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1.
J Ophthalmic Vis Res ; 19(2): 264-266, 2024.
Article in English | MEDLINE | ID: mdl-39055514

ABSTRACT

Brilliant blue 0.05% and trypan blue 0.1% were mixed in a proportion of 1:1 in a 1-mL syringe. This combination produced a waterfall effect with the fast sinking of the dye to the posterior pole and little diffusion through the vitreous cavity. Therefore, it can effectively stain the internal limiting membrane and the epiretinal membrane with a good contrast during surgeries for a macular hole, myopic foveoschisis, and macular pucker.

2.
Retin Cases Brief Rep ; 16(3): 289-292, 2022 May 01.
Article in English | MEDLINE | ID: mdl-31985711

ABSTRACT

PURPOSE: To describe a case of stellate nonhereditary idiopathic foveomacular retinoschisis associated with outer retinal layer defect treated with pars plana vitrectomy, internal limiting membrane removal, and C3F8 tamponade. METHODS: Spectral-domain optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany) scans of a 46-year-old woman with unilateral stellate nonhereditary idiopathic foveomacular retinoschisis were acquired at baseline and 1, 3, 6, and 12 months after surgery. RESULTS: Pars plana vitrectomy was performed after phacoemulsification. The vitreous was circumcised, and the internal limiting membrane was removed with a Tano brush, releasing tangential forces. The patient experienced progressive recovery of the outer retinal layers and improvement of visual acuity during follow-up. CONCLUSION: Stellate nonhereditary idiopathic foveomacular retinoschisis may be associated with outer retinal layer defect and severe vision loss. Pars plana vitrectomy with internal limiting membrane removal and C3F8 infusion seems to be a safe and feasible treatment in such cases, with potentially good anatomical and functional outcome.


Subject(s)
Retinoschisis , Female , Humans , Middle Aged , Retina , Retinoschisis/complications , Retinoschisis/diagnosis , Retinoschisis/surgery , Retrospective Studies , Tomography, Optical Coherence/methods , Visual Acuity , Vitrectomy
3.
Clinics (Sao Paulo) ; 74: e837, 2019.
Article in English | MEDLINE | ID: mdl-30970119

ABSTRACT

OBJECTIVE: To report our experience using conventional culture methods (CM) and pediatric blood culture bottles (PBCBs) for vitreous sample culture of acute postoperative endophthalmitis. METHODS: A retrospective study was conducted at the Department of Ophthalmology, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, BR, from January 2010 to December 2015, and it included 54 patients with clinically suspected acute postoperative endophthalmitis. Vitreous samples were obtained by vitreous tap or vitrectomy. Samples from January 2010 to December 2011 were cultivated in CM, whereas samples from January 2012 to December 2015 were inoculated in PBCBs. The measured outcome was the yield of positive cultures. RESULTS: Twenty cases were included in the CM group, and 34 cases were included in the PBCB group. The yield of positive cultures in PBCBs (64.7%) was significantly higher than that in conventional CM (35%, p=0.034). Staphylococcus epidermidis and Streptococcus viridans were the two most commonly found agents. CONCLUSION: PBCBs can be used successfully in clinically suspected endophthalmitis. The method showed a higher yield of positive cultures than the conventional method. This technique appears to have several advantages over the traditional method: it saves time, as only one medium needs to be inoculated; transportation to a laboratory is easier than in the traditional method, and there is no need to maintain a supply of fresh agar media. The use of PBCBs may be recommended as the primary method for microbiological diagnosis and is especially suitable for office settings and remote clinics.


Subject(s)
Blood Culture/instrumentation , Culture Media/standards , Endophthalmitis/diagnosis , Postoperative Complications/diagnosis , Staphylococcus epidermidis/isolation & purification , Viridans Streptococci/isolation & purification , Acute Disease , Blood Culture/methods , Child , Humans , Microbial Sensitivity Tests/methods , Retrospective Studies , Vitreous Body/microbiology
4.
Clinics ; 74: e837, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001824

