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1.
Retina ; 44(6): 1107-1110, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38176001

RESUMO

PURPOSE: The intraocular lens blocking technique described for the removal of intraocular foreign bodies emerged as a result of an effort to prevent the foreign body from being retracted into the posterior segment because of the resistance encountered while removing it from the corneal incision. However, in the technique described, in addition to the difficulty of the surgical procedure, the new concern is to create a posterior capsulorhexis according to the size of the foreign body and to pass the foreign body through the capsulorhexis. METHODS: Here, the authors describe a new approach to the intraocular lens blocking technique. In this approach, the intraocular foreign body, which is held with intraocular forceps without any opening in the posterior capsule, is held in a perpendicular position to the long axis, lifted directly into the anterior chamber, and safely removed from the front of the monoblock foldable intraocular lens. RESULTS: In all patients treated with this approach, IOFBs were successfully removed without intraoperative or postoperative complications, and postoperative intraocular lens centralization was achieved in all patients. CONCLUSION: This approach may provide practicality to the intraocular lens blocking technique.


Assuntos
Capsulorrexe , Corpos Estranhos no Olho , Lentes Intraoculares , Humanos , Corpos Estranhos no Olho/cirurgia , Corpos Estranhos no Olho/diagnóstico , Capsulorrexe/métodos , Masculino , Feminino , Adulto , Ferimentos Oculares Penetrantes/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
2.
Eye Contact Lens ; 49(7): 296-300, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37171496

RESUMO

PURPOSE: To compare the effects of cooled and room temperature irrigation on the preoperative and early postoperative corneal endothelial parameter values in posterior vitrectomy. MATERIALS AND METHODS: In this prospective, randomized, comparative study, 68 patients underwent a standard 3-port, 23-G posterior vitrectomy operation by a single surgeon. Cooled irrigation solution was applied to 36 patients during surgery (group 1), and room temperature irrigation solution was applied to 32 patients (group 2). The patients were also divided into four groups according to their history of noncomplicated cataract surgery (phakic or pseudophakic) and the types of tamponade used (silicone or gas). The central corneal thickness (CCT), endothelial cell density (ECD), mean cell area (MCA), hexagonal cell percent, and coefficient of variation of cell area (CV) parameter values of the groups at preoperative and postoperative 1 month were compared. RESULTS: There were no statistically significant differences between the preoperative and postoperative corneal parameter values in groups 1 and 2 ( P >0.05). However, it was remarkable that the percentage of preoperative-postoperative change in all the corneal parameter values was higher in group 2. When the results of the subgroup analyses of the patients who were pseudophakic and used gas tamponade (Group D) in group 2 were examined, it was determined that the negative effects were significantly higher in the postoperative values for the ECD, MCA, CV, and CCT parameters compared with the preoperative values ( P <0.05). CONCLUSION: In patients with pseudophakia and gas tamponade, cooled irrigation was found to be more advantageous for corneal parameters.


Assuntos
Endotélio Corneano , Vitrectomia , Humanos , Temperatura , Estudos Prospectivos , Córnea/cirurgia , Contagem de Células
3.
Retina ; 42(10): 1931-1938, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36129266

RESUMO

PURPOSE: To investigate the changes in the microvascular structure of the retina and optic disk by comparing the optical coherence tomography angiography findings in preeclamptic patients with those in healthy pregnant women and healthy nonpregnant women and also to evaluate the preeclamptic patients after delivery by showing whether the changes are permanent or not. METHODS: Fifty preeclamptic, 50 healthy pregnant, and 50 healthy nonpregnant women enrolled in three groups (preeclamptic pregnant women group, healthy pregnant women group, and nonpregnant women group; respectively). Patients in the preeclamptic pregnant women group were evaluated at three different time points including up to 3 hours before delivery (Group 1), 2, or 3 days after delivery (Group 2), and 6 weeks after delivery (Group 3), and compared with each other. All patients underwent a comprehensive ophthalmologic examination including optical coherence tomography angiography. RESULTS: Choriocapillaris blood flow area, deep foveal density, deep temporal density, deep nasal density, and radial peripapillary capillary inside disk density values were significantly lower in the preeclamptic pregnant women group than in the healthy pregnant women group. Deep foveal density and deep nasal density values were significantly higher in Group 3 than in Group 1 and 2, and deep temporal density was significantly higher in Group 3 than in Group 1. CONCLUSION: Optical coherence tomography angiography diagnosed decreased deep retinal capillary density values in the macula of patients with preeclampsia, but these results improved after delivery.


