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Human T-cell lymphotropic virus type 1-related uveitis, review about a case 与人类 T 细胞淋巴细胞病毒 1 型有关的葡萄膜炎,病例回顾
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_105_23
Margarida Baptista, C. Bruxelas, Miguel Cordeiro, Marta Guedes
Human T-cell lymphotropic virus type 1 (HTLV-1) is an endemic retrovirus associated with adult T-cell leukemia/lymphoma (ATL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM-TSP), and HTLV-1 uveitis (HU). The latter may occur in association with HAM-TSP, more rarely along ATL, or as an isolated manifestation of the viral infection. The authors present a review of the literature on HU, illustrated by a clinical case. A literature search was performed in the MEDLINE database (PubMed) and included surveys completed until 2022. HU prevalence is increasing in nonendemic metropolitan areas due to migration, thus it is becoming an increasingly relevant agent in the differential diagnosis of patients with uveitis.
人类 T 细胞淋巴细胞病毒 1 型(HTLV-1)是一种地方性逆转录病毒,与成人 T 细胞白血病/淋巴瘤(ATL)、HTLV-1 相关骨髓病/热带痉挛性截瘫(HAM-TSP)和 HTLV-1 葡萄膜炎(HU)有关。后者可能与 HAM-TSP 同时出现,但很少与 ATL 同时出现,也可能是病毒感染的一种独立表现。作者通过一个临床病例回顾了有关 HU 的文献。作者在 MEDLINE 数据库(PubMed)中进行了文献检索,并纳入了 2022 年之前完成的调查。由于人口迁移,HU 在非流行的大都市地区的流行率正在上升,因此它正日益成为葡萄膜炎患者鉴别诊断中的重要病原体。
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引用次数: 0
Comment on: Corneal drug delivery with tattoo technique 发表评论:用纹身技术在角膜上给药
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_107_23
Omer Faruk Yilmaz
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引用次数: 0
The increasing number of surgically excised chalazion during the COVID-19 pandemic 在 COVID-19 大流行期间,手术切除霰粒肿的数量不断增加
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_42_23
Jacqueline Coblentz, Mateus Arruda, Heitor Nogueira, Angela Fajardo, Kubra Ozdemir, MiguelN Burnier
Our goal is to determine the number of excised chalazion over the last 16 years to see if there is an increase in the last 36 months, particularly during the COVID-19 pandemic. In this retrospective study, 1772 surgically excised cases of chalazion were reviewed. The date range was between 2007 and 2021, and cases were grouped in intervals of 36 months. Information regarding age, sex, and location of the chalazion was also obtained. Of all cases, 54% of the patients (n = 952) were male and 46% (n = 820) were female. The mean age was 46.26 years, ranging from 44.65 to 47.28 in the different groups. There was a relative increase in the number of excised chalazion over the last 36 months. From 2019 to 2021, 506 cases were diagnosed. There were fewer cases in the other groups, as follows: 2016–2018-455 cases; 2013–2015-283 cases; 2010–2012-302 cases; and 2007–2009-226 cases. Regarding location of the excised lesion, 1098 (62%) were in the upper eyelid and 674 (38%) were in the lower eyelid. In the onset of the COVID-19 pandemic, fewer patients sought medical care for nonurgent conditions, such as chalazion. However, our data showed that despite that decrease, there was an increased number in chalazion excisions. Among several possible explanations, we suggest that the use of oral protection, such as masks, could have an impact in the increased incidence of chalazion, particularly the ones that end up being surgically removed.
