Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 659
Filtrar
1.
Medicine (Baltimore) ; 99(11): e19349, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176056

RESUMO

The visual system was reported to be affected in over half of patients with preeclampsia (PE), though fundus examination was performed only among patients complaining of visual symptoms. Delayed diagnosis and treatment of PE-related retinopathy may lead to permanent visual impairment. Therefore, we hypothesize that some clinical or laboratory parameters could predict severity of retinal damage.The aim of the study was to explore the risk factors for retinopathy in severe preeclampsia (sPE) and investigate pregnancy outcomes with different degrees of retinopathy.This retrospective cohort study included women with sPE who underwent ophthalmoscopy and delivered after admission to West China Second University Hospital, between June 2013 and December 2016. Clinical and laboratory characteristics were retrieved from medical records. Patients confirmed with retinopathy were followed up with telephones. Multiple logistic regression analysis was performed to identify risk factors of PE-related retinopathy.Five hundred thirty-four patients were included, of which 17.6% having stage-1/2 retinopathy, 14.6% having stage-3/4 retinopathy, and 67.8% having normal retina. Compared with patients without retinopathy, patients with stage 3/4 retinopathy were more likely to have preterm-birth and low-birth-weight babies. Significant risk factors for stage 3/4 retinopathy in sPE included severe hypertension (odds ratio [OR] 2.24, 95% confidence interval [CI]: 1.10-4.56), elevated white blood cell (WBC) counts (OR 1.88, 95% CI: 1.05-3.35), decreased platelet counts (OR 2.12, 95% CI: 1.07-4.48), lactate dehydrogenase (LDH) concentration of >800 IU/L (OR 2.31, 95% CI: 1.05-5.06), low hemoglobin (HGB) concentrations of <110 g/L (OR 3.73, 95% CI: 1.21-11.47), 24-hour proteinuria of 2 to 5 g (OR 6.39, 95% CI: 2.84-14.39), and >5 g (OR 8.66, 95% CI: 3.67-20.44).This study confirms the association between retinopathy and preterm-birth and low-birth weight in sPE. The risk factors for severe PE-related retinopathy, including severe hypertension, platelet and WBC count, HGB and LDH concentration, and proteinuria, are associated with the development of retinopathy. Routine and repeated fundus examination is recommended for maternal monitoring in sPE.


Assuntos
Pré-Eclâmpsia/epidemiologia , Resultado da Gravidez , Gravidez de Alto Risco , Doenças Retinianas/epidemiologia , Retinoscopia/métodos , China , Estudos de Coortes , Feminino , Idade Gestacional , Hospitais Universitários , Humanos , Recém-Nascido , Modelos Logísticos , Análise Multivariada , Pré-Eclâmpsia/diagnóstico , Gravidez , Nascimento Prematuro , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença
2.
Invest Ophthalmol Vis Sci ; 60(8): 2781-2786, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31260519

RESUMO

Purpose: To examine trends in the prevalence of myopia and myopic maculopathy in a general Japanese population. Methods: Residents of a Japanese community aged 40 years and older participated in surveys conducted in 2005, 2012, and 2017. Each participant underwent comprehensive eye examinations that included measurements of refractive error, axial lengths, and color fundus photography. Myopic maculopathy was defined according to the criteria of the Meta-analysis of Pathologic Myopia Study Group classification system. Trends in the prevalence of myopia and myopic maculopathy were tested by using a logistic regression analysis fitted by generalized estimating equations to account for individuals submitting to repeated examination. Results: The age-adjusted frequencies of myopia increased significantly from 2005 to 2017 (myopia, 37.7%-45.8%; high myopia 5.8%-9.5%; all P for trend <0.001). The age-adjusted frequency of an axial length level of 26.5 mm or more increased significantly from 2005 to 2017 (3.6%-6.0%; P for trend <0.001). The age-adjusted prevalence of myopic maculopathy also increased significantly with time (1.6% in 2005, 3.0% in 2012 and 3.6% in 2017; P for trend <0.001). Upward trends were observed in the prevalence of diffuse chorioretinal atrophy and patchy chorioretinal atrophy (all P for trend <0.05). Conclusions: Our findings suggest that the prevalence of myopia and myopic maculopathy, especially diffuse chorioretinal atrophy and patchy chorioretinal atrophy, increased significantly over the past 12 years in a general Japanese population.


