Compromiso oftálmico en enfermedad relacionada con IgG4 / Ophthalmic involvement in IgG4-related disease

Resumen Introducción: la enfermedad oftálmica relacionada con IgG4 (EOR-IgG4) presenta una frecuencia del 11-59%. Pocos estudios describen las disparidades con los pacientes con ER-IgG4 extraoftálmica (NO EOR-IgG4). Objetivos: describir las características clínicas, imagenológicas, anatomopatológicas, resultados de laboratorio y tratamiento de la EOR-IgG4, y compararlas con las de los pacientes NO EOR-IgG4. Materiales y métodos: se realizó un estudio descriptivo sobre una cohorte de 54 pacientes con ER-IgG4. Se reclutaron 16 pacientes con EOR-IgG4 y 38 con NO EOR-IgG4. Se compararon ambos grupos. Resultados: la EOR-IgG4 predominó en mujeres. El 75% presentó afectación oftálmica bilateral. El antecedente de asma se asoció al grupo NO EOR-IgG4 (p=0,018). Los pacientes con EOR-IgG4 presentaron niveles séricos menores de IgE e IgG total, y la glándula lagrimal fue la estructura más afectada. Predominó el infiltrado linfoplasmocitario y eosinofílico, siendo la fibrosis estoriforme más frecuente que la no estoriforme en el grupo EOR-IgG4. Conclusiones: si bien los resultados fueron similares a lo reportado previamente, en discordancia con otras series, encontramos asociación negativa entre el asma y los niveles de IgG total sérica en los pacientes EOR-IgG4.

Abstract Introduction: IgG4-related ophthalmic disease (IgG4-ROD) presents a frequency of 11-58.8%. Few studies describe the disparities with patients with extraophthalmic IgG4-related disease (NOT IgG4-ROD). Objectives: describe the clinical, imaging, pathological characteristics, laboratory results, and treatment of IgG4-ROD characteristics; and compare them with those of the NOT IgG4-ROD patients. Materials and methods: a descriptive study was carried out on a cohort of 54 patients with ER-IgG4. 16 patients with IgG4-ROD and 38 with NOT IgG4-ROD were recruited. The data was analyzed with the SPSS Statistics 19 software. Results: IgG4-ROD predominated in women. 75% presented bilateral ophthalmic involvement. A history of asthma was associated with the NOT IgG4-ROD group (p=0,018). Patients with IgG4-ROD presented lower serum levels of IgE and total IgG, and the lacrimal gland was the most affected structure. Lymphoplasmacytic and eosinophilic infiltrates predominated, with storiform fibrosis being more frequent than non-storiform in the IgG4-ROD group. Conclusions: although the results were similar to those previously reported, in disagreement with other series, we found a negative association between asthma and serum total IgG levels with EOR-IgG4 patients.

Problemas visuales en niños de edad escolar / Visual Impairment in School-Age Children

Introducción: A partir de su formación permanente y continuada, desde la educación en el trabajo, el tecnólogo de la salud en optometría y óptica desarrolla modos de actuación en la atención primaria de salud, mediante la interacción con escuelas de la comunidad, para identificar problemas visuales en niños y contribuir a su rehabilitación, al brindar educación especializada a familias y docentes. Objetivo: Exponer los resultados de una investigación sobre problemas visuales en niños en edad escolar atendidos en el Policlínico Mario Escalona para la socialización de datos que contribuyan a la educación especializada de familias y docentes en la rehabilitación visual. Métodos: Se realizó un estudio descriptivo, transversal, desde enero de 2020 hasta abril de 2022, para conocer la incidencia del uso de dispositivos electrónicos en niños en edad escolar atendidos en el Policlínico Mario Escalona. Conformaron el universo 1953 niños. Se valoró el defecto refractivo y el tiempo de uso de los dispositivos electrónicos. Resultados: El astigmatismo miópico fue la ametropía más frecuente, con una incidencia superior al 50 por ciento. En encuestas realizadas a los padres se corroboró el uso desmedido de dispositivos electrónicos. Conclusiones: Como acto de responsabilidad profesional, desde la atención primaria de salud, el tecnólogo de la salud en optometría y óptica debe identificar los problemas visuales en niños en edad escolar y brindar educación especializada a familias y docentes, que contribuya a la rehabilitación visual(AU)

Introduction: From his or her permanent and continuous training, from education at work, the health technologist in Optometry and Optics develops modes of action in primary health care, through interaction with community schools, to identify visual problems in children and contribute to their rehabilitation, by providing specialized education to families and professors. Objective: To present the results of a research on visual problems in school-age children treated at Mario Escalona Polyclinic for the socialization of data that contribute to the specialized education of families and teachers in visual rehabilitation. Methods: A descriptive, cross-sectional study was carried out from January 2020 to April 2022, in order to know the incidence of the use of electronic devices in school-age children attended at Policlínico Docente Dr. Mario Escalona Reguera. The universe consisted of 1953 children. The refractive defect and the time of use of electronic devices were assessed. Results: Myopic astigmatism was the most frequent ametropia, with an incidence higher than 50 percent. Surveys of parents corroborated an excessive use of electronic devices. Conclusions: As an act of professional responsibility, from primary health care, the health technologist in Optometry and Peptics should identify visual problems in school-age children, as well as provide specialized education to families and professors, contributing to visual rehabilitation(AU)

Dolor y edema de miembros inferiores por dermopatía tiroidea: presentación inusual de la enfermedad de Graves en una paciente adolescente / Lower limb pain and edema due to thyroid dermopathy: an unusual presentation of Graves disease in an adolescent patient

