RESUMEN
OBJECTIVE: To evaluate the usefulness of a semiautomatic measuring system of arteriovenous relation (RAV) from retinographic images of hypertensive patients in assessing their cardiovascular risk and silent brain ischemia (ICS) detection. METHODS: Semi-automatic measurement of arterial and venous width were performed with the aid of Imedos software and conventional fundus examination from the analysis of retinal images belonging to the 976 patients integrated in the cohort Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study (ISSYS), group of hypertensive patients. All patients have been subjected to a cranial magnetic resonance imaging (RMN) to assess the presence or absence of brain silent infarct. RESULTS: Retinal images of 768 patients were studied. Among the clinical findings observed, association with ICS was only detected in patients with microaneurysms (OR 2.50; 95% CI: 1.05-5.98) or altered RAV (<0.666) (OR: 4.22; 95% CI: 2.56-6.96). In multivariate logistic regression analysis adjusted by age and sex, only altered RAV continued demonstrating as a risk factor (OR: 3.70; 95% CI: 2.21-6.18). CONCLUSIONS: The results show that the semiautomatic analysis of the retinal vasculature from retinal images has the potential to be considered as an important vascular risk factor in hypertensive population.
Asunto(s)
Infarto Encefálico/epidemiología , Hipertensión/complicaciones , Procesamiento de Imagen Asistido por Computador/métodos , Vasos Retinianos/patología , Retinoscopía/métodos , Anciano , Arteriolas/patología , Automatización , Infarto Encefálico/etiología , Femenino , Fondo de Ojo , Humanos , Hipertensión/patología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Medición de Riesgo , Factores de Riesgo , Programas Informáticos , Vénulas/patologíaRESUMEN
CASO CLÍNICO: Paciente con sida y uveítis por virus Epstein-Barr (VEB). La PCR de VEB fue positiva para humor acuoso y vítreo. Las cuantificaciones del virus fueron 56,602 × 106 copias/ml en humor vítreo, 173.400 copias/ml en sangre periférica y negativo en líquido cefalorraquídeo (LCR). El paciente desarrolló un linfoma no-Hodgkin (LNH) diagnosticado en la necropsia. CONCLUSIÓN: La uveítis por VEB es poco frecuente y para el diagnóstico es necesario realizar una PCR cuantitativa. Una elevada cantidad de DNA de VEB se ha asociado con mayor incidencia de LNH
CLINICAL CASE: Patient with AIDS and Epstein-Barr virus (EBV) uveitis. The PCR of the aqueous and vitreous humor was positive for EBV, and DNA quantification was 56.602 × 106 copies/ml in the vitreous humor, 173,400 copies/ml in the peripheral blood, and negative in the cerebrospinal fluid (CSF). The patient developed a non-Hodgkin's lymphoma (NHL), diagnosed in the autopsy. CONCLUSION: The EBV is a rare cause of uveitis and it may be necessary to perform a quantitative PCR to reach the diagnosis. High amounts of EBV DNA are associated with a greater incidence of NHL
Asunto(s)
Humanos , Masculino , Linfoma/metabolismo , Linfoma/patología , Linfoma no Hodgkin/genética , Linfoma no Hodgkin/metabolismo , Sistema Nervioso Central/anomalías , Sistema Nervioso Central/metabolismo , Toxoplasma/genética , Hepatitis/metabolismo , Hepatitis/patología , Linfoma/clasificación , Linfoma/complicaciones , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/diagnóstico , Sistema Nervioso Central/citología , Sistema Nervioso Central/lesiones , Toxoplasma/metabolismo , Hepatitis/complicaciones , Hepatitis/diagnósticoRESUMEN
CLINICAL CASE: Patient with AIDS and Epstein-Barr virus (EBV) uveitis. The PCR of the aqueous and vitreous humor was positive for EBV, and DNA quantification was 56.602×10(6) copies/ml in the vitreous humor, 173,400 copies/ml in the peripheral blood, and negative in the cerebrospinal fluid (CSF). The patient developed a non-Hodgkin's lymphoma (NHL), diagnosed in the autopsy. CONCLUSION: The EBV is a rare cause of uveitis and it may be necessary to perform a quantitative PCR to reach the diagnosis. High amounts of EBV DNA are associated with a greater incidence of NHL.