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1.
BMC Ophthalmol ; 24(1): 84, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388877

RESUMO

BACKGROUND: To observe morphologic and functional changes in meibomian glands in pediatric patients with and without lower eyelid epiblepharon. METHODS: In this prospective observation study, 55 eyes of 55 patients( 24 males, 31 females; mean age ± SD,9.82 ± 2.59 years; range 6-14 years) and 60 eyes of 60 controls ( 32 males, 28 females; mean age ± SD,10.57 ± 2.75 years; range 6-14 years) were included. The following tests were performed: eyelid margin abnormality by slit-lamp examination, measurement of noninvasive keratographic break-up time (NIKBUT), grading of absence of meibomian gland (meibography score) assessed with noncontact meibography, morphologic changes of meibomian glands (thinning, dilatation and distortion), tear production by the Schirmer 1 test, and grading of meibum quality and meibomian gland expressibility. RESULTS: The morphologic changes in meibomian glands were more common in the epiblepharon group (56.36%) than in the control group (28.33%) (p = 0.002). The meibum quality was worse in the epiblepharon group than in the control group (p = 0.009), and the NIKBUT was significantly shorter in the epiblepharon group than in the control group (p = 0.012). There was no significant difference in the Schirmer 1 test, meibomian gland expressibility, eyelid margin abnormality score or total meibography score between the two groups. Morphologic changes in the meibomian glands in the upper eyelids (38.18%) were more common than those in the lower eyelids (20%) (p = 0.036) in the epiblepharon group, and the meibography score was higher in the upper eyelids than in the lower eyelids (p = 0.001). CONCLUSION: There are morphological and functional changes in meibomian glands in pediatric patients with lower eyelid epiblepharon. Although the inverted eyelashes were located in the lower eyelid, morphological changes in the meibomian glands were more common in the upper eyelid.


Assuntos
Síndromes do Olho Seco , Doenças Palpebrais , Criança , Feminino , Humanos , Masculino , Síndromes do Olho Seco/diagnóstico , Doenças Palpebrais/diagnóstico , Glândulas Tarsais/diagnóstico por imagem , Exame Físico , Estudos Prospectivos , Microscopia com Lâmpada de Fenda , Lágrimas , Adolescente
2.
BMC Ophthalmol ; 24(1): 34, 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263030

RESUMO

BACKGROUND: The structural features have an impact on the surgical prognosis for congenital corneal opacity (CCO). The structural classification system of CCO, however, is lacking. Based on data from ultrasound biomicroscopy (UBM) findings in infants and toddlers with CCO, this research proposed a classification system for the anterior segment structure severity. METHODS: Medical records, preoperative UBM images and slit-lamp photographs of infants and toddlers diagnosed with CCO at University Third Hospital between December 2018 and June 2022 were reviewed. According to the anterior segment structural features observed in UBM images, eyes were classified as follows: U1, opaque cornea only; U2, central anterior synechia; U3, peripheral anterior synechia combined with angle closure; and U4, aniridia or lens anomaly. The opacity appearance and corneal vascularization density observed in slit-lamp photographs were assigned grades according to previous studies. The extent of vascularization was also recorded. The corresponding intraocular anomaly classifications and ocular surface lesion severity were analysed. RESULTS: Among 81 eyes (65 patients), 41 (50.6%) were right eyes, and 40 (49.4%) were left eyes. The median age at examination was 6.91 months (n = 81, 1.00, 34.00). Two (2.5%) of the 81 eyes were classified as U1, 20 (24.7%) as U2, 22 (27.2%) as U3a, 11 (13.6%) as U3b and 26 (32.1%) as U4. Bilateral CCO eyes had more severe UBM classifications (P = 0.019), more severe dysgenesis (P = 0.012) and a larger angle closure (P = 0.009). Eyes with more severe UBM classifications had higher opacity grades (P = 0.003) and vascularization grades (P = 0.014) and a larger vascularization extent (P = 0.001). Eyes with dysgenesis had higher haze grades (P = 0.012) and more severe vascularization (P = 0.003 for density; P = 0.008 for extent), while the angle closure range was related to haze grade (P = 0.013) and vascularization extent (P = 0.003). CONCLUSIONS: This classification method based on UBM and slit-lamp photography findings in the eyes of CCO infants and toddlers can truly reflect the degree of abnormality of the ocular surface and anterior segment and is correlated with the severity of ocular surface anomalies. This method might provide meaningful guidance for surgical procedure design and prognostic determinations for keratoplasty in CCO eyes.


