Browsing by Author "Stevenson, Ricardo"

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    A national telemedicine network for retinopathy of prematurity screening
    (2018) Ossandon, Diego; Zanolli, Mario; Stevenson, Ricardo; Agurto, Ricardo; Ortiz, Paula; Dotan, Gad
    To report the results of retinopathy of prematurity (ROP) screening by a telemedicine sys- tem in Chile and evaluate its usefulness for referring patients who require treatment. METHODS Premature infants at risk of developing ROP from 11 neonatal intensive care units were included. Screening was performed on all infants born at a gestational age of \32 weeks and/or birth weight of\1500 g. A trained nonphysician operator used an imaging system to capture retinal images, which were reviewed by two independent ROP experts. All in- fants that required treatment were referred for further evaluation. RESULTS The study included 2,048 eyes of 1,024 premature infants. Mean gestational age was 28.8 2.2 weeks, and mean birth weight was 1128 279 g. A total of 5,263 telemedicine examinations were performed and reported. The average number of image sets per patient was 2.6 2.5. Of the 5,263 images, 4,903 (93%) were recorded to at least the end of zone II; 5,172 (98%) were graded as having good quality, allowing for staging of ROP disease. Forty-two infants (4%) were referred for treatment. Discharged patients with ROP type 2 that regressed did not present with any complications or adverse effects during 6 months’follow-up. CONCLUSIONS Our study demonstrates the utility of telemedicine screening for ROP with ophthalmologist readers in a developing country. Telemedicine screening was able to detect treatment-requiring ROP. Most of the images had good quality and showed the end of zone II, two variables sufficient to discharge patients.
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    Prevalencia de patología oftalmológica en prematuros menores de un año de edad
    (2012) López, Juan Pablo; Ossandón, Diego; Denk, Oliver; Stevenson, Ricardo; Agurto, Ricardo; Uauy, Andrés; Salinas, Ricardo; Pérez, Marcelo; Cox, Horacio; Maturana, Andrés; Elías, Soledad
    Reportar hallazgos oftalmológicos en niños prematuros examinados antes del año de edad gestacional corregida (EGC). Pacientes y Método: Revisión retrospectiva de fichas clínicas de una serie de prematuros ([peso nacimiento (PN) ≤ 1 500 g y/o ≤ 32 sem edad gestacional (EG)] nacidos en CAS entre 2006-2009, examinados antes del año de EGC. Se consignó EG, PN, antecedente de retinopatía del prematuro (ROP), EGC al examen, refracción, anisometropía y estrabismo. Resultados: De 149 prematuros nacidos en el período, 100 tuvieron examen oftalmológico antes del año de edad (67,14%); el promedio de EG y PN fue 29,3 (rango 23- 36) semanas y 1217 (343-2190) g, respectivamente. El 29% presentó ROP, requiriendo tratamiento el 4%. La EGC promedio al examen oftalmológico fue 6,4 (3-11,5) meses. El equivalente esférico fue +1,34D (-1,75 a +5,75), presentando anisometropía >1D el 2,2%(95% IC, -0,82-5,26). El 3,3%(95% IC, -0,38-7,04) presentaba indicación de lentes según recomendaciones internacionales y el 4%(95% IC, 0,16-7,84) presentó estrabismo. Conclusiones: La baja prevalencia de factores de riesgo para ambliopía detectada en esta cohorte comparada con la reportada para prematuros con ROP severa podría explicarse por la baja prevalencia de ésta última en la presente serie.
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    Primer Consenso Chileno de Grupo de Estudio de Tuberculosis Ocular
    (2023) URZUA, CRISTHIAN ALEJANDRO; Liberman, Paulina; Escobar, Nadia; Sabat, Pablo; Hernández, Mariluz; Peña, Luis; Stevenson, Ricardo; Pérez, María Eugenia; Balcells, María Elvira
    El tratamiento de la tuberculosis (TB) ocular es un tema que genera controversia en el mundo. Para el correcto manejo de estos pacientes, es necesario el desarrollo de guías que consideren la epidemiología de la TB ocular en cada nación. El objetivo de este consenso fue discutir de forma interdisciplinaria la epidemiología, fisiopatología, clínica, diagnóstico, estudio y tratamiento de los pacientes con TB ocular, para establecer un algoritmo de tratamiento y proponer qué pacientes deben ser tratados en Chile y con qué tratamiento. Además, se establecieron acuerdos para efectuar quimioprofilaxis de los pacientes con TB latente que tienen indicación de tratamiento inmunosupresor por enfermedades inflamatorias oculares.
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    Resultados anatómicos y refractivos en pacientes tratados por retinopatía del prematuro
    (Elsevier, 2017) Lolas, M; Tuma, Anton; Zanolli, Mario; Agurto, Ricardo; Stevenson, Ricardo; Ossandón, Diego
    OBJECTIVE: To describe the anatomical and refractive outcomes after treatment with intravitreal bevacizumab or laser in a patient cohort with retinopathy of prematurity (ROP). METHODS: A multicentre, prospective, and observational study was performed on patients with ROP treated at Hospital Roberto del Río. Those patients with less than 6months of follow-up were excluded. Cases with posterior zone II, zone I ROP, and aggressive posterior ROP (AP-ROP) were treated with intravitreal bevacizumab. All other patients were treated with laser. Follow-up was performed every 3 months, and included fondo evaluation, refraction, and Teller tests. RESULTS: The treated group included 144 eyes of 72 patients, of whom 49 were treated with laser and 23 with intravitreal bevacizumab. One (1.4%) patient from the laser group progressed to stage 4b retinal detachment and required bilateral vitrectomy. Of the remainder, 45 cases had type 1 ROP, 16 had threshold disease, and 11 had AP-ROP. The median of gestational age was 26 weeks (range 23-30), and median of birth weight was 800g (range 405-1350). Median follow-up was 10 months (range 6-8). The Teller test median was 3.2 cycles/cm (range 0.32-13). There were 16 (22%) cases with a myopic refraction of -6 D or more. The sphere median was -1.75 D (range -16.00 to +3.50 D) and the cylindrical median was 0.00 (range -4.5 to +1.5 D). Anatomical success was achieved in 71 (98.6%) of patients. CONCLUSION: Treatment with laser or intravitreal bevacizumab is a highly successful primary treatment for ROP. Anatomical success can be achieved in most cases. Treated patients develop frequent and severe refractive defects, which should be corrected. Vision outcome, measured using the Teller preferential test, shows good results

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