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Rodrigues MV, Garcia JMB, Pacheco KD, Borges FT, Isaac DLC, Avila M. Pseudophakic macular edema in nondiabetic and diabetic patients without diabetic retinopathy treated with intravitreal dexamethasone implant. Int J Retina Vitreous 2023; 9:56. [PMID: 37723594 PMCID: PMC10506302 DOI: 10.1186/s40942-023-00489-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the impact of intravitreal dexamethasone (DEX) implant during a 12-month period in nondiabetic and diabetic patients without diabetic retinopathy (DR) as a treatment for refractory pseudophakic cystoid macular edema (PCME) following prior treatment with topical nepafenac 0.1% and prednisolone 1%. METHODS Forty-two consecutive medical records of patients diagnosed with PCME after uneventful cataract surgery were included. The outcomes measured included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Linear regression analysis was statistically applied. RESULTS Following topical treatment, nondiabetic and diabetic subjects presented a mean ± SD gain of - 0.11 ± 0.11 and - 0.18 ± 0.11 BCVA logMAR and a CFT reduction of - 43.42 ± 53.66 µm and - 58.76 ± 36.28 µm, respectively. The mean BCVA gain at month 12 subsequent to DEX implantation was - 0.35 ± 0.17 in nondiabetic (p < 0.001) and - 0.55 ± 0.26 in diabetic patients (p < 0.001), with CFT reductions of - 195.71 ± 93.23 µm (p < 0.001) and - 260.81 ± 198.69 µm (p < 0.001), respectively. Patients who responded with better VA after topical treatment presented better visual outcomes at month 12 following DEX implantation (r2 = 0.46; rho = - 0.71, p < 0.01). CONCLUSION Nondiabetic and diabetic patients without DR demonstrated similar results after DEX implant after combined topical therapy, suggesting that selected diabetic patients may have a response comparable to that of nondiabetic patients with PCME.
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Affiliation(s)
- Magna Vanessa Rodrigues
- Centro Brasileiro da Visao, Brasilia, DF, Brazil.
- Federal University of Goias, Centro de Referencia em Oftalmologia (CEROF), Goiania, GO, Brazil.
| | | | | | | | | | - Marcos Avila
- Centro Brasileiro da Visao, Brasilia, DF, Brazil
- Federal University of Goias, Centro de Referencia em Oftalmologia (CEROF), Goiania, GO, Brazil
- Centro Brasileiro de Cirurgia de Olhos, Goiania, GO, Brazil
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Isaac DLC, Lando L, Silva HM, Avila MP. A bullous variant of central serous chorioretinopathy treated with oral spironolactone. Arq Bras Oftalmol 2023; 86:375-379. [PMID: 35417525 DOI: 10.5935/0004-2749.20230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/17/2021] [Indexed: 07/20/2023] Open
Abstract
We report the case of a 39-year-old male patient who presented with visual loss in the right eye for 6 weeks. The best-corrected visual acuity was counting fingers in the right eye and 20/30 in the left eye. The fundus examination demonstrated a right retinal detachment inferiorly extending to the fovea and a left macular serous detachment. After multimodal imaging study, the patient was diagnosed as having a bullous variant of central serous chorioretinopathy and treated with oral spironolactone associated with adjuvant laser photocoagulation. The retinal changes resolved after 6 months. The final visual acuity was 20/20 in both eyes.
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Affiliation(s)
| | - Leonardo Lando
- Retina Service, Department of Ophthalmology, Universidade Federal de Goiás, Goiânia, Brazil
| | - Hugo Mendes Silva
- Retina Service, Department of Ophthalmology, Universidade Federal de Goiás, Goiânia, Brazil
| | - Marcos P Avila
- Retina Service, Department of Ophthalmology, Universidade Federal de Goiás, Goiânia, Brazil
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Abud MB, Baranov P, Patel S, Hicks CA, Isaac DLC, Louzada RN, Dromel P, Singh D, Sinden J, Ávila MP, Young M. In vivo study to assess dosage of allogeneic pig retinal progenitor cells: Long-term survival, engraftment, differentiation and safety. J Cell Mol Med 2022; 26:3254-3268. [PMID: 35481949 PMCID: PMC9170813 DOI: 10.1111/jcmm.17332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/22/2022] [Accepted: 03/26/2022] [Indexed: 12/02/2022] Open
Abstract
Despite notable efforts and significant therapeutical advances, age‐related macular degeneration remains the single most common reason for vision loss. Retinal progenitor cells (RPCs) are considered promising candidates for cellular treatments that repair and restore vision. In this allogenic study, the phenotypic profile of pig and human RPCs derived using similar manufacturing processes is compared. The long‐term (12‐week) survival of green fluorescent protein‐pig retinal progenitor cells GFP‐pRPC after subretinal transplantation into normal miniature pig (mini‐pig) retina is investigated. Human eyes are both anatomically and physiologically mimicked by pig eyes, so the pig is an ideal model to show an equivalent way of delivering cells, immunological response and dosage. The phenotypic equivalency of porcine and clinically intended human RPCs was established. Thirty‐nine mini‐pigs are used in this study, and vehicle‐injected eyes and non‐injected eyes serve as controls. Six groups are given different dosages of pRPCs, and the cells are found to survive well in all groups. At 12 weeks, strong evidence of integration is indicated by the location of the grafted cells within the neuro‐retina, extension of processes to the plexiform layers and expression of key retinal markers such as recoverin, rhodopsin and synaptophysin. No immunosuppression is used, and no immune response is found in any of the groups. No pRPC‐related histopathology findings are reported in the major organs investigated. An initial dose of 250 k cells in 100 µl of buffer is established as an appropriate initial dose for future human clinical trials.
