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1.
Int Ophthalmol ; 43(7): 2533-2543, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36869977

RESUMO

PURPOSE: To investigate microcirculation characteristics of the inner retinal layers at the macula and the peripapillary area using Optical Coherence Tomography Angiography (OCT-A) of patients in early stages of Parkinson's disease (PD). METHODS: 32 PD patients and 46 age- and gender-matched healthy controls were included in this cross sectional study. OCT-A imaging was performed to analyze microcirculation characteristics at each separate macular region (fovea, parafovea, and perifovea) and the peripapillary area of the inner retinal layers. RESULTS: Individuals with PD had significantly lower parafoveal, perifoveal and total vessel density (VD) in the superficial capillary plexus (SCP) than controls (all p < 0.001), while foveal VD was higher in PD eyes than that of controls, though not statistically significant. Similarly, individuals with PD had significantly lower parafoveal, perifoveal and total perfusion in the SCP than control eyes (all p < 0.001), while foveal perfusion was significantly higher in PD eyes than that of controls (p = 0.008). PD eyes had significantly smaller FAZ area and perimeter accompanied by decreased circularity at the SCP as compared to controls (all p < 0.001). Concerning the peripapillary area, individuals with PD had significantly lower radial peripapillary capillary perfusion density and flux index at the SCP than controls (all p < 0.001). All p values remained statistically significant even after using the Bonferroni correction for multiple comparisons, except for that of foveal perfusion. CONCLUSIONS: Our study indicates alterations of the inner retinal layers at the macula and the peripapillary area at the preliminary stages of PD. OCT-A parameters could potentially comprise imaging biomarkers for PD screening and improve the diagnostic algorithms.


Assuntos
Doença de Parkinson , Vasos Retinianos , Humanos , Estudos Transversais , Angiofluoresceinografia/métodos , Vasos Retinianos/diagnóstico por imagem , Doença de Parkinson/diagnóstico , Microvasos , Tomografia de Coerência Óptica/métodos
2.
Int Ophthalmol ; 43(10): 3633-3650, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37428299

RESUMO

PURPOSE: To analyse the demography, etiology, and classification of uveitis at a tertiary academic referral center. METHODS: An observational study was conducted on the archives of uveitic patients at the Ocular Inflammation Service of the Department of Ophthalmology at the University Hospital of Ioannina (Greece) from 1991 to 2020. This study aimed to investigate the epidemiological profile of patients, including their demographics and the main etiologic factors of uveitis. RESULTS: Out of 6191 cases with uveitis, 1925 were infectious, 4125 were non-infectious, and an overall of 141 masquerade syndromes were recorded. Among these cases, 5950 patients were adults, with a slight female predominance, while 241 were children (< 18 years old). Interestingly, 24.2% of cases (1500 patients) were associated with 4 specific microorganisms. Herpetic uveitis (HSV-1 and VZV/HZV) was the most common cause of infectious uveitis (14.87%), followed by toxoplasmosis (6.6%) and tuberculosis (2.74%). In 49.2% of non-infectious uveitis cases, no systematic correlation was found. The most frequent causes of non-infectious uveitis included sarcoidosis, white dot syndromes, ankylosing spondylitis, lens-induced uveitis, Adamantiades-Behçet disease, and idiopathic juvenile arthritis. Infectious uveitis was more common in the rural population, whereas non-infectious uveitis was more frequently recorded in the urban population CONCLUSIONS: Although our study was conducted on a predominantly white Caucasian population, it also reflects the effect of increasing immigration, improvements of diagnostic techniques, changes in referral patterns, and various actual changes in disease incidence.


Assuntos
Síndrome de Behçet , Uveíte , Adulto , Criança , Humanos , Feminino , Adolescente , Masculino , Uveíte/diagnóstico , Uveíte/epidemiologia , Uveíte/etiologia , Síndrome de Behçet/complicações , Síndrome de Behçet/epidemiologia , Centros de Atenção Terciária , Morbidade , Encaminhamento e Consulta , Estudos Retrospectivos
3.
Orbit ; : 1-3, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35730243

RESUMO

This study aims to report an acute dacryocystitis associated with Raoultella planticola infection. The patient's medical records and laboratory were thoroughly assessed. A thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items. This is the first recorded case of acute dacryocystitis attributed to Raoultella planticola infection. A limited number of studies has related this pathogen with conjunctivitis. Acute dacryocystitis on rare occasions can also be caused by atypical organisms. Swabs must be obtained and patients must be started on empirical treatment while waiting for the laboratory results.

