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1.
Graefes Arch Clin Exp Ophthalmol ; 262(8): 2601-2615, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38446198

RESUMEN

PURPOSE: To describe the epidemiology, clinical features, and classification of uveitis in a large cohort of Colombian patients. METHODS: Data were collected from seven ophthalmological referral centers in the four main cities in Colombia. The study included patients with a confirmed diagnosis of uveitis from January 2010 to December 2022. Information on demographics, ophthalmic examination findings, uveitis classification, and etiology was recorded. RESULTS: The study reviewed 3,404 clinical records of patients with uveitis. The mean age at diagnosis was 41.1 (SD 19.0) years, and 54.2% of the patients were female. Overall, 1,341(39.4%) were infectious, 626 (18.4%) non-infectious, and four masquerade syndromes (0.1%). The most common types of uveitis were unilateral (66.7%), acute (48.3%), and non-granulomatous (83%). Anterior uveitis was the most common anatomical localization (49.5%), followed by posterior uveitis (22.9%), panuveitis (22.3%), and intermediate uveitis (5.2%). A diagnosis was established in 3,252 (95.5%) cases; idiopathic was the most common cause (27.7%), followed by toxoplasmosis (25.3%) and virus-associated uveitis (6.4%). The age group between 30 and 50 exhibited the highest frequency of uveitis. CONCLUSION: This multicenter study comprehensively describes uveitis characteristics in Colombian patients, providing valuable insights into its demographic and clinical features. The study findings emphasize the need to continue updating the changing patterns of uveitis to improve diagnosis and treatment strategies for diseases associated with intraocular inflammation.


Asunto(s)
Uveítis , Humanos , Colombia/epidemiología , Femenino , Masculino , Adulto , Uveítis/epidemiología , Uveítis/diagnóstico , Uveítis/clasificación , Estudios Retrospectivos , Persona de Mediana Edad , Adolescente , Adulto Joven , Niño , Anciano , Incidencia , Distribución por Edad , Distribución por Sexo , Preescolar , Agudeza Visual
2.
Ophthalmic Res ; 67(1): 232-247, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38447539

RESUMEN

INTRODUCTION: Glaucoma is a neurodegenerative disease characterized by the loss of retinal ganglion cells. Recent research suggests immunological changes such as cytokine imbalance may affect its pathophysiology. This implies that immunomodulation, like that of mesenchymal cells, could be a potential therapeutic avenue for this disease. However, the effects of intravitreal injections of human Wharton's jelly-derived mesenchymal stromal cells (hWJ-MSCs) on intraocular immune response have not been assessed in ocular hypertension (OH) models. METHODS: We explored this by measuring cytokine levels and expression of other markers, such as glial fibrillary acidic protein (GFAP) and T cells, in 15 randomly divided New Zealand rabbits: G1: OH, G2: hWJ-MSCs, and G3: OH+hWJ-MSCs. We analyzed the aqueous humor (IL-6, IL-8, and TNF-α) and vitreous humor (IFN-γ, IL-10, and TGF-ß) using ELISA and flow cytometry (cell populations), as well as TCD3+, TCD3+/TCD4+, and TCD3+/TCD8+ lymphocytes, and GFAP in the retina and optic nerve through immunohistochemistry. RESULTS: We found a decrease in TNF-α, IL-6, IFN-γ, IL-10, and IL-8 in G3 compared to G1 and an increase in TGF-ß in both G2 and G3. TCD3+ retinal infiltration in all groups was primarily TCD8+ rather than TCD4+ cells, and strong GFAP expression was observed in both the retina and optic nerves in all groups. CONCLUSION: Our results suggest that cellular and humoral immune responses may play a role in glaucomatous optic neuropathy and that intravitreal hWJ-MSCs can induce an immunosuppressive environment by inhibiting proinflammatory cytokines and enhancing regulatory cytokines.


