Mpox-Related Ophthalmic Disease: A Retrospective Observational Study in a Single Center in Mexico.

Mpox-related ophthalmic disease has been reported as infrequent. We retrospectively describe the ocular manifestations present in 11 of 100 patients with confirmed mpox; 9 were people with HIV. We suggest that an ophthalmological evaluation should be performed in all patients with ocular symptoms or moderate and severe mpox disease.

Efficacy of a fixed combination of 0.09 % xanthan gum/0.1 % chondroitin sulfate preservative free vs polyethylene glycol/propylene glycol in subjects with dry eye disease: a multicenter randomized controlled trial.

BACKGROUND: Dry eye disease (DED) is multifactorial, affecting 5-34 % of the global adult population and reducing quality of life. The artificial tears or lubricants are the therapy most used for the treatment of DED, due to their low side effect profile, which attempt to modify the properties of the tear film. The aim of the present study was to evaluate the clinical efficacy of a fixed combination of xanthan gum and chondroitin sulfate preservative free on the ocular surface of patients with dry eye disease during 60 days of intervention. METHODS: A phase III, double-blind, masked, controlled, multicenter, clinical trial of 148 subjects, randomized to either a fixed combination of xanthan gum 0.09 % and chondroitin sulfate 0.1 % (XG/CS) ophthalmic solution (n = 76) or a fixed combination of polyethylene glycol 400 0.4 % and propylene glycol 0.3 % (PEG/PG) (n = 72). Subjects self-dosed four times daily during 60 days. Follow-up was set on days 2, 7, 15, 30 and 60. Assessments of anterior/posterior segment ocular signs were performed. The outcome measures included Schirmer test, tear film break-up time and OSDI score. Security variables included intraocular pressure, lisamine green and fluorescein ocular surface stains. RESULTS: The primary efficacy endpoints were similar between groups at baseline. After intervention time Schirmer test increased in both groups compared to baseline, XG/CS (6.4 ± 2.2 vs 11.0 ± 6.6; p = 0.002) and PEG/PG (6.5 ± 2.5 vs 10.5 ± 5.6; p = 0.019) respectively. Similar results were reported in the tear film break-up time in XG/CS (5.5 ± 2.1 vs 7.4 ± 2.9; p = 0.027) and PEG/PG (5.2 ± 2.0 vs 7.4 ± 2.7; p = 0.046) respectively. The OSDI score decreased to normal values in both groups, XG/CS (19.3 ± 7.4 vs 7.3 ± 5.9; p = 0.001) and PEG/PG (19.3 ± 7.5 vs 7.9 ± 8.2; p = 0.001) respectively. There was no significant difference between treatments for any parameter. Moreover, both groups decreased the presence of burning sensation, tearing, foreign body sensation, conjunctival hyperemia and photophobia. The adverse events were not related to the interventions. CONCLUSIONS: Xanthan gum/chondroitin sulfate preservative free showed similar clinical efficacy, evaluated with OSDI score, TBUT and Schirmer test compared to polyethylene glycol/propylene glycol in the treatment of dry eye disease. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01657253 . Date of registration May 19, 2014.

A Practical Approach to Severity Classification and Treatment of Dry Eye Disease: A Proposal from the Mexican Dry Eye Disease Expert Panel.

Dry eye disease (DED) has a higher prevalence than many important systemic disorders like cardiovascular disease and diabetes mellitus, representing a significant quality of life burden for the affected patients. It is a common reason for consultation in general eye clinics worldwide. Nowadays, the diagnostic and therapeutic approach at the high corneal and ocular surface specialty level should be reserved for cases of severe and chronic dry eye disease associated with systemic autoimmune diseases or complicated corneal and ocular surface pathologies. In such cases, the diagnostic and therapeutic approach is often complex, elaborate, time-consuming, and costly due to the use of extensive dry eye questionnaires, noninvasive electronic diagnostic equipment, and clinical laboratory and ancillary tests. However, other eye care specialists attend a fair amount of DED cases; therefore, its diagnosis, classification, and management should be simple, practical, achievable, and effective. Considering that many patients attending non-specialized dry eye clinics would benefit from better ophthalmological attention, we decided to elaborate a practical DED classification system based on disease severity to help clinicians discriminate cases needing referral to subspecialty clinics from those they could attend. Additionally, we propose a systematic management approach and general management considerations to improve patients' therapeutic outcomes according to disease severity.

[Alterations in voice, speech and swallowing in patients with Sjögren's syndrome]. / Alteraciones de la voz, el habla y la deglución en pacientes con síndrome de Sjögren.

