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.

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.

Optical coherence tomography findings in acute phase of branch retinal artery occlusion: case report.

PURPOSE: to report a case of branch retinal artery occlusion in the acute phase, using optical coherence tomography to evaluate the morphologic changes. A 27 year-old man had a sudden superior scotoma in the right eye, with fundus examination compatible with inferior temporal branch retinal artery obstruction. The optical coherence tomography revealed increase in thickness and hyper-reflectivity of the inner retinal layers in affected area, with decreased reflectivity of photoreceptor and retinal pigment epithelial layers. The optical coherence tomography findings are consistent with intracellular edema, and not with secondary vascular leakage of extracellular fluid, according to histopathological theories of retinal ischemia and necrosis that occurs after retinal artery occlusion.

Rhegmatogenous retinal detachment in Wyburn-Mason syndrome: case report.

Wyburn-Mason is a rare vascular disorder, comprised of arteriovenous malformations (AVMs) of the midbrain and retina. It can cause visual symptoms depending on its localization and extension. Vitreous and intraretinal hemorrhage and neovascular glaucoma have been previously described. A case of rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome is described. A 27 year-old woman previously diagnosed with Wyburn-Mason syndrome, sought attendance with sudden low vision in right eye 3 months before. She presented moderate vitreous hemorrhage and retinal detachment with a superior tear. She underwent a successful posterior vitrectomy with implantation of silicone oil, with reattachment of the retina. Rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome has been not previously described in the literature. Vitrectomy in this case present challenges related to intraoperatory bleeding risk, to a posterior pole tear among AVMs and the difficulty of obtaining free retina for photocoagulation.

Joubert syndrome: large clinical variability and a unique neuroimaging aspect.

Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g, pigmentary retinopathy, oculomotor apraxia and nystagmus), renal cysts and hepatic fibrosis. Respiratory abnormalities, as apnea and hyperpnea, may be present, as well as mental retardation. At least seven JS loci have been determined and five genes identified. Herein, we report five children, belonging to independent families, with JS: they shared the same typical MRI abnormality, known as molar tooth sign, but had an otherwise quite variable phenotype, regarding mostly their cognitive performance, visual abilities and extra-neurological compromise.

[Optical coherence tomography imaging in commotio retinae: case report]. / Tomografia de coerência óptica na commotio retinae: relato de caso.

The purpose of this case report was to correlate optical coherence tomography findings and visual outcomes of patients with different degrees of commotio retinae. A 20-year-old male and a 23-year-old male that presented with decreased vision due to Berlin's edema after blunt ocular trauma were evaluated by optical coherence tomography and retinography. The visual acuity in the affected eye was 20/25 in the first patient and counting fingers in the second one. The ophthalmic examination showed traumatic uveitis and fundoscopy revealed mild retinal opacification in the first case and severe opacification in the latter. The optical coherence tomography confirmed the reduction of foveal depression on the first case and the disarrangement of all retinal layers on the second. There has been complete functional and anatomical resolution by optical coherence tomography in the first patient, while the second evolved to permanent visual loss. Optical coherence tomography is a useful method in the evaluation of retinal trauma, helping to understand its physiopathology and to predict its prognosis through the anatomical analysis of the affected region.

[Clinical and tomographic aspects of macular microholes]. / Aspectos clínicos e tomográficos dos microburacos maculares.

PURPOSE: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. METHODS: Seven patients were assessed (8 eyes) with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. RESULTS: Ages ranged from 26 to 69 years. Six patients were female (85.7%) and five of them had microhole in the right eye. The presenting symptom was decrease in visual acuity (71.3%) and central scotoma in (14.3%). Five eyes (71.4%) had no defects shown by fluorescent angiography. A defect in the outer retina was demonstrated in all eyes on optical coherence tomography. The lesions were nonprogressive. CONCLUSION: Macular microholes are small lamellar defects in the outer retina. The condition is nonprogressive, generally unilateral and compatible with good visual acuity. Fundus biomicroscopy associated with an optical coherence tomography are the main elements in the diagnosis and study of this pathology.

