ABSTRACT In vitro neuronal cell cultures, as biological systems, provide valuable molecular material for understanding and visualizing protein and biochemical interactions of the various signalling pathways in the CNS and the neurotropism of various pathogens such as viruses. In addition, Canine Distemper Virus (CDV) is transmitted among susceptible domestic canines and is recognized as a pathogen that affects the CNS of multiple hosts. The present investigation aimed to determine the effect of CDV in promoting the regulation of phosphorylation of the cytoplasmic protein CaMKII in neuronal cell cultures from embryonic hen retina. Cell viability and cytotoxicity of incubated neuronal cells and CDV 104 homogenates for 48 h were evaluated through the MTT assay, phase contrast microscopy and nuclear labelling by DAPI. The phosphorylation of the cytoplasmic protein CaMKII was determined in E8C2 retinal neuronal cultures by western blot and immunofluorescence techniques. The results obtained indicate that CDV with 104 in 48 h induces an apoptotic type excitotoxic neuronal cytotoxicity, glial inflammatory reaction, as well as the cytoplasmic phosphorylation of CamKIIThr286. It is concluded that CDV with TCID50 104 uses a regulatory mechanism through the phosphorylation of CaMKII (P-CamKIIThr286) at the glial/neuronal level in the induction of apoptotic neuronal death.

RESUMEN Los cultivos de células neuronales in vitro, como sistemas biológicos, proveen un material molecular valioso en la comprensión y visualización de interacciones proteicas y bioquímicas de las diversas rutas de señalización en el SNC y del neurotropismo de diversos patógenos tales como los virus. A esto, el Virus del Distemper Canino (VDC) se transmite entre caninos domésticos susceptibles y es reconocido como un patógeno que afecta el SNC de múltiples huéspedes. La presente investigación tuvo por objetivo determinar el efecto del VDC en promover la regulación de la fosforilación de la proteína citoplasmática de la CaMKII en cultivo de células neuronales de retina embrionaria de gallina. Se evaluó la viabilidad celular y citotoxicidad de células neuronales incubadas y homogenizados de VDC 104 por 48 h a través del ensayo de MTT, microscopía de contraste de fase y marcación nuclear por DAPI. Se determinó la fosforilación de la proteína citoplasmática CaMKII en cultivos neuronales de retina E8C2 por la técnica de western blot e inmunofluorescencia. Los resultados obtenidos indican que VDC con 104 en 48 h induce una citotoxicidad neuronal excitotóxica de tipo apoptótica, reacción inflamatoria glial, así como la fosforilación de CamKIIThr286 de tipo citoplasmática. Se concluye que VDC conTCID50104utilizaunmecanismo regulatorio a través de la fosforilación de CaMKII (PCamKIIThr286) a nivel glial/neuronal en la inducción de muerte neuronal apoptótica.

ABSTRACT Purpose: To characterize the extracellular vesicle protein cargo in the aqueous humor and plasma of patients with ocular toxoplasmosis. Methods: Aqueous humor and plasma were collected from six patients with active ocular toxoplasmosis and six patients with cataract. Extracellular vesicles were isolated, and western blotting and mass spectrometry were performed for protein analysis. Results: All plasma samples from patients with ocular toxoplasmosis and cataract were positive for the tetraspanins CD63 and TSG101. However, the aqueous humor from patients with ocular toxoplasmosis was positive only for CD63. Sixty-seven new unreported proteins were identified in the aqueous humor and plasma of patients with the ocular toxoplasmosis and cataract. Of the 67 proteins, 10 and 7 were found only in the cataract and ocular toxoplasmosis groups, respectively. In general, these proteins were involved in immune system activation and retina homeostasis and were related to infections and retina-associated diseases. Conclusion: The distinct protein signatures between ocular toxoplasmosis and cataract may be helpful in the differential diagnosis of ocular toxoplasmosis. However, more studies are needed to better understand the role of these proteins in the pathogenesis of ocular toxoplasmosis.

