Navegando por Palavras-chave "Conjunctiva"

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    Aerobic bacterial microbiota of the conjunctiva in diabetic patients withnormal and altered glycated hemoglobin levels in two regions inBrazil
    (Conselho Brasileiro de Oftalmologia, 2014-12-01) Moreno, Natalia Pimentel [UNIFESP]; Moreno, Renaldo Duarte; Sousa, Luciene Barbosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Federal University of Acre Department of Ophthalmology
    Purpose:To study the aerobic bacterial microbiota of the conjunctiva in diabetic patient with regard to the management of diabetes, assessed using glycated hemoglobin levels.Methods:A cross-sectional study was conducted using conjunctival smears of diabetic patients from both sexes and with different ages, residing in two different Brazilian cities (Sorocaba and Rio Branco). A control group of non-diabetic patients was also included. The diabetic patients were considered to have controlled diabetes when their glycated hemoglobin level was ≤7% and blood glucose level was ≤126 mg/dL. Patients with non-controlled diabetes were those with glycated hemoglobin levels >7% and blood glucose levels >126 mg/dL. The samples obtained were inoculated in Brain-Heart Infusion broth and in culture media for aerobic bacteria (blood and chocolate agars); bacterial growth wa evaluated in a microbiology laboratory.Results:A total of 120 eyes of 120 patients were included in the present study. The percentage of cultures in which bacterial growth was observed was greater in diabetic patients, although the difference was not statistically significant (p=0.103). There was a greater trend toward bacterial growth in the conjunctiva of diabetic patients with altered fasting blood glucose. There was no difference in the frequency of bacterial growth on the conjunctiva between diabetic patient with normal or altered glycated hemoglobin levels. In Sorocaba, conjunctival bacterial growth was similar to that observed in Rio Branco. The microorganism most frequently detected in the present study was Staphylococcuepidermidis, followed by Staphylococcus aureus,Proteus mirabilis, and Escherichia coli.Conclusion:There was no difference between diabetic patients with normal or altered glycated hemoglobin levels. The microorganisms found were similar to those found in studie investigating the conjunctival bacterial flora of diabetic and non-diabetic patients.
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    Alterações oculares induzidas pela quimioterapia
    (Conselho Brasileiro de Oftalmologia, 2007-08-01) Chaves, Alessandra Pinheiro [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Antineoplastic agents offer an increase in the patients' survival rates, but may induce side effects in different organs and tissues. Mucositis is one of the most common side effects during chemotherapy with certain agents. The ocular toxicity induced by these drugs may manifest as changes in the ocular surface and in the tear film. The purpose of this research was to study the ocular surface changes induced by chemotherapy and to establish their clinical correlation with the chemotherapy and mucositis. The 39 selected patients underwent a full ophthalmological examination and supplementary tests. We compared 2 groups of patients: with (case) and without mucositis (control). Statistical analysis was performed with the Statistical Package for Social Sciences software. Mucositis was identified in 51.4% of the patients after chemotherapy. The brakeup time showed a statistically significant decrease after chemotherapy (p<0.0001). Punctate epitheliopathy was seen in 78.4% of cases. Schirmer test results did not show significant changes pre x post-chemotherapy. Chemotherapy may induce tear film changes, as shown in this study by the brakeup time, Schirmer test and biomicroscopy. Chemotherapy-induced mucositis involves also the conjunctival mucosa, which was subjectively characterized by the ocular symptoms and proved in our study by impression cytology and microbiology.
