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1.
Arq Bras Oftalmol ; 87(2): e20210435, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38422355

RESUMO

PURPOSE: This study aimed to analyze the association between magnetic resonance imaging apparent diffusion coefficient map value and histopathological differentiation in patients who underwent eye enucleation due to retinoblastomas. METHODS: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student's t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent. RESULTS: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 103 mm2/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 103 mm2/s and 0.774 × 103 mm2/s, respectively. CONCLUSION: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 103 mm2/s, whereas in well and moderately differentiated, the mean was 0.774 × 103 mm2/s.


Assuntos
Neoplasias da Retina , Retinoblastoma , Criança , Humanos , Retinoblastoma/diagnóstico por imagem , Retinoblastoma/terapia , Estudos Retrospectivos , Olho , Fotocoagulação , Neoplasias da Retina/diagnóstico por imagem , Neoplasias da Retina/terapia , Imageamento por Ressonância Magnética
2.
Arq. bras. oftalmol ; Arq. bras. oftalmol;87(2): e2021, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1533794

RESUMO

ABSTRACT Purpose: This study aimed to analyze the association between magnetic resonance imaging apparent diffusion coefficient map value and histopathological differentiation in patients who underwent eye enucleation due to retinoblastomas. Methods: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student's t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent. Results: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 103 mm2/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 103 mm2/s and 0.774 × 103 mm2/s, respectively. Conclusion: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 103 mm2/s, whereas in well and moderately differentiated, the mean was 0.774 × 103 mm2/s.

3.
Am J Ophthalmol Case Rep ; 28: 101728, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36312791

RESUMO

Purpose: To describe a successful surgical approach to macula-off retinal detachment in von Hippel-Lindau disease. Observations: A 28-year-old male with a history of von Hippel-Lindau disease presented to us with significant worsening of vision in his single functional eye after undergoing a cryotherapy and laser session for multiple retinal capillary hemangioblastomas. Given a tractional and exudative retinal detachment involving macula, we performed a vitrectomy, epiretinal membrane peeling, internal limiting membrane peeling, endophotocoagulation of all hemangioblastomas, and fluid-air exchange. Over 30 days, there was total resolution of retinal detachment and improvement of his vision. At 13-month follow-up, the patient exhibited anatomical and functional stability. Conclusions and Importance: Double peeling and endolaser ablation may be an alternative treatment approach for patients with tractional and exudative retinal detachment in von-Hippel-Lindau disease.

7.
Sao Paulo Med J ; 136(4): 276-286, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30304202

RESUMO

BACKGROUND: Investigation of alterations to retinal microvasculature may contribute towards understanding the role of such changes in the pathophysiology of several chronic non-communicable diseases. The objective here was to evaluate the validity and reproducibility of retinal arteriole and venule diameter measurements made by Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) graders. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: To evaluate validity, each of 25 retinal images from the University of Wisconsin (gold standard) was measured by five ELSA-Brasil graders. To evaluate reproducibility, 105 images across the spectrum of vessel diameters were selected from 12,257 retinal images that had been obtained between 2010 and 2012, and each image was reexamined by the same grader and by an independent grader. All measurements were made using the Interactive Vessel Analysis (IVAN) software. Bland-Altman plots, paired t tests and intraclass correlation coefficients (ICCs) were analyzed. RESULTS: Mean differences between ELSA-Brasil and gold-standard readings were 0.16 µm (95% CI -0.17-0.50; P = 0.31) for central retinal artery equivalent (CRAE), -0.21 µm (95% CI -0.56-0.14; P = 0.22) for central retinal vein equivalent (CRVE) and 0.0005 (95% CI -0.008-0.009; P = 0.55) for arteriole/venule ratio (AVR). Intragrader ICCs were 0.77 (95% CI 0.67-0.86) for CRAE, 0.90 (95% CI 0.780.96) for CRVE and 0.70 (0.55-0.83) for AVR. Intergrader ICCs were 0.75 (95% CI 0.64-0.85) for CRAE, 0.90 (95% CI 0.79-0.96) for CRVE and 0.68 (95% CI 0.55-0.82) for AVR. CONCLUSIONS: Retinal microvascular diameter measurements are valid and present moderate to high intra and intergrader reproducibility in ELSA-Brasil.