ABSTRACT Purpose: This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson’s disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function. Methods: A total of 46 eyes of 23 patients with Parkinson’s disease and 40 eyes of 20 healthy controls were included in the study. The patients’ cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer’s Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed. Results: The scores of the Katz Index of Independence and Pfeffer’s Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson’s disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer’s Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness. Conclusion: The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson’s disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson’s disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment.

Abstract Introduction: The retinal vein occlusion constitutes the second cause of vascular disease of the retina, preceded by diabetic retinopathy. Objective: To characterize patients with retinal vein occlusion according to epidemiological and clinical variables. Methods: A descriptive and cross-sectional study was carried out on 56 patients with retinal vein occlusion, assisted in the ophthalmological center of "Dr. Juan Bruno Zayas Alfonso” General Hospital in Santiago de Cuba, from September 2021 to July 2023. Absolute frequencies and percentages were considered as summary measures; mean and standard deviation were determined for the age. Results: The groups of predominant ages were 50-59 years and 70 years or over, both in 28.6%. There was a prevalence of the male sex (53.6 %), hypertension as systemic risk factor (76.8 %), occlusion of the retinal central vein of ischemic type (37.5 %) and the cystoid macular edema as a complication (53.6 %). There was a higher number of patients with a better corrected initial visual acuteness; lower than 0.1 (64.3 %) and after 6 months of treatment the highest percentage of patients were between 0.1 and 0.4 (44.6 %). Conclusions: The epidemiologic and clinical characteristics in patients with retinal vein occlusion, evidenced that hypertension constituted an important risk factor to develop the disease; where the ischemic damage caused complications and decrease of visual acuteness. Timely treatment allowed the patient's vision to improve.

Resumen Introducción: La oclusión venosa retiniana constituye la segunda causa de enfermedad vascular de la retina, precedida por la retinopatía diabética. Objetivo: Caracterizar los pacientes con oclusión venosa retiniana según variables epidemiológicas y clínicas. Métodos: Se realizó un estudio descriptivo y transversal en 56 pacientes con oclusión venosa retiniana, atendidos en el centro oftalmológico del Hospital General “Dr. Juan Bruno Zayas Alfonso” de Santiago de Cuba, durante septiembre 2021 a julio 2023. Se estimaron como medidas de resumen, frecuencias absolutas y porcentajes; para la edad se determinaron la media y desviación estándar. Resultados: Los grupos de edades predominantes fueron de 50-59 años y de 70 años o más, ambos en 28,6 %. Prevaleció el sexo masculino (53,6 %), la hipertensión arterial como factor de riesgo sistémico (76,8 %), la oclusión de la vena central de la retina de tipo isquémico (37,5 %) y como complicación el edema macular cistoide (53,6 %). Hubo mayor número de pacientes con agudeza visual inicial mejor corregida inferior a 0,1 (64,3 %) y luego de los 6 meses de tratamiento se logró que el mayor porcentaje de pacientes estuvieran entre 0,1 y 0,4 (44,6 %). Conclusiones: Las características epidemiológicas y clínica en los pacientes con oclusión venosa retiniana, evidenciaron que la hipertensión arterial constituyó un factor de riesgo importante para desarrollar la enfermedad; donde el daño isquémico provocó complicaciones y disminución de la agudeza visual. El tratamiento oportuno permitió mejorar la visión del paciente.

ABSTRACT Introduction: Information Management is considered as the process of obtaining adequate and secure information. Its main objective is the processing of entries, the storage of data related to the entity and the production of reports and other types of data summary tools. Objective: to determine the current status for the management of the Clinical History of the Retina Consultation in the Ophthalmology Service and the information and communication technologies in the General Teaching Hospital “Abel Santamaría Cuadrado”. Methods: the research obeys to a qualitative-quantitative study applying theoretical and empirical historical-logical, analytical-synthetic and documentary analysis methods to carry out a deep analysis about the evolution and development of the Retina Clinical History, in order to elaborate a clinical management software in the Retina Clinic of the General Teaching Hospital “Abel Santamaría Cuadrado” in Pinar del Río province. Results: description of the current state that will contribute to the improvement of the Clinical History of the Retina Clinic of the Ophthalmology Service of the General Teaching Hospital Abel Santamaría Cuadrado of Pinar del Río. Conclusions: this research would have a social impact for ophthalmologic entities, benefiting both patients and professionals. The importance of this web application is to improve doctor-patient communication so that patients feel satisfied with the care provided.

