Arquivos brasileiros de oftalmologia最新文献

{"title":"The role of meibomian gland morphological alterations in the development of dry eye disease in type 2 diabetes.","authors":"Meryem Altin Ekin","doi":"10.5935/0004-2749.2025-0230","DOIUrl":"10.5935/0004-2749.2025-0230","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether specific meibomian gland morphological features can serve as diagnostic indicators of dry eye disease in patients with type 2 diabetes mellitus.</p><p><strong>Methods: </strong>This cross-sectional study included patients with type 2 diabetes mellitus and age-matched healthy controls. All participants underwent a comprehensive ocular surface evaluation, including the ocular surface disease index, tear break-up time, Schirmer's I test, corneal staining, eyelid margin scoring, meibum expressibility assessment, meibography scoring, and evaluation of meibomian gland loss area. Meibomian gland morphology was assessed bilaterally. Dry eye severity was determined based on ocular surface disease index scores, tear break-up time, Schirmer's test results, and corneal staining scores. Correlations between meibomian gland features and ocular surface parameters, age, diabetes duration, and hemoglobin A1c levels were analyzed. Receiver operating characteristic analysis was performed to determine the diagnostic value of specific meibomian gland features for dry eye disease.</p><p><strong>Results: </strong>Dry eye disease was diagnosed in 56.6% of patients with diabetes and 22.6% of controls. Compared with controls, patients with diabetes had significantly higher ocular surface disease index scores, greater corneal staining, worse meibum expressibility, increased meibomian gland loss, and lower tear break-up time and Schirmer values (all p<0.05). Meibomian gland dropout, shortening, tortuosity, distortion, overlapping, ghost glands, and lack of extension to the lid margin were significantly more prevalent in patients with diabetes (p<0.05) and showed significant correlations with age, HbA1c levels, and diabetes mellitus duration. Receiver operating characteristic analysis identified meibomian gland dropout, ghost glands, shortening, and lack of extension to the lid margin as the most predictive morphological features for dry eye disease in patients with diabetes.</p><p><strong>Conclusion: </strong>Type 2 diabetes mellitus is associated with distinct meibomian gland morphological alterations that correlate with both dry eye disease severity and systemic diabetic parameters, suggesting potential diagnostic value.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0230"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The artificial intelligence revolution in medical education.","authors":"Newton Kara-Junior, Christian Valle Morinaga, Denise Greff Machado","doi":"10.5935/0004-2749.2026-1020","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-1020","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"1020"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of autonomic dysfunction with dynamic pupillometry in non-obese young women with polycystic ovary syndrome.","authors":"Kübra Gündogan, Ali Osman Gündogan, Emine Türen Demir, Naciye Tora","doi":"10.5935/0004-2749.2025-0244","DOIUrl":"10.5935/0004-2749.2025-0244","url":null,"abstract":"<p><strong>Purpose: </strong>Polycystic ovary syndrome is frequently associated with autonomic nervous system dysfunction, even in the absence of obesity or overt metabolic abnormalities. Alterations in pupillary responses may reflect early autonomic involvement and serve as a potential tool for early diagnosis, risk stratification, and disease monitoring. This study aimed to investigate pupillary reflex parameters using dynamic pupillometry in newly diagnosed non-obese women with polycystic ovary syndrome and to compare the findings with those of healthy controls.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 48 newly diagnosed women with polycystic ovary syndrome and 44 ageand sex-matched healthy controls. Pupillary function parameters were measured using dynamic pupillometry (MonPackOne; Metrovision, France).</p><p><strong>Results: </strong>The mean age did not differ significantly between the groups (p=0.870). Initial pupil diameter, pupil contraction amplitude, and contraction velocity were significantly lower in the PCOS group than in the control group, whereas pupillary dilation duration was significantly longer (p<0.001, p<0.001, p=0.007, and p=0.032, respectively). No significant differences were observed between the groups regarding contraction latency, contraction duration, dilation latency, or dilation velocity (p=0.749, p=0.925, p=0.653, and p=0.310, respectively).