A new look into uveitis in Colombia: changes in distribution patterns and clinical characteristics over the last 25 years.

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.

Colombian ocular diseases epidemiology study (CODES): glaucoma incidence and sociodemographic characterisation 2015-2020.

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.

Colombian Ocular Diseases Epidemiology Study (CODES): incidence and sociodemographic characterisation of keratoconus between 2015 and 2020.

OBJECTIVE: To estimate the incidence and describe the demographic characteristics of keratoconus (KC) in Colombia using national health registry data between January 1st 2015 and December 31th 2020. METHODS AND ANALYSIS: We conducted a nationwide, population-based study using the Integrated Social Protection Information System from the Colombian Ministry of Health, the unique official database in the country. We used the International Classification of Diseases code for KC (H186) to identify the number of new cases of KC and estimate the incidence rates both overall and according to age and sex. We made a standard morbidity ratio map to graph Colombia's morbidity risk of KC onset. RESULTS: Of 50 372 424 subjects, 21 710 had KC between 2015 and 2020. However, due to the COVID-19 pandemic, all the incidence rates of this study were based on the 18 419 reported until 2019. The incidence rate in the general population was 10.36 (95% CI 10.08 to 10.64) per 100 000 inhabitants. The incidence peak among males was in their early 20s and females in their late 20s. The overall male to female incidence rate ratio was 1.60. Regarding the distribution of the disease, most cases were reported in Bogotá (48.64%), Antioquia (14.04%) and Cundinamarca (10.38%). CONCLUSION: We performed the first nationwide, population-based study of KC in Latin America, finding distribution patterns similar to those reported in the literature. This study provides valuable information on the epidemiology of KC in Colombia, which is helpful in the development of policies for the diagnosis, prevention and treatment of the disease.

Diagnóstico prenatal de ambigüedad genital, correlación posnatal y revisión de la literatura / Prenatal diagnosis of ambiguous genitalia, postnatal correlation and review of the literature

Objetivo. Presentar un caso de diagnóstico prenatal de ambigüedad genital, con la posterior confirmación posnatal de pseudohermafroditismo masculino. Describir los rasgos más importantes de ultrasonido obstétrico en las malformaciones genitales y realizar una revisión de la literatura que permita al lector un abordaje fácil a este tipo de literatura. Métodos. Se realizó la evaluación prenatal en un embarazo de 22 semanas de una madre de 38 años y se observó un feto con genitales externos ambiguos y posible hipospadias. La paciente entró en el programa de vigilancia fetal y se realizaron ecografías periódicas y un estrecho control prenatal. Durante la etapa posnatal se realizó la evaluación clínica, hormonal y genética del recién nacido. Posteriormente, se hizo estimulación con testosterona y se observó una respuesta favorable con mejor caracterización de los genitales externos: aumento del grosor del pene y pigmentación del escroto.Resultados. Se le realizó el diagnóstico prenatal de genitales ambiguos, hipospadias, apéndice preauricular izquierdo; se le ofreció a la madre determinar el cariotipo prenatal, a lo cual se negó. El diagnóstico de pseudohermafroditismo masculino fue realizado al relacionar los hallazgos ecográficos encontrados prenatalmente, con los hallazgos descritosen el examen físico, el estudio de cariotipo 46 XY y los marcadores hormonales en la etapa posnatal.Conclusiones. El diagnóstico prenatal de alteraciones de la diferenciación sexual del feto no es siempre fácil. Comprende un estudio minucioso,cuidadoso y multidisciplinario de las posibles causas de la alteración para lograr determinar de la mejor manera las acciones terapéuticas en beneficio del desarrollo biopsicosexual del individuo afectado por este tipo de patología.