Arquivos brasileiros de oftalmologia最新文献

{"title":"Levator muscle changes in Marcus Gunn jaw-winking syndrome and other forms of ocular congenital cranial dysinnervation disorder.","authors":"Hind Manaa Alkatan, Nawaf Alkuhaimi, Adel H Alsuhaibani, Azza M Y Maktabi","doi":"10.5935/0004-2749.2024-0236","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0236","url":null,"abstract":"<p><strong>Purpose: </strong>This study was conducted to report the histopathological and clinical features of the Marcus Gunn phenomenon and other similar conditions of upper eyelid misfiring.</p><p><strong>Methods: </strong>This was a retrospective study of patients with congenital ptosis with Marcus Gunn phenomenon who have undergone surgical repair over a period of 12 years and another two patients with upper eyelid misfiring in association with extraocular movements to identify their histopathological findings as subtypes representing ocular congenital cranial dysinnervation disorder.</p><p><strong>Results: </strong>Among 136 patients with congenital ptosis, 11 (8%) patients with Marcus Gunn phenomenon or misfiring were identified, of whom 9 (6.6%) had typical known Marcus Gunn phenomenon and 2 (1.4%) had eyelid misfiring similar to Marcus Gunn phenomenon. In all patients, the histopathological changes of the excised levator muscle included overall loss and/or atrophy of muscle fibers and irregular-modified Gomori trichrome staining.</p><p><strong>Conclusion: </strong>The Marcus Gunn phenomenon and similar misfiring conditions with synkinetic extraocular muscle movements share findings that are consistent with the neurogenic type of muscle atrophy. This result suggests a common underlying etiology with variable clinical findings, representing the ocular counterpart of congenital cranial dysinnervation disorder, which has been reported as ocular congenital cranial dysinnervation disorder.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240236"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975175","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":"Inverted tunnel scleral fixation technique for dropped intraocular lens complex: the double-flanged suture method.","authors":"Selim Doganay, Duygu Erdem, Derya Doganay, Mehmet Omer Kiristioglu","doi":"10.5935/0004-2749.2024-0190","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0190","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to describe a minimally invasive and atraumatic technique for managing the polypropylene suture-assisted scleral fixation of intraocular lens-capsular bag complex or artificial iris-intraocular lens complex for repositioning late luxated or subluxated intraocular lens-capsular bags and artificial iris-intraocular lens complexes.</p><p><strong>Methods: </strong>In this retrospective and observational study, we evaluated 11 patients, including 10 patients with capsular bag-intraocular lens complex subluxation or luxation into the vitreous cavity and 1 patient with an aniridia-intraocular lens complex. A single senior surgeon performed the procedures. After anesthesia, a 4 × 4 mm conjunctival peritomy was created, and a 6-0 polypropylene suture was passed through the sclera marked 2.0 mm posterior to the limbus. The suture ends were cauterized into a flange under 0.5 mm and inserted inversely into a scleral tunnel, concealed within a 2-mm scleral tunnel to ensure secure intraocular lens positioning.</p><p><strong>Results: </strong>We analyzed 11 patients with dislocated or dropped capsular bag-intraocular lens complexes. The patients' median age was 67 (range 44-78) years, with a median follow-up of 10 (range: 4-16) months. There were 8 (72%) men and 3 (27%) women. Conjunctival peritomy was performed in 4 (36%) patients. Predominantly, preoperative diagnoses indicated 7 (63%) patients with dislocated capsular bag-intraocular lens complexes. The capsular bag-intraocular lens complexes were centralized in all patients, and optical coherence tomography confirmed accurate suture positioning within the sclera. No suture-related complications were observed throughout the follow-up period, and no vision-threatening complications were reported during the postoperative follow-up.</p><p><strong>Conclusions: </strong>Our technique provides a simple, effective solution for treating decentralized or dislocated capsular bag-intraocular lens complexes, eliminating the need for complex interventions such as large corneal wounds, scleral flaps, intraocular lens exchange, and intraocular lens externalization.