Arquivos brasileiros de oftalmologia最新文献

{"title":"Reliability of a Scheimpflug-based tomographer compared with a Placido-based topographer and specular microscopy in healthy eyes.","authors":"Camyla Lemos Budib, Caio Henrique Peres Oliani, Guilherme de Oliveira Ferreira, Ulysses Tachibana, José Álvaro Pereira Gomes, Bernardo Kaplan Moscovici, Luiz Roberto Colombo-Barboza, Marcello Novoa Colombo-Barboza, Guilherme Novoa Colombo-Barboza","doi":"10.5935/0004-2749.2025-0259","DOIUrl":"10.5935/0004-2749.2025-0259","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the reliability and comparability of a Scheimpflug-based tomographer relative to a Placido-based topographer and specular microscopy in healthy eyes.</p><p><strong>Methods: </strong>This cross-sectional study included 40 patients (80 eyes). Each eye underwent randomized imaging with a Scheimpflug-based tomographer, a Placido-based topographer, and Tomey EM-4000 specular microscopy. Three acquisitions per device were obtained. For interdevice comparisons, the best-quality scan per eye/device was selected, whereas all three scans were used for intradevice repeatability analyses. Unreliable scans were repeated (up to five attempts) and excluded if acceptable quality was not achieved, resulting in variable denominators. Between-device comparisons were performed using generalized estimating equations with participant-level clustering and robust standard errors and were supplemented by Bland-Altman analysis.</p><p><strong>Results: </strong>The effective sample size varied by parameter (independent summaries: 59-67 eyes; paired comparisons: 48-51 eyes). In paired-eye analyses, the Scheimpflug-based tomographer measured slightly higher keratometry values than the Placido-based topographer (K1: 43.95 vs. 43.78 D, p=0.003; K2: 44.91 vs 44.73 D, p=0.002), more negative Q-values (p=0.001), smaller photopic pupil diameter (p<0.001), and shorter kappa distance (p<0.001). Mean absolute differences were 0.32 D for K1 and 0.30 D for K2, with high dispersion for angular metrics (kappa angle coefficient of variation: 195%).</p><p><strong>Conclusions: </strong>The Scheimpflug-based tomographer provides reproducible corneal measurements in healthy eyes. However, systematic differences relative to the Placido-based topographer-particularly for keratometry, asphericity, and pupil and kappa metrics-suggest limited interchangeability. Consistent device use is recommended when these parameters inform clinical decision-making.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20250259"},"PeriodicalIF":1.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040554","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 sensitivity recovery after phacoemulsification: quantitative esthesiometric analysis.","authors":"Isabella Passarelli Giabardo Marques, Christiana Velloso Rebello Hilgert, Caio Henrique Peres Oliani, Juliana Carolina Contrera, Marcello Novoa Colombo-Barboza, Guilherme Novoa Colombo-Barboza, Bernardo Kaplan Moscovici","doi":"10.5935/0004-2749.2025-0312","DOIUrl":"10.5935/0004-2749.2025-0312","url":null,"abstract":"<p><strong>Purpose: </strong>To quantitatively assess changes in central corneal sensitivity after phacoemulsification and to characterize recovery patterns up to 90 days using standardized esthesiometry.</p><p><strong>Methods: </strong>This prospective observational study included 44 patients (88 eyes) undergoing uncomplicated phacoemulsification with intraocular lens implantation. Central corneal sensitivity was measured using a Cochet-Bonnet® esthesiometer preoperatively and at 30 and 90 days postoperatively. Repeated-measures data were analyzed using Friedman and Wilcoxon signed-rank tests (p<0.05). Inter-eye differences were assessed with a paired Wilcoxon test. Individual changes from baseline (∆30, ∆90) were calculated, and 90-day recovery was categorized according to thresholds aligned with the 5-mm device resolution. Spearman correlation was used to explore associations between age and ∆90.</p><p><strong>Results: </strong>Corneal sensitivity decreased after surgery. In right eyes, mean sensitivity declined from 41.14 ± 7.77 mm at baseline to 36.82 ± 9.03 mm at 30 days and partially recovered to 38.64 ± 7.73 mm at 90 days. In left eyes, sensitivity decreased from 44.11 ± 6.29 mm to 37.39 ± 9.05 mm at 30 days and recovered to 41.82 ± 7.63 mm at 90 days. Left eyes showed higher sensitivity than right eyes at baseline (p=0.023) and at 90 days (p=0.018). At 90 days, complete or near-complete recovery (within ± 5 mm of baseline) occurred in 73.2% of right eyes and 78.0% of left eyes, while improvement above baseline (≥ +5 mm) occurred in 7.3% and 4.9%, respectively. Age showed weak, nonsignificant correlations with ∆90 (p=-0.14 to -0.19; p>0.2).