Comparison of culture media for ex vivo cultivation of limbal epithelial progenitor cells.

PURPOSE: To compare the effectiveness of three culture media for growth, proliferation, differentiation, and viability of ex vivo cultured limbal epithelial progenitor cells. METHODS: Limbal epithelial progenitor cell cultures were established from ten human corneal rims and grew on plastic wells in three culture media: supplemental hormonal epithelial medium (SHEM), keratinocyte serum-free medium (KSFM), and Epilife. The performance of culturing limbal epithelial progenitor cells in each medium was evaluated according to the following parameters: growth area of epithelial migration; immunocytochemistry for adenosine 5'-triphosphate-binding cassette member 2 (ABCG2), p63, Ki67, cytokeratin 3 (CK3), and vimentin (VMT) and real-time reverse transcription polymerase chain reaction (RT-PCR) for CK3, ABCG2, and p63, and cell viability using Hoechst staining. RESULTS: Limbal epithelial progenitor cells cultivated in SHEM showed a tendency to faster migration, compared to KSFM and Epilife. Immunocytochemical analysis showed that proliferated cells in the SHEM had lower expression for markers related to progenitor epithelial cells (ABCG2) and putative progenitor cells (p63), and a higher percentage of positive cells for differentiated epithelium (CK3) when compared to KSFM and Epilife. In PCR analysis, ABCG2 expression was statistically higher for Epilife compared to SHEM. Expression of p63 was statistically higher for Epilife compared to SHEM and KSFM. However, CK3 expression was statistically lower for KSFM compared to SHEM. CONCLUSIONS: Based on our findings, we concluded that cells cultured in KSFM and Epilife media presented a higher percentage of limbal epithelial progenitor cells, compared to SHEM.

Comparison between two surgical techniques for lower eyelid rejuvenation: safety analysis and outcomes.

BACKGROUND: The purpose of this study was to analyze prospectively 50 patients submitted to lower blepharoplasty allocated to two surgical groups at Federal University of São Paulo, between April 2005 and May 2007. METHODS: Fifty patients were assigned for interventions into two surgical groups by using random allocation. The SG1 (control group) was composed of 25 patients who were submitted to conservatively standard fat-resection lower blepharoplasty, and routine lateral canthal support. The SG2 (experimental group) was represented by 25 patients submitted to lower blepharoplasty with periorbital fat mobilization and arcus marginalis redrape, and routine lateral canthal support. Preoperative demographic and morphological data from patient charts and standardized photographs obtained before and after surgery were evaluated by an independent observer. Surgical techniques and management of complications were determined from operative reports and clinical notes. RESULTS: The median follow-up was 395 days (range 364 to 547 days). The mean age was 48.8 years; the population's gender was predominantly female (96%). Analysis of preoperative and postoperative photographs showed that all patients achieved significant improvement. Lateral canthal support was performed in all patients with statistically significant results. CONCLUSION: The authors concluded that both procedures are safe and effective, with low complication rates.

Effect of lower blepharoplasty on self-esteem.

BACKGROUND: Cosmetic surgery is an increasingly common medical procedure whose benefits to patients have not been quantified objectively. Although physicians historically have focused on minimizing side effects and optimizing the physical outcome, a broad spectrum of patient needs also factors in treatment success. Unfortunately, few data are available regarding the effects of cosmetic procedures on patient's self-esteem. OBJECTIVE: To prospectively examine long-term self-esteem outcomes for patients undergoing lower blepharoplasty at São Paulo Federal University between April 2005 and May 2007. METHODS: The self-esteem of 50 patients undergoing blepharoplasty at São Paulo Federal University was compared with that of 25 age-matched volunteers from the general population. The parameters of the Rosenberg Self-Esteem Scale (RSES) were determined preoperatively and at 6-month intervals postoperatively. The data from the instrument were analyzed using the Wilcoxon test. RESULTS: Self-esteem scores improved from a baseline preoperative mean level+/-standard deviation of 5.1+/-4.1 to 3.6+/-3.5 6 months after surgery (p=.001). The self-esteem of 31 (62%) subjects improved after the surgery. CONCLUSION: Marked improvement in self-esteem, evaluated using RSES at 6-month follow-up, was observed in patients undergoing blepharoplasty.

