Técnica modificada del flap invertido superior con vitrectomía versus vitrectomía con pelado de membrana limitante interna para el desprendimiento de retina con agujero macular miópico / Modified superior inverted internal limiting membrane flap technique with vitrectomy versus vitrectomy with internal limiting membrane peeling for retinal detachment with myopic macular hole

Objetivo Evaluar la eficacia de la técnica del flap invertido superior de membrana limitante interna (MLI) modificada para el tratamiento del desprendimiento de retina (DR) por agujero macular (AM), comparada con el pelado clásico de la MLI. Materiales y métodos Análisis retrospectivo de 10 pacientes que requirieron vitrectomía pars plana por DR con AM. Se dividieron en dos grupos, según la técnica quirúrgica realizada: grupo del flap (5 pacientes) y de pelado de MLI (5 pacientes). Se comparó la agudeza visual mejor corregida (AVMC) pre y posquirúrgica, la resolución del DR, la tasa de cierre del AM y la restauración de las capas externas de la retina entre los grupos. Resultado La AVMC poscirugía mejoró en ambos grupos, sin diferencias significativas (p=0,9). La tasa de cierre del AM fue del 100% en el grupo del flap y del 80% del grupo de pelado de la MLI, sin diferencias significativas entre los grupos. La retina se reaplicó en el 100% de los casos en ambos grupos. Solo se restauraron las capas externas de la retina en 2 pacientes del grupo del flap invertido (40%) y en ninguno del grupo de pelado de la MLI (p=0,62). Conclusiones Las técnicas de pelado de MLI y del flap invertido superior modificada son útiles para el tratamiento del DR con agujero macular en ojos miopes (AU)

Purpose To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. Methods Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. Results There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12months after surgery (P=.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (P=.62). Conclusions ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes (AU)

Modified superior inverted internal limiting membrane flap technique with vitrectomy versus vitrectomy with internal limiting membrane peeling for retinal detachment with myopic macular hole.

PURPOSE: To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. METHODS: Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. RESULTS: There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p=0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0.62). CONCLUSIONS: ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.

The rye transcription factor ScSTOP1 regulates the tolerance to aluminum by activating the ALMT1 transporter.

Plants have evolved different mechanisms to increase their tolerance to aluminum (Al) toxicity and low pH in the soil. The Zn finger transcription factor SENSITIVE TO PROTON RHIZOTOXICITY1 (STOP1) plays an essential role in the adaptation of plants to Al and low pH stresses. In this work, we isolated the ScSTOP1 gene from rye (Secale cereale L.), which is located on chromosome 3RS. The ectopic expression of ScSTOP1 complements the Arabidopsis stop1 mutation in terms of root growth inhibition due to Al and pH stress, as well as phosphate starvation tolerance, suggesting that rye ScSTOP1 is a functional ortholog of AtSTOP1. A putative STOP1 binding motif was identified in the promoter of a well-known STOP1 target from rye and Arabidopsis and was later corroborated by genomic DAP-seq analyses. Coexpression analyses verified that ScSTOP1 activated the promoter of ScALMT1. We have also identified a putative phosphorylatable serine in STOP1 that is phylogenetically conserved and critical for such activation. Our data indicated that ScSTOP1 also regulated Al and pH tolerance in rye.

A Pushing Mechanism for Microtubule Aster Positioning in a Large Cell Type.

After fertilization, microtubule (MT) sperm asters undergo long-range migration to accurately position pronuclei. Due to the large sizes of zygotes, the forces driving aster migration are considered to be from pulling on the astral MTs by dynein, with no significant contribution from pushing forces. Here, we re-investigate the forces responsible for sperm aster centration in sea urchin zygotes. Our quantifications of aster geometry and MT density preclude a pulling mechanism. Manipulation of aster radial lengths and growth rates, combined with quantitative tracking of aster migration dynamics, indicates that aster migration is equal to the length of rear aster radii, supporting a pushing model for centration. We find that dynein inhibition causes an increase in aster migration rates. Finally, ablation of rear astral MTs halts migration, whereas front and side ablations do not. Collectively, our data indicate that a pushing mechanism can drive the migration of asters in a large cell type.

