João Jorge Nassaralla Junior

Degenerações periféricas da retina do olho míope X LASIK

The purpose of this paper is to present the most frequent peripheral retinal degenerations in myopic eyes and discuss those degenerations which are a great risk for the retina and to point out the features associated with retinal detachment, its relation to LASIK and the indication for prophylactic treatment.

Catarata em árvore de Natal

The Christmas tree cataract is a rare type of lens opacification characterized by deposits of needle-shaped polychromatic cortex deep in the core, that can be isolated or associated with other opacities. We report and record, through photographs, two cases of this type of lens opacity.

Análise da microbiota em tonômetros de aplanação de Goldmann

Objective: Analyze the microbiota prevalence in the Goldmann applanation tonometers in the clinic of the SUS to define the contamination of the tonometers and the efficacy of asepsis of the applanation tonometer cone. Methods: A cross-sectional study was carried out to collect 60 “swabs” divided into the three aplanation tonometers of SUS clinics at two different times. In the first one, the collection will be performed at the beginning of the visits and at the second moment, the collection will be performed at the end of all the visits. All swabs will be harvested in the Stuart medium and culture was carried to sow bacteria. Results: Of the 60 samples, only one showed pathogen growth, Escherichia coli. Conclusion: Regardless of the various ways the ophthalmologist chooses to perform asepsis, it is essential for the maintenance of good patient eye health, thus avoiding the transmission and propagation of pathogens through ophthalmologic examination, and we also conclude that the method used by our patient seems to be effective in this prophylaxis.

Therapeutical evaluation of bevacizumab application in relapsed pterygium

Objective: Therapeutic evaluation of Bevacizumab application in relapsed pterygium concerning visual acuity, keratometry, refraction, symptomatology. Methods: Group 1 (4 patients) received 0.1 ml of Bevacizumab (avastin), being evaluated posteriorly on the tenth and thirtieth days after the application, seeking to compare with the exam previously made, being it realized with the other two groups, in which Group 2 (4 patients) received 0.2 ml of Bevacizumab and the Group 3 (3 patients) received 1 ml of the placebo injection. Results: In this study, eleven eyes of eleven patients were evaluated. Among these patients, 7 were women (63.6%) and 4 men (36.4%). There was a variation in the cylindrical diopter after the treatment with a dose of 0.1 ml of bevaciumab during the evaluation on the thirtieth day. Whereas the cylindrical shaft had a significantly larger modification after the application of 0.2 ml. Regarding the spherical diopter variation, there were modifications in the 3 groups. The keratometry varied in the 3 groups, mostly after the thirtieth day of evaluation. In relation to symptomatology, it was observed a reduction in the subjective evaluation of the eye burning sensation, the prurience mentioned by the patient and a reduction of the hyperemia biomicroscopy evaluation. Conclusion: In bevacizumab application in the recurrent pterygium treatment, there is modification of the spherical and cylindrical parameters of refraction, besides the changes in keratometry and the reduction of the symptomatology.

Analysis of the prevalence of patients in need eyeglasses in Ophthalmologic Hospital in Goiânia, Goiás, Brazil: Projeto Olhar Brasil

