Elisabeth Nogueira Martins

Fundus autofluorescence in patients with blunt ocular trauma.

Acta Ophthalmol. 2011: 89: e89–e94

Biopharmaceutical industry-sponsored global clinical trials in emerging countries

OBJECTIVE To evaluate biopharmaceutical industry-sponsored clinical trials placed in countries previously described as emerging regions for clinical research, and potential differences for those placed in Brazil. METHODS Data regarding recruitment of subjects for clinical trials were retrieved from www.clinicaltrials.gov on February 2nd 2009. Proportions of sites in each country were compared among emerging countries. Multiple logistic regressions were performed to evaluate whether trial placement in Brazil could be predicted by trial location in other countries and/or by trial features. RESULTS A total of 8,501 trials were then active and 1,170 (13.8%) included sites in emerging countries (i.e., Argentina, Brazil, China, Czech Republic, Hungary, India, Mexico, Poland, Russia, South Korea, and South Africa). South Korea and China presented a significantly higher proportion of sites when compared to other countries (p<0.05). Multiple logistic regressions detected no negative correlation between placement in other countries when compared to Brazil. Trials involving subjects with less than 15 years of age, those with targeted recruitment of at least 1,000 subjects, and seven sponsors were identified as significant predictors of trial placement in Brazil. CONCLUSION No clear direct competition between Brazil and other emerging countries was detected. South Korea showed the higher proportion of sites and ranked third in total number of trials, appearing as a major player in attractiveness for biopharmaceutical industry-sponsored clinical trials.

Usefulness of corneal esthesiometry for screening diabetic retinopathy

OBJECTIVE To assess the usefulness of corneal esthesiometry for screening diabetic retinopathy. METHODS A cross-sectional study was carried out comprising 575 patients attending a diabetic retinopathy-screening program in the city of São Paulo. Corneal esthesiometry was assessed with the Cochet-Bonnet esthesiometer. The presence of diabetic retinopathy was detected with indirect fundoscopy. The validity of corneal esthesiometry in identifying diabetic retinopathy was evaluated by the Receiver Operating Characteristic (ROC) curve. RESULTS Sensitivity and specificity analyses of the corneal esthesiometry for detecting the stages of diabetic retinopathy using different cut-offs showed values less than 80%. The best indices (72.2% sensitivity and 57.4% specificity) were obtained for the identification of patients with proliferative diabetic retinopathy. CONCLUSIONS In the study series, corneal esthesiometry was not a good indicator of diabetic retinopathy.

Enfisema orbitário compressivo após asseio nasal: relato de caso

Orbital emphysema is the abnormal presence of air in the orbit. Occurrence in the absence of orbital fracture is rare. We report a case of a 40-year-old female presenting unilateral orbital emphysema after vigorous nose blowing. She developed sudden visual loss as a result of elevated intraocular pressure and urgent treatment was required. She underwent an orbital decompression, performed using a 24-gauge needle puncture adjacent to the supraorbital notch. After treatment, she reported considerable decrease of symptoms.

Hifema traumático: seguimento de um ano

OBJETIVO: Analisar retrospectivamente a evolucao de pacientes portadores de hifema decorrente de trauma ocular contuso quanto a acuidade visual inicial e final, aumento da pressao intra-ocular, ocorrencia de ressangramento, tempo de absorcao do coagulo, e necessidade de cirurgia. METODOS: Foram avaliados 54 pacientes com idade superior a 15 anos, com diagnostico de traumatismo ocular fechado, assistidos no Pronto Socorro de Oftalmologia do Hospital Sao Paulo, no periodo de dezembro de 2000 a janeiro de 2002. O hifema foi classificado em cinco subgrupos: microscopico; grau I; grau II; grau III e grau IV (hifema total). Os pacientes foram divididos em dois grupos, de acordo com o comprometimento ou nao do segmento posterior, para comparacao dos dados pelo teste de Mann-Whitney e o teste exato de Fisher. A acuidade visual final foi avaliada por meio de regressao linear multipla. RESULTADOS: Noventa e um por cento dos pacientes eram do sexo masculino, com idade media de 32 anos. Na admissao, 37% dos pacientes apresentaram PIO superior a 24 mmHg. O ressangramento ocorreu em 8% deles. Durante a evolucao, seis pacientes necessitaram de intervencao cirurgica. No grupo I (sem lesoes de segmento posterior) houve melhora estatisticamente significante da AV (p<0,001), o que nao foi observado no grupo II (p=0,4772). CONCLUSAO: A classificacao do hifema permite avaliacao da gravidade da lesao, prognostico e conduta. A baixa de visao persistente correlacionou-se principalmente ao comprometimento do seguimento posterior e a acuidade visual na admissao. O sucesso do tratamento depende da identificacao dos fatores de risco, medicacao apropriada e indicacao cirurgica precisa.

Deficiência de vitamina A: relato de caso

Relatamos um caso de deficiencia primaria de vitamina A com apresentacao inicial ocular tratado topica e sistemicamente com vitamina A 100.000 UI por dia via oral e colirio de 5.000 UI/ml, quatro vezes ao dia. Com o tratamento houve total resolucao das manifestacoes oftalmologicas.

Charcot-Marie-Tooth disease and posterior scleritis: a case report

Objetivo: Descrever a associacao entre doenca de Charcot-Marie-Tooth (DCMT) e esclerite posterior. Metodologia: Relato de caso de uma paciente do sexo feminino, 16 anos de idade, com baixa de acuidade visual e dor em ambos os olhos. Resultados: O exame oftalmologico revelou esclerite posterior, observada tambem por ultra-som e angiofluoresceinografia. Deformidades de pernas e pes foram identificadas na paciente e em seus familiares. O diagnostico de DCMT na paciente estudada foi confirmado por estudos eletrofisiologicos. Conclusoes: A presenca de esclerite posterior em paciente com DCMT nao e descrita na literatura, nao se encontrando tambem relatos de outras doencas oculares inflamatorias, nestes pacientes.