Genetic, morphological and electrophysiological findings in a patient with a rare pathogenic variant in the RS1 gene.

PURPOSE: In this study, we report a case of a young adult with X-linked juvenile retinoschisis (XLRS) with a rare pathogenic variant in the RS1 gene (c.522 + 2 T > A). METHODS: Ophthalmological evaluation, optical coherence tomography, full-field and multifocal electroretinograms and extensive genetic screening of genes related to visual loss were carried out in the participant. RESULTS: Clinical ophthalmological exams revealed a mild to moderate impairment of visual acuity. Retinal imaging showed bilateral foveal schisis, as well as normal a-wave, reduction in the b-wave amplitudes in dark- and light- adapted full-field electroretinograms, and abnormal oscillatory potentials. We found also diffuse amplitude reduction in multifocal electroretinogram arrays. A canonical splice variant was identified in the RS1 gene (c.522 + 2 T > A). CONCLUSION: A rare pathogenic variant of the RS1 gene was associated with diffuse retinal involvement (central and peripheral retina), probably in inner retina, and mild to moderate visual acuity impairment. The phenotypical characterization of rare mutations is relevant to provide information about the disease.

Sex-related difference in the retinal structure of young adults: a machine learning approach.

Purpose: To compare the accuracy of machine learning (ML) algorithms to classify the sex of the participant from retinal thickness datasets in different retinal layers. Methods: This cross-sectional study involved 26 male and 38 female subjects. Data were acquired using HRA + OCT Spectralis, and the thickness and volume of 10 retinal layers were quantified. A total of 10 features were extracted from each retinal layer. The accuracy of various algorithms, including k-nearest-neighbor, support vector classifier, logistic regression, linear discriminant analysis, random forest, decision tree, and Gaussian Naïve Bayes, was quantified. A two-way ANOVA was conducted to assess the ML accuracy, considering both the classifier type and the retinal layer as factors. Results: A comparison of the accuracies achieved by various algorithms in classifying participant sex revealed superior results in datasets related to total retinal thickness and the retinal nerve fiber layer. In these instances, no significant differences in algorithm performance were observed (p > 0.05). Conversely, in other layers, a decrease in classification accuracy was noted as the layer moved outward in the retina. Here, the random forest (RF) algorithm demonstrated superior performance compared to the others (p < 0.05). Conclusion: The current research highlights the distinctive potential of various retinal layers in sex classification. Different layers and ML algorithms yield distinct accuracies. The RF algorithm's consistent superiority suggests its effectiveness in identifying sex-related features from a range of retinal layers.

Using sellar region tumor's size as a predictor of psychophysical and electrophysiological perimetric visual losses: a logistic regression approach.

BACKGROUND: Sellar region tumor growth represents an important cause of visual loss due to mechanical compression of the optic nerve apparatus. Many investigations have used non-invasive tools to evaluate the visual field consequences of this damage, and good associations have been reported between psychophysical and electrophysiological perimetries. Few reports have considered the tumor size as a predictor of visual field loss. AIMS: In the present study, we evaluated the association between the visual perimetry measured by Humphrey visual field analyzer and multifocal visual evoked cortical potential (mfVECP) and the tumor size. METHODS: Our sample was composed of 14 patients diagnosed with sellar tumors by magnetic resonance imaging. We accounted the number of sectors with negative visual responses for both methods. A simple logistic regression analysis was used to evaluate the association between the tumor dimensions and the visual field features RESULTS: Three patients had preserved visual fields, three patients showed hemianopic defects, and eight patients had generalized visual field losses at both evaluations. We observed that the three maximum diameters of the tumor and total tumor volume had different predictive abilities regarding the extent of visual field loss when using psychophysical and mfVECP data. The maximum craniocaudal diameter of the tumor was the better predictor of the psychophysical measurements, whereas for the mfVECP results, all tumor dimensions and volumes had similar values that predict visual field losses. CONCLUSION: Tumor size as a predictor of visual loss has potential to assist in the clinical intervention and to prevent the irreversible visual impairment caused by tumors of the sellar region.

Psychophysical Evaluation of Visual Functions of Ex-Alcoholic Subjects After Prolonged Abstinence.