</p><p><strong>Conclusion: </strong>Newly diagnosed non-obese women with polycystic ovary syndrome exhibit significant alterations in pupillary dynamics, suggesting a generalized reduction in both sympathetic and parasympathetic activity. Dynamic pupillometry may represent a practical, noninvasive tool for detecting early autonomic hypoactivity and identifying patients at risk for future metabolic or cardiovascular complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0244"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of tear film function and meibomian gland morphology in newly diagnosed atopic dermatitis.","authors":"Ali Osman Gündogan, Refik Oltulu, Selman Belviranli, Ali Tezcan, Selami Aykut Temiz, Esra Altay","doi":"10.5935/0004-2749.2025-0257","DOIUrl":"10.5935/0004-2749.2025-0257","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze ocular sur-face parameters and evaluate meibomian gland dys-function using meibography in newly diagnosed patients with atopic dermatitis compared with healthy controls.</p><p><strong>Methods: </strong>This cross-sectional clinical study included 51 newly diagnosed patients with atopic dermatitis and 45 ageand sex-matched healthy controls. Disease severity was assessed using the Eczema Area Severity Index. The Ocular Surface Disease Index questionnaire, Schirmer test, tear meniscus height, noninvasive tear break-up time, conjunctival redness grading, and meibography staging were performed. Meibomian gland dropout was graded for each eyelid from 0 (no loss) to 3 (loss of >2/3 of the total gland area).</p><p><strong>Results: </strong>Schirmer test values, tear meniscus height, and noninvasive tear break-up time were significantly lower in the atopic dermatitis group than in the control group (p<0.001, p<0.001, and p<0.001, respectively). In contrast, Ocular Surface Disease Index scores, conjunctival redness grades, and total meiboscores were significantly higher in the atopic dermatitis group than in the control group (p<0.001, p<0.001, and p<0.001, respectively). Moreover, in the atopic dermatitis group, a significant positive correlation was observed between the Eczema Area Severity Index score and total meiboscore (rₛ=0.390, p=0.005), while a significant negative correlation was found between the Eczema Area Severity Index score and Schirmer test results (rₛ=-0.301, p=0.032).</p><p><strong>Conclusions: </strong>Newly diagnosed patients with atopic dermatitis exhibit significant alterations in tear film parameters and meibomian gland morphology compared with healthy individuals. These patients should be monitored for early development of dry eye disease and meibomian gland dysfunction to prevent associated complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0257"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural analysis of amniotic membrane for use in ophthalmology with different preservation techniques.","authors":"Caio Costa Santos, Roberta Tovo Borghetto Abud, Alvio Isao Shiguematsu, Daniela Carvalho Dos Santos","doi":"10.5935/0004-2749.2025-0105","DOIUrl":"10.5935/0004-2749.2025-0105","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate structural differences in amniotic membrane fragments subjected to different preservation techniques for potential ophthalmologic applications.</p><p><strong>Methods: </strong>Three placentas were collected from healthy donors, and four amniotic membrane fragments were prepared from each placenta. The fragments were divided into four groups with three samples each: cryopreserved, lyophilized, vacuum--dried using a vacuum concentrator, and fresh (control). After processing, the fragments were fixed, sectioned, and analyzed using scanning transmission electron microscopy to assess tissue morphology.</p><p><strong>Results: </strong>All samples met the established evaluation criteria. No morphological differences were observed among the groups. The structural characteristics of lyophilized and vacuum-dried membranes were comparable with those of cryopreserved and fresh membranes. However, vacuum drying demonstrated the greatest practicality for ophthalmologic use, as it allows membrane availability at any time and storage at room temperature.</p><p><strong>Conclusion: </strong>Vacuum drying using a vacuum concentrator, lyophilization, and cryopreservation preserve the morphological characteristics of the human amniotic membrane similar to those of fresh tissue. A standardized protocol using a vacuum concentrator may be established owing to its advantages in storage convenience and accessibility.