The Pan-American Journal of Ophthalmology最新文献

{"title":"An approach to the characteristics of ophthalmologists’ daily work in five Peruvian Amazonian departments","authors":"Luis Felipe Arévalo Arévalo, Gioconda Lourdes Armas Herrera, Inger Arévalo Esparza","doi":"10.4103/pajo.pajo_39_23","DOIUrl":"https://doi.org/10.4103/pajo.pajo_39_23","url":null,"abstract":"The objective of the study was to describe the characteristics of the daily work of ophthalmologists in five Peruvian Amazonian departments, including aspects of professional practice, eye health services, and the effectiveness of the strategies implemented in the fight for vision. A descriptive case study based on a survey prepared and executed by the clinic’s team of ophthalmologists in the teaching and research area. Of the 16 participating ophthalmologists, 56.3% have dual practice in the public and private sectors. The primary pathologies identified from their professional practice include cataracts, glaucoma, and refractive errors. More than 80% indicate that information on visual health in the Peruvian Amazonian departments is unavailable, insufficient, and outdated. Regarding the availability of visual health services, 68.8% agree that such services are accessible, whereas 75% agree that clinical and surgical ophthalmologists are available. However, 81.3% disagree that subspecialty ophthalmologists are readily available. Furthermore, over 80% disagree that visual health services are accessible to all population sectors geographically. In addition, more than 60% disagree that the information provided to patients regarding diagnosis and treatment has a culturally relevant approach. Key criteria for designing and implementing strategies to fight for vision include epidemiological analysis and fieldwork. Among the main strategies employed, there is a notable emphasis on the consultation process and coordination with various stakeholders. Notably, the applied strategies have increased through early detection and prevention actions. Lessons learned from this case study highlight the importance of training medical and nonmedical personnel as good practice while cautioning against the inappropriate handling of patient information. The findings provide valuable insights into the characteristics of ophthalmologists’ field of action and shed light on various aspects, such as the focus of professional practice, prevalent pathologies encountered in daily care, dimensions of information, availability, access, and cultural relevance of visual health services. In addition, the study examines the criteria used, strategies implemented, resulting outcomes, and lessons learned in the fight for vision.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant cell arteritis: Is there a link between ocular and systemic involvement?","authors":"Mariana Portela, M. Correia, Margarida Baptista, C. Bruxelas, D. Pinto, João Costa","doi":"10.4103/pajo.pajo_65_22","DOIUrl":"https://doi.org/10.4103/pajo.pajo_65_22","url":null,"abstract":"Introduction: Giant cell arteritis (GCA) is a systemic disease that may cause severe visual loss. Our purpose was to determine which factors contribute to ocular manifestations (OMs) in patients with temporal artery biopsy-proven GCA. Methods: This was a retrospective review of all cases diagnosed in our center from 2010 to 2021 (>6 months follow-up). We analyzed demographic data, comorbidities, type and duration of symptoms before diagnosis, ocular features, and systemic and laboratory findings. Results: Out of 51 patients (60.8% females, mean age 74.8 ± 13.5), 32 (63%) had OM, of whom 28% had transient visual loss, 69% had permanent visual loss, and 9% had diplopia. Apart from scalp tenderness (P = 0.039), OM did not correlate with other ischemic symptoms such as jaw claudication or headache and were even significantly associated with the absence of fever (P = 0.026). Patients with OM also showed lower values of C-reactive protein (CRP) (P = 0.045). Conclusion: In our sample, visual involvement was not significantly associated with any systemic symptom apart from scalp tenderness, which highlights the importance of having a high index of suspicion for GCA in an ophthalmology setting, especially in older patients with visual loss. Furthermore, OMs were significantly associated with the absence of fever and lower values of CRP which may suggest a lower inflammatory state may in these patients.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130400280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to electronic gadgets and refractive errors among adolescents: A case–control study","authors":"N. Inchara, S. Jammula, B. Praveen Kumar","doi":"10.4103/pajo.pajo_68_22","DOIUrl":"https://doi.org/10.4103/pajo.pajo_68_22","url":null,"abstract":"Introduction: The increasing use of electronic gadgets (e-gadgets) has dramatically changed the adolescent lifestyle. There are rising concerns about the ill effects of the high usage of illuminated screens on vision, especially in adolescents. Objectives: The objective was to explore the pattern of e-gadget use and its association with refractive errors (REs) among adolescents. Methods: A case–control study was carried out among adolescents attending a tertiary care hospital. Adolescents with REs (cases) were compared with those without REs (controls) based on the inclusion and exclusion criteria. Two hundred matched adolescents (case-to-control ratio 1:1) were interviewed for exposure history to e-gadget use and pattern. The Chi-square test and odds ratio (OR) were calculated