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1.
Med Clin North Am ; 105(3): 397-407, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926637

RESUMO

Incidence of cataract, diabetic retinopathy, macular degeneration, and glaucoma will significantly increase by 2050. Visual impairment can increase morbidity and mortality in nonocular disease. There are different patterns of vision loss in cataract, diabetic retinopathy, age-related macular degeneration, and glaucoma. Internists and medical subspecialists play an important role in prevention, detection, and early treatment of eye disease. Awareness of screening guidelines for eye disease as well as a basic ocular history and simple penlight examination can decrease incidence of vision loss and its impact. Visual impairment places a significant financial burden on society.


Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Oftalmopatias/complicações , Oftalmopatias/prevenção & controle , Humanos , Medicina Interna , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/prevenção & controle , Transtornos da Visão/terapia
2.
Med Clin North Am ; 105(3): 409-423, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926638

RESUMO

Primary care physicians see nearly half of all clinical visits, and 2% to 3% of those are for eye complaints. Taking a good ocular history is essential to establishing the diagnosis. Patient complaints fall into several categories including visual change, redness, and pain. Primary care physicians can screen for patients at risk of vision loss from glaucoma, diabetes, and toxic medication and ensure that patients have appropriate eye evaluations. Examination techniques such as direct ophthalmoscopy, evaluation of the red reflex, eversion of the upper lid, checking pupillary response, and using fluorescein to stain the cornea are helpful in evaluating patients' ocular complaints.


Assuntos
Oftalmopatias/diagnóstico , Emergências , Oftalmopatias/etiologia , Oftalmopatias/terapia , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/etiologia , Traumatismos Oculares/terapia , Humanos , Programas de Rastreamento , Atenção Primária à Saúde , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/terapia
3.
Lancet Digit Health ; 3(1): e29-e40, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33735066

RESUMO

BACKGROUND: In current approaches to vision screening in the community, a simple and efficient process is needed to identify individuals who should be referred to tertiary eye care centres for vision loss related to eye diseases. The emergence of deep learning technology offers new opportunities to revolutionise this clinical referral pathway. We aimed to assess the performance of a newly developed deep learning algorithm for detection of disease-related visual impairment. METHODS: In this proof-of-concept study, using retinal fundus images from 15 175 eyes with complete data related to best-corrected visual acuity or pinhole visual acuity from the Singapore Epidemiology of Eye Diseases Study, we first developed a single-modality deep learning algorithm based on retinal photographs alone for detection of any disease-related visual impairment (defined as eyes from patients with major eye diseases and best-corrected visual acuity of <20/40), and moderate or worse disease-related visual impairment (eyes with disease and best-corrected visual acuity of <20/60). After development of the algorithm, we tested it internally, using a new set of 3803 eyes from the Singapore Epidemiology of Eye Diseases Study. We then tested it externally using three population-based studies (the Beijing Eye study [6239 eyes], Central India Eye and Medical study [6526 eyes], and Blue Mountains Eye Study [2002 eyes]), and two clinical studies (the Chinese University of Hong Kong's Sight Threatening Diabetic Retinopathy study [971 eyes] and the Outram Polyclinic Study [1225 eyes]). The algorithm's performance in each dataset was assessed on the basis of the area under the receiver operating characteristic curve (AUC). FINDINGS: In the internal test dataset, the AUC for detection of any disease-related visual impairment was 94·2% (95% CI 93·0-95·3; sensitivity 90·7% [87·0-93·6]; specificity 86·8% [85·6-87·9]). The AUC for moderate or worse disease-related visual impairment was 93·9% (95% CI 92·2-95·6; sensitivity 94·6% [89·6-97·6]; specificity 81·3% [80·0-82·5]). Across the five external test datasets (16 993 eyes), the algorithm achieved AUCs ranging between 86·6% (83·4-89·7; sensitivity 87·5% [80·7-92·5]; specificity 70·0% [66·7-73·1]) and 93·6% (92·4-94·8; sensitivity 87·8% [84·1-90·9]; specificity 87·1% [86·2-88·0]) for any disease-related visual impairment, and the AUCs for moderate or worse disease-related visual impairment ranged between 85·9% (81·8-90·1; sensitivity 84·7% [73·0-92·8]; specificity 74·4% [71·4-77·2]) and 93·5% (91·7-95·3; sensitivity 90·3% [84·2-94·6]; specificity 84·2% [83·2-85·1]). INTERPRETATION: This proof-of-concept study shows the potential of a single-modality, function-focused tool in identifying visual impairment related to major eye diseases, providing more timely and pinpointed referral of patients with disease-related visual impairment from the community to tertiary eye hospitals. FUNDING: National Medical Research Council, Singapore.