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Affiliation(s)
- Murilo Batista Abud
- Federal University of Goias, Goiania, GO, Brazil.,Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Petr Baranov
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Ricardo Noguera Louzada
- Federal University of Goias, Goiania, GO, Brazil.,Postgraduate Program in Surgical Science, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pierre Dromel
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Deepti Singh
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Michael Young
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
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Rassi AT, Santana TSD, Isaac DLC, Martinez RC, Garcia JMBDB, Ávila MPD. Pars plana vitrectomy and visual stimulation for treatment of vitreomacular traction secondary to toxoplasmosis retinochoroiditis in a 5-year-old child. Revista Brasileira de Oftalmologia 2022. [DOI: 10.37039/1982.8551.20220012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Isaac DLC, Magacho L, Pereira I EA, Iwamoto KOF, Ferreira AR, Falone WMFC, Ávila MPD. Reduction in eye emergency attendance and the correlation between the COVID-19 and conjunctivitis diagnoses during the COVID-19 pandemic. Arq Bras Oftalmol 2021; 84:517-518. [PMID: 34550222 DOI: 10.5935/0004-2749.202100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Leopoldo Magacho
- Ophthalmology Department, Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiania, GO, Brazil
| | - Eduardo Akio Pereira I
- Ophthalmology Department, Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiania, GO, Brazil
| | | | - Aline Rabelo Ferreira
- Ophthalmology Department, Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiania, GO, Brazil
| | | | - Marcos Pereira de Ávila
- Ophthalmology Department, Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiania, GO, Brazil
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Garcia JMB, Silva HM, Isaac DLC, Ávila MP. Multimodal imaging in a patient with combined hamartoma of the retina and retina pigment epithelium. Arq Bras Oftalmol 2021; 85:297-300. [PMID: 34431902 DOI: 10.5935/0004-2749.20220027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/12/2021] [Indexed: 11/20/2022] Open
Abstract
Combined hamartoma of the retina and retinal pigment epithelium is a rare, benign intraocular tumor. Hamartoma of the retina and retinal pigment epithelium has been described in the literature as a condition presenting with variable retinal damage, ranging from partial epiretinal involvement to complete distortion of the retinal layers and retinal pigment epithelium. We report the case of an 8-year-old girl presenting with longstanding strabismus who was diagnosed with Hamartoma of the retina and retinal pigment epithelium based on multimodal imaging assessment. We explored the particular imaging findings from studies using spectral-domain optical coherence tomography, fundus autofluorescence, optical coherence tomography angiography, and fluorescein angiography.
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Affiliation(s)
| | - Hugo Mendes Silva
- Reference Center in Ophthlamology, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Marcos Pereira Ávila
- Reference Center in Ophthlamology, Universidade Federal de Goiás, Goiânia, Brazil
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Lando L, Silva HM, Cardoso LL, Isaac DLC, Teixeira KISS, Avila M. Retinal ischemia following mandible tumor treatment with steroid injection. Arq Bras Oftalmol 2021; 83:543-546. [PMID: 33470284 DOI: 10.5935/0004-2749.20200099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/03/2020] [Indexed: 11/20/2022] Open
Abstract
Central giant cell granuloma is a rare osseous tumor affecting young patients with anatomical and functional compromise of the maxilla and mandible. Steroid injection therapy constitutes a less invasive treatment modality for disease control in selected cases. Retinal ischemia is a reported complication of multiple medical procedures, including dental interventions, and may lead to loss of vision with poor prognosis. We report a case of retinal arteriolar ischemic disease following central giant cell granuloma management with local injected corticosteroids.
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Affiliation(s)
- Leonardo Lando
- Departamento de Oftalmologia, Universidade Federal de Goiás, GO, Brazil
| | - Hugo Mendes Silva
- Departamento de Oftalmologia, Universidade Federal de Goiás, GO, Brazil
| | | | | | | | - Marcos Avila
- Departamento de Oftalmologia, Universidade Federal de Goiás, GO, Brazil
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Bastos ALCDM, Ávila MPD, Isaac DLC, Aguiar LP, Aguiar AG. Surgical results regarding the correction of macular hole with and without face-down posturing using 25% SF6 gas: a retrospective case series. Arq Bras Oftalmol 2020; 83:361-365. [PMID: 33084811 DOI: 10.5935/0004-2749.20200044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/15/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study aims to compare the anatomical success rates of vitrectomy and SF6 gas tamponade for macular hole surgery with and without postoperative face-down posturing. METHODS This was an observational, longitudinal, and retrospective case series analysis. The study included 52 eyes from 52 patients who underwent pars plana vitrectomy with trypan blue-assisted internal limiting membrane peeling and 25% SF6 tamponade for stages 2, 3, and 4 macular holes. After surgery, all patients were provided with a postoperative postural regimen: 31 patients were instructed not to maintain face-down posturing, whereas 21 were instructed to maintain face-down posturing for 7 days. The primary outcome measure was the macular hole closure rate. Statistical analysis was performed using Epi Info 7.1. RESULTS A total of 47 (90.3%) patients achieved hole closure. The nonface-down posturing group and face-down posturing group obtained closure rates of 90.3% and 90.4%, respectively; these rates were not significantly different. Statistical analysis revealed that no significant differences existed in sex, age, hole duration, hole stage, preoperative visual acuity, or postoperative visual acuity between the two groups. CONCLUSION Our results suggest that macular hole surgery with the use of short duration gas (SF6) is safe and effective and that maintaining a postural orientation of nonface-down posturing is also safe. However, these recommendations should be assessed further in a prospective and randomized study to comprehensively delineate the associated benefits and risks.
