ABSTRACT
ABSTRACT Objective: To characterize the effectiveness of anti-vascular endothelial growth factor drugs in exudative age-related macular degeneration. Methods: Retrospective longitudinal study of 54 patients with age-related macular degeneration receiving bevacizumab or aflibercept. Demographic data, visual acuity, and central retinal thickness measurements were collected. Improvement/stability of visual acuity and reduction in retinal thickness configured satisfactory responses. Results: Among the 60 eyes studied, there was no difference (p = 0.262) in satisfactory response when using bevacizumab (48.5%) or aflibercept (63.0%). Snellen's visual acuity, letter gain, and retinal thickness showed improvement or maintenance in 55.0%, 32.8%, and 78.3% of cases, respectively. The percentage of improvement/maintenance was higher in eyes with an initial visual acuity of < Snellen 20/400 (70.0% versus 40.0%; p = 0.002). Conclusion: A higher percentage of improvement/stabilization of visual acuity and macular thickness was observed in patients with age-related macular degeneration, with better response in patients with visual acuity worse than Snellen 20/400.
RESUMO Objetivo: Caracterizar a efetividade de medicamentos antifactor de crescimento endotelial vascular na degeneração macular relacionada à idade exsudativa. Métodos: Estudo longitudinal retrospectivo em 54 pacientes com degeneração macular relacionada à idade que usaram bevacizumab ou aflibercept. Foram coletados dados demográficos, da acuidade visual e da espessura central da retina. Melhora/estabilidade da acuidade visual e redução da espessura configuraram respostas satisfatórias. Resultados: Entre 60 olhos estudados, não houve diferença (p = 0,262) de acordo com o uso de bevacizumab (48,5%) ou aflibercept (63,0%). Acuidade visual segundo Snellen, ganho de letras e espessura retiniana demonstraram melhora ou estabilidade em 55,0%, 32,8% e 78,3% dos casos, respectivamente. Entre os olhos com acuidade visual inicial < 20/400, o percentual de melhora/estabilidade foi superior (70,0% versus 40,0%; p = 0,002). Conclusão: Em pacientes com degeneração macular relacionada à idade, foi percebida uma maior proporção de melhora ou estabilização da acuidade visual e espessura macular, com melhor resposta entre os pacientes com visão pior que 20/400.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/therapeutic use , Receptors, Vascular Endothelial Growth Factor/administration & dosage , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Wet Macular Degeneration/drug therapy , Bevacizumab/administration & dosage , Bevacizumab/therapeutic use , Macular Degeneration/drug therapy , Visual Acuity , Retrospective Studies , Cohort Studies , Longitudinal Studies , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Tomography, Optical Coherence , Wet Macular Degeneration/diagnosis , Intravitreal Injections , Macular Degeneration/diagnosisABSTRACT
Abstract Purpose: This article aims to describe the prevalence of retinal alterations on the indirect binocular ophthalmoscopy exam in patients with sickle cell disease (HbSS or HbSC) who are over 40 years of age. Methods: This is a retrospective study in which patients with sickle cell disease (SCD) with an age group of 40 years or older were attended in a service of retina in Salvador, Brasil on the last 10 years. All patients were submitted to the clinical file filling, which includes the sociodemographic profile, clinical profile and ophthalmologic examination. The patients were divided in two groups (SS or SC), according to genotypic profile of hemoglobinopathy (HbSS or HbSC). The classification of retinopathy was performed according to Goldberg in proliferative and non-proliferative retinopathy. A P-value <0.05 was considered statistically significant. Results: A total of 97 patients (194 eyes) were evaluated, being 44 (45%) of the SC group and 53 (55%) of the SS group. Of the 97 patients, 19 (19.5%) did not present retinal changes and 78 (80,5%) present sickle cell retinopathy. Of the 78 patients with retinopathy, 22 (28%) had nonproliferative sickle retinopathy and 56 (72%) had proliferative alterations. The increase in vascular tortuosity was the most observed nonproliferative sign (26.8% of eyes) in both groups. The SC patients presented a greater proportion of findings of areas of retinal non perfusion (30%) than SS patients (p = 0.015). Conclusion: The results suggest the need for regular ophthalmologic follow-up of patients with SCD, especially in the older age group, due to the high prevalence of 80.5% of findings of sickle cell retinopathy on examination in patients over 40 years old.
Resumo Objetivos: Este artigo tem como objetivo avaliar a prevalência de alterações retinianas observadas pelo exame de oftalmoscopia binocular indireta em pacientes com doença falciforme (HbSS e HbSC) com mais de 40 anos de idade. Métodos: Estudo retrospectivo com pacientes com doença falciforme (DF) na faixa etária acima de 40 anos, atendidos em serviço especializado em Salvador, Brasil nos últimos 10 anos. Todos os pacientes foram submetidos ao preenchimento da ficha clínica, em que incluía perfil sociodemográfico, clínico e exame oftalmológico. Os pacientes foram divididos em dois grupos (SS ou SC), de acordo com seu padrão genotípico da hemoglobinopatia (HbSS ou HbSC). A classificação da retinopatia foi realizada de acordo com Goldberg em retinopatia não proliferativa e proliferativa. Um valor de p<0.05 foi considerado estatisticamente significante. Resultados: Um total de 97 pacientes (194 olhos) foram avaliados, sendo 44 (45%) do grupo SC e 53 (55%) do grupo SS. Dos 97 pacientes, 19 (19,5%) não apresentavam alterações retinianas e 78 (80,5%) apresentavam retinopatia falcêmica. Destes 78 pacientes com alterações retinianas, 22 (28%) possuem sinais de retinopatia não proliferativa e 56 (72%) possuem alterações proliferativas. O aumento da tortuosidade vascular foi o sinal de doença não proliferativa mais observado (26,8% dos olhos) em ambos os grupos. Os pacientes do grupo SC apresentaram a maior proporção de achados proliferativos, como áreas de não perfusão retiniana, que os pacientes SS (30%) (p = 0.015). Conclusão: Os resultados sugerem a necessidade de manter um acompanhamento oftalmológico regular dos pacientes com DF, especialmente pacientes com maior faixa etária, devido à alta prevalência observada (80,5%) de retinopatia falcêmica em pacientes acima de 40 anos de idade.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Retinal Diseases/epidemiology , Hemoglobin SC Disease/epidemiology , Anemia, Sickle Cell/epidemiology , Retrospective StudiesABSTRACT
Abstract Hemoglobin C is the second most frequent Hb variant in Brazil and the world. Hemoglobin C trait is described as a benign and asymptomatic condition. There is little information in the literature about the association of retinal vascular disease and the presence of hemoglobin AC, being this information restricted to a few case reports. This case report describes a 26-year-old female patient with hemoglobin C trait. She presents areas of non-perfusion and arteriovenous shunts in the retinal temporal periphery of the left eye, like changes in Goldberg's stage II of proliferative sickle retinopathy. After three years of follow-up, the patient exhibits the same the alteration in right eye as well.
