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1.
Rev. cuba. oftalmol ; 34(2): e1018, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341461

ABSTRACT

La catarata comprende la opacidad del cristalino, la cual puede afectar la corteza y el núcleo subcapsular anterior y posterior de manera progresiva, secundario a la acumulación de proteínas dañadas a este nivel, con pérdida del equilibrio entre la producción y la eliminación de las especies reactivas libres de oxígeno. La importancia de retrasar o identificar marcadores específicos, además de promover un nuevo blanco terapéutico, también es motivo de análisis y de estudio en diferentes líneas de investigación. Se realizó una revisión de la literatura del 01 de enero al 20 de julio del año 2020. Se utilizaron metabuscadores en inglés y español de PUBMED, INFOMED, CLINICALKEY, LILACS, EBSCO, SCIELO, PRISMA y UPTODATE, con el objetivo de identificar la nueva evidencia científica relacionada con el estrés oxidativo y su participación en la formación de la catarata. La barrera del cristalino funciona como un medio de intercambio entre diferentes moléculas, lo que impide el paso de antioxidantes al núcleo y provoca su opacificación. Las mitocondrias a nivel de la corteza del cristalino permiten la remoción de oxígeno. Posteriormente la fosforilación oxidativa forma radicales libres de superóxido que, de manera natural, con el paso del tiempo se acumulan a este nivel. Con la edad, la homeostasis adaptativa pierde la capacidad de responder ante los cambios de estrés oxidativo, por lo que el uso de antioxidantes -de manera profiláctica e intencionada- puede cambiar el destino último para esta patología. La falta de equilibrio en los procesos de óxido-reducción es responsable de la formación de la catarata(AU)


Cataract comprises opacification of the crystalline lens, which may progressively affect the cortex and the anterior subcapsular nucleus, secondary to accumulation of damaged proteins on this level, with loss of balance between production and elimination of free reactive oxygen species. The importance of delaying or identifying specific markers, as well as promoting a new therapeutic target, is the object of study and analysis of a variety of research lines. A review was conducted of the literature published from 1 January to 20 July 2020. Use was made of PubMed, Infomed, Clinical Key, Lilacs, EBSCO, SciELO, Prisma and UpToDate metasearch engines in English and Spanish to identify new scientific evidence about oxidative stress and its involvement in cataract formation. The crystalline lens barrier serves as a medium for exchange between various molecules, preventing entrance of antioxidants into the nucleus, which results in opacification. Mitochondria on the crystalline lens cortex allow oxygen removal. Oxidative phosphorylation then forms free superoxide radicals which naturally accumulate on this level with the passing of time. With aging, adaptive homeostasis loses its ability to respond to oxidative stress changes, but the prophylactic, targeted use of antioxidants may change the ultimate fate of this condition. Lack of balance in oxidation-reduction processes is the cause of cataract formation(AU)


Subject(s)
Humans , Oxidation-Reduction , Cataract/etiology , Reactive Oxygen Species , Homeostasis , Lens Cortex, Crystalline , Review Literature as Topic
2.
Rev. cuba. oftalmol ; 34(2): e887, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341459

ABSTRACT

La catarata se presenta como la principal causa de ceguera prevenible en todo el mundo. La facoemulsificación con implante de lente intraocular es el procedimiento quirúrgico estándar más comúnmente utilizado. Las lentes intraoculares son consideradas prótesis de material biocompatible que se usan para sustituir el cristalino humano, y se han diseñado para limitar las aberraciones de orden superior y mejorar la calidad de la visión al conseguir la emetropía. Varias son las generaciones de lentes intraoculares diseñadas hasta este momento, con el fin de lograr su perfeccionamiento para ofrecerle al paciente una mayor independencia y excelentes resultados visuales después de la cirugía de catarata para todas las distancias. De ahí la motivación para realizar una búsqueda de diversos artículos publicados, con el objetivo de describir los lentes intraoculares Premium. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)


Cataract is the leading cause of preventable blindness worldwide. Phacoemulsification with intraocular lens implantation is the standard surgical procedure most commonly used. Intraocular lenses are biocompatible material prosthesis that replace the human crystalline lens. They have been designed to limit higher order aberrations and improve vision quality, achieving emmetropia. Several generations of intraocular lenses have been developed so far with the purpose of improving their quality and providing patients with greater independence and excellent visual results for all distances after cataract surgery. Hence the motivation to conduct a search for a variety of published papers, with the purpose of characterizing the Premium intraocular lenses. Use was made of the Infomed platform, particularly the Virtual Health Library with all its search engines(AU)


Subject(s)
Humans , Cataract/etiology , Phacoemulsification/methods , Lens Implantation, Intraocular/methods , Review Literature as Topic , Databases, Bibliographic
3.
Article in English | WPRIM | ID: wpr-878326

ABSTRACT

Objective@#To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability (YLD) rates and to determine whether ultraviolet radiation (UVR) levels modify the effect of socioeconomic status on this health burden.@*Methods@#National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease (GBD) study 2017. The human development index (HDI) from the Human Development Report was used as a measure of socioeconomic status. Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument (OMI) dataset of the National Aeronautics and Space Administration (NASA).@*Results@#Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95% confidence interval ( @*Conclusion@#Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.


