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1.
Rev. bras. oftalmol ; 83: e0024, 2024.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1559595

ABSTRACT

RESUMO Objetivo: Avaliar a prevalência de miopia em crianças de escolas públicas da Região Metropolitana de Porto Alegre (RS, Brasil). Métodos: Estudo transversal prospectivo, com amostra de 330 estudantes de escolas públicas da Região Metropolitana de Porto Alegre entre 5 e 20 anos de idade. Os escolares foram submetidos à avaliação oftalmológica completa, incluindo acuidade visual com e sem correção, autorrefração dinâmica e estática, refração subjetiva dinâmica e estática sob cicloplegia e medida do diâmetro axial. Um questionário sobre tempo de uso de telas diário foi aplicado. Os desfechos foram prevalência de miopia, alta miopia e baixa miopia. O teste do qui-quadrado de Pearson foi utilizado para avaliar a relação da prevalência com a variável contemplada no questionário. Resultados: A prevalência de miopia foi de 17,4% (IC95% 13,8-21,7%). Baixa e alta miopia corresponderam a 15,2% (IC95% 11,9-19,3%) e 2,1% (IC95% 1,1-4,1%), respectivamente. Conclusão: Essa é a maior prevalência de miopia sob cicloplegia encontrada no Brasil até a presente data. Outros estudos para entender a prevalência e a evolução da ametropia no país são necessários.


ABSTRACT Objective: To assess myopia prevalence in children from public schools of the metropolitan region of Porto Alegre, in Rio Grande do Sul. Methods: It is a prospective cross-sectional study with a sample of 330 children from public schools of the metropolitan region of Porto Alegre, from 5 to 20 years old. The students were submitted to an ophthalmological evaluation including auto-refractor measurements, best corrected and uncorrected visual acuity, subjective refraction under cycloplegia and axial length. The outcomes were prevalence of myopia, high myopia, and low myopia. Pearson's chi-squared test was used to assess the relationship between prevalence and the variable contemplated in the questionnaire. Results: The prevalence of myopia was 17.4% (CI 13.8 - 21.7%). Low and high myopia corresponded to 15.2% (CI 11.9 - 19.3%) and 2.1% (CI 1.1 - 4.1%), respectively. Conclusion: This is the highest prevalence of myopia under cycloplegia found in Brazil to date. Other studies are necessary to understand the prevalence and evolution of the condition in the country.

2.
Ophthalmic Genet ; 42(1): 71-74, 2021 02.
Article in English | MEDLINE | ID: mdl-32940091

ABSTRACT

BACKGROUND: Classic homocystinuria (HCU), or cystathionine beta-synthase (CBS) deficiency, is a rare inborn error of methionine metabolism. Main clinical features may include skeletal and vascular manifestations, developmental delay, intellectual disability and eye disorders. MATERIAL AND METHODS: This is an observational and retrospective study aiming at describing eye abnormalities presented by a cohort of late-diagnosed HCU patients. Data regarding ophthalmological evaluation included visual acuity, refraction, biomicroscopy, Perkins tonometry, fundus examination, retinography, biometry, ocular ultrasound, optical coherence tomography, anterior segment photography and topography. RESULTS: Ten patients with HCU (20 eyes) were included. The most frequent findings were ectopia lentis(n = 20) and myopia (n = 9). Biometry, ultrasound, OCT and topography findings were available for four patients. One patient had keratoconus; one had abnormal retinal pigmentation; and two had lens surgery scars with irregular astigmatism. CONCLUSIONS: Eye abnormalities are very frequent in late-diagnosed HCU patients. The presence of ectopia lentis should always raise the diagnostic hypothesis of HCU.


Subject(s)
Astigmatism/pathology , Ectopia Lentis/pathology , Homocystinuria/complications , Myopia/pathology , Adolescent , Adult , Astigmatism/etiology , Ectopia Lentis/etiology , Female , Humans , Male , Myopia/etiology , Prognosis , Retrospective Studies , Young Adult
3.
Arq. bras. oftalmol ; 82(1): 68-71, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-973863

ABSTRACT

ABSTRACT The authors describe an unusual association between posterior keratoconus and iris atrophy, confirmed by a complete ocular evaluation, scheimpflug imaging and pachymetric curve. A hypothesis for concomitant findings is discussed.


