S. Parreira, G. Andrade, H. Nascimento, C. Muccioli
PURPOSE: To present a case of hemorrhagic occlusive retinal vasculitis (HORV) associated with intravitreal injection of vancomycin after pars plana vitrectomy (PPV).METHODS: Single case report.RESULTS: A 67-year-old woman presented with best corrected visual acuity (BCVA) of 20/400 in left eye. For clinical suspicion of chronic endophthalmitis, empirical treatment was initiated with vancomycin and ceftazidime without clinical improvement. The patient was submitted to pars plana vitrectomy. During surgery rhegmatogenous retinal detachment was observed and treated. At the end of surgery, intravitreal vancomycin was injected. After 18 days BCVA was counting fingers and fundus examination showed diffuse retinal vascular sheathing, intraretinal hemorrhages and ischemic macular whitening. The clinical diagnosis was compatible with HORV secondary to retinal toxicity due to intraocular vancomycin.CONCLUSIONS: This case illustrates the importance of including intravitreal vancomycin during PPV surgery on the list of potential causes when investigating a case of suspected hemorrhagic occlusive retinal vasculitis.
{"title":"Postoperative Hemorrhagic Occlusive Retinal Vasculitis Associated with Intravitreal Injection of Vancomycin","authors":"S. Parreira, G. Andrade, H. Nascimento, C. Muccioli","doi":"10.15234/VPA.V17I3.497","DOIUrl":"https://doi.org/10.15234/VPA.V17I3.497","url":null,"abstract":"PURPOSE: To present a case of hemorrhagic occlusive retinal vasculitis (HORV) associated with intravitreal injection of vancomycin after pars plana vitrectomy (PPV).METHODS: Single case report.RESULTS: A 67-year-old woman presented with best corrected visual acuity (BCVA) of 20/400 in left eye. For clinical suspicion of chronic endophthalmitis, empirical treatment was initiated with vancomycin and ceftazidime without clinical improvement. The patient was submitted to pars plana vitrectomy. During surgery rhegmatogenous retinal detachment was observed and treated. At the end of surgery, intravitreal vancomycin was injected. After 18 days BCVA was counting fingers and fundus examination showed diffuse retinal vascular sheathing, intraretinal hemorrhages and ischemic macular whitening. The clinical diagnosis was compatible with HORV secondary to retinal toxicity due to intraocular vancomycin.CONCLUSIONS: This case illustrates the importance of including intravitreal vancomycin during PPV surgery on the list of potential causes when investigating a case of suspected hemorrhagic occlusive retinal vasculitis.","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88643279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Interprofessional Education Collaborative (IPEC) Interprofessional Leadership Development Program (ILDP) is a three-day, interactive professional development experience, distinguished by an emphasis on leading in an interprofessional environment. Facilitated by AAL, the ILDP engages leaders responsible for the development, implementation, and assessment of campus-wide interprofessional education (IPE) initiatives, and residency/fellowship leaders in IPE for collaborative practice (IPECP)
{"title":"MESSAGE FROM THE PRESIDENT","authors":"J. F. Arevalo","doi":"10.15234/vpa.v17i4.527","DOIUrl":"https://doi.org/10.15234/vpa.v17i4.527","url":null,"abstract":"The Interprofessional Education Collaborative (IPEC) Interprofessional Leadership Development Program (ILDP) is a three-day, interactive professional development experience, distinguished by an emphasis on leading in an interprofessional environment. Facilitated by AAL, the ILDP engages leaders responsible for the development, implementation, and assessment of campus-wide interprofessional education (IPE) initiatives, and residency/fellowship leaders in IPE for collaborative practice (IPECP)","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86481505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moisés Enghelberg, A. Wong, Zenia P. Aguilera, R. Warman
Purpose: We evaluate presenting features of pediatric thyroid eye disease, and discuss the morbidity and clinical course of this condition in the pediatric population. Methods: A retrospective chart review of 11 patients referred for evaluation of thyroid eye disease at a pediatric tertiary care facility in Miami, Florida.Results: The average age at presentation was 12.7 years. The most common ocular complaint was mild irritation. Patients tended to be positive for thyroid stimulating immunoglobulin and thyroid peroxidase antibody. The average displacement on Hertel exophthalmometry was 21mm for the right eye, and 21.45mm for the left eye. Lower scleral show was the most common eyelid finding. Conclusion: In contrast to thyroid eye disease in adults, the condition tends to present with mild ocular findings in children. Pediatric patients presenting with thyroid eye disease respond very well to medical therapy aimed at enhancing the altered ocular surface.
