Slow coagulation versus micropulse transscleral cyclophotocoagulation for refractory childhood glaucoma.

PURPOSE: To compare the safety and efficacy of micropulse laser (MP-TSCP) and slow coagulation transscleral cyclophotocoagulation (TSCP) with a diode laser for reducing intraocular pressure (IOP) in patients with refractory childhood glaucoma (CG). METHODS: Patients with CG and at least 12 months of medical chart data were included. Data on preoperative and postoperative outcomes were analyzed. The primary outcomes were an IOP of 6-21 mmHg and/or ≥ 20% reduction in the baseline value. RESULTS: A total of 17 eyes were included. The preoperative mean IOP was 28 mmHg in the MP-TSCP and 29.9 mmHg in the TSCP. The mean IOP decreased significantly to 17.26 ± 3.27 mmHg in the MP-TSCP and 14.68 ± 5.79 mmHg TSCP at the last medical record. Three anti-glaucoma meds were administered to the eyes preoperatively in both groups. A mean of 1.02 eye drops was administered to the MP-TSCP and 2.06 to the TSCP. The number of medications decreased by 2.38 ± 1.55 in the MP-TSCP and 0.82 ± 1.68 in the TSCP. The median preoperative visual acuity (logMAR) was 1.51 ± 1.06 in the MP-TSCP and 1.87 ± 0.74 in the TSCP. The variation in mean visual acuity (logMAR) was -0.027 ± 0.05 in the MP-TSCP and -0.40 ± 0.58 in the TSCP. The most frequent complication was corneal decompensation (one - MP-TSCP and two - TSCP). CONCLUSION: Both techniques were effective and relatively safe for reducing IOP. These techniques appear to extend the indications of cyclophotocoagulation in CG eyes and improve the functional prognosis.

Mid-Term Evaluation of iStent Inject® Trabecular Micro-Bypass Stent Implantation with or without Phacoemulsification: A Retrospective Study.

INTRODUCTION: This study evaluated the 6-month performance and safety of micro-invasive glaucoma surgery (MIGS) with iStent inject either with or without cataract surgery. MATERIAL AND METHODS: Longitudinal retrospective study of 86 surgeries in 49 patients with inadequately controlled open-angle glaucoma (OAG) or ocular hypertension who underwent iStent inject trabecular micro-bypass implantation either alone (isolated group) or combined with cataract surgery (combined group). The two primary outcomes included an intraocular pressure (IOP) drop of ≥20% versus preoperative values (adequate drop) and IOP maintenance between 6 and 18 mmHg (adequate Range). For both outcomes, we determined "complete" and "qualified" success if patients did not require or did require glaucoma medications, respectively, at the end of follow-up. Safety outcomes included best-corrected visual acuity, adverse events, and secondary surgeries. RESULTS: In the adequate drop analysis, 30.2% achieved "complete success," and 37.2% achieved "qualified success." For adequate range, 40.7% achieved "complete success" and 39.5% achieved "qualified success." There was no difference in medication decrease (p=0.77) nor IOP reduction (p=0.46) between the isolated and combined groups. Safety was generally favorable and similar between groups, with mild transient adverse events that resulted in no sequelae. DISCUSSION/CONCLUSION: iStent inject implantation either with or without cataract surgery was able to safely decrease IOP and medication requirements through 6 months after surgery.

Effects of benzalkonium chloride and cyclosporine applied topically to rabbit conjunctiva: a histomorphometric study / Efeitos do uso tópico do conservante cloreto de benzalcônio e ciclosporina na conjuntiva de coelhos: estudo histomorfométrico

