Findings of ocular examinations in healthy full-term newborns / Achados de exame ocular realizado em recém-nascidos a termo saudáveis

ABSTRACT Purpose: To assess the anterior and posterior segments of full-term neonates over a 1.5-year period. Methods: The findings of full-term neonates who underwent ophthalmological examinations between June 2019 and December 2020 were analyzed, and the results were retrospectively recorded. Results: The study comprised 2972 neonates with a mean birth week of 38.7 ± 1.2 weeks and a mean birth weight of 3235 ± 464 g. The neonates were examined on an average of 49.3 ± 18.9 postnatal days. Of the examined neonates, 185 (6.2%) showed abnormal ophthalmological findings, the most prevalent of which were retinal hemorrhage in 2.3% (n=68) and white changes in the peripheral retina in 1.9% (n=55) of the neonates. Cases of optic disc pathologies (n=20), choroidal nevus (n=10), iris-choroidal coloboma (n=5), subconjunctival hemorrhage (n=6), non-specific retinal pigmentary change (n=4), congenital cataract (n=3), posterior synechia (n=3), iris nevus (n=3), corneal opacity (n=1), choroidal coloboma (n=1), iris coloboma (n=1), buphthalmos (n=1), anophthalmos (n=1), microphthalmia (n=1), lid hemangioma (n=1), and vitreous hemorrhage (n=1) collectively accounted for approximately 2% of all neonates. Pathologies that could potentially impair vision, which were detected by ophthalmological examination, accounted for 1.2% of all neonates (n=37). Conclusion: The most prevalent finding of the ophthalmological examinations of neonates in the present study was retinal hemorrhage. Ophthalmological examinations of neonates can help in identifying diseases that may affect their vision and are curable or may lead to amblyopia in the long term.

RESUMO Objetivo: Avaliar os segmentos anterior e posterior em recém-nascidos a termo durante um período de 1,5 anos. Métodos: Foram analisados recém-nascidos a termo que tiveram os olhos examinados entre junho de 2019 e dezembro de 2020, e os resultados foram registrados retrospectivamente. Resultados: O estudo foi composto por 2.972 recém-nascidos com média de uma semana de nascimento de 38,7 ± 1,2 semanas e um peso médio ao nascer de 3235 ± 464 g. Os recém-nascidos foram examinados em média pós-natal de 49,3 ± 18,9 dias. Dos recém-nascidos, 185 (6,2%) apresentaram resultados oculares anormais. Os achados oculares anormais mais prevalentes foram hemorragia da retina em 2,3% (n=68) e alterações brancas na retina periférica em 1,9% (n=55) dos recém-nascidos. Casos de patologias de disco óptico (n=20), nevo de coroide (n=10), coloboma iris-coroide (n=5), hemorragia subconjuntival (n=6), alteração pigmentar da retina não específica (n=4), catarata congênita (n=3), Sinequia posterior (n=3), nevo da íris (n=3), opacidade da córnea (n=1), coloboma de coroide (n=1), coloboma de íris (n=1), buftalmos (n=1), anoftalmia (n=1), microftalmia (n=1), hemangioma de pálpebra (n=1) e hemorragia vítrea (n=1) contabilizaram coletivamente cerca de 2% dos recém-nascidos. As patologias que potencialmente prejudicam a visão, detectadas por exame ocular, representaram 1,2% dos recém-nascidos (n=37). Conclusão: O achado mais prevalente de exames oculares de recém-nascidos neste estudo foi hemorragia da retina. Exames oftalmológicos em recém-nascidos podem ser úteis na identificação de doenças que podem impactar a visão deles, podendo ser curáveis ou levar à ambliopia no longo prazo.

Findings of ocular examinations in healthy full-term newborns.

PURPOSE: To assess the anterior and posterior segments of full-term neonates over a 1.5-year period. METHODS: The findings of full-term neonates who underwent ophthalmological examinations between June 2019 and December 2020 were analyzed, and the results were retrospectively recorded. RESULTS: The study comprised 2972 neonates with a mean birth week of 38.7 ± 1.2 weeks and a mean birth weight of 3235 ± 464 g. The neonates were examined on an average of 49.3 ± 18.9 postnatal days. Of the examined neonates, 185 (6.2%) showed abnormal ophthalmological findings, the most prevalent of which were retinal hemorrhage in 2.3% (n=68) and white changes in the peripheral retina in 1.9% (n=55) of the neonates. Cases of optic disc pathologies (n=20), choroidal nevus (n=10), iris-choroidal coloboma (n=5), subconjunctival hemorrhage (n=6), non-specific retinal pigmentary change (n=4), congenital cataract (n=3), posterior synechia (n=3), iris nevus (n=3), corneal opacity (n=1), choroidal coloboma (n=1), iris coloboma (n=1), buphthalmos (n=1), anophthalmos (n=1), microphthalmia (n=1), lid hemangioma (n=1), and vitreous hemorrhage (n=1) collectively accounted for approximately 2% of all neonates. Pathologies that could potentially impair vision, which were detected by ophthalmological examination, accounted for 1.2% of all neonates (n=37). CONCLUSION: The most prevalent finding of the ophthalmological examinations of neonates in the present study was retinal hemorrhage. Ophthalmological examinations of neonates can help in identifying diseases that may affect their vision and are curable or may lead to amblyopia in the long term.