Características clínicas y análisis de OCT de una serie de casos de microftalmos posterior / Clinical characteristics and OCT analysis of a case series of posterior microphthalmos

El microftalmos posterior es un cuadro poco frecuente que puede encontrarse en pacientes pediátricos con hipermetropía elevada y visión reducida. Presentamos un estudio retrospectivo de 5casos de microftalmía posterior en niños de edades comprendidas entre 4 y 13 años. Se obtuvieron los siguientes parámetros: agudeza visual, refracción bajo cicloplejía, biometría, examen en lámpara de hendidura, presión intraocular y ecografía ocular. La refracción, la longitud axial y la agudeza visual media fueron de +15,35 Dp; 16,20 mm y 0,13, respectivamente. Se examinó el fondo de ojo, se realizó tomografía de coherencia óptica y, en uno de los casos, retinografía y angiografía fluoresceínica. En todos los casos se evidenció ausencia de depresión foveal y diferentes morfotipos del pliegue papilo-macular por tomografía. Al no existir un tratamiento específico, es importante una adecuada detección, manejo y seguimiento de esta enfermedad para mejorar y mantener la visión de los pacientes y reconocer posibles complicaciones

Posterior microphthalmos is a rare condition that can be found in paediatric patients with increased farsightedness and reduced vision. A retrospective study is presented of 5 cases of posterior microphthalmia aged between 4 and 13 years. The following parameters were obtained: visual acuity, cycloplegic refractive error, optical biometry, slit lamp examination, intraocular pressure, and ocular ultrasound. The refraction, axial length and average visual acuity was + 15.35 Dp, 16.20 mm and 0.13, respectively. The fundus was examined, optical coherence tomography was performed, and also retinography and fluorescein angiography in one case. In all cases, the absence of foveal depression and different morphotypes of the papillo-macular fold were observed in the tomography. In the absence of a specific treatment, the appropriate detection, management, and monitoring of this disease is important to improve and maintain the vision of patients and recognise possible complications

Clinical characteristics and OCT analysis of a case series of posterior microphthalmos. / Características clínicas y análisis de OCT de una serie de casos de microftalmos posterior.

Posterior microphthalmos is a rare condition that can be found in paediatric patients with increased farsightedness and reduced vision. A retrospective study is presented of 5cases of posterior microphthalmia aged between 4 and 13 years. The following parameters were obtained: visual acuity, cycloplegic refractive error, optical biometry, slit lamp examination, intraocular pressure, and ocular ultrasound. The refraction, axial length and average visual acuity was+15.35 Dp, 16.20mm and 0.13, respectively. The fundus was examined, optical coherence tomography was performed, and also retinography and fluorescein angiography in one case. In all cases, the absence of foveal depression and different morphotypes of the papillo-macular fold were observed in the tomography. In the absence of a specific treatment, the appropriate detection, management, and monitoring of this disease is important to improve and maintain the vision of patients and recognise possible complications.

Episodio maníaco tras la administración simultánea de 4 vacunas: relación temporal frente a relación causal. A propósito de un caso / Manic episode after the simultaneous administration of 4 vaccines: temporal relationship versus causal relationship. A case report

Ante un cambio radical en el comportamiento en un varón de 17 años, a las 12 horas de administrar, en el mismo día, las vacunas contra el Meningococo C, Hepatitis B, Triple Vírica y Varicela, y la detección de un cuadro maníaco a la semana, se sospechó que se tratase de un cuadro de encefalitis post-vacunal. A pesar de la ausencia de hallazgos patológicos en las exploraciones complementarias realizadas, y aunque en la literatura científica no se haya demostrado una asociación temporal a día de hoy, no podemos aceptar ni descartar con certeza la sospecha diagnóstica dado que no contamos con la serología infecciosa o un estudio de anticuerpos en líquido cefalorraquídeo. Los efectos secundarios graves tras vacunaciones no han quedado claramente demostrados, lo que sí está ampliamente demostrado es que la inmunidad adquirida es uno de los mayores logros de la medicina que ha ayudado a erradicar enfermedades potencialmente mortales