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Affiliation(s)
| | | | | | - Levy Paz Aguiar
- Department of Ophthalmology, Humberto Castro Lima Hospital, Salvador, BA, Brasil
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da Silva Tavares Neto JE, Coelho IN, Jorge R, Isaac DLC, de Ávila MP. Pedicle internal limiting membrane flap technique for very large macular holes: a preliminary report. Int J Retina Vitreous 2020; 6:43. [PMID: 32974054 PMCID: PMC7507815 DOI: 10.1186/s40942-020-00248-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Conventional vitrectomy technique for macular hole surgery has a good outcome in small and medium macular holes, but for very large macular holes (minimum linear diameter higher than 700 μm) other techniques were developed aiming to achieve greater rates of closure and visual acuity gain. The purpose of this article is to report the anatomical and functional outcomes of four very large macular hole (MH) cases which have undergone vitrectomy with the pedicle internal limiting membrane (ILM) flap technique. Methods This is a retrospective series of four patients with large MH who were treated with vitrectomy and the pedicle ILM flap technique. Comprehensive ophthalmologic evaluation was performed before surgery and included ETDRS best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT) for MH measures: height, minimum linear diameter (MLD) and external base diameter. The particular detail of this technique is related to ILM flap creation. During the peeling, the ILM was not removed completely from the retina but was left attached to the edges of the macular hole and subsequently trimmed with the vitrectomy probe using the scissors mode. Results Four patients with very large MH underwent PPV and the pedicle ILM flap technique was used to pursue macular closure. Median preoperative BCVA was 20/400 (range: 20/320 to 20/400) and median postoperative BCVA was 20/200 (range: 20/320 to 20/200). Of the 4 cases reported, 3 obtained anatomical closure (75%), and also presented BCVA improvement after surgery, considering the last follow-up visit of each case. No additional procedures were performed in either case. One patient demonstrated no anatomic and functional improvement. Conclusion The present study describes the first Brazilian case series of very large MH treated by the inverted pedicle ILM flap technique. This technique was associated with anatomic and visual improvement in most cases, and represents an alternative therapeutic approach for large macular holes.Trial Registration Project registered in Plataforma Brasil with CAAE number 30163520.0.0000.5440 and approved in ethics committee from Ribeirão Preto Medical School Clinics Hospital, University of São Paulo-Ribeirão Preto, São Paulo, Brazil (appreciation number 3.948.426 gave the approval).
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Affiliation(s)
- José Edísio da Silva Tavares Neto
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900. Bandeirantes Ave, Ribeirão Preto, SP 14049-900 Brazil
| | - Igor Neves Coelho
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900. Bandeirantes Ave, Ribeirão Preto, SP 14049-900 Brazil
| | - Rodrigo Jorge
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900. Bandeirantes Ave, Ribeirão Preto, SP 14049-900 Brazil
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Barbosa MC, Ávila MPD, Isaac DLC, Rebouças MC, Salviano LMO, Nassaralla Neto JJ, Teixeira CC, Luzini RR, Trentin CDO. Strabismic amblyopia: compliance with occlusion treatment in a tertiary hospital in
Midwestern Brazil. Revista Brasileira de Oftalmologia 2020. [DOI: 10.5935/0034-7280.20200065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Oliveira T, Isaac DLC, Garcia JMBDB, Schelini M, Avila MP. Oct angiography compared to fluorescein angiography, indocyanine green angiography and optical coherence tomography in the detection of choroidal neovascularization in pigment epithelial detachment. Acta Ophthalmol 2019; 97:e1006-e1012. [PMID: 31012539 DOI: 10.1111/aos.14117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/24/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the agreement between multimodal imaging-MI (fluorescein angiography, indocyanine green angiography, optical coherence tomography) and optical coherence tomography angiography (OCTA) in the detection of choroidal neovascularization (CNV) in patients with pigment epithelial detachment with subretinal/intraretinal fluid (PED+F) compared to patients with PED without subretinal/intraretinal fluid (PED-F). METHODS Twenty-two eyes of 15 patients were divided into two groups (PED+F and PED-F). All patients underwent MI and OCTA with manual and automatic segmentation. MI findings were compared to OCTA findings and then analysed. RESULTS In the PED+F group (10 eyes), all studied eyes demonstrated CNV in MI. In manual segmentation OCTA assessment, 9 of 10 eyes (90%) were detected with CNV. When evaluated by automatic segmentation, 8 of 10 eyes (80%) revealed the presence of CNV. In the PED-F (12 eyes) group, all eyes did not demonstrate CNV in MI and OCTA evaluations, either by manual or automatic segmentation. The agreement between MI and OCTA shows concordance (k: 0.908; 95% CI, 0.491-1.000); the evaluation of the agreement between the automatic and manual segmentation also shows concordance (k: 0.904; 95% CI, 0.488-1.000). CONCLUSION The solid agreement between the multimodal imaging regarding the ability of OCTA to identify possible initial CNV in a patient with PED-F was observed. Accuracy was 95.45%. In addition, the agreement between manual and automatic segmentation to identify CNV on OCTA was also shown.