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240190"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969998","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":"Traumatic cataract following high-intensity focused ultrasound eyelid procedure.","authors":"Carlos Augusto Moreira Neto, José Pereira do Rêgo Neto, Thiago Meister","doi":"10.5935/0004-2749.2024-0360","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0360","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240360"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961242","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 effectiveness of a portable device for diagnosing cataract.","authors":"Camila Ribeiro Koch, Rafael Scherer, Liliane Souza Pereira, Tauanne Cândido, Milton Ruiz Alves, Newton Kara-Junior","doi":"10.5935/0004-2749.2024-0249","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0249","url":null,"abstract":"<p><strong>Purpose: </strong>Access to cataract treatment and diagnostic tools continues to be hindered by financial and logistical barriers. Thus, photography-based cataract analysis via portable devices offers a promising solution for the detection of cataracts in remote regions. In this study, the accuracy of a portable device that is based on the Lens Opacities Classification III System for diagnosing cataracts was analyzed.</p><p><strong>Methods: </strong>Photographs of the anterior segment of the eye were taken in a low-light environment, and the pupillary region markings were automatically delineated using infrared photography. The captured images were automatically analyzed using a convolutional neural network. The study group included patients with cataracts, and the control group included patients without cataracts.</p><p><strong>Results: </strong>A total of 270 eyes were analyzed, which included 143 eyes with cataracts and 127 control eyes. A total of 599 photos were analyzed. The isolated nuclear cataract was the most frequently detected subtype (37.5%), followed by a nuclear cataract associated with a cortical cataract (30.3%). The device's accuracy was 88.5% (Confidence intervals (CI), 83.19%-94.69%), specificity was 84.62% (CI 71.79%-97.30%), positive predictive value was 91.78% (CI 74.36%-97.30%), and negative predictive value was 82.50% (CI 74.36%-97.30%).</p><p><strong>Conclusion: </strong>The portable device is a simplified user-friendly cataract screening technique that can interpret results in remote regions. This innovation could mitigate the occurrence of cataract-induced blindness and prevent premature surgical interventions in early-stage cataracts.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240249"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960122","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":"Surgical treatment of eyelid sequelae due to trachoma performed by a few São Paulo hospitals of the Brazilian Unified Health System.","authors":"Vera Helena Turola Machado Joseph, Norma Helen Medina, Maria de Fátima Costa Lopes, Juliana Albano de Guimarães, Antonio Augusto Velasco E Cruz","doi":"10.5935/0004-2749.2024-0279","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0279","url":null,"abstract":"<p><strong>Purpose: </strong>Trachoma is the major infectious cause of preventable blindness in the world, and its sequelae include the presence of cicatricial entropion and trachomatous trichiasis. Trachoma can be corrected by surgical treatment of the eyelids and, if left untreated, may result in corneal opacification, low vision, and blindness. There are limited data on trachomatous trichiasis in Brazil. This study was conducted to estimate the frequency of entropion and trichiasis surgeries of trachomatous origin based on the records of procedures performed in specialized hospitals that served the Unified Health System (SUS) in the years 2016 and 2017.</p><p><strong>Methods: </strong>This was a retrospective study conducted in the oculoplastic sectors of the ophthalmology services of the following three hospitals in the state of São Paulo: Hospital das Clínicas da Faculdade de Medicina de Botucatu (HC Botucatu), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HC Ribeirão Preto), and Hospital Estadual de Bauru (HE Bauru). Medical records corresponding to the codes of interest were evaluated.</p><p><strong>Results: </strong>In total, 462 medical records were evaluated, including 170 (36.8%) at HC Botucatu, 61 (13.2%) at HE Bauru, and 231 (50.0%) at HC Ribeirão Preto. There were 39 (8.4%) cases of trachomatous trichiasis, ranging from 9 (14.8%) at HE Bauru to 15 (6.5%) at HC Ribeirão Preto.