ABSTRACT

OBJECTIVE: To report our experience using conventional culture methods (CM) and pediatric blood culture bottles (PBCBs) for vitreous sample culture of acute postoperative endophthalmitis. METHODS: A retrospective study was conducted at the Department of Ophthalmology, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, BR, from January 2010 to December 2015, and it included 54 patients with clinically suspected acute postoperative endophthalmitis. Vitreous samples were obtained by vitreous tap or vitrectomy. Samples from January 2010 to December 2011 were cultivated in CM, whereas samples from January 2012 to December 2015 were inoculated in PBCBs. The measured outcome was the yield of positive cultures. RESULTS: Twenty cases were included in the CM group, and 34 cases were included in the PBCB group. The yield of positive cultures in PBCBs (64.7%) was significantly higher than that in conventional CM (35%, p=0.034). Staphylococcus epidermidis and Streptococcus viridans were the two most commonly found agents. CONCLUSION: PBCBs can be used successfully in clinically suspected endophthalmitis. The method showed a higher yield of positive cultures than the conventional method. This technique appears to have several advantages over the traditional method: it saves time, as only one medium needs to be inoculated; transportation to a laboratory is easier than in the traditional method, and there is no need to maintain a supply of fresh agar media. The use of PBCBs may be recommended as the primary method for microbiological diagnosis and is especially suitable for office settings and remote clinics.


Subject(s)
Humans , Child , Postoperative Complications/diagnosis , Staphylococcus epidermidis/isolation & purification , Endophthalmitis/diagnosis , Culture Media/standards , Viridans Streptococci/isolation & purification , Blood Culture/instrumentation , Vitreous Body/microbiology , Microbial Sensitivity Tests/methods , Acute Disease , Retrospective Studies , Blood Culture/methods
5.
J Nat Med ; 72(1): 161-165, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28884433

ABSTRACT

Umbelliferous medicinal plants, such as Angelica acutiloba Kitagawa and Angelica dahurica Bentham et Hooker filius ex Franchet et Savatier, account for a large percentage of crude drug consumption in Japan. The most serious problem in the cultivation of umbelliferous medicinal plants is the feeding damage caused by the common yellow swallowtail (Papilio machaon hippocrates C. & R. Felder, 1864). When we compared the numbers of eggs laid by P. machaon on six umbelliferous medicinal plants, the eggs on A. acutiloba, A. dahurica, and Glehnia littoralis Fr. Schmidt ex Miquel were the most numerous, those on Saposhnikovia divaricata Schischkin and Cnidium officinale Makino were rare, and Bupleurum falcatum Linné was not oviposited at all. To identify oviposition inhibitors for P. machaon in B. falcatum, S. divaricata, and C. officinale, the volatile chemical constituents of these umbelliferous medicinal plants were compared with GC-MS. We carried out multivariate analysis of gas chromatographic data and concluded that germacrene D, α-humulene, and trans-caryophyllene play important roles in protecting plants from oviposition by P. machaon. Their oviposition repellent activity was confirmed by the fact that the number of eggs laid on the leaves around a repellent device containing a mixture of germacrene D, α-humulene, and trans-caryophyllene was reduced by 40% compared to a control.


Subject(s)
Oviposition/physiology , Plant Leaves/chemistry , Plants, Medicinal/chemistry , Animals , Birds
6.
Ecol Evol ; 8(24): 12981-12990, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30619598

ABSTRACT

Despite our understanding of chemical defenses and their consequences for plant performance and herbivores, we know little about whether defensive chemicals in plant tissues, such as alkaloids, and their spatial variation within a population play unappreciated and critical roles in plant-herbivore interactions. Neighboring plants can decrease or increase attractiveness of a plant to herbivores, an example of a neighborhood effect. Chemical defensive traits may contribute to neighborhood effects in plant-herbivore interactions. We examined the effects of nicotine in leaves (a non-emitted defense chemical) on plant-herbivore interactions in a spatial context, using two varieties of Nicotiana tabacum with different nicotine levels. A common garden experiment demonstrated that visits by grasshoppers decreased with increasing density of neighboring plants with a greater nicotine level. In contrast, visits of leaf caterpillars were not affected by neighbors, irrespective of nicotine levels. Thus, our results clearly highlighted that the neighborhood effect caused by the nicotine in leaves depended on the insect identity, and it was mediated by plant-herbivore interactions, rather than plant-plant interactions. This study demonstrates that understanding of effects of plant defensive traits on plant-herbivore interactions requires careful consideration of the spatial distribution of plant defenses, and provides support for the importance of spatial context to accurately capture the ecological and evolutionary consequences of plant-herbivore interactions.

