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1.
Article in English | MEDLINE | ID: mdl-32626601

ABSTRACT

BACKGROUND: Many factors can influence the functional outcomes of macular hole surgery and some studies have tried to describe anatomical features that could predict successful treatment. The purpose of this study is to describe a new technique for evaluating the healing of macular holes after two surgical techniques using a black-and-white pixel binarization histogram software by optical coherence tomography angiography and its potential functional implications. METHODS: This was a retrospective, observational case series of patients who presented with idiopathic full-thickness macular holes and underwent vitreoretinal surgery for successful macular hole closure using the internal limiting membrane peeling technique or the inverted peeling technique or the free internal limiting membrane flap technique. Optical coherence tomography angiography 3.0 × 3.0-mm scans were obtained postoperatively. The outer retina layer was analyzed separately; three different analyses were performed within a 3.0-mm-diameter area central circle, a 1.5-mm-diameter area, and a 0.5-mm-diameter area from the foveal center. The outer retinal layer images were evaluated by counting the number of black and white pixels. The inclusion criteria were patients with idiopathic macular holes who underwent ophthalmologic examinations and swept-source optical coherence tomography 1 week and 1 and 6 months postoperatively. The exclusion criteria were a traumatic macular hole or a history of eye trauma and a diagnosis of glaucoma or any other chronic ocular disease. The Mann-Whitney test was used to determine significance; P < 0.05 was considered significant. RESULTS: Ten eyes of 10 patients who underwent vitreoretinal surgery to treat a macular hole either with the conventional peeling technique (n = 5) or the inverted/free internal limiting membrane flap technique (n = 5) were included. In the peeling group, the percentage of white pixels ranged from 7.22% to 18.40% in the 0.5 × 0.5-millimeter area in the macular center; the mean postoperative logarithm of the minimum angle of resolution best-corrected visual acuity was 0.3 ± 0.2. In the inverted flap group, the percentage of white pixels ranged from 3.65% to 8.93% in the 0.5 × 0.5-millimeter area in the macular center; the mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.9 ± 0.4. CONCLUSIONS: A simple method of optical coherence tomography angiography imaging analysis of the outer retina using a binarization technique of the black and white pixels was created and may have functional implications during the analysis of the healing process after macular hole surgery. We hypothesized that higher numbers of white pixels correspond to viable cellularity and better prognoses postoperatively.

2.
Arq. bras. oftalmol ; 82(6): 481-487, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038688

ABSTRACT

ABSTRACT Purpose: The aim of this study was to determine the functional and anatomical success rates as well as the safety of sutureless combined surgery involving vitreous base removal and internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining for the management of idiopathic macular holes after three years. Methods: Forty-six eyes of 46 patients with an idiopathic macular hole were enrolled in this retrospective study. The inclusion criteria were macular holes with a minimum linear diameter below 1,500 mm, 0.05 or better decimal best-corrected visual acuity and duration of symptoms less than two years. The exclusion criteria included pregnancy, optic nerve atrophy, advanced glaucoma, and other chronic ocular diseases. The surgical procedure included internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining, along with C3F8 tamponade and face-down positioning for three days postoperatively. Ophthalmologic examinations and optical coherence tomography were performed at 1 and 7 days and 1, 6, 12, 24, and 36 months postoperatively. If no anatomic closure of the macular holes occurred within the first month, the area of the internal limiting membrane peeling was enlarged in a second procedure. Multiple logistic regression and chi-squared tests were used for data analyses, and p-values of <0.05 were considered significant. Results: Out of 46 eyes with a preoperative idiopathic macular hole, anatomic closure was achieved in 42 (91.3%) after one procedure and in 45 (97.8%) after an additional surgery. The median postoperative best-corrected visual acuity improvement was 0.378 (range: 0.050-0.900) decimal. None of the patients experienced macular hole reopening, surgery-related complications, or ocular complications related to the dye. Conclusion: Combined surgery including vitreous base removal and internal limiting membrane peeling after staining with Brilliant Blue G (0.5 mg/mL) for the management of idiopathic macular holes resulted in adequate staining, best-corrected visual acuity improvement, and macular hole closure with no signs of ocular toxicity at the three-year follow-up examination.


