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1.
Medicine (Baltimore) ; 98(44): e17738, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689821

RESUMO

This study aimed to evaluate a novel real-time rotational optical coherence tomography (OCT) imaging system (OCTIS) with a fiber-optic probe to look at endometrium and to correlate the OCTIS images with standard histology. OCT could obtain real-time images resembling histological examination. With recent development of customized probes, it allows OCT to be used in the field of gynecology.This is a pilot, prospective, ex-vivo and observational study. Women underwent hysterectomy for various gynecological conditions were recruited and OCTIS images were obtained from endometrium of 15 fresh uterus specimens immediately after hysterectomy. The excised uterus was cut open and OCTIS imaging was obtained. The scanned region of endometrium was excised for histological examination and OCTIS images were precisely compared to corresponding histological images and ultrasound images. Blinded qualitative analysis on OCTIS images was performed by 2 assessors to determine inter-rating reliability on the histopathological diagnosis.Epithelium, glands, cysts, and stroma of endometrium were clearly seen by the OCTIS. Different phases of menstrual cycle of normal endometrium could be differentiated and pathological condition such as hyperplastic and dysplasic endometrium, which corresponded well with histological findings, could be identified. The inter-rater reliability between assessors on overall OCTIS endometrium and neoplastic OCTIS endometrium was moderate (Kendall τb of 0.58) and substantial (Kendall τb of 0.76), respectively.OCTIS can provide real-time, high-resolution and rotational imaging modality to view endometrial structure with high consistency with histological examination and satisfactory agreement between observers. It has a great potential to be developed in the clinical use of endometrial assessment for gynecological applications.


Assuntos
Hiperplasia Endometrial/diagnóstico por imagem , Endométrio/diagnóstico por imagem , Aumento da Imagem/métodos , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Endométrio/patologia , Feminino , Humanos , Histerectomia , Aumento da Imagem/instrumentação , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Período Pós-Operatório , Estudos Prospectivos , Reprodutibilidade dos Testes , Método Simples-Cego , Tomografia de Coerência Óptica/instrumentação
2.
Int Heart J ; 60(5): 1154-1160, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484855

RESUMO

In-stent neoatherosclerosis is an important problem after percutaneous coronary intervention. To explore the mechanisms and treatment of in-stent neoatherosclerosis, an animal model is needed. To avoid the disadvantages of current animal models, such as excessive use of X-rays and a high mortality rate, we attempted to develop an improved animal model. We explored a method that uses a short time interval to establish a rabbit model of in-stent neoatherosclerosis with a high survival rate and to evaluate its indicators. Sixty rabbits were divided into three equal groups: group A, the traditional method; group B, the standard intervention method; and group C, the improved method. In group C, we made two small incisions in each rabbit's neck, separated the common carotid, punctured it, and implanted a stent. The incision was then sutured. Four weeks later, we used optical coherence tomography (OCT) to scan all rabbits for neoatherosclerosis. We found no significant differences in OCT data between our new animal model and the traditional and interventional groups (P > 0.05). The technological success rate was higher in the new animal model (P < 0.001). We developed a new method to establish an animal model of neoatherosclerosis, which had similar results to the traditional and interventional methods.


Assuntos
Reestenose Coronária/diagnóstico por imagem , Estenose Coronária/cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Stents/efeitos adversos , Tomografia de Coerência Óptica/métodos , Animais , Reestenose Coronária/mortalidade , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/mortalidade , Modelos Animais de Doenças , Humanos , Masculino , Neointima/diagnóstico por imagem , Neointima/patologia , Variações Dependentes do Observador , Intervenção Coronária Percutânea/métodos , Intervenção Coronária Percutânea/mortalidade , Falha de Prótese , Coelhos , Distribuição Aleatória , Fatores de Risco , Estatísticas não Paramétricas , Taxa de Sobrevida
3.
Int Heart J ; 60(5): 1022-1029, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484858

RESUMO

Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) may increase contrast volume. However, the impact of OCT-guided PCI on the decline in kidney function (DKF) in actual clinical practice remains unclear.Among 1,003 consecutive patients who underwent either OCT-guided or intravascular ultrasound (IVUS)-guided PCI in our institute, we identified 202 propensity score-matched pairs adjusted by baseline factors. The incidence of DKF was compared between the OCT-guided PCI group and the IVUS-guided PCI group. DKF was defined as an increase in serum creatinine level of ≥ 0.5 mg/dL or a relative increase of ≥ 25% over baseline within 48 hours (acute DKF) or 1 month (sustained DKF) after PCI.Baseline characteristics, including the prevalence of chronic kidney disease (54% versus 46%, P = 0.09), were comparable between the OCT- and IVUS-guided PCI groups except for the age. The contrast volume was comparable between the two groups (153 ± 56 versus 144 ± 60 mL, P = 0.09), although it was significantly greater in the OCT-guided PCI group in patients with acute coronary syndrome (ACS; 175 ± 55 versus 159 ± 43 mL, P = 0.04). The incidence of acute DKF (0.5% versus 2.5%, P = 0.22) and sustained DKF (5.0% versus 10.4%, P = 0.31) was comparable between the two groups. Multivariate analysis demonstrated that ACS (odds ratio 4.74, 95% confidence interval 2.72-8.25, P < 0.001) was a predictor of sustained DKF.Compared with IVUS-guided PCI, OCT-guided PCI did not increase the incidence of DKF in actual clinical practice, although the increased contrast volume was observed in ACS cases.