Chronic alcohol abuse can lead to a brain damages, and the health status of alcoholics even after a long-term alcohol abstinence is a public health concern. The present study investigated the color vision and spatial luminance contrast sensitivity of a group of 17 ex-alcoholics (46.3 ± 6.7 years old) in long-term alcohol abstinence after having been previously under alcohol dependence for many years. We also investigated the association of impaired psychophysical performance in different tests we applied. The mean time of alcohol consumption was 16.9 ± 5.1 years and the mean abstinence period was 12.4 ± 8.5 years. Achromatic vision of all subjects was evaluated using spatial luminance contrast sensitivity function (CSF) test and color vision was evaluated using Mollon-Reffin color discrimination test (MR) and the Farnsworth-Munsell 100 hue arrangement test (FM100). Relative to controls, the spatial luminance contrast sensitivity was lower in 10/17 of the ex-alcoholic subjects. In the color vision tests, 11/16 ex-alcoholic subjects had impaired results compared to controls in the FM100 test and 13/14 subjects had color vision deficits measured in the MR test. Fourteen subjects performed all visual tests, three subjects had impaired results for all tests, seven subjects had impaired results in two tests, three subjects had visual deficit in one test, and one had normal results for all tests. The results showed the existence of functional deficits in achromatic and chromatic vision of subjects with history of chronic alcoholism after long abstinence. Most subjects had altered result in more than one test, especially in the color vision tests. The present investigation suggests that the damage in visual functions produced by abusive alcohol consumption is not reversed after long term alcohol abstinence.

Optical coherence tomography and multifocal electroretinography of patients with advanced neovascular age-related macular degeneration before, during, and after treatment with ranibizumab.

PURPOSE: To evaluate retinal morphology and function of patients with advanced neovascular age-related macular degeneration (AMD) before, during, and after treatment with ranibizumab. METHODS: Twenty-one eyes diagnosed with advanced AMD were studied with optical coherence tomography (OCT) and multifocal electroretinography (mfERG). Three intravitreal injections of ranibizumab were administered at 1-month intervals. Evaluations were performed before the first injection (D0) and at 30 (D30), 60 (D60), and 90 days (D90) after the first injection and compared to an age-matched control group (n=21 eyes). RESULTS: The thickness of macular retinal layers increased before treatment due to the presence of intraretinal fluid. A thick retinal pigment epithelium-choriocapillaris complex (RPE-CC) suggested the presence of choroidal neovascular membrane. Intraretinal edema decreased after treatment (P<0.01), but persisting RPE-CC thickness resulted in a subretinal scar. Three different annular retinal areas were studied with mfERG (from center to periphery: rings R1, R2, and R3). The amplitude of the first negative component (N1) decreased in R1, R2, and R3 at D30, D60, and D90 when compared with that in controls (P<0.05); the N1 implicit time was delayed in R3 at D30 (P<0.05). The amplitude of the first positive component (P1) was reduced in R1 and R2 at D30, D60, and D90 when compared with that in controls (P<0.01); the P1 implicit time was delayed in R1 at D0 and D60 (P<0.05), in R2 at D0, D30, and D90 (P<0.01), and in R3 at D30 and D60 (P<0.05). CONCLUSION: Ranibizumab reduces intraretinal edema, even in advanced cases. Central macular activity appeared to increase after the initiation of treatment, improving over time.

Optical coherence tomography and multifocal electroretinography of patients with advanced neovascular age-related macular degeneration before, during, and after treatment with ranibizumab / Tomografia de coerência óptica e eletrorretinografia multifocal de pacientes com degeneração macular relacionada à idade, neovascular avançada, antes, durante e após o tratamento com ranibizumabe

