Arquivos brasileiros de oftalmologia最新文献

{"title":"Unilateral acute cataract after facial aesthetic procedure: a case report.","authors":"Rafael Norio Makibara, Leonardo Pimenta de Oliveira, Marcela Drummond de Andrade Rocha","doi":"10.5935/0004-2749.2023-0248","DOIUrl":"https://doi.org/10.5935/0004-2749.2023-0248","url":null,"abstract":"<p><p>Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230248"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340163","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":"A comparative analysis of the effectiveness of laser correction with a mechanical and laser microkeratome for myopia.","authors":"Chaoge Liu","doi":"10.5935/0004-2749.2023-0292","DOIUrl":"https://doi.org/10.5935/0004-2749.2023-0292","url":null,"abstract":"<p><strong>Purpose: </strong>Myopia, or nearsightedness, is one of the most common eye conditions worldwide. However, a comparison of the effectiveness of different laser-assisted interventions is lacking. Thus, we aimed to compare the efficacy and safety of LASIK and IntraLASIK in addressing myopia.</p><p><strong>Methods: </strong>The study was conducted in two ophthalmology clinics in Beijing, China, in 2022. A total of 84 patients (152 eyes) with different degrees of myopia were examined and underwent LASIK (n=46, 80 eyes) or IntraLASIK (n=38, 72 eyes). Keratometry, corneal topography, pachymetry, visual acuity evaluation, and corneal biomechanical analysis were performed before and after the intervention.</p><p><strong>Results: </strong>IntraLASIK produced more precise flaps than LASIK, with deviations of <8 mm and 0.1 mm from the intended thickness and diameter, respectively. LASIK resulted in nonuniform flaps, with thickness deviations of 5-86 mm. IntraLASIK demonstrated a superior efficacy for patients with severe myopia and thin corneas, with a mean spherical equivalent of 0.9 D at 6 months compared to the 1.4 D for LASIK. Approximately 91% and 83% of the patients with mild to moderate and severe myopia, respectively, achieved results within ± 0.49 D from the refractive target with IntraLASIK.</p><p><strong>Conclusions: </strong>Corneal hysteresis and corneal resistance factor decreased with an increase in laser intensity, and they decreased faster with thinner corneas. Thus, IntraLASIK is more useful than LASIK in patients with thin corneas and severe myopia.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230292"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340151","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":"A novel predictor of persistent ocular hypotony after pars plana vitrectomy for rhegmatogenous retinal detachment: The initial intraocular pressure difference between the eye with RRD and the fellow eye.","authors":"Ecem Önder Tokuç, V Levent Karabaş, Sevim Ayça Seyyar, Ece Başaran Emengen, Ahmet Burak Güray, Kübra Atay Dinçer, Ceren Deniz Önder, Emrah Gökay Özgür","doi":"10.5935/0004-2749.2023-0326","DOIUrl":"10.5935/0004-2749.2023-0326","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the predictive value of initial intraocular pressure difference of the detached and fellow eyes of patients with complex rhegmatogenous retinal detachment on postoperative persistent ocular hypotony.</p><p><strong>Methods: </strong>This retrospective observational study included 538 eyes of 538 unilateral complex rhegmatogenous retinal detachment patients with a proliferative vitreoretinopathy grade of C-1 or higher, treated with silicone oil endotamponade following pars plana vitrectomy. The patients were divided into Group A (patients having silicone oil removal without ocular hypotony; n=504) and Group B (patients with persistent ocular hypotony following silicone oil removal [n=8, 23.5%] and with retained silicone oil [n=26, 76.5%] due to the risk of persistent ocular hypotony; total n=34). Ocular hypotony was defined as an intraocular pressure of <6 mmHg on two or more occasions. Patients' demographics, including age, sex, and follow-up time, and ocular characteristics, including ocular surgical and trauma history, initial and final best-corrected visual acuity, intraocular pressure and initial intraocular pressure difference of the detached and fellow eyes, and anatomical success rates and postoperative complications, were retrospectively collected from the electronic patient files.</p><p><strong>Results: </strong>The initial intraocular pressure was significantly lower in the detached eyes of Group B than in Group A (8.3 ± 3.5 vs. 12.9 ± 3.3, p<0.001). Also, the initial intraocular pressure difference was significantly higher in Group B than in Group A (8.9 ± 3.2 vs. 2.2 ± 2.7mmHg, p<0.001). The receiver operating characteristic curve analysis showed that the cutoff value of the initial intraocular pressure difference was 7.5mmHg for the risk of persistent ocular hypotony. The most influential factors on postoperative persistent ocular hypotony in the binary logistic regression analysis were the initial intraocular pressure difference and the need for a retinectomy.