Subject(s)
Blindness/etiology , Cataract/etiology , Female , Global Burden of Disease/statistics & numerical data , Humans , Male , Quality-Adjusted Life Years , Social Class , Socioeconomic Factors , Ultraviolet Rays/adverse effects
4.
Clin. biomed. res ; 41(2): 141-147, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1337663

ABSTRACT

Introdução: A diabetes tipo 2 (DM2) é uma desordem metabólica ocasionada pela disfunção das células beta pancreáticas que interferem na produção de insulina e/ou pela resistência dos órgãos alvos a esse hormônio. Níveis elevados de radicais livres em conjunto com o declínio das defesas antioxidantes presente na DM2 podem ocasionar danos a organelas celulares, promovendo complicações da doença. As glutationas S- transferases (GST) são as principais enzimas antioxidantes que participam da defesa celular contra o estresse oxidativo. Os polimorfismos nos genes que codificam essas enzimas podem acarretar o surgimento de complicações oftalmológicas em diabéticos. Este trabalho avaliou a influência dos polimorfismos nos genes GST no desenvolvimento de doenças como a catarata e o glaucoma em pacientes com DM2 na Grande Vitória (ES). Metodologia: Os polimorfismos dos genes GSTM1 e GSTT1 foram investigados através da técnica de PCR multiplex. Para o gene GSTP1 utilizou-se a técnica PCR- RFLP. A análise estatística foi realizada através do teste exato de Fisher ou do teste do qui-quadrado com P-valor < 0.05. Resultados: Não foi encontrada relação entre os polimorfismos nos genes GSTM1, GSTT1 e GSTP1 e o surgimento de doenças como glaucoma e catarata em pacientes com DM2. Conclusão: Nossos dados sugerem que os polimorfismos nulos nos genes GSTM1 e GSTT1 e o polimorfismo Ile105Val no gene GSTP1 não estão associados com a suscetibilidade individual para o desenvolvimento de complicações oftalmológicas em pacientes com DM2. (AU)


Introduction: Type 2 diabetes mellitus (T2DM) is a metabolic disorder caused by beta cell dysfunction that interferes with insulin production and/or by the resistance of target organs to this hormone. An increase in free radicals together with a decline in antioxidant defenses, present in T2DM, can damage cellular organelles and promote the occurrence of disease complications. Glutathione S-transferases (GSTs) are the main antioxidant enzymes involved in cellular defense against oxidative stress, and polymorphisms in genes encoding GSTs can lead to ophthalmic complications in persons with diabetes. In this study, we evaluated the influence of GST polymorphisms on the development of diseases such as cataract and glaucoma in patients with T2DM in Grande Vitória, Espírito Santo, Brazil. Methods: GSTM1 and GSTT1 polymorphisms were investigated using a multiplex PCR technique. PCR-RFLP was used for the GSTP1 gene. Statistical analysis was performed with Fisher's exact test or the chi-square test, with P-value <0.05. Results: There was no relationship between GSTM1, GSTT1, or GSTP1 polymorphisms and the occurrence of diseases such as glaucoma and cataract in patients with T2DM. Conclusion: Our data suggest that the GSTM1 and GSTT1 null polymorphisms and the ile105Val polymorphism in the GSTP1 gene are not associated with individual susceptibility to the development of ophthalmic complications in persons with T2DM. (AU)


Subject(s)
Humans , Polymorphism, Genetic , Diabetes Mellitus, Type 2/complications , Cataract/etiology , Glaucoma/etiology , Oxidative Stress
5.
Rev. cuba. oftalmol ; 33(3): e872,
Article in Spanish | LILACS, CUMED | ID: biblio-1139097

ABSTRACT

RESUMEN Para el ser humano la información suministrada por sus ojos resulta esencial en su interacción con el entorno. Por esta razón todos consideramos la vista como nuestro sentido más valioso. Es fácil comprender, por tanto, que cualquier individuo sometido a una operación oftalmológica desarrollará un alto grado de ansiedad; de ahí la importancia de su cooperación para evitar las complicaciones quirúrgicas, donde en muchas ocasiones la cirugía se realiza con anestesia local. Es por eso que evitar el dolor y abolir los movimientos oculares va a ser un paso previo fundamental en la cirugía. Con el advenimiento del desarrollo tecnológico aplicado a la Oftalmología, nuevos procedimientos quirúrgicos persiguen una recuperación visual y social temprana de los pacientes. Dentro de ellos la cirugía de catarata por facoemulsificación exige métodos anestésicos que permitan lograr este propósito, y en la actualidad ya podemos mencionar la anestesia tópica y la crioanalgesia como avances en este sentido, las cuales se aplican en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Se realizó una búsqueda de diversos artículos publicados en la plataforma de PubMed, con el objetivo de conocer el desarrollo y las características de los anestésicos aplicados en la cirugía de catarata(AU)


ABSTRACT The information obtained by human beings through their eyes is essential for their interaction with the environment. This is the reason why we all consider our sight as our most valuable sense. It is thus easy to understand that any individual undergoing eye surgery will develop a high degree of anxiety. Hence the importance of their cooperation to prevent surgical complications, since on many occasions surgery is performed with local anesthesia. Preventing pain and stopping eye movement are therefore a crucial previous step in surgery. With the application of technological development to ophthalmology, new surgical procedures have emerged aimed at the patients' visual recovery and early social reincorporation. One of those procedures is phacoemulsification cataract surgery, which requires anesthetic methods that make it possible to achieve such an end. Examples of advances in this field are topical anesthesia and cryoanalgesia, both of which are applied at Ramón Pando Ferrer Cuban Institute of Ophthalmology. A search was conducted for papers published on the PubMed platform with the purpose of becoming acquainted with the development and characteristics of the anesthetics used in cataract surgery(AU)