RESUMO Objetivo: Determinar, após 3 anos de seguimento, as taxas de sucesso funcional e anatômico e a segurança da cirurgia combinada sem sutura, incluindo remoção da base vítrea e da membrana limitante interna após coloração com azul brilhante (0,5 mg/ml) para o manejo de buracos maculares idiopáticos. Métodos: Quarenta e seis olhos de 46 pacientes com buraco macular idiopático foram incluídos neste estudo retrospectivo. Os critérios de inclusão foram: buraco macular com diâmetro linear mínimo menor que 1500 micrômetros, acuidade visual com melhor correção de 0,05 decimal ou melhor e tempo de sintomas menor que 2 anos. Os critérios de exclusão foram gravidez, atrofia do nervo óptico, glaucoma avançado ou outra doença ocular crônica. A técnica cirúrgica incluiu a remoção da membrana limitante interna após coloração com Azul Brilhante 0,5 mg/ml, tamponamento com C3F8 posicionamento em prona ção durante 3 dias de pós-operatório. O seguimento foi realizado por exame oftalmológico e Tomografia de Coerência Óptica no 1 e 7 dias, 1, 6, 12, 24 e 36 meses de pós-operatório. Se o fechamento anatômico do buraco macular não fosse atingido na visita de um mês, realizava-se um segundo procedimento no qual a área do peeling da membrana limitante interna era ampliada. Para análise estatística, foram utilizados testes de regressão logística múltipla e Qui-quadrado. Valores de p menores que 0.05 foram considerados estatisticamente significativos. Resultados: Dos 46 olhos com buraco macular idiopático, 42 (91,3%) obtiveram fechamento do buraco macular após um procedimento cirúrgico e 45 (97,8%) após uma cirurgia adicional. A média de melhora da acuidade visual com melhor correção no pós-operatório foi de 0.378 (0.050-0.900) decimal. Não foram observados: reabertura do buraco macular, complicações relacionadas ao procedimento cirúrgico ou complicações relacionadas ao corante. Conclusão: A cirurgia combinada sem sutura que incluiu remoção da base vítrea e remoção membrana limitante interna após coloração com Azul Brilhante (0,5 mg/ml) para o tratamento de buracos maculares idiopáticos foi realizada com adequada capacidade de coloração, melhora da acuidade visual e fechamento do buraco macular sem sinais de toxicidade ocular no seguimento de 3 anos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Retinal Perforations/surgery , Vitrectomy/methods , Postoperative Period , Reference Values , Benzenesulfonates , Visual Acuity , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Injections, Intraocular
3.
Arq Bras Oftalmol ; 82(6): 481-487, 2019.
Article in English | MEDLINE | ID: mdl-31576925

ABSTRACT

PURPOSE: The aim of this study was to determine the functional and anatomical success rates as well as the safety of sutureless combined surgery involving vitreous base removal and internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining for the management of idiopathic macular holes after three years. METHODS: Forty-six eyes of 46 patients with an idiopathic macular hole were enrolled in this retrospective study. The inclusion criteria were macular holes with a minimum linear diameter below 1,500 mm, 0.05 or better decimal best-corrected visual acuity and duration of symptoms less than two years. The exclusion criteria included pregnancy, optic nerve atrophy, advanced glaucoma, and other chronic ocular diseases. The surgical procedure included internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining, along with C3F8 tamponade and face-down positioning for three days postoperatively. Ophthalmologic examinations and optical coherence tomography were performed at 1 and 7 days and 1, 6, 12, 24, and 36 months postoperatively. If no anatomic closure of the macular holes occurred within the first month, the area of the internal limiting membrane peeling was enlarged in a second procedure. Multiple logistic regression and chi-squared tests were used for data analyses, and p-values of <0.05 were considered significant. RESULTS: Out of 46 eyes with a preoperative idiopathic macular hole, anatomic closure was achieved in 42 (91.3%) after one procedure and in 45 (97.8%) after an additional surgery. The median postoperative best-corrected visual acuity improvement was 0.378 (range: 0.050-0.900) decimal. None of the patients experienced macular hole reopening, surgery-related complications, or ocular complications related to the dye. CONCLUSION: Combined surgery including vitreous base removal and internal limiting membrane peeling after staining with Brilliant Blue G (0.5 mg/mL) for the management of idiopathic macular holes resulted in adequate staining, best-corrected visual acuity improvement, and macular hole closure with no signs of ocular toxicity at the three-year follow-up examination.