Color vision impairment in type 2 diabetes assessed by the D-15d test and the Cambridge Colour Test.

Color vision impairment emerges at early stages of diabetes mellitus type 2 (DM2) and may precede diabetic retinopathy or the appearance of vascular alterations in the retina. The aim of the present study was to compare the evaluation of the color vision with two different tests - the Lanthony desaturated D-15d test (a traditional color arrangement test), and the Cambridge Colour Test (CCT) (a computerized color discrimination test) - in patients diagnosed with DM2 without clinical signs of diabetic retinopathy (DR), and in sex- and age-matched control groups. Both color tests revealed statistically significant differences between the controls and the worst eyes of the DM2 patients. In addition, the degree of color vision impairment diagnosed by both tests correlated with the disease duration. The D-15d outcomes indicated solely tritan losses. In comparison, CCT outcomes revealed diffuse losses in color discrimination: 13.3% for best eyes and 29% for worst eyes. In addition, elevation of tritan thresholds in the DM2 patients, as detected by the Trivector subtest of the CCT, was found to correlate with the level of glycated hemoglobin. Outcomes of both tests confirm that subclinical losses of color vision are present in DM2 patients at an early stage of the disease, prior to signs of retinopathy. Considering the advantages of the CCT test compared to the D-15d test, further studies should attempt to verify and/or improve the efficiency of the CCT test.

Frequência da microftalmia associada à catarata congênita, sua frequência etiológica e o resultado visual pós-cirúrgico / Frequency and ethiological frequency of congenital cataract associated with microphthalmia and postoperative visual results

Resumo Objetivo: Determinar a frequência da microftalmia associada à catarata congênita e sua frequência etiológica. Comparar o resultado visual após a cirurgia da catarata congênita em olhos microftálmicos, com o resultado visual obtido em olhos não microftálmicos. Método: Estudo retrospectivo de 76 pacientes portadores de microftalmia e catarata congênita, selecionados após análise de 1050 prontuários dos pacientes atendidos no ambulatório de catarata congênita da UNIFESP. A microftalmia foi determinada pela ecobiometria ultrassonica. Exames oculares e complementares foram feitos para esclarecer a causa etiológica. O resultado visual pós- operatório do Grupo I (com microftalmia) foi confrontado com o resultado visual obtido no Grupo II (sem microftalmia). Resultados: O diâmetro ântero-posterior dos olhos microftálmicos variou de 13 à 21 mm. A frequência etiológica da catarata congênita associada aos olhos microftálmicos foi assim distribuída: doenças infecciosas (55,3%); seguidos de idiopáticas (26,3%), colobomas (7,9%), hereditárias (6,6%), persistência do vítreo primário hiperplásico (2,6%) e associada à síndrome de Lenz (1,3%) .A frequência da microftalmia foi de 7,23 %. 68,3% de olhos afácicos microftálmicos atingiram visão melhor e ou igual à 20/200. Conclusão: A frequência da microftalmia associada à catarata congênita foi de 7,23%. A maior frequência etiológica ocorreu nas doenças infecciosas (55,3%), Embora os olhos microftálmicos tenham tendência para piores resultados visuais quando comparados aos não microftálmicos, nesta pesquisa os olhos microftálmicos afácicos que atingiram visão melhor ou igual a 20/200 foram de 68,3%.

