Papers by Alejandro Rodríguez-García
International Journal of Ophthalmic Pathology, 2015
Purpose: To report a case of bilateral corneal edema in a patient with a history of cocaine abuse... more Purpose: To report a case of bilateral corneal edema in a patient with a history of cocaine abuse and bipolar-depression treated with amantadine for 6 months, and to review the literature on amantadine corneal toxicity. Methods: The clinical record of a patient with amantadine corneal toxicity and the existing literature on this subject were extensively reviewed for prevalence, clinical presentation, pathogenesis and therapy. Results: A 27 year-old male who suffered from depression and cocaine abuse presented with sudden visual loss (20/150 OD and 20/200 OS) caused by bilateral corneal stromal edema without ocular inflammation. Corneal edema was related to amantadine therapy (200 mg per day) for 6 months. Visual acuity improved to 20/20 OU and corneal edema resolved after one month of cessation of therapy. Corneal endothelial cell density after 3 months of discontinuation of amantadine therapy was 636 ± 359 cells/mm² in the right eye and 1,176 ± 238 cells/mm² in the left eye. There was also increased pleomorphism (45.3% 6A cells OD, 56.4% 6A cells OS) and polymegatism (coefficient of variation, 39.04 ± 6.38 OD and 34.76 ± 2.68 OS). Conclusions: Amantadine therapy has become popularized for the treatment of many neurologic and behavioral disorders at all ages. It has been associated with reversible corneal edema but may cause irreversible endothelial cell damage after prolonged administration. This report summarizes the information currently available in the literature regarding amantadine corneal toxicity.
Investigative ophthalmology & visual science, 1994
To examine the effects of modification of immune effector cells, including macrophages, in the pa... more To examine the effects of modification of immune effector cells, including macrophages, in the pathogenesis of herpes simplex virus retinitis in BALB/c mice. Two intravitreal injections (2 microliters each) of anti-CD11b monoclonal antibody (mAb) [13 micrograms/microliters] were administered to the contralateral eyes of 10 BALB/c mice on days 6 and 8 after HSV inoculation into the right anterior chamber (AC) with HSV-1. A control group consisted of mice injected with anti-HLA-DR mAb in the same fashion. Specific macrophage depletion was performed in an additional group of 12 BALB/c mice by intravenous (i.v.) injection of dichloromethylene diphosphonate (Cl2MDP)-liposomes 7 days before AC HSV-1 inoculation into the eye. Control group consisted of mice receiving i.v. PBS-liposomes. Mice were clinically observed for 14 days postinfection, and the incidence of chorioretinal disease was confirmed by histopathologic studies. Intravitreal injections of anti-CD11b mAb produced a dramatic su...
Ophthalmology, 1995
Background: Ocular cicatricial pemphigoid is a chronic, progressive, autoimmune disease that scar... more Background: Ocular cicatricial pemphigoid is a chronic, progressive, autoimmune disease that scars mucous membranes and may lead to blindness. It is of critical importance to be able to make the diagnosis as early as possible to allow early treatment. Conjunctival biopsy facilitates the early diagnosis of this condition. Materials and Methods: Conjunctival biopsy results of 166 consecutive patients seen over a 7-year period, in whom the diagnosis of ocular cicatricial pemphigoid was conSidered, were reviewed. Results: One hundred twenty-one patients ultimately received a diagnosis of ocular cicatricial pemphigoid. Immunofluorescence studies demonstrated characteristic deposition of immunoreactants at the epithelial basement membrane zone in 63 patients (sensitivity = 52%). When immunofluorescent-negative or inconclusive biopsies were processed further using an immunoperoxidase technique an additional 37 diagnoses were made. This represented an increase in sensitivity from 52% with immunofluorescence only to 83% with the addition of the immunoperoxidase technique. Conclusion: The routine use of the immunoperoxidase technique in immunofluorescent-negative biopsies, allied with appropriate harvesting and handling of biopsied conjunctiva, should significantly increase the diagnostic yield in patients with clinically suspect ocular cicatricial pemphigoid.
