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Article in Chinese | WPRIM | ID: wpr-880414


Dry eye is a common ophthalmic disease caused by eye maladjustment due to meibomian gland dysfunction (MGD), which is often accompanied by symptoms such as increased tear film osmotic pressure and ocular surface inflammation. In the treatment of dry eye patients, dredging gland obstruction caused by meibomian gland secretion is an effective treatment method. Based on electrothermal effect and hyperelasticity of the silicone, an auxiliary treatment instrument for MGD is designed, which can improve the blood circulation of the glands through heat compress and massage to achieve the purpose of dredging the meibomian glands. The therapy device can display the temperature and pressure during the treatment in real time, so that the surgeon can grasp the progress of the treatment in real time. The therapy device constructs a user-oriented interactive interface based on parametric modeling method, which can be customized by 3D printing according to the user's eyeball geometric parameters. The designed therapeutic device was finally tested on New Zealand white rabbits. The experimental results show that the therapeutic device has significant effectiveness and safety, as well as clinical application prospects.

Animals , Dry Eye Syndromes/therapy , Humans , Meibomian Gland Dysfunction , Meibomian Glands , Rabbits , Tears , Treatment Outcome
Rev. bras. oftalmol ; 80(5): e0043, 2021. tab
Article in English | LILACS | ID: biblio-1347257


ABSTRACT Introduction: The SARS-CoV-2 pandemic has been a major challenge for the international scientific community. Since its inception, studies aiming to describe pathophysiological aspects and clinical manifestations of the disease have been conducted, raising hypotheses and confirming possible associations. One aspect of this scientific medical production is the role of the ocular surface as a means of transmission and clinical presentation of viral syndrome. Objectives: To analyze the role of the ocular surface in transmission, pathophysiology, and clinical manifestations of SARS-CoV-2, by means of a systematic review. Methods: The search was carried out in three databases: Cochrane, PubMed Central Journals and MEDLINE, using the following descriptors: "COVID-19, ophthalmology". The filters last five years and studies on humans resulted in 32 studies; in that 12 were excluded for not meeting the purpose of the study. Results: There are still few published studies on the relation between SARS-CoV-2 and the ocular route. Most studies showed an association between the presence of nonspecific ocular manifestations and infection by the new coronavirus, with limitations in the number of patients analyzed and the methodology adopted. Hypotheses about the pathophysiological role are largely anchored in the association of SARS-CoV and the ocular surface evaluated in the past. Comments: The results found are still not sufficient to confirm the role of the ocular surface in the pathophysiology of the disease. Most of these preliminary studies are of considerable importance in raising hypotheses based on the medical analysis of the patients studied. However, larger studies with standardized methodology for diagnostic protocol and laboratory analysis of the individuals assessed are required.

RESUMO Introdução: A pandemia da SARS-CoV-2 tem sido um grande desafio para a comunidade científica internacional. Desde seu surgimento, estudos com a intenção de descrever os aspectos fisiopatológicos e as manifestações clínicas da doença vêm sendo conduzidos, levantando hipóteses e confirmando possíveis associações. Um dos temas dessa produção médica científica é o papel da superfície ocular como meio de transmissão e apresentação clínica da síndrome viral. Objetivo: Analisar o papel da superfície ocular na transmissão, na fisiopatologia e nas manifestações clínicas de SARS-CoV-2, através de uma revisão sistemática. Realizou-se a busca em três bancos de dados Cochrane Database, PubMed® e MEDLINE®, utilizando os descritores "COVID-19 e ophthalmology". Foram definidos como filtros o artigo ter sido publicado nos últimos 5 anos e estudo realizado em humanos, tendo sido encontrados 32 artigos. Destes, foram excluídos 12 por não corresponderem ao objetivo do estudo. Resultados: Ainda são poucos os estudos publicados sobre a relação entre o coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2) e a via ocular. A maioria dos estudos mostrou associação entre a presença de manifestações oculares inespecíficas e a infecção pelo novo coronavírus, com limitações no número de pacientes analisados e na metodologia adotada. Hipóteses sobre o papel fisiopatológico se ancoram, em grande parte, na associação estudada entre o SARS-CoV-2 e a superfície ocular no passado. Comentários: Os resultados encontrados ainda não são suficientes para confirmar o papel da superfície ocular na fisiopatologia da doença. Grande parte desses estudos preliminares têm importância considerável ao levantar hipóteses baseadas na análise clínica dos pacientes estudados. No entanto, são necessários estudos maiores e com metodologia padronizada para protocolo diagnóstico e análise laboratorial dos indivíduos avaliados.

Humans , Eye Infections, Viral/transmission , Coronavirus Infections/complications , Coronavirus Infections/transmission , Eye Diseases/virology , Eye Manifestations , Tears/virology , Conjunctivitis, Viral/transmission , Conjunctiva/virology , Eye/virology , Betacoronavirus/isolation & purification , SARS-CoV-2 , COVID-19
Arq. bras. oftalmol ; 83(6): 511-516, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1153082


ABSTRACT Purpose: The effects of sex steroid hormones on tearparameters are known. Theaim of this studywas to examine the effects on tear parameters during exposure to high-dose sex steroids in a short period of time. Methods: Forty patients who were admitted to the infertility clinic of our hospital and planned to undergo ovulation induction with exogenous gonadotropins were included in our study. Prior tothe initiation of ovulation induction, the basal levels of estradiol were measured on day 3 of the menstrual cycle and ophthalmologic examinations were performed by the ophthalmology department of our hospital. The estradiol levels were-measured on the day ofovulation induction usinghuman chorionic gonadotropin and compared with basal estra­diol; eye examinations were also repeated. Result: Forty women with reproductive period and average age of 33.3 ± 4.2 years were included in this study. Basal levels of estradiol were significantly (p<0.001) higher after ovulation induction than before induction. The scores in the break-up timeand after induction were 6.2 ± 2.8 sn and 8.4 ± 1.4 sn, respectively. The values of Schirmer's test were 14.3 ± 7.1 mm and 20.6 ± 6.2 mm before and after induction, respectively. Both values were significantly higher after ovulation induction (p<0.001; p=0.001, respectively). Conclusion: We observed impro­vemet in tear function tests following the use of estradiol even for a limited time.The use of estradiol during menopause may improve dry eye symptoms in patients.

