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1.
Transl Vis Sci Technol ; 11(5): 1, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35499823

RESUMO

Purpose: To identify the ocular factors of microvascular fractal dimension (FD) and blood vessel tortuosity (BVT) of macula measured with optical coherence tomography angiography (OCTA) in a healthy Chinese population. Methods: Healthy subjects without ocular disorders were recruited at Zhongshan Ophthalmic Center. The FD and BVT in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at the macula were obtained from OCTA images. The FD was calculated using the box-counting method, and the BVT was defined as the ratio of the actual distance between two points to the straight distance on the skeletonized image. Univariate and stepwise multivariate linear regression analyses were performed to identify the ocular factors of FD and BVT, and the results are presented as coefficients and 95% confidence intervals (CIs). Only the right eye of each subject was included. Results: A total of 2189 healthy individuals (2189 eyes) were included with a mean age of 49.9 ± 13.2 years; 54.4% were female. In the multivariate model, the FD in the SCP was significantly associated with higher intraocular pressure (IOP) (ß = 0.204; 95% CI, 0.073-0.335; P < 0.001), axial length (AL) (ß = -0.875; 95% CI, -1.197 to -0.552; P < 0.001; R2 = 0.26; root mean square error [RMSE] = 7.78). The FD in the DCP was significantly associated with best-corrected visual acuity (ß = -6.170; 95% CI, -10.175 to -2.166; P = 0.003) and anterior chamber depth (ß = -0.348; 95% CI, -0.673 to -0.023; P = 0.036; R2 = 0.10; RMSE = 2.58). Superficial BVT was independently associated with IOP (ß = -0.044; 95% CI, -0.079 to -0.009; P = 0.012) and AL (ß = 0.097; 95% CI, 0.014-0.181; P = 0.022; R2 = 0.15; RMSE = 2.02). Deep BVT was independently associated with IOP (ß = -0.004; 95% CI, -0.009 to -0.0005; P = 0.028) and lens thickness (ß = 0.036, 95% CI, 0.003-0.060; P = 0.028; R2 = 0.07, RMSE = 0.25). Conclusions: The IOP and AL were dependent ocular parameters variables of FD and BVT in the SCP in this healthy population. The FD in the DCP was also influenced by visual acuity and anterior chamber depth. These factors should be considered when microvascular geometrics are used in the future studies. Translational Relevance: This work discovered the influence factors of OCTA geometrics parameters for further establishment of diagnostic model or method for glaucoma and other microvasculature-related ocular diseases.


Assuntos
Vasos Retinianos , Tomografia de Coerência Óptica , Adulto , China , Feminino , Angiofluoresceinografia/métodos , Fractais , Humanos , Masculino , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
2.
PLoS One ; 17(5): e0266423, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511907

RESUMO

PURPOSE: Early detection of microvascular changes in the retina may be important for the risk assessment of cardiovascular health. Therefore, the purpose of this study was to investigate imaging biomarkers in fluorescein angiography (FA) as potential predictors for cardiovascular mortality. METHODS: In this retrospective, matched case-control study, we included FA images from clinical routine data between 2007 and 2018 of 100 patients who died of macrovascular events (Group 1) and 100 age- and sex-matched controls (Group 2). All patients were under treatment for different, mostly retinal, ocular diseases. FA images were used for the measurement of the foveal avascular zone (FAZ) and the arteriolar and venular caliber. RESULTS: Patients mean age on examination day was 69.5 ± 8.3 years with a 1:1 female:male subject ratio. Mean FAZ area of our sample was 0.340 ± 0.135 mm2 for Group 1 and 0.264 ± 0.137 mm2 for Group 2 (P < 0.001), showing a larger FAZ area in patients who subsequently died of macrovascular-related systemic diseases. CONCLUSIONS: Individuals effected by a macrovascular-related disease show a larger FAZ on FA examinations before the event compared to patients which are unaffected. Our results highlight a possible role of the FAZ as additional biomarker for the cardiovascular condition.


