RESUMEN
A terceira edição do manual sobre intervenção de rotação tarsal bilamelar para o tratamento do entrópio devido à triquíase tracomatosa, publicado pela Organização Mundial da Saúde (OMS), apresenta várias atualizações e melhorias. Desde sua primeira edição em 1993 e a segunda em 2015, esta nova versão amplia o conteúdo inicial, incorpora avanços acordados na quarta Reunião Científica Mundial sobre Tracoma em 2018 e melhora significativamente a estrutura e apresentação do manual. Descrições detalhadas sobre o exame do entrópio foram adicionadas, listas de instrumentos cirúrgicos necessários foram otimizadas e orientações sobre cuidados pós-operatórios foram aprimoradas. Além disso, ilustrações atualizadas foram incluídas e conteúdo redundante foi removido, tornando o manual mais acessível e útil. O manual foi desenvolvido principalmente para instrutores encarregados de treinar cirurgiões na técnica de rotação tarsal bilamelar. Está dividido em duas partes: a primeira centra-se nas competências necessárias para a formação dos cirurgiões e serve como documento de referência, incluindo objetivos pedagógicos específicos e exercícios práticos. A segunda parte destina-se exclusivamente a formadores, abordando a seleção e avaliação final dos alunos. Este recurso integral não apenas detalha o conhecimento teórico, mas também as habilidades práticas essenciais que precisam ser desenvolvidas e avaliadas durante o treinamento cirúrgico.
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Tracoma , Triquiasis , Ceguera , Párpados , Entropión , Cirugía GeneralRESUMEN
[ABSTRACT]. Objective. To determine the prevalence and causes of vision loss and calculate the effective cataract surgery coverage (eCSC) in adults aged 60 years and older in Latin America and the Caribbean in 2020. Methods. The International Agency for the Prevention of Blindness Vision Atlas and the Rapid Assessment of Avoidable Blindness databases were used as data source. The collected data were used to estimate the prevalence and causes of vision loss in people aged 60 years and older, and to determine the eCSC. Results. The overall prevalence of moderate to severe vision impairment (MSVI) and blindness in Latin America and the Caribbean were 14.14% and 2.94%, respectively. Tropical Latin America was the subregion with the highest prevalence of blindness (3.89%) while Southern Latin America had the lowest (0.96%). For both MSVI and blindness, cataract was the main cause of vision loss. The eCSC rates showed great variation, ranging from 4.0% in Guatemala to 75.2% in Suriname. Conclusions. The prevalence of vision loss in adults aged 60 years and older in Latin America and the Caribbean was higher than previous estimates on younger groups. Cataract was the main cause of blindness, and the eCSC indicates that the outcomes from cataract surgery should be improved. Specific actions associated with improving access, integrating eye assessment with primary care programs, expanding the use of telemedicine, and improving data quality should be taken by public health authorities aiming to address vision loss in this group.
[RESUMEN]. Objetivo. Determinar la prevalencia y las causas de la pérdida de visión y calcular la cobertura efectiva de la cirugía de las cataratas en personas mayores de 60 años en América Latina y el Caribe en el 2020. Métodos. Se utilizaron como fuentes la base de datos del Atlas de la Visión de la Agencia Internacional para la Prevención de la Ceguera y la de Rapid Assessment of Avoidable Blindness [evaluación rápida de la ceguera evitable]. Los datos recopilados se utilizaron para estimar la prevalencia y las causas de la pérdida de visión en personas mayores de 60 años y para determinar la cobertura efectiva de la cirugía de las cataratas. Resultados. La prevalencia general de la discapacidad visual moderada a grave y de la ceguera en América Latina y el Caribe fue del 14,14% y el 2,94%, respectivamente. La subregión de América Latina tropical presentó la mayor prevalencia de ceguera (3,89%), mientras que la de América Latina austral registró la menor (0,96%). Tanto en el caso de la discapacidad visual moderada a grave como en el de la ceguera, la causa principal de pérdida de visión fueron las cataratas. Hubo grandes diferencias en la tasa de cobertura efectiva de la cirugía de las cataratas, con valores que iban del 4,0% en Guatemala al 75,2% en Suriname. Conclusiones. La prevalencia de la pérdida de visión en personas mayores de 60 años en América Latina y el Caribe fue superior a la indicada por las estimaciones anteriores en grupos de menor edad. Las cataratas fueron la principal causa de ceguera, y la cobertura efectiva de la cirugía de las cataratas indica la necesidad de mejorar los resultados de estas intervenciones. Las autoridades de salud pública que pretendan abordar la pérdida de visión en este grupo deben adoptar medidas específicas que se asocien a una mejora del acceso, la integración de las exploraciones oftalmológicas en los programas de atención primaria, la ampliación del uso de la telemedicina y la mejora de la calidad de los datos.
