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1.
Ophthalmologe ; 118(1): 81-94, 2021 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-33394092

RESUMO

The posttraumatic ocular hypotony (3% after ocular contusion, 50-74% after open globe injury) can lead to severe secondary damage of the eyeball. In addition to corneal folds, ciliary body and choroidal detachment, papilledema e vacuo and macular folds, the shrinking of the eye can lead to substantial visual impairment. Subsequently, the contralateral eye may react with ocular hypertension. The cause of the hypotony must be identified and causally treated. A preservation of the globe is possible if more than 210 ° of the ciliary body are intact. One of the major causes of posttraumatic hypotony is cyclodialysis. Smaller cyclodialysis clefts respond to a cycloplegic treatment, larger clefts require a surgical approach. The direct cyclopexy can be combined with primary wound repair or pole to pole surgery. An alternative consists of silicone oil endotamponade or occlusion of Schlemm's canal. The posttraumatic ocular hypotony is complex and requires exact diagnostics to be able to differentially and specifically treat the causes of hypotony.


Assuntos
Traumatismos Oculares , Hipotensão Ocular , Corpo Ciliar/cirurgia , Tamponamento Interno , Traumatismos Oculares/complicações , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/cirurgia , Humanos , Pressão Intraocular , Hipotensão Ocular/diagnóstico , Hipotensão Ocular/etiologia
3.
Rev. inf. cient ; 99(5): 461-467, tab
Artigo em Espanhol | LILACS | ID: biblio-1139208

RESUMO

RESUMEN * Introducción: En el Hospital General Docente "Dr. Agostinho Neto" se desconocen las características de los pacientes atendidos por trauma ocular. Objetivo: Caracterizar el trauma ocular en pacientes ingresados en el servicio de Oftalmología del citado hospital en el período de enero de 2014 a julio de 2019. Método: Se realizó un estudio descriptivo, retrospectivo y longitudinal del total de pacientes con este diagnóstico (n=49). Se estudiaron las variables: sexo, edad, procedencia, ocupación, tipo de trauma, diagnóstico y complicaciones, y modificaciones de la agudeza visual de acuerdo al tratamiento que aplicó. Resultados: El 79,0 % de los pacientes fueron hombres, tenían entre 19 y 40 años de edad (43,0 %), procedían de áreas rurales (57,0 %) y se dedicaban a labores agrícolas (45,0 %). El 76,0 % presentó un trauma ocular abierto, la herida corneal fue el más usual (55,1 %). El 95,9 % de los pacientes recibieron tratamiento quirúrgico y reparación de la herida el 83,6 %. Antes y después del tratamiento, el 47,0 % y el 41,0 % respectivamente de los pacientes presentaron agudeza visual y visión cuenta dedos a percepción luminosa. La catarata traumática fue la complicación más frecuente (33,0 %). Conclusiones: El trauma no es un problema de salud, pero sí limita la calidad de vida de los perjudicado al afectar la agudeza visual.


ABSTRACT * Introduction: The characteristics of the patients with eye trauma treated in the General Teaching Hospital Dr. Agostinho Neto remain mostly unknown. Objective: To characterize eye trauma in the patients in the ophthalmology consultation in the mentioned institution, in the stretch of time between January 2014 to July 2019. Method: A descriptive, retrospective and longitudinal study was carried out on the total amount of patients with the diagnosis (n=49). The different variables taken into account were: gender, age, place of origin, occupation, type of trauma, diagnosis and complications, and the modifications in visual acuity according to the treatment given. Results: 79.0 % of the patients were men, with ages ranging between 19 to 40 years old (43.0 %), from rural areas (57.0 %), and involved in agricultural works (45.0 %). 76.0 % were open eye traumas, being corneal wounds the most common one (55.1%). 95.9 % of the patients were surgically treated, and 83.6 % went through wound healing processes. Before and after the treatment, the 47.0 % and the 41.0 % of the patients, respectively, presented visual acuity and good 'counting fingers' and 'visual perception' tests results. Traumatic cataracts were the most common complication (33.0 %). Conclusions: eye traumas are not a significant health issue, but impacts directly in the life quality of the affected, damaging their visual acuity.