Assuntos
Fóvea Central , Doenças Retinianas , Biomarcadores , Estudos de Casos e Controles , Feminino , Angiofluoresceinografia/métodos , Fóvea Central/irrigação sanguínea , Humanos , Masculino , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
4.
Sci Rep ; 12(1): 7115, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35504937

RESUMO

This study aimed to evaluate the distribution of retinal pigment epithelium (RPE) melanin in patients with retinitis pigmentosa (RP) using entropy measurements by custom-made polarization-sensitive optical coherence tomography (PS-OCT) images, and compare entropy with the intensity of short-wavelength (SW) and near-infrared (NIR) autofluorescence (AF). We retrospectively reviewed the retinal images, including PS-OCT, SW-AF, and NIR-AF of patients with RP who had a hyperautofluorescent ring on AF. A total of 12 eyes of 12 patients (8 women and 4 men; mean age: 37.9 years) were included. There was a strong positive correlation between entropy value and NIR-AF intensity (r = 0.626, p < 0.001), and there was a very weak negative correlation between entropy value and SW-AF (r = - 0.197, p = 0.001). The mean values of the entropy in the foveal, temporal (2 mm from the fovea), and nasal (2 mm from the fovea) sections were 0.41 (± 0.09), 0.29 (± 0.08), and 0.26 (± 0.08), respectively. The entropy was significantly higher in the foveal section than in the temporal and nasal sections (p = 0.002 and p = 0.003, respectively). There was no significant difference between the entropies values for the temporal and nasal sections (p = 0.157). Age, logMAR best-corrected visual acuity, ellipsoid zone width, and central retinal thickness were not correlated with foveal entropy. We presented RPE melanin imaging in patients with RP using PS-OCT for the first time. PS-OCT can be a useful tool for monitoring patients with RP.


Assuntos
Retinite Pigmentosa , Tomografia de Coerência Óptica , Adulto , Feminino , Angiofluoresceinografia/métodos , Humanos , Masculino , Melaninas , Epitélio Pigmentado da Retina/diagnóstico por imagem , Retinite Pigmentosa/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
5.
Invest Ophthalmol Vis Sci ; 63(5): 8, 2022 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-35522303

RESUMO

Purpose: To investigate differences in alpha smooth muscle actin (αSMA) expression and parafoveal blood flow pathways in diabetic retinopathy (DR). Methods: Human donor eyes from healthy subjects (n = 8), patients with diabetes but no DR (DR-; n = 7), and patients with clinical DR (DR+; n = 13) were perfusion labeled with antibodies targeting αSMA, lectin, collagen IV, and filamentous actin. High-resolution confocal scanning laser microscopy was used to quantify αSMA staining and capillary density in the parafoveal circulation. Quantitative analyses of connections between retinal arteries and veins within the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were performed. Results: Mean age between the groups was not different (P = 0.979). αSMA staining was seen in the SVP and ICP of all groups. The DCP was predominantly devoid of αSMA staining in control eyes but increased in a disease stage-specific manner in the DR- and DR+ groups. The increase in αSMA staining was localized to pericytes and endothelia of terminal arterioles and adjacent capillary segments. Capillary density was less in the DCP in the DR+ group (P < 0.001). ICP of the DR- and DR+ groups received more direct arteriole supplies than the control group (P < 0.001). Venous outflow pathways were not altered (all P > 0.284). Conclusions: Alterations in αSMA and vascular inflow pathways in preclinical DR suggest that perfusion abnormalities precede structural vascular changes such as capillary loss. Preclinical DR may be characterized by a "steal" phenomenon where blood flow is preferentially diverted from the SVP to the ICP and DCP.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Actinas , Angiofluoresceinografia , Humanos , Músculo Liso , Vasos Retinianos , Tomografia de Coerência Óptica
6.
Asia Pac J Ophthalmol (Phila) ; 11(2): 149-159, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35533334

