Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 25
Filter
1.
Rev. bras. oftalmol ; 80(3): e0009, 2021. graf
Article in Portuguese | LILACS | ID: biblio-1280121

ABSTRACT

RESUMO Este trabalho visou evidenciar a importância da detecção precoce da coroidite interna punctata e destacar sua fisiopatologia inflamatória e possíveis diagnósticos diferenciais dentro das white dot syndromes. O destaque foi dado principalmente à coroidite multifocal e à panuveíte, ao se demonstrar sua epidemiologia peculiar em mulheres jovens, caracterizar sua apresentação clínica típica na fundoscopia e explorar as vantagens e as desvantagens de realizar os exames complementares que fazem parte da análise multimodal útil para o diagnóstico (especialmente a angiografia fluoresceínica, a tomografia de coerência óptica e a indocianina verde). Descreve-se o caso de uma mulher de 28 anos diagnosticada com coroidite interna punctata com membrana neovascular coroidal em olho direito. O tratamento foi realizado com injeção intravítrea de aflibercepte e corticoterapia sistêmica 1mg/kg ao dia. Este relato é importante por permitir debater o manejo da coroidite interna punctata durante a gestação e a decisão de realizar o tratamento mediante uma diversidade de opções terapêuticas.


ABSTRACT This work aimed to demonstrate the importance of early detection of punctate inner choroidopathy, highlighting the pathophysiology of inflammation and the differential diagnoses among white dot syndromes. Special attention was given to multifocal choroiditis and panuveitis, by demonstrating the peculiar epidemiology in young women, characterizing the typical clinical presentation in ophthalmoscopy, and exploring the advantages and disadvantages of performing the complementary examinations, which are part of the multimodal analysis useful for diagnosis (particularly fluorescein angiography, optical coherence tomography, and indocyanine green). We report the case of a 28-year-old female, diagnosed as punctate inner choroidopathy with choroidal [N.T. no título aparece subretinal = subrretiniana] neovascular membrane in the right eye. She was treated with intravitreal injection of aflibercept and systemic corticosteroid 1 mg/kg/day. This case report is important for addressing the management of punctate inner choroidopathy during pregnancy, and the decision to carry out treatment considering diverse therapeutic options.


Subject(s)
Humans , Female , Adult , Choroiditis/complications , Choroiditis/diagnosis , Choroiditis/physiopathology , Choroidal Neovascularization/etiology , Angiogenesis Inhibitors/therapeutic use , Intravitreal Injections/methods , Fluorescein Angiography/methods , Tomography, Optical Coherence/methods
2.
Rev. bras. oftalmol ; 79(4): 270-272, July-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1137965

ABSTRACT

Abstract We present a case of 50-years-old, man with vision loss, dysmorphopsia and micropsy in the right eye with for 6 months. Ocular history included uncomplicated cataract surgery 10 years before. Best corrected visual acuity was 20/100 in the right eye and 20/20 in the left eye. Anterior segment OD demonstrated intra-ocular lens (IOL) haptic in the anterior chamber with iris perforation. Fundus examination revealed cystoid macular edema in right eye. Surgical approach with reposition of the IOL and triamcinolone acetonide intravitreal injection were performed with visual and tomographical improvement.


Resumo Apresentamos o caso de um homem de 50 anos, com queixa de perda de visão, dismorfopsia e micropsia em olho direito (OD) há 6 meses. A história ocular incluiu cirurgia de catarata sem complicações 10 anos antes. A melhor acuidade visual corrigida foi 20/100 em OD e 20/20 em olho esquerdo. O segment anterior do OD demonstrou háptica da lente intraocular (LIO) na câmara anterior com perfuração da íris. A fundoscopia revelou edema macular cistoide em OD. A abordagem cirúrgica com reposição da LIO e injeção intravítrea de triancinolona acetonida foi realizada com melhora visual e tomográfica.


Subject(s)
Humans , Male , Middle Aged , Retinal Perforations , Triamcinolone Acetonide/therapeutic use , Iris/injuries , Macular Edema/complications , Lens Implantation, Intraocular/methods , Intravitreal Injections/methods
3.
Arq. bras. oftalmol ; 82(3): 233-235, May-June 2019. graf
Article in English | LILACS | ID: biblio-1001310

ABSTRACT

ABSTRACT A 21-year-old man presented with visual acuity of 20/200 in both eyes. The fundus picture, fluorescein angiography, and optical coherence tomography revealed severe bilateral acute posterior multifocal placoid pigment epitheliopathy and serous macular detachments. We treated the patient with triamcinolone acetonide, an intravitreal injection (4 mg/0.1 mL) in one eye and a posterior subtenon injection (40 mg/1 mL) in the other eye. Within 2 weeks the visual acuity was 20/80 in both eyes. At the 8-week follow-up visit his vision was 20/63 bilaterally. One year later the vision remained 20/63 in both eyes. In this patient, the triamcinolone acetonide injections, whether administered intravitreally or via the posterior subtenon route, achieved similar anatomic and functional recovery results.


RESUMO Um homem de 21 anos apresentou acuidade visual de 20/200 em ambos os olhos. O quadro de fundo de olho, angiofluoresceinografia e a tomografia de coerência óptica revelaram epiteliopatia pigmentar placóide multifocal posterior aguda e descolamento macular seroso. Tratamos o paciente com triancinolona acetonida, uma injeção intravítrea (4 mg/0,1 ml) em um olho e uma injeção subtenoniana posterior (40 mg/1 ml) no outro olho. Após 2 semanas, a acuidade visual foi de 20/80 em ambos os olhos. Na visita de acompanhamento de 8 semanas, sua visão foi de 20/63 bilateralmente. Um ano depois, a visão permaneceu 20/63 em ambos os olhos. Neste paciente, as injeções de triancinolona, administradas por via intravítrea ou por via subtenoniana posterior, obtiveram resultados semelhantes na recuperação anatômica e funcional.


Subject(s)
Humans , Male , Triamcinolone Acetonide/administration & dosage , Tenon Capsule , Intravitreal Injections/methods , White Dot Syndromes/drug therapy , Anti-Inflammatory Agents/administration & dosage , Time Factors , Fluorescein Angiography , Visual Acuity , Treatment Outcome , Tomography, Optical Coherence/methods , White Dot Syndromes/pathology , White Dot Syndromes/diagnostic imaging
4.
Arq. bras. oftalmol ; 82(3): 195-199, May-June 2019. tab
Article in English | LILACS | ID: biblio-1001305

ABSTRACT

ABSTRACT Purpose: To investigate changes in axial length after intravitreal dexamethasone implantation in patients with macular edema. Methods: We performed a prospective comparative study of 46 patients with unilateral macular edema, due to diabetic retinopathy, retinal vein occlusion, and non-infectious uveitis, who underwent dexamethasone implantation. The fellow eyes of the patients were considered the control group. The central macular thickness was measured by spectral-domain optical coherence tomography, and axial length was measured by IOLMaster 700 optical coherence biometry. We compared axial length and central macular thickness values within the groups. Results: In the study group, the baseline central macular thickness was 460.19 ± 128.64 mm, significantly decreasing to 324.00 ± 79.84 mm after dexamethasone implantation (p=0.000). No significant change in central macular thickness measurements was seen in the control group (p=0.244). In the study group, the baseline axial length was 23.16 ± 0.68 mm, significantly increasing to 23.22 ± 0.65 mm after dexamethasone implantation (p=0.039). However, the control group exhibited no significant change in axial length (p=0.123). Conclusions: In addition to significantly reducing central macular thickness measurements, intravitreal dexamethasone implantation also significantly changes optical biometry-based axial length measurements.


