Reply to Otiti-Sengeri et al. Chorioretinitis among Immigrant and Travellers. Comment on "Mansour et al. Presumed Onchocerciasis Chorioretinitis Spilling over into North America, Europe and Middle East. Diagnostics 2023, 13, 3626".

The comments by Otiti et al [...].

Presumed Onchocerciasis Chorioretinitis Spilling over into North America, Europe and Middle East.

BACKGROUND: Newer generation ophthalmologists practicing in the developed world are not very familiar with some tropical ocular diseases due to the absence of reports in the ophthalmic literature over the past thirty years. Because of world globalization or due to influx of immigrants from sub-Saharan Africa, exotic retinal diseases are being encountered more often in ophthalmology clinics. METHODS: A multicenter case series of chorioretinitis or optic neuritis with obscure etiology that used serial multimodal imaging. RESULTS: Four cases qualified with the diagnosis of presumed ocular onchocerciasis based on their residence near fast rivers in endemic areas, multimodal imaging, long term follow-up showing progressive disease and negative workup for other diseases. Characteristic findings include peripapillary choroiditis with optic neuritis or atrophy, subretinal tracts of the microfilaria, progressive RPE atrophy around heavily pigmented multifocal chorioretinal lesions of varying shapes, subretinal white or crystalline dots, and response to ivermectin. Typical skin findings are often absent in such patients with chorioretinitis rendering the diagnosis more challenging. CONCLUSIONS: Familiarity with the myriad ocular findings of onchocerciasis, and a high-degree of suspicion in subjects residing in endemic areas can help in the correct diagnosis and implementation of appropriate therapy. Onchocercal chorioretinitis is a slow, insidious, progressive, and prolonged polymorphous disease.

HISTOPATHOLOGIC CONFIRMATION OF LYMPHOCYTIC INFILTRATION OF THE OPTIC NERVE AND INNER RETINA IN BIRDSHOT CHORIORETINOPATHY.

PURPOSE: To describe new histological findings involving the inner retina in birdshot chorioretinopathy. METHODS: Evaluation of the inner retinal pathology of the eye of a patient with bilateral birdshot chorioretinopathy who underwent enucleation for a unilateral ciliochoroidal melanoma. RESULTS: Histopathological sections showed focal perivascular lymphocytic infiltration at the optic nerve head that extended into the adjacent inner retina, mainly involving the ganglion and nerve fiber layers. CONCLUSION: We have previously shown that birdshot chorioretinopathy has multiple foci of lymphocytes in the choroid. This is the first report that demonstrates lymphocytic infiltration of the inner retinal layers. This may lead to the bipolar and Müller cell dysfunction that ultimately results in an electronegative electroretinogram.

Ophthalmia neonatorum due to Escherichia coli: A rare cause or an emerging bacterial etiology of neonatal conjunctivitis?

Since the introduction of universal gonococcal and chlamydia prophylaxis, other etiologies for neonatal conjunctivitis such as Escherichia coli have become more common. Early eye culturing as part of the management plan could provide swifter treatment and preservation of vision potential in affected neonates.

Expresión oral en inglés para el discurso médico en la presentación y discusión de casos

RESUMEN La investigación se desarrolló durante el curso 2019-2020; pertenece al proyecto Desarrollo de la expresión oral en inglés con fines médicos, del departamento de Idiomas de la universidad de Ciencias Médicas de Camagüey. El artículo tiene como objetivo fundamentar la estructura, etapas y acciones de una estrategia didáctica para el desarrollo de la expresión oral en inglés para favorecer el discurso médico durante la presentación real o simulada de casos y su discusión diagnóstica. En su desarrollo se emplearon métodos teóricos, empíricos y matemático-estadísticos. La lógica didáctica que se ofrece en las etapas Exploratoria inicial/perspectiva, Planeación/orientación, Ejecución y Evaluación contribuyen a la autogestión de conocimientos de los estudiantes de 4to año de la carrera Medicina, a la movilización de sus recursos afectivos, cognitivos y procedimentales, para fomentar la ejecución de acciones didácticas lingüístico-estratégicas para el desarrollo de la expresión oral en inglés, como potencialidad para la reinterpretación y reconstrucción personalizada y enriquecedora de significados y sentidos.

ABSTRACT During 2019-2020, the research was developed; it belongs to the project "Development of speaking in English with medical purposes of Language Department of the University of Medical Sciences of Camagüey. The article aims to support the structure, phases and actions of a didactic strategy for the development of speaking to favor medical speech during real or simulated reports of cases and their diagnostic discussion. In the investigation, the theoretical, empirical and mathematical-statistical methods were used. The didactic logic present in the phases Initial/perspective exploration, Planning/orientation, Implementation, and Assessment contributes to knowledge self-management of fourth year medical students, to the use of their emotional, cognitive and procedural sources, to contribute the implementation of linguistic-strategic didactic actions for the development of speaking, in reinterpreting and personal and enriching reconstruction of meaning and sense.

An Adult Loa loa Worm in the Upper Eyelid: An Atypical Presentation of Loiasis in the United States.

Purpose. To report a case of ocular involvement of Loa loa parasite. Observations. We present a rare case report of a Loiasis diagnosed in the United States from a patient presenting with subcutaneous migration of an adult worm within an eyelid who was found to have systemic disease with microfilaria in his blood. This is the second report in the United States and the eighth case in published literature worldwide. Conclusions and Importance. Due to the relatively mild disease course, Loiasis is relatively ignored in public health in low resource health districts. Understandably, the focus of public health in endemic areas must focus on basic health needs like malnutrition and diseases that entail a greater disease burden. As globalization has increased the amount of trade of physical goods, the effect of immigration also has implications for the spread of infectious disease. Medical practitioners in the United States should be aware of endemic diseases from foreign lands.