To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in p... more To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in people living with HIV, in this study, a consecutive series of 79 people living with HIV (PLHIV) were evaluated. Two series of MDI were taken: - macula and optic nerve - nine gaze fields, which findings were compared with those obtained by a retina specialist. Both examiners were unaware of each other’s results. Average age was 32.2 years old, predominantly male (75.9%). Most frequent complications were HIV retina microangiopathies (6.3%) and toxoplasmosis (5.1%), followed by Cytomegalovirus and neuro-retinitis, optic neuritis and vitreitis, each one with 1.3%. Sensitivity with two MDI was 92.8% (CI 95% 66.0–100.0) and with nine 100% (CI 95% 77.0–100.0) and specificity of 95.4% (CI 95% 87.0–99.0) for both series. The positive predictive value was 81.3 and 82.4%, and negative predictive value was 98.4 and 100% respectively. The strength of agreement was substantial for the two series with ...
Revista Peruana de Medicina Experimental y Salud Pública, 2019
Para determinar la frecuencia y el grado de severidad de retinopatía diabética (RD) en pacientes ... more Para determinar la frecuencia y el grado de severidad de retinopatía diabética (RD) en pacientes con diabetes mellitus (DM) tipo 2 se realizó un estudio descriptivo transversal en 3239 pacientes del Instituto Regional de Oftalmología de la ciudad de Trujillo, región La Libertad, Perú. Previa dilatación pupilar, personal entrenado tomó dos fotografías de cada ojo, centrado en mácula y nervio óptico. La frecuencia de RD fue de 25,9 % con mayor proporción en varones con RD (28,2%) y en aquellos con más de 10 años de enfermedad por DM (49,0%). La mayoría de pacientes tuvieron retinopatía diabética no proliferativa (RDNP) leve a moderada (79,3%), el 10,1% tuvo RDNP severa y el 10,6 % RD proliferativa. Concluimos que la RD se presenta en uno de cada cuatro pacientes y alrededor del 20% en grados avanzados. Es preciso ampliar la cobertura de tamizaje desde el momento del diagnóstico de DM e implementar medidas preventivas como el control metabólico y el examen periódico del fondo de ojo.
Background: This study aimed to assess the acceptability and effectiveness of training second and... more Background: This study aimed to assess the acceptability and effectiveness of training second and final-year residents, at the Regional Institute of Ophthalmology, a tertiary-level ophthalmic training center in Trujillo, Peru, in phacoemulsification cataract surgery through structured distance surgical mentorship wet lab courses. Methods: Delivered three five-week distance surgical mentorship wet lab courses, administered through Cybersight, Orbis International’s telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution’s wet lab and uploaded to Cybersight for grading. Competency was assessed through the anonymous grading of pre- and post-training surgical simulation videos, masked as to which videos were recorded before and after training, using a standardized competency rubric adapted from the International Coun...
Background This study assessed the impact of distance cataract surgical wet laboratory training o... more Background This study assessed the impact of distance cataract surgical wet laboratory training on surgical competency of ophthalmology residents at a tertiary-level ophthalmic training center in Trujillo, Peru. Methods Three five-week distance wet lab courses were administered through Cybersight, Orbis International’s telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution’s wet lab and uploaded to Cybersight for grading. Competency was assessed through anonymous grading of pre- and post-training surgical simulation videos, masked as to which occurred before and after training, using a standardized competency rubric adapted from the Ophthalmology Surgical Competency Assessment Rubric (OSCAR, scale of 0–32). Day one best-corrected post-operative visual acuity (BVCA) was assessed in the operative eye on the initi...
Objetivo: Describir las características epidemiológicas de los traumatismos oculares atendidos en... more Objetivo: Describir las características epidemiológicas de los traumatismos oculares atendidos en el Instituto Regional de Oftalmología (IRO). Materiales y métodos: Estudio descriptivo y prospectivo, en el cual se aplicó un protocolo estandarizado de registro de datos demográficos y clínicos de pacientes con traumatismos oculares que acudieron al servicio de emergencia del IRO, entre enero 2016 y abril 2017. Resultados: Un total de 1 288 pacientes cumplieron los criterios de selección, la edad promedio fue de 37 años, en su mayoría los afectados fueron varones (84,7 %) y el grupo etario más afectado fue el de 21 a 40 años (46,7 %). Los accidentes laborales fueron la causa más frecuente (63,7 %), ocurriendo principalmente en trabajadores de metalmecánica, construcción y albañilería; seguido de los accidentes domésticos (19,2 %). El 95,4 % fueron traumatismos cerrados, predominantemente con compromiso unilateral, ocupando el primer lugar los cuerpos extraños corneales (73,4 %), seguid...