Assuntos
Humanos , Traumatismos Oculares/cirurgia , Traumatismos Oculares/complicações , Traumatismos Oculares/diagnóstico , Acuidade Visual , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos Longitudinais
5.
Am J Ophthalmol ; 218: 78-83, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32574776

RESUMO

PURPOSE: This study investigated the clinical manifestation and risk factors associated with remission in filamentary keratitis. DESIGN: Retrospective, interventional, comparative case series. METHODS: We retrospectively reviewed the medical records of 116 patients with filamentary keratitis diagnosed and treated between January 2012 and December 2018. We investigated the 5 causative factors including brain lesion, dry eye syndrome, autoimmune disease, ocular surgery or injury, and other conditions; treatment methods and duration; and remission status, and analyzed the risk factors associated with remission. RESULTS: The mean age of the patients was 56.9 ± 19.1 years and the mean follow-up duration was 14.9 ± 22.8 months. The most common underlying condition associated with filamentary keratitis was identified as a brain lesion (36.2%), followed by dry eye syndrome (30.2%) and autoimmune disease (24.1%). A comparison of remission rates among the causative factors revealed that cases associated with brain lesions had significantly lower remission rates (33.3%) than those associated with other causative factors (>60%) (P = .001). After adjustment for sex, age, diabetes mellitus, and hypertension, the treatment failure rate in patients affected by brain lesions was 6.602-fold higher than that associated without brain lesion (P = .001). The treatment method-dependent differences in the remission rate were observed in brain lesion and dry eye syndrome (P = .041 and P = .005, respectively). CONCLUSIONS: The most common condition leading to filamentary keratitis was a brain lesion, followed by dry eye syndrome and autoimmune disease. The treatment failure rate was statistically significantly low only in patients with filamentary keratitis associated with brain lesions.


Assuntos
Doenças Autoimunes/complicações , Encefalopatias/complicações , Síndromes do Olho Seco/complicações , Traumatismos Oculares/complicações , Ceratite/diagnóstico , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Acetilcisteína/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Fluoresceína/administração & dosagem , Seguimentos , Depuradores de Radicais Livres/administração & dosagem , Humanos , Ceratite/etiologia , Ceratite/terapia , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Estudos Retrospectivos , Fatores de Risco , Soro/fisiologia , Microscopia com Lâmpada de Fenda
6.
J Craniofac Surg ; 31(5): e522-e525, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32541272

RESUMO

INTRODUCTION: A closed globe trauma is often associated with orbital wall fractures. In addition to diplopia, further eye disturbances can be observed. The aim of this preliminary prospective study was to investigate the optical coherence tomography (OCT) findings in patients that presented with orbital fractures in association with diplopia but without decreased visual acuity or further ocular symptoms. METHODS: Only patients who were admitted and surgically treated for orbital wall fractures and that presented diplopia were included in this study. Patients with post traumatic ocular symptoms were excluded. All the patients that were diagnosed with an orbital fracture underwent an ophthalmological assessment, including best-corrected visual acuity (BCVA), examination of fundus oculi, Hess Scheme, OCT, and OCT angiography. RESULTS: Five patients met the inclusion criteria and were enrolled. Hess Scheme examinations confirmed the presence of diplopia in all the included patients. The examination of fundus oculi did not reveal any pathology in 4 patients, whereas in a patient a commotio retinae (Berlin's Edema) was diagnosed in the infero-papillary field. Following OCT assessment, a pachycoroid was observed in 4 patients. CONCLUSIONS: A thorough ophthalmological assessment in patients that have suffered from orbital fractures is fundamental. In particular, OCT examinations seem to provide more insight into the detection and monitoring of choroidal changes after ocular trauma without visible macular changes.


Assuntos
Fraturas Orbitárias/diagnóstico por imagem , Adolescente , Adulto , Diplopia/diagnóstico , Diplopia/etiologia , Traumatismos Oculares/complicações , Traumatismos Oculares/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas Orbitárias/complicações , Fraturas Orbitárias/cirurgia , Estudos Prospectivos , Tomografia de Coerência Óptica , Acuidade Visual , Adulto Jovem
8.
Zhonghua Yan Ke Za Zhi ; 56(5): 370-375, 2020 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-32450670