Abstract Objective: To determine the frequency of microphthalmia associated with congenital cataract and its etiological frequency. Compare the result of visual acuity in aphakic microphthalmus eyes, with the visual acuity result obtained in non microphthalmus eyes. Methods: Retrospective study of 76 patients with microphthalmia and congenital cataract, selected after analysis of 1050 medical records of patients seen in congenital cataract clinic of UNIFESP. All patients underwent complete ophthalmologic examination and microphthalmia determined by ultrasound biometry. Investigations were made to clarify the etiological cause. The postoperative visual outcome of Group I (with microphthalmia) was faced with the visual results obtained in Group II (control group without microphthalmia). Results: The anteroposterior diameter of microphthalmus eyes ranged from 13 to 21 mm. The etiological frequency of microphthalmia and congenital cataract was distributed as follows: infectious diseases (55.3%), idiopathic (26.3%), colobomas (7.9%), hereditary (6.6%), persistent hyperplastic vitreous (2.6%) and linked to the Lenz's syndrome (1.3%). The visual acuity in aphakic eyes that reached better view and or equal to 20/200 was 68.3%. Conclusion: The frequency of microphthalmia associated with congenital cataract was 7.23%. The etiological occurred more frequently in infectious disease (55.3%). The aphakics eyes with microphthalmia tend to have worse visual acuity results than the eyes without microphthalmia. If we consider the visual results same and above 20/200 as successful in this search, aphakic eyes with microphthalmia that hit these indices are 68.3%.

[Lower blepharoplasty: would the surgery provide satisfaction to the patient?]. / Blefaroplastia inferior: poderia a cirurgia proporcionar satisfação aos pacientes?

PURPOSE: The purpose of this study was to analyze prospectively fifty patients submitted to lower eyelid blepharoplasty at the Federal University of São Paulo, between April 2005 and May 2007. METHODS: Fifty patients were assigned to interventions into two surgical groups by using random allocation. The Surgical Group1 (control group) was composed of 25 patients who were submitted to conservatively standard fat-resection lower eyelid blepharoplasty, and routine lateral canthal support. The Surgical Group 2 (experimental group) was represented by 25 patients submitted to lower eyelid blepharoplasty with periorbital fat mobilization and arcus marginalis redrape, and routine lateral canthal support. The self-esteem of all patients was compared with those in 25 age-matched volunteers from the general population. The parameters of the Rosenberg Self-Esteem Scale were determined preoperatively and at 6-month interval postoperatively. Standardized photographs obtained before and after surgery were evaluated by three independent observers. RESULTS: The median follow-up was 395 days (range 364 to 547 days). The mean age was 48.8 years, the population's gender was predominantly female (96%). Analysis of preoperative and postoperative photographs showed that 96% patients achieved significant improvement. Self-esteem scores improved from baseline preoperative mean levels of 5.1 (Standard Deviation = 4.1) to a mean level of 3.6 (Standard Deviation = 3.5) at 6 months post-surgery (p=0.001). No patients had orbital hematoma, blepharitis, lagophthalmos or ectropion. CONCLUSIONS: The authors concluded that both procedures are safe and effective with low complication rates, and marked improvement in self-esteem was observed in patients at 6-month follow-up.

Clinical outcomes, patients' satisfaction and aesthetic results after lower eyelid blepharoplasty.

OBJECTIVE: To evaluate the results of fifty patients undergoing transcutaneous lower eyelid blepharoplasty. METHODS: We conducted a prospective, randomised, controlled trial between April 2005 and May 2007. Patients were randomly divided into two groups: Group 1 consisted of 25 surgical patients undergoing traditional lower blepharoplasty and routine lateral canthopexy; Group 2 consisted of 25 patients undergoing lower blepharoplasty with fat bags transposition and routine lateral canthopexy. We used the Rosenberg Self-Esteem Scale UNIFESP / EPM to assess patients' self-esteem. We also requested the participation of three independent surgeons, who examined the pre and postoperative photographs and quantified the results with the aid of a topographic scale. RESULTS: The mean age was 48.8 years, predominantly females (96%). The analysis of photographs showed a 96% significant improvement. Self-esteem scores improved from a preoperative average of 5.1 (SD = 4.1) to a mean of 3.6 (SD = 3.5) six months after the operation (p = 0.001). CONCLUSION: Both procedures are safe and effective with low complication rates, causing improvement of self-esteem assessed six months after the operation.