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    Análise clínica, cirúrgica e laboratorial de pacientes com conjuntivocálase
    (Conselho Brasileiro de Oftalmologia, 2004-08-01) Souza, Carlos Eduardo Borges [UNIFESP]; Engel, Dinorah Piacentini [UNIFESP]; Branco, Bruno Castelo [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Souza, Luciene Barbosa de [UNIFESP]; Barros, Jaison [UNIFESP]; Freitas, Denise de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate clinical, surgical and laboratorial findings in patients with conjunctivochalasis. METHODS: Ophthalmologic examinations using 1% rose bengal, Schirmer test and impression cytology were performed in ten patients and after surgery. RESULTS: Sintomatology improved in all patients on surgery. Impression cytology revealed metaplasia in eight patients. CONCLUSION: Surgical treatment may improve signs and symptoms in patients with conjuctivochalasis. Scamous metaplasia was a frequent finding in these patients.
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    Are cutaneous hypersensitivity tests to inhalant allergens a severity marker for vernal keratoconjunctivitis?
    (Conselho Brasileiro de Oftalmologia, 2007-12-01) Oliveira, Lauro Augusto de [UNIFESP]; Mallozi, Marcia Carvalho [UNIFESP]; Solé, Dirceu [UNIFESP]; Freitas, Denise de [UNIFESP]; Sousa, Luciene Barbosa De [UNIFESP]; Mannis, Mark J.; Universidade Federal de São Paulo (UNIFESP); University of California Department of Ophthalmology & Vision Science
    PURPOSE: The purpose of this study was to analyze the cutaneous sensitivity to a variety of allergens in patients with vernal keratoconjunctivitis (VKC) and to demonstrate the relation between skin response and clinical aspects of the disease. METHODS: Twenty patients with vernal keratoconjunctivitis were randomly chosen from the External Disease and Cornea Sector. They were clinically evaluated, and a score ranging from 0 to 20 was applied based on signs and symptoms on ophthalmic examination. All subjects underwent a skin prick test against standardized allergens, such as house dust mites D. pteronyssinus, D. farinae, and Blomia tropicalis, as well as allergens from cat, dog, fungi and feather. RESULTS: Seventy-five per cent of patients were positive for at least one of the allergens tested. House dust mites were responsible for the majority of the cases (75%). There was a poor correlation between the clinical score and sensitivity to allergens (r= - 0.119 for fungi; r= - 0.174 for dog; r= - 0.243 for house dust mites; r= - 0.090 for feather). A significant correlation was found only for cat allergen extract (r = - 0.510; p=0.024). CONCLUSIONS: Our study demonstrated poor correlation between cutaneous hypersensitivity tests and clinical findings in patients with vernal keratoconjuntivitis. We concluded that skin response to inhalant allergens is not a useful test to identify clinical severity and chronicity of inflammatory process in this disease.
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    Avaliação da presença de células caliciformes na córnea humana
    (Conselho Brasileiro de Oftalmologia, 2004-02-01) Barros, Jeison de Nadai [UNIFESP]; Mascaro, Vera Lucia Degaspare [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); FMO I.A.M.S.P.E Hospital do Servidor Público Estadual
    PURPOSE: To analyze by impression cytology the presence of goblet cells on corneal surfaces with conjunctivalization. METHODS: Corneal-conjunctival impression cytology was performed in 65 eyes of 65 patients who had clinical signs of conjunctivalization with or without previous ocular surgery. Patients were classified into two groups according to previous history of ocular surface reconstructive surgery associated with limbal transplantation and human amniotic membrane. In group I, 49 patients without previous ocular surgery were evaluated and in group II 16 patients were included after ocular surface reconstructive surgery with conjunctivalization recurrence. Samples were obtained in the affected eye between February 2000 and February 2002 at the UNIFESP's External Eye Disease Laboratory. Limbal deficiency was detected when one or more goblets cells were found on the corneal surface. RESULTS: In group I one or more goblet cells were found on the corneal surface of 21 eyes (42.85%). In group II goblet cells were found on the corneal surface of 9 patients (56.25%). CONCLUSION: Presence of goblet cells on the corneal surface detected by impression cytology in patients with conjunctivalization can confirm limbal stem cell deficiency, however, its absence does not exclude the diagnosis.
