The Shiny Cowbird, Molothrus bonariensis (Gmelin, 1789) (Aves: Icteridae), at 2,800 m asl in Quito, Ecuador.

BACKGROUND: The Shiny Cowbird, Molothrus bonariensis Gmelin, 1789, is a brood parasite of hundreds of small-bodied birds that is native to South American lowlands. Within the last 100 years this species has been expanding its range throughout the Caribbean, towards North America, but has rarely been seen above 2,000 m asl. NEW INFORMATION: Here, we present records of Shiny Cowbirds in Quito, a city located 2,800 m above sea level that harbors a bird community typical of the Andean valleys. We found two juvenile individuals parasitizing two different pairs of Rufous-collared Sparrow (Zonotrichia capensis Müller, 1776). This report constitutes an altitudinal range expansion of reproductive populations of ca. 500m, which may have beenprompted by anthropogenic disturbance.

Aplicaciones clínicas de la toxina botulínica en el estrabismo: estudio de las inyecciones realizadas durante un año en un hospital general / Botulinum toxin uses in strabismus: A review of the injections performed during one year in a general hospital

OBJETIVO: Analizar las indicaciones, dosis y eficacia de las inyecciones de toxina botulínica A en el departamento de Estrabología. MÉTODO: En este estudio prospectivo, 28 pacientes diagnosticados de estrabismo fueron tratados con toxina botulínica. Se recopilaron los pacientes tratados en 2013 en el Hospital Rey Juan Carlos (Móstoles) para estudiar las indicaciones, la dosis empleada, y se analizaron los resultados de la última revisión, tanto en niños como en adultos, con un seguimiento mínimo de 14 meses. RESULTADOS: Se recogieron datos de 11 niños, 6 mujeres (54,5%), y 17 adultos, 11 varones (64%). La edad media fue 4,42 ± 3,48 años y 58,71 ± 18,07 años en niños y adultos respectivamente. En ambos grupos la mayoría de los casos eran endotropias (81,8% en niños y 47,1% en adultos), aunque el grupo de adultos presentaba enfermedades más heterogéneas incluyendo 4 pacientes con exotropía (26,5%), 4 con hipertropía (26,5%) y uno con nistagmo aislado (5,9%). La media de inyecciones en niños fue de 1,45 ± 0,93, aunque el 72,7% recibieron una única inyección; en el grupo de adultos la media de inyecciones fue de 3,27 ± 1,41. Se encontró una diferencia estadísticamente significativa en la comparación de tropia y foria prepostinyección en niños y adultos (p < 0,05). En ambos grupos hubo una mejoría significativa en el tortícolis postinyección comparado con el previo (p < 0,05). En 4 niños pudimos detectar una mejoría en la estereoagudeza. Dos niños (18,2%) y 5 adultos (29,4%) precisaron intervención quirúrgica posterior. Ocho adultos (49,1%) presentaban diplopia en posición primaria de la mirada, que se resolvió en 6 casos con inyecciones de toxina, pero 2 necesitaron cirugía para la corrección de la diplopia. Las diferencias entre tropia y foria pre- y postintervención fueron estadísticamente significativas (p < 0,05), así como las diferencias entre el tortícolis pre- y postinyección. En 4 casos se pudo detectar mejoría en la estereoagudeza. CONCLUSIONES: La toxina botulínica es un fármaco muy útil en el estrabismo, con mejores resultados sensoriales y motores en los niños, pero eficaz como tratamiento sintomático en algunos casos de estrabismo en adultos

