Blood flow velocity in monocular retinoblastoma assessed by color doppler

OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p <0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p =0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p =0.675 and p =0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p =0.027). The pulse index in the central retinal vein was lower in male patients (p =0.017) and in eyes with optic nerve invasion (p =0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.

Estabilidade visual na retinopatia diabética tratada por panfotocoagulação com laser / Visual stability in diabetic retinopathy treated by panretinal laser photocoagulation

OBJETIVO: Avaliar o efeito da "laserterapia" na acuidade visual em portadores de retinopatia diabética avançada e sem queixas visuais. MÉTODOS: Desenvolveu-se estudo observacional descritivo em portadores de retinopatia diabética avançada e sem queixas visuais, submetidos a panfotocoagulação retiniana com laser de argônio. Foi realizado exame oftalmológico completo. Entre o 3° e o 5° meses do tratamento, foi repetido o exame inicial. Para comparação da acuidade visual, entre período pré e pós-tratamento, foi utilizado o teste não-paramétrico de Wilcoxon. RESULTADOS: A amostra foi constituída por 44 pacientes, totalizando 67 olhos, sendo que 37 (55,2 por cento) apresentavam retinopatia diabética proliferativa e 30 (44,8 por cento) não proliferativa grave ou muito grave. A acuidade visual pré-tratamento variou de 0,5 a 1,0 (média de 0,83 ± 0,17). Não houve alteração estatisticamente significante na acuidade visual (p= 0,057) pré e pós-tratamento no período estudado. CONCLUSÃO: Houve estabilidade visual pós-tratamento com a panfotocoagulação, o que enfatiza a necessidade de intervenções em fases mais precoces da retinopatia diabética para preservar a função visual.

PURPOSE: To evaluate the effect of laser treatment in the visual acuity caused by advanced diabetic retinopathy without visual complaints. METHODS: A descriptive observational study was developed in advanced diabetic retinopathy patients not presenting visual complaints. The patients were submitted to argon laser panretinal photocoagulation after ophthalmological examination as well as retinography and retinal angiofluoresceinography. The same initial exams were repeated between third and fifth months after the treatment. The non-parametric Wilcoxon test was employed for statistical evaluation between the visual acuities before and after the treatment. RESULTS: The sample involved 67 eyes of 44 patients. Of these 67 eyes, 37 (55.2 percent) presented proliferative diabetic retinopathy and 30 (44.8 percent) showed severe and severe non proliferative diabetic retinopathy. The visual acuity before the treatment ranged from 0.5 to 1.0 (mean 0.81 ± 0.16). There was no significant statistical difference between the visual acuity (p= 0.057) before and after the treatment during the follow-up period of five months. CONCLUSION: The visual stability after panretinal argon laser photocoagulation indicated the need of this treatment in early phases of diabetic retinopathy in order to preserve the visual function.