Abstract Objective: To perform an updated meta-analysis of cataract surgical coverage (CSC) data in Latin American studies to confirm that gender equity exists in terms of receiving cataract surgery. Materials and methods: A literature search of Rapid Assessment of Avoidable Blindness (RAAB) studies in Latin American published since 2011 was done. Older studies from countries that did not have newer data published were also included. Using summary original study data of CSC rates on an individual basis, a random effects model of meta-analysis was performed to evaluate the differences in CSC between men and women. Results: Nineteen studies from 17 countries were included (Mexico data were pooled). The odds ratios at a visual acuity (VA) of <3/60 and <6/18 were 1.04 [95% confidence interval (CI): 0.82-1.32] and 1.04 (95% CI: 0.90-1.19), respectively, without heterogeneity. There were no significant gender differences for CSC at any VA level. Conclusions: This updated meta-analysis of CSC data from Latin American countries supports that gender inequity in terms of receiving cataract surgery is not an issue in the region. The results do not provide insight into gender inequity in terms of the quality of cataract surgery and other types of eye care services.

Resumen Objetivo: Realizar un metaanálisis actualizado de la cobertura de cirugía de catarata en estudios latinoamericanos para confirmar que existe equidad de género en términos del acceso a cirugía de catarata. Material y métodos: Se realizó una búsqueda de la literatura de “Rapid Assessments of Avoidable Blindness (Encuestas Rápida de Ceguera Evitable)” publicados en Latinoamérica desde el 2011. Se incluyeron también estudios anteriores de países que no tenían publicados datos más recientes. Utilizando el compendio de datos de los estudios originales de la cobertura de cirugía de catarata (Cataract Surgery Coverage, CSC por sus siglas en inglés) en base individual, se realizó un modelo de efectos aleatorios de metaanálisis para evaluar las diferencias en la CSC entre hombres y mujeres. Resultados: Se incluyeron 19 estudios de 17 países (los datos de México fueron agrupados). La oportunidad relativa (razón de probabilidades) para una agudeza visual (AV) de <3/60 y <6/18 fueron de 1.04 [95% Intervalo de confianza (IC): 0.82-1.32] y 1.04 (95% IC: 0.90-1.19), respectivamente, sin heterogeneidad. No hubo diferencias significativas para la CSC a ningún nivel de AV. Conclusiones: Este metaanálisis actualizado de la CSC de Latinoamérica, confirma que no existe inequidad de género en términos de acceso a cirugía de catarata en esta región.

Abstract Purpose: To report the perceptions and actions undertaken by members of the Mexican Society of Ophthalmology (SMO) during the first months of the COVID-19 pandemic. The paper focuses on the association between professional characteristics and the extent of implementation of the recommendations published by the SMO. Methods: An online survey at Google® Forms was sent via email to ophthalmologists registered with the SMO. A total of 3,296 questionnaires were sent. Two principal variables were selected for the purpose of analyzing the exploratory hypotheses: seniority of the respondents and type of practice. Results: A total of 363 replies were obtained (11.01%). At the time of the survey, 223 ophthalmologists (61.3%) were continuing to see patients in their clinics, while 140 participants (38.5%) had ceased all activities. The main reason for stopping clinical work was the fear that the practices would become transmission hubs. There was a statistical association between higher seniority and discontinuing patient care (p = 0.002). A total of 107 (29.7%) participants continued performing surgical procedures. Participants with less than 10 years of experience had a higher probability of engaging in emergency surgical procedures (p = 0.04). The most commonly employed preventive measure was the use of face masks for patients, followed by the use of N95 respirators by doctors. Conclusion: The majority of the participants maintained their clinical work; in contrast, less than a third continued surgical activities. There was great diversity in the actions taken and in the adoption of SMO recommendations. The use of personal protective equipment was the most employed security measure.