A radical behavioral change was observed in a 17-year-old male 12 hours after having received vaccines for Meningococcus C, Hepatitis B, Triple Viral and Varicella on the same day. Moreover a manic episode was detected one week later. It was suspected that this was a case of post-vaccinal encephalitis. In spite of the absence of pathological findings in the complementary explorations carried out and although a temporal association has not been demonstrated to date in the scientific literature, we can not be certain of this diagnostic suspicion since we do not have the infectious serology or a study of antibodies in central spinal fluid. Serious side effects after vaccinations have never been clearly demonstrated, while it has been widely demonstrated that the acquired immunity from these vaccines is one of the greatest achievements of medicine, and this has helped to eradicate life-threatening diseases

Presión intraocular elevada en catarata pediátrica intervenida en un centro de referencia / Elevated intraocular pressure in paediatric cataract surgery in a reference centre

Objetivo: Estudiar la presión intraocular postoperatoria (PIOP) elevada tras la intervención de catarata pediátrica en un centro de referencia y comparar los resultados obtenidos con aquellos más relevantes de la literatura mundial. Materiales y métodos: Estudio retrospectivo observacional. Recogida de información de historias clínicas de 99 pacientes (142 ojos) operados de catarata pediátrica unilateral o bilateral entre los años 2000 y 2008. Resultados: La frecuencia de PIOP elevada (≥ 20 mmHg) fue de 79,3% en el grupo de catarata bilateral frente al 20,7% en el grupo de catarata unilateral (p = 0,032). La frecuencia de PIOP elevada entre los ojos con cirugía de catarata antes del mes de edad fue mayor, 50%, que entre los ojos en los que la cirugía de catarata se realizó después del mes de edad, 17,2% (p = 0,009). Los valores de PIOP ≥ 20mmHg se asociaron con una menor agudeza visual mejor corregida a los 5 años de la cirugía de catarata (p = 0,020). La proporción de ojos con PIOP ≥ 20 mmHg y sin lentes intraoculares fue mayor, 69%, que la proporción de ojos con PIOP ≥ 20 mmHg y lentes intraoculares, 31% (p < 0,001). Conclusiones: Un 20,4% del total de ojos estudiados presentaron PIOP elevada ≥ 20 mmHg en un periodo de seguimiento de 5 años, apareciendo con más frecuencia en aquellos con catarata bilateral que unilateral, y en ojos afáquicos que en pseudofáquicos. La elevación de la PIOP se asoció con la realización de la cirugía de la catarata a edades tempranas

Objective: To study elevated postoperative intraocular pressure (PIOP) after paediatric cataract surgery in a reference centre and to compare the results obtained with the most relevant world literature. Materials and methods: A retrospective observational study was conducted, collecting information from clinical records of 99 patients (142 eyes) operated on due to unilateral or bilateral paediatric cataracts between 2000 and 2008. Results: The proportion of eyes with PIOP ≥ 20 mmHg and bilateral cataracts was higher, 79.3%, than the proportion of eyes with PIOP ≥ 20mmHg and a unilateral cataract, 20.7% (P = .032). The proportion of eyes with PIOP ≥ 20 mmHg between the eyes with cataract surgery before one month of age was higher, 50%, than between the eyes in which the cataract surgery was performed after one month of age, 17.2% (P=.009). PIOP values ≥ 20 mmHg were associated with a lower best corrected visual acuity at 5 years after cataract surgery (P = .020). The proportion of eyes with PIOP ≥ 20 mmHg and without intraocular lenses was higher, 69%, than the proportion of eyes with PIOP ≥ 20 mmHg and intraocular lenses, 31% (P < .001). Conclusions: A PIOP > 20 mmHg was observed in 20.4% of eyes in a 5-year follow-up period, appearing more frequently in eyes with bilateral cataract than unilateral, and in aphakic eyes more than pseudophakic eyes. Elevation of the PIOP was associated with the performance of cataract surgery at early ages

Elevated intraocular pressure in paediatric cataract surgery in a reference centre. / Presión intraocular elevada en catarata pediátrica intervenida en un centro de referencia.

