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1.
Graefes Arch Clin Exp Ophthalmol ; 257(7): 1459-1466, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31053943

RESUMO

PURPOSE: To investigate long-term effect (96 months) of intravitreal ranibizumab administered for exudative age-related macular degeneration (AMD) on retinal nerve fiber layer (RNFL) thickness when used following a pro re nata regimen. METHODS: In this prospective study, 20 eyes of 20 patients diagnosed with exudative AMD were included. Contralateral non-exudative AMD eyes of nine of these patients were included as controls. Data on intraocular pressure (IOP) and number of injections were recorded. Spectralis optic coherence tomography (OCT) of the circumpapillary RNFL was performed under dilation when diagnosis was made and before the three loading injections. "Follow-up" software was selected to accurately compare baseline with subsequent images through the 8 years of the study. RESULTS: Baseline IOP was 14.1 mmHg both in study (standard deviation, SD: 0.8) and control eyes (SD: 0.9) and remained unchanged during the study. Mean number of injections was 21 (SD: 2.8) at the end of the study. Mean average thickness of RNFL in the study eye group at the end of the study was 96.5 µm (SD: 2.1). Mean loss for the study period was 5.3 µm (SD: 0.7; p < 0.0001). Corresponding RNFL values for controls were 92.9 (SD: 3.2) and 5.8 µm (SD: 1.2; p < 0.001). Superior temporal sector had the greatest loss in both groups, followed by inferior and nasal sectors. No statistically significant differences were found when comparing losses in injected eyes versus control eyes. CONCLUSIONS: RNFL thickness decreased both equally in injected eyes and control eyes. Thus, no long-term effects of intravitreal ranibizumab were observed on the retinal nerve fiber layer thickness.


Assuntos
Fibras Nervosas/patologia , Ranibizumab/administração & dosagem , Células Ganglionares da Retina/patologia , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Pressão Intraocular/efeitos dos fármacos , Pressão Intraocular/fisiologia , Injeções Intravítreas , Masculino , Fibras Nervosas/efeitos dos fármacos , Estudos Prospectivos , Células Ganglionares da Retina/efeitos dos fármacos , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual , Degeneração Macular Exsudativa/diagnóstico
2.
Semin Ophthalmol ; 31(3): 271-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-25375636

RESUMO

PURPOSE: To describe the prevalence of epiphora and associated factors after uncomplicated phacoemulsification. METHODS: Prospective and descriptive design. A group of 125 patients was asked about tearing one to two weeks after cataract surgery. A comprehensive examination was performed on the patients who answered affirmatively. All patients were re-interviewed by phone after three months and those who complained of epiphora were explored again. RESULTS: Two weeks after surgery, prevalence of epiphora was 10.4%, but only 3.2% appeared after surgery. In patients with preoperative epiphora, the most frequently associated factors were ocular surface alterations (89%) and unctual and canalicular stenosis (56%). In patients with "new onset" epiphora (4 patients), these factors were: blepharitis (2/4), low tear break-up time (2/4), high tear meniscus (2/4), partial nasolacrimal duct obstruction (2/4), and unctual stenosis (1/4). Three months after surgery, the prevalence of epiphora was 13%, but only 7% appeared after surgery (6 patients). Of those 6 patients, 4 were re-examined: nasolacrimal duct obstruction (2/4), ocular surface problems (3/4), and unctual stenosis (1/4). CONCLUSIONS: Presence of epiphora two weeks after phacoemulsification was infrequent, despite being present in a high proportion of patients before surgery. There was not a noticeable increase in epiphora at three months. The most frequently related factors were mixed disorders of the ocular surface and lacrimal system, without an important incidence of unctual and canalicular stenosis. We consider that our perception about complaints from patients after phacoemulsification may be biased due to those who had previously suffered from epiphora.


Assuntos
Doenças do Aparelho Lacrimal/epidemiologia , Facoemulsificação , Complicações Pós-Operatórias , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Dexametasona/uso terapêutico , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Doenças do Aparelho Lacrimal/diagnóstico , Doenças do Aparelho Lacrimal/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Lágrimas/química , Tobramicina/uso terapêutico
3.
Invest Ophthalmol Vis Sci ; 53(10): 6214-8, 2012 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-22915037

RESUMO

PURPOSE: To assess the effects of intravitreal ranibizumab therapy on intraocular pressure (IOP) and retinal nerve fiber (RNFL) thickness. METHODS: Forty-nine eyes of 49 patients with neovascular age-related macular degeneration (AMD) treated with intravitreal ranibizumab injections and 27 fellow eyes not requiring treatment were followed for 1 year. RNFL thickness, as measured by Fourier domain optical coherence tomography, and IOP were determined pre- and postinjection. RESULTS: After 12 months, the mean number of injections received was 4.8 ± 1.6. The incidence of IOP elevations (>5 mm Hg over baseline) observed at the time of injection was 0.4%. Baseline RNFL thickness was 105.7 ± 12.2 µm in the treatment group compared with 101.8 ± 11.6 µm in the control group (P = 0.176). At the end of follow-up, significant RNFL thinning was noted in the treatment group (100.2 ± 11.0 µm, P < 0.001), whereas no differences were found in the control group (100.5 ± 10.8 µm, P = 0.477). CONCLUSIONS: Intravitreal ranibizumab injections used to treat AMD caused a significant change in RNFL thickness after 12 months of follow-up.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Degeneração Macular/tratamento farmacológico , Fibras Nervosas/efeitos dos fármacos , Retina/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Análise de Fourier , Humanos , Pressão Intraocular/efeitos dos fármacos , Injeções Intravítreas , Degeneração Macular/patologia , Degeneração Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Prospectivos , Ranibizumab , Retina/patologia , Tomografia de Coerência Óptica/métodos
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