[RESUMO]. Objetivo. Determinar a prevalência e as causas da perda de visão e calcular a cobertura efetiva da cirurgia de catarata em adultos com 60 anos ou mais na América Latina e no Caribe em 2020. Métodos. Foram usadas as bases de dados do Atlas da Visão da Agência Internacional para a Prevenção da Cegueira e da Avaliação Rápida da Cegueira Evitável (RAAB, na sigla em inglês) como fonte de dados. Os dados coletados foram usados para estimar a prevalência e as causas da perda de visão em pessoas com 60 anos ou mais e para determinar a cobertura efetiva da cirurgia de catarata. Resultados. A prevalência global de deficiência visual moderada a grave e cegueira na América Latina e no Caribe foi de 14,14% e 2,94%, respectivamente. A América Latina Tropical foi a sub-região com a maior prevalência de cegueira (3,89%), ao passo que a América Latina Meridional teve a menor prevalência (0,96%). Tanto na deficiência visual moderada a grave quanto na cegueira, a catarata foi a principal causa da perda de visão. As taxas de cobertura efetiva da cirurgia de catarata variaram muito, desde 4,0% na Guatemala até 75,2% no Suriname. Conclusões. A prevalência da perda de visão em adultos com 60 anos ou mais na América Latina e no Caribe foi maior do que as estimativas anteriores em grupos de indivíduos mais jovens. A catarata foi a principal causa de cegueira, e a cobertura efetiva da cirurgia de catarata indica que os desfechos dessa cirurgia precisam ser melhorados. Medidas específicas associadas à melhoria do acesso, à integração da avaliação oftalmológica aos programas de atenção primária, à expansão do uso da telemedicina e à melhoria da qualidade dos dados devem ser adotadas pelas autoridades de saúde pública com o objetivo de enfrentar a perda de visão nesse grupo.
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Envejecimiento , Ceguera , Trastornos de la Visión , Oftalmología , Salud Pública , América Latina , Región del Caribe , Envejecimiento , Ceguera , Trastornos de la Visión , Oftalmología , Salud Pública , América Latina , Región del Caribe , Envejecimiento , Ceguera , Trastornos de la Visión , Oftalmología , Salud Pública , Región del CaribeRESUMEN
PURPOSE: This study aimed to evaluate the perception and degree of satisfaction of blind individuals regarding an electronic cane prototype with a wearable haptic interface. METHODS: Two scenarios with different obstacles were created to conduct tests with the canes (the user's cane and the prototype one). The perception and satisfaction of participants regarding the electronic cane were assessed using a questionnaire, the number of collisions during the tests, and the time each individual took to complete the course in each scenario. RESULTS: Ten blind individuals who used the white cane participated in this study. Eight were males, and two were females. Their age ranged from 23 to 43 (average 32.3 ± 7.13 years and median 32 years). There was a tendency for fewer collisions with ground obstacles when the electronic cane was used than when the white cane was used. However, there was no statistically significant difference between the number of collisions and the course completion time in each scenario with either canes tested. CONCLUSION: Overall, the perception and satisfaction of individuals regarding the prototype used were positive.
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Bastones , Dispositivos Electrónicos Vestibles , Humanos , Femenino , Masculino , Adulto , Adulto Joven , Encuestas y Cuestionarios , Diseño de Equipo , Ceguera/psicología , Personas con Daño Visual/psicología , Percepción , Satisfacción Personal , Factores de Tiempo , Tacto , Estadísticas no ParamétricasRESUMEN
A 40-year old female chimpanzee (Pan troglodytes) developed hyporexia, weight loss, followed by progressive and complete blindness. Tomography demonstrated an intracranial mass in the rostroventral brain involving the optic chiasm, with a presumptive diagnosis of neoplasm. However, histopathology revealed a granulomatous meningoencephalitis, and tissue samples tested positive for Mycobacterium tuberculosis.
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Enfermedades del Simio Antropoideo , Ceguera , Meningoencefalitis , Mycobacterium tuberculosis , Pan troglodytes , Animales , Femenino , Enfermedades del Simio Antropoideo/diagnóstico , Enfermedades del Simio Antropoideo/microbiología , Enfermedades del Simio Antropoideo/patología , Mycobacterium tuberculosis/aislamiento & purificación , Ceguera/veterinaria , Ceguera/etiología , Ceguera/microbiología , Ceguera/diagnóstico , Meningoencefalitis/veterinaria , Meningoencefalitis/microbiología , Meningoencefalitis/diagnóstico , Granuloma/veterinaria , Granuloma/microbiología , Granuloma/patología , Granuloma/diagnóstico , Tuberculosis/veterinaria , Tuberculosis/diagnóstico , Tuberculosis/complicacionesRESUMEN
PURPOSE: This study aimed to describe the behavioral patterns of data on cataract surgery performed in the Brazilian public health system before, during, and after the COVID-19 outbreak and estimate the setbacks generated by the pandemic to guide public policies. MATERIALS AND METHODS: This was an observational, longitudinal, and descriptive epidemiological study based on data retrieved from the public health system's databases of cataract surgeries performed each year and in each region from 2015 to 2022. RESULT: In Brazil, compared with the average of the 5-years preceding the pandemic, a 23 % reduction in the number of cataract surgeries was observed in 2020, followed by a 21 % increase in 2021, compensating for the majority of patients that were not operated on. However, the worsening situation of blindness caused by cataracts due to the pandemic not be avoided in the Central-West region, where unrecovered cases continue to accumulate. CONCLUSION: The COVID-19 pandemic did not worsen the situation of cataract blindness in Brazil due to the efficacy of the measures taken by the government in resuming elective surgeries. However, the auhtors recommend that the distribution of resources for cataract surgeries should consider regional discrepancies based on epidemiological data.