RESUMO Os autores descrevem a rara associação entre ceratocone posterior e atrofia de íris, confirmada por avaliação oftalmológica completa, imagens de scheimpflug e curva paquimétrica. Sugere-se uma hipótese que explique a concomitância de ambas as alterações.


Subject(s)
Humans , Female , Middle Aged , Iris/pathology , Iris Diseases/complications , Keratoconus/complications , Astigmatism/complications , Astigmatism/pathology , Atrophy , Amblyopia/complications , Amblyopia/pathology , Corneal Topography/methods , Corneal Pachymetry/methods , Keratoconus/pathology
4.
Arq Bras Oftalmol ; 82(1): 68-71, 2019.
Article in English | MEDLINE | ID: mdl-30652770

ABSTRACT

The authors describe an unusual association between posterior keratoconus and iris atrophy, confirmed by a complete ocular evaluation, scheimpflug imaging and pachymetric curve. A hypothesis for concomitant findings is discussed.


Subject(s)
Iris Diseases/complications , Iris/pathology , Keratoconus/complications , Amblyopia/complications , Amblyopia/pathology , Astigmatism/complications , Astigmatism/pathology , Atrophy , Corneal Pachymetry/methods , Corneal Topography/methods , Female , Humans , Keratoconus/pathology , Middle Aged
5.
Arq. bras. oftalmol ; 81(4): 336-338, July-Aug. 2018. graf
Article in English | LILACS | ID: biblio-950467

ABSTRACT

ABSTRACT Homocystinuria is one of a group of genetic disorders called inborn errors of metabolism. It is characterized by a deficiency of the enzyme that converts homocysteine to cystathionine. Keratoconus is an ophthalmologic condition characterized by thinning of the corneal stroma, which causes the cornea to assume a conical shape. There is little information in the scientific literature about the association between keratoconus and homocystinuria. We believe that a collagen cross-linking defect may be the key to understand the connection between these two conditions. This case report describes a 38-year-old male patient with a diagnosis of classical homocystinuria since age 13. At the age of 16, he received a diagnosis of asymmetrical keratoconus when referred for lensectomy with vitrectomy of his left eye. To the best of our knowledge, this is the first report of a patient with simultaneous homocystinuria and keratoconus.


RESUMO Homocistinúria é parte de um grupo de doenças genéticas chamado erros inatos do metabolismo. É caracterizada por uma deficiência da enzima que converte a homocisteína em cistationina. O ceratocone é uma patologia oftalmológica caracterizada pelo afinamento do estroma corneano, o que faz com que a córnea assuma um formato cônico. Há pouca informação na literatura científica sobre a associação entre ceratocone e homocistinúria. Acreditamos que um defeito no cross-linking do colágeno possa ser a chave para entender a conexão entre estas duas condições. Este relato de caso descreve um paciente masculino de 38 anos com diagnóstico de homocistinúria clássica desde os 13 anos. Aos 16 anos, recebeu o diagnóstico de ceratocone assimétrico quando foi encaminhado para lensectomia com vitrectomia do olho esquerdo. Até onde sabemos, este é o primeiro relato de um paciente com homocistinúria e ceratocone simultâneos.


Subject(s)
Humans , Male , Adult , Homocystinuria/complications , Keratoconus/complications , Lens, Crystalline/surgery , Vitrectomy , Tomography, Optical , Homocystinuria/surgery , Keratoconus/surgery
6.
Arq Bras Oftalmol ; 81(4): 336-338, 2018.
Article in English | MEDLINE | ID: mdl-29995127

ABSTRACT

Homocystinuria is one of a group of genetic disorders called inborn errors of metabolism. It is characterized by a deficiency of the enzyme that converts homocysteine to cystathionine. Keratoconus is an ophthalmologic condition characterized by thinning of the corneal stroma, which causes the cornea to assume a conical shape. There is little information in the scientific literature about the association between keratoconus and homocystinuria. We believe that a collagen cross-linking defect may be the key to understand the connection between these two conditions. This case report describes a 38-year-old male patient with a diagnosis of classical homocystinuria since age 13. At the age of 16, he received a diagnosis of asymmetrical keratoconus when referred for lensectomy with vitrectomy of his left eye. To the best of our knowledge, this is the first report of a patient with simultaneous homocystinuria and keratoconus.