OBJECTIVE: To study elevated postoperative intraocular pressure (PIOP) after paediatric cataract surgery in a reference centre and to compare the results obtained with the most relevant world literature. MATERIALS AND METHODS: A retrospective observational study was conducted, collecting information from clinical records of 99 patients (142 eyes) operated on due to unilateral or bilateral paediatric cataracts between 2000 and 2008. RESULTS: The proportion of eyes with PIOP≥20mmHg and bilateral cataracts was higher, 79.3%, than the proportion of eyes with PIOP≥20mmHg and a unilateral cataract, 20.7% (P=.032). The proportion of eyes with PIOP≥20mmHg between the eyes with cataract surgery before one month of age was higher, 50%, than between the eyes in which the cataract surgery was performed after one month of age, 17.2% (P=.009). PIOP values≥20mmHg were associated with a lower best corrected visual acuity at 5 years after cataract surgery (P=.020). The proportion of eyes with PIOP≥20mmHg and without intraocular lenses was higher, 69%, than the proportion of eyes with PIOP≥20mmHg and intraocular lenses, 31% (P<.001). CONCLUSIONS: A PIOP>20mmHg was observed in 20.4% of eyes in a 5-year follow-up period, appearing more frequently in eyes with bilateral cataract than unilateral, and in aphakic eyes more than pseudophakic eyes. Elevation of the PIOP was associated with the performance of cataract surgery at early ages.

Diagnostic precision of triage algorithms for mass casualty incidents. English version.

BACKGROUND: Regarding survival and quality of life recent mass casualty incidents again emphasize the importance of early identification of the correct degree of injury/illness to enable prioritization of treatment amongst patients and their transportation to an appropriate hospital. The present study investigated existing triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as its process duration in a relevant emergency patient cohort. METHODS: In this study 500 consecutive air rescue missions were evaluated by means of standardized patient records. Classification of patients was accomplished by 19 emergency physicians. Every case was independently classified by at least 3 physicians without considering any triage algorithm. Existing triage algorithms Primary Ranking for Initial Orientation in Emergency Medical Services (PRIOR), modified Simple Triage and Rapid Treatment (mSTaRT), Field Triage Score (FTS), Amberg-Schwandorf Algorithm for Triage (ASAV), Simple Triage and Rapid Treatment (STaRT), Care Flight, and Triage Sieve were additionally carried out computer based on each case, to enable calculation of quality criteria. RESULTS: The analyzed cohort had an age of (mean ± SD) 59 ± 25 years, a NACA score of 3.5 ± 1.1 and consisted of 57% men. On arrival 8 patients were deceased. Consequently, 492 patients were included in the analysis. The distribution of triage categories T1/T2/T3 were 10%/47%/43%, respectively. The highest diagnostic quality was achieved with START, mSTaRT, and ASAV yielding a SE of 78% and a SP ranging from 80-83%. The subgroup of surgical patients reached a SE of 95% and a SP between 85-91%. The newly established algorithm PRIOR exerted a SE of 90% but merely a SP of 54% in the overall cohort thereby consuming the longest time for overall decision. CONCLUSION: Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (over-triage) the recently developed PRIOR algorithm will cause overload of available resources for the severely injured within mass casualty incident missions. Non-surgical patients still are poorly identified by the available algorithms.

[Diagnostic quality of triage algorithms for mass casualty incidents]. / Diagnostische Güte von Vorsichtungsalgorithmen für den Massenanfall von Verletzten und Erkrankten.

BACKGROUND: Regarding survival and quality of life, recent mass casualty incidents have once more emphasized the importance of early identification of the correct degree of injury or illness, to enable prioritizing treatment of patients and transportation to an appropriate hospital. The present study investigated international triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as the process duration in a relevant emergency patient cohort. METHODS: A total of 500 consecutive air rescue missions were evaluated by means of standardized patient records. Interdisciplinary classification of patients was accomplished by 19 emergency physicians. Every case was independently classified according to the triage category by at least three physicians without considering any triage algorithm. The available triage algorithms PRIOR (Primary Ranking for Initial Orientation in Emergency Medical Services), mSTaRT (modified Simple Triage and Rapid Treatment), FTS (Field Triage Score), ASAV (Amberg-Schwandorf Algorithm for Triage), STaRT (Simple Triage and Rapid Treatment), CareFlight triage and Triage Sieve were additionally carried out for each patient in a computer-based procedure, to enable calculation of test quality criteria for all procedures. RESULTS: The analyzed cohort had a mean age of 59 ± 25 years (±SD), a National Advisory Committee for Aeronautics (NACA) score of 3.5 ± 1.1 and consisted of 57% men. On arrival 8 patients were already deceased, consequently 492 patients were included in the analysis. The distributions of triage categories I/II/III were 10%/47%/43%, respectively. The highest diagnostic quality was achieved with START, mSTaRT, and ASAV with 78% SE and 80-83% SP. The subgroup of surgical patients achieved 95% SE and 85-91% SP. The newly established algorithm PRIOR exerted an SE of 90% but an SP of only 54% in the overall cohort thereby taking the longest overall time for decisions. CONCLUSION: Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (overtriage) in this study, the recently developed PRIOR algorithm could result in exhaustion of available resources for the severely injured and therefore to undertreatment of correctly assigned triage category I cases within mass casualty incidents. Non-surgical patients are still poorly allocated by the available algorithms. Contribution available free of charge by "Free Access".