Asunto(s)
Citocinas , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Células Madre Mesenquimatosas , Hipertensión Ocular , Gelatina de Wharton , Animales , Conejos , Gelatina de Wharton/citología , Humanos , Hipertensión Ocular/metabolismo , Citocinas/metabolismo , Humor Acuoso/metabolismo , Presión Intraocular/fisiología , Citometría de Flujo , Trasplante de Células Madre Mesenquimatosas/métodos , Inyecciones Intravítreas , Inmunohistoquímica , Células Ganglionares de la Retina/patología , Glucocorticoides , Nervio Óptico/patología
3.
Graefes Arch Clin Exp Ophthalmol ; 261(2): 561-573, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35994112

RESUMEN

PURPOSE: To describe the distribution patterns and clinical characteristics of patients diagnosed with uveitis at a specialized uveitis center in Bogotá, Colombia, from 2013 to 2021 and compare these patterns with the previously reported between 1996 and 2006. METHODS: We performed an observational descriptive cross-sectional study systematically reviewing clinical records of patients attending between 2013 and 2021. Data were analyzed and compared with previous reports. RESULTS: Of the 489 patients with uveitis, 310 were females (63.4%). The mean age of onset was 38.7, with a range between 1 and 83 years. Bilateral (52.8%), anterior (45.8%), non-granulomatous (90.8%), and recurrent (47.6%) were the most common types of uveitis found in our population sample. The most common cause of uveitis in this study was idiopathic, followed by toxoplasmosis and HLA-B27 + associated uveitis, which differs from the previous Colombian study where ocular toxoplasmosis was the most frequent cause. This highlights a significant shift from infectious etiologies to more immune-mediated processes as the cause of uveitis in Colombia nowadays. CONCLUSION: The results of this study provide a comparison between the clinical patterns of presentation of uveitis from 1996 to 2006 and the patterns observed from 2013 to 2021, enhancing awareness about the changing dynamics of uveitis in Colombia to guide a better understanding of the diagnosis, classification, and correlation with other systemic conditions of the disease.


Asunto(s)
Toxoplasmosis Ocular , Uveítis , Femenino , Humanos , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Masculino , Colombia/epidemiología , Estudios Transversales , Uveítis/diagnóstico , Uveítis/epidemiología , Uveítis/etiología , Toxoplasmosis Ocular/diagnóstico , Toxoplasmosis Ocular/epidemiología , Antígeno HLA-B27 , Estudios Retrospectivos
4.
BMC Ophthalmol ; 23(1): 216, 2023 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-37189079

RESUMEN

BACKGROUND: To describe the ocular features of a cohort of children with Down Syndrome (DS) in Bogotá, Colombia. METHODS: We performed a cross-sectional study, evaluating 67 children with DS. A pediatric ophthalmologist performed a complete optometric and ophthalmological evaluation of each child, including visual acuity, ocular alignment, external eye examination, biomicroscopy, auto-refractometry, retinoscope in cycloplegia, and fundus examination. Results were reported as frequency distribution tables with percentages for categorical variables and means and standard deviation or median and interquartile ranges for continuous variables, according to their distribution. We used the Chi-square test or Fisher's exact test for categorical variables and ANOVA or Kruskal-Wallis for continuous variables when indicated. RESULTS: A total of 134 eyes from 67 children were evaluated. Males represented 50.7%. The children's age ranged from 8-16 years, with a mean of 12.3 (SD 2.30). The most frequent refractive diagnosis per eye was hyperopia (47%), followed by myopia (32.1%) and mixed astigmatism (18.7%). The most frequent ocular manifestations were oblique fissure (89.6%), followed by amblyopia (54.5%) and lens opacity (39.4%). Female sex was associated with strabismus (P = 0.009) and amblyopia (P = 0.048). CONCLUSION: Our cohort had a high prevalence of disregarded ophthalmological manifestations. Some of these manifestations, such as amblyopia, can be irreversible and severely affect the neurodevelopment of DS children. Therefore, ophthalmologists and optometrists should be aware of the visual and ocular affection of children with DS to assess and provide appropriate management. This awareness could improve rehabilitation outcomes for these children.