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    Citologia de impressão da superfície ocular: técnica de exame e de coloração
    (Conselho Brasileiro de Oftalmologia, 2001-04-01) Barros, Jeison de Nadai [UNIFESP]; Mascaro, Vera Lucia Degaspare Monte [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Freitas, Denise de [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To present an examination technique and to standardize the staining procedure of samples of impression cytology of the ocular surface in a reference service. Methods: 28 samples of impression cytology were obtained from patients with ocular surfaces alterations of the External Eye Diseases Sector in the period of July to November 1999. They were stained and microscopically evaluated in the Ocular Microbiology Laboratory of the Federal University of São Paulo. Results: We developed a design of a filter paper with apex, base and lateral opening that promoted its adequate position both in the eye at collection and on the glass microscope slides for fixing and staining procedures. The staining technique that uses periodic acid-Schiff, hematoxilin and Papanicolaou is an easy and economic procedure which stains goblet and epithelial cells. Conclusions: The modified method for staining showed to be ideal for the cytologic evaluation of samples of the impression cytology examination. Impression cytology is a very reliable method to study ocular surface, and has proved to be really simple, a cheaper and more confortable procedure for the patient than invasive biopsies.
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    Citologia de impressão na ceratoconjuntivite primaveril
    (Conselho Brasileiro de Oftalmologia, 2004-12-01) Camargo, Gustavo Bueno de; Nishiwaki-dantas, Maria Cristina; Barros, Jeison de Nadai [UNIFESP]; Lake, Jonathan Clive; Santa Casa de São Paulo; Santa Casa de São Paulo Ambulatório de Córnea e Doenças Externas; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To study conjunctival surface changes caused by chronic inflammation in vernal keratoconjunctivitis using impression cytology. METHODS: Samples of conjunctival epithelium were collected from 30 patients with vernal keratoconjunctivitis and 30 patients without ocular diseases that were used as a control group. Each sample was collected from the superior bulbar conjunctiva using filter paper with 0.45µm pores. The material was then fixed and dyed with PAS, HE, and modified Papanicolaou. The tissue was examined with an optical microscope evaluating the following parameters: polymorphonuclear cells, intercellular junctions, mucin, goblet cells, and nuclear/cytoplasm (N/C) ratios. Thereafter, each sample was graded using the Nelson classification. RESULTS: Samples from patients with vernal keratoconjunctivitis presented larger amounts of polymorphonuclear cells, smaller amounts of mucin, and more alterations in the nuclear/cytoplasm ratios than in the control group. The amount of goblet cells did not vary. The Nelson classification showed a general inflammatory involvement of the conjunctiva in vernal keratoconjunctivitis. CONCLUSION: Impression cytology was able to evaluate and characterize the degree of inflammatory involvement of the conjunctiva in vernal keratoconjunctivitis.