RESUMO

ABSTRACT: Structural and functional alterations in the microcirculation by systemic hypertension can cause significant organ damage at the eye, heart, brain, and kidneys. As the retina is the only tissue in the body that allows direct imaging of small vessels, the relationship of hypertensive retinopathy signs with development of disease states in other organs have been extensively studied; large-scale epidemiological studies using fundus photography and advanced semi-automated analysis software have reported the association of retinopathy signs with hypertensive end-organ damage includes the following: stroke, dementia, and coronary heart disease. Although yielding much useful information, the vessels assessed from fundus photographs remain limited to the larger retinal arterioles and venules, and abnormalities observed may not be that of the earliest changes. Newer imaging modalities such as optical coherence tomography angiography and adaptive optics technology, which allow a greater precision in the structural quantification of retinal vessels, including capillaries, may facilitate the assessment and management of these patients. The advent of deep learning technology has also augmented the utility of fundus photographs to help create diagnostic and risk stratification systems. Particularly, deep learning systems have been shown in several large studies to be able to predict multiple cardiovascular risk factors, major adverse cardiovascular events within 5 years, and presence of coronary artery calcium, from fundus photographs alone. In the future, combining deep learning systems with the imaging precision offered by optical coherence tomography angiography and adaptive optics could pave way for systems that are able to predict adverse clinical outcomes even more accurately.


Assuntos
Hipertensão , Retina , Angiofluoresceinografia , Fundo de Olho , Humanos , Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
7.
Indian J Ophthalmol ; 70(5): 1669-1677, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35502048

RESUMO

Purpose: To evaluate the retinal and optic disc microvascular changes according to disease severity in patients with stable chronic obstructive pulmonary disease (COPD), and the correlation of pulmonary parameters with optical coherence tomography angiography (OCTA) findings. Methods: Forty patients with COPD and 30 age- and sex-matched subjects (control group) were included in this cross-sectional prospective study. The COPD group was then divided into two subgroups according to GOLD classification and disease severity as mild-to-moderate COPD group (group 1) and severe COPD group (group 2). OCTA was performed with 6 mm × 6 mm sections for the macula and 4.5 mm × 4.5 mm sections for the optic disc. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, and vessel density in different sections of the retina and optic disc were analyzed. Results: The mean ages, gender, intraocular pressures, peripapillary RNFL thickness, FRT, and optic disc vessel densities were similar among the groups. Compared to the control group and group 1, group 2 showed significantly lower mean foveal vessel density measurements in superficial and deep capillary plexus (P = 0.014 and P = 0.007, respectively). Cigarette packets/year, exacerbation per year, and Modified Medical Research Council showed significant negative correlations, whereas forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed significant positive correlations with foveal vessel densities. Conclusion: COPD severity seems to have a negative effect on OCTA measurements. OCTA may reflect the severity of inflammation and hypoxia in COPD and may provide useful detailed information on the role of retinal vascular changes in the follow-up and progression of patients with COPD.


Assuntos
Disco Óptico , Doença Pulmonar Obstrutiva Crônica , Estudos Transversais , Angiofluoresceinografia/métodos , Humanos , Microvasos , Disco Óptico/irrigação sanguínea , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Vasos Retinianos , Tomografia de Coerência Óptica/métodos
8.
Indian J Ophthalmol ; 70(5): 1780-1786, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35502072

RESUMO

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID-19 during the second wave of the pandemic in North India. Methods: In this observational cross-sectional study, 70 eyes of 35 patients who recovered from severe COVID-19 during the second wave underwent detailed ophthalmic evaluation 4-6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell-inner plexiform layer (GC-IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID-19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature.


Assuntos
COVID-19 , Macula Lutea , Adulto , COVID-19/complicações , COVID-19/epidemiologia , Feminino , Angiofluoresceinografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
12.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(4): 230-233, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35523470

RESUMO

A 35-year-old woman arrived in the emergency department due to loss of vision in the left eye. She had a subfoveal yellowish-looking lesion that, on optical coherence tomography (OCT), corresponded to a hyper-reflective lesion from the external nuclear layer to the retinal pigment epithelium. The lesion was reabsorbed at 6 weeks, leaving a discontinuity in the photoreceptor and retinal pigment epithelium lines. The patient was diagnosed with acute retinal pigmentary epitheliitis (ARPE). ARPE is a self-limiting disease with a good prognosis. Emphasis is placed on the importance of a correct diagnosis using funduscopy, OCT, and fluorescent angiography, in order to avoid unnecessary treatments.