RESUMO Objetivo: Os efeitos dos hormônios esteróides se­xuais nos parâmetros lacrimais são conhecidos. O objetivo deste estudo foi examinar como os efeitos nos parâmetros lacrimais durante a exposição a altas doses de esteróides sexuais em um curto período de tempo. Métodos: Quarenta pacientes que foram admitidas na clínica de infertilidade do nosso hospital e planejavam a indução de ovulação por gonadotropinas exógenas. Antes do início da indução da ovulação, os níveis basais de estradiol foram medidos no terceiro dia do ciclo menstrual e os exames oftalmológicos foram efetuados pelo Departamento de Oftalmologia do nosso hospital. Os níveis de estradiol foram medidos no dia da indução da ovulação usando gonadotrofina coriónica humana e comparados aos estradiol basal; exames oftalmológicos também foram repetidos. Resultado: Quarenta mulheres com período reprodutivo e idade média de 33,3 ± 4,2 anos foram incluídas neste estudo. Os níveis basais de estradiol foram significativamente maiores (p<0,001) após a indução da ovulação do que antes desta. Os resultados dos testes de ruptura do filme lacrimal e após a indução foi de 6,2 ± 2,8 s e 8,4 ± 1,4 s respectivamente. Os valores do teste de Schirmer foram 14,3 ± 7,1 mm e 20,6 ± 6,2 mm, respectivamente antes e depois da indução. Ambos os valores foram significativamente maiores após a indução da ovulação (p<0,001; p=0,001 respectivamente). Conclusão: Observamos uma melhora nos testes de função lacrimal após o uso de estradiol, mesmo por tempo limitado. O uso de estradiol durante a menopausa poderá melhorar os sintomas do olho seco em pacientes.

Humans , Female , Adult , Dry Eye Syndromes , Tomography, Optical Coherence , Estradiol , Ovulation Induction , Tears
Arq. bras. oftalmol ; 83(4): 312-317, July-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131612


ABSTRACT Purpose: To analyze the clinical outcomes of the ocular surface in patients with vitamin D deficiency after oral replacement. Methods: A total of 40 patients with vitamin D deficiency were enrolled in the study. The patients received 50,000 units of oral vitamin D weekly over a period of 8 weeks. After 8 weeks, 1,500-2,000 units/d were administered for 24 weeks. Eyelid margin score, meibomian gland expressibility score, Oxford grading, Schirmer I test, tear breakup time, tear osmolarity, and the Ocular Surface Disease Index score were evaluated at baseline, and at 8, 12, and 24 weeks. Results: The meibomian gland expressibility score, Schirmer I, tear breakup time, tear osmolarity, and Ocular Surface Disease Index score showed improvement 8 weeks after vitamin D supplementation (p<0.05). Compared with the pretreatment values, the eyelid margin score and Oxford grading were decreased at week 12 (p<0.05). Conclusion: Vitamin D replacement appears to improve ocular surface in individuals with vitamin D deficiency.

RESUMO Objetivo: Analisar os resultados clínicos da superfície ocular em pacientes com deficiência de vitamina D após reposição oral. Métodos: Foram incluídos no estudo 40 pacientes com deficiência de vitamina D. Os pacientes receberam 50.000 unidades de vitamina D semanalmente por um período de oito semanas. Após esse período, 1.500-2.000 unidades/dia foram administradas por 24 semanas. Escores da margem palpebral, escores de expressibilidade da glândula meibomiana, classificação de Oxford, teste de Schirmer I, tempo de ruptura lacrimal, osmolaridade da lágrima e escore do Índice de Doenças da Superfície Ocular foram avaliados no início e após 8, 12 e 24 semanas. Resultados: O escore de expressibilidade da glândula meibomiana, Schirmer I, tempo de ruptura lacrimal, osmolaridade da lágrima e o Índice de Doenças da Superfície Ocular apresentaram melhoras após 8 semanas de suplementação de vitamina D (p<0,05). Comparado com os valores do pré-tratamento, o escore da margem palpebral e a classificação de Oxford diminuíram na 12ª semana (p<0,05). Conclusão: A reposição de vitamina D parece melhorar a superfície ocular em indivíduos com deficiência de vitamina D.

Humans , Vitamin D/therapeutic use , Dry Eye Syndromes/drug therapy , Eyelid Diseases/drug therapy , Osmolar Concentration , Tears , Meibomian Glands
Arq. bras. oftalmol ; 83(3): 250-261, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1131583


ABSTRACT To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

RESUMO Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.

Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Conjunctiva/virology , Eye Diseases/complications , COVID-19 , Ophthalmology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Tears/virology , Review Literature as Topic , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Evidence-Based Medicine , Pandemics/prevention & control
Arq. bras. oftalmol ; 83(2): 103-108, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088971


ABSTRACT Purpose: To analyze whether inter-eye osmo larity differences were related to dry eye symptomatology. Methods: A total of 135 participants were randomly recruited from those who visited in the Optometry Clinic of the Optometry Faculty (Universidade de Santiago de Compostela). In a single scheduled session after the recruitment, Ocular Surface Disease Index was filled out following the standard instructions and TearLab measurements were made in both the participants' eyes (10-15 min lapse). Osmolarity values were compared between the right and left eyes and the absolute inter-ocular difference (-OD-OS-) correlated with the Ocular Surface Disease Index score for the whole sample. Based on the Ocular Surface Disease Index score, the sample was divided into four symptomatic subgroups, and differences in the -OD-OS- values were calculated. Results: The whole sample showed a statistically significant inter-eye osmolarity difference (p=0.025; -OD-OS- = 9.2 ± 9.3 mOsm/l) and the correlation between Ocular Surface Disease Index and -OD-OS- (r=0.369; p<0.001). A statistically significant difference was found in the -OD-OS- value between symptomatic subgroups (Kruskal-Wallis, p=0.003). Mann-Whitney U test showed a significant difference between asymptomatic vs. moderate (p=0.006) vs. severe symp tomatic patients (p=0.001) and between mild vs. severe symptomatic patients (p=0.045), whereas no difference on -OD-OS- was found between participants with contiguous symptomatic subgroups (all p³0.174). Conclusion: Tear film inter-eye osmolarity differences are significantly higher in severe dry eye disease symptoms.

