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Visioli G, Zeppieri M, Iannucci V, Manni P, Albanese GM, Salati C, Spadea L, Pirraglia MP. From Bedside to Diagnosis: The Role of Ocular Fundus in Systemic Infections. J Clin Med 2023; 12:7216. [PMID: 38068267 PMCID: PMC10707096 DOI: 10.3390/jcm12237216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 01/23/2024] Open
Abstract
In this comprehensive review, we delve into the significance of the ocular fundus examination in diagnosing and managing systemic infections at the bedside. While the utilization of advanced ophthalmological diagnostic technologies can present challenges in bedside care, especially for hospitalized patients confined to their beds or during infection outbreaks, the ocular fundus examination often emerges as an essential, and sometimes the only practical, diagnostic tool. Recent discussions have highlighted that the role of an ocular fundus examination might not always be advocated as a routine diagnostic procedure. With this context, we introduce a decision tree tailored for assessing the ocular fundus in inpatients with systemic infections. We also present an overview of systemic infections that impact the eye and elucidate key signs detectable through a bedside ocular fundus examination. Targeted primarily at non-ophthalmology clinicians, this review seeks to offer a comprehensive insight into a multifaceted approach and the enhancement of patient clinical outcomes.
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Affiliation(s)
- Giacomo Visioli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Valeria Iannucci
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Priscilla Manni
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Giuseppe Maria Albanese
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Leopoldo Spadea
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
- Eye Clinic, Policlinico Umberto I University Hospital, 00161 Rome, Italy
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Cifuentes-González C, Barraquer-López D, Mejía-Salgado G, Reyes-Guanes J, Rojas-Carabali W, Polanía-Tovar D, de-la-Torre A. Colombian ocular infectious epidemiology study (COIES): presumed ocular tuberculosis incidence and sociodemographic characterization, 2015-2020. Ophthalmic Epidemiol 2022:1-10. [PMID: 36196030 DOI: 10.1080/09286586.2022.2129076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
PURPOSE This study aims to describe the incidence and geographical distribution of presumed ocular tuberculosis (POTB) in Colombia between 2015 and 2020 based on the Colombian Ministry of Health and Social Protection data. METHODS We conducted a claims-based study using the Integrated Social Protection Information System database from the Colombian Ministry of Health. We used the specific code of the International Classification of Diseases for Ocular Tuberculosis (A18.5) and tuberculosis from 2015 to 2020 to estimate the incidence and the demographic status of the disease in Colombia. We used STROBE guidelines. RESULTS During the 6 years of study, the crude unadjusted incidence was 0.2 new cases of POTB in one million consulting patients and 55 new cases of POTB in 100,000 patients with TB showing a decreasing pattern of the disease. From the 28 new cases, the mean age of presentation was 41.4 years (SD ± 25.3) with a female predominance (60.7% of the cases). Distribution by age shows a higher proportion of cases in groups 15-19 (14%), 20-24 (11%), 55-59 (11%), and 60-64 (11%) years of age. The geographic analysis showed a higher number of cases in Andean region, followed by the Caribbean and Pacific regions. CONCLUSIONS This is the first study that determines the incidence of POTB in a developing country from Latin America. POTB incidence in Colombia is lower than the reported worldwide. It could be attributed to a low burden of Tuberculosis in Colombia, underdiagnosis, and a low rate of immigration from countries with a high burden of TB.
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Affiliation(s)
- Carlos Cifuentes-González
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
| | - Doménico Barraquer-López
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
| | - Germán Mejía-Salgado
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
| | - Juliana Reyes-Guanes
- Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Escuela Barraquer. Research Group. Escuela Superior de Oftalmología - Instituto Barraquer de América, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
| | - Diego Polanía-Tovar
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NEUROS), NeuroVitae Research Center, Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia.,Ophthalmology Interest Group, Neuroscience Research Group (NEUROS). Escuela de Medicina Y Ciencias de la Salud, Universidad Del Rosario, Bogotá, Colombia
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Ocular tuberculosis epidemiology, clinic features and diagnosis: A brief review. Tuberculosis (Edinb) 2020; 124:101963. [PMID: 32745954 DOI: 10.1016/j.tube.2020.101963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/20/2020] [Accepted: 06/29/2020] [Indexed: 11/21/2022]
Abstract
The spread of tuberculosis is directly related to the processes of globalization and migration. Tuberculosis has also been the main cause of fatality associated with antimicrobial resistance and also the main cause of death in people who have HIV infection. Additionally, tuberculosis smites the lungs in 80% of patients, and in the remaining 20% of patients the tuberculosis may smites other organs, such as the vision/eye. Ocular tuberculosis is a specific infectious disease of bacterial etiology with a chronic and persistent course, the prognosis of which is extremely doubtful. Even effective chemotherapy can be accompanied by a decrease in visual acuity, and clinical recovery is not always persistent. Ocular tuberculosis often leads to permanent disability and, as a result, the quality of life of patients decreases. A statistical reporting of this disease does not always reflect the true picture, since ocular tuberculosis sometimes develops against the background of an existing specific lesion in the lung tissue. Currently, ocular tuberculosis remains substantially a conjectural clinical diagnosis. This review paper presents an analytical review of the literature on the epidemiology, clinical features, and diagnosis methods of ocular tuberculosis. The results of recent studies that focused on the modern clinical manifestations of this pathology, its diagnosis, and complex therapy are systematized. The development of new rational regimens and pathogenetic treatment methods are also highlighted in this review.
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