Assuntos
Macula Lutea , Disco Óptico , Pré-Eclâmpsia , Feminino , Angiofluoresceinografia/métodos , Humanos , Macula Lutea/irrigação sanguínea , Disco Óptico/irrigação sanguínea , Pré-Eclâmpsia/diagnóstico , Gravidez , Vasos Retinianos/fisiologia , Tomografia de Coerência Óptica/métodos
4.
Int Ophthalmol ; 42(6): 1763-1769, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35079939

RESUMO

PURPOSE: Comparison of postoperative intraocular pressure (IOP) course and early complications in 23-gauge (23-G) pars plana vitrectomy (PPV) using vertical entry sclerotomy and scleral tunnel sclerotomy in uncomplicated rhegmatogenous retinal detachment (RRD). METHOD: A prospective, randomized, comparative, interventional clinical trial of 103 23-G vitrectomy cases using two different transconjunctival sutureless sclerotomy techniques performed by a single vitreoretinal surgeon for uncomplicated RRD. Fifty-two eyes underwent PPV using a three-port 23-G single stage, vertical trocar entry without creating a scleral tunnel (Group 1), while in 51 eyes, a two-stage, oblique trocar entry with creation of a scleral tunnel was performed (Group 2). Sulfur hexafluoride (SF6) gas (20%) was used in all cases as a buffer. Intraocular pressure measurements and detailed biomicroscopic examination of the groups were recorded on the postoperative first day, first week, and first month. Visual acuity and fundoscopic examinations were recorded at one month. The effects of the two methods on postoperative intraocular pressure and early complications were compared. RESULTS: There was no significant difference between the two groups in terms of age and gender (p > 0.05). The mean postoperative intraocular pressure on the first day was 15.06 ± 3.71 for Group 1 and 16.14 ± 3.09 mmHg for Group 2. The lowest recorded IOP was 6 mmHg. Postoperative visual acuity did not differ between the two groups (p > 0.05). In addition, IOP values did not differ statistically between the two groups (p > 0.05). In both groups, the mean IOP values measured at different intervals did not differ statistically (p > 0.05). CONCLUSION: There was no significant difference in terms of postoperative IOP between vertical entry 23-G sclerotomy and 23-G tunnel entry sclerotomy for PPV with 20% SF6 tamponade surgery.


Assuntos
Oftalmopatias , Hipotensão Ocular , Descolamento Retiniano , Cirurgia Vitreorretiniana , Oftalmopatias/cirurgia , Humanos , Pressão Intraocular , Microcirurgia/métodos , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Hexafluoreto de Enxofre , Vitrectomia/métodos
5.
Can J Ophthalmol ; 57(3): 195-200, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33887261

RESUMO

OBJECTIVE: The aim of this study was to evaluate the incidence, severity, and treatment modalities of retinopathy of prematurity (ROP) in moderate and late preterm infants with a gestational age (GA) >31 + 6 weeks. METHODS: ROP screening results of preterm infants with GA >31 + 6 weeks to 36 + 6 weeks between March 2013 and January 2019 were evaluated retrospectively. Infants were divided into 2 groups according to GA as 32-33 + 6 weeks (moderate preterm) and 34-36 + 6 weeks (late preterm). In these groups, any ROP and severe ROP (requiring treatment) development rates and ROP types and treatment modalities were evaluated. RESULTS: A total of 4156 preterm infants, 1875 (45.1%) female and 2281 (54.9%) male, were included. Overall, 1466 (35.2%) of the infants were moderate preterm and 2690 (64.8%) were late preterm. The incidences of any ROP and severe ROP were 22% and 2.5%, respectively. The rate of severe ROP was 5.3% in moderate preterm infants and 0.9% in late preterm infants. Significant correlations were determined between duration of hospital stay, birth weight (BW), and GA with ROP development (r = +0.415, r = -0.258, r = -0.199, respectively; p < 0.001 for all). Of 102 patients (2.5%) requiring treatment, 64 (62.7%) had laser, 34 (33.3%) had intravitreal bevacizumab (IVB), 2 (1.9%) had sequential IVB and laser, and 2 (1.9%) had vitreoretinal surgery. CONCLUSION: ROP seems to still be an important health problem in moderate and late preterm infants in our country according to data from screening high-risk preterm infants with a GA >31 + 6 weeks. In this cohort, ROP development correlates with GA, BW, and duration of hospitalization significantly.