Subject(s)
Homocystinuria/complications , Keratoconus/complications , Lens, Crystalline/surgery , Adult , Homocystinuria/surgery , Humans , Keratoconus/surgery , Male , Tomography, Optical , Vitrectomy
7.
Oxid Med Cell Longev ; 2016: 9780193, 2016.
Article in English | MEDLINE | ID: mdl-27635188

ABSTRACT

Importance. Autologous serum (AS) eye drops are recommended for severe dry eye in patients with ocular surface disease. No description of the antioxidant balance of AS eye drops has been reported in the literature. Objective. This study sought to evaluate the total reactive antioxidant potential (TRAP) and concentration of reactive oxygen species (ROS) in samples of 50% AS eye drops and their correlations with the demographic characteristics and lifestyle habits of patients with ocular surface disease and healthy controls. Design. This was a case-control study with a 3-month follow-up period. Participants. 16 patients with severe dry eye disease of different etiologies and 17 healthy controls matched by age, gender, and race were included. Results. TRAP and ROS were detected at all evaluated times. There were no differences in the mean ROS (p = 0.429) or TRAP (p = 0.475) levels between cases and controls. No statistically significant differences in the concentrations of ROS or TRAPs were found at 0, 15, or 30 days (p for ROS = 0.087 and p for TRAP = 0.93). Neither the demographic characteristics nor the lifestyle habits were correlated with the oxidative balance of the 50% AS eye drops. Conclusions and Relevance. Both fresh and frozen 50% AS eye drops present antioxidant capacities and ROS in an apparently stable balance. Moreover, patients with ocular surface disease and normal controls produce equivalent AS eye drops in terms of oxidative properties.


Subject(s)
Dry Eye Syndromes/drug therapy , Ophthalmic Solutions/therapeutic use , Oxidative Stress , Serum/chemistry , Adult , Antioxidants/metabolism , Case-Control Studies , Female , Follow-Up Studies , Humans , Life Style , Male , Middle Aged , Quality of Life , Reactive Oxygen Species/metabolism , Transplantation, Autologous
8.
Arq Bras Oftalmol ; 69(4): 565-70, 2006.
Article in Portuguese | MEDLINE | ID: mdl-17119732

ABSTRACT

PURPOSE: To study the antioxidant status of human tears, stimulated by onion fumes and the possible influence of the life habits thereon were measured. METHODS: Subjects were ten healthy young adults, who answered a questionnaire about smoking, alcohol ingestion, fruit, vegetable, cereal, and vitamin intake and/or intake of other drugs, and physical exercise habits. Chemoluminescensce of luminol was used to analyze the total reactive antioxidant potential (TRAP), inhibition of piragollol was used to measure superoxide dismutase (SOD) and absorbance of H2O2 at 240 nm was used to identify catalase. RESULTS: Mean +/- SD value for total reactive antioxidant potential was 33.8+/-11.5 microM and for superoxide dismutase 10.8+/-1.9 U/mL. Catalase was not identified. Regular exercise was associated with increased total reactive antioxidant potential values (p=0.021), with a difference of 18.6 microM between individuals who exercise at least once a week and sedentary individuals. Male gender and total reactive antioxidant potential values were statistically associated (p=0.013), with a difference of 16.3 microM between genders. There was an association between smoking and increased superoxide dismutase values (p=0.041), with a difference of 3.3 U/mL between smokers of more than five cigarettes/day and non-smokers. Also, vitamin C intake and superoxide dismutase values were associated (p=0.018); the difference for vitamin C takers was 3.3 U/mL. CONCLUSION: Reflex tearing antioxidants were measurable in healthy young adults, and different variables apparently influenced their values.