Purpose: To evaluate retinal morphology and function of patients with advanced neovascular age-related macular degeneration (AMD) before, during, and after treatment with ranibizumab. Methods: Twenty-one eyes diagnosed with advanced AMD were studied with optical coherence tomography (OCT) and multifocal electroretinography (mfERG). Three intravitreal injections of ranibizumab were administered at 1-month intervals. Evaluations were performed before the first injection (D0) and at 30 (D30), 60 (D60), and 90 days (D90) after the first injection and compared to an age-matched control group (n=21 eyes). Results: The thickness of macular retinal layers increased before treatment due to the presence of intraretinal fluid. A thick retinal pigment epithelium-choriocapillaris complex (RPE-CC) suggested the presence of choroidal neovascular membrane. Intraretinal edema decreased after treatment (P<0.01), but persisting RPE-CC thickness resulted in a subretinal scar. Three different annular retinal areas were studied with mfERG (from center to periphery: rings R1, R2, and R3). The amplitude of the first negative component (N1) decreased in R1, R2, and R3 at D30, D60, and D90 when compared with that in controls (P<0.05); the N1 implicit time was delayed in R3 at D30 (P<0.05). The amplitude of the first positive component (P1) was reduced in R1 and R2 at D30, D60, and D90 when compared with that in controls (P<0.01); the P1 implicit time was delayed in R1 at D0 and D60 (P<0.05), in R2 at D0, D30, and D90 (P<0.01), and in R3 at D30 and D60 (P<0.05). Conclusion: Ranibizumab reduces intraretinal edema, even in advanced cases. Central macular activity appeared to increase after the initiation of treatment, improving over time. .

Objetivo: Avaliar a morfologia e função da retina em pacientes com doença macular relacionada à idade (DMRI), neovascular avançada, antes, durante e após o tratamento com ranibizumabe. Métodos: Vinte e um olhos com diagnóstico de DMRI avançada foram avaliados pela tomografia de coerência óptica (OCT) e eletrorretinografia multifocal (mfERG). Três injeções intravítreas de ranibizumabe foram administradas em intervalos de 1 mês. As avaliações foram realizadas antes da primeira injeção (D0) e aos 30 (D30), 60 (D60), e 90 dias (D90) após a primeira injeção e comparados com um grupo controle (n=21 olhos). Resultados: A espessura macular estava aumentada antes do tratamento devido à presença de fluido intrarretiniano, e o aumento da espessura do complexo EPR-CC foi compatível com a presença de membrana neovascular coroidal. O edema intrarretiniano diminuiu após o tratamento (P<0,01). Três diferentes áreas retinianas anulares (do centro para a periferia: anéis R1, R2 e R3) foram consideradas no mfERG. A amplitude do componente N1 diminuiu nos anéis R1, R2 e R3 em D30, D60 e D90 comparados com o grupo controle (P<0,05); e o tempo implícito de N1 aumentou no anel R3 em D30 (P<0,05). A amplitude do componente P1 diminuiu em R1 e R2 nos dias D30, D60 e D90 comparados com os controles (P<0,01); o tempo implícito de N1 aumentou no anel R1 em D0 e D60 (P<0,05), no anel R2 em D0, D30 e D90 (P<0,01) e no anel R3 em D30 e D60 (P<0,05). Conclusão: O ranibizumabe reduziu o edema intrarretiniano, mesmo em casos avançados. A atividade central macular parece aumentar após o início do tratamento e melhorar ao longo do tempo. .

Life quality assessment of patients after phacoemulsification or extracapsular cataract extraction.

PURPOSE: To study the quality of life, treatment outcomes, and satisfaction in patients who have undergone cataract surgery Methods: This comparative case series study was conducted at the Ophthalmology Service of the Bettina Ferro de Souza University Hospital, Belém, Pará, Brazil. Totally, 60 patients with cataract were included; 50% underwent conventional extracapsular cataract extraction (ECEE) and 50% underwent cataract extraction by phacoemulsification (PHACO). Patients were interviewed using the Visual Function 14 (VF-14) questionnaire to determine the quality of life before and 30 days after surgery. The results of ophthalmological examination were recorded in the patients' files and were available throughout this study. One-way ANOVA, Tukey's post-hoc comparison, and the sign test were used for statistical analyses. RESULTS: The mean VF-14 satisfaction index was 38.0 and 89.4 before and after surgery, respectively, for the ECEE group and 47.0 and 94.1, respectively, for the PHACO group. The improvement in patient quality of life after surgery was significant in both groups (p<0.0001), with a similar amount of improvement in both groups. CONCLUSIONS: The observed improvement in quality of life was significant (p<0.0001) and directly related to patient satisfaction with surgical outcomes, which was also significant (p<0.0001) as assessed using the VF-14. Satisfaction and quality of life are individual factors; consequently, patient responses to questions regarding improvements in the ability to perform each activity are subjective and depend uniquely on individual perception.