Asunto(s)
Ambliopía , Síndrome de Down , Errores de Refracción , Estrabismo , Masculino , Niño , Humanos , Femenino , Adolescente , Ambliopía/diagnóstico , Ambliopía/epidemiología , Ambliopía/etiología , Errores de Refracción/diagnóstico , Colombia/epidemiología , Síndrome de Down/complicaciones , Síndrome de Down/epidemiología , Estudios Transversales , Estrabismo/epidemiología , Prevalencia
5.
Graefes Arch Clin Exp Ophthalmol ; 260(12): 3957-3967, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35796822

RESUMEN

PURPOSE: This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors associated with the clinical presentation. METHODS: Retrospective case series of patients with scleritis from 2015 to 2020. Clinical records were obtained from seven uveitis referral centers in Colombia. Patients with a diagnosis of episcleritis were excluded. RESULTS: We evaluated 389 patients with scleritis (509 eyes). There was a female predominance (75.6%) with a mean age of 51 ± 15 years. Most cases were noninfectious (94.8%) and unilateral (69.2%). The most frequent type of inflammation was diffuse anterior scleritis (41.7%), followed by nodular scleritis (31.9%) and necrotizing scleritis (12.3%). Systemic autoimmune diseases were found in 41.3% of patients, the most common being rheumatoid arthritis (18.5%) and granulomatosis with polyangiitis (5.9%). Polyautoimmunity was found in 10.4% of those with a systemic autoimmune disease. The most frequent treatment was systemic steroids (50.9%), followed by systemic NSAIDs (32.4%). Steroid-sparing immunosuppression was required in 49.1% of patients. Systemic autoimmune diseases were more common in patients with necrotizing scleritis and those older than 40 years of age. Best-corrected visual acuity of 20/80 or worse at presentation was more common in necrotizing scleritis and subjects with associated uveitis, ocular hypertension, or who were over 40 years of age. CONCLUSIONS: This is the first study in Colombia and the largest in Latin America describing the clinical characteristics and presentation patterns of scleritis. The most common presentation was in females, with unilateral, anterior diffuse noninfectious scleritis. Systemic autoimmune diseases and polyautoimmunity were frequent, as was the need for steroid-sparing immunosuppression. Age over 40 and necrotizing scleritis were associated with higher odds of having a systemic autoimmune disease and worse visual acuity at presentation.


Asunto(s)
Enfermedades Autoinmunes , Escleritis , Uveítis , Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Masculino , Escleritis/diagnóstico , Escleritis/tratamiento farmacológico , Escleritis/epidemiología , Colombia/epidemiología , Estudios Retrospectivos , Uveítis/complicaciones , Factores de Riesgo , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/complicaciones
6.
BMC Ophthalmol ; 22(1): 384, 2022 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-36153505

RESUMEN

BACKGROUND: This study aimed to report a case of bilateral anterior non-granulomatous chronic non-infectious uveitis associated with isolated nail psoriasis without articular involvement. CASE PRESENTATION: A 55-year-old man with a history of open-angle glaucoma was referred to our uveitis and ocular immunology center with intraocular inflammation concordant with chronic non-infectious bilateral anterior non-granulomatous uveitis. At presentation, he had moderate inflammation in the anterior chamber bilaterally and lesions characteristic of nail psoriasis. Nail psoriasis was later confirmed by nail ultrasonography performed by a radiologist who specialized in psoriasis. Appropriate clinical and paraclinical assessments were conducted, ruling out all other possible causes of uveitis. The patient required dual systemic immunomodulatory therapy with methotrexate and adalimumab, topical anti-inflammatory drugs (steroidal and non-steroidal), and anti-glaucoma therapy to achieve satisfactory inflammatory and ocular pressure control. DISCUSSION AND CONCLUSIONS: This is the first report of non-infectious uveitis associated with nail compromise in a patient without other manifestations of psoriasis. Despite reports on the relationship between psoriatic disease and uveitis, there is insufficient information on clinical phenotypes associated with uveitis that could lead to later diagnosis and treatment of associated intraocular inflammation. Clinicians should be aware of all subtypes of psoriasis that increases a risk of developing uveitis in these patients.