to find the association between e-gadget use and REs. Results: Age (17.3 ± 3.4 vs. 16.8 ± 3.3 years) and gender distribution between cases and controls were comparable. The e-gadget exposure among cases was higher than in controls (OR 1.4 P > 0.05); however, it is the duration of e-gadget exposure for >5 years was significantly higher among the cases (OR 4.6 P < 0.05). During e-gadget usage, sitting posture (OR 7.5 P < 0.05), poor lighting, indoor activity, and irregular sleep patterns were higher among cases. The purpose of using e-gadgets was predominantly for social media and browsing in cases and the educational or reading purpose among controls. Conclusion: Lesser duration, correct posture, and proper purpose of exposure to e-gadget are associated with lesser risk for REs. Results highlight the collective role of adolescents, parents, teachers, and doctors in education and lifestyle modification on e-gadget use.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122211173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Susac syndrome – A Portuguese experience","authors":"Mariana Portela, V. Nogueira, Marco Liverani, L. Figueira, Jeniffer Jesus, T. Lorga, Margarida Baptista, M. Guedes","doi":"10.4103/pajo.pajo_57_22","DOIUrl":"https://doi.org/10.4103/pajo.pajo_57_22","url":null,"abstract":"Introduction: Susac syndrome (SS) is characterized by microvascular occlusions in the brain, retina, and inner ear. Despite significant advances in understanding this disorder, it remains an under- and misdiagnosed entity in the clinical setting. Methods: This study was retrospective review of clinical records. Results: We present the cases of three young adults complaining of visual loss, hearing impairment, and headache. In all patients, the fundoscopy and fluorescein angiography revealed nonperfused arteriolar segments and multifocal arterial vasculitis. The brain magnetic resonance imaging demonstrated characteristic white matter brain lesions and the audiometry revealed low-frequency hearing loss. The diagnosis of SS was therefore established. We present and discuss the different treatment regimens applied and the course and outcomes of each case. Conclusion: SS is a rare and complex disease with possibly severe consequences that must be promptly diagnosed and treated. However, as no prospective or randomized controlled trials exist, empirical treatment strategies are still the norm, mainly based on the case reports and series.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114890021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immature orbital teratoma: A rare case diagnosed in utero - A clinicopathological case report","authors":"V. Brandão, L. Neves, L. Rangel, S. Fiúza, Thaís Sobreira, L. Régis-Pacheco, Ricardo Neves, L. Régis-Pacheco","doi":"10.4103/2666-4909.370224","DOIUrl":"https://doi.org/10.4103/2666-4909.370224","url":null,"abstract":"To report a rare case of orbital teratoma diagnosed in utero by ultrasound examination at 24 + 4 weeks of gestation. The fetus was delivered by cesarean section, by terminative medical indication, at 39 weeks of pregnancy, due to the possibility of dystocia caused by the size of the tumoral mass, or the risk of tumor rupture during vaginal delivery, with risk to fetal survival. The neonate, a 3 day-old female patient was examined in our Department with a large tumoral mass in the right orbit, severe proptosis, producing severe disfigurement. The diagnosis of orbital teratoma was confirmed by clinical, image, and histopathological exams. To the authors best knowledge this is the first case of orbital teratoma in Brazilian literature reporting a case where the diagnosis was made in utero, at 24 + 4 weeks of gestation.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126003620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior uveitis as the first manifestation of COVID-19 infection","authors":"A. G. Gameiro Filho, Rafael Godoy, Jaqueline Tura, Daniella Socci da Costa, C. D. de Souza, Heloísa Nascimento Salomão","doi":"10.4103/pajo.pajo_61_22","DOIUrl":"https://doi.org/10.4103/pajo.pajo_61_22","url":null,"abstract":"The aim of this article was to report a well-documented case of anterior uveitis as the first manifestation of COVID-19. A 27-year-old male patient sought assistance at our emergency room complaining of bilateral painful conjuntival redness associated with photophobia for 3 weeks. These symptoms were followed by fever and chills, with a positive polymerase chain reaction for COVID-19. While his systemic symptoms improved, the ocular complaints remained. A complete panel for uveitis were performed, with negative results, except for COVID-19. The outbreak of COVID-19 in 2020 has several implications in our society. Previous reports described ocular manifestations of this condition. The ophthalmologists should be aware of the possibility of COVID-19 when facing a patient with red eye.