RESUMO Objetivo: Investigar alterações no comprimento axial após implante de dexametasona intravítrea em pacientes com edema macular. Métodos: Foi realizado um estudo prospectivo e comparativo de 46 pacientes com edema macular unilateral, devido à retinopatia diabética, oclusão da veia retiniana e uveíte não infecciosa, que foram submetidos ao implante de dexametasona. Os olhos contralateral de cada paciente foram considerados o grupo controle. A espessura macular central foi medida por tomografia de coerência óptica de domínio espectral, e o comprimento axial foi medido por meio de biometria de coerência óptica de domínio espectral e o comprimento axial foi medido pela biometria de coerência óptica com IOLMaster 700. Comparamos o comprimento axial e os valores da espessura macular central dentro dos grupos. Resultados: No grupo de estudo, a espessura macular basal foi de 460,19 ± 128,64 mm, diminuindo significativamente para 324,00 ± 79,84 mm após o implante de dexametasona (p=0,000). Nenhuma mudança significativa nas medidas da espessura macular central foi observada no grupo controle (p=0,244). No grupo de estudo, o comprimento axial basal foi de 23,16 ± 0,68 mm, aumentando significativamente para 23,22 ± 0,65 mm após o implante de dexametasona (p=0,039). No entanto, o grupo controle não apresentou alteração significativa no comprimento axial (p=0,123). Conclusões: Além de reduzir significativamente as medidas da espessura macular central, o implante de dexametasona intravítrea também altera significativamente as medidas de comprimento axial baseadas na biometria óptica.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Dexamethasone/administration & dosage , Macular Edema/drug therapy , Axial Length, Eye/drug effects , Intravitreal Injections/methods , Glucocorticoids/administration & dosage , Macula Lutea/drug effects , Visual Acuity , Macular Edema/pathology , Prospective Studies , Biometry/methods , Treatment Outcome , Statistics, Nonparametric , Tomography, Optical Coherence/methods , Diabetic Retinopathy/drug therapy , Axial Length, Eye/pathology , Macula Lutea/pathology
5.
Arq. bras. oftalmol ; 82(1): 25-31, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-973871

ABSTRACT

ABSTRACT Purpose: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. Methods: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. Results: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). Conclusion: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.


RESUMO Objetivo: Comparar os efeitos de iodopovidona tópico a 5% com azitromicina e moxifloxacina profiláticas sobre a flora bacteriana em pacientes submetidos à injeção intravítrea. Métodos: Um total de 132 pacientes foram aleatoriamente designados para receber tratamento com azitromicina ou moxifloxacina ou nenhum tratamento (grupo controle). No total, 528 amostras foram obtidas no momento na admissão, 4 dias antes da injeção intravítrea, 4 dias após a injeção intravítrea e 8 dias após a injeção intravítrea. As amostras foram imediatamente enviadas para o laboratório de microbiologia para incubação. Resultados: O microorganismo mais frequentemente observado foi o Staphylococcus coagulase-negativo (23,8%). Quando os resultados das amostras obtidas no dia 4 antes da injeção foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi significativamente menor no grupo mo xifloxacina, em comparação com os controles (p=0,049). Acinetobacter baumannii continuou a crescer após a administração de azitromicina (p=0,033). Quando os resultados de 4 dias após a injeção intravítrea foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi maior no controle, em comparação com pacientes que receberam azitromicina ou moxifloxacina (p=0,004). A taxa de erradicação também foi significativamente maior no grupo moxifloxacina do que no grupo controle (p=0,001). As amostras obtidas no dia 8 após injeção intravítrea mostraram níveis semelhantes de crescimento bacteriano em todos os grupos (p=0,217). Conclusão: A moxifloxacina foi mais eficaz do que 5% de iodopovidona no controle do crescimento da flora bacteriana conjuntival. O uso de moxifloxacina em combinação com 5% de iodopovidona resultou em um efeito sinérgico.


Subject(s)
Humans , Povidone-Iodine/administration & dosage , Azithromycin/administration & dosage , Conjunctiva/microbiology , Intravitreal Injections/methods , Moxifloxacin/administration & dosage , Anti-Infective Agents, Local/administration & dosage , Anti-Bacterial Agents/administration & dosage , Time Factors , Acinetobacter/isolation & purification , Acinetobacter/drug effects , Conjunctivitis, Bacterial/microbiology , Conjunctivitis, Bacterial/prevention & control , Endophthalmitis/microbiology , Endophthalmitis/prevention & control , Treatment Outcome , Conjunctiva/drug effects , Escherichia coli/isolation & purification , Escherichia coli/drug effects
6.
Rev. cuba. oftalmol ; 30(1): 0-0, ene.-mar. 2017. ilus
Article in Spanish | LILACS | ID: biblio-901353

ABSTRACT

Se describe el caso de un paciente varón de 22 años, miope, sometido a vitrectomía pars plana 23 G en ojo único (valioso), por desprendimiento de retina regmatógeno. A las 24 horas presentó pérdida de visión, dolor, signos inflamatorios en globo y anejos oculares. Acudió al Servicio de Emergencias, donde se decidió su ingreso hospitalario para la toma de muestra y la aplicación de inyección intravítrea de vancomicina (1 mg/0,1 mL) y ceftazidima (2 mg/0,1 mL), con lo que mostró mejoría clínica. El estudio microbiológico reportó Pseudomona aeruginosa sensible a la ceftazidima y a la ciprofloxacina. La mejor visualización fundoscópica al quinto día posintravítrea permitió observar depósitos blanquecinos en la interfaz aceite de silicona-retina, y se decidió la extracción de aceite por incisiones mixtas 23 g y 20 g (infusión, endoiluminación y extracción respectivamente), lavado de cámara anterior, cámara vítrea, reposición de aceite de silicón y segunda dosis de ceftazidima, con evolución posoperatoria favorable. Se dio el alta una semana después, con la retina aplicada y una mejor visión corregida de 0,1(AU)