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Affiliation(s)
- Tauan Oliveira
- Department of Ophthalmology Federal University of Goias Goiania Goias
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Abud MB, Louzada RN, Isaac DLC, Souza LG, Dos Reis RG, Lima EM, de Ávila MP. In vivo and in vitro toxicity evaluation of liposome-encapsulated sirolimus. Int J Retina Vitreous 2019; 5:35. [PMID: 31572617 PMCID: PMC6757363 DOI: 10.1186/s40942-019-0186-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/12/2019] [Indexed: 12/22/2022] Open
Abstract
Background To evaluate the in vivo and in vitro toxicity of a new formulation of liposome-encapsulated sirolimus (LES). Methods In vitro experiments were done using ARPE-19 and HRP cells. An MTT assay was used to determine cell metabolic activity and a TUNEL assay for detecting DNA fragmentation. In vivo experiments were conducted on New Zealand albino rabbits that received intravitreal injections of empty liposomes (EL) or different concentrations of LES. Histopathological and immunohistochemical analyses were performed on the rabbit’s eyes following injection. Results Eighteen eyes of nine rabbits were used. MTT assay cell viability was 95.04% in group 1 (12.5 µL/mL LES). 92.95% in group 2 (25 µL/mL LES), 91.59% in group 3 (50 µL/mL LES), 98.09% in group 4 (12.5 µL/mL EL), 95.20% on group 5 (50 µL/mL EL), 98.53% in group 6 (50 µL/mL EL), and 2.84% on group 8 (50 µL/mL DMSO). There was no statistically significant difference among groups 1 to 7 in cell viability (p = 1.0), but the comparison of all groups with group 8 was significant (p < 0.0001). The TUNEL assay comparing two groups was not statistically significant from groups 1 to 7 (p = 1.0). The difference between groups 1 to 7 and group 8 (p < 0.0001) was significant. Histopathological changes were not found in any group. No activation of Müller cells was detected. Conclusion A novel formulation of LES delivered intravitreally did not cause in vitro toxicity, as evaluated by MTT and TUNEL assays, nor in vivo toxicity as evaluated by histopathology and immunohistochemistry in rabbit eyes.
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Affiliation(s)
| | - Ricardo Noguera Louzada
- 1Federal University of Goias, Goiania, GO Brazil.,Present Address: Instituto de Olhos São Sebastião, Largo do Machado 54, 1208, Rio de Janeiro, RJ 22221-020 Brazil
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Freitas LGAD, Isaac DLC, Lima EM, Souza LG, Abud MA, Reis RGD, Tannure WT, Ávila MPD. Retinal changes in rabbit after intravitreal injection of sunitinib encapsulated
into solid lipid nanoparticles and polymeric nanocapsules. Arq Bras Oftalmol 2018; 81:408-413. [DOI: 10.5935/0004-2749.20180079] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/13/2018] [Indexed: 11/20/2022] Open
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Garcia JM, Lavigne LC, Freitas ÉC, Salviano LMO, Nassaralla Neto JJ, Isaac DLC, Ávila MPD. Causes of low vision in patients referred to the Low Vision Service in a Reference
Center of Ophthalmology. Revista Brasileira de Oftalmologia 2018. [DOI: 10.5935/0034-7280.20180001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Santana TSD, Ávila MPD, Isaac DLC, Tobias GC, Paranaguá TTDB. Impacto da facectomia na qualidade de vida de idosos atendidos em campanha assistencial de catarata. Rev Eletr Enf 2017. [DOI: 10.5216/ree.v19.39498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivou-se avaliar a melhora da acuidade visual (AV) antes e no 15° dia do pós-operatório de facectomia e o seu impacto na qualidade de vida dos idosos. Estudo prospectivo, desenvolvido com 156 pacientes submetidos à facectomia em campanha oftalmológica. De acordo com a tabela de Snellen, a AV média, em logMAR, após 15 dias da cirurgia melhorou de 1,23 para 0,57 nos idosos (p=0,000). Na comparação das médias de qualidade de vida, pelo questionário de avaliação da qualidade de vida Visual Functioning Questionnaire (VQF-25), o subdomínio visão geral apresentou a maior diferença entre as médias antes e após a facectomia (de 29,65 para 89,87). A análise de correlação apontou que a melhora da AV melhorou a satisfação geral, em relação à atividade para longe, dor ocular, saúde mental e dependência, levando a um impacto positivo na qualidade de vida dos idosos. Levantaram-se indicadores que direcionam à terapêutica mais individualizada.