ABSTRACT Purpose: Chronic instillation of benzalkonium chloride, a preservative, has inflammatory effects on the ocular surface. However, addition of the anti-inflammatory agent cyclosporine to a therapeutic protocol may mitigate these effects. This study compared the toxic effects of a 0.1% benzalkonium chloride solution and the possible protective effect of 0.05% cyclosporine when applied topically to the rabbit conjunctiva. Methods: Fifteen age- and weight-matched, female New Zealand white rabbits were categorized into three groups and treated for 30 consecutive days. Group 1, 2, and 3 - benzalkonium chloride received 0.1% every 24 h, 0.05% cyclosporine every 6 h, and both treatments, respectively. In each rabbit, the left eye was subjected to treatment and the right eye was a control. The rabbits were euthanized at after the experiment. Goblet cells and blood vessels were then enumerated in conjunctival tissues stained with periodic acid-Schiff and hematoxylin-eosin, respectively. Differences between treated and untreated eyes and between groups were compared using the t-test and analysis of variance. Results: Benzalkonium chloride treatment, with and without cyclosporine, significantly reduced (p≤0.05) in the number of goblet cells in treatment eyes compared with that in respective control eyes. Alternatively, adding cyclosporine to benzalkonium chloride did not prevent the loss of conjunctival goblet cells, and a significant reduction in the number of goblet cells was noted. Benzalkonium chloride-induced significant increase in the number of new blood vessels was mitigated significantly by the addition of cyclosporine. Conclusion: This study demonstrated the magnitude of conjunctival injury caused by chronic instillation of benzalkonium chloride. Although cyclosporine did not mitigate the effects on goblet cells, its addition minimized inflammatory angiogenesis induced by benzalkonium chloride.

RESUMO Objetivo: A instilação crônica de cloreto de benzal­cônio, um conservante, tem efeitos inflamatórios na superfície ocular. No entanto, a adição do agente anti-inflamatório ciclosporina a um protocolo terapêutico pode atenuar esses efeitos. Este estudo comparou os efeitos tóxicos de uma solução de cloreto de benzalcônio a 0,1% e o possível efeito protetor de ciclosporina a 0,05% quando aplicado topicamente à conjuntiva de coelho. Métodos: Quinze coelhos fêmeas brancos da raça Nova Zelândia, pareados por idade e peso, foram categorizados em três grupos e tratados por 30 dias consecutivos. Os grupos 1, 2 e 3 - receberam cloreto de benzalcônio 0,1% a cada 24h, ciclosporina a 0,005% a cada 6h e ambos os tratamentos, respectivamente. Em cada coelho, o olho esquerdo foi submetido a tratamento e o olho direito foi controle. Os coelhos foram submetidos à eutanásia após o experimento. Células caliciformes e vasos sanguíneos foram então enumerados em tecidos conjuntivais corados com ácido periódico-Schiff e hematoxilina-eosina, respectivamente. As diferenças entre os olhos tratados e não tratados e entre os grupos foram comparadas usando o teste t e análise de variância. Resultados: O tratamento com cloreto de benzalcônio, com e sem ciclosporina, reduziu significativamente (p£0,05) o número de células caliciformes nos olhos tratados em comparação com os olhos controle correspondentes. Alternativamente, a adição de ciclosporina ao cloreto de benzalcônio não impediu a perda de células caliciformes conjuntivais, e foi observada uma redução significativa no número de células caliciformes. O aumento significativo induzido pelo cloreto de benzalcônio no número de novos vasos sanguíneos foi significativamente mitigado pela adição da ciclosporina. Conclusão: Este estudo demonstrou a magnitude da lesão conjuntival resultante da instilação crônica de cloreto de benzalcônio. Embora a ciclosporina não tenha atenuado os efeitos nas células caliciformes, sua adição minimizou a angiogênese inflamatória induzida pelo cloreto de benzalcônio.

Effects of benzalkonium chloride and cyclosporine applied topically to rabbit conjunctiva: a histomorphometric study.

