ABSTRACT
ABSTRACT Purpose: To test the hypothesis that Chagas disease predisposes to optic nerve and retinal nerve fiber layer alterations. Methods: We conducted a cross-sectional study including 41 patients diagnosed with Chagas disease and 41 controls, paired by sex and age. The patients underwent ophthalmologic examinations, including intraocular pressure measurements, optic nerve and retinal nerve fiber layer screening with retinography, optical coherence tomography, and standard automated perimetry. Results: All of the patients with Chagas disease had a recent cardiologic study; 15 (36.6%) had heart failure, 14 (34.1%) had cardiac form without left ventricular dysfunction, and 12 (29.3%) had indeterminate form. Optic nerve/retinal nerve fiber layer alterations were observed in 24 patients (58.5%) in the Chagas disease group and 7 controls (17.1%) (p£0.01). Among these, optic nerve pallor, optic nerve alterations suggestive of glaucoma, notch, peripapillary hemorrhage, and localized retinal nerve fiber layer defect were detected. Alterations were more prominent in patients with Chagas disease and heart failure (11 patients), although they also occurred in those with Chagas disease without left ventricular dysfunction (7 patients) and those with indeterminate form (6 patients). Optical coherence tomography showed that themean of the average retinal nerve fiber layer thickness measured 89 ± 9.7 mm, and the mean of retinal nerve fiber layer superior and inferior thickness measured 109 ± 17.5 and 113 ± 16.8 mm, respectively were lower in patients with Chagas disease. In controls, these values were 94 ± 10.6 (p=0.02); 117 ± 18.1 (p=0.04), and 122 ± 18.4 mm (p=0.03). Conclusion: Changes in optic nerve/ retinal nerve fiber layer were more prevalent in patients with Chagas disease.
RESUMO Objetivo: Testar a hipótese de que a doença de Chagas predispõe a alterações no nervo óptico e camada de fibras nervosas peripapilar. Métodos: Foi realizado um estudo transversal com 41 pacientes diagnosticados com doença de Chagas e 41 controles, pareados por sexo e idade. Os pacientes foram submetidos a exames oftalmológicos, incluindo medida da pressão intraocular, avaliação do nervo óptico e camada de fibras nervosas através de retinografia, tomografia de coerência óptica e perimetria automatizada padrão. Resultados: Todos os pacientes com doença de Chagas apresentavam estudo cardiológico recente; 15 pacientes (36,6%) apresentavam insuficiência cardíaca; 14 (34,1%) forma cardíaca sem disfunção de ventrículo esquerdo e 12 (29,3%), forma indeterminada. Alterações do nervo óptico/camada de fibras nervosas foram observadas em 24 pacientes (58,5%) do grupo com doença de Chagas e 07 controles (17,1%) (p£0,01). Dentre estas, palidez do nervo óptico, alterações do nervo óptico sugestivas de glaucoma, entalhe, hemorragia peripapilar e defeito da camada de fibras localizado foram detectados. As alterações foram mais proeminentes nos pacientes com doença de Chagas e insuficiência cardíaca (11 pacientes) embora também ocorressem naqueles com doença de Chagas sem disfunção de ventrículo esquerdo (7 pacientes) e com forma indeterminada (6 pacientes). A tomografia de coerência óptica mostrou que a média da espessura da camada de fibras nervosas da retina mediu 89 ± 9,7 mm), e a média da espessura da camada de fibras nervosas superior e inferior mediu 109 ± 17,5 e 113 ± 16,8 mm, respectivamente, foi menor em pacientes com doença de Chagas. Nos controles, esses valores foram de 94 ± 10,6 mm (p=0,02); 117 ± 18,1 (p=0,04) e 122 ± 18,4 mm (p=0,03). Conclusão: Alterações do nervo óptico/camada de fibras nervosas da retina foram mais prevalentes nos pacientes com doença de Chagas.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Optic Nerve/pathology , Retina/pathology , Chagas Disease/pathology , Nerve Fibers/pathology , Optic Nerve/physiopathology , Optic Nerve/diagnostic imaging , Reference Values , Retina/physiopathology , Retinal Diseases/etiology , Retinal Diseases/pathology , Case-Control Studies , Optic Nerve Diseases/physiopathology , Optic Nerve Diseases/pathology , Cross-Sectional Studies , Analysis of Variance , Chagas Disease/complications , Chagas Disease/physiopathology , Tomography, Optical Coherence , Visual Field Tests , Intraocular PressureABSTRACT
Objective: The aim of the present study was to characterize sickle cell disease retinopathy in children and teenagers from Bahia, the state in northeastern Brazil with the highest incidence and prevalence of sickle cell disease. Methods: A group of 51 sickle cell disease patients (36 hemoglobin SS and 15 hemoglobin SC) with ages ranging from 4 to 18 years was studied. Ophthalmological examinations were performed in all patients. Moreover, a fluorescein angiography was also performed in over 10-year-old patients. Results: The most common ocular lesions were vascular tortuosity, which was found in nine (25%) hemoglobin SS patients, and black sunburst, in three (20%) hemoglobin SC patients. Peripheral arterial closure was observed in five (13.9%) hemoglobin SS patients and in three (13.3%) hemoglobin SC patients. Arteriovenous anastomoses were present in six (16.5%) hemoglobin SS patients and six (37.5%) hemoglobin SC patients. Neovascularization was not identified in any of the patients. Conclusions: This study supports the use of early ophthalmological examinations in young sickle cell disease patients to prevent the progression of retinopathy to severe disease and further blindness...