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Garcia JMBDB, Isaac DLC, Ávila MPD. Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema. Arq Bras Oftalmol 2017; 79:113-5. [PMID: 27224076 DOI: 10.5935/0004-2749.20160033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/21/2015] [Indexed: 11/20/2022] Open
Abstract
Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Although majority of patients with PCME remain asymptomatic, it remains an important cause of vision loss after cataract surgery. The pathogenesis of PCME remains unclear, but most authors agree that inflammation plays a major role in its development. There is no standard algorithm for treatment procedures for PCME. A biodegradable 0.7 mg dexamethasone intravitreal implant can be used to deliver medication into the posterior segment of eyes. This drug acts on all inflammatory mediators and has been approved for the treatment of macular abnormalities secondary to retinal vein occlusion and for non-infectious posterior uveitis. In this case series, we report six patients who presented with PCME and were treated with a 0.7 mg dexamethasone intravitreal implant. Favorable anatomical outcomes were demonstrated by spectral domain-optical coherence tomography images.
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de Barros Garcia JMB, Isaac DLC, Avila M. Diabetic retinopathy and OCT angiography: clinical findings and future perspectives. Int J Retina Vitreous 2017; 3:14. [PMID: 28293432 PMCID: PMC5346852 DOI: 10.1186/s40942-017-0062-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/22/2017] [Indexed: 01/21/2023] Open
Abstract
In diabetic retinopathy (DR), macular involvement can present as either macular edema or ischemia. Fluorescein angiography remains the gold standard in the evaluation of retinal vascular perfusion and diagnosis of macular ischemia. However, it is a costly, time-consuming technique, it requires venipuncture, and reports of anaphylaxis and death related to fluorescein injections have been documented, despite their rarity. Optical coherence tomography (OCT) provides a fast and non-invasive method to assess retinal structures at a microscopic level. OCT angiography permits the noninvasive study of retinal and choroid circulation via motion contrast imaging. Split-spectrum amplitude decorrelation angiography combined with OCT angiography has furthered the understanding of retinal and choroidal vascular diseases, allowing the evaluation of retinal microvasculature and identification of subsequent disorders, including DR. Previous studies using OCT angiography have demonstrated that it may demonstrate DR findings such as microaneurysms, arteriolar wall staining, retinal neovascularization, and intraretinal microvascular abnormalities. The purpose of this article is to describe and discuss different concepts regarding OCT angiography, as well as its role in the diagnosis of DR and maculopathy.
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Affiliation(s)
| | - David Leonardo Cruvinel Isaac
- Federal University of Goias, Av. Primeira Avenida, S/N, Rua 234, 38, Apto 1011, Setor Leste Universitario, Goiania, GO CEP 74605-020 Brazil
| | - Marcos Avila
- Federal University of Goias, Av. Primeira Avenida, S/N, Rua 234, 38, Apto 1011, Setor Leste Universitario, Goiania, GO CEP 74605-020 Brazil
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Garcia JMBDB, Salviano LMO, Santana TSD, Nassaralla Neto JJ, Isaac DLC, Ávila MPD. En face and OCT angiography findings in macular retinoschisis. Revista Brasileira de Oftalmologia 2017. [DOI: 10.5935/0034-7280.20170034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Garcia JMBDB, Isaac DLC, Sardeiro T, Aquino É, Avila M. Benign familial fleck retina: multimodal imaging including optical coherence tomography angiography. Arq Bras Oftalmol 2017; 80:321-323. [DOI: 10.5935/0004-2749.20170078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/13/2017] [Indexed: 11/20/2022] Open
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Garcia JMBDB, Isaac DLC, Ávila M. Initial experience with ocriplasmin in the treatment of vitreomacular traction. Arq Bras Oftalmol 2016; 79:85-7. [PMID: 27224069 DOI: 10.5935/0004-2749.20160026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 12/02/2015] [Indexed: 11/20/2022] Open
Abstract
This study aimed to report the clinical and structural outcomes of intravitreal ocriplasmin in the treatment of vitreomacular interface disorders in two tertiary centers in Brazil. A retrospective study was performed by reviewing medical records and spectral domain optical coherence tomography (SD-OCT) findings of seven patients who were treated with a single ocriplasmin injection. A total of 57.14% of patients achieved resolution of vitreomacular traction as evidenced by SD-OCT. Regarding our functional results, 87.71% maintained or improved visual acuity after follow-up. To the best of our knowledge, this is the first study reporting initial results of ocriplasmin therapy in Brazil.