Resumo A hemoglobina C é a segunda variante de hemoglobina mais comum no Brasil e no mundo. O traço C é descrito como uma condição benigna e assintomática. Há pouca informação na literatura sobre a associação de doença vascular retiniana e a presença de hemoglobina AC, sendo esta informação restrita a alguns poucos relatos de casos. Este relato de caso descreve uma paciente do gênero feminino de 26 anos de idade com traço C. Ela apresenta áreas de não perfusão e shunts artério-venosos na periferia temporal da retina do olho esquerdo, similar ao estágio II de Goldberg de retinopatia proliferativa falciforme. Após três anos de acompanhamento, a paciente apresentou a mesma alteração também em olho direito.
Subject(s)
Humans , Female , Adult , Retinal Diseases/etiology , Hemoglobin C Disease/complications , Retinal Diseases/blood , Hemoglobin C Disease/blood , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/bloodABSTRACT
BACKGROUND: To evaluate the composition and characteristics of capuchin monkey (CM) tear film. METHODS: Eleven CM (Sapajus sp.) was evaluated. Strip meniscometry test (SMT), osmolarity, and tear ferning test (TFT) (by Rolando and Masmali scales) were assessed. Tear protein profile (SDS-PAGE), and total protein, albumin, urea, glucose, and cholesterol levels in tear film and blood serum were screened. RESULTS: Median ± semi-interquatil range for SMT and osmolarity values were 8.0 ± 1.625 and 303.0 ± 9.875, respectively. TFT for Rolando was 2.0 ± 0.5, and Masmali was 2.0 ± 0.0. Monkeys's tear obtained type II and III for Rolando, and 1 and 2 for Masmali. Tear components showed protein bands among 23-217 kDa, and presence of albumin, urea, glucose, and cholesterol. CONCLUSIONS: The results of SMT, osmolarity, TFT, SDS-PAGE, and tear biochemistry may serve as a reference baseline for CM, and the data may serve as a basis for future experimental model evaluations.
Subject(s)
Cebinae , Proteome/analysis , Tears/chemistry , Tears/physiology , Animals , Cebus , Crystallization , Female , Osmolar ConcentrationABSTRACT
OBJECTIVE: The aim of the present study was to characterize sickle cell disease retinopathy in children and teenagers from Bahia, the state in northeastern Brazil with the highest incidence and prevalence of sickle cell disease. METHODS: A group of 51 sickle cell disease patients (36 hemoglobin SS and 15 hemoglobin SC) with ages ranging from 4 to 18 years was studied. Ophthalmological examinations were performed in all patients. Moreover, a fluorescein angiography was also performed in over 10-year-old patients. RESULTS: The most common ocular lesions were vascular tortuosity, which was found in nine (25%) hemoglobin SS patients, and black sunburst, in three (20%) hemoglobin SC patients. Peripheral arterial closure was observed in five (13.9%) hemoglobin SS patients and in three (13.3%) hemoglobin SC patients. Arteriovenous anastomoses were present in six (16.5%) hemoglobin SS patients and six (37.5%) hemoglobin SC patients. Neovascularization was not identified in any of the patients. CONCLUSIONS: This study supports the use of early ophthalmological examinations in young sickle cell disease patients to prevent the progression of retinopathy to severe disease and further blindness.
ABSTRACT
Objective: The aim of the present study was to characterize sickle cell disease retinopathy in children and teenagers from Bahia, the state in northeastern Brazil with the highest incidence and prevalence of sickle cell disease. Methods: A group of 51 sickle cell disease patients (36 hemoglobin SS and 15 hemoglobin SC) with ages ranging from 4 to 18 years was studied. Ophthalmological examinations were performed in all patients. Moreover, a fluorescein angiography was also performed in over 10-year-old patients. Results: The most common ocular lesions were vascular tortuosity, which was found in nine (25%) hemoglobin SS patients, and black sunburst, in three (20%) hemoglobin SC patients. Peripheral arterial closure was observed in five (13.9%) hemoglobin SS patients and in three (13.3%) hemoglobin SC patients. Arteriovenous anastomoses were present in six (16.5%) hemoglobin SS patients and six (37.5%) hemoglobin SC patients. Neovascularization was not identified in any of the patients. Conclusions: This study supports the use of early ophthalmological examinations in young sickle cell disease patients to prevent the progression of retinopathy to severe disease and further blindness...