</p><p><strong>Conclusion: </strong>Phacoemulsification with a 2.75-mm clear corneal incision leads to a temporary reduction in central corneal sensitivity, with partial recovery by 90 days. Recovery patterns vary among individuals, highlighting the value of postoperative sensitivity monitoring to identify atypical trajectories and guide ocular surface care during visual rehabilitation.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20250312"},"PeriodicalIF":1.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040407","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":"Topical losartan in the treatment of corneal injuries: a systematic review.","authors":"Laura Goldfarb Cyrino, Lucas Macedo Nascimento, Alexandre Yamada Fujimura, Vitor Expedito Alves Ribeiro, Caio Ernesto do Rêgo Castro, Dillan Cunha Amaral, Jaime Guedes, Lycia Maria M P Pedral Sampaio","doi":"10.5935/0004-2749.2024-0310","DOIUrl":"10.5935/0004-2749.2024-0310","url":null,"abstract":"<p><p>This study aimed to evaluate the efficacy and safety of topical losartan for treating corneal injuries and stromal fibrosis based on preclinical and clinical evidence. A systematic search was conducted in October 2024 following PRISMA guidelines across Embase, PubMed, Web of Science, and the Cochrane Library. Studies assessing topical losartan use in animal models or human patients with corneal injury were included. No randomized clinical trials were identified. Of 750 articles screened, 12 met the inclusion criteria - seven preclinical studies and five case reports. Preclinical evidence indicated that topical losartan at 0.2-0.8 mg/dL reduced stromal opacity and myofibroblast differentiation. Higher concentrations (8-80 mg/dL) offered no additional benefit and were associated with ocular surface irritation. The five case reports included 11 patients (12 eyes); eight eyes showed visual improvement, and no adverse effects were observed at a dose of 0.8 mg/dL. Topical losartan demonstrates potential as an antifibrotic agent for corneal injuries. However, variability in outcomes and dose-related toxicity at higher concentrations highlight the need for controlled clinical trials to confirm efficacy, establish optimal dosing, and ensure safety.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20240310"},"PeriodicalIF":1.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040550","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":"Musculoskeletal disorders in ophthalmologists and ophthalmology residents in Brazil.","authors":"Jabneel Tassiano Dos Santos Nogueira, Taíse Maria Clemente de Araújo, Carlos Eduardo Ximenes da Cunha, Carlos Henrique de Almeida Cipriano, Camila Vieira Ventura, Michel Bittencourt Santos","doi":"10.5935/0004-2749.2025-0272","DOIUrl":"10.5935/0004-2749.2025-0272","url":null,"abstract":"<p><strong>Purpose: </strong>To assess musculoskeletal symptoms, identify the most affected body areas, and investigate factors associated with the development of musculoskeletal disorders among ophthalmologists in Brazil.</p><p><strong>Methods: </strong>A survey was conducted using an online questionnaire and snowball sampling. Statistical analyses were performed using Jamovi version 2.3.28, and graphs were generated using RStudio version 2023.06.2 + 561.</p><p><strong>Results: </strong>A total of 233 participants (42 ophthalmology residents and 191 ophthalmologists) were included, with a mean age of 40.4 years (standard deviation 11.3; range 25-73 years). Musculoskeletal symptoms were reported by 83% of participants. The cervical region (57.1%), upper back (54.5%), and lumbar region (53.6%) were the most frequently reported sites of pain. A high body mass index was identified in 54.9% of the sample, and 50.2% of participants reported using painkillers in the previous year for musculoskeletal symptoms. The mean duration of professional activity in ophthalmology was 13.5 years, and the mean weekly workload was 39 hours. A significant association was observed between weekly workload and the presence of musculoskeletal disorders (p=0.045).</p><p><strong>Conclusion: </strong>This study demonstrated a high prevalence of musculoskeletal disorders among ophthalmologists in Brazil, particularly involving the cervical, lumbar, and upper back regions, consistent with findings reported in international studies. Important contributing factors include long working hours, a high patient volume, and repetitive or awkward postures during examinations and procedures. Preventive strategies and improvements in working conditions are needed to protect the health and well-being of ophthalmologists.