4.
Int Ophthalmol ; 42(12): 3977-3991, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35604623

RESUMO

PURPOSE: The retina may provide a window to estimate systemic vascular status; therefore, there has been interest in identifying microcirculation characteristics that possibly reflect hypoxic alterations in obstructive sleep apnea/hypopnea syndrome (OSAS). Emerging evidence has suggested that retinal microvasculature investigation holds the potential to characterize the pathophysiology involved in ocular manifestations of OSAS. The advent of optical coherence tomography angiography (OCT-A) has attracted significant attention as this technique offers detailed analysis of the retinal capillary plexus. METHODS: A detailed literature search was performed in PubMed database until December 2021. We identified and reviewed all papers referring to the alterations of the retinal capillary plexus in OSAS using OCT-A. RESULTS: A comprehensive update indicates that microcirculation alterations of the retinal capillary plexus utilizing OCT-A may differ with severity of OSAS and imply the potential underlying pathophysiology of ocular manifestations. The reviewed series have revealed variability concerning microvasculature characteristics at the macular and the peripapillary area. Further studies are warranted to establish the OCT-A parameters as biomarkers regarding the evaluation of OSAS in clinical practice. CONCLUSION: Retinal capillary plexus characteristics as seen on OCT-A reflect microvasculature alterations, potentially leading to concomitant ocular comorbidity in the context of OSAS. The reviewed literature may confirm the diagnostic and prognostic value of OCT-A in the assessment of the pathophysiology of ocular manifestations in OSAS and highlight unmet needs to be addressed by future research.


Assuntos
Apneia Obstrutiva do Sono , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Microcirculação , Retina , Angiografia , Vasos Retinianos , Angiofluoresceinografia/métodos
5.
Doc Ophthalmol ; 142(3): 283-292, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33381858

RESUMO

PURPOSE: To review the evidence on the usefulness of the multifocal visual evoked potential (mfVEP) test in patients with optic neuritis (ON) and/or multiple sclerosis (MS). METHODS: We critically review key published evidence on the use of mfVEP in ON/MS patients and its association with other functional and structural tests. RESULTS: Multifocal VEP tests are useful in detecting abnormality in patients with ON/MS and monitor the progression of lesions (remyelination, atrophy). In addition, mfVEP has good correlation with conventional visual evoked potential (VEP), standard automated perimetry, optical coherence tomography and magnetic resonance imaging. In patients with ON, mfVEP might be useful in predicting the risk of conversion to MS.


Assuntos
Esclerose Múltipla , Neurite Óptica , Eletrorretinografia , Potenciais Evocados Visuais , Humanos , Esclerose Múltipla/diagnóstico , Neurite Óptica/diagnóstico , Testes de Campo Visual
6.
Postgrad Med J ; 97(1146): 256-263, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32788313

RESUMO

Neuro-ophthalmological emergency disorders typically present with symptoms of visual loss, diplopia, ocular motility impairment or anisocoria. The ocular manifestations of these disorders are sometimes indicative of a more serious global neurology disease rather than an isolated ocular disease. The aim of this review is to highlight four important neuro-ophthalmological emergency disorders that must not be missed by an ophthalmologist. These include acute painful Horner's syndrome, painful cranial nerve III palsy, giant cell arteritis and transient ischaemic attack with amaurosis fugax. The delayed diagnosis of these clinical entities puts the patient at risk of blindness or death. Therefore, prompt diagnosis and management of these conditions are essential. This can be acquired from understanding the main signs and symptoms of the disease presentation together with a high index of suspicion while working at a busy eye emergency department.


Assuntos
Cegueira/etiologia , Serviço Hospitalar de Emergência , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Síndrome de Horner/complicações , Síndrome de Horner/diagnóstico , Humanos , Ataque Isquêmico Transitório/complicações , Ataque Isquêmico Transitório/diagnóstico , Doenças do Nervo Oculomotor/complicações , Doenças do Nervo Oculomotor/diagnóstico
7.
Int Ophthalmol ; 41(12): 4111-4126, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34297303