Life quality assessment of patients after phacoemulsification or extracapsular cataract extraction / Avaliação da qualidade de vida de pacientes submetidos à facoemulsificação ou extração extracapsular de catarata

Purpose: To study the quality of life, treatment outcomes, and satisfaction in patients who have undergone cataract surgery Methods: This comparative case series study was conducted at the Ophthalmology Service of the Bettina Ferro de Souza University Hospital, Belém, Pará, Brazil. Totally, 60 patients with cataract were included; 50% underwent conventional extracapsular cataract extraction (ECEE) and 50% underwent cataract extraction by phacoemulsification (PHACO). Patients were interviewed using the Visual Function 14 (VF-14) questionnaire to determine the quality of life before and 30 days after surgery. The results of ophthalmological examination were recorded in the patients' files and were available throughout this study. One-way ANOVA, Tukey's post-hoc comparison, and the sign test were used for statistical analyses. Results: The mean VF-14 satisfaction index was 38.0 and 89.4 before and after surgery, respectively, for the ECEE group and 47.0 and 94.1, respectively, for the PHACO group. The improvement in patient quality of life after surgery was significant in both groups (p<0.0001), with a similar amount of improvement in both groups. Conclusions: The observed improvement in quality of life was significant (p<0.0001) and directly related to patient satisfaction with surgical outcomes, which was also significant (p<0.0001) as assessed using the VF-14. Satisfaction and quality of life are individual factors; consequently, patient responses to questions regarding improvements in the ability to perform each activity are subjective and depend uniquely on individual perception. .

Objetivo: Estudar a qualidade de vida, resultados e satisfação em pacientes que se submeteram à cirurgia de catarata. Métodos: O trabalho foi realizado no Serviço de Oftalmologia do Hospital Universitário Bettina Ferro de Souza, Belém, Pará, Brasil. O desenho experimental consistiu em séries de casos comparados. O estudo incluiu 60 indivíduos com catarata. Metade dos pacientes foi submetida à extração de catarata extracapsular convencional (ECEE) e a outra metade à extração de catarata por facoemulsificação (PHACO). Os pacientes foram entrevistados usando-se o questionário Visual Function 14 (VF-14) para determinar a qualidade de vida antes e 30 dias depois da cirurgia. Os resultados do exame oftalmológico foram registrados no arquivo de cada paciente e disponibilizados ao longo do trabalho. Foram usados análise de variância simples e comparação post-hoc com teste de Tukey e teste dos sinais para a análise estatística dos resultados. Resultados: O índice de satisfação médio VF-14 foi 38,0 e 89,4 antes e após a cirurgia, respectivamente, para o grupo ECEE, sendo 47,0 e 94,1 para o grupo PHACO. A melhora na qualidade de vida após a cirurgia foi significativa em ambos os grupos de pacientes (p<0,0001), tendo sido semelhante em ambos os grupos. Conclusão: A melhora observada na qualidade de vida avaliada foi significativa e diretamente relacionada à satisfação dos pacientes com os resultados da cirurgia, a qual também foi significativa (p<0,0001). A satisfação e a qualidade de vida são fatores individuais. Consequentemente, as respostas dos pacientes relativas à melhoria em cada atividade são subjetivas e dependem unicamente da percepção individual. .

Multifocal electroretinography after high dose chloroquine therapy for malaria.

PURPOSE: To investigate changes in multifocal electroretinography (mfERG) parameters associated with high dose chloroquine therapy for treatment of malaria in the Amazonia region of Brazil. METHODS: Forty-eight subjects who had received chloroquine treatment for single or multiple malaria infections with a cumulative dose ranging from 1,050 to 27,000mg were included. The control group consisted of 37 healthy aged-matched subjects. Data was collected on amplitude and implicit time of the N1, P1 and N2 waves in the central macular hexagon (R1) and in five concentric rings at different retinal eccentricities (R2-R6). RESULTS: No significant difference was observed in any mfERG parameter between chloroquine treated patients and control subjects. A comparison with previous data obtained from patients with rheumatologic disorders in the same region of Brazil who had received larger cumulative doses of chloroquine and had displayed mfERG changes, indicated that retinal toxicity seems to be dependent on cumulative dose. CONCLUSION: Lack of mfERG changes in the current study suggests that intensive high dose chloroquine therapy for treatment of malaria is not associated with retinal toxicity.