Subject(s)
Retinal Perforations/surgery , Vitrectomy/methods , Adult , Aged , Aged, 80 and over , Benzenesulfonates , Female , Follow-Up Studies , Humans , Injections, Intraocular , Male , Middle Aged , Postoperative Period , Reference Values , Retrospective Studies , Treatment Outcome , Visual Acuity , Young Adult
4.
Ophthalmic Surg Lasers Imaging Retina ; 49(5): 374-379, 2018 05 01.
Article in English | MEDLINE | ID: mdl-29772050

ABSTRACT

BACKGROUND AND OBJECTIVE: To report the efficacy, safety, and benefits of femtosecond laser-assisted cataract surgery (FLACS) combined with sutureless 23-gauge pars plana vitrectomy (PPV). PATIENTS AND METHODS: This multicenter, retrospective study evaluated patient records and videos of 43 cases with retinal pathologies and cataract who underwent the combined procedure. RESULTS: In 44.2% and 55.8% of cases, respectively, the LenSx Laser (femtosecond machine; Alcon, Fort Worth, TX) and the Constellation (vitreous cutter; Alcon, Fort Worth, TX), and the Victus (femtosecond machine; Bausch + Lomb, Rochester, NY) and Stellaris PC (vitreous cutter; Bausch + Lomb, Rochester, NY) were used. No complications developed during capsulorrhexis, even without a red fundus reflex, retrobulbar block, or scleral indentation. Foldable intraocular lenses remained stable in the capsular bag during the vitreoretinal surgeries and postoperative visits. The mean times of femtosecond phacoemulsification, vitreoretinal surgery, and total surgery were 22.9 minutes ± 4.7 minutes, 43.1 minutes ± 9.8 minutes, and 65.3 minutes ± 8.6 minutes, respectively. CONCLUSION: This emerging technology is safe and offers several potential benefits for the success of the combined procedure. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:374-379.].


Subject(s)
Cataract Extraction/methods , Eye Diseases/surgery , Laser Therapy/methods , Phacoemulsification/methods , Vitrectomy/methods , Vitreoretinal Surgery/methods , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies
5.
Arq. bras. oftalmol ; 79(6): 407-410, Nov.-Dec. 2016. graf
Article in English | LILACS | ID: biblio-838762

ABSTRACT

ABSTRACT Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema. Here, we describe three patients with iris metastasis and discuss the diagnostic challenges and unusual findings associated with these cases.


RESUMO A maioria das metástases oculares do câncer sistêmico são encontrados na coroide. As metástases para a íris são incomuns, podendo se manifestar como nódulo estromal, espessamento de íris de limites mal definidos ou como uma iridociclite ou hifema. Relatamos 3 pacientes com lesão de íris e história pregressa de câncer sistêmico. Enfatizamos a dificuldade no diagnóstico e raridade dessas lesões comparando com relatos anteriores.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carcinoma/secondary , Iris Neoplasms/secondary , Breast Neoplasms/pathology , Carcinoma/therapy , Carcinoma/diagnostic imaging , Adenocarcinoma/pathology , Iris Neoplasms/therapy , Iris Neoplasms/diagnostic imaging , Fatal Outcome , Kidney Neoplasms/pathology
6.
Arq Bras Oftalmol ; 79(3): 197-9, 2016.
Article in English | MEDLINE | ID: mdl-27463635

ABSTRACT

We report enhanced depth imaging optical coherence tomography (EDI-OCT) features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle. Both lesions had multiple intralesional layers and a typical intrinsic transparency with visibility of the sclerochoroidal junction.


Subject(s)
Choroid Neoplasms/diagnostic imaging , Choroidal Neovascularization/diagnostic imaging , Osteoma/diagnostic imaging , Tomography, Optical Coherence/methods , Adult , Choroid/diagnostic imaging , Choroid/pathology , Choroid Neoplasms/pathology , Choroidal Neovascularization/pathology , Female , Humans , Image Enhancement , Male , Osteoma/pathology , Reproducibility of Results , Young Adult
7.
Arq. bras. oftalmol ; 79(3): 197-199, graf
Article in English | LILACS | ID: lil-787332

ABSTRACT

ABSTRACT We report enhanced depth imaging optical coherence tomography (EDI-OCT) features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle. Both lesions had multiple intralesional layers and a typical intrinsic transparency with visibility of the sclerochoroidal junction.