La enfermedad de Graves es un proceso inmunomediado en el que autoanticuerpos se dirigen contra el receptor de tirotrofina. Por su acción estimulante sobre la glándula tiroides, se genera crecimiento glandular difuso y aumento de la hormonogénesis. Se caracteriza por el comienzo subagudo de síntomas constitucionales, neuromusculares, cardiovasculares, gastrointestinales y oculares, seguidos en algunos casos de la aparición de manifestaciones cutáneas como la dermopatía tiroidea o mixedema. En pediatría la enfermedad de Graves es infrecuente (aunque es la causa más frecuente de hipertiroidismo), pero la cronología de aparición de los síntomas está bien descrita; es rara la aparición de dermopatía en ausencia de otros síntomas de hipertiroidismo y sin afectación ocular. Se presenta el caso de una paciente de 15 años con dermopatía tiroidea por enfermedad de Graves sin oftalmopatía ni otros síntomas de hipertiroidismo clínico asociados.

Graves disease is an immune-mediated process characterized by the presence of autoantibodies to thyrotropin receptors. Its stimulating action on the thyroid gland causes diffuse glandular growth and increased hormone production. Graves disease is characterized by a subacute onset of non-specific, neuromuscular, cardiovascular, gastrointestinal, and eye symptoms, sometimes followed by skin manifestations, such as thyroid dermopathy or myxedema. In pediatrics, Graves disease is rare (although it is the most frequent cause of hyperthyroidism). However, the chronology of symptom onset has been well described; the development of dermopathy in the absence of other symptoms of hyperthyroidism and without eye involvement is rare. Here we describe the case of a 15-year-old female patient with thyroid dermopathy due to Graves disease without eye disease or other associated clinical symptoms of hyperthyroidism.

Avaliação dos alunos deficientes visuais e videntes do Instituto de Cegos Padre Chico / Evaluation of the visually impaired and sighted students at the Instituto de Cegos Padre Chico

RESUMO Objetivo Avaliar o perfil dos alunos concluintes, deficientes visuais e videntes do Instituto de Cegos Padre Chico entre os anos 2011 e 2020. Métodos Entre janeiro e março de 2021, foi realizada uma análise documental dos alunos concluintes entre os anos de 2011 e 2020. Foram coletados dados relacionados à situação social, educacional, socioeconômica e oftalmológica. Os dados foram tratados no programa Microsoft Excel 2013 da Microsoft e analisados no software livre Bioestat, versão 5.0. Resultados Foram coletados os dados de 110 concluintes cegos, com baixa visão e videntes. Mais de 90% dos alunos declararam rendimento familiar equivalente a um salário-mínimo e meio. Do total da amostra, 52 alunos eram cegos; 38 tinham baixa visão, e 20 eram videntes. Dentre as 36 patologias identificadas entre os alunos, 57,78% levaram à cegueira e 42,22%, à baixa visão. Em alunos cegos, as patologias mais frequentes foram glaucoma congênito (32,69%) e amaurose congênita de Leber (11,53%); em alunos com baixa visão, foram glaucoma congênito e distrofias de retina (ambas em 10,53% da amostra). Conclusão É de suma importância a avaliação da saúde ocular para que o professor realize de forma mais rápida as práticas de ensino e alcance resultados satisfatórios na alfabetização de crianças com deficiência visual.

ABSTRACT Objective To evaluate the profile of visually impaired and sighted students at the Instituto de Cegos Padre Chico (ICPC) between 2011 and 2020. Methods Between January and March 2021, a document analysis of the students who completed the undergraduate course between 2011 and 2020. Data related to social, educational, socioeconomic, and ophthalmological situation were collected. The data were treated in Microsoft Excel 2013 and analyzed in the free software Bioestat, version 5.0. Results Retrospective data were collected from 110 blind, low-vision and sighted students who were graduating. More than 90% of the students declared family income equivalent to one and a half minimum wages. Of the total sample, 52 students were blind; 38 had low vision, and 20 were sighted students. Among the 36 pathologies identified among the students, 57.78% led to blindness, and 42.22%, to low vision. In blind students, the most frequent diagnosis was congenital glaucoma (32.69%) and Leber congenital amaurosis (11.53%); in low vision students, congenital glaucoma and retinal dystrophies (both in 11.53% of the population of this study). Conclusion The evaluation of the eye health is of vital importance for the teacher to perform teaching practices faster and achieve satisfactory results in the literacy of visually impaired children.

Knowledge and Attitude of Commercial Drivers in Benin City towards Utilization of Eye Care Services

Background: An excellent vision is crucial in driving and many driving related injuries and fatalities have been associated with visual problems especially for commercial drivers. Visual efficiency plays an important role during driving. This study determined the knowledge and attitude of commercial drivers in Benin towards utilization of eye care services. Method: This was a cross sectional study conducted among 100 commercial drivers in Benin City metropolis. Data was collected using an interviewer administered questionnaire, among commercial drivers from 3 major parks in Benin City. Data was analyzed using SPSS version 22. Descriptive and inferential statistics was used to analyze the data. Statistical significance was set at p < 0.05. Results:The results revealedthat majorityofcommercial drivers in Benin city had knowledge of which an eye care provider is (60%), as well as knowing the eye care providers closest to them. However, 75% of them do not see it necessary to utilize the eye care services. Results of this study will help eye care professionals to better advise commercial drivers, concerning their eye health.Conclusion: Findingsrevealed that commercial drivers had a good knowledge of whom eye care providers are but a poor level of utilization of eye care services that they provide (P< 0.05). The factors affecting the poor utilization of eye care services was not statistically significant.

