Normative data for macular perimetry using the MP-3 microperimeter in healthy individuals / Dados normativos para perimetria macular usando o microperímetro MP-3 em indivíduos normais

ABSTRACT Purpose: Microperimetry has been used for several years as a form of visual function testing in patients with retinal diseases. Normal microperimetry values obtained with microperimeter MP-3 have not yet been fully published, and baseline values for topographic macular sensitivity and correlations with age and sex are needed to establish degrees of impairment. This study aimed to determine values for light sensitivity thresholds and fixation stability using the MP-3 in healthy individuals. Methods: Thirty-seven healthy volunteers (age, 28-68 years), underwent full-threshold microperimetry using a 4-2 (fast) staircase strategy with the standard Goldmann III stimulus size and 68 test points positioned identically to those in the Humphrey Field Analyzer 10-2 test grid. The fixation stability was simultaneously recorded during the microperimetry test. The relationship between global sensitivity and age was calculated using linear regression analysis. Results: Microperimetry was performed on 37 participants (74 eyes). The global mean sensitivity was 29.01 ± 1.44 (range, 26-31) dB. The mean central sensitivity at 2° measured by the MP-3 was 28.5 ± 1.77 dB in the right eye (OD) and 28.75 ± 1.98 dB in the left eye (OS). The total median fixation stability values within 2° and 4° were 80% and 96%, respectively. The linear regression analysis also revealed an age-related global sensitivity decline per year of -0.051 dB ± 0.018 (OD) and -0.078 dB ± 0.021 (OS). Conclusions: Microperimetry performed with the MP-3 allows for an automatic, accurate, and topography-specific examination of retinal sensitivity thresholds. The results of this study provide a normal and age-matched database of MP-3 microperimetry.

RESUMO Objetivos: A microperimetria tem sido usada há vários anos como uma forma de teste de função visual em pacientes com doenças da retina. Os valores normais de microperimetria obtidos com MP-3 ainda não foram totalmente publicados e os valores basais para sensibilidade macular topográfica e correlações com idade e sexo são necessários para estabelecer graus de comprometimento. O objetivo do trabalho é determinar valores para limiares de sensibilidade à luz e estabilidade de fixação usando o MP-3 em indivíduos normais. Métodos: Trinta e sete voluntários saudáveis (idade: 28-68 anos), submetidos à microperimetria de limiar total usando uma estratégia de escada 4-2 (rápida) com o tamanho de estímulo padrão Goldmann III e 68 pontos de teste posicionados de forma idêntica aos do Humphrey Field Analyzer 10-2 grade de teste. A estabilidade da fixação foi registrada simultaneamente durante o teste de microperimetria. A relação entre a sensibilidade global e a idade foi calculada por meio de análise de regressão linear. Resultados: A microperimetria foi realizada em 37 indivíduos (74 olhos). A sensibilidade média global foi de 29,01 ± 1,44 dB, intervalo: 26-31 dB. A mediana da sensibilidade central a 2° medida pelo MP-3 foi de 28,5 ± 1,77 dB (ER) e 28,75 ± 1,98 dB (OE). Os valores médios totais de estabilidade da fixação em 2° e 4° foram 80% e 96%, respectivamente. A análise de regressão linear também revelou um declínio de sensibilidade global relacionado à idade por ano de -0,051 dB ± 0,018 (ER) e -0,078 dB ± 0,021 (LE). Conclusões: A microperimetria realizada com o MP-3 permite um exame automático, preciso e específico da topografia dos limiares de sensibilidade da retina. Os resultados deste estudo fornecem um banco de dados normal e de idade correspondente da microperimetria MP-3.

Normative data for macular perimetry using the MP-3 microperimeter in healthy individuals.