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COVID-19 , Extracción de Catarata , Pandemias , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Brasil/epidemiología , Extracción de Catarata/estadística & datos numéricos , Estudios Retrospectivos , Catarata/epidemiología , Estudios Longitudinales , Ceguera/epidemiología , Ceguera/etiología , Ceguera/prevención & control , Masculino , SARS-CoV-2 , FemeninoRESUMEN
BACKGROUND: Several studies suggested that cavefish populations of Astyanax mexicanus settled during the Late Pleistocene. This implies that the cavefish's most conspicuous phenotypic changes, blindness and depigmentation, and more cryptic characters important for cave life, evolved rapidly. RESULTS: Using the published genomes of 47 Astyanax cavefish from la Cueva de El Pachón, El Sótano de la Tinaja, La Cueva Chica and El Sótano de Molino, we searched for putative loss-of-function mutations in previously defined sets of genes, i.e., vision, circadian clock and pigmentation genes. Putative non-functional alleles for four vision genes were identified. Then, we searched genome-wide for putative non-functional alleles in these four cave populations. Among 512 genes with segregating putative non-functional alleles in cavefish that are absent in surface fish, we found an enrichment in visual perception genes. Among cavefish populations, different levels of shared putative non-functional alleles were found. Using a subset of 12 genes for which putative loss-of-function mutations were found, we extend the analysis of shared pseudogenes to 11 cave populations. Using a subset of six genes for which putative loss-of-function mutations were found in the El Sótano del Toro population, where extensive hybridization with surface fish occurs, we found a correlation between the level of eye regression and the amount of putative non-functional alleles. CONCLUSIONS: We confirm that very few putative non-functional alleles are present in a large set of vision genes, in accordance with the recent origin of Astyanax mexicanus cavefish. Furthermore, the genome-wide analysis indicates an enrichment of putative loss-of-function alleles in genes with vision-related GO-terms, suggesting that visual perception may be the function chiefly impacted by gene losses related to the shift from a surface to a cave environment. The geographic distribution of putative loss-of-function alleles newly suggests that cave populations from Sierra de Guatemala and Sierra de El Abra share a common origin, albeit followed by independent evolution for a long period. It also supports that populations from the Micos area have an independent origin. In El Sótano del Toro, the troglomorphic phenotype is maintained despite massive introgression of the surface genome.
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Characidae , Animales , Alelos , Characidae/genética , Mutación , Ceguera/genética , Visión OcularRESUMEN
OBJECTIVE: This preliminary study suggests a way to artificially extend vibrissae of blind dogs to assist ambulation and avoiding facial contact with obstacles. PROCEDURES: Fourteen irreversibly blind dogs had 5-6 mystacial vibrissae on each side of the face supplementally extended by attaching carefully chosen adult pig hairs to them and were subjected to a maze test before and after the procedure. In three of these dogs the test was repeated one more time after all the extensions had fallen off. Collision counts and course times with and without extensions were analyzed and compared. A p-value > 0.05 was considered significant. RESULTS: Median number of collisions was significantly higher post-extensions (5 IQR 2.25) and after extensions had fallen off (4 IQR 7.50) compared to pre-extensions (1 IQR 1), p = 0.021. Median times were significantly higher pre-extension (25.6 IQR 8.98) and after the extensions had fallen off, compared to the post-extension performance (22.8 IQR 8.55), p = 0.04. CONCLUSION: Vibrissae play an important role in the tactile perception of blind dogs, and our preliminary results suggest that extending this sensory organ possibly improves obstacle location and their quality of life.
