Arquivos brasileiros de oftalmologia最新文献

{"title":"Intrastromal autologous blood injection for treating corneal hydrops.","authors":"Lucas Baldissera Tochetto, Flavio Eduardo Hirai, Ítalo Pena de Oliveira, Klaus Tyrrasch, Tais Hitomi Wakamatsu, José Álvaro Pereira Gomes","doi":"10.5935/0004-2749.2025-0120","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0120","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the technique and outcomes of intrastromal autologous blood injection in patients with severe corneal hydrops.</p><p><strong>Methods: </strong>Nineteen patients with corneal hydrops underwent intrastromal autologous blood injection. Postoperative assessments included best-corrected visual acuity and time to resolution of corneal edema.</p><p><strong>Results: </strong>Corneal edema resolved within 1 week in 5 patients, within 1 month in 11, and within 3 months in 3. The mean duration of edema persistence was 37.94 ± 33.05 days (range, 6-124). Corneal thickness decreased from 2.06 ± 0.71-mm preoperatively to 1.34 ± 0.65-mm at day 7, 0.85 ± 0.56-mm at day 30, and 0.57 ± 0.13-mm at day 90 (p<0.001). Descemet's membrane (DM) detachment decreased from 1.01 ± 0.75-mm to 0.44 ± 0.57-mm, 0.24 ± 0.36-mm, and 0.08 ± 0.11-mm on postoperative days 7, 30, and 90, respectively (p<0.001). DM break size decreased from 1.12 ± 1.19-mm to 0.62 ± 0.84-mm at 3 months (p<0.005). Three patients developed hematocornea; no other major complications were observed. At 3 months, mean best-corrected visual acuity improved from 2.37 ± 0.66 to 0.41 ± 0.17 logMAR with hard contact lenses (p<0.001).</p><p><strong>Conclusions: </strong>Intrastromal autolo gous blood injection is an effective treatment for severe corneal hydrops, promoting faster edema resolution and visual improvement with minimal complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250120"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298216","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":"Quality of life and treatment adherence in glaucoma: a cross-sectional analysis using the NEI-VFQ25 and MMAS-8 questionnaires.","authors":"Marina Siqueira Saito, Bernardo Kaplan Moscovici, Marcello Novoa Colombo-Barboza, Guilherme Novoa Colombo-Barboza, Luiz Roberto Colombo-Barboza, Cybelle Silva Guimarães, Priscilla Fernandes Nogueira","doi":"10.5935/0004-2749.2024-0355","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0355","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the quality of life and treatment adherence of patients with glaucoma at different disease stages, considering factors such as sex, visual acuity, disease severity, and treatment characteristics.</p><p><strong>Methods: </strong>This cross-sectional study included 174 patients (346 glaucomatous eyes) recruited from clinical records and routine follow-ups at a specialized ophthalmology center. Their mean age was 39-90 years, and 60.9% of them were women. Their quality of life and adherence were assessed using the NEI-VFQ25 and MMAS-8 questionnaires, respectively. Complementary tests included 24:2 visual field test, retinography, and optical coherence tomography. Patients diagnosed with glaucoma for at least 6 months were included, whereas pregnant patients and those with ocular diseases were excluded.</p><p><strong>Results: </strong>Among the participants, 59.2% adhered to the treatment whereas 40.8% showed low adherence. The mean quality of life score was 81.87. Patients with low adherence had slightly higher quality of life scores (mean 83.1) than those with good adherence (mean 81.0), but the difference was not statistically significant. Disease severity was associated with increased optic nerve cupping, reduced thickness of the nerve fiber and ganglion cell layers, and great visual field loss. No significant correlation was observed between adherence and quality of life, indicating the independence of these factors and the influence of psychological or social elements.</p><p><strong>Conclusion: </strong>The absence of a correlation between quality of life and treatment adherence highlights the need for tailored interventions for psychological and social aspects. These findings indicate the importance of a comprehensive approach to managing glaucoma, preserving visual function, strengthening doctor-patient relationships, and considering psychosocial factors to enhance quality of life and treatment adherence.