Subject(s)
Humans , Surgical Procedures, Operative/methods , Cataract/etiology , Phacoemulsification/methods , Anesthesia/history , Technological Development/adverse effects
6.
Rev. cuba. oftalmol ; 33(3): e888, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139092

ABSTRACT

RESUMEN La cirugía de catarata es uno de los procedimientos quirúrgicos más frecuentes de toda la medicina. El objetivo de la técnica es eliminar el cristalino opacificado y sustituirlo con lentes intraoculares para lograr una rehabilitación de la función visual. El cálculo preciso de la posición efectiva del lente es crítico para lograr un buen resultado refractivo. Esta es la única variable que no puede medirse en el preoperatorio y que debe predecirse, por lo que representa uno de los retos más grande para el cirujano de catarata, ya que puede influir ampliamente en el resultado visual del paciente. Investigaciones recientes proponen nuevos parámetros para la estimación de la posición efectiva del lente, que están relacionados con la geometría del cristalino. Se realizó una búsqueda con el objetivo de describir la importancia de una adecuada estimación de la posición efectiva del lente y para conocer las últimas fórmulas propuestas para el cálculo del lente. Se encontraron estudios de investigación recientes en varias partes del mundo que proponen nuevas fórmulas basadas en parámetros anatómicos del cristalino. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)


ABSTRACT Cataract surgery is one the most common surgeries within medicine. The technique's objective is the removal of the natural lens of the eye that has developed an opacification, and its replacement with an intraocular lens to provide optimal visual acuity. An accurate assessment of the effective lens position is critical to achieve a good postoperative refractive outcome. This is the only variable that cannot be measured in the preoperative period and most be predicted, therefore it represents one of the greatest challenge for the cataract surgeon, since it can greatly influence the visual outcome of the patient. Recent research proposes new parameters of the estimation of the effective lens position that are related to the geometry of the lens. Research has been made in order describe the importance of an adequate estimation of the effective lens position and to learn more about the lastest formulas proposed for its calcutation. Many studies proposed new formulas based on lens geometry parameters. The Infomed platform, specifically the Virtual Health Library, was used with all its search engines(AU)


Subject(s)
Humans , Surgical Procedures, Operative/rehabilitation , Cataract/etiology , Forecasting , Lenses, Intraocular/adverse effects , Search Engine/methods
7.
Rev. cuba. oftalmol ; 33(2): e856, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139074

ABSTRACT

RESUMEN Objetivo: Determinar los resultados de la facotrabeculectomía por dos vías como tratamiento combinado de pacientes cubanos con glaucoma y catarata. Métodos: Se realizó un estudio observacional descriptivo longitudinal prospectivo en pacientes adultos cubanos tratados con facotrabeculectomía en el Servicio de Glaucoma del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre junio del año 2016 y abril de 2017. El universo estuvo constituido por todos los pacientes operados con facotrabeculectomía por dos vías. La muestra la integraron pacientes operados por un mismo cirujano, quienes estuvieron de acuerdo con participar en la investigación. Se excluyeron aquellos con cirugía intraocular previa. Salieron del estudio los que no pudieron mantener el seguimiento en la institución. Se estudiaron las variables edad, sexo, color de la piel, agudeza visual mejor corregida, presión intraocular, número de medicamentos hipotensores oculares y complicaciones presentadas. El seguimiento fue por dos años con consultas al día siguiente, a los siete y a los treinta días; a los tres y a los seis meses; al año y a los dos años. Resultados: Se observaron 31 pacientes. La edad promedio fue de 70 años, con predominio del sexo femenino y el color de la piel no blanco; la agudeza visual mejor corregida preoperatoria media 0,58 y la posoperatoria 0,73. La presión intraocular media preoperatoria 22,04 mmHg y a los dos años 16,37 mmHg. La media de los medicamentos hipotensores preoperatorios fue 3,0 y 0,3 a los dos años. Las complicaciones más frecuentes resultaron la ruptura transquirúrgica de la cápsula posterior y la opacidad posquirúrgica de la cápsula posterior. Conclusiones: Con la facotrabeculectomía por dos vías disminuye la presión intraocular; mejora la agudeza visual mejor corregida y se reduce el número de fármacos hipotensores oculares al menos durante dos años. Las complicaciones asociadas a la técnica son mínimas(AU)


ABSTRACT Objective: Determine the results of two-site phacotrabeculectomy as combined therapy for Cuban patients with glaucoma and cataract. Methods: An observational prospective longitudinal descriptive study was conducted of Cuban patients undergoing phacotrabeculectomy at the Glaucoma Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from June 2016 to April 2017. The study universe was all the patients undergoing two-site phacotrabeculectomy. The sample was patients operated on by the same surgeon who consented to participate in the research. Patients with a history of intraocular surgery were excluded, as well as those who could not be followed up at the institution. The variables considered were age, sex, skin color, best corrected visual acuity, intraocular pressure, number of ocular hypotensive drugs, and complications developed. Follow-up extended for two years with visits on the next day, at seven and thirty days, at three and six months, and at one and two years. Results: Thirty-one patients were observed. Mean age was 70 years, with a predominance of the female sex and non-white skin color. Best corrected visual acuity was 0.58 preoperative and 0.73 postoperative. Mean preoperative intraocular pressure was 22.04 mmHg, whereas at two years it was 16.37 mmHg. Hypotensive drugs averaged 3.0 preoperative and 0.3 at two years. The most common complications were intraoperative posterior capsule rupture and postsurgical posterior capsule opacity. Conclusions: Two-site phacotrabeculectomy reduces intraocular pressure, improves best corrected visual acuity and lowers the number of ocular hypotensive drugs for at least two years. The complications associated to the technique are minimum(AU)