7.
Clinics (Sao Paulo) ; 72(2): 81-86, 2017 Feb 01.
Article in English | MEDLINE | ID: mdl-28273240

ABSTRACT

OBJECTIVES:: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. METHODS:: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505. RESULTS:: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 µm and 345.79±83.66 µm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. CONCLUSIONS:: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.


Subject(s)
Angiogenesis Inhibitors/administration & dosage , Bevacizumab/administration & dosage , Choroid/pathology , Diabetic Retinopathy/therapy , Retina/pathology , Combined Modality Therapy , Diabetic Retinopathy/pathology , Female , Humans , Intravitreal Injections , Laser Coagulation , Male , Middle Aged , Retrospective Studies , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity
8.
Clinics ; 72(2): 81-86, Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-840045

ABSTRACT

OBJECTIVES: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. METHODS: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505. RESULTS: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. CONCLUSIONS: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.


Subject(s)
Humans , Male , Female , Middle Aged , Retina/pathology , Choroid/pathology , Angiogenesis Inhibitors/administration & dosage , Diabetic Retinopathy/therapy , Bevacizumab/administration & dosage , Visual Acuity , Retrospective Studies , Treatment Outcome , Laser Coagulation , Combined Modality Therapy , Tomography, Optical Coherence , Diabetic Retinopathy/pathology , Intravitreal Injections
9.
Ophthalmic Res ; 51(3): 140-5, 2014.
Article in English | MEDLINE | ID: mdl-24525617

ABSTRACT

PURPOSE: To evaluate the results of intravitreal bevacizumab (IVB) injection on contrast sensitivity (CS), best-corrected visual acuity (BCVA), foveal thickness (FT) and macular volume (MV) as measured by optical coherence tomography in patients with macular edema (ME) from central retinal vein occlusion (CRVO). METHODS: Sixteen consecutive eyes from 16 patients with ME from unilateral CRVO were treated with a single IVB injection. The CS, BCVA, FT and MV measurements were obtained before the treatment and 1 and 3 months after the injection. RESULTS: CS demonstrated significant improvement at all spatial frequencies - 1.5, 3, 6, 12 and 18 cycles per degree (cpd) - 1 month after the injection and at 6 cpd at the 3-month follow-up. The mean BCVA measurements in log of the minimum angle of resolution (logMAR) units improved from 1.03 at baseline to 0.83 logMAR 1 month after the injection, but worsened to 0.97 logMAR at 3 months. The mean baseline FT ± standard deviation (SD; 620.06 ± 177.60 µm) was reduced significantly 1 month (270.93 ± 74.17 µm) and 3 months (535.56 ± 222.33 µm) after the treatment. The mean baseline MV ± SD (12,765.56 ± 3,769.70 mm(3)) was reduced significantly at the 1-month (8,324.93 ± 932.04 mm(3)) and 3-month (11,319.44 ± 3,044.74 mm(3)) follow-up visits. CONCLUSIONS: IVB improved CS, BCVA, FT and MV within a short time period (1 month). Although VA was not improved at 3 months, improvements were observed for CS, FT and MV, which indicates that, despite ME recurrence, there still was some benefit to visual function.


Subject(s)
Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Contrast Sensitivity/drug effects , Macula Lutea/drug effects , Macular Edema/drug therapy , Retinal Vein Occlusion/complications , Aged , Bevacizumab , Female , Follow-Up Studies , Humans , Intravitreal Injections , Macular Edema/etiology , Macular Edema/physiopathology , Male , Middle Aged , Prospective Studies , Visual Acuity/drug effects
10.
Arq Bras Oftalmol ; 75(4): 283-5, 2012.
Article in English | MEDLINE | ID: mdl-23258663

ABSTRACT

This case report describes the presence of bilateral macular atrophy in a patient with Alport syndrome and compares this finding with literature. At fundoscopy, there was a discrete circumscribed macular thinning showing intense retinal pigment epithelium color and the presence of whitish circular retinal lesions ("dots" and "flecks") at nasal mid periphery of both eyes. Optical coherence tomography showed bilateral partial atrophy of the neurosensory retina in the macula, with a greater extent in the temporal region. This case describes a rare ophthalmological finding in Alport syndrome and important to be recognized for a precise diagnosis as well as for determining visual prognosis.