RESUMO

PURPOSE: Analysis of cases with spirochetal uveitis related to spirochetes in a tertiary referral academic center. METHODS: Retrospective study of patients diagnosed with uveitis attributed to Treponema pallidum, Leptospira spp. and Borrelia burgdorferi from June 1991 until December 2019. RESULTS: A total of 57 cases of spirochetal uveitis (22 patients with T. pallidum, 26 with Leptospira spp., and 9 with B. burgdorferi) that consisted 1% of the overall number of uveitics were recorded. All these cases presented with a wide spectrum of clinical presentations (anterior uveitis, posterior uveitis, panuveitis, vasculitis, papillitis, and in some rare cases concomitant posterior scleritis). The treatment included mainly penicillin or doxycycline, while corticosteroids were administered systematically in some cases with Borrelia or Leptospira infection. The final visual outcome was favorable (> 6/10 in Snellen visual acuity) in approximately 76% of our patients. CONCLUSION: Despite being rare, spirochetal uveitis can be detrimental for the vision and must always be included in the differential diagnosis.


Assuntos
Esclerite , Sífilis , Uveíte , Humanos , Estudos Retrospectivos , Spirochaetales , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/epidemiologia
8.
Rheumatol Int ; 40(4): 671-677, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31392499

RESUMO

Immunoglobulin G4-related disease (IgG4RD) is a systemic fibro-inflammatory disease of unknown aetiology, which is characterized by tumefactive lymphoplasmatocytic infiltrative lesions, with a predominance of IgG4 positive plasma cells, fibrosis and obliterative phlebitis. Adult-onset asthma and periocular xanthogranuloma (AAPOX) is a rare disease of unknown aetiology characterized by violaceous or yellow cutaneous papules and nodules usually accompanied with adult-onset asthma. We report a case of IgG4RD associated with AAPOX. We also conducted a literature search with keywords including IgG4RD and AAPOX. A 36-year-old woman presented with bilateral exophthalmos and periorbital oedema. Keratoconjunctivitis sicca, painless left parotid gland and submandibular left lymph node enlargement were also noted. Two and half years ago biopsy of yellow plaques of her right lower eyelid confirmed periorbital xanthogranuloma. She underwent parotid gland biopsy which showed IgG4RD. She was treated with steroids and two cycles of rituximab with complete remission. The literature review revealed 8 articles describing 14 cases with IgG4RD and AAPOX, 9 men and 5 women (ratio M:F = 1.8:1) were affected. The age at diagnosis was greater in men compared to women. In the majority of patients, ophthalmic presentation included bilateral upper and lower eyelid swelling while systemic features were asthma, lacrimal and parotid involvement, lymphadenopathy, sclerosing pancreatitis and sclerosing cholangitis. Prednisone and rituximab were effective treatments. It has to be clarified whether the association between IgG4RD and AAPOX represents shared pathophysiology, a common underlying cause or coincidence. Rituximab added to steroids resulted in complete remission of the two entities.


Assuntos
Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Rituximab/uso terapêutico , Adulto , Asma/complicações , Asma/diagnóstico , Oftalmopatias/complicações , Oftalmopatias/diagnóstico por imagem , Oftalmopatias/patologia , Feminino , Granuloma/complicações , Granuloma/tratamento farmacológico , Granuloma/patologia , Humanos , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Xantomatose/complicações , Xantomatose/diagnóstico por imagem , Xantomatose/patologia
9.
Graefes Arch Clin Exp Ophthalmol ; 257(6): 1061-1078, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30706134

RESUMO

PURPOSE: The purpose of this review is to provide an update on current management and recent research for amblyopia treatment. Part I will review patching, atropine penalization, and pharmacological treatments. Part II will focus on perceptual learning, video gaming, and binocular dichoptic approaches. METHODS: A literature search was performed in PubMed, ClinicalTrials.gov , Google Scholar, and reference lists of retrieved articles until December 20, 2018, for all papers containing "amblyopia treatment" or "amblyopia therapy." We have included RCTs, prospective observational studies, prospective and retrospective cohort studies, pilot studies, and review articles. RESULTS: The mainstay of treatment for amblyopia has been based on increasing visual stimulation of the amblyopic eye by occlusion, atropine, or optical penalization of the dominant eye. It has been established that refractive adaptation alone can significantly enhance visual acuity. However, the duration of optical correction varies between studies and the effectiveness of spectacle wear over early beginning of patching is still under investigation. Additionally, by means of occlusion dose monitors, it was found that adherence to occlusion affects the outcome, as a dose-response relationship exists between adherence and visual acuity. Treatment efficiency declines with age; however, recent evidence indicates cortical plasticity beyond the "critical period" and recommends that an attempt at treatment should be offered to all amblyopic children regardless of age, including those in later childhood. Novel approaches targeted to the restoration of binocular functions, such as perceptual learning, video gaming, and dichoptic training, have shown small effects on visual acuity and have failed to demonstrate non-inferiority over standard treatments. CONCLUSIONS: On review, significant evidence for the successful management of amblyopia, with occlusion therapy and atropine, has been found. However, the management of amblyopia remains challenging, mainly due to compliance issues and suboptimal treatment outcomes during occlusion and atropine penalization. Recent studies have found evidence of new ways of treating amblyopia particularly in regard to binocular treatment although these remain under investigation. Further robust clinical trials on these new treatment modalities are still warranted in order to establish their role in treating amblyopia.