</p><p><strong>Conclusions: </strong>The frequency of surgery due to trachoma was low in these oculoplastic services. The state of São Paulo might have reached the goal for trachoma elimination in the surgical component. The questionnaire used for data collection was successfully tested despite some difficulties in collecting data from the medical records. Studies with the same methodology are recommended in other services in the areas of endemic trachoma in the past to understand the frequency of eye lid surgeries performed for treating trachomatous sequelae.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240279"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964564","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 dermoid.","authors":"Amanda Ginelli, Nicole Bulgarão Maricondi de Almeida, Newton Kara-Júnior","doi":"10.5935/0004-2749.2024-0405","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0405","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240405"},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498152","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":"Epidemiology of orbital diseases in a tertiary ophthalmic outpatient clinic in Sao Paulo, Brazil.","authors":"Lissa Beltrão Fernandes, Marina Brandão Schmidt, Mário L R Monteiro, Allan C Pieroni Gonçalves","doi":"10.5935/0004-2749.2024-0278","DOIUrl":"10.5935/0004-2749.2024-0278","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prevalence of orbital conditions in a tertiary ophthalmic outpatient hospital in Sao Paulo, Brazil, with a focus on the main diagnoses and their distribution.</p><p><strong>Methods: </strong>A retrospective chart review was conducted involving patients registered and admitted to the orbital disease unit at the Department of Ophthalmology, University of São Paulo Medical School, from January 2004 to March 2018. A total of 838 medical charts were analyzed, of which 37 were excluded due to incomplete data. The remaining charts were categorized into eight diagnostic groups: Graves' orbitopathy , inflammatory disorders, tumors, vascular lesions, acquired structural abnormalities, congenital structural abnormalities, infectious diseases, and others.</p><p><strong>Results: </strong>Of the 837,300 ophthalmological appointments, 3,372 (0.4%) were related to orbital diseases. The study included 801 patients, of whom 63.45% were women. The patients' mean age was 42.86 years. Graves' orbitopathy was the most common (55%), followed by tumor (17%), inflammatory disorders (9%), vascular lesions (7%), acquired structural abnormalities (5%), congenital structural abnormalities (4%), others (2%), and infectious diseases (1%). The study found significant differences in the incidence and types of orbital diseases, indicating the specialized nature of tertiary care and referral biases.</p><p><strong>Conclusions: </strong>Published data on epidemiological orbital diseases is scarce. Therefore, this study focused on the diverse nature of orbital diseases and their low incidence among ophthalmology appointments. The major trends align with other epidemiological studies, demonstrating a preponderance of Graves' orbitopathy in middle-aged adults and a bimodal distribution of tumors. These findings are essential in shaping resident training programs and healthcare policies, particularly in tertiary settings. Understanding the epidemiology of orbital diseases can improve diagnostic accuracy, treatment approaches, and patient outcomes as well as support future systemic prospective studies.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240278"},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498156","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":"Postoperative complications of pediatric cataract surgery and their comparison between limbal and pars plana approaches: a meta-analysis.","authors":"Bing Zhang, Minying Zhu, Yune Zhao","doi":"10.5935/0004-2749.2024-0151","DOIUrl":"10.5935/0004-2749.2024-0151","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the incidence rates of complications following pediatric cataract surgery between the limbal and pars plana approaches.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and ClinicaITriaIs.gov were systematically searched for studies comparing the two surgical approaches. We pooled the incidence rates of postoperative complications using a random-effects model.