Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 10 de 10
Filtrar
Mais filtros











Intervalo de ano de publicação
1.
Eye (Lond) ; 38(3): 520-528, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37673971

RESUMO

BACKGROUND/OBJECTIVE: The prokinetic levosulpiride elevates vasoinhibin levels in the vitreous of patients with proliferative diabetic retinopathy (PDR) suggesting clinical benefits due to the anti-vasopermeability and anti-angiogenic properties of vasoinhibin. We investigated the biological activity of levosulpiride in centre-involving diabetic macular oedema (DME). PATIENTS/METHODS: Prospective, randomized, double-blinded, dual-centre, phase 2 trial in patients with centre-involving DME orally treated with placebo (n = 17) or levosulpiride (n = 17) for 8 weeks or in patients with PDR undergoing elective pars plana vitrectomy and receiving placebo (n = 18) or levosulpiride (n = 18) orally for the 1 week before vitrectomy. RESULTS: Levosulpiride improved changes from baseline in best-corrected visual acuity (p ≤ 0.037), central foveal thickness (CFT, p ≤ 0.013), and mean macular volume (MMV, p ≤ 0.002) at weeks 4, 6, and 8 compared to placebo. At 8 weeks, the proportion of eyes gaining ≥5 ETDRS letters at 4 m (41% vs. 28%), losing ≥21 µm in CFT (55% vs. 28%), and dropping ≥0.06 mm3 in MMV (65% vs. 29%) was higher after levosulpiride than placebo. The overall grading of visual and structural parameters improved with levosulpiride (p = 0.029). Levosulpiride reduced VEGF (p = 0.025) and PlGF (p = 0.008) levels in the vitreous of PDR patients. No significant adverse side-effects were detected. CONCLUSIONS: Oral levosulpiride for 8 weeks improved visual and structural outcomes in patients with centre-involving DME by mechanisms that may include intraocular upregulation of vasoinhibin and downregulation of VEGF and PlGF. Larger clinical trials evaluating long-term efficacy and safety are warranted.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Edema Macular , Sulpirida/análogos & derivados , Humanos , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/cirurgia , Fator A de Crescimento do Endotélio Vascular/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Estudos Prospectivos , Injeções Intravítreas , Inibidores da Angiogênese
2.
Case Rep Ophthalmol ; 13(2): 490-498, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35950030

RESUMO

We report 2 cases of an aggressive choroidal neovascularization phenotype. A 77-year-old hypertensive woman, with a 4-year history of visual loss in her left eye, due to vitreous hemorrhage associated with a dome-shaped mass lesion underwent pars plana vitrectomy. An extensive subretinal hemorrhage was found, associated with extensive subretinal fibrosis, which was treated with endophotocoagulation and intravitreal injection of anti-VEGF. Best-corrected visual acuity after surgery was light perception. A 74-year-old woman with a 4-year history of treatment for choroidal neovascularization in both eyes presented with an extensive subretinal hemorrhage associated with exudation in the temporal peripheral retina. Lesions became larger despite monthly intravitreal anti-VEGF injections (14 injections) and verteporfin photodynamic therapy in both eyes. Throughout the years, the choroidal neovascular lesion continued to enlarge until it developed a severe vitreous hemorrhage. The patient rejected treatment and ended up with no light perception at the end of the follow-up (8 years). A rare severe choroidal neovascularization phenotype is presented here and would be considered to be at the aggressive extreme of the spectrum of a neovascular age-related macular degeneration or polypoidal choroidal vasculopathy that presents massive hemorrhage and exudation as much as in the posterior pole as in the peripheral retina.