Assuntos
Ambliopia/terapia , Atropina/administração & dosagem , Óculos , Refração Ocular/fisiologia , Visão Binocular/fisiologia , Acuidade Visual , Ambliopia/fisiopatologia , Humanos , Midriáticos/administração & dosagem , Soluções Oftálmicas , Privação Sensorial , Resultado do Tratamento
10.
Int Ophthalmol ; 39(1): 213-217, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29582258

RESUMO

BACKGROUND: To report midterm outcomes of strabismus strategy for management of diplopia in chronic progressive external ophthalmoplegia and specific surgical planning rationale. DESIGN: Retrospective interventional case series. RESULTS: Two patients, a 26-year-old male and a 36-year-old female, diagnosed with chronic progressive external ophthalmoplegia presented with blepharoptosis and intermittent diplopia. Ocular motility examination was significant for bilateral profound impairment of adduction with relative preservation of abduction, infraduction and elevation. Control of intermittent exotropia gradually worsened over 3 and 1.5 years of follow-up, respectively, in the presence of documented stability of the angle of exodeviation. Strabismus surgery involving modest amounts of bilateral medial rectus resection and lateral rectus recessions was undertaken. Surgical intervention was successful in controlling alignment in primary position and alleviating diplopia and asthenopia after 9 and 8 years of follow-up time, respectively, despite slow progression of ophthalmoplegia. CONCLUSION: Bilateral selective impairment of adduction and intermittent exotropia may be the presenting ocular motility disturbance in chronic progressive external ophthalmoplegia. Properly designed strabismus surgery may provide sustainable, in the midterm, control of alignment and symptomatic relief in selected patients with CPEO.


Assuntos
Diplopia/cirurgia , Movimentos Oculares/fisiologia , Músculos Oculomotores/cirurgia , Oftalmoplegia Externa Progressiva Crônica/cirurgia , Refração Ocular/fisiologia , Estrabismo/cirurgia , Acuidade Visual , Adulto , Diplopia/etiologia , Diplopia/fisiopatologia , Feminino , Humanos , Masculino , Músculos Oculomotores/fisiopatologia , Oftalmoplegia Externa Progressiva Crônica/complicações , Oftalmoplegia Externa Progressiva Crônica/fisiopatologia , Estudos Retrospectivos , Estrabismo/complicações , Estrabismo/fisiopatologia
11.
Int Ophthalmol ; 39(11): 2505-2515, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30852734

RESUMO

PURPOSE: To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD). METHODS: This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out. RESULTS: This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications. CONCLUSION: CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.


Assuntos
Bartonella henselae/isolamento & purificação , Bartonella quintana/isolamento & purificação , Doença da Arranhadura de Gato/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Febre das Trincheiras/diagnóstico , Uveíte/diagnóstico , Adolescente , Adulto , Idoso , Doença da Arranhadura de Gato/microbiologia , Criança , Corioide/patologia , Diagnóstico Diferencial , Infecções Oculares Bacterianas/microbiologia , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/patologia , Retina/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia de Coerência Óptica , Febre das Trincheiras/microbiologia , Uveíte/microbiologia , Adulto Jovem
12.
Graefes Arch Clin Exp Ophthalmol ; 256(7): 1217-1224, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29619550

RESUMO

PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed. RESULTS: Apart from the updated modified criteria, OCT has been found to be important for the diagnosis of IIH, along with assessment of clinical signs and symptoms, brain imaging, and lumbar puncture. On the other hand, there is no current consensus for the management of IIH, but various interventions have been used, such as dietary therapy (weight loss, bariatric surgery, lifestyle modification, low-salt diet), medications, and surgical treatment. CONCLUSIONS: IIH is a challenging and serious disorder, which may lead to permanent visual impairment if there is a delay in its diagnosis. Advances in retinal imaging have led to better understanding of the pathogenesis of the disease and prompt diagnosis even in subtle cases can be done using OCT. Surgical interventions should be minimized and only used in cases refractory to medical treatment and in those with rapid progression.


