D-15 mostr&#243; alteraci&#243;n en 11 ojos &#40;40&#44;7&#37;&#41;&#44; siendo la tritanomal&#237;a la m&#225;s frecuente en 9 &#40;81&#44;8&#37;&#41;&#44; seguida de la deuteranomal&#237;a y la deuteranop&#237;a&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Al evaluar la agudeza visual previa al tratamiento se encontr&#243; una mediana por logMar de 0&#44;4 &#40;RIC 0&#44;2-0&#44;6&#41;&#44; o 20&#47;50 por Snellen &#40;IQR 0&#44;4-0&#44;6&#41; y una AV postratamiento de 0&#44;2 &#40;RIC 0&#44;0-0&#44;6&#41; o 20&#47;30 por Snellen &#40;0&#44;1-0&#44;7&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">Al comparar las secuelas de CSC estratificadas por grupo de tratamiento vs observaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#44; se encontr&#243; una diferencia estad&#237;sticamente significativa en la edad y en el tiempo de evoluci&#243;n entre ambos&#46; No se observaron diferencias en la distribuci&#243;n por sexo y en las secuelas por OCT&#44; encontrando un espesor foveal de 226 micras &#40;214-252&#41; para el grupo de tratamiento y de 219 micras &#40;195-244&#41; para el grupo de observaci&#243;n&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Las alteraciones en la sensibilidad al contraste&#44; el test de color&#44; la agudeza y el campo visual no fueron estad&#237;sticamente significativas cuando se compararon entre los grupos&#44; y la MS encontrada fue de 24&#44;6<span class="elsevierStyleHsp" style=""></span>dB en el grupo de tratamiento y de 26&#44;5<span class="elsevierStyleHsp" style=""></span>dB en el de observaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0140" class="elsevierStylePara elsevierViewall">En la mayor&#237;a de los ojos&#44; la CSC aguda se resuelve espont&#225;neamente o inmediatamente despu&#233;s del tratamiento&#44; lo que resulta en un buen pron&#243;stico visual<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a>&#46; La recuperaci&#243;n de la visi&#243;n generalmente ocurre dentro de uno a cuatro meses&#44; coincidiendo con la reinserci&#243;n de la retina neurosensorial&#44; con pocas secuelas conocidas&#44; que incluyen p&#233;rdida permanente de la funci&#243;n visual&#44; alteraci&#243;n en la visi&#243;n del color&#44; alteraciones del campo visual y sensibilidad al contraste<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Baran et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">23</span></a>&#44; en su estudio&#44; incluyeron 62 ojos de 31 pacientes diagnosticados de CSC unilateral&#44; seguidos 50&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#44;5 meses despu&#233;s de su fase aguda sin recurrencias&#46; Se realiz&#243; la prueba de color Farnsworth Munsen-40&#44; campo visual 10-2 y sensibilidad al contraste&#46; Se encontr&#243; defecto de discriminaci&#243;n crom&#225;tica en el 48&#44;4&#37; de los ojos y afectaci&#243;n del ojo contralateral en el 54&#44;8&#37;&#46; La sensibilidad al contraste fue menor en los ojos CSC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; y en la perimetr&#237;a&#44; el valor de desviaci&#243;n media para los ojos CSC fue de 6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6<span class="elsevierStyleHsp" style=""></span>dB en el ojo afectado y de 4&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1<span class="elsevierStyleHsp" style=""></span>dB en el ojo contralateral &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; El presente estudio tambi&#233;n demostr&#243; alteraci&#243;n del test de Farnsworth D-15 en el 40&#44;7&#37;&#44; siendo m&#225;s frecuente la tritanomal&#237;a en el 81&#44;8&#37; de ellos&#59; la sensibilidad al contraste estuvo alterada en el 77&#44;8&#37;&#44; siendo m&#225;s frecuente el tipo<span class="elsevierStyleHsp" style=""></span>2 en el 44&#44;4&#37;&#59; la OCT macular confirm&#243; secuelas en el 74&#44;1&#37;&#44; siendo las m&#225;s frecuentes disrupci&#243;n y elevaci&#243;n del EPR en el 40&#44;7 y el 25&#44;9&#37;&#44; respectivamente&#46; El campo visual mostr&#243; sensibilidad disminuida en los 10&#176; centrales en el 100&#37;&#44; encontrando escotomas centrales y paracentrales en el 40&#44;7&#37;&#46; En todas las pruebas&#44; no hubo diferencias significativas entre ambos grupos&#59; sin embargo&#44; el tiempo de evoluci&#243;n de cada uno mostr&#243; significaci&#243;n estad&#237;stica&#44; indicando la homogeneidad de la muestra&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">La sensibilidad al contraste es la capacidad del sistema visual para distinguir entre un objeto y el fondo<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a>&#46; Koskela et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">24</span></a> evaluaron 21 pacientes entre 6 y 15<span class="elsevierStyleHsp" style=""></span>a&#241;os despu&#233;s de la fase aguda de la CSC&#46; En la mayor&#237;a de los casos&#44; la sensibilidad al contraste fue significativamente menor en el ojo afectado en frecuencias espaciales bajas y medias &#40;1-6&#41;&#46; Maaranen y M&#228;ntyj&#228;rvi<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">25</span></a> estudiaron a 31 pacientes con enfermedad resuelta y encontraron alteraci&#243;n significativa en las 5 frecuencias&#44; en comparaci&#243;n con ojos normales&#46; Estos resultados concuerdan con los obtenidos en el presente estudio&#44; donde se vieron afectadas las frecuencias altas&#44; medias y bajas&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Durante muchos a&#241;os&#44; uno de los m&#233;todos est&#225;ndar para medir la disfunci&#243;n visual ha sido la perimetr&#237;a&#44; una t&#233;cnica f&#225;cil y no invasiva para evaluar los cambios en la sensibilidad