Subject(s)
Humans , Female , Aged , Cataract/etiology , Trabeculectomy/methods , Glaucoma/epidemiology , Combined Modality Therapy/methods , Phacoemulsification/methods , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies , Observational Studies as Topic
8.
Rev. cuba. oftalmol ; 33(2): e739, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139068

ABSTRACT

RESUMEN Objetivo: Relacionar la severidad del edema corneal poscirugía de catarata en pacientes con córnea guttata, considerados sin riesgo o bajo riesgo de edema posquirúrgico según densidad celular, con los parámetros de la microscopia endotelial. Métodos: Se realizó un estudio descriptivo, prospectivo de 42 pacientes con córnea guttata, considerados sin riesgo o bajo riesgo de edema posquirúrgico según la densidad celular, quienes fueron sometidos a la cirugía de catarata por el mismo cirujano en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", desde abril del año 2016 a diciembre de 2017. Se determinó la severidad del edema corneal y se relacionó con el grado de córnea guttata, así como con los parámetros de la microscopia endotelial. Resultados: El 52,4 por ciento fueron mayores de 70 años y el 64,3 por ciento mujeres. No hubo edema en el 54,8 por ciento en las primeras 24 horas, y fue en el 26,2 por ciento leve y en el 19,0 por ciento mínimo, donde predominó la córnea guttata grado 3 y presentaban un bajo riesgo prequirúrgico. Sin embargo, no hubo diferencias en relación con el polimegatismo y el pleomorfismo. Conclusiones: La severidad del edema corneal en pacientes con córnea guttata posfacoemulsificación a los siete días no se asocia con el polimegatismo, ni con el polimorfismo prequirúrgico, pero sí con el conteo endotelial prequirúrgico(AU)


ABSTRACT Objective: Determine the relationship between the severity of corneal edema in cornea guttata patients undergoing cataract surgery considered to be at no risk or low risk for postsurgical edema in terms of cell density, and endothelial microscopy parameters. Methods: A descriptive prospective study was conducted of 42 cornea guttata patients considered to be at no risk or low risk for postsurgical edema in terms of cell density, who underwent cataract surgery performed by the same surgeon at Ramón Pando Ferrer Cuban Institute of Ophthalmology from April 2016 to December 2017. Corneal edema severity was determined and related to cornea guttata grade and endothelial microscopy parameters. Results: Of the patients studied, 52.4 percent were aged over 70 years and 64.3 percent were women. Edema was not observed in 54.8 percent in the first 24 hours, whereas it was mild in 26.2 percent and minimum in 19.0 percent. Grade 3 cornea guttata and low presurgical risk prevailed. However, no differences were found in relation to polymegethism and pleomorphism. Conclusions: At seven days, corneal edema severity in cornea guttata patients undergoing phacoemulsification is not associated to polymegethism or presurgical polymorphism, but it as associated to the presurgical endothelial count(AU)


Subject(s)
Humans , Female , Aged , Cataract/etiology , Corneal Edema , Cell Count/methods , Phacoemulsification/methods , Observational Studies as Topic , Reference Standards/adverse effects , Epidemiology, Descriptive , Prospective Studies , Microscopy/methods
9.
Arq. bras. cardiol ; 112(4): 392-399, Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001281

ABSTRACT

Abstract Background: Posterior subcapsular cataract is a tissue reaction commonly found among professionals exposed to ionizing radiation. Objective: To assess the prevalence of cataract in professionals working in hemodynamics in Brazil. Methods: Professionals exposed to ionizing radiation (group 1, G1) underwent slit lamp examination with a biomicroscope for lens examination and compared with non-exposed subjects (group 2, G2). Ophthalmologic findings were described and classified by opacity degree and localization using the Lens Opacities Classification System III. Both groups answered a questionnaire on work and health conditions to investigate the presence of risk factors for cataract. The level of significance was set at 5% (p < 0.05). Results: A total of 112 volunteers of G1, mean age of 44.95 (±10.23) years, and 88 volunteers of G2, mean age of 48.07 (±12.18) years were evaluated; 75.2% of G1 and 85.2% of G2 were physicians. Statistical analysis between G1 and G2 showed a prevalence of posterior subcapsular cataract of 13% and 2% in G1 and G2, respectively (0.0081). Considering physicians only, 38% of G1 and 15% of G2 had cataract, with the prevalence of posterior subcapsular cataract of 13% and 3%, respectively (p = 0.0176). Among non-physicians, no difference was found in the prevalence of cataract (by types). Conclusions: Cataract was more prevalent in professionals exposed to ionizing radiation, with posterior subcapsular cataract the most frequent finding.