Subject(s)
Antioxidants/analysis , Catalase/metabolism , Superoxide Dismutase/metabolism , Tears/chemistry , Adult , Exercise , Female , Humans , Life Style , Luminescence , Luminol , Male , Smoking , Surveys and Questionnaires , Tears/enzymology
9.
Arq Bras Oftalmol ; 69(3): 327-31, 2006.
Article in Portuguese | MEDLINE | ID: mdl-16936954

ABSTRACT

PURPOSE: To quantify and compare the in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to different intraocular lenses (IOLs). METHODS: Fourteen intraocular lenses were used in the experiment. Four of polymethylmethacrylate (PMMA), four of silicone, four of hydrogel and two of acrylic. Eight intraocular lenses were placed in eight test tubes containing 4 ml of Pseudomonas alcaligenes suspension, and six intraocular lenses were placed in six test tubes containing 4 ml of Staphylococcus epidermidis suspension. The bacterial suspension used for adherence tests was 10(8) colony-forming units per milliliter (CFU/mL) which corresponds to 0.5 in the scale of McFarland. The lenses were incubated at 37 degrees for two hours. After this, intraocular lenses were removed from the test tubes and dried twice with the use of distilled and sterile water. The material was spread on blood-agar for cultivation at 35-37 degrees C and was evaluated every 24 hours up to 72 hours. In the samples where there was bacterial growth, the colonies were counted using the conventional laboratory methods. All assays were performed in duplicate. RESULTS: Adherence of Staphylococcus epidermidis to PMMA intraocular lenses was lower than to hydrogel and silicone intraocular lenses. Adherence of Pseudomonas alcaligenes to hydrogel intraocular lenses was lower than to PMMA, acrylic and silicone intraocular lenses. CONCLUSIONS: Results suggest that in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to intraocular lenses is influenced by type of material of the lens and by microorganism species. Bacterial adherence may play a role in the pathogenesis of some forms of endophthalmitis after cataract surgery. More in vitro and clinical studies are necessary to elucidate the mechanisms by which Staphylococcus epidermidis and Pseudomonas alcaligenes cause endophthalmitis.


Subject(s)
Bacterial Adhesion/physiology , Lenses, Intraocular/microbiology , Pseudomonas alcaligenes/growth & development , Staphylococcus epidermidis/growth & development , Colony Count, Microbial
10.
Arq. bras. oftalmol ; 69(4): 565-570, jul.-ago. 2006. tab
Article in Portuguese, English | LILACS | ID: lil-435744

ABSTRACT

OBJETIVO: Estudar os antioxidantes da lágrima humana, estimulada pelo corte de cebola e a possível influência dos hábitos de vida sobre estas medidas. MÉTODOS: A amostra consistiu de dez adultos jovens, que responderam questionário sobre o hábito de fumar, de ingerir bebidas alcoólicas, frutas, vegetais e cereais, de usar vitaminas e/ou drogas e de praticar exercícios. O potencial reativo antioxidante total (TRAP) foi analisado por meio da quimioluminescência do luminol, a superóxido dismutase (SOD) foi medida pela inibição do piragolol e a absorbância de H2O2 a 240 nm foi utilizada para identificar a catalase. RESULTADOS: A média ± DP dos valores de potencial reativo antioxidante total foi 33,8±11,5 µM e de superóxido dismutase foi 10,8±1,9 U/mL. Não foi identificada atividade da catalase. Detectou-se associação entre a prática regular de exercícios e aumento nos valores de potencial reativo antioxidante total (p=0,021), com diferença de 18,6 µM entre os indivíduos que se exercitavam pelo menos uma vez por semana e os sedentários. Sexo masculino e aumento na concentração de potencial reativo antioxidante total também se associaram estatisticamente (p=0,013), com diferença de 16,3 µM entre os sexos. Houve associação entre hábito tabágico e aumento na superóxido dismutase (p=0,041), com diferença de 3,3 U/mL entre fumantes de mais de cinco cigarros/dia e não fumantes. O uso de vitamina C também demonstrou associação com a superóxido dismutase (p=0,018); a diferença para os que tomavam vitamina C foi de 3,3 U/mL a mais. CONCLUSÃO: Os antioxidantes do lacrimejamento reflexo foram mensuráveis em adultos jovens, e diferentes variáveis parecem ter influenciado nos resultados.