RESUMEN Introducción: la Gestión de la información es considerada como el proceso para la obtención de la información adecuada y segura. Su principal objetivo es el procesamiento de entradas, el almacenamiento de datos relacionados con la entidad y la producción de reportes y otro tipo de instrumentos de resumen de datos. Objetivo: determinar el estado actual para la gestión de la Historia Clínica de la Consulta de Retina en el Servicio de Oftalmología y las tecnologías de la información y las comunicaciones en el Hospital General Docente “Abel Santamaría Cuadrado. Métodos: la investigación obedece a un estudio cualitativo cuantitativo aplicando los métodos teóricos y empíricos histórico-lógico, analítico-sintético, análisis documental para realizar un profundo análisis acerca de la evolución y desarrollo de la Historia Clínica de Retina, para elaborar un software de gestión clínica en la Consulta de Retina del Hospital General Docente Abel Santamaría Cuadrado de la provincia de Pinar del Río. Resultados: descripción del estado actual que contribuirá al mejoramiento de la Historia Clínica de la Consulta de Retina del Servicio de Oftalmología del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río. Conclusiones: esta investigación tendría como impacto social para las entidades oftalmológica, beneficiar tanto al paciente como a los profesionales. La importancia que tiene la realización de esta aplicación web es mejorar la comunicación médica-paciente para que ellos se sientan satisfechos por la atención brindada.

SUMMARY: The present study aimed to investigate the in vitro effect of human adipose derived stem cells (hADSCs) and their secretions on viability of retinal cells and the axonal growth. After isolation, the rat retina was kept in containers covered with poly-D-lysine/laminin, after preparing the supernatant of hADSCs, the retina along with cells and hADSCs conditioned medium (CM) were co-cultured. The viability was assessed by 3-[4,5- dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay at days 1, 7 and 14, and axonal growth of retinal cells was analyzed by Image J software using Neurite J plug-in. The expression of PI3K/Akt pathway genes and its proteins were evaluated through real-time polymerase chain reaction (PCR) and western blot, respectively. Anti-oxidant effects of hADSCs and their CM were measured by measuring the retina cells level of thiobarbituric acid reactive substance (TBARS), ferric reducing ability of plasma (FRAP) and glutathione (GSH). Brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and NT-4 in the CM were measured by enzyme-linked immunosorbent assay (ELISA). The CM contained high levels of BDNF, NT-3 and NT-4 compared to the control group. The expression of genes and proteins of the PI3K/Akt pathway along with levels of TBARS, FRAP and GSH was also increased in the group of hADSCs and their CM compared to the control group. The results of this study showed that hADSCs can increase the axonal growth and survival of rat retinal cells through anti-inflammatory, anti-apoptotic, and paracrine stimulation, as well as through the PI3K/Akt pathway.