Assuntos
Gerenciamento Clínico , Pseudotumor Cerebral , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Baixa Visão , Adulto , Humanos , Pseudotumor Cerebral/complicações , Pseudotumor Cerebral/diagnóstico , Pseudotumor Cerebral/terapia , Baixa Visão/diagnóstico , Baixa Visão/etiologia , Baixa Visão/terapia
13.
Optom Vis Sci ; 95(11): 1077-1082, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30339636

RESUMO

SIGNIFICANCE: Bilateral strokes are rare and should be considered when patients present with bilateral visual field loss characterized by patterns consistent with right and left-sided homonymous visual field defects. Perimetry, dilated funduscopy, and immediate neuroimaging are mandatory for diagnosis, because patients may present with vague symptoms. These cases reflect the retinotopic features of the striate cortex. PURPOSE: The purposes of this study were to describe the unusual presentation of bilateral homonymous visual field defects in three patients with bilateral ischemic strokes and to discuss the clinical and neuroanatomical correlations. CASE REPORTS: Neuro-ophthalmological examination including perimetry and brain magnetic resonance imaging (MRI) was performed in three patients with bilateral homonymous scotomas. Two of three patients presented with superior altitudinal hemianopia, resulting from right and left homonymous superior quadrantanopia due to bilateral occipital strokes below the calcarine fissure. A 57-year-old man (patient 1) with a history of atrial fibrillation presented with driving difficulties. Perimetry revealed bilateral superior altitudinal hemianopia. Brain MRI demonstrated a subacute right occipital stroke and a chronic left occipital stroke, both inferior to the calcarine fissure. An 83-year-old woman (patient 2) presented with reading disorders. Perimetry showed a left incomplete homonymous hemianopia and a right horizontal wedge-shaped homonymous scotoma. Brain MRI showed a chronic ischemic stroke in the left occipital lobe and acute ischemia in the right thalamus. A 40-year-old man (patient 3) was referred with headache, disorientation, and bilateral blurry vision. Perimetry showed bilateral superior altitudinal hemianopia, and MRI demonstrated acute bilateral occipital ischemia. Patients 1 and 2 suffered sequential bilateral strokes and were not aware of the initial scotoma, whereas patient 3 presented with bilateral concurrent strokes. CONCLUSIONS: Bilateral homonymous visual field defects due to bilateral strokes are rare. Patient history, a careful neuro-ophthalmological examination, and correlation of visual field defect patterns with neuroimaging should prompt the clinician to the presence of this unique entity.


Assuntos
Isquemia Encefálica/complicações , Hemianopsia/etiologia , Imageamento por Ressonância Magnética/métodos , Córtex Visual/diagnóstico por imagem , Campos Visuais/fisiologia , Adulto , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Feminino , Hemianopsia/diagnóstico , Hemianopsia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Visual/fisiopatologia , Testes de Campo Visual/métodos
14.
J BUON ; 23(3): 826-831, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30003758

RESUMO

PURPOSE: Pterygium is a distinct clinicopathological entity characterized by degenerated and neoplastic-like features. Concerning its rise on normal conjunctiva epithelia, the role of specific gene deregulations including apoptotic/anti-apoptotic factors and significant suppressor genes in signaling transduction pathways is under investigation. In the current study, we co-analyzed p53, survivin and PTEN proteins in pterygia and normal conjunctiva. METHODS: Using a liquid-based cytology assay, 50 cell specimens were obtained by a smooth scraping on conjunctiva epithelia and fixed accordingly. Among them, 38 were pterygia and the remaining (n=12) normal epithelia (control group). Immunocytochemistry assays were implemented on the corresponding slides by applying ani-p53, survivin, and PTEN antibodies. Digital image analysis was performed for evaluating objectively the corresponding immunostaining intensity levels. RESULTS: The majority of the examined pterygia cases overexpressed the markers p53:22/38-57.9%, survivin:30/38-78.9%, and PTEN:25/38-65.7%. Interestingly, overall p53/PTEN co-expression was found to be statistically significant (p=0.022). CONCLUSIONS: Survivin overexpression leads to an increased anti-apoptotic activity playing a central molecular role in the pathogenesis and progression of pterygia. Furthermore, although p53 expression is observed in these lesions, its impact seems to be low compared to survivin's influence on them. Additionally, the role of PTEN in the process is potentially significant providing a suppressor balance to the p53/ survivin complex.