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    Conjunctival vessel abnormalities in sickle cell diseases: the influence of age and genotype
    (Acta Ophthalmologica, 1989-12-19) Chamon, Wallace; Figueiredo, Mauro S.; Cruz, Antonio Augusto Velasco; Zago, Marco Antonio; http://lattes.cnpq.br/3165995344927892
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    Detection of human papillomavirus in epithelial lesions of the conjunctiva
    (Associação Paulista de Medicina - APM, 2000-09-07) Palazzi, Maristela Amaral [UNIFESP]; Erwenne, Clélia Maria [UNIFESP]; Villa, Luísa Lina; Universidade Federal de São Paulo (UNIFESP); University of São Paulo Faculty of Medicine
    CONTEXT: Many factors like exposure to UV radiation, climatic conditions, genetic predisposition, immunological state and, more recently, the presence of HPV have been implicated in the genesis of some lesions of the conjunctiva, especially the carcinoma. OBJECTIVE: To evaluate the presence of HPV DNA in acquired lesions of the conjunctiva and in normal mucosa. TYPE OF STUDY: Cross-sectional study. SETTING: A public university referral center (the Ophthalmology Service of the A.C. Camargo Hospital - A. Prudente Foundation, São Paulo). PARTICIPANTS: Thirty patients with acquired lesions of the conjunctiva and 60 matched controls (by age and sex) were evaluated in this study, from June 1993 to March 1995. PROCEDURES: The detection of HPV DNA in the normal conjunctiva and in acquired lesions was done by the PCR technique and dot blot hybridization. The material was collected by scraping the normal mucosa and the surface of the lesions. A fragment of fresh frozen tissue and paraffin embedded specimens of each lesion were also included. MAIN MEASUREMENTS: The association between the HPV infection and the presence or absence of conjunctival lesions. RESULTS: Sequences of HPV DNA were detected in 4 of the 31 lesions evaluated (12.9%) and in the healthy mucosa of one individual of the control group (1.6%). HPV type 16 was detected in 2 carcinomas and in the normal mucosa of one individual of the control group. HPV type 11 was demonstrated in 2 papillomas of one patient with lesions in both eyes. CONCLUSIONS: The low frequency of HPV DNA found in the lesions of this sample and the detection of the viral genome in the normal mucosa indicate that there is a weak possibility of association between HPV infection and the carcinoma of the conjunctiva.
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    Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation
    (Conselho Brasileiro de Oftalmologia, 2003-01-01) Cunha, Rosana Nogueira Pires da [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Dulley, Frederico Luis; Rojas, Bianca; Foster, Charles Stephen; Universidade Federal de São Paulo (UNIFESP); São Paulo University Medicine College Fundação Pró-sangue Hemocentro of São Paulo; Harvard Medical School Massachusetts Eye & Ear Infirmary Department of Ophthalmology
    PURPOSE: The primary ocular targets of chronic graft-versus-host disease (GVHD) are the lacrimal gland (LG) and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (KCS). The purpose of the present study was to evaluate the frequency of signs and symptoms of KCS present in patients submitted to BMT, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to GVHD. METHODS: Forty-seven patients were clinically classified into two groups: Group I, with ocular GVHD, submitted to allogeneic BMT and Group II, without ocular GVHD, submitted to autologous and allogeneic BMT. Thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the LG were performed in the pre- and posttransplantation period. The biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. RESULTS: Of the 28 (82.4%) patients with chronic GVHD, 13 (46.4%) presented ocular GVHD. Of the six patients without GVHD, one (16.7%) presented ocular GVHD. None of those submitted to autologous BMT presented ocular GVHD and 14 (41.2%) of 34 patients with allogeneic BMT presented ocular GVHD. All patients with ocular GVHD (Group I) had symptoms and the most frequent were burning, foreign body sensation, blurred vision and dryness. The rose bengal test was one of the most sensitive in this study and slit lamp examination was very useful in the evaluation of corneal and conjunctival alterations, since these alterations were always present in patients with dry eye in our study. Neither symptoms and signs of dry eye nor significant immunologic reaction was observed in the conjunctiva and in the LG of patients without ocular GVHD (Group II). There was an increase in the T lymphocyte population, of T helper lymphocyte (Th/i) and T suppressor-cytotoxic lymphocyte (Ts/c) subpopulation in the conjunctiva and in the LG of patients with ocular GVHD after the transplantation. CONCLUSIONS: Patients submitted to allogeneic BMT may develop ocular GHVD characterized by KCS. The immunohistochemical study of the conjunctiva and lacrimal gland biopsies of these patients suggested that these tissues are the target of the T cell mediated immunological reaction.