Assuntos
Arteríolas/anatomia & histologia , Interpretação de Imagem Assistida por Computador , Vasos Retinianos/anatomia & histologia , Vênulas/anatomia & histologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Socioeconômicos
8.
São Paulo med. j ; São Paulo med. j;136(4): 276-286, July-Aug. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-962735

RESUMO

ABSTRACT BACKGROUND: Investigation of alterations to retinal microvasculature may contribute towards understanding the role of such changes in the pathophysiology of several chronic non-communicable diseases. The objective here was to evaluate the validity and reproducibility of retinal arteriole and venule diameter measurements made by Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) graders. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: To evaluate validity, each of 25 retinal images from the University of Wisconsin (gold standard) was measured by five ELSA-Brasil graders. To evaluate reproducibility, 105 images across the spectrum of vessel diameters were selected from 12,257 retinal images that had been obtained between 2010 and 2012, and each image was reexamined by the same grader and by an independent grader. All measurements were made using the Interactive Vessel Analysis (IVAN) software. Bland-Altman plots, paired t tests and intraclass correlation coefficients (ICCs) were analyzed. RESULTS: Mean differences between ELSA-Brasil and gold-standard readings were 0.16 µm (95% CI -0.17-0.50; P = 0.31) for central retinal artery equivalent (CRAE), -0.21 µm (95% CI -0.56-0.14; P = 0.22) for central retinal vein equivalent (CRVE) and 0.0005 (95% CI -0.008-0.009; P = 0.55) for arteriole/venule ratio (AVR). Intragrader ICCs were 0.77 (95% CI 0.67-0.86) for CRAE, 0.90 (95% CI 0.780.96) for CRVE and 0.70 (0.55-0.83) for AVR. Intergrader ICCs were 0.75 (95% CI 0.64-0.85) for CRAE, 0.90 (95% CI 0.79-0.96) for CRVE and 0.68 (95% CI 0.55-0.82) for AVR. CONCLUSIONS: Retinal microvascular diameter measurements are valid and present moderate to high intra and intergrader reproducibility in ELSA-Brasil.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Arteríolas/anatomia & histologia , Vasos Retinianos/anatomia & histologia , Vênulas/anatomia & histologia , Interpretação de Imagem Assistida por Computador , Fatores Socioeconômicos , Estudos Transversais , Reprodutibilidade dos Testes , Estudos Longitudinais
9.
Arq Neuropsiquiatr ; 75(6): 339-344, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28658401

RESUMO

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset, neurodegenerative disorder caused by mutations in SACS, firstly reported in Quebec, Canada. The disorder is typically characterized by childhood onset ataxia, spasticity, neuropathy and retinal hypermyelination. The clinical picture of patients born outside Quebec, however, is often atypical. In the present article, the authors describe clinical and neuroradiological findings that raised the suspicion of an ARSACS diagnosis in two female cousins with Germanic background from Rio Grande do Sul, Brazil. We present a review on the neuroimaging, ophthalmologic and neurophysiologic clues for ARSACS diagnosis. The early-onset, slowly progressive, spastic-ataxia phenotype of reported patients was similar to ARSACS patients from Quebec. The SACS sequencing revealed the novel homozygous c.5150_5151insA frameshift mutation confirming the ARSACS diagnosis. ARSACS is a frequent cause of early onset ataxia/spastic-ataxia worldwide, with unknown frequency in Brazil.


Assuntos
Proteínas de Choque Térmico/genética , Espasticidade Muscular/diagnóstico por imagem , Espasticidade Muscular/genética , Mutação/genética , Ataxias Espinocerebelares/congênito , Adulto , Brasil , Feminino , Humanos , Imageamento por Ressonância Magnética , Linhagem , Fenótipo , Ataxias Espinocerebelares/diagnóstico por imagem , Ataxias Espinocerebelares/genética
10.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;75(6): 339-344, June 2017. graf
Artigo em Inglês | LILACS | ID: biblio-838918

RESUMO

ABSTRACT Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset, neurodegenerative disorder caused by mutations in SACS, firstly reported in Quebec, Canada. The disorder is typically characterized by childhood onset ataxia, spasticity, neuropathy and retinal hypermyelination. The clinical picture of patients born outside Quebec, however, is often atypical. In the present article, the authors describe clinical and neuroradiological findings that raised the suspicion of an ARSACS diagnosis in two female cousins with Germanic background from Rio Grande do Sul, Brazil. We present a review on the neuroimaging, ophthalmologic and neurophysiologic clues for ARSACS diagnosis. The early-onset, slowly progressive, spastic-ataxia phenotype of reported patients was similar to ARSACS patients from Quebec. The SACS sequencing revealed the novel homozygous c.5150_5151insA frameshift mutation confirming the ARSACS diagnosis. ARSACS is a frequent cause of early onset ataxia/spastic-ataxia worldwide, with unknown frequency in Brazil.