Assuntos
Retinopatia da Prematuridade , Bevacizumab , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/terapia , Estudos Retrospectivos , Fatores de Risco
6.
Eye (Lond) ; 35(12): 3302-3310, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33514904

RESUMO

OBJECTIVES: This study evaluated the efficacy of intravitreal bevacizumab (IVB) monotherapy for aggressive posterior retinopathy of prematurity (APROP) and Type 1 retinopathy of prematurity (ROP), along with recurrence rates and treatment outcomes for recurrences. METHODS: This retrospective cohort study reviewed the records of infants with ROP (Type 1 and APROP), who received IVB treatment between March 2013 and February 2018. RESULTS: A total of 257 eyes from 130 cases (unilateral eyes in three cases) were included. Cases were followed for 121.7 ± 45.7 weeks (range: 70-260 weeks). Recurrence requiring treatment was determined in 14.8% of all eyes at a mean of 9.6 ± 2.7 weeks (range: 6-15 weeks) after initial treatment and a mean of 42.3 ± 2.2 weeks (range: 38-48 weeks) postmenstrual age. Recurrence requiring treatment was observed in 20.8% of APROP and 5.8% of Type 1 ROP eyes at a statistically significant difference (p = 0.001). Persistent avascular areas were found in 54 eyes (25.8%) at the corrected age of 1 year, and prophylactic laser treatment was applied. This was statistically significantly higher in APROP (38.6%) than in Type 1 ROP (10.5%) (p < 0.001). An unfavourable structural outcome (progression to retinal detachment) occurred in one eye (0.4%), which developed insufficient regression and progression. CONCLUSIONS: IVB monotherapy is effective for APROP and Type 1 ROP with Zone 1 and posterior Zone 2 localisation. However, because of recurrences requiring treatment and persistent peripheral avascular areas, severe, late complications must be considered, and follow-up examinations must be made. Prophylactic laser treatment for persistent avascular areas seems effective for minimising long-term complications.


Assuntos
Retinopatia da Prematuridade , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Injeções Intravítreas , Fotocoagulação a Laser , Recidiva , Retinopatia da Prematuridade/terapia , Estudos Retrospectivos
7.
Curr Eye Res ; 44(6): 645-650, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30657707

RESUMO

Purpose: Pterygium, one of the most common ocular surface diseases, is characterized by inflammatory infiltrates, proliferation, angiogenesis, fibrosis, and extracellular matrix breakdown. The objective of this study was to elucidate the levels of the intercellular adhesion molecule (ICAM)-2, and ICAM-3 gene and protein expressions in pterygium. Methods: A total of 59 patients with pterygium were included in this study. mRNA from pterygial and conjunctival autograft tissues were extracted, and real-time polymerase chain reaction on the BioMark HD dynamic array system was performed for the ICAM-2 and ICAM-3 gene expressions. ICAM-2 and ICAM-3 protein expressions using western blot and immunohistochemistry methods were also investigated in pterygial and conjunctival autograft tissues. Results: ICAM-2 and ICAM-3 gene expressions were markedly augmented in pterygial tissues (P = 0.0018 and P = 0.0023, respectively). Significant increases in protein expressions in pterygial tissues were also detected for ICAM-2 and ICAM-3 (P = 0.0116 and P = 0.0252, respectively). In the immunohistochemical studies, there was a marked increase in ICAM-3 (P = 0.0152), but not in ICAM-2 (P = 0.1041), protein expressions in pterygial tissues. Significant positive correlations between pterygia grading with ICAM-2 protein expression (P = 0.0398) and ICAM-3 immunohistochemical scores (P = 0.0138) were observed. Conclusion: These results demonstrate, for the first time, the expressions of ICAM-2 and ICAM-3 in the pterygium. These findings may help to understand the signal transduction mechanisms in the pterygium formation and provide a new therapy strategy for pterygium treatment.