Assuntos
Doenças da Córnea , Opacidade da Córnea , Anormalidades do Olho , Doenças da Íris , Lactente , Humanos , Pré-Escolar , Microscopia Acústica , Microscopia com Lâmpada de Fenda , Neovascularização Patológica , Córnea
3.
Rev. bras. oftalmol ; 83: e0002, 2024. graf
Artigo em Português | LILACS | ID: biblio-1529930

RESUMO

RESUMO O propósito deste estudo foi reportar as alterações oculares observadas após picada de abelha com ferrão retido na córnea. Destacamos o tratamento e o desfecho de uma lesão de córnea incomum e sua patogênese. Trata-se de relato de caso e revisão da literatura de lesões oculares por picada de abelha. Paciente do sexo feminino, 63 anos, procurou atendimento oftalmológico de urgência devido à picada de abelha na córnea do olho direito há 6 dias. Queixava-se de embaçamento visual, dor e hiperemia ocular. Apresentou acuidade visual de vultos no olho afetado. Ao exame, notaram-se hiperemia moderada de conjuntiva bulbar, edema corneano com dobras de Descemet e presença do ferrão alojado na região temporal, no estroma profundo da córnea. A paciente foi internada para ser abordada no centro cirúrgico sob anestesia geral. Durante a cirurgia, o ferrão teve que ser retirado via câmara anterior, mediante a realização de uma paracentese e uma lavagem da câmara anterior, com dupla via e solução salina balanceada. Ainda não existe na literatura um tratamento padrão na abordagem de pacientes com lesões oculares por picada de abelha, sendo importantes a identificação e o reconhecimento precoce de possíveis complicações que ameacem a visão.


ABSTRACT The purpose of this study was to report the ocular changes observed after a bee sting with a stinger retained in the cornea. We show the treatment and outcome of an unusual corneal injury and its pathogenesis. This is a case report and literature review of ocular injuries caused by bee stings. A 63-year-old female patient sought emergency ophthalmic care because of a bee sting on the cornea of her right eye six days before. She complained of blurred vision, pain, and ocular hyperemia. She had glare sensitivity on visual acuity in the affected eye. Examination revealed moderate hyperemia of the bulbar conjunctiva, corneal edema with Descemet's folds and a stinger lodged in the temporal region, in the deep stroma of the cornea. The patient was admitted to the operating room under general anesthesia. During surgery, the stinger had to be removed via the anterior chamber, by performing a paracentesis and washing the anterior chamber with a double flushing and balanced saline solution. There is still no standard treatment in the literature for patients with eye injuries caused by bee stings, and early identification and recognition of possible sight-threatening complications is important.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Venenos de Abelha/efeitos adversos , Edema da Córnea/etiologia , Corpos Estranhos no Olho/complicações , Lesões da Córnea/etiologia , Mordeduras e Picadas de Insetos/complicações , Procedimentos Cirúrgicos Oftalmológicos/métodos , Edema da Córnea/diagnóstico , Edema da Córnea/fisiopatologia , Iridociclite , Corpos Estranhos no Olho/cirurgia , Corpos Estranhos no Olho/diagnóstico , Lesões da Córnea/cirurgia , Lesões da Córnea/diagnóstico , Microscopia com Lâmpada de Fenda , Gonioscopia , Mordeduras e Picadas de Insetos/cirurgia , Mordeduras e Picadas de Insetos/diagnóstico
4.
Turk J Ophthalmol ; 53(5): 313-317, 2023 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-37870044

RESUMO

Epithelial ingrowth is a rare condition that is generally seen after laser in situ keratomileusis (LASIK) and has been reported in the literature in a small number of cases after small-incision lenticule extraction (SMILE) surgery. "Epithelial inoculation" should also be considered in patients presenting with decreased vision and an appearance similar to epithelial ingrowth in the early period after SMILE surgery. A 23-year-old woman presented to our clinic with a request for refractive surgery. Her manifest refractions were -7.50 -1.00 x 180° in the right eye and -7.25 -1.00 x 150° in the left eye, and best corrected distance visual acuity was 10/10 in both eyes. The SMILE procedure was performed with the Visumax femtosecond laser (Carl Zeiss Meditec AG). Slit-lamp examination at postoperative 1 week revealed a small grayish-white intrastromal opacity resembling epithelial ingrowth in the central optic axis of the right eye. Irrigation of the interface was performed with balanced salt solution using an irrigation cannula and the epithelial cluster was removed. The patient remained clinically stable 6 months after surgery and has experienced no recurrence. When epithelial inoculation is observed early after SMILE surgery, immediate irrigation of the interface appears to be an effective and safe treatment.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Feminino , Humanos , Adulto Jovem , Substância Própria/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Miopia/cirurgia , Miopia/diagnóstico , Microscopia com Lâmpada de Fenda , Acuidade Visual
5.
PLoS One ; 18(10): e0291613, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37796869