Assuntos
Síndrome Coronariana Aguda/cirurgia , Lesão Renal Aguda/induzido quimicamente , Meios de Contraste/efeitos adversos , Intervenção Coronária Percutânea/métodos , Tomografia de Coerência Óptica/métodos , Ultrassonografia de Intervenção/métodos , Centros Médicos Acadêmicos , Síndrome Coronariana Aguda/diagnóstico por imagem , Lesão Renal Aguda/epidemiologia , Idoso , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Incidência , Japão , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Razão de Chances , Segurança do Paciente/estatística & dados numéricos , Intervenção Coronária Percutânea/efeitos adversos , Pontuação de Propensão , Estudos Retrospectivos , Medição de Risco , Cirurgia Assistida por Computador/efeitos adversos , Cirurgia Assistida por Computador/métodos , Tomografia de Coerência Óptica/efeitos adversos , Ultrassonografia de Intervenção/efeitos adversos
4.
Int Heart J ; 60(5): 1061-1069, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484870

RESUMO

Plaque erosion (PE) is a significant substrate of acute coronary thrombosis. An improved ability to distinguish plaque phenotype in vivo among patients with ST-segment elevation myocardial infarction (STEMI) is of considerable interest because of the potential to formulate tailored treatment. This study assessed the plaque features and screened the circulating microRNAs (miRNAs) characteristically expressed in patients with PE compared with those with plaque rupture (PR). An miRNA microarray profile was generated in an initial cohort of eight STEMI patients with PE and eight clinically matched subjects with PR to select the circulating miRNAs with significant differences. miRNAs of interest were validated in a prospective cohort, and the plaque characteristics of enrolled patients were assessed by optical coherence tomography (OCT). Thirty culprit lesions were classified as PE (32.6%) and 46 as PR (50%). The main component of PE was fibrotic tissue, whereas the chief component of PR was lipids (P < 0.001). Thirty-four miRNAs were differentially expressed between the two groups; we validated five candidates and found that only the level of circulating miR-3667-3p exhibited significant discriminatory power in predicting the presence of PE (AUC = 0.767; P < 0.001). Our results show that high levels of circulating miR-3667-3p are closely related to PE in STEMI patients, which provides further evidence for PE pathophysiology and potential tailor treatment strategies.


Assuntos
MicroRNA Circulante/sangue , Trombose Coronária/diagnóstico por imagem , Placa Aterosclerótica/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Tomografia de Coerência Óptica/métodos , Idoso , Área Sob a Curva , Estudos de Casos e Controles , China , Angiografia Coronária/métodos , Trombose Coronária/mortalidade , Trombose Coronária/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/patologia , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Medição de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Estatísticas não Paramétricas , Análise de Sobrevida , Resultado do Tratamento
5.
Adv Clin Exp Med ; 28(10): 1367-1375, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31518493

RESUMO

BACKGROUND: Glaucoma, a degenerative and progressive disease, leads to structural and functional changes in the optic nerve head and retinal ganglion cells (RGCs), while the vasculature of the iris stays intact. OBJECTIVES: The aim of this study was to determine whether the coherence level associated with pupil geometry and peripheral arterial pulsation can be the basis for differentiating glaucoma and glaucoma-suspected patients from a control group. MATERIAL AND METHODS: This is an investigator-initiated, single-center prospective cohort study. Patients with diagnosed glaucoma (glaucoma group - GG) or glaucoma suspects (glaucoma suspects group - GSG), as well as healthy participants (control group - CG), were prospectively enrolled in the study. Glaucoma-diagnosed patients and glaucoma suspects who converted to glaucoma within 5 years were included. All patients underwent a full ophthalmological examination that included measurements of the thicknesses of the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) along with other parameters. A custom-made pupilometer was synchronized with a pulsometer to simultaneously record an image of the pupil and the peripheral arterial pulsation signal. All readings were processed with a script developed by the researchers. The main indicator of an increased influence of the vascular structures of the iris on pupil geometry in the patients and CG were the coherence levels (levC) between parameters describing the pupillary shape and peripheral arterial pulsation. RESULTS: Differences in the median value of the levCpS, levCpε and levCpθ parameters between the GG and GSG compared to the CG were found (p < 0.001). During the follow-up period, a larger decrease was observed in RNFL thickness and GCC thickness in the GSG than in the GG (p < 0.05). Strong correlations were found between levCpS and RNFL and GCC loss among the GSG group (p < 0.001), while in the GG this parameter correlated with RNFL and GCC thickness (p < 0.001). CONCLUSIONS: This is the first attempt to relate changes in the neuronal signaling pathways in glaucoma to the vascular-dependent changes of pupil geometry. The findings presented herein suggest that this approach can be used to determine which glaucoma suspects have autonomic system impairment in the eye, increasing their probability of glaucoma conversion.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma/diagnóstico , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Estudos de Casos e Controles , Glaucoma de Ângulo Aberto/diagnóstico , Homeostase , Humanos , Pressão Intraocular/fisiologia , Estudos Prospectivos , Pupila
6.
Cornea ; 38(9): 1154-1160, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31394554

