Navegando por Palavras-chave "retinopathy"
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- ItemSomente MetadadadosAvaliação de retinopatia por antimalárico em pacientes com lúpus eritematoso sistêmico: retinografia e exame com a tela de amsler não são adequados para detecção(Universidade Federal de São Paulo (UNIFESP), 2016-09-28) Reis, Felipe Sebastiao de Assis [UNIFESP]; Sato, Emilia Inoue Sato [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate the ability of Retinography and Amsler Grid Test to detect antimalarial retinopathy (AM), considering the spectral domains optical coherence tomography (SD-OCT) as the gold standard, and to identify factors associated with retinopathy. Patients and Methods: In a cross-sectional study 89 SLE patients using antimalarial for over a year were evaluated. All patients underwent Retinography and Amsler Grid Test. Data as comorbidities, demographic characteristics, duration and cumulative dose of AM were collected. Patients with alterations suggestive of AM retinopathy in the Retinography or in the Amsler Grid test, or, with cumulative dose higher than 1000g of hydroxychloroquine or 400g of chloroquine diphosphate were asked to perform SD-OCT. Association analysis were performed between different variables and retinopathy diagnosed by the SD-OCT. Logistic regression analysis were also performed. Results: 55 patients performed SD-OCT and six (10.9%) were diagnosed with AM retinopathy. There was no correlation between changes in the Amsler Grid test or in Retinography and the diagnosis of retinopathy by SD-OCT. Patients with retinopathy in SD-OCT showed higher levels of creatinine (p = 0.027) and more frequent history of eye disease (p = 0.009). In logistic regression analysis, antecedent of eye disease increased by 11.7 times (p = 0.019) the chance of developing antimalarial retinopathy. Reduction of one unit in the creatinine clearance (Cl Cr) increased the chance of AM retinopathy by 1,025 times (p = 0.78). In the subgroup of 25 patients who used only hydroxychloroquine, whose with retinopathy were significantly thinner, older and had lower CI Cr values. Conclusion: Retinography and Amsler Grid Test are not suitable to evaluate antimalarial retinopathy. Patients with a history of eye disease or decreased creatinine clearance had increased risk for developing antimalarial retinopathy.
- ItemSomente MetadadadosImpaired glucose tolerance plus hyperlipidaemia induced by diet promotes retina microaneurysms in New Zealand rabbits(Wiley-Blackwell, 2011-02-01) Helfenstein, Tatiana [UNIFESP]; Fonseca, Francisco A. [UNIFESP]; Ihara, Silvia S. [UNIFESP]; Bottos, Juliana M. [UNIFESP]; Moreira, Flavio T. [UNIFESP]; Pott, Henrique; Farah, Michel E. [UNIFESP]; Martins, Maria C. [UNIFESP]; Izar, Maria C. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)P>With the increasing prevalence of diabetes mellitus and metabolic syndrome worldwide, experimental models are required to better understand the pathophysiology and therapeutic approaches to preserve pancreatic beta cells, attenuate atherosclerosis and protect target organs. the aims of this study were to develop an experimental model of impaired glucose tolerance combined with hypercholesterolaemia induced by diet and assess metabolic alterations and target organ lesions. New Zealand male rabbits were fed high-fat/high-sucrose (10/40%) and cholesterol-enriched diet for 24 weeks, when they were sacrificed. Biochemistry, fundus photographs with fluorescein angiography and pathological analyses were performed. Cholesterol-fed and normal animals of same age were compared. Results: the animals with diet-induced impaired glucose tolerance combined with hypercholesterolaemia gained weight, increased blood glucose, total cholesterol, LDL-C and triglycerides and decreased HDL-C (P < 0.05 vs. baseline). Fructosamine levels and the homeostasis model assessment of insulin resistance (HOMA-IR) index were increased, while there was a reduction in the HOMA-beta (P < 0.05 for all vs. baseline). Histomorphologic findings of this model were aortic atherosclerosis, hepatic steatofibrosis and glomerular macrophage infiltration. Early clinical features of diabetic retinopathy with hyperfluorescent dots consistent with presence of retina microaneurysms were seen since week 12, progressing up to the end of the experiment (P < 0.0005 vs. baseline and 12 weeks). Our model reproduced several metabolic characteristics of human diabetes mellitus and promoted early signs of retinopathy. This non-expensive model is suitable for studying mechanistic pathways and allowing novel strategic approaches.