RESUMO

Corneal transparency is essential to provide a clear view into and out of the eye, yet clinical means to assess such transparency are extremely limited and usually involve a subjective grading of visible opacities by means of slit-lamp biomicroscopy. Here, we describe an automated algorithm allowing extraction of quantitative corneal transparency parameters with standard clinical spectral-domain optical coherence tomography (SD-OCT). Our algorithm employs a novel pre-processing procedure to standardize SD-OCT image analysis and to numerically correct common instrumental artifacts before extracting mean intensity stromal-depth (z) profiles over a 6-mm-wide corneal area. The z-profiles are analyzed using our previously developed objective method that derives quantitative transparency parameters directly related to the physics of light propagation in tissues. Tissular heterogeneity is quantified by the Birge ratio Br and the photon mean-free path (ls) is determined for homogeneous tissues (i.e., Br~1). SD-OCT images of 83 normal corneas (ages 22-50 years) from a standard SD-OCT device (RTVue-XR Avanti, Optovue Inc.) were processed to establish a normative dataset of transparency values. After confirming stromal homogeneity (Br <10), we measured a median ls of 570 µm (interdecile range: 270-2400 µm). By also considering corneal thicknesses, this may be translated into a median fraction of transmitted (coherent) light Tcoh(stroma) of 51% (interdecile range: 22-83%). Excluding images with central saturation artifact raised our median Tcoh(stroma) to 73% (interdecile range: 34-84%). These transparency values are slightly lower than those previously reported, which we attribute to the detection configuration of SD-OCT with a relatively small and selective acceptance angle. No statistically significant correlation between transparency and age or thickness was found. In conclusion, our algorithm provides robust and quantitative measurements of corneal transparency from standard SD-OCT images with sufficient quality (such as 'Line' and 'CrossLine' B-scan modes without central saturation artifact) and addresses the demand for such an objective means in the clinical setting.


Assuntos
Córnea , Tomografia de Coerência Óptica , Córnea/diagnóstico por imagem , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica/métodos , Algoritmos , Artefatos , Paquimetria Corneana
6.
Ophthalmologie ; 120(12): 1238-1250, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-37707672

RESUMO

Corneal diseases include a wide spectrum of different manifestations (inflammatory/noninflammatory) that need to be accurately classified for precise diagnosis and targeted treatment. In addition to the anamnesis and slit lamp biomicroscopy, further device-based examinations can be performed to narrow down the diagnosis. Nowadays, modern corneal imaging provides a variety of technologies, such as topography, tomography, in vivo confocal microscopy and analysis of biomechanics, which are able to reliably classify different pathologies. Knowledge of the available examination modalities helps to guide differential diagnostic considerations, facilitating the indication for stage-appropriate microsurgical intervention.


Assuntos
Córnea , Doenças da Córnea , Humanos , Córnea/diagnóstico por imagem , Doenças da Córnea/diagnóstico , Microscopia com Lâmpada de Fenda , Exame Físico , Microscopia Confocal/métodos
7.
J AAPOS ; 27(5): 308-309, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37714425

RESUMO

We describe a novel method for clinical ophthalmic photography that uses the inherent macro-photography mode available in most recent smartphones, without additional attachments. This method facilitates acquisition of high-quality external and anterior segment clinical photography in children who may have difficulty remaining still enough for anterior segment photography at the slit lamp. We describe this technique and discuss its advantages and limitations.


Assuntos
Segmento Anterior do Olho , Smartphone , Humanos , Criança , Segmento Anterior do Olho/diagnóstico por imagem , Microscopia com Lâmpada de Fenda , Lâmpada de Fenda , Fotografação/métodos
8.
Cornea ; 42(12): 1590-1600, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37603692