RESUMEN: El presente estudio tuvo como objetivo investigar el efecto in vitro de las células madre derivadas de tejido adiposo humano (hADSC) y sus secreciones sobre la viabilidad de las células de la retina y el crecimiento axonal. Después del aislamiento, la retina de la rata se mantuvo en recipientes cubiertos con poli-D-lisina/laminina, después de preparar el sobrenadante de las hADSC, se co-cultivaron la retina junto con las células y el medio acondicionado (CM) de las hADSC. La viabilidad se evaluó mediante el ensayo de bromuro de 3-[4,5-dimetiltiazol-2-il]-2,5 difenil tetrazolio (MTT) los días 1, 7 y 14, y el crecimiento axonal de las células de la retina se analizó mediante el software Image J utilizando el complemento Neurite J. La expresión de los genes de la vía PI3K/Akt y sus proteínas se evaluaron mediante reacción en cadena de la polimerasa (PCR) en tiempo real y transferencia Western, respectivamente. Los efectos antioxidantes de las hADSC y su CM se evaluaron midiendo el nivel de sustancia reactiva al ácido tiobarbitúrico (TBARS), capacidad reductora férrica del plasma (FRAP) y glutatión (GSH) en las células de la retina. El factor neurotrófico derivado del cerebro (BDNF), la neurotrofina- 3 (NT-3) y la NT-4 en el CM se midieron mediante un ensayo inmunoabsorbente ligado a enzimas (ELISA). El CM contenía altos niveles de BDNF, NT-3 y NT-4 en comparación con el grupo control. La expresión de genes y proteínas de la vía PI3K/Akt junto con los niveles de TBARS, FRAP y GSH también aumentaron en el grupo de hADSC y sus CM en comparación con el grupo control. Los resultados de este estudio mostraron que las hADSC pueden aumentar el crecimiento axonal y la supervivencia de las células de la retina de rata a través de la estimulación antiinflamatoria, antiapoptótica y paracrina, así como a través de la vía PI3K/Akt.

Abstract: Vision problems are common in patients with diabetes mellitus (DM) because they may suffer from diabetic retinopathy (DR). Because the symptoms of this condition are not easy to detect without the intervention of an expert technician, the use of convolutional neural networks (CNN) has been implemented to speed up the process of analyzing retina images. Due to the good results of this technology, efforts have been made to combine it with other technologies. In this paper, we present the use of an intelligent hybrid system that uses CNNs and Fuzzy Logic with the aim of improving the accuracy obtained. The implementation of fuzzy logic to adjust the hyperparameters of the network allowed us to obtain a mean of 0.9526 with a standard deviation of 0.008521158 in the binary case study, while in the multiclass case study we obtained a mean of 0.7299 and a standard deviation of 0.015614013, offering better results when fuzzy logic is combined compared to when not.

Resumen Objetivo: Comparar e investigar los parámetros de la tomografía de coherencia óptica (OCT) de los lados sanos y afectados de pacientes con pérdida auditiva neurosensorial súbita idiopática (PANSI). Método: La evaluación ocular bilateral de los pacientes diagnosticados con PANSI se realizó con OCT. Se registraron los valores de espesor del complejo de células ganglionares (CCG) y de la capa de fibras nerviosas de la retina (CFNR), y se examinaron las diferencias entre los dos ojos. Resultados: Se evaluaron 39 pacientes, con una edad media de 44.82 ± 14.90 años. Se determinó que el grosor de la CFNR de los ojos era una media de 89.87 ± 3.65 µm en el lado afectado y 103.87 ± 3.98 µm en el lado de control sano (p = 0.0001). Se determinó que el CCG medio era 90.46 ± 3.49 µm en el lado afectado y 103.77 ± 3.96 µm en el lado de control sano (p = 0.0001). Conclusiones: Se encontró una diferencia estadísticamente significativa entre los ojos sanos y afectados de pacientes con PANSI con respecto al CCG medio y al espesor medio de la CFNR. La OCT podría ser una técnica útil para medir esta degeneración neuronal.

Abstract Objective: The objective of the study is to compare the optic coherence tomography (OCT) parameters of the healthy and affected sides of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to investigate the relationships between these and the improvement in hearing levels. Methods: A bilateral eye evaluation of patients diagnosed with ISSNHL was performed with OCT. The ganglion cell complex (GCC) and retina nerve fiber layer (RNFL) thickness values were recorded and the differences between the two eyes were examined. Results: An evaluation was made of 39 patients with a mean age of 44.82 ± 14.90 years. The RNFL thickness of the eyes was determined to be mean 89.87 ± 3.65 µm on the affected side and 103.87 ± 3.98 µm on the healthy control side (p = 0.0001). The mean GCC was determined to be mean 90.46 ± 3.49 µm on the affected side and 103.77 ± 3.96 µm on the healthy control side (p = 0.0001). Conclusions: A statistically significant difference was observed between the healthy and affected eyes of patients with ISSNHL with respect to mean GCC and mean RNFL thickness. OCT could be a useful technique for measuring this neural degeneration.