[Peripheral retinal arterial obstruction associated with hyperhomocysteinemia: case report]. / Obstrução arterial retiniana periférica associada com hiper-homocisteinemia: relato de caso.

Hyperhomocysteinemia is a risk factor for thromboembolic events of the retina associated with vascular venous or arterial occlusion. We describe a patient with occlusion of the peripheral arteriolar network without active vasculitis, associated with neovascular proliferation, peripheral vitreous-retinal traction and relapsing vitreous hemorrhage. The high serum homocysteine level resulting from vitamin B12 and folic acid deficiency, without further changes in the coagulation cascade including the test for Leiden's Factor V, indicates hyperhomocysteinemia as a direct causal factor in this clinical condition. Despite a high PPD, Eales Disease, a major differential diagnosis, was not fully considered, since it is established by exclusion. The patient was treated with photocoagulation and vitamin supplements and the condition was successfully controlled. Patients with retinal vascular obstruction should have their total plasma homocysteine levels measured, since this modifiable risk factor can be easily treated with dietary approaches including vitamin supplementation.

Triamcinolone-assisted 3D-vitrectomy in diabetic vitreomacular traction.

PURPOSE: To evaluate the efficacy of triamcinolone as an aid in vitreous visualization during 3D-vitrectomy for the treatment of diabetic vitreomacular traction. METHODS: Prospective interventional study in patients with symptomatic vitreomacular traction. Pre- and postoperative assessments included visual acuity, retinography, intraocular pressure and optical coherence tomography. All patients were operated by the same surgeon (OOMJ). Triamcinolone was used as a visual enhancer during surgery. The parameters of the vitreophage (Accurus 800CS, Alcon) were set to the 3D-system (dual dynamic drive), contact lenses (plain and wide angle) being used for visualization. Peripheral 360 masculine vitreous circumcision at high cut rate was performed, carefully releasing the vitreomacular adhesion at the posterior pole by means of an appropriate pic or vitreoretinal forceps. RESULTS: The sample consisted of five consecutive patients (five eyes), three female and two male, with symptomatic vitreomacular traction. Their age ranged from 54 to 71 years (mean 62.6 +/- 6.3 years). During the surgical procedure, the areas with vitreomacular traction were properly visualized and identified after the application of triamcinolone. No complications were recorded during or after surgery. There was a statistically significant improvement in visual acuity after the surgical procedure (p=0.0313). CONCLUSION: Triamcinolone facilitates the surgical treatment of vitreomacular traction by improving visibility of both the vitreous humor and the vitreous-retina interface. Triamcinolone-assisted 3D vitrectomy proved to be an effective procedure in these cases.

[Visual acuity and macular thickness in diabetic retinopathy treated with panphotocoagulation]. / Espessura macular e acuidade visual na retinopatia diabética tratada por panfotocoagulação.

PURPOSE: To compare the visual acuity and macular thickness in patients with diabetic retinopathy presenting and not presenting macular edema before treatment and submitted to argon laser retinal panphotocoagulation. METHODS: Patients were included and classified into two groups before the treatment. All patients were submitted to ophthalmological examination and optical coherence tomography, following panphotocoagulation. The results were evaluated by measuring visual acuity at the end and by optical coherence tomography after one week, one and three months following the treatment. RESULTS: The sample was composed of 37 patients (37 eyes). Group 1 included 29 patients with diabetic retinopathy without macular edema; Group 2 included 8 patients with macular edema. The two groups were similar regarding gender, age, and the mean of argon laser spots treatment. The groups showed differences in visual acuity (p<0.001) and Group 2 patients presented decrease of visual acuity three months after the treatment (p<0.001). Group 2 patients showed a greater mean of macular thickness measurements on optical coherence tomography evaluation. CONCLUSION: Variation of the macular thickness as well as decrease in visual acuity was present in the patients with macular edema previously to panphotocoagulation. Only minimal increase in macular thickness was observed in the absence of macular edema.