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240355"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298266","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":"Effectiveness of surgical training in ophthalmology residency programs in Brazil.","authors":"Newton Kara-Júnior, Renan Magalhães-E-Silva, Silvana Rossi","doi":"10.5935/0004-2749.2025-0033","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0033","url":null,"abstract":"<p><strong>Purpose: </strong>In Brazil, it has traditionally been standard practice to teach a wide range of surgical techniques to all ophthalmology residents, with the aim of equipping them to manage most ocular conditions. However, with modern developments, access to subspecialists has expanded to nearly the entire country. This raises the question of whether it is still necessary to teach numerous surgical techniques to every resident. This study evaluates the effectiveness of surgical training in Brazilian ophthalmology residency programs to determine if comprehensive surgical training for all residents is truly effective, thereby providing evidence to inform educational policy decisions.</p><p><strong>Methods: </strong>A cross-sectional study using a questionnaire distributed to physicians engaged in eye care.</p><p><strong>Results: </strong>A total of 137 physicians responded to the survey, with 104 (76.0%) having already completed their specialization. The findings indicate that most practicing ophthalmologists received surgical training during residency in cataract, glaucoma, oculoplastic, and strabismus surgeries. Nonetheless, many of these specialists no longer perform most of these surgeries in practice, except for cataract surgery. While 53.8% of those who completed residency reported satisfaction with their training, 35.6% indicated that they wished they had received better surgical preparation.</p><p><strong>Conclusion: </strong>The training of ophthalmology specialists must be made more efficient. Training efficiency is reduced when time and resources are devoted to surgical procedures that many specialists will not perform in their careers.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250033"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298068","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":"Efficacy of povidone and propylene glycol-based artificial tears in the treatment of dry eye disease.","authors":"Laura Caldas Dos Santos, Alléxya Affonso, Rubens Belfort, Denise de Freitas","doi":"10.5935/0004-2749.2025-0153","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0153","url":null,"abstract":"<p><strong>Purpose: </strong>This clinical study aimed to assess the effectiveness of microemulsion artificial tears containing povidone and propylene glycol in the management of dry eye disease. Secondary objectives included evaluating improvements in tear-film stability, measured by tear break-up time and corneal staining scores, along with the tolerability and safety of the formulation.</p><p><strong>Methods: </strong>This was a prospective, single-arm interventional study involving 30 participants (52 eyes) diagnosed with dry eye disease. Participants self-administered the investigational eye drops twice daily for 28 consecutive days. Primary and secondary outcomes included changes in the Ocular Surface Disease Index, tear break-up time, and corneal staining scores. Adverse events were documented throughout the study period.</p><p><strong>Results: </strong>Significant improvements in Ocular Surface Disease Index scores were observed, reflecting a reduction in dry eye disease symptoms. Tear break-up time increased notably between baseline and follow-up assessments, with the proportion of eyes exhibiting tear break-up time ≥10 s rising from 25.0% to 63.5%. Additionally, the percentage of eyes with a corneal staining score of zero improved from 23.1% to 69.2%. Conjunctival staining also decreased, with the proportion of eyes with scores of 2 and 3 dropping from 11.5% to 3.8% and 5.8% to 0%, respectively.</p><p><strong>Conclusions: </strong>The findings suggest that povidone and propylene glycol-based artificial tears significantly enhance tear-film stability and alleviate symptoms in patients with mild to moderate dry eye disease, with minimal adverse effects. This formulation represents a safe and effective short-term treatment option for dry eye disease management.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250153"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298077","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":"Trends in female participation at the Brazilian Congress of Ophthalmology, 2016-2023.","authors":"Stéphanie Pessoa Regueira, Taíse Maria Clemente de Araújo, Julia Melo Silva Santiago, Gustavo Rosa Gameiro, Wilma Lelis Barboza, Camila V Ventura","doi":"10.5935/0004-2749.2024-0333","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0333","url":null,"abstract":"<p><strong>Purpose: </strong>To assess female participation in the Brazilian Congress of Ophthalmology.</p><p><strong>Methods: </strong>This retrospective, descriptive-analytical study examined the profiles of individuals involved in the scientific program of the Brazilian Congress of Ophthalmology from 2016 to 2023. Data were provided by the Brazilian Council of Ophthalmology and were categorized by ophthalmology subspecialty, participant role, and geographic region of origin within Brazil. Roles were grouped into three main categories: coordinator, speaker, and moderator/discussant.