PURPOSE: To study the antioxidant status of human tears, stimulated by onion fumes and the possible influence of the life habits thereon were measured. METHODS: Subjects were ten healthy young adults, who answered a questionnaire about smoking, alcohol ingestion, fruit, vegetable, cereal, and vitamin intake and/or intake of other drugs, and physical exercise habits. Chemoluminescensce of luminol was used to analyze the total reactive antioxidant potential (TRAP), inhibition of piragollol was used to measure superoxide dismutase (SOD) and absorbance of H2O2 at 240 nm was used to identify catalase. RESULTS: Mean ± SD value for total reactive antioxidant potential was 33.8±11.5 µM and for superoxide dismutase 10.8±1.9 U/mL. Catalase was not identified. Regular exercise was associated with increased total reactive antioxidant potential values (p=0.021), with a difference of 18.6 µM between individuals who exercise at least once a week and sedentary individuals. Male gender and total reactive antioxidant potential values were statistically associated (p=0.013), with a difference of 16.3 µM between genders. There was an association between smoking and increased superoxide dismutase values (p=0.041), with a difference of 3.3 U/mL between smokers of more than five cigarettes/day and non-smokers. Also, vitamin C intake and superoxide dismutase values were associated (p=0.018); the difference for vitamin C takers was 3.3 U/mL. CONCLUSION: Reflex tearing antioxidants were measurable in healthy young adults, and different variables apparently influenced their values.


Subject(s)
Humans , Male , Female , Adult , Antioxidants/analysis , Catalase/metabolism , Superoxide Dismutase/metabolism , Tears/chemistry , Exercise , Life Style , Luminescence , Luminol , Smoking , Surveys and Questionnaires , Tears/enzymology
11.
Arq. bras. oftalmol ; 69(3): 327-331, maio-jun. 2006. ilus, graf
Article in Portuguese | LILACS | ID: lil-433795

ABSTRACT

OBJETIVO: Quantificar e comparar a aderência in vitro das bactérias Staphylococcus epidermidis e Pseudomonas alcaligenes em diferentes tipos de lentes intra-oculares (LIOs). MÉTODOS: Quatorze lentes intra-oculares foram usadas no experimento. Quatro de polimetilmetacrilato (PMMA), quatro de silicone, quatro de hidrogel e duas de acrílico. Oito lentes intra-oculares foram colocadas em oito tubos de ensaio contendo 4 ml de suspensão de Pseudomonas alcaligenes, e seis lentes intra-oculares foram colocadas em seis tubos de ensaio contendo 4 ml de suspensão de Staphylococcus epidermidis. A concentração do caldo utilizada para o teste de aderência foi de 10(8) unidades formadoras de colônias por mililitro (CFU/mL) que corresponde a 0,5 na escala de McFarland. As lentes foram incubadas a 37° por duas horas. Após, foram removidas dos caldos e enxaguadas em água destilada estéril por duas vezes. As lentes foram cultivadas em placas de ágar-sangue a 35-37° e evaliadas a cada 24h por um período de 72h. Nas amostras que tiveram crescimento bacteriano, foram contadas as colônias utilizando os métodos convencionais de laboratório. Todos os ensaios foram executados em duplicata. RESULTADOS: A aderência do Staphylococcus epidermidis nas lentes de PMMA foi menor se comparada com as de silicone e de hidrogel. A aderência daPseudomonas alcaligenes nas lentes de hidrogel foi menor se comparada com as de silicone, PMMA e acrílico. CONCLUSÃO: Os resultados sugerem que a aderência do Staphylococcus epidermidis e da Pseudomonas alcaligenes nas lentes intra-oculares é influenciada pelo tipo de material da lente e pela espécie do microorganismo. A aderência bacteriana pode ter papel importante na patogenicidade da endoftalmite pós-cirurgia de catarata.


Subject(s)
Bacterial Adhesion/physiology , Lenses, Intraocular/microbiology , Pseudomonas alcaligenes/growth & development , Staphylococcus epidermidis/growth & development , Colony Count, Microbial
12.
Arq Bras Oftalmol ; 69(2): 261-3, 2006.
Article in Portuguese | MEDLINE | ID: mdl-16699681

ABSTRACT

PURPOSE: To evaluate the efficacy of the laser in situ keratomileusis (LASIK) technique in the reduction of anisometropy in adults, for whom conventional treatment was not successful. METHODS: A sequence of cases of three eyes of three adult patients, two females and one male, age ranging from 28 and 49 years (average 38.3 years), who underwent LASIK. Two patients were followed up for eighteen months and one for six months. RESULTS: Comparing the corrected visual acuity before surgery with the non-corrected visual acuity after surgery, one eye gained two lines of vision, one eye remained the same and one eye lost one line of vision. All eyes remained without spheric refraction, and astigmatism did not exceed -0.75 D after surgery. There has been an improvement in the symptoms of asthenopia in the three patients. CONCLUSION: The LASIK technique proved to be efficient in the correction of anisometropy in adults, improving visual accuity and asthenopia complaints, and leading to a similar refraction in both eyes.