RESUMO

PURPOSE: This study aimed to predict the best-corrected visual acuity (BCVA) based on swept-source optical coherence tomography (SS-OCT) parameters in eyes with keratoconus. METHODS: We retrospectively reviewed 135 eyes of 135 patients with keratoconus (mean age: 31.9 ± 12.4 years). The average keratometry value and BCVA (logarithm of the minimal angle of resolution [Snellen]) were 48.68 ± 5.44 diopter and 0.20 ± 0.36 (20/25), respectively. Eleven parameters were calculated using SS-OCT. Apart from the corneal height and elevation, all the other parameters were calculated from both anterior and posterior corneal OCT data. The patients were divided into 2 groups, 1 for creating the prediction equation (prediction group, 86 eyes) and another for verifying the equation (verification group, 49 eyes). In the former, individual correlations between the BCVA and SS-OCT parameters were analyzed. A stepwise multiple regression analysis was performed with the BCVA as a dependent variable and SS-OCT parameters as independent variables. After its creation, the accuracy of the prediction equation was verified in the verification group. RESULTS: All the parameters, except for age and total corneal cylinder, showed statistically significant correlations with BCVA (P < 0.0001). Using the stepwise multiple regression analysis, we selected 2 explanatory variables: root mean square of anterior corneal elevation (standardized regression coefficient: 1.221; P < 0.0001) and total coma aberration (standardized regression coefficient: -0.575; P = 0.001; adjusted R = 0.546). The prediction was correct in 84.6% of the eyes within ±1 line of Snellen BCVA. CONCLUSIONS: Using the equation we derived from SS-OCT parameters is a promising method to predict visual function in patients with keratoconus.


Assuntos
Córnea/fisiopatologia , Topografia da Córnea/métodos , Ceratocone/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia , Adulto , Feminino , Humanos , Ceratocone/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Adulto Jovem
7.
BMC Ophthalmol ; 19(1): 186, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31419954

RESUMO

BACKGROUND: This study aims to investigate the choroidal thickness and choroidal vascular density parameters and their correlation with severity of diabetic retinopathy (DR) in diabetes mellitus (DM) patients. METHODS: An observational cross-sectional study was conducted of 104 eyes, which were divided into 4 groups: Healthy controls (n = 38), DM with no DR eyes (n = 22), panretinal photocoagulation-untreated non-proliferative DR eyes (PRP-untreated NPDR eyes) (n = 24), PRP-untreated proliferative DR eyes (PRP-untreated PDR eyes) (n = 20). Optical coherence tomography (OCT) was performed. The total choroidal area (TCA), stromal area (SA), the luminal areas (LA) and the ratio of the luminal to choroidal area (L/C ratio) were compared. The choroidal parameters were also compared between PRP untreated and PRP-treated DR eyes. RESULTS: The L/C ratio values were 0.68 ± 0.06 in controls and 0.63 ± 0.04 in DM eyes (P < 0.001). But there were no statistically significant differences in retinal nerve fiber layer (RNFL) thickness, retinal thickness and subfoveal choroidal thickness (SCT) measurements between the two groups (P = 0.407, P = 0.654 and P = 0.849; respectively). The vessel density values were significantly different in DM with no DR eyes, PRP-untreated NPDR eyes and PRP-untreated PDR eyes (P < 0.001 for SCT, TCA and SA). The L/C ratio values in the three groups were significant different (P = 0.019). There was no significant difference in SCT, TCA, LA, SA and the L/C ratio between PRP-untreated and PRP-treated DR eyes. CONCLUSION: Eyes of patients with DM showed the L/C ratio decreased compared with normal controls. The SCT increased, but L/C ratio significantly decreased with severity of DR eyes compared with DM and normal eyes. Changes in the L/C ratio may predict DR development before they are otherwise evident clinically. Choroidal blood flow deficit can be an early pathologic change in DR.