Assuntos
Antígenos CD/genética , Moléculas de Adesão Celular/genética , Regulação da Expressão Gênica/fisiologia , Pterígio/metabolismo , Adulto , Idoso , Antígenos CD/metabolismo , Biomarcadores/metabolismo , Western Blotting , Moléculas de Adesão Celular/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Adulto Jovem
8.
Int Ophthalmol ; 39(9): 2077-2081, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30467664

RESUMO

PURPOSE: To present a surgical intervention for a posterior haptic trapped between the cartridge and plunger during intraocular lens (IOL) implantation. MATERIALS AND METHODS: Posterior haptic incarceration was detected in 36 cases during implantation of a one-piece foldable IOL during cataract surgery with phacoemulsification. In 11 of the patients (Group 1), recovery was achieved by forcibly pulling out the incarcerated posterior haptic. In 25 cases (Group 2), the haptic was recovered by using an MVR knife to cut the cartridge tip from the bottom up parallel to the trapped haptic. RESULTS: In Group 1, tears were seen on the incarcerated haptic in all cases (100%). In Group 2, the procedure was successful in all 25 cases and there was no accidental cutting of the haptic. In all cases, the surgeries were completed with the recovered IOL in Group 2. CONCLUSIONS: Posterior haptic incarceration in cataract surgery can be solved by the simple and easy method of cutting the cartridge tip from the bottom upwards and releasing the haptic.


Assuntos
Resinas Acrílicas , Cápsula do Cristalino/cirurgia , Lentes Intraoculares/efeitos adversos , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Acuidade Visual , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Reoperação , Estudos Retrospectivos
9.
Arq Bras Oftalmol ; 81(4): 302-309, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29995122

RESUMO

PURPOSE: Scleral fixation surgery is a pivotal procedure that depends on the availability of robust and innovative surgical fixation methods. There continues to be a need for innovation in suture fixation techniques, particularly for intraocular lens implantation. METHODS: We conceived and designed a "knot ball" scleral fixation technique for suture burial in a retrospective sample of 108 patients with primary (n=40) or secondary (n=68) scleral-fixated intraocular lens. Importantly, our technique did not require additional scleral flap or tunnel procedures. We evaluated pre- and postoperative best-corrected visual aquity (BCVA) and postoperative complications. All data were analyzed and compared between groups. RESULTS: The preoperative mean BCVA improved significantly in both groups using the "knot ball" fixation technique (p<0.01). The extent of the improvement in the best-corrected visual acuity and late complications one month post-surgery were not significantly different between the groups (p>0.05). These clinical outcomes were consistent with those described in the ophthalmology literature. CONCLUSION: A "knot ball" scleral fixation technique is reported; to the best of our knowledge, this is the first report of such a technique, which offers a less invasive and simplified surgical procedure for transscleral fixation of scleral-fixated intraocular lenses. Moreover, the technique appears to display similar effectiveness and safety compared with existing scleral fixation techniques. We suggest that the "knot ball" technique warrants further research focus and clinical evaluation in future studies.


Assuntos
Implante de Lente Intraocular/métodos , Doenças da Esclera/cirurgia , Técnicas de Sutura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Adulto Jovem
10.
Arq Bras Oftalmol ; 81(2): 95-101, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29846417

RESUMO

PURPOSE: To compare the use of topical anesthesia and retrobulbar anesthesia during silicone oil removal with a mixed pars plana technique, through evaluating the pain experience of patients. METHODS: We selected patients according to their behavior during previous vitreoretinal surgery and ophthalmologic examinations and divided them into two anesthesia groups: topical (n=36) and retrobulbar (n=33). We used a mixed technique for the passive removal of silicone oil in both groups. During each step of the surgery, the patients' pain experience and the surgeon's comfort were scored according to a pain scale. RESULTS: The pain experienced during the application of the anesthesia was significantly greater in the retrobulbar group (p<0.001). The topical group experienced greater pain during trocar insertion (p<0.001). There was no significant difference between the groups regarding the overall pain experience or complications. CONCLUSIONS: The pain experience of the selected patients during silicone oil removal was comparable between the topical and the retrobulbar anesthesia. Topical anesthesia with the mixed pars plana technique is an effective and safe alternative option for silicone oil removal surgery.