Background: Pterygium surgery is a procedure commonly performed by ophthalmologists. Valid, objec... more Background: Pterygium surgery is a procedure commonly performed by ophthalmologists. Valid, objective methods are needed to assess competence in this procedure. Methods: A panel of 5 specialists consisting of members from different regions of the world including Pakistan, United States, Iran, Mongolia and Peru was formed to create a rubric for assessment of pterygium surgery by residents. The assessment rubric was developed using the standard template of Ophthalmology Surgical Competency Assessment Rubrics (OSCARs) previously published. The rubric was designed using a modified Dreyfus model of skill acquisition on a four-point behavioral scale. Results: The rubric consisted of 14 essential steps in pterygium surgery and 5 global indices. The content and face validity of the rubric was refined by repeatedly reviewing the rubric on Googledocs and considering critiques by a panel of 10 cornea specialists from around the world. Each step was divided into four levels, from novice to competent. The skill required for each level was described specifically to help decrease rater subjectivity. Conclusions: The OSCAR for pterygium surgery has face-validity and can be used effectively for both teaching and assessing ophthalmology residents in training programs across the world.
Efecto de la cirugía de catarata en la sensibilidad al contraste y la calidad de vida de paciente... more Efecto de la cirugía de catarata en la sensibilidad al contraste y la calidad de vida de pacientes con diferentes tipos de catarata Effect of cataract surgery on contrast sensitivity and quality of life in patients with different types of cataract
The effect of cataract surgery was assessed in 103 patients whose visual acuity, as measured in d... more The effect of cataract surgery was assessed in 103 patients whose visual acuity, as measured in dim light and with high contrast Snellen letters, was 20/50 or better. The patients desired cataract surgery. They complained of glare symptoms, had given up driving at night, or both. Contrast sensitivity was measured under simulated night conditions with a calibrated Vistech MCT 8000 device. No patient who had a contrast sensitivity of less than 27 at 6 cycles per degree (20/70 "equivalent acuity") had cataract surgery. The mean preoperative contrast sensitivity function showed abnormally low values for all frequencies (cycles/degree) tested. Postoperatively the values returned to normal. Of 99 patients who answered a postoperative questionnaire, 41 (41 %) had been driving at night preoperatively and 80 (80%) were driving at night postoperatively. A control group of 24 noncataractous patients (48 eyes) was in the normal range of the test device used. These results support the view that the benefits of cataract surgery are not well predicted by Snellen acuity, even though functional vision may be significantly reduced.
To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in p... more To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in people living with HIV, in this study, a consecutive series of 79 people living with HIV (PLHIV) were evaluated. Two series of MDI were taken: - macula and optic nerve - nine gaze fields, which findings were compared with those obtained by a retina specialist. Both examiners were unaware of each other’s results. Average age was 32.2 years old, predominantly male (75.9%). Most frequent complications were HIV retina microangiopathies (6.3%) and toxoplasmosis (5.1%), followed by Cytomegalovirus and neuro-retinitis, optic neuritis and vitreitis, each one with 1.3%. Sensitivity with two MDI was 92.8% (CI 95% 66.0–100.0) and with nine 100% (CI 95% 77.0–100.0) and specificity of 95.4% (CI 95% 87.0–99.0) for both series. The positive predictive value was 81.3 and 82.4%, and negative predictive value was 98.4 and 100% respectively. The strength of agreement was substantial for the two series with ...
Revista Peruana de Medicina Experimental y Salud Pública, 2019
Para determinar la frecuencia y el grado de severidad de retinopatía diabética (RD) en pacientes ... more Para determinar la frecuencia y el grado de severidad de retinopatía diabética (RD) en pacientes con diabetes mellitus (DM) tipo 2 se realizó un estudio descriptivo transversal en 3239 pacientes del Instituto Regional de Oftalmología de la ciudad de Trujillo, región La Libertad, Perú. Previa dilatación pupilar, personal entrenado tomó dos fotografías de cada ojo, centrado en mácula y nervio óptico. La frecuencia de RD fue de 25,9 % con mayor proporción en varones con RD (28,2%) y en aquellos con más de 10 años de enfermedad por DM (49,0%). La mayoría de pacientes tuvieron retinopatía diabética no proliferativa (RDNP) leve a moderada (79,3%), el 10,1% tuvo RDNP severa y el 10,6 % RD proliferativa. Concluimos que la RD se presenta en uno de cada cuatro pacientes y alrededor del 20% en grados avanzados. Es preciso ampliar la cobertura de tamizaje desde el momento del diagnóstico de DM e implementar medidas preventivas como el control metabólico y el examen periódico del fondo de ojo.
