Seroepidemiology of Toxoplasma gondii infection in drivers involved in road traffic accidents in the metropolitan area of Guadalajara, Jalisco, Mexico.

BACKGROUND: The prevalence of toxoplasmosis in the general population of Guadalajara, Mexico, is around 32%. Toxoplasmosis can cause ocular lesions and slowing of reaction reflexes. Latent toxoplasmosis has been related with traffic accidents. We aimed to assess the prevalence of anti-Toxoplasma gondii antibodies and visual impairments related with traffic accidents in drivers from the metropolitan Guadalajara. METHODS: We prospectively evaluated the prevalence of IgG and IgM anti-T. gondii antibodies in 159 individuals involved in traffic accidents, and in 164 control drivers never involved in accidents. Cases of toxoplasmosis reactivation or acute infection were detected by PCR in a subset of 71 drivers studied for the presence of T. gondii DNA in blood samples. Ophthalmologic examinations were performed in drivers with IgG anti-T. gondii antibodies in search of ocular toxoplasmosis. RESULTS: Fifty-four (34%) traffic accident drivers and 59 (36%) controls were positive to IgG anti-T. gondii antibodies (p = 0.70). Among the 113 seropositive participants, mean anti-T. gondii IgG antibodies titers were higher in traffic accident drivers than in controls (237.9 ± 308.5 IU/ml vs. 122.9 ± 112.7 IU/ml, respectively; p = 0.01 by Student's t test, p = 0.037 by Mann-Whitney U test). In multivariate analyses, anti-T. gondii IgG antibody titers were consistently associated with an increased risk of traffic accidents, whereas age showed an inverse association. The presence of IgM-anti-T. gondii antibodies was found in three (1.9%) subjects among traffic accident drives, and in two (1.2%) controls. Three (4.2%) samples were positive for the presence of T. gondii DNA, all among seropositive individuals. No signs of ocular toxoplasmosis were found in the entire cohort. Moreover, no other ocular conditions were found to be associated with the risk of traffic accidents in a multivariate analysis. CONCLUSIONS: Anti-T. gondii antibody titers are associated with the risk of traffic accidents. We could not determine any association of ocular toxoplasmosis with traffic accidents. Our results warrant further analyses in order to clarify the link between toxoplasmosis and traffic accidents.

Fishing-related ocular trauma.

PURPOSE: To evaluate the characteristics of fishing-related ocular injuries. DESIGN: Retrospective observational analysis of a computerized databank. METHODS: The United States Eye Injury Registry was used to analyze 143 patients with fishing-related ocular injury. Epidemiologic and clinical information was evaluated including the age and gender of the subjects, classification of ocular trauma, surgical management, and final visual acuity. RESULTS: Of the 732 cases of sport-related ocular trauma, 143 (19.54%) occurred while fishing; of these, 79% were male patients who ranged in age from 6 to 68 years (mean, 37 years). Corneal laceration, globe rupture, and hyphema were the most common diagnoses at presentation and were caused by fishing hooks, lures, and weights. Thirty-five bystanders are included in the study. Thirty-eight percent of patients had visual acuity less than 20/50, and 21% had a visual acuity of less than 20/200. Open globe injuries portended a poor visual outcome compared with closed globe injuries. CONCLUSIONS: Fishing-related ocular injuries represent a large percent of sports-related trauma, often resulting in significant visual loss. Preventive measures such as the use of protective eyewear should be advised in this activity.

The epsilon4 allele of apolipoprotein E gene is a potential risk factor for the severity of macular edema in type 2 diabetic Mexican patients.

PURPOSE: The objective of this study was to determine the relationship between APOE polymorphism and the severity of retinal hard exudates in Mexican patients with type 2 diabetes. METHODS: We studied 36 patients with diabetic retinopathy and 22 unrelated and apparently healthy age-matched individuals. Blood samples for DNA genotyping and lipid profile were taken. Genotyping of polymorphic APOE alleles was done after polymerase chain reaction amplification of genomic DNA, digestion with HhaI, and agarose gel electrophoresis. Stereoscopic 35 degrees color fundus photographs were taken of seven standard fields. Diabetic retinopathy, macular edema and hard exudates were graded according to a standardized procedure. RESULTS: The results showed that the lipid profile was higher but not statistically significant (p > 0.05) in e4 allele carriers, with the exception of total lipids (p > 0.05). The frequency of severe retinal hard exudates was higher in those epsilon4 allele carriers (p < 0.05). The higher frequency of visual impairment (VA < 0.5 Log MAR) in epsilon4 carriers showed a tendency towards statistical significance (p = 0.057). CONCLUSION: Our results suggest that the epsilon4 allele of the ApoE gene is a potential risk factor for the severity of retinal hard exudates and visual loss in type 2 diabetic Mexican patients with diabetic retinopathy.

Aplicación de la teleoftalmología en la estimación de la profundidad de la cámara anterior / Using teleophthalmology in athe assessment of the anterior chamber depth

Propósito: Investigar el desempeño de la evaluación de imágenes digitalizadas del segmento anterior como una herramienta de teleoftalmología, en comparación con la gonioscopia convencional y la valoración clínica de la profundidad del segmento anterior mediante biomicroscopia. Métodos: Las imágenes de 770 ojos (385 individuos) fueron obtenidas con una cámara analógica acoplada a un biomicroscopio y enviadas a través de una red local a una computadora, a través de cuya pantalla (17 pulgadas) dos expertos determinaron la profundidad de la cámara anterior empleando la técnica de Van Herick. Se analizaron las concordancias con dos aproximaciones (estadística kappa no ponderada) entre las descripciones de los dos examinadores y las de estos con la de gonioscopia y de profundidad de cámara anterior realizadas durante una campaña de detección de enfermedades oculares. Se estimaron la sensibilidad y especificidad de los examinadores de la profundidad de la cámara anterior. Resultados: La concordancia entre los examinadores de la profundidad de la cámara anterior y la gonioscopia fue muy reducida (k<0.204, P=0.0001), la de los examinadores de las imágenes digitalizadas fue mayor, especialmente cuando se recategorizaron las escalas del ángulo y de la profundidad de cámara anterior (OD, k=0.576; OI, k=0.552; ambos ojos con P=0.0001). La sensibilidad de los examinadores para reconocer ángulos estrechos fue deficiente (menor a 55 por ciento), aunque fue considerablemente más elevada la especificidad (mayor de 80 por ciento). Conclusiones: Nuestros hallazgos sugieren que empleo de la técnica de Van Herick para describir imágenes digitalizadas en un sistema de teleoftalmología parece tener un papel limitado debido a su baja concordancia entre examinadores y con la gonioscopia convencional.