Assuntos
Administração Oftálmica , Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Injeções Intraoculares/métodos , Medição da Dor , Dor Processual/prevenção & controle , Óleos de Silicone , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas/efeitos adversos , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Sucção/instrumentação , Sucção/métodos , Resultado do Tratamento , Acuidade Visual , Cirurgia Vitreorretiniana/efeitos adversos , Cirurgia Vitreorretiniana/métodos , Adulto Jovem
11.
Cornea ; 37(4): 466-469, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29303886

RESUMO

PURPOSE: To investigate anterior segment parameters in patients with Wilson disease (WD). METHODS: In this cross-sectional study, 22 patients with WD (study group) and 22 healthy subjects (control group) were enrolled. Each participant underwent a comprehensive ophthalmic assessment including best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination, and intraocular pressure. Anterior segment parameters were measured by the Sirius anterior segment analyzer system (Costruzione Strumenti Oftalmici, Florence, Italy). RESULTS: Mean central corneal thickness was 522 ± 47 µm in the study group and 568 ± 37 µm in the control group (P < 0.001). Mean flat keratometry was 42.4 ± 1.7 diopter (D) in the study group and 41.5 ± 1.16 D in the control group (P = 0.011); mean steep keratometry was 43.4 ± 2.0 and 42.4 ± 1.4 D in the study and control groups, respectively (P = 0.025). The anterior corneal elevation value was 5.5 ± 3.2 µm in the study group and 4.08 ± 2.2 µm in the control group (P = 0.029); the mean posterior corneal elevation value was 15.1 ± 6.0 and 10.1 ± 4.1 µm in the study and control groups, respectively (P = 0.002). The mean anterior chamber depth was 2.97 ± 0.3 µm in the study group and 3.16 ± 0.3 µm in the control group (P = 0.01); the mean horizontal visible iris diameter was 11.9 ± 0.4 and 12.2 ± 0.4 µm in the study and control groups, respectively (P = 0.001). CONCLUSIONS: This study indicates that patients with WD have differences in the anterior segment parameters including central corneal thickness, keratometric values, anterior and posterior elevations, horizontal visible iris diameter, and anterior chamber depth when compared with healthy controls.


Assuntos
Segmento Anterior do Olho/patologia , Degeneração Hepatolenticular/patologia , Adulto , Idoso , Câmara Anterior/patologia , Estudos de Casos e Controles , Córnea/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Int Ophthalmol ; 37(2): 349-356, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27334604

RESUMO

The objective of this study is to compare pain and discomfort scores of patients during 23-G vitreoretinal surgery under topical and retrobulbar anesthesia without using sedation. A total of 157 patients with various vitreoretinal disorders were included in this study. Patients were randomly divided into two groups: topical (group 1, n = 76) and retrobulbar anesthesia (group 2, n = 81). Patients underwent 23-G vitreoretinal surgery without using sedation. All patients rated the level of experienced pain during the surgical procedure using a visual analogue pain scale. Pain and discomfort scores while performing anesthesia were significantly higher in group 2 than group 1 (p < 0.001). Patients in group 1 experienced more pain than group 2 during trocar insertion, endolaser photocoagulation, and scleral indentation steps of surgery (for all; p < 0.001). There was no significant difference in overall pain and discomfort scores and surgeon comfort scores between groups (p = 0.163, p = 0.097; respectively). None of the patients required additional anesthesia or sedation during or after the procedure. Topical anesthesia without using sedation is a safe and effective, alternative method for 23-G vitreoretinal surgeries in selected patients with various vitreoretinal pathologies.


Assuntos
Anestesia Local/métodos , Lidocaína/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Satisfação do Paciente , Cirurgia Vitreorretiniana/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais/administração & dosagem , Feminino , Humanos , Injeções , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Órbita , Medição da Dor , Dor Pós-Operatória/diagnóstico , Adulto Jovem
13.
Semin Ophthalmol ; 32(3): 270-275, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-26337191