This is the report about a male 22 years-old myopic patient who underwent a pars plana 23 G vitrectomy in one eye (valuable) due to regmatogen retinal detachment. Twenty four hours after the surgery, he presented with vision loss, pain, eye bulb inflammation and ocular adnexa. He went to the emergency service where it was decided to admitted him to the hospital for sample taking and application of intravitreal injection of vancomycin (1 mg/0,1 mL) and ceftazidime (2 mg/0,1 mL) which brought about clinical improvement. The microbiological test reported the presence of ceftazidime and ciprofloxacine-susceptible Pseudomona aeruginosa. The fundus oculi performed five days after vitrectomy allowed observing whitish deports in the silicon oil/retina interface, so it was decided to remove the oil by making mixed incisions of 23 and 20 g (infusion, endoilumination and extraction, respectively), washing the anterior chamber, the vitreal chamber, returning the silicon oil and a second dosage of ceftazidime, all of which caused favorable postoperative progress. One week later, he was discharged from the hospital with replaced retina and better corrected vision of 0.1(AU)


Subject(s)
Humans , Male , Adult , Endophthalmitis/drug therapy , Intravitreal Injections/methods , Pseudomonas Infections/microbiology , Vancomycin/therapeutic use , Vitrectomy/adverse effects
7.
Arq. bras. oftalmol ; 79(3): 155-158, graf
Article in English | LILACS | ID: lil-787336

ABSTRACT

ABSTRACT Purpose: To evaluate choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT) imaging at baseline and 6 months after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with diabetic macular edema (DME). Methods: A retrospective chart review was performed to identify patients with DME who underwent intravitreal injection of anti-VEGF (bevacizumab or ranibizumab) in a pro re nata (PRN) regimen. Subfoveal choroidal thickness was compared between values obtained at baseline and at 6-month follow-up visits. Results: Thirty-nine eyes (15 females, 24 males) from 39 patients were enrolled (mean age, 62.43 ± 8.7 years; range, 44-79 years). Twenty-three and 16 eyes were treated with ranibizumab and bevacizumab respectively. The mean number of anti-VEGF injections was 2.28 ± 1.27 (range, 1-5). Mean nasal, subfoveal, and temporal choroidal thickness (CT) measurements at baseline were 234.10 ± 8.63 µm, 246.89 ± 8.94 µm, and 238.12 ± 8.20 µm, respectively, and those at 6 months post-treatment were 210.46 ± 8.00 µm, 215.66 ± 8.29 µm, and 212.43 ± 8.14 µm, respectively. Significant differences in CT were observed between baseline and the 6-month follow-up at all measured points (p=0.0327). Conclusions: Over a 6-month period, the use of intravitreal anti-VEGF was associated with significant thinning of the choroid in patients with DME. The clinical significance of a thinner choroid in DME is currently unknown; however, it may contribute to long-term adverse effects on choroidal and retinal function, representing an area requiring future investigation.


RESUMO Objetivos: Avaliar a espessura de coroide pré-tratamento e após 6 meses da injeção intravítrea de anti-fator de crescimento vascular endotelial (anti-VEGF) em pacientes com edema macular diabético (EMD), utilizando a tomografia de coerência óptica de domínio espectral (SD-OCT). Métodos: Análise retrospectiva, com revisão de prontuários, foi realizada para identificação de pacientes submetidos a tratamento com injeções intravítreas de anti-VEGF, no regime pro re nata, para tratamento de EMD. As medidas da espessura de coroide pré-tratamento foi comparada com as medidas após acompanhamento de 6 meses. Resultados: Trinta e nove olhos de 39 pacientes (15 femininos, 24 masculinos) foram incluídos, com idade média de 62,43 ± 8,7 anos (variando de 44-79 anos). Trinta e três olhos foram tratados com ranibizumab e 18 com bevacizumab. O número médio de injeções de anti-VEGF foi 2,28 ± 1,27 (variando de 1-5). A medida média pré-tratamento da espessura de coroide nasal, subfoveal e temporal foi 234,10 ± 8,63 µm, 246,89 ± 8,94 µm e 238,12± 8,20 µm, respectivamente. Após acompanhamento de 6 meses as medidas médias da espessura de coroide foram 210,46 ± 8,00 µm, 215,66 ± 8,29 µm e 212,43 ± 8,14 µm. A diferença entre as medidas médias pré e pós tratamento foi estatisticamente significante (p=0,0327) em todos os pontos medidos. Conclusão: Após um período de 6 meses, o uso de injeções intravítreas de anti-VEGF foi associado com diminuição significante da espessura de coroide nos pacientes com EMD. O significado clínico de uma coroide mais fina nos pacientes com EMD é desconhecido mas pode causar eventos adversos a longo prazo para função da coroide e retina, representando uma área para futura investigações.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Macular Edema/drug therapy , Choroid/drug effects , Choroid/pathology , Diabetic Retinopathy/drug therapy , Bevacizumab/administration & dosage , Ranibizumab/administration & dosage , Time Factors , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Treatment Outcome , Angiogenesis Inhibitors/administration & dosage , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Tomography, Optical Coherence , Intravitreal Injections/methods , Bevacizumab/adverse effects , Ranibizumab/adverse effects
8.
Bogotá; IETS; mayo 2016. tab, ilus, graf.
Monography in Spanish | LILACS, BRISA | ID: biblio-846624

ABSTRACT

Problema de investigación: Realizar el análisis de costo-efectividad del uso de ranibizumab comparado con aflibercept, implante intravítreo de dexametasona, triamcinolona y bevacizumab para pacientes con edema macular secundario a oclusión de la vena central de la retina en Colombia. Tipo de evaluación económica: Evaluación económica descriptiva de tipo costo-efectividad. Población objetivo: Población con la condición de degeneración macular relacionada a la edad mayor de 50 años en Colombia. Intervención y comparadores: I: Ranibizumab, C: aflibercept, implante intravítreo de dexametasona, triamcinolona y bevacizumab. Horizonte temporal: 24 años. Perspectiva: La del Sistema General de Seguridad Social en Salud (SGSSS). Tasa de descuento: Es de 5% tanto para los costos como para los desenlaces de efectividad. Estructura del modelo: Modelo de Markov de 6 estados con ciclos de 6 meses. Fuentes de datos de efectividad y seguridad: Ensayos clínicos y meta-análisis. Desenlaces y valoración: Años de vida ajustados por calidad (AVAC). Costos incluidos: Costos de medicamentos, Costos de procedimientos e insumos. Fuentes de datos de costos: Consulta a proveedores, SISMED, Manual tarifario ISS 2001. Resultados del caso base: El ranibizumab presenta una efectividad similar, expresada en AVAC, frente a los demás medicamentos antiangiogénicos (bevacizumab y aflibercept). Con respecto al aflibercept, el ranibizumab es una estrategia dominada. Por su parte, al compararlo con bevacizumab, no es una estrategia costo efectiva ya que su RICE supera el umbral de tres PIB per cápita. Análisis de sensibilidad: El ranibizumab es una estrategia dominada en cada uno de los escenarios planteados para las distintas tasas de descuento. El bevacizumab por su parte sigue presentando la mejor costo-efectividad en cada uno de los escenarios, ya que aunque su efectividad es similar, el costo asociado al tratamiento es menor que el de otras alternativas antiangiogénicas. \r\nConclusiones y discusión: Ranibizumab no es una alternativa costo-efectiva comparada con bevacizumab ni con aflibercept. El ranibizumab es costo-efectivo comparado con implante intravítreo de dexametasona y \r\npotencialmente costo-efectivo con triamcinolona.(AU)