Assuntos
Retinite , Doença Aguda , Adulto , Feminino , Angiofluoresceinografia , Humanos , Epitélio Pigmentado da Retina/diagnóstico por imagem , Epitélio Pigmentado da Retina/patologia , Pigmentos da Retina , Retinite/diagnóstico , Retinite/patologia
13.
Ann Palliat Med ; 11(4): 1589-1594, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35523759

RESUMO

BACKGROUND: A case of Vogt-Koyanagi-Harada syndrome (VKH) first diagnosed with encephalitis was reported and it bring us the clinical reflection. CASE DESCRIPTION: A 73-year-old Chinese woman was first diagnosed in the department of neurology with headache, nausea, vomiting, and elevated body temperature. Cerebrospinal fluid (CSF) assays showed significant increases in leukocytes and Cerebrospinal fluid total protein (CS-TP). Gradually, symptoms appeared in the eyes including decreased vision, keratic precipitates (KP) (+++), iris local posterior adhesion, vitreous opacity, and optic disc congestion edema. The fundus fluorescence examination showed optic disc hyperfluorescence with both eyes exudative retinal detachment. Type-B ultrasonography of obit showed a large number of flocculent opacities in the vitreous and retinal edema. Optical coherence tomography (OCT) showed that significant edema was evident in the macular area and papillary, and there were wavy changes in the retinal pigment epithelium layer. Review of the clinical, photographic, fundus fluorescence angiography (FFA) data of the patient suggested a clinical diagnosis of VKH. CONCLUSIONS: VKH is an autoimmune disease involving many systems. It has specific systemic symptoms, such as tinnitus, dizziness, headache, nausea, skin injury and so on. But Neurological and auditory manifestations usually precede the involvement of other sites especially in the neurological manifestations. So we should pay attention to the diversity of clinical manifestations, so as to avoid delaying treatment or even misdiagnosis in clinical diagnosis and treatment.


Assuntos
Papiledema , Síndrome Uveomeningoencefálica , Idoso , Feminino , Angiofluoresceinografia/efeitos adversos , Angiofluoresceinografia/métodos , Cefaleia/complicações , Humanos , Medicina Interna , Náusea , Papiledema/diagnóstico , Papiledema/etiologia , Síndrome Uveomeningoencefálica/complicações , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/tratamento farmacológico
14.
Sci Rep ; 12(1): 7442, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524159

RESUMO

Drusen are a hallmark lesion of age-related macular degeneration (AMD) and changes in their area and/or volume are strongly associated with disease progression. Assessment of longitudinal change in drusen size in clinical practice however is limited to a single commercial tool or manual inspection by clinicians. In this study we analysed change in drusen area in 33 eyes with intermediate AMD across two separate visits using a novel technique known as multispectral pattern recognition for en face retinal images from various imaging modalities (infrared (815 nm), fundus autofluorescence (488 nm) and green (532 nm) scanning laser ophthalmoscopy). We found 91% (30/33 eyes) agreement in the direction of drusen change for multispectral pattern recognition relative to expert graders who graded eyes as having drusen progression, regression or being stable. Multispectral pattern recognition showed 100% sensitivity (22/22 eyes) and 73% specificity (8/11 eyes). In comparison, we found only 70% (23/33 eyes) agreement in the direction of drusen change with a commercially available change analysis software, the Cirrus Advanced RPE Analysis relative to expert graders, with a sensitivity 64% (14/22 eyes) and specificity of 82% (9/11 eyes). Total drusen area or amount of change between visits had no significant effect on agreement. This suggests multispectral pattern recognition can quantify longitudinal change in drusen area from multimodal imaging with greater congruency to expert graders than a commercially available platform based on a single imaging modality. Considering the association of drusen area and disease progression, this method could aid clinical assessment and monitoring of AMD.