RESUMO Relatamos as características na tomografia computadorizada óptica (EDI-OCT) de 2 pacientes recém diagnosticados com osteoma de coroide apresentando perda visual secundária à membranas neovasculares coroideanas. As características descritas em nossos 2 casos foram consistentes com trabalhos anteriores, exibindo a compressão da coriocapilar e desorganização das camadas médias e de grandes vasos. Notamos também o padrão em esponja anteriormente descrito, porém de forma discreta. Ambas as lesões tinham várias camadas intralesionais e uma transparência intrínseca típica com visibilidade da junção da esclero-coroideana.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Osteoma/diagnostic imaging , Choroid Neoplasms/diagnostic imaging , Choroidal Neovascularization/diagnostic imaging , Tomography, Optical Coherence/methods , Osteoma/pathology , Image Enhancement , Choroid Neoplasms/pathology , Reproducibility of Results , Choroid/pathology , Choroid/diagnostic imaging , Choroidal Neovascularization/pathology
8.
Arq Bras Oftalmol ; 79(6): 407-410, 2016.
Article in English | MEDLINE | ID: mdl-28076572

ABSTRACT

Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema. Here, we describe three patients with iris metastasis and discuss the diagnostic challenges and unusual findings associated with these cases.


Subject(s)
Carcinoma/secondary , Iris Neoplasms/secondary , Adenocarcinoma/pathology , Adult , Breast Neoplasms/pathology , Carcinoma/diagnostic imaging , Carcinoma/therapy , Fatal Outcome , Female , Humans , Iris Neoplasms/diagnostic imaging , Iris Neoplasms/therapy , Kidney Neoplasms/pathology , Male , Middle Aged
10.
Ophthalmic Surg Lasers Imaging ; 42 Online: e4-5, 2011 Feb 01.
Article in English | MEDLINE | ID: mdl-21323260

ABSTRACT

The authors describe a rare case of full-thickness macular hole formation in a 10-year-old boy with X-linked juvenile retinoschisis.


Subject(s)
Retinal Perforations/etiology , Retinoschisis/complications , Child , Electroretinography , Fluorescein Angiography , Humans , Male , Retinal Perforations/diagnosis , Retinoschisis/diagnosis , Sensory Aids , Visual Acuity/physiology
11.
Arq Bras Oftalmol ; 73(2): 186-8, 2010.
Article in English | MEDLINE | ID: mdl-20549052

ABSTRACT

Cystoid macular edema is an uncommon, but well known, side effect of latanoprost. Two cases of bilateral and simultaneous cystoid macular edema associated with latanoprost use are described, which complete resolution of the edema is observed upon drug discontinuation.


Subject(s)
Antihypertensive Agents/adverse effects , Macular Edema/chemically induced , Prostaglandins F, Synthetic/adverse effects , Aged, 80 and over , Female , Fluorescein Angiography , Humans , Latanoprost , Macular Edema/diagnostic imaging , Male , Middle Aged , Radiography
12.
Arq. bras. oftalmol ; 73(2): 186-188, Mar.-Apr. 2010. ilus
Article in English | LILACS | ID: lil-548153

ABSTRACT

Cystoid macular edema is an uncommon, but well known, side effect of latanoprost. Two cases of bilateral and simultaneous cystoid macular edema associated with latanoprost use are described, which complete resolution of the edema is observed upon drug discontinuation.


O edema macular cistóide é um efeito colateral incomum, porém bem conhecido, do latanoprost. São descritos dois casos de edema macular cistóide bilateral e simultâneo associado ao uso de latanoprost, em que foi observada completa resolução do edema após a suspensão da droga.


Subject(s)
Aged, 80 and over , Female , Humans , Male , Middle Aged , Antihypertensive Agents/adverse effects , Macular Edema/chemically induced , Prostaglandins F, Synthetic/adverse effects , Fluorescein Angiography , Macular Edema
13.
Ophthalmic Surg Lasers Imaging ; : 1-2, 2010 Mar 09.
Article in English | MEDLINE | ID: mdl-20337319

ABSTRACT

The optical coherence tomography (OCT) findings of a 26-year-old HIV-positive male with acute exudative polymorphous vitelliform maculopathy were described. His with best-corrected visual acuity at the presentation of the disease was 20/25 in the right eye and 20/30 in the left eye. Fundus examination showed bilateral yellowish subretinal lesions arranged in a honeycombed pattern throughout the posterior pole in both eyes. OCT scans on the topography of these lesions showed well-defined hyporeflective spaces that occasionally merged, limited superiorly by the retinal pigment epithelium and inferiorly by a hypereflective tissue that could correspond to Bruch's membrane. Sub-sensory fluid was found in both maculas.