Assuntos
Miopia/epidemiologia , Doenças Retinianas/epidemiologia , Idoso , Grupo com Ancestrais do Continente Asiático/etnologia , Comprimento Axial do Olho/patologia , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Prevalência , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Acuidade Visual
3.
Turk J Ophthalmol ; 49(3): 149-153, 2019 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-31245977

RESUMO

Objectives: To determine length of hydroxychloroquine use and cumulative dose and evaluate the ocular effects by 10-2 central visual field test, microperimetry (MP), color fundus photography, optical coherence tomography (OCT), and fundus autofluorescence (FAF) in hydroxychloroquine users. Materials and Methods: Patients who used hydroxychloroquine continuously for at least 2 years for various connective tissue diseases were included in the study. A total of 300 eyes of 150 patients aged 19-78 years who were followed due to risk of developing hydroxychloroquine maculopathy in the Istanbul University Istanbul Faculty of Medicine Ophthalmology Department between the years 1995-2017 were evaluated. Best corrected visual acuity (BCVA), biomicroscopic, and fundoscopic examination were performed at all visits. MP, FAF, OCT, fundus photography, and central 10-2 visual field examinations were performed 3 times at 6-month intervals. Results: The mean age of patients was 48.9±10.8 years; 141 (94%) patients were female and 9 (6%) were male. The mean duration of hydroxychloroquine use was 10.5±6.4 (2-30) years. Fifty-six patients had been using the drug for 5 years or less. The mean cumulative drug dose was 754.7±447.2 (146-1825) g. Mean BCVA was 0.02±0.08 LogMAR at all follow-up visits (p=0.999). Mean MP values at the first, second, and third examinations were 14.07±3.24 dB, 14.18±3.35 dB, and 14.54±2.79 dB, respectively (p>0.05). Mean central macular thickness was 221.9±19.8 µm at initial examination, 221.8±19.9 µm at the second visit, and 221.8±19.8 µm at the final visit (p=0.113). There was a weak negative correlation between age and MP values at all three visits (visit 1: p=0.003, r=- 0.170; visit 2: p=0.001, r=-0.185, visit 3: p=0.011, r=-0.146). There was statistically significant relationship between MP values and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). Duration of use was not associated with changes in 10/2 visual field (p=0.124). There were significant relationships between alterations in FAF and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). Conclusion: FAF alterations were significantly associated with duration of hydroxychloroquine use and cumulative dose. As objective methods are more reliable, examinations such as FAF can be recommended as auxiliary methods in the follow-up and early detection of toxic maculopathy.


Assuntos
Hidroxicloroquina/efeitos adversos , Macula Lutea/patologia , Doenças Retinianas/induzido quimicamente , Acuidade Visual , Adulto , Idoso , Antirreumáticos/efeitos adversos , Doenças do Tecido Conjuntivo/tratamento farmacológico , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Incidência , Macula Lutea/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Doenças Retinianas/epidemiologia , Células Ganglionares da Retina/efeitos dos fármacos , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Turquia/epidemiologia , Campos Visuais/fisiologia , Adulto Jovem
4.
J Fr Ophtalmol ; 42(7): 753-761, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31202776

RESUMO

AIM: Contribute to the improvement of diagnostic and prognostic approaches to treating children with neuro-malaria in Yaoundé. PATIENTS AND METHOD: A prospective and analytical study carried out in 2 hospitals of Yaoundé from October 2015 to March 2016. All patients aged 3 months to 15 years hospitalized for neuro-malaria in one of the 2 hospitals benefited from a fundus examination. The variables studied were: age, sex, Glasgow or Blantyre score, fundus examination and parasitaemia. For statistical analysis, we used the software R 3.3.0, Chi2, exact of Fisher or Kolmogorov-Smirnov tests with a significance P<5%. RESULTS: Out of the 178 children hospitalized during the study period, 44 had neuro-malaria (24.71%) and 26 (46 diseased eyes) among them presented retinal lesions at a frequency of 14.60%. The mean age was 5.54±3.49 years with a sex ratio of 1.09. The under 5-years-old were the most affected with 31 (70.45%) cases. The fundus lesions of 26 (59.09%) were retinal hemorrhages in 24 (54.54%), retinal whitening and vessel discoloration in 8 (18.18%) respectively. Papillary edema was associated in 4 (9.09%). Macular involvement was noted in 9 cases. These lesions were correlated with age, depth of coma, duration, and clinical course. The rate of parasitaemia did not affect their occurrence. CONCLUSION: Retinal lesions are frequent and serious during neuro-malaria in our environment, especially in children under five. They must therefore be an emphasis in the systematic exam to rule it out for a better prognostic evaluation and a fast and adequate multidisciplinary management.


