Human T-cell lymphotropic virus type 1 infection and ocular manifestations in São Paulo, Brazil.

OBJECTIVES: Although human T-cell lymphotropic virus type 1 (HTLV-1)-associated uveitis has been well recognized in Japan, related studies in Brazil are scarce. We performed a serologic survey for HTLV-1 infection among patients with uveitis and investigated the ocular findings in HTLV-1-asymptomatic carriers. METHODS: One hundred ninety serum samples from patients with uveitis of determined (n = 137) and undetermined origins (n = 53) being examined at the Uveitis Service, University of São Paulo, São Paulo, Brazil, underwent testing using HTLV enzyme-linked immunosorbent assay and discriminatory Western blots. One hundred five asymptomatic blood donors and/or their relatives who were seropositive for HTLV-1 (carrier group) and 105 age- and sex-paired blood donors who were seronegative for HTLV-1 (control group) underwent ocular evaluation. For the statistical analysis, chi2 test was used. RESULTS: Only 1 patient with uveitis was seropositive for HTLV- 1, and she belonged to the group with uveitis of undetermined origin. Results of tear films were evaluated in 52 carriers. The prevalence of a decreased tear break-up time was significantly higher in the carrier compared with the control group (P = .02). Two carriers had keratoconjunctivitis sicca. Three of the 105 carriers exhibited mild uveitis (cells in the vitreous, retinal and choroidal infiltrates, retinal vasculitis, and bilateral pars planitis). Retinal pigmentary changes were found in both groups (no statistical difference). CONCLUSIONS: Early tear abnormalities may be present in asymptomatic carriers, and mild uveitis may be found among them. The relatively low seroprevalence of HTLV-1 in the Brazilian population made it difficult to establish the real importance of HTLV-1-associated uveitis among our patients with uveitis.

[Perforating eye injuries caused by motor vehicle accidents: cases assisted during the year 1994]. / Ferimentos perfurantes do globo ocular por acidentes automobilísticos: casos atendidos durante o ano de 1994.

A prospective study of 32 patients with perforating eye injuries caused by motor vehicle accidents, 24.32% of the 131 cases of perforating injuries admitted at the University of São Paulo Medical School Hospital from January to december, 1994 was performed. Most of the accidents occurred at night (68.75%), and in urban areas (65.63%). There were more male victims (65.63%), mostly under 25 years of age (53.13%). None of the victims were using seat belts and those in the front seats were more vulnerable. Safety precautions should be effectively in use in order to reduce frequency and morbidity of these injuries.

Ferimentos perfurantes oculares com lesao cristaliniana: consideracoes sobre a conduta cirurgica inicial. / Perforating ocular injuries with crystallins injuries: considerations on the initial surgical procedure

Os autores realizaram um estudo retrospectivo envolvendo 52 pacientes com lesao cristalina entre 411 pacientes com FPO nos quais no ato cirurgico inicial nao se realizou remocao completa das massas. Destacam que apenas 3 deles (5,8%) apresentaram reabsorcao expontanea com acuidade visual final de 20/60 e 20/25. Concluem pela necessidade de remocao das massas quando houver seguranca no diagnostico de presenca delas em camara anterior bem como de vitrectomia anterior quando do envolvimento do segmento posterior

Ferimentos perfurantes do globo ocular por acidentes automobilisticos. / Perforating eyeball wounds caused by automobile accidents

Apresenta-se um estudo de 50 pacientes com ferimentos oculares durante 29 meses e da proporcao de tais ferimentos no total de cirurgias

Pterigio: Avalicao critica das indicacoes cirurgicas como pre-requisito de admissao de candidatos a forca de trabalho. / Pterygium: critical evaluation of the surgical indications as a pre-requirement for the applicant's admission to the labour force

Os autores discutem inicialmente sobre a etiopatogenia do pterigio, destacando o quanto ignorantes estamos frente a uma entidade nosologica aparentemente tao banal. Em seguida, comentam as indicacoes cirurgicas, incluindo nelas em nosso meio, a exigencia dos empregadores como pre-requisito de admissao de candidatos a forca do trabalho. Finalmente, discutem o numero de recidivas operatorias e a sintomatologia ocular prexistente em casos tratados cirurgicamente com sucesso ou nao, ressaltando a necessidade de uma melhor avaliacao critica dessas indicacoes cirurgicas

Diagnostico e conduta na presenca de ferimentos perfurantes do globo ocular. / Diagnosis and management at the presence of perforating injuries of the eyeball

Os autores apresentam sua experiencia no diagnostico e conduta de tratamento dos ferimentos perfurantes oculares, ressaltando a necessidade de suspeita-los em cada laceracao palpebral ou em pacientes politraumatizados. Uma vez constatada a presenca de ferimentos perfurantes oculares, eles indicam que o restande da avalicao deve ser realizado sob microscopia, com o paciente anestesiado. Discutem, ainda, a conduta cirurgica a ser seguida nesses casos, enfatizando que o tratamento das perfuracoes oculares tem marcado a prioridade de atendimento sobre as laceracoes faciais

Ceratite punctata superficial de Thygeson. / Thygeson's superficial punctate keratitis

Os autores apresentam 2 (dois) casos de ceratite de Thygeson. Ressaltam que se trata de entidade distinta do ponto de vista semiologico e evolutivo e que, embora presente em nosso meio, nao havia sido ainda relatada. E ressaltada a necessidade de sistematizacao semiologica no diagnostico das ceratites superficiais, visando uma terapeutica racional, que evite o excesso de medicacao e consequente iatrogenia