Relationships between corneal biomechanics and the structural and functional parameters of glaucoma damage / Relações entre a biomecânica da córnea e os parâmetros estruturais e funcionais do dano do glaucoma

ABSTRACT Purpose: To investigate the relationships between (i) thickness of the retinal nerve fiber layer, optic nerve head topography, and visual field parameters and (ii) corneal biomechanical properties in normal controls and patients with ocular hypertension and primary open-angle glaucoma. Methods: This observational, cross-sectional study included 68 eyes with primary open-angle glaucoma, 99 eyes with ocular hypertension and 133 control eyes. Corneal biomechanical properties, optic nerve head topographic features, retinal nerve fiber layer thickness, and visual fields were assessed in all cases. Corneal biomechanical properties, retinal nerve fiber layer thicknesses, and optic nerve head topographic features were compared among the groups. The associations between structural and functional measures of glaucomatous damage and corneal biomechanical factors were also evaluated. Results: Significantly lower corneal hysteresis and corneal resistance factor values were observed in the primary open-angle glaucoma and ocular hypertension groups as compared with the control group, but there were no significant differences between the primary open-angle glaucoma and ocular hypertension groups. In the ocular hypertension group, no associations were observed between the corneal hysteresis and corneal resistance factor with values and the structural and functional parameters. In the primary open-angle glaucoma group, positive correlations were observed between the corneal hysteresis values and the global retinal nerve fiber layer thickness (p<0.01, r=0.27), mean retinal nerve fiber layer thickness (p<0.01, r=0.33), and mean deviation (p<0.01, r=0.26), and negative correlations were observed between the corneal resistance factor values, and the cup area (p<0.01, r=-0.39), cup-to-disk ratio (p=0.02, r=-0.28), linear cup-to-disk ratio (p=0.02, r=-0.28), and cup shape (p=0.03, r=-0.26). In the control group, weak correlations were detected between the corneal hysteresis and the cup area (p=0.03, r=0.19), cup-to-disk ratio (p=0.01, r=0.21), and linear cup-to-disk ratio (p=0.01, r=0.22). Conclusions: Distinct correlations were identified between the corneal hysteresis and corneal resistance factor values and the functional and structural parameters in the primary open-angle glaucoma and control groups. Corneal hysteresis and corneal resistance factor may have different roles in the pathophysiology of glaucoma.

RESUMO Objetivo: Investigar as relações entre (i) espessura da camada de fibras nervosas da retina, topografia do nervo óptico e parâmetros do campo visual e (ii) propriedades biomecânicas da córnea, em controles normais e pacientes com hiperten são ocular e glaucoma primário de ângulo aberto. Métodos: Este estudo observacional, transversal, incluiu 68 olhos com glaucoma primário de ângulo aberto, 99 olhos com hipertensão ocular e 133 olhos controle. As propriedades biomecânicas da córnea, as características topográficas da cabeça do nervo óptico, a espessura da camada de fibras nervosas da retina e os campos visuais foram avaliados em todos os casos. As propriedades biomecânicas da córnea, a espessura da camada de fibras nervosas da retina e as características topográficas da cabeça do nervo óptico foram comparadas entre os grupos. As associações entre medidas estruturais e funcionais de danos glaucomatosos e fatores biomecânicos da córnea também foram avaliadas. Resultados: Valores de histerese corneana e da resistência corneana foram significativamente menores nos grupos com glaucoma primário de ângulo aberto e hipertensão ocular em com paração ao grupo controle, mas não houve diferenças significativas entre os grupos de glaucoma primário de ângulo aberto e hipertensão ocular. No grupo com hipertensão ocular, não foram observadas associações entre histerese da córnea e o fator de resistência corneana com os valores e os parâmetros estruturais e funcionais. No grupo com glaucoma primário de ângulo aberto foram observadas correlações positivas entre os valores de histerese corneana e a espessura a camada de fibras nervosas da retina (p<0,01, r=0,27), espessura média da camada de fibras nervosas da retina (p<0,01, r=0,33) e desvio médio (p<0,01, r=0,26), e correlações negativas entre o os valores do fator de resistência da córnea e a área de escavação (p<0,01, r=-0,39), a relação escavação/disco (p=0,02, r=-0,28), a relação copo-para-disco linear (p=0,02, r=-0,28) e a forma da escavação (p=0,03, r=-0,26). No grupo controle, correlações foram detectadas entre a histerese da córnea e área de escavação (p=0,03, r=0,19), relação escavação/disco (p=0,01, r=0,21) e relação copo-para-disco linear (p=0,01, r=0,22). Conclusões: Correlações distintas foram identificadas entre histerese da córnea e os valores de resistência da córnea e os parâmetros funcionais e estruturais nos grupos de glaucoma primário de ângulo aberto e controle. A histerese da córnea e o fator de resistência da córnea podem ter diferentes papéis na fisiopatologia do glaucoma.