RESUMO

Objective: To analyze the clinical characteristics and treatment of ocular injury caused by chestnut burr. Methods: Retrospective case series study. Data of 48 patients (48 eyes) with ocular injuries caused by chestnut burrs hospitalized in Qingdao Eye Hospital were collected from January 2013 to March 2019. All patients were followed up for at least 3 months. The time of seeking medical advice, lesion region, and characteristics and treatment methods were analyzed. Results: There were 48 patients, including 33 males and 15 females, aged 19 to 74 years [mean, (56±10) years]. The time of injury was late September (25 cases) and early October (23 cases). The shortest time to visit our hospital was 3 hours after injury, and the longest was 8 months after injury. There were 13 cases (27.1%, 13/48) with corneal and/or scleral foreign bodies. All patients were treated with corneal or scleral foreign body extraction. Twenty-four patients (50.0%, 24/48) developed fungal keratitis. Among them, 18 patients had a corneal ulcer, and the infection involved the superficial or full-thickness corneal layer. Six patients had no corneal ulcer, and the infection involved the deep stroma and corneal endothelial surface. The positive rate of fungal examination by confocal microscopy was 87.5% (21/24). Antifungal drugs (2 cases), corneal debridement (5 cases), conjunctival flap covering (2 cases), corneal stroma injection (1 case), and penetrating keratoplasty(14 cases) were given according to the depth of fungal infection. Most of the pathogens were Alternaria spp. Eleven patients (22.9%, 11/48) with necrotizing scleritis were treated with exploration of the sclera. Three patients had scleral foreign body residues on ultrasound biomicroscopy examination, which were removed by operation. Four patients were found to have fungi at the necrotic site of the sclera. Conclusions: The main types of ocular injuries caused by chestnut burrs are corneal and/or scleral foreign bodies, fungal keratitis, and necrotizing scleritis. Chestnut burr foreign bodies should be removed as soon as possible. In the case of fungal keratitis, a drug or surgical intervention should be carried out as early as possible. Necrotizing scleritis is often induced by long-term foreign body retention. Scleral incision and exploration is an effective form of treatment. (Chin J Ophthalmol, 2020, 56: 370-375).


Assuntos
Úlcera da Córnea , Infecções Oculares Fúngicas , Traumatismos Oculares , Micoses , Adulto , Idoso , Antifúngicos , Traumatismos Oculares/complicações , Traumatismos Oculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
9.
Tunis Med ; 98(1): 49-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32395777

RESUMO

AIM: Various materials for reconstruction of bone defects in orbital floor fractures have been developed and clinically applied. The aim of this study is to evaluate the contribution of using the Polypropylene mesh as a reconstructive material for orbital floor mean-size defects. METHODS: We retrospectively reviewed the clinical charts of 40 patients who underwent post traumatic orbital floor reconstructive surgery. The selection criterias were : unilateral Blow-out orbital floor fracture with a defect size less then 2 cm² and the presence of diplopia, orbital tissue incarceration or enophtalmous ≥ 2mm. RESULTS: A male predominance was observed (82.5%) with a mean age of 31.3 years. The main injury etiology was vehicle accidents (62.5%). Preoperatively, diplopia (62.5%) and enophtalmous (50%) were predominant. The diagnosis of fracture was confirmed by the computed tomography. The orbital floor was explored via a transconjunctival approach in the majority of cases (92.5%). The reconstruction was made with polypropylene mesh. No infection or exposure of the material had happened. Postoperatively, diplopia remained in 36% of cases, enophtalmos in 15% of cases and infraorbital nerve hypoesthesia in 33.3% of cases. CONCLUSIONS: In this study, we found that since the availibility, the non resorbable character, the easy manipulation and the stability of the postoperative results which are similar to those of other studies, the Polypropylene mesh could be introduced in the reconstruction of the mean-size orbital floor fractures.


Assuntos
Procedimentos Cirúrgicos Oftalmológicos/métodos , Fraturas Orbitárias/cirurgia , Polipropilenos/uso terapêutico , Procedimentos Cirúrgicos Reconstrutivos/métodos , Telas Cirúrgicas , Diplopia/epidemiologia , Diplopia/etiologia , Diplopia/cirurgia , Traumatismos Oculares/complicações , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/cirurgia , Humanos , Procedimentos Cirúrgicos Oftalmológicos/estatística & dados numéricos , Órbita/lesões , Fraturas Orbitárias/epidemiologia , Fraturas Orbitárias/etiologia , Polipropilenos/química , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
12.
J Mycol Med ; 30(1): 100922, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31959581