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0105"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a propylene-glycol-hydroxypropyl guar nanoemulsion on symptoms and ocular surface parameters in patients with evaporative dry eye.","authors":"Cristian Cartes, Claudia Zapata, Camila Lopez, Camila Gaete, Nicolás Aguilera, Christian Segovia","doi":"10.5935/0004-2749.2025-0148","DOIUrl":"10.5935/0004-2749.2025-0148","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of a propylene glycol-hydroxypropyl guar nanoemulsion on symptoms and ocular surface parameters in patients with evaporative dry eye.</p><p><strong>Methods: </strong>This prospective, single-center, interventional study included patients aged 18-50 years with evaporative dry eye who received a propylene glycol-hydroxypropyl guar nanoemulsion. Participants were instructed to instill the nanoemulsion three times daily for 90 days. Evaluations included the Ocular Surface Disease Index, tear osmolarity, tear meniscus height, lipid layer thickness, noninvasive tear break-up time, fluorescein tear break-up time, corneal fluorescein staining (National Eye Institute Scale), Schirmer's test I, and meibum quality.</p><p><strong>Results: </strong>Thirty-three participants were enrolled, and 30 completed the study. The mean age was 36 ± 10 yr, and 73.3% were women. The mean Ocular Surface Disease Index score significantly decreased from 43.1 ± 20 at baseline to 25.2 ± 17 at 3 months (p=0.009). Median corneal fluorescein staining decreased from 2 (IQ range=1-3) to 1 (IQ range 25-75 = 0-1) at the final follow-up (p=0.002). The mean fluorescein tear break-up time increased significantly increased from 3.8 ± 2.1 at baseline to 5.8 ± 2.2 at 3 months (p=0.002). Tear osmolarity decreased significantly (p=0.01) and lipid layer thickness improved markedly (p<0.001). No significant changes were observed in tear meniscus height or noninvasive tear break-up time (p>0.05).</p><p><strong>Conclusions: </strong>Treatment with a propylene glycol-hydroxypropyl guar nanoemulsion significantly improved dry-eye symptoms, corneal staining, tear film stability, and lipid layer quality in patients with evaporative dry eye. No adverse events were reported, supporting the safety and efficacy of this formulation.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"0148"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazil among the world's most cited researchers: Significance, methods, and the place of Ophthalmology.","authors":"Marcony R Santhiago","doi":"10.5935/0004-2749.2026-1021","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-1021","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"1021"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alumni in Focus: Profile, scientific production, and career of graduates from the postgraduate program in ophthalmology at UNIFESP.","authors":"Rosângela Demetrio, Adriano Cypriano Faneli, Denise de Freitas, Caio Vinicius Saito Regatieri","doi":"10.5935/0004-2749.2025-0224","DOIUrl":"10.5935/0004-2749.2025-0224","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the academic and professional trajectories of graduates from the Graduate Program in Ophthalmology and Visual Sciences at the Escola Paulista de Medicina, Universidade Federal de São Paulo, including geographic distribution, occupational characteristics, and scientific productivity.</p><p><strong>Methods: </strong>This descriptive, retrospective, quantitative study included 498 alumni who completed the program between 1979 and 2021. Data were obtained from institutional records and supplemented by public databases (Google Scholar, Lattes Platform, and LinkedIn). The analyzed variables included demographic characteristics, academic background, current professional role, and bibliometric indicators (citation count and h-index). Statistical analyses comprised nonparametric tests and linear regression, with a significance level set at 5%.</p><p><strong>Results: </strong>Most alumni were Brazilian (96.6%) and physicians (90.7%), predominantly located in the Southeast region (66.9%). Doctoral training was completed by 80.5% of participants. Alumni with current institutional ties to Universidade Federal de São Paulo or Hospital São Paulo demonstrated significantly higher citation counts and h-index values. No significant correlation was observed between time since graduation and citation count (p=0.185). Alumni engaged in academic roles or with postdoctoral training showed greater scientific productivity.</p><p><strong>Conclusions: </strong>The findings highlight the strong academic performance and professional integration of alumni from Universidade Federal de São Paulo, particularly within public institutions and the Southeast region of Brazil. Doctoral training and institutional affiliation were associated with higher scientific productivity. Alumni tracking provides valuable insights into the impact of postgraduate programs and informs strategic planning and development.