Eduardo F. Damasceno

Acquired unilateral rubella retinopathy in adult.

The authors report an uncommon case of unilateral rubella retinopathy in an adult patient, described for the first time in medical literature. A 28-year-old healthy white man acquired a case of vasculitis and retinitis on his right eye with sudden vision loss, preceded by an acute viral disease (best correct visual acuity was 20/200). Serology examinations on several viral diseases reveled positive signs to rubella. The treatment was based on corticoids therapy due to macular commitment with final visual acuity of 20/60. Serology concluded rubella etiology, with positive levels in the acute initial stage of viral infection, even during viral retinopathy.

Leuconostoc as a Cause of Endophthalmitis Post-intravitreal Injection of Ranibizumab

Abstract Purpose: The authors report a case of endophthalmitis after intravitreal injection of ranibizumab. Methods: After searching for extensive laboratory tests to isolate the etiologic agent Results: The agent was determined as Leuconostoc mesenteroides, gram-positive cocci, vancomycin resistant. Discussion: Considerations regarding this bacterium were done by calling attention to its rarity, difficulty of isolation, and action on secondary comorbidities as opportunistic pathogen.

Anterior Uveitis After Treatment of Hepatitis C with Alpha Interferon: The Recurrence of a Previous Inflammatory Process due to Presumed Ocular Toxocariasis

Objective: To report a case of recurrent unilateral presumed ocular toxocariasis after treatment of hepatitis C. Design: Case study. Methods: Clinical findings, ultrasonography, computed tomography, and serological tests were performed. Once diagnosis was made, effective treatment was administered. Results: A 46-year-old woman with a long history of decreased unilateral visual acuity presented with anterior uveitis after the use of interferon alpha and ribavirin for treatment of hepatitis C. A biomicroscopic examination revealed active anterior uveitis, with ultrasonography and computed tomography demonstrating a central granuloma due to partially calcified toxocariasis. After treatment with corticosteroids and cycloplegics, the symptoms were alleviated. Conclusion: immunostimulation could cause a relapse of the inflammatory reaction found in uveitis due to toxocariasis.

Análise da capacidade de acomodação em pacientes présbitas com baixo índice de massa corporal

PURPUSE: To determine the correlation between presbyopia and body mass index. METHODS: Cross-sectional study involving 1030 patients with visual acuity of 20/20 emmetropy, aged between 36-40 years, 51-55 years and 60-65 years, excluding patients with positive test cover, anisometropy with convergence insufficiency or high correlation convergence / accommodation. Assessment of body mass index of all patients, RESULTS: Cross-sectional study involving 1030 patients with visual acuity of 20/20 emmetropy, aged between 36-40 years, 51-55 years and 60-65 years, excluding patients with positive cover test, anisometropy with convergence insufficiency or high correlation convergence / accommodation. Assessment of body mass index of all patients CONCLUSION: As demonstrated by statistical analysis there is a significant correlation between low body weight defined as a body mass index below 18.5 and a lower incidence of presbyopia or delay its onset and progression with age.

Refração e síndrome de fadiga visual no uso de sistema de televisão ULTRA- HD-3D- 4K de tela curva

Purpose: To evaluate eye sensitivity disorder (similar to glare), with symptoms of visual fatigue, through watching television ULTRA HD3D-55-inch 4K curved screen among volunteers with normal eye examination. Methods: A prospective, longitudinal, case-control study, with inclusion and exclusion criteria and groups formation enrolled by age range. A comparison of a video documentary presented with the ULTRA HD TV 4K and with the FULL HD TV before and after the previous tele-audience, consisting of an evaluation of three phases of the study regarding the case-control criteria. The main variable analyzed was a questionnaire of visual fatigue syndrome complaints which was compared with secondary variables as the contrast sensitivity test, amplitude of accommodation test, blink frequency test, and test of conjugated saccadic eye movements of big amplitude. Tablets with digital camera equipment were used for video recording of the blink frequency, and saccadic eye movements throughout the television audience. Statistical analysis with Chi Square test. Results: Eighty healthy volunteers were evaluated and assessed as expressiveness of statistical inference alpha (α) of 10%, without obtaining significance of 5% for complaints of a questionnaire Visual Fatigue Syndrome. Other statistical tests showed 5% of significance of data in a global inference research on the frequency of blinking and combined saccadic movements of great amplitude. Conclusion: High resolution television screens ULTRA HD 4K may cause complaints of eyestrain in a population with some uncommon characteristics (low eyelid blink frequency and conjugated saccades movements). The low statistical significant index could be increased in a research with a higher number of participants. The authors call attention to the possibility of increasing this visual fatigue effect in the future advent of Television System ULTRA HD 8K.