RESUMEN Introducción: La cirugía del macroadenoma hipofisario garantiza la sobrevida del paciente pero no la recuperación de la función visual. Objetivo: Evaluar la estructura de las células ganglionares de la retina mediante tomografía de coherencia óptica y la función de la vía visual con potenciales evocados visuales para el diagnóstico y seguimiento de pacientes con macroadenoma hipofisario. Métodos: Se realizó un estudio descriptivo, transversal y longitudinal durante (3 y 12) meses. Se incluyeron 42 pacientes en el longitudinal, 37 en el tranversal y 35 controles, emparejados con el programa por puntaje de propensión. La evaluación neuroftalmológica completa incluyó el análisis global y segmentado de la capa de fibras nerviosas de la retina y del complejo de células ganglionares, la amplitud y latencia del componente P100 de los potenciales evocados visuales. El análisis estadístico se condujo en R y Python. Las asociaciones se evaluaron mediante correlaciones de Spearman. Resultados: Las sensibilidades de las amplitudes de la P 100 fueron de 0,999; y las especificidades de los sectores binasales del complejo de células ganglionares fueron de 0,999. Se encontraron asociaciones significativas entre los sectores binasales con amplitud a 12’ (rho > 0,7; p < 0,01) y la desviación mediana del campo visual (rho > 0,5; p < 0,01) a los 3 meses. Los valores de los sectores binasales y la amplitud de la P 100 pueden predecir la desviación media y la amplitud de los potenciales evocados visuales (Oz, 12’) a los 3 meses postoperatorios (r2 > 0,5). Conclusiones: Los sectores binasales y la amplitud de la onda P100 son biomarcadores eficientes en el diagnóstico de los pacientes con macroadenoma hipofisario. Los valores preoperatorios de los sectores binasales y las amplitudes de la onda P 100 podrían ayudar a predecir la restauración del tráfico por la vía parvocelular tras la descompresión.

ABSTRACT Introduction: Pituitary macroadenoma surgery guarantees patient survival but not recovery of visual function. Objective: To evaluate the retinal ganglion cell structure using optical coherence tomography and the visual pathway function employing visual evoked potentials in the diagnosis and monitoring of patients with pituitary macroadenoma. Methods: It was conducted a descriptive, cross-sectional, and longitudinal study (3 and 12 months follow-up) on forty-two patients. They were included 42 patients in the longitudinal study, 37 in the cross-sectional and 35 controls matched to the program by propensity score. It was carried out full neuro-ophthalmological evaluation (structural and functional) including global and segmented retinal nerve fiber layer/ganglion cell complex analysis and amplitude and latency of P100 component in the electrophysiology. It was conducted statistical data analysis with R version 3.6.3 and Python version 3.8. They were evaluated associations using Spearman’s correlations. Results: Amplitude sensitivities were 0.999, and bi-nasal sectors of ganglion cell complex thickness specificities were 0.999. This structural parameter had the highest diagnostic value (area under curve = 0.923). Significant associations were found between bi-nasal sectors with amplitude at 12′ (rho > 0.7, p < 0.01) and median deviation of the visual field (rho > 0.5, p < 0.01) at three months. Pre-surgical values of bi-nasal sectors and amplitude can predict post-surgically median deviation and amplitude (Oz, 12′) at three months with r2 > 0.5. Conclusions: Bi-nasal sectors and P100 wave amplitude are efficient biomarkers of visual pathway damage for pituitary macroadenoma patients management. Pre-surgical values of the bi-nasal sector and visual evoked potentials amplitude could help to predict the restoration of parvocellular pathway traffic after decompression.