RESUMO Objetivo: Analisar se as diferenças entre osmolaridade entre os olhos foram relacionadas à sintomatologia do olho seco. Métodos: Um total de 135 participantes foram recrutados aleatoriamente entre os indivíduos da Clínica de Optometria da Faculdade de Optometria (Universidade de Santiago de Compostela). Em uma única sessão agendada após o recrutamento, o Índice de Doenças da Superfície Ocular foi preenchido seguindo as instruções padrão e as mensurações do TearLab foram feitas em ambos os olhos dos participantes (lapso de 10 a 15 min). Os valores de osmolaridade foram com parados entre os olhos direito e o esquerdo e a diferença absoluta ocular (-OD-OS-) correlacionada com a pontuação do Índice de Doença da Superfície Ocular para toda a amostra. Com base na pontuação do Índice de Doença da Superfície Ocular, a amostra foi dividida em quatro subgrupos sintomáticos, e as diferenças nos -OD-OS- os valores foram calcula dos. Resultados: A amostra total mostrou uma diferença de osmolarida de entre os olhos estatisticamente significativa (p=0,025; -OD-OS- = 9,2 ± 9,3 mOsm/l) e a correlação entre o Índice de Doença da Superfície Ocular e -OD-OS- (r=0,369; p<0,001). Diferença estatisticamente significativa foi encontrada no valor -OD-OS- entre os subgrupos sintomáticos (Kruskal-Wallis, p=0,003). O teste U de Mann-Whitney mostrou uma diferença significativa entre pacientes assintomáticos versus moderados (p=0,006) versus sintomáticos graves (p=0,001) e entre pacientes sinto máticos leves e graves (p=0,045), enquanto que nenhuma di ferença de -OD-OS- foi encontrada entre os participantes de subgrupos sintomáticos contíguos (todos p³0,174). Conclusão: As diferenças entre osmolaridade inter-ocular do filme lacrimal são significativamente maiores nos sintomas graves da doença do olho seco.

Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Tears/chemistry , Dry Eye Syndromes/physiopathology , Osmolar Concentration , Reference Values , Severity of Illness Index , Surveys and Questionnaires , Statistics, Nonparametric
Article in Korean | WPRIM | ID: wpr-811330


PURPOSE: The Ocular Surface Disease Index (OSDI) and the Standardized Patient Evaluation of Eye Dryness (SPEED) which are standard questionnaires of dry eye syndrome were used to determine the associations between clinical dry eye tests and meibomian gland dysfunctions (MGD).METHODS: Forty-one patients with MGD were enrolled in this study. The score of the dry eye syndrome questionnaire and the degree of blepharitis (score: 0–4), Schirmer test results, degree of fluorescence staining of cornea (Oxford Grading System), tear break-up time (TBUT), Pentacam imaging, and anterior segment optical coherence tomography results were used to compare and analyze the results of each test for possible correlations with the dry eye questionnaire answers.RESULTS: There was a significant correlation between OSDI and SPEED (R = 0.278, p = 0.011). SPEED was correlated with the Oxford grade (R = 0.478, p < 0.001) and MGD grade (R = 0.280, p = 0.011) while there was no significant correlation with corneal aberrations, tear meniscus height, tear meniscus area, Schirmer test results, or TBUT. The OSDI correlated with the MGD grade (R = 0.651, p < 0.001), TBUT (R = −0.360, p = 0.001), and age (R = −0.230, p = 0.037). Using multiple regression analyses, the MGD grade affected the OSDI (β = 0.580, p < 0.001) and the Oxford grade significantly influenced the SPEED (β = 0.447, p < 0.001).CONCLUSIONS: In Koreans, the OSDI questionnaire answers were associated with the MGD grade and SPEED questionnaire answers were associated with the corneal surface status. The OSDI questionnaire was therefore clinically useful in patients with meibomian gland dysfunction.

Blepharitis , Cornea , Dry Eye Syndromes , Fluorescence , Humans , Meibomian Glands , Tears , Tomography, Optical Coherence
Article in Korean | WPRIM | ID: wpr-811329


PURPOSE: To determine whether eyeliner tattoo affects the meibomian gland (MG) and ocular surface.METHODS: The medical charts of an eyeliner tattoo group (16 eyes of 8 patients) and a control group (16 eyes of 18 patients) were retrospectively reviewed. The ocular surface disease index questionnaire, ocular surface staining score, tear film break-up time (TBUT), upper eyelid abnormality, meibum expressibility and quality, and MG loss and tear film lipid layer thickness (LLT) which measured with LipiView® (TearScience, Morrisville, NC, USA) were compared. In the tattoo group, the correlation between the distance from the MG orifice to the tattoo pigment and other indices were analyzed.RESULTS: Compared to controls, the tattoo group had a significantly higher ocular surface disease index (p = 0.002), shorter TBUT (p < 0.001), higher vessel engorgement of the upper lid (p = 0.016), poorer meibum expressibility and quality (p = 0.006 and p < 0.001, respectively), higher MG loss (p < 0.001), and thinner LLT (p = 0.024). In the tattoo group, the closer the tattoo was to the MG orifice, the more the upper lid vessel was engorged and the more MG loss occurred (r(s) = −0.560, p = 0.024; r(s) = −0.563, p = 0.023, respectively), and a thinner LLT was observed (r(s) = 0.567, p = 0.022).CONCLUSIONS: Eyeliner tattoos may be related to changes in the lid margin, loss of the MG, and thinning of the LLT.