OBJECTIVE: To identify and describe voice, speech and swallowing abnormalities in patients with Sjögren's Syndrome (SS). MATERIALS AND METHODS: This was a prospective cross-sectional descriptive observational study. Patients with SS were interviewed and physically explored. Nasolaryngeal endoscopy, video laryngeal stroboscopy, fiberoptic endoscopic evaluation of swallowing and computerized voice spectrographic analysis (PRAAT® software) of voice and speech were also performed. RESULTS: We included 31 patients (96.7% women). Average time of evolution was 5 years; mean age was 48.4 years. Of these SS cases, 87% were secondary and 13% primary. Symptomatology: 70.9% dysphagia, 41.9% dysphonia, 35.4% dysglossia, 3.2% dysarthria. We found abnormalities principally in: one or more cranial nerves (V, VII, IX, X, XII) (67.7%), nasopharyngolaryngeal mucosa (77.4%), mucosal wave of vocal cords (90%), swallowing mechanism (90.3%), spectrogram of the vowels /e/ (58.06%) and /i/ (51.61%), and rhythm of the trisyllable "pataka" (35.48%). CONCLUSIONS: Patients with SS have voice, speech and swallowing abnormalities, not only associated to xerosis, but perhaps also to neurological abnormalities, probably secondary to the syndrome.

Alteraciones de la voz, el habla y la deglución en pacientes con síndrome de Sjögren / Alterations in voice, speech and swallowing in patients with Sjögren’s syndrome

Objetivo: Identificar y describir alteraciones de voz, habla y deglución en pacientes con síndrome de Sjögren (SS). Material y métodos: Estudio prospectivo, descriptivo, transversal, observacional. Pacientes con SS fueron interrogados y explorados físicamente, realizamos además nasofibrolaringoendoscopia, videolaringoestroboscopia, evaluación fibroendoscópica de la deglución y análisis espectrográfico computarizado de voz y habla (software PRAAT®). Resultados: Incluimos 31 pacientes (96,7% mujeres), tiempo de evolución promedio 5 años 8meses, edad promedio 48,4 años. El SS en 87% secundario, en 13% primario. Sintomatología: 70,9% disfagia, 41,9% disfonía, 35,4% disglosias, 3,2% disartria. Encontramos principalmente alteraciones en: uno o más pares craneales (V, VII, IX, X, XII) (67,7%), mucosa nasofaringolaríngea (77,4%), ondulación de la mucosa alterada en cuerdas vocales (90%), mecanismo de la deglución (90,3%), espectrograma de vocales /e/ (58,06%), /i/ (51,61%) y ritmo del trisílabo «pataka» (35,48%). Conclusiones: El SS presenta alteraciones en voz, habla y deglución, quizá no sólo asociadas axerosis, sino también a trastornos neurológicos probablemente secundarios al síndrome (AU)

Objective: To identify and describe voice, speech and swallowing abnormalities in patients with Sjögren’s Syndrome (SS). Materials and methods: This was a prospective cross-sectional descriptive observational study. Patients with SS were interviewed and physically explored. Nasolaryngeal endoscopy, videolaryngeal stroboscopy, fiberoptic endoscopic evaluation of swallowing and computerized voice spectrographic analysis (PRAAT® software) of voice and speech were also performed. Results: We included 31 patients (96.7% women). Average time of evolution was 5 years; mean age was 48.4 years. Of these SS cases, 87% were secondary and 13% primary. Symptomatology: 70.9% dysphagia, 41.9% dysphonia, 35.4% dysglossia, 3.2% dysarthria. We found abnormalities principally in: one or more cranial nerves (V, VII, IX, X, XII) (67.7%), nasopharyngolaryngeal mucosa (77.4%), mucosal wave of vocal cords (90%), swallowing mechanism (90.3%), spectrogram of the vowels /e/ (58.06%) and /i/ (51.61%), and rhythm of the trisyllable ‘‘pataka’’(35.48%). Conclusions: Patients with SS have voice, speech and swallowing abnormalities, not only associated to xerosis, but perhaps also to neurological abnormalities, probably secondary to the syndrome (AU)

Lesiones endoteliales en quemaduras corneales / Endothelial injuries in corneal burnings

Las quemaduras corneales pueden presentarse por varios agentes químicos tanto ácidos como alcalinos o por agentes térmicos, las lesiones microscópicas se pueden valorar por los signos clínicos y la clasificiación de Huges-Roper-Hall, pero las lesiones microscópicas de los tejidos, en especial del endotelio corneal, no son valorables por este medio, por lo que la microscopía especular sería muy útil en estos casos. Se incluyeron a todos los pacientes con quemaduras unioculares, se les realizó microscopía especular en ambos ojos y se relacionó el grado de quemadura con las alteraciones endoteliales encontradas. Los cambios celulares encontrados fueron disminución de la densidad celular que es directamente proporcional a la disminución del porcentaje de hexagonalidad y esto a su vez presentó un agrandamiento celular y espacios intercelulares amplios