Resumen Objetivo: Analizar el impacto de la emergencia sanitaria por COVID-19 en las percepciones y acciones de los miembros de la Sociedad Mexicana de Oftalmología (SMO) durante los primeros meses. Se describe la asociación entre las características profesionales y la implementación de medidas de bioseguridad publicadas por la SMO Método: Encuesta en línea, mediante Google® Forms, enviada por correo electrónico a oftalmólogos registrados en la SMO. Se enviaron en total 3296 cuestionarios. Se codificaron dos variables principales para analizar las hipótesis exploratorias: experiencia de los encuestados y tipo de práctica. Resultados: Se obtuvieron 363 respuestas (11.01%). Al momento de la encuesta, 223 (61.3%) oftalmólogos continuaban la atención clínica y 140 (38.5%) habían cesado toda actividad. La principal razón para detener el trabajo clínico fue el temor a convertirse en centros de transmisión. Hubo una asociación entre la mayor experiencia y la interrupción de la atención al paciente (p = 0.002). Continuaron realizando cirugías 107 (29.7%) oftalmólogos. Los participantes con menos de 10 años de experiencia tenían mayor probabilidad de realizar cirugías de emergencia (p = 0.04). La medida de seguridad más empleada fue el uso de cubrebocas en los pacientes, seguido del uso de mascarillas N95 por parte de los médicos. Conclusiones: La mayoría de los participantes mantuvieron su trabajo clínico, pero menos de un tercio continuaron las actividades quirúrgicas. Hubo una gran diversidad en las acciones emprendidas y en la adopción de las recomendaciones de la SMO. El uso de equipo de protección personal fue la acción más frecuente entre los participantes.

Abstract A 4-year-old patient, without relevant history, sustained a rocket explosion in the left eye a day before consultation (September 15), at midnight. He presented visual loss, bleeding and pain. Ocular examination showed a visual acuity in the right eye of count fingers at 3 m, and in the left eye of no light perception. Right eye showed no eyelid alterations and left eye showed a superficial laceration in the inner canthus region of approximately 5 cm× 5 cm, eyelid edema and dried blood in the base of the eyelashes. Regarding anterior segment examination, the right eye showed no alterations and the left eye presented a collapsed eyeball with loss of architecture, diagnosing a Grade E open globe injury. The ocular trauma score was of 1, with a 74% probability of no light perception at 6 months. The patient underwent evisceration + medpor implant of the left eye 72 h after the injury. The ocular prosthesis department is in charge of the patient’s follow-up.

Resumen Paciente de 4 años de edad, sin antecedentes de relevancia, recibe un día anterior a la consulta (15 de septiembre), a la media noche, una explosión de un cohete en el ojo izquierdo, que cursa con baja visual, sangrado y dolor. A la exploración oftalmológica presenta agudeza visual en el ojo derecho de contar dedos a 3 metros, en el ojo izquierdo, de no percepción de luz. En los anexos, el ojo derecho no presenta alteraciones, y el ojo izquierdo presenta laceración superficial en el canto interno de aproximadamente 5 x 5 cm, blefaroedema y tejido hemático en la base de las pestañas. En el segmento anterior, el ojo derecho presenta cornea transparente, cámara anterior formada, iris íntegro, pupila central normorreactiva, cristalino transparente, y el ojo izquierdo presenta estallamiento del globo ocular, con pérdida de su arquitectura. Se integra el diagnóstico de ojo izquierdo con trauma ocular abierto tipo ruptura, grado E, pupila no valorable, zona III. Tiene una puntuación de 1 en el Ocular Trauma Score, con pronóstico visual a 6 meses de no percepción de luz de un 74%. Se sometió al paciente a evisceración e implante de Medpor del ojo izquierdo a las 72 h. Posteriormente, y hasta la fecha, ha sido manejado por el Departamento de Prótesis Ocular.

RESUMO Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.

ABSTRACT To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.

Abstract Objective: To describe the causes of blindness in the students of the school for blind children "Josefa Vergara" in Querétaro, Mexico; as well as identifying treatable causes in the studied population. Methodology: The study was conducted in the period from December 2017 to February 2018, at the school for blind children "Josefa Vergara" in Querétaro, Mexico. Thirty students participated. The patients were interviewed and examined by the authors. The results obtained in the study were analyzed with the SPSS™ software version 21. Results: The majority of subjects were blind 28 (93%). The most frequent causes of visual loss were retinopathy of prematurity in 11 patients (36.7%) and congenital cataract in 5 patients (16.6%). In a lower percentage, Leber’s congenital amaurosis was found in 2 patients (6.7%), congenital retinal detachment in 2 patients (6.7%), retinoblastoma in 2 patients (6.7%), optic nerve hypoplasia in 2 patients (6.7%), among others. 73% of the participants in the study had a treatable cause of blindness. Conclusions: The retina was the main anatomical site affected. The most common diagnosis was sequelae of retinopathy of prematurity. Most patients had treatment alternatives that could prevent blindness in early stages of their disease. It is necessary to implement and intensify measures in the Mexican health system for the prevention of blindness in the pediatric population.

