Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Uveitis"

Navegando por Palavras-chave "Uveitis"

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Achados ultrassonográficos em toxocaríase ocular
(Conselho Brasileiro de Oftalmologia, 2012-02-01) Morais, Fábio Barreto [UNIFESP]; Maciel, Ana Lúcia [UNIFESP]; Arantes, Tiago Eugênio Farias e [UNIFESP]; Muccioli, Cristina [UNIFESP]; Allemann, Norma [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis. METHODS: 11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique). RESULTS: In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity. CONCLUSION: The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.
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Alterações oculares em pacientes com tuberculose
(Conselho Brasileiro de Oftalmologia, 2006-04-01) Almeida, Simone Ribeiro Araújo De [UNIFESP]; Finamor, Luciana Peixoto [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To analyze clinical findings of ocular tuberculosis and its epidemiological features. METHODS: Were reviewed clinical files of patients who attended the Ophthalmology - Uveitis and AIDS sector of UNIFESP-EPM, São Paulo, Brazil between January 1999 and July 2002 and had a diagnosis of ocular tuberculosis. Patients who had Mantoux test higher than 10 mm, epidemiological history of tuberculosis and ocular findings that improved after specific treatment were included. RESULTS: Seventeen medical files were analyzed, of those, 12 (70,6%) were females. The mean age was 54 (24-84) years. The average time between symptoms and diagnosis was 100 days. Ocular findings at the first interview were multiple but most were at the anterior segment of the eye and 41% of patients who had clinical findings that suggested tuberculosis other than ocular. Situations as glaucoma, retinal detachment and vitreous hemorrhage were responsible for reduction of visual acuity. CONCLUSIONS: Ocular tuberculosis showed a low prevalence but important visual loosing morbidity. The multiplicity of clinical findings is responsible for the delay of diagnosis.
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Applicability of the 2001 revised diagnostic criteriain Brazilian Vogt-Koyanagi-Harada disease patients
(Conselho Brasileiro de Oftalmologia, 2008-02-01) Cardoso, Isabel Habeyche [UNIFESP]; Zajdenweber, Moysés Eduardo [UNIFESP]; Muccioli, Cristina [UNIFESP]; Fimamor, Luciana Peixoto [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); McGill University Hospital Center & Henry C. Witelson Ocular Pathology Laboratory Department of Ophthalmology and Pathology
PURPOSE: To determine the applicability of the international revised diagnostic criteria for Vogt-Koyanagi-Harada disease. METHODS: Retrospective study. Medical charts of 140 patients with the diagnosis of Vogt-Koyanagi-Harada disease, from the Uveitis Sector of the Federal University of São Paulo (UNIFESP), were revised and classified following the revised diagnostic criteria. RESULTS: Of the 140 patients, 12.85% fulfilled the criteria for complete disease, 29.28% incomplete disease, 28.57% probable Vogt-Koyanagi-Harada disease and 28.27% were considered not Vogt-Koyanagi-Harada disease. CONCLUSION: The authors consider that the international revised diagnostic criteria have good applicability and are very useful to help in the diagnosis of Vogt-Koyanagi-Harada disease.
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Avaliação estrutural do polo posterior em pacientes com doença de Behçet
(Conselho Brasileiro de Oftalmologia, 2011-12-01) Corrêa, Ticiana Paula Resende [UNIFESP]; Arantes, Tiago Eugênio Faria e [UNIFESP]; Lima, Verônica Castro [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To evaluate demographic findings, ocular manifestations, vascular and morphological changes by fluorescein and indocyanine green angiography and optical coherence tomography of retina and choroid in cases of ocular Behçet's disease. METHODS: Medical records were reviewed to obtain data from 16 patients with Behçet's disease who were in inactive phase. All patients underwent ophthalmic examination, simultaneous fluorescein and indocyanine green angiography and optical coherence tomography. They were also divided into two groups according to disease duration. RESULTS: Thirteen females and three males were evaluated. The main findings of ocular exams were narrowing of vessels, cataract, atrophy of the optic disc and macular epiretinal membrane. 62.5% had visual acuity equal to or better than 0.1. The main findings of fluorescein angiography were capillary leak and impregnation of the vascular wall. The most important findings of indocyanine green angiography were hypofluorescent well defined lesions. The main findings of optical coherence tomography were macular epiretinal membrane and retinal atrophy. Analyzing the visual acuity, no statistical correlation was found between gender, disease duration or presence of retinal edema in fluorescein angiography or optical coherence tomography. The increase in macular thickness was not correlated positively with patient age, disease duration or with the visual acuity. Vascular narrowing seen on fluorescein angiography was correlated with longer duration of illness (p=0.033). The remaining test findings were not correlated with disease duration. CONCLUSION: Fluorescein and indocyanine green angiography and optical coherence tomography are valuable tools to assess the posterior pole in Behçet's disease. Despite the apparent clinical control, these tests may show persistent inflammatory activity, which causes progression of visual loss and a significant number of patients with legal blindness.