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Ceguera , Tacto , Vibrisas , Animales , Perros/fisiología , Ceguera/veterinaria , Ceguera/fisiopatología , Vibrisas/fisiología , Tacto/fisiología , Masculino , Femenino , Enfermedades de los Perros/fisiopatologíaRESUMEN
Audio description improves access to visual culture for people who are unable to fully participate in it due to visual impairments. Because of this direct benefit to disabled people, it is usually defined as an accommodation or inclusion service. Rather than adopting this view, we see disability as a creative force, arguing that it can engender a new dimension of art: audio description as a form of cinematic ekphrasis. This claim is made by drawing on the 2017 movie Radiance, by Japanese director Naomi Kawase. This movie puts audio description in the spotlight and stimulates discussion on this underdeveloped and under-recognised art. Radiance is structured around the process of making the audio description, thus offering good insight into the artistry and main challenges of this process. Between the words of this meditation on the art of audio description, Kawase also challenges the dominant ocular normative narrative on blindness as a deficiency and provokes a discussion on the contribution that blindness-with its different, still culturally unexplored modes of perception-could make to the interpretation of visual arts. Radiance can thus be treated as an artful argument for the greater recognition of disabled people's right to participate in cultural life.
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Ceguera , Personas con Discapacidad , Películas Cinematográficas , Humanos , Personas con Discapacidad/psicología , Arte/historiaRESUMEN
K+ channel Kir7.1 expressed at the apical membrane of the retinal pigment epithelium (RPE) plays an essential role in retinal function. An isoleucine-to-threonine mutation at position 120 of the protein is responsible for blindness-causing vitreo-retinal dystrophy. We have studied the molecular mechanism of action of Kir7.1-I120T in vitro by heterologous expression and in vivo in CRISPR-generated knockin mice. Full-size Kir7.1-I120T reaches the plasma membrane but lacks any activity. Analysis of Kir7.1 and the I120T mutant in mixed transfection experiments, and that of tandem tetrameric constructs made by combining wild type (WT) and mutant protomers, leads us to conclude that they do not form heterotetramers in vitro. Homozygous I120T/I120T mice show cleft palate and tracheomalacia and do not survive beyond P0, whereas heterozygous WT/I120T develop normally. Membrane conductance of RPE cells isolated from WT/WT and heterozygous WT/I120T mice is dominated by Kir7.1 current. Using Rb+ as a charge carrier, we demonstrate that the Kir7.1 current of WT/I120T RPE cells corresponds to approximately 50% of that in cells from WT/WT animals, in direct proportion to WT gene dosage. This suggests a lack of compensatory effects or interference from the mutated allele product, an interpretation consistent with results obtained using WT/- hemizygous mouse. Electroretinography and behavioral tests also show normal vision in WT/I120T animals. The hypomorphic ion channel phenotype of heterozygous Kir7.1-I120T mutants is therefore compatible with normal development and retinal function. The lack of detrimental effect of this degree of functional deficit might explain the recessive nature of Kir7.1 mutations causing human eye disease.NEW & NOTEWORTHY Human retinal pigment epithelium K+ channel Kir7.1 is affected by generally recessive mutations leading to blindness. We investigate one such mutation, isoleucine-to-threonine at position 120, both in vitro and in vivo in knockin mice. The mutated channel is inactive and in heterozygosis gives a hypomorphic phenotype with normal retinal function. Mutant channels do not interfere with wild-type Kir7.1 channels which are expressed concomitantly without hindrance, providing an explanation for the recessive nature of the disease.
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Isoleucina , Retina , Ratones , Humanos , Animales , Isoleucina/metabolismo , Retina/metabolismo , Ceguera/metabolismo , Mutación/genética , Treonina/metabolismoRESUMEN
BACKGROUND: Little was known about the population coverage and causes of sight impairment (SI) registration within the Caribbean, or the extent to which register studies offer insights into population eye health. METHODS: We compared causes of SI registration in the Trinidad and Tobago Blind Welfare Association (TTBWA) register with findings from the 2014 National Eye Survey of Trinidad and Tobago (NESTT), and estimated registration coverage. Cross-sectional validation studies of registered clients included interviews, visual function and cause ascertainment in July 2013, and interviews and visual function in July 2016. RESULTS: The TTBWA register included 863 people (all ages, 48.1%(n = 415) male) registered between 1951 and 2015. The NESTT identified 1.1%(75/7158) people aged ≥5years eligible for partial or severe SI registration, of whom 49.3%(n = 37) were male. Registration coverage was approximately 7% of the eligible population of Trinidad. Nevertheless, there was close agreement in the causes of SI comparing the register and population-representative survey. Glaucoma was the leading cause in both the register (26.1%,n = 225) and population-based survey (26.1%, 18/69 adults), followed by cataract and diabetic retinopathy. In the validation studies combined, 62.6%(93/151) clients had severe SI, 28.5%(43/151) had partial SI and 9.9%(15/151) did not meet SI eligibility criteria. SI was potentially avoidable in at least 58%(n = 36/62) adults and 50%(n = 7/14) children. CONCLUSION: We report very low register coverage of the SI population, but close agreement in causes of SI to a contemporaneous national population-based eye survey, half of which resulted from preventable or treatable eye disease.
