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1.
PLoS One ; 15(8): e0236819, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817645

RESUMO

AIMS: To examine the relationship between baseline structural characteristics of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) and functional disease progression in patients with open-angle glaucoma (OAG) over 5 years. METHODS: 112 OAG patients were prospectively examined at baseline and every 6 months over a period of five years. Structural glaucomatous changes were examined with optical coherence tomography (OCT) and Heidelberg retinal tomography-III (HRT-III), and functional disease progression with automated perimetry (Humphrey visual fields). Cox proportional hazard models were used to assess the relationship between baseline structural measurements and functional disease progression. RESULTS: From baseline over a 5-year period, statistically significant increases were found in OCT disc (D) area (p<0.001), cup (C) area (p<0.001), C/D area ratio (p<0.001), C/D horizontal ratio (p<0.001), C/D vertical ratio (p = 0.018), and a decrease in superior RNFL thickness (p = 0.008). Statistically significant increases were found in HRT-III C volume (p = 0.021), C/D area ratio (p = 0.046), mean C depth (p = 0.036), C shape (p = 0.008), and height variation contour (p = 0.020). Functional disease progression was detected in 37 of the 112 patients (26 of European descent and 11 of African descent; 33%). A statistically significant shorter time to functional progression was seen in patients with larger baseline OCT D area (p = 0.008), C area (p = 0.003), thicker temporal RNFL (p = 0.003), and in patients with a larger HRT-III C area (p = 0.004), C/D area ratio (p = 0.004), linear C/D ratio (p = 0.007), C shape (p = 0.032), or smaller rim area (p = 0.039), rim volume (p = 0.005), height variation contour (p = 0.041), mean RNFL thickness (p<0.001), or RNFL cross-sectional area (p = 0.002). CONCLUSION: Baseline ONH and RNFL structural characteristics were associated with a significantly shorter time to functional glaucomatous progression and visual field loss through the five-year period in OAG patients.


Assuntos
Cegueira/diagnóstico , Glaucoma de Ângulo Aberto/patologia , Fibras Nervosas/fisiologia , Disco Óptico/fisiopatologia , Idoso , Cegueira/etiologia , Complicações do Diabetes/patologia , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/complicações , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Modelos de Riscos Proporcionais , Estudos Prospectivos , Retina/diagnóstico por imagem , Retina/fisiopatologia , Tomografia de Coerência Óptica , Testes de Campo Visual
2.
Zhonghua Yan Ke Za Zhi ; 56(8): 593-599, 2020 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-32847334

RESUMO

Objective: To investigate the prevalence, causes and risk factors of moderate or severe visual impairment and blindness in people with type 2 diabetes over 50 years old in Funing County, Yancheng. Methods: This is a cross-sectional study. Using cluster random sampling, 84 survey sites were selected, and eye examination was performed on people with type 2 diabetes over 50 years old who were registered with the chronic disease information center of Funing County Center for Disease Control and Prevention in Yancheng, Jiangsu. The prevalence of moderate or severe visual impairment and blindness were calculated by different ages and genders. The causes of blindness and visual impairment were determined, and their influencing factors were analyzed by univariate and multivarite logistic regression. Results: A total of 2 067 people were investigated in this study, and 1 909 people were included. The response rate was 92.4%. Based on PVA, the prevalence of blindness and moderate to severe visual impairment was 5.29% (95%CI: 4.29%-6.30%) and 18.54% (95%CI: 16.80%-20.29%). The prevalence of blindness was related to age, marital status, education, duration of diabetes, history of diabetic nephropathy, systolic blood pressure and nuclear opacity. The prevalence of moderate or severe visual impairment was related to age, gender, educational level, diabetes treatment, exercise, and glycated hemoglobin. The prevalence of blindness and moderate to severe visual impairment was 3.67% (95%CI: 2.82%-4.51%) and 9.80% (95%CI: 8.46%-11.13%) based on BCVA. The prevalence of blindness was related to age, marital status, education, duration of diabetes, history of diabetic nephropathy, exercise and systolic blood pressure, while the prevalence of moderate or severe visual impairment was related to age, educational level, diabetes treatment and nuclear opacity. The primary cause of blindness and visual impairment is cataract, followed by diabetic retinopathy. Conclusions: The prevalence of moderate or severe visual impairment and blindness in people with type 2 diabetes in Funing County is relatively high. Attention should be paid to the prevention of blindness in this population. (Chin J Ophthalmol, 2020, 56: 593-599).