Eye care utilization among older subjects with visual impairment in Northwest Ethiopia

Purpose: To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North Western Ethiopia, 2021. Methods: An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted. Results: A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2­23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5­7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0­9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5­5.6), being blind (AOR = 2.9; 95% CI: 1.5­5.6), duration of visual impairment ≤1 year (AOR = 2.5; 95% CI: 1.3­4.9) were all significantly associated. Conclusion: In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

Therapeutic landscape for inherited ocular diseases: Current and emerging therapies

Inherited ocular diseases comprise a heterogeneous group of rare and complex diseases, including inherited retinal diseases (IRDs) and inherited optic neuropathies. Recent success in adeno-associated virus-based gene therapy, voretigene neparvovec (Luxturna®) for RPE65-related IRDs, has heralded rapid evolution in gene therapy platform technologies and strategies, from gene augmentation to RNA editing, as well as gene agnostic approaches such as optogenetics. This review discusses the fundamentals underlying the mode of inheritance, natural history studies and clinical trial outcomes, as well as current and emerging therapies covering gene therapy strategies, cell-based therapies and bionic vision.

Diabetes mellitus y salud visual como referentes esenciales en la práctica médica / Diabetes mellitus and visual health as essential references in medical practice

Introducción: La diabetes mellitus, requiere atención médica multifactorial y multisectorial. La oftalmopatía diabética demanda sistemas de salud integrados que faciliten la prevención, detección y tratamiento de las complicaciones en los niveles de atención primaria, secundaria y terciaria. Objetivo: Exponer los conceptos teóricos, prácticos y las tendencias actuales sobre diabetes mellitus y salud visual. Métodos: Se realizó una revisión bibliografía y documental sobre diabetes mellitus y salud visual, estudios y documentos publicados por instituciones nacionales e internacionales, temas vinculados a la diabetes mellitus y la salud visual, se accedió a artículos desde diferentes fuentes, revistas indexadas, metaanálisis y fuentes primarias no publicadas, tesis de maestría, y doctorados. Resultados: Para conservar la salud visual es necesario llevar a cabo medidas que conlleven a prevenir la pérdida de la visión por catarata, glaucoma, retinopatia y edema macular diabético, que incluyen no sólo un buen control de los parámetros metabólicos y las revisiones periódicas al oftalmólogo, sino también el cumplimiento de la educación diabetológica por un equipo multidisciplinario y actualización sobre este tema de los prestadores de salud. La disminución visual que provoca la catarata y otras enfermedades oculares puede conducir a padecer discapacidades como, pérdida de autonomía para administrarse los medicamentos, limitar las actividades de la vida cotidiana e incapacidad laboral y social, con la consiguiente afectación de la calidad de vida Conclusiones: Acudir al oftalmólogo con frecuencia, mantener el control glucémico, del colesterol y presión arterial representan el pilar fundamental para preservar la salud visual en el paciente diabético(AU)

Introduction: Diabetes mellitus requires multifactorial and multisectoral medical attention. Diabetic ophthalmopathy demands integrated health systems that facilitate the prevention, detection and treatment of complications at the primary, secondary and tertiary care levels. Objective: To show the theoretical and practical concepts and current trends on diabetes mellitus and visual health. Methods: A bibliographic and documentary review on diabetes mellitus and visual health was carried out. Studies and documents published by local and international institutions, articles, topics related to diabetes mellitus and visual health were retrieved from different sources, indexed journals, meta-analysis and unpublished primary sources, research degree and master's, theses. Results: To preserve visual health, it is necessary to carry out reading that lead to preventing vision loss due to cataract, glaucoma, retinopathy and diabetic macular edema, which include not only good control of metabolic parameters and regular check-ups with the ophthalmologist , but also compliance with diabetes education by a multidisciplinary team and updating the health providers on this subject. The visual decrease caused by cataract and other eye diseases can lead to disabilities such as loss of autonomy to manage medications, limit activities of daily life and work and social incapacity, with the consequent impact on quality of life. Conclusions: Frequently going to the ophthalmologist, maintaining glycemic, cholesterol and blood pressure control represent the fundamental pillar to preserve visual health in diabetic patients(AU)

COVID-19: quais motivos levaram os pacientes a procurarem pronto atendimento oftalmológico durante a pandemia? / COVID-19: what reasons led patients to seek emergency care during the pandemic?

RESUMO Objetivo Analisar o motivo pelo qual pacientes procuraram o pronto atendimento oftalmológico durante a pandemia da COVID-19. Métodos Estudo de corte transversal, retrospectivo, realizado a partir da análise de prontuários de pacientes atendidos em um pronto atendimento oftalmológico de um serviço privado da cidade de Santos (SP) entre 11 de março de 2020 e 16 de julho de 2020. Resultados Foram atendidos 386 pacientes no período analisado. A maior parte das consultas (60,36%) deu-se a pessoas do sexo feminino. Pessoas da faixa etária entre 19 e 59 anos foram as que mais procuraram o pronto atendimento (57,25%). Ao se considerar a profissão desses pacientes, estudantes e aposentados apresentaram a mesma proporção (10,26%) seguidos de pessoas do lar (6,99%). Do total de casos atendidos, 59 pacientes foram diagnosticados com conjuntivite, enquanto 58 tiveram diagnóstico de traumatismo de olho e órbita. Conclusão No período analisado, o pronto atendimento oftalmológico recebeu, predominantemente, mulheres na faixa etária entre 19 e 59 anos, e os diagnósticos mais frequentes foram de conjuntivite e trauma.