Assuntos
Infecções Oculares Parasitárias/epidemiologia , Malária Cerebral/complicações , Malária Cerebral/epidemiologia , Malária/complicações , Malária/epidemiologia , Doenças Retinianas/epidemiologia , Adolescente , Camarões/epidemiologia , Criança , Pré-Escolar , Infecções Oculares Parasitárias/complicações , Infecções Oculares Parasitárias/diagnóstico , Feminino , Humanos , Lactente , Malária/diagnóstico , Malária Cerebral/diagnóstico , Malária Falciparum/complicações , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologia , Masculino , Plasmodium falciparum/fisiologia , Prognóstico , Doenças Retinianas/diagnóstico , Doenças Retinianas/parasitologia , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/epidemiologia , Hemorragia Retiniana/parasitologia
5.
Graefes Arch Clin Exp Ophthalmol ; 257(8): 1759-1764, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31119427

RESUMO

PURPOSE: To explore the presence of serum anti-retinal antibodies (ARAs) in the Chinese patients with presumed autoimmune retinopathy (AIR). METHODS: Twenty-three Chinese patients with presumed AIR, disease controls including 40 RP patients, 22 bilateral uveitis patients, 18 acute zonal outer occult retinopathy (AZOOR) patients, and 30 healthy donors were included. Serum samples of all the subjects were obtained and analyzed for the presence of four ARAs including recoverin, α-enolase, carbonic anhydraseII (CAII), and collapsin response-mediated protein (CRMP)-5 by Western bolt assay. RESULTS: ARAs were present in the serum of either presumed AIR patients, disease control, or healthy donors. One or more ARAs were present in the 78.2% of presumed AIR while they were indicated in the 35.0% of RP patients (p < 0.01) and 33.3% of healthy donors (p < 0.01). The prevalence of ARAs in the bilateral uveitis and AZOOR was 63.3% and 100% respectively. Positive rate of α-enolase antibody present in the presumed AIR, disease control, and healthy donors was 73.9%, 47.5%, and 33.3% respectively. Positive rate of CAII antibody present above groups was 52.1%, 50%, and 33.3% respectively. Recoverin antibody seemed to be specifically present in the serum of patients with cancer-associated retinopathy. CONCLUSION: Presence of serum ARAs including recoverin, α-enolase, CAII, or CRMP-5 in the Chinese patients with presumed AIR occurred significantly more often than RP patients and healthy donors. Seropositivity of ARAs had diagnostic value for the presumed AIR but mere presence was not sufficient for the diagnosis due to identification of them in the healthy controls and other retinal diseases.


Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/imunologia , Retina/imunologia , Doenças Retinianas/imunologia , Adulto , Idoso , Doenças Autoimunes/sangue , Doenças Autoimunes/epidemiologia , Western Blotting , Anidrase Carbônica II/sangue , Anidrase Carbônica II/imunologia , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Proteínas do Tecido Nervoso/sangue , Proteínas do Tecido Nervoso/imunologia , Fosfopiruvato Hidratase/sangue , Fosfopiruvato Hidratase/imunologia , Prevalência , Recoverina/sangue , Recoverina/imunologia , Doenças Retinianas/sangue , Doenças Retinianas/epidemiologia , Estudos Retrospectivos
6.
Invest Ophthalmol Vis Sci ; 60(6): 1996-2002, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31067319