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Sistema de Registros , Humanos , Trinidad y Tobago/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Adulto , Adolescente , Anciano , Niño , Ceguera/epidemiología , Preescolar , Encuestas Epidemiológicas , Adulto Joven , Personas con Daño Visual/estadística & datos numéricos , Anciano de 80 o más Años , LactanteRESUMEN
PURPOSE: To determine the impact on the functionality associated with visual loss (VFIP) in people with severe ocular trauma (SOT) caused by kinetic impact projectiles used in police crowd control through a prioritization tool in people admitted to a rehabilitation program in Santiago de Chile from December 02, 2019, to November 13, 2020. METHODS: A cross-sectional descriptive study of SOT victims (N = 85), average age 31.4 ± 11.9. The data were recorded through a new 9-item screening instrument for assessment and prioritization of rehabilitation created for this emergency scenario. RESULTS: The impact of the use of kinetic weapons resulted in monocular blindness in the majority of those affected (n = 68; 80.0%). The highest VFIP observed was among young men from lower social strata. There were extreme difficulties in the performance of productive tasks (occupational and/or educational) (n = 42; 49.4%) and the pursuit of hobbies and pastimes (n = 23; 27.1%), as well as a high difficulty in adapting to changes in brightness (n = 29; 34.1%) and handling objects accurately (n = 22; 25.9%). CONCLUSION: The use of kinetic weapons for crowd control resulted in high and extreme VFIP and, in most cases, monocular blindness, causing major difficulties in work, study, and development of hobbies and pastimes in the affected population, highlighting the urgent need for effective rehabilitative care, which requires special attention in order to generate an adequate rehabilitation program. The use of kinetic weapons for crowd control contravenes international goals, policies, and plans set by the WHO and the International Agency for the Prevention of Blindness on strategies to prevent avoidable blindness worldwide until 2020. It is essential to ban the use of these weapons in Chile and worldwide, as well as to revise police protocols for crowd control.
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Ceguera , Lesiones Oculares , Masculino , Humanos , Adulto Joven , Adulto , Estudios Transversales , Chile/epidemiología , Ceguera/epidemiología , Ceguera/etiología , Lesiones Oculares/complicaciones , Lesiones Oculares/epidemiología , HospitalizaciónRESUMEN
PURPOSE: The present review will summarize FECD-associated genes and pathophysiology, diagnosis, current therapeutic approaches, and future treatment perspectives. METHODS: Literature review. RESULTS: Fuchs' endothelial corneal dystrophy (FECD) is the most common bilateral corneal dystrophy and accounts for one-third of all corneal transplants performed in the US. FECD is caused by a combination of genetic and non-heritable factors, and there are two types: early-onset FECD, which affects individuals from an early age and is usually more severe, and late-onset FECD, which is more common and typically manifests around the age of 40. The hallmark findings of FECD include progressive loss of corneal endothelial cells and the formation of focal excrescences (guttae) on the Descemet membrane. These pathophysiological changes result in progressive endothelial dysfunction, leading to a decrease in visual acuity and blindness in later stages. The present review will summarize FECD-associated genes and pathophysiology, diagnosis, current therapeutic approaches, and future treatment perspectives. CONCLUSION: With the characterization and understanding of FECD-related genes and ongoing research into regenerative therapies for corneal endothelium, we can hope to see more significant improvements in the future in the management and care of the disease.
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Trasplante de Córnea , Distrofia Endotelial de Fuchs , Humanos , Distrofia Endotelial de Fuchs/diagnóstico , Distrofia Endotelial de Fuchs/genética , Distrofia Endotelial de Fuchs/terapia , Células Endoteliales , Endotelio Corneal , CegueraRESUMEN
The retina is the sensory tissue responsible for the first stages of visual processing, with a conserved anatomy and functional architecture among vertebrates. To date, retinal eye diseases, such as diabetic retinopathy, age-related macular degeneration, retinitis pigmentosa, glaucoma, and others, affect nearly 170 million people worldwide, resulting in vision loss and blindness. To tackle retinal disorders, the developing retina has been explored as a versatile model to study intercellular signaling, as it presents a broad neurochemical repertoire that has been approached in the last decades in terms of signaling and diseases. Retina, dissociated and arranged as typical cultures, as mixed or neuron- and glia-enriched, and/or organized as neurospheres and/or as organoids, are valuable to understand both neuronal and glial compartments, which have contributed to revealing roles and mechanisms between transmitter systems as well as antioxidants, trophic factors, and extracellular matrix proteins. Overall, contributions in understanding neurogenesis, tissue development, differentiation, connectivity, plasticity, and cell death are widely described. A complete access to the genome of several vertebrates, as well as the recent transcriptome at the single cell level at different stages of development, also anticipates future advances in providing cues to target blinding diseases or retinal dysfunctions.