PURPOSE: Microperimetry has been used for several years as a form of visual function testing in patients with retinal diseases. Normal microperimetry values obtained with microperimeter MP-3 have not yet been fully published, and baseline values for topographic macular sensitivity and correlations with age and sex are needed to establish degrees of impairment. This study aimed to determine values for light sensitivity thresholds and fixation stability using the MP-3 in healthy individuals. METHODS: Thirty-seven healthy volunteers (age, 28-68 years), underwent full-threshold microperimetry using a 4-2 (fast) staircase strategy with the standard Goldmann III stimulus size and 68 test points positioned identically to those in the Humphrey Field Analyzer 10-2 test grid. The fixation stability was simultaneously recorded during the microperimetry test. The relationship between global sensitivity and age was calculated using linear regression analysis. RESULTS: Microperimetry was performed on 37 participants (74 eyes). The global mean sensitivity was 29.01 ± 1.44 (range, 26-31) dB. The mean central sensitivity at 2° measured by the MP-3 was 28.5 ± 1.77 dB in the right eye (OD) and 28.75 ± 1.98 dB in the left eye (OS). The total median fixation stability values within 2° and 4° were 80% and 96%, respectively. The linear regression analysis also revealed an age-related global sensitivity decline per year of -0.051 dB ± 0.018 (OD) and -0.078 dB ± 0.021 (OS). CONCLUSIONS: Microperimetry performed with the MP-3 allows for an automatic, accurate, and topography-specific examination of retinal sensitivity thresholds. The results of this study provide a normal and age-matched database of MP-3 microperimetry.

Retinal arterial macroaneurysms in patients recovered from COVID-19 / Macroaneurismas arteriais retinianos em pacientes recuperados da COVID-19

ABSTRACT This is a case series about retinal arterial macroaneurysms in three patients recovered from COVID-19. None of them had previous past ocular and systemic history. The first patient was a 47-year-old man, with best-corrected visual acuity of 20/20 in both eyes. He presented a cotton wool spot in the right eye and two peripheral exudative retinal arterial macroaneurysms in the left eye. Laser photocoagulation was performed and best-corrected visual acuity remained stable. The second one was a 62-year-old-woman with acute visual loss in the right eye (best-corrected visual acuity of 20/400). There was vitreous hemorrhage and a peripheral retinal arterial macroaneurysm in the right eye. Laser photocoagulation was performed and best-corrected visual acuity improved to 20/20. The third patient was a 54-year-old woman, with best-corrected visual acuity of 20/20 in the right eye and 20/600 in the left eye. Fundus examination showed multiple layer hemorrhage in the macular region and retinal arterial macroaneurysms in the superior temporal branch. The cases underwent fluorescein angiography, which confirmed the diagnosis of retinal arterial macroaneurysms.

RESUMO Esta é uma série de casos sobre macroaneurismas arteriais da retina em três pacientes recuperados da COVID-19. Nenhum tinha história ocular e sistêmica prévias. O primeiro era um homem de 47 anos, com melhor acuidade visual corrigida de 20/20 em ambos os olhos. Apresentava mancha algodonosa em olho direito e dois macroaneurismas arteriais da retina exsudativos periféricos em olho esquerdo. Foi realizada fotocoagulação a laser, e a melhor acuidade visual corrigida permaneceu estável. A segunda era uma mulher de 62 anos com perda visual aguda em olho direito (melhor acuidade visual corrigida de 20/400). Havia hemorragia vítrea e um macroaneurisma periférico em olho direito. O laser foi realizado, e a melhor acuidade visual corrigida melhorou para 20/20. A terceira paciente era uma mulher de 54 anos, com melhor acuidade visual corrigida 20/20 em olho direito e 20/600 olho esquerdo. A fundoscopia mostrou hemorragia em múltiplas camadas na região macular e um macroaneurisma arterial da retina no ramo temporal superior. Os casos foram submetidos à angiofluoresceinografia, que confirmou o diagnóstico de macroaneurismas arteriais da retina.

A standardized method to quantitatively analyze optical coherence tomography angiography images of the macular and peripapillary vessels.

