Multimodal Imaging Features of the Posterior Segment in Ocular Syphilis and HIV Co-Infection: A Single Center Case Series.

OBJECTIVE: To analyze the frequent multimodal imaging features in posterior syphilitic uveitis. PURPOSE: Syphilis infection has re-emerged as a global health problem. Multimodal imaging approach has been proposed for diagnosis and follow-up; there are not previous reports dedicated to the anatomic and visual outcomes in patients diagnosed with ocular syphilis and concomitant HIV infection. METHODS: All demographic information was recovered; a complete ophthalmological examination and multimodal imaging evaluation (retinal fluorescein angiography (FA), autofluorescence (AF), optical coherence tomography (OCT)) were performed on initial visit and 1 month after antibiotic therapy. RESULTS: 18 eyes of 9 patients were included. The most frequent features observed were: Hyperfluorescence on optic disk on FA, Hyperautofluorescence punctate pattern on AF, Vitritis on SD-OCT. After treatment, there was a functional and anatomical improvement. CONCLUSION: Ocular syphilis represents a diagnostic challenge. Multimodal imaging approach allows identification of structural changes, follow-up and early detection of complications.

Characterization of nonpathological intrascleral cartilage in the domestic sheep (Ovis aries) / Caracterização de cartilagem intraescleral não patológica em ovinos (Ovis aries)

Birds, cartilaginous and teleost fish, reptiles, and some amphibians have intrascleral cartilage and/or bone; however, these are rarely reported in therian mammals. This study aimed to investigate and characterize a nonpathological formation of cartilage in the posterior sclera of sheep macroscopically, histologically, and by immunohistochemical exam (IHC). Ninety eyes from 45 domestic sheep were collected, underwent gross examination, fixed in formalin, and embedded in paraffin for the microscopical assessment. Sections with histological shreds of cartilage were selected to perform IHC to confirm the presence of cartilage. Intrascleral cartilage was detected in 60 eyeballs (66.66%) from 37 sheep (82.22%). A slight whitish thickening was grossly seen in the posterior sclera. The histologic exam revealed a few scattered, isolated chondrocytes to larger aggregates of cartilaginous islands in the posterior sclera. Eighteen (30%) of 60 eyeballs revealed marked anti-collagen type II immunolabeling. The development of cartilaginous structures in the eyes is considered rare in mammalian animals. The high occurrence of intrascleral cartilage in the examined sheep eyes suggests that this finding corresponds to an anatomical component of sheep sclera, despite the age, breed, or body condition.

Aves, peixes cartilaginosos e teleósteos e répteis, bem como alguns anfíbios possuem cartilagem e/ou osso intraescleral, contudo, isso é raramente descrito em marsupiais. O objetivo deste trabalho foi investigar e caracterizar a formação não patológica de cartilagem hialina na esclera posterior de ovinos, por exame macroscópico, histológico e imuno-histoquímico. Olhos de 45 ovinos foram coletados, submetidos a exame macroscópico, fixados em formalina a 10% tamponada e incluídos em parafina para o exame histológico. Amostras com evidência de formação cartilaginosa ao exame histológico foram selecionadas para a realização da técnica de imuno-histoquímica para confirmação. Cartilagem intraescleral foi detectada em 60 amostras oculares (66,66%) de 37 ovinos (82,22%), caracterizada na avaliação macroscópica como discretos espessamentos esbranquiçados na esclera posterior. O exame histológico revelou formações que variaram de condrócitos isolados e dispersos a grandes agregados, formando ilhas cartilaginosas na esclera. Dezoito (30%) de 60 bulbos oculares mostraram imunomarcação anti-colágeno tipo II. O desenvolvimento de estruturas cartilaginosas nos bulbos oculares é considerado raro em mamíferos. A identificação de cartilagem intraescleral em 66% dos olhos ovinos avaliados no estudo indica que a formação de cartilagem corresponde a um componente anatômico normal na esclera de ovinos, independente de idade, raça ou condição corporal.