Assuntos
Corioide/patologia , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Capilares/patologia , Corioide/irrigação sanguínea , Estudos Transversais , Retinopatia Diabética/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Índice de Gravidade de Doença
8.
BMC Ophthalmol ; 19(1): 178, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399077

RESUMO

BACKGROUND: This study is to evaluate the accuracy of machine learning for differentiation between optic neuropathies, pseudopapilledema (PPE) and normals. METHODS: Two hundred and ninety-five images of optic neuropathies, 295 images of PPE, and 779 control images were used. Pseudopapilledema was defined as follows: cases with elevated optic nerve head and blurred disc margin, with normal visual acuity (> 0.8 Snellen visual acuity), visual field, color vision, and pupillary reflex. The optic neuropathy group included cases of ischemic optic neuropathy (177), optic neuritis (48), diabetic optic neuropathy (17), papilledema (22), and retinal disorders (31). We compared four machine learning classifiers (our model, GoogleNet Inception v3, 19-layer Very Deep Convolution Network from Visual Geometry group (VGG), and 50-layer Deep Residual Learning (ResNet)). Accuracy and area under receiver operating characteristic curve (AUROC) were analyzed. RESULTS: The accuracy of machine learning classifiers ranged from 95.89 to 98.63% (our model: 95.89%, Inception V3: 96.45%, ResNet: 98.63%, and VGG: 96.80%). A high AUROC score was noted in both ResNet and VGG (0.999). CONCLUSIONS: Machine learning techniques can be combined with fundus photography as an effective approach to distinguish between PPE and elevated optic disc associated with optic neuropathies.


Assuntos
Oftalmopatias Hereditárias/diagnóstico , Aprendizado de Máquina/normas , Disco Óptico/diagnóstico por imagem , Doenças do Nervo Óptico/diagnóstico , Neurite Óptica/diagnóstico , Células Ganglionares da Retina/patologia , Acuidade Visual , Diagnóstico Diferencial , Humanos , Fibras Nervosas/patologia , Curva ROC , Reprodutibilidade dos Testes , Tomografia de Coerência Óptica/métodos
9.
BMC Ophthalmol ; 19(1): 171, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382925

RESUMO

BACKGROUND: To investigate the area of foveal avascular zone (FAZ) and macular vessel density (VD) after correction for magnification error in unilateral amblyopia using optical coherence tomography angiography (OCTA). METHODS: Participants comprised 15 patients with unilateral amblyopia due to anisometropia with or without strabismus (mean age, 9.8 ± 3.4 years; range, 6-17 years). OCTA images were obtained by using spectral-domain OCT with angiography software. The OCTA scanning protocol used was 3 × 3-mm volume scan centered on the fovea. OCTA images were corrected for magnification errors using individual axial length (AL), and an adjusted 2.3 × 2.3-mm square was derived as a region of interest. The FAZ area and VD in both superficial capillary plexus (SCP) and deep capillary plexus (DCP) layers, foveal minimum thickness (FMT) were assessed using built-in OCTA software and ImageJ software (NIH, Bethesda, MD). RESULTS: LogMAR in the amblyopic eyes was significantly poorer than that of the fellow eye (p < 0.001). AL was significantly shorter in the amblyopic eye than in the fellow eye (p < 0.001). FAZ area of SCP in amblyopic eyes was significantly smaller than that of fellow eyes (p < 0.001). No significant differences were seen in FAZ area of DCP, VD of SCP, VD of DCP, and FMT between amblyopic and fellow eyes (p = 0.07, 0.43, 0.55, and 0.25, respectively). CONCLUSIONS: Our present study after magnification error correction found smaller FAZ area of SCP in the amblyopic eye compared with the fellow eyes, but there was no significant difference in the macular VD between the amblyopic and fellow eyes.


Assuntos
Ambliopia/diagnóstico , Angiofluoresceinografia/métodos , Macula Lutea/irrigação sanguínea , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adolescente , Ambliopia/fisiopatologia , Capilares/patologia , Criança , Estudos Transversais , Feminino , Fóvea Central , Fundo de Olho , Humanos , Macula Lutea/diagnóstico por imagem , Masculino , Estudos Retrospectivos
10.
BMC Ophthalmol ; 19(1): 179, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409322

RESUMO

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is a T-cell-mediated autoimmune disorder characterized by bilateral granulomatous panuveitis with various systemic manifestations. Although VKH disease rarely occurs in the pediatric population, the clinical course tends to be aggressive, and the visual prognosis is worse than that in adult patients due to severe ocular complications secondary to recurrent inflammation. CASE PRESENTATION: A 3-year-old girl with probable VKH was referred to Kobe University Hospital. She had severe bilateral panuveitis with posterior synechiae of the iris, marked optic disk swelling, and serous retinal detachment in both eyes, and her best corrected visual acuities (BCVAs) were 20/200 OD and 20/125 OS. A third course of therapy was administered because serous retinal detachment remained after two courses of therapy. She was treated with three courses of high-dose intravenous corticosteroid therapy, followed by slow tapering of oral corticosteroids. Her BCVAs recovered to 20/16 OU, and relapse of ocular inflammation and side effect of treatment were not observed during the 1.5-year follow-up period. CONCLUSIONS: We experienced a pediatric patient with probable VKH disease who was treated with three courses of high-dose intravenous corticosteroid therapy. With the favorable clinical course in our patient, initial treatment with repeated high-dose intravenous corticosteroid therapy might be beneficial in pediatric VKH disease.