Assuntos
Degeneração Macular , Drusas Retinianas , Progressão da Doença , Angiofluoresceinografia , Humanos , Degeneração Macular/complicações , Degeneração Macular/diagnóstico por imagem , Drusas Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
15.
BMC Ophthalmol ; 22(1): 205, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524216

RESUMO

BACKGROUND: To report the multimodal imaging and treatment of fifteen retinal capillary hemangioblastomas (RCHs) associated with Von Hippel-Lindau syndrome in a monocular patient during a long-term following-up, which supply high-resolution exquisite SS-OCTA images (VG200; SVision Imaging, Ltd., Luoyang, China) and management experience about multiple RCHs. CASE PRESENTATION: A 34-year-old monocular male patient complained decreased visual acuity (20/100) without pain and redness in the left eye five years ago. Von Hippel-Lindau syndrome were diagnosed with genetic testing. He, his son and daughter all carried a heterozygosity missense variant c.499C > T (p. Arg167Trp) in the Hg19 gene, a VHL gene located in Chr3:10,191,506. Fifteen RCHs were identified by the application of multimodal imaging, which including fundus photo, fundus autofluorescence (FAF), B-scan ultrasonography (US), fluorescein fundus angiography (FFA), indocyanine green angiography (ICGA) and swept-source optical coherence tomography angiography (SS-OCTA). Transscleral cryotherapy and laser photocoagulation were performed to destroy the largest RCH with the size of 4 PD in diameter. Laser photocoagulation was conducted to seal the middle or tiny RCHs (< 1.5 PD) and their nourishing vessels. The retinal edema and exudative macular detachment were successfully relieved by intraocular injection of bevacizumab for 5 times. The RCHs in the left eye responded well to these treatments and best corrected visual acuity was 20/25 for three years. Three-month recall visits were recommended for him. CONCLUSION: For multiple retinal capillary hemangioblastomas in monocular patients, precise combined therapy guided by multimodal imaging has a profound impact on the management of new and recurrent RCHs.


Assuntos
Hemangioblastoma , Neoplasias da Retina , Doença de von Hippel-Lindau , Adulto , Angiofluoresceinografia/métodos , Hemangioblastoma/complicações , Hemangioblastoma/diagnóstico , Humanos , Masculino , Imagem Multimodal , Neoplasias da Retina/complicações , Neoplasias da Retina/diagnóstico , Tomografia de Coerência Óptica/métodos , Doença de von Hippel-Lindau/complicações , Doença de von Hippel-Lindau/diagnóstico
16.
PLoS One ; 17(4): e0266974, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35421194

RESUMO

INTRODUCTION: Cerebral Small Vessel Disease (CSVD), a progressive degenerative disorder of small caliber cerebral vessels, represents a major contributor to stroke and vascular dementia incidence worldwide. We sought to conduct a systematic review of the role of retinal biomarkers in diagnosis and characterization of CSVD. METHODS: We conducted a systematic review of MEDLINE, PubMed, Scopus, the Cochrane Library Database, and Web of Science. We identified studies of sporadic CSVD (including CSVD not otherwise specified, Cerebral Amyloid Angiopathy, and Hypertensive Arteriopathy) and the most common familial CSVD disorders (including CADASIL, Fabry disease, and MELAS). Included studies used one or more of the following tools: visual fields assessment, fundus photography, Optical Coherence Tomography and OCT Angiography, Fluorescein Angiography, Electroretinography, and Visual Evoked Potentials. RESULTS: We identified 48 studies of retinal biomarkers in CSVD, including 9147 cases and 12276 controls. Abnormalities in retinal vessel diameter (11 reports, n = 11391 participants), increased retinal vessel tortuosity (11 reports, n = 617 participants), decreased vessel fractal dimension (5 reports, n = 1597 participants) and decreased retinal nerve fiber layer thickness (5 reports, n = 4509 participants) were the biomarkers most frequently associated with CSVD. We identified no reports conducting longitudinal retinal evaluations of CSVD, or systematically evaluating diagnostic performance. CONCLUSION: Multiple retinal biomarkers were associated with CSVD or its validated neuroimaging biomarkers. However, existing evidence is limited by several shortcomings, chiefly small sample size and unstandardized approaches to both biomarkers' capture and CSVD characterization. Additional larger studies will be required to definitively determine whether retinal biomarkers could be successfully incorporated in future research efforts and clinical practice.