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Angiogenesis Inhibitors/administration & dosage , Bevacizumab/administration & dosage , Dexamethasone/administration & dosage , Drug Implants , Intravitreal Injections/methods , Macular Edema/drug therapy , Ranibizumab/administration & dosage , Retinal Vein Occlusion/complications , Triamcinolone/administration & dosage , Biomedical Technology , Colombia , Cost-Benefit Analysis/economics , Health Evaluation/economics
9.
Arq. bras. oftalmol ; 78(5): 300-304, Sep.-Oct. 2015. tab, ilus
Article in English | LILACS | ID: lil-761523

ABSTRACT

ABSTRACTPurpose:To evaluate 2-year outcomes following intravitreal bevacizumab (IVB) as monotherapy for aggressive posterior retinopathy of prematurity (APROP).Methods:Medical records of 40 infants were retrospectively reviewed. Group I included infants who had received IVB injections for APROP. Group II included infants who underwent laser treatment for APROP. Anatomic and refractive outcomes and the presence of anisometropia and strabismus were assessed at follow-up examinations.Results:Group I included 48 eyes of 25 infants (11 males) with a mean gestational age (GA) of 26.40 ± 1.82 weeks and a mean birth weight (BW) of 901.40 ± 304.60 g. Group II included 30 eyes of 15 infants (6 males) with a mean GA of 27.30 ± 1.82 weeks and a mean BW of 941.00 ± 282.48 g. GA, BW, and gender distributions were similar between groups (P=0.187, P=0.685, and P=1.000, respectively). Refractive errors were significantly less myopic in group I (0.42 ± 3.42 D) than in group II (-6.66 ± 4.96 D) at 2 years (P=0.001). Significantly higher rates of anisometropia and strabismus were observed in group II than in group I (P=0.009 and P=0.036, respectively).Conclusions:The study demonstrated that IVB monotherapy can be useful in the treatment of APROP. The decreased incidence of early unfavorable refractive and functional outcomes in the IVB group compared with the laser group showed a potential benefit for patients treated with IVB, and this needs to be better evaluated in future prospective studies.


RESUMOObjetivo:Avaliar a evolução de 2 anos em crianças que receberam bevacizumab intravítreo (IVB) como monoterapia para retinopatia da prematuridade posterior agressiva (APROP).Métodos:Arquivos médicos de 40 crianças foram revisados retrospectivamente. Grupo I incluiu as crianças que tiveram injeções IVB para APROP. Grupo II foi composto por crianças que se submeteram a tratamento a laser para APROP. Os resultados anatômicos e refracionais, presença de anisometropia e estrabismo foram avaliados durante exames de acompanhamento.Resultados:Grupo I incluiu 48 olhos de 25 crianças (11 do sexo masculino) com média de idade gestacional (GA) de 26,40 ± 1,82 semanas, e média de peso ao nascimento (BW) de 901,40 ± 304,60 g. Grupo II incluiu 30 olhos de 15 crianças (6 do sexo masculino) com GA de 27,30 ± 1,82 semanas e BW de 941,00 ± 282,48 g. GA, BW e distribuição por sexo foram semelhantes entre os grupos (p=0,187, p=0,685, p=1,000, respectivamente). Nenhuma anormalidade anatômica foi observada em ambos os grupos. Erro refrativo foi significativamente menos míope no grupo I (0,42 ± 3,42 D) do que o grupo II (-6,66 ± 4,96 D) em exames aos 2 anos (p=0,001). Houve significativamente maior taxa de anisometropia e estrabismo no grupo II em relação ao grupo I (p=0,009, p=0,036, respectivamente).Conclusões:O estudo demonstrou que a monoterapia IVB pode ser útil no tratamento de APROP. A diminuição da incidência de resultados refracionais e funcionais desfavoráveis precoces no grupo IVB em comparação com o grupo do laser mostraram um benefício potencial para os pacientes tratados com IVB, e isto tem de ser melhor avaliado em estudos prospectivos no futuro.


Subject(s)
Female , Humans , Infant , Male , Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Intravitreal Injections/methods , Retinopathy of Prematurity/drug therapy , Birth Weight , Gestational Age , Logistic Models , Laser Coagulation/methods , Retrospective Studies , Risk Factors , Refractive Errors/etiology , Retinopathy of Prematurity/surgery , Statistics, Nonparametric , Time Factors , Treatment Outcome
10.
Rev. chil. pediatr ; 86(4): 279-282, ago. 2015. graf
Article in Spanish | LILACS | ID: lil-764085

ABSTRACT

Introducción: La rabdomiólisis es una enfermedad poco frecuente en pediatría. El objetivo es presentar un paciente en el que se desarrolló secundario a una deshidratación hipernatrémica grave tras una diarrea aguda. Caso clínico: Lactante de 11 meses que consultó por fiebre, vómitos, diarrea y anuria. Presentó convulsión tónico-clónica autolimitada. Ingresó en mal estado general, severamente deshidratado, con escasa reactividad. En las pruebas complementarias destacó acidosis metabólica grave, hipernatremia e insuficiencia renal prerrenal. Al tercer día apreció leve hipotonía axial y elevación de creatín fosfokinasa 75.076 UI/l, interpretado como rabdomiólisis. Se inició hiperhidratación y alcalinización sistémica, con buena respuesta clínica y bioquímica, siendo dado de alta sin secuelas motoras. Conclusiones: La hipernatremia grave está descrita como causa rara de rabdomiólisis e insuficiencia renal. En pacientes críticos es importante un alto índice de sospecha de rabdomiólisis y determinación seriada de la creatín fosfokinasa para su detección y tratamiento precoz.


Introduction: Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Case report: Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Conclusions: Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment.


Subject(s)
Animals , Guinea Pigs , Rabbits , Cytosine/analogs & derivatives , Delayed-Action Preparations/administration & dosage , Delayed-Action Preparations/chemistry , Organophosphonates/administration & dosage , Organophosphonates/chemistry , Vitreous Body/drug effects , Antiviral Agents/administration & dosage , Antiviral Agents/chemistry , Chemistry, Pharmaceutical/methods , Cytosine/administration & dosage , Cytosine/chemistry , Drug Delivery Systems/methods , Half-Life , Herpes Simplex/drug therapy , Herpesvirus 1, Human/drug effects , Intravitreal Injections/methods , Micelles , Prodrugs/administration & dosage , Prodrugs/chemistry , Retina/drug effects , Retina/virology , Vitreous Body/virology
11.
Arq. bras. oftalmol ; 78(3): 168-172, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-753026

ABSTRACT

ABSTRACT Purpose: To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE) tears after receiving ranibizumab injections. Methods: Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA), anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT) images were obtained. The height of pigment epithelial detachment (PED) was measured by SD-OCT. Results: Twelve eyes with RPE tears were studied. Nine eyes (75%) developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma), and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5). In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112). Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm. Conclusions: In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears. .