Early visual changes in diabetic patients with no retinopathy measured by color discrimination and electroretinography

Early visual changes caused by diabetes include color vision losses and an abnormal full-field electroretinogram. The purpose of this study was to evaluate color vision in type 2 diabetic patients with no clinically detectable retinopathy using an objective psychophysical color vision test, evaluate retinal function assessed by full-field electroretinography (ffERG), and verify the agreement among the changes detected by each of these tests. Color vision was tested and ffERG was performed in 34 diabetic patients (20 males; ages 56 ± 9 years). Results were compared with those obtained from age-matched control groups. Color discrimination losses occurred in all three color-confusion axes with a higher incidence on the protan axis. The full-field electroretinographic data indicated that inner retinal components (i.e., ffERG oscillatory potentials) were more affected than outer retinal components, indicating impairment of second- and third-order retinal neurons early in the disease. Previous studies reported tritan losses as a classic color vision defect in diabetes, but our results showed that all three color-confusion axes (i.e., protan, deutan, and tritan) are compromised, at least during the very early stages of the disease, reflecting a diffuse pattern of color vision loss. The full-field electroretinographic results that showed abnormalities of the inner retina support the color vision findings...

Blefaroplastia inferior: poderia a cirurgia proporcionar satisfação aos pacientes? / Lower blepharoplasty: would the surgery provide satisfaction to the patient?

OBJETIVO: Foi realizado um estudo prospectivo com objetivo de avaliar os resultados de cinquenta pacientes submetidos a blefaroplastia inferior transcutânea, visando a análise do resultado clínico e a satisfação dos pacientes na Universidade Federal de São Paulo, entre abril de 2005 e maio de 2007. MÉTODOS: Os pacientes foram alocados aleatoriamente em dois grupos cirúgicos. O Grupo Cirúrgico 1 (Grupo Controle) foi composto por 25 pacientes submetidos a blefaroplastia inferior tradicional e cantopexia lateral de rotina. O Grupo Cirúrgico 2 (Grupo Experimental) foi composto por 25 pacientes submetidos a blefaroplastia inferior com transposição das bolsas adiposas e cantopexia lateral de rotina. Para avaliar os resultados obtidos foi utilizado a avaliação da autoestima dos pacientes, por meio da Escala de Autoestima de Rosenberg UNIFESP/EPM. O outro método utilizado foi solicitar a participação de três cirurgiões independentes que avaliaram as fotografias de pré e pós-operatório e com auxílio de uma escala topográfica, quantificaram os resultados. RESULTADOS: A média de idade foi de 48,8 anos, com predomínio do sexo feminino (96%). A análise das fotografias mostrou que 96% dos pacientes apresentaram melhora significativa. A autoestima melhorou de um escore médio no pré-operatório de 5,1 (desvio padrão = 4,1) para um valor médio de 3,6 (desvio padrão = 3,5) após 6 meses da cirurgia (p=0,001). CONCLUSÃO: Os autores concluíram que ambos os procedimentos seriam seguros e eficazes, com baixo índice de complicação, apresentando melhora da autoestima, visível após seis meses da cirurgia.

PURPOSE: The purpose of this study was to analyze prospectively fifty patients submitted to lower eyelid blepharoplasty at the Federal University of São Paulo, between April 2005 and May 2007. METHODS: Fifty patients were assigned to interventions into two surgical groups by using random allocation. The Surgical Group1 (control group) was composed of 25 patients who were submitted to conservatively standard fat-resection lower eyelid blepharoplasty, and routine lateral canthal support. The Surgical Group 2 (experimental group) was represented by 25 patients submitted to lower eyelid blepharoplasty with periorbital fat mobilization and arcus marginalis redrape, and routine lateral canthal support. The self-esteem of all patients was compared with those in 25 age-matched volunteers from the general population. The parameters of the Rosenberg Self-Esteem Scale were determined preoperatively and at 6-month interval postoperatively. Standardized photographs obtained before and after surgery were evaluated by three independent observers. RESULTS: The median follow-up was 395 days (range 364 to 547 days). The mean age was 48.8 years, the population's gender was predominantly female (96%). Analysis of preoperative and postoperative photographs showed that 96% patients achieved significant improvement. Self-esteem scores improved from baseline preoperative mean levels of 5.1 (Standard Deviation = 4.1) to a mean level of 3.6 (Standard Deviation = 3.5) at 6 months post-surgery (p=0.001). No patients had orbital hematoma, blepharitis, lagophthalmos or ectropion. CONCLUSIONS: The authors concluded that both procedures are safe and effective with low complication rates, and marked improvement in self-esteem was observed in patients at 6-month follow-up.

