ABSTRACT
Resumo Objetivos: Identificar e descrever as alterações oculares em idosos com HIV ou aids através de exame oftalmológico. Avaliar a associação entre as alterações oculares encontradas e o nível de linfócitos T CD4, tempo da terapia antirretroviral, características demográficas e faixa etária. Métodos: Série de 40 casos de pacientes idosos com HIV examinados nos serviços de oftalmologia e imunologia do Hospital Universitário Gaffrée e Guinle (HUGG) de janeiro de 2017 a junho de 2018. Foi realizado o seguinte exame oftalmológico: anamnese, acuidade visual, motilidade ocular, reflexo pupilar, biomicroscopia, tonometria de aplanação e fundoscopia. As análises estatísticas foram realizadas pelo SPSS 20.0. Resultados: A média de idade dos 40 pacientes foi 64,7 anos (dp: 5,1) e o diagnóstico de infeção pelo HIV foi em média há 16.6 anos (dp:7). A maioria dos pacientes examinados possui visão normal (n=22; 55%) e pressão intraocular normal (entre 11 e 21 mmHg). As principais queixas dos pacientes durante a anamnese foram: embaçamento visual (50%), redução da acuidade visual (47.5%), prurido ocular (27.5%), lacrimejamento (25%) e ardência (25%). As alterações biomicroscópicas mais frequentes foram catarata (92.5%), seguida de olho seco (32.5%). Na fundoscopia encontrou-se 43,8 % de alterações da vascularização retiniana, 43.8 % de alterações relacionadas ao nervo óptico e 31,3% relacionadas ao pólo posterior da retina. Conclusão: Alterações oculares foram comuns e podem ser justificadas pela: senilidade, estado inflamatório gerado pela infecção crônica do HIV, efeitos adversos da Terapia antirretroviral prolongada e senescência biológica precoce associada a infecção do HIV.
Abstract Objectives: Identify and describe ocular changes in elderly with HIV or aids through ophthalmological examination. Evaluate the association between ocular alterations and the level of TCD4 lymphocytes, time of antiretroviral therapy, demographic characteristics and age range. Methods: Case series of 40 elderly patients with HIV infection. The study was carried out at the ophthalmology and immunology outpatient clinics of the Gaffrée and Guinle University Hospital (HUGG) from january 2017 to june 2018. The patients were attended at the ophthalmology clinic and underwent a ophthalmological exam including: anamnesis, visual acuity, ocular motility, pupillary reflex, biomicroscopy, aplanation tonometry and fundoscopy. Statistical analyses were performed using SPSS 20.0. Results: The average of the 40 patients was 64.7 years (sd: 5.1), aged between 60 and 78 years, and the average time of HIV infection was 16.6 years (sd: 7 years). Most of the patients examined had normal vision (55%) and normal intraocular pressure (between 11 and 21 mmHg). The main complaints of patients during anamnesis were visual blurring (50%), visual acuity reduction (47.5%), ocular itchiness (27.5%), tearing (25%) and burning (25%).The most frequent changes in biomicroscopy were: cataract (92.5%) and dry eye (32.5%). Funduscopy found 43.8% of retinal vascularization alterations, 43.8% of alterations related to the optic nerve and 31.3% related to retinal posterior pole. Conclusion: Ocular changes were common and can be explained by senility, inflamatory changes caused by chronic HIV infection, adverse effects of antiretroviral therapy and early biological ageing associated to HIV infection.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , HIV Infections/complications , Eye Diseases/etiology , Time Factors , CD4-Positive T-Lymphocytes , HIV Infections/drug therapy , Age Factors , CD4 Lymphocyte Count , Anti-HIV Agents , Antiretroviral Therapy, Highly Active , Diagnostic Techniques, Ophthalmological , Eye Diseases/diagnosisABSTRACT
Las alteraciones oculares pueden ser funcionales o estructurales y se originan tanto en el desarrollo embrionario como en el fetal. Algunas alteraciones son inherentes a la edad gestacional, mientras que otras se relacionan a errores innatos del metabolismo, síndromes genéticos, toxicomanías o tratamientos farmacológicos recibidos por la madre en el primer trimestre de la gestación. Material y métodos: De enero de 2000 a agosto de 2012 se realizó un estudio prospectivo, transversal, observacional y descriptivo en el que se efectuó una valoración oftalmológica de todos los neonatos hospitalizados en la Unidad de Terapia Intensiva y en la Unidad de Cuidados Intermedios del recién nacido. Los niños del programa de seguimiento pediátrico también fueron evaluados. Las variables maternas medidas fueron: edad, patología endocrinológica y adicciones. Las variables neonatales fueron: sexo, edad gestacional al nacer y tipo de alteración ocular. Se utilizó estadística descriptiva. Resultados: Se estudiaron 4,583 pacientes hospitalizados y 7,815 ambulatorios. Se identificaron 179 (1.4%) niños con malformaciones oculares; 33 presentaron diversos síndromes que incluían malformaciones oculares asociadas. Hubo 93 hijos de madre diabética, 24 hijos de madres con alguna adicción y 29 hijos de madres adolescentes. El intervalo de la edad gestacional al nacer fue de 24 a 40 semanas. Conclusiones: Las anormalidades oculares en hijos de madres con DM o toxicomanías fueron más frecuentes, y se presentaron de manera única o formando parte de alteraciones congénitas múltiples.