Subject(s)
Macular Degeneration/genetics , Nephritis, Hereditary/complications , Retina/abnormalities , Female , Humans , Macular Degeneration/diagnosis , Middle Aged , Tomography, Optical Coherence , Visual Acuity
11.
Arq. bras. oftalmol ; 75(4): 283-285, jul.-ago. 2012. ilus, tab
Article in English | LILACS | ID: lil-659626

ABSTRACT

This case report describes the presence of bilateral macular atrophy in a patient with Alport syndrome and compares this finding with literature. At fundoscopy, there was a discrete circumscribed macular thinning showing intense retinal pigment epithelium color and the presence of whitish circular retinal lesions ("dots" and "flecks") at nasal mid periphery of both eyes. Optical coherence tomography showed bilateral partial atrophy of the neurosensory retina in the macula, with a greater extent in the temporal region. This case describes a rare ophthalmological finding in Alport syndrome and important to be recognized for a precise diagnosis as well as for determining visual prognosis.


Este relato de caso descreve a presença de atrofia macular bilateral em uma paciente com síndrome de Alport e compara este achado com a literatura. Ao exame fundoscópico, havia discreto afinamento macular circunscrito demonstrando a coloração intensa do epitélio pigmentado da retina e a presença de lesões retinianas circulares esbranquiçadas ("dots" e "flecks") na média periferia nasal em ambos os olhos. A tomografia de coerência óptica identificou atrofia parcial da retina neurossensorial bilateral na mácula, com maior extensão na área temporal. O caso descreve uma alteração oftalmológica rara da síndrome de Alport e de importante reconhecimento para precisar o diagnóstico e também para determinar o prognóstico visual.


Subject(s)
Female , Humans , Middle Aged , Macular Degeneration/genetics , Nephritis, Hereditary/complications , Retina/abnormalities , Macular Degeneration/diagnosis , Tomography, Optical Coherence , Visual Acuity
12.
Arq Bras Oftalmol ; 73(3): 288-90, 2010.
Article in English | MEDLINE | ID: mdl-20730290

ABSTRACT

Retinitis and panuveitis in immunocompetent patients is a rare and sight-threatening disease, of difficult diagnosis. A case of a 31-year-old male who presented with unilateral placoid retinitis and panuveitis, unsuccessfully treated as acute retinal necrosis, that in fact was syphilis, with neurosyphilis and excellent response to treatment is reported.


Subject(s)
Eye Infections, Bacterial/complications , Panuveitis/microbiology , Retinal Necrosis Syndrome, Acute/diagnosis , Retinitis/microbiology , Syphilis/diagnosis , Adult , Diagnosis, Differential , Eye Infections, Bacterial/drug therapy , Humans , Male , Panuveitis/drug therapy , Penicillins/therapeutic use , Retinitis/drug therapy , Syphilis/complications , Syphilis/drug therapy
13.
Arq. bras. oftalmol ; 73(3): 288-290, jun. 2010. ilus, tab
Article in English | LILACS | ID: lil-555074

ABSTRACT

Retinitis and panuveitis in immunocompetent patients is a rare and sight-threatening disease, of difficult diagnosis. A case of a 31-year-old male who presented with unilateral placoid retinitis and panuveitis, unsuccessfully treated as acute retinal necrosis, that in fact was syphilis, with neurosyphilis and excellent response to treatment is reported.


Retinite com panuveíte em pacientes imunocompetentes é um condição rara e ameaçadora para a visão, e de difícil diagnóstico. É relatado um caso de um paciente do sexo masculino com 31 anos de idade, que se apresentou com retinite em placas e panuveíte, inicialmente tratado sem sucesso como necrose aguda de retina, que na verdade era um caso de sífilis ocular, com afecção do sistema nervoso central e ótima resposta ao tratamento sistêmico para sífilis.