BACKGROUND: Optical coherence tomography angiography (OCTA) is a relatively new non-invasive imaging technique to evaluate retinal vascular complexes. However, there is still a lack of standardization and reproducibility of its quantitative evaluation. Furthermore, manual analysis of a large amount of OCTA images makes the process laborious, with greater data variability, and risk of bias. Therefore, the aim of this study is to describe a fast and reproducible quantitative analysis of the foveal avascular zone (FAZ), macular superficial and deep vascular complexes (mSVC and mDVC, respectively), and peripapillary superficial vascular complex (pSVC) in OCTA images. METHODS: We survey models and methods used for studying retinal microvasculature, and software packages used to quantify microvascular networks. These programs have provided researchers with invaluable tools, but we estimate that they have collectively achieved low adoption rates, possibly due to complexity for unfamiliar researchers and nonstandard sets of quantification metrics. To address these existing limitations, we discuss opportunities to improve effectiveness, affordability, and reproducibility of microvascular network quantification with the development of an automated method to analyze the vessels and better serve the current and future needs of microvascular research. OCTA images of the macula (10°x10°, 15°x15°, or 20°x20° centered on the fovea) and peripapillary area (15 × 15º centered on optic nerve head) were exported from the device and processed using the open-source software Fiji. The mSVC, mDVC, and pSVC were automatically analyzed regarding vascular density in the total area and four sectors (superior, inferior, nasal, and temporal). We also analyzed the FAZ regarding its area, perimeter, and circularity in the SVC and DVC images. RESULTS: We developed an automated model and discussed a step by step method to analyze vessel density and FAZ of the macular SVC and DVC, acquired with OCTA using different fields of view. We also developed an automated analysis of the peripapillary SVC. CONCLUSION: Our developed automated analysis of macular and peripapillary OCTA images will allow a fast, reproducible, and precise quantification of SVC, DVC, and FAZ. It would also allow more accurate comparisons between different studies and streamlines the processing of images from multiple patients with a single command.

Adesão ao Tratamento e Perfil Epidemiológico dos Pacientes Hipertensos Cadastrados na Casa Família Água Cristal ­ Belém/PA / Treatment adherence and epidemiological profile of hypertensive patients registered in the family house �gua Cristal - Bel�m / PA

Este estudo teve por objetivo tra�ar o perfil epidemiol�gico de pacientes hipertensos, bem como analisar a ades�o/abandono ao tratamento recomendado. Para tal, foi realizada uma pesquisa caracterizada por ser de corte, prospectiva e descritiva com delineamento transversal. Foram estudados 164 portadores de hipertens�o arterial - HA cadastrados em uma Unidade Sa�de da Fam�lia ? USF, com faixa et�ria de 40 a 70 anos. Para a coleta de dados, foi elaborado um protocolo contendo perguntas relacionadas �s condi��es s�cio-econ�micas, � patologia e ao posicionamento do paciente em rela��o ao tratamento. Verificou-se predom�nio da patologia em pacientes do sexo feminino (65,24%), compreendidos na faixa et�ria de 53 a 59 anos (28,05%), com renda de 1 a 3 sal�rios m�nimos (74,39%), com 1� grau incompleto (55,49%), aus�ncia de obesidade (60,98%), que n�o praticavam exerc�cios (53,66%), n�o et�licos (75,61%), n�o fumantes (81,10%), com total esclarecimento sobre a doen�a (53,05%), que afirmaram seguir corretamente as orienta��es do m�dico (48,17%).

The present study aimed to evaluate the epidemiological profile of the hypertensives from a Family Health Unit, as well as analyzing the adhesion/desertion to the treatment. The research was characterized by cross-sectional study, with 164 hypertensives from 40 and 70 years of age. For data collection, a questionnaire was used about the economic conditions, pathology and positioning of the patient in relation to the treatment. There was predominance of the pathology in female patients (65.24%), between 53 and 59 years old (28.05%), with income from 1 to 3 minimum wages (74.39%), Fifty-forty nine percent of the individuals had incomplete fundamental degree, 60.98% were not obese, 53.66% did not practice exercises, 75.61% were not ethylic patients, and 81.10% had never smoked. 53.05% knew about the illness, and 48.17% had followed the doctor?s prescriptions correctly.

[Diffuse unilateral subacute neuroretinitis (DUSN): current update]. / Neuroretinite unilateral subaguda difusa (DUSN): atualização continuada.

Diffuse unilateral subacute neuroretinitis (DUSN) is a form of uveitis that can potentially lead to blindness. In Brazil and other parts of South America, diffuse unilateral subacute neuroretinitis is an important cause of posterior uveitis in children and healthy young adults. If diagnosed and treated in early stage, allows a resolution of symptoms with improvement of visual acuity. If the disease progresses to the late stage, can result in significant visual loss. In this study, through a literature review, we describe the main characteristics of this disease, including the following aspects: history, etiology, physiopathology, clinical features, diagnosis, differential diagnosis and treatment.