Current Eye Research, 1993
The corneal destruction associated with herpes simplex keratitis (HSK) is primarily the result of... more The corneal destruction associated with herpes simplex keratitis (HSK) is primarily the result of the host's immune response to herpes simplex virus type-1 (HSV-1) infection. We examined the role of T cells and T cell subsets in the pathogenesis of HSK. Naive and immune T cells and HSV-1 immune CD4+ and CD8+ subsets from Igh-1 disparate BALB/c congenic mice were adoptively transferred into athymic BALB/c nude mice, which normally do not develop HSK. The results demonstrated that while the transfer of naive T cells from either HSK-susceptible C.AL-20 (Igh-1d) or HSK-resistant C.B-17 (Igh-1b) mice had little influence on HSK development, transfer of either CD3+ or CD4+ HSV-1 immune T cells from C.AL-20 mice resulted in the development of severe HSK in all of the recipients. Transfer of the same cell populations from C.B-17 mice resulted in the development of only a mild keratitis in 50% of the recipients. Transfer of CD8+ cells from either donor strain did not result in stromal disease in any recipient mouse. These results clearly demonstrate the pivotal role of CD4+ T cells in the development of necrotizing herpes stromal keratitis, and further demonstrate that CD8+ T cells are not essential in HSK development in the BALB/c system.
Cornea, 1996
The purpose of this study was to describe the clinical characteristics and course of peripheral u... more The purpose of this study was to describe the clinical characteristics and course of peripheral ulcerative keratitis (PUK) secondary to herpes varicella-zoster virus in patients with the acquired immunodeficiency syndrome (AIDS). Three AIDS patients with ocular herpes zoster infection (mean age at onset, 33.0 years; range, 30-42) developed PUK. The three patients had skin involvement, and two of them had bilateral keratouveitis. All were treated with high-dose oral acyclovir (4 g/day) with or without topical antiviral therapy. Two of the patients responded well to oral acyclovir, but one of them stopped the treatment, and bilateral progressive outer retinal necrosis and lethal encephalitis developed. The third patient had a recurrent episode of inflammation with PUK, extensive stromal scarring, and deep neovascularization. AIDS patients with herpes varicella-zoster virus infection may have severe and protracted corneal manifestations, including PUK. The correct diagnosis and aggressive early long-term systemic antiviral treatment must be instituted to control inflammation, ulcer progression, and complications.
British Journal of Ophthalmology, 1997
Day 1* Day 2 Day 3 Day 4 Day 8 Fluorometholone 12 16 18 13 11 Maxitrol 12 20 24 † 16 12 *Baseline... more Day 1* Day 2 Day 3 Day 4 Day 8 Fluorometholone 12 16 18 13 11 Maxitrol 12 20 24 † 16 12 *Baseline IOP was taken on day 1. †All drugs were withdrawn when the IOP doubled the baseline reading.
… del desarrollo de …, 2010
RESUMEN Introducción: El simulador de cirugía oftalmológica EyeSi® ofrece una experiencia virtual... more RESUMEN Introducción: El simulador de cirugía oftalmológica EyeSi® ofrece una experiencia virtual de realización de cirugía oftalmológica muy semejante a una cirugía real. En este trabajo se comparan los resultados de las pruebas del simulador entre residentes ...
Disability and Health Journal, 2022
BACKGROUND The needs of informal caregivers who provide care to family relatives with visual impa... more BACKGROUND The needs of informal caregivers who provide care to family relatives with visual impairment are often neglected, resulting in burden and depression. OBJECTIVE To determine the degree of burden and the prevalence of major depression experienced by caregivers, defined as non-paid family relatives, of legally blind individuals in a Mexican population. METHODS Observational, single-center, cross-sectional study in adults providing care to their family relatives with visual impairment (visual acuity ≤ 20/200 in the best eye for at least 3 months). According to visual impairment degree, care provided included activities of daily living (ADL) and instrumental ADL. Burden of care was evaluated with the Zarit burden interview (ZBI)-22 and the prevalence of major depression was determined by the patient health questionnaire (PHQ)-9. RESULTS 115 patients and 115 caregivers were included. Male caregivers had significantly higher ZBI-22 (28.7 ± 15.5 vs. 19.2 ± 12.6, p = 0.001) and PHQ-9 (10.0 ± 5.5 vs. 5.3 ± 5.1, p < 0.001) scores than females. Likewise, parent caregivers of adult children and the hours of daily care were significantly associated with higher burden and depression scores. A significant linear correlation between ZBI-22 and PHQ-9 scores in caregivers was also found (r = 0.649, p < 0.001). CONCLUSIONS Male caregivers, parent caregivers of adult children, and caregivers providing greater hours of care were at higher risk of burden and depression. Upon diagnosis of visual impairment, adults providing care to visually impaired family relatives should be screened for burden and depression and referred to a mental health specialist when necessary. Tailored interventions targeting the caregivers' needs are required to reduce burden and depression.