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Affiliation(s)
| | | | - Marcos Ávila
- Ophthalmology Department, Centro de Referência em Oftalmologia, Goiânia, GO, Brazil
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Mendonça LSDM, Lavigne LC, Chaves LFOB, Garcia JMBDB, Isaac DLC, Ávila M. Benign concentric annular macular dystrophy. Revista Brasileira de Oftalmologia 2015. [DOI: 10.5935/0034-7280.20150038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lavigne LC, Isaac DLC, Duarte Júnior JO, Ávila MPD. Transient spectral domain optical coherence tomography findings in classic MEWDS: a case report. Arq Bras Oftalmol 2014; 77:185-7. [DOI: 10.5935/0004-2749.20140047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 01/27/2014] [Indexed: 11/20/2022] Open
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Geraissate JCÁ, Yamamoto RE, Isaac DLC, Ávila MPD. Hemorrhagic retinopathy in an infant with hemolytic-uremic syndrome. Arq Bras Oftalmol 2014; 77:397-9. [DOI: 10.5935/0004-2749.20140099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 05/01/2014] [Indexed: 11/20/2022] Open
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Rocha MNAM, Ávila MPD, Isaac DLC, Mendonça LSDM, Nakanishi L, Auad LJ. Prevalence of eye diseases and refractive errors in children seen at a referral center for ophthalmology in the central-west region, Brazil. Revista Brasileira de Oftalmologia 2014. [DOI: 10.5935/0034-7280.20140049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Freitas LGAD, Isaac DLC, Gabriel LAR, Bianchi LCDSN, Ávila MPD. Oclusão de ramo arterial retiniano bilateral. Rev bras oftalmol 2013. [DOI: 10.1590/s0034-72802013000400013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Freitas LGAD, Isaac DLC, Tannure WT, Gabriel LAR, Reis RGD, Rassi AR, Freitas CAD, Ávila MPD. Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series. Arq Bras Oftalmol 2013; 76:180-4. [DOI: 10.1590/s0004-27492013000300010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hannouche RZ, Avila MPD, Isaac DLC, Silva RSCE, Rassi AR. Correlation between central subfield thickness, visual acuity and structural changes in diabetic macular edema. Arq Bras Oftalmol 2013; 75:183-7. [PMID: 22872201 DOI: 10.1590/s0004-27492012000300007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/25/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To correlate the central subfield thickness (CST) measured by Cirrus™ SD-OCT with best-corrected visual acuity (BCVA) and structural changes in diabetic macular edema (DME). METHODS The transversal study evaluated 200 patients with non-proliferative diabetic retinopathy (NPDR) and selected 55 eyes with DME between January, 2010 and April, 2011. Spectral domain OCT was performed in patients with type 2 diabetes and DME. CST and BCVA were correlated with the edema morphology and the ELM (external limiting membrane) integrity. Statistical tests were applied to validate the results. RESULTS There was no difference between genders in the NPDR classification. 47.3% of the patients showed moderate NPDR. The CST average for male was of 393.58 µm and 434.16 µm for female, with no statistically significant difference. The patients with continuous ELM showed lower CST average (368.73 µm) than those with disrupted ELM (521.43 µm). There was a strong correlation between the macular volume and CST (59.63%), but poor correlation between age and CST (2.9%). Also, there was a significant difference between the average CST and the type of macular edema. Patients with serous detachment showed higher CST average (488.71 µm) than those with cystoid macular edema (CME) and diffuse edema. Patients with severe NPDR showed higher CST average (491.45 µm), if compared to mild and moderate NPDR. Cystoid macular edema was the most common type of edema (49.1%) and showed the worse VA. Patients with disrupted ELM showed worse BCVA. Patients with higher CST showed worse BCVA. There was a significant difference between the CST average of the case group (407.6 ± 113,1 µm) and the control group (diabetic patients without DME: 252 ± 12.5 µm). There was also a significant difference in the BCVA variables and macular volume between case and control groups. CONCLUSION The study suggests that the CST of diabetic patients with edema is higher than the control group, the increase in CST of diabetic patients with edema leads to worsening of BCVA and macular volume. Continuous ELM showed lower CST average, and the serous detachment showed higher CST average. Cirrus™ proved to be an important tool in the DME evaluation.
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Freitas LGAD, Gabriel LAR, Isaac DLC, Freitas CAD, Ávila MPD. Asymptomatic ocular sarcoidosis. Rev bras oftalmol 2013. [DOI: 10.1590/s0034-72802013000200009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Rocha MNAM, Ávila M, Isaac DLC, Oliveira LLD, Mendonça LSDM. Análise das causas de atendimento e prevalência das doenças oculares no serviço de urgência. Rev bras oftalmol 2012. [DOI: 10.1590/s0034-72802012000600008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rassi AR, Rigueiro MP, Isaac DLC, Dourado L, Abud MB, Freitas EC, Carneiro LB, Avila MPD. [A safety study of retinal toxicity after serial intravitreal injections of infliximab in rabbits eyes]. Arq Bras Oftalmol 2012; 74:352-6. [PMID: 22183996 DOI: 10.1590/s0004-27492011000500009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 08/30/2011] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To determine retinal and choroid toxicity levels of two and three infliximab intravitreous injections in albino rabbits by means of electroretinographic, histological and ophthalmological clinical tests. METHODS 12 albino rabbits were used in the study. Each eye was given two (n=10 eyes) or three (n=10 eyes) serial intravitreous 2 mg infliximab injections dissolved in 0.06 ml of saline, at monthly intervals. A separate group of rabbits (n=4 eyes) served as a control group. Ninety days after the study had begun, the rabbits underwent clinical and electroretinographic tests, and after being enucleated, the eyes were examined for histological changes. RESULTS Slit-lamp biomicroscopy and fundoscopic examination did not reveal any significant retinal abnormalities in the eyes injected with infliximab and control eyes or in pre- and post-treated eyes. The histological change that was noted was the presence of rare lymphocytes and eosinophils in the posterior vitreous of some of the rabbits subjected to two or three injections, but it was not considered clinically significant. A severe inflammatory reaction with vitreous exudates and ganglion cell edema in a single rabbit was clinically significant. The electroretinographic tests showed amplitudes that were on the average 12-13% smaller than those obtained before the treatment, however, there were no statistically significant differences when comparing the amplitude or the implicit time between pre- and post-treatment electroretinographic findings. CONCLUSION Two and three intravitreous 2 mg infliximab injections in rabbits at monthly intervals did not cause any changes after a 90-day follow-up, according to histological and electroretinographic tests and after clinical evaluation. Differently from prior studies that have investigated potential retinotoxicity effects after single administrations, this study investigated the possibility of retinotoxicity after multiple injections. Clinical studies in humans should be conducted to better evaluate the safety of this drug in the treatment of certain diseases affecting the retina and the choroid.
