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1.
Vasc Med ; 25(4): 302-308, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32308146

RESUMO

Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits (p > 0.05 for all). However, patients with RVO had impaired FMD (p = 0.002) and increased PWV (p = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a significant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.


Assuntos
Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Artéria Radial/fisiopatologia , Oclusão da Veia Retiniana/fisiopatologia , Rigidez Vascular , Vasodilatação , Idoso , Artéria Braquial/diagnóstico por imagem , Velocidade da Onda de Pulso Carótido-Femoral , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oclusão da Veia Retiniana/diagnóstico , Ultrassonografia
2.
Microvasc Res ; 100: 54-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25937082

RESUMO

Ocular involvement occurs in sarcoidosis (Sar) patients mainly in the form of uveitis. This study was designed to determine if uveitis in Sar patients is associated with vascular impairment. We enrolled 82 Sar patients and 77, age and sex matched, control subjects (Cl). Sar patients were divided into those with ocular sarcoidosis (OS) and those without ocular sarcoidosis (WOS). Endothelial function was evaluated by flow-mediated dilation (FMD). Pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections. Although there was no significant difference in sex, age and mean arterial pressure, patients with OS compared to WOS patients and Cl subjects had impaired FMD (p<0.001), increased AIx (p=0.02) and increased PWV (p=0.001). Interestingly, impaired FMD in Sar patients was independently, from possible covariates (age, sex, smoking habits, arterial hypertension, dyslipidemia), associated with increased odds of ocular involvement (odds ratio=1.69, p=0.001). More precisely ROC curve analysis revealed that FMD had a significant diagnostic ability for the detection of OS (AUC=0.77, p<0.001) with a sensitivity of 79% and a specificity of 68% for an FMD value below 6.00%. To conclude in the present study we have shown that ocular involvement in Sar patients is associated with impaired endothelial function and increased arterial stiffness. These results strengthen the vascular theory which considers uveitis a consequence of vascular dysfunction in Sar patients and reveals a possible clinical importance of the use of endothelial function tests.


Assuntos
Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Sarcoidose/complicações , Uveíte/etiologia , Doenças Vasculares/etiologia , Rigidez Vascular , Vasodilatação , Artéria Braquial/diagnóstico por imagem , Estudos de Casos e Controles , Endotélio Vascular/diagnóstico por imagem , Humanos , Valor Preditivo dos Testes , Prognóstico , Análise de Onda de Pulso , Sarcoidose/diagnóstico , Ultrassonografia , Uveíte/diagnóstico , Uveíte/fisiopatologia , Doenças Vasculares/diagnóstico , Doenças Vasculares/fisiopatologia
3.
Cornea ; 34(6): 664-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25811721

RESUMO

PURPOSE: To evaluate corneal stromal demarcation line depth after very high intensity (18 mW/cm) ultraviolet-A irradiation for a 5-minute corneal collagen cross-linking (CXL) protocol with the use of anterior segment optical coherence tomography. METHODS: This prospective interventional study enrolled 14 patients (18 eyes) with progressive keratoconus who underwent CXL with an ultraviolet-A irradiation intensity of 18 mW/cm for 5 minutes. One month postoperatively, corneal stromal demarcation line depth was measured with the use of anterior segment optical coherence tomography by 2 independent observers. The rate of reepithelialization and endothelial cell density at a 3-month follow-up period were also evaluated. RESULTS: No intraoperative or postoperative complications were observed in any of the patients. No statistically significant difference between the 2 observers' measurements was observed (P = 0.989). Mean corneal stromal demarcation line depth was 223 ± 32 µm (range, 159-265 µm). The mean endothelial cell density decreased from 2714 ± 174 preoperatively to 2671 ± 192 at 3 months postoperatively; however, this decrease was not statistically significant (P = 0.221). CONCLUSIONS: Corneal stromal demarcation line depth after a very high intensity 5-minute CXL protocol seems to be shallower than the standard Dresden protocol.


Assuntos
Colágeno/metabolismo , Substância Própria/patologia , Reagentes de Ligações Cruzadas , Ceratocone/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Tomografia de Coerência Óptica/métodos , Adulto , Contagem de Células , Perda de Células Endoteliais da Córnea/diagnóstico , Substância Própria/metabolismo , Topografia da Córnea , Endotélio Corneano/patologia , Feminino , Seguimentos , Humanos , Ceratocone/metabolismo , Masculino , Estudos Prospectivos , Riboflavina/uso terapêutico , Raios Ultravioleta , Adulto Jovem
4.
Cornea ; 34(6): 704-6, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25811728

RESUMO

PURPOSE: To present a case of significant progressive corneal flattening and thinning after corneal cross-linking (CXL), with 5 years of follow-up. METHODS: Case report. RESULTS: A 23-year-old woman presented with bilateral progressive keratoconus and received CXL treatment (Dresden protocol) for both eyes in March 2009. The patient has demonstrated gradual significant corneal thinning (from a preoperative value of 464 µm to 243 µm) and progressive flattening (+11.1-diopter change in spherical equivalent) in her right eye, over a 5-year period. The fellow eye remained stable during the same postoperative period. CONCLUSIONS: This is the first case report of significant progressive corneal flattening and thinning after undergoing CXL treatment for progressive keratoconus.