British Journal of Ophthalmology
Background/aimsTo evaluate the role of early immunosuppressive therapy (IMT) in the management of... more Background/aimsTo evaluate the role of early immunosuppressive therapy (IMT) in the management of rheumatoid arthritis (RA)-associated peripheral ulcerative keratitis (PUK).MethodsSingle-centre, retrospective, comparative cohort study. Patients with RA-associated PUK were divided into two groups; those exposed to and those not exposed to early IMT, defined as administrating therapy within the first 4 weeks from the PUK onset. Outcomes included PUK recurrence, control of inflammation and development of ocular complications, including corneal scarring and perforation, cataract formation or progression and permanent visual loss.ResultsA total of 52 eyes from 36 patients were included for analysis; 37 (71.2%) eyes received early IMT and 15 (28.8%) eyes did not. Follow-up time was 41.2+53.3 months (range: 4–236 months). While early IMT was a protective factor (HR 0.345, 95% CI 0.126 to 0.946, p=0.039), late RA diagnosis after PUK onset (HR 4.93, 95% CI 1.75 to 13.85, p=0.002) and retarde...
International Journal of Retina and Vitreous, 2021
Background To analyze the relationship between the central foveal thickness (CFT) and the integri... more Background To analyze the relationship between the central foveal thickness (CFT) and the integrity of the ellipsoid portion of inner segments (EPIS) and interdigitating zone (IZ) retinal layers in the visual outcome of uveitic macular edema (UME). Methods Prospective, observational, and cross-sectional study of eyes with UME. Spectral-domain optical coherence tomography (SD-OCT) macular morphological pattern, CFT, and integrity of the outer retinal layers were analyzed. We arranged the data by EPIS or IZ integrity and contrasted it with student t-test (quantitative variables) and Fisher exact test or χ² distribution (categorical variables) to evaluate visual impairment and retinal measures. Receiver operator curve (ROC) estimation and logistic regression (probit) assessed if the sample´s variance could be associated with IZ or EPIS integrity. Results We included 145 SD-OCT macular scans from 45 patients at different stages of UME. Cystoid macular edema (CME) increased the risk of s...
European Journal of Ophthalmology, 2022
Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in opht... more Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. Methods An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included “dry eye disease” associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. Results Although DED is fr...
Revista Mexicana de Oftalmología, 2010
Las manifestaciones oculares de infección por Mycobacterium leprae son subestimadas en el diferen... more Las manifestaciones oculares de infección por Mycobacterium leprae son subestimadas en el diferencial de enfermedades inflamatorias oculares. Se comunica el caso de un hombre de 57 años, habitante del medio rural, que acudió por ojo rojo, disminución insidiosa de la agudeza visual y síntomas de ojo seco. Se diagnosticó con esclerouveítis granulomatosa bilateral. Se tomó biopsia de piel y se diagnosticó lepra. Se inició tratamiento con base en multidrogas y esteroide tópico, logrando la remisión de la uveítis. El diagnóstico de las uveítis anteriores es complejo y aunque el origen es predominantemente inmunológico, se deben descartar etiologías infecciosas antes de iniciar tratamiento. ◗ Summary
Revista Mexicana de Oftalmología, 2012
Introducción: El glaucoma neovascular (GNV) es un glaucoma agresivo de difícil manejo. Los proces... more Introducción: El glaucoma neovascular (GNV) es un glaucoma agresivo de difícil manejo. Los procesos ciclodestructivos son una opción de tratamiento y la ciclodiodo-ablación, ha sido propuesta como un método seguro y efectivo. El objetivo del presente estudio, es evaluar la efectividad y seguridad de la ciclodiodo-ablación, en el GNV diabético. Métodos: Se realizó un estudio ambispectivo de 38 ojos (n=19 grupo control GC, n=19 grupo terapéutico GT). Se definió éxito como una presión intraocular (PIO) < 22 mmHg, o una reducción del 30% de la PIO basal. Se describió la PIO, número de ◗ Abstract
Journal of American Association for Pediatric Ophthalmology and Strabismus, 2021
The Ocular Surface, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Clinical Ophthalmology, 2018