Poor Muscle Strength and Low Physical Activity Are the Most Prevalent Frailty Components in Community-Dwelling Older Adults.

OBJECTIVE: To determine the prevalence of five physical frailty phenotype components and to assess the relationship between them and other clinical factors. METHOD: A population-based cross-sectional study was performed. Subjects 75 years and older were randomly selected from primary care databases (with sampling stratified by gender). Physical frailty phenotypes were assessed using Fried's criteria. Sociodemographic data, comorbidities, nutritional status, and functional capacity were assessed. RESULTS: 126 subjects were recruited (47% women). Prevalence rates were poor muscle strength: 50%; low physical activity: 29%; slow gait: 28%; exhaustion: 27%; and weight loss: 5%. Prefrailty and frailty prevalence rates were 35.7% and 29.4%, respectively. Poor muscle strength and low physical activity showed a close relationship and concordance (kappa = 0.92). Most frailty components were associated with outdoor activity, hours walked daily, and certain comorbidities. CONCLUSIONS: Poor muscle strength was the most prevalent frailty component and was closely associated with physical activity, suggesting that training programs may revert or prevent the frailty process.

Fiabilidad en el cribado de la retinopatía del prematuro mediante el análisis de retinografías / Reliability of retinal imaging screening in retinopathy of prematurity

INTRODUCCIÓN: La retinopatía del prematuro (ROP) es una de las principales causas de ceguera infantil potencialmente evitable. Los avances en los cuidados neonatales consiguen la supervivencia de niños de bajo peso extremo asociado con una mayor incidencia de la enfermedad. El objetivo de este estudio es evaluar la fiabilidad en el diagnóstico de la ROP a través de retinografías obtenidas con la cámara de campo amplio RetCam3 y estudiar la variabilidad en el diagnóstico de ROP en función del evaluador. MATERIAL Y MÉTODOS: El examen con oftalmoscopio indirecto fue realizado por un oftalmólogo pediátrico experto en ROP. Las imágenes retinianas fueron obtenidas por el mismo oftalmólogo y un técnico especializado en la captura de imágenes digitales. Un total de 30sets de imágenes fueron analizados por 3 grupos enmascarados: grupo A (8 oftalmólogos), grupo B (5 expertos en visión) y grupo C (2 oftalmólogos expertos en ROP). RESULTADOS: Acorde con el diagnóstico mediante oftalmoscopia indirecta, la sensibilidad (26-93), el índice Kappa (0,24-0,80) y el porcentaje de aciertos fueron estadísticamente significativos en el grupo C para el diagnóstico de ROP tipo1. En el diagnóstico de ROP tipo1+tipo2 el índice Kappa (0,17-0,33) y el porcentaje de aciertos (58-90) fueron estadísticamente significativos, obteniendo valores superiores en el grupo C. CONCLUSIONES: El diagnóstico realizado por oftalmólogos expertos en ROP con el retinógrafo móvil RetCam3 ha demostrado ser un método fiable

INTRODUCTION: The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator. MATERIAL AND METHODS: The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam3 wide-angle camera. A total of 30image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists). RESULTS: According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type1. In the diagnosis of ROP Type1+Type2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C. CONCLUSION: The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam3 has proved to be a reliable method

Removal of bacteria, protozoa and viruses through a multiple-barrier household water disinfection system.