RESUMO

PURPOSE: There are no defined diagnostic criteria and severity classification for Fuchs endothelial corneal dystrophy (FECD), which are required for objective standardized assessments. Therefore, we performed a systematic literature review of the current diagnosis and severity classification of FECD. METHODS: We searched the Ovid MEDLINE and Web of Science databases for studies published until January 13, 2021. We excluded review articles, conference abstracts, editorials, case reports with <5 patients, and letters. RESULTS: Among 468 articles identified, we excluded 173 and 165 articles in the first and second screenings, respectively. Among the 130 included articles, 61 (47%) and 99 (76%) mentioned the diagnostic criteria for FECD and described its severity classification, respectively. Regarding diagnosis, slitlamp microscope alone was the most frequently used device in 31 (51%) of 61 articles. Regarding diagnostic findings, corneal guttae alone was the most common parameter [adopted in 23 articles (38%)]. Regarding severity classification, slitlamp microscopes were used in 88 articles (89%). The original or modified Krachmer grading scale was used in 77 articles (78%), followed by Adami's classification in six (6%). Specular microscopes or Scheimpflug tomography were used in four articles (4%) and anterior segment optical coherence tomography in one (1%). CONCLUSIONS: FECD is globally diagnosed by the corneal guttae using slitlamp examination, and its severity is predominantly determined by the original or modified Krachmer grading scale. Objective severity grading using Scheimpflug or anterior segment optical coherence tomography can be applied in the future innovative therapies such as cell injection therapy or novel small molecules.


Assuntos
Distrofia Endotelial de Fuchs , Humanos , Distrofia Endotelial de Fuchs/diagnóstico , Tomografia de Coerência Óptica/métodos , Microscopia com Lâmpada de Fenda , Endotélio Corneano
9.
Vet Ophthalmol ; 26(5): 440-445, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37565779

RESUMO

OBJECTIVE: To compare tear film (TF) osmolarity measured using TearLab® and I-PEN® osmometers in the same dogs without any ocular surface disease. ANIMAL STUDIED: Fifty-two dogs (98 eyes) of different breeds were evaluated. PROCEDURES: Tear film (TF) osmolarity was evaluated at 2-min intervals. The test was randomly determined, and single measurements were performed using each osmometer. Subsequently, complete ophthalmologic examinations were performed based on Schirmer tear test-1 (STT-1) analysis, tear film breakup time (TFBUT), and slit-lamp biomicroscopy. For each osmometer, the mean ± standard deviation of the TF osmolarity was calculated, and a paired Student's t-test was used to compare the values obtained. Pearson correlation analysis was performed to assess the association between osmolarity and other values such as STT-1, TFBUT, and age. RESULTS: Tear film osmolarity determined using TearLab® (340.42 ± 15.87 mOsm/L) and I-PEN® (321.58 ± 17.39 mOsm/L) were significantly different (p < .001). However, statistical significance could not be confirmed between osmolarity and other values, such as STT-1, TFBUT, and age. CONCLUSIONS: In dogs, the TF osmolarity values obtained using TearLab® tend to be higher than those obtained using I-PEN®, contrary to that observed in humans. These findings can serve as a reference for establishing normal values for each osmometer for clinical use in measuring TF osmolarity in dogs.


Assuntos
Doenças do Cão , Lacerações , Animais , Cães , Olho , Lacerações/veterinária , Concentração Osmolar , Osmometria/veterinária , Microscopia com Lâmpada de Fenda , Lágrimas
10.
BMJ Case Rep ; 16(6)2023 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-37316286

RESUMO

A male patient in his 30s, with a history of bilateral microkeratome-assisted myopic laser-assisted in situ keratomileusis (LASIK) 8 years ago at another centre, presented to us with gradually progressive diminution of vision and glare in both eyes for the last 4 years. On presentation, uncorrected distance visual acuity (UDVA) was 6/24 and 6/15 in the right eye and left eye, respectively, with normal intraocular pressures. Slit-lamp examination and anterior segment optical coherence tomography revealed well-defined white deposits, limited to an area within the LASIK flap. The deposits were confluent, at the level of the LASIK flap interface, and few discrete opacities were present in the posterior stroma. His father also had a similar clinical picture in both eyes. A diagnosis of both eyes post-LASIK exacerbation of granular corneal dystrophy with epithelial ingrowth was made. He underwent right eye femtosecond laser-assisted sutureless superficial anterior lamellar keratoplasty. At 6-month follow-up, UDVA improved to 6/12 with graft clarity of 4+ and coexistent grade 1 epithelial ingrowth.


