Introducción: La pandemia ocasionada por COVID-19 ha condicionado cambios en la experiencia clínica y quirúrgica durante la formación en la especialidad médica. Los cuestionarios sobre ambientes clínicos (posgrados) se ocupan de la percepción del estudiante con respecto a su autonomía, enseñanza y apoyo social. PHEEM (Postgraduate Hospital Educational Environment Measure) se considera el instrumento más adecuado para examinar los entornos educativos en la formación médica de posgrado. Material y métodos: Se utilizó el cuestionario PHEEM para evaluar el ambiente educacional en residentes de oftalmología del Centro Médico Nacional Siglo XXI. Resultados: La clasificación obtenida con respecto al clima total fue de 93.9 puntos, lo que la clasifica en el grupo de percepción más positiva que negativa. No hubo diferencias importantes por género. Los residentes de primer año tuvieron una percepción más positiva. Conclusión: El resultado del cuestionario indica una percepción del AE más positiva que negativa, con posibilidades para mejorar. La evaluación de forma periódica en búsqueda constante mejoría en al ambiente educacional permitirá una mejor formación de especialistas.

Microcephaly and chorioretinopathy are genetic disorders that are inherited in an autosomal recessive manner. The most frequent ocular manifestation is the presence of lacunar atrophy in the retina and choroid. The diagnosis of this condition can be challenging as several potential causes and related syndromes need to be ruled out. We present two cases of microcephaly and chorioretinopathy in Mexican patients, their clinical characterization, and discuss the differential diagnoses that should be considered. An 8-year-old girl was examined due to a history of decreased vision in both eyes. Fundus examination showed excavated, well-defined, sectorial, bilateral, and symmetrical areas of chorioretinal atrophy. An 18-year-old male had a history of poor vision since childhood. Previous ophthalmological examinations reported bilateral symmetric chorioretinal atrophy with pigment accumulation. Both patients had a prior diagnosis of microcephaly and language delay. Blood tests and a comprehensive systemic evaluation ruled out intrauterine infections. The electroretinogram showed decreased amplitude and increased implicit time in the photopic and scotopic responses. Genetic tests revealed mutations in the TUBGCP4 gene, leading to a diagnosis of microcephaly and chorioretinopathy. As observed in these cases, there was variability in retinal lesions. The presence of chorioretinal lacunae and genetic testing can help to correctly diagnose this disorder.

Background In this study, the characteristics and prognostic factors associated with the progression of myopic traction maculopathy (MTM) were evaluated in a Mexican population. Methods This is a retrospective observational study that analyzed patients with MTM who underwent optical coherence tomography (OCT). Clinical-ocular information, the MTM classification, and initial and final visual acuity (VA) were recorded. Results In total, 101 eyes of 84 patients (mean age 63.5 +/- 10.7 years) were included (88.1% female and 11.9% male). The mean spherical equivalent was-16.8 +/- 6.4 D, axial length was 29.6 +/- 2.1 mm, and mean initial VA was 0.8 +/- 0.5 logMAR. The mean follow-up time was 25.7 +/- 27.6 months. The change in final VA from diagnosis to the last follow-up was +0.1 (0.2) (p = 0.001). Overall, 24.8% of patients progressed, 72.3% did not progress, and 3% showed regression. The patient-year progression rate was 0.20 +/- 0.44. Factors associated with progression were initial logMAR VA (p= 0.012) and staphyloma (p= 0.001). Conclusions One in four patients with MTM progressed, and the patient-year progression rate was 0.5. The factors associated with disease progression were initial VA and the presence of staphyloma. The characteristics of Mexican patients with MTM are similar to those described in other populations.

Purpose: To present a patient with stellate nonhereditary idiopathic foveomacular retinoschisis found with multimodal imaging. Methods: A single case was evaluated. Results: A 70-year-old woman presented with schisis cavities in the outer plexiform layer in the left eye on macular optical coherence tomography. No leakage was detected by fluorescein angiography. After ruling out other causes of nonvasogenic cystoid maculopathy, the patient was diagnosed with stellate nonhereditary idiopathic foveomacular retinoschisis. After 5 years, the best-corrected visual acuity remained stable. The retinoschisis in the left eye had resolved, and cystoid spaces appeared in the lower portion of the macula in the right eye despite the absence of vitreomacular traction. There was no history of ocular procedures or medication use that could have affected the course of the pathology during the intervening period. Conclusions: This case emphasizes the importance of performing multimodal imaging to monitor the characteristics of stellate nonhereditary idiopathic foveomacular retinoschisis as they evolve.