14.
Arq Bras Oftalmol ; 71(4): 581-4, 2008.
Article in English | MEDLINE | ID: mdl-18797673

ABSTRACT

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.


Subject(s)
Eye Injuries, Penetrating/complications , Macula Lutea/injuries , Retinal Perforations/etiology , Wounds, Gunshot/complications , Wounds, Nonpenetrating/complications , Child , Female , Humans , Macula Lutea/pathology , Male , Retinal Perforations/pathology , Tomography, Optical Coherence , Visual Acuity/physiology , Young Adult
15.
Arq. bras. oftalmol ; 71(4): 581-584, jul.-ago. 2008. ilus
Article in English | LILACS | ID: lil-491894

ABSTRACT

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.


O buraco macular traumático é doença cuja patogênese não é totalmente esclarecida e a melhor conduta terapêutica ainda é controversa. Relatamos 2 casos de buraco macular traumático para os quais adotamos condutas diferentes. No primeiro caso, um menino de 9 anos apresentou buraco macular traumático secundário a trauma ocular contuso com uma pedra, com visão inicial de 20/300. Foi submetido a tratamento cirúrgico e obteve visão final igual a 20/70 com buraco fechado após 1 ano de seguimento. No segundo caso, mulher de 20 anos sofreu traumatismo penetrante por projétil de arma de fogo na fronte, do lado esquerdo. O trauma causou avulsão do nervo óptico no olho esquerdo com perda de percepção luminososa neste olho. No olho direito apresentou buraco macular traumático e sinais sugestivos de coriorretinite esclopetária, com acuidade visual igual a 20/60. O caso foi inicialmente observado e a visão melhorou para 20/30 com diminuição do diâmetro do buraco. A visão e o diâmetro do buraco mantiveram-se estáveis por 8 meses.


Subject(s)
Child , Female , Humans , Male , Young Adult , Eye Injuries, Penetrating/complications , Macula Lutea/injuries , Retinal Perforations/etiology , Wounds, Gunshot/complications , Wounds, Nonpenetrating/complications , Macula Lutea/pathology , Retinal Perforations/pathology , Tomography, Optical Coherence , Visual Acuity/physiology , Young Adult
16.
Rev. bras. oftalmol ; 66(4): 242-247, jul.-ago. 2007. tab
Article in Portuguese | LILACS | ID: lil-481139

ABSTRACT

OBJETIVOS: Identificar as bactérias que compõem a microbiota conjuntival de pacientes sadios com catarata senil, a susceptibilidade delas aos antibióticos testados e a eficácia de um regime de administração de antibióticos tópicos na redução dessa microbiota. MÉTODOS: Coorte prospectiva, não-randomizada, de 40 olhos de 40 pacientes divididos em 4 grupos de 10 pacientes cada, que utilizaram diferentes antibióticos tópicos (tobramicina, ciprofloxacino e gatifloxacino). Foram realizadas culturas de material conjuntival antes do uso dos medicamentos e 15, 30 e 60 minutos após o uso dos mesmos. Foram realizados testes de resistência bacteriana das bactérias isoladas e comparação da redução do crescimento bacteriano pela análise do número de unidade formadoras de colônias (UFC). RESULTADOS: Houve crescimento bacteriano em 92,5% dos pacientes. O estafilococo coagulase negativo foi a bactéria mais comumente encontrada (50% dos casos), seguido pelo Staphylococcus Aureus (23%) e pelas bactérias gram negativas (26%). Das bactérias isoladas, 81,8% foram sensíveis a todos os antibióticos utilizados no estudo. Houve cinco casos de resistência ao ciprofloxacino e à tobramicina e dois de resistência ao gatifloxacino. Em todos os grupos houve diminuição do número de pacientes com cultura positiva em relação ao momento zero e em relação ao placebo. CONCLUSÃO: As bactérias gram-positivas, especialmente o estafilococo coagulase negativo, foram os microrganismos mais encontrados na conjuntiva normal dos pacientes estudados. As bactérias isoladas mostraram alta taxa de susceptibilidade aos antibióticos testados. O regime de uso desses antibióticos diminuiu o número de unidades formadoras de colônias em relação ao grupo controle, embora sem significância estatística na maioria dos casos.