PURPOSE: Chronic instillation of benzalkonium chloride, a preservative, has inflammatory effects on the ocular surface. However, addition of the anti-inflammatory agent cyclosporine to a therapeutic protocol may mitigate these effects. This study compared the toxic effects of a 0.1% benzalkonium chloride solution and the possible protective effect of 0.05% cyclosporine when applied topically to the rabbit conjunctiva. METHODS: Fifteen age- and weight-matched, female New Zealand white rabbits were categorized into three groups and treated for 30 consecutive days. Group 1, 2, and 3 - benzalkonium chloride received 0.1% every 24 h, 0.05% cyclosporine every 6 h, and both treatments, respectively. In each rabbit, the left eye was subjected to treatment and the right eye was a control. The rabbits were euthanized at after the experiment. Goblet cells and blood vessels were then enumerated in conjunctival tissues stained with periodic acid-Schiff and hematoxylin-eosin, respectively. Differences between treated and untreated eyes and between groups were compared using the t-test and analysis of variance. RESULTS: Benzalkonium chloride treatment, with and without cyclosporine, significantly reduced (p≤0.05) in the number of goblet cells in treatment eyes compared with that in respective control eyes. Alternatively, adding cyclosporine to benzalkonium chloride did not prevent the loss of conjunctival goblet cells, and a significant reduction in the number of goblet cells was noted. Benzalkonium chloride-induced significant increase in the number of new blood vessels was mitigated significantly by the addition of cyclosporine. CONCLUSION: This study demonstrated the magnitude of conjunctival injury caused by chronic instillation of benzalkonium chloride. Although cyclosporine did not mitigate the effects on goblet cells, its addition minimized inflammatory angiogenesis induced by benzalkonium chloride.

Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial.

OBJECTIVES: To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of prostaglandin analogues (travoprost, latanoprost and bimatoprost) with 0.5% timolol maleate METHODS: A prospective, multicenter, randomized, parallel group, single-blind clinical trial was performed in 33 patients with ocular hypertension or open angle glaucoma who had not been previously treated. The ocular surface was evaluated prior to and three months after treatment, with a daily drop instillation of one of the three medications. The main outcome measurements included the tear film break-up time, Schirmer's test, Lissamine green staining, the Ocular Surface Disease Index questionnaire, impression cytology using HE and PAS and immunocytochemistry for interleukin-6 and HLA-DR. Ensaiosclinicos.gov.br: UTN - U1111-1129-2872 RESULTS: All of the drugs induced a significant reduction in intraocular pressure. Decreases in the Schirmer's test results were observed with all of the drugs. Decreases in tear-film break-up time were noted with travoprost/timolol and latanoprost/timolol. An increase in the Lissamine green score was noted with travoprost/timolol and bimatoprost/timolol. The Ocular Surface Disease Index score increased after treatment in the travoprost/timolol group. Impression cytology revealed a significant difference in cell-to-cell contact in the same group, an increase in cellularity in all of the groups and an increase in the number of goblet cells in all of the groups. The fixed combinations induced an increase in IL-6 expression in the travoprost/timolol group, in which there was also an increase in HLA-DR expression. CONCLUSIONS: All of the fixed combinations induced a significant reduction in intraocular pressure, and the travoprost/timolol group showed increased expression of the inflammatory markers HLA-DR and interleukin-6. All three tested medications resulted in some degree of deterioration in the ocular surface after three months of glaucoma treatment.

Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial

OBJECTIVES: To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of prostaglandin analogues (travoprost, latanoprost and bimatoprost) with 0.5% timolol maleate METHODS: A prospective, multicenter, randomized, parallel group, single-blind clinical trial was performed in 33 patients with ocular hypertension or open angle glaucoma who had not been previously treated. The ocular surface was evaluated prior to and three months after treatment, with a daily drop instillation of one of the three medications. The main outcome measurements included the tear film break-up time, Schirmer's test, Lissamine green staining, the Ocular Surface Disease Index questionnaire, impression cytology using HE and PAS and immunocytochemistry for interleukin-6 and HLA-DR. Ensaiosclinicos.gov.br: UTN - U1111-1129-2872 RESULTS: All of the drugs induced a significant reduction in intraocular pressure. Decreases in the Schirmer's test results were observed with all of the drugs. Decreases in tear-film break-up time were noted with travoprost/timolol and latanoprost/timolol. An increase in the Lissamine green score was noted with travoprost/timolol and bimatoprost/timolol. The Ocular Surface Disease Index score increased after treatment in the travoprost/timolol group. Impression cytology revealed a significant difference in cell-to-cell contact in the same group, an increase in cellularity in all of the groups and an increase in the number of goblet cells in all of the groups. The fixed combinations induced an increase in IL-6 expression in the travoprost/timolol group, in which there was also an increase in HLA-DR expression. CONCLUSIONS: All of the fixed combinations induced a significant reduction in intraocular pressure, and the travoprost/timolol group showed increased expression of the inflammatory markers HLA-DR and interleukin-6. All three tested medications resulted in some degree of deterioration in ...