[Diffuse unilateral subacute neuroretinitis (DUSN): current update]. / Neuroretinite unilateral subaguda difusa (DUSN): atualização continuada.

Diffuse unilateral subacute neuroretinitis (DUSN) is a form of uveitis that can potentially lead to blindness. In Brazil and other parts of South America, diffuse unilateral subacute neuroretinitis is an important cause of posterior uveitis in children and healthy young adults. If diagnosed and treated in early stage, allows a resolution of symptoms with improvement of visual acuity. If the disease progresses to the late stage, can result in significant visual loss. In this study, through a literature review, we describe the main characteristics of this disease, including the following aspects: history, etiology, physiopathology, clinical features, diagnosis, differential diagnosis and treatment.

Neuroretinite unilateral subaguda difusa (DUSN): atualização continuada / Diffuse unilateral subacute neuroretinitis (DUSN): current update

A neurorretinite subaguda difusa unilateral (DUSN) é uma forma de uveíte que pode potencialmente levar à cegueira. No Brasil e em outras partes da América do Sul, a neurorretinite subaguda difusa unilateral cada vez mais é considerada uma causa importante de uveíte posterior em crianças e em adultos jovens e saudáveis. Se diagnosticada e tratada ainda em fase inicial, permite uma resolução dos sintomas com melhora da acuidade visual. Caso progrida para a fase tardia, poderá acarretar uma perda visual significativa. Nesse estudo, por meio de uma revisão da literatura, descreve-se as principais características desta doença, incluindo os seguintes aspectos: histórico, etiologia, fisiopatologia, quadro clínico, diagnóstico, diagnóstico diferencial e tratamento.

Diffuse unilateral subacute neuroretinitis (DUSN) is a form of uveitis that can potentially lead to blindness. In Brazil and other parts of South America, diffuse unilateral subacute neuroretinitis is an important cause of posterior uveitis in children and healthy young adults. If diagnosed and treated in early stage, allows a resolution of symptoms with improvement of visual acuity. If the disease progresses to the late stage, can result in significant visual loss. In this study, through a literature review, we describe the main characteristics of this disease, including the following aspects: history, etiology, physiopathology, clinical features, diagnosis, differential diagnosis and treatment.

Dengue maculopathy: visual electrophysiology and optical coherence tomography.

The objective of this study was to evaluate the visual loss due to dengue fever using retinal and cortical electrophysiology and retinal imaging. The participants were three female patients with low visual acuity after dengue fever. They were evaluated by routine ophthalmological investigations, transient pattern electroretinogram (tPERG), transient pattern visual evoked cortical potential (tPVECP), and retinal optical coherence tomography (retinal OCT). tPERG and tPVECP amplitude (microV) and implicit time (ms) were the parameters evaluated using OCT retinal thickness (microm) and reflectivity. All patients presented low visual acuity and scotomata with or without changes in the oculus fundus. tPERG from two patients showed decreased amplitude or absence of the main components; it was not possible to record a reliable response in the third patient due to excessive blinking. tPVECP at 0.5 cpd was normal in all three patients, while at 2 cpd the main components were absent in one patient and normal in the other two patients. OCT image was abnormal in two patients, one of them with high reflectance areas and another with decreased retinal thickness (the third patient was not studied with this technique).The dengue fever can lead to visual impairment detectable by ophthalmological exams such as angiography, retinography, and OCT imaging, as well as retinal and cortical electrophysiology. Dengue maculopathy which could be caused by vascular alterations and/or aberrant immune response after infection may result in temporary or permanent visual losses.

[Prevalence of arterial hypertension in branch retinal vein occlusion patients]. / Prevalência de hipertensão arterial em pacientes com oclusão do ramo da veia central da retina.

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

[Evaluation of hypertensive retinopathy through the oscillatory potentials of the electroretinogram]. / Avaliação da retinopatia hipertensiva através do potencial oscilatório do eletrorretinograma.

