Oswaldo Ferreira Moura Brasil

Regression of vasoproliferative tumor with systemic infliximab.

The anti-tumor necrosis factor (TNF) monoclonal antibody infliximab inhibits the pleiotropic actions of TNF and is widely used for the treatment of inflammatory diseases, such as uveitis. A pathogenetic role of TNF in ocular inflammatory conditions has recently emerged. The authors describe a patient with collagen mixed disease who had decreased vision in the left eye. Fundus examination disclosed bilateral peripheral vasoproliferative tumors and macular edema in the left eye. The patient underwent treatment with infliximab intravenously for his systemic condition. Regression of the vasoproliferative tumors in both eyes and improvement of macular edema in the left eye was observed. Although the data are limited, anti-TNF antibodies such as infliximab may be useful in the treatment of retinal vascular tumors.

Regression of Macular Cavernous Hemangioma with Systemic Infliximab.

Cavernous hemangioma of the retina is an unusual vascular hamartoma that has been reported to occur either sporadically or as a dominantly inherited trait. A case of a large and sporadic macular cavernous hemangioma that was successfully treated with systemic infliximab as a first line of treatment is presented. The patient was referred with decreased vision of the right eye for 6 months. Fundus examination disclosed a reddish elevated lesion in the posterior pole that obscured the macula and encroached on the fovea. It consisted of grapelike aneurysms. The patient underwent treatment with infliximab intravenously. Two weeks after the second infusion of infliximab, visual acuity improved to 20/80 with a marked involution of the tumor in the right eye. Although the data are limited, we think that a new perspective for treatment of retinal vascular tumors may appear in the future considering antibodies to tumor necrosis factor (TNF)-alpha.

Terapia fotodinâmica com verteporfirina em neovascularização coroidiana subfoveal secundária a coriorretinopatia serosa central: relato de caso

We report the use of photodynamic therapy with verteporfin for subfoveal choroidal neovacularization in central serous chorioretinopathy. Visual acuity improved (0.5 to 1.0) 30 days after the first session. After 141 days, the choroidal neovascularization reactivated and the patient was retreated. Again, visual acuity improved (0.5 to 1.0) 30 days afterwards. It remains stable after 20 months. Photodynamic therapy can be efficient in the treatment of choroidal neovascularization in central serous chorioretinopathy.

Macular hole secondary to X-linked juvenile retinoschisis.

The authors describe a rare case of full-thickness macular hole formation in a 10-year-old boy with X-linked juvenile retinoschisis.

Optical Coherence Tomography Findings of the Acute Exudative Polymorphous Vitelliform Maculopathy.

The optical coherence tomography (OCT) findings of a 26-year-old HIV-positive male with acute exudative polymorphous vitelliform maculopathy were described. His with best-corrected visual acuity at the presentation of the disease was 20/25 in the right eye and 20/30 in the left eye. Fundus examination showed bilateral yellowish subretinal lesions arranged in a honeycombed pattern throughout the posterior pole in both eyes. OCT scans on the topography of these lesions showed well-defined hyporeflective spaces that occasionally merged, limited superiorly by the retinal pigment epithelium and inferiorly by a hypereflective tissue that could correspond to Bruchs membrane. Sub-sensory fluid was found in both maculas.

Macrovaso retiniano congênito: relato de caso

Congenital retinal macrovessel is a rare vascular anomaly in which a large vessel and its tributaries cross the macula. We describe a case of retinal macrovessel in a patient complaining of decrease in visual acuity.

Coroidopatia lúpica: relato de 2 casos

Descrevemos 2 casos de coroidopatia lupica, uma manifestacao ocular incomum do lupus eritematoso sistemico, caracterizada por elevacao serosa do epitelio pigmentario retiniano e/ou retina sensorial e moteamento do epitelio pigmentario.

Combined Femtosecond Laser-Assisted Cataract Surgery and Small-Gauge Pars Plana Vitrectomy Using Different Devices: A New Trend for Vitreoretinal Surgery?

BACKGROUND AND OBJECTIVE To report the efficacy, safety, and benefits of femtosecond laser-assisted cataract surgery (FLACS) combined with sutureless 23-gauge pars plana vitrectomy (PPV). PATIENTS AND METHODS This multicenter, retrospective study evaluated patient records and videos of 43 cases with retinal pathologies and cataract who underwent the combined procedure. RESULTS In 44.2% and 55.8% of cases, respectively, the LenSx Laser (femtosecond machine; Alcon, Fort Worth, TX) and the Constellation (vitreous cutter; Alcon, Fort Worth, TX), and the Victus (femtosecond machine; Bausch + Lomb, Rochester, NY) and Stellaris PC (vitreous cutter; Bausch + Lomb, Rochester, NY) were used. No complications developed during capsulorrhexis, even without a red fundus reflex, retrobulbar block, or scleral indentation. Foldable intraocular lenses remained stable in the capsular bag during the vitreoretinal surgeries and postoperative visits. The mean times of femtosecond phacoemulsification, vitreoretinal surgery, and total surgery were 22.9 minutes ± 4.7 minutes, 43.1 minutes ± 9.8 minutes, and 65.3 minutes ± 8.6 minutes, respectively. CONCLUSION This emerging technology is safe and offers several potential benefits for the success of the combined procedure. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:374-379.].

Enhanced depth imaging optical coherence tomography of choroidal osteoma with secondary neovascular membranes: report of two cases.

We report enhanced depth imaging optical coherence tomography (EDI-OCT) features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle. Both lesions had multiple intralesional layers and a typical intrinsic transparency with visibility of the sclerochoroidal junction.

Iris metastases from systemic cancer: a report of three cases

Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema. Here, we describe three patients with iris metastasis and discuss the diagnostic challenges and unusual findings associated with these cases.