Use of surgical videos available on social media among retina surgeons: results of a vitreoretinal specialist survey / Uso de vídeos cirúrgicos nas mídias sociais entre cirurgiões de retina: resultados de uma pesquisa com especialista em retina

ABSTRACT Purpose: This study aimed to assess and interpret how vitreoretinal surgeons use surgical videos available on social media as complementary learning tools to improve, review, or update their abilities, considering their different levels of expertise. Methods: In this cross-sectional survey, an online survey was sent to vitreoretinal specialists and fellows. Results: This survey included 258 participants, of whom 53.88% had been in practice for >10 years (senior surgeons), 29.07% between 4 and 10 years (young surgeons), and 17.05% for <3 years (surgeons in training). Retinal surgical videos available on social media were used by 98.84% of the participants (95% confidence interval, 97.52%-100%). YouTube (91%) was the most common source of videos, and surgeons in training watched more videos on YouTube than senior surgeons. Regarding the preferred method when preparing for a procedure, 49.80% of the participants watched surgical videos available on social media, 26.27% preferred to "consult colleagues", and 18.82% preferred to seek information in scientific articles. Participants valued the most the "image quality" (88%) and presence of "surgical tips and tricks" (85%). Conclusion: Surgical videos can provide benefits in acquiring strategic skills, such as decision-making, surgical planning, and situational awareness. Retina surgeons used them as teaching aids regardless of their level of expertise, despite being relatively more valuable to surgeons in training or young surgeons.

RESUMO Objetivo: Avaliar e interpretar como os cirurgiões vitreorretinianos utilizam os vídeos cirúrgicos disponíveis nas mídias sociais como ferramentas complementares de aprendizagem para melhorar, revisar ou atualizar suas habilidades, considerando seus diferentes níveis de especialização. Métodos: Nesta pesquisa transversal, um survey online foi enviado à especialistas e aprendizes na área vítreo-retiniana. Resultados: Esta pesquisa incluiu 258 participantes, dos quais 53,88% atuavam há mais de 10 anos (cirurgiões seniores), 29,07% entre 4 e 10 anos (cirurgiões jovens) e 17,05% há menos de 3 anos (cirurgiões em treinamento). Vídeos cirúrgicos de retina nas mídias sociais foram usados por 98,84% dos participantes (intervalo de confiança de 95%, 97,52%-100%). A fonte mais comum de acesso aos vídeos foi o YouTube (91%), e o grupo de cirurgiões com menos de 3 anos de experiência assistiu mais vídeos no YouTube em comparação aos cirurgiões seniores. Assistir a vídeos cirúrgicos nas redes sociais foi o método preferido na preparação para um procedimento para 49,80% dos participantes versus 26,27% que preferiram "consultar colegas" e 18,82% que preferiram buscar informações em artigos científicos. A "qualidade de imagem" (88%) e a presença de "dicas e truques cirúrgicos" (85%) foram as características dos vídeos mais valorizadas pelos participantes. Conclusão: O uso de vídeos cirúrgicos pode trazer benefícios na aquisição de habilidades estratégicas, como tomada de decisão, planejamento cirúrgico e consciência situacional. Sua aplicação como auxiliar de ensino foi utilizada por cirurgiões de retina independentemente de seu nível de especialização, apesar de ser relativamente mais valioso para cirurgiões em formação ou com menos de 10 anos de experiência.

Use of surgical videos available on social media among retina surgeons: results of a vitreoretinal specialist survey.

PURPOSE: This study aimed to assess and interpret how vitreoretinal surgeons use surgical videos available on social media as complementary learning tools to improve, review, or update their abilities, considering their different levels of expertise. METHODS: In this cross-sectional survey, an online survey was sent to vitreoretinal specialists and fellows. RESULTS: This survey included 258 participants, of whom 53.88% had been in practice for >10 years (senior surgeons), 29.07% between 4 and 10 years (young surgeons), and 17.05% for <3 years (surgeons in training). Retinal surgical videos available on social media were used by 98.84% of the participants (95% confidence interval, 97.52%-100%). YouTube (91%) was the most common source of videos, and surgeons in training watched more videos on YouTube than senior surgeons. Regarding the preferred method when preparing for a procedure, 49.80% of the participants watched surgical videos available on social media, 26.27% preferred to "consult colleagues", and 18.82% preferred to seek information in scientific articles. Participants valued the most the "image quality" (88%) and presence of "surgical tips and tricks" (85%). CONCLUSION: Surgical videos can provide benefits in acquiring strategic skills, such as decision-making, surgical planning, and situational awareness. Retina surgeons used them as teaching aids regardless of their level of expertise, despite being relatively more valuable to surgeons in training or young surgeons.