Assuntos
Catarata , Diabetes Mellitus Tipo 2/complicações , Baixa Visão/epidemiologia , Cegueira/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Transtornos da Visão/epidemiologia
6.
Plast Reconstr Surg ; 146(4): 745, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32590524

RESUMO

BACKGROUND: Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However, blindness may be delayed for up to 2 weeks, sometimes following injection at remote sites, suggesting alternative pathways and pathogenesis. METHODS: Seeking solutions, fresh cadaver radiographic lead oxide injection, dissection, and histologic studies of the orbital and facial pathways of the ophthalmic angiosome, performed by the ophthalmic artery and vein, both isolated and together, and facial artery perfusions, were combined with total body archival arterial and venous investigations. RESULTS: These revealed (1) arteriovenous connections between the ophthalmic artery and vein in the orbit and between vessels in the inner canthus, allowing passage of large globules of lead oxide; (2) the glabella, inner canthi, and nasal dorsum are the most vulnerable injection sites because ophthalmic artery branches are anchored to the orbital rim as they exit, a plexus of large-caliber avalvular veins drain into the orbits, and arteriovenous connections are present; (3) choke anastomoses between posterior and anterior ciliary vessels supplying the choroid and eye muscles may react with spasm to confine territories impacted with ophthalmic artery embolus; (4) true anastomoses exist between ophthalmic and ipsilateral or contralateral facial arteries, without reduction in caliber, permitting unobstructed embolus from remote sites; and (5) ophthalmic and facial veins are avalvular, allowing reverse flow. CONCLUSION: The authors' study has shown potential arterial and venous pathways for filler embolus to cause blindness or visual field defects, and is supported clinically by a review of the case literature of blindness following facial filler injection.


Assuntos
Cegueira/etiologia , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Embolia/etiologia , Artéria Oftálmica/anatomia & histologia , Artéria Oftálmica/fisiologia , Cadáver , Embolia/complicações , Face/irrigação sanguínea , Humanos
7.
West Afr J Med ; 37(3): 284-289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476124

RESUMO

Takayasu's arteritis (TA) is an idiopathic form of large vessel granulomatous vasculitis that mainly affects the aorta and its major branches, most frequently in young women under 50 years. While traditionally, it is a disease found commonly in Asia continent, it has also been reported from different parts of the world, albeit with a few reports from Sub-Sahara Africa. The clinical presentations are variable and are commonly from systemic inflammation, vascular occlusive diseases and aneurysm. Asymptomatic cases of TA have been documented and are usually discovered incidentally on physical examination. Common vascular symptoms from different series include vascular claudication, reduced or absent pulse, carotid bruit, hypertension and headache. Facial mononeuropathy and retinal ischaemic changes are rare findings in TA. However, occlusive disease of ulnar artery has not been reported in TA despite our extensive literature search. Here, we present a 48-year-old woman, who was admitted via the medical emergency with community acquired pneumonia but was incidentally diagnosed with Takayasu arteritis with lower motor neuron facial nerve palsy, unilateral blindness, and ulnar artery occlusion. Multidisciplinary management was instituted and patient was discharged after resolution of community acquired pneumonia, vascular claudication, and chronic headache. TA often presents asymptomatically and sometimes with atypical features and thus we suggest high index of suspicion and detailed cardio-vascular examination in young individuals with unexplained chronic headache, facial nerve palsy and visual symptoms.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Cegueira/etiologia , Doenças do Nervo Facial/etiologia , Arterite de Takayasu/diagnóstico , Ulna/irrigação sanguínea , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade , Neurônios Motores , Pneumonia/diagnóstico
8.
Adv Gerontol ; 33(2): 339-345, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32593250