3.
Arq Bras Oftalmol ; 85(2): 120-127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34431895

RESUMO

PURPOSE: To analyze the macular ganglion cell-inner plexiform and retinal nerve fiber layer thicknesses after vitrectomy with the inverted flap technique for idiopathic macular holes. METHODS: A prospective study was conducted on 28 eyes treated with surgery for idiopathic macular holes. The inverted internal limiting membrane flap technique assisted with Brilliant Blue staining (0.05%) was performed. Ophthalmologic examinations and quantitative analysis of the macular ganglion cell complex thickness were performed at baseline,1 and 3 months after surgery. RESULTS: The preoperative mean thicknesses of the ganglion cell-inner plexiform layer and ganglion cell-inner plexiform layer + retinal nerve fiber layer were 88.9 and 124.8 µm, respectively. The mean ganglion cell-inner plexiform layer thicknesses at 1 and 3 months after surgery were reduced to 72.8 and 65.2 µm, respectively (p<0.001 and p<0.001, respectively). The mean postoperative ganglion cell-inner plexiform layer + retinal nerve fiber layer thickness was also reduced at 1 and 3 months (108.8 and 99.3 µm, respectively; p<0.001 and p<0.001, respectively). No significant difference was found between the preoperative and postoperative best-corrected visual acuities at 1 and 3 months (p<0.73 and p<0.14, respectively). CONCLUSION: The macular ganglion cell-inner plexiform layer and ganglion cell-inner plexiform layer + retinal nerve fiber layer thicknesses were significantly reduced after vitrectomy with the inverted flap technique assisted with Brilliant Blue staining (0.05%) for idiopathic macular holes.


Assuntos
Perfurações Retinianas , Humanos , Estudos Prospectivos , Células Ganglionares da Retina , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos
4.
J Vitreoretin Dis ; 5(2): 99-107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-37009080

RESUMO

Purpose: This work examines the relationship between first- and third-month anatomical and visual response with antivascular endothelial growth factor for diabetic macular edema. Methods: We prospectively evaluated 58 eyes with center-involved diabetic macular edema. Response was categorized upon the anatomical status after 3 monthly doses based on the reduction of central macular thickness (CMT) from baseline (≥20% or not). Correlation analysis between the anatomical response status, gained letters, optical coherence tomography morphological features, and other baseline characteristics were obtained. Results: Twenty-five eyes (43.1%) achieved an anatomical reduction of ≥20% at the third month. Those with a reduction of ≥20% of CMT had subretinal fluid (P < .01), lower hemoglobin A1c values (P < .01), lower proportion of intraretinal cysts (P < .01), a greater anatomical reduction, and visual improvement at the first month of treatment. Multiple logistic regression analysis, showed that the change of CMT after the first injection was an independent predictor for the anatomical reduction of ≥20% after the loading phase (P < .05). Best corrected visual acuity gain after the first dose showed a significant association with an improvement of ≥10 letters after the loading phase (P < .05), but not for macular thickness reduction. Conclusions: First month anatomical reduction was associated with the anatomical response at 3 months (P = .042) after monthly ranibizumab therapy. Visual improvement at the first month was predictive only for the visual outcome after the 3 monthly doses (P = .032).

