Nivaldo Vieira de Souza

Retinal changes and tumorigenesis in Ramon syndrome : Follow-up of a Brazilian family

We report on the clinical evolution of the Brazilian family with Ramon syndrome described by de Pina-Neto et al. [1986, Am J Med Genet 25:441-443]. Three members (patients IV-2, IV-18, and IV-19) have developed pigmentary changes in the retina and paleness of the optic disk. Patient IV-18 also has developed giant hypertrophy of the labia minora that, when examined histopathologically, was found to be due to neoplastic fibroblast and epithelial proliferation caused by a fibromatous process similar to that reported in the gingivae of the patients with this syndrome. Audiologic function of patient IV-2 was normal, and no skin lesions were detected. The articular signs and symptoms show that the affected relatives developed rheumatoid arthritis, which is currently inactive in patient IV-18, whereas patient IV-2 did not develop these alterations.

Toxicidade retiniana do gás hexafluoreto de enxofre, líquido perfluorocarbono, ar e solução salina balanceada em olhos de coelhos

PURPOSE: To determine retinal toxicity after intravitreous balanced salt solution, sulfur hexafluoride gas, and perfluorocarbon liquid injection in rabbit eyes. METHODS: Twenty-two eyes of sixteen New Zealand albino rabbits were divided into groups: balanced salt solution (7 eyes); sulfur hexafluoride gas (4 eyes); and perfluorocarbon liquid (5 eyes). After the introduction of a needle through the sclera the vitreous was aspirated (0.3 ml), balanced salt solution, sulfur hexafluoride gas 100% and perfluorocarbon liquid (0.3 ml) were injected into rabbit vitreous cavity. The control group (6 eyes) was not submitted to any procedure. After three weeks the vitreous was aspirated and submitted to biochemical analysis and the eyes prepared for histological analysis. RESULTS: The eyes submitted to perfluorocarbon liquid and sulfur hexafluoride gas injection showed a greater L-glutamate increase in the vitreous compared to balanced salt solution and control groups (p<0.05). Histological results confirmed small changes in the sulfur hexafluoride group and important lesions in perfluorocarbon liquid group, such as external photoreceptor segment disruption, external and internal plexiform layer thinning, ganglionar and internal nuclear layer decrease of nucleus number, edema, and presence of macrophages in the superficial layers. No major histological changes were observed with balanced salt solution and in control groups. CONCLUSION: Liquid intravitreous injection of sulfur hexafluoride gas and perfluorocarbon are potentially toxic to rabbit retina, compared to control and balanced salt solution groups.

Retinopatia diabética em pacientes de um programa de atendimento multidisciplinar do Hospital das Clínicas de Ribeirão Preto - USP

PURPOSE: To analyze the ophthalmological profile of diabetic patients assisted by the multidisciplinary program at the Clinical Hospital of Ribeirao Preto-USP. METHODS: The analysis of the records of fundus ophthalmoscopy, performed by the same ophthalmologist, was carried out in 2.360 diabetic patients from 1983 to 2002, who were divided according to the follow-up period: group A - 0 to 4, group B - 5 to 9, group C - 10 to 14 and group D - 15 to 19 years. RESULTS: The frequency of retinopathy was: A - 16%, B - 29%, C - 36% and D - 44%. There were significant differences between A and the other groups (p 0,05). CONCLUSION: Even with an organized and multidisciplinary care, diabetic retinopathy continues to be a frequent and hard control disease among diabetic patients.

Experimental closed system surgical procedures and intraocular pressure fluctuation

PURPOSE To determine the behavior of intraocular pressure and its relationship with infusion pressure in vitrectomy, phacofragmentation and phacoemulsification surgeries in rabbits. METHODS Intraocular pressure fluctuation was measured in 24 eyes of 12 rabbits submitted to vitrectomy, phacofragmentation and phacoemulsification procedures (eight eyes per group). The procedures were divided according to the force of aspiration of the instrument. Intraocular pressure was monitored with a computerized polygraph by means of a cannula introduced into the vitreous chamber. RESULTS Intraocular pressure showed a mean variation from 33 mmHg (maximum) to 6 mmHg (minimum). Vitrectomy showed the greatest difference between weak and strong aspiration. The greatest fluctuations occurred during procedures with strong aspiration, with phacoemulsification showing the widest variation, with maximum peaks almost reaching 50 mmHg. The infusion pressure varied less than the intraocular pressure, especially at the lowest pressures. CONCLUSIONS The fluctuation of intraocular pressure during ocular surgeries was not great. The higher the aspiration pressure, the higher the intraocular pressure. The infusion pressure did not show a good correlation with intraocular pressure.

Ophthalmologic conditions of aids patients with long-term follow-up

PURPOSE To evaluate the ophthalmologic conditions of patients with AIDS, with long-term follow-up, previously evaluated by an ophthalmologist, considering general conditions related with AIDS. METHODS Observational study of 42 patients with AIDS divided into two groups: Group I: 8 patients with previous AIDS-related cytomegalovirus retinitis, Group II: 34 patients with AIDS without cytomegalovirus retinitis. Each patient had been submitted to one ophthalmologic examination. General data of the patients were obtained from the medical records. RESULTS The majority of the patients presented visual acuity in the best eye between logMAR 0.0 (68.3%) and 0.1 (26.9%). Optic prescription for refractive errors benefited 39.4% of the patients in Group II but none of the patients in Group I. Presbyopia was corrected in 27.3% of Group II and in 12.5% of Group I patients. No current ocular AIDS-related manifestations were detected in any group. Ocular posterior segment alterations, all of them consisting of retinitis / retinochoroiditis scars, were found in 10 patients, 7 (16.7%) belonging to Group I and 3 (7.1%) to Group II. CONCLUSION Ten (24.4%) patients presented visual alteration due to age. Except for the patients presenting previous retinitis and retinochoroiditis, all the other patients were in good ophthalmic conditions and most of them were in immunologic recovery due to the use of highly active antiretroviral therapy.