Resumo Fundamento: A catarata subcapsular posterior é uma reação tecidual encontrada com frequência nos profissionais expostos à radiação ionizante. Objetivo: Avaliar a prevalência de catarata nos profissionais que atuam na área de hemodinâmica no Brasil. Métodos: Profissionais expostos à radiação ionizante (grupo 1, G1) foram submetidos ao exame biomicroscópico com lâmpada de fenda para avaliação do cristalino, e comparados aos não expostos (grupo 2, G2). Os achados foram descritos e classificados quanto ao grau de opacidade e localização por meio do Lens opacities classification system III. Ambos os grupos responderam questionário sobre condições de trabalho e de saúde para afastar fatores de risco para catarata, e foram comparados quanto aos achados. Foi utilizado um nível de significância de 5% (p < 0,05). Resultados: Foram avaliados 112 voluntários (G1) com média de idade 44,95 (±10,23) anos e 88 voluntários (G2) com média de 48,07 (±12,18) anos. Desses, 75,2% (G1) e 85,2% (G2) eram médicos. A análise estatística entre os grupos G1 e G2 mostrou uma prevalência da catarata no grupo G1 de 33% comparada ao G2 de 16% (p = 0,0058), sendo a catarata subcapsular posterior presente em 13% no G1 e 2% no G2 (p = 0,0081). Considerando apenas os médicos, 38% no G1 e 15% no G2 (p = 0,0011) apresentaram catarata, sendo a subcapsular posterior 13% e 3% (p = 0,0176), respectivamente. No grupo dos profissionais não médicos, não houve diferença estatisticamente significativa na prevalência dos achados oftalmológicos. Conclusões: A catarata esteve mais presente no grupo de profissionais expostos à radiação ionizante, sendo que a catarata subcapsular posterior foi o dano tecidual mais encontrado.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cataract/epidemiology , Radiation Exposure/adverse effects , Cardiologists/statistics & numerical data , Lens, Crystalline/radiation effects , Occupational Diseases/epidemiology , Radiation, Ionizing , Cataract/etiology , Brazil/epidemiology , Prevalence , Risk Factors , Occupational Exposure/adverse effects , Statistics, Nonparametric , Radiation Exposure/statistics & numerical data , Eye Protective Devices/statistics & numerical data , Hemodynamics , Occupational Diseases/etiology
10.
Rev. bras. oftalmol ; 78(2): 103-106, mar.-abr. 2019. tab
Article in English | LILACS | ID: biblio-1003570

ABSTRACT

Abstract Objective: To identify the main causes of traumatic cataracts in childhood, based on a scientific review. Methods: Review in Lilacs, Pubmed, Cochrane, Bireme and Sciencedirect databases for the keywords: infant cataract, traumatic cataract, child, pediatrics, low vision, blindness, cause, incidence, ocular trauma. Results: Seventy-two (72) articles on traumatic cataract were found. From these, 17 presented tables relating the cause of ocular trauma to the formation of cataract in pediatrics. This article presents the main findings and analysis of the topic in the literature. Conclusion: The traumas etiologies which were most prominent in the studies analyzed were pointed objects such as cuttings, splinters and wood stick. Boys were more affected and there was a relation with practice of internal and external activities of domicile, in rural and urban zones.


Resumo Objetivo: Identificar as principais causas das cataratas traumáticas na infância, baseado numa revisão científica. Métodos: Pesquisa nas bases de dados Lilacs, Pubmed, Cochrane, Bireme e Sciencedirect com as palavras- chave: catarata infantil, catarata traumática, criança, pediatria, baixa visão, cegueira, causa, incidência, trauma ocular. Resultados: Foram encontrados setenta e dois (72) artigos sobre catarata traumática. Destes, 17 apresentaram tabelas relacionando a causa do trauma ocular com a formação de catarata em pediatria. Este artigo apresenta os principais achados e análise do tema na literatura. Conclusão: As etiologias dos traumas que apresentaram maior destaque nos estudos analisados foram com objetos pontiagudos como estaca, lascas e graveto de madeira. Meninos foram mais acometidos e houve relação com prática de atividades internas e externas ao domicilio, em zona rural e urbana.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Cataract/etiology , Eye Injuries/complications , Eye Injuries/etiology , Wounds, Nonpenetrating/complications , Wounds, Penetrating/complications , Cataract/epidemiology , Eye Injuries/epidemiology
11.
Rev. bras. oftalmol ; 76(4): 210-212, July-Aug. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-899072

ABSTRACT

Resumo Objetivo: A doença de Behçet é uma vasculite inflamatória sistémica, de etiologia desconhecida. Pode atingir virtualmente todos os sistemas, sendo as manifestações oculares comuns. O objectivo deste trabalho foi analisar doentes com doença de Behçet ocular quanto aos parâmetros demográficos, manifestações clinicas, terapêutica e principais complicações. Métodos: Estudo descritivo e retrospetivo, que incluiu 11 doentes com o diagnóstico de doença de Behçet ocular, segundo os critérios do ISG, observados na consulta de Inflamação Ocular do Hospital Prof. Doutor Fernando da Fonseca nos últimos 3 anos. Resultados: Identificaram-se 11 doentes, 5 homens e 6 mulheres, todos caucasianos. A idade média ao diagnóstico foi de 33,45±6,49 anos. A manifestação ocular foi o primeiro sinal da doença em 2 doentes. Em 72,7% dos casos as manifestações oculares foram bilaterais. Identificaram-se 4 casos de panuveíte, 3 de uveíte posterior, 2 de uveíte anterior, 1 de queratite e 1 caso de episclerite. O glaucoma e a catarata foram a complicação ocular mais frequente. O tratamento sistémico incluiu a corticoterapia oral em associação com terapêutica adjuvante imunossupressora, sendo os mais utilizados a azatioprina e a ciclosporina. Em 3 doentes houve necessidade de terapêutica biológica com infliximab para controlo da doença. Conclusão: A manifestação ocular mais frequente foi a panuveíte. Esta doença pode condicionar complicações oculares com diminuição irreversível da acuidade visual. A orientação destes doentes exige uma abordagem global e interdisciplinar.