我们的目标是确定过去 16 年中切除霰粒肿的数量,看看在过去 36 个月中,尤其是在 COVID-19 大流行期间是否有所增加。 在这项回顾性研究中,共回顾了 1772 例经手术切除的霰粒肿病例。日期范围为 2007 年至 2021 年,病例以 36 个月为间隔分组。研究还获得了霰粒肿的年龄、性别和位置等信息。 在所有病例中,54% 的患者(952 人)为男性,46% 的患者(820 人)为女性。各组患者的平均年龄为 46.26 岁,从 44.65 岁到 47.28 岁不等。在过去的36个月中,切除霰粒肿的数量相对增加。从 2019 年到 2021 年,共确诊 506 例。其他组的病例数较少,具体如下:2016-2018年-455例;2013-2015年-283例;2010-2012年-302例;2007-2009年-226例。关于切除病灶的位置,1098 例(62%)位于上眼睑,674 例(38%)位于下眼睑。 在COVID-19大流行时,因霰粒肿等非急症就医的患者较少。然而,我们的数据显示,尽管人数减少了,霰粒肿切除术的数量却增加了。在几种可能的解释中,我们认为口罩等口腔保护措施的使用可能会对霰粒肿发病率的增加产生影响,尤其是最终通过手术切除的霰粒肿。
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引用次数: 0
Drusen classification and quantification in pseudophakic postmortem eyes implanted with or without blue-light filtering intraocular lenses 在植入或未植入蓝光过滤眼内镜片的假性角膜病死后眼球中进行眼底色素分类和量化
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_87_23
E. I. Nassrallah, Christina Mastromonaco, Emily Marcotte, Emma Youhnovska, Mohamed Abdouh, M. Burnier
To investigate the effect of blue-light filtering intraocular lenses on drusen formation in postmortem eyes via histopathological analysis. One hundred and ninety-three postmortem pseudophakic eyes (100 with a clear intraocular lenses [cIOL] and 93 with a yellow, yellow intraocular lenses [yIOL]) were obtained from the Lions Gift of Sight eye bank. Sex, age-at-surgery, age-at-death, surgery-to-death time, and clinical history were collected. Eyes were sectioned on their coronal and sagittal axes, and formalin-fixed paraffin-embedded macular cross sections were obtained. Sections were stained with hematoxylin and eosin and scanned with the Zeiss Axio Scan. Z1 scanner. Drusen were classified by type, size or subtype, and quantity. Large, soft drusen were present in 49% (n = 95) of eyes, 9% (n = 17) had cuticular drusen, 16% (n = 30) had hard drusen, and 26% (n = 51) had no drusen. There were significantly more cIOL eyes with large, soft drusen (P < 0.001). There were significantly more yIOL eyes with no drusen (P < 0.0001). No significant differences in the presence of hard or cuticular drusen were found. yIOL eyes had significantly higher mean age-at-surgery (P < 0.001) and mean age-at-death (P < 0.05), while cIOL eyes had a significantly higher mean surgery-to-death time (P < 0.05). Finally, significantly more yIOL eyes had a history of smoking (P < 0.01) and hypertension (P < 0.05), while significantly more cIOL eyes had a history of glaucoma (P < 0.05). Large, soft drusen were significantly less prevalent in yIOL eyes than in cIOL eyes and significantly more yIOL eyes had no drusen. These findings suggest that yIOLs may prevent the incidence and development of age-related macular degeneration after cataract surgery.
通过组织病理学分析,研究蓝光过滤性眼内镜片对死后眼球中色素形成的影响。 从狮子会视力礼品眼库获取了 193 只死后假性角膜缺损的眼睛(其中 100 只配戴了透明眼内透镜 [cIOL],93 只配戴了黄色眼内透镜 [yIOL])。收集了性别、手术年龄、死亡年龄、手术至死亡时间和临床病史。对眼球进行冠状轴和矢状轴切片,并获得福尔马林固定石蜡包埋的黄斑横切面。切片用苏木精和伊红染色,并用蔡司 Axio Scan.Z1 扫描仪进行扫描。根据类型、大小或亚型以及数量对黄斑色素进行分类。 49%的眼睛(n = 95)有大块软性色素,9%的眼睛(n = 17)有角质色素,16%的眼睛(n = 30)有硬性色素,26%的眼睛(n = 51)没有色素。具有大块软性色素的 cIOL 眼睛明显较多(P < 0.001)。yIOL 眼睛中没有色素的比例明显更高(P < 0.0001)。yIOL 眼睛的平均手术年龄(P < 0.001)和平均死亡年龄(P < 0.05)明显更高,而 cIOL 眼睛的平均手术到死亡时间(P < 0.05)明显更高。最后,有吸烟史(P < 0.01)和高血压史(P < 0.05)的 yIOL 眼睛明显多于 cIOL 眼睛(P < 0.05)。 在 yIOL 眼睛中,大而软的色素沉着明显少于 cIOL 眼睛,而且没有色素沉着的 yIOL 眼睛明显多于 cIOL 眼睛。这些研究结果表明,yIOL 可预防白内障手术后老年性黄斑变性的发生和发展。
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引用次数: 0
Fundoscopic changes in preeclampsia and eclampsia and their association with fetal outcome 子痫前期和子痫的眼底变化及其与胎儿预后的关系
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_38_23
Nikitha Nataraju, N. Apoorva, K. M. Chandana, B. Rachana
Hypertensive disorder is a major cause of maternal and perinatal mortality and morbidity, with preeclampsia and eclampsia being the most common. Preeclampsia is characterized by endothelial dysfunction and vasospasm of vessels, which can be observed by an ocular fundus examination. The fundus usually develops changes such as hypertensive retinopathy, papilledema, exudative retinal detachment, and vitreous and preretinal hemorrhages. Retinopathy is associated with placental insufficiency and intrauterine growth retardation. Therefore, this study has been undertaken to assess the prevalence of retinal changes in preeclampsia and their association with fetal