macular<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">26&#44;27</span></a>&#46; Folk y su grupo<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">28</span></a> evaluaron a 18 sujetos con CSC un a&#241;o despu&#233;s de la reabsorci&#243;n del l&#237;quido subretiniano mediante perimetr&#237;a central de 15&#176;&#44; demostrando depresi&#243;n del campo visual central y persistencia de una menor sensibilidad a largo plazo&#46; Ojima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a> estudiaron 21 pacientes con CSC resuelta y compararon los hallazgos entre el campo visual 10-2 y la OCT macular&#44; mostrando irregularidades y alteraciones del EPR en 11 y 15 ojos&#44; respectivamente&#44; con sensibilidades retinianas significativamente m&#225;s bajas que los ojos sanos &#40;17&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;4<span class="elsevierStyleHsp" style=""></span>dB&#41;&#46; En el presente estudio&#44; 20 pacientes &#40;74&#44;1&#37;&#41; presentaron alteraciones en el OCT&#59; sin embargo&#44; el 100&#37; presentaron disminuci&#243;n de la sensibilidad retiniana y solo en el 55&#44;5&#37; se observaron escotomas en el campo visual&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En 2016 se realiz&#243; un estudio prospectivo indio en 60 ojos de 30 pacientes del Al Salama Eye Hospital&#44; Perinthalmanna&#44; a quienes se les realiz&#243; el test Farnsworth D-15 e Ishihara&#44; donde&#44; tras un ataque agudo&#44; la mayor&#237;a presentaban defectos en la visi&#243;n del color &#40;73&#44;33&#37;&#41;&#44; principalmente del eje trit&#225;n &#40;50&#37;&#41;&#46; Maaranen y Tuppurainen<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> siguieron a 39 pacientes durante 10<span class="elsevierStyleHsp" style=""></span>a&#241;os con antecedente de CSC que presentaban agudeza visual normal &#40;logMar<span class="elsevierStyleHsp" style=""></span>0&#41;&#44; encontrando alteraci&#243;n del color en 26 pacientes &#40;67&#37;&#41;&#44; la mayor&#237;a en el eje trit&#225;n&#44; lo cual se correlaciona con el presente estudio&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Las pruebas del color&#44; del campo visual y de la sensibilidad al contraste demuestran que los pacientes con un curso leve de CSC experimentan una p&#233;rdida anat&#243;mica y funcional significativa que antes no se hab&#237;a detectado&#46; Aunque existen terapias est&#225;ndar para inducir la absorci&#243;n del fluido subretiniano&#44; estas no son apropiadas en todos los casos y el momento &#243;ptimo para la intervenci&#243;n sigue siendo incierto<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n de este estudio es el reducido tama&#241;o de la muestra&#44; ya que&#44; a pesar de ser la CSC un motivo de consulta frecuente&#44; varios individuos pierden seguimiento oftalmol&#243;gico cuando sus s&#237;ntomas iniciales se ven resueltos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="par0175" class="elsevierStylePara elsevierViewall">La CSC deja secuelas a largo plazo que pueden ser imperceptibles por los pacientes y &#250;nicamente detectadas por los estudios propuestos en este trabajo&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">La CSC puede dejar secuelas a largo plazo en la agudeza y en la calidad visual&#44; detectadas por OCT macular&#44; prueba de sensibilidad al contraste&#44; campo visual 10-2 y prueba de color Farnsworth D-15&#44; que no difieren entre la observaci&#243;n o el tratamiento en fase aguda&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Las secuelas corresponden a un defecto de tipo<span class="elsevierStyleHsp" style=""></span>2 en la sensibilidad al contraste&#44; p&#233;rdida de la sensibilidad central en la perimetr&#237;a y defecto en la percepci&#243;n del color azul&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicto de intereses</span><p id="par0190" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaAceptado" => "2022-04-25"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar las secuelas cl&#237;nicas y funcionales de pacientes con diagn&#243;stico de coriorretinopat&#237;a serosa central &#40;CSC&#41; resuelta&#44; mediante OCT macular&#44; prueba de sensibilidad al contraste&#44; campo visual 10-2 y prueba de colores Farnsworth D-15&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron y evaluaron 27 ojos de 26 individuos con CSC resuelta por OCT macular&#59; a los pacientes se les realiz&#243; prueba de sensibilidad al contraste con el equipo Optec 6500&#44; campo visual 10-2 con Octopus 900 Haag- Streit y prueba de color Farnsworth D-15&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se observaron secuelas en 20 ojos &#40;74&#44;1&#37;&#41; por OCT macular y en 21 &#40;77&#44;8&#37;&#41; en la sensibilidad al contraste&#44; predominantemente defecto tipo<span class="elsevierStyleHsp" style=""></span>2&#46; Tambi&#233;n 27 &#40;100&#37;&#41; ten&#237;an un campo visual 10-2 alterado correspondiente a sensibilidad foveal reducida&#44; y 11 ojos &#40;40&#44;7&#37;&#41; correspond&#237;an a escotomas centrales y paracentrales&#46; La prueba de color mostr&#243; alteraci&#243;n en 11 &#40;40&#44;7&#37;&#41; del total de ojos evaluados&#44; encontrando tritanomal&#237;a en 9 de ellos &#40;81&#44;8&#37;&#41;&#46; No se observaron diferencias significativas en los estudios entre el grupo de observaci&#243;n vs el grupo de tratamiento&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La CSC puede dejar secuelas en la calidad visual de los pacientes a pesar de su tratamiento en fase aguda&#46; La agudeza visual antes y despu&#233;s del tratamiento en el grupo de intervenci&#243;n no tuvo diferencia significativa&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the