RESUMO Objetivo: Apresentar os resultados anatômicos e visuais de injeções de ranibizumab em pacientes que foram diagnosticados com roturas do epitélio pigmentado da retina (RPE). Métodos: Olhos com um mínimo de seis meses de acompanhamento após diagnóstico de roturas do RPE foram avaliados retrospectivamente. Cada olho foi tratado com, pelo menos, três doses de ranibizumab em intervalos mensais. Acuidade visual com a melhor correção (BCVA), achados do segmento anterior, pressão intraocular e exames de fundo de olho foram avaliados nas visitas de controle. Retinografia colorida, angiografias fluoresceínicas, autofluorescência de polo posterior e tomografia de coerência óptica imagens de domínio espectral (SD-OCT) foram obtidos. A altura do descolamento do epitélio pigmentado (PED) foi medida com SD-OCT. Resultados: Doze olhos com roturas do epitélio pigmentado da retina foram incluídos no estudo. Nove olhos (75%) desenvolveram roturas do epitélio pigmentado da retina durante as injeções ranibizumab para neovascularização de coroide (oito olhos com descolamento do epitélio pigmentado vascularizado e um olho com osteoma de coroide), a rotura ocorreu em três olhos antes de quaisquer injeções. A mediana do número de injeções de ranibizumab após o diagnóstico da rotura do RPE foi de 3 (mínimo 2, máximo 5). Na visita de acompanhamento mais recente, não houve correlação estatisticamente significante entre o grau de RPE e logMAR de BCVA (p>0,05, r=0,112). Oito dos doze olhos tinham descolamento do epitélio pigmentado, desses, 7 olhos tinham PEDs com contornos irregulares antes da injeção. A altura média do PED foi 447 ± 122 µm. Conclusões: Nesta série, as roturas de epitélio pigmentado da retina aconteceram principalmente após a injeção intravítrea anti-VEGF para descolamento do epitélio pigmentado vascularizado. O aumento da altura vertical e contornos irregulares dos PEDs podem ser considerados fatores de risco para a formação da rotura ...


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angiogenesis Inhibitors/administration & dosage , Macular Degeneration/drug therapy , Ranibizumab/administration & dosage , Retinal Detachment/drug therapy , Retinal Pigment Epithelium/drug effects , Angiogenesis Inhibitors/adverse effects , Choroidal Neovascularization/drug therapy , Fluorescein Angiography , Follow-Up Studies , Intraocular Pressure/physiology , Intravitreal Injections/methods , Macular Degeneration/diagnosis , Retrospective Studies , Ranibizumab/adverse effects , Retinal Detachment/chemically induced , Retinal Detachment/diagnosis , Retinal Pigment Epithelium/physiopathology , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity/drug effects
12.
Arq. bras. oftalmol ; 78(1): 27-31, Jan-Feb/2015. tab, graf
Article in English | LILACS | ID: lil-741154

ABSTRACT

Purpose: To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel. Methods: Ninety-two patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group Drops), proparacaine 0.5% drops plus subconjunctival lidocaine (Group SC), or 2% lidocaine gel (Group Gel). Patients were asked to score their pain experience using a visual analog scale of 0 to 10 immediately following the injections and 10 min, 1 h, 6 h, and 24 h after the injections. Patients also graded the overall injection experience as Excellent, Very Good, Fair, Poor, or Awful. The physician evaluated the patients’ eye movement during intravitreal injection on 3 levels: (0) none or minimal, (1) not compromising the injection, and (2) compromising the injection. Results: The patients in Group Drops had the worst mean pain scores during the injection and 10 min after, with the highest occurrence of movements compromising the procedure (Grade 2; 38.7%). The patients in Group SC had a higher percentage of good experiences (37.9%) but a higher incidence of chemosis (16.7%). The patients in Group Gel had similar overall pain scores to Group Drops patients but a higher incidence of keratitis (19.4%). There was no statistically significant correlation between the use of aspirin or anticoagulants and the occurrence of hyperemia or hyposphagma. Conclusion: Subconjunctival lidocaine was most effective in preventing pain and eye movements during intravitreal injections. Although 2% lidocaine gel produced a good overall experience for the patients, the incidence of keratitis was very high (19.4%). Therefore, we do not recommend 2% lidocaine gel as the first anesthetic choice for intravitreal injections. There is no evidence to suspend the use of aspirin or other anticoagulants drugs prior to intravitreal injections. .


Objetivo: Comparar a eficácia anestésica entre proparacaína tópica, lidocaína subconjuntival e lidocaína gel a 2%. Métodos: Noventa e dois pacientes em tratamento com injeções intravítreas foram randomizados para um de três grupos: proparacaína 0,5% gotas (Grupo gotas), proparacaína 0,5% gotas seguida de lidocaína subconjuntival (Grupo SC), ou lidocaína gel a 2%. (Grupo Gel). Os pacientes foram orientados a graduar a sua experiência de dor por uma escala visual analógica, numa escala de 0 a 10, imediatamente após as injeções, bem como 10 minutos, 1 hora, 6 horas e 24 horas após. Os pacientes também classificaram a experiência global de injeção como excelente, muito boa, regular, ruim ou horrível. O médico avaliou o movimento do olho do paciente durante a injeção intravítrea em três níveis: nenhuma ou mínima (0), não comprometendo a injeção (1), comprometendo a injeção (2). Resultados: Os pacientes do grupo gotas apresentaram uma graduação média de dor pior durante a injeção e 10 minutos após, com maior ocorrência de movimentos comprometendo a injeção (grau 2) (38,7%). Os pacientes do grupo SC, apresentaram maior percentual de boa experiência durante o procedimento (37,9%) e maior ocorrência de quemose (16,7%). Os pacientes do grupo Gel apresentaram escore de dor geral semelhante ao grupo Gotas e maior incidência de ceratite (19,4%). Não houve correlação estatisticamente significativa com o uso de aspirina ou anticoagulantes e a ocorrência de hiperemia ou hiposfagma. Conclusão: Lidocaína subconjuntival foi mais eficaz na prevenção da dor durante injeção intravítrea com movimentação ocular mínima. Embora os pacientes do grupo lidocaína gel a 2% tenham apresentado uma boa experiência, consideramos a incidência ceratite muito elevada (19,4%) e não recomendamos lidocaína gel a 2% como a primeira escolha como anestésico para injeções intravítreas. Não há evidência para a suspensão do uso de aspirina ou drogas anti-coagulantes em pacientes ...