Assuntos
Distrofias Hereditárias da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Masculino , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Distrofias Hereditárias da Córnea/cirurgia , Olho , Microscopia com Lâmpada de Fenda
11.
Semin Ophthalmol ; 38(8): 713-721, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37171162

RESUMO

Teleophthalmology is a widely recognised way to provide health care to patients living in rural and remote regions by leveraging limited clinician availability and resources. This is most important in low socioeconomic areas, where the disparity between prevalence of preventable blindness and practicing ophthalmologists is greatest. The ubiquity and accessibility of smartphones allow them to be utilised in a clinical setting and facilitate teleophthalmology. While the current market of smartphone adapters capable of imaging ocular pathology is expanding, few focus on the anterior segment and operate independently of the slit-lamp microscope. This article reviews the available smartphone adapters capable of imaging anterior segment pathology.


Assuntos
Oftalmologia , Telemedicina , Humanos , Oftalmologia/métodos , Smartphone , Telemedicina/métodos , Microscopia com Lâmpada de Fenda , Cegueira
12.
BMC Ophthalmol ; 23(1): 204, 2023 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-37165312

RESUMO

PURPOSE: To demonstrate the practicability of a portable instrument in assessing tear film breakup time (TFBUT): a lens attachment for smartphones (LAS). METHODS: By applying LAS in combination with the iPhone 12 pro, and a recordable slit-lamp microscope, we obtained TFBUT videos from 58 volunteers. The comparison between the conventional slit-lamp microscope and LAS by an experienced ophthalmologist. Moreover, we also invited an ophthalmic postgraduate student and an undergraduate student with no clinical experience to assess TFBUT in those videos. The inter-observer reliability was assessed using intraclass correlation coefficients (ICC). RESULTS: The TFBUT of 116 eyes in total was recorded. Reliability indexes were adequate. The Spearman's correlation analysis and the intraclass correlation coefficient suggested a strong correlation between the 2 modalities (Right eye: Spearman's r = 0.929, 95% confidence interval (CI) = 0.847-0.963, ICC = 0.978, p < 0.001; Left eye: Spearman's r = 0.931, 95% CI = 0.866-0.964, ICC = 0.985, p < 0.001;). Between instruments, the majority of TFBUT measurements showed good agreement on Bland Altman plot. A high concordance was observed in TFBUT, when assessed by an ophthalmologist and an ophthalmic postgraduate student (Left eye: LAS ICC = 0.951, p < 0.001; Left eye: slit-lamp microscope ICC = 0.944, p < 0.001). CONCLUSIONS: Compared with the conventional slit-lamp microscope, the LAS has sufficient validity for evaluating TFBUT in clinics or at home.


Assuntos
Síndromes do Olho Seco , Humanos , Síndromes do Olho Seco/diagnóstico , Reprodutibilidade dos Testes , Smartphone , Olho , Microscopia com Lâmpada de Fenda , Lágrimas
14.
Clin Exp Optom ; 106(7): 694-702, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36641840

RESUMO

The conjunctival microcirculation is an accessible complex network of micro vessels whose quantitative assessment can reveal microvascular haemodynamic properties. Currently, algorithms for the measurement of conjunctival haemodynamics use either manual or semi-automated systems, which may provide insight into overall conjunctival health, as well as in ocular and systemic disease. These algorithms include functional slit-lamp biomicroscopy, laser doppler flowmetry, optical coherence tomography angiography, orthogonal polarized spectral imaging, computer-assisted intravitral microscopy, diffuse reflectance spectroscopy and corneal confocal microscopy. Furthermore, several studies have demonstrated a relationship between conjunctival microcirculatory haemodynamics and many diseases such as dry eye disease, Alzheimer's disease, diabetes, hypertension, sepsis, coronary microvascular disease, and sickle cell anaemia. This review aims to describe conjunctival microcirculation, its characteristics, and techniques for its measurement, as well as the association between conjunctival microcirculation and microvascular abnormalities in disease states.


Assuntos
Túnica Conjuntiva , Hemodinâmica , Humanos , Velocidade do Fluxo Sanguíneo , Microcirculação , Túnica Conjuntiva/irrigação sanguínea , Microscopia com Lâmpada de Fenda
15.
Can J Ophthalmol ; 58(4): 369-374, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35231395