Neuroretinite unilateral subaguda difusa (DUSN): atualização continuada / Diffuse unilateral subacute neuroretinitis (DUSN): current update

A neurorretinite subaguda difusa unilateral (DUSN) é uma forma de uveíte que pode potencialmente levar à cegueira. No Brasil e em outras partes da América do Sul, a neurorretinite subaguda difusa unilateral cada vez mais é considerada uma causa importante de uveíte posterior em crianças e em adultos jovens e saudáveis. Se diagnosticada e tratada ainda em fase inicial, permite uma resolução dos sintomas com melhora da acuidade visual. Caso progrida para a fase tardia, poderá acarretar uma perda visual significativa. Nesse estudo, por meio de uma revisão da literatura, descreve-se as principais características desta doença, incluindo os seguintes aspectos: histórico, etiologia, fisiopatologia, quadro clínico, diagnóstico, diagnóstico diferencial e tratamento.

Diffuse unilateral subacute neuroretinitis (DUSN) is a form of uveitis that can potentially lead to blindness. In Brazil and other parts of South America, diffuse unilateral subacute neuroretinitis is an important cause of posterior uveitis in children and healthy young adults. If diagnosed and treated in early stage, allows a resolution of symptoms with improvement of visual acuity. If the disease progresses to the late stage, can result in significant visual loss. In this study, through a literature review, we describe the main characteristics of this disease, including the following aspects: history, etiology, physiopathology, clinical features, diagnosis, differential diagnosis and treatment.

Perfil clínico-epidemiológico de pacientes com psoríase / Clinical and epidemiological profile of psoriasis patients

Objetivo: determinar o perfil clínico-epidemiológico dos portadores de psoríase atendidos, durante o ano de 2009 no Ambulatório de Dermatologia da UEPA, Belém-Pa. Método: estudo transversal, no qual foram entrevistados 50 pacientes portadores da doença. A entrevista baseou-se em um protocolo composto de uma parte inicial com perguntas relacionadas ao perfil sócio-econômico e aos aspectos relativos a fatores associados com doença em estudo e uma parte subseqüente, na qual foram avaliados aspectos da apresentação clínica da psoríase. Resultados: verificou-se que predominou o sexo feminino, faixa etária de 38 a 48 anos de idade, com ensino fundamental incompleto e que afirmaram estar passando por alguma situação estressante na época do surgimento da doença. Predominou a psoríase em placa, disseminada e os membros inferiores foi a localização mais acometida. Conclusão: é de grande importância o incentivo de pesquisas que visem delinear o perfil clínico-epidemiológico, a fim de se conhecer melhor as populações que são atingidas por esta dermatose no Brasil.

Objective: was to determine clinical and epidemiological profile of patients with psoriasis treated during the year of 2009 in UEPA Dermatology Clinic, Belém-Pa-Brazil. Methods: It was performed a transversal and prospective study, in which 50 patients with the disease were interviewed. The interview was based on a protocol that included in its initial portion questions related to socio-economic profile and aspects related to factors associated with the disease under study and a subsequent part, in which analyze psoriasis clinical presentation.Results: It was found that most patients were female, aged between 38 to 48 years-old, with incomplete basic education and they said they were going through some stressful situation at the time of disease onset. The predominant clinical presentation was disseminated plaque psoriasis and lower limbs was the most affected location. Conclusions: It is very important the incentive for research aimed at delineating clinical and epidemiological profile, in order to better understand people who are suffering from this dermatosis in Brazil.