Subject(s)
Anisometropia/surgery , Keratomileusis, Laser In Situ , Adult , Female , Humans , Male , Middle Aged , Prospective Studies , Visual Acuity
13.
Arq. bras. oftalmol ; 69(2): 261-263, mar.-abr. 2006. tab
Article in Portuguese | LILACS | ID: lil-426727

ABSTRACT

OBJETIVO: Avaliar a eficácia da técnica laser in situ keratomileusis (LASIK) na redução de anisometropia em adultos, para os quais os tratamentos convencionais não tiveram sucesso. MÉTODOS: Série de casos de três olhos de três pacientes adultos, dois do sexo feminino e um do sexo masculino, com idade entre 28 e 49 anos (média de 38,3 anos), os quais foram submetidos à técnica de LASIK. Dois pacientes foram acompanhados por dezoito meses e um por seis meses após a cirurgia. RESULTADOS: Comparando a acuidade visual corrigida do pré-operatório com a acuidade visual não corrigida do pós-operatório, um olho ganhou duas linhas de visão, um olho manteve-se igual e um olho perdeu uma linha de visão. Todos os olhos se mantiveram sem ametropia esférica, e o astigmatismo não excedeu -0,75 D no pós-operatório. CONCLUSÃO: A técnica LASIK mostrou-se eficaz na correção de alta anisometropia em adultos, melhorando a acuidade visual e as queixas astenopéicas, e diminuindo a anisometropia.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anisometropia/surgery , Keratomileusis, Laser In Situ , Prospective Studies , Visual Acuity
14.
Arq Bras Oftalmol ; 68(3): 393-5, 2005.
Article in Portuguese | MEDLINE | ID: mdl-16059576

ABSTRACT

Corticosteroids can increase intraocular pressure when administered topically, systemically and even when inhaled. They are routinely used after refractive surgeries to lower or prevent an inflammatory action. In this case history, we present a 36-year-old patient who had a total myopic regression two weeks after LASIK for low myopia, caused by steroid-induced ocular hypertension. The purpose of this report is to describe how the case was managed, the diagnostic hypothesis, and to stress the importance of intraocular pressure measurement after LASIK.


Subject(s)
Anti-Inflammatory Agents/adverse effects , Dexamethasone/adverse effects , Keratomileusis, Laser In Situ , Myopia/surgery , Ocular Hypertension/complications , Adult , Anti-Bacterial Agents/therapeutic use , Female , Humans , Ocular Hypertension/diagnosis , Severity of Illness Index , Tobramycin/therapeutic use
15.
Arq. bras. oftalmol ; 68(3): 393-395, maio-jun. 2005.
Article in Portuguese | LILACS | ID: lil-410456

ABSTRACT

Os corticoesteróides podem aumentar a pressão intra-ocular quando administrados de maneira tópica, sistêmica e até mesmo inalatória. É rotina sua utilização após cirurgias refrativas para diminuir ou prevenir reação inflamatória. No presente relato, apresentamos o caso de uma paciente de 36 anos que, após duas semanas de cirurgia de LASIK para correção de miopia leve, teve regressão total da miopia causada pela hipertensão ocular cortisônica. O objetivo desse relato é descrever como foi conduzido o caso, as hipóteses de diagnósticos que foram levantadas, e salientar a importância da mensuração da pressão intra-ocular no pós-operatório.


Subject(s)
Humans , Male , Adult , Anti-Inflammatory Agents , Dexamethasone/adverse effects , Ocular Hypertension/complications , Keratomileusis, Laser In Situ , Myopia/surgery , Anti-Bacterial Agents/therapeutic use , Ocular Hypertension/diagnosis , Severity of Illness Index , Tobramycin/therapeutic use
16.
Arq Bras Oftalmol ; 68(1): 133-5, 2005.
Article in Portuguese | MEDLINE | ID: mdl-15824819