RESUMO

OBJECTIVE: To evaluate the efficacy of patient-sided breath shields in preventing oronasal droplet transmission during slit-lamp examination. DESIGN: Experimental study testing the efficacy of patient-sided breath shields on a slit lamp. METHODS: Two commercially available patient-sided breath shields and a 3-dimensional (3D)-printed shield designed by the authors were attached to a slit-lamp chin rest for testing. Each shield was exposed to 3 standardized sprays of coloured dye from a spray gun with its nozzle adjusted to simulate the angular dispersion of a human sneeze. Any overspray not blocked by the shields was recorded and compared with spray with no shield (control). Image-processing software was used to ascertain the surface area of overspray not blocked by the tested shield compared with the control of no shield. RESULTS: With typical use, both commercially available patient-sided shields and the 3D-printed shield blocked 100% of forward-travelling measurable droplets from a simulated sneeze spray. Even when set to the furthest distance setting to simulate the worst-case scenario, shield 1 and the 3D-printed shield blocked 99.96% and 99.65% of overspray, respectively. However, slow-motion footage did reveal that a considerable amount of spray rebounded off the shields and extended peripherally past its borders. CONCLUSIONS: With typical use, all tested shields prevented 100% of oronasal transmission. To encourage accessibility, the authors offer a free 3D model and instructions for creating the tested patient-sided breath shield. Patient-sided shields should be combined with other infection-control measures to minimize transmission.


Assuntos
Equipamentos de Proteção , Respiração , Microscopia com Lâmpada de Fenda , Humanos , Aerossóis e Gotículas Respiratórios
16.
Eur J Ophthalmol ; 33(5): NP130-NP136, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36083167

RESUMO

PURPOSE: The purpose of this study was to report the clinicopathological features and management of the first case of bilateral synchronous conjunctival myxoma. METHODS: This study was a case report and literature review. RESULTS: A 66-year-old Chinese male with past ocular history of uncomplicated bilateral phacoemulsification and intraocular lens (IOLs) 3 years ago prior to presentation presented with bilateral red and swollen conjunctiva for over a year. On examination his corrected distance visual acuity (CDVA) was 25/20 in the right eye 20/20 in the left eye. Slit lamp examination revealed swollen temporal conjunctiva bilaterally which appeared as painless, well-circumscribed, salmon-pink, fleshy patches. The lesion in the right eye was subsequently excised, followed by excision of the lesion in the left eye at 3-week interval. Microscopically, histopathological examination of both excised specimens revealed hypocellular conjunctival mucosa covered by non-dysplastic epithelium, with presence of myxoid degeneration in the subepithelial stroma and immunostaining findings consistent with conjunctival myxoma. At his latest follow-up at 24 months, there were no recurrences of the conjunctival masses and the CDVA was the same as preoperatively.


Assuntos
Neoplasias da Túnica Conjuntiva , Mixoma , Masculino , Humanos , Idoso , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/cirurgia , Neoplasias da Túnica Conjuntiva/patologia , Túnica Conjuntiva/patologia , Mixoma/diagnóstico , Mixoma/cirurgia , Mixoma/patologia , Microscopia com Lâmpada de Fenda , Acuidade Visual
17.
Rev. bras. oftalmol ; 82: e0050, 2023. graf
Artigo em Português | LILACS | ID: biblio-1521785

RESUMO

RESUMO Ao longo da vida, o cristalino produz novas fibras dispostas de forma concêntrica, que aumentam seu diâmetro anteroposterior e peso, tornando seu núcleo mais compacto e endurecido. A catarata hipermadura é uma forma de progressão avançada dessa proliferação de fibras, que pode desencadear uma variedade de complicações. A ruptura espontânea da cápsula anterior do cristalino, evoluindo com deslocamento anterior do núcleo, é uma complicação rara e com poucos casos publicados na literatura. Descrevemos o caso de uma paciente do sexo feminino, 68 anos, que apresentou ruptura espontânea da cápsula anterior do cristalino com deslocamento anterior do núcleo em olho esquerdo sem histórico de trauma ocular. A paciente foi submetida à facoemulsificação do cristalino e ao controle da pressão intraocular, evoluindo com melhora do quadro clínico.


ABSTRACT Throughout life, the lens produces new fibers arranged concentrically, which increase its anteroposterior diameter and weight, making its nucleus more compact and hardened. Hypermature cataract is an advanced stage of this fiber proliferation, which can trigger a variety of complications. Spontaneous rupture of the anterior lens capsule evolving with anterior displacement of the nucleus is a rare complication, with few cases published in the literature. We describe the case of a 68-year-old female patient, who presented spontaneous rupture of the anterior lens capsule with anterior displacement of the nucleus in the left eye, without a history of ocular trauma. The patient underwent phacoemulsification and clinical control of intraocular pressure, improving her condition.