</p><p><strong>Conclusion: </strong>In eyes with complex rhegmatogenous retinal detachment treated with pars plana vitrectomy and silicone oil tamponade, the initial intraocular pressure difference could be of value in predicting postoperative persistent ocular hypotony and could guide surgeons on the decision of silicone oil removal.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230326"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340152","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":"Guardians of the ocular surface: lessons learned from a challenging case of Langerhans cell histiocytosis with eyelid involvement.","authors":"Laura Goldfarb Cyrino, Andrea Santucci Cesar, Lia Zumblick, Juliana Kato, Patricia Picciarelli, Ruth Miyuki Santo","doi":"10.5935/0004-2749.2024-0007","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0007","url":null,"abstract":"<p><p>Langerhans cell histiocytosis comprises a heterogeneous range of clinical manifestations secondary to clonal proliferation of histiocytes, characterized by the accumulation of these cells in various organs and tissues. The ophthalmological component commonly involved is the orbit. Herein, we report a rare case of Langerhans cell histiocytosis with eyelid involvement, which resulted in severe ocular surface complications, which subsequently significantly impacted the patient's quality of life. This case report highlights the fact that despite being rare, Langerhans cell histiocytosis should be included in the differential diagnosis of eyelid lesions. Furthermore, a multidisciplinary approach with a systemic overview is crucial for managing the ocular complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20240007"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340157","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":"Lacrimal gland enlargement in inactive thyroid eye disease: a case series and literature review.","authors":"Abdullah M Khan, Abeer Alawi, Sahar M Elkhamary, Osama Sheikh, Hamad M Alsulaiman, Rajiv Khandekar, Silvana A Schellini","doi":"10.5935/0004-2749.2024-0113","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0113","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the morphometric and volumetric dimensions of the lacrimal gland in patients with inactive thyroid eye disease and compare them with the values reported in the literature.</p><p><strong>Methods: </strong>This case series evaluated consecutive patients with inactive thyroid eye disease treated at a tertiary eye hospital from 2015 to 2020. The patients' baseline demographics and clinical characteristics were obtained. The axial and coronal length, width, and volume of the lacrimal gland were measured on computed tomography scan images, and the results were statistically analyzed.</p><p><strong>Results: </strong>A total of 21 patients (42 orbits) with inactive thyroid eye disease were evaluated. Their mean age was 49.0 ± 14.6 years, and 12 (57.1%) of them were men. The main complaint was dryness, and the majority of the patients had good vision and mild proptosis. The mean axial length and width of the lacrimal gland were 19.3 ± 3.9 mm and 7.5 ± 2.1 mm, respectively; coronal length and width, 20.4 ± 4.5 mm and 7.5 ± 2.1 mm, respectively; and lacrimal gland volume, 0.825 ± 0.326 mm3. Age, sex, or laterality were not found to be determinants of lacrimal gland enlargement.</p><p><strong>Conclusion: </strong>Patients with thyroid eye disease have enlarged lacrimal gland even in the nonactive phase of the disease multifactorial aspects influence the lacrimal gland in thyroid eye disease, making it difficult to establish a clear correlation with predisposing factors. Further studies are warranted to better understand the association between thyroid eye disease and the lacrimal gland.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20240113"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340158","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":"Prevalence of myopic eyes in private practice and public care services in Brazil: 11 years of retrospective analysis.","authors":"André A Homsi Jorge, Harley E A Bicas, Bruno Henrique Silva, João A de Paula Filho, Graziela Boschetti, Marina R de Sunti, Renata J de Moura","doi":"10.5935/0004-2749.2022-0367","DOIUrl":"https://doi.org/10.5935/0004-2749.2022-0367","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the prevalence of myopic eyes over 11 years (2008-2018) in a private clinic and a public assistance service.