[Examination of the retinal nerve fiber layer in diabetic retinopathy treated by argon laser panphotocoagulation]. / Avaliação da camada de fibras nervosas na retinopatia diabética tratada por panfotocoagulação com laser de argônio.

PURPOSE: To evaluate the alterations in the retinal nerve fiber layer in diabetic retinopathy treated by argon laser panphotocoagulation. METHODS: Prospective study of patients with diabetic retinopathy submitted to retinal panphotocoagulation. Initially, complete ophthalmologic examination and optical coherence tomography were performed. All patients were submitted to panphotocoagulation with argon laser in one of the eyes. The retinal fiber layer was evaluated by means of optical coherence tomography in the first week, in the first, third and sixth months after treatment. RESULTS: The sample was composed of 27 patients (27 eyes) with type 2 diabetes mellitus. The age varied from 41 to 64 years (mean of 53.7 +/- 6.2 years), with 10 (37%) males and 17 (63%) females. Regarding the retinopathy, 22.2% presented proliferative DR and 77.8% very severe non proliferative DR. There was a significant increase in the fiber layer thickness measurements, remaining in the temporal sectors, 3 and 4 hours, after 6 months of follow-up. Reduction of thickness was not observed in any of the analyzed parameters. CONCLUSIONS: Reduction of the fiber layer thickness, identifiable by means of optical coherence tomography, in short and average term, was not observed in patients with diabetic retinopathy treated with panphotocoagulation. On the other hand, some sectors showed thickness increase during the follow-up.

[Macula study in Stargardt's disease]. / Estudo macular na doença de Stargardt.

PURPOSE: To evaluate de macular structural damage in Stargardt's disease by optical coherence tomography, correlating with visual acuity and disease duration. METHODS: Patients with Stargardt's disease were included and submitted to visual acuity (logMAR) measurement and complementary examinations performed were color fundus photographs, fluorescein angiography and optical coherence tomography. All cases were reexamined for diagnostic confirmation and the duration of symptoms was determined. The control group was composed of the same number of subjects, matched by sex and age, without any ophthalmologic alteration. RESULTS: The sample was composed of 22 patients (44 eyes) with Stargardt's disease, 11 (50%) males and 11 (50%) females. The duration of the disease varied from 3 to 21 years (mean of 11.4 +/- 5.3 years). The groups did not show significant differences in age (p= 0.98) and sex. Concerning the macular thickness in optical coherence tomography, the variation in the study group differed significantly from the control group, presenting smaller values of thickness (p<0.001). There was negative and significant correlation between the duration of disease and the macular thickness assessed by optical coherence tomography (r=-0.57 and p=0.005). There was positive correlation between the duration of the disease and the visual acuity (r=0.50 and p=0.0167) and negative correlation between the visual acuity and the macular thickness in optical coherence tomography (r=-0.83 and p=0.0001). CONCLUSION: It was evidenced that patients with Stargardt's disease have a thinner macular thickness when compared to normal subjects, and this reduction is related to the duration of symptoms of the disease. Additionally, the thickness and also the duration of the disease influence the visual prognosis of the patients.

Surgical treatment of macular detachment secondary to congenital pit of the optic disc: case report.

The authors describe a patient with macular detachment in the right eye, secondary to congenital pit of the optic disc, submitted to vitrectomy, drainage of the subretinal fluid, perfluorocarbon, endolaser and perfluoropropane gas (C3F8). A sample of the vitreous humor was taken for comparative analysis with the subretinal fluid. Results of retinography, optical coherence tomography, and illustrations of the surgical procedure are presented. Optical coherence tomography revealed the detachment resolved 6 months after surgery. Visual acuity improved from 20/400 to 20/30. This surgical technique can lead to successful reattachment of the macula and improvement of central vision. Additionally, a qualitative and comparative analysis showed a similar biochemical composition of the subretinal fluid and the vitreous. Despite technical limitations, this analysis can confirm the pathophysiology of the disease, suggesting that the subretinal fluid may originate from the vitreous cavity in macular detachment secondary to congenital pit of the optic disc.