Perfil dos pacientes atendidos pelo programa Tratamento Fora de Domicílio no Município de Belém, Estado do Pará, Brasil / Profile of patients treated through the Tratamento Fora de Domicílio program in the Municipality ofBelém, Pará State, Brazil

A presente pesquisa objetivou traçar o perfil demográfico e outras características dos pacientes portadores de leucemia ou de doença renal crônica e verificar se os mesmos estão sendo atendidos conforme o previsto na normalização do programa. Para tanto foi realizado um estudo de coorte, prospectivo, descritivo, com delineamento transversal. Foram entrevistados 65 pacientes, de ambos os sexos, atendidos pelo programa Tratamento Fora de Domicílio no período de agosto a setembro de 2008. Foram coletados dados relacionados ao perfil do paciente, tais como sexo e local de origem, e relacionados ao tratamento do paciente fora de domicílio. Verificou-se que 67,7 por cento eram portadores de leucemia. Houve predomínio do sexo masculino (63,1 por cento) e da faixa de idade entre 1 e 10 anos (36,9 por cento). Observou-se ainda que, para a maioria dos atendidos, o tempo médio de espera para receber a primeira ajuda de custo foi de dois a quatro meses (32,3 por cento); a ajuda de custo não foi suficiente para suprir as despesas com o deslocamento (38,5 por cento) e houve atraso no pagamento do benefício (75,4 por cento). Conclui-se assim que o Programa Tratamento Fora de Domicílio, apesar de ser um importante programa de saúde, ainda apresenta algumas limitações que necessitam ser superadas.

The objective of the present study is to trace demographic profiles and other characteristics of patients with leukemia or chronic renal disease and to verify whether these patients are being treated according to the directives of the program. A prospective, descriptive, transversal, delineated cohort study was performed. We interviewed 65 patients of both genders who were treated through the Tratamento Fora de Domicílio (Out-of-Home Treatment) program from August to September 2008. Data related to the patients' profiles, such as gender and area of residence, were collected along with data related to their treatment. We observed that 67.7 per cent of the patients had leukemia. There was a masculine predominance (63.1 per cent) and the greater percentage of patients was between the age range of 1 and 10 years (36.9 per cent). For many of the patients, the most common waiting time to receive financial support ranged from two to four months (32.3 per cent); in many cases (38.5 per cent), the financial support offered by the program was not sufficient to meet the patients' traveling expenses; and its payment was late in 75.4 per cent of cases. We concluded that despite being an important health program, the Tratamento Fora de Domicílio program still has some limitations that need to be overcome.

Copaiba oil effects on survival rate after cecal ligation and puncture in mice / Efeitos do óleo de copaíba na sobrevida de camundongos submetidos à ligadura e perfuração cecal

to assess survival rate of mice subjected to cecal ligation and puncture (CLP) treated with copaiba oil subcutaneous injection. Methods: twenty-one BALB/c male mice were randomly distributed into three following groups: Sham (subjected to all surgical procedures except for the CLP procedures); Control (subjected to CLP procedures with no treatment); and Experimental (subjected to CLP procedures treated with copaiba oil, 0.63 ml per kg, injected once a day subcutaneously for five days). Sepsis was induced by CLP procedure and after that, mice were monitored every 6 h till 120 h completed. Survival rate was assessed by the Kaplan-Meier curve and the long-rank test. Results: there was a significant difference on survival of mice subjected to copaiba oil injection (p < 0.0001), survival rate in Control was 0% after 72 h, as expected, but Experimental survival rate was 71.43% till the last observation time (120 h). Conclusion: copaiba oil treatment improved survival in mice subjected to CLP.

analisar a sobrevida de camundongos submetidos à ligadura e perfuração cecal (LPC) tratados com injeção subcutânea de óleo de copaiba. Método: pesquisa experimental com vinte e um camundongos machos BALB/c foram distribuídos randomicamente nos três seguintes grupos: Padrão (submetidos à todos os procedimentos cirúrgicos exceto pelos procedimentos de LPC); Controle (submetidos ao procedimento de LPC e sem tratamento); e Experimental (submetidos ao procedimento de LPC e tratados com óleo de copaiba, 0.63 ml por kg, injetado no subcutâneo uma vez ao dia por cinco dias). Sepse foi induzida por LPC e posteriormente os camundongos foram monitorados a cada 6 h até completar 120 h. A sobrevida foi avaliada pela curva de Kaplan-Meier e pelo teste long-rank. Resultados: houve diferença significante na sobrevida dos animais que receberam injeção de óleo de copaíba, a taxa de sobrevida dos animais do Controle foi de 0% após 72 h, como esperado, porém a taxa de sobrevida dos animais do Experimental foi de 71.43% até o último período de observação (120h). Conclusão: o tratamento com óleo de copaiba aumentou a sobrevida de camundongos submetidos à LPC.