ABSTRACT

Presence of fungus in the conjunctiva is a constant threat to the eyes, because these microorganisms, defined as opportunistic, may provoke severe ocular infections, in situations as low organic resistance, use of immunosuppressants, antibiotics and epithelial alteration. Our goal here is to report a case of ocular aspergillosis in an immunosuppressed patient where paroxysmal nocturnal hemoglobinuria was diagnosed. A 51-year-old immunosuppressed, thrombocytopenic patient was hospitalized with a diagnosis of paroxysmal nocturnal hemoglobinuria. On examination, she had a visual acuity of 20/40 in the right eye (RE) and light perception in the left (LE). She presented hyposphagma, bilateral conjunctival edema on biomicroscopy and had some multiple and circumscribed conjunctival abscesses in both eyes; clear cornea in both eyes. Fundoscopy of the RE did show any particularity, in the LE there was a smear hemorrhage. Computed tomograph showed a fat periocular infiltration. Magnetic resonance lead to the same finding, compatible with orbital cellulitis. Hemoculture showed Aspergillus growth and direct smears of conjunctival material was negative. There was great improvement while treating her with amphotericin B, but there was complete remission after using 5% natamicyn eye drops. Orbital infections caused by Aspergillus are uncommon, usually appearing in immunosuppressed patients. Frequently they progress insidiously, and can be confounded with other orbital processes. Immunological impairment can inhibit the expression of local and systemic symptoms, resulting in diagnostic confusion. The diagnosis is established by laboratory tests, but culture can be negative in spite of the classical presentation, making the beginning of treatment difficult. In these cases management starts according to the symptoms.


Subject(s)
Aspergillosis/complications , Conjunctival Diseases/microbiology , Eye Infections, Fungal/microbiology , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Aspergillosis/drug therapy , Conjunctival Diseases/drug therapy , Eye Infections, Fungal/drug therapy , Female , Humans , Middle Aged
17.
Arq. bras. oftalmol ; 68(1): 133-135, jan.-fev. 2005. ilus
Article in Portuguese | LILACS | ID: lil-396370

ABSTRACT

A presença de fungos na conjuntiva representa constante ameaça para os olhos, pois estes microrganismos, definidos como oportunistas, podem provocar infecções oculares graves, em situações como baixa resistência orgânica, uso de medicações imunossupressoras, antibióticos e alteração epitelial. O objetivo desta, é relatar um caso de aspergilose ocular em paciente imunodeprimida com diagnóstico de hemoglobinúria paroxística noturna. Paciente feminina de 51 anos, internou imunossuprimida e plaquetopênica com diagnóstico de hemoglobinúria paroxística noturna. Ao exame, apresentava acuidade visual de 20/40 OD (olho direito) e percepção luminosa OE (olho esquerdo). Apresentava à biomicroscopia hiposfagma, edema conjuntival bilateral e abscessos conjuntivais múltiplos em ambos os olhos; córnea transparente AO (ambos os olhos). Boa motilidade ocular. A fundoscopia em OD não demonstrava particularidades, em OE havia hemorragia macular. A tomografia computadorizada de órbita revelou infiltração de gordura periocular. A ressonância nuclear magnética mostrou os mesmos achados da tomografia computadorizada, compatível com celulite orbitaria. Foi realizada hemocultura que demonstrou crescimento de Aspergillus sp e a cultura do raspado conjuntival foi negativa. O tratamento sistêmico com anfotericina B demonstrou melhora do quadro ocular, que regrediu completamente após a introdução de colírio de natamicina a 5 por cento. As infecções orbitárias causadas por Aspergillus são incomuns, aparecendo usualmente em pacientes imunodeprimidos. Com freqüência têm curso insidioso, podendo ser confundidas com outros processos orbitarios. O comprometimento imunológico pode inibir a expressão dos sintomas locais e sistêmicos, resultando em confusão diagnóstica. O diagnóstico é feito com exames laboratoriais, mas a cultura pode ser negativa apesar do quadro clínico clássico, dificultando assim, o início do tratamento. Nesses casos inicia-se o manejo, segundo o quadro de sintomas.