Asunto(s)
Glaucoma de Ángulo Abierto , Psoriasis , Uveítis Anterior , Uveítis , Adalimumab/uso terapéutico , Glaucoma de Ángulo Abierto/complicaciones , Humanos , Inflamación/tratamiento farmacológico , Masculino , Metotrexato , Psoriasis/complicaciones , Psoriasis/diagnóstico , Psoriasis/tratamiento farmacológico , Uveítis/complicaciones , Uveítis/etiología , Uveítis Anterior/diagnóstico , Uveítis Anterior/etiología
7.
Ocul Immunol Inflamm ; : 1-5, 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38889439

RESUMEN

BACKGROUND: To report a case of coinfection of Toxoplasma gondii (Tg) and Epstein Barr Virus (EBV) in a diabetic patient with rheumatoid arthritis and immunosuppressive biological therapy. CASE PRESENTATION: A 70-year-old female with a history of rheumatoid arthritis on therapy with corticosteroids, methotrexate, and abatacept presented bilateral granulomatous panuveitis associated with retinal necrosis and macular involvement. A diagnostic vitrectomy detected Tg and EBV. Treatment with clindamycin, trimethoprim-sulfamethoxazole, and acyclovir was established, achieving improvement. CONCLUSIONS: Patients undergoing immunosuppressive therapy are at risk of developing opportunistic infections, often presenting with severe and atypical clinical manifestations. In such cases, multiplex polymerase chain reaction is an invaluable diagnostic tool that helps identify the specific pathogens involved. This enables healthcare professionals to make informed treatment decisions and provide targeted therapy for each identified pathogen.

8.
Ophthalmol Ther ; 13(6): 1799-1811, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38705913

RESUMEN

INTRODUCTION: The efficacy of diagnostic and monitoring tools in ophthalmology is significantly influenced by patient engagement levels. This presents a notable challenge, especially in the context of developing tools designed for telemedicine applications. Ensuring consistent patient engagement is therefore crucial for the accurate and reliable utilization of these technologies. This study assesses patient perceptions and experiences after using a purpose-built web application, called PocDoc. METHODS: A cross-sectional questionnaire-based survey was conducted among 440 patients recruited from general and specialist eye clinics between March 2022 and October 2023, both before and after using the PocDoc app. RESULTS: Pre-test findings revealed that 86.8% of patients thought that a remote eye monitoring application would have use, while 70.9% anticipated frequent usage. Only 16.4% found it overly complex, and 55.2% perceived it as easy to use. Additionally, 34.5% foresaw the need for technical support, while 72.5% believed they would quickly grasp its use. In the post-test questionnaire, 63.3% of patients still expressed intent for frequent PocDoc usage. The perception of complexity decreased to 20.4%, with 79.3% finding it easy to use. The belief in the need for technical support decreased to 36.5%, while 89.9% felt confident in mastering the application quickly. Moreover, 77.3% found the application's functions well-integrated, and 64.6% were very confident using PocDoc. CONCLUSIONS: Results suggest patient receptivity to web-based applications, confirming their viability for specific patient groups. Overall, our study contributes to the growing body of evidence indicating that greater exposure to digital health tools can significantly influence patient acceptance and perceived ease of use, an insight that has important implications for the implementation and design of these technologies in clinical settings.

9.
Ocul Immunol Inflamm ; 32(3): 262-265, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36854135

RESUMEN

This retrospective case series aims to describe the ophthalmic manifestations of the Monkeypox virus infection in seven patients evaluated in two countries of South America (Colombia and Brazil). Two had skin lesions in the eyelid, and five had conjunctivitis. None had intraocular involvement. Three of seven patients had a history of Human Immunodeficiency Virus infection, and all patients had lesions in the genital region, suggesting sexual-contact transmission. In 6 of 7 cases, conjunctival RT-PCR was positive for the Monkeypox virus, including one case without conjunctival vesicles. In all cases, lesions resolved without complications, and just two required antiviral treatment. All patients demonstrated improvement without complications. RT-PCR positivity in conjunctiva demonstrated the presence of the Monkeypox virus, suggesting that ocular-mediated transmission could be plausible. Ophthalmologists should be aware of this ophthalmic manifestation.