Dry Eye Syndromes , Eyelids , Meibomian Glands , Retrospective Studies , Tears
Article in Korean | WPRIM | ID: wpr-811317


PURPOSE: To evaluate clinical findings in phlyctenular keratoconjunctivitis patients and assess the function and morphology of Meibomian glands using an interferometer (LipiView®, TearScience, Morrisville, NC, USA) in such patients.METHODS: This retrospective study included 19 eyes of 13 patients diagnosed with phlyctenular keratoconjunctivitis. The lipid layer thickness (LLT) and meibograph of each eye was quantified by tear interferometry. Tear film break-up time (TBUT) and corneal staining score were measured. Meibomian gland morphology (lid margin vascularity, plugging of gland orifices, lid margin irregularity, lid margin thickening, and partial glands) was evaluated based on anterior photographs and meibographs.RESULTS: The mean age was 21.3 years (8–44 years). Mean BUT and Oxford corneal staining scores were 2.6 ± 1.2 seconds and 1.9 ± 0.8, respectively. Abnormal findings of the Meibomian glands were observed in all patients. The mean LLT was 79.6 ± 27.4 µm and the incomplete eye blinking frequency was 3.8 ± 5.9 during 20 seconds. The graphs of the tear lipid layer showed various patterns such as flat, up-hill, down-hill, and mixed.CONCLUSIONS: Meibomian gland dysfunctions and changes in the tear film lipid layer were noted in patients with phlyctenular keratoconjunctivitis. These factors are to be considered for the treatment of phlyctenular keratoconjunctivitis in young patients under 10 years of age.

Blinking , Humans , Interferometry , Keratoconjunctivitis , Meibomian Glands , Retrospective Studies , Tears
Article in English | WPRIM | ID: wpr-811117


BACKGROUND: There is a paucity of literature on the use of hip arthroscopy for pathologic conditions in skeletally immature patients. Thus, the indications and safety of the procedure are still unclear. The purpose of this study was to investigate the safety and functional outcomes of hip arthroscopy for pediatric and adolescent hip disorders. We further attempted to characterize arthroscopic findings in each disease.METHODS: We retrospectively reviewed 32 children and adolescents with hip disorders who underwent 34 hip arthroscopic procedures at a tertiary care children's hospital from January 2010 to December 2016. We evaluated functional limitations and improvement after operation by using the modified Harris hip score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), subjective pain assessment with a visual analog scale (VAS), and range of hip motion as well as the complications of hip arthroscopy. Arthroscopic findings in each disease were recorded.RESULTS: Hip arthroscopy was performed for Legg-Calvé-Perthes disease (n = 6), developmental dysplasia of the hip (n = 6), slipped capital femoral epiphysis (n = 5), idiopathic femoroacetabular impingement (n = 6), sequelae of septic arthritis of the hip (n = 3), hereditary multiple exostosis (n = 2), synovial giant cell tumor (n = 3), idiopathic chondrolysis (n = 2), and posttraumatic osteonecrosis of the femoral head (n = 1). Overall, there was a significant improvement in the modified HHS, WOMAC, VAS, and range of hip motion. Symptom improvement was not observed for more than 18 months in four patients who had dysplastic acetabulum with a labral tear (n = 2) or a recurrent femoral head bump (n = 2). There were no complications except transient perineal numbness in five patients.CONCLUSIONS: Our short-term follow-up evaluation shows that hip arthroscopy for pediatric and adolescent hip disorder is a less invasive and safe procedure. It appears to be effective in improving functional impairment caused by femoroacetabular impingement between the deformed femoral head and acetabulum or intra-articular focal problems in pediatric and adolescent hip disorders.

Acetabulum , Adolescent , Arthritis, Infectious , Arthroscopy , Child , Exostoses, Multiple Hereditary , Femoracetabular Impingement , Follow-Up Studies , Giant Cell Tumors , Head , Hip , Humans , Hypesthesia , Legg-Calve-Perthes Disease , Ontario , Osteoarthritis , Osteonecrosis , Pain Measurement , Retrospective Studies , Slipped Capital Femoral Epiphyses , Tears , Tertiary Healthcare , Visual Analog Scale
Article in Korean | WPRIM | ID: wpr-786596


PURPOSE: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate.MATERIALS AND METHODS: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 – 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed.RESULTS: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%.CONCLUSION: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Female , Humans , Lifting , Male , Maxilla , Membranes , Methods , Prostheses and Implants , Retrospective Studies , Suppuration , Survival Rate , Tears , Transplants
Rev. salud bosque ; 10(1): 1-11, 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1104443


El fluido lagrimal se caracteriza por ser una mezcla de moléculas que incluye proteínas, lípidos, metabolitos, entre otros; estas moléculas juegan un papel importante en la fisiopatología de distintas enfermedades, por lo cual las lágrimas han sido de gran interés para la comunidad científica en la búsqueda de biomarcadores y en el desarrollo de estrategias terapéuticas para enfermedades sistémicas y oculares. La poca invasividad y el bajo riesgo al obtener la lágrima la convierten en una interesante muestra en comparación con algunos fluidos corporales que pueden ser mucho más costosos y molestos para su obtención. Lo anterior ha sido demostrado en diversos estudios que sugieren estrategias para obtener la muestra e indican un posterior análisis mediante avanzadas técnicas de biología molecular y celular, entre ellas los análisis ómicos, que han logrado una mejor caracterización lagrimal.Los análisis ómicos han contribuido en la identificación diferencial de distintas moléculas que pueden desempeñar un papel importante en el diagnóstico, seguimiento y/o tratamiento de enfermedades oculares y sistémicas. Por tanto, el propósito del presente artículo fue describir las diferentes características del fluido lagrimal, así como los posibles candidatos de biomarcadores de patologías oculares y sistémicas reportados.