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Clinical presentation and genetic paradigm of diffuse infiltrating retinoblastoma: a review
(Acta Cirurgica Brasileira, 2016) Traine, Peter G.; Schedler, Katharina J.; Rodrigues, Eduardo B. [UNIFESP]
Retinoblastoma is the most common childhood cancer. Thanks to modern technology and good medical access, mortality in Europe has decreased to about 5%. Diffuse infiltrating retinoblastoma is a very rare subtype of this neoplasm and is characterized by its atypical growth pattern. Diffuse infiltrating retinoblastoma may mimic other more innocuous diseases and may therefore be misdiagnosed. The purpose of this paper was to provide a short review of the main symptoms of diffuse infiltrating retinoblastoma presenting to the ophthalmologist and give a comparison to typical retinoblastoma. The second purpose was to set up a discussion of the genetic paradigm of diffuse infiltrating retinoblastoma. It has often been described to occur sporadically
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Coleção fluídica na interface do LASIK causada por glaucoma secundário à ceratouveíte herpética: relato de caso
(Conselho Brasileiro de Oftalmologia, 2007-02-01) Nakano, Eliane Mayumi [UNIFESP]; Kuchembuck, Márcio; Nakano, Kozo; Oliveira, Marivaldo; Alvarenga, Lenio Souza [UNIFESP]; Portellinha, Waldir; Hospital Santa Cruz; Universidade Federal de São Paulo (UNIFESP); Universidade da Califórnia
Herpes simplex virus infection is a frequent cause of intraocular inflammation or anterior uveitis. Ocular hypertension is a common feature in herpetic keratouveitis. We describe a fluid accumulation and flap displacement in late postoperative period (28 months) of LASIK associated with ocular hypertension caused by herpetic keratouveitis. This finding supports the theory that flap attachment after LASIK is only partial and the virtual space remains indefinitely. The presence of ocular hypertension may lead to corneal edema and fluid accumulation in the interface.
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Contribuição ao estudo da toxoplasmose ocular
(Universidade Federal de São Paulo (UNIFESP), 1988) Belfort, Rubens Junior [UNIFESP]
Acesso aberto (Open Access)
Corneal specular microscopy in infectious and noninfectious uveitis
(Conselho Brasileiro de Oftalmologia, 2009-08-01) Oliveira, Filipe de [UNIFESP]; Motta, Ana Carolina de Oliveira [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: Involvement of the cornea endothelium during uveitis has not been extensively studied even though it might participate in or constitute a target of ocular inflammation. Formation of keratic precipitates (KP) is a characteristic finding in several forms of uveitis. The aim of this prospective study was to examine the vicinity of keratic precipitates in infectious and noninfectious uveitis by specular microscopy. METHODS: Patients with infectious and noninfectious uveitis in any activity level and presence of keratic precipitates were enrolled. The mean age was 40.5 years (± 14.2 years). A Topcon SP-2000P noncontact specular microscope was used to capture endothelial images in the vicinity of keratic precipitates. Automated morphometric analysis was done for cell size, cell density and cells coefficient of variation. Statistical comparisons were made between the infectious and noninfectious groups. RESULTS: From the 25 patients enrolled in this study, 16 (44%) eyes presented infectious uveitis, 19 (53%) noninfectious uveitis and 1 (3%) eye was excluded due to the impossibility to obtain a specular image. The mean cell density estimated was 2,628 ± 204 cells/mm² in infectious group and 2,622 ± 357 cells/mm² in noninfectious group. The mean cellular area in infectious and noninfectious group was respectively 385 ± 31 µm² and 390 ± 60 µm². The coefficient of variation (%) of the cellular area in the vicinity of keratic precipitates was 26.36 ±3.44 in infectious and 27.69 ± 4.61 in noninfectious group. The differences between the groups were not statistically significant (P<0.005 / Mann-Whitney test) for the three morphologic variables. CONCLUSION: The clinical applicability of specular microscopy in patients with uveitis can be an useful tool to evaluate the corneal endothelium in the presence of keratic precipitates, however the handicap of the specular image formation might not be discarded in some cases. The differences found were not clinically meaningful between the infectious and noninfectious groups, however the uveitis in various degrees of intraocular inflammation and the relatively small number of patients in each clinical category of this study, indicates that further studies can be required to evaluate better the morphology of the endothelium.