Assuntos
Angiofluoresceinografia/métodos , Pressão Intraocular/fisiologia , Metilprednisolona/uso terapêutico , Tomografia de Coerência Óptica/métodos , Síndrome Uveomeningoencefálica/diagnóstico , Acuidade Visual , Pré-Escolar , Feminino , Fundo de Olho , Glucocorticoides/uso terapêutico , Humanos , Oftalmoscopia , Recidiva , Síndrome Uveomeningoencefálica/tratamento farmacológico , Síndrome Uveomeningoencefálica/fisiopatologia
11.
BMC Ophthalmol ; 19(1): 182, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409385

RESUMO

BACKGROUND: To compare and correlate anterior segment measurements of myopic eyes implanted with Implantable Collamer lens (ICL V4c) by using anterior segment optical coherence tomography (AS-OCT), Pentacam and ultrasound biomicroscopy (UBM). METHODS: Anterior chamber depth (ACD), distance between corneal endothelium and anterior surface of ICL(C-ICL) and central vault were measured in 82 phakic myopic eyes of 82 patients who underwent ICL surgery, by using AS-OCT, Pentacam and UBM consecutively at 3 months follow up. The correlation and agreement of instruments were accessed by using Intraclass correlation coefficient (ICC) and the Bland-Altman plot. RESULTS: AS-OCT showed higher ACD, C -ICL and central vault measurements than both of Pentacam and UBM (P < 0.001), while Pentacam showed lower measurements than UBM (P < 0.05). The Pearson correlation coefficient (r) was 0.91 to 0.96, and ICC was 0.95 to 0.98 for all measurements between difference devices (all P < 0.001). The 95% limits of agreement of ACD, C-ICL, vault measurements were 0.13 to 0.38 mm, - 0.07 to 0.27 mm, 0.08 to 0.34 mm between AS-OCT and Pentacam, - 0.03 to 0.33 mm, - 0.16 to 0.31 mm, - 0.10 to 0.26 mm between AS-OCT and UBM, and - 0.29 to 0.07 mm, - 0.25 to 0.20 mm, - 0.31 to 0.05 mm between Pentacam and UBM, respectively. CONCLUSIONS: AS-OCT demonstrated significantly higher value, while Pentacam demonstrated significantly lower value than UBM for ACD, C-ICL and central vault measurements in myopic eyes after ICL surgery. Measurements with these instruments were highly correlated, but could not replace each other especially for vault. This study provided valuable information about how to judge the results of anterior segment parameters of eyes implanted with ICL V4c from different devices. TRIAL REGISTRATION: Registration number: ChiCTR-OOC-16008987 . Retrospectively registered: 08 August 2016.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Microscopia Acústica/métodos , Miopia/diagnóstico , Lentes Intraoculares Fácicas , Refração Ocular/fisiologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Feminino , Seguimentos , Humanos , Masculino , Miopia/fisiopatologia , Miopia/cirurgia , Período Pós-Operatório , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
12.
Asia Pac J Ophthalmol (Phila) ; 8(4): 280-284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369405

RESUMO

PURPOSE: The aim of this study was to provide a retrospective analysis of the presentation, demographics, and treatment regimens for ocular toxoplasmosis at a large tertiary referral uveitis center. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 48 patients with ocular toxoplasmosis who presented to Sydney Eye Hospital participated in this study. METHODS: This is a retrospective review of patient files who presented to Sydney Eye Hospital between 2007 and 2016 with clinical features consistent with ocular toxoplasmosis. Baseline risk factors and treatment details were recorded and analyzed. Main outcome measures were visual acuity and relapse rate compared with other studies in ocular toxoplasmosis. RESULTS: The median age was 35.5 (interquartile range 21-50) with 30 (60%) patients having no previous symptomatic episodes or evidence of chorioretinal scarring. Visual acuity at presentation was 0.51 or 6/19 (SE 0.096) and at follow-up 0.31 or 6/12 (SE 0.094). Nine patients experienced a recurrence during the period of observation with median time to recurrence 2.2 years (SE 0.45) and the relapse rate was 0.09/person-years. Location of lesion was predominantly within the vascular arcades (n = 44) with macular involvement in 9 patients. Most patients received clindamycin therapy (n = 34) with pyrimethamine and sulfadiazine was used for those with macula involvement. CONCLUSIONS: Patients with ocular toxoplasmosis had fewer recurrences compared with other published series and had better visual recovery. The majority of patients received clindamycin and oral prednisolone which were well tolerated with pyrimethazine and sulfadiazine reserved for those with macula-involving disease.