B-Mode and Doppler ocular ultrasound evaluation in healthy and positive dogs for visceral canine leishmaniasis

Background: The use of ultrasound examination in the evaluation of ophthalmopathies has been gaining more and more space within the ophthalmologic clinical routine. The hemodynamic study of ocular vascularization may anticipate future changes, aiding in the adequate establishment of therapeutic conduits. The objective of this study was to evaluate the structures of the ocular bulb and to perform the hemodynamic evaluation of the flow of the external ophthalmic artery of dogs with canine visceral leishmaniasis (CVL) correlating with healthy animals. Materials, Methods & Results: For this purpose, 100 animals were used, of these 70 positive for CVL and 30 healthy animals, submitted to B-mode and Doppler ultrasound examination. Two-dimensional evaluation included identification of ocular changes and biometry of the following segments: axial length (M1), anterior chamber depth (M2), lens thickness (M3), lens length (M4), glass chamber depth (M5), optical disc length (M6) and optic nerve length (M7). The Doppler velocimetric evaluation included the identification and hemodynamic evaluation of the external ophthalmic artery, being measured: systolic peak velocity (SPV), final diastolic velocity (FDV), resistivity index (RI) and pulsatility index (PI). Ophthalmopathies were frequent in animals with leishmaniasis in both right (91.42%) and left (29.14%) eyes, with identification of capsular cataract, lens dislocation, retinal detachment and lens rupture. No significant statistical difference (P > 0.05) was observed when comparing the biometric values between the right and left eyes of the animals with CVL, as well as for the measurements between healthy and CVL animals. Hemodynamic indexes of the flow of the external ophthalmic artery presented narrow limits for the right and left eyes of the positive animals, not statistically...

Esclerite posterior / Posterior scleritis

Resumo Esclerite Posterior (EP) é uma inflamação do segmento escleral posterior, de etiologia inflamatória ou infecciosa, pouco diagnosticada, com evolução rápida, progressiva e irreversível com severo comprometimento visual, principalmente se o diagnóstico e o tratamento da (EP) não forem realizados a tempo hábil. A dor ocular, dor à movimentação ocular, cefaléia e embaçamento visual são os principais sinais e sintomas. Pode ser de causa Idiopática ou associada a doença sistêmica em até 45% dos caso. A Artrite Reumatoide é descrita como a associação mais comum. Causas infecciosas podem estar presente tais como: Herpes Simples, Herpes Zoster Oftálmico, Sífilis e Tuberculose. A bilateralidade pode ocorrer em até 35% dos casos sendo mais prevalente em mulheres a partir da quinta década de vida.

Abstract Posterior Scleritis (PS) is an inflammation of the posterior scleral segment, of low inflammatory or infectious etiology, with a rapid, progressive and irreversible evolution with severe visual impairment, especially if the diagnosis and treatment of (PS) are not performed in time skillful. Ocular pain, eye movement pain, headache and visual haze are the main signs and symptoms. It can be of idiopathic cause or associated with systemic disease in up to 45% of the cases. Rheumatoid arthritis is described as the most common association. Infectious causes may be present such as: Simple Herpes, Ophthalmic Herpes Zoster, Syphilis and Tuberculosis. Bilaterality can occur in up to 35% of cases being more prevalent in women from the fifth decade of life.

Proptosis ocular a causa de la infección-enfermedad por VIH-sida / Ocular proptosis caused by HIV-AIDS infection-disease

RESUMEN Se presenta a un paciente que ingresó en el antiguo Hospital Provincial Clínico Quirúrgico Docente "José Ramón López Tabrane", de Matanzas. El motivo del ingreso fue una proptosis ocular derecha de instauración súbita en el curso de la infección-enfermedad por VIH-sida. Se le realizaron múltiples estudios para poder definir la causa, y, pese a imponer tratamiento oportuno, falleció a los 15 días del mismo. La epidemia de sida continúa creciendo mundialmente. El conocimiento de las manifestaciones oculares; tanto las alteraciones del segmento anterior como las del posterior, y las infecciones asociadas, permiten mayor posibilidad de preservar la función visual en estos pacientes (AU).

ABSTRACT We present the case of a patient who entered the former Provincial Teaching Clinical Surgical Hospital "José Ramón López Tabrane", of Matanzas. The cause of admission was a sudden right ocular proptosis in the course of an HIV-AIDS infection-disease. Many different studies were carried out to define the cause, and although he was timely treated, he died 15 days after the treatment. The AIDS epidemic is still growing around the world. The knowledge of ocular manifestations, the alterations of the anterior segment as much as the alterations of the posterior one, and the associated infections allow a higher possibility of preserving the visual function in these patients (AU).

