Helicobacter pylori as a potential target for the treatment of central serous chorioretinopathy

OBJECTIVES: The objective of this study was to evaluate the relationship between the treatment of Helicobacter pylori gastric infection and changes in best-corrected visual acuity and macular detachment in patients with chronic central serous chorioretinopathy. METHODS: Seventeen patients diagnosed with central serous chorioretinopathy were examined for gastric infection with Helicobacter pylori using the urease test and gastric biopsy. Helicobacter pylory-positive patients were treated with the appropriate medication. The response to therapy was monitored by evaluating the best-corrected visual acuity and optical coherence tomography. The data were analyzed using Student's t-test before and after treatment. RESULTS: Fourteen patients (15 eyes) aged 30-56 years (mean 43.4 ± 8.3 years) were positive for Helicobacter pylori. Most of the positive patients had gastric symptoms (78.5%); one had bilateral central serous chorioretinopathy. The mean baseline best-corrected visual acuity was 20/98 (logMAR = 0.53 ± 0.28). Three months after starting treatment with antibiotics, the serous detachment had resolved in 14 of 15 eyes, but two cases required laser treatment. The follow-up period ranged from 6 to 27 months. The mean final best-corrected visual acuity differed significantly from baseline. CONCLUSION: Our findings suggest that Helicobacter pylori infection may be present in many chronic central serous chorioretinopathy patients and that treatment for the infection may have a favorable effect on the outcome of chronic central serous chorioretinopathy. Due to the possibility of the spontaneous regression of chronic central serous chorioretinopathy and the high prevalence of the infection in the general population, prospective and masked clinical trials are necessary to confirm that treatment for Helicobacter pylori infection may benefit patients with chronic central serous chorioretinopathy.

Retinal detachment and gyrate atrophy of the choroid and retina: case report / Descolamento de retina e atrofia girata da coroide e retina: relato de caso

To report a case of gyrate atrophy of the choroid and retina associated with retinal detachment. Hyperornithinemia confirmed the diagnosis of gyrate atrophy. Pars plana vitrectomy with silicone oil infusion was performed with good anatomical results, despite the persistence of low visual acuity. Retinal detachment is a rare complication of gyrate atrophy and can be managed with pars plana vitrectomy and silicone oil. We discuss the possible mechanisms that led to low visual acuity.

Descrever um caso de atrofia girata da coroide e retina associado com descolamento de retina. Altos níves de ornitina sérica confirmaram o diagnóstico de atrofia girata. Vitrectomia via pars plana com infusão de óleo de silicone foi realizada, com bom resultado anatômico, apesar da baixa acuidade visual persistente. Descolamento de retina é uma rara complicação da atrofia girata e pode ser manejada com vitrectomia via pars plana e óleo de silicone. Discutiremos os possíveis mecanismos que levaram à baixa acuidade visual.

Prevalence of age-related macular degeneration in Japanese immigrants and their descendants living in Londrina (PR) - Brazil / Prevalência da degeneração macular relacionada à idade em japoneses e descendentes em Londrina (PR) - Brasil

PURPOSE: To determine the prevalence of early and late-stage age-related macular degeneration (ARMD) and its association with risk factors such as age, gender, smoking, body mass index, hypertension and diabetes history, cataracts and pseudophakia. Design: Population-based cross-sectional study in an elderly Japanese-Brazilian population from Londrina (Paraná, Brazil). METHODS: The study included 483 (80.5 percent) of the 600 registered members of a local association for Japanese immigrants and their descendants, aged 60 years and up. The presence of early and late-stage age-related macular degeneration was determined using the standard protocol and the international classification system. RESULTS: The mean age of the study subjects was 71 years. The overall prevalence of age-related macular degeneration was 15.1 percent (CI 95 percent; 12-18.7). The prevalence of early-stage age-related macular degeneration was 13.8 percent (CI 95 percent; 10.9-17.3), geographic atrophy was present in 0.4 percent and neovascular age-related macular degeneration in 0.8 percent. Age-related macular degeneration was significantly (p=0.004) and linearly (p=0.001) associated with age. CONCLUSION: Our study population displays a prevalence of early and late-stage age-related macular degeneration and component lesions similar to those of other Western countries, and data suggest a higher prevalence than that reported for populations in Japan. Since the age-related macular degeneration prevalence tends to rise as the population ages, studies identifying risk factors and exploring prevention methods are becoming increasingly important.

OBJETIVO: Identificar a prevalência da degeneração macular relacionada à idade (DMRI) inicial e tardia na população de japoneses e descendentes e verificar a associação com os fatores de risco: idade, sexo, hábito de fumar, índice de massa corpórea, história de hipertensão e diabetes, catarata e pseudofacia. MÉTODOS: Realizado um estudo transversal na população de japoneses e descendentes, acima de 60 anos, residentes na cidade de Londrina (PR) - Brasil. Quatrocentos e oitenta e três (80,5 por cento) das 600 pessoas registradas foram submetidas ao exame oftalmológico completo. A presença de degeneração macular relacionada à idade foi determinada seguindo um protocolo padrão e classificação internacional, no período de setembro de 2002 a julho de 2003. RESULTADOS: A média de idade foi de 71 anos (60-92 anos). A prevalência da degeneração macular relacionada à idade foi de 15,1 por cento (intervalo de confiança (I.C. 95 por cento: 12-18,7), sendo na fase inicial em 13,8 por cento (I.C. 95 por cento: 10,9-17,3) e na fase tardia (atrofia geográfica 0,4 por cento e membrana neovascular sub-retiniana 0,8 por cento) em 1,3 por cento. A degeneração macular relacionada à idade foi associada à idade (p=0,004) e apresentou tendência linear (p=0,001). Não foi observada associação entre a DMRI e os outros fatores de risco analisados. CONCLUSÃO: A prevalência da degeneração macular relacionada à idade neste estudo foi semelhante aos dos países do Ocidente, e é possível que ela seja maior do que a da população do Japão. Os dados comprovam a importância da degeneração macular relacionada à idade nessa população de japoneses e descendentes, e mais estudos são necessários para identificar os fatores de riscos e os métodos de prevenção.