OBJECTIVE: To analyse the indications, dosage and efficacy of botulinum toxin A injection performed in patients in a Strabismus Department. METHODS: In this prospective study, botulinum toxin A was injected into 28 patients diagnosed with strabismus. Data was obtained from the records of patients that were evaluated during 2013 in the Strabismus Unit of Rey Juan Carlos Hospital (Móstoles, Madrid, Spain) in order to assess the indications and dosage of botulinum toxin A use in strabismus, as well as its clinical effect and differences in paediatric and adult patients. The outcomes in the last visit, at least 14 months after the injections, were analysed. RESULTS: An analysis was performed on the data from 11 children, 6 females (54.5%), and 17 adults, 11 males (64%). The mean age was 4.42 ± 3.48 years and 58.71 ± 18.07 years in the children and adult groups, respectively. The majority of cases in both groups were esotropia (81.8% in children and 47.1% in adults). However the pathologies in the adult group were quite heterogeneous, including 4 patients with exotropia (26.5%), 4 with hypertropia (26.5%), and one with isolated nystagmus (5.9%). The mean number of the botulinum toxin injections in children was 1.45 ± 0.93, although 72.7% received a single injection. In the adult group, the mean number of injections was 3.27 ± 1.41. There was a statistically significant difference between pre- and post-injection in the tropia and phoria measurements in children and adults group (P<.05). In both groups there was a statistically significant improvement in post-injection torticollis when compared with the pre-injection measurement (P<.05). An improvement in the stereoacuity could be detected in 4 children. Two children (18.2%) and 5 adults (29.4%) required subsequent surgical intervention. Eight adult patients (49.1%) complained of diplopia in the primary position, which was resolved in 6 cases with toxin injection, whereas 2 needed surgery for diplopia correction. CONCLUSIONS: Botulinum toxin is a very useful tool in the management of strabismus, obtaining better sensory and motor results in children, but it is also effective as a symptomatic treatment in some types of strabismus in adults

Botulinum toxin uses in strabismus: A review of the injections performed during one year in a general hospital.

OBJECTIVE: To analyse the indications, dosage and efficacy of botulinum toxin A injection performed in patients in a Strabismus Department. METHODS: In this prospective study, botulinum toxin A was injected into 28 patients diagnosed with strabismus. Data was obtained from the records of patients that were evaluated during 2013 in the Strabismus Unit of Rey Juan Carlos Hospital (Móstoles, Madrid, Spain) in order to assess the indications and dosage of botulinum toxin A use in strabismus, as well as its clinical effect and differences in paediatric and adult patients. The outcomes in the last visit, at least 14 months after the injections, were analysed. RESULTS: An analysis was performed on the data from 11 children, 6 females (54.5%), and 17 adults, 11 males (64%). The mean age was 4.42±3.48 years and 58.71±18.07 years in the children and adult groups, respectively. The majority of cases in both groups were esotropia (81.8% in children and 47.1% in adults). However the pathologies in the adult group were quite heterogeneous, including 4 patients with exotropia (26.5%), 4 with hypertropia (26.5%), and one with isolated nystagmus (5.9%). The mean number of the botulinum toxin injections in children was 1.45±0.93, although 72.7% received a single injection. In the adult group, the mean number of injections was 3.27±1.41. There was a statistically significant difference between pre- and post-injection in the tropia and phoria measurements in children and adults group (P<.05). In both groups there was a statistically significant improvement in post-injection torticollis when compared with the pre-injection measurement (P<.05). An improvement in the stereoacuity could be detected in 4 children. Two children (18.2%) and 5 adults (29.4%) required subsequent surgical intervention. Eight adult patients (49.1%) complained of diplopia in the primary position, which was resolved in 6 cases with toxin injection, whereas 2 needed surgery for diplopia correction. CONCLUSIONS: Botulinum toxin is a very useful tool in the management of strabismus, obtaining better sensory and motor results in children, but it is also effective as a symptomatic treatment in some types of strabismus in adults.

Diágnóstico del lenticono en el síndrome de Alport: cálculo del ángulo apical de la cápsula anterior del cristalino mediante imágenes Scheimpflug / Lenticonus diagnosis in Alport's syndrome: Anterior capsule apical angle calculation using Scheimpflug imagery

OBJETIVO: Se describe un método simplificado para detectar lenticono anterior. Realizamos imágenes Scheimpflug del segmento anterior con Pentacam a 3 ojos de 2 pacientes con lenticono anterior y 16 ojos de controles sanos. Se identificó el ángulo del ápex de la cápsula anterior y se midió con AutoCAD. RESULTADOS: El ángulo medio fue 173,06° (DE: 1,91) en los controles sanos y 158,33° (DE: 3,05) en los lenticonos. El ángulo obtenido en los pacientes resultó ser más agudo en más de 3 DE que el de los controles. CONCLUSIONES: El método del cálculo del ángulo apical parece discriminar adecuadamente entre cristalinos normales y lenticono anterior

