Instituto de la Visión

In Mexico, suicidal behavior is a matter of concern because, although the rates of death by suicide are below global mean (11.4 vs. 4.1 x 100,000 population), between 1970 and 2007 they increased by 175 %, especially among young people, in whom it is the third leading cause of death. For this reason, several preventive actions have been developed but have not had the expected success, because they are poorly designed. They lack a uniform and clear case definition. Their approach is reductionist, it focuses only on the public health aspect and does not go beyond traditional plans of primary, secondary and tertiary prevention. This review aims to offer different options, such as adopting the case definition provided by Atlanta's Centers for Disease Control and Prevention (CDC). It aims to broaden the vision in order to include philosophical, psychosocial and psychiatric aspects, as well as to include, as a theoretical framework, the "diathesis-stress" psychological model and propose a population-based intervention preventive strategy.

En muchas sociedades las religiones han intentado esclarecer cuestiones fundamentales para el orden socio-político, como el origen, la meta final y el sentido de la existencia y la identidad de los seres humanos. Este texto quiere recordar algunos aspectos importantes acerca de esta temática que no han perdido actualidad, como el valor sociopolítico de los fenómenos religiosos en el campo de la protección ecológica, en lo referente a la necesidad de solidaridad en las relaciones sociales y en la fundamentación de una concepción amplia de justicia (según Jürgen Habermas). Es interesante señalar que esta actividad intelectual empezó en la antigua Mesopotamia.

El Museo de La Plata tiene una larga trayectoria en el estudio de los reptiles fósiles continentales, representada por dinosaurios, cocodrilos, tortugas y escamados. Sus estudios se remontan hacia finales del siglo XIX, motorizados por los estudios pioneros de Florentino Ameghino, Santiago Roth, Richard Lydekker y Arthur Smith Woodward, principalmente. Durante la primera mitad del siglo XX los estudios de formas continentales son saltuarios, destacándose los aportes de Friedrich von Huene y Ángel Cabrera. En la década de 1960 se produjeron dos hechos singulares. Por un lado, las expediciones a Patagonia lideradas por Rodolfo Casamiquela, generando conocimientos sobre la herpetofauna mesozoica, y depositando los especímenes en las colecciones del Museo de La Plata. Por otro lado, la visión de Rosendo Pascual, profesor y jefe de la División Paleontología de Vertebrados, quién a finales de esa década, incentiva a jóvenes postulantes al estudio sobre anfibios, reptiles y aves, conformándose la primera promoción de paleoherpetólogos con títulos académicos y especialidades temáticas: Ana María Báez en anuros, Zulma Brandoni de Gasparini en crocodiliformes y Eduardo P. Tonni en aves. Todos ellos dejaron escuela, la que se advierte claramente en las camadas de discípulos que aún trabajan en esos clados. A comienzos del siglo XXI se establecen líneas de investigación derivadas del legado de Gasparini, basadas en el estudio de la anatomía, las relaciones filogenéticas y la paleobiología de arcosaurios continentales. Las mismas tienen foco en los pseudosuquios y dinosaurios sauropodomorfos, lideradas por Paula Bona, Julia Desojo y Alejandro Otero, todos con lugar de trabajo permanente en la institución.

Introduccin y objetivo: La visin es el sentido ms importante y desarrollado del ser humano, una disminucin en la agudeza visual as como la ceguera son problemas de salud pblica y social. El glaucoma primario de ngulo abierto es la principal causa irreversible de ceguera, por lo que se cree que las horas de sueo podran ser un factor de riesgo para su desarrollo. En el presente estudio se determin la asociacin entre presin intraocular y las horas de sueo. Material y mtodos: Estudio de tipo observacional, transversal y prospectivo. Se estudi a pacientes que acudieron a la consulta en el Instituto de la Visin en Montemorelos, N.L, de julio a agosto de 2021. Las variables medidas fueron la presin intraocular y las horas de sueo. Se utiliz como estadstica inferencial el coeficiente de correlacin de Pearson. Resultados: Se analizaron 75 participantes del Instituto de la Visin en Montemorelos Nuevo Len; 52% del sexo femenino, y edad promedio de 58.64 aos (DE 17.181 mn. 10, mx. 86); 58.7% tienen una somnolencia excesiva; 84.0% se encuentran en rangos normales de presin intraocular de ojo (PIO) derecho y 61% en presin intraocular de ojo izquierdo. Un promedio de 6.67 horas de sueo (DE 1.26, mn. tres, mx. nueve), 53.3% pertenece a un rango normal de horas de sueo y 46.7% insuficiente. Se calcularon las asociaciones para las variables sueo y presin intraocular, sin rechazar la hiptesis nula. Conclusin: No se encontr que la disminucin en la cantidad de horas de sueo influye directamente en la elevacin de la presin intraocular, a pesar de que estudios indican que la disminucin en las horas de sueo influye en la elevacin de la PIO.