Proptosis ocular a causa de la infección-enfermedad por VIH-sida / Ocular proptosis caused by HIV-AIDS infection-disease

RESUMEN Se presenta a un paciente que ingresó en el antiguo Hospital Provincial Clínico Quirúrgico Docente "José Ramón López Tabrane", de Matanzas. El motivo del ingreso fue una proptosis ocular derecha de instauración súbita en el curso de la infección-enfermedad por VIH-sida. Se le realizaron múltiples estudios para poder definir la causa, y, pese a imponer tratamiento oportuno, falleció a los 15 días del mismo. La epidemia de sida continúa creciendo mundialmente. El conocimiento de las manifestaciones oculares; tanto las alteraciones del segmento anterior como las del posterior, y las infecciones asociadas, permiten mayor posibilidad de preservar la función visual en estos pacientes (AU).

ABSTRACT We present the case of a patient who entered the former Provincial Teaching Clinical Surgical Hospital "José Ramón López Tabrane", of Matanzas. The cause of admission was a sudden right ocular proptosis in the course of an HIV-AIDS infection-disease. Many different studies were carried out to define the cause, and although he was timely treated, he died 15 days after the treatment. The AIDS epidemic is still growing around the world. The knowledge of ocular manifestations, the alterations of the anterior segment as much as the alterations of the posterior one, and the associated infections allow a higher possibility of preserving the visual function in these patients (AU).

Ophthalmological changes of the posterior segment in patients with testicular cancer in a mixed-race population of the General Hospital of Mexico. / Alteraciones oftalmológicas del segmento posterior en pacientes con cáncer testicular en población latino-mestiza del Hospital General de México.

INTRODUCTION: The curing of a testicular tumour is currently feasible in more than 95% of patients, and in 80% of those with metastases. Until now, there has been no study or series of cases that describe the ocular changes of the posterior segment associated with testicular cancer. OBJECTIVE: To evaluate patients with a diagnosis of testicular cancer in order to determine the presence of changes in the posterior segment and the relationship to the stage. MATERIAL AND METHOD: An observational, cross-sectional, and descriptive study was conducted on 21 male patients (42 eyes) with a diagnosis of testicular cancer. Age, histological type, time of evolution, stage, treatment, and comorbidities were recorded, as well as visual acuity measurement (LogMAR), biomicroscopy of the anterior segment, and photographic records of the posterior pole and peripheral retina. RESULTS: The mean age was 29 years (18-43 years). All (100%) of the patients were treated surgically. The most frequent histological type was classic seminoma (42.8%), followed by the mixed germinal tumour (38.0%). At the time of evaluation, 42.8% of patients had a stage II, and 23.8% had distant metastasis. The changes in the posterior segment were: vascular tortuosity (14.2%), retinopathy associated with cancer (9.5%), choroidal metastasis (9.5%), pigmentary changes of the retinal pigment epithelium (9.5%), and retinal metastasis (4.7%). CONCLUSIONS: It is possible to find changes at the level of retinal pigment epithelium, as well as vascular tortuosity, retinopathy associated with cancer, and choroidal and/or retina metastases.

Esclerite posterior bilateral simultânea e unilateral recorrente / Simultaneous bilateral and unilateral recurrent posterior scleritis

Resumo Esclerite posterior é uma doença inflamatória ocular que acomete a esclera e cujo diagnóstico é difícil. A clínica da doença envolve a piora da qualidade visual com dor ocular e achados do segmento posterior, como descolamento de retina seroso, dobras de coroide, edema de disco óptico e espessamento escleral. Deve-se ficar atento aos achados sistêmicos, pois, muitas vezes, está associada a doenças como artrite reumatoide, lúpus eritematoso sistêmico, doença inflamatória intestinal e doenças infecciosas, como sífilis e tuberculose. Este trabalho objetiva descrever dois casos: uma paciente com quadro de esclerite posterior bilateral simultânea, sem alterações sistêmicas correlacionadas com a doença. A apresentação bilateral é incomum nesta patologia; e outro caso de esclerite anterior e posterior unilateral recorrente.

Abstract Posterior scleritis is an ocular inflammatory disease that affects the sclera e whose diagnosis is difficult. The main clinical manifestations are worsening of visual quality, ocular pain and finding in the posterior segment, such as serous retinal detachment, choroidal folds, optic disc edema and sclera thickening. We should award for systemic findings, because it is often accompanied by rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease and infections, such as syphilis and tuberculosis.This paper aims to describe two cases: one patient with simultaneous bilateral posterior scleritis without systemic alterations correlated with the disease. Bilateral presentation is uncommon in this pathology; and another case of recurrent unilateral anterior and posterior scleritis.