The lacrimal fluid is characterized by a mixture of molecules from proteins, lipids, metabolites among others, which play an important role in the pathophysiology of different diseases, for which it has been of great interest in the scientific community for the search of biomarkers and development of therapeutic strategies in systemic and eye diseases. The lower invasiveness and risk when obtaining the tear, makes it an interesting sample compared to some bodily fluids that can be much more expensive and annoying to obtain. The above has been demonstrated through various studies in which they suggest different strategies to obtain the sample and its subsequent analysis using techniques of molecular and cellular biology among them advanced molecular technology such as those such as omic analyses, which have achieved a better lacrimal characterization. These analyses have contributed to the differential identification of different molecules that may play an important role in the diagnosis, monitoring and/or treatment of eye and systemic diseases. The purpose of this article is to describe the different characteristics of the tear fluid as well as the possible candidates for biomarkers of mainly reported eye and systemic pathologies.

O líquido lacrimal é caracterizado por ser uma mistura de moléculas que inclui proteínas, lipídios, metabólitos, entre outros; Essas moléculas desempenham um papel importante na fisiopatologia de diferentes doenças, motivo pelo qual as lágrimas têm sido de grande interesse para a comunidade científica na busca de biomarcadores e no desenvolvimento de estratégias terapêuticas para doenças sistêmicas e oculares. A baixa invasividade e o baixo risco de obter a lágrima fazem dela uma amostra interessante em comparação com alguns fluidos corporais que podem ser muito mais caros e problemáticos de obter. Isso foi demonstrado em vários estudos que sugerem estratégias para obter a amostra e indicam uma análise subsequente usando técnicas avançadas de biologia molecular e celular, incluindo análise ômica, que alcançaram melhor caracterização das lágrimas.A análise ômica contribuiu para a identificação diferencial de diferentes moléculas que podem desempenhar um papel importante no diagnóstico, monitoramento e / ou tratamento de doenças oculares e sistêmicas. Portanto, o objetivo deste artigo foi descrever as diferentes características do líquido lacrimal, bem como os possíveis candidatos a biomarcadores de patologias oculares e sistêmicas relatadas.

Tears , Technology , Therapeutics , Methods , Cell Biology , Eye , Molecular Biology
Rev. bras. oftalmol ; 78(6): 394-398, nov.-dez. 2019. tab
Article in English | LILACS | ID: biblio-1057916


Abstract Objective: To investigate the effects of two types of contact lenses made of two different types of silicone hydrogel material on ocular physiological parameters and tear function tests. Methods: The contact lenses with the appropriate diopters were supplied to the volunteering patients. The patients were evaluated before wearing the contact lenses (visit0:V0), at the first month(visit1:V1) and at the thirth month(visit2:V2) following their wear. At all visits a detailed biomicroscopic examination was done, ocular physiological variables were collected, the tear function tests were performed and the tear meniscus area (TMA) was visualized and measured with anterior segment optical coherence tomography (AS-OCT). Results: The results of Schirmer 1 test were 12.07 ± 1.51 [9-16] mm for the right eyes (samfilcon A group) and 12.09 ± 1.5 [9-16] mm for the left eyes (senofilcon A group) at V0. (p=0.950) At V2, the mean Schirmer 1 test results were 11.92±1.34 [9-15] mm in the samfilcon A group and 12.2±1.41 [9-16] mm in the senofilcon A group (p=0.239). The mean TMA dimensions in the AS-OCT images were 338.42±47.1 [241-401] microns in the samfilcon A group and 338.42±47.1 [241-401]microns in the senofilcon A group at V0. (p>0.05). At V2, the mean TMA dimensions were 337.2±45.53 [241-402] microns in thesamfilcon A group and 340.31±48.22 [240-411] microns in the senofilcon A group (p=0.728). Conclusions: Our study has demonstrated that contact lenses containing samfilcon A and senofilcon A silicone hydrogel material do not cause meaningful ocular surface problems.

Resumo Objetivo: Investigar os efeitos de dois tipos de lentes de contacto feitas de dois tipos diferentes de material de hidrogel de silicone nos parâmetros fisiológicos oculares e testes de função lacrimal. Métodos: As lentes de contacto com as dioptrias apropriadas foram fornecidas aos pacientes voluntários. Os pacientes foram avaliados antes do uso das lentes de contacto (visita0: V0), no primeiro mês (visita1: V1) e no terceiro mês (visita2: V2), após o uso destas. Em todas as visitas, foi realizado um exame biomicroscópico detalhado, as variáveis fisiológicas oculares foram recolhidas, os testes de função lacrimal foram realizados e a área do menisco lacrimal (TMA) foi visualizada e medida com tomografia de coerência óptica do segmento anterior (AS-OCT). Resultados: Os resultados do teste de Schirmer 1 foram 12,07 ± 1,51 [9-16] mm para os olhos direitos (grupo samfilcon A) e 12,09 ± 1,5 [9-16] mm para os olhos esquerdos (grupo senofilcon A) em V0. (p = 0,950) Em V2, os resultados médios do teste de Schirmer 1 foram 11,92 ± 1,34 [9-15] mm no grupo samfilcon A e 12,2 ± 1,41 [9-16] mm no grupo senofilcon A (p = 0,239). As dimensões médias do TMA nas imagens AS-OCT foram 338,42 ± 47,1 [241-401] mícrons no grupo samfilcon A e 338,42 ± 47,1 [241-401] mícrons no grupo senofilcon A em V0. (p> 0,05).> Em V2, as dimensões médias do TMA foram 337,2 ± 45,53 [241-402] mícrons no grupo samfilcon A e 340,31 ± 48,22 [240-411] mícrons no grupo senofilcon A (p = 0,728). Conclusões: O nosso estudo demonstrou que as lentes de contacto que contêm material de hidrogel de silicone de samfilcon A e senofilcon A não causam problemas significativos na superfície ocular.