Background: This study aimed to assess the acceptability and effectiveness of training second and... more Background: This study aimed to assess the acceptability and effectiveness of training second and final-year residents, at the Regional Institute of Ophthalmology, a tertiary-level ophthalmic training center in Trujillo, Peru, in phacoemulsification cataract surgery through structured distance surgical mentorship wet lab courses. Methods: Delivered three five-week distance surgical mentorship wet lab courses, administered through Cybersight, Orbis International’s telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution’s wet lab and uploaded to Cybersight for grading. Competency was assessed through the anonymous grading of pre- and post-training surgical simulation videos, masked as to which videos were recorded before and after training, using a standardized competency rubric adapted from the International Coun...
Background This study assessed the impact of distance cataract surgical wet laboratory training o... more Background This study assessed the impact of distance cataract surgical wet laboratory training on surgical competency of ophthalmology residents at a tertiary-level ophthalmic training center in Trujillo, Peru. Methods Three five-week distance wet lab courses were administered through Cybersight, Orbis International’s telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution’s wet lab and uploaded to Cybersight for grading. Competency was assessed through anonymous grading of pre- and post-training surgical simulation videos, masked as to which occurred before and after training, using a standardized competency rubric adapted from the Ophthalmology Surgical Competency Assessment Rubric (OSCAR, scale of 0–32). Day one best-corrected post-operative visual acuity (BVCA) was assessed in the operative eye on the initi...
Objetivo: Describir las características epidemiológicas de los traumatismos oculares atendidos en... more Objetivo: Describir las características epidemiológicas de los traumatismos oculares atendidos en el Instituto Regional de Oftalmología (IRO). Materiales y métodos: Estudio descriptivo y prospectivo, en el cual se aplicó un protocolo estandarizado de registro de datos demográficos y clínicos de pacientes con traumatismos oculares que acudieron al servicio de emergencia del IRO, entre enero 2016 y abril 2017. Resultados: Un total de 1 288 pacientes cumplieron los criterios de selección, la edad promedio fue de 37 años, en su mayoría los afectados fueron varones (84,7 %) y el grupo etario más afectado fue el de 21 a 40 años (46,7 %). Los accidentes laborales fueron la causa más frecuente (63,7 %), ocurriendo principalmente en trabajadores de metalmecánica, construcción y albañilería; seguido de los accidentes domésticos (19,2 %). El 95,4 % fueron traumatismos cerrados, predominantemente con compromiso unilateral, ocupando el primer lugar los cuerpos extraños corneales (73,4 %), seguid...
Background: Pterygium surgery is a procedure commonly performed by ophthalmologists. Valid, objec... more Background: Pterygium surgery is a procedure commonly performed by ophthalmologists. Valid, objective methods are needed to assess competence in this procedure. Methods: A panel of 5 specialists consisting of members from different regions of the world including Pakistan, United States, Iran, Mongolia and Peru was formed to create a rubric for assessment of pterygium surgery by residents. The assessment rubric was developed using the standard template of Ophthalmology Surgical Competency Assessment Rubrics (OSCARs) previously published. The rubric was designed using a modified Dreyfus model of skill acquisition on a four-point behavioral scale. Results: The rubric consisted of 14 essential steps in pterygium surgery and 5 global indices. The content and face validity of the rubric was refined by repeatedly reviewing the rubric on Googledocs and considering critiques by a panel of 10 cornea specialists from around the world. Each step was divided into four levels, from novice to competent. The skill required for each level was described specifically to help decrease rater subjectivity. Conclusions: The OSCAR for pterygium surgery has face-validity and can be used effectively for both teaching and assessing ophthalmology residents in training programs across the world.
Efecto de la cirugía de catarata en la sensibilidad al contraste y la calidad de vida de paciente... more Efecto de la cirugía de catarata en la sensibilidad al contraste y la calidad de vida de pacientes con diferentes tipos de catarata Effect of cataract surgery on contrast sensitivity and quality of life in patients with different types of cataract
The effect of cataract surgery was assessed in 103 patients whose visual acuity, as measured in d... more The effect of cataract surgery was assessed in 103 patients whose visual acuity, as measured in dim light and with high contrast Snellen letters, was 20/50 or better. The patients desired cataract surgery. They complained of glare symptoms, had given up driving at night, or both. Contrast sensitivity was measured under simulated night conditions with a calibrated Vistech MCT 8000 device. No patient who had a contrast sensitivity of less than 27 at 6 cycles per degree (20/70 "equivalent acuity") had cataract surgery. The mean preoperative contrast sensitivity function showed abnormally low values for all frequencies (cycles/degree) tested. Postoperatively the values returned to normal. Of 99 patients who answered a postoperative questionnaire, 41 (41 %) had been driving at night preoperatively and 80 (80%) were driving at night postoperatively. A control group of 24 noncataractous patients (48 eyes) was in the normal range of the test device used. These results support the view that the benefits of cataract surgery are not well predicted by Snellen acuity, even though functional vision may be significantly reduced.
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