RESUMO

BACKGROUND: To report a case of fungal keratitis caused by Colletotrichum gloeosporioides in an east coast city of China, which are rare pathogens that cause fungal keratitis in humans. METHODS: A 52-year-old man whose right eye was injured by a branch of an apple tree during farm work was referred to our Hospital. He was examined by Slit-lamp and the HRT II-RCM confocal scanning microscope, thus suggesting filamentous. Orneal scrapings were acquired and then inoculated into Sabouraud medium incubated at 28°C and 37°C. In vitro antifungal susceptibility tests were performed following the CLSI M38-A2 for Filamentous Fungi. Surgical intervention was advised because the abscess in the anterior chamber of the right eye was not completely absorbed. RESULTS: The Colletotrichum gloeosporioides isolate was identified by MALDI-TOF mass spectrometry and the BLAST after DNA sequencing of the amplified internal transcribed spacer (ITS) in rRNA. The patient's eye condition is under control and the patient's vision remains at the level of light perception (LP). CONCLUSIONS: We report the rare keratitis caused by C. gloeosporioides in eastern China, which has not been published. Suddenly ocular trauma and old surgical intervention may be the risk factors associated with Colletotrichum keratitis.


Assuntos
Colletotrichum/isolamento & purificação , Infecções Oculares Fúngicas/microbiologia , Ceratite/microbiologia , Antifúngicos/uso terapêutico , China , Colletotrichum/genética , Úlcera da Córnea/tratamento farmacológico , Úlcera da Córnea/microbiologia , Úlcera da Córnea/cirurgia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/tratamento farmacológico , Infecções Oculares Fúngicas/cirurgia , Traumatismos Oculares/complicações , Traumatismos Oculares/tratamento farmacológico , Traumatismos Oculares/microbiologia , Traumatismos Oculares/cirurgia , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Ceratite/cirurgia , Masculino , Malus/microbiologia , Pessoa de Meia-Idade , Técnicas de Tipagem Micológica/métodos , Análise de Sequência de DNA , Árvores/microbiologia
15.
Br J Sports Med ; 54(1): 23-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30988018

RESUMO

OBJECTIVES: To describe ocular injuries caused by badminton and to explore the implications for future prevention strategies. METHODS: We enrolled 85 patients with ocular trauma caused by badminton. Information collected from patients included type of game, instigator, instrument of injury and lessons in badminton from a professional, and ocular trauma information such as type of injury, treatment and final outcomes. RESULTS: The 85 patients (52 men, 33 women) were aged 15-65 years with an average age of 42.9 (±10.7) years. In 60 cases the player was hit by a shuttlecock and in 25 the player was hit by a racquet. 73 cases occurred in doubles matches and 10 in singles matches. In 31 cases the trauma was caused by an opponent and in 52 cases by a partner; 2 cases involved bystanders, not players. About 70% (43/61) of the injured and 82% (40/49) of the instigators had not received badminton lessons from a professional. 80 injuries were non-penetrating and 5 were penetrating. There were 58 cases with hyphaema, 36 with secondary glaucoma, 23 with lens subluxation and 2 with retinal detachment. Surgery comprised phacoemulsification or lensectomy and vitrectomy in 16 cases, silicone oil tamponade in 2 cases, trabeculectomy in 3 cases and direct cyclopexy in 5 cases. CONCLUSION: The vast majority of the badminton related eye injuries occurred among doubles players and were instigated by the injured person's partner. Non-penetrating injury was more frequent; penetrating injury was usually more serious. We recommend that badminton players use protective eyewear and receive safety education and professional coaching/instruction on techniques to protect against serious eye injuries.


Assuntos
Traumatismos Oculares/etiologia , Traumatismos Oculares/prevenção & controle , Esportes com Raquete/lesões , Adolescente , Adulto , Traumatismos Oculares/complicações , Traumatismos Oculares/cirurgia , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/etiologia , Ferimentos Oculares Penetrantes/prevenção & controle , Ferimentos Oculares Penetrantes/cirurgia , Dispositivos de Proteção dos Olhos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/etiologia , Ferimentos não Penetrantes/prevenção & controle , Ferimentos não Penetrantes/cirurgia , Adulto Jovem
16.
J Glaucoma ; 29(1): 67-70, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31460884

RESUMO

During blunt ocular trauma, the anteroposterior compressive forces confronted lead to consequent equatorial expansion of the globe. This may result in ciliary body trauma, typically manifesting as angle recession or cyclodialysis. The authors hypothesize that a likely asymmetric contraction between the longitudinal and circular ciliary fibers, and an intrinsic weak "oblique buffer zone" creates a plane of separation between the 2, resulting in angle recession. When stronger forces are met with, the equatorial expansion of the sclera may outperform the ability of the ciliary body to follow it, and the taut longitudinal ciliary fibers may subsequently disinsert from the scleral spur causing cyclodialysis. In addition to this, the routinely thought dismembering aqueous jets directed toward the angle may also accentuate ciliary body trauma. Therefore, the vivid distractive external forces along with the complex ciliary muscle anatomy and differential functionality may play a crucial role in causation of post-traumatic angle recession and cyclodialysis.