OBJECTIVE: We describe a simplified method to detect anterior lenticonus. Three eyes of 2 patients with anterior lenticonus, plus 16 eyes from 16 healthy controls underwent Scheimpflug imaging of their anterior segment with Pentacam. The anterior capsule apex angle was manually identified and automatically measured by AutoCAD. RESULTS: The mean angle was 173.06° (SD: 1.91) in healthy subjects, and 158.33° (SD: 3.05) in anterior lenticonus eyes. The angle obtained from patients was more than 3 SD steeper than those from healthy subjects. CONCLUSIONS: The apical angle calculation method seems to discriminate well between normal eyes and eyes suspected of having anterior lenticonus

Lenticonus diagnosis in Alport's syndrome: Anterior capsule apical angle calculation using Scheimpflug imagery.

OBJECTIVE: We describe a simplified method to detect anterior lenticonus. Three eyes of 2 patients with anterior lenticonus, plus 16 eyes from 16 healthy controls underwent Scheimpflug imaging of their anterior segment with Pentacam. The anterior capsule apex angle was manually identified and automatically measured by AutoCAD. RESULTS: The mean angle was 173.06° (SD: 1.91) in healthy subjects, and 158.33° (SD: 3.05) in anterior lenticonus eyes. The angle obtained from patients was more than 3 SD steeper than those from healthy subjects. CONCLUSIONS: The apical angle calculation method seems to discriminate well between normal eyes and eyes suspected of having anterior lenticonus.

Iridotomía periférica láser frente a facoemulsificación en el cierre angular primario: estudio comparativo prospectivo / Peripheral yttrium aluminium garnet (YAG) iridotomy versus phacoemulsification in primary angle closure: Prospective comparative study

OBJETIVO: Describir los cambios en el segmento anterior y en la presión intraocular (PIO) entre la iridotomía periférica láser (IPL) y la facoemulsificación en pacientes con sospecha de cierre angular primario (PACS) y cierre angular primario (PAC). MÉTODO: Se seleccionaron 47 ojos de 47 pacientes que presentaban un ángulo 0-II (Shaffer) en la gonioscopia y se excluyó a los pacientes con lesiones glaucomatosas. Según la esclerosis cristaliniana y la agudeza visual se separaron en 2 grupos: IPL (n = 18) o facoemulsificación (n = 29). Se realizó tonometría, gonioscopia, funduscopia y medidas de la cámara anterior (CA) con Pentacam antes de cada intervención, al mes y a los 3 meses. RESULTADOS: La facoemulsificación redujo la PIO al mes y a los 3 meses (p < 0,01), mientras que la IPL redujo la PIO de forma estadísticamente significativa a los 3 meses (p < 0,04; al mes p = 0,38). La PIO fue 16,1 mmHg (DE: 3,59) en el grupo facoemulsificación versus 16,83 mmHg (DE: 2,36) en el grupo IPL al mes (p = 0,4) y 15,52 (DE: 2.95) versus 16,05 (DE: 2,46) a los 3 meses (p = 0,5). No se encontraron diferencias significativas en la media de fármacos antiglaucomatosos. La apertura angular mediante gonioscopia fue mayor en el grupo de facoemulsificación (p < 0,01), encontrándose la mayor diferencia en el cuadrante superior. La profundidad, el ángulo y el volumen de la CA obtenidos con Pentacam fueron superiores en el grupo de facoemulsificación (p < 0,01). CONCLUSIONES: Tanto la IPL como la facoemulsificación son técnicas efectivas para prevenir el bloqueo pupilar en PAC, pero con la facoemulsificación se obtiene mayor amplitud del ángulo y de la CA de forma precoz