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129156868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus retinitis in Crohn's disease treated with anti-tumor necrosis factor-alpha antibody","authors":"Cristóbal Nazar, J. San Martín, R. Garretón, A. Muñoz","doi":"10.4103/pajo.pajo_116_21","DOIUrl":"https://doi.org/10.4103/pajo.pajo_116_21","url":null,"abstract":"Cytomegalovirus (CMV) is a double-stranded DNA virus. It is an opportunistic infection that usually affects individuals with AIDS or with profound immunosuppression. CMV retinitis is the most frequent ocular manifestation. Infrequently, this pathology has been observed in patients undergoing immunosuppressive treatment due to autoimmune diseases. This article presents a case of Crohn's disease with systemic and ocular involvement by CMV after starting treatment with infliximab (anti-tumor necrosis factor-alpha antibody).","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133229047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eyelid dermoid cyst: Case report of a rare manifestation","authors":"Eshwar Rajesh, R. Charumathi","doi":"10.4103/pajo.pajo_118_21","DOIUrl":"https://doi.org/10.4103/pajo.pajo_118_21","url":null,"abstract":"Dermoid cysts are epidermis-like cysts with dermal adnexal structures such as sebaceous glands, hair follicles, or sweat glands in the cyst wall. They contain mature or immature germ cells of pluripotent origin. The usual sites of occurrence in the periorbital region include the lateral angle of the orbit, medial angle, limbal, and deep orbital region. Here, we present a case of 16-year-old female who came to the hospital with complaints of swelling in the upper eyelid and intermittent pain. After an excisional biopsy of the mass was done, the diagnosis of tarsal dermoid cyst was confirmed. Due to the paucity of cases in literature, reporting this case may help shed light on the importance of including dermoid cyst in the differential diagnosis of a tarsus-based eyelid mass.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134647156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of visual acuity and final refraction after phacoemulsification surgery with intra- or postoperative complications","authors":"A. Baccega, B. Patrús, G. Neves, Beatriz Pedrosa Casagrande, MarceloVicente de Andrade Sobrinho","doi":"10.4103/pajo.pajo_121_21","DOIUrl":"https://doi.org/10.4103/pajo.pajo_121_21","url":null,"abstract":"Objective: The objective of this study was to assess the incidence of complications intra- and postoperative (until the 30th day) of phacoemulsification surgery performed by residents of the third year, and its implications on final refraction and best-corrected visual acuity (VA), compared to those who did not exhibit any complication. Methods: This was a retrospective analysis of 300 medical records of patients who had their surgeries performed from January 2019 to February 2020 by the same three third-year residents. Fifty medical records were excluded. Initial VA logarithm of the minimum resolution angle and final VA with the best correction were analyzed, comparing whether there was a correlation with the presence of complications. Results: Of the 250 medical records analyzed, 29 (11.6%) presented complications during the intraoperative period, been posterior capsule rupture the mean one. The mean VA of patients without complications was 0.13 ± 0.17 (0.00–1.00) compared to 0.29 ± 0.28 (0.00–1.00) for those who had complications. The spherical equivalent of those without complications was −0.87 ± 0.98 (−4.38–2.00) compared to −1.19 ± 1.14 (−3.75–0.50) of the that had. Conclusion: As shown in this study, the percentage of complications is compatible with those found in the literature, also exhibits that surgeries with complications do imply in worst VA. However, when compared among themselves, before and after surgery, there was a significant improvement in the VA even in patients with complications.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115813158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual outcome of pediatric ocular trauma in a Latin American population","authors":"N. Espinosa, L. Montoya, Andrés Gaviria, A. Solano","doi":"10.4103/PAJO.PAJO_43_20","DOIUrl":"https://doi.org/10.4103/PAJO.PAJO_43_20","url":null,"abstract":"Objective: The aim is to assess associated factors regarding the type of pediatric ocular trauma and final visual acuity (VA) of the patients received ophthalmology service at tertiary care facility between 2013 and 2018. Methods: Retrospective cohort study. The clinical history of patients between 0 and 15 years of age diagnosed with ocular trauma was examined. The exposure variable was the type of ocular trauma (open or closed). Other variables related to ocular trauma were studied. Results: A total of 183 ocular trauma cases were studied. The median age was 9 years (interquartile range: 5–12), most patients were males (65.5%), blunt and sharp objects were the most frequent causes of ocular trauma (41% and 33.3%, respectively). Closed ocular trauma was found in 82.5% of the cases and zone 1 was the most frequently involved (76,5%). Sixty-four percent of cases required surgical management and 26% presented complications at the final follow-up. About 78.7% of the patients had VA equal or higher than 20/40. The risk factors associated with worse visual outcome (worse than 20/40) was found to be open ocular trauma (relative risk [RR] = 5.5; 95%IC: 3.3–9.2), the affected zone (higher risk in zone 3 with RR = 7.62; 95% confidence interval: 7.61–7.63) and time elapsed between the moment of trauma and receiving ophthalmological treatment (RR = 1.01; 95%IC: 1.01–1.01). Conclusion: Most patients that presented with ocular trauma had satisfactory final VA, considering that closed ocular trauma was more frequent. Open ocular trauma, the affected zone, and the time elapsed before starting treatment were associated with worse VA outcomes in our study.","PeriodicalId":378703,"journal":{"name":"The Pan-American Journal of Ophthalmology","volume":"218 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115732551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}