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Arq. bras. oftalmol ; 85(4): 339-343, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383813


ABSTRACT Purpose: To investigate the effect of hemoglobin A1c level on central macular thickness and central, nasal, and temporal choroidal thickness in patients with gestational diabetes mellitus. Methods: This retrospective study included 41 patients who had been diagnosed with gestational diabetes mellitus and undergone a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation. They were divided into two groups based on their hemoglobin A1c level (group 1: hemoglobin A1c <6.0% and group 2: hemoglobin A1c ≥6.0%). All patients underwent a complete ophthalmologic examination. The central macular thickness and central, nasal, and temporal choroidal thickness were measured using optical coherence tomography. Results: Of the 3,016 pregnant women screened, 7.5% (n=228) were diagnosed with gestational diabetes mellitus during the study period and 41 of these patients were included in the study. Group 1 comprised 48 eyes from 24 patients and Group 2 consisted of 34 eyes of 17 patients. The average body mass index values were 30.8 ± 3.3 and 35.1 ± 9.0, respectively (p=0.002). The insulin use rates were 29.2% and 76.5%, respectively (p=0.000). Mean central macular thickness values were 250.8 ± 14.3 µm and 260.9 ± 18.1 µm, respectively, and the difference was significant (p=0.008). Conclusions: Although the body mass index and central macular thickness values were significantly higher in Group 2, there was no difference in the central, nasal, and temporal choroidal thickness between the two groups.

RESUMO Objetivos: Investigar o efeito do nível de hemoglobina A1c (HbA1c) na espessura macular central e na espessura da coróide central, nasal e temporal em pacientes com diabetes mellitus gestacional. Métodos: Este estudo retrospectivo incluiu 82 olhos de 41 pacientes diagnosticadas com diabetes mellitus gestacional, as quais fizeram um teste de tolerância oral à glicose de 75 g entre 24 e 28 semanas de gestação. As pacientes foram divididas em dois grupos de acordo com o nível de hemoglobina A1c (hemoglobina A1c <6,0% e hemoglobina A1c ≥6,0%). Todas as pacientes foram submetidas a exame oftalmológico completo e, a espessura macular central, a espessura central, nasal e temporal da coroide foram mensuradas por tomografia de coerência óptica. Resultados: Durante o período do estudo, das 3.016 gestantes triadas, 7,5% (n=228) foram diagnosticadas com diabetes mellitus gestacional. Destas, 41 pacientes foram analisadas de acordo com os critérios do estudo. Houve 48 olhos de 24 pacientes no primeiro grupo com hemoglobina A1c <6,0% e 34 olhos de 17 pacientes no segundo grupo com hemoglobina A1c ≥6,0%. Os valores médios do índice de massa corporal foram de 30,8 ± 3,3 e 35,1 ± 9,0, respectivamente (p=0,002). As taxas referentes ao uso de insulina foram de 29,2% e 76,5%, respectivamente (p=0,000). Os valores médios da espessura macular central foram medidos em 250,8 ± 14,3 µm e 260,9 ± 18,1 µm, respectivamente e a diferença foi significativa entre os dois grupos (p=0,008). Conclusões: Embora os valores do índice de massa corporal e da espessura macular central tenham sido significativamente maiores no Grupo 2 com hemoglobina A1c alta, não houve diferenças nas medidas de espessura coroidal central, nasal e temporal entre os dois grupos.

International Eye Science ; (12): 693-697, 2022.
Article in Chinese | WPRIM | ID: wpr-922995


@#AIM: To investigate the pathogenic mutations of the <i>OAT</i> gene in a Chinese family affected with gyrate atrophy of choroid and retina(GA)and describe their clinical manifestations.METHODS: All available family members have underwent detailed ophthalmological examinations. The sequencing results and pathogenic mutations were clarified by whole exome sequencing, bioinformatics analysis and Sanger sequencing.RESULTS: Based on the clinical manifestations and symptoms, the proband was diagnosed with GA. A missense mutation of c.722C>T(p.P241L)in exon 6 and a nonsense mutation of c.1186C>T(p.R396X)in exon 10 were identified in the <i>OAT</i> gene of the proband, which was a compound heterozygotic mutation. This compound heterozygous mutation showed co-segregation in the family. The heterozygous pathogenic variant of p.R396X was detected in both the proband's father and elder brother, and the heterozygous pathogenic variant of p.P241L was detected in proband's mother. Except for the proband, no other family members have abnormal clinical manifestations.CONCLUSION: The proband of this family is a compound heterozygous mutation, in which p.P241L is the first reported gene mutation type. This result expands the range of <i>OAT</i> gene variation and is conducive to further understanding the pathogenic factors of GA at the molecular basis level. The discovery and confirmation of the novel mutation type will also help to provide a new basis for the clinical diagnosis and gene therapy of GA.

International Eye Science ; (12): 973-976, 2022.
Article in Chinese | WPRIM | ID: wpr-924216


@#Migraine is acommon chronic neurovascular disorder, its pathophysiological mechanisms are not fully understood. There are various clinical phenotypes of migraine, among which visual migraine may present as visual aura. Retinal migraine and ophthalmoplegic migraine also belong to the category of visual migraine. Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)can be used to detect the circulation of retinal nerve fiber layer, ganglion cell layer, optic papilla, retina and choroid qualitatively and quantitatively. Based on above two imaging findings, studies have addressed that during visual migraine pathogenesis, the transitory and recurrent constriction of the retinal and ciliary arteries, which may cause ischemic damage to the optic nerve, retina and choroid in patients with migraine, with the subsequent reduction in thickness of retinal nerve fiber layer, ganglion cell layer, and retinal microvasculature decrement. The fundus imaging examinations are helpful to improve our understanding on pathophysiological mechanisms of visual migraine, these imaging findings based on OCT and OCTA may serve as indicators to evaluate course and severity of visual migraine.

