Lucas Brandolt Farias

Intraocular pressure in very low birth weight preterm infants and its association with postconceptional age

OBJECTIVE: To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age. METHODS: The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight ≤1,500 g and gestational age ≤32 weeks) admitted to Hospital de Clínicas de Porto Alegre, Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination) in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values. RESULTS: Fifty preterm infants with a mean gestational age of 29.7±1.6 weeks and a mean birth weight of 1,127.7±222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9±4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: −0.58 to −0.0035). The mean intraocular pressure (P10–P90) decreased from 16.3 mmHg (10.52–22.16) at 26.3 weeks to 13.1 mmHg (7.28–18.92) at 37.6 weeks of postconceptional age. CONCLUSIONS: The mean intraocular pressure in very low birth weight preterm infants was 14.9±4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.

Microalbuminuria Is Associated With Early Retinal Neurodegeneration in Patients With Type 2 Diabetes

BACKGROUND AND OBJECTIVE To evaluate retinal layer changes in patients with type 2 diabetes, microalbuminuria, and no diabetic retinopathy, and to investigate its possible relationship with age, gender, diabetes duration, urinary albumin excretion (UAE), glycosylated hemoglobin, and hypertension. PATIENTS AND METHODS A prospective, cross-sectional study was performed in 60 patients divided into three groups: diabetic patients with normal UAE, diabetic patients with microalbuminuria, and controls. Retinal thickness was evaluated by Early Treatment Diabetic Retinopathy Study grid using spectral-domain optical coherence tomography. RESULTS The average and sectoral macular thicknesses of the ganglion cell layer (GCL) were significantly thinner in the microalbuminuria group compared to normal UAE group and controls (P < .005). UAE was the only factor related to this reduction in a multiple linear regression analysis. CONCLUSIONS The GCL thickness was reduced in eyes in patients with type 2 diabetes and microalbuminuria before clinical signs of diabetic retinopathy. Inner retinal neurodegeneration was independently associated with albuminuria. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e36-e43.].

Changes in choroidal thickness and volume are related to urinary albumin excretion in type 2 diabetic patients without retinopathy

Purpose To evaluate choroidal thickness and volume in patients with type 2 diabetes and microalbuminuria using spectral-domain optical coherence tomography. Methods We recruited 37 diabetic patients without diabetic retinopathy (18 normoalbuminuric and 19 microalbuminuric) and 21 healthy controls. Choroidal thickness and volume were mapped using the automated Early Treatment Diabetic Retinopathy Study grid and a topographic map of thickness was generated manually. Choroid was also measured at 10 locations under the fovea, temporally and nasally. Results Mean choroidal thickness and volume among patients with diabetes and microalbuminuria was reduced in all locations compared to controls (P<0.05). A sectoral decrease of choroidal thickness and volume was shown between microalbuminuric and normoalbuminuric groups. Conclusion Choroidal changes were present in type 2 diabetic patients before clinical development of retinopathy. Microalbuminuria was associated with a decrease in choroidal thickness and volume in diabetic patients without diabetic retinopathy.

Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography

Purpose To analyze choroidal thickness (CT) of pregnant women with type 1 diabetes mellitus (DM), type 2 DM and gestational diabetes mellitus (GDM) using spectral-domain optical coherence tomography. Patients and methods This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations. We also analyzed possible confounding factors, such as gestational age, glycosylated hemoglobin, time from DM diagnosis, hypertension and severity of diabetic retinopathy. Results The comparison between the four groups showed a thinner choroid in patients with type 1 DM in all locations, with statistical significance in subfoveal and temporal measurements. When comparing only patients with type 1 and type 2 DM, adjusting for confounding factors, the choroid of patients with type 1 DM remained thinner at all macular points, also with statistical significance in subfoveal and temporal measurements. Conclusion Pregnant women with type 1 DM had significantly thinner CT measurements on subfoveal and temporal locations. No differences were found in CT between the control group and pregnant women with GDM and type 2 DM.