clinical and functional sequelae of patients with a diagnosis of resolved central serous chorioretinopathy &#40;CSC&#41;&#44; through macular OCT&#44; contrast sensitivity test&#44; visual field 10-2 and Farnsworth D-15 color test&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">27 eyes of 26 individuals with CSC resolved by macular OCT were included and evaluated&#46; The patients underwent a contrast sensitivity test with the Optec 6500 equipment&#44; a 10-2 visual field with an Octopus 900 Haag-Streit&#44; and a Farnsworth D-15 color test&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Sequelae were observed in 20 eyes &#40;74&#46;1&#37;&#41; by macular OCT and in 21 &#40;77&#46;8&#37;&#41; in contrast sensitivity&#44; predominantly type<span class="elsevierStyleHsp" style=""></span>2 defect&#46; Also 27 &#40;100&#37;&#41; had a visual field 10-2 altered corresponding to reduced foveal sensitivity&#44; 11 eyes &#40;40&#46;7&#37;&#41; corresponded to central and paracentral scotomas&#46; The color test showed alteration in 11 &#40;40&#46;7&#37;&#41; of the total eyes evaluated&#44; finding tritanomaly in 9 of them &#40;81&#46;8&#37;&#41;&#46; No significant differences were observed in the studies between observation group vs the treatment group&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">CSC can leave sequelae in the visual quality of patients despite treatment in the acute phase&#46; Visual acuity before and after treatment in the intervention group had no significant difference&#46;</p></span>"
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                  \t\t\t\t">74&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disrupci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elevaci&#243;n EPR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">25&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Irregularidades EPR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrosis EPR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Espesor foveal &#40;&#956;m&#41;&#44; Me &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">223 &#40;205-247&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sensibilidad contraste alterada</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">77&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Campo visual alterado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas centrales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas paracentrales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas centrales y paracentrales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disminuci&#243;n de la sensibilidad foveal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sensibilidad foveal &#40;dB&#41;&#44; Me &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;5 &#40;22&#44;3-27&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Test color alterado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tritan&#243;malos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Deuteran&#243;malos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Deuteranopes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Agudeza visual Log Mar Me &#40;RIC&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pretratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4 &#40;0&#44;2-0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disrupci&#243;n EPR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Espesor foveal &#40;&#956;m&#41;&#44; Me &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">219 &#40;195-244&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">11 &#40;73&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;83&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;6618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">7 &#40;46&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Campo visual alterado</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas centrales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;4444&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas paracentrales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;9998&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Escotomas centrales y paracentrales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;46&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;6959&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sin escotomas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;7063&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sensibilidad foveal &#40;dB&#41;&#44; Me &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">25&#44;3 &#40;23&#44;0-27&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#44;5 &#40;21&#44;6-28&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;6959&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Test color alterado</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;4516&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tritanopes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tritan&#243;malos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3 &#40;60&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;1818&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Deuteranopes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;4545&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Deuteran&#243;malos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;1818&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Protanopes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Protan&#243;malos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 03656691
Idioma original: Español
DOI:10.1016/j.oftal.2022.04.002
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