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20250272"},"PeriodicalIF":1.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040392","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":"Presumed ocular histoplasmosis syndrome phenocopy in Brazil.","authors":"Ana Paula Couto, Ricardo Japiassú, Raul Nunes Galvarro Vianna","doi":"10.5935/0004-2749.2025-0350","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0350","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20250350"},"PeriodicalIF":1.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040440","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":"Repeat selective laser trabeculoplasty in glaucoma and ocular hypertension: a review of efficacy and safety.","authors":"Guilherme Barroso Guedes, Tiago Santos Prata, Matheus Pedrotti Chavez, Augusto Paranhos","doi":"10.5935/0004-2749.2025-0232","DOIUrl":"10.5935/0004-2749.2025-0232","url":null,"abstract":"<p><p>Repeat selective laser trabeculoplasty has emerged as a valuable option for managing intraocular pressure in pa-tients with primary open-angle glaucoma or ocular hypertension. This review synthesizes current evidence of the efficacy, safety, and clinical applicability of repeat selective laser trabeculoplasty. Evidence from randomized controlled trials, systematic reviews, and observational studies indicate that repeat selective laser trabeculoplasty effectively sustains significant intraocular pressure reduction with minimal complications. This procedure demonstrates comparable efficacy to that of initial selective laser trabeculoplasty, supporting its role as a sustainable, drop-free management strategy. However, further research is warranted to optimize treatment intervals, assess long-term outcomes, and evaluate cost-effectiveness across different healthcare settings.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 3","pages":"e20250232"},"PeriodicalIF":1.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of meibomian gland morphological alterations in the development of dry eye disease in type 2 diabetes.","authors":"Meryem Altin Ekin","doi":"10.5935/0004-2749.2025-0230","DOIUrl":"10.5935/0004-2749.2025-0230","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether specific meibomian gland morphological features can serve as diagnostic indicators of dry eye disease in patients with type 2 diabetes mellitus.</p><p><strong>Methods: </strong>This cross-sectional study included patients with type 2 diabetes mellitus and age-matched healthy controls. All participants underwent a comprehensive ocular surface evaluation, including the ocular surface disease index, tear break-up time, Schirmer's I test, corneal staining, eyelid margin scoring, meibum expressibility assessment, meibography scoring, and evaluation of meibomian gland loss area. Meibomian gland morphology was assessed bilaterally. Dry eye severity was determined based on ocular surface disease index scores, tear break-up time, Schirmer's test results, and corneal staining scores. Correlations between meibomian gland features and ocular surface parameters, age, diabetes duration, and hemoglobin A1c levels were analyzed. Receiver operating characteristic analysis was performed to determine the diagnostic value of specific meibomian gland features for dry eye disease.</p><p><strong>Results: </strong>Dry eye disease was diagnosed in 56.6% of patients with diabetes and 22.6% of controls. Compared with controls, patients with diabetes had significantly higher ocular surface disease index scores, greater corneal staining, worse meibum expressibility, increased meibomian gland loss, and lower tear break-up time and Schirmer values (all p<0.05). Meibomian gland dropout, shortening, tortuosity, distortion, overlapping, ghost glands, and lack of extension to the lid margin were significantly more prevalent in patients with diabetes (p<0.05) and showed significant correlations with age, HbA1c levels, and diabetes mellitus duration. Receiver operating characteristic analysis identified meibomian gland dropout, ghost glands, shortening, and lack of extension to the lid margin as the most predictive morphological features for dry eye disease in patients with diabetes.</p><p><strong>Conclusion: </strong>Type 2 diabetes mellitus is associated with distinct meibomian gland morphological alterations that correlate with both dry eye disease severity and systemic diabetic parameters, suggesting potential diagnostic value.