PURPOSE: A study was designed to determine and describe the changes induced in the anterior segment of the eye and the intraocular pressure (IOP) after laser peripheral iridotomy (LPI) versus phacoemulsification in primary angle closure suspects (PACS) and primary angle closure (PAC). METHODS: Forty-seven eyes (47 patients) with Shaffer gonioscopy 0-II were included and split into 2 groups: cataract surgery (n = 29) or LPI (n = 18), depending on the lens sclerosis and visual acuity. Tonometry, gonioscopy, funduscopy, and automated measurements of the anterior chamber by Pentacam were performed before the intervention, and one and 3 months after the technique. RESULTS: Phacoemulsification reduces IOP after one and 3 months (P<.01). LPI reduces IOP after 3 months (P<0.04), and after one month (P<0.38). IOP was 16.2 mmHg (SD: 3.59) in the phacoemulsification group vs. 16.83 mmHg (SD: 2.36) in the LPI group after one month (P=0.4), and 15.52 (SD: 2.95) vs. 16.05 (SD: 2.46) in the third month (P=0.5). There were no significant differences in the antiglaucoma drugs. Shaffer gonioscopy grading was greater in the phacoemulsification group vs. in the LPI group one and 3 months after the intervention (P=0.01). The highest difference between both techniques was found in the superior quadrant. The anterior chamber depth, angle and volume by Pentacam were wider in the phacoemulsification group after one and 3 months (P<0.01). CONCLUSIONS: Although phacoemulsification and LPI could both be effective techniques in the prevention of pupillary block in PAC, faster and greater amplitude of the angle and the anterior chamber can be obtained after phacoemulsification than after LPI

Peripheral yttrium aluminium garnet (YAG) iridotomy versus phacoemulsification in primary angle closure: prospective comparative study.

PURPOSE: A study was designed to determine and describe the changes induced in the anterior segment of the eye and the intraocular pressure (IOP) after laser peripheral iridotomy (LPI) versus phacoemulsification in primary angle closure suspects (PACS) and primary angle closure (PAC). METHODS: Forty-seven eyes (47 patients) with Shaffer gonioscopy 0-II were included and split into 2 groups: cataract surgery (n=29) or LPI (n=18), depending on the lens sclerosis and visual acuity. Tonometry, gonioscopy, funduscopy, and automated measurements of the anterior chamber by Pentacam were performed before the intervention, and one and 3 months after the technique. RESULTS: Phacoemulsification reduces IOP after one and 3 months (P<.01). LPI reduces IOP after 3 months (P<.04), and after one month (P<.38). IOP was 16.2mmHg (SD: 3.59) in the phacoemulsification group vs. 16.83mmHg (SD: 2.36) in the LPI group after one month (P=.4), and 15.52 (SD: 2.95) vs. 16.05 (SD: 2.46) in the third month (P=.5). There were no significant differences in the antiglaucoma drugs. Shaffer gonioscopy grading was greater in the phacoemulsification group vs. in the LPI group one and 3 months after the intervention (P=.01). The highest difference between both techniques was found in the superior quadrant. The anterior chamber depth, angle and volume by Pentacam were wider in the phacoemulsification group after one and 3 months (P<.01). CONCLUSIONS: Although phacoemulsification and LPI could both be effective techniques in the prevention of pupillary block in PAC, faster and greater amplitude of the angle and the anterior chamber can be obtained after phacoemulsification than after LPI.

Serie pediátrica en una campaña oftalmológica en Turkana (Kenia) / Pediatric case series in an ophthalmic camp in Turkana (Kenya)

