Résumé
Objective To test the hypothesis that the macular pigment may be a marker of foveal cone function and consequently the structural integrity of foveal cones. Methods Sixteen patients (32 eyes) diagnosed to have Stargardt dystrophy and three patients with full thickness macular holes by clinical criteria were studied with a scanning laser ophthalmoscopy (SLO) comparing argon laser blue and infra-red images for the presence or absence of macular pigment (MP) in the fovea. An C ++ computer based program was used to evaluate the density of MP. Eyes were graded into three categories: those without foveal macular pigment, those with partial pigment and those with normal amounts of macular pigment. These categories were compared with visual acuity determined by the Snellen chart. Results Thirteen eyes with a visual acuity of 20/200 or worse had no macular pigment in the fovea. Eleven eyes with visual acuity of 20/40 or better had a normal amount of macular pigment in the fovea and 1 eye had partial macular pigment. Eleven eyes with partial macular pigment had intermediary acuity value. Conclusions Foveal macular pigment is closely related to foveal cone acuity and therefore may be a marker for the presence of foveal cones. Infrared light is a sensitive indicator of early macular diseases
Résumé
Anestesia local com sedaçäo foi realizada com sucesso em 268 pacientes submetidos à vitrectomia via pars plana. Em 109 pacientes a duraçäo dos procedimentos cirúrgicos estendeu-se por tempo superior a 2 horas e, mesmo nesses casos, näo houve intercorrências que impossibilitassem a continuaçäo. O emprego de soluçäo de Bupivacaína 0,75 por cento associado a lidocaína 2 por cento com epinefrina e hialuronidase administrada via retrobulbar e peribulbar possibilitou anestesia e imobilidade ocular satisfatórias. A sedaçäo intra-operatória realizada por anestesiologista competente foi considerada fundamental para o sucesso do procedimento