Lentes intraoculares fácicas de câmara posterior / Phakic posterior chamber intraocular lenses

Resumo O objetivo deste artigo foi reunir estudos que reportam resultados disponíveis na literatura científica, considerando a previsibilidade, segurança, eficácia, e estabilidade das lentes intraoculares fácicas de câmara posterior. E relatar as complicações documentadas para estas lentes. A revisão criteriosa dos estudos publicados na literatura ate o momento revelam resultado satisfatórios quanto à eficácia, elevada previsibilidade, estabilidade e segurança do implante de lente intraocular de câmara posterior, para correção das miopia, hipermetropia e astigmatismo.

Abstract The objective of this article was to gather studies that report results available in the scientific literature, considering the predictability, safety, efficacy, and stability of posterior chamber phakic intraocular lenses. And report the documented complications for these lenses.

Iris coloboma in one eye and pigment dispersion syndrome in the fellow eye.

We report a case of a 43-year-old patient with coloboma of the iris, zonule, ciliary body, choroid and retina in the right eye and pigment dispersion syndrome in the left eye. Considering the hypothesis of the pigment dispersion syndrome pathogenesis in which a difference of pressures in the anterior and posterior chambers creates a posterior convexity of the iris leading to reverse pupillary block, iris touch and consequently causing pigment dispersion, we suggest that the presence of an iris coloboma, by equalising the pressures in the two chambers, prevented the onset of syndrome in that eye.

The involvement of anti-inflammatory protein, annexin A1, in ocular toxoplasmosis.

PURPOSE: The aim of this study was to evaluate the expression of the protein annexin A1 (ANXA1), a potent endogenous regulator of the inflammatory process, in ocular toxoplasmosis. METHODS: C57BL/6 female mice were infected using intravitreal injections of either 10(6) tachyzoites of Toxoplasma gondii (RH strain; T. gondii) or PBS only (control groups). After 24, 48, and 72 h, animals were sacrificed and their eyes were harvested for histopathological, immunohistochemical, and ultrastructural immunocytochemical analysis of ANXA1. Human retinal pigment epithelial (RPE) cells (ARPE-19) were infected in vitro with T. gondii and collected after 60, 120, 240 min, and 24 h. RESULTS: Compared with non-infected eyes, an intense inflammatory response was observed in the anterior (24 h after infection) and posterior segments (72 h after infection) of the infected eye, characterized by neutrophil infiltration and by the presence of tachyzoites and their consequent destruction along with disorganization of normal retina architecture and RPE vacuolization. T. gondii infection was associated with a significant increase of ANXA1 expression in the neutrophils at 24, 48, and 72 h, and in the RPE at 48 and 72 h. In vitro studies confirmed an upregulation of ANXA1 levels in RPE cells, after 60 and 120 min of infection with T. gondii. CONCLUSIONS: The positive modulation of endogenous ANXA1 in the inflammatory and RPE cells during T. gondii infection suggests that this protein may serve as a therapeutic target in ocular toxoplasmosis.

Biomicroscopia com lâmpada de fenda - revisão de literatura / Slit lamp biomicroscopy - a review

A biomicroscopia, realizada com auxílio da lâmpada de fenda, é um método de estudo das estruturas dobulbo ocular que vem se popularizando e se afirmando como uma importante ferramenta no exame oftálmicodos animais domésticos. O objetivo deste artigo é elucidar os princípios básicos do funcionamentoda lâmpada de fenda, a técnica de exame e as suas aplicações na oftalmologia veterinária.

Biomicroscopy performed with the slit lamp is a method of studying the eyeball structures and is becomingmore popular and a very important tool to veterinary ophthalmology. The aim of this article is toelucidate the basic principles of slit lamp operation and its application in veterinary ophthalmology.

Biomicroscopia com lâmpada de fenda - revisão de literatura / Slit lamp biomicroscopy - a review

A biomicroscopia, realizada com auxílio da lâmpada de fenda, é um método de estudo das estruturas dobulbo ocular que vem se popularizando e se afirmando como uma importante ferramenta no exame oftálmicodos animais domésticos. O objetivo deste artigo é elucidar os princípios básicos do funcionamentoda lâmpada de fenda, a técnica de exame e as suas aplicações na oftalmologia veterinária.(AU)

Biomicroscopy performed with the slit lamp is a method of studying the eyeball structures and is becomingmore popular and a very important tool to veterinary ophthalmology. The aim of this article is toelucidate the basic principles of slit lamp operation and its application in veterinary ophthalmology.(AU)