Resultados clínicos e satisfação dos pacientes após blefaroplastia inferior / Clinical outcomes, patients' satisfaction and aesthetic results after lower eyelid blepharoplasty

OBJETIVO: Avaliar os resultados de cinquenta pacientes submetidos à blefaroplastia inferior transcutânea. MÉTODOS: Estudo prospectivo, randomizado e controlado realizado entre abril de 2005 e maio de 2007. Os pacientes foram alocados aleatoriamente em dois grupos: Grupo Cirúrgico 1 composto por 25 pacientes submetidos à blefaroplastia inferior tradicional e cantopexia lateral de rotina e Grupo Cirúrgico 2 composto por 25 pacientes submetidos à blefaroplastia inferior com transposição das bolsas adiposas e cantopexia lateral de rotina. Para avaliar os resultados obtidos foi utilizada a avaliação da autoestima dos pacientes, através da Escala de Autoestima de Rosenberg UNIFESP/ EPM. O outro método utilizado foi solicitar a participação de três cirurgiões independentes que avaliaram as fotografias de pré e pós-operatórios e com o auxílio de uma escala topográfica, quantificaram os resultados. RESULTADOS: A média de idade foi de 48,8 anos, com predomínio do sexo feminino (96 por cento). A análise das fotografias mostrou que 96 por cento dos pacientes apresentaram melhora significativa. A autoestima melhorou de um escore médio no pré-operatório de 5,1 (desvio padrão = 4,1) para um valor médio de 3,6 (desvio padrão = 3,5) seis meses após a operação (p = 0,001). CONCLUSÃO: Os autores concluíram que ambos os procedimentos seriam seguros e eficazes, com baixo indíce de complicação, apresentando melhora da autoestima, avaliada seis meses após a operação.

OBJECTIVE: To evaluate the results of fifty patients undergoing transcutaneous lower eyelid blepharoplasty. METHODS: We conducted a prospective, randomised, controlled trial between April 2005 and May 2007. Patients were randomly divided into two groups: Group 1 consisted of 25 surgical patients undergoing traditional lower blepharoplasty and routine lateral canthopexy; Group 2 consisted of 25 patients undergoing lower blepharoplasty with fat bags transposition and routine lateral canthopexy. We used the Rosenberg Self-Esteem Scale UNIFESP / EPM to assess patients' self-esteem. We also requested the participation of three independent surgeons, who examined the pre and postoperative photographs and quantified the results with the aid of a topographic scale. RESULTS: The mean age was 48.8 years, predominantly females (96 percent). The analysis of photographs showed a 96 percent significant improvement. Self-esteem scores improved from a preoperative average of 5.1 (SD = 4.1) to a mean of 3.6 (SD = 3.5) six months after the operation (p = 0.001). CONCLUSION: Both procedures are safe and effective with low complication rates, causing improvement of self-esteem assessed six months after the operation.

Color space distortions in patients with type 2 diabetes mellitus.

Color vision impairment was examined in patients with type 2 diabetes mellitus (DM2) without retinopathy. We assessed the type and degree of distortions of individual color spaces. DM2 patients (n = 32), and age-matched controls (n = 20) were tested using the Farnsworth D-15 and the Lanthony D-15d tests. In addition, subsets of caps from both tests were employed in a triadic procedure (Bimler & Kirkland, 2004). Matrices of inter-cap subjective dissimilarities were estimated from each subject's "odd-one-out" choices, and processed using non-metric multidimensional scaling. Two-dimensional color spaces, individual and group (DM2 patients; controls), were reconstructed, with the axes interpreted as the R/G and B/Y perceptual opponent systems. Compared to controls, patient results were not significant for the D-15 and D-15d. In contrast, in the triadic procedure the residual distances were significantly different compared to controls: right eye, P = 0.021, and left eye, P = 0.022. Color space configurations for the DM2 patients were compressed along the B/Y and R/G dimensions. The present findings agree with earlier studies demonstrating diffuse losses in early stages of DM2. The proposed method of testing uses color spaces to represent discrimination and provides more differentiated quantitative diagnosis, which may be interpreted as the perceptual color system affected. In addition, it enables the detection of very mild color vision impairment that is not captured by the D-15d test. Along with fundoscopy, individual color spaces may serve for monitoring early functional changes and thereby to support a treatment strategy.