Subject(s)
Humans , Child , Adolescent , Adolescent , Anemia, Sickle Cell , Child , Hemoglobin SC Disease , Retinal DiseasesABSTRACT
OBJETIVO: O objetivo deste estudo foi determinar a prevalência e gravidade das complicações oculares em pacientes com mucopolissacaridoses (MPS). MÉTODOS: Vinte e nove pacientes com diagnóstico de mucopolissacaridoses foram estudados. Foram avaliados: idade, sexo, acuidade visual, presença de estrabismo, erros refrativos, exame de fundo de olho, pressão intraocular, espessura corneal central e ultrassonografia ocular. RESULTADOS: Foram avaliados três pacientes com MPS I (12 por cento), 11 pacientes com MPS II (37,9 por cento), um paciente com MPS III (3,4 por cento) e 14 pacientes com MPS VI (48,3 por cento). A média de idade foi de 9,5 anos (DP 5,5). Observou-se hipermetropia em 88,5 por cento (23 pacientes) e astigmatismo em 51,7 por cento (15 pacientes). A média da acuidade visual corrigida foi de 0,45 logMAR (DP 0,68). A média do equivalente esférico foi +3,57 D (DP 2,46) e da pressão intraocular foi 17 mmHg (DP 3,9). Os achados mais comuns foram: espessamento palpebral 24,1 por cento (7 pacientes); opacidade da córnea, 55,2 por cento dos casos (16 pacientes); atrofia do nervo óptico, 23,1 por cento (6 pacientes); dobras radiais na retina 24 por cento (7 pacientes). O fundo de olho não foi examinado em 3 pacientes devido à opacidade de córnea. A média da espessura do complexo esclera-retina-coroide (ERC) medida por ultrassom foi de 1,78 mm (DP 0,51). CONCLUSÃO: Os achados oftalmológicos mais proeminentes foram espessamento palpebral, diminuição da acuidade visual, hipermetropia moderada, opacidade da córnea, dobras radiais na retina perimacular e atrofia do nervo óptico.
PURPOSE: The objective of this study was to determine the prevalence and severity of ocular complications in patients with mucopolysaccharidosis (MPS). METHODS: Twenty-nine patients with diagnosis of mucopolysaccharidosis were studied. Age, gender, visual acuity, presence of strabismus, refractive error, fundus examination, intraocular pressure, central corneal thickness and ocular echography were assessed for each individual. RESULTS: There were three patients with MPS I (12 percent), eleven patients with MPS II (37.9 percent), one patient with MPS III (3.4 percent) and fourteen patients with MPS VI (48.3 percent). Mean age was 9.5 years (ranged from 1.2 to 20 years, DP 5.5). Refraction was available in 26 patients, from which 88.5 percent (23 patients) were hyperopic, and 53.8 percent (14 patients) presented astigmatism. Best corrected visual acuity was available in 18 patients and the mean was 0.45 logMAR (DP 0.68). The mean spherical equivalent was +3.57 D (SD 2.46) and intraocular pressure was 17 mmHg (SD 3.9). The most common findings were: eyelid thickening in 24.1 percent (7 patients); corneal opacity in 55.2 percent of cases (16 patients); optic nerve atrophy in 23.1 percent (6 patients); and radial folds in the retina in 24 percent (7 patients). The fundus was examined in 26 out of 29 patients because corneal opacity avoided the exam in 3 of them. The average thickness of the complex sclera-retina-choroid (SRC was 1.78 mm (SD 0.51). CONCLUSION: The most prominent ophthalmologic findings were eyelid thickening, decreased visual acuity, high hyperopia, corneal opacity, perimacular radial folds in the retina and optic nerve atrophy.