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Enfermedades de la Retina , Animales , Humanos , Ceguera , Estado de Salud , Neuroglía , Neuronas , RetinaRESUMEN
Background: The current medical scenario is closely linked to recent progress in telecommunications, photodocumentation, and artificial intelligence (AI). Smartphone eye examination may represent a promising tool in the technological spectrum, with special interest for primary health care services. Obtaining fundus imaging with this technique has improved and democratized the teaching of fundoscopy, but in particular, it contributes greatly to screening diseases with high rates of blindness. Eye examination using smartphones essentially represents a cheap and safe method, thus contributing to public policies on population screening. This review aims to provide an update on the use of this resource and its future prospects, especially as a screening and ophthalmic diagnostic tool. Methods: In this review, we surveyed major published advances in retinal and anterior segment analysis using AI. We performed an electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE), EMBASE, and Cochrane Library for published literature without a deadline. We included studies that compared the diagnostic accuracy of smartphone ophthalmoscopy for detecting prevalent diseases with an accurate or commonly employed reference standard. Results: There are few databases with complete metadata, providing demographic data, and few databases with sufficient images involving current or new therapies. It should be taken into consideration that these are databases containing images captured using different systems and formats, with information often being excluded without essential detailing of the reasons for exclusion, which further distances them from real-life conditions. The safety, portability, low cost, and reproducibility of smartphone eye images are discussed in several studies, with encouraging results. Conclusions: The high level of agreement between conventional and a smartphone method shows a powerful arsenal for screening and early diagnosis of the main causes of blindness, such as cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration. In addition to streamlining the medical workflow and bringing benefits for public health policies, smartphone eye examination can make safe and quality assessment available to the population.
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Retinopatía Diabética , Telemedicina , Humanos , Inteligencia Artificial , Teléfono Inteligente , Reproducibilidad de los Resultados , Retinopatía Diabética/diagnóstico , Telemedicina/métodos , CegueraRESUMEN
A 45-year-old woman presented with sudden complete vision loss in her left eye and retroorbital pain worsened by eye movements. A previous milder episode of vision loss had occurred in the same eye 1 year before, with complete recovery after high-dose intravenous methylprednisolone. She had no light perception in the left eye with a swollen optic disc, but with a normal right optic disc. There were no systemic manifestations or infections. MR scan of the brain showed extensive enlargement and enhancement of the left optic nerve and optic chiasm. After excluding infections and autoimmune markers, a left optic nerve biopsy confirmed non-caseating granulomas, leading to a diagnosis of neurosarcoidosis.
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Enfermedades del Sistema Nervioso Central , Neuritis , Enfermedades del Nervio Óptico , Sarcoidosis , Femenino , Humanos , Persona de Mediana Edad , Enfermedades del Nervio Óptico/diagnóstico por imagen , Enfermedades del Nervio Óptico/etiología , Nervio Óptico/patología , Sarcoidosis/complicaciones , Sarcoidosis/diagnóstico por imagen , Neuritis/patología , CegueraRESUMEN
BACKGROUND: Blindness and vision loss (BVL) is a major global health issue affecting older adults, but its burden in transition countries has received limited attention. Therefore, we aimed to assess the trends in the burden of BVL among older adults between 1990 and 2019 across Brazil, Russia, India, China, and South Africa (BRICS), and predict the burden by 2040. METHODS: Data on BVL and its related causes were obtained from the Global Burden of Disease 2019 study. We investigated the temporal trends by calculating the average annual percentage change using joinpoint regression analysis. Subsequently, we performed Bayesian age-period-cohort modeling to estimate the burden of BVL and its related causes by 2040. RESULTS: Most BRICS countries experienced a significant decline (p < 0.05) in age-standardized prevalence rates, and the decreasing trends tend to continue. However, by 2040, the number of BVL cases is expected to increase by approximately 50% across BRICS, with an estimated approximately 192, 170, 25, 17, and 7 million cases in China, India, Russia, Brazil, and South Africa, respectively. The related ranks of BVL causes are also estimated to change in the future, particularly in India. CONCLUSIONS: The different burdens and trends of BVL across BRICS reflected the different stages of population health transition. Effective eye disease prevention requires appropriate public health interventions. Developing effective health policies and services for older adults is urgently needed in BRICS countries.
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Ceguera , Atención a la Salud , Humanos , Anciano , Prevalencia , Teorema de Bayes , Ceguera/epidemiología , Ceguera/etiología , China/epidemiología , India/epidemiología , Sudáfrica/epidemiología , Brasil/epidemiologíaRESUMEN
RESUMO Com o crescimento da indústria cosmética global, a busca pela estética e pelo rejuvenescimento impulsionou o aumento de procedimentos estéticos. A gordura autóloga é o tipo de preenchimento mais comum e mais grave relacionado à cegueira iatrogênica. A oclusão iatrogênica da artéria oftálmica é uma complicação rara (mas devastadora) das injeções de preenchimento facial. Embora diversos tratamentos tenham sido relatados e propostos, até o momento não há eficácia comprovada. Na identificação da oclusão de artéria central da retina, o tempo é de fundamental importância para o prognóstico visual do paciente. Os resultados, em geral, são insatisfatórios, e há pouca ou nenhuma evidência favorável. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou oclusão de artéria central da retina após procedimento cosmético com gordura autóloga em região nasolabial.