Rev. bras. oftalmol ; 81: e0030, 2022. graf
Article in Portuguese | LILACS | ID: biblio-1376783


RESUMO O hemangioma de coroide é um tumor vascular benigno, de coloração vermelho-alaranjada, bem delimitado, caracterizado por uma placa elevada. É um tumor raro, com prevalência de um caso a cada 40 tumores de coroide. O diagnóstico pode ser feito por meio da clínica associada à avaliação biomicroscópica e a exames complementares para diferenciação de outros tumores. O tratamento pode ser expectante nos casos assintomáticos. Para os casos sintomáticos ou com presença de fluido sub-retiniano, existem diversas terapias. O objetivo deste estudo foi relatar um caso de hemangioma circunscrito de coroide submetido a tratamento combinado de terapia fotodinâmica com verteporfina e injeção intravítrea de antiangiogênico (bevacizumabe). A decisão de tratar um hemangioma de coroide deve ser individualizada com base nos sintomas, na perda visual e em qualquer potencial de sua recuperação. O exame oftalmológico completo é necessário, mesmo em casos assintomáticos, para rastreamento precoce de doenças oculares.

ABSTRACT Choroid hemangioma is a benign, well-delimited orange-red, vascular tumor characterized by an elevated plaque. It is a rare tumor with a prevalence of one case in every 40 choroidal tumors. It can be diagnosed by the clinic associated with biomicroscopic evaluation and complementary tests to differentiate from other tumors. Treatment can be expectant in asymptomatic cases. For symptomatic cases or those with the presence of subretinal fluid, there are several therapies. The objective of this study was to report a case of circumscribed choroidal hemangioma submitted to combined treatment of photodynamic therapy with verteporfin and intravitreal injection of an antiangiogenic agent (bevacizumab). The decision to treat choroidal hemangioma must be individualized based on symptoms, visual loss, and any potential for recovery. A complete eye examination is necessary, even in asymptomatic cases, for early screening for eye diseases.

Humans , Male , Middle Aged , Photochemotherapy/methods , Choroid Neoplasms/diagnosis , Choroid Neoplasms/therapy , Tomography, Optical Coherence , Bevacizumab/therapeutic use , Verteporfin/therapeutic use , Hemangioma/diagnosis , Hemangioma/therapy , Fluorescein Angiography , Choroid Neoplasms/pathology , Ultrasonography , Angiogenesis Inhibitors/therapeutic use , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Drug Therapy, Combination , Hemangioma/pathology
Arq. bras. oftalmol ; 84(5): 467-473, Sept.-Oct. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1339219


ABSTRACT Purpose: To comparatively evaluate the subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness in patients with chronic heart failure relative to control subjects. Methods: A total of 72 chronic heart failure patients and 40 healthy control subjects were enrolled in this study. The patients were categorized into 2 groups: group 1: patients with 30-50% left ventricle ejection fraction and group 2: patients with the corresponding fraction value of <30%. The subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness were measured by spectral domain-optical coherence tomography. Results: The mean subfoveal choroidal thickness was 250.24 ± 68.34 µm in group 1 and 216.72 ± 71.24 µm in group 2, while it was 273.64 ± 77.68 µm in the control group. The differences among the 3 groups were statistically significant. The average peripapillary retinal nerve fiber layer thicknesses were 100.34 ± 8.24, 95.44 ± 6.67, and 102.34 ± 8.24 µm, respectively. No significant differences were noted in the peripapillary retinal nerve fiber layer thicknesses between group 1 and control group, but it was significantly lower in group 2. Conclusion: Our study thus revealed that the subfoveal choroidal thickness was lower in patients belonging to both the chronic heart failure groups in comparison to those in the control group. However, the alteration in the peripapillary retinal nerve fiber layer thickness was noted in only patients with <30% left ventricle ejection fraction. In the clinical practice, reductions in these values are correlated with decreased left ventricle ejection fraction, which may be important for the follow-up of chorioretinal diseases and the evaluation of glaucoma risks in patients with chronic heart failures.