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0224"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of intrastromal micropuncture in Eye Bank corneas using a tattoo machine.","authors":"Michelle de Lima Farah, Samir Arbache, Rubens Belfort","doi":"10.5935/0004-2749.2025-0208","DOIUrl":"10.5935/0004-2749.2025-0208","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the reliability and penetration depth of an automated micropuncture system using a tattoo machine.</p><p><strong>Methods: </strong>Twenty human corneas were obtained and subjected to intrastromal micropuncture using a tattoo machine. Each cornea was divided into two halves: one received pigment, while the other received saline solution as a control. The Cheyenne tattoo machine was operated at 60 Hz, with standardized needle exposure (six passes per application). The machine used cartridges containing five microneedles. The study was registered with Agência Nacional de Vigilância Sanitária ANVISA (numbers 80281110015, 80281110016, and 80281110019). The pigment used was Electric Ink black ink, with a density of 1,271,460 μg/mL. Puncture depth was measured before and after the procedure using both anterior segment optical coherence tomography and histopathological analysis. Puncture depth measurements were analyzed using ImageJ software. Each cornea was measured thrice, and the results were subsequently compared.</p><p><strong>Results: </strong>No corneal perforations were observed with the use of the tattoo machine, and puncture depth measurements ranged from 107 to 486 μm.</p><p><strong>Conclusions: </strong>The use of a tattoo machine represents a viable and accessible approach for keratopigmentation, with potential for both cosmetic and therapeutic applications. Its adaptation for controlled intrastromal drug delivery may enable the targeted treatment of deep infectious keratitis, corneal neovascularization, and stromal inflammatory disorders, representing a promising approach for corneal stromal diseases. Further research is needed to optimize techniques and evaluate long-term safety and efficacy, particularly for the delivery of antimicrobial, anti-inflammatory, and anti-vascular endothelial growth factor agents.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0208"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the pachychoroid spectrum in patients with mild autonomous cortisol secretion.","authors":"Elif Kiliç Kan, Emrah Kan, Bilge Eraydin, Betül Gündüz, Ozlem Eski Yucel","doi":"10.5935/0004-2749.2025-0184","DOIUrl":"10.5935/0004-2749.2025-0184","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate choroidal structural and vascular changes in patients with mild autonomous cortisol secretion using enhanced depth imaging optical coherence tomography and optical coherence tomography angiography.</p><p><strong>Methods: </strong>This cross-sectional study included 60 eyes of 30 patients with mild autonomous cortisol secretion and 60 eyes of 30 subjects with nonfunctional adenoma (controls) between February 2023 and January 2024. Subfoveal choroidal thickness, pachychoroid spectrum disease and choroidal vascularity index were evaluated using spectral-domain optical coherence tomography. Group comparisons were performed, and correlations between subfoveal choroidal thickness and clinical features were analyzed.</p><p><strong>Results: </strong>Pachyvessels were more common in patients with mild autonomous cortisol secretion than in controls (71.4% vs. 42.9%, p=0.002). The frequency of pachychoroidal spectrum disease was significantly higher in the mild autonomous cortisol secretion Group (68.3% vs. 31.7%; p<0.001). Median subfoveal choroidal thickness was 355 μm (range, 150-535) in the mild autonomous cortisol secretion Group and 297 μm (range, 162-597) in controls (p=0.014). Choroidal vascularity index was comparable between groups (p=0.072). Subfoveal choroidal thickness correlated significantly with axial length, spherical equivalent, post-1-mg dexamethasone suppression test cortisol level, and disease duration.</p><p><strong>Conclusion: </strong>Patients with mild autonomous cortisol secretion exhibited greater subfoveal choroidal thickness and a higher frequency of pachychoroidal spectrum disease compared with controls, whereas stromal and vascular structural alterations were proportionally similar between groups.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"0184"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}