Assuntos
Algoritmos , Aprendizado Profundo , Oftalmopatias/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Idoso , Área Sob a Curva , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação/métodos , Estudo de Prova de Conceito , Curva ROC , Sensibilidade e Especificidade , Singapura/epidemiologia
4.
Medicine (Baltimore) ; 100(10): e24670, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725826

RESUMO

ABSTRACT: To report the rationale, design, and baseline demographic characteristics of TuYou-County Pediatric Eye study, which mainly aimed to determine the retinal microvascular changes with optical coherence tomography angiography (OCTA) and its association with eye abnormalities in school aged children and adolescents at suburban location in Northern China.TuYou-County Pediatric Eye study was a school-based survey conducted in TuYou-County. Multi-ethnic (Mongol, Han, and Hui) participants will be followed up for 5 years. Standardized ophthalmological examinations include visual acuity, ocular biometry, retinal photography, and OCTA. A questionnaire survey was conducted to collect variables regarding to eye disease such as parental history of eye diseases, near work, outdoor activities, living and eating habits, etc.After sampling, 687 participants were eligible for investigation, and 20 students did not attend the investigation, living 667 (response rate, 97.1%) students completed questionnaires and all ocular examinations. The average age of all participants was 14.9 ±â€Š5.11.TYPE study is the first large-scale school-based multi-ethnic survey in suburban site of Northern China. Continuous identification of retinal microvascular changes with eye diseases will provide new insights into the control related diseases in school-age children and adolescents.


Assuntos
Microvasos/diagnóstico por imagem , Projetos de Pesquisa , Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Transtornos da Visão/diagnóstico , Adolescente , Angiografia , Criança , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , Tomografia de Coerência Óptica , Transtornos da Visão/epidemiologia , Acuidade Visual
5.
Lancet Glob Health ; 9(4): e418-e430, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33607015

RESUMO

BACKGROUND: The number of individuals with vision impairment worldwide is increasing because of an ageing population. We aimed to systematically identify studies describing the association between vision impairment and mortality, and to assess the association between vision impairment and all-cause mortality. METHODS: For this systematic review and meta-analysis, we searched MEDLINE (Ovid), Embase, and Global Health database on Feb 1, 2020, for studies published in English between database inception and Feb 1, 2020. We included prospective and retrospective cohort studies that measured the association between vision impairment and all-cause mortality in people aged 40 years or older who were followed up for 1 year or more. In a protocol amendment, we also included randomised controlled trials that met the same criteria as for cohort studies, in which the association between visual impairment and mortality was independent of the study intervention. Studies that did not report age-adjusted mortality data, or that focused only on populations with specific health conditions were excluded. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We graded the overall certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. We did a random-effects meta-analysis to calculate pooled maximally adjusted hazard ratios (HRs) for all-cause mortality for individuals with a visual acuity of <6/12 versus those with ≥6/12; <6/18 versus those with ≥6/18; <6/60 versus those with ≥6/18; and <6/60 versus those with ≥6/60. FINDINGS: Our searches identified 3845 articles, of which 28 studies, representing 30 cohorts (446 088 participants) from 12 countries, were included in the systematic review. The meta-analysis included 17 studies, representing 18 cohorts (47 998 participants). There was variability in the methods used to assess and report vision impairment. Pooled HRs for all-cause mortality were 1·29 (95% CI 1·20-1·39) for visual acuity <6/12 versus ≥6/12, with low heterogeneity between studies (n=15; τ2=0·01, I2=31·46%); 1·43 (1·22-1·68) for visual acuity <6/18 versus ≥6/18, with low heterogeneity between studies (n=2; τ2=0·0, I2=0·0%); 1·89 (1·45-2·47) for visual acuity <6/60 versus ≥6/18 (n=1); and 1·02 (0·79-1·32) for visual acuity <6/60 versus ≥6/60 (n=2; τ2=0·02, I2=25·04%). Three studies received an assessment of low risk of bias across all six domains, and six studies had a high risk of bias in one or more domains. Effect sizes were greater for studies that used best-corrected visual acuity compared with those that used presenting visual acuity as the vision assessment method (p=0·0055), but the effect sizes did not vary in terms of risk of bias, study design, or participant-level factors (ie, age). We judged the evidence to be of moderate certainty. INTERPRETATION: The hazard for all-cause mortality was higher in people with vision impairment compared with those that had normal vision or mild vision impairment, and the magnitude of this effect increased with more severe vision impairment. These findings have implications for promoting healthy longevity and achieving the Sustainable Development Goals. FUNDING: Wellcome Trust, Commonwealth Scholarship Commission, National Institutes of Health, Research to Prevent Blindness, the Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research, Moorfields Biomedical Research Centre, Sightsavers, the Fred Hollows Foundation, the Seva Foundation, the British Council for the Prevention of Blindness, and Christian Blind Mission.