RESUMO

Purpose: To investigate the prevalence of vitreomacular interface abnormalities (VMIAs) in a French elderly glaucomatous population. Methods: Using a population-based study, the MONTRACHET (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) study conducted in Dijon from 2009 to 2013 in individuals older than 75 years, the prevalence of VMIAs was estimated on glaucoma patients. Results: A total of 1130 participants (2225 eyes) were included in the study. The mean age of participants was 82.3 ± 3.8 years, and 62.74% were women. Regarding the frequency of all VMIAs, there was no statistical difference between glaucoma patients and nonglaucoma participants (51.85% vs. 53.92%, respectively, P = 0.372). In univariate analysis, vitreomacular adherences were more frequent in nonglaucoma participants (18.39% vs. 10.78%, P = 0.036). Epiretinal membranes were more frequent in the glaucomatous population (47.06% vs. 38.13%, P = 0.018). The prevalence of macular cysts was comparable in the two groups (7.84% vs. 5.64%, P = 0.262). Macular cysts were more frequent in eyes treated with preservative-free, IOP-lowering eye drops when compared with the eyes of nonglaucomatous participants treated with IOP-lowering eye drops containing a preservative (26.67% vs. 3.37% and 5.76%, respectively, P < 0.001). In multivariate analysis, these results were no longer significant. Conclusions: The prevalence of VMIAs was high in this elderly population and similar in both glaucomatous and nonglaucomatous participants. The information provided by macular optical coherence tomography scans should be considered with caution when used for glaucoma management in elderly patients.


Assuntos
Glaucoma/diagnóstico , Pressão Intraocular/fisiologia , Doenças Retinianas/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Seguimentos , França/epidemiologia , Glaucoma/epidemiologia , Glaucoma/fisiopatologia , Humanos , Masculino , Fibras Nervosas/patologia , Estudos Prospectivos , Doenças Retinianas/epidemiologia , Doenças Retinianas/fisiopatologia
7.
Zhonghua Yan Ke Za Zhi ; 55(4): 241-245, 2019 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-30982285

RESUMO

In recent years, the incidence of tuberculosis, HIV, syphilis and other infectious diseases has a "rising" trend. The incidence of infectious fundus diseases is also increasing, and missed diagnosis and misdiagnosis are becoming more common. How to diagnose infectious fundus diseases accurately, avoid missed diagnosis and misdiagnosis, carry out standardized treatment in time, carry out research on infectious fundus diseases related to systemic infectious diseases, and save the visual function of patients are the problems we are facing. This article discusses the related issues. (Chin J Ophthalmol, 2019, 55: 241-245).


Assuntos
Infecções Oculares/diagnóstico , Infecções Oculares/terapia , Fundo de Olho , Doenças Retinianas/diagnóstico , Doenças Retinianas/terapia , Erros de Diagnóstico , Infecções Oculares/epidemiologia , Humanos , Doenças Retinianas/epidemiologia , Acuidade Visual
9.
Medicine (Baltimore) ; 98(14): e15122, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946384

RESUMO

Hydroxychloroquine (HCQ), an analog of chloroquine, is widely used in various rheumatologic and dermatologic disorders. However, it may cause severe retinopathy with long-term use. The guidelines proposed by the American Academy of Ophthalmology suggested a baseline fundus examination and an annual screening after 5 years by using automated visual fields (VF) plus spectral-domain optical coherence tomography (SD-OCT). Both multifocal electroretinogram (mfERG) and fundus autofluorescence (FAF) can also be used to improve the accuracy of diagnosis. The purpose of this study was to examine if the current HCQ screening practice in Taiwan was sufficient according to the guidelines to prevent severe macular complications.This study could remind every doctor to explain visual side effects thoroughly to every patient using HCQ, and refer patients for the ophthalmologic survey to eliminate potential visual impairment caused by this medicine.This nationwide population-based cohort study included all patients who started taking HCQ (n = 5826) from January 1, 1997, to December 31, 2007, in the Longitudinal Health Insurance Database 2000. The ICD codes used for HCQ retinopathy were 362.10, 362.55, 362.89, and 362.9. Patients previously diagnosed these retinal disorders were excluded. Demographic data including sex, age, diagnostic tools used, and the date of the initial diagnosis of the subsequent HCQ-related retinal disorder were collected. Patients were divided into 2 groups. The patients taking HCQ <5 years were defined as group 1, and >5 years as group 2. The risk of developing retinal diseases between these 2 groups was compared with a 2-sample t-test for continuous variables, and Fisher's exact test for discrete variables. Multiple logistic regressions were used for odds ratio calculation.The baseline examination ratio of the automated VF, SD-OCT scans, and multifocal electroretinograms (mfERGs) in the first 3 months were only 0.2% in both groups. The screening ratio of the 3 examination tools after 5 years were 1.1% in group 1 and 1.2% in group 2. 2.5% and 3.9% of patients developed a retinal disorder after HCQ use in group 1 and 2, respectively. The risk of developing retinal disorder was significantly higher in group 2 (relative risk = 1.53, P = .006). The odds ratio (OR) was also significantly higher in group 2 (1.67 with 95% cumulative incidence 1.20-2.30)The examination ratio according to the guidelines was very low in Taiwan. Thus, it is very important for doctors who prescribe HCQ to schedule both baseline and annual ophthalmology screening tests and inform patients of possible severe ocular complications, even in the patient taking HCQ <5 years. It is also important for ophthalmologists to review medical history carefully to find out the causes of retinotoxicity. Medications should be stopped, if possible when toxicity is recognized or strongly suspected.