Subject(s)
Adult , Humans , Male , Eye Infections, Bacterial/complications , Panuveitis/microbiology , Retinal Necrosis Syndrome, Acute/diagnosis , Retinitis/microbiology , Syphilis/diagnosis , Diagnosis, Differential , Eye Infections, Bacterial/drug therapy , Panuveitis/drug therapy , Penicillins/therapeutic use , Retinitis/drug therapy , Syphilis/complications , Syphilis/drug therapy
14.
Arq Bras Oftalmol ; 72(3): 313-20, 2009.
Article in Portuguese | MEDLINE | ID: mdl-19668959

ABSTRACT

PURPOSE: To evaluate different diagnostic methods for high risk chloroquine retinopathy due to prolonged use of chloroquine (more than 5 years) by systemic lupus erythematosus patients. METHODS: Seventy-two eyes of 36 consecutive patients, followed in the Division of Rheumatology, School of Medicine, University of São Paulo, were analyzed from July 2007 to April 2008. Demographic and clinical data were evaluated in order to study risk factors and to compare the following different ophthalmological methods: visual acuity, biomicroscopy, fundus examination, retinography, fluorescein angiogram, visual field test and, color vision tests. RESULTS: From 36 patients, 34 (94.4%) were female. The mean age was 39.9 +/- 9.8 years and the disease duration was 13.9 +/- 6.6 years. Besides chronic use of chloroquine, patients also showed high daily and cumulative doses. These high risk factors were not related to a higher retinopathy prevalence. Visual field showed 38.9% of retinopathy prevalence. Other ophthalmological methods failed in detecting most cases. CONCLUSION: High prevalence of retinopathy in high risk patients was observed by visual field test, but other ophthalmological methods failed in detecting alterations. Ophthalmological assessment of these patients should include visual field, even in the absence of clinical alterations.


Subject(s)
Antimalarials/adverse effects , Chloroquine/analogs & derivatives , Diagnostic Techniques, Ophthalmological/standards , Lupus Erythematosus, Systemic/drug therapy , Retinal Diseases/chemically induced , Adult , Aged , Antimalarials/administration & dosage , Body Weight/physiology , Chi-Square Distribution , Chloroquine/administration & dosage , Chloroquine/adverse effects , Cornea/drug effects , Cornea/pathology , Diagnostic Techniques, Ophthalmological/classification , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Prevalence , Retina/drug effects , Retina/pathology , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Risk Factors , Time Factors , Visual Fields/drug effects , Young Adult
15.
Arq. bras. oftalmol ; 72(3): 313-320, May-June 2009. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-521464

ABSTRACT

OBJETIVOS: Avaliar diferentes métodos diagnósticos para a avaliação de pacientes portadores de lúpus eritematoso sistêmico, usuários crônicos do difosfato de cloroquina (DFC) e, portanto, com alto risco para retinopatia tóxica. MÉTODOS: Foram analisados 72 olhos de 36 pacientes consecutivos, seguidos no Serviço de Reumatologia do Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, de julho de 2007 a abril de 2008. Dados demográficos e clínicos foram avaliados com o intuito de estudar os fatores de alto risco e comparar os seguintes métodos oftalmológicos: acuidade visual, biomicroscopia da córnea, biomicroscopia do fundo, retinografia, angiofluoresceinografia da retina, campo visual macular com mira branca. RESULTADOS: Dos 36 pacientes, 34 (94,4 por cento) eram mulheres. A média de idade foi 39,9 ± 9,8 anos, com tempo de doença igual a 13,9 ± 6,6 anos. Além do uso crônico da cloroquina, os pacientes apresentaram altas doses diárias (>3 mg/kg) e cumulativas. Não foi observada relação entre estes fatores de alto risco e maior prevalência de retinopatia. Foi encontrada prevalência de retinopatia igual a 38,9 por cento, confirmada por alterações bilaterais, centrais ou paracentrais e reprodutíveis no exame de campo visual. Outros exames indicados para seguimento, como acuidade visual, biomicroscopia de fundo e angiofluoresceinografia não foram capazes de diagnosticar a maioria das alterações confirmadas pelo campo visual. CONCLUSÃO: Foi observada alta prevalência de retinopatia por cloroquina entre os pacientes com alto risco, usuários crônicos do DFC, segundo os achados do campo visual. A avaliação desses pacientes deve considerar a realização do exame de campo visual em intervalos menores que os propostos, mesmo quando não há suspeita clínica.