Resumen La detección y el diagnóstico de diabetes e hipertensión presentan un escenario desafiante, principalmente en etapas tempranas. Estos dos son degenerativos y de graves consecuencias, provocando daños en múltiples órganos, incluidos los ojos. El oftalmólogo examina el fondo de la retina para discriminar el tipo de enfermedad. En el caso de la retinopatía, como enfermedad crónica, se evidencia en varias clases de progresión. La retinopatía diabética se clasifica en cuatro, que incluyen etapas leve, moderada, grave y proliferativa. En la etapa proliferativa, la retina produce factores vasoproliferativos que estimulan el crecimiento de nuevos vasos sanguíneos, aumentando el riesgo de pérdida de visión. En cuanto a la retinopatía hipertensiva, el método de clasificación más utilizado es la clasificación de Keith-Wagener-Barker. Similar a la retinopatía diabética, también consta de cuatro clases, que van de leves a graves. En la etapa grave, existe un mayor riesgo de desarrollar papiledema o edema retiniano. El objetivo principal de esta investigación es realizar la segmentación y clasificación de imágenes de fondo de retina con retinopatía diabética e hipertensiva. Se propuso una combinación de una red convolucional UNet y una ConvNet para la segmentación de máscara de vasos y la clasificación de retinopatía, respectivamente. El proceso de clasificación se basa en diez clases definidas, donde los valores que van del 0 al 4 representan la retinopatía diabética y los valores del 5 al 9 corresponden a la retinopatía hipertensiva. Los resultados aproximados en la segmentación fueron índices Jaccard de 74%, F1 de 85% y un Accuracy de 96%, y en la clasificación un Accuracy de 80%.

Abstract The detection and diagnosis of diabetes and hypertension present a challenging scenario, mainly in the early stages. These two are degenerative and with severe consequences, causing damage to multiple organs, including the eyes. The ophthalmologist examines the retinal fundus to discriminate between the type of disease. In the case of retinopathy, as a chronic disease, evidence in various classes of progression. Diabetic retinopathy is categorized into four, which include mild, moderate, severe, and proliferative stages. In the proliferative stage, the retina produces vasoproliferative factors that stimulate the growth of new blood vessels, increasing the risk of vision loss. As for the hypertensive retinopathy the most widely used method for classifying is the Keith-Wagener-Barker classification. Like diabetic retinopathy, it consists also of four classes, ranging from mild to severe. In the severe stage, there is an increased risk of developing papilledema or retinal edema. The main objective of this research is to perform segmentation and classification of diabetes and hypertensive retinopathy retinal fundus images. Using a combination of a convolutional network UNet and a ConvNet was proposed for vessel mask segmentation and retinopathy classification, respectively. The classification process relies on ten defined classes, where values ranging from 0 to 4 represent diabetic retinopathy, and values ranging from 5 to 9 correspond to hypertensive retinopathy. The approximate results in the segmentation were Jaccard index of 74%, F1 of 85%, and an Accuracy of 96%, and in the classification was Accuracy of 80%.

RESUMEN Introducción: Se reconoce la asociación entre los factores de riesgo aterogénico y las alteraciones microvasculares de la retina, pero no hay consenso sobre si estas afectaciones en la retina preceden o son una respuesta fisiopatológica a dichos factores. Objetivo: Determinar si la presencia de los factores de riesgo aterogénico predice las alteraciones vasculares retinianas, a través del fondo de ojo y la retinografía. Métodos: Estudio trasversal en 55 sujetos mayores de 19 años de edad, de cualquier sexo, sin opacidades en los medios transparentes del ojo. Se estudiaron las variables edad, sexo, dislipidemia, hábito de fumar, consumo de alcohol, hipertensión arterial, diabetes mellitus tipo 2, presión arterial sistólica y diastólica, índice de masa corporal, colesterol, glicemia, triglicéridos, creatinina, lipoproteínas de alta densidad, urea, eritrosedimentación y conteo leucocitario. Resultados: El 65,45 % presentó alteraciones en el fondo de ojo: aumento del brillo arteriolar (53,03 %) y disminución del calibre arteriolar generalizado (52,24 %). La retinografía mostró daño en el 58,18 %: rectificación de los cruces arteriovenosos (65,71 %), tortuosidad venosa (28,21 %) y cruces arteriovenosos con aplastamiento (85,71 %). El aumento del colesterol sérico (p= 0,003) se asoció con la presión arterial sistólica (p= 0,037) en el fondo de ojo, y con el antecedente de hipertensión arterial (p= 0,023) en la retinografía. Conclusiones: El colesterol sérico, las cifras elevadas de tensión arterial sistólica y antecedentes de hipertensión arterial son los factores de riesgo que mejor predicen el daño vascular retinal.

