Purpose: To report technique preferences for intravitreal injections among retina specialists in Mexico. Methods: Cross-sectional survey. Ophthalmologists with a two-year retina training, active members of the Mexican Retina Association, were contacted through email to answer a survey consisting of 37 items regarding their IVI application technique. Results: A total of 133 retina specialists participated, with a response rate of 78%. Fortyfive percent applied the intravitreal injections in an operating room designated for the procedure. Sixty-three percent reported never injecting both eyes on the same day. Ninetysix percent wore a face mask during the procedure and 91% wore gloves. Eighty-two percent used a lid speculum. Tetracaine drops were the anesthetic method employed by 97% of participants. All participants utilized povidone-iodine for antisepsis. Eighty percent measured the puncture site with a caliper. Superotemporal quadrant was the one chosen to place the injection by 63% of participants. Fifty-nine percent indicated post-injection antibiotic drops for several days. Post-injection counting fingers visual acuity was verified by 53% of the participants. Fifty-six percent of the participants placed an eye-patch after the procedure. Conclusion: There are different practices regarding the application of intravitreal injections among retina specialists in Mexico. Performing this type of survey periodically could show changes in preferences, as new evidence is incorporated into clinical practice.

Determinar la incidencia de retinopatía del prematuro (ROP) y analizar los principales factores de riesgo en la población de recién nacidos prematuros del Hospital Lic. Adolfo López Mateos. Método: Se realizó un estudio prospectivo en el que se incluyeron prematuros con edad ≤ 34 semanas de gestación (SDG), con peso ≤ 2,000 g, durante el periodo de septiembre de 2017 a julio de 2018. Se analizaron factores de riesgo como edad gestacional, peso al nacer, oxigenoterapia, sepsis, transfusión sanguínea, uso de surfactante, uso de esteroide posnatal, síndrome de distrés respiratorio, gestación múltiple, displasia broncopulmonar, persistencia del conducto arterioso, hemorragia intraventricular, episodios de apnea. Se realizó un análisis estadístico para variables continuas y variables categóricas, regresión logística univariada y multivariada.

Objective: To determine the incidence of retinopathy of prematurity (ROP), and to analyze the main risk factors in premature newborns of the Hospital Lic. Adolfo López Mateos. Methods: We performed a prospective study with preterm infants with < 34 weeks of gestational age and a weight < 2000 g, during the period from September 2017 to July 2018. We analyzed risk factors such as gestational age, birth weight, treatment with oxygen, sepsis, blood transfusion, surfactant use, postnatal steroid use, respiratory distress syndrome, multiple pregnancy, bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, and apnea episodes. We analyzed continuous and categorical variables, performed a univariate logistic regression, and calculated a multivariate logistic regression model. Results: Ninety-one premature patients were studied from which 27 had ROP (29.6%). ROP incidence was greater in patients weighing < 1300 g or with a gestational age < 29 weeks. We found a significant risk association with sepsis (Odds ratio [OR] 8.48, gestational age ≤ 29 weeks (16.3,, and birth weight < 1000 g (OR 11.25,. Conclusions: This study demonstrates that the main risk factors for ROP are sepsis, gestational age, and birth weight. A gestational age < 29 weeks and a birth weight < 1000 g are particularly important. In a multivariate logistic regression model, sepsis and gestational age were the main factors associated with ROP. It is important to evaluate all newborns with a gestational age ≤ 34 weeks and/or weighing < 1750 g, with particular emphasis to smaller newborns.

Purpose: The purpose of this study was to evaluate visual acuity (VA) and central retinal thickness (CRT) outcomes in patients treated with ranibizumab for diabetic macular edema (DME) in a clinical setting in Mexico. Methods: A prospective, open-label, single-arm study was performed on 48 eyes of 34 patients with center-involving DME at four high-specialty ISSSTE hospitals in Mexico. Patients initially received a loading dose of three injections of ranibizumab followed by monthly monitoring based on VA and CRT to determine retreatment need. VA, CRT, early treatment diabetic retinopathy (DR) study (ETDRS) DR severity scale (DRSS) score, and number of injections were recorded at baseline and monthly for 12 months. Results: The mean VA, mean CRT, and mean DRSS score at baseline were 19 (± 14) ETDRS letters, 362 (± 98) µm and 50.59 (± 7.9). The mean VA change at 12 months was + 8.6 (± 4.3) letters (p < 0.001) from baseline. The proportion of eyes that gained ≥ 10 letters was 38.58% (n = 19) and 37.50% (n = 18) gained < 10 letters; 4.16% (n = 2) had no change; and 18.75% (n = 9) lost < 10 letters. At month 12, mean CRT change was −85.34 (± 32.1) µm (p < 0.001) and the DRSS score was 45.79 (± 7.9) (p < 0.001). Patients received a mean of 6.7 (± 2.2) injections over 12 months. Conclusion: Patients showed visual and anatomical improvement after receiving ranibizumab in a clinical setting in Mexico.

Evaluar los resultados de agudeza visual (AV) y grosor retiniano central (GRC) en pacientes con edema macular diabético (EMD) tratados con ranibizumab en la práctica clínica de rutina en México. Métodos: Se realizó un estudio prospectivo, abierto y de un solo grupo en 48 ojos de 34 pacientes con EMD con involucro central, en cuatro hospitales de alta especialidad del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSTE). Los pacientes iniciaron con una dosis de carga de 3 inyecciones de ranibizumab 0.5 mg, seguido de monitoreo mensual con base en la AV y el GRC, para determinar la necesidad de retratamiento. La AV, el GRC, el puntaje en la Escala de severidad de la retinopatía diabética (DRSS) del ETDRS y el número de inyecciones se registraron al inicio y de manera mensual hasta los 12 meses. Resultados: La AV promedio, el GRC promedio y el puntaje promedio de la DRSS basales fueron 19 (±14) letras ETDRS, 362 (±98) µm y 50.59 (±7.9), respectivamente. El cambio promedio en AV a los 12 meses fue de +8.6 (±4.3) letras (p < 0.001) respecto a la situación basal. El 39.58% de los ojos (n = 19) ganó ≥ 10 letras y el 37.50% (n = 18) ganó < 10 letras. El 4.16% (n = 2) se mantuvo estable y el 18.75% (n = 9) perdió < 10 letras. A los 12 meses, el cambio promedio en el GRC fue de −85.34 (±32.1) µm (p < 0.001). El puntaje promedio de la DRSS fue de 45.79 (±7.9) en el mes 12 (p < 0.001). Una media de 6.7 (±2.2) inyecciones fue aplicada durante 12 meses. Conclusión: Los pacientes mostraron mejoría visual y anatómica después de recibir ranibizumab en la práctica clínica en México.