Abstract Objective: Behçet's disease is a systemic inflammatory vasculitis of unknown etiology. It can virtually reach all systems, being common ocular manifestations. The aim of this study was to analyze patients with ocular Behcet's disease regarding demographic parameters, clinical manifestations, therapeutic approach and main complications. Methods: Descriptive and retrospective study, including 11 patients diagnosed with ocular Behcet's disease, according to the ISG criteria, observed in the Ocular Inflammation appointment of the Hospital Prof. Doutor Fernando da Fonseca in the last 3 years. Results: We identified 11 patients, 5 males and 6 females, all caucasian. The mean age at diagnosis was 33.45 ± 6.49 years. Ocular manifestation was the first sign of the disease in 2 patients. In 72.7% of the cases, ocular manifestations were bilateral. There were four cases of panuveitis, 3 of posterior uveitis, 2 of anterior uveitis, 1 of keratitis and 1 case of episcleritis. Glaucoma and cataract were the most frequent ocular complications. Systemic treatment included oral corticosteroid therapy in combination with adjuvant immunosuppressive therapy, and the most commonly used was azathioprine and cyclosporine. In 3 patients there was a need for biological treatment with infliximab to control the disease. Conclusion: The most frequent ocular manifestation was panuveitis. This disease can promote eye complications with an irreversible decrease in visual acuity. Orientation of these patients requires a global and interdisciplinary approach.


Subject(s)
Humans , Male , Female , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/therapy , Eye Manifestations , Azathioprine/therapeutic use , Uveitis , Cataract/etiology , Panuveitis , Scleritis , Colchicine/therapeutic use , Glaucoma/etiology , Epidemiology, Descriptive , Retrospective Studies , Cyclosporine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , HLA-B51 Antigen , Infliximab/therapeutic use , Keratitis
12.
International Journal of Radiation Research. 2017; 15 (1): 91-99
in English | IMEMR | ID: emr-187500

ABSTRACT

Background: In response to the need for diagnosis and treatment, medical radiation has been increasingly used worldwide. This study investigated the medical utilization of radiation-related diseases among radiological technologists [RTs] and factors that influence such diseases


Materials and Methods: Data were collected from the Taiwan National Health Insurance Research Database. A panel study was conducted with a sample of 3,432 RTs obtained in 2007 and followed up until 2011. Logistic regression applying generalized estimating equations was used for investigating the relationship between RTs and radiation-related diseases


Results: Among the RTs, the annual medical utilization rate of hospitalization for radiation-related neoplasms was 1.17%o-4.43%0, that for circulatory diseases was 4.68%o-11.50%o, and the annual medical utilization rate of outpatient visits for cataracts was 2.91%o-7.38%0. After sex, age, hospital accreditation level, and hospital ownership were controlled, the odds of hospitalization for neoplasms and circulatory diseases among the RTs were nonsignificantly higher than those of pharmacists, and the odds of outpatient visits for cataracts among the RTs were nonsignificantly lower than those of pharmacists


Conclusion: No sufficient evidence exists to substantiate the argument that the exposure of RTs to current doses of radiation could increase the risk of neoplasms, circulatory diseases, and cataracts. Considering the increased use of radiation treatment in current medical facilities, all speculation on occupational radiation-induced diseases must be further investigated and verified


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasms, Radiation-Induced/epidemiology , Cardiovascular System/radiation effects , Cataract/etiology , Radiologists , Occupational Exposure
13.
Arq. bras. oftalmol ; 79(4): 222-225, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-794577

ABSTRACT

ABSTRACT Purpose: To evaluate lenticular oxidative stress in rat menopausal models. Methods: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3), and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4). Total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurements of the crystalline lenses were analyzed. Results: The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p >0.05). The mean TOS values were similar between the groups (p >0.05), whereas the mean TAC of group 1 was significantly higher than that of the other groups (p <0.001). Conclusions: Our results indicate that menopause may not promote cataract formation.


RESUMO Objetivo: Avaliar o estresse oxidativo lenticular em modelos de ratas na menopausa. Métodos: Quarenta ratos albinos femininos tipo Wistar foram incluídos neste estudo. Trinta ratas foram submetidas à ooforectomia para gerar o modelo de menopausa e 10 ratas formaram o grupo controle (Grupo 1). Dentre as ratas ooforectomizadas, 10 formaram o grupo controle menopausa (Grupo 2), 10 ratas receberam injeção diária de metilprednisolona até ao final do estudo (Grupo 3) e 10 ratas receberam estreptozotocina por via intraperitoneal para induzir diabetes mellitus (Grupo 4). O estado oxidante total (TOS), a capacidade total antioxidante (TAC) e as medições do índice de estresse oxidativo (OSI) dos cristalinos foram analisados. Resultados: A média de OSI foi menor no grupo 1 e maior no grupo 4. Todavia, a diferença entre os grupos não foi estatisticamente significativa (p>0,05). Os valores médios TOS foram semelhantes entre os grupos (p>0,05), enquanto a média de TAC grupo 1 foi mais elevada do que nos outros grupos ( p<0,001). Conclusões: Nossos resultados indicam que a menopausa podem não promover a formação de catarata.


