ABSTRACT
RESUMO Objetivos: Traçar o perfil epidemiológico, clínico, evolução e desfechos dos pacientes com ceratocone diagnosticados no serviço de referência oftalmológica do estado de Santa Catarina, Brasil. Métodos: Foram analisados retrospectivamente os prontuários de todos os pacientes com ceratocone do setor de córnea do Hospital Regional de São José, entre Janeiro de 2016 e dezembro de 2018. Os seguintes dados foram extraídos: sexo, idade, estágio da doença, doenças sistêmicas, sintomas oftalmológicos, adaptação de lentes de contato, tratamentos prévios, melhor acuidade visual monocular, medidas ceratométricas, condutas oftalmológicas, desfechos clínicos. Resultados: Os prontuários de 267 pacientes foram avaliados. A média de idade foi de 23 anos (intervalo: 06 - 60 anos), 159 (59,55%) eram do sexo masculino. 12 (4,49%) pacientes já haviam realizado ceratoplastia penetrante; 22 (8,24%) haviam realizado crosslinking; 07 (2,62%) já possuíam implante de anel intraestromal. 81 (30,34%) pacientes já haviam adaptado lentes de contato. 168 (62,92%) possuíam acuidade visual corrigida, do melhor olho, igual ou superior a 20/40. Encontrou-se uma distribuição entre casos leves, moderados e graves de: 03 (1,12%), 78 (29,21%), 157 (58,80%), respectivamente. Ao longo do período, efetivaram-se 51 (73,9%) transplantes de córnea, 09 (90,0%) implantes de anel intraestromal, 35 (32,4%) crosslinking, 22 (23,4%) adaptações de lentes de contato; 205 (76,77%) pacientes perderam seguimento, 12 (4,49%) receberam alta. Conclusão: Os pacientes são em sua maioria jovens, com doença moderada a grave, e boa acuidade visual no melhor olho. Ainda assim, muitos receberam indicação de tratamento cirúrgico. A perda de seguimento clínico constitui um fator importante na qualidade da assistência oftalmológica desta população.
ABSTRACT Objectives: To describe the epidemiological and clinical profile, evolution and outcomes of keratoconus patients diagnosed in the ophthalmologic reference service of the state of Santa Catarina, Brazil. Methods: The medical records of all patients with keratoconus attended at the Cornea service of the Regional Hospital of São José, between January 2016 and December 2018 were retrospectively analyzed. The following data were extracted: sex, age, disease stage, systemic diseases, ophthalmological symptoms, adaptation of contact lenses, previous treatments, best monocular visual acuity, keratometric measurements, ophthalmological procedures, clinical outcomes. Results: The medical records of 267 patients were analyzed. The average age was 23 years (range: 06 - 60 years), 159 (59.55%) were male. 12 (4.49%) patients had already performed penetrating keratoplasty; 22 (8.24%) had performed crosslinking; 07 (2.62%) had already an intrastromal ring implant. 81 (30.34%) patients had already adapted contact lenses. 168 (62.92%) had best corrected visual acuity, of the better eye, equal to or greater than 20/40. A distribution between cases was found light, moderate and severe of: 03 (1.12%), 78 (29.21%), 157 (58.80%), respectively. Throughout the period, a total of 51 (73,9%) corneal transplants, were performed 09 (90,0%) intrastromal ring implants, 35 (32,4%) crosslinking, 22 (23,4%) contact lens adaptations were performed; 205 (76.77%) patients lost follow-up, 12 (4.49%) were discharged. Conclusion: The patients are mostly young, with moderate to severe illness and good visual acuity in the best eye. Even so many received a surgical management. The loss of clinical follow-up is an important factor in the quality of ophthalmic care in this population.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Tertiary Care Centers , Keratoconus/diagnosis , Keratoconus/epidemiology , Retrospective Studies , Cohort Studies , Observational StudyABSTRACT
Urinalysis is one of the basic laboratory tests in patient care and routine examinations. But few studies have been carried out about the prevalence of proteinuria and hematuria in Korea, especially in tertiary referral hospital, and the meanings of them are not clear until now. So we performed a cross- sectional study to find out the prevalence of proteinuria and hematuria at a tertiary referral hospital, Seoul National University Hospital. From Jan. 1. 1995 to Dec. 31. 1995, there were 35,361 adults (17,123 males and 18,238 females) in whom urinalyses were carried out. The age of them ranged from 15 to 96 years and the average was 49 years with the distribution of 2.3% in 15-19 years, 10.6% in 20-29 years, 16.0% in 30-39 years, 19.6% in 40-49 years, 24.3% in 50-59 years, 19.2% in 60-69 years, and 8.0% in 70 years or older. The degree of proteinuria was classified to '-', '+/-', '+', '++', '+++' by dipstick method. In males, 80.0% were '-', 6.3% '+/-, 6.8% '+', 3.7% '++', 3.2% '+++', and 5.0% '+/-', 5.1% '+', 2.8% '++', 2.1% '+++' in females. Proteinuria of degree '+/-' or higher was defined as significant and found in 19.9% of males and 14.9% of females. According to the age groups, 17.0% in 15 to 19 years, 17.3% in 20 to 29 years, 16.3% in 30 to 39 years, 15.2% in 40 to 49 years, 16.8% in 50 to 59 years, 18.6% in 60 to 69 years, 23.6% in 70 years or older had significant proteinuria. Hematuria was classified by the number of erythrocytes per 400X high-power field, to grade 1 (30), 6 (many). In males, 62.9% were grade 1, 23.5% grade 2, 5.3% grade 3, 3.9% grade 4, 1.9% grade 5, 2.6% grade 6, and 47.4% grade 1, 32.6% grade 2, 8.8% grade 3, 5.3% grade 4, 2.4% grade 5, 3.4% grade 6 in females. Hematuria of grade 3 or higher was defined as significant and found in 13.6% of males and 20.0% of females. According to the age groups, 11.1% in 15 to 19 years, 13.7% in 20 to 29 years, 16.8% in 30 to 39 years, 17.4% in 40 to 49 years, 16.7% in 50 to 59 years, 18.0% in 60 to 69 years, 19.9% in 70 years or older had significant hematuria.