RESUMO

There are about 1,3 billion people worldwide with visual disorders such as cataract and glaucoma, the prevalence of which is significantly higher in elder persons. Eye diseases remain a global medical, social and economic problem, associated with both the progression of the disease up to blindness and the lack of pathogenetic therapy methods. Timely detection of pathology is secondary prevention of glaucoma. At present, a number of diagnostic techniques have been developed, including mainly instrumental techniques. Undoubtedly, laboratory indicators should be used as screening methods of early diagnosis. Today, a group of biomarkers with different degrees of sensitivity and specificity has been identified. However, these markers have some difficulty in indicating. Finding signs of glaucoma in complete blood count is an important task. Glaucoma is recognized as a systemic disease, which should be reflected in the change in morphofunctional properties of blood elements.


Assuntos
Glaucoma/diagnóstico , Glaucoma/prevenção & controle , Qualidade de Vida , Idoso , Cegueira/etiologia , Cegueira/prevenção & controle , Diagnóstico Precoce , Glaucoma/complicações , Humanos , Pessoa de Meia-Idade
10.
Eur J Ophthalmol ; 30(5): 1185-1187, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32450718

RESUMO

SARS-CoV-2 infection recently reached pandemic proportions, with high risk of death for the worldwide population. In this dramatic scenario, all the resources are addressed to the intensive care units for the assessment of the emergency. However, more attention should be paid with respect to the risk of viral diffusion among asymptomatic people. Italy is the second most involved country in the world, and we needed to gain a lot of experience in a very limited time. At least 1 m of distance among people is recommended; however, some clinical practices cannot allow this distance. In this context, we believe that the careful safety assessment of clinical settings, like ophthalmologic ones, may have a remarkable impact on the fight against SARS-CoV-2 spread.


Assuntos
Betacoronavirus , Cegueira/epidemiologia , Infecções por Coronavirus/complicações , Oftalmologia , Pandemias , Pneumonia Viral/complicações , Cegueira/etiologia , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Incidência , Pneumonia Viral/epidemiologia
11.
Nat Commun ; 11(1): 1703, 2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245977

RESUMO

Optogenetic therapies for vision restoration aim to confer intrinsic light sensitivity to retinal ganglion cells when photoreceptors have degenerated and light sensitivity has been irreversibly lost. We combine adaptive optics ophthalmoscopy with calcium imaging to optically record optogenetically restored retinal ganglion cell activity in the fovea of the living primate. Recording from the intact eye of a living animal, we compare the patterns of activity evoked by the optogenetic actuator ChrimsonR with natural photoreceptor mediated stimulation in the same retinal ganglion cells. Optogenetic responses are recorded more than one year following administration of the therapy and two weeks after acute loss of photoreceptor input in the living animal. This in vivo imaging approach could be paired with any therapy to minimize the number of primates required to evaluate restored activity on the retinal level, while maximizing translational benefit by using an appropriate pre-clinical model of the human visual system.


Assuntos
Cegueira/terapia , Optogenética/métodos , Células Fotorreceptoras de Vertebrados/patologia , Degeneração Retiniana/terapia , Células Ganglionares da Retina/fisiologia , Animais , Cegueira/diagnóstico , Cegueira/etiologia , Modelos Animais de Doenças , Feminino , Fóvea Central/citologia , Fóvea Central/diagnóstico por imagem , Fóvea Central/patologia , Vetores Genéticos/administração & dosagem , Vetores Genéticos/genética , Humanos , Macaca fascicularis , Masculino , Oftalmoscopia , Imagem Óptica , Parvovirinae/genética , Degeneração Retiniana/complicações , Degeneração Retiniana/diagnóstico por imagem , Degeneração Retiniana/patologia
13.
J Craniofac Surg ; 31(4): e378-e380, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32176009