Acesso aberto (Open Access)
Correlation between clinical diagnosis and PCR analysis of serum, aqueous, and vitreous samples in patients with inflammatory eye disease
(Conselho Brasileiro de Oftalmologia, 2007-02-01) Matos, Kimble [UNIFESP]; Muccioli, Cristina [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Rizzo, Luiz Vicente; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
PURPOSE: To study the applicability (sensitivity, specificity) of polymerase chain reaction (PCR) tests in the detection of cytomegalovirus (CMV), herpes virus (HSV) and varicella zoster (VZV), Epstein-Barr virus (EBV), Mycobacterium sp and Toxoplasma gondii in the diagnosis of patients with or without AIDS, with presumably infectious uveitis, using serum, aqueous humor and vitreous humor samples. METHODS: Twenty individuals with uveitis of presumed infectious origin were evaluated. Sixteen of them had AIDS, four were immunocompetent individuals. We also evaluated 4 normal controls who underwent vitrectomy surgery. Clinical evaluation of the patients was performed together by three clinicians. PCR evaluations of the serum, aqueous, and vitreous humor were performed in a masked fashion by the laboratory staff. RESULTS: Twelve patients had a clinical diagnosis of CMV retinitis. Of these 6 (50%) had a positive PCR for CMV in the vitreous, three (25%) had a positive PCR for CMV in the serum, and none were positive in the aqueous. Five patients had a clinical diagnosis of acute retinal necrosis (ARN). Three (60%) of these had positive PCR for HSV/VZV in the vitreous. One of these patients had a positive PCR reaction for both EBV and HSV/VZV in the vitreous samples. One patient with cutaneous herpes zoster had a positive PCR reaction for HSV/VZV in the serum. Four patients had a presumed diagnosis of ocular toxoplasmosis, one patient (25%) had a positive PCR for Toxoplasma gondii in the serum, 3 (75%) had positive results in the aqueous, and 2 (50%) had positive results in the vitreous. One patient with presumed ocular tuberculosis had a positive PCR reaction both in the serum and in the vitreous samples. Finally, none of the four control individuals revealed any positive PCR reaction. CONCLUSION: PCR is an auxiliary diagnostic procedure that should be evaluated together with ophthalmological aspects of the patient.
Acesso aberto (Open Access)
Corticoterapia e Uveítes
(Conselho Brasileiro de Oftalmologia, 2002-08-01) Finamor, Luciana Peixoto [UNIFESP]; Finamor Jr, Francisco [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Sociedade Brasileira de Uveítes
Corticosteroids have been used in clinical practice since 1949, and their potential beneficial effects in Ophthalmology, including inflammatory and autoimmune diseases, are now a fact. Nowadays, these steroids are used, systemically or locally, to treat a constellation of eye diseases. This article considers the most used corticosteroids in Ophthalmology, their indications, their side effects, and routes of administration.