</p><p><strong>Results: </strong>Seven studies comprising 375 eyes from 260 patients were included. No significant differences in complication rates were observed between the limbal and pars plana approaches. The pooled incidence rates (95% confidence Interval) of postoperative visual axis opacity (VAO), VAO treated with laser or surgery, secondary glaucoma, wound leakage, corneal edema, anterior chamber reaction, posterior iris synechiae, capsular phimosis, intraocular lens dislocation, posterior capsular rupture, and intravitreal lens fragmentation were 4.7% (0.8%-10.8%), 3.9% (1.0%-8.1%) , 2.8% (0%-11.4%), 0 (0%-1.3%), 2.9% (0%-11.8%), 5.6% (0.1%-16.5%), 2.4% (0%-8.5%), 3.8% (0.6%-8.9%), 2.2% (0%-6.4%), 9.2% (4.1%-15.8%) and 1.3% (0%-6.3%), respectively. Both surgical approaches demonstrated improved visual acuity postoperatively.</p><p><strong>Conclusions: </strong>Pediatric cataract surgery, performed via the limbal or pars plana approach, is effective and safe, with a low incidence of complications when conducted by trained surgeons. Neither method demonstrated a significant difference in the visual acuity improvement or complication rates.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240151"},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498159","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":"Retinal degeneration in spinocerebellar ataxia type 7: an overview of the current knowledge.","authors":"Bruna Ferraço Marianelli, Flávio Moura Rezende Filho, Mariana Vallim Salles, José Luiz Pedroso, Orlando Graziani P Barsottini, Juliana Maria Ferraz Sallum","doi":"10.5935/0004-2749.2024-0248","DOIUrl":"10.5935/0004-2749.2024-0248","url":null,"abstract":"<p><p>Spinocerebellar ataxia type 7 is a form of spinocerebellar ataxia, which is a clinically and genetically heterogeneous group of rare inherited neurodegenerative disorders. Among the spinocerebellar ataxias, the association between cerebellar ataxia and cone-rod retinal dystrophy is a strong indicator of spinocerebellar ataxia type 7. Spinocerebellar ataxia type 7 cone-rod dystrophy is a progressive, disabling, and incurable form of hereditary retinopathy. However, the field of genetics has markedly progressed in the last decades, which resulted in improved understanding of multiple aspects of spinocerebellar ataxia type 7 retinal degeneration and the emergence of new modalities of genetic therapies for other types of retinal dystrophies. This study aimed to evaluate the current knowledge on spinocerebellar ataxia type 7 retinal degeneration, including genetics and molecular mechanisms as well as their implications in pathogenesis, clinical manifestations, and potential therapeutic strategies.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 4","pages":"e20240248"},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498162","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":"Simulated phacoemulsification training using the OrbiTau artificial eye: Experience at a single institute.","authors":"Tauanni Cândido, Roberto Pineda, Silvana Rossi, Jéssica Véras Moura Lanza, Newton Kara-Júnior","doi":"10.5935/0004-2749.2024-0084","DOIUrl":"10.5935/0004-2749.2024-0084","url":null,"abstract":"<p><strong>Purpose: </strong>The OrbiTau surgical simulator is a synthetic eye model developed to enhance cataract surgical training. Herein, we aimed to describe the perspectives of Harvard's Ophthalmology faculty and residents regarding the effectiveness of OrbiTau.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in which 11 surgeons from the Massachusetts Eye and Ear Infirmary, with prior experience utilizing simulated phacoemulsification platforms, conducted cataract surgery with the OrbiTau. Subsequently, they completed a satisfaction questionnaire using the Likert scale.</p><p><strong>Results: </strong>Regarding the various OrbiTau components, 90.90% of the participants reported that the OrbiTau lens capsule was comparable to that of the human lens during capsulotomy. Furthermore, 72.72% of the participants found that the OrbiTau lens consistency was analogous to that of the human lens nucleus. Approximately 63.63% of the participants reported that the model's posterior lens capsule resembled the native posterior capsule, and 72.72% of the participants noted that the model's red reflex was similar to that of the dilated human pupil. Most participants believed that the OrbiTau was easier to use and more realistic than other commercially available simulators.</p><p><strong>Conclusion: </strong>Our single-institution survey of the Orbitau demonstrated that this model realistically replicates ocular structures and may be a viable option for cataract surgery training.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 3","pages":"e20240084"},"PeriodicalIF":1.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498038","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}