PURPOSE: To evaluate different diagnostic methods for high risk chloroquine retinopathy due to prolonged use of chloroquine (more than 5 years) by systemic lupus erythematosus patients. Methods: Seventy-two eyes of 36 consecutive patients, followed in the Division of Rheumatology, School of Medicine, University of São Paulo, were analyzed from July 2007 to April 2008. Demographic and clinical data were evaluated in order to study risk factors and to compare the following different ophthalmological methods: visual acuity, biomicroscopy, fundus examination, retinography, fluorescein angiogram, visual field test and, color vision tests. RESULTS: From 36 patients, 34 (94.4 percent) were female. The mean age was 39.9 ± 9.8 years and the disease duration was 13.9 ± 6.6 years. Besides chronic use of chloroquine, patients also showed high daily and cumulative doses. These high risk factors were not related to a higher retinopathy prevalence. Visual field showed 38.9 percent of retinopathy prevalence. Other ophthalmological methods failed in detecting most cases. CONCLUSION: High prevalence of retinopathy in high risk patients was observed by visual field test, but other ophthalmological methods failed in detecting alterations. Ophthalmological assessment of these patients should include visual field, even in the absence of clinical alterations.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antimalarials/adverse effects , Chloroquine/analogs & derivatives , Diagnostic Techniques, Ophthalmological/standards , Lupus Erythematosus, Systemic/drug therapy , Retinal Diseases/chemically induced , Antimalarials/administration & dosage , Body Weight/physiology , Chi-Square Distribution , Chloroquine/administration & dosage , Chloroquine/adverse effects , Cornea/drug effects , Cornea/pathology , Diagnostic Techniques, Ophthalmological/classification , Fluorescein Angiography , Prevalence , Risk Factors , Retina/drug effects , Retina/pathology , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Time Factors , Visual Fields/drug effects , Young Adult
16.
Arq Bras Oftalmol ; 71(4): 493-8, 2008.
Article in Portuguese | MEDLINE | ID: mdl-18797656

ABSTRACT

PURPOSE: To assess the efficacy of intravitreal use of triamcinolone acetonide combined with laser photocoagulation for the treatment of diffuse diabetic macular edema and to compare it with the separate use of each treatment. METHODS: After systemic clinical control, thirty patients with diffuse diabetic macular edema were divided into 3 treatment groups: (1) macular grid photocoagulation; (2) intravitreal injection of 4 mg of triamcinolone acetonide; (3) combination of the two previous therapies. Follow-up was scheduled at predetermined intervals of one day, one week and monthly until completion of six months. The following parameters were analyzed: LogMAR best corrected visual acuity, central macular thickness, total macular volume and intraocular pressure. RESULTS: Grid photocoagulation did not significantly reduce the central macular thickness or the total macular volume. On the other hand, this reduction was statistically significant in the other two groups. All groups improved their mean visual acuity, however, the group that received both treatments had a higher percentage of patients that gained 10 or more letters. CONCLUSION: The simultaneous administration of grid photocoagulation with intravitreal triamcinolone can be considered an option for the treatment of diffuse diabetic macular edema.


Subject(s)
Diabetic Retinopathy , Glucocorticoids/therapeutic use , Laser Coagulation , Macular Edema , Triamcinolone Acetonide/therapeutic use , Combined Modality Therapy/methods , Data Interpretation, Statistical , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/surgery , Female , Follow-Up Studies , Humans , Injections , Intraocular Pressure/drug effects , Intraocular Pressure/physiology , Macular Edema/drug therapy , Macular Edema/physiopathology , Macular Edema/surgery , Male , Middle Aged , Treatment Outcome , Visual Acuity/drug effects , Visual Acuity/physiology , Vitreous Body
17.
Arq. bras. oftalmol ; 71(4): 493-498, jul.-ago. 2008. graf, tab
Article in Portuguese | LILACS | ID: lil-491877