ABSTRACT Objective To analyze the reason why patients sought emergency eye care during the pandemic of COVID-19. Methods This was a retrospective cross-sectional study based on the analysis of medical records of patients seen at an ophthalmology emergency department of a private service in the city of Santos (SP) between March 11, 2020 and July 16, 2020. Results A total of 386 patients were seen in the analyzed period. Most appointments (60.36%) were attended by women. People between 19 and 59 years old were the ones who most sought the emergency room (57.25%). When considering the profession of these patients, students and retired people presented the same proportion (10.26%), followed by housewives (6.99%). Of the total number of cases seen, 59 patients were diagnosed with conjunctivitis, while 58 were diagnosed with eye and orbit trauma. Conclusion In the analyzed period, the ophthalmology emergency care predominantly received women in the age group between 19 and 59 years old, and the most frequent diagnoses were conjunctivitis and trauma.

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

Oftalmopatías: situación epidemiológica de egresos hospitalarios en el Hospital Regional Guillermo Grant Benavente entre los años 2018 y 2021 / Ophthalmopathy: epidemiological situation of hospital discharges at the Guillermo Grant Benavente Regional Hospital between 2018 and 2021

Introducción: La salud visual es de vital importancia para el individuo, habiendo una mayor incidencia de oftalmopatías sobre los 50 años. Pese a su impacto sanitario, Chile carece de estudios epidemiológicos suficientes. La gran variabilidad de sus presentaciones hace importante conocer cuales ameritan el tratamiento intrahospitalario. Objetivo: Describir las principales causas de egresos hospitalarios por enfermedades del ojo y sus anexos en el Hospital Regional Guillermo Grant Benavente entre los años 2018 y 2021. Materiales y métodos: Estudio ecológico que analizó 1764 egresos hospitalarios por enfermedades del ojo y sus anexos del Hospital Guillermo Grant Benavente entre los años 2018 y 2021. Los datos corresponden al Departamento de Estadísticas e Información en Salud (DEIS). Resultados: Las patologías más prevalentes fueron: Trastornos De La Coroides Y De La Retina (33%) (TCR) Trastornos Del Cristalino (14,7%), Trastornos De La Esclerótica, Córnea, Iris Y Cuerpo Ciliar (10,2). Trastornos Del Párpado, Aparato Lagrimal Y Órbita (12,7%) (TPAO) Esta última con diferencias estadísticamente significativas para el sexo. Conclusión: Se ve una disminución de la atención hospitalaria desde el año 2020 debido a la pandemia del virus SARS-COV-2. No hay diferencias por sexo, excepto para la TPAO, similar a lo visto en la literatura. La acumulación de oftalmopatías en el rango de población adulta y adulta mayor, refleja un envejecimiento poblacional. Se reconoce además a los TCR como la patología con mayor incidencia. El estudio contribuye a la epidemiologia local, aportando a la falta de conocimientos actualizados, describiendo los diagnósticos más frecuentes de la especialidad.

Introduction: Eye care is vital for the individual, with a higher incidence of ophthalmopathy over 50 years. Despite its health impact, Chile lacks sufficient epidemiological studies. The great variability of their presentations makes it important to know which ones merit in-hospital treatment. Objective: To describe the main causes of hospital discharges for eye diseases and its adnexa at the Guillermo Grant Benavente Regional Hospital between 2018 and 2021. Material and methods: An ecological descriptive study that analyzed 1,764 hospital discharges for eye diseases and its adnexa from the Hospital Guillermo Grant Benavente between the years 2018 and 2021. The data corresponds to the Department of Statistics and Health Information (DEIS). Results: The most prevalent pathologies were: Disorders of the Choroid and Retina (33%) (TCR), Disorders of the Lens (14.7%), Disorders of the Sclera, Cornea, Iris, and Ciliary Body (10.2). Disorders of the Eyelid, Lacrimal Apparatus and Orbit (12.7%) (TPAO) The latter with statistically significant differences for sex. Conclusion: A decrease in hospital care is seen since 2020 due to the SARS-COV-2 virus pandemic. There are no differences by sex, except for PPAO, similar to what has been seen in the literature. The accumulation of ophthalmopathy in the range of the adult population and older adults, reflects an aging population. TCR is also recognized as the pathology with the highest incidence. The study contributes to the local epidemiology and the lack of updated knowledge, describing the most frequent diagnoses of the specialty.

Peperomia pellucida (L.) Kunth and eye diseases: A review on phytochemistry, pharmacology and toxicology / 中西医结合学报

Peperomia pellucida (L.) Kunth is a medicinal plant used to manage inflammatory illnesses such as conjunctivitis, and gastrointestinal and respiratory tract disorders in tropical and subtropical regions. However, little is known about its pharmacological mechanism of action against eye diseases. This review aims to critically discuss the phytochemistry, pharmacology and toxicology of P. pellucida as well as its roles in the treatment of cataract, glaucoma and diabetic retinopathy. Recent developments in the uses of P. pellucida for healthcare and nutraceutical products by the pharmaceutical industry are also covered in this review. For this review, a literature search was performed with PubMed, ScienceDirect, SciFinder Scholar and Scopus databases, using relevant keywords. Among the various phytochemicals identified from P. pellucida, β-caryophyllene, carotol, dillapiole, ellagic acid, pellucidin A, phytol and vitexin exhibit strong pharmacological activities within the mitogen-activated protein kinase and nuclear factor-κB signalling pathways in inflammatory eye diseases. The antihypertensive, anti-inflammatory, antioxidant, antihyperglycemic and anti-angiogenic activities displayed by P. pellucida extracts in many in vitro, in vivo and clinical studies suggest its potential role in the management of inflammatory eye diseases. P. pellucida extract was non-toxic against normal cell lines but displayed mild toxicity in animal models. The growing public interest in P. pellucida has inspired the nutraceutical and pharmaceutical industries to process the plant into health products. Although the potential pharmacological mechanisms against eye diseases have been summarized, further studies of the interactions among constituent phytochemicals from P. pellucida within various signalling pathways shall support the use of the plant as an alternative therapeutic source.