Humans , Male , Female , Adolescent , Adult , Silicones/pharmacology , Tears/metabolism , Contact Lenses, Hydrophilic , Hydrogels/pharmacology , Ophthalmoscopy , Visual Acuity , Prospective Studies , Tomography, Optical Coherence , Slit Lamp Microscopy , Anterior Eye Segment/diagnostic imaging , Myopia/therapy
Rev. bras. oftalmol ; 78(5): 293-296, Sept.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1042378


Abstract Objective: To study the association of dry eye with lupus disease activity and cumulative damage. To verify if epidemiological, treatment and autoantibody profile of SLE (systemic Lupus erythematosus) patients influence the presence of dry eye. Methods: We studied 70 SLE patients for the presence of dry eye by Schirmer test, disease activity by SLEDAI (SLE-Disease activity index) and cumulative damage by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index). Patients were also submitted to the OSDI (Ocular Surface Disease Index) questionnaire. Epidemiological and treatment data and autoantibody profile were extracted from the charts. Results: Dry eye by Schirmer test was present in 51.4% of the sample. No association of the presence of dry eye with SLEDAI and SLICC DI were found (p = ns). Subjective symptoms of dry eye measured by OSDI showed a modest correlation with SLEDAI (Spearman rho = 0.32). Treatment profile did not influence in the presence of dry eye that was more common in older patients (p < 0.0001). Anti dsDNA had a negative association with the presence of positive Schirmer test (p = 0.0008). Conclusions: Dry eye detected by Schirmer test in SLE patients has no association with disease activity nor cumulative damage. Anti dsDNA seems to have a protective effect in this context.

Resumo Objetivos: Estudar a associação do olho seco com a atividade do lúpus eritematoso sistêmico (LES) e seus danos cumulativos. Verificar se o perfil epidemiológico, de tratamento e de auto anticorpos de pacientes com LES influencia a presença de olho seco. Métodos: Foram estudados 70 pacientes com LES para a presença de olho seco pelo teste de Schirmer, atividade da doença por SLEDAI (SLE Disease Activity Index) e dano cumulativo por SLICC/ACR DI (Clínicas Colaborativas Internacionais de Lúpus Eritematoso Sistêmico/American College of Rheumatology Damage Index). Os pacientes também foram submetidos ao questionário OSDI (índice de doenças da superfície ocular). Os dados epidemiológicos e de tratamento e o perfil de auto anticorpos foram extraídos dos prontuários. Resultados: Olho seco pelo teste de Schirmer esteve presente em 51,4% da amostra. Nenhuma associação da presença de olho seco com SLEDAI e SLICC/ACR DI foi encontrada (p = ns). Os sintomas subjetivos do olho seco medidos por OSDI mostraram uma correlação modesta com SLEDAI (Rho de Spearman = 0,32) . O perfil do tratamento não influenciou na presença de olho seco que era mais comum em uns pacientes mais idosos (p < 0, 1). Anti dsDNA teve uma associação negativa com a presença de teste positivo de Schirmer (p = 0, 8). Conclusões: Olho seco detectado pelo teste de Schirmer em pacientes com LES não tem associação com atividade da doença nem dano cumulativo. Anti dsDNA parece ter um efeito protetor neste contexto.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/etiology , Dry Eye Syndromes/immunology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Systemic/therapy , Lupus Erythematosus, Systemic/epidemiology , Quality of Life , Autoantibodies , Tears/metabolism , Severity of Illness Index , DNA/immunology , Antibodies, Antinuclear/immunology , Cross-Sectional Studies , Surveys and Questionnaires
Arq. bras. oftalmol ; 82(5): 394-399, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1019429


ABSTRACT Purpose: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. Methods: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. Results: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. Conclusion: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.

RESUMO Objetivo: A estenose punctal pode resultar em sintomas como a epífora e diminuir significativamente a qua­lidade de vida dos pacientes. A inserção de um tampão perfurado é um procedimento fácil que é comumente usado como o primeiro passo do tratamento para a estenose punctal. Métodos: Dados clínicos, demográficos e de resultado foram coletados retrospectivamente de 54 olhos de 21 homens e 11 mulheres que consecutivamente se apresentaram em nossa Clínica de Oculoplástica e foram submetidos a inserção de um tampão de silicone perfurado Micro Flow. Todos os pacientes tinham epífora com estenose punctal. Resultados: Dos 54 tampões, 26 (48,1%) foram perdidos e 28 (51,8%) permaneceram no local. Destes últimos, 8 foram removidos devido a oclusão do tampão com secreção e conjuntivite recorrente, além disso, 2 migraram profundamente no canalículo vertical. Dos 54 tampões, apenas 18 (33,3%) foram bem tolerados com significativa melhora dos sintomas. Conclusão: A perda de tampões é um problema de destaque em pacientes implantados com tampões perfurados. Tampões de silicone falharam em 66,7% dos pacientes durante um seguimento médio de 14,2 meses.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Silicones/administration & dosage , Dry Eye Syndromes/surgery , Punctal Plugs/adverse effects , Lacrimal Apparatus/surgery , Lacrimal Duct Obstruction/therapy , Prostheses and Implants , Tears , Dry Eye Syndromes/complications , Prosthesis Implantation , Lacrimal Duct Obstruction/etiology
Arq. bras. oftalmol ; 82(5): 436-445, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019427


ABSTRACT This systematic review aimed to assess the effectiveness of using preservative-free artificial tears versus preserved lubricants for the treatment of dry eyes in Universidade Federal de Alagoas (PROSPERO 2018 CRD42018089933). Online databases were searched (LILACS, EMBASE, MEDLINE, and CENTRAL) from inception to April 2018; references from included papers were also searched. The following keywords were used: lubricants OR artificial tears OR artificial tears, lubricants AND dry eye OR dry eye syndrome OR syndromes, dry eye OR dry eyes. Among the 2028 electronic search results, 29 full papers were retrieved and four were considered relevant. The number of participants from these studies ranged from 15 to 76. Meta-analysis was possible for the following outcomes: score of symptoms according to the Ocular Surface Disease Index - Allergan (OSDI), tear secretion rate using the Schirmer test, tear evaporation rate using the tear film breakup time test, burning, foreign body sensation, and photophobia. No statistically significant difference was observed between the two groups, and no side effects were attributed to the interventions. Evidence proving that preservative-free artificial tears are more effective than preserved artificial tears is lacking.