Objective: Measure the “Projeto Olhar Brasil” under a critic point of view, examining the prevalence of patients referred for ophthalmological appointment, post-screening, that show refractive errors uncorrected. Methods: Review of records between March 2014 and August 2016, in totality of 339 patients between 6 and 18 years old, 5 preschools (2 – 6 years and 11 months) 124 school (7 – 9 years and 11 months) and 210 teenagers (10 – 20 years old). There were 156 males and 183 females, in an Ophthalmologic Hospital in Goiânia, Goiás, Brazil. Results: In total of 339 patients examined, 143 (42.1%) needed optical correction against 196 (57.8%) that not benefiting from the same. There were 74 (47.4%) males patients who required the use of eyeglasses, against 69 (37.7%) of females gender who obtained eyes test alterations. In relation to age, the teenagers, school and preschool showed in absolute numbers and percentage respectively 102 (48.5%), 40 (32.2%) and 2 (40%) indications of corrective lenses. Conclusion: The “Projeto Olhar Brasil” has great importance for society in general reducing the loss of students in school, improving school performance and consequently the quality of life of the beneficiaries, although it needs better training and improvement of professionals in primary health care, elementary school teachers and educators that are responsible for screening.Objetivo: Avaliar o projeto Olhar Brasil sob um olhar crítico, examinando a prevalência dos pacientes encaminhados para consulta oftalmológica, pós-triagem, que realmente apresentem vícios de refração não corrigidos. Métodos: Revisão de prontuários entre Março de 2014 e Agosto de 2016, totalizando 339 pacientes entre 6 e 18 anos de idade, sendo 5 pré-escolares (2 – 6 anos e 11 meses), 124 escolares (2 – 6 anos e 11 meses) e 210 adolescentes (10-20 anos) entre os quais 156 do sexo masculino e 183 do feminino , em um hospital oftalmológico em Goiânia, Goiás, Brasil. Resultados: No total dos 339 pacientes examinados 143 (42,1 %) necessitaram de correção e 196 (57,8%) não. Entre os 156 pacientes do sexo masculino 74 (47,4%) apresentaram necessidade de uso de óculos contra 82 (52,5%) que não precisaram, em relação ao sexo feminino os números foram de 69 (37,7%) que tiveram alteração ao exame e 114 (62,2%) que não apresentaram alterações refrativas. Em relação a faixa etária, os adolescentes, escolares, e pré-escolares apresentaram em números absolutos e porcentagem respectivamente 102 (48,5%), 40 (32,2%) e 2 (40%) de indicação de lentes corretivas. Conclusão: O projeto Olhar Brasil tem importância relevante para sociedade em geral, com diminuição da evasão escolar, melhor rendimento escolar e consequentemente da qualidade de vida dos beneficiários, embora necessite melhor treinamento e aperfeiçoamento dos profissionais da Atenção Básica em Saúde, professores do ensino fundamental e os alfabetizadores que são responsáveis pela triagem. Descritores: Acuidade visual; Prevalência; Refração; Saúde escolar; Saúde ocular AbstrAct

Pachychoroid, an update from the new finding to the usual investigation in selected diseases

The authors make an update of pachychoroid in a group of the choroidal-retinal diseases that choroidal thickening is an usualenhanced depth image - optic coherence tomography (EDI-OCT) finding like as central serous chorioretinopathy, pachychoroid neovasculopathy, polipoidal choroidal vasculopathy and pachychoroid pigment epitheliopathy.

Síndrome de Cogan Reese

Study conducted to report a case of Cogan Reese syndrome. Female patient, 55 years old with diagnosis of Cogan Reese syndrome. Best visual acuity of 0.67 in the right eye and 0.2 in the left eye. By biomicroscopic examination there was no abnormalities in the right eye. In the left eye there were pigmented nodules on the anterior surface of the iris, corneal irregularities and iris hole (pseudopolycoria). The intraocular pressure was 18 mmHg in the left eye and there was glaucomatous optic atrophy of the optic disk. The patient had been subjected to trabeculectomy three years ago. Recently medical treatment allowed the relative control of intraocular pressure. Gonioscopy revealed peripheral anterior synechiae. Corneal specular microscopy showed ICE-cells and low cell count. Glaucoma filtering surgery is usually successful when done early, but it may fail due to endothelialization of the fistula by the abnormal corneal endothelium. Medical treatment was effective despite a fail trabeculectomy.

Increased prevalence of myopia in a ophthalmologic hospital in Goiânia - Goiás

Objetivo: Avaliar o aumento da prevalencia de miopia entre pacientes atendidos em periodos diferentes em um servico oftalmologico de Goiânia. Metodos: Foram comparados dados coletados em dois estudos cientificos realizados em um servico de oftalmologia, em diferentes periodos de tempo, que avaliaram dentre outros fatores, os erros refracionais dos participantes a partir destes dados comparou-se a porcentagem de pacientes portadores de miopia presentes nos estudos. Resultados: Observou-se um aumento na prevalencia de Miopia dentre os participantes dos dois estudos. Na avaliacao realizada entre 1995 e 2000 a porcentagem de pessoas com miopia representou 3,6% do total, ja no estudo realizado no ano de 2014 a prevalencia de pacientes com miopia foi de 9%. Dentre os pacientes com erros refracionais a prevalencia de miopia no primeiro estudo foi de 9,97%, ja no segundo a prevalencia foi de 22%. Conclusao: Observou-se um aumento na prevalencia de miopia entre os dois estudos, dados esses que corroboram com analises feitas que mostram um aumento da prevalencia de miopia em todo mundo nos ultimos 30 anos. Porem em uma proporcao menor do que a observada em outros estudos populacionais.