Relationships between corneal biomechanics and the structural and functional parameters of glaucoma damage.

PURPOSE: To investigate the relationships between (i) thickness of the retinal nerve fiber layer, optic nerve head topography, and visual field parameters and (ii) corneal biomechanical properties in normal controls and patients with ocular hypertension and primary open-angle glaucoma. METHODS: This observational, cross-sectional study included 68 eyes with primary open-angle glaucoma, 99 eyes with ocular hypertension and 133 control eyes. Corneal biomechanical properties, optic nerve head topographic features, retinal nerve fiber layer thickness, and visual fields were assessed in all cases. Corneal biomechanical properties, retinal nerve fiber layer thicknesses, and optic nerve head topographic features were compared among the groups. The associations between structural and functional measures of glaucomatous damage and corneal biomechanical factors were also evaluated. RESULTS: Significantly lower corneal hysteresis and corneal resistance factor values were observed in the primary open-angle glaucoma and ocular hypertension groups as compared with the control group, but there were no significant differences between the primary open-angle glaucoma and ocular hypertension groups. In the ocular hypertension group, no associations were observed between the corneal hysteresis and corneal resistance factor with values and the structural and functional parameters. In the primary open-angle glaucoma group, positive correlations were observed between the corneal hysteresis values and the global retinal nerve fiber layer thickness (p<0.01, r=0.27), mean retinal nerve fiber layer thickness (p<0.01, r=0.33), and mean deviation (p<0.01, r=0.26), and negative correlations were observed between the corneal resistance factor values, and the cup area (p<0.01, r=-0.39), cup-to-disk ratio (p=0.02, r=-0.28), linear cup-to-disk ratio (p=0.02, r=-0.28), and cup shape (p=0.03, r=-0.26). In the control group, weak correlations were detected between the corneal hysteresis and the cup area (p=0.03, r=0.19), cup-to-disk ratio (p=0.01, r=0.21), and linear cup-to-disk ratio (p=0.01, r=0.22). CONCLUSIONS: Distinct correlations were identified between the corneal hysteresis and corneal resistance factor values and the functional and structural parameters in the primary open-angle glaucoma and control groups. Corneal hysteresis and corneal resistance factor may have different roles in the pathophysiology of glaucoma.

Evaluation of a birth-related foveal hemorrhage in an infant using optical coherence tomography.

During the routine ophthalmologic examination of a 38-day old female infant, indirect ophthalmoscopy revealed a dense hemorrhage on the fovea and a couple of superficial hemorrhages in the nasal retina of the left eye. No hemorrhage was observed in the right eye. A hand-held spectral domain optical coherence tomography (SD-OCT) was used at the time of diagnosis. The hemorrhage at the nasal retina resolved in the first week of follow-up, and the foveal hemorrhage resolved 12 weeks after birth. Spectral domain optical coherence tomography was repeated once the foveal hemorrhage had resorbed, and it showed that the foveal contour had reformed without any sequelae. This case suggests that birth-related foveal hemorrhages do not cause any disturbance in the foveal architecture.

Evaluation of a birth-related foveal hemorrhage in an infant using optical coherence tomography / Avaliação de uma hemorragia foveal relacionada ao nascimento de uma criança usando tomografia de coerência óptica

ABSTRACT During the routine ophthalmologic examination of a 38-day old female infant, indirect ophthalmoscopy revealed a dense hemorrhage on the fovea and a couple of superficial hemorrhages in the nasal retina of the left eye. No hemorrhage was observed in the right eye. A hand-held spectral domain optical coherence tomography (SD-OCT) was used at the time of diagnosis. The hemorrhage at the nasal retina resolved in the first week of follow-up, and the foveal hemorrhage resolved 12 weeks after birth. Spectral domain optical coherence tomography was repeated once the foveal hemorrhage had resorbed, and it showed that the foveal contour had reformed without any sequelae. This case suggests that birth-related foveal hemorrhages do not cause any disturbance in the foveal architecture.