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    Eficácia de um regime de administração de antibióticos tópicos na redução da microbiota conjuntival de pacientes sadios com catarata senil
    (Sociedade Brasileira de Oftalmologia, 2007-08-01) Oliveira, Renato Corrêa Souza De [UNIFESP]; Brasil, Oswaldo Ferreira Moura [UNIFESP]; Arantes, Rodrigo Setúbal; Caldas, Leomar Afonso Da Silva; Ferreira, Adriana Lucia Íris; Moraes Junior, Haroldo Vieira De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Brasileiro de Oftalmologia Médico do Setor de Retina e Vítreo; Universidade Federal do Rio de Janeiro; Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho Laboratório de Bacteriologia Clínica
    PURPOSE: To evaluate the conjunctival bacterial flora of healthy patients and its antibiotic resistance pattern and determine the effective of a regime of topical antibiotics on reduction of endogenous microbiota. METHODS: Its a prospective non randomized study. Fourty eyes of 40 patients, divided in 4 groups of 10 eyes each, used four differents topical antibiotics (ciprofloxacin, tobramycin and gatifloxacin). One group served as a control group. Were performed conjunctival cultures before instillation of the antibiotics drops and after 15, 30 and 60 minutes. Were performed susceptibility tests of the specimes isolated to these antibiotics. We compared the reduction of bacterium growth by assessing the number of UFC (colonies forming units) before and after the instillation of antibiotics drops. RESULTS: Of the 40 eyes, 92,5% had positive cultures. The coagulase-negative Staphylococcus (CNS) was the most frequent organism isolated (50%), followed by Staphylococcus Aureus (23%) and gram-negative bacteria (26%). More than 81% of the isolates of this bacterium were susceptible to all antibiotics tested. Five bacterium isolates were resistant to ciprofloxacin and tobramycin and two to gatifloxacin. All groups had diminished the number of patients with positive culture specimes from the conjuntiva compared to moment zero and to placebo. CONCLUSION: The gram positive bacterium, specially the coagulase-negative Staphylococcus, were the most frequent microorganism found on conjunctiva of healthy patients. The most of the bacterium isolated were sensitivity to the antibiotics tested. The proposed regime of use of these antibiotics reduced the number of UFC (colonies forming units) compared to placebo although without statics relevance in most of cases.
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    Estudo da flora fúngica da conjuntiva normal de cortadores de cana-de-açúcar e de anemófilos da região canavieira de Santa Rita - Paraíba (Brasil)
    (Universidade Federal de São Paulo (UNIFESP), 1988) Vieira, Luiz Antonio [UNIFESP]; Belfort, Rubens Junior [UNIFESP]
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    Estudo da micobiota em conjuntiva sadia de diabéticos, residentes na área urbana da cidade de São Paulo - Brasil
    (Conselho Brasileiro de Oftalmologia, 2006-02-01) Andrade, Alfredo José Muniz de [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Yu, Maria Cecília Zorat [UNIFESP]; Godoy, Patricio [UNIFESP]; Gompertz, Olga Fischman [UNIFESP]; Bonfim, Sabrina de Souza [UNIFESP]; Andrade, Francisco Eudes Muniz de; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco
    PURPOSE: To determine the mycobiota of the healthy conjunctiva in diabetic individuals, according to diabetes type, age, sex, disease time, type of treatment, and stage of diabetic retinopathy of the individuals. To identify the anemophilus mycobiota in the sampling rooms. METHODS: A cross-sectional study was carried out on 803 diabetics who reside in the urban area of São Paulo-SP/Brazil. Sabouraud's dextrose agar culture with chloramphenicol was used for primoisolation, and the key of De Hoog was used to identify filamentous fungi. RESULTS: Of the evaluated diabetics, 6.6% (53/803) presented type 1 diabetes and 93.4% (750/803) type 2. The positive cultures for fungi in the conjunctiva of diabetics was 4.2% (34/803), with 1.9% (1/53) in type 1 diabetics and 4.4% (33/740) in type 2 diabetics (p=0.720). With respect to the presence or not of isolated fungi, there was no statistically significant association regarding age (p=0.575), sex (p=0.517), disease time (p=0.633), type of treatment (p=0.422), and diabetic retinopathy stage (p=0.655) of the tested individuals. The identified fungi were all filamentous: Aspergillus spp. represented 59.5% (25/42) of isolations and 47.6% (20/42) of isolated species were Aspergillus niger. Growth of anemophilus fungi occurred in the air of the room and coincidences were observed between the isolated species from the air and those from the conjunctiva. CONCLUSIONS: Presence of mycobiota in healthy conjunctivas of diabetics was identified, with no significant association between the greater number of positive fungi isolations and the type of diabetes, age, sex, disease type, type of treatment, and stage of diabetic retinopathy. In the collection rooms, anemophilus mycobiota was identified.