Resumen Objetivo: Describir las causas de ceguera en los alumnos de la escuela para niños ciegos Josefa Vergara en Querétaro, México; así como identificar causas tratables en la población estudiada. Metodología: El estudio se llevó a cabo en el periodo de diciembre de 2017 a febrero de 2018 en la escuela para niños ciegos Josefa Vergara de Querétaro, México. Participaron 30 estudiantes. Los pacientes fueron entrevistados y examinados por los autores. Los resultados obtenidos con el estudio fueron analizados con el programa SPSSMR versión 21. Resultados: La mayoría de los sujetos eran ciegos (28, 93%). Las causas más frecuentes de pérdida visual fueron retinopatía del prematuro en 11 pacientes (36.7%) y catarata congénita en 5 pacientes (16.6%). En menor porcentaje se encontró amaurosis congénita de Leber, en 2 pacientes (6.7%), desprendimiento de retina congénito, en 2 pacientes (6.7%), retinoblastoma, en 2 pacientes (6.7%), hipoplasia del nervio óptico, en 2 pacientes (6.7%), entre otras. El 73% de los participantes en el estudio tenían una causa tratable de ceguera. Conclusiones: La retina fue el principal sitio anatómico afectado. El diagnóstico más común fue secuelas de retinopatía del prematuro. La mayoría de los pacientes tenían alternativas de tratamiento que habrían podido evitar la ceguera en estadios tempranos de su enfermedad. Es necesario implementar y reforzar medidas en el sistema de salud mexicano para la prevención de ceguera en la población pediátrica.

RESUMO | Objetivo: Estimar a prevalência de cegueira e deficiência visual em idosos que vivem na Guatemala. Métodos: Indivíduos com idade ³50 anos foram selecionados por amostragem aleatória por conglomerados, e os participantes do estudo foram avaliados pelo método de Avaliação Rápida da Cegueira Evitável. A acuidade visual foi medida e o cristalino foi examinado. Se a acuidade visual apresentada fosse <20/60, então também foi testada com um buraco estenopeico e a fundoscopia realizada. A cegueira e a deficiência visual foram classificadas como deficiência visual moderada com acuidade visual <20/60-20/200; deficiência visual grave com acuidade visual <20/200-20/400; ou cegueira com acuidade visual <20/400. A principal causa de cegueira ou deficiência visual em cada olho foi determinada, e naqueles com catarata, as barreiras ao tratamento foram avaliadas. Resultados: O estudo incluiu 3.850 pessoas com ³50 anos de idade; 3.760 (97,7%) foram examinadas. A prevalência de cegueira ajustada à idade e ao sexo foi de 2,9% (intervalo de confiança de 95%, 2,0-3,8%), 5,2% (4,0-6,4%) deficiência visual grave e 27,6% (23,3-32,0%) deficiência visual moderada. A catarata foi a principal de cegueira (77,6%), seguida de outras doenças do segmento posterior (6,0%). Catarata causada por 79,4% de deficiência visual grave, enquanto erros refrativos não corrigidos causaram 67,9% de deficiência visual moderada. Após a cirurgia de catarata, 75% dos participantes tiveram uma acuidade de 20/200, ou melhor, e 19,0% a deficiência visual não foi melhor do que 20/200 com a correção. O custo foi a principal barreira à cirurgia de catarata (56.7%). Conclusões: A prevalência de cegueira em idosos é maior na Guatemala do que na maioria dos outros países da América Central. A maioria dos casos de cegueira e deficiência visual era evitável ou tratável. O aumento da disponibilidade de tratamento de catarata a preços acessíveis e de alta qualidade teria um impacto substancial na prevenção da cegueira.