Assuntos
Saúde Global/estatística & dados numéricos , Mortalidade , Transtornos da Visão/epidemiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Índice de Gravidade de Doença , Transtornos da Visão/diagnóstico
6.
Medicine (Baltimore) ; 100(3): e24006, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33545995

RESUMO

INTRODUCTION: Retinitis pigmentosa is a major cause of visual disability and blindness. Photopsia is usually presented in patients with retinal traction caused by posterior vitreous detachment in clinic, which would occur more commonly in those suffer from moderate or high myopia. We describe a patient with leopard-like retinopathy initially complaining of photopsia caused not by myopia but by retinitis pigmentosa. PATIENT CONCERNS: A 39-year-old woman with a history of moderate myopia presented to us complaining of photopsia for several days. DIAGNOSIS: Fundus examination revealed leopard-like retinopathy with normal optic disc and macula appearance in both eyes. The atrophy of retinal pigment epithelium was found in peripheral retina while no bone spicule was present. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa (sine pigmento), later confirmed by genetic testing. INTERVENTIONS: At current no specific treatment was applied, but the patient was required for follow-up observation every six months. OUTCOMES: Follow-up observation. CONCLUSION: This case highlights the potential for retinitis pigmentosa sine pigmento to present with photopsia under cover of myopia and the importance of performing multimodal imaging including fundus autofluorescence for fundus disorders. Careful history review and multimodal imaging with genetic testing would help for the correct diagnosis of retinitis pigmentosa sine pigmento.


Assuntos
Miopia/diagnóstico , Retinite Pigmentosa/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Retinite Pigmentosa/complicações , Transtornos da Visão/etiologia
8.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461994

RESUMO

A 26-year-old male driver presented with a history of pain in the neck for the past 1 week following trauma due to a road traffic accident. The patient had no neurological deficit. He had type 1 diabetes and was on regular oral hypoglycemics. After radiological investigations, the patient was diagnosed to have traumatic AO Spine Classification type C translational injury involving anterolisthesis of C6 over C7. After a detailed preoperative assessment, the patient was taken up for surgery. The patient underwent posterior stabilisation with instrumentation from C5 to T2. On extubation from anaesthesia, he immediately complained of complete painless loss of this vision in his left eye. Ophthalmological investigations attributed the cause to be due to central retinal artery occlusion. The patient was discharged with reassurance on the 20th postoperative day with minimal improvement in his vision and at 6-month follow-up, his vision improved to 1/60 and was advised for close follow-up.


Assuntos
Vértebras Cervicais/lesões , Complicações Pós-Operatórias/diagnóstico , Oclusão da Artéria Retiniana/etiologia , Traumatismos da Coluna Vertebral/cirurgia , Transtornos da Visão/etiologia , Adulto , Vértebras Cervicais/cirurgia , Humanos , Masculino , Oclusão da Artéria Retiniana/diagnóstico , Traumatismos da Coluna Vertebral/diagnóstico , Transtornos da Visão/diagnóstico
9.
J Stroke Cerebrovasc Dis ; 30(4): 105618, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33482571

RESUMO

Recurrent episodes of neurological dysfunction and white matter lesions in a young adult raise suspicion for multiple sclerosis (MS). However, occlusive retinopathy, hearing loss and absence of CSF oligoclonal bands are atypical for MS and should make the clinician consider an alternative diagnosis. We describe a man with hearing loss, visual signs and symptoms, and an accumulating burden of brain lesions, who was treated for a clinical diagnosis of MS for nearly two decades. Genetic testing revealed a unifying diagnosis.