Eyelash growth induced by topical prostaglandin analogues, bimatoprost, tafluprost, travoprost, and latanoprost in rabbits.

PURPOSE: Prostaglandin analogues (PGA) are ocular hypotensive agents used for the treatment of glaucoma. Hypertrichosis of the eyelashes has been reported in humans as a side effect. Eyelash growth was investigated with clinical trials in people using bimatoprost. Scattered reports of eyelash growth during the treatment of glaucoma with other PGA are also found in the literature. We investigated the effect of 4 different topical PGA on eyelash length. METHODS: Forty New Zealand white rabbits were divided into 4 groups and received daily topical application of bimatoprost, tafluprost, travoprost, and latanoprost in the left eye for 4 weeks. The right eye received no treatment. Eyelash length was measured in both eyes before and after treatment using a stainless steel digital caliper. RESULTS: Bimatoprost and tafluprost groups had significant increases in eyelash length. We did not observe significant eyelash growth in rabbits receiving travoprost and latanoprost after 1 month of treatment. CONCLUSIONS: Today, only bimatoprost is approved for growing eyelashes, and our research shows that tafluprost could be further explored by the cosmetic and pharmaceutical industry. Additional research using travoprost and latanoprost as agents for eyelash growth should be performed in the future using prolonged treatment periods to determine whether or not these PGA induce eyelash growth, and investigate other possible side effects.

Conjunctival changes and inflammatory aspects in rabbits' conjunctivas induced by fixed combinations of prostaglandin analogues and timolol maleate.

BACKGROUND: The purpose of this research is to compare the histological and immunohistochemical changes induced by fixed combinations of timolol maleate and prostaglandin analogues in the rabbit conjunctiva. Thirty left eyes of rabbits, divided into three groups, were treated for 30 days with the following combinations of drugs: bimatoprost 0.03% + timolol 0.5%, travoprost 0.004% + timolol 0.5% and latanoprost 0.005 + timolol 0.5%. The right eyes served as controls and received no medication. At the end of the experiment, after enucleation, the conjunctivas were assessed through histomorphometry (number of inflammatory and goblet cells, epithelial thickness) and immunohistochemistry (anti-actin antibody to assess the degree of fibrosis). RESULTS: Histomorphometrically, there was infiltration of inflammatory cells in all the treated eyes. An increased number of goblet cells was observed with the use of all fixed combinations of prostaglandin analogues associated with timolol maleate in comparison with the control group. The combination travoprost + timolol resulted in more intense fibrosis. The effect of bimatoprost + timolol caused an intermediate reaction pattern among the other drugs, fostering higher numbers of goblet cells in the conjunctival epithelium, more than the other fixed combinations in this study. There was a difference in the comparison of goblet cells of eyes treated with bimatoprost + timolol (16.11 ± 2.42) and of those treated with latanoprost + timolol (13.18 ± 1.60) (P = 0.016). CONCLUSION: It was found that all fixed combinations of prostaglandins analogues + timolol induce a reaction in the conjunctiva, increasing the inflammatory infiltrate.

Reference values for selected ophthalmic diagnostic tests of the capuchin monkey (Cebus apella).

PURPOSE: To perform selected ophthalmic diagnostic tests in healthy capuchin monkeys (Cebus apella) with the aim of establishing normal physiological reference values for this species. METHODS: A total of 15 healthy, capuchin monkeys were used to test most of the parameters in this investigation. Five of the 15 monkeys were used for the evaluation of normal conjunctival flora. Ages varied from 6 to 20 years of age. Selected diagnostic ocular tests were performed including Schirmer tear test (STT), tonometry using an applanation tonometer (Tonopen), central corneal thickness (CCT) using an ultrasonic pachymeter (Sonomed, Micropach), Model 200P+) and culture of the normal conjunctival bacterial flora. RESULTS AND DISCUSSION: Results for selected ocular diagnostic tests investigated here for the capuchin monkey eye were as follows: IOP: 18.4 +/- 3.8 mmHg; STT: 14.9 +/- 5.1 mm/min; CCT: 0.46 +/- 0.03 mm. No statistically significant differences between ages or genders were found for any of the results. Streptococcus sp. and Corynebacterium sp. were isolated from healthy conjunctival and eyelid margins, suggesting they are normal constituents of the conjunctival flora of the capuchin monkey. The data obtained in this investigation will help veterinary ophthalmologists and laboratory animal medicine specialists to more accurately diagnose ocular diseases in the capuchin monkey. These ophthalmic reference values will be particularly useful to diagnose discrete or unusual pathological changes of the capuchin monkey eye.