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Diagnóstico pela laser flare fotometria da inflamação intra-ocular e da retinite por citomegalovírus em pacientes infectados pelo vírus da imunodeficiência humana
(Universidade Federal de São Paulo (UNIFESP), 1993) Muccioli, Cristina [UNIFESP]; Belfort, Rubens Junior [UNIFESP]
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Efeitos da injeção subtenoniana posterior de corticóide em pacientes com uveíte
(Conselho Brasileiro de Oftalmologia, 2003-06-01) Finamor, Luciana Peixoto [UNIFESP]; Dimantas, Maria Angélica P. [UNIFESP]; Campos, Vânia Ewert de [UNIFESP]; Prata Junior, João Antonio [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To determine the effects of posterior subtenon steroid injection (PSSI) according to intraocular pressure and visual acuity, in patients with uveitis. METHODS: Eighteen patients with diagnosis of uveitis were analized and submitted to posterior subtenon steroid injection of triancinolone acetonide (Kenalog® 40mg - 9 patients, 14 injections) or of methyl- prednisolone acetate (Depomedrol® 40mg - 9 patients, 15 in- jections) for the treatment of chronic eye inflammation or cystoid macular edema. RESULTS: Final visual acuity improved in 92% of the patients after the first injection; 50% improved one line, and 42% improved at least three lines. The mean time for improvement was three weeks. Increase of IOP occurred in 44% of the patients (8 patients), who showed a mean intraocular pressure of 31 mmHg and a range of 21 to 38 mmHg. It was more frequent among young patients, and in the Kenalog® group, with onset after 2.5 weeks on average. CONCLUSION: A subtenoninjection of corticosteroids appears to be an effective treatment for decreased vision associated with some types of uveitis, such as intermediate uveitis, Behçet's disease, Vogt-Koyanagi-Harada syndrome, retinal vasculitis and rheumatoid arthritis. However, it may contribute to increase in intraocular pressure in some cases, specially in children and young patients.
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Epidemiology of Behcet Disease
(Informa Healthcare, 2012-10-01) Khairallah, Moncef; Accorinti, Massimo; Muccioli, Cristina [UNIFESP]; Kahloun, Rim; Kempen, John H.; Fattouma Bourguiba Univ Hosp; Univ Monastir; Univ Roma La Sapienza; Universidade Federal de São Paulo (UNIFESP); Univ Penn
Behcet disease (BD) is a multisystem inflammatory disorder that is an important cause of morbidity worldwide. BD is most common along the ancient Silk Road route in the Far East and Mediterranean basin. the eye is the most commonly involved organ in BD patients. the prototypical form of involvement is a relapsing remitting panuveitis and retinal vasculitis. Less commonly, BD may present in the form of conjunctivitis, conjunctival ulcers, keratitis, episcleritis, scleritis, and extraocular muscle paralysis. Uveitis in BD carries significant implications for the patient, because it is a chronic recurrent disease characterized by explosive attacks of severe inflammation that may cause significant, cumulative damage to the intraocular structures. This review summarizes the epidemiology of systemic and ocular clinical features of BD with particular focus on risk factors, clinical characteristics, complications, and prognosis of BD-associated uveitis.
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Evaluating the presence of Toxoplasma gondii in peripheral blood of patients with diverse forms of uveitis
(Springer, 2017) Belfort, Rubens N. [UNIFESP]; Isenberg, Jordan; Fernandes, Bruno F.; Di Cesare, Sebastian; Belfort, Rubens, Jr. [UNIFESP]; Burnier, Miguel N., Jr. [UNIFESP]
The purpose of this study was to evaluate the presence of Toxoplasmosis gondii in samples of peripheral blood from patients with varying etiologies of uveitis. Whole blood from patients with different forms of uveitis was tested for the presence of T. gondii using real-time PCR targeting the well-characterized 529 bp fragment. Extracted DNA was both frozen. Thirty-one patients were included in the current study and grouped as follows: acute toxoplasmosis (n = 10)
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Imunidade celular em pacientes com uveíte
(Universidade Federal de São Paulo (UNIFESP), 1985) Belfort, Rubens Junior [UNIFESP]; Mendes, Nelson Figueiredo [UNIFESP]
Acesso aberto (Open Access)
Linfoma intra-ocular primário de células tipo B: relato de caso
(Conselho Brasileiro de Oftalmologia, 2007-08-01) Cypel, Marcela [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Moraes, Nilva [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Ocular non-Hodgkin's lymphoma is a rare condition that can involve the retina, the vitreous and the optic nerve. It can occur alone or can be associated with lymphoma of the central nervous system and a frequent manifestation is a posterior uveitis of difficult treatment. This kind of ocular tumor is difficult and a challenge to diagnosis. We describe a case of non-Hodgkin's intraocular B-cell lymphoma in a 47-year-old woman who had a posterior uveitis as the first manifestation. We emphasize the importance of a careful investigation and of the general clinical examination since this is the most common type in the eye. We expect to call the attention to this disease that many times appears in an unspecific form with unspecific symptoms.