Subject(s)
Humans , Animals , Female , Menopause/metabolism , Oxidative Stress/physiology , Lens, Crystalline/metabolism , Reference Values , Spectrophotometry , Cataract/etiology , Cataract/metabolism , Methylprednisolone/pharmacology , Ovariectomy , Oxidants/metabolism , Rats, Wistar , Models, Animal , Diabetes Mellitus, Experimental/metabolism , Glucocorticoids/pharmacology , Antioxidants/analysis , Antioxidants/metabolism
14.
Arq. neuropsiquiatr ; 74(3): 183-188, Mar. 2016. tab, graf
Article in English | LILACS | ID: lil-777131

ABSTRACT

ABSTRACT The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1) patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP). Method Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P) and ophthalmic protocol. Results We evaluated 42 patients aged 17 to 64 years (mean 40.7 ± 12.5), 22 of which were men. IOP (n = 41) was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48%) and ptosis in 23 (54.76%). These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment.


RESUMO O objetivo do estudo foi avaliar a frequência das anormalidades oftalmológicas em uma coorte de pacientes com distrofia miotônica tipo 1 (DM1) correlacionando-as à função motora. Revisamos a fisiopatogenia da catarata e baixa pressão intraocular (PIO). Método Os pacientes foram incluídos após diagnóstico clínico-laboratorial de DM1. Aqueles que assinaram o termo de participação foram avaliados pela escala medida da função motora, versão em português (MFM-P) e protocolo oftalmológico. Resultados Avaliamos 42 pacientes de 17 a 64 anos (média 40,7 ± 12,5), 22 do sexo masculino. Encontramos catarata ou positividade de cirurgia em 38 (90,48%) e blefaroptose em 23 (54,76%) e esses sinais foram correlacionados significativamente à maior gravidade da disfunção motora. Baixa PIO também foi comum e não correlacionada à gravidade motora. Alterações da motilidade ocular e de estereopsia ocorreram. Conclusão Catarata e ptose palpebral são frequentes na DM1 e associadas à gravidade motora. Baixa PIO é comum e parece ser independente da evolução motora.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Blepharoptosis/etiology , Cataract/etiology , Intraocular Pressure/physiology , Myotonic Dystrophy/complications , Blepharoptosis/physiopathology , Cataract/physiopathology , Myotonic Dystrophy/physiopathology
15.
Rev. bras. oftalmol ; 74(3): 189-193, May-Jun/2015.
Article in English | LILACS | ID: lil-764235

ABSTRACT

Pediatric cataract is the most common treatable cause of blindness in children. Prevalence, etiology and morphology vary with the socioeconomic development. The treatment goal is to reduce amblyopia, being difficult management especially in unilateral cases. The decision on aphakia or primary intraocular lens should be individualized as well as correction with contact lens or spectacles. The intraocular lens single-piece hydrophobic acrylic are the most implanted in children and the preferably is in the capsular bag. The Sanders-Retzlaff-Kraff theoretic (SRK/T) stressing that is described as more predictable, following Holladay I and SRK II and the recommendation is to under correction +6.0 or +8.0 dioptrias expecting the growth of the eye. The posterior capsule opacity is the most frequent complication and varies with the material choice of the lens. Glaucoma is the most serious postoperative complication and depends on the timing of the surgery, primary lens implantation and time of post surgical follow-up. The adherence to occlusion therapy with patching is critical to the visual prognosis and is determined by the child’s age and laterality of the cataract. There was significant improvement in the surgery and in IOLs, however the final visual prognosis is still not desirable.


A catarata pediátrica é a causa mais comum de cegueira tratável em crianças. Prevalência, etiologia e morfologia variam conforme o desenvolvimento sócioeconômico. O tratamento tem como objetivo diminuir a ambliopia, sendo de difícil manejo principalmente em casos unilaterais. A decisão sobre afacia ou implante primário de lente intraocular deve ser individualizado, assim como a correção com lente de contato ou óculos. As lentes intraoculares acrílicas hidrofóbicas de peça única são as mais implantadas em crianças com preferência de implante no saco capsular. A fórmula biométrica Sanders-Retzlaff-Krafftheoretic (SRK/T) é a mais precisa em pacientes pediátricos, seguida de Holladay I e SRK II, com recomendação de sob correção de +6 a +8.0 dioptrias, devido ao esperado crescimento rápido do globo ocular. A opacidade de cápsula posterior é a complicação mais frequente e varia com o material da lente a ser implantada e o glaucoma é a complicação pós-operatória mais grave e depende da idade da criança na cirurgia, implante primário de LIOs e da duração do acompanhamento pós-cirúrgico. A adesão ao tratamento oclusivo é fundamental para o prognóstico visual, sendo determinado de acordo com a idade da criança e a lateralidade da catarata. Mesmo com a melhora do tratamento cirúrgico e das lentes intraoculares o prognóstico visual final ainda não é o desejável.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Aphakia, Postcataract/rehabilitation , Cataract Extraction , Contact Lenses , Cataract/congenital , Cataract/etiology , Lenses, Intraocular , Prognosis
16.
An. bras. dermatol ; 89(1): 26-36, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-703556