Conjunctival changes induced by prostaglandin analogues and timolol maleate: a histomorphometric study

PURPOSE: To compare histological changes induced by antiglaucoma medications in the rabbit conjunctiva. METHODS: Fifty New Zealand rabbits were divided in 5 groups of 10 animals. The left eyes were treated daily with one drop of bimatoprost 0.03 percent, travoprost 0.004 percent, latanoprost 0.005 percent, timolol maleate 0.5 percent or artificial tears containing benzalkonium chloride (BAK) for 30 days. The right eyes served as controls. Superior limbic conjunctival biopsies were performed at the 8th and 30th day in 5 rabbits of each group. The conjunctiva was fixed with 10 percent formaldehyde, followed by HE and PAS staining. Morphohistometric quantitative analyses were performed to evaluate the following parameters: inflammatory infiltrate, epithelial thickness, number of goblet cells, diameter and number of blood vessels. RESULTS: At the 8th and 30th posttreatment days, all groups, except one that received artificial tears, exhibited a diffuse inflammatory infiltrate, composed by lymphocytes and neutrophils, which was denser in the timolol group than in the prostaglandin (PG) analogues groups. At the 30th day, the timolol group also showed an increased subepithelial collagen density and a significant increase in epithelial thickness (p=0.0035). The goblet cell density was significantly increased at the 8th day in the group treated with travoprost (p=0.0006), and at the 30th day in those treated with bimatoprost (p=0.0021) and latanoprost (p=0.009). CONCLUSIONS: Although a moderate, diffuse inflammatory infiltrate was observed in PG-treated eyes, no changes in conjunctival epithelial thickness or subconjunctival collagen density were observed with these medications, suggesting that these drugs induce fewer changes than timolol maleate in the rabbit conjunctiva.

OBJETIVOS: Comparar alterações histológicas induzidas por medicação anti-glaucomatosa na conjuntiva de coelhos. MÉTODOS: Cinqüenta coelhos da raça Nova Zelândia foram divididos em 5 grupos de 10 animais. Os olhos esquerdos foram tratados com uma gota diária de bimatoprosta 0,03 por cento, travoprosta 0,004 por cento, latanoprosta 0,005 por cento, maleato de timolol 0,5 por cento ou lágrimas artificiais contendo cloreto de benzalcônio (BAK) por 30 dias. Os olhos direitos serviram como controles. Foram realizadas biópsias conjuntivais límbicas superiores no 8º e 30º dias em 5 coelhos de cada grupo. A conjuntiva foi fixada com formaldeído 10 por cento, seguido por coloração de HE e PAS. Foi realizada análise quantitativa morfohistométrica para avaliar os seguintes parâmetros: infiltrado inflamatório, espessura epitelial, número de células caliciformes, diâmetro e número de vasos sanguíneos. RESULTADOS: No 8º e 30º dias de tratamento, todos os grupos, exceto aquele que recebeu lágrimas artificiais, exibiram infiltrado inflamatório difuso, composto por linfócitos e neutrófilos, sendo mais denso no grupo timolol do que nos grupos dos análogos de prostaglandinas. No 30º dia, o grupo timolol apresentou um aumento na densidade de colágeno subepitelial e um aumento significativo da espessura epitelial (p=0,0035). A densidade de células caliciformes aumentou significativamente no 8º dia no grupo tratado com travoprosta (p=0,0006), e no 30º dia nos grupos tratados com bimatoprosta (p=0,0021) e latanoprosta (p=0,009). CONCLUSÕES: Embora tenha sido observado um infiltrado inflamatório difuso e moderado nos olhos tratados com análogos de prostaglandinas, não houve alterações na espessura epitelial conjuntival ou densidade colágena subepitelial com essas medicações, sugerindo que essas drogas induzem menores alterações que o maleato de timolol na conjuntiva de coelhos.