Fila cirúrgica digital como instrumento auxiliar de gestão hospitalar: Sugestões de adequações propostas por um serviço universitário de oftalmologia

Objetivo: Avaliar, atraves de busca na internet, quais os servicos publicos com atendimento oftalmologico no Brasil que possuem um pacote digital composto de pagina da instituicao na rede digital, prontuario eletronico, sistema de regulacao de atendimento e fila de espera cirurgica digital. Enfatizar a presenca destes elementos de pesquisa com a condicao de funcionamento de fila de espera cirurgica digital com possibilidade de consulta publica pelo paciente usuario. Metodos: Estudo transversal atraves de busca na internet de servicos de oftalmologia com este pacote digital completo ou parcial em carater nacional. Os dados foram pesquisados na internet no periodo de junho a julho de 2015. As instituicoes foram divididas em grupos de pesquisa, assim designados: hospitais multidisciplinares universitarios, hospitais multidisciplinares assistenciais, hospitais uni-disciplinares assistenciais (somente oftalmologia) e banco de olhos (como entidade de atendimento publico). Duas variaveis foram avaliadas: numero total e parcial de servicos publicos de oftalmologia que possuem este sistema digital e como foi desenvolvido este pacote digital por cada instituicao. Os dados foram avaliados atraves do teste Qui quadrado e prova exata de Fisher. O nivel de significância do estudo foi 0,05. Resultados: Foram encontradas 48 instituicoes publicas oftalmologicas detentoras deste pacote digital, sendo: 24 universitarias, 15 assistenciais, 3 hospitalares uni-disciplinares (somente oftalmologia), 6 bancos de olhos. Somente 10,4 % destas instituicoes apresentaram uma fila de espera cirurgica digital. Exclusivamente os bancos de olhos obtiveram dados significativos quanto a presenca de fila cirurgica digital, bem como a origem de seu desenvolvimento. Conclusao: Apenas algumas instituicoes apresentaram um pacote digital completo, porem a fila de espera cirurgica digital e o componente mais raro destas instituicoes. Razoes desta constatacao sao explanadas pelo estudo. Embora com pequena representacao, em todo territorio nacional somente dois bancos de olhos apresentaram fila cirurgica digital com possibilidade de consulta publica.

Acute Zonal Occult Outer Retinopathy (AZOOR) in a patient with Hashimoto's thyroiditis

Acute zonal occult outer retinopathy (AZOOR) is a rare disease characterized by an acute damage of one or more external retinal zones leading to the visual field or the visual acuity impairment associated with small or no changes in the fundus examination.The main clinical symptoms are scotomas and the sudden onset of photopsias. Abnormal findings on electroretinography and visual field defects are critical for the diagnosis. Central vision is usually preserved and the stabilization occurs in six months in most cases. The objective of this article is to describe a 24-month follow-up of a patient with AZOOR and correlate the findings with the typical features of this disease.

Evaluation of a simulation tool in ophthalmology: application in teaching funduscopy

Dear Editor: I read with interest the study with the above title by Androwiki, which reported regarding the funduscopy simulator device, that published in the ABO February 2015 edition. My team and I published a similar article entitled “Teaching ophthalmology at university medical undergraduate course: comparative study of direct ophthalmoscopy between conventional ophthalmoscope and wide field ophthalmoscope (panoptic) as evaluation method” in Revista Brasileira de Oftalmologia. We agree with the authors that teaching funduscopy through a new type of device is feasible; however, some considerations are required. a) In ophthalmology, the teaching of the beginners may be com plicated by eye fundus difficulties, such as high-refraction errors, small pupils, and lens opacities. The same difficulties are faced among physicians in other specialties. b) Limitations with simulators are known in several subspecialties (mainly surgical ones); however, in this particular study, the association with a wide-field direct ophthalmoscope could facilitate this type of teaching.

Ocular diseases at geriatric clinics in Rio de Janeiro: social and epidemiological considerations among patients with motor locomotion deficit

OBJECTIVE To identify the causes of low visual acuity and systemic morbidities that limit ambulation and access to eye care in geriatric clinics in Rio de Janeiro. METHODS This cross-sectional study evaluated 187 patients from three geriatric clinics in Rio de Janeiro between January 2010 and January 2011. The inclusion criteria were individuals with a visual acuity of less than of equal to 20/200 in either eye (118 individuals), without optical correction. The exclusion criteria were individuals who refused to participate and those unable to undergo screening because of mental disabilities (6 individuals). Of the 187 individuals evaluated, 63 had visual acuity above 20/200. RESULTS A total of 118 individuals with a visual acuity of ≤20/200 effectively participated in the study after meeting the inclusion and exclusion criteria. In addition, 57 participants (48.3%) presented systemic disabling morbidities. Of the 118 individuals with low visual acuity, 27.96% had cataract and 26.27% had refractive errors. CONCLUSION Most of the patients from geriatric clinics experienced ocular morbidities, but their proper treatment resulted in improved visual acuity. A more socially oriented problem associated with eye care involved the difficulty of access to ophthalmologic consultations.