</p><p><strong>Results: </strong>Female participation at the congress increased from 33% in 2016 to 42% in 2023, showing an annual upward trend of 1.33 (p<0.001). Around 64% of female participants were from the Southeast region, while 16% were from the Northeast. The coordinator role showed the largest increase in female participation, rising from 22% in 2016 to 40% in 2023 (Slope: 2; p<0.001), followed by the speaker role, which increased from 34% to 44% (Slope: 1.5; p<0.001), and the moderator/discussant role, which rose from 32% to 38% (Slope: 1.24; p=0.0586). Changes in female representation across ophthalmology subspecialties were not statistically significant.</p><p><strong>Conclusion: </strong>From 2016-2023, female participation in the Brazilian Congress of Ophthalmology increased across most subspecialties and conference roles. Although gender disparity has narrowed, continuous efforts are needed to achieve greater gender equity and equality in ophthalmology conferences.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240333"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298182","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":"Atypical presentation of sector retinitis pigmentosa.","authors":"Mariana Calheira Gontijo, Mariana Gouveia Bastos Meirelles, Ricardo Luz Leitão Guerra","doi":"10.5935/0004-2749.2025-0031","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0031","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250031"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298469","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":"Macular thickness measured via optic coherence tomography in healthy adults aged 45 years and older: The Brazilian Amazon Region Eye Survey.","authors":"Sung Eun Song Watanabe, Adriana Berezovsky, Arthur Gustavo Fernandes, Bruna Ferraço Marianelli, João Marcello Furtado, Marcela Cypel, Paulo Henrique Morales, Marcos Jacob Cohen, Cristina Coimbra Cunha, Márcia Higashi Mitsuhiro, Galton Carvalho Vasconcelos, Mauro Campos, Nívea Nunes Ferraz, Paula Y Sacai, Jacob Moysés Cohen, Sergio Muñoz, Rubens Belfort, Solange Rios Salomão","doi":"10.5935/0004-2749.2024-0411","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0411","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated macular thickness using spectral-domain optical coherence tomography in healthy participants from a population-based eye survey.</p><p><strong>Methods: </strong>The Brazilian Amazon Region Eye Survey was a population-based study assessing the prevalence and causes of visual impairment, blindness, and ocular diseases in adults aged ≥45 years from urban and rural areas of Parintins. A subgroup was selected based on inclusion criteria for both eyes: best-corrected visual acuity ≥20/32, normal eye examination results, and no prior ocular surgery. Scans were performed using the iVue optical coherence tomography device. Measurements were taken from the nine subfields defined by the Early Treatment Diabetic Retinopathy Study, examining the full retina as well as the inner and outer retinal layers. Associations of retinal thickness with age and sex were also analyzed. Statistical significance was set at p≤0.05.</p><p><strong>Results: </strong>In total, 70 healthy participants (25 males), aged 45-65 years (mean=52 ± 5), were included. Mean central foveal thickness was 248.71 ± 18.73 μm. A significant age-related reduction in macular thickness was observed, particularly in the inner superior parafovea (p=0.036), nasal perifovea (p=0.001), superior perifovea (p=0.028), outer layer of inferior parafovea (p=0.049), and the inferior perifovea of the full retina (p=0.029). Males showed significantly greater thickness in the outer layer, especially in the outer parafovea (p=0.004) and perifovea (p<0.0001).</p><p><strong>Conclusions: </strong>This study established normative macular thickness values for healthy older adults in the Brazilian Amazon region using spectral-domain optical coherence tomography. Age and sex were found to significantly influence macular thickness and should be considered when interpreting measurements. These data will support future studies of retinal diseases in this population.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240411"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298257","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":"Case report: a two-step approach in the management of angle-closure glaucoma associated with Plateau iris configuration.","authors":"Tiago Santos Prata, Isabella Cristina Tristão Pinto Resende, Daniela Mauricio Ribeiro, Fábio Nishimura Kanadani, Izabela Negrão Frota de Almeida","doi":"10.5935/0004-2749.2025-0020","DOIUrl":"10.5935/0004-2749.2025-0020","url":null,"abstract":"<p><p>Angle-closure glaucoma is a major cause of visual impairment worldwide, with Plateau iris syndrome presenting management challenges. We present a case report of a 58-year-old woman with advanced, uncontrolled angle--closure glaucoma and