Assuntos
Anti-Infecciosos/administração & dosagem , Infecções Oculares Parasitárias/diagnóstico , Glucocorticoides/administração & dosagem , Centros de Atenção Terciária , Toxoplasmose Ocular/diagnóstico , Acuidade Visual , Administração Oral , Adulto , Anticorpos Antiprotozoários/análise , Austrália/epidemiologia , DNA de Protozoário/análise , Quimioterapia Combinada , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/epidemiologia , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Fundo de Olho , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prognóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Toxoplasmose Ocular/tratamento farmacológico , Toxoplasmose Ocular/epidemiologia , Adulto Jovem
13.
Asia Pac J Ophthalmol (Phila) ; 8(4): 314-318, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31397675

RESUMO

PURPOSE: The aim of this study was to examine the hyperreflective dots seen in choroid on spectral domain optical coherence tomography (SDOCT) in eyes with diabetic macular edema (DME) and correlate it with visual acuity. DESIGN: Consecutive, cross-sectional case series of patients with DME between January 2017 and December 2017. METHODS: Eyes with DME having central foveal thickness ≥250 µm were included. SDOCT was performed using Spectralis system (Heidelberg Engineering, Germany). Hyperreflective choroidal foci (HCF) were defined as well-circumscribed dots within choroid having reflectivity equal to or higher than adjacent retinal pigment epithelium. HCF were counted manually within 1500 µm of fovea using a horizontal line scan by a blinded observer. Eyes were divided in 3 groups: group A (no HCF), group B (1-10 HCF), and group C (>10 HCF). RESULTS: One hundred nineteen eyes of 60 DME patients were included. Sixty (50.4%) eyes were in group A, whereas 42 (33.6%) and 17 (14.2%) eyes belonged to group B and group C, respectively. The mean logMAR best corrected visual acuity was significantly lower in group B (0.76 ±â€Š0.79) and C (1.2 ±â€Š0.78) as compared with group A (0.22 ±â€Š0.49) (P = 0.001). Mean central foveal thickness in group A (300.4 ±â€Š122.4 µm) was significantly lower than group B (455.52 ±â€Š209.1 µm) and group C (529.4 ±â€Š196.4 µm) with P value of 0.001. CONCLUSIONS: The present study describes HCF as novel prognostic SDOCT biomarker in DME whose presence denotes poor visual acuity. Further longitudinal studies are required to substantiate our findings.


Assuntos
Corioide/patologia , Retinopatia Diabética/complicações , Edema Macular/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Estudos Transversais , Retinopatia Diabética/diagnóstico , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Fundo de Olho , Humanos , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Epitélio Pigmentado da Retina/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença
14.
Acta Clin Croat ; 58(1): 87-94, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31363329

RESUMO

The aim of the study was to assess biometric factor aberrations and differences among groups of eyes with cataract and pseudoexfoliative syndrome, cataract and pseudoexfoliative glaucoma, and cataract and primary open-angle glaucoma (POAG), and to determine biometric factors of the eye specific for the group of glaucomatous patients with pseudoexfoliative syndrome by use of optical low-coherence reflectometry. This retrospective study included 72 patients, and the study sample of 102 eyes was divided into the following three groups according to diagnosis: 29 eyes with pseudoexfoliative syndrome and cataract; 36 eyes with POAG and cataract; and 37 eyes with pseudoexfoliative glaucoma and cataract. Data on biometric measurements (central corneal thickness, pupillary diameter, anterior chamber depth, lens thickness, axial length, retinal thickness, astigmatism and white-to-white) obtained by use of optical low-coherence reflectometry on a Lenstar LS 900® (Haag-Streit International) were collected and analyzed by thorough survey of medical documentation of patients scheduled for cataract surgery at Department of Ophthalmology, Sveti Duh University Hospital in Zagreb, Croatia. Comparative analysis of the groups yielded statistically significant differences in central corneal thickness (F2/99=7.066; p=0.001) and lens thickness (F2/96=5.133; p=0.008). The group of eyes diagnosed with pseudoexfoliative glaucoma and cataract had a significantly thinner cornea as compared with the other two groups and a significantly thicker lens as compared with the group of eyes with POAG and cataract. In conclusion, optical low-coherence reflectometry revealed differences in biometric factors among the three groups of eyes, with a statistically significantly thinner cornea and thicker lens in the group of glaucomatous patients with pseudoexfoliative syndrome.