{"title":"Retrospective Review of Pediatric Thyroid Eye Disease Cases Referred to Nicklaus Children's Hospital","authors":"Moisés Enghelberg, A. Wong, Zenia P. Aguilera, R. Warman","doi":"10.15234/VPA.V17I3.478","DOIUrl":"https://doi.org/10.15234/VPA.V17I3.478","url":null,"abstract":"Purpose: We evaluate presenting features of pediatric thyroid eye disease, and discuss the morbidity and clinical course of this condition in the pediatric population. Methods: A retrospective chart review of 11 patients referred for evaluation of thyroid eye disease at a pediatric tertiary care facility in Miami, Florida.Results: The average age at presentation was 12.7 years. The most common ocular complaint was mild irritation. Patients tended to be positive for thyroid stimulating immunoglobulin and thyroid peroxidase antibody. The average displacement on Hertel exophthalmometry was 21mm for the right eye, and 21.45mm for the left eye. Lower scleral show was the most common eyelid finding. Conclusion: In contrast to thyroid eye disease in adults, the condition tends to present with mild ocular findings in children. Pediatric patients presenting with thyroid eye disease respond very well to medical therapy aimed at enhancing the altered ocular surface.","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88305448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVER AND MASTHEAD","authors":"P. E. Dantas","doi":"10.15234/VPA.V15I1.338","DOIUrl":"https://doi.org/10.15234/VPA.V15I1.338","url":null,"abstract":"","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88528504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucio V L Maranhão, P. E. Dantas, N. R. L. Ramalho, Wanessa P Pinto
We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft.
{"title":"DMEK IN KERATOCONUS WITH ACUTE HYDROPS: A CASE REPORT","authors":"Lucio V L Maranhão, P. E. Dantas, N. R. L. Ramalho, Wanessa P Pinto","doi":"10.15234/VPA.V17I3.510","DOIUrl":"https://doi.org/10.15234/VPA.V17I3.510","url":null,"abstract":"We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft. ","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88455647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Silva, Ana Sofia Lopes, Luísa Colaço, M. Lisboa, Sara Pinto, M. Bernardo, Filomena Silva, I. Prieto
Purpose: Behçet uveitis is a cause of retinal vasculitis, with fluorescein angiography being the gold-standard diagnostic exam. Optical coherence tomography with angiography (OCT-A) is a non-invasive exam that analyzes macular retinal circulation with high resolution, and therefore, could be a useful diagnostic exam in these patients.Material and methods: Analysis of 14 eyes of 8 patients with Behçet uveitis from our institution that were examined by OCT A (AngioPlex®, Zeiss). Macular morphology, area, perimeter and circularity of the foveal avascular zone, as well as central internal and global macular vascular density were evaluated. We compared our results with healthy controls.Results: Mean visual acuity in the patient’s subgroup was 0,84±0,25 and 3 eyes had previous diagnosis of retinal vasculitis with fluorescein angiography. Morphologically we found attenuation of the superficial and deep capillary plexus in 8 eyes, and in 1 of these eyes atrophy of the internal retinal layers was also found in a localized territory. In the foveal avascular area, no statistically significant changes were observed in its area and perimeter (p=0.804 and p=0.380 respectively), although we did find significant changes in its circularity (p=0.027). Vascular density was significantly altered in the internal (p=0.023) and global (p=0.028) macular parameters.Conclusion: We found changes in the macular microcirculation in patients with Behçet uveitis, even in the absence of angiographic changes. Future studies with more patients are necessary to understand the clinical significance of these changes.