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0230"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"Evaluation of autonomic dysfunction with dynamic pupillometry in non-obese young women with polycystic ovary syndrome.","authors":"Kübra Gündogan, Ali Osman Gündogan, Emine Türen Demir, Naciye Tora","doi":"10.5935/0004-2749.2025-0244","DOIUrl":"10.5935/0004-2749.2025-0244","url":null,"abstract":"<p><strong>Purpose: </strong>Polycystic ovary syndrome is frequently associated with autonomic nervous system dysfunction, even in the absence of obesity or overt metabolic abnormalities. Alterations in pupillary responses may reflect early autonomic involvement and serve as a potential tool for early diagnosis, risk stratification, and disease monitoring. This study aimed to investigate pupillary reflex parameters using dynamic pupillometry in newly diagnosed non-obese women with polycystic ovary syndrome and to compare the findings with those of healthy controls.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 48 newly diagnosed women with polycystic ovary syndrome and 44 ageand sex-matched healthy controls. Pupillary function parameters were measured using dynamic pupillometry (MonPackOne; Metrovision, France).</p><p><strong>Results: </strong>The mean age did not differ significantly between the groups (p=0.870). Initial pupil diameter, pupil contraction amplitude, and contraction velocity were significantly lower in the PCOS group than in the control group, whereas pupillary dilation duration was significantly longer (p<0.001, p<0.001, p=0.007, and p=0.032, respectively). No significant differences were observed between the groups regarding contraction latency, contraction duration, dilation latency, or dilation velocity (p=0.749, p=0.925, p=0.653, and p=0.310, respectively).</p><p><strong>Conclusion: </strong>Newly diagnosed non-obese women with polycystic ovary syndrome exhibit significant alterations in pupillary dynamics, suggesting a generalized reduction in both sympathetic and parasympathetic activity. Dynamic pupillometry may represent a practical, noninvasive tool for detecting early autonomic hypoactivity and identifying patients at risk for future metabolic or cardiovascular complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0244"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of tear film function and meibomian gland morphology in newly diagnosed atopic dermatitis.","authors":"Ali Osman Gündogan, Refik Oltulu, Selman Belviranli, Ali Tezcan, Selami Aykut Temiz, Esra Altay","doi":"10.5935/0004-2749.2025-0257","DOIUrl":"10.5935/0004-2749.2025-0257","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze ocular sur-face parameters and evaluate meibomian gland dys-function using meibography in newly diagnosed patients with atopic dermatitis compared with healthy controls.</p><p><strong>Methods: </strong>This cross-sectional clinical study included 51 newly diagnosed patients with atopic dermatitis and 45 ageand sex-matched healthy controls. Disease severity was assessed using the Eczema Area Severity Index. The Ocular Surface Disease Index questionnaire, Schirmer test, tear meniscus height, noninvasive tear break-up time, conjunctival redness grading, and meibography staging were performed. Meibomian gland dropout was graded for each eyelid from 0 (no loss) to 3 (loss of >2/3 of the total gland area).</p><p><strong>Results: </strong>Schirmer test values, tear meniscus height, and noninvasive tear break-up time were significantly lower in the atopic dermatitis group than in the control group (p<0.001, p<0.001, and p<0.001, respectively). In contrast, Ocular Surface Disease Index scores, conjunctival redness grades, and total meiboscores were significantly higher in the atopic dermatitis group than in the control group (p<0.001, p<0.001, and p<0.001, respectively). Moreover, in the atopic dermatitis group, a significant positive correlation was observed between the Eczema Area Severity Index score and total meiboscore (rₛ=0.390, p=0.005), while a significant negative correlation was found between the Eczema Area Severity Index score and Schirmer test results (rₛ=-0.301, p=0.032).</p><p><strong>Conclusions: </strong>Newly diagnosed patients with atopic dermatitis exhibit significant alterations in tear film parameters and meibomian gland morphology compared with healthy individuals. These patients should be monitored for early development of dry eye disease and meibomian gland dysfunction to prevent associated complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0257"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}