Assuntos
Humanos , Feminino , Idoso , Catarata/complicações , Subluxação do Cristalino/diagnóstico , Subluxação do Cristalino/etiologia , Cápsula Anterior do Cristalino/patologia , Ruptura Espontânea/cirurgia , Catarata/terapia , Glaucoma Neovascular , Subluxação do Cristalino/cirurgia , Ultrassonografia , Facoemulsificação/métodos , Microscopia com Lâmpada de Fenda , Pressão Intraocular , Núcleo do Cristalino/patologia , Câmara Anterior/patologia
18.
Rev. bras. oftalmol ; 82: e0052, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1521787

RESUMO

ABSTRACT Waardenburg syndrome is a rare congenital genetic disorder characterized by sensorineural hearing loss and pigmentary abnormalities of the hair, skin, and eyes. Based on the different clinical presentations, it is divided into four subtypes as in WS1 to WS4. This report describes a 15-year-old boy who presented with low vision and bilateral hearing loss. His visual acuity was 20/200 in both eyes. Slit-lamp examination revealed complete iris heterochromia, with one blue iris and one brown iris. Fundus examination showed symmetrical pigmentation of the retina and choroid, with atrophy of the pigment epithelium in the macular region, notably also in the eye with normal iris pigment illustrating the broad spectrum of the iris and fundus pigmentation as part of this syndrome. A carefully clinical and ophthalmological evaluation should be done to differentiate various types of Waardenburg syndrome and other associated auditory-pigmentary syndrome. Early diagnosis in some cases may be crucial for the adequate development of patients affected with this condition.


RESUMO A síndrome de Waardenburg é uma doença genética congênita rara caracterizada por perda auditiva neurossensorial e anormalidades pigmentares do cabelo, da pele e dos olhos. Com base nas diferentes apresentações clínicas, é dividida em quatro subtipos (WS1 a WS4). Este relato descreve o caso de um menino de 15 anos que apresentava baixa visão e perda auditiva bilateral. Sua acuidade visual era de 20/200 em ambos os olhos. O exame em lâmpada de fenda revelou heterocromia completa da íris, com uma íris azul e uma íris marrom. A fundoscopia mostrou pigmentação simétrica da retina e coroide, com atrofia do epitélio pigmentar na região macular, notadamente também no olho com pigmento de íris normal, ilustrando o amplo espectro de pigmentação de íris e fundo como parte dessa síndrome. Uma avaliação clínica e oftalmológica criteriosa deve ser feita para diferenciar os vários tipos de síndrome de Waardenburg e outras síndromes auditivo-pigmentares associadas. O diagnóstico precoce em alguns casos pode ser crucial para o desenvolvimento adequado dos pacientes acometidos por essa condição.


Assuntos
Humanos , Masculino , Adolescente , Transtornos da Pigmentação/diagnóstico , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Síndrome de Waardenburg/complicações , Doenças da Íris/diagnóstico , Doenças da Íris/etiologia , Transtornos da Pigmentação/etiologia , Síndrome de Waardenburg/diagnóstico , Acuidade Visual , Microscopia com Lâmpada de Fenda , Fundo de Olho , Perda Auditiva Neurossensorial/etiologia
19.
Rev. bras. oftalmol ; 82: e0042, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1507882

RESUMO

ABSTRACT Objective Compare the thickness of conjunctival autografts in pterygium surgery using the Moscovici dissection technique with manual dissection and assess the difficulty of the techniques. Methods In this randomized clinical trial, 30 eyes of 30 patients undergoing pterygium surgery were divided into the Moscovici Dissection Technique Group and the Manual Dissection Group. The patients were treated at the Hospital Oftalmológico Visão Laser (Santos, São Paulo, Brazil). Optical coherence tomography was performed to measure graft thickness three months postoperatively. Three images were obtained from each eye, and three measurements were taken at a distance of 1.5mm perpendicular to the limbus in each capture. The surgeon graded the difficulty of obtaining the graft with the technique performed from one (lowest difficulty) to four (highest difficulty). Results We found statistically significant difference between the difficulty of the two techniques and the mean conjunctival autograft thickness in the two groups (p=0.01 e p=0.05, respectively). The average difficulty rating for the Moscovici Dissection Technique Group (Air Group) was 1.47, while that for the Manual Dissection Group (MD group) was 2.20. The mean thickness of the three measurements was 252µ in the Air Group and 298µ in the MD Group, with medians of 250µ and 278µ, respectively. Conclusion Our study showed that the Moscovici technique results in thinner grafts and can be performed with greater surgical ease.