Endophthalmitis: incidence and prevention.

PURPOSE OF REVIEW: To present current peer-reviewed articles related to the incidence and prevention of postoperative endophthalmitis. RECENT FINDINGS: Recent literature indicates that the incidence of postoperative endophthalmitis may be on the rise. Although the preoperative use of antibiotics as prophylaxis is still controversial, it is becoming more common. SUMMARY: The reports of endophthalmitis analyzed from peer-reviewed ophthalmic journals suggest that the incidence of endophthalmitis has increased, ranging from 0.1 to 0.18% in different countries. This may be related to factors associated with the incision. Although some resistance has been detected, fourth-generation fluoroquinolones seem to be a proper antibiotic for endophthalmitis prophylaxis because of their spectrum, mode of action, and penetration.

Ceratectomia fotorrefrativa para correçäo da baixa miopia utilizando diferentes perfis de ablaçäo / Photorefractive keratectomy for low myopia using different ablation profiles

Objetivos: O presente estudo prospectivo compara os resultados obtidos pela ceratectomia fotorrefrativa com uma ou duas zonas de ablaçäo para tratamento de baixa miopia. Métodos: Dezenove pacientes com graus de miopia até 6,00 dioptrias foram submetidos a PRK com diferentes perfis de ablaçäo em cada olho. Foi realizado tratamento esférico com uma única zona de ablaçäo de 6,0 mm, ao passo que o outro olho recebeu tratamento com duas zonas de ablaçäo, sendo uma de 6,0 mm e outra de 6,5 mm. Todos os tratamentos foram programados para correçäo total do equivalente esférico. Resultados: No grupo multizona (MZ), o equivalente esférico pré-operatório foi em média de -2,87 dioptrias (-1,25 a -4,62D). No grupo submetido à cirurgia com uma única zona de ablaçäo (ZU), o equivalente esférico pré-operatório foi de -2,78 dioptrias (-1,37 a -4,62 D). Näo foi observada diferença significante entre os resultados obtidos nos dois grupos com relaçäo ao equivalente esférico final (p = 0,391). No primeiro mês de pós-operatório, 84 por cento dos pacientes do grupo MZ (múltiplas zonas de ablaçäo) e 95 por cento do grupo ZU (única zona de ablaçäo), apresentaram acuidade visual sem correçäo melhor ou igual a 20/40. Com relaçäo ao tempo transcorrido até se atingir a melhor acuidade visual, näo houve diferença significante entre os dois grupos (p=0,53). Conclusäo: Os resultados obtidos utilizando-se diferentes perfis de ablaçäo para tratamento de baixas miopias foram equivalentes no que diz respeito a equivalente esférico final, induçäo de astigmatismo e incidência de complicaçöes. O estudo conclui que näo foi possível óbservar diferença estatisticamente significante entre os dois grupos, podendo-se utilizar qualquer um dos procedimentos no tratamento das baixas miopias.