Conjunctival changes induced by prostaglandin analogues and timolol maleate: a histomorphometric study.

PURPOSE: To compare histological changes induced by antiglaucoma medications in the rabbit conjunctiva. METHODS: Fifty New Zealand rabbits were divided in 5 groups of 10 animals. The left eyes were treated daily with one drop of bimatoprost 0.03%, travoprost 0.004%, latanoprost 0.005%, timolol maleate 0.5% or artificial tears containing benzalkonium chloride (BAK) for 30 days. The right eyes served as controls. Superior limbic conjunctival biopsies were performed at the 8th and 30th day in 5 rabbits of each group. The conjunctiva was fixed with 10% formaldehyde, followed by HE and PAS staining. Morphohistometric quantitative analyses were performed to evaluate the following parameters: inflammatory infiltrate, epithelial thickness, number of goblet cells, diameter and number of blood vessels. RESULTS: At the 8th and 30th posttreatment days, all groups, except one that received artificial tears, exhibited a diffuse inflammatory infiltrate, composed by lymphocytes and neutrophils, which was denser in the timolol group than in the prostaglandin (PG) analogues groups. At the 30th day, the timolol group also showed an increased subepithelial collagen density and a significant increase in epithelial thickness (p=0.0035). The goblet cell density was significantly increased at the 8th day in the group treated with travoprost (p=0.0006), and at the 30th day in those treated with bimatoprost (p=0.0021) and latanoprost (p=0.009). CONCLUSIONS: Although a moderate, diffuse inflammatory infiltrate was observed in PG-treated eyes, no changes in conjunctival epithelial thickness or subconjunctival collagen density were observed with these medications, suggesting that these drugs induce fewer changes than timolol maleate in the rabbit conjunctiva.

Reference values for selected ophthalmic diagnostic tests of the ferret (Mustela putorius furo).

PURPOSE: To perform selected ophthalmic diagnostic tests in healthy ferrets with the aim of establishing normal physiological reference values for this species. METHOD: A total of 15 healthy, unrelated ferrets were used to test most of the parameters in this investigation. Eight of the 15 ferrets were used for central corneal thickness evaluation. Ages varied from 1.5 to 6 years of age. Selected diagnostic ocular tests were performed including Schirmer tear test, tonometry using an applanation tonometer (Tonopen), central corneal thickness using an ultrasonic pachymeter (Sonomed, Micropach, Model 200P +) and culture of the normal conjunctival bacterial flora. RESULTS AND DISCUSSION: Staphylococcus sp. and Corynebacterium sp. were isolated from healthy conjunctival and eyelid margins, suggesting they are normal constituents of the conjunctival flora of the ferret. Results for selected ocular diagnostic tests investigated here for the ferret eye were as follows: intraocular pressure: 14.50 +/- 3.27 mmHg; Schirmer tear test: 5.31 +/- 1.32 mm/min; central corneal thickness: 0.337 +/- 0.020 mm. No statistically significant differences between ages or genders were found for any of the results. The reference data for the ocular tests obtained in this investigation will help veterinary ophthalmologists to more accurately diagnose ocular diseases in the ferret. Knowledge of these reference values will be particularly useful to diagnose discrete or unusual pathological changes of the ferret eye.

Impacto da Campanha Olho no Olho em escolas de ensino fundamental: percepção do pessoal de ensino / Effectiveness of visual screening in elementary schools: educators'perception