5.
Transl Vis Sci Technol ; 9(9): 27, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32879783

RESUMO

Purpose: High circulating levels of the hormone prolactin (PRL) protect against experimental diabetic retinopathy (DR) due to the retinal accumulation of vasoinhibin, a PRL fragment that inhibits blood vessel permeability and growth. A phase 2 clinical trial is investigating a new therapy for DR based on elevating serum PRL levels with levosulpiride, a prokinetic dopamine D2 receptor blocker. Here, we tested whether levosulpiride-induced hyperprolactinemia elevates PRL and vasoinhibin in the vitreous of volunteer patients with proliferative DR (PDR) undergoing elective pars plana vitrectomy. Methods: Patients were randomized to receive placebo (lactose pill, orally TID; n = 19) or levosulpiride (25 mg orally TID; n = 18) for the 7 days before vitrectomy. Vitreous samples from untreated non-diabetic (n = 10) and PDR (n = 17) patients were also studied. Results: Levosulpiride elevated the systemic (101 ± 13 [SEM] vs. 9.2 ± 1.3 ng/mL, P < 0.0001) and vitreous (3.2 ± 0.4 vs. 1.5 ± 0.2 ng/mL, P < 0.0001) levels of PRL, and both levels were directly correlated (r = 0.58, P < 0.0002). The vitreous from non-diabetic patients or from PDR patients treated with levosulpiride, but not from placebo-treated PDR patients, inhibited the basic fibroblast growth factor (bFGF)- and vascular endothelial growth factor (VEGF)-induced proliferation of endothelial cells in culture. Vasoinhibin-neutralizing antibodies reduced the vitreous antiangiogenic effect. Matrix metalloproteases (MMPs) in the vitreous cleaved PRL to vasoinhibin, and their activity was higher in non-diabetic than in PDR patients. Conclusions: Levosulpiride increases the levels of PRL in the vitreous of PDR patients and promotes its MMP-mediated conversion to vasoinhibin, which can inhibit angiogenesis in DR. Translational Relevance: These findings support the potential therapeutic benefit of levosulpiride against vision loss in diabetes.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Retinopatia Diabética/tratamento farmacológico , Células Endoteliais , Humanos , Prolactina , Sulpirida/análogos & derivados , Fator A de Crescimento do Endotélio Vascular , Corpo Vítreo
6.
Case Rep Ophthalmol ; 11(2): 315-321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774298

RESUMO

Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is not possible. We report the case of a 25-year-old female who presented complaining of blurred vision in her left eye associated with photopsias and metamorphopsias of 3 months duration. Initial visual acuity in the right eye was 20/20 and 20/100 in the left eye. Upon indirect ophthalmoscopy in the left eye, a yellow-white, dome-shaped, elevated lesion with foveal involvement was observed. The rest of the ophthalmological examination proved normal. With clinical findings and images, submacular cysticercosis was diagnosed, and vitreoretinal surgery was suggested. Nevertheless, the patient did not accept the treatment; therefore, medical management was initiated. Central nervous system involvement was ruled out, and treatment with praziquantel and systemic prednisolone was initiated. Cysticercosis was resolved with significant improvement of her symptoms and visual acuity.

7.
Medwave ; 20(2): e7831, 2020 Mar 03.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-32225130

RESUMO

INTRODUCTION: Macular hemorrhages result in a sudden and profound loss of vision. The primary treatment modalities include observation, intravitreal injection of antiangiogenic drugs, neodymium-doped yttrium aluminum garnet hialoidotomy, intravitreal injection of gas with or without tissue plasminogen activator, as monotherapy or combined with surgery. In this paper, we report four cases of macular hemorrhages of different causes treated with different approaches, and we review the literature in this regard. CASE PRESENTATION: All four patients presented different causes of macular hemorrhage. The first case had a preretinal hemorrhage due to a Valsalva retinopathy and was treated with surgery. Case 2 had a multilevel macular hemorrhage due to a rupture of a retinal arteriolar macroaneurysm and was treated with pneumatic displacement, laser, and intravitreal ranibizumab. Case 3 presented an extensive subretinal hemorrhage due to a choroidal rupture after high-energy ocular trauma that was also successfully treated with surgery. The last case was a preretinal hemorrhage due to diabetic retinopathy managed with neodymium-doped yttrium aluminum garnet laser. Different treatment approaches were successfully performed in all cases with good outcomes. CONCLUSION: There is an extensive range of options available for the management of macular hemorrhages, and the best option depends on the characteristics of each particular case. Proper and timely management of these diseases can achieve an excellent visual outcome, especially if the location of the hemorrhage is preretinal.