ABSTRACT Introduction: The association between atherogenic risk factors and retinal microvascular alterations is recognized, but there is no consensus on whether these retinal disorders precede or are a pathophysiological response to these factors. Objective: To determine if the presence of atherogenic risk factors predicts retinal vascular alterations, through fundus examination and retinography. Methods: Cross-sectional study in 55 subjects over 19 years of age, of either sex, without opacities in the transparent media of the eye. The variables studied were age, sex, dyslipidemia, smoking habit, alcohol consumption, arterial hypertension, type 2 diabetes mellitus, systolic and diastolic blood pressure, body mass index, cholesterol, glycemia, triglycerides, creatinine, high-density lipoproteins, urea, erythrocyte sedimentation rate and leukocyte count. Results: 65.45% presented alterations in the fundus of the eye: increased arteriolar brightness (53.03%) and decreased generalized arteriolar caliber (52.24%). Retinography showed damage in 58.18%: rectification of arteriovenous crossings (65.71%), venous tortuosity (28.21%), and arteriovenous crossings with crushing (85.71%). The increase in serum cholesterol (p= 0.003) was associated with systolic blood pressure (p= 0.037) in the fundus, and with a history of arterial hypertension (p= 0.023) in retinography. Conclusions: Serum cholesterol, high systolic blood pressure and a history of hypertension are the risk factors that best predict retinal vascular damage.

Resumen Se presentan técnicas de segmentación de vasos sanguíneos en imágenes de la retina. Estos métodos se pueden utilizar en análisis informáticos de imágenes retinales y en la detección semiautomática y automática de los vasos. Se tratará el método basado en la extracción de crestas de imágenes, que coinciden aproximadamente con las líneas centrales de los vasos, las crestas son utilizadas para componer elementos primitivos en forma de línea. Los métodos semiautomáticos disminuyen la demora en el análisis de las imágenes, frente a los métodos tradicionales manuales y contribuyen a una mejor calidad en las bases de datos.

Abstract Blood vessel segmentation techniques in retinal images are presented. These methods can be used in computational analysis of retinal images and in semiautomatic and automatic detection of vessels. The method based on the extraction of image ridges will be discussed, which approximately coincide with the central lines of the vessels, the ridges are used to compose primitive line-shaped elements. Semiautomatic methods reduce the delay in image analysis, compared to traditional manual methods, and contribute to better quality in the databases.

BACKGROUND: Understanding the relationship between biometric and structural changes in childhood myopia is necessary to effectively manage myopia progression AIM: To determine the relationship between ocular biometry, fovea and sub-fovea choroidal thickness in school-aged children with myopia of Nigerian descent SETTING: Abuja, Nigeria METHODS: This study involved 189 children (117 girls and 72 boys), and myopia was defined as cycloplegic spherical equivalent refraction (SER) of ≤ −0.50 D. Keratometry values, biometry data, fovea and sub-foveal choroidal thickness (SFChT) values were obtained from medical records retrospectively and analysed RESULTS: The median age was 13 years (interquartile range [IQR]: 5). The median SER, fovea and SFChTs were −2.63 D (IQR: 3.38), 249 μm (IQR: 118) and 225 μm (IQR: 341), respectively. Male children had flatter corneas, thicker fovea and thinner SFChT compared to female children. The vitreous chamber and axial length were longer and sub-fovea choroid was thinner in children with high myopia. There was a weak but significant positive correlation between myopia and sub-fovea choroidal thickness (r = 0.270 respectively, P < 0.01). A moderate negative correlation was found between myopia and vitreous chamber depth (r = −0.536, P < 0.001), and a strong negative correlation was found between myopia and axial length (r = −0.706, P < 0.001 CONCLUSION: Myopia in school-aged Nigerian children is associated with sub-fovea choroidal thinning, increased vitreous chamber depth and axial elongation CONTRIBUTION: This study provides data on the relationship between ocular biometry, fovea and sub-foveal choroidal thickness in school-aged Nigerian children with myopia