Assuntos
Doenças de Pequenos Vasos Cerebrais , Potenciais Evocados Visuais , Biomarcadores , Doenças de Pequenos Vasos Cerebrais/complicações , Angiofluoresceinografia/efeitos adversos , Humanos , Retina/diagnóstico por imagem
17.
Nutrients ; 14(7)2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35406133

RESUMO

BACKGROUND: To investigate the effects of a fixed combination of Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) on vascular parameters in mild to moderate diabetic macular edema (DME). DESIGN: Prospective, case-control study. METHODS: Fifty-six patients affected by diabetes mellitus type II were enrolled in the study. Twenty-eight patients with DME received 2 tablets/day, before meals of a dietary complementary supplement containing in fixed combination Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) (Intravit®, OFFHEALTH Spa, Firenze, Italy) for 6 months. Twenty-eight age-matched subjects affected by diabetes mellitus type II were given placebo and served as control group. Patients underwent best correct visual acuity (BCVA), swept optical coherence tomography (OCT), and OCT-Angiography (OCTA). OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained for each eye. By the end of the follow-up patients were defined responder to the therapy when a decrease of more than 30 µm was registered in central retinal thickness (CRT) measurement, while a poor responder was determined by the absence of reduction or an increase in central retinal thickness at 6 months. We assessed the foveal avascular zone (FAZ) area, vessel density and quantified the number of microaneurysms in each layer. RESULTS: A significant improvement of BCVA and CRT reduction was recorded at 6 months follow-up in the dietary complementary supplementation group compared to control (respectively p = 0.028 and p = 0.0003). VD of the total capillary plexus, microaneurysms count, glycaemia and HbA1c did not vary over the follow-up period between groups. Within the Intravit® group, poor responders tended to show a larger FAZ area, more microaneurysms, and a lower VD in the DCP compared to the good responders group (p < 0.0001). CONCLUSIONS: A fixed combination of Curcumin, Artemisia, Bromelain, and Black pepper oral administration may have a positive impact on central retinal thickness, visual acuity, and VD of the DCP in compensated type 2 diabetic patients with mild DME.


Assuntos
Artemisia , Curcumina , Diabetes Mellitus , Retinopatia Diabética , Edema Macular , Microaneurisma , Piper nigrum , Administração Oral , Bromelaínas , Estudos de Casos e Controles , Curcumina/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/tratamento farmacológico , Angiofluoresceinografia/métodos , Humanos , Edema Macular/tratamento farmacológico , Estudos Prospectivos , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
18.
P R Health Sci J ; 41(1): 9-12, 2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35438889

RESUMO

OBJECTIVE: To describe the systemic disease associations and clinical features upon initial presentation of a cohort of patients with type 2 macular telangiectasia who live in Puerto Rico. METHODS: A retrospective review of patients with macular telangiectasia was performed in 4 private retina practices in Puerto Rico. The demographic and clinical characteristics were recorded. RESULTS: Twenty-one patients who were diagnosed with macular telangiectasia were included in the analysis. The median age of presentation was 62 years; 86% were female, and all patients were Hispanics. The median visual acuity at presentation was 20/50. A prior medical diagnosis of type II diabetes mellitus was found in 15 (71.4%) patients, essential hypertension in 12 (57.1%), and dyslipidemia in 9 (42.9%). All patients had bilateral disease. The most common ocular findings were the presence of right-angle vessels in 32 (76.2%) eyes and angiographic hyperfluorescence temporal to the fovea, found in 22 (52.4%) of the affected eyes. One eye had evidence of choroidal neovascularization. CONCLUSION: Our cohort showed a higher prevalence of type 2 diabetes in patients with type 2 macular telangiectasia than in other cohorts. It also supports the findings of other studies showing that macular telangiectasia patients are more likely to have type 2 diabetes and hyperlipidemia. However, the increased prevalence of diabetes and hyperlipidemia may be due to selection bias, and further studies are needed to assess the significance of these findings.