INTRODUCCIÓN: Las hemorragias maculares producen una pérdida de la visión súbita y profunda. Las principales modalidades de tratamiento incluyen observación, inyección intravítrea de fármacos antiangiogénicos, hialoidotomía con láser neodymium-doped yttrium aluminium garnet, inyección intravítrea de gas y/o activador de plasminógeno tisular, en monoterapia o combinadas con cirugía. En el presente trabajo reportamos cuatro casos de hemorragias maculares de distintas causas, tratadas con diferentes abordajes, y realizamos una revisión de la literatura al respecto. PRESENTACIÓN DE CASOS: Los cuatro pacientes mostrados presentaron diferentes causas de hemorragias maculares. El primer caso tuvo una hemorragia prerretiniana debido a retinopatía de Valsalva y fue tratado con cirugía, el Caso 2 tuvo una hemorragia macular multinivel debido a una rotura de un macroaneurisma arteriolar retiniano y fue manejado con desplazamiento neumático, láser y ranibizumab intravítreo, el Caso 3 presentó una hemorragia subretiniana extensa debido a rotura coroidea posterior a un trauma ocular cerrado de alta energía y fue tratado exitosamente con cirugía. El último caso presentó una hemorragia prerretiniana debido a retinopatía diabética, manejada con láser neodymium-doped yttrium aluminium garnet. Los diferentes tratamientos fueron realizados exitosamente con buenos resultados. CONCLUSIÓN: Existen amplias opciones disponibles para el manejo de las hemorragias maculares y la mejor opción depende de las características de cada caso en particular. El manejo apropiado y oportuno de éstas puede lograr un resultado visual bueno, especialmente si la localización de la hemorragia es prerretiniana.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Terapia a Laser , Hemorragia Retiniana/terapia , Corioide/patologia , Retinopatia Diabética/complicações , Humanos , Injeções Intravítreas , Hemorragia Retiniana/etiologia , Ruptura , Ativador de Plasminogênio Tecidual
8.
Medwave ; 20(1): e7772, 2020 Jan 28.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-32119652

RESUMO

BACKGROUND: Determining the precise location of intraocular foreign bodies is crucial for the management of patients with open-globe injury. Computed tomography is the most common method for detecting intraocular foreign bodies in the posterior segment. In this article, we describe three cases of open-globe injury with different types of intraocular foreign bodies in the posterior segment that were accurately located using computed tomography scans and B-scan ultrasonography. CASE PRESENTATION: Each of the three cases of open-globe injury described in this report had different types of ocular trauma, clinical symptoms, and intraocular foreign bodies. Computed tomography scans showed the exact location of the intraocular foreign bodies in the posterior segment in two of the three cases. A B-scan ultrasound was used to determine the location of a non-metallic intraocular foreign body in the third case. All three patients had intraocular foreign bodies, and one of them had an additional orbital foreign body. Case 1 had a perforating eye injury with the additional intraorbital foreign body; Cases 2 and Case 3 had different types of intraocular foreign bodies and prognoses. Various treatment approaches were used, ranging from observation to surgery, depending on the location of the intraocular foreign bodies, and all cases were successfully managed. These three cases show that proper use of various types of imaging tests is indispensable in the context of an intraocular foreign body related to open-globe injury. CONCLUSION: Imaging techniques are crucial for the detection of an intraocular foreign body, and computed tomography is one of the simplest and most useful, especially in cases of open-globe injury.


ANTECEDENTES: La ubicación precisa de un cuerpo extraño intraocular es crucial para el manejo de pacientes con trauma ocular abierto. La tomografía computarizada se usa habitualmente para detectar su ubicación en el segmento posterior. Reportamos tres casos con diferentes cuerpos extraños intraoculares en el segmento posterior, que fueron localizados con precisión mediante la tomografía computarizada y ecografía modo B. PRESENTACIÓN DEL CASO: Presentamos tres casos con diferentes mecanismos de trauma, tipos de cuerpo extraño intraocular, síntomas clínicos y pronóstico visual. La tomografía computarizada determinó la ubicación exacta de todos los cuerpos extraños intraoculares en el segmento posterior. El ultrasonido modo B se realizó en un paciente con un cuerpo extraño intraocular no metálico. El primer caso tuvo una lesión ocular perforante con un cuerpo extraño intraorbitario; el caso dos y el caso tres presentaron diferentes tipos de cuerpos extraños intraoculares con pronóstico diferente. El manejo y el pronóstico fue distinto en todos los casos; todos se manejaron con éxito. La ubicación exacta de los cuerpos extraños intraoculares utilizando las diferentes modalidades de diagnóstico es importante en estos pacientes. Estos casos sirven como recordatorio de que el uso adecuado de las pruebas de imagen es indispensable en el contexto de un cuerpo extraño intraocular relacionado con trauma ocular abierto. CONCLUSIÓN: Las diferentes técnicas de imágenes son muy importantes para la detección de un cuerpo extraño intraocular. La tomografía computarizada es una de las modalidades de imagen más simple y efectiva para la localización de cuerpos extraños intraoculares relacionadas con trauma ocular abierto.