PURPOSE: To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. METHODS: Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. RESULTS: The sample was composed of 44 patients, with a mean age of 51.55 +/- 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1%) of the patients, while 18 (40.9%) were normotensives. The average of the obtained IO was 257.41 microv in the NT group and of 217.81 microv in HT (p=0.006). The averages of latencies obtained for peaks 1 (NT-18.42 and HT-17.91) and 2 (NT-24.54 and HT - 24.29) were not different between the groups (p>0.05). CONCLUSIONS: The hypertensive patients presented significantly smaller oscillatory index than the normotensives, suggesting that arterial hypertension might cause dysfunction of the internal retina.

Prevalência de hipertensão arterial em pacientes com oclusão do ramo da veia central da retina / Prevalence of arterial hypertension in branch retinal vein occlusion patients

OBJETIVOS: Identificar em pacientes com oclusão do ramo da veia central da retina utilizando a monitorização ambulatorial da pressão arterial e medidas clínicas da pressão arterial: prevalência de hipertensão e o perfil noturno da pressão arterial. MÉTODOS: Prospectivamente, 93 olhos de 83 pacientes com oclusão do ramo da veia central da retina foram submetidos à avaliação oftalmológica. Após, os pacientes foram encaminhados para avaliação clínica e monitorização da pressão arterial. Pacientes sem descenso da pressão durante o sono ("non-dipper") foram definidos como um declínio na pressão arterial sistólica < 10 por cento, e pacientes com descenso presente ("dipper") quando este valor fosse superior. RESULTADOS: A doença acometeu um olho em 73 (88 por cento) pacientes. O ramo temporal superior foi o local da oclusão em 61 (65,6 por cento) olhos, no restante o ramo temporal inferior foi afetado. Setenta e seis (92 por cento) pacientes formam diagnosticados como hipertensos após a avaliação clínica. A monitorização ambulatorial da pressão arterial identificou 76 hipertensos, 5 normotensos, 1 hipertenso do avental branco e 1 hipertenso mascarado. Estes 2 últimos foram excluídos da análise. Dos 81 pacientes, analisados. Quarenta (49 por cento) eram "dippers" e 41 (51 por cento) "non-dippers". Entre os hipertensos (n=76), 36 (47,4 por cento) eram "dippers" e 40 (52,6 por cento) "non-dippers". CONCLUSÃO: Prevalência de hipertensão arterial em nosso estudo foi extremamente elevada (92,8 por cento), que sugere que a fisiopatologia da doença tem íntima relação com as alterações promovidas pela hipertensão. Pouco mais da metade dos hipertensos eram "non-dipper" (n=40; 52,6 por cento). Estas evidências sugerem que um nível sustentado de pressão arterial possa ser um fator de risco adicional para a oclusão do ramo da veia central da retina.

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 < 10 percent, and dipper when this value was higher. RESULTS: Disease affected one eye in 73 (88 percent) patients. The temporal superior branch was the site of occlusion in 61 (65.6 percent) eyes, while in the others the infero-temporal branch was affected. Seventy six (92 percent) patients were diagnosed as hypertensive after clinical evaluation. Ambulatory blood pressure monitoring identified 76 hipertensives, 5 normotensives, 1 white-coat hypertensive and one masked hypertensive subjects. The two latter were excluded from the analysis. Of the 81 analyzed patients, forty (49 percent) were dippers and 41 (51 percent) were non-dippers. Among the HT (n=76), 36 (47 percent) were dippers and 40 (53 percent) were non-dippers. CONCLUSION: Prevalence of hypertension in our series was extremely high (92 percent) which suggests that physiopathology of the disease has a close relationship with changes promoted by hypertension. A little more than half of the hypertensives were non-dippers (n=40; 52,6 percent). These evidences suggest that a 24-hour sustained level of blood pressure may be an additional risk factor for branch retinal vein occlusion.

Avaliação da retinopatia hipertensiva através do potencial oscilatório do eletrorretinograma / Evaluation of hypertensive retinopathy through the oscillatory potentials of the electroretinogram