Assuntos
Perda Auditiva Unilateral/etiologia , Doença da Hemoglobina SC/diagnóstico , Hemoglobinas Anormais/genética , Leucoencefalopatias/etiologia , Esclerose Múltipla/diagnóstico , Transtornos da Visão/etiologia , Sequenciamento Completo do Exoma , Erros de Diagnóstico , Predisposição Genética para Doença , Perda Auditiva Unilateral/diagnóstico , Perda Auditiva Unilateral/fisiopatologia , Doença da Hemoglobina SC/complicações , Doença da Hemoglobina SC/genética , Humanos , Leucoencefalopatias/diagnóstico por imagem , Leucoencefalopatias/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Fenótipo , Valor Preditivo dos Testes , Transtornos da Visão/diagnóstico , Transtornos da Visão/fisiopatologia , Adulto Jovem
10.
Ophthalmologe ; 118(2): 197-207, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33443625

RESUMO

Functional visual perception significantly contributes to the child's development and consists of much more than just visual acuity and the visual field. It includes cognitive interpretation of visual stimuli and runs along the temporal and parietal pathways of visual processing. Central visual impairment (CVI) usually affects otherwise healthy children with often good visual acuity, whereas the multiply disabled visually impaired (MDVI) have visual impairment and multiple disabilities. In MDVI patients an ocular and/or CVI can be present. The examination of MDVI patients poses a great challenge for the ophthalmologist and reflective visual test procedures should also be used. Particular attention should be paid to refraction and accommodation. The main ocular diagnosis in MDVI is optic atrophy and the general diagnoses are dominated by sequelae of premature birth, often in combination with spasticity and epilepsy. Early intervention is essential and is independent of the underlying diagnoses.


Assuntos
Oftalmologistas , Baixa Visão , Pessoas com Deficiência Visual , Criança , Humanos , Pais , Estudos Retrospectivos , Transtornos da Visão/diagnóstico
11.
Curr Opin Ophthalmol ; 32(2): 92-97, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33443958

RESUMO

PURPOSE OF REVIEW: Perimetry remains important for the diagnosis and management of glaucoma despite advances in imaging technology. The purpose of this review is to describe advances in the acquisition and analysis of visual field data and highlight novel techniques for performing perimetry. RECENT FINDINGS: Studies have focused on improving the detection of patients at highest risk of severe vision loss and the development of innovative testing strategies that allow for more frequent testing. Artificial intelligence has been utilized in research settings to improve detection and characterization of glaucomatous field damage. Furthermore, tablet-based strategies and virtual reality headsets show promise for glaucoma screening and remote monitoring of patients with glaucoma. SUMMARY: New testing strategies and research findings have improved our ability to identify patients with both paracentral and mid-peripheral visual field progression. New strategies have the potential to make visual field testing more efficient, reliable and accessible for patients with glaucoma.


Assuntos
Glaucoma/diagnóstico , Transtornos da Visão/diagnóstico , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Inteligência Artificial , Progressão da Doença , Humanos , Transtornos da Visão/fisiopatologia
12.
Curr Opin Ophthalmol ; 32(2): 83-91, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33470671

RESUMO

PURPOSE OF REVIEW: The study was undertaken to assess the current importance of clinical examination of the optic nerve head (ONH) in glaucoma management. RECENT FINDINGS: ONH changes in glaucoma are easily assessed with good specificity on examination, whereas imaging has not been able to identify pallor of the neuroretinal rim (NRR), disc hemorrhages, or vascular signs of acquired cupping. Glaucomatous neuropathy in primary open angle glaucoma (POAG) has extensive databases on imaging machines, however, other glaucomas such as primary angle closure glaucoma (PACG), juvenile open angle glaucoma (JOAG), congenital, and secondary glaucomas have been reported to have a significantly different ONH morphology. Clinical evaluation with knowledge of the underlying cause of glaucoma allows easy diagnosis of any abnormality, whereas the absence of an imaging database in such eyes makes diagnosis difficult on optical coherence tomography (OCT) and so forth. In eyes with congenital anomalies and dysplastic discs, clinical examination and history provide better identification of glaucomatous damage. Staging of glaucoma on ONH examination when perimetry is unreliable provides a means of determining the amount of damage and appropriate reduction of intraocular pressure (IOP). SUMMARY: Clinical examination of the ONH is very relevant for screening, diagnosis, staging, and management of all glaucomas, and is irreplaceable in detecting nonglaucomatous causes of ONH cupping and visual field defects similar to those in glaucoma.