Assuntos
PTEN Fosfo-Hidrolase/metabolismo , Pterígio/metabolismo , Survivina/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Apoptose/fisiologia , Biomarcadores Tumorais/metabolismo , Túnica Conjuntiva/anormalidades , Túnica Conjuntiva/metabolismo , Feminino , Humanos , Imuno-Histoquímica/métodos , Proteínas Inibidoras de Apoptose/metabolismo , Masculino , Pessoa de Meia-Idade , Transdução de Sinais/fisiologia
15.
Acta Medica (Hradec Kralove) ; 60(4): 160-162, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29716683

RESUMO

We present the case of a female patient who grinded a ferrous sulfate tablet and placed it at the conjunctival fornix of her left eye. She rapidly developed severe ocular siderosis, with profoundly decreased visual acuity, corneal opacities, cataract, retinal degeneration and ultimately phthisis bulbi. To our knowledge, this is the first report on the consequences of application of an iron tablet on the conjunctiva.


Assuntos
Distúrbios Induzidos Quimicamente , Oftalmopatias , Compostos Ferrosos/efeitos adversos , Esquizofrenia/complicações , Distúrbios Induzidos Quimicamente/diagnóstico , Distúrbios Induzidos Quimicamente/etiologia , Distúrbios Induzidos Quimicamente/fisiopatologia , Distúrbios Induzidos Quimicamente/terapia , Técnicas de Diagnóstico Oftalmológico , Oftalmopatias/induzido quimicamente , Oftalmopatias/diagnóstico , Oftalmopatias/fisiopatologia , Oftalmopatias/terapia , Feminino , Hematínicos/efeitos adversos , Humanos , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Resultado do Tratamento
16.
J BUON ; 21(2): 516-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27273967

RESUMO

Head and neck cancers demonstrate an increased prevalence worldwide. The main therapeutic approaches are still surgery and radiotherapy, although in selective cases novel targeted therapeutic strategies based on monoclonal antibodies (ie anti-EGFR) are also applied. Concerning maxillofacial surgical oncology, a variety of methods has been developed. Among them the functional neck dissection technique seems to be a reliable and significant surgical approach, especially in removing identified cervical metastatic lymph node(s). In this technical paper, we focused on the method, its modifications adding our experience and also the challenges that arise in the modern robotic-based era regarding head and neck surgery.


Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Esvaziamento Cervical/métodos , Procedimentos Cirúrgicos Robóticos , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática , Esvaziamento Cervical/efeitos adversos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
17.
Nat Genet ; 38(11): 1242-4, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17013395

RESUMO

Idiopathic congenital nystagmus is characterized by involuntary, periodic, predominantly horizontal oscillations of both eyes. We identified 22 mutations in FRMD7 in 26 families with X-linked idiopathic congenital nystagmus. Screening of 42 singleton cases of idiopathic congenital nystagmus (28 male, 14 females) yielded three mutations (7%). We found restricted expression of FRMD7 in human embryonic brain and developing neural retina, suggesting a specific role in the control of eye movement and gaze stability.


Assuntos
Proteínas do Citoesqueleto/genética , Genes Ligados ao Cromossomo X , Proteínas de Membrana/genética , Nistagmo Congênito/genética , Encéfalo/embriologia , Encéfalo/metabolismo , Mapeamento Cromossômico , Cromossomos Humanos X , Proteínas do Citoesqueleto/fisiologia , Movimentos Oculares/genética , Movimentos Oculares/fisiologia , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Ligação Genética , Humanos , Masculino , Proteínas de Membrana/fisiologia , Mutação/fisiologia , Linhagem , Retina/metabolismo
18.
Acta Medica (Hradec Kralove) ; 57(4): 165-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25938901

RESUMO

Capsular bag distension syndrome is a very rare complication of cataract surgery. Most cases occur after uneventful phacoemulsification with continuous curvilinear capsulorhexis and implantation of an intraocular lens in the capsular bag. The entity presents with reduction of visual acuity and myopic shift in the early-to-late postoperative period. Characteristic findings include the distension of the capsular bag due to the accumulation of milky material and the forward displacement of the intraocular lens. We present two cases with an unusually delayed presentation of 6 and 8 years respectively following phacoemulsification, and describe their successful management with Nd:YAG laser posterior capsulotomy.