Noninvasive Blue-Light Channel Imaging of Retinal Nonperfusion in Vein Occlusion.

This case report discusses the use of blue-light channel imaging as an alternative to fluorescein angiography to evaluate the extent of retinal nonperfusion due to vein occlusion.

Multimodal evaluation of hemorrhages within intraretinal cystoid spaces in a blood-fluid level presentation.

INTRODUCTION: We describe characteristic findings on multimodal evaluation and the features of hemorrhage within a foveal cystoid space in a patient presenting cystoid macular edema secondary to Branch Retinal Vein Occlusion (BRVO). CASE DESCRIPTION: We report a case of a 64-year-old diabetic male patient presenting gradual blurry vision in the left eye. Fundoscopic findings were suggestive of BRVO, such as hard exudates and mild venous engorgement superotemporally and diffuse macular intraretinal hemorrhages. In the foveal area, there was cystoid edema with blood-fluid level (BFL) inside one of the cystoid spaces. Retina multimodal evaluation, including color, blue filter, and red-free fundus photography, fluorescein angiography, fundus autofluorescence, and spectral-domain optical coherence tomography (SD-OCT) B and C scan imaging, confirmed blood within foveal cystoid space. The patient underwent antiangiogenic therapy with significant improvement of macular edema and reduction of the cystoid space after 3 months. In addition, there was a resolution of visual symptoms. The cystoid space previously partially filled with blood, persisted, despite presenting smaller volume and medium reflectivity in the SD-OCT. CONCLUSIONS: Multimodal evaluation of blood-fluid level within foveal cystoid space in patients with BRVO has not been described previously. Identification of this sign may support the diagnosis of retinal vein occlusion in doubtful cases and further studies must be carried out to establish if the presence of BFL correlates with visual outcomes.

Evaluation of quality and utility of YouTube vitreoretinal surgical videos.

BACKGROUND: We evaluated the utility and quality of surgical videos posted on the main retinal YouTube channels by surgeons at different career stages and assessed how well the steps of the vitrectomy videos conformed to the parameters in the Casey Eye Institute Vitrectomy Indices Tool for Skills assessment (CEIVITS) scale. METHODS: Forty-five videos were included from nine retinal YouTube channels posted from 2011 to 2021. For each surgeon, 10 videos were randomized and the utility, quality, and educational content were assessed. For each video, the surgeons also assessed how the validated CEIVITS items were presented in the videos. The surgeons were divided based on years of experience: fellows (0-3 years), young surgeons (4-10 years), and senior surgeons (more than 10 years). RESULTS: The video image quality was rated as good in 63.52% of evaluations, moderate in 30.37%, and poor in 6.11%. The quality assessment of the videos among the groups did not differ. The fellows rated the use of the videos as educational tools higher (3.99) than the young (3.87) and senior surgeons (3.47) (p < 0.0002, Kruskal-Wallis test); 34.76% of the fellows reported learning something new from the videos compared with 19.17% of the senior surgeons (p < 0.05). The CEIVITS scale item that was seen more frequently was related to core vitrectomies (72.29%) and the least represented was about checking infusion lines (80.17%). CONCLUSIONS: Vitreoretinal surgical videos are useful educational tools during all stages of surgeons' careers, and the evaluation of the quality of the images did not differ significantly among the groups, however, surgeons with expertise shorter than 10 years report significantly greater use of videos than experienced surgeons. Videos posted to the public domain on different social media, most often YouTube, are widespread and unregulated for providing complimentary surgical education. Retinal societies should formulate guidelines and improve the educational value of the surgical videos posted on the Internet. Trial Registration The Federal University of São Paulo institution's Research Ethics Committee reviewed and approved this study protocol (Approval Number, 4.726.589).