Nanocristais de besifloxacino para o tratamento de conjuntivite bacteriana: preparação, caracterização físico-química e toxicidade / Besifloxacin nanocrystals for treating bacterial conjunctivitis: preparation, physicochemical characterization, and toxicity

A conjuntivite bacteriana tem significante impacto na Saúde Pública. Essa infecção representa mais de um terço das doenças oculares relatadas em âmbito global. É uma doença altamente contagiosa causada por variedade de bactérias aeróbias e anaeróbias. Diferentes antibióticos empregados no tratamento dessa doença têm apresentado elevada incidência de resistência bacteriana. Dentre os antibióticos de última geração, destaca-se o besifloxacino, antibiótico de quarta geração da classe das fluoroquinolonas, indicado exclusivamente para uso oftálmico tópico. Entretanto, esse fármaco possui baixa solubilidade em água, diminuindo sua biodisponibilidade. Tendo em vista superar esse desafio, foi proposta abordagem nanotecnológica para o desenvolvimento de nanocristais desse fármaco. A preparação de nanocristais de besifloxacino empregando moagem via úmida em escala reduzida foi promissora empregando tensoativo Povacoat®. O Diâmetro hidrodinâmico médio (DHM) da partícula foi de aproximadamente 550 nm, com índice de polidispersão (IP) menor que 0,2. Esse resultado permitiu aumentar a solubilidade de saturação em aproximadamente duas vezes em relação a matéria-prima, possibilitando aumentar a velocidade de dissolução desse fármaco e melhorar sua biodisponibilidade e segurança. Além disso, foi validado o método para quantificação do besifloxacino por CLAE, apresentando especificidade, linearidade no intervalo de 20 a 80µg/mL (r= 0,9996), precisão por repetibilidade (DPR= 1,20%, 0,84% e 0,39%), precisão intermediária (DPR= 0,94%) e exatidão 99,03%. Estudo de estabilidade acelerado (90 dias) na condição 40°C±2°C/75%UR±5%UR e estudo de estabilidade de acompanhamento (150 dias) na condição: 25°C ± 2°C / 60% UR ± 5% UR evidenciaram a estabilidade do teor no período avaliado. Ainda, a nanossuspensão de besifloxacino 0,6% m/m (nanocristais) na dose máxima (500 mg/kg) e o estabilizante Povacoat® (750 mg/kg) não apresentaram toxicidade em larvas de G. mellonella. A concentração inibitória mínima (CIM) para a formulação inovadora foi de 0,0960 µg/mL e 1,60 µg/mL frente a Staphylococcus aureus e Pseudomonas aeruginosa, respectivamente, confirmando eficácia in vitro

Bacterial conjunctivitis greatly impacts the population's health, presenting more than a third of eye diseases reported worldwide. It is an infection caused by various aerobic and anaerobic bacteria and is highly contagious. Therefore, it presents a high incidence of bacterial resistance to the antibiotics commonly used for treatment. Among the most recent antibiotics, besifloxacin is a fourth-generation fluoroquinolone antibiotic indicated exclusively for topical ophthalmic use. Due to its importance in treating bacterial conjunctivitis and its low solubility in the water, a nanotechnological approach was proposed to develop besifloxacin nanocrystals. The preparation of besifloxacin nanocrystals using small-scale wet milling was promising using Povacoat® surfactant. The particle's average hydrodynamic diameter (DHM) was approximately 550 nm, with a polydispersity index (IP) of less than 0.2. This result increased the saturation solubility approximately two times concerning the raw material, making it possible to increase the dissolution rate of this drug and improve its bioavailability and safety. In addition, the method for quantification of besifloxacin by HPLC was validated, presenting specificity, linearity in the range of 20 to 80µg/mL (r= 0.9996), precision by repeatability (DPR= 1.20%, 0.84% and 0.39%), intermediate precision (DPR= 0.94%) and accuracy 99.03%. Accelerated stability study (90 days) at 40°C±2°C/75%RH±5%RH condition and follow-up stability study (150 days) at 25°C ± 2°C / 60% RH ± condition 5% RH showed the stability of content in the evaluated period. Furthermore, the 0.6% besifloxacin nanosuspension (nanocrystals) at the maximum dose (500 mg/kg) and the Povacoat® stabilizer (750 mg/kg) did not show toxicity in G. mellonella larvae. The minimum inhibitory concentration (MIC) to innovative formulation was 0.0960 µg/mL and e 1.60 µg/mL against Staphylococcus aureus and Pseudomonas aeruginosa, respectively, confirming in vitro efficacy

Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists?

ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.

Metaboloma use in ophthalmology / Uso de metaboloma em oftalmologia: uma revisão narrativa

ABSTRACT It is part of the omic sciences to search for an understanding of how the cellular system of organisms works as well as studying their biological changes. As part of the omic sciences, we can highlight the genomics whose function is the study of genes, the transcriptomics that studies the changes in the transcripts, the proteomics responsible for understanding the changes that occur in proteins, and the metabolomics that studies all the metabolic changes that occur in a certain system when it is submitted to different types of stimuli. Metabolomics is the science that studies the endogenous and exogenous metabolites in biological systems, which aims to provide comparative quantitative or semi-quantitative information about all metabolites in the system. This review aims to describe the main applications of metabolomics science in ophthalmolog. We searched the literature on main applications of metabolomics science in ophthalmology, using the MEDLINE and LILACS databases, with the keywords "metabolomics" and "ophthalmology", from January 1, 2009, to April 5, 2021. We retrieved 216 references, of which 58 were considered eligible for intensive review and critical analysis. The study of the metabolome allows a better understanding of the metabolism of ocular tissues. The results are important to aid diagnosis and as predictors of the progression of many eye and systemic diseases.