RESUMO

PURPOSE: To evaluate the clinical outcomes of maximal levator muscle resection surgery in patients with poor levator function. METHODS: This prospective study included 29 eyelids of 23 patients who underwent maximal levator resection surgery. Pre- and postoperatively, all patients' routine ophthalmic examination including evaluation of upper eyelid skin crease positions; levator muscle function (LF), rima palpebrarum (RP), and margin-reflex distance (MRD) measurements were recorded. Outcome was considered successful when the difference between the two upper eyelids was ≤1 mm; if the difference between the two eyelid margins was more than 1 mm and less than 2 mm, it was considered to be satisfactory. More than 2 mm difference was considered to be poor. RESULTS: Mean patient age was 11.3 ± 8.6 years (3 months to 24 years). Mean follow-up time was 22.8 ± 6.9 months (10 to 36 months). Preoperatively mean RP, MRD, and LF measurements were 5.5 ± 1.7 mm, -0.14 ± 1.6 mm, 2.5 ± 1.4 mm (0-4 mm), respectively. Preoperatively, eight (27,6%) patients had skin crease. Abnormal head posture was detected in eight (34.8%) of the patients. Postoperatively, RP, MRD, and LF values increased significantly (p < 0.05). Mean RP, MRD, and LF measurements were 8.3 ± 1.5 mm, 2.6 ± 1.2 mm, 5.1 ± 2.1 mm, respectively. Fourteen subjects (60.9%) had successful results, two subjects (8.7%) had satisfactory results, and seven subjects (30.4%) had poor results. Abnormal head postures of all patients were resolved. CONCLUSIONS: Maximal levator resection may be a good alternative method to frontalis suspension in congenital blepharoptosis patients with poor levator function.


Assuntos
Blefaroplastia/métodos , Blefaroptose/cirurgia , Movimentos Oculares/fisiologia , Músculos Oculomotores/cirurgia , Adolescente , Adulto , Blefaroptose/fisiopatologia , Criança , Pré-Escolar , Pálpebras/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Músculos Oculomotores/fisiopatologia , Período Pós-Operatório , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
14.
Arq Bras Oftalmol ; 79(5): 336-338, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27982217

RESUMO

We report a case of bilateral acute angle-closure glaucoma in a patient with undiagnosed granulomatosis with polyangiitis (Wegener's). A 59-year-old man presented with a severe headache, ocular pain, blurred vision, shortness of breath, and mild fever. Clinical examination revealed conjunctival chemosis, corneal edema, and shallow anterior chambers. Closed angles were observed bilaterally on gonioscopy. The patient was treated with intravenous mannitol, oral acetazolamide, and anti-glaucomatous eye drops. Over the following two days, his vision improved and intraocular pressures decreased. Subsequently, laser iridotomies were performed bilaterally and the patient attended consultations with our departments of respiratory medicine, nephrology, and rheumatology and was subsequently diagnosed with granulomatosis with polyangiitis. Bilateral acute angle-closure glaucoma is a very rare ocular manifestation of granulomatosis with polyangiitis. The association of this clinical entity with Wegener's granulomatosis remains unknown.


Assuntos
Glaucoma de Ângulo Fechado/etiologia , Granulomatose com Poliangiite/complicações , Doença Aguda , Glaucoma de Ângulo Fechado/diagnóstico por imagem , Glaucoma de Ângulo Fechado/patologia , Glaucoma de Ângulo Fechado/terapia , Granulomatose com Poliangiite/diagnóstico por imagem , Granulomatose com Poliangiite/patologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Fatores de Tempo , Tomógrafos Computadorizados , Ultrassonografia
15.
Arq. bras. oftalmol ; 79(5): 336-338, Sept.-Oct. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-827966

RESUMO

ABSTRACT We report a case of bilateral acute angle-closure glaucoma in a patient with undiagnosed granulomatosis with polyangiitis (Wegener's). A 59-year-old man presented with a severe headache, ocular pain, blurred vision, shortness of breath, and mild fever. Clinical examination revealed conjunctival chemosis, corneal edema, and shallow anterior chambers. Closed angles were observed bilaterally on gonioscopy. The patient was treated with intravenous mannitol, oral acetazolamide, and anti-glaucomatous eye drops. Over the following two days, his vision improved and intraocular pressures decreased. Subsequently, laser iridotomies were performed bilaterally and the patient attended consultations with our departments of respiratory medicine, nephrology, and rheumatology and was subsequently diagnosed with granulomatosis with polyangiitis. Bilateral acute angle-closure glaucoma is a very rare ocular manifestation of granulomatosis with polyangiitis. The association of this clinical entity with Wegener's granulomatosis remains unknown.