Ocular disorders are anatomical or functional, and can appeared since embryo development or fetal stage, and be present at born. Some ocular abnormalities are related with gestacional age, while others are due to inborn metabolic errors, genetic syndromes, drug abuse or pharmacologic treatment in the mother. Methods: From January 2000 to August 2012, a prospective, transversal, observational and descriptive study was performed. An ophthalmological evaluation was made to all neonates hospitalized at the Neonatal Intensive and Intermediate Unit Care. Ambulatory infants of the follow up pediatric program also were evaluated. Maternal variables evaluated were: age, endocrine pathology, and addictions. Neonatal variables were sex, gestacional age at born, and type of ocular alteration. Descriptive statistic was done. Results: A total of 4,583 hospitalized patients and 7,815 ambulatory infants were under ophthalmological evaluation. An ocular abnormality was identified in 179 (1.4%) newborns, 33 patients had a syndrome which included ocular problems, 93 had a diabetic mother, 24 were born from addicted mother and 29 of a teen mom. The gestacional age at born range from 24 to 40 weeks. Conclusions: In this study sons of diabetic and addicted mothers seem to present more often congenital ocular malformations.
ABSTRACT
The objective of the present study was to investigate the histopathological alterations and detection of parasites that occur in the eyes of dogs naturally infected with Leishmania chagasi. The eyes of 25 dogs with a positive parasitological and serological exam for L. chagasi were submitted to routine ophthalmic examination. Fragments were obtained from the eyeball and were analyzed by immunohistochemistry and histopathology. Among the structures studied, the conjunctiva of the third eyelid was the tissue most frequently stained for L. chagasi. Histopathological analysis revealed a predominantly mononuclear inflammatory infiltrate whose intensity ranged from discrete to intense in the various ocular structures. Vascular congestion and perivasculitis were also observed. The histopathological alterations that occur in the eyeball of dogs with visceral leishmaniasis might be related to the presence of antibodies.
O objetivo deste trabalho foi estudar as alterações histopatológicas e a detecção do parasito nos olhos de cães naturalmente infectados por Leishmania chagasi. Utilizaram-se os olhos de 25 cães com exame parasitológico e sorológico positivo para Leishmania chagasi. Os animais foram submetidos à semiotécnica oftálmica rotineira. Fragmentos do globo ocular foram coletados e destinados à imunoistoquímica e histopatologia. Entre as estruturas avaliadas, a conjuntiva da terceira pálpebra foi a que mais demonstrou imunomarcação da Leishmania chagasi. Na avaliação histopatológica, foi observado predominantemente infiltrado inflamatório mononuclear, variando de discreto a intenso nas diversas estruturas oculares. Congestão vascular e perivasculite também foram observadas. As alterações histopatológicas do bulbo do olho em cães com leishmaniose visceral podem estar relacionadas à presença do anticorpo.
ABSTRACT
Constant exotropia is uncommon during the first year of life.We investigated characteristics, surgical outcome and associated ocular abnormalities in patients who had an exodeviation during the first year of life. The charts of 18 patients who were diagnosed as congenital exotropia before 1 year old were reviewed.We etrospectively analyzed 10 healthy patients who did not have associated systemic or ocular abnormalities and were followed for at least 3 months after surgery. The mean follow-up period was 1.2 years[range, 3 months to 3.5 years]and all of them had an exodeviation of 25 prism diopter[PD]or more[mean, 37.5PD, SD 10.6PD].Preoperative DVD and inferior oblique muscle overaction were found in 1 patient respectively. Surgery was performed in 9 cases and botulinum toxin was injected in 1 case.Seven patients[70%]showed stable alignment within 10PD with one operation and one patient required reoperation.Postoperative dissociated vertical deviation and inferior oblique muscle overaction were found in each 1 patients. Congenital exotropia has large deviation and may be associated with inferior oblique muscle overaction or dissociated vertical deviation as infantile esotropia and has stable alignment with single operation.But unlike infan-tile esotropia, nystagmus is extremely rare.