ABSTRACT

Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs in all patients. Additionally, other ectodermal tissues may be affected, such as the central nervous system, eyes, hair, nails and teeth. The disease has a X-linked dominant inheritance pattern and is usually lethal to male fetuses. The dermatological findings occur in four successive phases, following the lines of Blaschko: First phase - vesicles on an erythematous base; second phase - verrucous hyperkeratotic lesions; third phase - hyperchromic spots and fourth phase - hypochromic atrophic lesions.


Subject(s)
Humans , Male , Skin/pathology , Incontinentia Pigmenti/pathology , Tooth Abnormalities/etiology , Tooth Abnormalities/pathology , Cataract/etiology , Cataract/pathology , Incontinentia Pigmenti/complications , Central Nervous System Diseases/pathology , Alopecia/etiology , Alopecia/pathology , Mutation
17.
Indian J Ophthalmol ; 2013 Jan-Feb; 61(1): 30-32
Article in English | IMSEAR | ID: sea-145341

ABSTRACT

Cataract formation may be an indicator of early siderosis and has been associated with intralenticular foreign bodies. We report a unique case of histopathologically proven lens siderosis in a young man with a preceding history of trauma but no signs of retained intraocular foreign body. He presented with a total white cataract with brownish deposits on anterior capsule and underwent cataract surgery for same followed by histopathological staining of anterior capsule for iron deposits. This case illustrates the importance of close monitoring of patients with history of trauma or previous penetrating injury to the eye, albeit no intraocular foreign body, as they might develop ocular siderosis at a later stage.


Subject(s)
Adult , Cataract/diagnosis , Cataract/etiology , Cataract/pathology , Eye Injuries, Penetrating/complications , Eye Foreign Bodies/complications , Humans , Male , Siderosis/diagnosis , Siderosis/etiology , Siderosis/pathology
18.
Arq. bras. oftalmol ; 75(5): 348-351, set.-out. 2012. ilus, tab
Article in English | LILACS | ID: lil-667581

ABSTRACT

PURPOSE: To study the results of cataract surgery in children with radiation-induced cataract after treatment for retinoblastoma. METHODS: Retrospective interventional case series. Six consecutive patients diagnosed with secondary cataracts due to radiation therapy for retinoblastoma. Intervention: Phacoemulsification and foldable acrylic intraocular lens implantation. Outcomes measu- red: Visual acuity, binocular indirect ophthalmoscopy and slit-lamp biomicroscopy. Aspirated lens material and aqueous humor samples were collected during surgery. RESULTS: Six uniocular children between 3 to 5 years of age at time of surgery were studied. The mean time interval between radiotherapy and cataract diagnosis was 22.3 months. The mean follow-up after surgery was 17.2 months (range: 12 to 23 months). All eyes achieved a clear visual axis after surgery allowing monitoring of the tumor status. None developed recurrence or retinoblastoma dissemination. Histopathological analysis of the aspired material showed no tumoral cells in all samples. All patients improved vision after cataract surgery. CONCLUSIONS: Phacoemulsification with acrylic intraocular lens implantation seems to be a safe, feasible, and effective method for the removal of radiation-induced cataracts in patients with treated retinoblastoma.


OBJETIVOS: Estudar os resultados da cirurgia da catarata induzida pela radioterapia para o tratamento do retinoblastoma em crianças. MÉTODOS: Estudo retrospectivo intervencional em série de casos onde seis pacientes consecutivos apresentaram catarata secundária à terapia por radiação para o retinoblastoma. Intervenção: Facoemulsificação e implante de lente intraocular acrílica dobrável. Foram avaliadas: acuidade visual, oftalmoscopia binocular indireta e biomicroscopia. Material para análise histológica do cristalino e do humor aquoso foi coletado durante as cirurgias. RESULTADOS: Seis crianças, entre 3 e 5 anos de idade, com catarata secundária à radiação para tratamento de retinoblastoma foram submetidas à cirurgia de facoemulsificação com implante de lente intraocular. A média do intervalo de tempo decorrido entre a radioterapia e o diagnóstico da catarata foi 22,3 meses. O período médio de seguimento após a cirurgia foi de 17,2 meses (intervalo: 12 a 23 meses). Todos os olhos melhoraram a visão e mantiveram eixo visual livre permitindo a fundoscopia para monitorar o tumor. Nenhum paciente evoluiu com recorrência ou disseminação do retinoblastoma. A análise histopatológica do material colhido resultou em ausência de células tumorais nas amostras. CONCLUSÕES: A cirurgia de facoemulsificação com implante de lente intraocular acrílica dobrável mostrou ser um procedimento seguro e efetivo para o tratamento da catarata induzida pela radioterapia em pacientes portadores de retinoblastoma.


Subject(s)
Child, Preschool , Female , Humans , Male , Cataract/etiology , Lens Implantation, Intraocular , Lenses, Intraocular , Phacoemulsification/methods , Radiation Injuries/complications , Retinal Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Retrospective Studies
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