RESUMO Objetivo: O objetivo do nosso estudo foi avaliar a espessura coroidal subfoveal e a camada peripapilar de fibras nervosas da retina em pacientes com insuficiência cardíaca crônica, em comparação com um grupo de controle. Métodos: Setenta e dois pacientes com insuficiência cardíaca crônica e 40 controles saudáveis foram inscritos. Os pacientes com insuficiência cardíaca crônica foram divididos em dois grupos, de acordo com a fração de ejeção do ventrículo esquerdo. Pacientes com fração de ejeção do ventrículo esquerdo de 30-50% foram incluídos no grupo 1, enquanto valores de fração de ejeção do ventrículo esquerdo inferiores a 30% foram incluídos no grupo 2. A espessura coroidal subfoveal e a espessura da camada peripapilar de fibras nervosas da retina foram medidas por tomografia de coerência óptica de domínio espectral. Resultados: A espessura média da coroide subfoveal foi de 250,24 ± 68,34 µm no grupo 1, 216,72 ± 71,24 µm no grupo 2 e 273,64 ± 77,68 µm no grupo controle. As diferenças entre os três grupos foram estatisticamente significativas. A espessura média da camada peripapilar de fibras nervosas da retina foi de 100,34 ± 8,24 µm, 95,44 ± 6,67 µm e 102,34 ± 8,24 µm, respectivamente. Não houve diferença significativa na espessura da camada peripapilar de fibras nervosas da retina entre o grupo 1 e o grupo controle, mas os valores foram significativamente menores no grupo 2. Conclusão: Nosso estudo mostrou que a espessura coroidal subfoveal foi menor em ambos os grupos de insuficiência cardíaca crônica, em comparação com controles saudáveis. Porém, a camada peripapilar de fibras nervosas da retina mostrou-se alterada apenas em pacientes com menos de 30% da fração de ejeção do ventrículo esquerdo. Na prática clínica, reduções nesses valores, correlacionadas com a diminuição da fração de ejeção do ventrículo esquerdo, podem ser importantes para o acompanhamento de doenças coriorretinianas e a avaliação dos riscos de glaucoma em pacientes com insuficiência cardíaca crônica.

Arq. bras. oftalmol ; 84(4): 387-390, July-Aug. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1285294


ABSTRACT A 39-year-old policeman complained of decreased bilateral central vision over the last two years. On examination, visual acuity was 20/40 and 20/400 in the right (OD) and left eye (OS), respectively, and fundoscopy revealed a bilateral hypopigmented macular lesion. Fluorescein and indocyanine green angiography demonstrated leakage and hyperintense spots, respectively, within the macular areas. At baseline, optical coherence tomography showed subretinal fluid in the OD and a conforming focal choroidal excavation in the OS. Focal choroidal excavation converted from conforming to nonconforming type at 4-month follow-up and then reversed to conforming type at 12-month follow-up, and was associated with incomplete retinal pigment epithelium and outer retina atrophy over the area of excavation. Pachyvessels were also evidenced in the choroid, without neovascularization. We report for the first time a case of focal choroidal excavation that progressed from conforming to nonconforming type and then reverted to its primary configuration (conforming type) in a patient with concurrent bilateral central serous chorioretinopathy.

RESUMO Um policial de 39 anos se queixava de diminuição bilateral da visão central nos últimos 2 anos. A acuidade visual era 20/40 e 20/400 no olho direito (OD) e esquerdo (OE) e a fundoscopia revelou lesão macular hipopigmentada bilateral. A angiografia fluoresceínica e com indocianina verde revelaram, respectivamente, vazamento do corante e áreas hiperintensas nas regiões maculares. A tomografia de coerência óptica evi denciou fluido sub-retiniano no OD e escavação focal de coroide do tipo conformacional no OE. Após 4 meses, a escavação focal de coroide mudou de conformacional para não conformacional e, aos 12 meses, reverteu para conformacional associado a atrofia incompleta do epitélio pigmentar da retina e da retina externa na região da escavação. Também foi evidenciado paquicoroide, sem neovascularização. Relatamos pela primeira vez uma escavação focal de coroide que evoluiu de conformacional para não conformacional e, em seguida, retornou à configuração primária (conformacional) em um paciente com coriorretinopatia serosa central bilateral.

Arq. bras. oftalmol ; 84(2): 107-112, Mar,-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1153113


ABSTRACT Purpose: To investigate the effects of pharmacological accommodation and cycloplegia on ocular measurements. Methods: Thirty-three healthy subjects [mean (±SD) age, 32.97 (±5.21) years] volunteered to participate in the study. Measurement of the axial length, macular and choroidal thickness, refractive error, and corneal topography, as well as anterior segment imaging, were performed. After these procedures, pharmacological accommodation was induced by applying pilocarpine eye drops (pilocarpine hydrochloride 2%), and the measurements were repeated. The measurements were repeated again after full cycloplegia was induced using cyclopentolate eye drops (cyclopentolate hydrochloride 1%). The correlations between the measurements were evaluated. Results: A significant increase in subfoveal choroidal thickness after applying 2% pilocarpine was identified (without the drops, 319.36 ± 90.08 µm; with pilocarpine instillation, 341.60 ± 99.19 µm; with cyclopentolate instillation, 318.36 ± 103.0 µm; p<0.001). A significant increase in the axial length was also detected (without the drops, 23.26 ± 0.83 mm; with pilocarpine instillation, 23.29 ± 0.84 mm; with cyclopentolate instillation, 23.27 ± 0.84 mm; p=0.003). Comparing pharmacological accommodation and cycloplegia revealed a significant difference in central macular thickness (with pilocarpine instillation, 262.27 ± 19.34 µm; with cyclopentolate instillation, 265.93 ± 17.91 µm; p=0.016). Pilocarpine-related miosis (p<0.001) and myopic shift (p<0.001) were more severe in blue eyes vs. brown eyes. Conclusion: Pharmacological accommodation may change ocular measurements, such as choroidal thickness and axial length. This condition should be considered when performing ocular measurements, such as intraocular lens power calculations.(AU)