PURPOSE: To evaluate the conjunctival bacterial flora of healthy patients and its antibiotic resistance pattern and determine the effective of a regime of topical antibiotics on reduction of endogenous microbiota. METHODS: Its a prospective non randomized study. Fourty eyes of 40 patients, divided in 4 groups of 10 eyes each, used four differents topical antibiotics (ciprofloxacin, tobramycin and gatifloxacin). One group served as a control group. Were performed conjunctival cultures before instillation of the antibiotics drops and after 15, 30 and 60 minutes. Were performed susceptibility tests of the specimes isolated to these antibiotics. We compared the reduction of bacterium growth by assessing the number of UFC (colonies forming units) before and after the instillation of antibiotics drops. RESULTS: Of the 40 eyes, 92,5% had positive cultures. The coagulase-negative Staphylococcus (CNS) was the most frequent organism isolated (50%), followed by Staphylococcus Aureus (23%) and gram-negative bacteria (26%). More than 81% of the isolates of this bacterium were susceptible to all antibiotics tested. Five bacterium isolates were resistant to ciprofloxacin and tobramycin and two to gatifloxacin. All groups had diminished the number of patients with positive culture specimes from the conjuntiva compared to moment zero and to placebo. CONCLUSION: The gram positive bacterium, specially the coagulase-negative Staphylococcus, were the most frequent microorganism found on conjunctiva of healthy patients. The most of the bacterium isolated were sensitivity to the antibiotics tested. The proposed regime of use of these antibiotics reduced the number of UFC (colonies forming units) compared to placebo although without statics relevance in most of cases.


Subject(s)
Humans , Antibiotic Prophylaxis , Cataract Extraction , Drug Resistance , Endophthalmitis , Conjunctiva/microbiology
17.
Am J Ophthalmol ; 143(6): 1003-1008, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17434436

ABSTRACT

PURPOSE: To describe the clinical features of an acute, inflammatory, and progressive retinal necrosis that affects primarily the posterior pole. DESIGN: Retrospective, interventional case series. METHODS: Twenty-seven eyes of 24 patients diagnosed with and treated for acute retinal necrosis (ARN) were categorized into two groups according to the predominant location of retinitis at presentation: either in the peripheral retina or in the posterior pole. Clinical features, disease progression, visual outcomes, and complications of these two groups were compared. RESULTS: Fifteen eyes demonstrated the known peripheral retinitis pattern, and 12 eyes exhibited a pattern of retinitis that affected mainly the posterior pole. Eyes with peripheral retinitis showed focal, well-demarcated areas of retinal necrosis in the periphery with rapid circumferential progression and rare involvement of the posterior pole. All eyes with posterior pole retinitis had multifocal deep lesions posterior to the vortex veins at presentation, and half of these eyes had lesions in the macula. These lesions progressed to patches of confluent retinitis in both the periphery and the posterior pole. There was no significant difference between the two groups in the incidence of anterior chamber and vitreous cells, vascular sheathing, retinal hemorrhages, or optic disk edema. Patients with posterior retinitis involvement seemed to have a worse visual outcome during the first two years after diagnosis. The Cox proportional hazards model suggested a higher incidence of retinal detachment in patients with posterior retinitis (P = .07). CONCLUSIONS: The authors report a pattern of herpetic retinitis that affects predominantly the posterior pole and may have a worse visual prognosis and a higher rate of retinal detachment.


Subject(s)
Herpes Simplex/diagnosis , Herpes Zoster Ophthalmicus/diagnosis , Retinal Necrosis Syndrome, Acute/diagnosis , Disease Progression , Female , Herpes Simplex/complications , Herpes Simplex/surgery , Herpes Zoster Ophthalmicus/complications , Herpes Zoster Ophthalmicus/surgery , Herpesvirus 2, Human/isolation & purification , Herpesvirus 3, Human/isolation & purification , Humans , Laser Coagulation , Male , Middle Aged , Retinal Detachment/etiology , Retinal Detachment/surgery , Retinal Necrosis Syndrome, Acute/etiology , Retinal Necrosis Syndrome, Acute/surgery , Retrospective Studies , Scleral Buckling , Visual Acuity , Vitrectomy
18.
Br J Ophthalmol ; 91(6): 761-5, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17108013