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma / Autofluorescência e tomografia de coerência óptica de domínio espectral do melanocitoma do disco óptico

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT) findings of two consecutive patients who presented with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Os autores descrevem os achados do exame de autofluorescência do fundo de olho (AF) e da tomografia de coerência óptica (TCO) de domínio-espectral em dois pacientes consecutivos apresentando melanocitoma disco óptico (MDO) em um estudo retrospectivo, por revisão dos prontuários e exames oftalmológicos de imagem. Os achados no exame de tomografia de coerência óptica foram hiperrefletividade e elevação da superfície anterior da lesão, desorganização da retina adjacente, e, sombreamento óptico posterior. Sementes vítreas foram encontrados em um paciente. O exame de autofluorêscencia do fundo de olho revelou hipoautofluorescência marcante na área do tumor e isoautofluorescência nas demais áreas da retina. As características encontradas na tomografia de coerência óptica dos pacientes apresentados são consistentes com os achados relatados na literatura atual. A autofluorêscencia do fundo de olho tem sido utilizada na avaliação de tumores melanocíticos da coroide, mas ainda não em melanocitomas. Acreditamos que este seja a primeira descrição dos achados de autofluorêscencia do fundo de olho em pacientes com melanocitoma de disco óptico e que, quando seu padrão de tornar-se claramente definido, a autofluorêscencia do fundo de olho será uma ferramenta útil para evitar erros de diagnóstico em casos suspeitos.

Fundus autofluorescence in blunt ocular trauma.

PURPOSE: To describe the findings of fundus autofluorescence (FAF) imaging in patients with blunt ocular trauma. METHODS: In this non-interventional retrospective study, we reviewed medical records and imaging examination results. The data analyzed included gender, age, laterality, trauma etiology, time between trauma and imaging, visual acuity, changes in the retinal periphery, fundus examination results, and FAF imaging findings. FAF imaging was performed using a Topcon TRC-50DX Retinal Camera (Tokyo, Japan). RESULTS: Eight eyes from 8 patients were studied. The mean age was 27.6 years (range, 19-43 years). Men (n=7) were more frequently affected by blunt ocular trauma than women (n=1). Physical aggression was the most common trauma etiology (n=3), followed by accidents with fireworks (n=2). Other causes were car accidents (n=1), occupational trauma caused by a grinder (n=1), or being hit by a stone (n=1). Visual acuity ranged from 20/80 to light perception. Traumatic pigment epitheliopathy (TPE) was identified in 5 cases, choroidal rupture in 3 cases, subretinal hemorrhage in 3 cases, and Purtscher's retinopathy in 1 case. Hypoautofluorescence was observed in cases of choroidal rupture, recent subretinal hemorrhage, and intraretinal hemorrhage, and in two cases of TPE. Hyperautofluorescence was observed in cases of old subretinal hemorrhage and at the edge of the lesion in two cases of choroidal rupture. Mild hyperautofluorescence was observed in the posterior pole in Purtscher's retinopathy. Three cases of TPE exhibited hypoautofluorescence with diffuse hyperautofluorescent areas. CONCLUSION: FAF imaging is a non-invasive method for assessing changes in the posterior segment of the eye resulting from blunt ocular trauma. Furthermore, this technique provides valuable information. We described the findings of FAF imaging in cases of TPE, choroidal rupture, subretinal hemorrhage, and Purtscher's retinopathy.

Fundus autofluorescence in blunt ocular trauma / Autofluorescência do fundo de olho no trauma ocular contuso

Purpose: To describe the findings of fundus autofluorescence (FAF) imaging in patients with blunt ocular trauma. Methods: In this non-interventional retrospective study, we reviewed medical records and imaging examination results. The data analyzed included gender, age, laterality, trauma etiology, time between trauma and imaging, visual acuity, changes in the retinal periphery, fundus examination results, and FAF imaging findings. FAF imaging was performed using a Topcon TRC-50DX Retinal Camera (Tokyo, Japan). Results: Eight eyes from 8 patients were studied. The mean age was 27.6 years (range, 19-43 years). Men (n=7) were more frequently affected by blunt ocular trauma than women (n=1). Physical aggression was the most common trauma etiology (n=3), followed by accidents with fireworks (n=2). Other causes were car accidents (n=1), occupational trauma caused by a grinder (n=1), or being hit by a stone (n=1). Visual acuity ranged from 20/80 to light perception. Traumatic pigment epitheliopathy (TPE) was identified in 5 cases, choroidal rupture in 3 cases, subretinal hemorrhage in 3 cases, and Purtscher's retinopathy in 1 case. Hypoautofluorescence was observed in cases of choroidal rupture, recent subretinal hemorrhage, and intraretinal hemorrhage, and in two cases of TPE. Hyperautofluorescence was observed in cases of old subretinal hemorrhage and at the edge of the lesion in two cases of choroidal rupture. Mild hyperautofluorescence was observed in the posterior pole in Purtscher's retinopathy. Three cases of TPE exhibited hypoautofluorescence with diffuse hyperautofluorescent areas. Conclusion: FAF imaging is a non-invasive method for assessing changes in the posterior segment of the eye resulting from blunt ocular trauma. Furthermore, this technique provides valuable information. We described the findings of FAF imaging in cases of TPE, choroidal rupture, subretinal hemorrhage, and Purtscher's retinopathy. .