Introducción: Turkana es el distrito más grande de Kenia, situado en el extremo noroeste. Su población está en torno a 850.000 habitantes seminómadas dedicados principalmente al pastoreo. En torno al 60% de la población vive por debajo del umbral de la pobreza. La proporción de médicos por habitante es de 1:75.000.La última campaña realizada en Turkana en noviembre de 2011, con un objetivo puramente quirúrgico, contó con cinco oftalmólogos. La selección previa fue realizada acertadamente por personal local en áreas rurales y en Lodwar. Se realizaron 128 cirugías (123 pacientes) sobre 371 pacientes vistos en consulta. Objetivo: Describir la población pediátrica atendida en la última campaña del proyecto oftalmológico en Turkana. Método: Descripción del perfil de afecciones oculares presentadas por los niños atendidos durante esta campaña quirúrgica. Se expondrá la actitud diagnóstico-terapéutica tomada con relación a las limitaciones impuestas por las características del lugar y de la población. Resultados: De un total de 371 pacientes vistos en consulta, 54 eran menores de 15 años (14,5%); cuatro fueron intervenidos, del total de 123 pacientes operados (3,25%). En dos niños más se indicó la cirugía, por lo que seis de los 54 casos se podrían considerar quirúrgicos (11,1%).De los 54 niños atendidos, 17 sufrían enfermedades distintas a defectos de refracción o problemas leves de superficie ocular: cataratas traumáticas, impétigo, neuropatías, proptosis, distrofias retinianas, tumores dermoides, nictalopía… En 4 de los 17 niños, la causa eran traumatismos (23,5%). Conclusiones: Las campañas quirúrgicas en países en vías de desarrollo están en auge, aunque suelen ir enfocadas a tratar afecciones concretas como las cataratas o el tracoma. Esta serie muestra la necesidad de ir equipados para intervenir a menores de edad y de estar preparados para la complejidad de la situación que pueda surgir (AU)

Introduction: Turkana is the largest district in Kenya, situated in the Northwest of the country. It features a semi-nomadic population of 850,000. Around 60% of population lives below the poverty threshold. The ratio of doctors is 1:75,000 inhabitants. Five ophthalmologists took part in the last deployment in November. Local staff had previously selected the patients from the rural areas, as well as in Lodwar, the capital of the district. Of the 371 patients who attended the clinic, 128 required surgery. Objetive: To describe the pediatric population attended to in the last «Turkana Eye Project» Camp. Methods: Description of the ophthalmic pathologies of the children seen in the clinic in this surgical camp, and the diagnostic and therapeutic options according to the limitations of the environment. Results: Of the 371 patients, 54 were younger than 15 years old (14.5%). Four children had surgery (3.25% of the 128 patients). In 2 more cases surgery was the indicated but not performed. Therefore, of the total of 54 cases, 6 could be considered as surgical (11.1%), and 17 suffered ophthalmic problems other than refraction defects, or mild ocular surface pathologies: traumatic cataracts, neuropathies, impetigo, exophthalmos, retinal dystrophies, dermoid cysts, or nyctalopia. The etiology was traumatic in four of the 17 children (23.5%). Conclusion: Surgical camps are increasing in the developing countries. They are usually focused on particular pathologies, such as cataracts or trachoma. Our case series shows the importance of pediatric teams and the need to be prepared to face complex pediatric pathologies (AU)

[Pediatric case series in an ophthalmic camp in Turkana (Kenya)]. / Serie pediátrica en una campaña oftalmológica en Turkana (Kenia).

INTRODUCTION: Turkana is the largest district in Kenya, situated in the Northwest of the country. It features a semi-nomadic population of 850,000. Around 60% of population lives below the poverty threshold. The ratio of doctors is 1:75,000 inhabitants. Five ophthalmologists took part in the last deployment in November. Local staff had previously selected the patients from the rural areas, as well as in Lodwar, the capital of the district. Of the 371 patients who attended the clinic, 128 required surgery. OBJETIVE: To describe the pediatric population attended to in the last «Turkana Eye Project¼ Camp. METHODS: Description of the ophthalmic pathologies of the children seen in the clinic in this surgical camp, and the diagnostic and therapeutic options according to the limitations of the environment. RESULTS: Of the 371 patients, 54 were younger than 15 years old (14.5%). Four children had surgery (3.25% of the 128 patients). In 2 more cases surgery was the indicated but not performed. Therefore, of the total of 54 cases, 6 could be considered as surgical (11.1%), and 17 suffered ophthalmic problems other than refraction defects, or mild ocular surface pathologies: traumatic cataracts, neuropathies, impetigo, exophthalmos, retinal dystrophies, dermoid cysts, or nyctalopia. The etiology was traumatic in four of the 17 children (23.5%). CONCLUSION: Surgical camps are increasing in the developing countries. They are usually focused on particular pathologies, such as cataracts or trachoma. Our case series shows the importance of pediatric teams and the need to be prepared to face complex pediatric pathologies.