ABSTRACT

OBJETIVO: Avaliar a eficácia do uso intravítreo da triancinolona acetonida associada a fotocoagulação com laser no tratamento do edema macular difuso diabético. Comparar esta associação terapêutica com o uso isolado de cada tratamento. MÉTODOS: Após controle clínico sistêmico, trinta pacientes portadores de edema macular difuso diabético foram divididos em 3 grupos de tratamento: (1) fotocoagulação macular em grade com laser de argônio; (2) aplicação intravítrea de 4 mg de triancinolona acetonida; (3) associação dos itens anteriores. O seguimento foi realizado em intervalos predeterminados de um dia, uma semana e mensalmente, até completar 6 meses. Foram analisados os parâmetros: acuidade visual corrigida LogMAR, espessura macular central, volume macular total e pressão intra-ocular. RESULTADOS: A fotocoagulação com laser não reduziu de forma estatisticamente significativa a espessura macular central e o volume macular total. Esta redução foi significativa e estatisticamente semelhante nos outros dois grupos. Todos os grupos apresentaram melhora da acuidade visual, entretanto, o grupo que recebeu a associação do laser com a triancinolona intravítrea obteve maior porcentagem de pacientes com ganho de 10 ou mais letras de visão. CONCLUSÃO: O uso simultâneo da fotocoagulação com a triancinolona intravítrea pode ser considerado uma opção terapêutica para o edema macular difuso diabético.


PURPOSE: To assess the efficacy of intravitreal use of triamcinolone acetonide combined with laser photocoagulation for the treatment of diffuse diabetic macular edema and to compare it with the separate use of each treatment. METHODS: After systemic clinical control, thirty patients with diffuse diabetic macular edema were divided into 3 treatment groups: (1) macular grid photocoagulation; (2) intravitreal injection of 4 mg of triamcinolone acetonide; (3) combination of the two previous therapies. Follow-up was scheduled at predetermined intervals of one day, one week and monthly until completion of six months. The following parameters were analyzed: LogMAR best corrected visual acuity, central macular thickness, total macular volume and intraocular pressure. RESULTS: Grid photocoagulation did not significantly reduce the central macular thickness or the total macular volume. On the other hand, this reduction was statistically significant in the other two groups. All groups improved their mean visual acuity, however, the group that received both treatments had a higher percentage of patients that gained 10 or more letters. CONCLUSION: The simultaneous administration of grid photocoagulation with intravitreal triamcinolone can be considered an option for the treatment of diffuse diabetic macular edema.


Subject(s)
Female , Humans , Male , Middle Aged , Diabetic Retinopathy , Glucocorticoids/therapeutic use , Laser Coagulation , Macular Edema , Triamcinolone Acetonide/therapeutic use , Combined Modality Therapy/methods , Data Interpretation, Statistical , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/surgery , Follow-Up Studies , Injections , Intraocular Pressure/drug effects , Intraocular Pressure/physiology , Macular Edema/drug therapy , Macular Edema/physiopathology , Macular Edema/surgery , Treatment Outcome , Vitreous Body , Visual Acuity/drug effects , Visual Acuity/physiology
18.
Arq Bras Oftalmol ; 71(3): 394-9, 2008.
Article in Portuguese | MEDLINE | ID: mdl-18641828

ABSTRACT

PURPOSE: To compare the visual acuity and macular thickness in patients with diabetic retinopathy presenting and not presenting macular edema before treatment and submitted to argon laser retinal panphotocoagulation. METHODS: Patients were included and classified into two groups before the treatment. All patients were submitted to ophthalmological examination and optical coherence tomography, following panphotocoagulation. The results were evaluated by measuring visual acuity at the end and by optical coherence tomography after one week, one and three months following the treatment. RESULTS: The sample was composed of 37 patients (37 eyes). Group 1 included 29 patients with diabetic retinopathy without macular edema; Group 2 included 8 patients with macular edema. The two groups were similar regarding gender, age, and the mean of argon laser spots treatment. The groups showed differences in visual acuity (p<0.001) and Group 2 patients presented decrease of visual acuity three months after the treatment (p<0.001). Group 2 patients showed a greater mean of macular thickness measurements on optical coherence tomography evaluation. CONCLUSION: Variation of the macular thickness as well as decrease in visual acuity was present in the patients with macular edema previously to panphotocoagulation. Only minimal increase in macular thickness was observed in the absence of macular edema.


