RESUMO
Ocular chemical burns are a significant cause of visual impairment. This study aims to characterize ocular chemical burns in a southwestern Colombia referral center and identify associated factors with low vision. A cross-sectional study was carried out based on the review of medical records of patients diagnosed with chemical eye burns who consulted the emergency ophthalmology service between January 2016 and December 2019. Descriptive statistics were performed. Associations with low vision (Best Corrected Visual Acuity, BCVA, ≥20/70 in Snellen chart) in the last follow-up appointment were identified using a multivariate logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). 219 eyes affected by chemical burns were identified from 174 patients with a mean age of 39 years (SD±20), out of which 57.5% (n=100) were men. We ran a multivariate model adjusted by sex, eye wash, type of chemical, and Dua's classification. We found that the odds of low vision for patients without eyewash before the consult were three times the odds of those who had it (Adjusted OR [aOR]=3.5, 95%CI=1.3-9.4) and almost five times for those with Dua's classification greater than 1 (aOR=4.7, 95%CI=1.7-12.9). The ocular chemical burns reported in this study occurred more in young people of productive age. Acids were the principal causal agent. The association between lack of early management and the severity of the chemical burn with low vision has been highlighted. Ocular burns remain a relevant cause of consultation on the ophthalmology service in Cali, and prevention strategies are required.
RESUMO
Purpose: To evaluate the effects of long-standing early detection program in the incidence and trends of severe retinopathy of prematurity (ROP) in Cali, Colombia. Methods: This was a retrospective cohort study of infants included in an ROP prevention, early detection, and prompt treatment program, from January 01, 2002, to December 31, 2021 (20 years). Infants with gestational age (GA) <37 weeks or birth weight (BW) <2000 g and those with known ROP risk factors were screened. The incidence of severe ROP was calculated, and the average annual percent change (AAPC) was estimated through a joinpoint model. Results: 16,580 infants were screened, with an average GA and BW of 31.4 ± 2.8 weeks and 1526.5 ± 56.7 g, respectively. The incidence of severe ROP was 2.69% (446 cases, 95% confidence interval [95%CI]: 2.45%; 2.95%), with an average annual decrease of - 14% (AAPC, 95%CI: -16.3%; -11.6%) from 13.6% in 2002 to 0.7% in 2021. In infants with GA <32 weeks, the incidence was 5.21%. A significant reduction in the risk of ROP was observed with increasing GA and BW (P < 0.05). Among the cases with severe ROP, 6.5% (29/446) had a GA ≥32 weeks with a maximum of 37 weeks; only 0.4% (2/446) of the detected infants had a BW >2000 g. Conclusion: Awareness and screening as part of the early detection program to prevent ROP has shown a significant decline in the incidence of severe ROP over time. Screening infants with GA <32 weeks or BW <2000 g and preterm infants (<37 weeks) with risk factors may be a feasible decision for resource optimization.
