RESUMO
We report a case of bilateral central retinal vein occlusion following moderate acute rejection of a cardiac transplant. A 27-year-old man was admitted for sudden bilateral decreased vision due to bilateral central retinal vein occlusion. Visual acuity was 20/63 in the right eye and 20/25 in the left eye. This patient had undergone a heart transplant 6 months before and had presented with moderate acute rejection for a few days. The moderate acute rejection phenomenon includes inflammatory lymphocyte infiltrates, reflecting persistent immune response activation. Moderate acute rejection of a cardiac transplant graft might cause a bilateral central retinal vein occlusion.
Assuntos
Rejeição de Enxerto/etiologia , Transplante de Coração , Complicações Pós-Operatórias/etiologia , Oclusão da Veia Retiniana/etiologia , Doença Aguda , Adulto , Cardiomiopatias/cirurgia , Corpo Ciliar/cirurgia , Criocirurgia , Angiofluoresceinografia , Seguimentos , Glaucoma Neovascular/diagnóstico , Glaucoma Neovascular/etiologia , Glaucoma Neovascular/imunologia , Glaucoma Neovascular/terapia , Rejeição de Enxerto/diagnóstico , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/terapia , Transplante de Coração/imunologia , Humanos , Imunossupressores/administração & dosagem , Fotocoagulação , Edema Macular/diagnóstico , Edema Macular/etiologia , Edema Macular/imunologia , Edema Macular/terapia , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/imunologia , Complicações Pós-Operatórias/terapia , Reoperação , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/imunologia , Hemorragia Retiniana/terapia , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/imunologia , Oclusão da Veia Retiniana/terapia , Visão Binocular , Acuidade VisualRESUMO
PURPOSE: To investigate predictors of quality of life in refractive surgery: psychological status, quality of vision, visual acuity, and patient satisfaction. METHODS: In a prospective study, 143 patients were evaluated preoperatively and after the third postoperative month using the same questionnaire. Quality of vision, visual acuity, well-being, self-esteem, coping, and patient satisfaction were analyzed with 47 parameters. Refractive procedures included PRK, LASIK, and phakic IOL. Four groups of low (G1), medium (G2), and high myopia (G3) and hyperopia (G4) were individualized to compare the results. RESULTS: We noted a mean postoperative best corrected visual acuity (BCVA) of 20/25 or more for the G1, G2, and G4 groups. For the G3 group, the mean BCVA was increased, with a gain of two Snellen Lines from 20/50 to 20/32. Postoperative patient satisfaction improved, with a significant difference (p<0.05) in all groups. We noted no significant difference in all myopic groups in well-being and no significant decrease in G4. Concerning self-esteem and coping, scores improved, with a significant difference in G3 group (p<0.05). Quality of vision was directly correlated with improvement of quality of life (psychological status), satisfaction scores, and BCVA preoperatively and postoperatively in all patients, but no correlation was noted between visual acuity and patient satisfaction. CONCLUSION: In spite of good refractive results, modification of patient satisfaction depends on quality of vision and quality of life (psychological status) scores. These results give us a new tool that provides useful additional information in refractive surgery.