RESUMO Objetivo: Investigar os efeitos da acomodação farmacológica e da cicloplegia nas medições oculares. Métodos: participaram do estudo 33 voluntários saudáveis (média de idade [± DP], 32,97 anos [± 5,21 anos]). Foram medidos o comprimento axial, a espessura macular e coroidal e o erro refrativo, bem como realizados exames de imagem da topografia corneana e do segmento anterior. Em seguida, foi induzida a acomodação farmacológica aplicando-se colírio de pilocarpina (cloridrato de pilocarpina a 2%) e as medições foram repetidas nos participantes. As mesmas medições foram repetidas depois de induzir a cicloplegia completa com colírio de ciclopentolato (cloridrato de ciclopentolato a 1%) e foram avaliadas as correlações entre as medidas. Resultados: Identificou-se aumento significativo da espessura coroidal subfoveal com o uso da pilocarpina a 2% (sem colírio, 319,36 ± 90,08 µm; com a instilação de pilocarpina, 341,60 ± 99,19 µm; com a instilação de ciclopentolato, 318,36 ± 103,0 µm; p<0,001). Detectou-se também aumento significativo do comprimento axial (sem colírio, 23,26 ± 0,83 mm; com a instilação de pilocarpina, 23,29 ± 0,84 mm; com a instilação de ciclopentolato, 23,27 ± 0,84 mm; p=0,003). Ao se comparar a acomodação farmacológica e a cicloplegia, houve diferença significativa na espessura macular central (com a instilação de pilocarpina, 262,27 ± 19,34 µm; com a instilação de ciclopentolato, 265,93 ± 17,91 µm; p=0,016). Observou-se que a miose associada à pilocarpina (p<0,001) e o desvio miópico (p<0,001) foram mais severos nos olhos azuis que nos castanhos. Conclusão: A acomodação farmacológica pode alterar medidas oculares como a espessura da coroide e o comprimento axial. Essa possibilidade deve ser levada em consideração ao se efetuarem medições oculares, tais como cálculos de potência de lentes intraoculares.(AU)

Humans , Choroid/anatomy & histology , Accommodation, Ocular , Pilocarpine/pharmacology , Corneal Topography/instrumentation , Axial Length, Eye/anatomy & histology , Mydriatics/pharmacology
Int. j. morphol ; 39(1)feb. 2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1385307


SUMMARY: Pineal gland calcification is the most common physiological intracranial calcification followed by the choroid plexus calcification. The objective of the study was to determine the prevalence of the pineal gland and choroid plexus calcification among the Iraqi population attending computed tomography scan units in Baghdad, estimate the mean diameters of the pineal gland calcification, and to detect any correlation between these calcifications with age and sex. This multi-centric cross-sectional study examined 485 CT scans of Iraqi patients between the ages of 1 and 100 years attending CT scan units in the period 1 December 2018 to 1 April 2019. Descriptive and inferential statistics were used. The prevalence of pineal gland calcification was found to be 68 % with the 30-39 age group and male sex predominance. It was found to increase after the first decade of life without real consistency. The mean for pineal gland calcification anterior-posterior diameter was 4.55±2.13 and the mean of the right-left diameter was 3.95±1.54. These diameters were found to differ according to sex and age. Choroid plexus calcification was found to have a prevalence of 53.6 %. In most cases, choroid plexus calcification was found bilaterally (77.3 %). There was no difference in sex, but choroid plexus. In conclusion, calcification was noticed to increase gradually according to age. Both pineal gland and choroid plexus calcification have a relatively high prevalence. While pineal gland calcification formation was demonstrated to have a close relation to age and sex, choroid plexus calcification formation was noticed to relate only to age.

RESUMEN: La calcificación de la glándula pineal es la calcificación intracraneal fisiológica más común después de la calcificación del plexo coroideo. El objetivo del estudio fue determinar la prevalencia de calcificación de la glándula pineal y del plexo coroideo entre la población iraquí que asiste a las unidades de tomografía computarizada en Bagdad, estimar los diámetros medios de la calcificación de la glándula pineal y detectar la posible correlación entre estas calcificaciones con la edad y el sexo. Este estudio transversal multicéntrico examinó 485 tomografías computarizadas de pacientes iraquíes entre 1 y 100 años de edad que asistieron a unidades de tomografía computarizada en el período del 1 de diciembre de 2018 al 1 de abril de 2019. Se utilizaron estadísticas descriptivas e inferenciales. Se encontró una prevalencia de calcificación de la glándula pineal del 68 % con predominio del sexo masculino en el grupo de 30 a 39 años. Se observó que aumentaba después de la primera década de vida sin una coherencia real. La media del diámetro anteroposterior de la calcificación de la glándula pineal fue de 4,55 ± 2,13 y la media del DIÁ- METRO derecho-izquierdo fue de 3,95 ± 1,54; estos diámetros difieren según el sexo y la edad. La calcificación del plexo coroideo tiene una prevalencia del 53,6 %. En la mayoría de los casos, la calcificación del plexo coroideo se encontró de forma bilateral (77,3%). No hubo diferencia de sexo, no obstante en el plexo coroideo se observó que la calcificación aumentaba gradualmente según la edad. Tanto la calcificación de la glándula pineal como del plexo coroideo tienen una prevalencia relativamente alta. Si bien se demostró que la formación de calcificación de la glándula pineal está relacionada con la edad y el sexo, se observó que la formación de calcificación del plexo coroideo se relaciona solo con la edad.