Plateau iris. Her history included laser peripheral iridotomy and three glaucoma medications in both eyes. Different treatments were implemented. For the eye with lower intraocular pressure, fewer peripheral anterior synechiae, and milder disease: phacoemulsification with intraocular lens implantation. For the eye with more advanced disease, a two-step approach was used: slow-coagulation transscleral cyclophotocoagulation using the double-arc protocol, followed by phacoemulsification with intraocular lens implantation 2 months later. Both eyes achieved improved visual acuity and intraocular pressure control with fewer medications, without significant complications. This case highlights transscleral cyclophotocoagulation followed by phacoemulsification as an alternative to combined surgeries in uncontrolled angle-closure glaucoma with Plateau iris, offering a simpler technique, more predictable refractive and pressure-control outcomes, and more straightforward postoperative management.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 5","pages":"e20250020"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940336","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":"Impact of surgeon experience on corneal endothelial changes after cataract surgery.","authors":"Umberto Antonini Rizzuto, Larissa Lima Magalhães, Bruno Lovaglio Cançado Trindade","doi":"10.5935/0004-2749.2024-0368","DOIUrl":"10.5935/0004-2749.2024-0368","url":null,"abstract":"<p><strong>Purpose: </strong>To compare endothelial corneal cell changes following cataract surgery performed by phacoemulsification with intraocular lens implantation, conducted by surgeons with varying levels of experience.</p><p><strong>Methods: </strong>Two hundred and eighty-three eyes diagnosed with cataract were included. Lens opacity was classified into three categories (I, II, and III). Surgeons were categorized into four experience levels (1, 2, 3, and 4), based on years of practice and lifetime surgeries performed. Corneal endothelial characteristics were assessed using non-contact specular microscopy, with measurements taken before surgery and 30-60 days post-surgery.</p><p><strong>Results: </strong>Preand postoperative endothelial analysis showed no significant differences between surgeon levels regarding visual acuity achieved, corneal thickness, and endothelial hexagonality. However, the central endothelial cell density index showed a significantly greater reduction among level 1 surgeons (p=0.026). Grade II cataracts exhibited significant variations in the central endothelial cell density (p=0.011) and average cell size, with level 1 surgeons showing the largest increases (p=0.024).</p><p><strong>Conclusions: </strong>The analysis revealed significant differences in visual acuity and endothelial indices between surgeon experience levels, with less experienced surgeons showing greater variations and poorer performance. Clinical protocols should consider these data to establish safer training protocols.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 5","pages":"e20240368"},"PeriodicalIF":1.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833835","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":"Refractive surgery in glaucoma and suspected glaucoma patients: Critical analysis of the literature and clinical recommendations.","authors":"Sarah Mariz Veras Pinto Figueiredo, Olívia Moura de Paula Ricardo, Wilma Lelis Barbosa, Tiago Santos Prata","doi":"10.5935/0004-2749.2024-0351","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0351","url":null,"abstract":"<p><p>Myopia is a significant risk factor for glaucoma and a growing public health problem worldwide. Detecting glaucomatous changes in highly myopic eyes is diagnostically challenging due to the abnormal appearance of the optic nerve head. These patients also have a greater biomechanical susceptibility to pressure-induced glaucomatous damage. Refractive surgery has become increasingly popular, and many candidates for refractive surgery are myopic. Therefore, we sought to review the aspects of patient evaluation in those who have undergone refractive surgery for myopia concerned with the detection and monitoring of glaucoma development. We identified several important elements of patient evaluation for glaucoma after refractive surgery. These included the need for both structural and functional assessments before and after surgery, and the importance of monitoring for postoperative biomechanical changes in the cornea and their impact on intraocular pressure. We conclude that, in patients who undergo refractive surgery for myopia, it is essential to assess for the presence of glaucoma, to identify staging, and to plan for long-term control of the disease, regardless of IOP.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 5","pages":"e20240351"},"PeriodicalIF":1.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688710","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}