Asunto(s)
Monkeypox virus , Mpox , Humanos , Estudios Retrospectivos , Conjuntiva , Párpados
10.
Ocul Immunol Inflamm ; 32(1): 71-78, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36624966

RESUMEN

PURPOSE: To describe the differences between de novo uveitis in elderly patients (≥60 years of age) and younger patients (< 60 years of age) in Colombia. METHODS: Observational, analytic, cross-sectional study. RESULTS: In the elderly group, idiopathic was the most common type of uveitis, followed by immune-mediated and infectious uveitis.No masquerade syndromes were diagnosed. Elderly patients had worse average visual acuities than young. Significant differences between both groups were observed in corneal edema, macular edema, cataract, glaucoma, and epiretinal membrane. Additionally, there were differences in the drugs used, such as topical hypotensive drugs, ocular lubricants, topical steroids, methotrexate, hydroxychloroquine, and adalimumab. CONCLUSION: The present study demonstrated significant differences between elderly and young Colombian patients with de novo uveitis. The ophthalmologists should be aware of these patterns of presentation, which would help reach an adequate diagnosis and prevent complications based on the characteristics of each group.


Asunto(s)
Glaucoma , Uveítis , Anciano , Humanos , Colombia/epidemiología , Estudios Transversales , Glaucoma/etiología , Estudios Retrospectivos , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Uveítis/epidemiología , Trastornos de la Visión/etiología , Persona de Mediana Edad
11.
Ocul Immunol Inflamm ; : 1-7, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38592492

RESUMEN

PURPOSE: To present an atypical case of severe bilateral ocular toxoplasmosis with systemic involvement that initially mimicked an autoimmune etiology, posing challenges to its diagnosis and treatment. CASE REPORT: A 39-year-old immunocompetent male was admitted to the hospital due to a presumed pulmonary thromboembolism concomitant with an abrupt onset of vision loss. Initial differential diagnoses included antiphospholipid syndrome and systemic lupus erythematosus, prompting the administration of corticosteroid pulses and rituximab. Despite observing a partial systemic response, there was no improvement in visual acuity. Subsequent aqueous humor polymerase chain reaction confirmed Toxoplasma gondii infection, leading to the introduction of oral antibiotic therapy. The patient's condition showed a partially favorable response; however, the treatment could not reverse the permanent retinal damage. CONCLUSION AND IMPORTANCE: This case underscores the importance of ruling out an infectious etiology in all cases of uveitis. Additionally, it alerts clinicians to the possibility that elevated positive autoantibodies may result from a severe inflammatory reaction caused by pathogens rather than an autoimmune or autoinflammatory disease, particularly in instances of poor treatment response or atypical clinical presentation.

12.
Ocul Immunol Inflamm ; 32(8): 1882-1887, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39316714

RESUMEN

PURPOSE: To report two cases of ibrutinib-related uveitis and review the literature to date. METHODS: We report two cases of ibrutinib-related uveitis using CARE guidelines and review the cases reported in the literature. RESULTS: Case 1) A 55-year-old female with recurrent primary central nervous system lymphoma presented with bilateral decreased visual acuity, photophobia, and floaters that started one month after initiating oral treatment with ibrutinib. Chronic non-granulomatous bilateral anterior-intermediate uveitis with macular edema was identified. Secondary causes were ruled out, and a presumptive diagnosis of ibrutinib-related uveitis was made. Case 2) A 57-year-old female with Waldenström macroglobulinemia who was treated with ibrutinib for two years presented with bilateral blurred vision, photophobia, red eyes, and floaters. A diagnosis of non-granulomatous, noninfectious panuveitis with bilateral cystoid macular edema was made. Secondary causes were ruled out, and ibrutinib toxicity was the most likely cause. CONCLUSION: Ibrutinib-related uveitis is a novel and under-diagnosed clinical entity. The most frequent clinical presentation in the literature is bilateral, non-granulomatous, anterior, and intermediate uveitis. Macular edema is a frequent complication. Uveitis usually requires topical treatment and the suspension of ibrutinib. Switching to second-generation Bruton tyrosine kinase inhibitors is proposed as a potential therapeutic alternative.