Subject(s)
Humans , Botulinum Toxins , Esotropia , Exotropia , Follow-Up StudiesABSTRACT
The linear nevus sebaceous syndrome is a rare eurocutaneous syndrome that may be accompanied by ocular abnormalities. It consists of the triad of characteristic midline facial linear nevus sebaceous, neurologic abnormalities which may include cerebral and cerebellar hypoplasia, widening of the subarachnoid space, seizures, and mental retardation and ocular abnormalities that may include conjunctival lipodermoids, colobomas of the lids, iris, choroid, and disc, angiomas of the orbit, osseous choristomas of the choroid, and subretinal neovascularization. We experienced a 5 month-old patient who has normal gestational periods and karyotype 46, XY at chromosomal study. On physical examination, he was found to have a linear nevus sebaceous in the right midline of face and scalp. On ocular examination, he was found to have lipodermoid, optic atrophy, peripapillary staphyloma, macular hypogenesis and osseous choristoma of the choroid. CT scan showed widening of the subarachnoid spaces and cerebral and cerebellar hypoplasia. Histopathologically it was proved as nevus sebaceous. We report this unusual case with literature review.
Subject(s)
Humans , Infant , Choristoma , Choroid , Coloboma , Hemangioma , Intellectual Disability , Iris , Karyotype , Nevus , Optic Atrophy , Orbit , Physical Examination , Scalp , Seizures , Subarachnoid Space , Tomography, X-Ray ComputedABSTRACT
Alport's syndrome is a genetic disorder of basement membranes manifested by a progressive nephropathy and sensorineural hearing loss and ocular lesions. Type 4 collagen, main component of basement membranes, is composed of six genetically distinct chains. Mutation of gene COL4A5 which encodes the 5 chain of type IV collagen may prevent the normal incorporation of 3 and 4 into basement membranes. Main clinical features of this syndrome are hematuria, sensorineural hearing loss, ocular abnormalities including lenticonus and cataract. The characteristics of audiological manifestations are bilateral moderate sensorineural hearing loss with recruitment phenomenon and normal latencies of waves in brain stem evoked response audiometry. We recently experienced a case of Alport's syndrome in 10 year old male patient with sensori-neural hearing loss and esophageal achalasia. We report this case with review of literatures.
Subject(s)
Child , Humans , Male , Audiometry, Evoked Response , Basement Membrane , Brain Stem , Cataract , Collagen , Collagen Type IV , Esophageal Achalasia , Hearing Loss , Hearing Loss, Sensorineural , Hematuria , Nephritis, HereditaryABSTRACT
We present a case of systemic lupus erythematosus(SLE) asseci ted with vitiligo in a 57 year-old male patient. Physical examination revealed two distinct skin lesions those of itiligo showed as centrally located depigmented patches surrounded by erythernatous patch on the right cheek, scalp and left dorsurn of hand and those of SLE showed as erythematous papules and patchs with partial adherent scales on the face, scalp, neck, both extensor surface of arm, and left dorsun of hand. Their coexistence lends credence to the contention that altered autoimrnunity may play a role in the pathogenesis of each of these diseases. In Western countries and Japen, patients with lupus erythema osis have been observed to develop vitiligo or depigmented spots on the skin, while in Korea, its has not been previously observed.
Subject(s)
Humans , Male , Middle Aged , Arm , Cheek , Erythema , Hand , Korea , Lupus Erythematosus, Systemic , Neck , Physical Examination , Scalp , Skin , Vitiligo , Weights and MeasuresABSTRACT
A Case of lncontinentia pigmenti. Incontinentia pigmenti is a hereditary disorder of abnormal skin pigmentation with associated ocular, skeletal, and central nervous system abnormalities. Ocular findings are present in up to 35% of cases, but in Korea only two cases have been reported. Recently, the authors have experienced one case of incontinentia pigmenti in a five-day old female patient who manifested both the typical dermatologic findings and ocular abnormalities in the right eye. The fundus showed markedly dilated and tortuous vessels with flat retinal neovascularization, scattered retinal hemorrhage of right macular area. Retinal cryopexy and posterior vitrectomy were performed.