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    Estudo da microbiota fúngica da conjuntiva ocular em portadores de hanseníase e seus comunicantes
    (Conselho Brasileiro de Oftalmologia, 2006-12-01) Santos, Procópio Miguel Dos; Melo, Cinthia Mendonça De; Martins, Suy Anne Rebouças [UNIFESP]; Chaves, Adriano De Almeida; Sá, Débora Silva Pires De; Santos, Regina Cândido Ribeiro Dos; Faculdade de Medicina do Distrito Federal; Universidade de Brasília; Universidade Federal de São Paulo (UNIFESP); Centro de Visão de João Pessoa; FEPECS
    PURPOSE: To study the conjunctival fungal flora of patients with leprosy who live in the colony hospital and of those who deal with Hansen patients. METHODS: Sixty-one eyes (61 patiets) with Hansen's disease and twenty-five heathy eyes (25 individuals) of individuals who deal with patients were investigated. RESULTS: Conjunctival fungi growth occurred in 19.67% and 20% of the patients and healthy individuals, respectively. There was no significant difference (p<0.05) regarding fungi percentage of fungi isolated from the conjunctiva between both groups. Candida ssp was the most frequent fungus isolated from the conjunctiva of patients with Hansen's disease, whereas Penicillium spp was the most frequent fungus isolated from the group of people who deal with these patients. CONCLUSION: The most frequent yeast isolated from conjunctival samples of leprosy patients was Candida, which could be explained by cellular immunodeficiency of these patients, associated with dry eye and the prolonged use of antibiotics.
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    Estudo do raspado de conjuntiva de pacientes tratados de retinoblastoma: Etapa II -- citologia
    (Conselho Brasileiro de Oftalmologia, 2002-06-01) Santos, Maria Carmen Menezes; Santos, Gilda Da Cunha [UNIFESP]; Vozza, João Antônio; Medeiros, Nivaldo; Erwenne, Clélia Maria [UNIFESP]; Fundação Antônio Prudente Hospital A. C. Camargo; Universidade Federal de São Paulo (UNIFESP); Fundação Antônio Prudente Hospital A. C. Camargo Laboratório IPACE; Fundação Antônio Prudente Hospital A. C. Camargo Departamento de Patologia Clínica
    Purpose: Human conjunctival cytology has been extensively studied. Lack of data about the characteristics of conjunctival smears in patients treated for retinoblastoma who underwent enucleation and radiotherapy motivated this study. Methods: A previously studied group of 114 orbits of 58 patients was examined. The authors present the results of conjunctival cytology in 4 different situations, with and without enucleation, with and without radiotherapy. Results: In the leukocytic infiltrate in orbits with ocular bulbi predominated the lymphocyte, while in the others predominated the polymorphonuclear neutrophil. In general, the majority of epithelial cell alterations seen in the conjunctival smears of irradiated orbits were: cell with large nuclei, prominent nucleoli, and cytoplasmatic hyalinization. Conclusion: The cytological findings of the conjunctival smears do not indicate a characteristic and distinct pattern for each group.