Assuntos
Córnea/patologia , Reagentes de Ligações Cruzadas , Hiperopia/etiologia , Ceratocone/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Complicações Pós-Operatórias , Colágeno/metabolismo , Paquimetria Corneana , Substância Própria/metabolismo , Topografia da Córnea , Feminino , Seguimentos , Humanos , Ceratocone/metabolismo , Tamanho do Órgão , Tomografia de Coerência Óptica , Acuidade Visual , Adulto Jovem
5.
Cornea ; 33(10): 1071-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25170581

RESUMO

PURPOSE: The aim of this study was to present the long-term results of corneal collagen cross-linking (CXL) in patients with keratoconus. METHODS: In this prospective, interventional case series, patients with progressive keratoconus underwent CXL treatment according to the Dresden protocol. Visual, refractive, and topographic outcomes along with endothelial cell density were evaluated preoperatively and at 1, 2, 3, 4, and 5 years postoperatively. RESULTS: Twenty-one patients (25 eyes) were enrolled. The mean follow-up was 43.7 ± 12.2 (range, 24-60) months. Logarithm of the minimum angle of resolution (logMAR) mean uncorrected visual acuity and the mean best spectacle-corrected visual acuity improved significantly from 0.92 ± 0.54 and 0.29 ± 0.21 preoperatively to 0.63 ± 0.41 (P = 0.010) and 0.18 ± 0.18 (P = 0.011), respectively, at the last follow-up. Mean steep and mean flat keratometry readings reduced significantly from 52.53 ± 6.95 diopters (D) and 48.11 ± 5.98 D preoperatively to 49.10 ± 4.50 D (P < 0.001) and 45.58 ± 3.81 D (P = 0.001), respectively, at the last follow-up. The mean endothelial cell density was 2708 ± 302 cells per square millimeter preoperatively and did not change significantly (P > 0.05) at any postoperative interval (2593 ± 258 cells/mm at the last follow-up; P = 0.149). CONCLUSIONS: CXL seems to be effective and safe in halting progression of keratoconus over a long-term follow-up period up to 5 years postoperatively.


Assuntos
Colágeno/metabolismo , Substância Própria/metabolismo , Reagentes de Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Adolescente , Adulto , Contagem de Células , Topografia da Córnea , Endotélio Corneano/patologia , Feminino , Seguimentos , Humanos , Ceratocone/metabolismo , Ceratocone/fisiopatologia , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Refração Ocular/fisiologia , Riboflavina/uso terapêutico , Raios Ultravioleta , Acuidade Visual/fisiologia , Adulto Jovem
6.
Am J Ophthalmol ; 158(4): 671-675.e1, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25034113

RESUMO

PURPOSE: To compare the corneal stromal demarcation line depth using anterior segment optical coherence tomography (AS-OCT) after corneal collagen cross-linking (CXL) using 2 different treatment protocols: the standard Dresden protocol (30 minutes with 3 mW/cm(2)) and a modified-accelerated protocol (14 minutes with 9 mW/cm(2)). DESIGN: Prospective, comparative study. METHODS: Forty-three keratoconic patients (52 eyes) were enrolled. All patients underwent CXL using the same high-intensity ultraviolet-A (UV-A) irradiation device. Twenty-six eyes were treated for 30 minutes with 3 mW/cm(2) according to the standard Dresden protocol (Group 1), while 26 eyes were treated with a novel modified-accelerated CXL protocol for 14 minutes with 9 mW/cm(2) of UV-A irradiation intensity (Group 2). One month postoperatively, corneal stromal demarcation line depth was measured by 2 independent observers using AS-OCT. RESULTS: Corneal stromal demarcation line depth was assessed with no significant difference between observer measurements for both groups (P = .676 for Group 1 and P = .566 for Group 2). Mean corneal stromal demarcation line depth was 337.00 ± 46.46 µm for Group 1 and 322.91 ± 48.28 µm for Group 2. There was no statistically significant difference (P = .243) in the corneal stromal demarcation line depth between the 2 groups. CONCLUSIONS: Corneal stromal demarcation line depth using UV-A with 3 mW/cm(2) for 30 minutes and 9 mW/cm(2) for 14 minutes was similar. A modified-accelerated protocol of 14 minutes of CXL provided the same treatment depth as the classic Dresden protocol.


Assuntos
Substância Própria/patologia , Reagentes de Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Adolescente , Adulto , Colágeno/metabolismo , Paquimetria Corneana , Substância Própria/metabolismo , Feminino , Humanos , Ceratocone/metabolismo , Ceratocone/patologia , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Riboflavina/uso terapêutico , Tomografia de Coerência Óptica , Raios Ultravioleta , Adulto Jovem
8.
J Anxiety Disord ; 18(3): 233-54, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15125975

RESUMO

This study assessed the psychometric properties of self-reports on the Hellenic Fear Survey Schedule for Children (FSSC-GR), a Greek-language version of Ollendick's FSSC-R [Behav. Res. Ther. 21 (1983) 685-692], and explored the factor structure, intensity, prevalence, and content of fears of Hellenic children aged 7-12 years. Internal consistency and temporal stability assessments of responding on the FSSC-GR were comparable to those obtained on the FSSC-R. A seven-factor solution provided the best conceptual fit for the structure of children's fears in Greece, including five components similar to factors previously obtained for the FSSC-R, plus two unique components, "Travel and Agoraphobic Fears" and "School Performance Fears." Fear intensity and prevalence scores of Hellenic children were higher than scores observed in most countries. Self-reported fear scores were higher for Hellenic girls than for boys. The relation between age and self-reported fears in Greece was complex and interpreted in relation to age-related changes in environmental demands.


Assuntos
Cultura , Medo , Inquéritos e Questionários , Criança , Análise Fatorial , Feminino , Identidade de Gênero , Grécia , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes
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