Asunto(s)
Adenina , Piperidinas , Humanos , Femenino , Adenina/análogos & derivados , Adenina/efectos adversos , Persona de Mediana Edad , Piperidinas/efectos adversos , Tomografía de Coherencia Óptica , Agudeza Visual , Inhibidores de Proteínas Quinasas/efectos adversos , Uveítis/inducido químicamente , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Macroglobulinemia de Waldenström/tratamiento farmacológico , Macroglobulinemia de Waldenström/diagnóstico , Pirimidinas/efectos adversos , Pirimidinas/uso terapéutico , Edema Macular/inducido químicamente , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Angiografía con Fluoresceína , Pirazoles/efectos adversos , Pirazoles/uso terapéutico , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/diagnóstico
13.
Ocul Immunol Inflamm ; : 1-21, 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38759216

RESUMEN

Infectious uveitis is a major global cause of vision impairment. Despite the eye's immune privilege, afforded by the blood-ocular barrier that restricts microbial entry, several pathogens such as bacteria, viruses, fungi, and parasites can still infiltrate and cause ocular infections and complications. Clinicians often encounter significant challenges in treating infectious uveitis due to limited or ineffective treatment options. Modern molecular techniques and imaging can aid in diagnosing and assessing intraocular infections. Various antimicrobial therapies exist, spanning topical and systemic treatments, but these are constrained by issues like drug concentration, penetration, effective duration, toxicity, and side effects. Treatment approaches also differ based on the infection's etiology. This review provides recent updates on antimicrobial therapies from a clinical perspective, covering topical, systemic, and regional treatments for infectious uveitis.

14.
Ocul Immunol Inflamm ; : 1-5, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38564673

RESUMEN

PURPOSE: To report two cases of non-granulomatous unilateral anterior uveitis in two female patients associated with autoimmune liver diseases (ALD), emphasizing the possibility of this rare coexistence as a polyautoimmunity phenomenon. CASE DESCRIPTIONS: Case 1: An 18-year-old female with a history of congenital renal hypoplasia and metabolic syndrome presented with anterior uveitis in OS and a history of jaundice, blood elevated hepatic enzymes, and cholangioresonance compatible with primary sclerosing cholangitis (PSC). Laboratory work-up for additional autoimmune and infective causes were within normal limits. Case 2: An 58-year-old female presented an episode of anterior uveitis in OD and a history of Sjögren syndrome diagnosed at the age of 53, primary biliary cholangitis (PBC), systemic sclerosis, Raynaud's phenomenon, bilateral sacroiliitis, and vitiligo, consistent with polyautoimmunity and multiple autoimmune syndrome. CONCLUSIONS: Uveitis rarely coexists with ALD. However, it is essential to recognize the possibility of polyautoimmunity in patients presenting with ophthalmic manifestations and a previous diagnosis of ALD, such as PSC or PBC.

15.
Eye (Lond) ; 38(4): 714-722, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37789110

RESUMEN

OBJECTIVES: To describe the clinical features of patients diagnosed with uveitic glaucoma (UG) and ocular hypertension secondary to uveitis (OHT-SU). METHODS: A multicentric cross-sectional study using medical records of patients with uveitis between 2013 and 2021. Uveitis and glaucoma specialists examined all patients. Variables were analyzed using the chi-square or Fisher's exact test for categorical variables. Additionally, t test, Mann-Whitney, and Kruskal-Wallis variance analysis were used for continuous variables. Finally, a Kaplan-Meier survival analysis for UG and OHT-SU development over time was done. RESULTS: Of the 660 clinical records reviewed of patients with uveitis, 191 (28.9%) had OHT-SU in at least one visit, and 108 (16.4%) of them developed UG. In all ages, females were more affected than males. Anterior uveitis was the main anatomic localisation, and non-granulomatous, recurrent, and inactive uveitis were the most frequent clinical features. The mean final visual acuity was 0.3 (0.0-1.0) LogMAR. Also, 95.8% of the patients had additional sequelae related to uveitis regardless of UG and OHT-SU. Interestingly, males had earlier affection, with statistical significance in OHT for adults (P = 0.036) and UG for children (P = 0.04). Of all patients, 81.1% received topical hypotensive treatment and 29.8% required a surgical procedure. CONCLUSIONS: UG and OHT-SU are common complications of uveitis in the Colombian population. These sight-threatening conditions were more common and appeared sooner in men at any age. Our results suggest that earlier and more aggressive treatment with topical hypotensive agents could positively influence the visual outcomes and the requirement of surgical procedures.