Arq. bras. oftalmol ; 84(1): 2-10, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153103


ABSTRACT Purpose: The aim of the study is to evaluate the retinal and choroidal microvascular changes via optical coherence tomography angiography in patients who received hydroxy­chloroquine. Methods: In total, 28 eyes of 28 patients (24 females, and 4 males) receiving treatment with hydroxy­chloroquine were assessed in this cross-sectional cohort study (hydroxychloroquine group). The high-and low-risk groups consisted of patients receiving hydroxychloroquine for ≥5 years (14 eyes of 28 patients) and <5 years (14 eyes of 28 patients), respectively. A total of 28 age- and gender-matched volunteers were enrolled as the control group. The macular flow area (superficial, deep, and choriocapillaris), superficial and deep vessel density, foveal avascular zone area, central foveal thickness, and subfoveal choroidal thickness parameters were measured by optical coherence tomography angiography. Results: The mean age of the 28 patients who received hydroxychloroquine and the 28 age-matched controls was 45.5 ± 11.1 years (range: 29-70 years) and 44.5 ± 13.9 years (range: 28-70 years), respectively. In patients who received hydroxychloroquine, the values for the superficial, deep, and choriocapillaris macular flow areas were 13.578 ± 0.30, 13.196 ± 0.31, and 17.617 ± 0.42, respectively. In controls, these values were 16.407 ± 0.95, 13.857 ± 0.31, and 18.975 ± 0.76, respectively (p<0.05 for all). The superficial, deep, and cho­riocapillaris flow areas were significantly smaller in patients who received hydroxychloroquine than those in controls (p<0.05 for all). Superficial and deep vessel densities were significantly reduced in patients who received hydroxychlo­roquine in all regions (i.e., foveal, parafoveal, temporal, superior, nasal, and inferior) (p<0.05 for all). Moreover, significant difference was observed between the groups in the foveal avascular zone area (superficial and deep), central foveal thickness, and subfoveal choroidal thickness (p<0.05 for all). Conclusions: Retinochoroidal microvascular flow and vessel density of the macular area were significantly decreased in patients who received hydroxychloroquine. Hy­droxychloroquine may damage the retinochoroidal mi­cro­vascular architecture. Optical coherence tomography angiography may contribute to the early detection of hy­dro­xychloroquine-induced retinal toxicity.

RESUMO Objetivo: O objetivo do estudo foi de avaliar as alterações microvasculares da retina e da coroide em pacientes sob hidroxicloroquina, através da angiografia por tomografia de coerência óptica. Métodos: Este é um estudo transversal de coorte que avaliou um total de 28 olhos de 28 pacientes (24 mulheres e 4 homens) submetidos a tratamento com hidroxicloroquina (grupo da hidroxicloroquina). Catorze olhos de 28 pacientes em uso de hidroxicloroquina por mais de 5 anos foram definidos como sendo o grupo de alto risco, ao passo que o grupo de baixo risco consistiu em 14 olhos de 28 pacientes em uso de hidroxicloroquina por menos de 5 anos. Foram ainda incluídos 28 voluntários como grupo de controle, pareados por idade e sexo. Através de angiografia por tomografia de coerência óptica, foram medidos os seguintes parâmetros: área do fluxo macular (superficial, profundo e coriocapilar), densi­dade vascular superficial e profunda, área da zona avascular foveal e espessura da coroide subfoveal. Resultados: Foram recrutados para o estudo um total de 28 pacientes sob tratamento com hidroxicloroquina, com idade média de 45,5 ± 11,1 (29-70) anos, e 28 membros do grupo de controle, pareados por idade e sexo, com idade média de 44,5 ± 13,9 (28-70) anos. As áreas superficial, profunda e coriocapilar do fluxo macular foram respectivamente de 13,578 ± 0,30, 13,196 ± 0,31 e 17,617 ± 0,42 nos pacientes em tratamento com hidroxicloroquina e, respectivamente de 16,407 ± 0,95, 13,857 ± 0,31 e 18,975 ± 0,76 no grupo de controle (p<0,05 para todos os valores). As três medições de área do fluxo macular foram significativamente menores nos pacientes em uso de hidroxicloroquina em comparação com os indivíduos do grupo de controle (p<0,05 para todos os valores). As densidades vasculares superficial e profunda mostraram-se significativamente reduzidas em todas as regiões (foveal, parafoveal, temporal, superior, nasal e inferior) nos pacientes em uso de hidroxicloroquina (p<0,05 para todos os valores). Finalmente, também foi observada uma diferença significativa entre os grupos em relação à área da zona avascular foveal (superficial e profunda), à espessura foveal central e à espessura da coroide subfoveal (p<0,05 para todos os valores). Conclusão: O fluxo microvascular retinocoroidal e a densidade vascular da área macular mostraram-se significativamente diminuídos nos pacientes sob hidroxicloroquina. Este fármaco pode danificar a arquitetura microvascular retinocoroidal e a angiografia por tomografia de coerência óptica pode contribuir para a detecção precoce da toxicidade retiniana induzida pela hidroxicloroquina.