[Contrast sensitivity in diabetic retinopathy treated with argon laser panphotocoagulation]. / Sensibilidade ao contraste na retinopatia diabética tratada por panfotocoagulação com laser de argônio.

PURPOSE: To evaluate contrast sensitivity in patients with diabetic retinopathy (DR) treated with argon laser panphotocoagulation. METHODS: Prospective study of patients with diabetic retinopathy and 20/20 visual acuity, treated with retinal panphotocoagulation, following ETDRS criteria. The patients were submitted, initially, to complete ophthalmologic evaluation and contrast sensitivity testing (Vision Contrast Test System). After 3 months of treatment, they were reevaluated by means of visual acuity and contrast sensitivity. RESULTS: The sample comprised 28 patients (28 eyes), all with type II diabetes. A ranged from 45 to 77 years (mean 57.8+/-8.0), 19 (67.9%) patients were male and 9 (32.1%) female. Regarding the type of retinopathy, 18 (64.3%) had proliferative DR and 10 (35.7%) very severe non proliferative RD. No visual acuity alteration was observed after treatment. In relation to contrast sensitivity, there were no alterations between pre and post-treatment in all evaluated spacial frequencies 1.5 (p=0.191); 3.0 (p=0.850); 6.0 (p=0.374); 12.0 (p=0.674) e 18.0 (p=0.443). CONCLUSION: There was no significant alteration in the contrast sensitivity of patients with diabetic retinopathy after panphotocoagulation with argon laser in the studied period.

Quality of life in patients with age-related macular degeneration with monocular and binocular legal blindness.

OBJECTIVE: To evaluate the quality of life for persons affected by age-related macular degeneration that results in monocular or binocular legal blindness. METHODS: An analytic transversal study using the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was performed. Inclusion criteria were persons of both genders, aged more than 50 years old, absence of cataracts, diagnosis of age-related monocular degeneration in at least one eye and the absence of other macular diseases. The control group was paired by sex, age and no ocular disease. RESULTS: Group 1 (monocular legal blindness) was composed of 54 patients (72.22% females and 27.78% males, aged 51 to 87 years old, medium age 74.61 +/- 7.27 years); group 2 (binocular legal blindness ) was composed of 54 patients (46.30% females and 53.70% males aged 54 to 87 years old, medium age 75.61 +/- 6.34 years). The control group was composed of 40 patients (40% females and 60% males, aged 50 to 81 years old, medium age 65.65 +/- 7.56 years). The majority of the scores were statistically significantly higher in group 1 and the control group in relation to group 2 and higher in the control group when compared to group 1. CONCLUSIONS: It was evident that the quality of life of persons with binocular blindness was more limited in relation to persons with monocular blindness. Both groups showed significant impairment in quality of life when compared to normal persons.

[Optical coherence tomography macular study on eyes filled with silicone oil]. / Estudo macular em olhos com óleo de silicone por meio da tomografia de coerência óptica.

PURPOSE: To demonstrate optical coherence tomography efficacy to evaluate macular anatomical outcomes, in eyes with silicone oil-filled vitreous cavity after vitrectomy. METHODS: A descriptive observational study of 28 (twenty-eight) patients submitted to pars plana vitrectomy having silicone oil as vitreous substitute. The macular findings were observed by means of indirect binocular ophthalmoscope, biomicroscopy and optical coherence tomography examinations. RESULTS: During the follow-up period the retina remained attached in all patients. In some cases, intraretinal cysts, epiretinal membrane and lamellar macular hole were observed only by optical coherence tomography examination. CONCLUSION: Optical coherence tomography provided improved imaging of finer retinal structures in eyes with silicone oil-filled vitreous cavity. Therefore, optical coherence tomography examination should be systematically performed in eyes filled with silicone oil to recognize changes in retinal morphology.