Assuntos
Biometria/métodos , Catarata/diagnóstico , Glaucoma/diagnóstico , Tomografia de Coerência Óptica/métodos , Idoso , Croácia , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Cristalino/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/patologia , Estudos Retrospectivos
15.
Rom J Ophthalmol ; 63(2): 184-187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31334399

RESUMO

A 9-year-old girl from Equatorial Guinea presented to the emergency department complaining of foreign body sensation in her right eye. A thin and large, translucent, slowly moving, coiled worm was observed underneath the conjunctiva. Anterior segment optical coherence tomography revealed hyperreflective small areas surrounded by larger hyporeflective areas into the subconjunctival space. Loa loa microfilaria was evidenced on blood test. Surgical extraction of the subconjunctival worm was intended on slit lamp and under sedation in the operating room, but it was unsuccessful due to poor cooperation and rapid migration of the larva into the sub-Tenon's space. The patient received two cycles of oral albendazole and one cycle of diethylcarbamazine before achieving complete microfilaria seroconversion. Abbreviations: AS-OCT = Anterior Segment Optical Coherence Tomography, PCR = Polymerase Chain Reaction, DEC = diethylcarbamazine.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Túnica Conjuntiva/parasitologia , Doenças da Túnica Conjuntiva/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Loa , Loíase/diagnóstico , Tomografia de Coerência Óptica/métodos , Animais , Segmento Anterior do Olho/parasitologia , Criança , Túnica Conjuntiva/patologia , Doenças da Túnica Conjuntiva/parasitologia , Diagnóstico Diferencial , Infecções Oculares Parasitárias/parasitologia , Feminino , Humanos , Loíase/parasitologia
16.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1971-1979, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31312906

RESUMO

PURPOSE: To describe the characteristics of de novo uveitis in patients ≥ 60 years old. METHODS: Retrospective review of patients with uveitis followed in our tertiary center over a 14-year period. Patients aged 60-70 years and patients aged > 70 years were compared. RESULTS: A total of 283/1044 (27.1%) patients with uveitis were ≥ 60 years of age. Idiopathic uveitis (36.1%) and sarcoidosis (31.5%) were the most frequent etiologies. Sarcoidosis was significantly more frequent (31.5% vs. 13.7%, p < 0.0001) after the age of 60 years. Intraocular lymphoma (5.0% vs. 1.1%) and herpes virus infection (5.0% vs. 0.9%) were also more common in this age group, unlike HLA B27-related uveitis and spondyloarthritis (4.6% vs. 14.9%). Pure ophthalmologic entities: birdshot retinochoroidopathy (2.8%) or Fuchs uveitis (0.4%), were rare in patients ≥ 60 years of age and Posner Scholssman, Pars planitis, White dots syndrome, Behçet's disease, and Multiple Sclerosis were never reported. In patients > 70 years old, idiopathic uveitis (41.1% vs. 31.7%) and presumed sarcoidosis (56.5% vs. 25.6%) were more frequent than in the 60-70-year age group. CONCLUSION: In our center, sarcoidosis is the leading cause of non-idiopathic uveitis in older patients. Idiopathic uveitis and other entities account for less than two-thirds of cases. Ophthalmologic entities are rare after 60 years of age. We also report for the first time the characteristics of uveitis after 70 years of age.


Assuntos
Síndrome de Behçet/complicações , Neoplasias Oculares/complicações , Sarcoidose/complicações , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/diagnóstico , Fatores Etários , Idoso , Animais , Feminino , Angiofluoresceinografia/métodos , França/epidemiologia , Fundo de Olho , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Oftalmoscopia/métodos , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Uveíte/epidemiologia , Uveíte/etiologia
17.
Rev Med Chil ; 147(4): 426-436, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31344203

RESUMO

BACKGROUND: Balloon pulmonary angioplasty (BPA) is a therapeutic alternative for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). AIM: To report the initial experience with the "refined BPA technique" with the use of intravascular images. PATIENTS AND METHODS: Between June 2015 and June 2016 we selected fourteen patients with CTEPH who were considered candidates for BPA. Lesions targeted for treatment were further analyzed using intravascular imaging with optical frequency domain imaging (OFDI). We report the immediate hemodynamic results and four weeks of follow-up of the first eight patients of this series. RESULTS: We performed 16 BPA in eight patients aged 61 ± 14 years (88% women). Mean pulmonary artery pressure (PAPm) was 48.6 ± 5.8 mmHg. Success was achieved in seven patients (88%). A mean of 2.3 segments per patient were intervened in 11 sessions (1.6 sessions/ patient). Only one patient developed lung reperfusion injury. No mortality was associated with the procedure. After the last BPA session, PAPm decreased to 37.4 ± 8.6 mmHg (p=0.02). Pulmonary vascular resistance (RVP) decreased from 858,6 ± 377,0 at baseline to 516,6 ± 323,3 Dynes/sec/cm-5 (p<0.01) and the cardiac index increased from 2.4±0.6 at baseline to 2.8±0.3 L/min/m2 (p=0.01). At 4 weeks after the last BPA, WHO functional class improved from 3.3±0.5 to 2.5±0.5 (p<0,01) and six minutes walking distance from 331±92 to 451±149 m (p=0.01). CONCLUSIONS: BPA guided by OFDI for the treatment of inoperable CTEPH patients is a safe alternative with excellent immediate hemodynamic and clinical results.