OBJETIVO: Avaliar o comportamento do potencial oscilatório escotópico do eletrorretinograma de campo total (ERG) na retinopatia hipertensiva. MÉTODOS: Quarenta e quatro pacientes foram submetidos à avaliação clínica e subdivididos em dois grupos: 26 hipertensos (HT) com média de idade de 52,23 ± 5,79 anos divididos em 10 homens (38,46 por cento) e 16 mulheres (61,54 por cento) e 18 normotensos (NT) com média de idade de 51,79 ± 10,23 anos divididos em 5 homens (27,78 por cento) e 13 mulheres (72,22 por cento). Foram incluídos no estudo apenas hipertensos leves a moderados (estágio 1 e 2 respectivamente) sem lesões em outro órgão-alvo.Os pacientes hipertensos foram mantidos sob placebo durante o período do estudo. Em seguida, foram submetidos à avaliação oftalmológica e realização do ERG. O eletrorretinograma de campo total (ERG), com registro das respostas: escotópica, escotópica máxima, PO escotópico, fotópica e "flicker". Para análise da resposta do PO foi considerada a latência dos dois primeiros picos e o valor médio da amplitude dos três picos do complexo de três respostas consecutivas, denominado índice oscilatório (IO). RESULTADOS: A hipertensão arterial acometia 26 (59,1 por cento) dos pacientes, ao passo que 18 (40,9 por cento) eram normotensos. A média do IO obtido foi de 257,41µV no grupo de NT e de 217,81 µV no HT (p=0,006). As médias de latências obtidas para os picos 1 (NT-18,42 ms e HT-17,91 ms) e 2 (NT-24,54 ms e HT- 24,29 ms) não foram diferentes entre os grupos (p>0,05). CONCLUSÃO: Os hipertensos apresentam índice oscilatório significativamente menor que os normotensos, sugerindo que a hipertensão arterial pode ocasionar disfunção da retina interna.

PURPOSE: To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. METHODS: Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. RESULTS: The sample was composed of 44 patients, with a mean age of 51.55 ± 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1 percent) of the patients, while 18 (40.9 percent) were normotensives. The average of the obtained IO was 257.41 µv in the NT group and of 217.81 µv in HT (p=0.006). The averages of latencies obtained for peaks 1 (NT-18.42 and HT-17.91) and 2 (NT-24.54 and HT - 24.29) were not different between the groups (p>0.05). CONCLUSIONS: The hypertensive patients presented significantly smaller oscillatory index than the normotensives, suggesting that arterial hypertension might cause dysfunction of the internal retina.

[Central retinal artery occlusion secondary to brachial cineangiocoronography: case report]. / Oclusão da artéria central da retina secundária a cineangiocoronariografia via artéria braquial: relato de caso.

The authors report a case of a patient with coronary insufficiency who developed central retinal artery occlusion following cardiac catheterism through the brachial artery and cineangiocoronography. This procedure can lead to embolic phenomena like that which was reported.

Oclusão da artéria central da retina secundária a cineangiocoronariografia via artéria braquial: relato de caso / Central retinal artery occlusion secondary to brachial cineangiocoronography: case report

Os autores relatam o caso de um paciente com insuficiência coronariana que desenvolveu quadro de oclusão de artéria central da retina após ser submetido a cateterização cardíaca por via braquial e realização de cineangiocoronariografia. Este procedimento pode desencadear fenômenos embólicos oculares consistentes com o quadro descrito.

The authors report a case of a patient with coronary insufficiency who developed central retinal artery occlusion following cardiac catheterism through the brachial artery and cineangiocoronography. This procedure can lead to embolic phenomena like that which was reported.

[Congenital retinal macrovessel: case report]. / Macrovaso retiniano congênito: relato de caso.

The authors report a case of arteriolar retinal macrovessel, diagnosed by routine ophthalmologic examination, as well as its optic coherence tomography aspects. Congenital retinal macrovessel is a large aberrant vessel, often unilateral, usually a vein, rarely an artery, located in the posterior pole which can cross the fovea and median raphe.

Macrovaso retiniano congênito: relato de caso / Congenital retinal macrovessel: case report

Os autores apresentam o caso de um macrovaso arteriolar de retina, diagnosticado ao exame de rotina, bem como seu aspecto à tomografia de coerência óptica. O macrovaso retiniano congênito é um grande vaso aberrante, geralmente unilateral, usualmente uma veia, raramente uma artéria, presente no pólo posterior e que pode cruzar a região foveal e rafe mediana.

The authors report a case of arteriolar retinal macrovessel, diagnosed by routine ophthalmologic examination, as well as its optic coherence tomography aspects. Congenital retinal macrovessel is a large aberrant vessel, often unilateral, usually a vein, rarely an artery, located in the posterior pole which can cross the fovea and median raphe.