Ki-67 cell proliferation in familial and in esporadic unilateral retinoblastoma: case report.

PURPOSE: Ki-67 is a nuclear protein that is expressed at all phases of the cell cycle except the resting phase. This study is a clinicopathologic observational case report that aims to report on the cell proliferation rates, as measured by the Ki-67 antigen, in two enucleated retinoblastoma eyes. METHODS: One unilateral familial (mother with unilateral disease - patient 1) and one unilateral sporadic retinoblastoma (patient 2) patients were submitted to enucleation without previous treatment. The tumor cell proliferation rate was assessed by the Ki-67 antigen labeling index (stained cells / 100 cells) in five different fields of the tumor. RESULTS: Patient 1 was 23 months old and the tumor was exophytic with associated neovascularization of the iris; patient 2 was 6 years old and the tumor was endophytic with coarse vitreous seeds. Both enucleated eyes presented optic nerve with free surgical margins. Positive Ki-67 cell index in patient 1 varied from 75 to 90 (MD +/- SD: 79.5 +/- 6.61) and in patient 2 from 38 to 60 (MD +/- SD: 46.6 +/- 8.2). CONCLUSIONS: The familial retinoblastoma, besides the earlier age presentation, showed 45.8% more Ki-67 positive cells than the same stage sporadic one. This proliferation rate may explain the earlier presentation age of the tumor in the inherited disease.

[Delay in ophthalmologic examination of diabetic retinopathy patients]. / Avaliação oftalmológica tardia em portadores de retinopatia diabética.

OBJECTIVE: To assess the delay in the ophthalmic examination of patients affected with severe diabetic retinopathy but no visual complaint. METHODS: A transversal analytical study was conducted of 44 visually asymptomatic diabetic patients. All were eligible to retinal panphotocoagulation in at least one eye. Duration and type of the disease as well as time of the first ophthalmic examination were established. RESULTS: Of the 44 patients, 6 (13.7%) had diabetes type 1 and 38 (86.3%) had diabetes type 2. Proliferative diabetic retinopathy was present in 24 (54.5%) and severe or very severe non proliferative retinopathy was present in 20 (45.5%). Best visual acuity ranged from 0.5 to 1.0 (mean 0.83+/-0.17) according to the Snellen chart. The time interval between diagnosis of diabetes and the first ophthalmic examination ranged from 7 to 19.5 years (13.2+/-5.12) for diabetes type 1 and from 3 months to 18 years (5.2+/-4.81) for diabetes type 2. CONCLUSION: Advanced diabetic retinopathy may be detected at different times of the ophthalmic examination in both types of diabetes. Although the mean interval between the diagnosis and the first examination is 13 years for diabetes type 1 and 5 years for diabetes type 2, this severe kind of retinopathy occurred as early as three months after diagnosis of diabetes. This points to the need for an earlier ophthalmic examination in the case of this disease.

Ki-67 cell proliferation in familial and in esporadic unilateral retinoblastoma: case report