RESUMO Relatamos um caso glaucoma bilateral agudo de ângulo fechado em um paciente sem diagnóstico prévio de granulomatose com poliangeíte (Wegener). Um homem de 59 anos apresentou-se com uma forte dor de cabeça, dor nos olhos, visão turva, dificuldade em respirar e febre baixa. Observamos quemose conjuntival, edema da córnea e câmara anterior rasa. A gonioscopia demonstrou ângulos fechados bilateralmente. Ele foi tratado com manitol intravenoso, acetazolamida oral, olho e colírios antiglaucomatosos. Durante os dois dias seguintes a sua visão melhorou e as pressões intra-oculares diminuíram. A seguir, foram realizadas iridotomias a laser bilateralmente e ele foi referido para os departamentos de doenças pulmonares, nefrologia e reumatologia. Ele foi diagnosticado com poliangeíte granulomatosa. Glaucoma bilateral agudo de ângulo fechado é uma entidade clínica muito rara e sua associação com a granulomatose de Wegener é desconhecida e deve acrescentar-se à lista de manifestações oculares de granulomatose com poliangeíte.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Glaucoma de Ângulo Fechado/etiologia , Granulomatose com Poliangiite/complicações , Fatores de Tempo , Radiografia Torácica , Glaucoma de Ângulo Fechado/patologia , Glaucoma de Ângulo Fechado/terapia , Glaucoma de Ângulo Fechado/diagnóstico por imagem , Tomógrafos Computadorizados , Granulomatose com Poliangiite/patologia , Granulomatose com Poliangiite/diagnóstico por imagem , Doença Aguda , Ultrassonografia , Pressão Intraocular
16.
Arq Bras Oftalmol ; 79(4): 209-13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27626141

RESUMO

PURPOSE: To investigate the effects of the Valsalva maneuver (VM) on optic disc morphology, choroidal thickness, and anterior chamber parameters. METHODS: This prospective observational study included 60 eyes of 60 healthy subjects. The anterior chamber parameters, including central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), pupil diameter (PD), axial length (AL), subfoveal and peripapillary choroidal thickness, optic disc parameters, and intraocular pressure (IOP), were measured at rest and during VM. RESULTS: VM did not have any significant influence on AL, subfoveal and peripapillary choroidal thickness, optic disc area, rim area, cup area, cup-to-disc area ratio, vertical cup-to-disc ratio, rim volume, cup volume, and nerve head volume measurements (for all; p >0.05). IOP and PD significantly increased during VM (for both; p <0.001). VM significantly decreased CCT, ACD, ACA, and ACV values (for all; p <0.001). Moreover, the optic nerve cup volume decreased and the horizontal cup-to-disc ratio significantly increased during VM (for both; p <0.05). CONCLUSIONS: VM may cause transient changes in IOP, optic disc morphology, and anterior chamber parameters.


Assuntos
Câmara Anterior/anatomia & histologia , Corioide/anatomia & histologia , Pressão Intraocular/fisiologia , Disco Óptico/anatomia & histologia , Manobra de Valsalva/fisiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Óptico/fisiologia , Postura/fisiologia , Estudos Prospectivos , Valores de Referência , Análise de Regressão
18.
Wien Klin Wochenschr ; 128(Suppl 8): 587-595, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25860848

RESUMO

BACKGROUND: The aim of this study was to investigate the antioxidant and radioprotective effects of propolis, caffeic acid phenethyl ester (CAPE), Nigella sativa oil (NSO), and thymoquinone (TQ) against ionizing radiation-induced cataracts in lens after total cranium irradiation of rats with single dose of 5-Gy cobalt-60 gamma rays. METHODS: A total of 74 Sprague-Dawley rats were divided into 8 groups to test the radioprotective effectiveness of Nigella sativa oil, thymoquine, propolis, or caffeic acid phenethyl ester administered by either orogastric tube or intraperitoneal injection. Appropriate control groups were also studied. RESULTS: Chylack's cataract classification was used in the study. At the end of the tenth day, cataracts developed in 80 % of the rats in the radiotherapy group. After irradiation, cataract rate dropped to 20 % in NSO, 30 % in propolis, 40 % in CAPE, and 50 % in TQ groups and was limited to grade 1 and grade 2. Cataract formation was observed the least in NSO group and the most in TQ group. In the irradiated (IR) group, superoxide dismutase activity was lower, while glutathione peroxidase and xanthine oxidase activities and malondialdehyde level were higher compared with the other groups. Total superoxide scavenger activity and nonenzymatic superoxide scavenger activity were not statistically significant in IR group compared with the other groups. CONCLUSIONS: The findings obtained in the study might suggest that propolis, CAPE, NSO, and TQ could prevent cataractogenesis in ionizing radiation-induced cataracts in the lenses of rats, wherein propolis and NSO were found to be more potent.