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    Estudo do raspado de conjuntiva e margem palpebral de pacientes tratados de retinoblastoma: etapa I - Microflora aeróbica
    (Conselho Brasileiro de Oftalmologia, 2002-03-01) Santos, Maria Carmen Menezes; Santos, Gilda Da Cunha [UNIFESP]; Vozza, João Antônio; Medeiros, Nivaldo; Erwenne, Clélia Maria; Universidade Federal de São Paulo (UNIFESP); Fundação Antônio Prudente Hospital A. C. Camargo Laboratório IPACE; Fundação Antônio Prudente Hospital A. C. Camargo Departamento de Patologia Clínica; Fundação Antônio Prudente Hospital A. C. Camargo Serviço de Oftalmologia
    Purpose: Conjunctival discharge is a common complaint among patients treated for retinoblastoma who underwent enucleation and radiotherapy. Lack of data about the microflora in those patients motivated this study. Methods: One hundred and fourteen orbits of 58 patients were examined. The authors present the results of aerobic bacterial and fungal culture of conjunctival and eyelid margin smears, as well as conjunctival cytology, in 4 different conditions: with and without enucleation, with and without radiation. Microorganisms were identified according to the National Committee for Clinical Laboratory Standards, using Gram and Leishman staining. Results: Microorganisms were more frequent in irradiated anophthalmic sockets, both in the conjunctiva (54.5%) and eyelid margin (63.6%); however the difference was not statistically significant. On the other hand, in orbits with ocular bulbi, the radiation, in the late phase, represented a limiting factor for the presence of microorganims in the conjunctiva and eyelid margin, but without a statistically significant difference. The coagulase-negative Staphylococcus was the most frequent microorganism in the conjunctiva and eyelid margin in all groups. There was fungus growth, Candida tropicalis, in only one case. Conclusions: Topical antibiotics in patients treated for retinoblastoma who underwent enucleation, with or without radiotherapy, are suggested.
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    Floppy eyelid syndrome: review
    (Conselho Brasileiro de Oftalmologia, 2011-02-01) Miyamoto, Cristina [UNIFESP]; Espírito Santo, Lilian Cristina [UNIFESP]; Roisman, Luiz [UNIFESP]; Moreno, Pilar de Andrade Memoria [UNIFESP]; Cariello, Angelino Julio [UNIFESP]; Osaki, Midori Hentosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Floppy eyelid syndrome is characterized by the easy evertion of the upper eyelid which occurs spontaneously during the sleep, causing the exposure of the eye surface and chronic papillary conjunctivitis. Its pathogenesis is not totally defined yet: it is usually more frequent in middle-aged, male obese patients and it is associated with systemic disorders such as obstructive sleep apnea, high blood pressure and diabetes. On the occasions which conservative treatment fails, surgical procedures present good results, including surgical techniques which are constantly evolving.
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    Flora bacteriana conjuntival após uso tópico de ciprofloxacino e gatifloxacino em cirurgia de catarata
    (Conselho Brasileiro de Oftalmologia, 2008-04-01) Arantes, Tiago Eugênio Faria e [UNIFESP]; Castro, Célia Maria Machado Barbosa de; Cavalcanti, Ronald Fonseca; Severo, Maiara Santos; Diniz, Maria de Fátima Alves; Urtiga, Ricardo Walber de Deus; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco Departamento de Medicina Tropical; Fundação Altino Ventura Departamento de Córnea e Doenças Externas; UFPE Laboratório de Imunopatologia Keizo-Asami; FAV
    PURPOSE: To evaluate alterations of the conjunctival flora after the use of 0.3% ciprofloxacin and gatifloxacin in the prophylaxis of patients undergoing cataract surgery. METHODS: 40 patients undergoing cataract surgery were distributed into two groups according to the use of antibiotic eye drops: Group A: 0.3% ciprofloxacin and Group B: 0.3% gatifloxacin. Both groups used antibiotic eye drops 1 hour before surgery and 14 days after surgery. Conjunctival material was collected at 5 time points: 1 hour before surgery, without any topical medication (t0); immediately before the application of povidone-iodine (PVPI) (t1), before the beginning of surgery, after povidone-iodine (t2), 14 days (t3) and 28 days after surgery (t4). RESULTS: Preoperative antibiotics reduced the positivity of the cultures before the use of PVPI in both groups, although in Group A this reduction was not significant (Group A - p=0.07 and Group B - p=0.04). The number of positive cultures was reduced in all groups after the use of povidone-iodine and on the 14th postoperative day (p<0.05). In t4 there was a reduction in the frequency of coagulase-negative Staphylococcus in Group A compared with Group B (p<0.05); the susceptibility to ciprofloxacin was also reduced in all groups, when compared with t0. CONCLUSIONS: Gatifloxacin eye drops applied one hour before surgery significantly reduced the number of positive conjunctival cultures. Both antibiotics reduced the conjunctival flora when administered in the postoperative period.