Color vision loss in patients treated with chloroquine

Patient that make use of chloroquine or hydroxychloroquine, drugs which are frequently administered for treatment of rheumatoid arthritis, lupus erithromatosus or malaria, may suffer alterations in color vision and in contrast sensitivity. The present work evaluates the visual functions of these patients in a joint study of the University of São Paulo (USP), in São Paulo, and of the Federal University of Pará (UFPA), in belém. Thirty two chloroquine user patients without alterations in the eye fundus exam were evaluated in São Paulo (n=10; aged 38 to 71 years; mean=55,8 years) and in Belém (n=22; aged 20 to 67; mean=40 years). The described accumulated chloroquine dose was 45 to 430g (mean=213g; as=152g) for the São Paulo group, and 36 to 540g (mean=174g; sd=183g) for the Belém group. Tests were performed monocularly corrected eye refractive state. Color discrimination was evaluated using the Cambridge Colour Test (CCT): the color discrimination threshold was measured first in the protan, deutan and tritan axes and , in succession, three MacAdamÆs ellipses were determined. The patientÆs color vision was also evaluated with color arrangement tests: the Farnsworth-Munsell 100 Hue (FM100), the Farnsworth-Munsell D15, and the Lanthony Desaturated (D15d) tests. We also measured the contrast sensitivity for black-and-white sine wave grating of twenty two patients. The results were compared with control without ophthalmologic or neuro-ophthalmologic pathologies. Twenty four patients presented acquired dyschromatopsia. There were cases of selective loss (11 patients) and of diffuse loss (13 patients). Although losses were present in the FM100 there was no correlation between the FM100 error score and the ellipse area measured by the CCT. Moreover, three patients that scored normal in the FM100, failed to reach normal threshold in the CCT. The Lanthony test was less sensitive than the other two tests, since it failed to indicate loss in about half the patients, and the D15 was the least sensitive test, having failed to indicate loss in 9 out of 10 patients. Contrast sensitivity was within normal values for patients submitted to this test. The extent of losses in color discrimination was positively correlated with the accumulated dose. The CCT is recommended for follow up since it provides quantitative data that can be directly interpreted in CIE (Commission Internationalle dÆÉclairage) color space.

Alergia ocular / Ocular allergy

Processos alergicos oculares sao patologias frequentemente encontradas na pratica clinica.Os autores revisam algumas doenca salergicas e imunologicas considerando seus aspectos clinicos.Uma introducao sobre as caracteristicas singulares da imunologia do olho e oferecida.O papael dos mastocitos na alergia ocular e amplamente apresentado atraves da discussao da conjutivite alergica,primaveril,atopica e papilar gigante.A resposta mediada por anticorpos e outro aspecto das reacoes de hipersensibilidade afetando o olho.Penfigoide,ulcera de Mooren,granulomatose de wegener e arterite de celulas gigantes sao exemplos de tal mecanismo de destruicao do tecido ocular.Algumas etiologias uveiticas sao discutidas principalmente patologias com manifestacoes sistemica que o clinico geral pode enfrentar.

Estudo comparativo da açäo antiinflamatória da Dexametasona a 0,1 por cento e Diclofenaco sódico a 0,1 por cento tópicos nas uveítes anteriores, através da flare fotometria / Comparative study, by flare photometry, between the antiinflammatory action of dexamethasone 0,1 por cento and diclofenac sodium 0,1 por cento in acute anterior uveitis

A inflamaçäo na câmara anterior foi avaliada em 44 pacientes com indociclite aguda näo tratada, através da laser "flare" fotometria (KOWA FM-500), antes e após 2 e 7 dias da administraçäo tópica de dexametasona a 0,1 por cento um antiinflamatório näo esteróide (25 pacientes). Näo houve diferença significativa entre a açäo dos dois medicamentos.

Influência do epitélio corneal limbar sobre a expressäo antígeno dos linfócitos da mucosa humana (HML-1) / Corneal limbal epithelium influence on Human Mucosal Lymphocyte Antigen (HML-1) expression

Os linfócitos intraepiteliais (IELs) parecem desempenhar papel importante na defesa e na tolerância induzidas pelo tecido linfocitário associado à mucosa (MALT). No epitélio das mucosas, os IELs expressam a integrina HML-1, que é a responsável pela sua aderência no epitélio. Neste trabalho propöe-se estudar os mecanismos de expressäo do HML-1 nos linfócitos do sangue periférico associados ao epitélio corneal limbar. Culturas do epitélio da córnea de diferentes doadores e de linfócitos de sangue periférico de um paciente foram estabelecidas. Três grupos de estudo foram deteminados: Grupo A, linfócitos näo ativados juntamente com células epiteliais corneais limbares em meio de cultura; Grupo B, linfócitos näo-ativados separados do epitélio por membrana semi-permeável em meio de cultura; Grupo C, linfócitos näo-ativados em meio de cultura (controle). No sétimo dia, os linfócitos de todos os grupos ..