Asunto(s)
Glaucoma , Hipertensión Ocular , Uveítis , Adulto , Masculino , Niño , Femenino , Humanos , Colombia/epidemiología , Presión Intraocular , Prevalencia , Estudios Transversales , Estudios Retrospectivos , Glaucoma/epidemiología , Glaucoma/etiología , Glaucoma/terapia , Hipertensión Ocular/epidemiología , Hipertensión Ocular/etiología , Hipertensión Ocular/diagnóstico , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Uveítis/epidemiología
16.
Surv Ophthalmol ; 69(2): 253-264, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37804869

RESUMEN

Assessing anterior chamber inflammation is highly subjective and challenging. Although various grading systems attempt to offer objectivity and standardization, the clinical assessment has high interobserver variability. Traditional techniques, such as laser flare meter and fluorophotometry, are not widely used since they are time-consuming. With the development of optical coherence tomography with high sensitivity, direct imaging offers an excellent alternative to assess objectively inflammation with the potential for automated analysis. We describe various anterior chamber inflammation grading methods and discuss their utility, advantages, and disadvantages.


Asunto(s)
Uveítis Anterior , Humanos , Cámara Anterior/diagnóstico por imagen , Inflamación/diagnóstico , Tomografía de Coherencia Óptica/métodos , Pruebas de Visión
17.
Ocul Immunol Inflamm ; : 1-9, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38842198

RESUMEN

The aim of this perspective is to promote the theory of salutogenesis as a novel approach to addressing ophthalmologic inflammatory conditions, illustrating several concepts in which it is based upon and how they can be applied to medical practice. This theory can better contextualize why patients with similar demographics and exposures are not uniform in their clinical presentations. Stressors in daily life can contribute to a state of ill-health and there are various factors that help alleviate their negative impact. These alleviating factors are significantly impaired in people with poor vision, one of the most common presentations of ophthalmologic conditions. Salutogenic principles can guide the treatment of eye conditions to be more respectful of patient autonomy amidst shifting expectations of the doctor-patient relationship. Being able to take ownership of their health and feeling that their cultural beliefs were considered improves compliance and subsequently gives more optimal outcomes. Population-level policy interventions could also utilize salutogenic principles to identify previously overlooked domains that can be addressed. We identified several papers about salutogenesis in an ophthalmological context and acknowledged the relatively few studies on this topic at present and offer directions in which we can explore further in subsequent studies.

18.
Ophthalmic Epidemiol ; : 1-8, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38709171

RESUMEN

PURPOSE: To describe the prevalence, incidence, and sociodemographic characterization of moderate to severe vision impairment (MSVI) and blindness in Colombia based on the National Health Registry Integrated Social Protection Information System (SISPRO) Database. METHODS: We performed a nationwide population-based study using SISPRO and the International Classification of Diseases. Total and new cases were identified to calculate the prevalence and incidence per 100,000 inhabitants of MSVI and blindness between 2015 and 2019. Blindness was defined as a best-corrected visual acuity (BCVA) of less than 20/400 in the better-seeing eye. Meanwhile, MSVI is a BCVA from 20/70 to equal or better than 20/400 in the better-seeing eye. An ANOVA test was performed to identify age differences. A conditional autoregressive model was also employed to depict standardized morbidity rate maps. RESULTS: From the 50 million inhabitants, the average prevalence and incidence of MSVI were 13.94 and 13.34 between 2015 and 2019, respectively, while for blindness, they were 4.03 and 3.53. Females accounted for most reported cases, and there was a notable shift towards individuals over 50 years (p < 0.001). Valle del Cauca was the region with the most cases reported and the greatest disease burden. CONCLUSION: This is the first nationwide population-based study describing the prevalence, incidence, and sociodemographic characterization of blindness and MSVI in Colombia. In recent years, there has been an increased number of cases, prevalence, and incidence, with females over 50 particularly affected. This research provides insight into the country's vision impairment epidemiology landscape and contributes to formulating public health policies to improve eye health care.