RESUMO

The authors report a case of a 35-year-old man who presented with left maxillary toothache associated with left sided facial pain and a rapidly progressive loss of vision in the left eye. Clinical and radiological assessments revealed it to be an odontogenic orbital apex syndrome secondary to a vertical root fracture of a tooth. The infection was treated and controlled, postoperative follow-up showed no recurrent inflammation and the patient recovered well. However, the vision was lost permanently. Odontogenic orbital apex syndrome is a rare, aggressive disease. Once the infection spreads, it progresses rapidly, becoming a dangerous condition. To achieve better prognosis and improve survival rates, dental practitioners and oral surgeons should be aware of this distinct presentation and should have a high index of suspicion for the complication of tooth-related problems however minor they may seem.


Assuntos
Cegueira/etiologia , Doenças Orbitárias/complicações , Fraturas dos Dentes/etiologia , Raiz Dentária , Adulto , Humanos , Masculino , Extração Dentária
14.
J Fr Ophtalmol ; 43(6): 517-524, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32113668

RESUMO

PURPOSE: To analyse the clinical ocular characteristics and determine prognostic factors for functional recovery in eyes presenting with no light perception (NLP) after open globe ocular trauma. MATERIALS AND METHODS: In this retrospective study were included all the patients with no light perception after open globe trauma who presented to Amiens University Hospital between October 2014 and June 2018. RESULTS: Fifteen eyes of 15 patients were included in this study. The main mechanism of the trauma was globe rupture (80 %, n=12). The most common location was zone III (66 %, n=10). The wound size was greater than 10mm in 9 patients (60 %). The ocular lesions included expulsion of the crystalline lens or posterior chamber intraocular lens, hyphema, retinal detachment, vitreous hemorrhage and ciliochoroidal lesions. Damage to the ciliary body was a negative prognostic factor for functional recovery (P=0.04). Nine patients remained with no light perception, whereas 6 patients experienced an improvement in visual acuity (2.3 logMAR in 3 patients, 0.7 logMAR in 1 patient, 0.4 logMAR in 1 patient and 0.2 logMAR in 1 patient). These 6 patients had undergone posterior vitrectomy due to vitreoretinal involvement (P<0.001). CONCLUSION: In the case of open globe trauma with no light perception on presentation, a functional recovery is possible if there is no irreversible anatomical damage.


Assuntos
Cegueira/diagnóstico , Ferimentos Oculares Penetrantes/diagnóstico , Percepção Visual/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cegueira/etiologia , Cegueira/reabilitação , Cegueira/cirurgia , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Humanos , Luz , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia , Vitrectomia , Hemorragia Vítrea/diagnóstico , Hemorragia Vítrea/etiologia , Hemorragia Vítrea/cirurgia
15.
Biomed Environ Sci ; 33(3): 151-157, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32209173

RESUMO

Objective: The aim of this study was to investigate macular perfusion changes and ganglion cell complex (GCC) loss in patients with unexplained visual loss following vitrectomy and silicone oil (SO) tamponade, and to evaluate the correlation between retinal blood flow and GCC loss using optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT). Methods: This retrospective study included seven eyes (seven patients) with unexpected visual loss after vitrectomy and SO tamponade. OCTA was used to evaluate the alterations in retinal vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillary plexus (RPCP). OCT was used to measure the thickness of GCC and retinal nerve fiber layer (RNFL). Medical records of patients were reviewed. Results: Quantitative analysis of OCTA images revealed a significant reduction in SCP VD in the affected eyes compared with the controls (all sections P < 0.05). No difference was found in GCC thickness, but FLV (focal loss volume) and GLV (global loss volume) were significantly higher in the affected eyes (both P < 0.001). SCP VD was inversely correlated with FLV and GLV. Conclusions: Silicone oil-related severe visual loss was associated with superficial retinal microvasculature damage and ganglion cell apoptosis.