Assuntos
Antirreumáticos/efeitos adversos , Hidroxicloroquina/efeitos adversos , Doenças Retinianas/diagnóstico , Seleção Visual/métodos , Adulto , Idoso , Eletrorretinografia/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Vigilância da População , Doenças Retinianas/epidemiologia , Fatores de Risco , Taiwan/epidemiologia , Tomografia de Coerência Óptica/estatística & dados numéricos , Testes de Campo Visual/estatística & dados numéricos
10.
Blood Rev ; 35: 32-42, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30852057

RESUMO

For over four decades, efforts have been underway for the evaluation of sickle cell retinopathy (SCR) in an attempt to identify peripheral high-risk vascular abnormalities based on Goldberg's classification (gold-standard) (1971). The macula is an area in the center of the retina that is responsible for high-resolution central vision and is also affected in SCR. With the development of new technologies for retinal imaging, the macula became a main focus of interest in the study of sickle cell disease (SCD). Optical coherence tomography angiography is a modern non-invasive method that allows qualitative and quantitative analysis of the retinal vascular network in the macular region. We identified 86 studies on SCD and optical coherence tomography angiography. Of those, 12 met the inclusion criteria for this systematic review. The prevalence of sickle cell maculopathy was 45.6% in the SCD population and it increased with age. We present the main vascular findings and discuss visual impairment and pathophysiology, genotypes, and peripheral high-risk vascular abnormalities. The role of the hematologist, general practitioner, and pediatrician in treatment is also reviewed.


Assuntos
Anemia Falciforme/complicações , Angiografia , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Tomografia de Coerência Óptica , Anemia Falciforme/epidemiologia , Angiografia/métodos , Humanos , Prevalência , Doenças Retinianas/epidemiologia , Doenças Retinianas/terapia , Tomografia de Coerência Óptica/métodos
11.
Acta Ophthalmol ; 97(3): 265-272, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30073775

RESUMO

PURPOSE: To characterize ocular manifestations in a cohort of paediatric patients with incontinentia pigmenti (IP) and to define the guidelines for grading of IP-associated retinopathy (IPR). METHODS: This retrospective review was performed on patients under the age of 18 years with a diagnosis of IP. Data included demographics, medical history, ocular examination, and accessory examination. Ocular and systemic physical examinations of the parents were carried out to determine the familial history. RESULTS: Sixty-one children (58 females and three males) with median age of 3.7 months were observed consecutively. The median follow-up duration was 13.4 months (range: 6.5-75.0 months). A total of 47 patients had various ocular anomalies. Among them, 28 patients had bilateral ocular anomalies and 19 had unilateral anomalies. Vitreoretinal changes were noted in 73 of 122 eyes, including eight eyes with retinal pigment epithelium changes only (Stage 1), 22 eyes with retinal vascular abnormalities (Stage 2), five eyes with epiretinal membranes or fibrotic hyperplasia combined with avascularized zones (Stage 3), six eyes with retinal neovascularization (Stage 3), one eye with vitreous haemorrhage (Stage 3), 10 eyes with partial retinal detachment (RD) (Stage 4a), 15 eyes with total RD (Stage 4b) and eight eyes with phthisis bulbi and secondary glaucoma (Stage 5). CONCLUSION: Various vitreoretinal manifestations can be found in paediatric patients with IP and classified into five stages, which are characterized by retinal vasculopathy.