19.
Clin Exp Optom ; : 1-7, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39048299

RESUMEN

CLINICAL RELEVANCE: Glaucoma encompasses a group of eye diseases that progressively damage the optic nerve, leading to vision loss and blindness. Understanding the incidence and demographic distribution is vital for public health planning and patient care. BACKGROUND: Previous small-scale studies in Colombia have reported the prevalence of glaucoma in individuals over 40 years between 1.1% and 5.29%. These data may not fully capture the true extent of the disease. Furthermore, with the ageing population, the incidence of glaucoma is likely to increase, highlighting the need for up-to-date incidence data to guide healthcare planning. METHODS: Data were obtained from the Social Protection Information System, the primary health record repository of Colombia, using the International Classification of Disease 10 for glaucoma. Crude incidence rates were calculated and adjusted for sex, age, and gender. The 2020 incidence was compared with estimated rates from previous years to assess the impact of the coronavirus disease 2019 lockdown. A standardised morbidity map was created to show regional variations. RESULTS: The average incidence of glaucoma in Colombia was 17.36 per 1,000 inhabitants, increasing from 12.29 in 2015 to 24.22 in 2019. Of the 212,700 reported cases, 60.75% were females. Primary open-angle glaucoma was the most prevalent type, with significant incidence in the elderly over 70 years of age, irrespective of sex. Bogotá, Antioquia, and Valle del Cauca had the highest numbers of new cases. CONCLUSION: The increasing incidence of glaucoma and its demographic and geographical variations necessitate the awareness of ophthalmologists and optometrists. This study emphasises the need for continuous monitoring, effective interventions, and developing healthcare strategies to address the escalating challenge of glaucoma in Colombia.

20.
Ocul Immunol Inflamm ; 32(8): 1749-1754, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38133944

RESUMEN

PURPOSE: To estimate the incidence of Optic Neuritis (ON) in Colombia using data from the national health registry between January 1, 2015, and December 31, 2020. METHODS: A population-based study was conducted using the Integrated Social Protection Information System from the Colombian Ministry of Health and the International Classification of Diseases-10 code for ON to estimate the incidence of ON from 2015 to 2020. We also evaluated the impact of the COVID-19 lockdown on the epidemiology of the disease in 2020. Finally, a standardized morbidity rate map was created to assess a country's ON geographic distribution. RESULTS: From 2015 to 2019, 2,463 new cases of ON were reported. The overall 5-year incidence rate was 1.56 cases per 100,000 inhabitants per year, 66% of the patients were females. The peak of presentation in males was the quinquennium of 50-54 years, and in females, it was 45-49 years. In 2020, coinciding with the COVID-19 pandemic, there was a reduction in the incidence of ON by approximately 0.15 cases per 100,000 inhabitants. The regions with a high number of cases and an increasing risk of new cases were Bogotá, Antioquia, and Valle del Cauca. CONCLUSIONS: The incidence of ON in Colombia is lower compared to countries in the northern hemisphere, with women under 50 years being predominantly affected. The onset of the COVID-19 pandemic corresponded with a reduction in identifying new ON cases. This underscores governments' need to implement effective diagnostic strategies in the future.


Asunto(s)
COVID-19 , Neuritis Óptica , Sistema de Registros , SARS-CoV-2 , Humanos , Colombia/epidemiología , Incidencia , Neuritis Óptica/epidemiología , Neuritis Óptica/diagnóstico , Masculino , Femenino , COVID-19/epidemiología , Persona de Mediana Edad , Adulto , Adolescente , Anciano , Niño , Adulto Joven , Preescolar , Distribución por Sexo , Distribución por Edad , Lactante , Recién Nacido , Anciano de 80 o más Años
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