Municipal water disinfection systems in some areas are not always able to meet water consumer needs, such as ensuring distributed water quality, because household water management can be a contributing factor in water re-contamination. This fact is related to the storage options that are common in places where water is scarce or is distributed over limited time periods. The aim of this study is to assess the removal capacity of a multiple-barrier water disinfection device for protozoa, bacteria, and viruses. Water samples were taken from households in Mexico City and spiked with a known amount of protozoa (Giardia cyst, Cryptosporidium oocyst), bacteria (Escherichia coli), and viruses (rotavirus, adenovirus, F-specific ribonucleic acid (FRNA) coliphage). Each inoculated sample was processed through a multiple-barrier device. The efficiency of the multiple-barrier device to remove E. coli was close to 100%, and more than 87% of Cryptosporidium oocysts and more than 98% of Giardia cysts were removed. Close to 100% of coliphages were removed, 99.6% of the adenovirus was removed, and the rotavirus was almost totally removed. An effect of site by zone was detected; this observation is important because the water characteristics could indicate the efficiency of the multiple-barrier disinfection device.

[Reliability of retinal imaging screening in retinopathy of prematurity]. / Fiabilidad en el cribado de la retinopatía del prematuro mediante el análisis de retinografías.

INTRODUCTION: The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam 3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator. MATERIAL AND METHODS: The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam 3 wide-angle camera. A total of 30 image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists). RESULTS: According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type 1. In the diagnosis of ROP Type 1+Type 2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C. CONCLUSION: The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam 3 has proved to be a reliable method.

Role of inflammation in endophthalmitis.

Inflammation originating from infection of the vitreous cavity is called endophthalmitis. Attention has been focused on the epidemiologic, microbiologic reports, and treatment options; unfortunately, the role of the host immune reaction in the visual function damage is still not well understood. Endophthalmitis occurs most frequently after cataract surgery. In this paper we review the published literature regarding inflammatory mediators and apoptosis during the course of endophthalmitis. Toll-like receptors, cytokines, high-mobility group box 1 proteins, aB-crystallin and apoptosis have been studied during clinical and experimental cases of endophthalmitis. Further understanding of the host-immune reaction to vitreous infection is essential for the development of new therapies. The use of intravitreal antibiotics and corticosteroids, vitrectomy and systemic antibiotics for the preservation of visual function is still discouraging.

[Post-traumatic striate melanokeratosis in a Caucasian woman]. / Melanoqueratosis estriada postraumática en mujer de raza blanca.

CLINICAL CASE: A fair-skinned woman presented marked striate melanokeratosis in her left eye related to recurrent corneal erosion. The source of pigmentation was a conjunctival melanosis. The conjunctival melanosis responded to treatment with topical mitomycin, while the corneal pigmentation persisted. DISCUSSION: Striate melanokeratosis is a condition described in dark-skinned patients who show a well-defined pigmentation of the limbal area, with only one case of striate melanokeratosis reported previously in a Caucasian person. The stimuli for this proliferation are corneal lesions or melanosis close to the limbus. Avoiding both stimuli are the main steps in its management.

Melanoqueratosis estriada postraumática en mujer de raza blanca / Post-traumatic striate melanokeratosis in a caucasian woman

Caso clínico: Se presenta el caso de una mujer deraza blanca y piel clara, con erosión corneal recurrentey con melanosis conjuntival en OI, que desarrollóuna opacidad corneal por melanoqueratosis estriada.La melanosis conjuntival se trató con mitomicinatópica, manteniendo la pigmentación corneal.Discusión: La melanoqueratosis estriada se presentaen personas de piel oscura, con un único casodescrito en personas de raza caucásica. Ésta se originapor daño corneal o por migración de pigmentodesde melanosis conjuntivales, debiendo tratarambas condiciones para detener la pigmentación corneal(AU)

Clinical case: A fair-skinned woman presented markedstriate melanokeratosis in her left eye related torecurrent corneal erosion. The source of pigmentationwas a conjunctival melanosis. The conjunctivalmelanosis responded to treatment with topicalmitomycin, while the corneal pigmentation persisted.Discussion: Striate melanokeratosis is a conditiondescribed in dark-skinned patients who show awell-defined pigmentation of the limbal area, withonly one case of striate melanokeratosis reportedpreviously in a Caucasian person. The stimuli forthis proliferation are corneal lesions or melanosisclose to the limbus. Avoiding both stimuli are themain steps in its management(AU)