Uveítes na infância em Säo Paulo / Uveitis in children in Säo Paulo

Foram revistas as fichas de 1690 pacientes portadores de uveíte, atendidos na Secçäo de uveítes da Disciplina de Oftalmologia da Escola Paulista de Medicina em Säo Paulo, Brasil, de fevereiro de 1974 a outubro de 1985. Destes pacientes, 194 tinham idade inferior ou igual a 16 anos na ocasiäo da admissäo e tiveram suas fichas analisadas neste estudo. A porcentagem de uveítes na infância em nosso meio foi de 11,48% com predomínio do sexo feminino e de pacientes de 13 a 16 anos. Em relaçäo aos diagnósticos clínicos mais comuns, foram encontrados 61 (31,44%) casos de uveíte por Toxoplasmose, 5 (2,57%) de Uveíte Intermediária, 4 (2,06%) de uveíte por Tuberculose, 3 (1,54%) por Artrite Reumatóide Juvenil. Todos esses diagnósticos foram relacionados com as variáveis sexo e grupo etário

Ulceras de córnea em serviço de referência / Corneal ulcers in reference service

A determinaçäo dos agentes etiológicos causadores de úlcera de córnea é importante devido a incidência variável de microorganismos nas diferentes regiöes do país. No presente trabalho realizado com os dados obtidos junto ao laboratório de Microbiologia Ocular da Escola Paulista de Medicina foram analisados 126 pacientes representando 13% da amostragem geral, com diagnóstico de úlcera de córnea da qual foi colhido material para bacterioscopia, citologia e cultura, desta forma procedeu-se a identificaçäo do agente etiológico e sua sensibilidade aos agentes antimicrobianos. Dos casos estudados houve predomínio de pacientes do sexo masculino sendo traumatismo corneano (14%) o fator predisponente mais citado nos dados de anamnese. Em relaçäo ao uso de medicaçäo tópica 47% utilizavam antibióticos e 6% corticóides até 24 horas antes da colheita de material. Houve comprovaçäo de ceratite infecciosa em 76 pacientes (61%) - em 11 casos apenas o exame direto do material colhido foi positivo para microorganismos e a cultura negativa. Nos casos em que a cultura foi positiva observou-se um crescimento maior em ágar sangue (45%) e forma identificados 74 microorganismos sendo que em 9 exames forma isoladas mais de uma bacteria...

Efeito imunossupressor da ciclosporina intra-muscular administrada em diferentes períodos pós-operatórios em um modelo de transplante penetrante de córnea em ratos / Immunosuppressive effect of intramuscular cyclosporine used at different post-operative period on a penetrating keratoplasty model in the rat

Obetivo: Avaliar o efeito imunossupressor da ciclosporina intramuscular (I.M.), administrada por tempo limitado em diferentes períodos do pós-operatório, no transplante penetrante de córnea em um modelo experimental em rato, por meio de avaliaçäo clínica e anátoma-patológica do enxerto corneano. Método: Foram utilizados ratos isogênicos Fischer cmo doadores e Lewis como receptopres, em um modelo ortotópico de transplante de córnea. A administraçäo de ciclosporina I.M. 10mg/kg/ dia foi iniciada em diferentes períodos nos grupos estudados: no pós-operatório. A ciclosporina quando iniciada foi administrada até o 30 dia pós-operatório. UM grupo controle näo recebeu a ciclosporina. I.M. Os enxertos corneanos foram avaliadas clínica e histologicamente. Resultado: Rejeiçäo foi observada nas primeiras três semanas dp pós-operatório em 100 (por cento) dos casos no grupo contole (n=5) que näo recebeu a ciclosporina. Os ratos tratados com ciclosporina (n=15) apresentaram rejeiçäo em apenas um caso, que teve curta evoluçäo e poucos sinais clínicos. Os estudos histológicos confirmaram as avaliaçöes clínicas. O grupo controle apresentou infiltrado no enxerto corneal com predomínio de linfócitos sobre neutrófilos com amsi neovasos, com mais fibrose e com infiltrado inflamatório mais intenso do que os grupos tratados com ciclosporina. Conclusäo: Os dados obtidos indicam que a ciclosporina I.M., pode ter efeito benéfico sobre o controle da rejeiçäo do transplante de córnea, mesmo na sua fase ativa