ABSTRACT The global cosmetic industry growth and the desire for aesthetics and rejuvenation have increased the aesthetic procedures. Autologous fat is the most common and most serious type of filling related to iatrogenic blindness. Iatrogenic occlusion of the ophthalmic artery is a rare but devastating complication of facial filler injections. Although several treatments have been reported and proposed, to date there is no proven efficacy. In identifying central retinal artery occlusion, timing is crucial to the patient's visual prognosis. The results, in general, are unsatisfactory and there is little or no favorable evidence. This paper aimed to report the case of a patient who presented central retinal artery occlusion after a cosmetic procedure with autologous fat in the nasolabial region.
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Humanos , Femenino , Adulto , Arteria Oftálmica/patología , Oclusión de la Arteria Retiniana/etiología , Técnicas Cosméticas/efectos adversos , Embolia Grasa/etiología , Grasa Subcutánea/trasplante , Enfermedad Iatrogénica , Complicaciones Posoperatorias , Trasplante Autólogo , Inyecciones Intradérmicas/efectos adversos , Angiografía con Fluoresceína , Oclusión de la Arteria Retiniana/diagnóstico , Agudeza Visual , Ceguera/etiología , Tomografía de Coherencia ÓpticaRESUMEN
En esta tercera edición se actualiza la definición de la triquiasis tracomatosa según lo acordado en la cuarta Reunión Científica Mundial sobre el Tracoma (Ginebra, del 27 al 29 de noviembre del 2018), se agrega una descripción sobre cómo examinar el entropión, se mejoran las listas de instrumentos y material fungible necesarios para la cirugía, se amplía y se mejora la orientación sobre los cuidados posoperatorios, se incluyen ilustraciones actualizadas, se mejora la presentación en todo el libro, y se elimina el contenido redundante.
Asunto(s)
Tracoma , Triquiasis , Ceguera , Párpados , Entropión , Cirugía GeneralRESUMEN
Neurofibromas are neoplasms derived from nerve bundles and are frequent in humans but not common in animals. This report described the macroscopic, histologic, and immunohistochemistry findings of an orbitofacial neurofibroma in a sow. The sow presented left eyelids with marked expansion, associated with severe ectropion and reddening of both conjunctival mucosae. The mass on the cutting surface was homogeneous, with a light tan, and shiny, measuring 9.0 x 7.0 x 7.0 cm in width, compressing the eyeball. Microscopically, there was paucicellular neoplastic proliferation of elongated cells amid the accentuated myxoid matrix. There were multifocal areas where well-differentiated nervous fascicles and skeletal musculature were seen. Neoplastic cells were immunostained positive for GFAP, neurofilament, S-100, Sox-10, and vimentin. Cytokeratin showed immunolabeling around primitive nerve bundles and desmin around neoformed vessels and muscle bundles within the tumor. Orbitopalpebral and orbitofacial neurofibroma, despite being common in humans, have not been described in domestic pigs and should be considered as a differential diagnosis in eyelid tumors in pigs.
Neurofibromas são neoplasias derivadas dos feixes nervosos e são frequentes em humanos, mas incomuns em espécies animais domésticos. Esse relato tem como objetivo descrever os achados macroscópicos, histológicos e imuno-histoquímicos de um neurofibroma orbitofacial em uma matriz suína. O animal apresentava as pálpebras esquerdas acentuadamente expandidas, associada a severo ectrópio e avermelhamento de ambas as mucosas conjuntivais. A tumoração palpebral, na superfície de corte, era homogênea, levemente acastanhada e brilhante, medindo 9,0 x 7,0 x 7,0 cm, e comprimia o globo ocular. Microscopicamente foi observada uma proliferação neoplásica pobremente celular de células alongadas no meio de uma acentuada quantidade de matriz mixoide. Havia áreas intratumorias multifocais onde fascículos nervosos bem diferenciados e musculatura esquelética foram observados. As células neoplásicas foram positivas na imuno-histoquímica para GFAP, neurofilamento, S-100, Sox-10 e vimentina. Citoqueratina mostrou uma imunomarcação ao redor de feixes nervosos primitivos e desmina ao redor de vasos neoformados e feixes musculares dentro do tumor. O neurofibroma orbitofacial, apesar de comum em humanos, nunca foi descrito em suínos domésticos e deve ser considerado um diagnóstico diferencial para neoplasias palpebrais em suínos.