BACKGROUND: Accurate and objective diagnosis of centre-involving diabetic macular oedema (ci-DMO) requires the use of optical coherence tomography (OCT). There is limited data on the availability and rate of utilisation of OCT for the management of DMO in sub-Saharan Africa (SSA). AIM: To assess the availability and rate of utilisation of OCT for the management of DMO in SSA. SETTING: Retina-practising ophthalmologists in 18 countries across SSA. METHODS: In this cross-sectional survey, a structured questionnaire was distributed among ophthalmologists treating patients with retina diseases in SSA. Data were collected using Google Forms by sharing a link to the Google data sheet with participants via email. The responses were analysed, summarised and presented using proportions and frequency tables. RESULTS: A total of 42 ophthalmologists participated in this study. The proportion of diabetic retinopathy patients with DMO seen on a monthly basis was ≤ 20% among 24 (57.1%) participants and ≥ 40% among 14.3% participants. Thirty-eight (90.5%) participants had access to an OCT facility in their area of practice and 85.7% of them had Spectra Domain OCT. Twenty-five (64%) participants performed 1 to 50 OCT scans monthly and 34% performed > 50 OCT scans monthly. Important factors influencing OCT use in DMO patients were: the availability of OCT in the facility, patients' insurance coverage and the severity of DMO. CONCLUSION: Optical coherence tomography is readily available although there is wide variability in its use in SSA. CONTRIBUTION: This survey uncovers the need for standardising practice patterns and usage of OCT in the treatment of DMO in SSA.

BACKGROUND: There is rarity of normative data on retinal parameters associated with glaucoma in Ghanaians. AIM: This study aimed to provide normative data on retinal parameters associated with glaucoma in an at-risk Ghanaian clinical population. SETTING: The study was conducted at the Eye Clinic of the Komfo Anokye Teaching Hospital, Ghana. METHODS: Ophthalmic data were obtained from 338 eyes of 116 males and 222 females (mean age: 61.86 ± 9.54 years, range: 45-89 years). The participants underwent eye examinations including visual acuity measurement using the Snellen chart at 6 m, auto-refraction using the Retinomax K+ Screen Hand-Held Autorefractor Keratometer, Goldmann applanation tonometry, slit-lamp biomicroscopy, fundus examination using a 90D Volks lens, and optical coherence tomography (OCT) using the Zeiss Cirrus HD OCT (Carl Zeiss Meditec, Dublin, CA, United States). Height and weight of participants were measured using a measuring tape and a weighing scale, respectively. RESULTS: Mean ± standard deviation values for retinal parameters were: global peripapillary retinal nerve fibre layer (ppRNFL) = 96.11 ± 9.87 µm, global macula ganglion cell complex (mGCC) = 80.91 ± 5.61 µm, optic disc area = 2.05 ± 0.39 mm², rim area = 1.52 ± 0.27 mm², cup volume = 0.13 ± 0.12 mm³, average cup to disc ratio (ACDR) = 0.47 ± 0.15 and vertical cup to disc ratio (VCDR) = 0.44 ± 0.14. CONCLUSION: Thicker ppRNFL and mGCC may delay diagnosis of pre-perimetric glaucoma in Ghanaians, while larger ACDR and VCDR measurements may lead to glaucoma misdiagnosis. CONTRIBUTION: This study established normative values for retinal parameters associated with glaucoma in Ghanaians.