Objetivo: Descrever os achados do exame de autofluorescência do fundo de olho (AFF) em pacientes vítimas de trauma ocular contuso. Métodos: Estudo retrospectivo, não intervencionista, realizado através da revisão de prontuários e exames de imagem. Os dados analisados foram: sexo, idade, lateralidade, etiologia do trauma, tempo decorrente entre o trauma e a realização do exame, acuidade visual, alterações na periferia da retina, diagnóstico fundoscópico e achados ao exame de AFF (realizada no aparelho Topcon TRC-50DX Retinal Camera). Resultados: Oito olhos de 8 pacientes foram estudados. A idade média foi de 27,6 anos (de 19 a 43 anos), o sexo masculino (n=7) foi mais acometido do que o feminino (n=1), agressão física foi a etiologia mais comum do trauma (n=3), seguido de acidente com fogos de artifício (n=2). Outras causas foram acidente automobilístico (n=1), trauma ocupacional com lixadeira (n=1) e pedrada (n=1). A acuidade visual variou de 20/80 a percepção luminosa. Epiteliopatia pigmentar traumática (EPT ) foi identificada em 5 casos, rotura de coroide em 3, hemorragia subretiniana em 3 e retinopatia de Purtscher em 1 caso. Hipoautofluorescência foi observada nos casos de rotura de coroide, hemorragia subretiniana recente, hemorragia intrarretiniana e em 2 casos de EPT. Hiperautofluorescência foi visualizada nos casos de hemorragia subretiniana em degradação, na borda de 2 casos de roturas de coroide e discretamente no polo posterior na retinopatia de Purtcher. Três casos de EPT apresentaram hipoautofluorescência com pontos hiperautofluorescentes difusos. Conclusão: O exame de AFF permite avaliar as alterações do segmento posterior do olho decorrentes do trauma ocular contuso de forma não invasiva, somando informações valiosas. Foram descritos achados do exame ...

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma.

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT) findings of two consecutive patients who presented with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Dobras de coroide / Choroidal folds

Dobras de coroide é considerado o achado fundoscópico mais prevalente nos casos de tumor orbitário. São ondulações no epitélio pigmentado da retina, membrana de Bruch, porção interna da coriocapilar e que, em alguns casos, podem acometer a retina neurossensorial, sendo então chamadas de dobras coriorretinianas. Diversas condições, oculares e sistêmicas, cursam com dobras de coroide e devem ser corretamente investigadas e, caso necessário, prontamente tratadas. Nesta revisão iremos abordar os aspectos gerais das dobras de coroide, enfatizando suas características nos seguintes exames de imagem: Retinografia, autofluorescência, angiofluoresceínografia e tomografia de coerência óptica.

Choroidal folds is considered the most prevalent funduscopic finding in cases of orbital tumors. They are ripples in the retinal pigment epithelium, Bruch's membrane, the inner portion of the choriocapillaris and in some cases, may affect the neurosensory retina, and then called chorioretinal folds. Several ocular and systemic conditions are associated with the finding and must be properly investigated and, if necessary, promptly treated. In this review we discuss the general aspects of choroidal folds, emphasizing their characteristic features in the following ophthalmological imaging tests: Retinography, fundus autofluorescence, fluorescein angiography and optical coherence tomography.

Bilateral choroidal neovascularization response to unilateral intravitreal Ranibizumab injection in a patient with angioid streaks / Resposta de neovascularização bilateral de coróide à injeção unilateral de Ranibizumabe intravítreo de paciente com estrias angióides

Report of a 48 year-old male with bilateral decrease in vision due to choroidal neovascularization secondary to angioid streaks. Best corrected visual acuity was 20/80 in the right eye and counting fingers at 2 meters on the left eye. Patient underwent intravitreal injection of Ranibizumab (Lucentis) in the eye with worse visual acuity. Fifteen days after treatment patient reported better visual acuity on the fellow eye, which was measured to be 20/25. Treatment result was evaluated with visual acuity and optical coherence tomography. The effect of ranibizumab was observed in the treated eye, but the fellow eye had complete resolution of the choroidal neovascularization complex. This result may be a response to systemic absorption of the medication.