Assuntos
Incontinência Pigmentar/complicações , Retina/patologia , Doenças Retinianas/epidemiologia , Corpo Vítreo/patologia , Pré-Escolar , China/epidemiologia , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Incidência , Incontinência Pigmentar/diagnóstico , Lactente , Masculino , Oftalmoscopia , Prevalência , Prognóstico , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica
12.
Acta Ophthalmol ; 97(4): 364-371, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30242982

RESUMO

PURPOSE: The aim of the European Eye Epidemiology (E3) consortium was to develop a spectral-domain optical coherence tomography (SD-OCT)-based classification for macular diseases to standardize epidemiological studies. METHODS: A European panel of vitreoretinal disease experts and epidemiologists belonging to the E3 consortium was assembled to define a classification for SD-OCT imaging of the macula. A series of meeting was organized, to develop, test and finalize the classification. First, grading methods used by the different research groups were presented and discussed, and a first version of classification was proposed. This first version was then tested on a set of 50 SD-OCT images in the Bordeaux and Rotterdam centres. Agreements were analysed and discussed with the panel of experts and a final version of the classification was produced. RESULTS: Definitions and classifications are proposed for the structure assessment of the vitreomacular interface (visibility of vitreous interface, vitreomacular adhesion, vitreomacular traction, epiretinal membrane, full-thickness macular hole, lamellar macular hole, macular pseudo-hole) and of the retina (retinoschisis, drusen, pigment epithelium detachment, hyper-reflective clumps, retinal pigment epithelium atrophy, intraretinal cystoid spaces, intraretinal tubular changes, subretinal fluid, subretinal material). Classifications according to size and location are defined. Illustrations of each item are provided, as well as the grading form. CONCLUSION: The E3 SD-OCT classification has been developed to harmonize epidemiological studies. This homogenization will allow comparing and sharing data collection between European and international studies.


Assuntos
Estudos Epidemiológicos , Macula Lutea/patologia , Doenças Retinianas/classificação , Tomografia de Coerência Óptica/métodos , Idoso , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Doenças Retinianas/diagnóstico , Doenças Retinianas/epidemiologia , Índice de Gravidade de Doença
14.
Mult Scler ; 25(3): 361-371, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29125422

RESUMO

BACKGROUND: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. OBJECTIVE: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. METHODS: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. RESULTS: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10-5) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10-5 and 7 × 10-3, respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10-5). CONCLUSION: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.


Assuntos
Esclerose Múltipla/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Centros Médicos Acadêmicos , Adulto , Idoso , Estudos Transversais , Membrana Epirretiniana/diagnóstico por imagem , Membrana Epirretiniana/epidemiologia , Membrana Epirretiniana/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Doenças Retinianas/epidemiologia , Tomografia de Coerência Óptica
15.
Acta Ophthalmol ; 97(3): 247-259, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30593719

RESUMO

PURPOSE: The aim of this study was to describe the genetic and clinical characteristics of Chinese patients with autosomal recessive bestrophinopathy (ARB). METHODS: This study presents a retrospective observational case series. Twenty-one ARB patients and 25 clinically healthy family members were recruited. The coding regions and adjacent intronic regions of BEST1 were analysed via Sanger sequencing. Clinical examinations, including ultrasound biomicroscopy, A-scan, optical coherence tomography, fundus autofluorescence, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and visual electrophysiology, were reviewed. RESULTS: Six novel mutations (c.380C>T, p.T127M; c.397A>G, p.N133D; c.500A>G, p.E167G; c.817G>A, p.V273M; c.174_176del, p.Q58del; and c.950_955del, p.S318_L319) and 8 previously reported mutations were identified. The p.R255W mutation had the highest frequency in our cohort. Twenty patients had serous retinal detachment with multifocal subretinal vitelliform deposits in the posterior poles. One patient exhibited chorioretinal atrophy. FFA revealed peripheral vascular leakage in 10 patients, and ICGA revealed hyperfluorescent spots in 8 patients. Visual electrophysiology was abnormal in all patients. Fifteen patients with angle closure (AC) or angle-closure glaucoma (ACG) had shallower anterior chambers and shorter axial lengths than the patients with open angle, contributing to their risk of developing AC/ACG. One patient developed AC during the 7-year follow-up period. The misdiagnosis and missed rates were 35.3% and 58.8%, respectively. CONCLUSION: The six novel mutations and high frequency of p.R255W suggest ethnical differences in the BEST1 mutation spectrum among Chinese patients. BEST1 gene screening and detailed clinical examinations help establishing a diagnosis of ARB. Clinical evaluations of the risk of developing AC/ACG are recommended for ARB patients.