parameters. To study the fundus changes in preeclampsia. To study the relationship between fundus changes and fetal outcome with respect to various parameters like birth weight, APGAR score, stillbirth, and perinatal death. To study the relationship between fundus changes with respect to proteinuria and serum uric acid. Observational study. One hundred patients presenting to the department of obstetrics and gynecology diagnosed with preeclampsia at a tertiary care center were included in the study. The patient recruited underwent an ocular examination using Snellen’s chart, a pupillary examination, a slit lamp examination, and a dilated fundus examination. The retinopathy was graded according to Keith and Wagner’s classification. The fetal parameters considered were birth weight, APGAR score, stillbirth, and neonatal death. Patients ages ranged from 25 to 30 years old, with an average of 23.28 ± 3.37. Average systolic and diastolic blood pressures were 156.9 ± 17.961 and 104.88 ± 13.58, respectively. All patients had normal anterior segments. Visual acuity was6/6 in most of the patients. Fundus changes were noted in 48% of patients. Based on retinopathy classification, we found 66.7% patients with Grade 1 and 27.1% patients with Grade 2 hypertensive retinopathy. Only 6.3% of patients presented with Grade 3 hypertensive retinopathy. There was a significant association between retinopathy and proteinuria (P = 0.003), serum uric acid (P = 0.002), and the fetal birth weight (P = 0.001). Our findings suggest that progressive fundal changes in preeclampsia indicate worsening of the pathophysiological status of pregnancy-induced hypertension (PIH) and help in management. The degree of hypertensive retinopathy in women with preeclampsia is a valid and reliable prognostic factor that serves as an indirect marker of the severity of PIH and fetal outcome. Fundus examination is a simple, noninvasive, and cost-effective procedure that could be the initial finding in an asymptomatic patient who may require immediate management, which may help in saving the lives of both the mother and the baby. Fundus evaluation is essential for all patients with PIH.
高血压疾病是孕产妇和围产期死亡和发病的主要原因,其中以子痫前期和子痫最为常见。子痫前期的特点是血管内皮功能障碍和血管痉挛,可通过眼底检查观察到。眼底通常会出现高血压视网膜病变、乳头水肿、渗出性视网膜脱离、玻璃体和视网膜前出血等变化。视网膜病变与胎盘功能不全和宫内发育迟缓有关。因此,本研究旨在评估子痫前期视网膜病变的发生率及其与胎儿参数的关系。 研究子痫前期的眼底变化。研究眼底变化与胎儿出生体重、APGAR 评分、死胎和围产期死亡等各种参数之间的关系。研究眼底变化与蛋白尿和血清尿酸之间的关系。 观察研究。 研究纳入了 100 名在一家三级医疗中心妇产科就诊并被诊断为子痫前期的患者。被招募的患者接受了斯奈伦视力表、瞳孔检查、裂隙灯检查和散瞳眼底检查。视网膜病变根据基思和瓦格纳的分类进行分级。胎儿参数包括出生体重、APGAR 评分、死胎和新生儿死亡。 患者年龄从 25 岁到 30 岁不等,平均年龄(23.28±3.37)岁。平均收缩压和舒张压分别为(156.9 ± 17.961)和(104.88 ± 13.58)。所有患者的眼前节均正常。大多数患者的视力为 6/6。48%的患者出现眼底病变。根据视网膜病变分级,我们发现 66.7% 的患者患有一级高血压视网膜病变,27.1% 的患者患有二级高血压视网膜病变。只有 6.3% 的患者患有三级高血压视网膜病变。视网膜病变与蛋白尿(P = 0.003)、血清尿酸(P = 0.002)和胎儿出生体重(P = 0.001)有明显关系。 我们的研究结果表明,子痫前期患者眼底的渐进性变化预示着妊娠诱发高血压(PIH)的病理生理状态正在恶化,有助于治疗。子痫前期妇女的高血压视网膜病变程度是一个有效、可靠的预后因素,可作为 PIH 严重程度和胎儿预后的间接标志。眼底检查是一种简单、无创、经济的检查方法,可作为无症状患者的初步检查结果,患者可能需要立即接受治疗,这有助于挽救母婴生命。眼底评估对所有 PIH 患者都至关重要。
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引用次数: 0
Fluocinolone acetonide implant scleral fixation for cystoid macular edema in eyes with iris–lens diaphragm disruption 虹膜-晶状体膈膜中断眼囊样黄斑水肿的巩膜固定术--氟西诺龙-丙酮植入物
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_26_23
Rita C Basto, Catarina Francisco, A. Silva, Ana Rita Viana, Renato Correia Barbosa, Sofia Teixeira, Catarina Cunha Ferreira, Carolina Madeira, Rui Carvalho, Carla Teixeira, Paula Tenedório
This is a two-center, case series of three patients with postoperative refractory cystoid macular edema (CME) and disruption of the iris–lens diaphragm, submitted to scleral fixation of fluocinolone acetonide implant. All patients achieved successful CME reduction with visual acuity improvement. The surgical procedure was uneventful in all cases; however, one patient developed hypotony with leakage from the scleral tunnel, which was successfully resolved with reinforcement of the suture and injection of viscoelastics in the anterior chamber. No case of implant migration was observed and patients did not report any visual field disturbances. Our results emphasize this surgical technique as an effective and safe procedure for patients with persistent CME and disruption of the iris–lens diaphragm.