Humans , Adult , Middle Aged , Aged , Tomography, Optical Coherence , Hydroxychloroquine , Retinal Vessels/diagnostic imaging , Fluorescein Angiography , Visual Acuity , Cross-Sectional Studies , Choroid/diagnostic imaging , Hydroxychloroquine/adverse effects
Article in English | WPRIM | ID: wpr-922760


Danshen-Chuanxiongqin Injection (DCI) is a commonly used traditional Chinese medicine for the treatment of cerebral ischemic stroke in China. However, its underlying mechanisms remain completely understood. The current study was designed to explore the protective mechanisms of DCI against cerebral ischemic stroke through integrating whole-transcriptome sequencing coupled with network pharmacology analysis. First, using a mouse model of cerebral ischemic stroke by transient middle cerebral artery occlusion (tMCAO), we found that DCI (4.10 mL·kg

Brain Ischemia/genetics , Drugs, Chinese Herbal , Humans , Infarction, Middle Cerebral Artery/genetics , Ischemic Stroke , Myeloid Differentiation Factor 88/genetics , NF-kappa B/metabolism , Stroke/genetics , Toll-Like Receptor 2 , Toll-Like Receptor 4/metabolism
International Eye Science ; (12): 1773-1777, 2021.
Article in Chinese | WPRIM | ID: wpr-886722


@#AIM: To use spectral domain optical coherence tomography(SD-OCT)to measure macular subfoveal choroid thickness(SFCT)in patients with diabetic retinopathy(DR), observe the changes of SFCT, and to explore the relationship between SFCT and diabetes mellitus and diabetes retinopathy.<p>METHODS: A total of 152 patients with type 2 diabetes(T2DM)were collected and grouped according to their fundus conditions. There were 72 cases in the NDR group and 80 cases in the DR group. Eighty-five healthy subjects were used as the control group. Follow-up according to the clinical stage of DR, where the DR components were mild NPDR, moderate NPDR, severe NPDR and PDR. According to the United Nations World Health Organization, the age group was divided into three age groups: 18-44 years old(youth group), 45-59 years old(middle-aged group), and 60-75 years old(old group). Analyzed and compared the SFCT between each group.<p>RESULTS:There was no statistically significant difference in SFCT between the T2DM group and the control group(<i>P</i>>0.05). The SFCT of the all group was not significantly correlated with age and course of disease(<i>P</i>>0.05); the SFCT of the control group was negatively correlated with age(<i>P</i><0.05), and the SFCT of the elderly group was thinner than that of the middle-aged group and the young group(<i>P</i><0.05). There was no significant difference between young and middle-aged(<i>P</i>>0.05). The SFCT of the T2DM group was thinner than the control group(<i>P</i><0.001), and the SFCT of the NDR group and the DR group were thinner than the control group(<i>P</i><0.001); the difference in SFCT between DR staging was statistically significant(<i>P</i><0.001).<p>CONCLUSION: Age is a related factor that affects SFCT. Diabetic SFCT becomes thinner than normal people, and SFCT thickens with the severity of DR lesions.

International Eye Science ; (12): 1557-1560, 2021.
Article in Chinese | WPRIM | ID: wpr-886435


@#Rheumatic immune disease, as a group of recurrent systemic diseases, involves the vascular system through inflammatory factors. Eye reaction can be used as a sign of rheumatic immune reactivation or disease aggravation, together with the first systemic manifestation of rheumatic immune disease. As a part of the most abundant blood flow in the eyes, choroid is an excellent evaluation index for ocular involvement, and it is greatly affected by systemic vascular diseases. And optical coherence tomography provides a scientific and accurate measuring tool for the observation of choroid thickness. However, whether changes in choroid thickness can be utilized as markers of disease activity, and progression, our results require further research. In this paper, the changes of choroid thickness in rheumatic immune diseases are analyzed.

International Eye Science ; (12): 1068-1071, 2021.
Article in Chinese | WPRIM | ID: wpr-876757


@#AIM: To explore the effect of intravitreal conbercept in the treatment of chorionic neovascularization(CNV)of macular macula with high myopia. <p>METHODS: Totally 56 patients with high myopia caused by macular angiogenesis in our hospital were retrospectively selected as the research objects from June 2015 to December 2019. According to the treatment methods, patients were divided into the control group and the observation group. The 28 cases(28 eyes)of patients in the control group were treated with the intravitreous injection of Rayzumab, and 28 cases(28 eyes)of patients in the observation group were treated with intravitreal injection of conbercept. After the last treatment, the patients were followed up for 3mo to record the intraocular pressure, the best corrected visual acuity(BCVA)and the incidence of complications. Optical coherence tomography(OCT)was used to measure the thickness of macular fovea retinal(CMT), and horizontal linear scanning of OCT instrument was used to measure the CNV area.<p>RESULTS:After treatment, the visual acuity of patients in the observation group gradually increased, and the improvement of BCVA was significantly higher than that of the control group at the same time point(<i>P</i><0.05). After 3mo of treatment, it showed that IOP, CNV area and CMT in the observation group were significantly reduced after the combined treatment, and the improvement was better than that in the control group(<i>P</i><0.05). The incidence of complications in the observation group(4%)was significantly lower than that in the control group(18%).<p>CONCLUSION:The treatment of intravitreal conbercept injection for the high myopia CNV was superior to lucentis, which could improve clinical efficacy by increasing BCVA, reducing CMT thickness, improving vision and reducing postoperative complications.

International Eye Science ; (12): 2086-2089, 2021.
Article in Chinese | WPRIM | ID: wpr-904679


@#Amblyopia is a common eye disease in children. If not corrected and treated in time, it will cause irreversible damage to children's vision, resulting in loss of vision in one or both eyes. The pathogenesis of amblyopia is complex, and the specific pathogenesis is not clear at present, mainly focusing on the central theory and peripheral theory. Traditionally, there was no obvious organic change in the fundus of amblyopia patients. In recent years, optical coherence tomography(OCT)technology has developed rapidly. As a convenient and intuitive ophthalmic examination method, OCT has been increasingly used in retinal examination of amblyopia patients due to its advantages of safety, non-invasive, non-contact and rapid and clear. The abnormal anatomy structures of the amblyopia patients in fundus structure are also gradually been found. Providing some evidence and basis for peripheral theory of pathogenesis of amblyopia, amblyopia examine, postoperative evaluation and prognosis. In this article, the applications of OCT in retinal thickness, choroid thickness and vessel density are reviewed.