Subject(s)
Diabetic Retinopathy/surgery , Laser Coagulation , Macula Lutea/pathology , Macular Edema/surgery , Visual Acuity/physiology , Case-Control Studies , Diabetic Retinopathy/complications , Diabetic Retinopathy/pathology , Female , Follow-Up Studies , Humans , Laser Coagulation/methods , Macular Edema/etiology , Male , Middle Aged , Postoperative Period , Preoperative Care
19.
Arq Bras Oftalmol ; 71(2): 162-6, 2008.
Article in Portuguese | MEDLINE | ID: mdl-18516412

ABSTRACT

PURPOSE: To identify in patients with branch retinal vein occlusion using ambulatory blood pressure monitoring and clinical blood pressure measures: hypertension prevalence, and nocturnal profile of blood pressure. METHODS: Prospectively, 93 eyes of 83 patients with branch retinal vein occlusion were submitted to ophthalmological examination. Afterwards the patients were submitted to clinical evaluation and blood pressure monitoring. Non-dipper was defined as a fall in systolic blood pressure

Subject(s)
Hypertension/epidemiology , Retinal Vein Occlusion/complications , Adult , Aged , Blood Pressure/physiology , Blood Pressure Monitoring, Ambulatory/methods , Brazil/epidemiology , Circadian Rhythm , Female , Humans , Male , Middle Aged , Prevalence , Prospective Studies , Reference Values , Retinal Vein Occlusion/diagnosis , Time Factors
20.
Arq. bras. oftalmol ; 71(3): 394-399, maio-jun. 2008. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-486118

ABSTRACT

OBJETIVO: Comparar espessura macular e acuidade visual em pacientes portadores de retinopatia diabética, com e sem edema de mácula, submetidos à panfotocoagulação retiniana com laser de argônio. MÉTODOS: Os pacientes foram classificados em dois grupos antes do tratamento, sendo submetidos a exame oftalmológico e tomografia de coerência óptica. Todos os pacientes foram tratados com panfotocoagulação. O resultado foi avaliado por meio da acuidade visual no 3º mês e pela tomografia de coerência óptica na 1ª semana, nos 1º e 3º meses do tratamento. RESULTADOS: A amostra foi composta por 37 pacientes (37 olhos). Grupo 1 foi constituído por 29 portadores de retinopatia diabética sem edema macular e Grupo 2, por 8, com edema. Os grupos não apresentaram diferenças na idade, sexo e nas médias de disparos da panfotocoagulação. Os grupos apresentaram diferença na acuidade visual (p<0,001), sendo que o Grupo 2 teve piora da visão após tratamento (p<0,001). Quanto à espessura macular na tomografia de coerência óptica, o Grupo 2 apresentou médias de espessuras maculares maiores (p<0,001) e maior variabilidade entre os momentos avaliados. CONCLUSÃO: Evidenciou-se que portadores de retinopatia diabética com edema macular evoluíram com variação acentuada na espessura macular e perda visual após a panfotocoagulação. Naqueles sem edema, observou-se aumento na espessura macular ao longo do seguimento, porém sem repercussões funcionais.


PURPOSE: To compare the visual acuity and macular thickness in patients with diabetic retinopathy presenting and not presenting macular edema before treatment and submitted to argon laser retinal panphotocoagulation. Methods: Patients were included and classified into two groups before the treatment. All patients were submitted to ophthalmological examination and optical coherence tomography, following panphotocoagulation. The results were evaluated by measuring visual acuity at the end and by optical coherence tomography after one week, one and three months following the treatment. RESULTS: The sample was composed of 37 patients (37 eyes). Group 1 included 29 patients with diabetic retinopathy without macular edema; Group 2 included 8 patients with macular edema. The two groups were similar regarding gender, age, and the mean of argon laser spots treatment. The groups showed differences in visual acuity (p<0.001) and Group 2 patients presented decrease of visual acuity three months after the treatment (p<0.001). Group 2 patients showed a greater mean of macular thickness measurements on optical coherence tomography evaluation. CONCLUSION: Variation of the macular thickness as well as decrease in visual acuity was present in the patients with macular edema previously to panphotocoagulation. Only minimal increase in macular thickness was observed in the absence of macular edema.


Subject(s)
Female , Humans , Male , Middle Aged , Diabetic Retinopathy/surgery , Laser Coagulation , Macula Lutea/pathology , Macular Edema/surgery , Visual Acuity/physiology , Case-Control Studies , Diabetic Retinopathy/complications , Diabetic Retinopathy/pathology , Follow-Up Studies , Laser Coagulation/methods , Macular Edema/etiology , Postoperative Period , Preoperative Care
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