Assuntos
Glaucoma/diagnóstico , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Exame Físico , Humanos , Pressão Intraocular , Tonometria Ocular , Transtornos da Visão/diagnóstico , Transtornos da Visão/fisiopatologia , Testes de Campo Visual/métodos , Campos Visuais/fisiologia
13.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504525

RESUMO

Upside-down reversal of vision (UDRV) is a rare form of metamorphopsia, or visual illusions that can distort the size, shape or inclination of objects. This phenomenon is paroxysmal and transient in nature, with patients reporting a sudden inversion of vision in the coronal plane, which typically remains for seconds or minutes, though occasionally persists for hours or days, before returning to normal. Distorted egocentric orientation (ie, the patient perceives the body to be tilted away from the vertical plane) is even more rare as a co-occurring phenomenon. To the best of our knowledge, this is the first reported case of a veteran who presented with UDRV and distorted egocentric orientation during hospitalisation on an inpatient physical medicine and rehabilitation setting following an elective hip surgery. This case serves not only to document the presence of rare visual illusions, but also illustrates the importance and value of an interdisciplinary team approach.


Assuntos
Doença de Graves/diagnóstico , Ilusões , Transtornos da Percepção/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Veteranos , Transtornos da Visão/diagnóstico , Idoso , Antitireóideos/uso terapêutico , Artroplastia de Quadril , Moldes Cirúrgicos , Endocrinologia , Doença de Graves/tratamento farmacológico , Luxação do Quadril/cirurgia , Hospitais de Veteranos , Humanos , Masculino , Metimazol/uso terapêutico , Neuropsicologia , Equipe de Assistência ao Paciente , Transtornos da Percepção/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Psiquiatria , Reoperação , Transtornos da Visão/fisiopatologia
15.
Ophthalmologe ; 118(2): 113-118, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33315139

RESUMO

BACKGROUND: Neuronal ceroid lipofuscinoses are hereditary lysosomal storage diseases, which lead to a progressive neurodegeneration of the brain and retina. Visual loss can be the initial symptom but can also occur later in the course of the disease. OBJECTIVE: The aim of this article is to provide ophthalmologists with an overview of the characteristic ocular alterations and the general disease course of the 13 currently known various forms of NCL. MATERIAL AND METHODS: The findings from predominantly clinical articles are reviewed and summarized. RESULTS AND CONCLUSION: Retinal degeneration plays a crucial role in this group of neurodegenerative diseases. In several forms visual decline is the initial clinical symptom in affected patients. Therefore, the ophthalmologist is the first medical expert consulted. An early diagnosis is crucial for the future personal and family planning but is also important regarding upcoming therapeutic strategies, which might be much more effective in patients with early stage disease. When the presence of retinal degeneration due to an NCL disease is suspected an immediate genetic diagnostic confirmation and collaboration with neuropediatricians is recommended.


Assuntos
Lipofuscinoses Ceroides Neuronais , Oftalmologistas , Encéfalo , Humanos , Lipofuscinoses Ceroides Neuronais/diagnóstico , Lipofuscinoses Ceroides Neuronais/genética , Lipofuscinoses Ceroides Neuronais/terapia , Retina , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia
16.
Medicine (Baltimore) ; 99(50): e23183, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327235

RESUMO

Most of the craniopharyngioma is considered to derive from residual epithelial cells during the craniopharyngeal canal degeneration. Meningioma accounting for the primary intracranial neoplasm is considered to be mainly derived from cells of arachnoid granulations. Nevertheless, rare cases show coexistence of craniopharyngioma and meningioma.Case 1: A 43-year-old male patient referred to the hospital due to paroxysmal headache combined with blurred vision for 1 month. On physical examination, the visual acuity of left eye was poorer than that of the right eye. The visual acuity of the right eye near the nasal part showed defect.MRI and pathological examination were performed. The patient received intracranial tumor resection. After surgery, the patient showed hormone disorder, followed by corresponding treatment. However, the patient was lost in the 6-month follow-up.Case 2: The 64-year-old male patient presented to our department due to decline of visual acuity within 1 year combined with polydipsia (5,000 ml per day), polyuria and fatigue for 6 months. On physical examination, the bilateral visual acuity showed decline, especially the temporal part which was nearly hemiscotosis. MRI was performed. The adamantinomatous craniopharyngioma was diagnosed with the HE staining findings. The patient received intracranial resection. After surgery, the patient was in a deep coma condition, and was lost in the follow-up.In this case study, we presented 2 patients with coexistence of craniopharyngioma and meningioma. In addition, a complete literature review was carried out to illustrate the studies on coexistence of craniopharyngioma and meningioma. Meanwhile, we tried to explain the possible mechanisms for such condition.