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Affiliation(s)
- Alan Ricardo Rassi
- Ophthalmology Department, Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, Brazil.
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Freitas LGAD, Isaac DLC, Tannure WT, Lima EVDS, Abud MB, Tavares RS, Freitas CAD, Avila MPD. [Retinal manifestations in patients with sickle cell disease referred to a University Eye Hospital]. Arq Bras Oftalmol 2012; 74:335-7. [PMID: 22183992 DOI: 10.1590/s0004-27492011000500005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 09/15/2011] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To identify retinal manifestations in patients with sickle cell disease referred to a reference eye hospital in Goiânia (GO). METHODS Ophthalmic evaluation was made in 50 patients (100 eyes) with sickle cell disease to evaluate the most common manifestations of this group. RESULTS Hemoglobinopathy SS was the most commonly found, followed by hemoglobin SC, AS and Stahl. Twenty-two percent of the patients had retinal changes, of these 73% were male. Retinal changes observed were: "sea fan", "black sunburst", vitreous hemorrhage, and retinal detachment. In the classification of retinopathy, 73% had proliferative form, seen in the types AS and SC and 27% had non-proliferative retinopathy, seen in patients with SS type. CONCLUSIONS We observed a large numbers of patients with retinal changes, most of them with hemoglobinopathy SC, followed by AS and SS groups. The proliferative changes were the most commonly observed. Vitreous hemorrhage and retinal detachment were the most prevalent manifestations in proliferative retinopathy and showed to be more common in patients with SC hemoglobinopathy in the studied population.
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Affiliation(s)
- Luiz Guilherme Azevedo de Freitas
- Departamento de Retina e Vítreo, Centro de Referência em Oftalmologia, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, Brazil.
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Isaac DLC, Abud MB, Frantz KA, Rassi AR, Avila M. Comparing intravitreal triamcinolone acetonide and bevacizumab injections for the treatment of diabetic macular oedema: a randomized double-blind study. Acta Ophthalmol 2012; 90:56-60. [PMID: 20015098 DOI: 10.1111/j.1755-3768.2009.01817.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare the effect of a single intravitreal injection of triamcinolone acetonide and bevacizumab in reducing macular thickness, which was measured by optical coherence tomography (OCT) in patients with diabetic macular oedema (DMO). METHODS The patients received a single intravitreal injection of 1.25 mg bevacizumab in one randomly selected eye and 4.0 mg triamcinolone acetonide in the contralateral eye. Central foveal thickness measurement (CFT) with OCT was taken at the initial visit and at the 4-week, 12-week and 24-week visits. RESULTS Eleven patients (22 eyes) were enrolled and statistically analysed. CFT reduced in the eyes treated with triamcinolone and those treated with bevacizumab in weeks 4 and 12 (p < 0.05). At the 24-week follow-up, no significant difference was noted, relative to the initial visit. Comparing the two groups treated with different drugs, a statistically significant difference in CFT in weeks 4 and 12 was noted, with a more significant reduction in triamcinolone-treated eyes (p < 0.05). Regarding visual acuity (VA), patients treated with triamcinolone had improvement in VA at 4-week (p = 0.02) and 12-week follow-up (p = 0.01), while the group treated with bevacizumab had VA improvement at 4 -week follow-up (p = 0.02). Among the eyes treated with triamcinolone, intraocular pressure (IOP) measurement of more than 21 mmHg was found in three eyes (27.3%). CONCLUSIONS Intravitreal triamcinolone proved to be more efficient in reducing DMO, providing longer lasting visual improvement, relative to bevacizumab. Eyes treated with triamcinolone had the highest percentage increase in IOP. Further studies are needed to corroborate these findings.