Fatores de risco e incidência da retinopatia diabética

Objective:The present study aims to evaluate the incidence, and risk factors of diabetic retinopathy( disease duration and the presence of hypertension). Methods: This is a field study, retrospective with quantitative approach. The study population was patients diagnosed with diabetic retinopathy in the period of july 2015 to december 2015. The collection of the data was made through analysis of medical records, it was analyzed the following data : time of diagnosis of diabetes mellitus, presence or absence of systemic hypertension Results: The overall incidence of diabetic retinopathy was 24 new cases in thesis months of analysis. Of wich a total of 66%( 16 patients) had systemic arterial hypertension and 46% had inefficient glycemic control. It was observed that 66% of the patients had indication for photocoagulation laser or intravitreal injection of anti-angiogenic and among those, 35% had diabetes for over 20 years. Conclusion: There was a strong relation between severe diabetic retinopathy, the duration of disease, systemic hypertension and bad glycemic control, with a poor outcome for disease. It also concludes that there is a significant need for assessment of diabetic patients for the presence of DR.Objetivo: Conhecer a incidencia da RD, assim como avaliar os fatores de riscos na amostra em estudo. Metodos: Avalia da incidencia e os fatores de risco da RD (tempo de doenca e presenca de HAS em pacientes com diagnostico de RD atendidos no ambulatorio de retina de um hospital oftalmologico de referencia em Goias para pacientes do Sistema Unico de Saude, no periodo de julho de 2015 a dezembro de 2015 totalizando 6 meses. Resultados: Do total de 160 pacientes avaliados no ambulatorio de Retina, 15% apresentaram diagnostico de retinopatia diabetica. Em relacao ao tempo da doenca 35% dos pacientes, que tiveram indicacao de fotocoagulacao ou injecao intravitrea de inibidores do fator de crescimento do endotelio vascular, apresentavam DM ha mais de 20 anos. Quanto a coexistencia de HAS, 16 pacientes (66%) tambem apresentavam hipertensao arterial sistemica. Conclusao: Conclui-se com o presente estudo que existe importante necessidade de avaliacao de pacientes, quanto a presenca de RD, alem de forte associacao entre a RD, e os fatores de risco avaliados no presente estudo: HAS, tempo do diagnostico do diabetes mellitus e o controle glicemico.

Estudo da prevalência das uveítes em hospital oftalmológico terciário em Teresina, Piauí, Brasil

Objective: To analyze the prevalence of uveitis in patients treated at a tertiary ophthalmic service in Teresina, Piaui State, Brazil. Methods: This was a retrospective study based on medical records of patients treated at this service. Sex, age, origin, underlying diseases, anatomical diagnosis, clinical aspects and progression time were described. Results: 403 records were included, noting that 3.2 out of every 1,000 patients treated at the service had uveitis.The average age of patients was 42 years old, with both sexes (50.6% females and 49.4% males) affected similarly, and with 61.5% coming from the state capital, Teresina. The most common underlying disease was toxoplasmosis, followed by idiopathic uveitis with ocular manifestations only. As to the anatomical classification, 49.6% of them were posterior and only 3.5% were intermediate. Regarding the clinical aspects, 64% were granulomatous, 24.8% non-granulomatous, and 11.2% were not classifiable. According to the clinical progression, 41.4% were acute, followed by 30.8% chronic, 14.4% recurrent cases, and 13.4% of patients did not return for medical care. Conclusion: we found that for every 1,000 patients treated at the service, 3.2 had uveitis, with toxoplasmosis itself found to be an important source of uveitis.