International Eye Science ; (12): 2066-2071, 2021.
Article in Chinese | WPRIM | ID: wpr-904675


@#AIM: To analyze the effects of vitrectomy and macular epiretinal membrane dissection combined with or without internal limiting membrane(ILM)peeling on choroid thickness, vision and metamorphopsia in patients with idiopathic macular epiretinal membrane(IMEM).<p>METHODS: Totally 88 patients(88 eyes)with IMEM admitted to the hospital were selected between January 2016 and January 2020. They were divided into group A and group B by random number table method with 44 eyes in each group. Patients in group A were treated with vitrectomy and macular epiretinal membrane dissection combined with ILM peeling, while patients in group B were treated with vitrectomy and macular epiretinal membrane dissection. The choroid thickness, vision, metamorphopsia, central macular thickness(CMT), ellipsoid zone(EZ)continuity were compared between the two groups.<p>RESULTS: Compared with preoperative, the sub-foveal choroidal thickness(SFCT), choroidal thickness 1 000μm from nasal side central of fovea(NFCT)and choroidal thickness 1 000μm from temporal side central of fovea(TFCT)were significantly reduced in the two groups at 3mo and 6mo after operation(<i>P</i><0.05), but there was no statistically significant difference between the groups(<i>P</i>>0.5). Compared with preoperative, the best corrected visual acuity(BCVA)LogMAR was reduced, while mean sensitivity(MS)was increased in the two groups. The number of scotoma points(SP)increased in group A and decreased in group B. Group A had significantly lower MS and higher SP than group B at 1mo, 3mo, and 6mo after operation(<i>P</i><0.05). Compared with preoperative, the M scores(Angle of view when horizontal and vertical variability begins to disappear)and average M scores of the two groups were significantly reduced at 3mo and 6mo after operation, without statistically significant differences between the groups(<i>P</i>>0.05). Compared with preoperative, CMT was significantly reduced in the two groups at 1, 3 and 6mo after operation. The ratio of EZ continuity in group A at 1mo after operation was significantly lower than that before operation. The CMT of group A was larger than that of group B at 3mo and 6mo after operation(<i>P</i><0.05). No statistically significant differences were found in the ratio of EZ continuity and the incidence of complications between the groups(<i>P</i>>0.05).<p>CONCLUSION: Vitrectomy and macular epiretinal membrane dissection combined with or without ILM peeling both can improve vision and metamorphopsia in patients with IMEM, with similar effects on choroid thickness and safety. However, combined use of ILM peeling will lower MS and increase SP as well as CMT. Therefore, it has no significant advantages in the treatment of patients with IMEM.

Article in Chinese | WPRIM | ID: wpr-912371


Objective:To evaluate the changes in subfoveal choroidal thickness (SFCT) in amblyopic eyes.Methods:A evidence-based medicine study. Chinese and English as search terms for amblyopia and choroid was used to search literature in Wanfang, CNKI, and PubMed of National Library of Medicine. Incomplete or irrelevant literature and review literature were excluded. The literature was meta-analyzed using STATA 15.0. The weighted mean difference (WMD) and 95% confidence interval ( CI) were selected as the estimated value of effect size, and subgroup analysis and sensitivity analysis were used to detect the source of heterogeneity. Results:According to the search strategy, 75 articles were initially retrieved, and 15 articles were finally included for meta-analysis. A total of 650 patients with amblyopia, aged 3 to 65 years old, were included. The enhanced depth imaging technology of spectral domain optical coherence tomography was used to measure SFCT. The results of meta analysis showed that SFCT of amblyopic eyes was more effective than the contralateral eye (WMD=18.89 μm, 95% CI 14.81-22.98 μm, P<0.001) and normal eyes were thicken (WMD=39.49 μm, 95% CI 33.88-45.09 μm, P<0.001). There was no statistically significant difference in SFCT between anisometropic and strabismic amblyopia eyes (WMD=-5.03 μm, 95% CI -19.50-9.44 μm, P=0.495). Conclusions:The SFCT of amblyopic eyes in amblyopic patients is thicker than that of the contralateral eye and normal eyes. There is no difference in SFCT between anisometropia and strabismus amblyopia.