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Isaac DLC, Queiroz GHM, Feres CC, Ávila M. Distrofia macular cristalina em paciente com síndrome de Sjögren-Larsson: relato de caso. Arq Bras Oftalmol 2009; 72:239-42. [DOI: 10.1590/s0004-27492009000200021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 12/20/2008] [Indexed: 11/22/2022] Open
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Isaac DLC, Avila MPD, Cialdini AP. Comparison of the original Amsler grid with the preferential hyperacuity perimeter for detecting choroidal neovascularization in age-related macular degeneration. Arq Bras Oftalmol 2008; 70:771-6. [PMID: 18157300 DOI: 10.1590/s0004-27492007000500009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Accepted: 07/02/2007] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare the preferential hyperacuity perimeter (Preview PHP; Carl Zeiss Meditec, Dublin, CA) with the original Amsler grid in the detection of choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD). METHODS Patients were classified into groups, based on the severity of the age-related macular degeneration and underwent preferential hyperacuity perimeter and Amsler grid testing. High sensitivity and or high specificity of a method were defined as the observation of at least 80% of each one the parameters. RESULTS Sixty-five patients (65 eyes) were analyzed statistically. The sensitivity of detection of choroidal neovascularization was 70% by the Amsler grid and 90% by the preferential hyperacuity perimeter and the specificity of the Amsler grid was 85.5% and that of the preferential hyperacuity perimeter 81.8%. CONCLUSIONS The preferential hyperacuity perimeter has greater sensitivity than the Amsler grid in the detection of choroidal neovascularization among patients over 50 years of age and is a promising method for monitoring patients with age-related macular degeneration. Although the original Amsler grid is less sensitive, it is a portable method, not expensive, accessible and presents reasonable sensitivity and high specificity in the diagnosis of choroidal neovascularization. Its use can be recommended for self-monitoring in patients with age-related macular degeneration as an alternative to preferential hyperacuity perimeter and when this method is not available.
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Abstract
The authors present a case of butterfly-shaped pattern dystrophy diagnosed in a male patient, with retinal pigmented epithelium atrophy and central visual acuity decrease in one of the eyes. The evolution of this case was not benign as described in previous reports. A well-defined lesion located in the posterior pole of both eyes associated with fluorescein angiography allowed the diagnosis of this pattern dystrophy. Optical coherence tomography was performed, showing the aspects of the pathology, for the first time.
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Avila MPD, Freitas AM, Isaac DLC, Bastos ALDM, Pena RV. Retinopatia em paciente portador de hepatite C tratado com interferon peguilado e ribavirina: relato de caso. Arq Bras Oftalmol 2006; 69:255-9. [PMID: 16699680 DOI: 10.1590/s0004-27492006000200022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Interferon is an immunomodulating cytokine used to treat patients with different diseases, such as hepatitis C chronic infection. Pegylated interferon is a new type of interferon, developed to increase the half-life of the drug. Many side effects have been related to its use, including ocular toxicity and retinopathy. The most reported ocular findings are cotton-wool spots and hemorrhages located at the posterior pole and surrounding optic nerve head. We describe one case of pegylated interferon-associated retinopathy with visual loss. The patient had visual acuity improvement four weeks after discontinuation of the medication and the ocular findings became much more subtle.
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Lupinacci ÁPDC, Vanini R, Isaac DLC, Ghanem VC, Arieta CEL. Importância da ultra-sonografia ocular na avaliação pré-operatória de pacientes com catarata total. Arq Bras Oftalmol 2004. [DOI: 10.1590/s0004-27492004000100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Cruvinel Isaac DL, Ghanem VC, Nascimento MA, Torigoe M, Kara-José N. Prognostic factors in open globe injuries. Ophthalmologica 2004; 217:431-5. [PMID: 14573978 DOI: 10.1159/000073075] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2003] [Accepted: 05/23/2003] [Indexed: 11/19/2022]
Abstract
PURPOSES To evaluate the main factors related to visual outcome after open globe injuries (excluding intraocular foreign bodies). METHODS Retrospective study analyzing consecutive ocular lacerations, primarily repaired in this institution, between January 1993 and January 2000. Of the 364 cases, 283 (77.75%) lacerations were statistically analyzed, correlating the preoperative variables with the postoperative visual acuity (VA). Excluded from this study were all patients with less than 6 months of follow-up, previous ocular surgery, unreliable information on VA, intraocular foreign bodies and endophthalmitis. When a bilateral injury was detected, only 1 eye was randomly chosen. RESULTS It was observed, after statistical analysis (multivariate analysis), that the most important factors related to postoperative poor VA (less than 20/100) were: the length of the laceration, the elapsed time between the injury and the surgery and the presence or absence of vitreous loss, cataract (lens damage), hyphema, laceration posterior to rectus muscle insertion and retinal detachment. CONCLUSION With this study, it was possible to point out the most important factors related to visual prognosis in open globe injuries. The results found are similar to results previously reported.
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Ghanem VC, Isaac DLC, Nascimento MA, Castro RSD, Kara-José N. Eficácia na utilização de córneas no transplante penetrante. Arq Bras Oftalmol 2003. [DOI: 10.1590/s0004-27492003000300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Shiroma HF, Ferreira EDM, Isaac DLC, Ghanem VC, Arieta CEL. Comparação da eficácia da ropivacaína 1% quando associada ou não à hialuronidase na anestesia peribulbar para cirurgia de catarata. Arq Bras Oftalmol 2002. [DOI: 10.1590/s0004-27492002000500005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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