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    Granuloma conjuntival causado por fibras sintéticas
    (Conselho Brasileiro de Oftalmologia, 1999-10-01) Marback, Patrícia Maria Fernandes [UNIFESP]; Marback, Eduardo Ferrari [UNIFESP]; Borges, Fábio Lúcio; Sé, Danilo Cruz Sento; Marback, Roberto Lorens; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia; Fundação Monte Tabor Hospital São Rafael
    Purpose: To report a case of conjunctival synthetic fiber granuloma. Case Report: Six-year old female presented with an inferior conjunctival tumor in the right eye for six months. The lesion was excised and histopathological examination revealed granulomatous inflammation and multinucleated giant cells phagocy birefringent material, recognized as synthetic fibers. Discussion: Synthetic fiber granuloma of the conjunctiva is an uncommon lesion described mainly in children. Usually it occurs unilaterally and situated in the inferior conjunc-tival fornix. The contact of the eye with toys containing synthetic fibers in this age group could explain the origin of the lesion. Synthetic fiber conjunctival granuloma should be included in the differential diagnosis of conjunctival tumors in children.
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    Impression cytology and in vivo confocal microscopy in corneas with total limbal stem cell deficiency
    (Conselho Brasileiro de Oftalmologia, 2013-10-01) Araújo, Aline Lütz de [UNIFESP]; Ricardo, José Reinaldo da Silva [UNIFESP]; Sakai, Vivian Naomi [UNIFESP]; Barros, Jeison de Nadai [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSES: To describe corneal changes seen on in vivo confocal microscopy in patients with total limbal stem cell deficiency and to correlate them with cytological findings. METHODS: A prospective case series including 13 eyes (8 patients) with total limbal deficiency was carried out. Stem cell deficiency was diagnosed clinically and by corneal impression cytology. Confocal images of the central cornea were taken with the Heidelberg Retina Tomograph II, Rostock Corneal Module (Heidelberg Engineering, Heidelberg, Germany). RESULTS: Impression cytology of the cornea revealed conjunctival epithelial cells and goblet cells in all cases. In vivo confocal microscopy showed disruption of normal layers of the corneal epithelium in all eyes. Confocal images showed cells with characteristics of conjunctival epithelium at the cornea in 76.9% of the total. These findings on confocal microscopy were compatible to limbal stem cell deficiency. Additionally, goblet cells, squamous metaplasia, inflammatory cells and dendritic cells were observed. The sub-basal nerve plexus was not identified in any of the corneas. Corneal neovessels were observed at the epithelium and stroma. All cases showed diffuse hyper-reflective images of the stroma corresponding to opacity of the tissue. CONCLUSIONS: Limbal stem cell deficiency had been confirmed by impression cytology in all cases, and 76.9% of the cases could also be diagnosed by in vivo confocal microscopy through the conjunctival epithelial cell visualization on the corneal surface. Frequent confocal microscopy findings were abnormal cells at the cornea (conjunctival epithelial, goblet and inflammatory cells), corneal neovessels and diffuse hyper-reflection of the stroma.