RESUMO Faz parte das ciências ômicas buscar entender como funciona o sistema celular dos organismos e estudar suas alterações biológicas. Como parte das ciências ômicas, destacam-se a genômica, cuja função é o estudo dos genes; a transcriptômica, que estuda as mudanças nos transcritos; a proteômica, responsável por entender as mudanças que ocorrem nas proteínas, e a metabolômica, que estuda todo o metabolismo das alterações que ocorrem em um determinado sistema quando ele é submetido a diferentes tipos de estímulos. A metabolômica é a ciência que estuda os metabólitos endógenos e exógenos em sistemas biológicos, visando fornecer informações comparativas quantitativas ou semiquantitativas sobre todos os metabólitos do sistema. Esta revisão teve como objetivo descrever as principais aplicações da ciência metabolômica na oftalmologia. Trata-se de revisão narrativa desenvolvida por um grupo de pesquisa da Universidade Federal de São Paulo, em São Paulo (SP). Buscaram-se, na literatura, as principais aplicações da ciência metabolômica em oftalmologia, utilizando as bases de dados Medline® e Lilacs, com as palavras-chave "metabolomics" e "oftalmologia", de 1º de janeiro de 2009 a 5 de abril de 2021. Foram recuperadas 216 referências, das quais 58 foram consideradas elegíveis para revisão intensiva e análise crítica. O estudo do metaboloma permite um melhor entendimento do metabolismo dos tecidos oculares. Os resultados são importantes para auxiliar no diagnóstico e como preditores da progressão de muitas doenças oculares e sistêmicas.

TeleOftalmo: estratégia de ampliação da oferta de telediagnósticos oftalmológicos para a atenção primária à saúde no Sul do Brasil / TeleOftalmo: strategy to expand the offer of ophthalmologic telediagnostics for primary healthcare in the Southern Brazil / TeleOftalmo: estrategia de ampliación de la oferta de telediagnósticos oftálmicos en la atención primaria de salud en el sur de Brasil

O uso da teleoftalmologia pode ser uma estratégia viável para rastrear e diagnosticar as principais doenças oculares em pacientes na atenção primária à saúde. O objetivo deste estudo é descrever a realização de 30.315 telediagnósticos em oftalmologia em pacientes da atenção primária e a resolutividade desse serviço. Estudo transversal para avaliar os telediagnósticos realizados em pacientes atendidos nos oito pontos remotos do projeto TeleOftalmo entre 2 de janeiro de 2018 a 31 de dezembro de 2020. Foram avaliadas as características demográficas dos pacientes, os motivos de encaminhamento, os diagnósticos realizados conforme faixa etária e a resolutividade do telediagnóstico. Os pacientes eram, na maioria, do sexo feminino (66,1%), adultos (70,3%) e encaminhados ao telediagnóstico principalmente devido à baixa acuidade visual (60,5%). Os erros refrativos foram o diagnóstico mais prevalente em todas as faixas etárias. A presbiopia foi a doença ocular mais prevalente em adultos (65,4%) e idosos (64%), seguida da catarata (41,3%) e suspeita de glaucoma (10,6%) em idosos. Dos 30.315 pacientes que realizaram o telediagnóstico, 70,5% tiveram suas queixas oculares totalmente solucionadas, sem a necessidade de encaminhamento ao oftalmologista presencial. A telemedicina pode ser resolutiva para as doenças oculares mais prevalentes na população, aumentando a oferta de diagnósticos, qualificando e auxiliando na redução das filas de espera por atendimento oftalmológico.

The use of teleophthalmology may be a viable strategy to track and to diagnose major eye diseases primary health care patients. This study aimed to describe the performance of 30,315 telediagnoses in ophthalmology in primary care patients and the case management of this service. This is a cross-sectional study to evaluate the telediagnosis performed in patients treated at the eight remote points of the TeleOftalmo project from January 2nd, 2018, to December 31st, 2020. The patients' demographic characteristics, the reasons for referral, the diagnoses made according to age group, and the case management of the telediagnosis were evaluated. Most patients were female (66.1%), adults (70.3%), and referred to telediagnosis mainly due to reduced visual acuity (60.5%). Refractive errors were the most prevalent diagnosis in all age groups. Presbyopia was the most prevalent eye disease in adults (65.4%) and older adults (64%), followed by cataracts (41.3%) and suspected glaucoma (10.6%) in older adults. In total, 30,315 patients underwent telediagnosis, 70.5% had their ocular complaints fully resolved, without the need for referral to an in-person ophthalmologist. Telemedicine can be resolutory for the most prevalent eye diseases in the population, increasing the supply of diagnoses, qualifying and assisting in reducing waiting lines for ophthalmologic care.