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Intravitreal Injections/methods , Lidocaine/administration & dosage , Propoxycaine/administration & dosage , Eye Movements , Intravitreal Injections/adverse effects , Keratitis/chemically induced , Macular Degeneration/drug therapy , Macular Edema/drug therapy , Pain Measurement , Patient Satisfaction , Prospective Studies
13.
Arq. bras. oftalmol ; 78(1): 32-35, Jan-Feb/2015. tab
Article in English | LILACS | ID: lil-741161

ABSTRACT

Purpose: To evaluate and describe the precautions involved in the technique of intravitreal injection of antiangiogenic drugs adopted by the ophthalmologists who are members of the Brazilian Society of Retina and Vitreous (SBRV). Methods: A questionnaire containing 22 questions related to precautions taken before, during, and after intravitreal injection was sent electronically to 920 members of SBRV between November 15, 2013 and April 31, 2014. Results: 352 responses (38%) were obtained. There was a predominance of men (76%) from the southwest region of Brazil (51%). The professional experience varied between 6 and 15 years after medical specialization (50%). Most professionals (76%) performed an average of 1 to 10 intravitreal injections a week, and 88% of the procedures were performed in the operating room using povidone iodine (99%), sterile gloves, and blepharostat (94%). For inducing topical anesthesia, usage of anesthetic eye drops was the most used technique (65%). Ranibizumab (Lucentis®) was the most common drug (55%), and age-related macular degeneration (AMD) was the most treated disease (57%). Regarding the complications treated, 6% of the ophthalmologists had treated at least one case of retinal detachment, 20% had treated cases of endophthalmitis, 9% had treated cases of vitreous hemorrhage, and 12% had encountered cases of crystalline lens touch. Conclusion: Intravitreal injection is a procedure routinely performed by retina specialists and has a low incidence of complications. Performing the procedure in the operating room using an aseptic technique was preferred by most of the respondents. Ranibizumab was the most used drug, and AMD was the most treated disease. .


Objetivo: Avaliar e descrever os cuidados envolvidos durante o procedimento de injeção intravítrea de drogas antiangiogênicas realizado pelos oftalmologistas membros da Sociedade Brasileira de Retina e Vítreo (SBRV). Métodos: Foi enviado um questionário aos 920 membros da SBRV, por meio de correio eletrônico, entre o período de 15/11/2013 a 31/04/2014, contendo 22 questões, relacionado aos cuidados pré, intra e pós-operatório da injeção intravítrea. Resultados: Foram obtidas 352 respostas (38% dos sócios). Houve um predomínio do sexo masculino (76%), procedentes da região Sudeste (51%). O tempo de experiência profissional se concentrou entre 6 a 15 anos após o término da especialização (50%). A maioria dos participantes tem média semanal de 1 a 10 (76%), sendo 88% das vezes realizado dentro do centro cirúrgico, utilizando iodopovidona (99%), luvas e blefarostato estéreis (94%). A anestesia tópica com colírio anestésico foi a técnica mais utilizada (65%). Entre os participantes, ranibizumabe (Lucentis®) é a droga mais utilizada (55%) e a degeneração macular relacionada a idade (DMRI) é a doença mais tratada (57%). Das complicações citadas pelos oftalmologistas, 6% já vivenciaram pelo menos um caso de descolamento de retina, 20% endoftalmite, 9% hemorragia vítrea e 12% toque cristaliniano. Conclusão: A injeção intravítrea é um procedimento realizado rotineiramente por retinólogos, com baixo índice de complicações. A realização do procedimento no centro cirúrgico com técnica asséptica é preferida pelos pesquisados. A droga mais utilizada foi o ranibizumabe e a doença mais tratada foi a DMRI. .


Subject(s)
Female , Humans , Male , Intravitreal Injections/methods , Ophthalmology , Societies, Medical , Anesthesia, Local/methods , Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Brazil , Endophthalmitis/chemically induced , Health Care Surveys , Intravitreal Injections/adverse effects , Macular Degeneration/drug therapy , Ophthalmic Solutions/administration & dosage , Povidone-Iodine , Retinal Diseases/drug therapy , Surgicenters , Surveys and Questionnaires
14.
Bogotá; IETS; dic. 2014. ilus.
Monography in Spanish | LILACS, BRISA | ID: biblio-847124

ABSTRACT

Introducción: La oclusión de la vena central de la retina (OVCR) reduce las funciones individuales y la calidad de vida de aquellos individuos que la presentan; típicamente afecta a personas mayores y se considera que alrededor de un 90 % de los pacientes son mayores de 50 años al momento de inicio del cuadro. Es considerada la segunda causa más común de trastorno vascular de la retina después de la retinopatía diabética. Esta enfermedad puede conducir a pérdida visual severa a causa del edema o isquemia macular, hemorragia vítrea o glaucoma neovascular. Objetivo: examinar los beneficios y riesgos del uso de ranibizumab como uno de los criterios para informar la toma de decisiones relacionada con la posible inclusión de tecnologías en el Plan Obligatorio de Salud, en el marco de su actualización integral para el año 2015. Metodología la evaluación fue realizada de acuerdo con un protocolo definido a priori por el grupo desarrollador. Se realizó una búsqueda sistemática en MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, LILACS y Google, sin restricciones de idioma, fecha de publicación y tipo de estudio. Las búsquedas electrónicas fueron hechas en noviembre de 2014 y se complementaron mediante búsqueda manual en bola de nieve y consulta con expertos temáticos. La tamización de referencias se realizó por dos revisores de forma independiente y los desacuerdos fueron resueltos por consenso. La selección de estudios fue realizada mediante la revisión en texto completo de las referencias preseleccionadas, verificando los criterios de elegibilidad predefinidos. Las características y hallazgos de los estudios fueron extraídos a partir de las publicaciones originales. Resultados: efectividad triamcinolona, ranibizumab, bevacizumab, aflibercept, tienen alta probabilidad de presentar cambios en la mejor agudeza visual corregida comparado con placebo y con implante intravítreo de dexametasona. Los pacientes tratados con triamcinolona 4mg DEM 9,42 (IC 95 % 3,46-15,38), ranibizumab 0,5 mg DEM 14,06 (IC 95 % 10,46-17,65), bevacizumab 1,25 mg DEM 15,69 (IC 95 % 5,86-25,47), aflibercept 2 mg DEM 17,46 (IC 95% 14,37-20,57), tienen alta probabilidad de presentar cambio en la mejor agudeza visual corregida cuando se comparan con placebo. Cambios en la tomografía de coherencia óptica (grosor de la retina) Al mes de seguimiento : se presentó disminución significativa a favor de los inhibidores de VEGF cuando se comparan con placebo DEM - 264,67 (IC 95 % -377,00 ; -152,35), con una heterogeneidad extremadamente alta I2 94 %. A los seis meses se presentó disminución significativa a favor de los inhibidores de VEGF cuando se comparan con placebo DEM -224,52 (IC 95 % -377,77; -111,27), con una heterogeneidad extremadamente alta I2 93 %. A los doce meses: No se encontraron diferencias estadísticamente significativas. Conclusiones: efectividad triamcinolona, ranibizumab, bevacizumab, aflibercept, tienen alta probabilidad de presentar cambios en la mejor agudeza visual corregida comparado con placebo y con implante intravítreo de dexametasona. Además tienen alta probabilidad de ganar tres o más líneas comparado con placebo, así como, disminuir el grosor central de la retina. En relación con la seguridad del tratamiento para el edema macular secundario a oclusión de la vena central de la retina, se evidenció que el uso de corticoides como: la triamcinolona y la dexametasona incrementa la presión intraocular y la presencia de cataratas cuando se comparan con placebo; mientras que para los inhibidores de VEGF como: aflibercept, ranibizumab y bevacizumab no se reportaron de manera significativa eventos adversos oculares o sistémicos cuando se comparan con placebo. En esta revisión no se identificó evidencia que cumpliera con los criterios de inclusión para los desenlaces de grado de isquemia retiniana y mantenimiento de la ganancia en la agudeza visual, ni la comparación con láser.(AU)