Assuntos
Benzoquinonas/administração & dosagem , Ácidos Cafeicos/administração & dosagem , Catarata/tratamento farmacológico , Álcool Feniletílico/análogos & derivados , Óleos de Plantas/administração & dosagem , Própole/administração & dosagem , Lesões por Radiação/tratamento farmacológico , Animais , Antioxidantes/administração & dosagem , Catarata/metabolismo , Catarata/patologia , Irradiação Craniana/efeitos adversos , Relação Dose-Resposta a Droga , Masculino , Álcool Feniletílico/administração & dosagem , Lesões por Radiação/etiologia , Protetores contra Radiação/administração & dosagem , Ratos , Ratos Sprague-Dawley , Resultado do Tratamento
19.
Pediatr Neurol ; 53(2): 146-50, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26096619

RESUMO

BACKGROUND: Retinopathy of prematurity is a proliferative vascular disease affecting premature newborns and occurs during vessel development and maturation. The aim of this study was to evaluate the maternal iron deficiency anemia as possible risk factors associated with the development of retinopathy of prematurity among premature or very low birth weight infants. METHODS: In this study, mothers of 254 infants with retinopathy of prematurity were analyzed retrospectively, and their laboratory results of medical records during pregnancy were reviewed for possible iron deficiency anemia. RESULTS: In a cohort of 254 mothers of premature infants with retinopathy of prematurity, 187 (73.6%) had iron deficiency, while the remaining 67 (26.4%) mothers had no deficiency. Babies born to mothers with iron deficiency anemia with markedly decreased hemoglobin, hematocrit, mean corpuscular volume, serum iron, and ferritin levels were more likely to develop retinopathy of prematurity. CONCLUSIONS: Our results are the first to suggest that maternal iron deficiency is a risk factor for the development of retinopathy of prematurity. Our data suggest that maternal iron supplementation therapy during pregnancy might lower the risk of retinopathy of prematurity.


Assuntos
Anemia Ferropriva/fisiopatologia , Recém-Nascido Prematuro , Complicações na Gravidez/fisiopatologia , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/etiologia , Anemia Ferropriva/epidemiologia , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Gravidez , Complicações na Gravidez/epidemiologia , Fatores de Risco
20.
BMC Ophthalmol ; 15: 47, 2015 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-25946992

RESUMO

BACKGROUND: Intraorbital haematoma is a rare clinical entity which can be caused by orbital traumas, neoplasms, surgeries nearby sinuses and orbit, vascular malformations, acute sinusitis, systemic abnormalities, barotrauma and valsalva maneuver. CASE PRESENTATION: A 74-year-old male presented with sudden onset of ocular pain, upper eye lid swelling, proptosis and diplopia after a commercial flight. After complete ophthalmic ocular examination including pupillary light reflexes and laboratory examinations; computed tomography and magnetic resonance imaging of orbit revealed a subperiostal mass-like lesion in the right retrobulbar-extraconal region which was compatible with intraorbital haematoma. Visual acuity was not compromised so we planned a conservative approach with close observation. We administered systemic corticosteroid and topical dorzolamide/timolol combination therapy. At the first month follow-up, intraorbital haematoma resolved without significant sequelae. CONCLUSION: Intraorbital haematoma can be managed by conservative approach without any intervention if it does not threat visual acuity or optic nerve. We experienced a case of intraorbital haematoma during a commercial flight. We discussed the rarity of this condition and its management.


Assuntos
Viagem Aérea , Hematoma/etiologia , Doenças Orbitárias/etiologia , Manobra de Valsalva , Idoso , Diplopia/diagnóstico , Combinação de Medicamentos , Edema/diagnóstico , Dor Ocular/etiologia , Doenças Palpebrais/diagnóstico , Glucocorticoides/uso terapêutico , Hematoma/diagnóstico por imagem , Hematoma/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/tratamento farmacológico , Sulfonamidas/uso terapêutico , Tiofenos/uso terapêutico , Timolol/uso terapêutico , Tomografia Computadorizada por Raios X
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