Asunto(s)
Animales , Enfermedades de los Porcinos , Ceguera/veterinaria , Neoplasias de los Párpados/veterinaria , Neurofibroma/veterinariaRESUMEN
We aimed to identify the reports of symptoms of depression, anxiety, and stress among caregivers of children without visual impairment, with low vision, and with blindness and their relationship with the degree of social, emotional, material, and affective support. This cross-sectional and multicenter study was conducted in the municipality of Rio de Janeiro, Brazil, from 2019 to 2020. A questionnaire was applied to obtain caregivers' sociodemographic and economic data. The Medical Outcomes Study Social Support Scale (MOS-SSS) and The Depression, Anxiety, and Stress Scale (DASS-21) were used. Tests were used for multiple comparisons of these scales. The prevalence ratio of symptoms of depression, anxiety, and stress was estimated. Of all caregivers (N = 355), more than 90% were women-mothers. Caregivers of children with visual impairment show the highest proportion of no schooling, incomplete elementary education, or lower average monthly income. Most caregivers of children with blindness reported symptoms of depression, anxiety, and stress (66.7%, 73.3%, and 80%, respectively) as did those of children with low vision. The evaluation of the relationship between MOS-SSS and DASS-21 results shows greater support and lower scores of reports of depression, anxiety, and stress for caregivers of children without disabilities or with less visual impairment. For caregivers of blind children, the highest prevalence of such reports was independent of the received support. Results indicate the need for a care policy with mechanisms to protect the mental health of caregivers of visually impaired children.
O objetivo foi identificar os relatos de sintomas de depressão, ansiedade e estresse entre cuidadores de crianças sem deficiência visual, com baixa visão e com cegueira e sua relação com o grau de apoio social, emocional, material e afetivo. Estudo transversal e multicêntrico, realizado no Município do Rio de Janeiro, Brasil, entre 2019 e 2020. Aplicou-se um questionário para obter dados sociodemográficos e econômicos do cuidador. Foram utilizadas a Escala de Apoio Social (The Medical Outcomes Study Social Support Scale - MOS-SSS) e a Escala de Depressão, Ansiedade e Estresse (The Depression, Anxiety, and Stress Scale - DASS-21). Na comparação entre as escalas, foram utilizados testes para comparações múltiplas. Estimou-se a razão de prevalência de sintomas de depressão, ansiedade e estresse. Do total de cuidadores (N = 355), mais de 90% eram mulheres-mães e a maior proporção de cuidadores sem instrução ou Ensino Fundamental incompleto e com menor renda média mensal foi daqueles de crianças com deficiência visual. A maioria dos cuidadores de crianças com cegueira relatou sintomas de depressão, ansiedade e estresse (respectivamente, 66,7%, 73,3% e 80%), mesmo comportamento observado no grupo de cuidadores de crianças com baixa visão. Na avaliação da relação entre os resultados das escalas MOS-SSS e DASS-21, entre os cuidadores de crianças sem deficiência ou com menor comprometimento visual, observou-se maiores apoios e menores escores de relatos de depressão, ansiedade e estresse. Entre os cuidadores de crianças cegas, as maiores prevalências não dependeram dos apoios recebidos. Os resultados indicam a necessidade de uma política de cuidado com mecanismos de proteção à saúde mental dos cuidadores de crianças com deficiência visual.
El objetivo fue identificar los relatos de síntomas de depresión, ansiedad y estrés entre cuidadores de niños sin discapacidad visual, con baja visión y con ceguera y su relación con el grado de apoyo social, emocional, material y afectivo. Estudio transversal y multicéntrico realizado en la ciudad de Río de Janeiro, Brasil, entre el 2019 y el 2020. Se aplicó un cuestionario para obtener datos sociodemográficos y económicos del cuidador. Se utilizaron la Escala de Apoyo Social (The Medical Outcomes Study Social Support Scale - MOS-SSS) y Escala de Depresión, Ansiedad y Estrés (The Depression, Anxiety, and Stress Scale - DASS-21). Al comparar las escalas, se utilizaron pruebas para comparaciones múltiples. Se estimó la razón de prevalencia de síntomas de depresión, ansiedad y estrés. Del total de cuidadores (N = 355), más del 90% eran mujeres madres y la mayor proporción de cuidadores sin escolaridad o con primaria incompleta y con menor ingreso mensual promedio fueron los de niños con discapacidad visual. La mayoría de los cuidadores de niños con ceguera reportó síntomas de depresión, ansiedad y estrés, respectivamente, 66,7%, 73,3% y 80%, mismo comportamiento observado en el grupo de cuidadores de niños con baja visión. Al evaluar la relación entre los resultados de las escalas MOS-SSS y DASS-21, entre los cuidadores de niños sin discapacidad o con menor compromiso visual, se observó mayor apoyo y menores puntajes de relatos de depresión, ansiedad y estrés. Entre los cuidadores de niños ciegos, la mayor prevalencia de tales relatos no dependió del apoyo recibido. Los resultados indican la necesidad de una Política de Cuidado con mecanismos para proteger la salud mental de los cuidadores de niños con discapacidad visual.