ABSTRACT | Purpose: To estimate the prevalence of blindness and visual impairment in older adults living in Guatemala. Methods: Participants ³50 years of age were selected using random cluster sampling and evaluated using the Rapid Assessment of Avoidable Blindness method. Visual acuity was measured, and the lens was examined. If presenting visual acuity was <20/60, it was also tested with a pinhole and fundoscopy was performed. Blindness and visual impairment were classified as moderate visual impairment (presenting visual acuity <20/60 to 20/200), severe visual impairment (presenting visual acuity <20/200 to 20/400), or blindness (presenting visual acuity <20/400). The primary cause of blindness or visual impairment in each eye was determined, and if the cause was cataracts, the barriers to treatment were assessed. Results: The study included 3,850 people ³50 years of age, of whom 3,760 (97.7%) were examined. The age- and sex-adjusted prevalence of blindness was 2.9% (95% confidence interval, 2.0%-3.8%), while 5.2% (4.0%-6.4%) presented with severe visual impairment, and 27.6% (23.3%-32.0%) presented with moderate visual impairment. Cataracts were the leading cause of blindness (77.6%), followed by other posterior segment diseases (6.0%). Cataracts caused 79.4% of cases of severe visual impairment, while uncorrected refractive errors caused 67.9% of cases of moderate visual impairment. Following cataract surgery, 75% of participants had a presenting visual acuity of 20/200 or better, and in 19.0% of participants, visual acuity was not better than 20/200 with correction. Cost was the main barrier to cataract surgery (56.7%). Conclusions: The prevalence of blindness in older adults is higher in Guatemala than in most Central American countries. Most cases of blindness and visual impairment were either preventable or treatable. Increased availability of affordable, high-quality cataract treatment would have a substantial impact on blindness prevention.

RESUMO Objetivo: Avaliar a produção científica relacionada à oftalmologia e à visão na América Latina durante o período de 2006 a 2015. Métodos: As bases de dados PubMed, Lilacs (Bireme), Google Scholar, SciELO e Medigraphic foram utilizadas para realizar um estudo retrospectivo, descritivo e comparativo. Resultados: Foram identificados 1,510 artigos, sendo que o Brasil foi a principal fonte de produção quantitativa, com uma média de 85,4 artigos por ano; o México aparece em segundo lugar com 27,4 e a Argentina em terceiro lugar com 11,1 artigos por ano. Quarenta e um por cento dos artigos foram publicados em inglês; 28,1% trataram da subespecialidade da retina; e a principal fonte institucional de publicações foram as universidades, com 63%. A frequência de primeiros autores do sexo masculino foi de 58,9%, e a revista Arquivos Brasileiros de Oftalmologia representou 36,42% dos artigos identificados. Conclusões: O Brasil ocupa o primeiro lugar na América Latina na produção científica oftalmológica. Os bancos de dados não indexados no PubMed foram incluídos em nosso estudo, representam quase metade dos pesquisadores em oftalmologia na América Latina.

ABSTRACT Purpose: To assess scientific production related to ophthalmology and vision in Latin America during the period from 2006 to 2015. Methods: The PubMed, Lilacs (Bireme), Google Scholar, SciELO, and Medigraphic databases were evaluated for this retrospective, descriptive, and comparative study. Results: A total of 1,510 articles was identified. Brazil was the leader in quantitative production in ophthalmology, averaging 85.4 articles per year. Mexico was in second place with 27.4, and Argentina was in third place with 11.1 articles per year. Forty-one percent of articles were published in English, 28.1% dealt with the subspecialty of the retina, and 63% were published by researchers affiliated with universities. The frequency of male first authors was 58.9%, and the journal Arquivos Brasileiros de Oftalmologia accounted for 36.42% of the identified articles. Conclusions: Brazil stands in first place in Latin America in ophthalmologic scientific production. Nearly half of the researchers in ophthalmology in Latin America included in our study were listed in databases other than PubMed.