Assuntos
Bestrofinas/genética , DNA/genética , Oftalmopatias Hereditárias/genética , Mutação , Doenças Retinianas/genética , Adolescente , Adulto , Bestrofinas/metabolismo , China/epidemiologia , Análise Mutacional de DNA , Oftalmopatias Hereditárias/epidemiologia , Oftalmopatias Hereditárias/metabolismo , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Incidência , Masculino , Linhagem , Retina/patologia , Doenças Retinianas/epidemiologia , Doenças Retinianas/metabolismo , Tomografia de Coerência Óptica , Adulto Jovem
16.
Ocul Immunol Inflamm ; 27(4): 545-550, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29420099

RESUMO

Purpose: To describe a case series of ocular complications associated with upper respiratory tract infections. Methods: Four patients aged 21-61 years (three females, one male) had confirmed ocular complications connected with a general upper respiratory tract infection with myalgia and fever. Ophthalmological examination, including a visual acuity test, a slit-lamp exam, intraocular pressure measurements, fluorescein and indocyanine green angiography, optical coherence tomography (OCT), and diagnostic tests for influenza were performed in the patients (RT-PCR, HAI). Results: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) was diagnosed in three patients and serous macular detachment (SME) in one. Influenza virus infection was confirmed by molecular biological methods (RT-PCR) or the hemagglutination inhibition test (HAI) in two patients. All patients were treated with systemic prednisone. Conclusion: A coincidence between APMPPE and SME epitheliopathy and influenza virus infection was observed in different months of a given epidemic season.


Assuntos
DNA Viral/análise , Vírus da Influenza A/genética , Influenza Humana/complicações , Retina/patologia , Doenças Retinianas/etiologia , Acuidade Visual , Adulto , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Incidência , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Doenças Retinianas/diagnóstico , Doenças Retinianas/epidemiologia , Fatores de Risco , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica , Adulto Jovem
17.
Cell Physiol Biochem ; 51(5): 2445-2455, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30537745

RESUMO

BACKGROUND/AIMS: Familial exudative vitreoretinopathy (FEVR) is a complex hereditary eye disorder characterized by incomplete development of the retinal vasculature, thereby affecting retinal angiogenesis. METHODS: In this study, a Chinese autosomal dominant FEVR pedigree was recruited. Ophthalmic examinations were performed, targeted next-generation sequencing was used to identify the causative gene, and Sanger sequencing was conducted to verify the candidate mutation. Co-segregation analysis was performed to evaluate pathogenicity. Semi-quantitative reverse transcription-PCR was applied to investigate the spatial and temporal expression patterns of the frizzled class receptor 4 (FZD4) gene in the mouse. RESULTS: A novel heterozygous, deleterious variant of the FZD4 gene, c.A749G (p.Y250C), was identified in this FEVR pedigree, which co-segregated with the clinical phenotype. The amino acid tyrosine (Y) is highly conserved both orthologously and paralogously. The FZD4 gene was highly expressed in the retina, sclera of the eye, ovary, kidney, and liver; ubiquitously expressed in other tissues; and highly expressed in 6 different developmental stages/times of retinal tissue. CONCLUSION: Our study is the first to identify that the novel heterozygous variant c.A749G (p.Y250C) in the FZD4 gene may be the disease-causing mutation in this FEVR family, extending its mutation spectrum. These findings further our understanding of the molecular pathogenesis of FEVR and will facilitate the development of methods for the diagnosis, prevention, and genetic counseling of this disease.