RESUMO A ataxia espástica autossômica recessiva de Charlevoix-Saguenay (ARSACS) é uma doença neurodegenerativa de início precoce causada por mutações no gene SACS que foi inicialmente descrita na região de Quebec, Canadá. A apresentação típica de ARSACS é caracterizada por ataxia, espasticidade, polineuropatia e hipermielinização das fibras nervosas da retina de início infantil. No presente artigo, descrevemos os achados clínicos e neurorradiológicos que levaram à suspeita de ARSACS em duas primas descendentes de alemães naturais do Rio Grande do Sul, Brasil e revisamos os achados de neuroimagem, oftalmológicos e neurofisiológicos de ARSACS. O fenótipo de ataxia-espástica de início infantil precoce apresentado pelas pacientes era similar ao classicamente descrito em Quebec. O sequenciamento do SACS revelou a mutação nova c.5150_5151insA (mudança na matriz de leitura), em homozigose, confirmando o diagnóstico de ARSACS. A ARSACS é uma causa frequente de ataxia/ataxia-espástica de início precoce mundialmente, entretanto sua frequência é desconhecida no Brasil.


Assuntos
Humanos , Feminino , Adulto , Ataxias Espinocerebelares/congênito , Proteínas de Choque Térmico/genética , Espasticidade Muscular/genética , Espasticidade Muscular/diagnóstico por imagem , Mutação/genética , Linhagem , Fenótipo , Brasil , Imageamento por Ressonância Magnética , Ataxias Espinocerebelares/genética , Ataxias Espinocerebelares/diagnóstico por imagem
12.
Rev Inst Med Trop Sao Paulo ; 53(1): 51-3, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21412620

RESUMO

We report the first case of human ocular sparganosis in the state of Santa Catarina, southern Brazil. A young female patient presented with three periocular moveable inflammatory masses in her right eye, during two years. By surgical excisional biopsy, a helminth larval stage was removed and identified as sparganum. Clinical, laboratory and epidemiological data on this parasite are presented.


Assuntos
Infecções Oculares Parasitárias/diagnóstico , Esparganose/diagnóstico , Infecções Oculares Parasitárias/parasitologia , Feminino , Humanos , Esparganose/cirurgia , Adulto Jovem
13.
Rev. Inst. Med. Trop. Säo Paulo ; Rev. Inst. Med. Trop. Säo Paulo;53(1): 51-53, Jan.-Feb. 2011. ilus
Artigo em Inglês | LILACS | ID: lil-576967

RESUMO

We report the first case of human ocular sparganosis in the state of Santa Catarina, southern Brazil. A young female patient presented with three periocular moveable inflammatory masses in her right eye, during two years. By surgical excisional biopsy, a helminth larval stage was removed and identified as sparganum. Clinical, laboratory and epidemiological data on this parasite are presented.


Registra-se o primeiro caso de esparganose ocular humana no estado de Santa Catarina, sul do Brasil a partir de paciente adulta que apresentou três massas inflamatórias móveis perioculares, localizadas no olho direito, durante dois anos. Com a excisão cirúrgica o material foi para a biópsia e um estágio larval de helminto foi identificado como espargano. Dados clínicos, laboratoriais e epidemioógicos são apresentados neste trabalho.


Assuntos
Feminino , Humanos , Adulto Jovem , Infecções Oculares Parasitárias/diagnóstico , Esparganose/diagnóstico , Infecções Oculares Parasitárias/parasitologia , Esparganose/cirurgia
14.
Artigo em Português | LILACS | ID: lil-40705

RESUMO

Apresenta-se um caso de psoríase com envolvimento ocular em um homem de 57 anos. As manifestaçöes ocorreram após um ano e três meses do diagnóstico de psoríase e se caracterizaram por ectrópio da pálpebra inferior esquerda, reversível com o uso da corticóide local e recidivante com a retirada da terapêutica. Também apresenta-se uma revisäo da literatura salientando a infreqüência de tais manifestaçöes de psoríase


Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Oftalmopatias/etiologia , Psoríase/complicações
15.
Artigo em Português | LILACS | ID: lil-33768

RESUMO

Foram estudadas 151 crianças de 0 a 6 anos incompletos em uma vila periférica de Porto Alegre, quanto à correlaçäo entre peso de nascimento e desnutriçäo infantil (avaliada pela medida do perímetro braquial médio). Näo se encontrou associaçäo significativa entre ambos


Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Humanos , Peso ao Nascer , Desnutrição Proteico-Calórica , Antropometria , Brasil
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