- ItemSomente MetadadadosPrevalence of Diabetes and Diabetic Retinopathy in a Brazilian Population(Informa Healthcare, 2014-02-01) Schellini, Silvana Artioli; Carvalho, Geraldo Miranda de; Rendeiro, Fabricio Salles; Padovani, Carlos Roberto; Hirai, Flavio Eduardo [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate the prevalence of type 2 diabetes mellitus and diabetic retinopathy (DR) in a Brazilian population.Methods: Population-based, cross-sectional study conducted in 9 cities located in the Midwest region of the state of São Paulo, Brazil, between 2006 and 2007, including 4690 individuals aged >= 30 years. Diabetes was self-reported and DR was assessed by indirect ophthalmoscopy.Results: the prevalence of type 2 diabetes was 8.68% (95% confidence interval, CI, 7.87-9.48%), and DR was present in 7.62% (95% CI 5.02-10.20%) of participants with self-reported type 2 diabetes. Approximately 35.4% of individuals diagnosed with DR did not know they had diabetes prior to DR diagnosis. Prevalences of low vision and blindness were higher among those with diabetes and DR. Cataract was still a major cause of blindness in this population.Conclusion: This is the first large population-based study on DR in Brazil. High rates of visual impairment were found in persons with type 2 diabetes, but cataract is still one of the main causes of blindness. Large surveys are necessary for public health policy advocacy in developing countries.
- ItemAcesso aberto (Open Access)Prevalência de retinopatia da prematuridade em recém-nascidos de muito baixo peso(Sociedade Brasileira de Pediatria, 2006-02-01) Lermann, Viviane Levy; Fortes Filho, João Borges [UNIFESP]; Procianoy, Renato Soibelmann; Universidade Federal do Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP); Hospital de Clínicas de Porto Alegre Setor de Retinopatia da Prematuridade; HCPA Serviço de NeonatologiaOBJECTIVE: To evaluate the prevalence of retinopathy of prematurity and the risk factors affecting very low birth weight infants at a neonatal intensive care unit. METHODS: A cross-sectional study investigating all newborn infants with birth weights > 1,500 g and/or gestational ages > 32 weeks, admitted to the Neonatal ICU at the Hospital de Clínicas de Porto Alegre, from October 2002 to March 2004. Patients underwent indirect binocular ophthalmoscopy of the fundus at six weeks postpartum. Infants who progressed to threshold disease were given laser therapy. RESULTS: One hundred and fourteen newborn infants were studied. Eighty-three patients were not diagnosed with retinopathy of prematurity, 18 had stage I retinopathy of prematurity, seven stage II retinopathy of prematurity and six patients had threshold retinopathy of prematurity. The prevalence of retinopathy of prematurity was 27.2% (95% CI: 19.28-36.32) affecting 31 newborn infants, and the prevalence of retinopathy of prematurity progressing to threshold disease was 5.26% (95% CI: 1.96-11.10), affecting six patients. Retinopathy of prematurity was confirmed in 50% of the patients with weights below 1,000 g and 71.5% of newborn infants born at gestational ages of less than 28 weeks. Gestational age and birth weight were significantly lower among patients with retinopathy of prematurity than among those without. CONCLUSIONS: Although the results of this study demonstrate that the observed prevalence was similar to that described in literature, this ROP frequency remains elevated among very low birth weight infants. The development of retinopathy of prematurity was inversely proportional to weight and gestational age at birth.