To evaluate the benefits of internal limiting membrane peeling in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for the treatment of vitreous hemorrhage. Two hundred and fifty-eight proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage were enrolled into the trial. Patients were randomized into one of two cohorts: Group A patients underwent internal limiting membrane peeling, whereas Group B patients did not undergo internal limiting membrane peeling. The main outcome was best-corrected visual acuity at 6 months. Secondary outcomes were optical coherence tomography central macular thickness at 6 months, incidence of diabetic macular edema treatment during the postoperative trial period, and incidence of epiretinal membrane at 6 months. Two hundred and seven patients were randomized and completed 6 months follow-up. Group A had better best-corrected visual acuity at 6 months than Group B (P < 0.01). Group A had a lower incidence of diabetic macular edema treatment during the postoperative trial period and a lower incidence of epiretinal membrane at 6 months than Group B (P = 0.02 and P < 0.001, respectively). There was a trend toward lower central macular thickness on optical coherence tomography in Group A than Group B (P = 0.09). There were no significant differences in baseline details or complications intraoperatively or postoperatively between cohorts. This trial demonstrated better vision, fewer postoperative diabetic macular edema treatments, and a lower incidence of epiretinal membrane at 6 months when internal limiting membrane peeling was performed. Internal limiting membrane peeling may be considered a vital maneuver to perform in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage.

Fungal keratitis is an ocular infection that has no standardized treatment. The etiological agents most frequently reported in the literature are Fusarium spp., Aspergillus spp., Alternaria spp. and Curvularia spp., related to injuries and Candida albicans related to contact lens wear. Here we present a case of bilateral fungal keratitis of a few days of evolution with insufficient response to antifungal pharmacological treatment and with early application of cross-linking in both eyes as an adjuvant therapy. A review of the current status of cross-linking for the treatment of corneal infections is presented.

Objective: To report a case series of dome-shaped macula (DSM) and serous retinal detachment (SRD). Methods: A retrospective and observational case series study was performed at two centers of ophthalmology in Rosario-Argentina from January 2016 to December 2017. Eight eyes of 5 patients diagnosed with dome-shaped macula with subfoveal hyporeflective zone seen in optical coherence tomography (OCT) were included. Best-corrected visual acuity (BCVA), OCT, fluorescein angiography (FA), differential diagnoses, clinical course and different treatments were reviewed. Results: Baseline visual acuity ranged from 20/25 to 20/200. OCT revealed that the retinal choroidal macular complex had a convex shape and exhibited foveal neurosensory retinal detachment in all cases. FA showed mild diffuse hyperfluorescence due to changes in the retinal pigment epithelium (RPE). No sign of leakage was observed. Different treatments were used, including intravitreal antiangiogenic drugs, oral spironolactone, melatonin and observation. Follow-up time was between 6 and 18 months. BCVA and OCT findings remained unchanged after different options of treatment. Conclusions: DSM is an unusual entity, which can be confused with other maculopathies that cause neurosensory retinal detachment and do not respond to different types of treatment. Hence, in our opinion, observation is a reasonable approach for this disorder.

Purpose: To report an unusual case of postcataract endophthalmitis secondary to Candida parapsilosis. Case Presentation: A 77-year-old female patient was admitted to the emergency ward with reduced visual acuity (VA), and redness and pain in the right eye (RE) with a few hours of evolution. The patient underwent cataract surgery in the right eye 50 days earlier; no abnormalities were discovered in postsurgery check-ups on the following days. Biomicroscopy revealed corneal oedema, tyndall ++++, and flare +++. Capsule-shaped whitish deposits and posterior synechiae were also reported. Fundoscopy: not visible due to anterior segment opacity. RE ultrasound: mild vitritis, attached retina. Due to a strong suspicion of endophthalmitis, an aqueous humour biopsy was performed and the presence of Candida parapsilosis sensitive to amphotericin B and voriconazole was revealed. In view of a poor prognosis, we decided to carry out a vitrectomy, removal of the IOL + capsular bag complex and intravitreal injection of amphotericin B. After several check-ups, the patient reported being diagnosed with a fungal infection in her fingernails some time ago. She was referred for a microbiological testing, which confirmed the presence of Candida in the fingernails. Conclusions: Fungal endophthalmitis is uncommon in the postoperative setting, with most of the cases being attributable to the Candida species. The combination of pars plana vitrectomy, removal of the IOL + capsular bag complex and antifungal agents was able to successfully treat this case of postoperative endophthalmitis due to Candida parapsilosis. The relationship between postoperative Candida endophthalmitis and Candida nail infection is dramatic. To date, only one case of endogenous endophthalmitis associated with complicated onychomycosis has been reported.