Subject(s)
Humans , Female , Middle Aged , Aspergillosis , Hemoglobinuria, Paroxysmal/diagnosis , Eye Infections, Fungal/microbiology
18.
Rev. bras. oftalmol ; 63(3): 170-175, mar. 2004. tab
Article in Portuguese | LILACS | ID: lil-398680

ABSTRACT

Objetivo: Identificar os microorganismos presenes na conjuntiva de pacientes com catarata e portadores do HIV e compará-los com a microbiótica de pacientes não portadores do vírus. Avaliar a adequação da antibióticoprofilaxia para endoftalmite pós-operatória. Material e métodos: Dezoito pacientes do Setor de Uveítes do Serviço de Oftalmologia do HCPA preencheram os critérios de seleção. Foi coletado material do fórnice conjuvital inferior de ambos os olhos, com o auxílio de um swab conjuvital seco sem a utilização de anestésico tópico. O material foi semeado em dois meios de cultura sólidos (ágar-sangue e ágar-chocolate). As placas de ágar-sangue e ágar-chocolate foram incubadas a 35-37 graus centígrados em atmosfera de CO2 e avaliadas a cada 24 horas até completar 72 horas. Nas amostras em que houve crescimento bacteriano, as colônias foram isoladas e identificadas conforme métodos laboratoriais convencionais. Resultados: Nove dos 18 pacientes compareceram ao serviço para o estudo. Todos os pacientes eram do sexo masculino, a média de idade foi de 48 anos (variação de 36 a 73 anos). Houve crescimento aeróbico em 10 amostras (55,55 por cento). A bactéria mais prevalente foi o Staphylococcus epidermidis (33,33 por cento), seguido pelo Corynebacterum sp (11,11 por cento), pela Pseudomonas alcalígenes (11,11 por cento) e pelo Acinetobacter sp (5,56 por cento). Todos os microorganismos foram sensíveis a gentamicina, ciprofloxacina e cloranfenicol. Conclusões: Não houve diferença observável no tipo de microorganismos isolados na conjuntiva de pacientes sidéticos e de pacientes não portadores do vírus, segundo os registros da literatura. É interessante a utilização da antibióticoprofilaxia antes ao procedimento cirúrgico, como meio preventivo a endoftalmite


Subject(s)
Humans , Male , Adult , Middle Aged , Cataract , Conjunctiva , HIV , Acquired Immunodeficiency Syndrome/parasitology , Staphylococcus epidermidis , Acinetobacter , Corynebacterium , Pseudomonas
19.
Arq. bras. oftalmol ; 66(3): 373-374, maio-jun. 2003. ilus
Article in English | LILACS | ID: lil-345648

ABSTRACT

PURPOSE: To describe a rare complication at the donor site of conjunctival transplantation. METHODS: The authors report the clinical, surgical, postoperative and histologic aspects of a Tenon's granuloma that followed an uneventful pterygium excision with conjunctival transplantation. RESULTS: Histology identified an hemangiomatous-like structure with some areas of foreign body granuloma overlying necrotic epithelial cels, easily excised surgically. CONCLUSIONS: Pyogenic granuloma is an inadequate term to describe an inflammatory nonsuppurative reaction that may follow uneventful conjunctival surgery in susceptible individuals.


Subject(s)
Humans , Male , Adult , Conjunctiva , Granuloma, Pyogenic/physiopathology , Pterygium/surgery
20.
Arq. bras. oftalmol ; 61(1): 70-3, jan.-fev. 1998. ilus
Article in Portuguese | LILACS | ID: lil-207964

ABSTRACT

A tonometria de aplanaçäo necessita da instilaçäo de colírios, oferece potencial risco de infecçäo e pode ser alterada por vícios de aferiçäo. Entre estes estäo a hipofluorescência e a hiperfluorescência do filme lacrimal, a espessura corneana e o astigmatismo, especialmente irregular. Já a tonometria de näo-contato apresenta a vantagem de näo necessitar o uso de anestésicos, apresentar menor risco de infecçöes e ter a facilidade do uso. Este trabalho avalia 80 olhos de pacientes triados do setor de glaucoma e do ambulatório geral do Serviço de Oftalmologia do Hospital das Clínicas de Porto Alegre, comparando a tonometria de näo-contato com a tonometria de aplanaçäo. Säo medidas a pressäo intra-ocular (PO) com o tonômetro de aplanaçäo manual (Perkins) e com o tonômetro de näo-contato (Topcon CT-20), a ceratometria e a paquimetria ultrassônica. Houve ..


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Glaucoma , Intraocular Pressure , Manometry
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