Os autores descrevem paciente do sexo masculino, 48 anos, com diminuição visual bilateral há 15 dias por membrana neovascular sub-retiniana secundária a estrias angióides. A acuidade visual com melhor correção no olho direito era 20/80 e no olho esquerdo de conta dedos a 2 metros. Submetido à injeção intravítrea de Ranibizumabe (Lucentis) no olho com pior acuidade visual. Após 15 dias do tratamento, referiu melhora acentuada da visão no olho contralateral com visão de 20/25. O resultado foi avaliado por meio da acuidade visual e da tomografia de coerência óptica. O efeito do ranibizumabe foi observado no olho tratado, mas no olho contralateral houve completa resolução do complexo da membrana neovascular sub-retiniana. Levanta-se a hipótese de que esse resultado possa ser atribuído à absorção sistêmica da medicação.

An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification / Surto de quarenta e cinco casos de endoftalmite aguda por Pseudomonas aeruginosa após facoemulsificação

PURPOSE: To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed. METHODS: Clinical charts review of forty-five patients treated for endophthalmitis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients. RESULTS: Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomonas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period. CONCLUSION: Even with all the safety that cataract surgery has achieved, today, endophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.

OBJETIVO: Descrever surto de endoftalmite por Pseudomonas aeruginosa após facectomia. Os achados clínicos, o tratamento e o resultado são discutidos. MÉTODOS: Revisão dos prontuários de quarenta e cinco pacientes tratados para endoftalmite em um período de dois dias. Todos os pacientes foram tratados por vitrectomia primária, irrigação da câmara anterior e injeção vítrea de antibióticos. Culturas do vítreo e de amostras de câmara anterior foram realizadas em todos os pacientes. RESULTADOS: Quarenta e cinco pacientes (23 homens e 22 mulheres) foram identificados. A idade média foi 71,2 anos (variação, 56-83 anos). O olho direito (62%) foi mais afetado do que o esquerdo (38%). O intervalo médio entre a cirurgia e a apresentação da endoftalmite foi de 5,5 dias (intervalo de 5-6 dias). A acuidade visual no momento do diagnóstico foi melhor que 20/40 em um paciente (2%), de 20/40 a 20/200 em um paciente (2%), de 20/400 para contar dedos em dois pacientes (4%), movimento de mão em onze pacientes (24%), percepção de luz em trinta pacientes (68%). Pseudomonas aeruginosa foi o agente isolado em 26 amostras de vítreo e em três amostras da câmara anterior. No geral, um paciente (2%) obteve acuidade visual final melhor que 20/40, oito pacientes (18%) obtiveram acuidade visual final de 20/40 a 20/200, seis pacientes (13%) obtiveram acuidade visual final de 20/400 para contar os dedos; onze pacientes (25%) obtiveram acuidade visual final de movimento de mão; treze pacientes (29%) obtiveram acuidade visual final de percepção de luz e seis (13%) pacientes não havia percepção luminosa no último exame. Nenhum olho foi submetido à evisceração ou enucleação em três meses de acompanhamento. CONCLUSÃO: Mesmo com toda a segurança da cirurgia de catarata nos dias atuais, endoftalmite permanece um risco e uma complicação temível deste procedimento. No presente estudo não foi possível identificar a fonte do surto.

An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification.

PURPOSE: To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed. METHODS: Clinical charts review of forty-five patients treated for endophthalmitis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients. RESULTS: Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomonas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period. CONCLUSION: Even with all the safety that cataract surgery has achieved, today, endophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.

Alterações oculares em micose fungóide associada com vírus linfotrópico de células t humanas tipo I / Ocular fidings in mycosis fungoides associated with human t-lymphotropic virus type I

São relatados dois casos da associação de micose fungóide e HTLV-I. Os achados oftalmológicos observados foram, no caso 1: ceratopatia ponteada e ceratoconjuntivite seca e; no caso 2: ceratoconjuntivite seca, espessamento e nódulos difusos em bordas palpebrais. A associação de micose fungóide e HTLV-I nos dois casos sugere envolvimento deste vírus na etiopatogenia da doença. Maior conhecimento e realização de estudos bem controlados poderão ser úteis na determinação precisa desta hipótese.

Two cases of mycosis fungoides associated with HTLV-I are reported. The ophthalmological findings were, in the first case, punctate keratopathy and keratoconjunctivitis sicca, and in the second case, keratoconjunctivitis sicca, thickening and difuse nodulos on eyelid margin. The association of mycosis fungoides and HTLV-I in these cases suggests involvement of this agent in the pathogenesis of the disease.