Assuntos
Cegueira/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Retina/fisiopatologia , Descolamento Retiniano/cirurgia , Células Ganglionares da Retina/patologia , Óleos de Silicone/efeitos adversos , Vitrectomia/efeitos adversos , Adulto , Cegueira/etiologia , Cegueira/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Fluxo Sanguíneo Regional , Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
16.
J Fr Ophtalmol ; 43(3): 256-270, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32057527

RESUMO

Ischemic optic neuropathies are among the leading causes of severe visual acuity loss in people over 50 years of age. They constitute a set of various entities that are clinically, etiologically and therapeutically different. Anatomically, it is necessary to distinguish anterior and posterior forms. From an etiological point of view, the diagnosis of the arteritic form due to giant cell arteritis requires emergent management to prevent blindness and even death in the absence of prompt corticosteroid treatment. When this diagnosis has been ruled out with certainty, non-arteritic ischemic optic neuropathies represent a vast etiological context that in the majority of cases involves a local predisposing factor (small optic nerves, disc drusen) with a precipitating factor (severe hypotension, general anesthesia or dialysis) in a context of vascular disease (sleep apnea syndrome, hypertension, diabetes, etc.). In the absence of specific available treatment, it is the responsibility of the clinician to identify the risk factors involved, in order to reduce the risk of contralateral recurrence that may occur even several years later. Due to their complexity, these pathologies are the subject of debates regarding both the pathophysiological and therapeutic perspectives; this review aims to provide a synthesis of validated knowledge while discussing controversial data.


Assuntos
Neuropatia Óptica Isquêmica , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/etiologia , Cegueira/terapia , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/terapia , Humanos , Pessoa de Meia-Idade , Disco Óptico/patologia , Neuropatia Óptica Isquêmica/diagnóstico , Neuropatia Óptica Isquêmica/etiologia , Neuropatia Óptica Isquêmica/terapia , Acuidade Visual/fisiologia
17.
Ann Vasc Surg ; 66: 671.e1-671.e4, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32027984

RESUMO

Light-induced amaurosis is a rare manifestation of symptomatic carotid artery disease. Unlike amaurosis fugax, which is often attributed to embolic phenomenon associated with carotid artery disease, light-induced amaurosis has been associated with reduced perfusion to the eye, secondary to carotid artery disease, leading to retinal ischemia. The case described here is that of a 67-year-old male with bilateral vision loss in response to bright light. Imaging revealed severe internal carotid stenosis on the right and occlusion of the internal carotid artery on the left. Similar to previous cases reported in the literature, the symptoms resolved after carotid endarterectomy.


Assuntos
Cegueira/etiologia , Artéria Carótida Interna , Estenose das Carótidas/complicações , Luz/efeitos adversos , Idoso , Cegueira/diagnóstico , Cegueira/fisiopatologia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas , Humanos , Masculino , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Resultado do Tratamento , Visão Ocular , Percepção Visual
18.
Am J Trop Med Hyg ; 102(3): 634-636, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31971157

RESUMO

In posterior reversible encephalopathy syndrome, brain magnetic resonance imaging (MRI) reveals bilateral occipital, parietal, and subcortical white matter hyperintensities on T2/fluid-attenuated inversion recovery (FLAIR) sequences. After treatment, imaging abnormalities are usually reversible. Eclampsia is the most frequent cause of posterior reversible encephalopathy syndrome in pregnancy. We report a 24-year-old woman, who presented to our clinic 4 weeks after normal vaginal delivery with bilateral vision loss. Loss of vision was first noticed in the 20th week of pregnancy. Even after delivery, her vision did not improve. In the postpartum period, she started having periodic myoclonic jerks. Electroencephalography demonstrated periodic generalized discharges. A brain MRI performed in the 20th week of the antepartum period showed bilateral parieto-occipital cortical white matter T2/FLAIR hyperintensities. A follow-up brain MRI, 5 months later, revealed marked reversal of white matter signal changes. Cerebrospinal fluid examination revealed raised anti-measles antibody titer, confirming the diagnosis of subacute sclerosing panencephalitis. In conclusion, in a patient with subacute sclerosing panencephalitis (SSPE) during the postpartum period, cortical vision loss and parieto-occipital white matter T2/FLAIR hyperintensities can simulate eclampsia. Inadvertent treatment with magnesium sulfate is likely if the diagnosis is missed.