Abstract: Background: This systematic review aims to report the current knowledge of retinoblastoma (Rb) and its implications in Mexico. We analyzed clinical and demographic data of patients with Rb at select hospitals with Rb programs or that treat and refer patients with Rb, and identified the gaps in practice. We propose solutions to improve diagnosis, provide adequate treatment, and improve patient uptake. Methods: A general review was conducted on PubMed of peer-reviewed literature on Rb in Mexico. Ophthalmology Department Heads or Directors of Rb programs at seven hospitals in Mexico were contacted for data available on their patients with Rb. Results: Five hospitals provided clinical data on 777 patients with Rb in a period spanning 2000-2015. Of the 122 patients with treatment, 83.4% underwent enucleation. From 33 to 45.3% of Rb tumors in Mexico reach an advanced intraocular stage of development. Knowledge of the disease is limited, despite the fact that the Mexican Retinoblastoma Group has elaborated Rb treatment guidelines and is developing a national Rb registry. Especially in the Southern states, prevalence and outcomes are comparable to African and Asian countries, and only few patients are referred to national treatment centers. Only three institutions have comprehensive Rb programs. Conclusions: There is an immediate need in Mexico to expand primary care providers’ knowledge of Rb and to expand and upgrade current Rb programs to meet the needs of the population adequately. Diagnosis and care of Rb patients in Mexico can also be improved by the establishment of a national Rb registry and a national early detection program, and by increased use of the national treatment protocol.

Resumen: Introducción: Esta es una revisión sistemática de los conocimientos actuales del retinoblastoma (Rb) y sus implicaciones en los centros de referencia más importantes del país. Se presenta un análisis situacional de los programas de Rb en México, se identificaron las brechas en la práctica, y se proponen soluciones para mejorar el diagnóstico, tratamiento y referencia oportuna de pacientes. Métodos: Se realizó una revisión general de la literatura publicada sobre Rb en México a través de PubMed. Los datos sociodemográficos de pacientes con Rb fueron obtenidos a través de los directores de programas de retinoblastoma en siete hospitales. Resultados: Casi una tercera parte de los casos Rb se diagnostican en estadios avanzados. A pesar de la existencia del Grupo Mexicano de Retinoblastoma, el conocimiento de esta patología entre los médicos es limitado. Las diferencias en el tratamiento son notorias en el sur del país, donde la prevalencia y los resultados son comparables con África y Asia. Solamente tres instituciones a nivel nacional tienen un programa establecido de Rb. Conclusiones: Existe la necesidad inmediata de consolidar los programas de Rb para cubrir las necesidades reales de la población. Se requiere mejorar la educación del médico de primer contacto, establecer el registro nacional de casos y el programa de detección temprana, establecer los programas de salvamento ocular nacional, y reforzar las instituciones que brindan tratamiento.

AbstractThis is the first of a two-part review that aims to report the current knowledge of retinoblastoma (Rb) and its implications in Mexico (including the authors' experience at the leading Rb centers), identify the gaps in practice, and propose solutions to improve diagnosis, treatment, and patient uptake. In this first part, general knowledge of Rb diagnosis and management is summarized with a focus on the latest advances in chemotherapy. A general review of peer-reviewed literature of Rb was conducted on PubMed. Key findings were summarized.Provided there is early detection and referral of patients followed by appropriate conservative management, Rb is curable. In developed countries, the primary treatment outcome is ocular salvage with sight preservation. Advanced chemotherapeutic options such as intra-arterial and intravitreal chemotherapy can now save even the most advanced tumors.Advances in Rb therapy are generally limited to developed countries. The implications in Mexico, of the findings from this review will be discussed in Part 2, which will be a comprehensive situational analysis of the state of Rb programming in Mexico, including a review of current demographic data available from hospitals that have Rb programs or treat Rb.

ResumenEsta es la primera parte de un trabajo de revisión donde se reportan los conocimientos actuales del retinoblastoma (Rb) y sus implicaciones en México (incluyendo la experiencia de los autores en los principales centros de referencia), así como las brechas en la práctica y las posibles soluciones para mejorar el diagnóstico, tratamiento y referencia de pacientes. En esta parte se resumen los conocimientos generales del Rb, su diagnóstico y tratamiento. Se realizó una revisión de los avances más recientes en esta enfermedad publicados en PubMed y se resumieron los hallazgos más importantes.La sospecha oportuna y la referencia adecuada de pacientes permiten que el tratamiento conservador del Rb sea curativo. En países en vías de desarrollo, el tratamiento primario es el salvamento ocular y la preservación de la visión. Las opciones de quimioterapia intraarterial o intravítrea permiten ofrecer opciones terapéuticas en estos pacientes.Los avances en el tratamiento del Rb están generalmente limitados a países industrializados. Las implicaciones de los hallazgos de esta revisión serán discutidas en la segunda parte, la cual será un análisis de la situación de los programas hospitalarios del Rb en México, incluyendo la revisión de los datos demográficos disponibles de los centros de referencia más importantes.