RESUMO Esta revisão sistemática teve como objetivo avaliar a eficácia do uso de lágrimas artificiais sem conservantes em comparação com lubrificantes preservados no tratamento do olho seco na Universidade Federal de Alagoas (PROSPERO 2018 CRD42018089933). As bases de dados online foram pesquisadas (LILACS, EMBASE, MEDLINE e CENTRAL) desde o início até abril de 2018; referências de artigos incluídos também foram pesquisadas. Foram utilizados os seguintes descritores: lubrificantes OU lágrimas artificiais OU lágrimas artificiais, lubrificantes E olho seco OU síndrome do olho seco OU síndromes, olho seco OU olhos secos. Dos 2028 resultados de busca eletrônica, 29 artigos completos foram recuperados, e quatro foram considerados relevantes. O número de participantes desses estudos variou de 15 e 76. A meta-análise foi possível para as seguintes variáveis: escore de desfecho dos sintomas de acordo com o Índice de Doença da Superfície Ocular - Allergan (OSDI), taxa de secreção lacrimal pelo teste de Schirmer, taxa de evaporação lacrimal usando o teste de tempo de ruptura do filme lacrimal, queimação, sensação de corpo estranho e fotofobia. Nenhuma diferença estatisticamente significativa foi observada entre os dois grupos, e nenhum efeito adverso foi atribuído às intervenções. Evidências provando que as lágrimas artificiais sem conservantes são mais eficazes do que as lágrimas artificiais preservadas estão faltando.

Humans , Male , Female , Ophthalmic Solutions/pharmacology , Preservatives, Pharmaceutical/pharmacology , Dry Eye Syndromes/drug therapy , Lubricant Eye Drops/pharmacology , Ophthalmic Solutions/therapeutic use , Preservatives, Pharmaceutical/therapeutic use , Tears , Bias , Lubricant Eye Drops/therapeutic use
Rev. bras. ortop ; 54(5): 591-596, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1057939


Abstract Superior capsular reconstruction is a recently described procedure for the treatment of irreparable supraspinatus tendon tears. Graft options that have been previously described include autogenous fascia lata and decellularized dermal graft. No studies were published with the use of fascia lata allograft. The purpose of this technical note is to describe the surgical technique of superior capsular reconstruction using fascia lata allograft. The procedure is performed by arthroscopic visualization, with the patient positioned in the lateral decubitus position. The authors describe a technique based on the use of a double-pulley knot in the glenoid and greater tuberosity, facilitating the procedure and allowing the graft to be brought into the subacromial space in the definitive position, with the appropriate tension. The allografts are available from this institution's tissue bank, cryopreserved and submitted to microbiological and histopathological evaluation. Superior capsular reconstruction is a promising surgery. The technique described in the present technical note shows a viable arthroscopic alternative, with a smaller number of anchors when compared with other techniques.

Resumo A reconstrução da cápsula superior é um procedimento descrito recentemente para o tratamento das roturas irreparáveis do tendão do músculo supraespinal. Como opções de enxerto podemos citar o uso de fáscia lata autógena e enxerto dermal acelularizado. Nenhum estudo foi publicado com o uso de aloenxerto de fáscia lata. O objetivo desta nota é descrever a técnica cirúrgica da reconstrução da cápsula superior com aloenxerto de fáscia lata. O procedimento é feito por visão artroscópica, com o paciente posicionado em decúbito lateral. Os autores descrevem uma técnica baseada no uso do nó em dupla polia na glenoide e no tubérculo maior, que facilita o procedimento e permite que o enxerto seja levado para o espaço subacromial na posição definitiva e com a tensão adequada. Os aloenxertos usados são provenientes de banco de tecidos, onde são criopreservados e submetidos à avaliação microbiológica e histopatológica. A reconstrução da cápsula superior é uma cirurgia promissora. A técnica descrita mostra uma opção artroscópica viável, com uso de menor número de âncoras quando comparada com as demais descrições.

Humans , Shoulder , Tears , Tendons , Rotator Cuff , Rotator Cuff Tear Arthropathy , Rotator Cuff Injuries
Arq. bras. oftalmol ; 82(4): 270-274, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019408


ABSTRACT Purpose: We aimed to compare the thickness of anterior sclera, corneal layers, and pre-ocular tear film between patients with primary Sjögren's syndrome and healthy individuals. Methods: Fifty-one patients with primary Sjögren's syndrome and 41 healthy control participants were recruited in this cross-sectional and comparative study. The thickness of the pre-ocular tear film, corneal epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium were measured on the corneal apex. Anterior scleral thickness was measured at distances of 1 mm and 3 mm from the limbus. The anterior segment module of spectral-domain optical coherence tomography was used to measure thicknesses of pre-ocular tear film, corneal layers, and anterior sclera. Results: Tear film thickness, Schirmer's test, and tear break up time values were significantly lower in the Sjögren's disease group than in the healthy controls (p<0.05). The thickness measurements of corneal layers and sclera were similar between the groups. Tear film thickness was moderately correlated with the Schirmer's test results (r=0.34, p=0.001), but there was no correlation between the Schirmer's test results and tear break up time (r=0.18, p=0.09). Conclusions: Pre-ocular tear film, as measured by anterior segment optical coherence tomography, was thinner in patients with primary Sjögren's syndrome than in the healthy controls. The thicknesses of corneal layers and anterior sclera were similar between the groups.

RESUMO Propósito: Nosso objetivo foi comparar a espessura da esclera anterior, camadas da córnea e do filme lacrimal pré-ocular entre pacientes com síndrome de Sjögren primária e indivíduos saudáveis. Métodos: Cinquenta e um pacientes com síndrome de Sjögren primária e 41 controles saudáveis foram recrutados neste estudo comparativo e transversal. A espessura do filme lacrimal pré-ocular, epitélio corneal, camada de Bowman, estroma, membrana de Descemet e endotélio foram medidos no ápice corneal. A espessura da esclera anterior foi medida às distâncias de 1 mm e 3 mm do limbo. O módulo do segmento anterior da tomografia de coerência óptica de domínio espectral foi utilizado para mensurar as espessuras do filme lacrimal pré-ocular, camadas da córnea e esclera anterior. Resultados: A espessura do filme lacrimal, o teste de Schirmer e os valores do tempo de ruptura do filme lacrimal foram significativamente menores no grupo com síndrome de Sjögren do que nos controles saudáveis (p<0,05). As medidas de espessura das camadas corneais e da esclera foram similares entre os grupos. A espessura do filme lacrimal foi moderadamente correlacionada com os resultados do teste de Schirmer (r=0,34, p=0,001), mas não houve correlação entre os resultados do teste de Schirmer e tempo de ruptura (r=0,18, p=0,09). Conclusões: O filme lacrimal pré-ocular, medido pela tomografia de coerência óptica de segmento anterior, foi mais fino em pacientes com síndrome de Sjögren primária do que nos controles saudáveis. As espessuras das camadas da córnea e da esclera anterior foram semelhantes entre os grupos.