</p><p><strong>Methods: </strong>We retrospectively evaluated 6332 individuals (12,664 eyes) between 5 and 25 years old, seen at a private clinic-CEMO (2,663 individuals) and a public service-HOIP (3,669 individuals) from 2008 to 2018. We evaluated the prevalence of myopic eyes (EE ≤-0.50) and high myopic eyes (EE ≤-6.00).</p><p><strong>Results: </strong>Sex and services did not show statistical differences. The variation in the prevalence of myopic and high myopic eyes showed a random pattern during the study period (this prevalence could not be increased). Prevalences ranged from 20.7% (in 2017) to 32.4% (in 2015) for myopic eyes and from 1.6% (in 2009 and 2016) to 3.3% (in 2015) for eyes with high myopia. The prevalence of myopia showed a statistically significant increase based on the age group.</p><p><strong>Conclusion: </strong>The prevalence of myopic eyes did not increase in our study. The mean prevalence of myopic eyes was similar in the private clinic and public service.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 1","pages":"e20220367"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340150","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":"Optic disc edema and visual loss from paracentral acute middle maculopathy mimicking optic neuritis.","authors":"Clarissa R Pereira, Thais S A Benassi, Luiz Guilherme M Mello, Leonardo P Cunha, Rony Carlos Preti, Leandro C Zacharias, Eduardo C de Souza, Mário L R Monteiro","doi":"10.5935/0004-2749.2023-0185","DOIUrl":"https://doi.org/10.5935/0004-2749.2023-0185","url":null,"abstract":"<p><p>Optic neuritis is an important cause of unilateral and acute visual loss in young adults, but other differential diagnoses should be considered, especially when the disease has an atypical presentation. This report presents the case of a young woman with reduced visual acuity in her right eye, associated with optic disc edema and a relative afferent pupillary defect, that was initially misdiagnosed as optic neuritis and subsequently found to have paracentral acute middle maculopathy, possibly secondary to subtle impending central retinal vein occlusion. This case emphasizes the need to remember that retinal vascular diseases can occasionally mimic optic neuritis. Detailed anamnesis and ophthalmic examination can avoid unnecessary interventions.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230185"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340159","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":"Retinoblastoma in Ceara: An epidemiological study in a Brazilian pediatric oncology referral center.","authors":"Samuel Montenegro Pereira, Rian Vilar Lima, Carlos Otavio de Arruda Bezerra Filho, Clara Memória Santos, Maria Carolina Rocha Muniz, Daiane Memória Ribeiro Ferreira, Juliana de Lucena Martins Ferreira","doi":"10.5935/0004-2749.2023-0265","DOIUrl":"https://doi.org/10.5935/0004-2749.2023-0265","url":null,"abstract":"<p><strong>Purpose: </strong>Although Brazil has a high prevalence of retinoblastoma, there is a lack of epidemiological data on the disease. Thus, in this study, we aimed to evaluate the epidemiological profile of patients diagnosed with retinoblastoma in the ophthalmology department of a pediatric tertiary referral hospital in Ceara, Brazil.</p><p><strong>Methods: </strong>A descriptive and cross-sectional study was conducted by retrospectively analyzing the clinical and socioeconomic data from the medical records of pediatric patients followed-up at the hospital between 2007 and 2021. Retinoblastoma was diagnosed on the basis of a fundoscopic or histopathologic examination.</p><p><strong>Results: </strong>The data of 105 patients were included in the study, and the mean patient age at the time of diagnosis was 1.7 years. Most of the patients were women (50.5%) and hailed from rural areas (57.4%), which was associated with a higher tumor stage. Of the 150 patients, 57.1% initially presented with leukocoria. Ocular hyperemia was associated with more advanced stages of retinoblastoma (p=0.004). Bilateral involvement was observed in 25.7% of the patients and at a significantly younger age (p=0.009). The presence of retinal detachment, vascularized lesions, and vitreous seeds significantly increased the likelihood of requiring enucleation.</p><p><strong>Discussion: </strong>This study presents an epidemiological description of retinoblastoma in Brazil, which highlights the significance of early detection. Delayed diagnosis is associated with a poorer visual prognosis and higher mortality rate, particularly in patients with unilateral disease. Risk factors for a more severe disease were retinal detachment, vascularized lesions, and vitreous seeds. The correlation between histopathological features and clinical outcomes was limited.