Article in Chinese | WPRIM | ID: wpr-912356


Objective:To observe the optical coherence tomography angiography (OCTA) image characteristics of polypoid choroidal vascular disease (PCV) after intravitreal injection of anti-vascular endothelial growth factor drugs, and to discuss its significance in the diagnosis and follow-up of PCV.Methods:A retrospective case study. From August 2018 to January 2020, 22 eyes of 22 patients with PCV diagnosed in the ophthalmological examination of Affiliated Hospital of Weifang Medical University were included in the study. Among them, there were 10 males with 10 eyes and 12 females with 12 eyes; the average age was 67.75±9.53 years. Best corrected visual acuity (BCVA), OCTA, and indocyanine green angiography (ICGA) were performed. All the affected eyes were injected vitreously with 10 mg/ml Conbercept 0.05 ml (including Conbercept 0.5 mg) once a month for 3 consecutive months.Tthe macular area of 3 mm×3 mm and 6 mm×6 mm with an OCTA instrument was scanned, and the foveal retinal thickness (CRT) was measured, the area of abnormal branch blood vessels (BVN). pigment epithelial detachment before and 12 months after treatment (PED) height, foveal choroid thickness (SFCT) were performed. The diagnosis rate of PCV by OCTA was observed, as well as the changes of various indicators of BCVA and OCTA. Before and after treatment, BCVA and CRT were compared by paired t test; BVN area, PED height, and SFCT were compared by variance analysis. The changes in imaging characteristics of OCTA before and after treatment were analyzed. Results:Among the 22 eyes, 8 eyes were BVN; 5 eyes were polypoid lesions (polyps); 5 eyes were BVN combined with polyps; 3 eyes were not found with BVN and polyps; 1 eye with small vascular network structure, this eye was ICGA Appears as strong nodular fluorescence (polyps). The detection rate of PCV by OCTA was 86.36% (19/22). Twelve months after treatment, BVN was significantly reduced or disappeared in 16 eyes (72.72%, 16/22); polyps disappeared in 17 eyes (77.27%, 17/22). Compared with before treatment, 12 months after treatment, BCVA increased ( t=3.071), CRT decreased ( t=2.440), the difference was statistically significant ( P<0.05); the average BVN area, PED height, and SFCT decreased. The difference in average BVN area and PED height was statistically significant ( F=2.805, 3.916; P<0.05), and the difference in SFCT was not statistically significant ( F=0.047, P>0.05). Conclusions:The detection rate of PCV by OCTA is 86.36%. After PCV anti-vascular endothelial growth factor drug treatment, BVN area decrease and polyps subside. OCTA is an effective means for PCV diagnosis and follow-up after anti-VEGF drug treatment.

Rev. bras. oftalmol ; 80(4): e0017, 2021. graf
Article in English | LILACS | ID: biblio-1288630


ABSTRACT Choroidal tuberculomas are present in patients with ocular tuberculosis. They usually occur in a patient with previous history of tuberculosis, and are rarely the initial presentation, with no prior systemic manifestations. We present a patient with unilateral choroidal tuberculoma as the initial presentation of presumed ocular tuberculosis, which enabled earlier initiation of treatment.

RESUMO Os tuberculomas de coroide apresentam-se em pacientes com tuberculose ocular. Geralmente, ocorrem em indivíduos com história prévia de tuberculose e raramente têm apresentação inicial sem manifestações sistêmicas anteriores. Relatamos o caso de um paciente com tuberculoma de coroide unilateral com apresentação inicial de tuberculose ocular presumida, permitindo o início mais precoce do tratamento.

Humans , Female , Adult , Tuberculoma/diagnosis , Choroid Diseases/diagnosis , Tuberculoma/drug therapy , Fluorescein Angiography , Choroid Diseases/drug therapy , Uveitis, Posterior/diagnosis , Tuberculosis, Ocular , Choroid/diagnostic imaging , Fundus Oculi , Antitubercular Agents/therapeutic use
Int. j. morphol ; 38(6): 1577-1579, Dec. 2020. graf
Article in Spanish | LILACS | ID: biblio-1134481


RESUMEN: El plexo coroideo es una estructura del sistema nervioso central vinculada con la producción de parte del líquido cerebroespinal. Su conocimiento deriva de los tiempos de Herophilus de Calcedonia a quien se atribuye su nombre, el cual ha perdurado, asumiendo el componente coroideo como la forma de la piel de los animales después del proceso de curtido y preparado para diferentes usos en la industria. Se propone utilizar como nombre, uno estructural: el de plexo ventricular ependimario, para reemplazar el tradicional coroideo que indica similitud al cuero o piel encurtida de los animales.

SUMMARY: The choroid plexus is a structure of the central nervous system linked to the production of part of the cerebrospinal fluid. Its knowledge derives from the times of Herophilus of Chalcedon to whom its name is attributed, which has endured, assuming the choroidal component as the shape of the hide of animals following the tanning process preparing it for various industrial uses. It is proposed to use the structural name of the ependymal ventricular plexus to replace the traditional choroid that indicates similarity to leather tanning or cured animal hide.

Humans , Choroid Plexus/anatomy & histology , Terminology as Topic , Neuroanatomy
Arch. Clin. Psychiatry (Impr.) ; 47(6): 165-175, Nov.Dec. 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1248756


ABSTRACT Objective: The effect of antipsychotic (AP) drugs on optical coherence tomography (OCT) findings in schizophrenia has not yet been fully elucidated. In this study, we aimed to investigate the effects of APs (the first generation antipsychotic group [FGAG], the second generation antipsychotic group [SGAG], the clozapine group [CG]) on OCT findings in schizophrenia. Methods: The thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroidal thickness were measured using a spectral OCT device. Results: No significant difference was found between FGAG, SGAG, CG (p > 0.05) while there was a significant difference between the control group and the patients group in terms of RNFL, GCL, and IPL (p < 0.05). A significant difference between SGAG and CG, FGAG (p < 0.05); between control group and FGAG (p < 0.05) were found in terms of choroidal thickness. Conclusion: These findings suggested the deterioration of the metabolic parameters due to the SGA use. Thinner choroidal layer thickness in the CG compared to the SGAG and control group was thought to be related to the patients using clozapine had a resistance to the treatment.