Hugo Quiroz-Mercado

Nonmydriatic Fundus Camera for Diabetic Retinopathy Screening in a Safety Net Hospital: Effectiveness, Prevalence, and Risk Factors:

Purpose To evaluate diabetic retinopathy (DR) prevalence and risk factors, and the effectiveness of nonmydriatic fundus camera as a screening tool for the detection of DR, in a safety net hospital. Methods This was a retrospective, population-based, cross-sectional study. Diabetic patients, referred by their primary care physicians to a DR community screening program, were included. A Topcon TRC NW-6S camera was used to obtain 45-degree digital color fundus images. Images were interpreted by retina specialists using a quality rating system. Patients with retinal findings or unreadable photographs were referred for a complete examination. Outcome measures were attendance rates, photograph quality, DR prevalence, and associated risk factors. Results A total of 948 diabetic patients were sent for camera screening, with an attendance rate of 65.6%, which increased during the study period. The mean age was 55.8 ± 11.6 years, the majority (56.9%) were Hispanic, and 43.5% were uninsured. Overall photograph quality rating was relatively high, with 81.7% graded as good or fair. Thirty photographs (2.9%) were unreadable. The prevalence of newly diagnosed DR was 11.1%. Independent DR-associated risk factors included Hispanic race (odds ratio [OR] = 2.29), lack of health insurance (OR = 2.49), longer duration of diabetes (OR = 1.07), higher HbA1c levels (OR = 1.19), presence of diabetic complications (OR = 2.93), and lack of previous eye examination (OR = 13.22). Conclusions Nonmydriatic fundus camera is an effective and feasible screening tool for the early detection of DR in a safety net institution. It should be considered in areas with limited access to health care to improve quality of care and potentially reduce vision loss rates.

Comparison of cumulative dissipated energy delivered by active-fluidic pressure control phacoemulsification system versus gravity-fluidics

PurposeTo compare the cumulative dissipated energy (CDE), aspiration time and estimated aspiration fluid utilized during phacoemulsification cataract surgery using two phacoemulsification systems .MethodsA total of 164 consecutive eyes of 164 patients undergoing cataract surgery, 82 in the active-fluidics group and 82 in the gravity-fluidics group were enrolled in this study. Cataracts graded NII to NIII using LOCS II were included. Each subject was randomly assigned to one of the two platforms with a specific configuration: the active-fluidics Centurion ® phacoemulsification system or the gravity-fluidics Infiniti ® Vision System. CDE, aspiration time (AT) and the mean estimated aspiration fluid (EAF) were registered and compared.ResultsA mean age of 68.3xa0±xa09.8xa0years was found (range 57–92xa0years), and no significant difference was evident between both groups. A positive correlation between the CDE values obtained by both platforms was verified (rxa0=xa00.271, R2xa0=xa00.073, Pxa0=xa00.013). Similarly, a significant correlation was evidenced for the EAF (rxa0=xa00.334, R2xa0=xa00.112, Pxa0=xa00.046) and AT values (rxa0=xa00.156, R2xa0=xa00.024, Pxa0=xa00.161). A statistically significantly lower CDE count, aspiration time and estimated fluid were obtained using the active-fluidics configuration when compared to the gravity-fluidics configuration by 19.29, 12.10 and 9.29%, respectively (Pxa0=xa00.001, Pxa0<xa00.0001 and Pxa0=xa00.001).ConclusionsThe active-fluidics Centurion ® phacoemulsification system achieved higher surgical efficiency than the gravity-fluidics Infiniti ® IP system for NII and NIII cataracts.

Posterior Pole Manifestations of Cysticercosis

Cysticercosis is an infestation that results from the ingestion of eggs of Taenia solium. Eggs are found in fecally contaminated water or food. Autoinfection as a result of the entry of eggs into stomach due to retroperistalsis or accidental ingestion of eggs is possible. The larval stage of T. solium(cysticercus) locates in tissues with high blood requirement, such as the central nervous system (CNS), muscle, or eye. Ocular cysticerci may be located in any part of the eye. For diagnostic purposes, B-ultrasonography should be selected first. Cysticerci induce severe inflammation due to toxins contained inside the cyst. Surgical removal is the treatment of choice.