Assuntos
Cegueira/etiologia , Complicações Infecciosas na Gravidez/patologia , Panencefalite Esclerosante Subaguda/patologia , Anticorpos Antivirais/sangue , Cegueira/patologia , Diagnóstico Diferencial , Feminino , Humanos , Interferon-alfa/administração & dosagem , Interferon-alfa/uso terapêutico , Vírus do Sarampo/imunologia , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Período Pós-Parto , Gravidez , Panencefalite Esclerosante Subaguda/diagnóstico , Panencefalite Esclerosante Subaguda/tratamento farmacológico , Falha de Tratamento , Adulto Jovem
19.
Zhonghua Yan Ke Za Zhi ; 56(1): 3-8, 2020 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-31937056

RESUMO

Glaucoma is a major irreversible blindness-causing disease. Traditional Chinese Medicine literature have mentioned glaucoma since Qin and Han Dynasties. Progress has been made since 1949, especially in these 50 years. Since 1990, rapid progress has been achieved in the field of glaucoma, including the research of pathogenesis, education, training and establishment of diagnosis and treatment standard for glaucoma. Nowadays, Chinese glaucoma specialists are giving out more and more voice in the international platform. Though the outcome is delightful, we realize that we are still lack of original innovations. After all, the road is still long and rugged, more efforts should be put into the fight against glaucoma.(Chin J Ophthalmol, 2020, 56: 3-8).


Assuntos
Pesquisa Biomédica/tendências , Cegueira/etiologia , Glaucoma , Oftalmologia/tendências , Grupo com Ancestrais do Continente Asiático , China , Humanos
20.
J Fr Ophtalmol ; 43(2): e41-e54, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31952875

RESUMO

Ischemic optic neuropathies are among the leading causes of severe visual acuity loss in people over 50 years of age. They constitute a set of various entities that are clinically, etiologically and therapeutically different. Anatomically, it is necessary to distinguish anterior and posterior forms. From an etiological point of view, the diagnosis of the arteritic form due to giant cell arteritis requires emergent management to prevent blindness and even death in the absence of prompt corticosteroid treatment. When this diagnosis has been ruled out with certainty, non-arteritic ischemic optic neuropathies represent a vast etiological context that in the majority of cases involves a local predisposing factor (small optic nerves, disc drusen) with a precipitating factor (severe hypotension, general anesthesia or dialysis) in a context of vascular disease (sleep apnea syndrome, hypertension, diabetes, etc.). In the absence of specific available treatment, it is the responsibility of the clinician to identify the risk factors involved, in order to reduce the risk of contralateral recurrence that may occur even several years later. Due to their complexity, these pathologies are the subject of debates regarding both the pathophysiological and therapeutic perspectives; this review aims to provide a synthesis of validated knowledge while discussing controversial data.


Assuntos
Neuropatia Óptica Isquêmica/diagnóstico , Neuropatia Óptica Isquêmica/etiologia , Neuropatia Óptica Isquêmica/terapia , Doença Aguda , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/terapia , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/epidemiologia , Arterite de Células Gigantes/terapia , Humanos , Pessoa de Meia-Idade , Neuropatia Óptica Isquêmica/epidemiologia , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Transtornos da Visão/terapia
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