Subject(s)
Humans , Bevacizumab/therapeutic use , Dexamethasone/therapeutic use , Intravitreal Injections/methods , Light Coagulation/methods , Macular Edema/therapy , Ranibizumab/therapeutic use , Retinal Vein Occlusion/complications , Triamcinolone/therapeutic use , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Biomedical Technology , Colombia , Reproducibility of Results , Treatment Outcome
15.
Rev. cuba. oftalmol ; 27(3): 403-415, jul.-set. 2014. ilus, tab
Article in Spanish | LILACS, CUMED | ID: lil-744018

ABSTRACT

OBJECTIVE: to evaluate the results of the treatment of bevacizumab in the macular edema secondary to occlusion of a branch retinal vein. METHODS: prospective, interventional, not comparative study, in 18 patients with macular edema secondary to occlusion of branch retinal vein. The treatment was of intravitreal injection of Bevacizumab (up to 3 dose) followed by grid macular if was necessary. The initial evaluation went to the 3 months of the occlusion and they were followed the patients by 12 months. It was evaluated the corrected better visual acuity, macular thickness and the occurrence of complications. RESULTS: the patients were 7 men (38,89%) and 11 women (61,11 %) 63,1 (44-80) years of age average. Of the treatment, 7 required 1 dose (38,89 %), 6 with 2 dose (33,33 %) and 5 with 3 dose (27,77 %) more grid macular. To the beginning the average of the best visual acuity with correction was of 0,24 (0,05-0,5) and of the macular thickness of 546,2 (283-1 020) µ. To the 12 months the best visual acuity with correction average improved at 0,65 (0,1-1,0) and the macular thickness at 181,05 (112-312) µ. there were not complications associated with proceeding. CONCLUSION: the injection of bevacizumab constitutes an effective treatment in the edema secondary macular to occlusion of branch veined retiniana.


OBJETIVO: evaluar los resultados del tratamiento de intravítrea de bevacizumab en el edema macular secundario a oclusión de rama venosa retiniana. MÉTODOS: estudio prospectivo, intervencional, no comparativo, en 18 pacientes con edema macular secundario a oclusión de rama venosa retiniana. El tratamiento fue de inyección intravítrea de bevacizumab (hasta 3 dosis) seguido de grid macular si era necesario. La evaluación inicial fue a los 3 meses de la oclusión y se siguieron a los pacientes por 12 meses. Se evaluó la agudeza visual mejor corregida, el grosor macular y la ocurrencia de complicaciones. RESULTADOS: los pacientes fueron 7 hombres (38,89 %) y 11 mujeres (61,11 %). El promedio de edad fue de 63,1 (44-80). Durante el tratamiento, hubo 7 pacientes con 1 dosis (38,89 %), 6 con 2 dosis (33,33 %) y 5 con 3 dosis (27,77 %) más grid macular. Al inicio, el promedio de la mejor agudeza visual con corrección fue de 0,24 (0,05-0,5) y del grosor macular de 546,2 (283-1 020) µ. A los 12 meses la mejor agudeza visual con corrección promedio mejoró a 0,65 (0,1-1,0) y el grosor macular a 181,05 (112-312) µ. No hubo complicaciones asociadas con el proceder. CONCLUSIÓN: la inyección intravítrea de bevacizumab constituye un tratamiento eficaz en el edema macular secundario a oclusión de rama venosa retiniana.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Visual Acuity , Macular Edema/therapy , Intravitreal Injections/methods , Prospective Studies
16.
Einstein (Säo Paulo) ; 12(1): 106-108, Jan-Mar/2014. graf
Article in English | LILACS | ID: lil-705804

ABSTRACT

We report the case of a patient with congenital toxoplasmosis and submacular hemorrhage caused by a neovascular membrane who underwent an intravitreal injection of C3F8 and bevacizumab, and had a good visual recovery.


Relatamos o caso de uma paciente com toxoplasmose congênita e hemorragia submacular por uma membrana neovascular submetida à injeção intravítrea de C3F8 e bevacizumabe, com boa recuperação visual.


Subject(s)
Adolescent , Female , Humans , Intravitreal Injections/methods , Retinal Hemorrhage/drug therapy , Retinal Hemorrhage/etiology , Toxoplasmosis, Congenital/complications , Toxoplasmosis, Congenital/drug therapy , Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Contrast Media , Fluorocarbons , Time Factors , Treatment Outcome , Visual Acuity
17.
Rev. Soc. Colomb. Oftalmol ; 47(2): 127-136, 2014. tab. graf.
Article in Spanish | LILACS, COLNAL | ID: biblio-967871