目的:隐性葡萄膜炎是视网膜血管炎的一个原因，荧光素血管造影是诊断的金标准检查。光学相干断层扫描血管造影(OCT-A)是一种非侵入性检查，可以高分辨率地分析黄斑视网膜循环，因此对这些患者可能是一种有用的诊断检查。材料和方法:对我院8例behaperet葡萄膜炎患者的14只眼进行OCT A (AngioPlex®，蔡司)检查。评估黄斑形态、中央凹无血管区面积、周长和圆度，以及黄斑中央、内部和整体血管密度。我们将结果与健康对照进行了比较。结果:患者亚组平均视力为0.84±0.25，既往有3眼荧光素血管造影诊断为视网膜血管炎。形态学上我们发现8只眼的浅、深毛细血管丛衰减，其中1只眼的视网膜内部层也在局部区域出现萎缩。在中央凹无血管区，其面积和周长没有统计学意义上的变化(p=0.804和p=0.380)，尽管我们确实发现其圆度有显著变化(p=0.027)。黄斑内部(p=0.023)和整体(p=0.028)的血管密度显著改变。结论:我们发现behet葡萄膜炎患者的黄斑微循环发生了变化，即使没有血管造影改变。为了了解这些变化的临床意义，未来有必要对更多的患者进行研究。
{"title":"OPTICAL COHERENCE TOMOGRAPHY WITH ANGIOGRAPHY IN BEHÇET UVEITIS","authors":"Diana Silva, Ana Sofia Lopes, Luísa Colaço, M. Lisboa, Sara Pinto, M. Bernardo, Filomena Silva, I. Prieto","doi":"10.15234/vpa.v17i3.494","DOIUrl":"https://doi.org/10.15234/vpa.v17i3.494","url":null,"abstract":"Purpose: Behçet uveitis is a cause of retinal vasculitis, with fluorescein angiography being the gold-standard diagnostic exam. Optical coherence tomography with angiography (OCT-A) is a non-invasive exam that analyzes macular retinal circulation with high resolution, and therefore, could be a useful diagnostic exam in these patients.Material and methods: Analysis of 14 eyes of 8 patients with Behçet uveitis from our institution that were examined by OCT A (AngioPlex®, Zeiss). Macular morphology, area, perimeter and circularity of the foveal avascular zone, as well as central internal and global macular vascular density were evaluated. We compared our results with healthy controls.Results: Mean visual acuity in the patient’s subgroup was 0,84±0,25 and 3 eyes had previous diagnosis of retinal vasculitis with fluorescein angiography. Morphologically we found attenuation of the superficial and deep capillary plexus in 8 eyes, and in 1 of these eyes atrophy of the internal retinal layers was also found in a localized territory. In the foveal avascular area, no statistically significant changes were observed in its area and perimeter (p=0.804 and p=0.380 respectively), although we did find significant changes in its circularity (p=0.027). Vascular density was significantly altered in the internal (p=0.023) and global (p=0.028) macular parameters.Conclusion: We found changes in the macular microcirculation in patients with Behçet uveitis, even in the absence of angiographic changes. Future studies with more patients are necessary to understand the clinical significance of these changes.","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85433119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AAO 2018 in conjunction with PAAO","authors":"P. E. Dantas","doi":"10.15234/vpa.v17i3.499","DOIUrl":"https://doi.org/10.15234/vpa.v17i3.499","url":null,"abstract":"AAO 2018 in conjunction with PAAO","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77615934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. F. G. Goyeneche, Jeanneth Toquica Osorio, L. K. M. Malo
Background : Iridoschisis is a rare condition characterized by the thinning and cleavage of the anterior stroma of the Iris; usually bilateral and associated with narrow angles, ocular hypertension and glaucomatous optic neuropathy. We report a case series of three Latin American patients with iridoschisis; all of them associated with narrow angles, and one with history of chronic angle closure glaucoma. The patients had no previous history of ocular trauma or inherited ocular disease. As a new finding, we present a case of unilateral hyphema as the presenting sign of this entity. Conclusions: Chronic open-angle glaucoma; as well as intermittent angle-closure glaucoma, should be excluded in all patients with iridoschisis, and regular follow-up should be established after diagnosis. After having presented an unusual way of presentation; such as unilateral hyphema (with no previous documented reference of this sign) we have widened the spectrum of clinical findings for the suspicion and diagnosis of this pathology.
