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1.
J Cataract Refract Surg ; 45(8): 1119-1123, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31174985

RESUMO

PURPOSE: To determine the effects of epithelial basement membrane dystrophy (EBMD) and Salzmann nodular degeneration (SND) on optical biometry measurements. SETTING: Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA. DESIGN: Retrospective case series. METHODS: Cataractous eyes with EBMD or SND scheduled for superficial keratectomy (SK) or phototherapeutic keratectomy (PTK) had baseline biometry. Repeat biometry was performed 30 days or more postoperatively and compared with baseline. The primary outcome measures were keratometry (K) values, axial length and magnitude, and axis of corneal astigmatism. Secondary outcome measures were the change in intraocular lens (IOL) power, toricity, and axis. RESULTS: In the EBMD group (26 eyes), the mean absolute intersession difference showed an increase in mean K values (P < .001) and a change in IOL spherical power predicting a postoperative spherical equivalent (SE) closest to zero (P < .001) in 21 of 26 eyes (8 = 0.5 diopter [D]; 9 = 1.0 D; 4 >1.0 D). In toric IOL-eligible eyes, the recommended IOL toricity changed for 16 of 24 eyes, with a mean cylinder power change of 1.2 D. In the SND group (13 eyes), the mean absolute intersession difference showed an increase in mean K values (P = .023) and a change in IOL spherical power predicting a postoperative SE closest to zero (P < .001) in 11 of 13 eyes (3 = 0.5 D; 3 = 1.0 D; 5 >1.0 D). The recommended IOL toricity changed for 10 of 11 eyes (mean cylinder power change 1.5 D). CONCLUSIONS: Both EBMD and SND altered K measurements as evidenced by clinically significant changes in keratometry after SK or PTK. These changes affected the spherical and toric IOL power. Appropriate management of EBMD and SND before cataract surgery can yield more reliable biometric data for surgical planning.


Assuntos
Córnea/fisiopatologia , Distrofias Hereditárias da Córnea/patologia , Epitélio Corneano/patologia , Idoso , Idoso de 80 Anos ou mais , Astigmatismo/fisiopatologia , Membrana Basal/patologia , Biometria , Topografia da Córnea , Feminino , Humanos , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Óptica e Fotônica , Facoemulsificação , Refração Ocular/fisiologia , Estudos Retrospectivos , Acuidade Visual/fisiologia
2.
J Investig Med High Impact Case Rep ; 7: 2324709619838309, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31010318

RESUMO

Tolosa-Hunt syndrome is characterized by a painful ophthalmoplegia secondary to a granulomatous inflammation in or adjacent to the cavernous sinus. Magnetic resonance imaging will show enhancement of the cavernous sinus and/or the orbital apex. Although this syndrome is extremely rare in children, it should be a diagnostic consideration in patients presenting with painful ophthalmoplegia with variable involvement of cranial nerves II to VI. The differential diagnosis for unilateral cavernous sinus lesion is broad, including vascular lesions (cavernous sinus thrombosis), inflammatory processes (sarcoidosis, autoimmune), neoplastic processes (schwannoma, lymphoma), as well as infectious etiologies. We describe a pediatric patient presenting with neurological symptoms from a unilateral cavernous sinus magnetic resonance imaging abnormality and the thorough diagnostic approach to arrive at the diagnosis of Tolosa-Hunt syndrome.


Assuntos
Seio Cavernoso/patologia , Diplopia/etiologia , Cefaleia/etiologia , Síndrome de Tolosa-Hunt/diagnóstico , Adolescente , Diagnóstico Diferencial , Feminino , Glucocorticoides/uso terapêutico , Humanos , Aumento da Imagem , Imageamento por Ressonância Magnética , Síndrome de Tolosa-Hunt/tratamento farmacológico
3.
Ophthalmic Surg Lasers Imaging Retina ; 50(12): 752-759, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31877220

RESUMO

BACKGROUND AND OBJECTIVE: To compare outcomes in eyes with central retinal vein occlusion (CRVO) presenting with (group 1) or without (group 2) fovea-involving intraretinal hemorrhage (IRH). PATIENTS AND METHODS: Retrospective review of patients diagnosed with acute, treatment-naïve CRVO between January 2009 and July 2016. RESULTS: One hundred fifteen (39.8%) of 289 CRVO eyes had fovea-involving IRH. At baseline, eyes in group 1 had significantly worse visual acuity (VA) (1.2 ± 0.10 logMAR vs. 0.9 ± 0.06 logMAR; P = .001) and greater central subfield thickness (CST) (610.4 µm ± 35.9 µm vs. 435.0 µm + 21.6 µm; P < .001) than eyes in group 2. Final visual outcomes were comparable between groups (1.24 ± 0.09 logMAR vs. 1.02 ± 0.08 logMAR; P = .08). Group 1 received a significantly greater number of intravitreal anti-vascular endothelial growth factor injections during the first year (7.80 ± 0.40 vs. 5.20 ± 0.40; P = .001). CONCLUSIONS: Although treatment-naïve eyes with acute CRVO and fovea-involving IRH had worse VA and greater CST at presentation, the final VA was comparable to eyes without such a hemorrhage. Eyes with foveal IRH had a greater treatment burden in the first 12 months. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:752-759.].


Assuntos
Fóvea Central/patologia , Hemorragia Retiniana/diagnóstico , Oclusão da Veia Retiniana/diagnóstico , Doença Aguda , Idoso , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Feminino , Angiofluoresceinografia , Humanos , Injeções Intravítreas , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Hemorragia Retiniana/tratamento farmacológico , Hemorragia Retiniana/cirurgia , Hemorragia Retiniana/terapia , Oclusão da Veia Retiniana/tratamento farmacológico , Oclusão da Veia Retiniana/cirurgia , Oclusão da Veia Retiniana/terapia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia
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