</p><p><strong>Conclusion: </strong>Further studies are required to assess the influence of ocular hyperemia, fundoscopic assessment, and histopathologic findings on the prognosis of retinoblastoma. Moreover, it is critical to devise interventions to reduce the time-to-diagnosis in rural areas.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230265"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340161","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":"Early visual intervention, visual function analysis, and grating visual acuity outcomes in children with congenital Zika syndrome.","authors":"Marcia Beatriz Tartarella, Ana Paula Braga, Jean Hipolito M Borges, Rosana S A S Furtado, Natalia Gomes Diogo, Islane M C Verçosa, Eduarda Tartarella-Nascimento","doi":"10.5935/0004-2749.2022-0375","DOIUrl":"https://doi.org/10.5935/0004-2749.2022-0375","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess grating visual acuity and functional vision in children with congenital Zika syndrome.</p><p><strong>Methods: </strong>Initial and final grating visual acuity was measured using Teller acuity cards. Cerebral vision impairment standardized tests were used to assess functional vision. Patients were referred to the early visual intervention program for visually disabled children. Neuroimaging was performed.</p><p><strong>Results: </strong>In this study, 10 children were included with an age range of 1-37 months. Eight patients presented with macular atrophic scars. Neuroimaging revealed microcephaly and cerebral abnormalities in all patients. Low vision and cerebral vision impairment characteristics were observed in all children. The final grating visual acuity in this group varied from 3.00 to 0.81 logMAR.</p><p><strong>Conclusions: </strong>The grating visual acuity test revealed low vision in all children with congenital Zika syndrome. Functional vision evaluation revealed cerebral vision impairment characteristics in all patients, who were referred to the early visual intervention program. Visual acuity improved in six children.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 1","pages":"e20220375"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340149","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":"Should intravitreal dexamethasone implant in refractory diabetic macular edema be used as an adjuvant therapy or switch therapy?","authors":"Semih Çakmak, Gokhan Demir, Uğur Tunç, Elmas Yuksel Sukun, Yusuf Berk Akbas, Abdullah Ozkaya, Ozgur Artunay, Gurkan Erdogan","doi":"10.5935/0004-2749.2023-0229","DOIUrl":"https://doi.org/10.5935/0004-2749.2023-0229","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of intravitreal dexamethasone implant used as either an adjuvant or a switching therapy for diabetic macular edema in patients with poor anatomic response after three consecutive monthly injections of ranibizumab.</p><p><strong>Methods: </strong>This retrospective study included patients with diabetic macular edema who received three consecutive doses of ranibizumab as initial therapy and demonstrated poor response. A single dose of intravitreal de xamethasone implant was administered to these patients. The patients were divided into two groups according to the treatment modalities: the adjuvant therapy group, consisting of patients who continued treatment with ranibizumab injection after receiving intravitreal dexamethasone implant, and the switch therapy group, consisting of patients who were switched from ranibizumab treatment to intravitreal dexamethasone implant as needed. The main outcome measurements were best corrected visual acuity and central retinal thickness at baseline and at 3, 6, 9, and 12 months of follow-up.</p><p><strong>Results: </strong>In this study that included 64 eyes of 64 patients, the best corrected visual acuity and central retinal thickness values did not significantly differ between the groups at baseline and at 6 months of follow-up (p>0.05). However, at 12 months, the best corrected visual acuity values in the adjuvant and switch therapy groups were 0.46 and 0.35 LogMAR, respectively (p=0.012), and the central retinal thickness values were 344.8 and 270.9, respectively (p=0.007).</p><p><strong>Conclusions: </strong>In a real-world setting, it seems more reasonable to use intravitreal dexamethasone implant as a switch therapy rather than an adjuvant therapy for diabetic macula edema refractory to ranibizumab despite three consecutive monthly injections of ranibizumab. Patients switched to intravitreal dexamethasone implant were found to have better anatomic and visual outcomes at 12 months than those who continued ranibizumab therapy despite their less-than-optimal responses.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 2","pages":"e20230229"},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340162","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}