Humans , Male , Female , Adult , Middle Aged , Aged , Sclera/pathology , Sjogren's Syndrome/pathology , Cornea/pathology , Reference Values , Sclera/diagnostic imaging , Tears/physiology , Sjogren's Syndrome/physiopathology , Case-Control Studies , Cross-Sectional Studies , Cornea/diagnostic imaging , Tomography, Optical Coherence/methods
Arq. bras. oftalmol ; 82(4): 283-288, July-Aug. 2019. tab
Article in English | LILACS | ID: biblio-1019417


ABSTRACT Purpose: We aimed to assess ocular surface characteristics in children with Hashimoto's thyroiditis without thyroid-associated ophthalmopathy and compare the results with those of healthy children. Methods: Twenty-two children with Hashimoto's thyroiditis (Group 1) and 20 healthy children without any ocular and/or systemic disorder (Group 2) were enrolled in the study. Ocular Surface Disease Index questionnaire, tear film osmolarity measurement (TearLab Osmolarity System, San Diego, CA, USA), Schirmer and tear film breakup time tests, meibography, and conjunctival brush cytology were performed and compared the results between the groups. Results: The study group included 19 girls and 3 boys in Group 1 and 12 girls and 8 boys in Group 2 (p=0.081). Thyroid-associated ophthalmopathy was not identified in any of the patients. Mean tear film osmolarity was 310.23 ± 11.98 mOsm/l in Group 1 and 313.60 ± 15.03 mOsm/l in Group 2 (p=0.424). Mean Schirmer test score was lower in Group 1 (14.91 ± 6.27) compared with Group 2 (23.60 ± 5.63) (p=0.001). Mean tear film breakup time was lower in Group 1 (11.78 ± 4.07) compared with Group 2 (15.1 ± 1.6) (p=0.013). Moreover, mean meibomian gland area loss was 25.01% ± 10.04% in Group 1 and 16.54% ± 6.02% in Group 2 (p=0.002). Conjunctival cytologic analysis in Group 1 revealed grade 0 changes in 6 patients (27.3%), grade 1 changes in 14 patients (63.6%), and grade 2 changes in 2 patients (9.1%), whereas 18 patients (90%) had grade 0 changes and 2 patients (10%) had grade 1 changes (p=0.001) in Group 2. Conclusions: The study demonstrates several ocular surface changes in children with Hashimoto's thyroiditis. These findings may indicate a tendency for dry eye in pediatric Hashimoto's thyroiditis patients without clinical evidence of thyroid-associated ophthalmopathy.

RESUMO Objetivo: Avaliar as características da superfície ocular em crianças com tireoidite de Hashimoto sem oftalmopatia associada à tireoide e comparar os resultados com aqueles de crianças saudáveis. Métodos: Vinte e duas crianças com tireoidite de Hashimoto (Grupo 1) e 20 crianças saudáveis sem qualquer distúrbio ocular e/ou sistêmico (Grupo 2) participaram do estudo. Utilizou-se o questionário Índice da Doença da Superfície Ocular, medida de osmolaridade do filme lacrimal (Tearlab Osmolarity System, San Diego, CA, EUA), teste de Schirmer e tempo de ruptura do filme lacrimal, meibografia e citologia do raspado conjuntival e comparação dos resultados entre os grupos. Resultados: O grupo de estudo incluiu 19 meninas e 3 meninos no Grupo 1 e 12 meninas e 8 meninos no Grupo 2 (p=0,081). A oftalmopatia associada à tireoide não foi identificada em nenhum dos pacientes. A média da osmolari­dade do filme lacrimal foi 310,23 ± 11,98 mOsm/l no Grupo 1 e 313,60 ± 15,03 mOsm/l no Grupo 2 (p=0,424). A média do escore do teste de Schirmer foi menor no Grupo 1 (14,91 ± 6,27) do que no Grupo 2 (23,60 ± 5,63) (p=0,001). A média do tempo de ruptura do filme lacrimal foi menor no Grupo 1 (11,78 ± 4,07) em comparação com o Grupo 2 (15,1 ± 1,6) (p=0,013). Além disso, a média da perda de área da glândula meibomiana foi 25,01% ± 10,04% no Grupo 1 e 16,54% ± 6,02% no Grupo 2 (p=0,002). A análise da citologia conjuntival no Grupo 1 revelou alterações de grau 0 em 6 pacientes (27,3%), alterações de grau 1 em 14 pacientes (63,6%) e alterações de grau 2 em 2 pacientes (9,1%), enquanto 18 pacientes (90%) com alteração de grau 0 e 2 pacientes (10%) com alteração de grau 1 (p=0,001) no Grupo 2. Conclusões: O estudo demonstra várias alterações da superfície ocular em crianças com tireoidite de Hashimoto. Esses achados podem indicar uma tendência para olho seco em pacientes pediátricos com tireoidite de Hashimoto, sem evidências clínicas de oftalmopatia associada à tireoide.

Humans , Male , Female , Child , Adolescent , Dry Eye Syndromes/pathology , Conjunctiva/pathology , Hashimoto Disease/pathology , Reference Values , Tears/physiology , Severity of Illness Index , Dry Eye Syndromes/etiology , Case-Control Studies , Prospective Studies , Surveys and Questionnaires , Hashimoto Disease/complications , Hashimoto Disease/physiopathology , Meibomian Glands/pathology