ABSTRACT

AIM: To evaluate the predictive factors for visual outcome after intravitreal triamcinolone acetonide injection to treat refractory diabetic macular oedema (DME). METHODS: A retrospective chart review of patients with DME who met the following inclusion criteria was performed: clinically significant diabetic macular oedema, receipt of a 4 mg/0.1 ml intravitreal triamcinolone acetonide injection and an optical coherence tomography (OCT) of the macula performed up to 10 days before injection. All patients received a full ophthalmic examination including best-corrected Snellen visual acuity (VA). The main outcome measure was the mean change in vision 3 months after injection. RESULTS: Data from 73 eyes of 59 patients were analysed. After a mean follow-up of 324 days, the mean change in vision was -0.075 logarithm of minimum angle of resolution (logMAR) units, with 27.3% improving > or =3 lines, 6.8% declining > or =3 lines and 60.2% remaining stable within 1 line of baseline vision. Statistical analysis was performed using multivariate generalised estimating equations on the basis of data from 52 eyes of 42 patients. Factors associated with an improvement in vision 3 months after injection were worse baseline VA (-0.27 logMAR units/unit increase in baseline VA, p = 0.002) and presence of subretinal fluid (-0.17 logMAR units, p = 0.06). The presence of cystoid macular oedema negatively affected the visual outcome (0.15 logMAR units, p = 0.03). In addition, the presence of an epiretinal membrane (ERM) was associated with less visual improvement. ERM modified the effect of baseline VA as demonstrated by a significant interaction between these two variables (0.34 logMAR units/unit increase in baseline VA, p = 0.04). CONCLUSIONS: OCT factors and baseline VA can be useful in predicting the outcomes of VA 3 months after intravitreal triamcinolone acetonide injection in patients with refractory DME.


Subject(s)
Diabetic Retinopathy/drug therapy , Glucocorticoids/therapeutic use , Macular Edema/drug therapy , Triamcinolone Acetonide/therapeutic use , Aged , Diabetic Retinopathy/physiopathology , Drug Evaluation , Female , Humans , Injections , Macular Edema/physiopathology , Male , Middle Aged , Prognosis , Retrospective Studies , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity , Vitreous Body
19.
Arq Bras Oftalmol ; 69(5): 745-7, 2006.
Article in English | MEDLINE | ID: mdl-17187147

ABSTRACT

The congenital optic disc pit is a rare anomaly that can lead to major visual impairment associated with subretinal fluid accumulation. The authors describe the optical coherence tomography study of three cases of untreated congenital optic disc pits with different levels of visual impairment and its different presentations of intraretinal fluid collections.


Subject(s)
Cysts/diagnostic imaging , Optic Disk/abnormalities , Optic Nerve Diseases/congenital , Retinal Detachment/diagnostic imaging , Tomography, Optical Coherence , Adult , Aged , Humans , Macula Lutea/pathology , Male , Middle Aged , Optic Disk/diagnostic imaging , Optic Nerve Diseases/pathology , Radiography , Retinal Detachment/pathology , Tomography, Optical Coherence/standards
20.
Arq. bras. oftalmol ; 69(5): 745-747, set.-out. 2006. ilus
Article in English, Portuguese | LILACS | ID: lil-439325

ABSTRACT

The congenital optic disc pit is a rare anomaly that can lead to major visual impairment associated with subretinal fluid accumulation. The authors describe the optical coherence tomography study of three cases of untreated congenital optic disc pits with different levels of visual impairment and its different presentations of intraretinal fluid collections.


A fosseta congênita do disco óptico é uma anomalia rara que pode levar a importante comprometimento visual associado ao acúmulo de líquido sub-retiniano. Os autores descrevem o estudo pela tomografia de coerência óptica de três casos de fossetas congênitas do disco óptico não tratadas com diferente comprometimento visual e diferente apresentação das coleções de líquido intra-retiniano.


Subject(s)
Humans , Male , Adult , Middle Aged , Cysts , Optic Disk/abnormalities , Optic Nerve Diseases/congenital , Retinal Detachment , Tomography, Optical Coherence , Macula Lutea/pathology , Optic Disk , Optic Nerve Diseases/pathology , Retinal Detachment/pathology , Tomography, Optical Coherence/standards
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