OBJETIVOS: 1) Identificar conhecimentos do pessoal de ensino anteriores ao treinamento da Campanha Olho no Olho. 2) Identificar percepção da qualidade do treinamento. 3) Identificar percepção sobre os benefícios e adesão à campanha. MÉTODOS: Estudo analítico transversal. Escolas municipais de Curitiba-PR. Aplicação de questionário auto-aplicável. RESULTADOS: Foram entrevistados 89 por cento dos participantes e destes apenas 13 por cento eram professores regentes. O treinamento global foi considerado bom por 85,9 por cento. Dos professores todos tinham mais de 10 anos de magistério. Os professores consideraram importante obter em futuro treinamento melhores orientações sobre como controlar o caso de aluno encaminhado que necessite de tratamento (59,3 por cento). Das crianças triadas, 94,2 por cento foram atendidas e 84,9 por cento dos óculos foram entregues. Dos alunos que tiveram pres-crição de óculos, 85,7 por cento obtiveram melhora do desempenho escolar. O agente de saúde (36,1 por cento) e o médico oftalmologista (29,7 por cento) foram citados como responsáveis pela triagem; apenas 0,9 por cento acham que a triagem compete ao professor. Cerca de 50,5 por cento dos pais apresentaram interesse pelas atividades da campanha, e a maior justificativa para abstenções foi impossibilidade de faltar ao trabalho (68,5 por cento) e desconhecimento da dificuldade visual do filho (50,0 por cento). CONCLUSÕES: 1) Os professores do estudo apresentavam conhecimento satisfatório sobre triagem visual. 2) O treinamento produzido pela Campanha Olho no Olho foi considerado bom, ressaltando-se a necessidade de incluir explicações adicionais. 3) Houve melhora do desempenho do educando, a adesão dos pais à Campanha foi boa e o número de crianças atendidas excelente.

Extrusäo precoce de implante primário após evisceraçäo por endoftalmite / Early extrusion of primary implant post evisceration by endophtalmitis

A real taxa de extrusäo do implante primário em olhos submetidos à evisceraçäo por endoftalmite é desconhecida e há poucos trabalhos sobre o tema e na literatura. O objetivo do estudo é avaliar de forma comparativa a taxa de extrusäo precoce do implante primário após eviceraçäo por outras causas. Foi realizado um estudo prospectivo de todos os casos de evisceraçäo por outras causas. Foi realizado um estudo prospectivo de todos os casos de evisceraçäo realizados de jan.91 a dez.96 no HC da UFPR. Foram incluídos no estudo somente pacientes que possuiam pelo menos 3 meses de seguimento após o procedimento cirúrgico de evisceraçäo associados à colocaçäo de implante primário após evisceraçäo associados à colocaçäo de implante primário de luxite. No total, estudou-se número igual a 35 pacientes. Destes, 12 apresentavam infecçäo intraocular. Nos pacientes com endoftalmite, 16.6 por cento apresentaram extrusäo precoce do implante

Reabsorçäo de drusas moles após fotocoagulaçäo a laser: relato de dois casos / Soft drusen resorption after photocoagulation: description of two cases

As drusas moles säo precursoras da degeneraçäo macular senil atrófica e exsudativa. A reabsorçäo dessas drusas maculares em resposta à fotocoagulaçäo a laser tem sido descrita em trabalhos anteriores. No presente estudo mostramos dois casos em que houve reabsorçäo das drusas tratadas e näo tratadas por fotocoagulaçäo, apresentando também melhora da acuidade visual. O olho contra-lateral näo recebeu nenhum tratamento e mostrou-se inalterado durante o período de observaçäo. A fotocoagulaçäo das drusas pode reduzir significativamente a presença das mesmas no pólo posterior

Imagenologia: o impacto na epileptologia / The impact of of imasing on epileptology

Uma revisäo bibliográfica de métodos de neuroimagem estrutural e funcional é realizada, abordando aspectos históricos e metodológicos de relevância clínica para o médico atendendo pacientes portadores de epilepsias. A tomografia computadorizada foi inicialmente o método utilizado para visualizaçäo de anormalidades estruturais em portadores de epilepsia e deixou como principal herança o posicionamento do crânio para obtençäo de imagens do lobo temporal mesial. A ressonância magnética absorveu os avanços da tomografia e promoveu uma verdadeira revoluçäo no atendimento destes pacientes, por definir com espntoso grau de resoluçäo de detalhes anatômicos das estruturas cerebrais. Métodos quantitativos de medida de volume hipocampal foram definidos e aplicados em populaçöes brasileiras, permitindo uma maior facilidade na indicaçäo de procedimentos cirúrgicos em epileptologia, de maneira que muitos pacientes agora näo precisam mais investigaçäo com eletroencefalografia invasiva per-operatória