Assuntos
Craniofaringioma/complicações , Craniofaringioma/cirurgia , Meningioma/complicações , Meningioma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Craniofaringioma/diagnóstico por imagem , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Perda de Seguimento , Imagem por Ressonância Magnética/métodos , Masculino , Neoplasias Meníngeas/patologia , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Neoplasias Hipofisárias/patologia , Polidipsia/diagnóstico , Polidipsia/etiologia , Poliúria/diagnóstico , Poliúria/etiologia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Acuidade Visual
17.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318255

RESUMO

Influenza-associated encephalopathy/encephalitis (IAE) can result in serious neurological complications. We report a 4-year-old healthy female child with the diagnosis of IAE. Her clinical course was complicated by temporary visual impairment and significant motor deficits. Her unique ophthalmological findings have little precedent in previous literature.


Assuntos
Encefalopatias/diagnóstico , Encefalopatias/virologia , Influenza Humana/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/virologia , Encéfalo/patologia , Encéfalo/virologia , Encefalopatias/fisiopatologia , Pré-Escolar , Feminino , Humanos , Vírus da Influenza B , Imagem por Ressonância Magnética , Transtornos da Visão/fisiopatologia
18.
Niger J Clin Pract ; 23(11): 1500-1506, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221772

RESUMO

Objective: To evaluate the relationship between visual acuity (VA) and endocrine status among patients with giant sellar tumors pre and postsurgical treatment. Methods: A 7-year single institution prospective cohort study of patients with giant sellar tumors treated by pterional transylvian microsurgical resection. Patients were evaluated and followed-up by a collaborative team of ophthalmologists and neurosurgeons. Results: Sellar tumors represent 25% of our brain tumors cases (n = 257). Giant sellar tumors were 61 (23.7%) cases. Pituitary adenomas occurred in 40 patients and in 24 of these, the tumor was a functional adenoma. The age range was 16 to 75 years with a mean of 43.7 ± 3.3 years. Visual impairment (n = 60), headache (n = 55), and endocrinopathy (24) were among the common manifestations. VA and visual field defects were experienced by 59 and 39 patients, respectively. For both eyes, endocrine active tumors presented with poorer preoperative VA profile using mean logMAR VA [(χ2 = 10.3, P = 0.002 OD) and (χ2 = 8.9, P = 0.003 OS)]. Postoperatively, the mean logMAR VA profiles of endocrine active tumors showed a significantly better response when compared to endocrine inactive tumors in both eyes [(χ2 = 5.53, P = 0.029 OD) and (χ2 = 6.77, P = 0.037 OS)]. Conclusion: Visual acuity defects are almost invariable in patients with giant sellar tumor and may be associated with an endocrine profile. Surgical resection with normalization of hormone status is rewarded with VA improvement.


Assuntos
Adenoma/cirurgia , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Neoplasias Hipofisárias/cirurgia , Transtornos da Visão/etiologia , Acuidade Visual/fisiologia , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/complicações , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Recuperação de Função Fisiológica/fisiologia , Resultado do Tratamento , Transtornos da Visão/diagnóstico , Campos Visuais/fisiologia , Percepção Visual/fisiologia , Adulto Jovem
19.
Klin Monbl Augenheilkd ; 237(11): 1306-1311, 2020 Nov.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-33202463

RESUMO

Pituitary tumours are a common cause of functional impairment and degeneration of the anterior visual pathway. Depending on localization and size, they clinically manifest as initially reversible visual field defects. As part of interdisciplinary tumour management, ophthalmologic examinations are of particular importance concerning diagnostics, indication for tumour resection and documentation of functional surgical results. Based on the relationship between clinical dysfunction and manifest atrophy, together with the patient's age and the duration of symptoms, the ophthalmologist can provide insights into the postoperative visual prognosis. Under good conditions, surgical tumour resection often results in significant improvements to visual fields and acuity. Long-term ophthalmological controls are required in cases of persistent visual loss, radiotherapy or tumour remnants abutting the visual pathway.


Assuntos
Adenoma , Neoplasias Hipofisárias , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/cirurgia , Humanos , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/terapia , Testes de Campo Visual , Campos Visuais
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