Assuntos
Corpos Estranhos no Olho/diagnóstico por imagem , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia , Adolescente , Adulto , Traumatismos por Explosões/complicações , Traumatismos por Explosões/diagnóstico por imagem , Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/complicações , Vidro , Humanos , Imageamento por Ressonância Magnética , Masculino , Metais , Plásticos , Radiografia , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/diagnóstico por imagem
9.
Medwave ; 20(2): e7831, 31-03-2020.
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1095945

RESUMO

INTRODUCCIÓN: Las hemorragias maculares producen una pérdida de la visión súbita y profunda. Las principales modalidades de tratamiento incluyen observación, inyección intravítrea de fármacos antiangiogénicos, hialoidotomía con láser neodymium-doped yttrium aluminium garnet, inyección intravítrea de gas y/o activador de plasminógeno tisular, en monoterapia o combinadas con cirugía. En el presente trabajo reportamos cuatro casos de hemorragias maculares de distintas causas, tratadas con diferentes abordajes, y realizamos una revisión de la literatura al respecto. PRESENTACIÓN DE CASOS: Los cuatro pacientes mostrados presentaron diferentes causas de hemorragias maculares. El primer caso tuvo una hemorragia prerretiniana debido a retinopatía de Valsalva y fue tratado con cirugía, el Caso 2 tuvo una hemorragia macular multinivel debido a una rotura de un macroaneurisma arteriolar retiniano y fue manejado con desplazamiento neumático, láser y ranibizumab intravítreo, el Caso 3 presentó una hemorragia subretiniana extensa debido a rotura coroidea posterior a un trauma ocular cerrado de alta energía y fue tratado exitosamente con cirugía. El último caso presentó una hemorragia prerretiniana debido a retinopatía diabética, manejada con láser neodymium-doped yttrium aluminium garnet. Los diferentes tratamientos fueron realizados exitosamente con buenos resultados. CONCLUSIÓN: Existen amplias opciones disponibles para el manejo de las hemorragias maculares y la mejor opción depende de las características de cada caso en particular. El manejo apropiado y oportuno de éstas puede lograr un resultado visual bueno, especialmente si la localización de la hemorragia es prerretiniana.


INTRODUCTION: Macular hemorrhages result in a sudden and profound loss of vision. The primary treatment modalities include observation, intravitreal injection of antiangiogenic drugs, neodymium-doped yttrium aluminum garnet hialoidotomy, intravitreal injection of gas with or without tissue plasminogen activator, as monotherapy or combined with surgery. In this paper, we report four cases of macular hemorrhages of different causes treated with different approaches, and we review the literature in this regard. CASE PRESENTATION: All four patients presented different causes of macular hemorrhage. The first case had a preretinal hemorrhage due to a Valsalva retinopathy and was treated with surgery. Case 2 had a multilevel macular hemorrhage due to a rupture of a retinal arteriolar macroaneurysm and was treated with pneumatic displacement, laser, and intravitreal ranibizumab. Case 3 presented an extensive subretinal hemorrhage due to a choroidal rupture after high-energy ocular trauma that was also successfully treated with surgery. The last case was a preretinal hemorrhage due to diabetic retinopathy managed with neodymium-doped yttrium aluminum garnet laser. Different treatment approaches were successfully performed in all cases with good outcomes. CONCLUSION: There is an extensive range of options available for the management of macular hemorrhages, and the best option depends on the characteristics of each particular case. Proper and timely management of these diseases can achieve an excellent visual outcome, especially if the location of the hemorrhage is preretinal.