Assuntos
Oftalmopatias Hereditárias/genética , Receptores Frizzled/genética , Mutação de Sentido Incorreto , Mutação Puntual , Doenças Retinianas/genética , Grupo com Ancestrais do Continente Asiático/genética , Criança , China/epidemiologia , Análise Mutacional de DNA , Oftalmopatias Hereditárias/epidemiologia , Feminino , Predisposição Genética para Doença , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Linhagem , Doenças Retinianas/epidemiologia , Transcriptoma
18.
Neuro Endocrinol Lett ; 39(4): 321-324, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30531707

RESUMO

OBJECTIVES: Myopia is associated with increased frequency of retinal degenerative changes which are the risk factors of intra- and postpartal ophthalmological complications. Aim of this study was to analyze the degenerative lesions detected in opthalmological examination (including peripheral retinal lesions) as a potential risk factors for eyes' status in terms of delivery in myopic women. MATERIAL AND METHODS: 254 pregnant women affected with myopia underwent opthalmological examination as a screening method to examine retina. In case of any degenerative lesions, the qualification for laser photocoagulation treatment was performed. Furthermore, study group was divided into two subgroups due to presence or absence of the retinal lesions and opthalmological outcomes compared. Follow up examination was performed in every patient from the study group between 3 and 6 months after the delivery. RESULTS: Among 508 eyes, retinal lesions were revealed in 69 women (121 eyes) what constituted for 23.8%. In remaining 185 patients results of the opthalmological examination were normal. Average maternal age was higher in group affected with degenerative lesions (p<0.001). Myopia in women with retinal lesions ranged between -0.25 and -12 dioptries (D), while in 43 cases of degenerative lesions qualified for laser photocoagulation this value ranged between -0.5 and -12.0 D (p=ns). Postpartal follow-up examination did not reveal any abnormalities in this group, as well. CONCLUSION: Degenerative retinal lesions are present in one fourth of pregnant women. Both the severity and type of the lesions are not associated with severity of myopia. Among pregnant patients, retinal lesions occur in patients with more advanced maternal age. opthalmological examination remains an important prophylactic modality in retinal disorders, especially in primary retinal detachment due degenerative disorders.


Assuntos
Miopia/epidemiologia , Complicações na Gravidez/epidemiologia , Transtornos Puerperais/epidemiologia , Degeneração Retiniana/epidemiologia , Adulto , Feminino , Idade Gestacional , Humanos , Fotocoagulação a Laser , Oftalmoscopia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/terapia , Degeneração Retiniana/diagnóstico , Degeneração Retiniana/terapia , Doenças Retinianas/diagnóstico , Doenças Retinianas/epidemiologia , Doenças Retinianas/terapia , Fatores de Risco , Adulto Jovem
20.
Arch. Soc. Esp. Oftalmol ; 93(11): 542-550, nov. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-175138

RESUMO

La retina humana, como tejido transductor de la energía lumínica, está especialmente expuesta a la toxicidad inducida por la exposición a la luz. La maculopatía solar ha sido durante milenios la única forma de maculopatía fótica, muchas veces en relación con la observación de un eclipse. Durante el último siglo los avances tecnológicos han conducido a la aparición de nuevas formas de retinopatía fótica, en relación con la exposición a nuevas formas de luz artificial como los dispositivos de soldar o emisores de láser. En los últimos años la generalización del uso de punteros láser ha hecho que repunte el interés por esta dolencia. El objetivo de esta revisión es ofrecer una visión integrada de los diversos tipos de maculopatía fótica. La revisión se presenta dividida en 2 partes, debido a la extensión del tema tratado. En esta segunda parte se presentan la maculopatía fótica secundaria a explosiones nucleares, a láser, las formas iatrogénicas de maculopatía fótica y la retinitis foveomacular


The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of the topic, the review is presented divided into 2 parts. In this second part, atomic bomb maculopathy, laser maculopathy, iatrogenic forms of photic maculopathy, and foveomacular retinitis are presented


Assuntos
Humanos , Animais , Degeneração Macular/epidemiologia , Doenças Retinianas/epidemiologia , Lasers/efeitos adversos , Traumatismos Oculares/epidemiologia , Retina/lesões , Doenças Retinianas/veterinária , Luz/efeitos adversos , Luz Solar/efeitos adversos , Degeneração Macular/prevenção & controle , Catarata/epidemiologia , Retinite/epidemiologia , Traumatismos Oculares
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA