Arquivos brasileiros de oftalmologia最新文献

{"title":"Correlation between tear crystallization and corneal esthesiometry in patients with Sjögren's syndrome.","authors":"Karolyna Andrade de Carvalho, Lucas Paolera, Bernardo Kaplan Moscovici, Luiz Antônio Brito, Luiz Felipe Ramos Bueno, Sergio Felberg","doi":"10.5935/0004-2749.2024-0409","DOIUrl":"10.5935/0004-2749.2024-0409","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to look into the relationship between tear film osmolarity, tear crystallization, and corneal esthesiometry findings in Sjögren's syndrome patients.</p><p><strong>Methods: </strong>This cross-sectional observational study included 43 eyes from patients with a confirmed diagnosis of Sjögren's syndrome. Tear osmolarity was measured with an iPen osmometer, tear crystallization was graded using Roland's classification, and corneal sensitivity was evaluated with a Cochet-Bonnet aesthesiometer. Ocular symptoms were assessed using the Ocular Surface Disease Index questionnaire. Patients who had undergone keratoplasty or worn contact lenses within 4 hours of testing were excluded.</p><p><strong>Results: </strong>The cohort's mean tear osmolarity was 292.5±15.0 mOsm/L (median: 293 mOsm/L, IQR: 17.5). There was no significant difference between patients with primary Sjögren's syndrome (mean: 289.4 mOsm/L) and those with secondary Sjögren's syndrome (mean: 294.5 mOsm/L; p=0.413). Tear crystallization patterns were more severe in patients with primary Sjögren's syndrome (mean: 3.25, median: 3.5, IQR: 1.25) than in those with secondary Sjögren's syndrome (mean: 3.19, median: 3.0, IQR: 1.0), though the difference was not statistically significant (p=0.87). Corneal sensitivity was reduced by 3.5±1.7 mm (median: 4.0 mm, IQR: 2.13). Tear crystallization has a significant negative correlation with corneal sensitivity (r=-0.313, p=0.041), suggesting that poorer tear quality leads to decreased corneal sensitivity.</p><p><strong>Conclusion: </strong>Tear crystallization patterns and corneal sensitivity were found to be significantly correlated in Sjögren's syndrome patients. The findings also indicate that systemic medication use may affect tear film quality.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20240409"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683235","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":"Viral infectious characteristics of cornea donors from the Londrina eye bank: a retrospective study and the impact of the COVID-19 pandemic.","authors":"Isadora C José, Ana Paula M T Oguido, Sergio M Borghi, Silvio César S G Filho, Claudia R Morgado, Rodolfo C Feijó, Beatriz I Dos Santos, Beatriz Karine Taba Oguido, Pedro Henrique R Cerqueira, Antônio Marcelo B Casella","doi":"10.5935/0004-2749.2025-0034","DOIUrl":"10.5935/0004-2749.2025-0034","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of the COVID-19 pandemic and characterize the serological profile of discarded corneal donations in the coverage area of the Banco de Olhos de Londrina, through reverse transcription-polymerase chain reaction testing for COVID-19 and serological screening of cornea donors excluded because of positive test results.</p><p><strong>Methods: </strong>This observational retrospective study included 776 cornea donors who's serological and reverse transcription-polymerase chain reaction test results were processed at the Hospital of Universidade Estadual de Londrina between May 2020 and 2022. The number of corneal donations and tissue utilization rates throughout the years of operation of the Banco de Olhos de Londrina were also analyzed.</p><p><strong>Results: </strong>The mean donor age was 53.14 years; 332 donors (43%) were female, and 444 (57%) were male. Positive results were identified in 15.76% of donors for hepatitis B core antibody antibodies, 0.65% for hepatitis B surface antigen, 1.03% for hepatitis C antibodies, and 0.52% for human immunodeficiency virus and human T-lymphotropic vírus. Positive reverse transcription-polymerase chain reaction results for SARS-CoV-2 were observed in 2.7% of cases. Older adults were 2.6 times more likely to test positive for SARS-CoV-2 (95% CI, 1.06-6.34) and 3.0 times more likely to test positive for hepatitis B core antibody (95% CI, 1.95-4.41) than younger individuals. A 75.2% reduction in corneal donations was observed in 2020 compared with 2019, accompanied by a 5% increase in tissue utilization, possibly associated with the effectiveness of donor screening during the pandemic.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic had a profound impact on the number of corneal transplants worldwide, in Brazil, and at the Banco de Olhos de Londrina because of the substantial decline in donations during this period. Hepatitis B was the leading cause of corneal tissue discard due to positive serology in both this study and previous reports, highlighting the importance of prevention programs and improved vaccination coverage. Strict legislation, comprehensive serological screening, and appropriate processing of donated tissue remain essential to eliminate potential sources of infection and ensure transplantation safety.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250034"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683213","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":"Unusual intraoperative separation of the trabecular meshwork during gonioscopy-assisted transluminal trabeculotomy.","authors":"Mireia Cucurull-Martí, Paula García-Valentín, Jaime Rigo-Quera","doi":"10.5935/0004-2749.2026-0116","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-0116","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260116"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683183","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":"Corneal tomography in children and adolescents with systemic allergy.","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.5935/0004-2749.2026-0022","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-0022","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260022"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683178","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":"Clinical presentation and management outcomes of congenital dacryocystocele: a retrospective study.","authors":"Gülistan Oyur, Muhammed Mustafa Mazlum, Fatma Savur","doi":"10.5935/0004-2749.2025-0373","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0373","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the clinical factors associated with dacryocystitis and the need for surgical intervention in infants with congenital dacryocystocele.</p><p><strong>Methods: </strong>This retrospective study included 26 infants diagnosed with congenital dacryocystocele and divided them into two groups: complicated-congenital dacryocystocele (with dacryocystitis or preseptal cellulitis) and uncomplicated-congenital dacryocystocele (without infection). Demographic and perinatal characteristics such as age at diagnosis, gender, birth weight, gestational age, delivery method, and laterality were compared between the groups. For an uncomplicated-congenital dacryocystocele, treatment included conservative management and intravenous antibiotics, followed by probing with intraoperative nasal endoscopy and endonasal marsupialization for a complicated-congenital dacryocystocele.</p><p><strong>Results: </strong>Of the 26 infants, 14 (53.8%) had complicated-congenital dacryocystocele, while 12 (46.2%) had uncomplicated-congenital dacryocystocele. There were no significant differences between the groups in terms of demographic or perinatal characteristics (p>0.05). Surgical intervention was necessary for all complicated-congenital dacryocystocele cases (100%) and two uncomplicated-congenital dacryocystocele cases (16.7%; p<0.001). During a 6-month median follow-up period, all patients demonstrated complete clinical recovery with no intraoperative complications.</p><p><strong>Conclusion: </strong>In conclusion, approximately half of infants with congenital dacryocystocele developed infection-related complications. While perinatal factors were similar across groups, infectious presentation was linked to the need for surgical intervention. These findings suggest that early detection, prompt conservative management, and close follow-up can help reduce the risk of dacryocystitis and the need for surgery.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250373"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683198","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":"Agreement between structural parameters provided by the swept-source OCT and Laguna ONhE.","authors":"Gilvan Vilarinho da Silva Filho, Gustavo Coelho Caiado, Olívia Moura de Paula Ricardo, Sergio Henrique Teixeira, Tiago Dos Santos Prata, Carolina Pelegrini Barbosa Gracitelli, Augusto Paranhos","doi":"10.5935/0004-2749.2025-0377","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0377","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the agreement between optic nerve head structural parameters obtained using swept-source optical coherence tomography and the Laguna ONhE software.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 353 eyes from healthy individuals, glaucoma suspects, ocular hypertensive patients, and patients with glaucoma. Optic nerve head parameters-including disc area, vertical and area cup-to-disc ratios, and rim volume-were measured using swept-source optical coherence tomography and Laguna ONhE. Agreement between methods was assessed using Bland-Altman analysis. A regression-based calibration model was developed for disc area measurements.</p><p><strong>Results: </strong>Laguna ONhE systematically underestimated disc area (p < 0.001) and cup-to-disc ratios (p<0.001) and overestimated rim volume (p=0.0002) compared with swept-source optical coherence tomography. After applying the calibration equation for disc area, agreement improved substantially, with no statistically significant bias (p=0.3).</p><p><strong>Conclusion: </strong>Laguna ONhE provides structural estimates comparable with those obtained with swept-source optical coherence tomography after calibration, suggesting it may serve as a practical and cost-effective alternative for glaucoma evaluation.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 5","pages":"e20250377"},"PeriodicalIF":1.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618268","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 mitomycin C exposure time on refractive results, pain, and corneal haze after photorefractive keratectomy.","authors":"Paula Virginia Brom Dos Santos Soares, Elisa Moya Kazmarek, Elisabeth Brandao Guimaraes, Marizilda Rita de Andrade, Renato Giovedi Filho, Bernardo Kaplan Moscovici","doi":"10.5935/0004-2749.2025-0313","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0313","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical outcomes associated with different intraoperative mitomycin C exposure times during photorefractive keratectomy for myopia and astigmatism correction.</p><p><strong>Methods: </strong>This prospective, comparative, contralateral-eye study included 41 patients (82 eyes), comprising 28 eyes with ablation <60µm and 13 eyes with ablation >60µm, who underwent photorefractive keratectomy with varying mitomycin C application times based on ablation depth. In eyes with ablation <60µm, mitomycin C was applied for 15 s in one eye and 30 s in the fellow eye. In eyes with ablation >60µm, mitomycin C was applied for 30 s in one eye and 60 s in the fellow eye. Outcomes included visual acuity, postoperative pain (visual analog scale), subjective tearing, corneal haze, and refractive results at 3 months.</p><p><strong>Results: </strong>No statistically significant differences were observed between mitomycin C application times within either group for postoperative pain, tearing, visual acuity, refractive outcomes (spherical, cylindrical, and spherical equivalent), or haze prevalence (p>0.05 for all comparisons). Visual acuity improved in all groups, and no eyes lost ≥2 lines of corrected distance visual acuity.</p><p><strong>Conclusions: </strong>Shorter mitomycin C exposure times (15 or 30 s) appear to be as effective and safe as longer durations (30 or 60 s) for haze prevention after photorefractive keratectomy without compromising refractive outcomes or increasing postoperative discomfort at 3-month follow-up.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250313"},"PeriodicalIF":1.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547693","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":"Assessing a large language model for glaucoma knowledge: ChatGPT-5 versus residents.","authors":"Mauro Gobira, Rodrigo Moreira, Flavio J L Galhardo Carvalho Filho, Kevin Waquim Pessoa Carvalho, Francisco N Murta, Lucas Antônio Avelar Carvalho, Rubens Belfort, Ivan M Tavares","doi":"10.5935/0004-2749.2025-0283","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0283","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the performance of a contemporary large language model (ChatGPT-5) against ophthalmology residents on a standardized set of glaucoma multiple-choice questions.</p><p><strong>Methods: </strong>We conducted a cross-sectional comparative study with 189 text-only glaucoma multiple-choice questions from the Cybersight question bank. ChatGPT-5 was tested under standardized conditions, with each item placed in a new chat and limited to letter-only outputs. Six ophthalmology residents from a Brazilian training program (two Postgraduate Year 1, two Postgraduate Year 2, and two Postgraduate Year 3) answered the same questions under supervision. Accuracy was calculated using the official key. McNemar's exact test was used to compare items between ChatGPT-5 and residents, and matched odds ratios and 95% confidence intervals (95% CIs) were calculated using the Haldane-Anscombe correction.</p><p><strong>Results: </strong>ChatGPT-5 received 164 of 189 correct responses (86.8%; 95% CI, 81.2-90.9). Residents' overall accuracy was 62.9% (713/1,134; 95% CI, 60.0-65.6). The top-performing resident earned 76.7%. ChatGPT-5 outperformed all residents in head-to-head comparisons, with odds ratios ranging from 1.84 (95% CI, 1.10-3.08) to 13.15 (95% CI, 5.93-29.20), all p≤0.023. ChatGPT-5 correctly answered 17/189 items (9.0%), but fewer than half of residents were correct (\"large language model-only wins\"), whereas residents were more successful on items that ChatGPT-5 overlooked.</p><p><strong>Conclusions: </strong>ChatGPT-5 outperformed ophthalmology residents on text-based glaucoma multiple-choice questions, indicating its potential as a subspecialty education and assessment tool. Generalizability is limited by the single question bank, text-only items, a small resident cohort, and the evaluation of one large language model version at a single time point. Before incorporating these findings into clinical decision-making, larger, multimodal, and longitudinal studies are required.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250283"},"PeriodicalIF":1.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547688","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":"Comparative impact of pro re nata and treat-and-extend regimens on quality of life in patients with neovascular age-related macular degeneration.","authors":"Plínio Augusto Trindade Abreu, Juan Silva Locks Camargo, Lais Bomediano de Souza, José Paulo Cabral de Vasconcelos, Osias Francisco de Souza","doi":"10.5935/0004-2749.2025-0225","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0225","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the impact of pro re nata and treat-and-extend regimens on quality of life in patients with neovascular age-related macular degeneration.</p><p><strong>Methods: </strong>This cross-sectional study included 81 patients with neovascular age-related macular degeneration who completed the National Eye Institute Visual Function Questionnaire-25.</p><p><strong>Results: </strong>No statistically significant differences were observed between pro re nata and treat-and-extend regimens across quality-of-life domains measured by National Eye Institute Visual Function Questionnaire-25.</p><p><strong>Conclusions: </strong>Pro re nata and treat-and-extend regimens demonstrated comparable effects on quality of life in patients with neovascular age-related macular degeneration. Further studies are warranted to determine optimal standardized treatment strategies.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250225"},"PeriodicalIF":1.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547784","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":"Combined anti-VEGF and intravitreal dexamethasone treatment versus anti-VEGF alone for persistent diabetic macular edema: a comprehensive systematic review and meta-analysis.","authors":"Dillan Cunha Amaral, Tiago Nelson de Oliveira Rassi, William Binotti, Vinícius Freire Costa Alves, Eduardo Henrique Cassins Aguiar, Raphaela Masetto Fuganti, Raíza Jacometti, Mário Luiz Ribeiro Monteiro, Antonio Marcelo Barbante Casella, Ricardo Noguera Louzada","doi":"10.5935/0004-2749.2025-0180","DOIUrl":"10.5935/0004-2749.2025-0180","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to compare the effectiveness and safety profiles of anti-vascular endothelial growth factor therapy with dexamethasone vs anti-vascular endothelial growth factor alone in patients with persistent diabetic macular edema. It was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Our data were prospectively registered on the International Prospective Register of Systematic Reviews (CRD42023482385). We searched the PubMed, Embase, Cochrane, and Web of Science databases for studies that compared treatment with anti-vascular endothelial growth factor and dexamethasone to anti-vascular endothelial growth factor alone in patients with persistent diabetic macular edema. The primary outcomes were changes in best corrected visual acuity, changes in central macular thickness, and the incidence of serious adverse events. Four studies were included, totaling 315 eyes. Of these 154 (48.88%) received anti-vascular endothelial growth factor alone, while 161 (51.12%) underwent combined therapy. Overall, combined therapy was associated with better central macular thickness (mean difference -68.21; p<0.001), although this did not translate into a significant difference in best-corrected visual acuity at 1 month follow-up (mean difference 1.29; p=0.55). There were significantly more intraocular pressure-related events (odds ratio 10.84; p=0.02) and cataract-related events (odds ratio 41.24; p<0.001) in the combined group than the anti--vascular endothelial growth factor alone group. Our results suggest that combined therapy improves macular morphology in persistent diabetic macular edema without increasing the risk of serious adverse events. However, its effects on final visual acuity outcomes were no better than those resulting from anti-vascular endothelial growth factor therapy alone.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250180"},"PeriodicalIF":1.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547637","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}