La teleoftalmología puede ser una estrategia viable para el tamizaje y diagnóstico de las principales enfermedades oculares en pacientes en la atención primaria de salud. El objetivo de este estudio es describir la realización de 30.315 telediagnósticos en oftalmología en pacientes de atención primaria y la resolución de este servicio. Estudio transversal para evaluar los telediagnósticos realizados a pacientes en los ocho puntos de atención remota del proyecto TeleOftalmo entre el 2 de enero de 2018 y el 31 de diciembre de 2020. Se evaluaron las características demográficas de los pacientes, los motivos de derivación, los diagnósticos realizados según el grupo de edad y la resolución de los telediagnósticos. Los pacientes eran en su mayoría mujeres (66,1%), adultos (70,3%) y remitidos para telediagnóstico, principalmente por baja agudeza visual (60,5%). Los errores de refracción fueron el diagnóstico más prevalente en todos los grupos de edad. La presbicia fue la enfermedad ocular más frecuente en adultos (65,4%) y ancianos (64%), seguida de catarata (41,3%) y sospecha de glaucoma (10,6%) en ancianos. De los 30.315 pacientes que realizaron el telediagnóstico, el 70,5% tuvo sus quejas oculares totalmente resueltas, sin necesidad de derivación presencial al oftalmólogo. La telemedicina puede ser una herramienta útil para detectar las enfermedades oculares más prevalentes en la población debido al aumento de los diagnósticos y la ayuda que produce al reducir la lista de espera para atención oftalmológica.

COVID-19 inductor del síndrome visual informático y sus afectaciones a las personas / COVID-19 inducer of computer visual syndrome and its effects on people

El objetivo de este artículo es analizar la literatura existente sobre el SVI y sus afectaciones a las personas producto por alta exposición a equipos electrónicos generados por la pandemia del COVID-19 El tipo de investigación es revisión de literatura, de diseño bibliográfico o documental; el método de investigación empleado fue el de revisión de literatura. La población estuvo constituida por 35 artículos y la muestra de 19 artículos en diversos idiomas, seleccionados de manera intencional de acuerdo a criterios de inclusión y exclusión previamente establecidos; las técnicas e instrumentos empleados para el recojo de información fueron el análisis documental, y el fichaje y la computadora respectivamente. Entre los principales resultados se tiene que el SVI tiene gran prevalencia en personas que tienen gran periodo de exposición a pantallas de dispositivos electrónicos, asimismo, vinculados a fallas en las condiciones ergonómicas en sus estaciones de trabajo o estudio. Se concluye, el promedio de prevalencia del SVI en los artículos revisados es de 73.2%, siendo el máximo 98.7% y el mínimo 50%, siendo más frecuente en mujeres; respecto a los síntomas más frecuente que se presentan se tienen: dolor en ojos, cansancio visual o visión borrosa, picazón, sequedad en los ojos, sensación de empeoramiento de la vista, lagrimeo y párpados pesados(AU)

The objective of this article is to analyze the existing literature on IVS and its effects on people as a result of high exposure to electronic equipment generated by the COVID-19 pandemic. The type of research is literature review, bibliographic or documentary design; the research method used was the literature review. The population consisted of 35 articles and the sample of 19 articles in various languages, intentionally selected according to previously established inclusion and exclusion criteria; the techniques and instruments used for the collection of information were the documentary analysis, and the signing and the computer respectively. Among the main results is that SVI has a high prevalence in people who have a long period of exposure to electronic device screens, also linked to failures in ergonomic conditions in their workstations or study. It is concluded that the average prevalence of SVI in the reviewed articles is 73.2%, the maximum being 98.7% and the minimum 50%, being more frequent in women; Regarding the most frequent symptoms that appear, there are: pain in the eyes, visual fatigue or blurred vision, itching, dry eyes, sensation of worsening of sight, tearing and heavy eyelids(AU)

Algunos desafíos en mucopolisacaridosis tipo I / A few challenges in mucopolysaccharidosis type I

Se describen como desafíos actuales en mucopolisacaridosis I la necesidad de una clasificación adecuada, vinculándola a las indicaciones terapéuticas; el diagnóstico temprano desde la pesquisa neonatal, sus ventajas y dificultades hasta la sospecha clínica de las formas grave y atenuada; el cuidado de la patología espinal y oftalmológica, desde el diagnóstico, el seguimiento y el tratamiento; las reacciones alérgicas por terapia de reemplazo enzimático, su diagnóstico y tratamiento. Por último, la transición hacia el cuidado adulto

Here we describe the current challenges of mucopolysaccharidosis type I: the need for an adequate classification, establishing its relationship to therapeutic indications; an early diagnosis, from neonatal screening, its advantages and barriers, to clinical suspicion of severe and attenuated forms; spinal and eye disease care, from diagnosis to follow-up and treatment; allergic reactions caused by enzyme replacement therapy, their diagnosis and treatment. And lastly, transition to adult care

Global publication trends in ophthalmic genetics and gene therapy research: A Scientometric analysis / Tendências globais de publicação de pesquisas sobre genética oftálmica e terapia genética: uma análise cientométrica

ABSTRACT Objective: A scientometric analysis produced in ophthalmic genetics and gene therapy research is lacking. The purpose of this study is to present a holistic analysis of ophthalmic genetics literature. Methods: The data used in this study were obtained from the Web of Science (WoS) Core Collection. All published documents between 1975-2019 were included. The data exported from WoS enabled the extensive details of ophthalmic genetics related literature including countries, institutions, authors, citations and keywords. Scientometric network maps of keywords and also country and institution co-authorships were created with free software. Global contributions of the countries to the ophthalmic genetics literature were shown by a graphic. Results: The search query revealed a total of 2322 documents. Most of the documents were original articles (75.75%). USA was the leading country by producing 45.39% of all documents in ophthalmic genetics research followed by UK, Germany, China and France. Pennsylvania University was the most contributing institution in the literature (5.25%) followed by University College London and Moorfields Eye Hospital. The average citations per item was 29.4. The most used keywords over a 40-year period were 'family', 'cell', 'photoreceptor' and 'expression'. Conclusions: USA and UK dominated the ophthalmic genetics research. A substantial increase in the number of published documents in this field were observed after 2010.