PURPOSE: Ki-67 is a nuclear protein that is expressed at all phases of the cell cycle except the resting phase. This study is a clinicopathologic observational case report that aims to report on the cell proliferation rates, as measured by the Ki-67 antigen, in two enucleated retinoblastoma eyes. METHODS: One unilateral familial (mother with unilateral disease - patient 1) and one unilateral sporadic retinoblastoma (patient 2) patients were submitted to enucleation without previous treatment. The tumor cell proliferation rate was assessed by the Ki-67 antigen labeling index (stained cells / 100 cells) in five different fields of the tumor. RESULTS: Patient 1 was 23 months old and the tumor was exophytic with associated neovascularization of the iris; patient 2 was 6 years old and the tumor was endophytic with coarse vitreous seeds. Both enucleated eyes presented optic nerve with free surgical margins. Positive Ki-67 cell index in patient 1 varied from 75 to 90 (MD ± SD: 79.5 ± 6.61) and in patient 2 from 38 to 60 (MD ± SD: 46.6 ± 8.2). CONCLUSIONS: The familial retinoblastoma, besides the earlier age presentation, showed 45.8 percent more Ki-67 positive cells than the same stage sporadic one. This proliferation rate may explain the earlier presentation age of the tumor in the inherited disease.

OBJETIVO: O Ki-67 é antígeno nuclear que se expressa em todas as fases do ciclo celular, exceto no período de repouso. Este é um estudo de casos com correlação clínico-patológica que visa avaliar a taxa de proliferação celular, medida pelo antígeno Ki-67, em 2 olhos enucleados com retinoblastoma. MÉTODOS: Um paciente com retinoblastoma unilateral familiar (mãe com doença unilateral - paciente 1) e outro com retinoblastoma unilateral esporádico (paciente 2) foram submetidos à enucleação ocular sem outro tratamento prévio. A taxa de proliferação celular foi avaliada segundo índice obtido pela contagem de células marcadas com Ki-67, em 5 campos sob microscópia óptica (células marcadas/100 células). RESULTADOS: O paciente 1, com 23 meses de idade, apresentou tumor exofítico com neovascularização de íris associada; o paciente 2, de 6 anos, apresentou tumor de crescimento endofítico, com sementes vítreas importantes. Ambos os olhos enucleados apresentaram margens cirúrgicas do nervo óptico livres de neoplasia. O índice de células positivas no paciente 1 variou de 75 a 90 (Média ± DP: 79,5 ± 6,61), e no paciente 2, de 38 a 60 (Média ± DP: 46,6 ± 8,2). O retinoblastoma familiar, além de sua manifestação em idade mais precoce, apresentou 45,8 por cento mais células positivas que o retinoblastoma esporádico com o mesmo estadiamento. CONCLUSÃO: O retinoblastoma familiar, além de surgimento mais precoce, apresentou 45,8 por cento mais células em proliferação que o retinoblastoma esporádico em mesmo estádio. Essa taxa de proliferação pode explicar a menor idade de aparecimento do tumor nos casos de doença herdada.

[Rhegmatogenous retinal detachment: a postoperative study of the macula]. / Descolamento regmatogênico de retina: avaliação pós-operatória da mácula.

PURPOSE: To evaluate the structure and function of the macula following rhegmatogenous retinal detachment surgery. METHODS: Prospective study of patients submitted to scleral buckle surgery or pneumatic retinopexy. The follow-up comprised a complete ophthalmologic exam and optical coherence tomography. RESULTS: The sample was composed of 14 eyes (14 patients), 71.4% operated with the scleral buckle technique, and 28.6% with the pneumatic retinopexy. The age range was from 24 to 59 years (mean of 39.3 years). There was a negative correlation between the final visual acuity and age of patient (r=-0.64, p=0.0127) and between final vision and duration of detachment (r=-0.54, p=0.0447). There was a positive correlation between visual acuity at initial follow-up and that at the final follow-up (r=0.69, p=0.0059). The optical coherence tomography of the initial follow-up showed subclinical foveal detachment in four eyes (28.6% of cases); at the final follow-up the retina was applied by itself with improved vision in all eyes (p=0.031), regardless the time span until reapplication (p=0.5546). CONCLUSION: The results show that the younger the patient and the earlier the surgical procedure, the better the final visual acuity. Furthermore, there is a positive correlation between initial and final postoperative vision and, all cases that presented foveal detachment on the optical coherence tomography at the initial follow-up had the retina flattened and the vision improved at the final examination.