Assuntos
Capsulorrexe/efeitos adversos , Cápsula do Cristalino/patologia , Cápsula do Cristalino/cirurgia , Facoemulsificação/efeitos adversos , Idoso , Opacificação da Cápsula/etiologia , Feminino , Humanos , Terapia a Laser , Masculino , Síndrome , Acuidade Visual
19.
Maedica (Bucur) ; 18(4): 623-630, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38348075

RESUMO

Background: Pregnancy induces a cascade of hemodynamic changes that are likely to affect the maternal systemic and ocular circulation. Objective:The current study aimed to investigate retinal microvasculature alterations in women with preterm and full-term pregnancy using optical coherence tomography angiography (OCT-A). Design:This was a cross-sectional, comparative, single-center study. Methods:The present study included 21 women with preterm pregnancy, who were in the early postpartum period, and 18 controls with full-term pregnancy. Optical coherence tomography angiography imaging was performed to analyze macular microvasculature characteristics at the retinal superficial capillary plexus (SCP) and the choriocapillaris (CC). Results:In females with preterm pregnancy, the mean values of vessel density (VD) at the SCP of the total macular area were significantly higher than those in females with full-term pregnancy (p=0.001), and the mean values of foveal, parafoveal and perifoveal VD at the SCP were higher, though not statistically significant. Similarly, the mean values of perfusion at the SCP of the total macular area were significantly higher in females with preterm pregnancy than controls (p=0.023), while the mean values of foveal, parafoveal and perifoveal perfusion were higher, though not statistically significant. The mean values of foveal avascular zone (FAZ) parameters (area, perimeter, circularity) at the SCP in females with preterm pregnancy did not have any significant differences from those of controls. Concerning the measurements of choroidal parameters, there were no statistically significant differences in subfoveal choroidal thickness, as well as the CC OCT-A characteristics between females with preterm and full-term pregnancy. Conclusions:Our study indicates that retinal blood flow alterations may be present in the early postpartum period in women with preterm pregnancy. Increased macular vasculature may reflect the systemic perfusion changes compensating for placental insufficiency.

20.
Asia Pac J Ophthalmol (Phila) ; 12(1): 44-57, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36588192

RESUMO

PURPOSE: The purpose of this study is to present the diagnostic and therapeutic algorithms, complications, and final outcome in the management of uveitic patients at a tertiary academic referral center. DESIGN: Observational study. METHODS: Analysis of the archives of 6191 uveitic patients at the Ocular Inflammation Service of the Department of Ophthalmology of the University Hospital of Ioannina in Greece from 1991 to 2020. RESULTS: During the 30 years of the study, the diagnostic ability climbed from 45.43% (1991-1995) to 73.4% (2016-2020). This improvement was linked to several factors including the increase in the number of diagnostic paracenteses for the analysis of intraocular fluids, the range and quality of laboratory blood tests, the multimodal ophthalmic imaging, the proper use of nonophthalmic imaging, and the multidisciplinary approach. The degree of uveitis-related complications was related to the severity and cause of inflammation, the recurrence rate, inappropriate treatment, and the prolonged or initially inactive inflammation. The 3 most common complications included cataract, macular edema, and glaucoma. Apart from the modern treatments and surgical techniques, the 3-month preoperative control of inflammation played a critical role in the surgical outcomes. The percentage of patients with a successful outcome increased from 72% (2001-2005) to 90.50% (2016-2020). The center's experience, prompt referral, patient's compliance, and regular follow-ups are associated with a better outcome. The analysis of the results allowed the development of diagnostic and therapeutic algorithms. CONCLUSIONS: Developing diagnostic and therapeutic algorithms allows for the efficient management of uveitis, leading to better visual outcome and therefore a better quality of life.


Assuntos
Glaucoma , Uveíte , Humanos , Qualidade de Vida , Uveíte/diagnóstico , Uveíte/terapia , Uveíte/complicações , Glaucoma/cirurgia , Olho , Inflamação , Estudos Retrospectivos , Resultado do Tratamento
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