{"title":"Iridoschisis in Latin America: a case report and literature review","authors":"H. F. G. Goyeneche, Jeanneth Toquica Osorio, L. K. M. Malo","doi":"10.15234/vpa.v17i2.475","DOIUrl":"https://doi.org/10.15234/vpa.v17i2.475","url":null,"abstract":"Background : Iridoschisis is a rare condition characterized by the thinning and cleavage of the anterior stroma of the Iris; usually bilateral and associated with narrow angles, ocular hypertension and glaucomatous optic neuropathy. We report a case series of three Latin American patients with iridoschisis; all of them associated with narrow angles, and one with history of chronic angle closure glaucoma. The patients had no previous history of ocular trauma or inherited ocular disease. As a new finding, we present a case of unilateral hyphema as the presenting sign of this entity. Conclusions: Chronic open-angle glaucoma; as well as intermittent angle-closure glaucoma, should be excluded in all patients with iridoschisis, and regular follow-up should be established after diagnosis. After having presented an unusual way of presentation; such as unilateral hyphema (with no previous documented reference of this sign) we have widened the spectrum of clinical findings for the suspicion and diagnosis of this pathology.","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"37 1","pages":"84-88"},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77842265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rey, Shirley Rosenstiehl, Willy Carpio Rosso, Claudia Carvajal
Proposito: Obtener retroalimentacion de la conducta del paciente de glaucoma con su tratamiento e identificar que factores puedan estar relacionados con la adherencia en un centro oftalmologico de referencia en Bogota - Colombia. Metodos: Se realizo un estudio transversal, que incluyo a 105 pacientes que acudieron a la consulta de glaucoma en la Fundacion Oftalmologica Nacional, entre abril de 2010 y junio de 2011. Resultados: La distribucion con respecto al genero fue similar, el 53.3% fueron hombres. La edad promedio fue 64.8 anos (rango 25-88 anos). El nivel de escolaridad fue similar en los diferentes grupos: primaria 34.3%, licenciatura 35%, profesional 29.9%. El 67.7% de los pacientes documentaron adherencia al tratamiento; de estos, el 91.4% tiene un proveedor estable de las gotas, en el 53.3% las gotas fueron suministradas por su seguro medico, en el 37.1% fueron compradas por el paciente, en el 5.7% fueron suministradas como una muestra medica por el oftalmologo tratante y el 3.8% respondio que no tienen un proveedor estable para las gotas. El genero no se asocio con la adherencia al tratamiento (p 0,53). No se encontro asociacion estadisticamente significativa entre la adherencia al tratamiento y el nivel educativo (p 0,56), si se comprende o no la informacion proporcionada por el medico tratante (p 0,314) o el numero de viales requeridos para el tratamiento (p 0,75). Los pacientes que tenian un proveedor estable de las gotas tenian una mayor adherencia al tratamiento (p <0.001). El proveedor estable de las gotas es un factor protector para la adherencia al tratamiento del glaucoma (OR 0.26 CI 0.186-0.365). Conclusion: Podemos concluir que la causa principal de la no adherencia al tratamiento topico del glaucoma o la hipertension intraocular en nuestro pais es no tener acceso a la medicacion. Sera interesante analizar el impacto en el futuro del nuevo sistema de salud propuesto por nuestra autoridad competente en la adherencia a los tratamientos cronicos en oftalmologia.