Purpose: To analyze potential risk factors for ocular surface damage in a representative populati... more Purpose: To analyze potential risk factors for ocular surface damage in a representative population of Mexican patients with dry eye disease (DED). Patients and methods: A prospective and cross-sectional population-based epidemiologic cohort study was conducted through a survey of patients with symptoms, signs, known preexisting diagnosis, and clinical conditions related to DED. Fluorescein staining, tear break-up time (TBUT), and Oxford lissamine green staining were performed on both eyes of patients enrolled in the study. Results: A total of 2,725 surveys including 1,543 (56.6%) women and 1,182 (43.3%) men were analyzed. Most common pre-existing diagnosis included dry eye (58%), chronic blepharitis (17%), and ocular allergy (15%). More than 70% of patients had a positive fluorescein test, and this prevalence increased proportionally to the number of reasons for consultation. The same was true for gender (P,0.001) and age (P,0.0001), with women showing a strong correlation with age (R 2 =0.93912, P=0.001). The association between positive fluorescein staining and diagnosis was significant for dry eye (P,0.0001), Sjögren's syndrome (P,0.0001), and glaucoma (P,0.05). No significant association between TBUT and age or gender was found, but the shorter the TBUT, the larger the prevalence of fluorescein staining. Reduced TBUT was seen more frequently in patients with dry eye (57%), ocular allergy (16%), and chronic blepharitis (15%). Most patients (39%) with Oxford grades III and IV were older, complained of red eye (51.0%), foreign body sensation (47.0%), burning (46.0%), and were using eye drops (67%) and systemic medications (47%). Conclusion: The Mexican profile of patients with significant ocular surface damage related to DED includes women at older ages, complaining of red eye, foreign body, and burning sensation. Diagnoses of dry eye, Sjögren's syndrome, and glaucoma were also risk factors for significant ocular surface damage, along with long-term use of preserved eyes drops and systemic medications.
Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society, Jan 6, 2018
Diabetic retinopathy (DR) is one of the most common of all diabetic complications. The number of ... more Diabetic retinopathy (DR) is one of the most common of all diabetic complications. The number of people with DR in the United States is expected to increase to 16 million by 2050. DR is the leading cause of blindness among working-age adults in many different countries, including the United States. In later DR stages, neovascularization is associated with extensive retinal capillary non-perfusion and vitreo-proliferation leading to retinal detachment. This neovascularization is orchestrated by an imbalance of growth factors in the retina from which somatolactogens (pituitary growth hormone, GH-N; placental growth hormone, GH-V; prolactin, PRL; and placental lactogen, PL, also referred as chorionic somatomammotropin, CSH), may play an important role. Somatolactogens are a group of hormones that share many structural and functional features. They are important for physiological changes in pregnancy, for adequate development of the fetus, and in the case of GH-N, for promoting growth a...
Rev Mex …, 2010
del orden Dipterae. Es una entidad clínica poco común, de prevalencia desconocida, que presenta d... more del orden Dipterae. Es una entidad clínica poco común, de prevalencia desconocida, que presenta diversas manifestaciones oftalmológicas. El diagnóstico de la enfermedad es primordialmente clínico, mediante los hallazgos fundoscópicos característicos y la presencia de la larva flotando libremente en la cavidad vítrea. El abordaje terapéutico varía desde la observación estrecha con examen oftalmológico completo hasta el tratamiento con esteroides, fotocoagulación con láser argón o quirúrgico para remover el agente causal. Presentamos un caso de OIP cuya manifestación inicial fue la visión de halos alrededor de las luces y disminución leve de la agudeza visual en el ojo derecho. Se realiza el abordaje diagnóstico y terapéutico. Se propone el tratamiento conservador mediante observación periódica por la ausencia de manifestaciones oftalmológicas que potencialmente comprometan la integridad ocular. Este es el primer caso de OIP reportado en la literatura mexicana.
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Papers by Alejandro Rodríguez-García