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Ocular manifestations of Zika virus: What we do and do not know
(Masson Editeur, 2017) Benzekri, R.; Belfort, R., Jr. {UNIFESP]; Ventura, C. V. [UNIFESP]; Freitas, B. de Paula; Maia, M. [UNIFESP]; Leite, M.; Labetoulle, M.; Rousseau, A.
Zika virus (ZIKV) disease outbreak, which was declared by the end of 2015 inBrazil, has become the largest one to date. Being reported in the Americas and in certain islands of the Pacific, it has the potential to spread worldwide. Although ZIKV infections are mostly self-limiting and/or asymptomatic in the healthy adult, they are responsible for devastating congenital neurologic malformations ZIKV (mainly microcephaly) when contracted during the first months of pregnancy. Ocular manifestations during the acute adult infection include conjunctivitis and more rarely ocular inflammation. Congenital infection is associated with chorioretinal atrophy pigment mottling of the retina retinal vasculature abnormalities and optic nerve atrophy. Therefore, complete ophthalmological evaluation is recommended for suspected congenital infections. (C) 2017 Elsevier Masson SAS. All rights reserved.
Acesso aberto (Open Access)
Ocular masquerade syndrome due to intraocular lymphoma - two forms of retinal pigment epithelium involvement: case reports
(Conselho Brasileiro de Oftalmologia, 2007-06-01) Amaro, Miguel Hage [UNIFESP]; Muccioli, Cristina [UNIFESP]; Abreu, Mariza Toledo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Ocular masquerade syndrome was diagnosted in two patients with chronic uveitis. The patients presented non-Hodgkin's lymphoma as the final diagnosis two forms of intraocular retinal pigment epithelium involvement was seen. One case was flecks of the retinal pigment epithelium and another case was a solid retinal pigment epithelium detachment. These unusual presentations of non-Hodgkin's lymphoma is an alert to all involved in lymphoma care.
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Optical coherence tomography and indocyanine green angiography findings in acute syphilitic posterior placoid choroidopathy: case report
(Conselho Brasileiro de Oftalmologia, 2009-12-01) Meira-Freitas, Daniel [UNIFESP]; Farah, Michel Eid [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Aggio, Fabio Bom [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The optical coherence tomography (OCT) and indocyanine green angiography (ICGA) findings of a 58-year-old male with acute syphilitic posterior placoid chorioretinitis are reported herein. Best-corrected visual acuity was 20/150 in the right eye (OD) and 20/30 in the left eye (OS) at presentation. On funduscopy, there was a central subretinal placoid yellowish lesion in OD. VDRL and serum FTA-ABS were positive. OCT showed increased reflectance and thickening of the subfoveal RPE-choriocapillaris complex corresponding to the lesion in OD. ICGA revealed a hypofluorescent spot corresponding to the lesion in OD and confluent small dots extending to periphery, without any correspondence in fundus examination. The same dots were also seen in OS, even though no lesions could be observed clinically. Intravenous ceftriaxone 2 g daily was given for 10 days. One month after the first visit, visual acuity improved to 20/30 and marked improvement of the lesion was seen. OCT was normal in both eyes at the final visit.
Acesso aberto (Open Access)
Pseudohypopyon immediately after intravitreal injection of triamcinolone acetonide: case reports
(Conselho Brasileiro de Oftalmologia, 2005-04-01) Campos, Vânia Ewert de [UNIFESP]; Maia, André [UNIFESP]; Muccioli, Cristina [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Report on the development of pseudohypopyon immediately after intravitreal injection of triamcinolone acetonide (TAAC). Two phakic patients presenting with a transient pseudohypopyon after having been treated with intravitreal triamcinolone. One had a clinically significant macular edema with cystoid component (CSME with CMS) and the other, active Vogt-Koyanagi-Harada (VKH) with serous retinal detachment of the macula. One eye from each patient developed a pseudohypopyon with crystal deposits adherent to the corneal endothelium. In one case it appeared right after the injection and disappeared spontaneously in 24 hours. In the other patient it appeared on day 3 and disappeared also spontaneously within 2 days. The pseudohypopyon is an important sign that can be observed after intravitreal injection of TAAC, in phakic patients, with spontaneous resolution and without complication. The pseudohypopyon caused by the deposition of TAAC in the anterior chamber immediately after its injection into the vitreous should be differentiated from other forms of hypopyon associated with this type of treatment.

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