目的:获取青光眼患者治疗行为的反馈，并确定哪些因素可能与哥伦比亚波哥大眼科参考中心的坚持有关。方法:对2010年4月至2011年6月在Fundacion Oftalmologica Nacional就诊的105例青光眼患者进行横断面研究。摘要目的:探讨墨西哥国立自治大学(national university of自治大学)的一项研究，该研究评估了一项研究的结果，该研究的目的是评估一项研究的结果。平均年龄64.8岁(25-88岁)。不同群体的教育水平相似:小学34.3%，学士35%，专业29.9%。67.7%的患者坚持治疗;这些,91.4%的稳定供应商提供的珠子,53.3%的珠子是37.1%的健康保险,在购买了5.7%,为病人提供医学作为一个示例oftalmologo经销商和3.8%,他没有稳定的供应商滴。性别与治疗依从性无关(p 0.53)。治疗依从性与教育水平(p 0.56)之间没有统计学上显著的关联，无论是否理解治疗医生提供的信息(p 0.314)或治疗所需的药瓶数量(p 0.75)。有稳定滴剂供应的患者对治疗的依从性更高(p <0.001)。稳定的滴剂供应是坚持青光眼治疗的保护因素(OR 0.26 CI 0.186-0.365)。结论:我们可以得出结论，我国青光眼或眼内高血压不坚持局部治疗的主要原因是无法获得药物。分析我们主管当局提出的新卫生系统对坚持眼科慢性治疗的未来影响将是有趣的。
{"title":"Adherencia al tratamiento tópico para glaucoma en una población colombiana","authors":"S. Rey, Shirley Rosenstiehl, Willy Carpio Rosso, Claudia Carvajal","doi":"10.15234/VPA.V17I2.454","DOIUrl":"https://doi.org/10.15234/VPA.V17I2.454","url":null,"abstract":"Proposito: Obtener retroalimentacion de la conducta del paciente de glaucoma con su tratamiento e identificar que factores puedan estar relacionados con la adherencia en un centro oftalmologico de referencia en Bogota - Colombia. Metodos: Se realizo un estudio transversal, que incluyo a 105 pacientes que acudieron a la consulta de glaucoma en la Fundacion Oftalmologica Nacional, entre abril de 2010 y junio de 2011. Resultados: La distribucion con respecto al genero fue similar, el 53.3% fueron hombres. La edad promedio fue 64.8 anos (rango 25-88 anos). El nivel de escolaridad fue similar en los diferentes grupos: primaria 34.3%, licenciatura 35%, profesional 29.9%. El 67.7% de los pacientes documentaron adherencia al tratamiento; de estos, el 91.4% tiene un proveedor estable de las gotas, en el 53.3% las gotas fueron suministradas por su seguro medico, en el 37.1% fueron compradas por el paciente, en el 5.7% fueron suministradas como una muestra medica por el oftalmologo tratante y el 3.8% respondio que no tienen un proveedor estable para las gotas. El genero no se asocio con la adherencia al tratamiento (p 0,53). No se encontro asociacion estadisticamente significativa entre la adherencia al tratamiento y el nivel educativo (p 0,56), si se comprende o no la informacion proporcionada por el medico tratante (p 0,314) o el numero de viales requeridos para el tratamiento (p 0,75). Los pacientes que tenian un proveedor estable de las gotas tenian una mayor adherencia al tratamiento (p <0.001). El proveedor estable de las gotas es un factor protector para la adherencia al tratamiento del glaucoma (OR 0.26 CI 0.186-0.365). Conclusion: Podemos concluir que la causa principal de la no adherencia al tratamiento topico del glaucoma o la hipertension intraocular en nuestro pais es no tener acceso a la medicacion. Sera interesante analizar el impacto en el futuro del nuevo sistema de salud propuesto por nuestra autoridad competente en la adherencia a los tratamientos cronicos en oftalmologia.","PeriodicalId":53032,"journal":{"name":"Vision PanAmerica","volume":"68 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90285669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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