Assuntos
Segmento Anterior do Olho/patologia , Corpo Ciliar/lesões , Fendas de Ciclodiálise/etiologia , Traumatismos Oculares/complicações , Ferimentos não Penetrantes/complicações , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino
18.
BMC Ophthalmol ; 19(1): 239, 2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31771544

RESUMO

BACKGROUND: So far only single cases with short follow-up have been reported on the use of intravitreal anti-VEGF for traumatic choroidal neovascularizations (CNV). This paper reports a large case series of patients with CNV secondary to choroidal rupture after ocular trauma receiving intravitreal anti-VEGF (vascular endothelial growth factor) injections. METHODS: Fifty-four patients with unilateral choroidal rupture after ocular trauma diagnosed between 2000 and 2016 were retrospectively evaluated. Eleven patients with CNV secondary to choroidal rupture were identified. Five eyes with traumatic secondary CNV were treated with anti-VEGF and were systematically analysed. The other 4 patients with inactive CNV underwent watchful observation. RESULTS: Four men and one woman with a mean age of 29 years (SD 12.4; range 19-45) had intravitreal anti-VEGF therapy for traumatic CNV. Another 4 patients with a mean age of 37 years (SD 6.6; range 31-46) presented with inactive CNV and did not receive specific treatment. In all 9 cases the mean interval between the ocular trauma and the diagnosis of CNV was 5.7 months (SD 4.75; range 2-12). In the treatment group per eye 4.2 injections (SD 3.2; range 1-8) were given on average. Four eyes were treated with bevacizumab and one eye with ranibizumab. Regression of CNV was noted in all eyes. In 4 eyes visual acuity (VA) improved, one eye kept stable visual acuity. CONCLUSIONS: Here, we present the up to now largest case series of traumatic CNV membranes treated with anti-VEGF injections with a mean follow-up period of 5 years. Intravitreal anti-VEGF therapy seems to be safe and effective for secondary CNV after choroidal rupture. Compared to exudative age-related macular degeneration fewer injections are needed to control the disease. TRIAL REGISTRATION: Retrospective registration with local ethics committee on 21 March 2019. Trial registration number is 19-1368-104.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Corioide/lesões , Neovascularização de Coroide/tratamento farmacológico , Traumatismos Oculares/complicações , Ranibizumab/uso terapêutico , Adulto , Neovascularização de Coroide/etiologia , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura/complicações , Acuidade Visual , Adulto Jovem
20.
Saudi Med J ; 40(10): 1063-1066, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588488

RESUMO

OBJECTIVES: To describe causes of blindness and visual impairment (VI) in children in Eastern province, Saudi Arabia. Methods: A record-based descriptive cross-sectional study was conducted. Medical records of patients aged 2 to 16 years who were following up in the Pediatric Ophthalmology Clinics, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia between September and December 2018 were reviewed. Causes of vision loss according to visual acuity (VA) with best correction were recorded. Blindness was defined as VA less than 20/400, VI as VA from 20/400 to 20/60, and visual loss as VA of ≤20/60. RESULTS: Of 818 patients, 39% had visual loss, 22.9% were blind, and 71.2% had VI. Common etiologies of bilateral blindness were retinal dystrophy disease and Leber's congenital amaurosis, whereas unilateral blindness was most common due to trauma and refractive error (RE). Common etiologies of bilateral VI were RE, esotropia, and retinal dystrophy. Unilateral VI was mainly due to RE, cataract, congenital esotropia, and trauma. Of all patients, 58.8% had treatable causes, 22.6% had preventable causes, and 19.5% had non-preventable and non-treatable causes; mostly genetic or congenital (59.7%) rather than acquired (40.2%). CONCLUSION: Genetic or congenital causes are major factors causing blindness. Most causes are treatable and preventable, emphasizing on early detection and treatment of those causes.


Assuntos
Cegueira/etiologia , Adolescente , Fatores Etários , Cegueira/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Traumatismos Oculares/complicações , Traumatismos Oculares/epidemiologia , Feminino , Humanos , Masculino , Distrofias Retinianas/epidemiologia , Distrofias Retinianas/etiologia , Arábia Saudita/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia
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