RESUMO Objetivo: A literatura carece de análise cienciométrica produzida em genética oftálmica e de pesquisa em terapia genética. O objetivo deste estudo é apresentar uma análise holística da literatura genética oftálmica. Métodos: Os dados utilizados neste estudo foram obtidos na base de dados Web of Science (WoS) Core Collection. Todos os documentos publicados entre 1975 e 2019 foram incluídos na análise. Os dados exportados da WoS viabilizaram acesso a amplos detalhes da literatura relacionada à genética oftálmica, incluindo países, instituições, autores, citações e palavras-chave. Mapas de rede cienciométrica foram criados por meio de software gratuito, com base em palavras-chave e em coautorias de países e instituições. As contribuições globais dos países para a literatura sobre genética oftálmica foram apresentadas em gráfico. Resultados: a busca por pesquisas revelou um total de 2.322 documentos cuja maioria eram artigos originais (75,75%). Os EUA foram o país que mais produziu artigos sobre o tema, com 45,39% de todos os documentos em pesquisa genética oftálmica; ele foi seguido pelo Reino Unido, Alemanha, China e França. A Universidade da Pensilvânia foi a instituição que mais contribuiu para a literatura (5,25%), e foi seguida pela University College London e pelo Moorfields Eye Hospital. A média de citações por item foi de 29,4. As palavras-chave mais usadas em um período de 40 anos foram 'família', 'célula', 'fotorreceptor' e 'expressão'. Conclusões: Os EUA e o Reino Unido dominaram a pesquisa em genética oftálmica. Após 2010, observou-se um aumento substancial no número de documentos publicados nessa área.

Ocular Affection as an Extraintestinal Manifestation in Cases of Inflammatory Bowel Disease at the Kafrelsheikh Governorate / Afecção ocular como manifestação extraintestinal em casos de doença inflamatória intestinal

Abstract Introduction The manifestations of inflammatory bowel disease (IBD) are not restricted to the gastrointestinal tract. Musculoskeletal conditions are considered the most common extraintestinal manifestations, followed by mucocutaneous and ocular diseases. Many general practitioners are unaware of the variety and severity of the ocular affection in IBD patients. Objective To assess the prevalence of extraintestinal manifestations in IBD patients at Kafrelsheikh governorate, and to evaluate the different ocularmanifestations and their relationship to the severity of the disease. Methods A cross-sectional study evaluating 120 patients treated at the Kafrelsheikh University Hospital. The diagnosis of IBD was made between December 2018 and December 2019 through clinical, endoscopic and histopathological examinations. All patients were assessed for any extraintestinal manifestation or evidence of ocular affection through slit-lamp examinations, tonometry, visual acuity, and indirect ophthalmoscopy. Results The mean age of the sample was 35.5 ± 13.3 years. In total, 52 (43.3%) patients were male and 68 (56.7%) were female. Ocular manifestations represent ~ 22.5% of extraintestinal manifestations. The most common ocular findings were conjunctivitis (25.8%) and anterior uveitis (10.8%), followed by scleritis (9.2%) and cataract (8.3%). Other extraintestinal manifestations were observed in 41 (34.1%) 29 (29.9%) of ulcerative colitis cases, and 12 (52%) of Crohn disease cases. There was no statistically significant difference in the presence of ocular involvement in relation to the two types of IBD included in the Montreal classification. Conclusion Ocular manifestations in cases of IBD are common and usually nonspecific in presentation. The severity of the IBD does not reflect the severity of the ocular affection.

Resumo Introdução As manifestações da doença inflamatória intestinal (DII) não se restringem ao trato gastrointestinal. Distúrbios musculoesqueléticos são considerados as manifestações extraintestinais mais comuns, seguidos de doenças oculares e mucocutâneas. Muitos clínicos gerais desconhecem a variedade e a severidade das afecções oculares em casos de DII. Objetivo Determinar a prevalência das manifestações extraintestinais em pacientes com DII na província de Kafrelsheikh, no Egito, e avaliar as diferentes manifestações oculares e sua relação com a gravidade da doença. Métodos Um estudo transversal que avaliou 120 pacientes tratados no Kafrelsheikh University Hospital. O diagnóstico de DII foi feito entre dezembro de 2018 e dezembro de 2019 por meio de exames clínicos, endoscópicos e histopatológicos. Por meio de exames de lâmpada de fenda, tonometria, acuidade visual, e oftalmoscopia indireta, todos os pacientes foram avaliados para se determinar a ocorrência de quaisquer manifestações extraintestinais ou afecções oculares. Resultados Amédia de idade da amostra foi de 35,5 ± 13,3 anos. No total, 52 (43,3%) pacientes com DII eram do sexo masculino, e 68 (56,7%), do sexo feminino. As manifestações oculares representaram ~ 22,5% das manifestações extraintestinais. Os achados oculares mais comuns foram conjuntivite (25,8%) e uveíte anterior (10,8%), seguidas de esclerite (9,2%) e catarata (8,3%). Outras manifestações extraintestinais foram observadas em 41 (34,1%) pacientes, entre elas, 29,9% de casos de colite ulcerativa, e 52% de casos de doença de Crohn. Não houve diferença estatisticamente significativa na presença de envolvimento ocular com relação aos dois tipos de DII descritos na classificação de Montreal. Conclusão Asmanifestações oculares empacientes de DII são comuns e, geralmente, não específicas em termos de apresentação. A gravidade da DII não reflete a gravidade da afecção ocular.