Prevalencia de retinopatía diabética y edema macular en población diabética del CESFAM Cordillera Andina de Los Andes

Introducción: La retinopatía diabética(RD) es una microangiopatía progresiva a nivel retinal que aparece como complicación de la diabetes y es una de las principales causas de ceguera en el mundo. En los diabéticos la principal causa de pérdida visual es el edema macular diabético (EMD). Presentamos un trabajo cuyo objetivo es describir la prevalencia de RD y subtipos y EMD en una población de pacientes diabéticos en un centro de atención primaria del país. Materiales y métodos: Estudio transversal descriptivo realizado en un grupo de 468 pacientes diabéticos del CESFAM Cordillera Andina de Los Andes, sometidos a examen anual de fondo de ojo. Los parámetros analizados en este estudio fueron: sexo, edad, años de diagnóstico de diabetes mellitus(DM), presencia de RD y subtipos y EMD. Resultados: Se encontró una prevalencia de RD de 24,78%. El grupo etario entre los 50-70 años presentó la mayor prevalencia de RD mientras que el 51,7% de pacientes con RD tenía 10 o más años de diagnóstico de DM2. El subtipo más frecuente fue la RD no proliferativa (RDNP) leve(37,1%). La prevalencia de EMD fue 3,8%. Conclusiones: Se aportan nuevos datos a la escasa literatura nacional disponible, destacando la medición de prevalencia de EMD

Evaluation of the accuracy of T-SPOT.TB for the diagnosis of ocular tuberculosis in a BCG-vaccinated, non-endemic population

Purpose: To determine the performance of T-SPOT.TB, an interferon gamma release assay test, in patients with ocular tuberculosis (TB) in a BCG-vaccinated, non-endemic population. Methods: We employed a nested case control design. In total, 45 subjects were enrolled (23 patients with ocular tuberculosis and 22 patients with other causes of uveitis). A blood sample was collected from each subject, and T-SPOT.TB was executed. Laboratory professionals were blinded to the disease status of each subject. Results: Five patients were excluded because of indeterminate results. The calculated sensitivity and specificity were 0.80 and 0.85, respectively. The positive likelihood ratio was 5.33 and the negative likelihood ratio was 0.23. The overall accuracy of the test was 0.83. Conclusions: T-SPOT.TB adequately diagnosed ocular TB. This technique is particularly useful in populations where BCG vaccinations are still mandatory

Clinical Features and Prognostic Factors in Presumed Ocular Tuberculosis

© 2017 Taylor & Francis Group, LLC.Purpose: To characterize the clinical features in patients with presumed ocular tuberculosis (TB) and determine prognostic factors of visual outcomes and complications in this disease. Material and methods: Retrospective case series of 35 patients (29 females, 6 males) with presumed ocular TB from referral centers in Chile and Spain between 2002 and 2012. Medical records were reviewed, and data regarding clinical features, complications, best-corrected visual acuity (BCVA), duration of disease, extraocular manifestations, and therapy were retrieved. Prognostic factors for low vision (BCVA 20/50 or less), legal blindness (BCVA 20/200 or less), and complications (cataract, glaucoma, and macular lesion) were evaluated. To calculate correlations, we used Spearman’s rank correlation test. To determine clinical predictors, we used the binary logistic regression test. Results: Anterior and non-granulomatous uveitis was the most common types of inflammation

Inmunidad antitumoral en neoplasias intraoculares

A physiological function of the immune system is to recognize and destroy cells transformed clones before they become tumors and eliminate tumors after they are formed. This is accomplished by innate and adaptive immune responses, however is a complex task considering the mechanisms of evasion by tumors. Particularly, intraocular neoplasms (ION) would have an advantage against the immune system because the eye is considered a site of immune privilege that through anatomical, physiological and immunoregulatory mechanisms restrict the immune response. Regulatory T lymphocytes(Treg) subtype CD4 + CD25 + Foxp3 + and IL-10 producers, would be crucial in induction of self-tolerance .The loss of balance between proinflammatory profile given by LTh1 and LTh17 and its production of IFN-g and IL-17 versus the modulating function of Treg secreting IL-10 and TGF-β determines a faster tumor growth or not. There is still no conclusive evidence determining the specific mechanisms of immune imbalance in the ION. In this review we updated an overview of antitumor immunity, its particularities to intraocular level and current evidence about echanisms of immune evasion in most common primary malignant ION in adults: uveal melanoma and primary intraocular lymphoma