RESUMO
OBJECTIVE: To evaluate and compare the symptomatology and clinical findings in hyposecretory dry eye of the treatment with platelet-rich plasma (PRP) and artificial tears of sodium hyaluronate (SH). METHODS: Blind single-centre prospective comparative randomized study including 83 patients with hyposecretory dry eye and mean age of 64.0 years. Two groups were differentiated depending on the treatment applied: 44 patients treated with PRP (PRP group), and 39 patients treated with artificial tears of SH (SH group). Changes in Schimer test, tear osmolarity, corneal and conjunctival staining, tear film break-up time (TF-BUT), conjunctival hyperaemia, dry eye-related symptoms with the Ocular Surface Disease Index questionnaire, and caliciform cell density were evaluated during 30 days of treatment. RESULTS: Significantly larger reduction in symptomatology (p < 0.001), visual improvement (p < 0.001), reduction in hyperaemia (p < 0.001), and corneal and conjunctival staining (p < 0.001), increment of Schirmer test outcome (p ≤ 0.005), and reduction of osmolarity were found in the PRP group in both eyes compared to SH group at 15 and 30 days of treatment. Likewise, a significantly higher increment of caliciform cell density (p < 0.001) was found in the PRP group. Strong and statistically significant correlations were found in the PRP group of the change achieved in visual acuity, hyperaemia, osmolarity, and conjunctival and corneal staining with the baseline values of these variables (p < 0.001). CONCLUSION: PRP treatment in hyposecretory dry eye induces a more significant positive effect over symptomatology and different dry eye signs than SH, especially in moderate and severe cases.
Assuntos
Síndromes do Olho Seco/terapia , Plasma Rico em Plaquetas , Lágrimas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Células , Túnica Conjuntiva/patologia , Córnea/patologia , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/metabolismo , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Concentração Osmolar , Estudos Prospectivos , Método Simples-Cego , Microscopia com Lâmpada de Fenda , Coloração e Rotulagem , Resultado do TratamentoRESUMO
El glaucoma maligno es una forma rara de glaucoma, que suele seguir a la cirugía en pacientes con ángulo cerrado y glaucoma primario de ángulo cerrado. En esta revisión bibliográfica se discuten las características clínicas, la clasificación, la patogenia y el manejo de esta afección. La revisión bibliográfica la efectuamos a partir de una búsqueda en Medline (los principales artículos de PubMed y en Internet) y bases Cochrane (The Cochrane Library). Las imágenes aportadas son propias y las hemos efectuado con tomografía de coherencia óptica SS-1000 de segmento anterior CASIA de Tomey ®. El objetivo de la revisión es revisar las evidencias sobre una afección rara y actualizar los protocolos diagnósticos y terapéuticos con las nuevas técnicas a nuestro alcance. Consideramos que el nombre de glaucoma maligno para esta patología debería evitarse, ya que actualmente con los medios disponibles el pronóstico es relativamente bueno. Es por esto, que preferimos nombres como el síndrome de misdirección del humor acuoso, o glaucoma por bloqueo ciliar(AU)
Malignant glaucoma is a rare form of glaucoma that typically follows surgery in patients with primary angle closure and primary angle-closure glaucoma. In this bibliographic review we discuss the clinical characteristics, classification, pathogenesis, and management. The literature review is based on a search in Medline (the main articles of PubMed, Internet) and Cochrane databases (The Cochrane Library). The images provided we have done them with SS-1000 Optical Coherence Tomography CASIA of Tomey ®. The aim of the review is to review the evidence for a rare condition and update the diagnostic and therapeutic protocols with the new techniques. In addition, the review authors thought that the name of malignant glaucoma for this pathology should be avoided, because of prognosis is relatively good. This is the reason, we prefer names such as misdirected aqueous humor syndrome, or ciliary blockage glaucoma(AU)