Subject(s)
Child , Female , Humans , Male , Corneal Opacity/etiology , Mucopolysaccharidoses/complications , Optic Atrophy/etiology , Refractive Errors/etiology , Corneal Opacity/diagnosis , Intraocular Pressure/physiology , Optic Atrophy/diagnosis , Prevalence , Refractive Errors/diagnosis , Severity of Illness Index , Visual Acuity/physiologyABSTRACT
PURPOSE: The purpose of this study was to evaluate the fluctuation of intraocular pressure measurements obtained by Goldmann applanation tonometry, dynamic contour tonometry, and corneal compensated non-contact tonometry during office hours in glaucoma and healthy participants. This study also aims at correlating the intraocular pressure fluctuations with fluctuations of corneal hysteresis, central corneal thickness, mean central corneal curvature and ocular pulse amplitude. METHODS: A total of 12 controls (24 eyes) and 21 patients (38 eyes) with open-angle glaucoma were recruited. Intraocular pressure measured by Goldmann applanation tonometry, dynamic contour tonometry and corneal compensated non-contact tonometry, ocular pulse amplitude, central corneal curvature and thickness, corneal hysteresis, and resistance factor were obtained at intervals of 2 hours, between 9 AM and 5 PM. RESULTS: Intraocular pressure fluctuated significantly throughout the day in controls and glaucoma individuals with all tonometers (P<0.001). There was no statistically significant variation in mean corneal curvature (P=0.048 in controls; P=0.04 in glaucomatous) or hysteresis over time (P=0.12 in controls; P=0.36 in glaucomatous). The ocular pulse amplitude showed a significant diurnal fluctuation in both groups (P<0.001). There was a significant correlation between the intraocular pressure measured by dynamic contour tonometry and ocular pulse amplitude (P<0.001). CONCLUSION: There was significant intraocular pressure fluctuation over office hours on measurements performed by Goldmann applanation tonometry, dynamic contour tonometry, and corneal compensated non-contact tonometry in normal and glaucoma individuals. Intraocular pressure varied independently of corneal hysteresis, central corneal thickness, and central curvature variation. However, there was significant correlation between ocular pulse amplitude and intraocular pressure measurements performed ...
OBJETIVO: Avaliar a flutuação das medidas da pressão intraocular obtidas pela tonometria de aplanação de Goldmann, tonometria de contorno dinâmico e pela tonometria de não-contato com compensação corneana durante o período ambulatorial, em participantes com glaucoma e saudáveis. Esse estudo também correlacionou as flutuações da pressão intraocular com as flutuações da histerese corneana, espessura corneana central, média da curvatura corneana central e amplitude de pulso ocular. MÉTODOS: Um total de 12 controles (24 olhos) e 21 pacientes com glaucoma de ângulo aberto (38 olhos) foram selecionados. A pressão intraocular medida pela tonometria de aplanação de Goldmann, tonometria de contorno dinâmico e tonometria de não-contato com compensação corneana, amplitude de pulso ocular, a curvatura central e espessura corneanas, a histerese corneana e o fator de resistência foram medidos em intervalos de 2 horas, entre 9 AM e 5 PM. RESULTADOS: A pressão intraocular flutuou significativamente durante o dia em indivíduos controles e com glaucoma em todos os tonômetros (P<0,001). Não houve variação estatisticamente significante na média da curvatura corneana central (P=0,048 em controles; P=0,04 em glaucomatosos) ou na histerese no período pesquisado (P=0,12 em controles; P=0,36 em glaucomatosos). A amplitude de pulso ocular mostrou uma flutuação diurna significativa em ambos os grupos (P<0,001). Houve uma correlação significante entre a pressão intraocular medida pela tonometria de contorno dinâmico e a amplitude de pulso ocular (P<0,001). CONCLUSÃO: Houve uma flutuação significante da pressão intraocular ao longo do período ambulatorial nas medidas realizadas pela tonometria de aplanação de Goldmann, tonometria de contorno dinâmico, e tonometria de não-contato com compensação corneana em indivíduos normais e com glaucoma. A pressão intraocular variou independente da variação da histerese, espessura e curvatura central corneanas. Entretanto, houve ...
Subject(s)
Adult , Aged , Humans , Cornea/physiopathology , Glaucoma, Open-Angle/physiopathology , Intraocular Pressure/physiology , Tonometry, Ocular/methods , Case-Control Studies , Circadian Rhythm , Cornea/anatomy & histology , Linear Models , Monitoring, AmbulatoryABSTRACT
Relato do caso de um paciente com diagnóstico de glaucoma primário de ângulo aberto, que foi submetida a esclerectomia profunda em olho direito, com sucesso. No pós-operatório de 3 meses, o procedimento cirúrgico foi avaliado com biomicroscopia ultra-sônica (UBM) utilizando-se dois equipamentos distintos (UBM 840-Zeiss; UBM-VUMAX-Sonomed) com transdutores de 50 MHz. O método diagnóstico com biomicroscopia ultra-sônica pode ser usado como método não invasivo para avaliar a arquitetura interna ocular na topografia da esclerectomia profunda. Permite identificar as estruturas do segmento anterior, sua relação anatômica, bem como a membrana trabéculo-Descemet íntegra e o espaço intra-escleral. Biomicroscopia ultra-sônica demonstrou utilidade na avaliação pós-operatória do procedimento cirúrgico.
Case report of a woman with the diagnosis of primary open-angle glaucoma who was submitted to a successful surgical procedure of deep sclerectomy in the right eye. In the postoperative period, at month 3, the surgical procedure was evaluated with ultrasound biomicroscopy (UBM) utilizing two distinct equipments (UBM 840-Zeiss; UBM-VUMAX-Sonomed), with 50-MHz transducers. The diagnostic method of ultrasound biomicroscopy can be utilized as a non invasive method to evaluate the internal architecture of the eye at the topography of deep sclerectomy. It allows to identify the anterior segment structures, their anatomical relationship, and also the intact trabecular-Descemet membrane and the intrascleral space. Ultrasound biomicroscopy showed to be useful in evaluating postoperative status of the surgical procedure.