Assuntos
Diabetes Mellitus Tipo 2 , Telangiectasia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Estudos Retrospectivos , Telangiectasia/diagnóstico , Acuidade Visual
19.
P R Health Sci J ; 41(1): 41-44, 2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35438895

RESUMO

Optical coherence tomography angiography (OCT-A) is a modern non invasive imaging technique that may aid in the evaluation of retinal diseases through the assessment of chorioretinal vasculature. The literature regarding OCT-A in sclerochoroidal calcification is scarce. We present the case of a 57-year-old female who was referred to the clinic due to an atypical choroidal lesion in the right eye. OCT-A showed an apparent decrease in the vascular flow of the choroidal/choriocapillaris layers and an apparent increase in the vascular flow of the deep retinal layers. A mass effect may be seen in OCT-A en face imaging that may create artifactual vascular flow pattern. This case reports the first OCT-A findings of sclerochoroidal calcification.


Assuntos
Corioide , Tomografia de Coerência Óptica , Corioide/irrigação sanguínea , Feminino , Angiofluoresceinografia/métodos , Humanos , Pessoa de Meia-Idade , Tomografia de Coerência Óptica/métodos
20.
J Med Case Rep ; 16(1): 167, 2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35449024

RESUMO

BACKGROUND: Retinal arterial occlusive events in young patients are rare. However, because of physiological multifactorial adaptations during pregnancy, retinal vascular occlusive disease may occur spontaneously. In addition, a patent foramen ovale is a risk factor for an ischemic thromboembolic event. Since fluorescein angiography, a central tool in the evaluation of these occlusions, should be avoided during pregnancy, optical coherence tomography angiography, a novel technique, offers a good opportunity for visualizing vascular perfusion of retinal tissue. CASE PRESENTATION: Here we present a case series of three patients (Caucasian, nonsmoker) who visited our clinic owing to acute visual impairment and central scotoma. Using regular optical coherence tomography and optical coherence tomography angiography, retinal vascular occlusions were detected, thus initiating the evaluation of systemic risk factors. We report two patients (30 and 32 years old) who developed cilioretinal artery occlusion but whose etiology differed: one was of thromboembolic origin associated with patent foramen ovale, while the other was caused by hemodynamic blockade secondary to central retinal vein occlusion. In both cases, optical coherence tomography angiography revealed reperfusion of the cilioretinal artery occlusion. However, transient ischemia led to retinal atrophy after a few weeks. In the third patient (32 years old), 8 weeks after onset of scotoma, optical coherence tomography angiography revealed atrophy of the middle layers and impaired perfusion in the deep capillary plexus, and thus a paracentral acute middle maculopathy was diagnosed. All patients regained normal visual acuity and had otherwise uncomplicated pregnancies, and laboratory blood tests did not reveal any defects or alterations. CONCLUSIONS: As shown here, optical coherence tomography angiography enables risk-free imaging of retinal vessel perfusion during pregnancy. Together with regular optical coherence tomography, it allows one to predict functional outcome according to the existing retinal occlusion-related atrophy.


Assuntos
Forame Oval Patente , Oclusão da Artéria Retiniana , Doenças Retinianas , Adulto , Atrofia/complicações , Atrofia/patologia , Feminino , Angiofluoresceinografia/métodos , Forame Oval Patente/complicações , Humanos , Isquemia/diagnóstico , Gravidez , Oclusão da Artéria Retiniana/diagnóstico por imagem , Oclusão da Artéria Retiniana/etiologia , Doenças Retinianas/etiologia , Vasos Retinianos/patologia , Escotoma , Tomografia de Coerência Óptica/métodos
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