RESUMO Objetivo Comparar a espessura de autoenxertos conjuntivais em cirurgia de pterígio utilizando a técnica de dissecção de Moscovici com a de dissecção manual e avaliar a dificuldade das técnicas. Métodos Neste ensaio clínico randomizado, 30 olhos de 30 pacientes submetidos à cirurgia de pterígio foram divididos em um Grupo de Técnica de Dissecção de Moscovici e um Grupo de Dissecção Manual. Os pacientes foram tratados e avaliados no Hospital Oftalmológico Visão Laser (Santos, São Paulo, Brasil). A tomografia de coerência óptica foi realizada para medir a espessura do enxerto 3 meses após a cirurgia. Três imagens foram obtidas de cada olho, e três medidas foram realizadas a uma distância de 1,5mm perpendicular ao limbo em cada captura. O cirurgião classificou a dificuldade de obtenção do enxerto com a técnica realizada de um (menor dificuldade) para quatro (maior dificuldade). Resultados Encontramos diferenças estatisticamente significantes entre a dificuldade das duas técnicas e a espessura média do autoenxerto conjuntival nos dois grupos (p=0,01 e p=0,05, respectivamente). A classificação média de dificuldade para o Grupo de Técnica de Dissecção de Moscovici foi de 1,47, enquanto a do Grupo de Dissecção Manual foi de 2,20. A espessura média das três medidas foi de 252μ no Grupo de Técnica de Dissecção de Moscovici e de 298μ no Grupo de Dissecção Manual, com medianas de 250μ e 278μ, respectivamente. Conclusão Nosso estudo mostrou que a técnica de Moscovici resulta em enxertos mais finos e pode ser realizada com maior facilidade cirúrgica.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Transplante Autólogo/métodos , Pterígio/cirurgia , Túnica Conjuntiva/transplante , Acuidade Visual , Túnica Conjuntiva/patologia , Tomografia de Coerência Óptica , Autoenxertos/patologia , Microscopia com Lâmpada de Fenda , Pressão Intraocular
20.
Rev. bras. oftalmol ; 82: e0012, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1431670

RESUMO

ABSTRACT Cavernous sinus and superior ophthalmic vein thrombosis is a rare clinical condition, and little described in the literature. The clinical presentation is nonspecific and highly variable, and symptoms may include red eye, ophthalmoplegia, coma, and death. The main etiology results from infection of the paranasal sinuses. The final diagnosis must be made through imaging tests such as magnetic resonance imaging. We describe a case of cavernous sinus and superior ophthalmic vein thrombosis after COVID-19 infection in a 64-year-old patient with persistent ocular hyperemia and pain on eye movement. Ophthalmological examination showed preserved visual acuity, conjunctival hyperemia, dilation of episcleral vessels and retinal vascular tortuosity in the right eye. Magnetic resonance imaging confirmed the diagnosis. The association with the COVID-19 was raised, excluding other infectious causes. Enoxaparin and Warfarin were started with significant improvement in the ocular clinical presentation and maintenance of initial visual acuity after 12 months of follow-up.


RESUMO A trombose de seio cavernoso e veia oftálmica superior é uma condição clínica rara e pouco descrita na literatura. A apresentação clínica é inespecífica e altamente variável. Os sintomas podem incluir olho vermelho, oftalmoplegia, coma e morte. A etiologia principal resulta da infecção dos seios paranasais. O diagnóstico final deve ser efetuado por meio de exames de imagem, como ressonância magnética. Descrevemos um caso de trombose de seio cavernoso e veia oftálmica superior após COVID-19 em paciente de 64 anos e com quadro de hiperemia ocular persistente e dor à movimentação ocular. Ao exame oftalmológico, observou-se acuidade visual preservada, hiperemia conjuntival, dilatação de vasos episclerais e tortuosidade vascular retiniana em olho direito. A ressonância confirmou o diagnóstico. A associação com a COVID-19 foi levantada, excluindo-se demais causas infecciosas. Prescrevemos enoxaparina e varfarina, com melhora do quadro clínico ocular e manutenção da acuidade visual inicial após 12 meses de acompanhamento.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Trombose Venosa/etiologia , Trombose do Corpo Cavernoso/etiologia , COVID-19/complicações , Vasos Retinianos/patologia , Tonometria Ocular , Varfarina/administração & dosagem , Imageamento por Ressonância Magnética , Enoxaparina/administração & dosagem , Túnica Conjuntiva/patologia , Trombose Venosa/diagnóstico , Trombose Venosa/tratamento farmacológico , Trombose do Corpo Cavernoso/diagnóstico , Trombose do Corpo Cavernoso/tratamento farmacológico , Microscopia com Lâmpada de Fenda , SARS-CoV-2 , Anticoagulantes/administração & dosagem
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