ABSTRACT

Objetivo: describir la prevalencia de contaminación bacteriana de agujas utilizadas en inyecciones intravítreas en pacientes tratados con Ranibizumab, analizar la flora normal conjuntival, identificar el germen más común en cultivos de agujas utilizadas y establecer la eficacia de profilaxis antibiótica preoperatoria en la reducción de la flora normal conjuntival presente en el procedimiento. Métodos: estudio observacional descriptivo tipo serie de casos. Se incluyen pacientes de la Fundación Oftalmológica Nacional sometidos a inyección intravítrea de Ranibizumab desde Abril 6 a Septiembre 28 del 2010. Edades entre 44 - 91 años. Se tomó frotis conjuntival del fondo de saco inferior para cultivo de flora normal al momento de la inyección y de la aguja utilizada y no utilizada. Se siembran muestran en tres medios de cultivo a 37ºC/ 5 días. Resultados: se realizaron 150 cultivos, 50 ojos de 50 pacientes. 44 pacientes (88%) fueron consistentes y se incluyeron en el análisis. 6 (12%) fueron no consistentes. Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Difteroides y Staphylococcus haemolyticus. El Staphylococcus aureus fue la bacteria causal más frecuente contaminante de la aguja utilizada (10%), Difteroides (4%) y Bacillus subtilis (4%). Difteroides, Bacillus subtilis y Staphylococcus aureus fueron los contaminantes de las agujas no utilizadas. El Staphylococcus haemolyticus, aureus, epidermidis y Difteroides fueron cultivados en la flora normal conjuntival de pacientes con cultivo de aguja negativo. El 61.4% de los cultivos no presentaron crecimiento bacteriano. Conclusión: el Staphylococcus aureus fue la bacteria causal más frecuente de contaminación de las agujas utilizadas siendo el Bacillus subtilis el principal contaminante de agujas no utilizadas. El uso de profilaxis antibiótica previa al procedimiento reduce significativamente el inóculo bacteriano. Se requieren futuros estudios con ampliación de la muestra para controlar posibles fallas técnicas.


Purpose: to evaluate the prevalence of bacterial contamination in needles used for intravitreal injections of Ranibizumab, analyze conjunctival flora, identify the most common microorganism present in used needles and evaluate the efficacy of antibiotic prophylaxis in reducing conjunctival flora at the time of the procedure. Methods: a case series study. Patients of the Fundación Oftalmológica Nacional, who underwent intravitreal injections of Ranibizumab between April 6 and September 28, 2010. Ages 44 to 91 years. The used needle, an unused control needle and a conjunctival scraping from the inferior fornix were inoculated in tryptone soy broth at 37°C for 5 days. Results: 150 cultures were obtained from 50 patients.44 patients had consistent results (negative control needle) and were included in the analysis. Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Difteroides, y Staphylococcus haemolyticus were identified. Staphylococcus aureus was the most frequent contaminant of the used needles (10%), followed by Difteroides (4%) and Bacillus subtilis (4%). Difteroides, Bacillus subtilis and Staphylococcus aureus were found in unused needles. Staphylococcus haemolyticus, aureus, epidermidis and Difteroides were found in the conjunctival samples. 61.4% had negative cultures. Conclusion: Staphylococcus aureus was the most frequent contaminant of used needles and Bacillus subtilis of control needles. The use of antibiotic profilaxis previous to the procedure, significantly reduces the bacterial inoculums. Futures studies are required to increase sample size and control technical errors.


Subject(s)
Intravitreal Injections/methods , Staphylococcal Infections/drug therapy , Endophthalmitis/therapy , Antibiotic Prophylaxis/statistics & numerical data
18.
Arq. bras. oftalmol ; 76(6): 377-379, nov.-dez. 2013. ilus
Article in Portuguese | LILACS | ID: lil-701292

ABSTRACT

Retinose pigmentar indica um grupo heterogêneo de doenças genéticas oculares raras em que tanto bastonetes quanto cones estão danificados, levando a um prognóstico ruim com eventual perda da visão. Descrevemos o caso de mulher de 22 anos com edema macular recorrente devido à retinose pigmentar. Obteve-se sucesso terapêutico após o tratamento com o implante intravítreo de dexamentasona (Ozurdex®, Allergan,USA).


Retinitis pigmentosa denotes a heterogeneous group of rare genetic diseases in which both rods and cones eye are damaged. It is a disease of poor prognosis. We describe the case of a 22 years old woman successfully treated with intravitreal implant of dexamentasone (OZURDEX®, Allergan, USA) for the treatment of macular edema due to retinitis pigmentosa.


Subject(s)
Female , Humans , Young Adult , Dexamethasone/administration & dosage , Glucocorticoids/administration & dosage , Intravitreal Injections/methods , Macular Edema/drug therapy , Retinitis Pigmentosa/drug therapy , Drug Implants , Macular Edema/etiology , Retinitis Pigmentosa/complications , Time Factors , Treatment Outcome , Visual Acuity
19.
Rev. bras. oftalmol ; 72(3): 185-187, maio-jun. 2013. ilus
Article in English | LILACS | ID: lil-690247

ABSTRACT

The authors relate a predominantly hemorrhagic choroidal neovascular lesion from neovascular. Age-related macular degeneration patient case treated with intravitreal ranibizumab therapy. Monthly ranibizumab (six intravitreal injections) displayed a promising response but this limited report is insufficient to guarantee the indication for all predominantly hemorrhagic choroidal neovascular lesion from neovascular age-related macular degeneration. Further studies will be necessary for complete validation of our results for all predominantly hemorrhagic choroidal neovascular lesions from CNV due to AMD...


Os autores apresentam um caso de paciente com lesão neovascular predominantemente hemorrágica com degeneração macular relacionada à idade, tratada mensalmente com injenções intravítrea com ranibizumab. Discutem sua evolução, que apesar da boa resposta terapêutica, necessita de maiores estudos para confirmação de seus resultados...


Subject(s)
Humans , Female , Aged , Antibodies, Monoclonal/therapeutic use , Macular Degeneration/drug therapy , Immunologic Factors/therapeutic use , Intravitreal Injections/methods , Choroidal Neovascularization/drug therapy
20.
Indian J Ophthalmol ; 2013 Jan-Feb; 61(1): 3-7
Article in English | IMSEAR | ID: sea-145335

ABSTRACT

Purpose: To evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on retinal sensitivity in cases of macular edema(ME) secondary to branch retinal vein occlusion (BRVO). Materials and Methods: Total of 14 eyes of 14 cases of BRVO were included in this prospective study. In each eye, at baseline and 1, 3, and 6 months after IVTA injection, logMAR visual acuity, central 4° retinal sensitivity by MP-1 microperimetry, and optical coherence tomography foveal thickness were assessed. Results: Cases ages ranged from 60 to 79 years (mean 68 ± 8 years). At 1, 3, and 6 months, the logMAR visual acuity had increased from 0.71 ± 0.21 to 0.42 ± 0.21, 0.46 ± 0.30, and 0.46 ± 0.27; the mean foveal thickness had decreased from 540 ± 88 μm to 254 ± 51 μm, 288 ± 84 μm, and 280 ± 91 μm; and the mean retinal sensitivity had increased from 4.7 ± 2.5 dB to 7.9 ± 2.7 dB, 8.2 ± 3.6 dB, and 8.3 ± 4.6 dB, respectively. Conclusion: In eyes with ME secondary to BRVO, IVTA injections result in a significant increase in not only the visual acuity but also the central 4° retinal sensitivity in 6 months follow-up.


Subject(s)
Aged , Female , Humans , Intravitreal Injections/methods , Macular Edema/drug therapy , Macular Edema/etiology , Male , Retinal Vein Occlusion/complications , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/therapeutic use , Visual Acuity/drug effects , Visual Field Tests/methods
SELECTION OF CITATIONS
SEARCH DETAIL