这是一个由两个中心共同完成的病例系列,其中有三位患者因术后难治性囊样黄斑水肿(CME)和虹膜-透镜膈膜破坏而接受了氟西酮缩氨酸植入物的巩膜固定术。所有患者都成功减轻了 CME,并改善了视力。所有病例的手术过程都很顺利,但有一名患者因巩膜隧道渗漏而导致眼压过低,经过加固缝合线并在前房注入粘弹剂后,患者的问题得到了成功解决。没有观察到植入物移位的情况,患者也没有报告任何视野障碍。我们的研究结果表明,这种手术技术对于持续性 CME 和虹膜-透镜膈膜破坏的患者来说是一种有效而安全的手术方法。
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引用次数: 0
Commentary: “To study the role of hematological biomarkers in type 2 diabetes patients with diabetic retinopathy” 评论"研究血液生物标志物在患有糖尿病视网膜病变的 2 型糖尿病患者中的作用
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_109_23
Edgar Lozano-Cruz
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引用次数: 0
Incidence of malignant eyelid tumors: A 6-year period review (2015–2021) 眼睑恶性肿瘤的发病率:六年回顾(2015-2021 年)
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_72_23
Daniele Oliveira, Adriana Ribeiro, Sílvia Diniz, Helena Cabral-Marques, Diogo Sousa-Martins
Basal cell carcinoma (BCC), the most common malignant tumor, accounts for 85%–95% of cases of eyelid malignant tumors. Demographic factors such as age, gender, tumor location, and subtype play a crucial role in epidemiological knowledge. We investigated eyelid BCC diagnosis and treatment at the Department of Ophthalmology in Centro Hospitalar de Setúbal (CHS). A retrospective study was conducted on patient cases with suspected eyelid epithelial tumors who underwent excisional biopsy surgery. The study included data from the CHS database between 2015 and 2021. Data collection and subsequent analysis were based on histopathological results. In our study, were analyzed a total of 47 tumor cases, with 68.1% located on the lower eyelids and 31.9% on the upper eyelids. Among these cases, 25 (53.2%) were classified as benign, while 22 (46.8%) were identified as malignant eyelid tumors. BCCs accounted for 90.9% of all malignant cases, with an average age of 71.7 ± 16.6 years. The nodular subtype was the most prevalent, followed by infiltrative and superficial subtypes. Superficial BCC patients were older than infiltrative BCC patients (median age = 69.5 years vs. 61.5 years). BCC primarily affected the lower eyelids compared to the upper eyelid, and there was a slight female predominance (n = 11). All diagnosed BCCs correlated with sun-exposed regions. Timely intervention is crucial for reducing morbidity. These findings emphasize the need for improved registration and notification systems to enhance the prevention and treatment of eyelid BCCs. Furthermore, despite advancements in ultraviolet-blocking technologies, further development of sunscreen specifically formulated for ocular use remains necessary to reduce the incidence of eyelid tumors.