RESUMO Durante o exame oftalmológico de rotina de uma criança do sexo feminino de 38 dias, a oftalmoscopia indireta revelou uma hemorragia densa na fóvea e algumas hemorragias superficiais na retina nasal do olho esquerdo. Nenhuma hemorragia foi observada no olho direito. Foi utilizada uma tomografia de coerência óptica de domínio espectral no momento do diagnóstico. A hemorragia na retina nasal foi resolvida na primeira semana de acompanhamento e a hemorragia foveal foi resolvida em 12 semanas após o nascimento. A tomografia de coerência óptica de domínio espectral foi repetida uma vez que a hemorragia foveal foi reabsorvida, e mostrou que o contorno foveal havia se reformado sem sequelas. Este caso sugere que as hemorragias foveais relacionadas ao nascimento não causam qualquer distúrbio na arquitetura foveal.

Treatment success of laser therapy for retinopathy of prematurity in referred and non-referred patients.

PURPOSE: Comparison of laser therapy (LT) outcomes in patients with retinopathy of prematurity (ROP) followed up in our clinic and referred from other centers. METHODS: Medical records of 1,856 ROP patients were retrospectively evaluated, and a total of 128 patients who underwent LT were included in the study. The study population was divided into the following two groups: patients who were followed up and treated in our clinic (group 1, N=45) and patients who were referred to our clinic from other centers (group 2, N=83). Data regarding birth weight, sex, gestational age, postnatal treatment time, disease localization, and stage were analyzed and compared between the two groups. Treatment success was defined by anatomic success 6 months after treatment. RESULTS: Patients in the referred group presented with a more advanced disease (p<0.01), a lower treatment success rate (p=0.01), and a longer time interval between diagnosis and LT (p=0.04). CONCLUSIONS: The treatment success rate of ROP was significantly lower in referred patients because of the potential delay in LT and more advanced disease at the time of treatment initiation.

Treatment success of laser therapy for retinopathy of prematurity in referred and non-referred patients / O sucesso do tratamento com terapia a laser para retinopatia da prematuridade em pacientes encaminhados e não encaminhados

ABSTRACT Purpose: Comparison of laser therapy (LT) outcomes in patients with retinopathy of prematurity (ROP) followed up in our clinic and referred from other centers. Methods: Medical records of 1,856 ROP patients were retrospectively evaluated, and a total of 128 patients who underwent LT were included in the study. The study population was divided into the following two groups: patients who were followed up and treated in our clinic (group 1, N=45) and patients who were referred to our clinic from other centers (group 2, N=83). Data regarding birth weight, sex, gestational age, postnatal treatment time, disease localization, and stage were analyzed and compared between the two groups. Treatment success was defined by anatomic success 6 months after treatment. Results: Patients in the referred group presented with a more advanced disease (p<0.01), a lower treatment success rate (p=0.01), and a longer time interval between diagnosis and LT (p=0.04). Conclusions: The treatment success rate of ROP was significantly lower in referred patients because of the potential delay in LT and more advanced disease at the time of treatment initiation.

RESUMO Objetivos: A comparação dos resultados da terapia a laser (LT) em pacientes com retinopatia da prematuridade (ROP) acompanhados em nossa clínica e encaminhados por outras clínicas. Método: Os arquivos de 1.856 pacientes com ROP foram analisados retrospectivamente e um total de 128 pacientes submetidos à LT foram incluídos no estudo. A população do estudo foi dividida em dois grupos; os pacientes que foram acompanhados e tratados em nossa clínica (grupo 1, n=45) e os pacientes que foram encaminhados à nossa clínica por outros centros (grupo 2, n=83). Os dados referentes a peso de nascimento, sexo, idade gestacional, tempo de tratamento pós-natal, localização e fase da doença foram analisados e comparados entre os grupos. O sucesso do tratamento foi definido pelo sucesso anatômico no sexto mês após o tratamento. Resultados: Pacientes no grupo de pacientes encaminhados apresentaram doença mais avançada (p<0,01), taxa de sucesso inferior (p=0,01) e maior intervalo de tempo entre o diagnóstico e tratamento a laser (p=0,04). Conclusões: A taxa de sucesso do tratamento da ROP é significativamente menor em pacientes encaminhados por causa de possível atraso da LT e do estágio mais avançado da doença observado.