Assuntos
Angioplastia com Balão/métodos , Hipertensão Pulmonar/terapia , Embolia Pulmonar/terapia , Adulto , Idoso , Angiografia/métodos , Doença Crônica , Feminino , Hemodinâmica , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/fisiopatologia , Reprodutibilidade dos Testes , Fatores de Tempo , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento
18.
J Pediatr Ophthalmol Strabismus ; 56: e41-e44, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31282959

RESUMO

A patient treated for retinoblastoma developed vitreous floaters 15 years later and was referred for recurrence with vitreous seeding. Clinical examination demonstrated a regressed scar and numerous calcified vitreous opacities with a "clear zone" on ultrasonography. The final diagnosis was asteroid hyalosis in an eye with regressed retinoblastoma. [J Pediatr Ophthalmol Strabismus. 2019;56:e41-e44.].


Assuntos
Oftalmopatias/diagnóstico , Neoplasias da Retina/diagnóstico , Retinoblastoma/diagnóstico , Corpo Vítreo/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Tomografia de Coerência Óptica/métodos , Ultrassonografia
19.
Semin Ophthalmol ; 34(6): 446-450, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361521

RESUMO

Purpose: To evaluate the relationship between visual acuity, visual field and spectral domain optical coherence tomography (OCT) parameters, including retinal nerve fiber layer (RNFL), ganglion cell-internal plexiform layer (GC-IPL) thicknesses, and optic nerve head parameters in patients with severe glaucoma. Material and Methods: Patients with the diagnosis of severe glaucoma were recruited from the data gathered at our glaucoma department. A detailed ophthalmic examination was performed using the Standard Automated Perimetry (the 30-2 SITA standard program was used for VF testing). Cirrus EDI-OCT was used for peripapillary RNFL and GC-IPL thickness measurements. Optic nerve head parameters, including mean cup-to-disc (c/d) ratio, rim area, vertical c/d ratio, cup volume, were also measured by spectral domain OCT. Correlations between these structural parameters and functional parameters (visual acuity, VF parameters) were investigated. Results: Forty-one eyes of 34 patients with severe glaucoma were enrolled in this study. Correlations between BCVA and mean GC-IPL thickness (p = .03), superior GC-IPL thickness (p = .03), inferonasal GC-IPL thickness (p = .01), superonasal GC-IPL thickness (p = .01), superotemporal GC-IPL thickness (p = .04), and rim area (p = .00) were found to be positive statistically significant. There was also a positive statistically significant correlation between MD and inferotemporal GC-IPL thickness (p = .03). Negative statistically significant correlations were found between BCVA and mean c/d ratio (p = .00), vertical c/d ratio (p = .02) and cup volume (p = .00). Discussion: Mean, superior, inferonasal, superonasal, and superotemporal GC-IPL thicknesses and mean c/d ratio, vertical c/d ratio and cup volume were found to be correlated with BCVA in patients with severe glaucoma.


Assuntos
Glaucoma/diagnóstico , Pressão Intraocular/fisiologia , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais , Idoso , Idoso de 80 Anos ou mais , Feminino , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Índice de Gravidade de Doença , Vazamento Acidental em Seveso , Acuidade Visual
20.
Cornea ; 38(8): 943-947, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31276457

RESUMO

PURPOSE: To describe the findings of anterior segment optical coherence tomography (AS-OCT) in patients with microsporidial keratoconjunctivitis. METHODS: The observational study included 13 eyes from 13 patients. Slit-lamp photography and AS-OCT were performed using the Swept source OCT before corneal scraping. All cases were positive for Gram-chromotrope (modified trichrome) staining for Microsporidia spp. RESULTS: Three significant AS-OCT findings were observed. First, hyperreflective dots were limited to the epithelial layers of the cornea, and second, there were no extensions into the stromal layer in all cases. Last, hyperreflective dots slightly raised above the epithelial surface were observed in most cases (12/13%, 92.3%). CONCLUSIONS: AS-OCT represents an alternative, noninvasive tool to diagnose microsporidial keratoconjunctivitis, especially if corneal scraping is not possible.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Infecções Oculares Fúngicas/diagnóstico por imagem , Ceratoconjuntivite/diagnóstico por imagem , Microsporídios/isolamento & purificação , Microsporidiose/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Antibacterianos/uso terapêutico , Desbridamento , Infecções Oculares Fúngicas/tratamento farmacológico , Infecções Oculares Fúngicas/microbiologia , Feminino , Humanos , Ceratoconjuntivite/tratamento farmacológico , Ceratoconjuntivite/microbiologia , Masculino , Microsporidiose/tratamento farmacológico , Microsporidiose/microbiologia , Pessoa de Meia-Idade , Moxifloxacina/uso terapêutico , Microscopia com Lâmpada de Fenda , Acuidade Visual
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