基底细胞癌(BCC)是最常见的恶性肿瘤,占眼睑恶性肿瘤病例的85%-95%。年龄、性别、肿瘤位置和亚型等人口统计学因素在流行病学知识中起着至关重要的作用。我们对塞图巴尔中心医院眼科的眼睑 BCC 诊断和治疗进行了调查。 我们对接受切除活检手术的疑似眼睑上皮肿瘤患者病例进行了回顾性研究。研究包括2015年至2021年期间CHS数据库中的数据。数据收集和后续分析均基于组织病理学结果。 在我们的研究中,共分析了47例肿瘤病例,其中68.1%位于下眼睑,31.9%位于上眼睑。其中,25 例(53.2%)被归类为良性肿瘤,22 例(46.8%)被确定为恶性眼睑肿瘤。BCC占所有恶性病例的90.9%,平均年龄为(71.7 ± 16.6)岁。结节亚型最常见,其次是浸润亚型和表皮亚型。浅表型 BCC 患者的年龄大于浸润型 BCC 患者(中位年龄 = 69.5 岁对 61.5 岁)。与上眼睑相比,BCC主要累及下眼睑,而且女性略占多数(n = 11)。所有确诊的 BCC 都与暴露在阳光下的区域有关。 及时干预对降低发病率至关重要。这些发现强调了改进登记和通知系统以加强眼睑BCC预防和治疗的必要性。此外,尽管紫外线阻隔技术取得了进步,但仍有必要进一步开发眼部专用的防晒霜,以降低眼睑肿瘤的发病率。
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引用次数: 0
Anatomical and functional results of femtosecond laser-assisted descemet stripping automated endothelial keratoplasty compared to microkeratome-assisted descemet stripping automated endothelial keratoplasty 飞秒激光辅助下的脱落斑剥离自动内皮角膜成形术与微角膜辅助下的脱落斑剥离自动内皮角膜成形术的解剖和功能效果比较
Pub Date : 2024-01-01 DOI: 10.4103/pajo.pajo_98_23
Daniela Chacón-Zambrano, Jaime Andrés Suárez-Garavito, José Leonardo Ramírez Casas, Shirley M. Rosenstiehl, Matilde Mora
Femtosecond laser devices have been praised for their precision in corneal surgery; however, their performance in endothelial corneal graft surgery is still in development compared to the standard microkeratome technique. The purpose of this study is to describe the anatomical and functional differences in surgical outcomes between microkeratome (mk) and femtosecond laser (fs) assisted Descemet stripping automated endothelial keratoplasty (DSAEK). This is an analytic, observational, pilot study of patients who underwent mk-DSAEK or fs-DSAEK. The data were obtained from the clinical records and the institutional transplant registry with a focus on graft measurements, survival, transparency, visual acuity and was further analyzed. A total of 37 participants were included in the study with 70.3% (n = 26) of them being female and 29.7% of them being male (n = 11). Of the 37 eyes, 23 (62.2%) of them underwent mk-DSAEK and 14 (37.8%) of them underwent fs-DSAEK. Optimized femtosecond laser parameters are reported. There was a statistically significant difference in donor graft thickness which was thinner in the fs-DSAEK group with a median of 110 mm interquartile range (IQR) (102.25–117.5) versus a median of 233 mm IQR (219–243.75) P = 0.00 in the mk-DSAEK group. There were no significant differences for other variables between techniques. Fs-DSAEK allowed significantly thinner graft obtention in comparison to mk-DSAEK; however, there were no significant differences between mk-DSAEK and fs-DSAEK in terms of transparency, graft survival, or visual acuity.
飞秒激光设备因其在角膜手术中的精确性而备受赞誉;然而,与标准的微角膜刀技术相比,飞秒激光设备在角膜内皮移植手术中的性能仍处于发展阶段。本研究的目的是描述微角膜刀(mk)和飞秒激光(fs)辅助德斯米剥离自动内皮角膜移植术(DSAEK)在手术效果上的解剖和功能差异。 这是一项分析性、观察性、试验性研究,研究对象是接受了 mk-DSAEK 或 fs-DSAEK 的患者。研究数据来自临床记录和移植机构登记处,重点关注移植物的测量、存活率、透明度、视力,并进行了进一步分析。 共有 37 名参与者参与了研究,其中女性占 70.3%(n = 26),男性占 29.7%(n = 11)。在 37 只眼睛中,23 只(62.2%)接受了 mk-DSAEK,14 只(37.8%)接受了 fs-DSAEK。报告了优化的飞秒激光参数。供体移植物厚度在统计学上有显著差异,fs-DSAEK 组更薄,中位数为 110 毫米,四分位数间距 (IQR) 为 102.25-117.5,而 mk-DSAEK 组的中位数为 233 毫米,四分位数间距 (IQR) 为 219-243.75,P = 0.00。不同技术之间的其他变量无明显差异。 与mk-DSAEK相比,Fs-DSAEK的移植物植入厚度明显更薄;但在透明度、移植物存活率或视力方面,mk-DSAEK和fs-DSAEK没有明显差异。
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引用次数: 0
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The Pan-American Journal of Ophthalmology
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