Assuntos
Humanos , Hemorragia Retiniana/terapia , Inibidores da Angiogênese/uso terapêutico , Terapia a Laser , Ruptura , Hemorragia Retiniana/etiologia , Corioide/patologia , Ativador de Plasminogênio Tecidual , Retinopatia Diabética/complicações , Injeções Intravítreas
10.
Medwave ; 20(1): e7772, 2020.
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1087876

RESUMO

ANTECEDENTES La ubicación precisa de un cuerpo extraño intraocular es crucial para el manejo de pacientes con trauma ocular abierto. La tomografía computarizada se usa habitualmente para detectar su ubicación en el segmento posterior. Reportamos tres casos con diferentes cuerpos extraños intraoculares en el segmento posterior, que fueron localizados con precisión mediante la tomografía computarizada y ecografía modo B. PRESENTACIÖN DEL CASO Presentamos tres casos con diferentes mecanismos de trauma, tipos de cuerpo extraño intraocular, síntomas clínicos y pronóstico visual. La tomografía computarizada determinó la ubicación exacta de todos los cuerpos extraños intraoculares en el segmento posterior. El ultrasonido modo B se realizó en un paciente con un cuerpo extraño intraocular no metálico. El primer caso tuvo una lesión ocular perforante con un cuerpo extraño intraorbitario; el caso dos y el caso tres presentaron diferentes tipos de cuerpos extraños intraoculares con pronóstico diferente. El manejo y el pronóstico fue distinto en todos los casos; todos se manejaron con éxito. La ubicación exacta de los cuerpos extraños intraoculares utilizando las diferentes modalidades de diagnóstico es importante en estos pacientes. Estos casos sirven como recordatorio de que el uso adecuado de las pruebas de imagen es indispensable en el contexto de un cuerpo extraño intraocular relacionado con trauma ocular abierto. CONCLUSIÓN Las diferentes técnicas de imágenes son muy importantes para la detección de un cuerpo extraño intraocular. La tomografía computarizada es una de las modalidades de imagen más simple y efectiva para la localización de cuerpos extraños intraoculares relacionadas con trauma ocular abierto.


BACKGROUND: Determining the precise location of intraocular foreign bodies is crucial for the management of patients with open-globe injury. Computed tomography is the most common method for detecting intraocular foreign bodies in the posterior segment. In this article, we describe three cases of open-globe injury with different types of intraocular foreign bodies in the posterior segment that were accurately located using computed tomography scans and B-scan ultrasonography. CASE PRESENTATION: Each of the three cases of open-globe injury described in this report had different types of ocular trauma, clinical symptoms, and intraocular foreign bodies. Computed tomography scans showed the exact location of the intraocular foreign bodies in the posterior segment in two of the three cases. A B-scan ultrasound was used to determine the location of a non-metallic intraocular foreign body in the third case. All three patients had intraocular foreign bodies, and one of them had an additional orbital foreign body. Case 1 had a perforating eye injury with the additional intraorbital foreign body; Cases 2 and Case 3 had different types of intraocular foreign bodies and prognoses. Various treatment approaches were used, ranging from observation to surgery, depending on the location of the intraocular foreign bodies, and all cases were successfully managed. These three cases show that proper use of various types of imaging tests is indispensable in the context of an intraocular foreign body related to open-globe injury. CONCLUSION: Imaging techniques are crucial for the detection of an intraocular foreign body, and computed tomography is one of the simplest and most useful, especially in cases of open-globe injury.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Tomografia Computadorizada por Raios X , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Corpos Estranhos no Olho/diagnóstico por imagem , Ultrassonografia , Plásticos , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/diagnóstico por imagem , Traumatismos por Explosões/complicações , Traumatismos por Explosões/diagnóstico por imagem , Imageamento por Ressonância Magnética , Radiografia , Ferimentos Oculares Penetrantes/complicações , Corpos Estranhos no Olho/etiologia , Vidro , Metais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA