RESUMEN
RESUMEN Presentamos el caso de un paciente con foseta del disco óptico, quien presentó una disminución de la agudeza visual secundaria a desprendimiento seroso de retina. Se decidió realizar una inyección intravítrea de 0.3ml de gas C3F8 (100%), seguida de fotocoagulación con láser de argón en el borde temporal de la foseta, logrando reaplicación total de la retina, con reabsorción de todo el líquido subretiniano visible en la tomografía de coherencia optica (OCT) luego de 400 días. Además hubo una mejoría significativa en la agudeza visual.
ABSTRACT We present the case of a patient with an optic disk pit, presenting with great loss of visual acuity secondary to serous retinal detachment. The management chosen was an intravitreal injection of 0.3 mL of C3F8 (100%), followed by argon laser photocoagulation on the temporal edge of the pit, ), achieving total retinal reattachment , and reabsorption of all subretinal fluid visible at optical coherence tomography after 400 days, in addition to great improvement in visual acuity.
Asunto(s)
Humanos , Femenino , Anciano , Disco Óptico/anomalías , Enfermedades de la Retina/terapia , Desprendimiento de Retina , Anomalías del Ojo/terapia , Endotaponamiento/métodos , Fluorocarburos/administración & dosificación , Fotocoagulación , Degeneración Macular/terapia , Argón , Enfermedades de la Retina/diagnóstico , Anomalías del Ojo/diagnóstico , Tomografía de Coherencia Óptica , Inyecciones Intravítreas , Mácula Lútea , Degeneración Macular/diagnósticoRESUMEN
ABSTRACT Optic disc pit is a rare congenital anomaly that can cause serous macular detachment. It has no universally accepted single treatment. Recently, several investigators have performed new procedures to directly seal the pit. Herein, we report a case showing a promising method for optic pit maculopathy surgical treatment. We created an inverted internal limiting membrane flap and fold it over the pit to promote barrier in order to stop further fluid accumulation. Gradual absorption of subretinal fluid was observed over 12 months of follow-up. Optical coherence tomography can demonstrate internal limiting membrane folded over the pit and progressive subretinal fluid resolution. This technique resulted in a satisfactory anatomic outcome with good functional improvement in the best-corrected visual acuity.
RESUMO A fosseta do disco óptico é uma rara anomalia con gênita que pode causar descolamento de retina seroso na mácula. Não há um tratamento cirúrgico padrão universalmente aceito. Recentemente, cirurgiões têm realizado procedimentos novos que visam selar o buraco diretamente. Esse caso clínico mostra um método promissor para o tratamento cirúrgico da maculopatia causada pela fosseta do disco. Optamos por criar um flap invertido com a membrana limitante interna, dobrando-o sobre a fosseta para promover uma barreira, impedindo o acúmulo de fluido. A absorção gradual do líquido subretiniano foi observada ao longo de 12 meses de acompanhamento. Imagens de tomografia de coerência óptica podem demonstrar a membrana limitante interna dobrada sobre a fosseta e a resolução progressiva do fluido subretiniano. Esta técnica resultou em um resultado anatômico satisfatório com boa melhora funcional na acuidade visual.
Asunto(s)
Humanos , Femenino , Adulto , Vitrectomía/métodos , Desprendimiento de Retina/cirugía , Anomalías del Ojo/cirugía , Tomografía de Coherencia Óptica/métodos , Disco Óptico/anomalías , Enfermedades de la Retina , Desprendimiento de Retina/etiología , Agudeza Visual , Anomalías del Ojo/complicaciones , Líquido Subretiniano , Degeneración Macular/complicacionesRESUMEN
Optic disc pit is a rare congenital anomaly that can cause serous macular detachment. It has no universally accepted single treatment. Recently, several investigators have performed new procedures to directly seal the pit. Herein, we report a case showing a promising method for optic pit maculopathy surgical treatment. We created an inverted internal limiting membrane flap and fold it over the pit to promote barrier in order to stop further fluid accumulation. Gradual absorption of subretinal fluid was observed over 12 months of follow-up. Optical coherence tomography can demonstrate internal limiting membrane folded over the pit and progressive subretinal fluid resolution. This technique resulted in a satisfactory anatomic outcome with good functional improvement in the best-corrected visual acuity.
Asunto(s)
Anomalías del Ojo/cirugía , Desprendimiento de Retina/cirugía , Tomografía de Coherencia Óptica/métodos , Vitrectomía/métodos , Adulto , Anomalías del Ojo/complicaciones , Femenino , Humanos , Degeneración Macular/complicaciones , Disco Óptico/anomalías , Desprendimiento de Retina/etiología , Enfermedades de la Retina , Líquido Subretiniano , Agudeza VisualRESUMEN
PURPOSE: To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to describe structural features on spectral domain optical coherence tomography in misdiagnosed and all other consecutive cases of ODPM. METHODS: Multicenter international retrospective cohort study. PARTICIPANTS: 59 eyes from 59 patients with ODPM. MAIN OUTCOME MEASURES: 1) Proportion of patients with ODPM initially misdiagnosed, inaccurate diagnosis and treatment. 2) Morphologic features on spectral domain optical coherence tomography: other causes of subretinal and/or intraretinal fluid, inner/outer retinoschisis, communication with optic disk pit, and retinal pigment epithelium alterations. 3) Visual and anatomical outcomes 6 months after proper treatment. RESULTS: Fifteen patients (25.4%) with ODPM were correctly diagnosed initially and those were significantly younger than misdiagnosed cases (age 33.8 ± 15.2 vs. 58.7 ± 15.8 years, P < 0.0001). Forty of forty-four misdiagnosed eyes (90.9%) were treated for their presumed diagnosis before referral. Eyes with initial misdiagnosis had significantly more outer retinoschisis at baseline (88.4 vs. 40.0%, P = 0.0002) and more retinal pigment epithelium alterations (90.0 vs. 27.3%, P < 0.0001) 6 months after proper treatment. CONCLUSION: Optic disk pit maculopathy is an underdiagnosed entity and can mimic other causes for subretinal fluid. Awareness and identification of pertinent spectral domain optical coherence tomography features can help avoid inappropriate and delayed treatment.
Asunto(s)
Anomalías del Ojo/patología , Mácula Lútea/patología , Degeneración Macular/diagnóstico , Disco Óptico/anomalías , Tomografía de Coherencia Óptica/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anomalías del Ojo/complicaciones , Femenino , Humanos , Degeneración Macular/etiología , Masculino , Persona de Mediana Edad , Disco Óptico/patología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto JovenRESUMEN
Resumo Nós descrevemos uma rara associação entre estafiloma peripapilar congênito e drusa de disco óptico em uma mulher de 47 anos de idade e visão normal.
Abstract We described a rare association between peripapillary staphyloma and optic disk drusen in a woman with 47 years old and normal vision.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Disco Óptico/anomalías , Drusas del Disco Óptico/etiología , Anomalías del Ojo/complicaciones , Informes de Casos , Angiografía con Fluoresceína , Agudeza Visual , Drusas del Disco Óptico/diagnóstico por imagen , Enfermedades del Nervio Óptico/complicaciones , Enfermedades del Nervio Óptico/congénito , Ultrasonografía , Pruebas del Campo VisualRESUMEN
Las fosetas congénitas papilares son poco comunes. Se trata de una entidad caracterizada típicamente por depresiones papilares unilaterales, ovales, de color blanco grisáceo. Reportamos un caso con dicha entidad asociada al desprendimiento seroso tratado con fotocoagulación. Se realizó un estudio descriptivo a una paciente femenina de 14 años quien refirió pérdida de visión del ojo izquierdo de un mes de evolución. Se realizó fotocoagulación láser al borde yuxtapapilar temporal de la foseta, con evoluciones al mes y a los 3, 6, 9, 12 y 24 meses posteriores, mediante tomografía de coherencia óptica, mejor agudeza visual corregida y oftalmoscopia. Se logró progresiva disminución del desprendimiento macular y mejoría de la agudeza visual desde el primer mes de control. A los 9 meses se observó normal arquitectura macular en la tomografía de coherencia óptica y mejoría de la agudeza visual a 20/25 (95 VAR), con iguales resultados en los controles a los 12 y 24 meses. La terapéutica con fotocoagulación puede resultar eficiente, simple, mínimamente invasiva y económica para la maculopatía asociada a la foseta papilar(AU)
Congenital optic disc pits are an infrequent condition typically characterized by unilateral oval grayish-white papillary depressions. A case report is presented of this condition associated to serous detachment treated with photocoagulation. A descriptive study was conducted of a 14-year-old female patient who reported loss of vision in her left eye with a month of evolution. Laser photocoagulation was performed on the temporal juxtapapillary edge of the pit, with evolution checks at 3, 6, 9, 12 and 24 months by optical coherence tomography, best corrected visual acuity and ophthalmoscopy. Progressive macular detachment reduction and visual acuity improvement were observed since the first control. At 9 months optical coherence tomography showed a normal macular architecture and visual acuity improvement to 20/25 (95 VAR) with identical results at 12 and 24 months. Photocoagulation therapy may be efficient, simple, minimally invasive and economical for maculopathy associated to optic disc pits(AU)
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Oftalmoscopía/métodos , Disco Óptico/anomalías , Coagulación con Láser/efectos adversos , Tomografía de Coherencia Óptica/métodosRESUMEN
Las fosetas congénitas papilares son poco comunes. Se trata de una entidad caracterizada típicamente por depresiones papilares unilaterales, ovales, de color blanco grisáceo. Reportamos un caso con dicha entidad asociada al desprendimiento seroso tratado con fotocoagulación. Se realizó un estudio descriptivo a una paciente femenina de 14 años quien refirió pérdida de visión del ojo izquierdo de un mes de evolución. Se realizó fotocoagulación láser al borde yuxtapapilar temporal de la foseta, con evoluciones al mes y a los 3, 6, 9, 12 y 24 meses posteriores, mediante tomografía de coherencia óptica, mejor agudeza visual corregida y oftalmoscopia. Se logró progresiva disminución del desprendimiento macular y mejoría de la agudeza visual desde el primer mes de control. A los 9 meses se observó normal arquitectura macular en la tomografía de coherencia óptica y mejoría de la agudeza visual a 20/25 (95 VAR), con iguales resultados en los controles a los 12 y 24 meses. La terapéutica con fotocoagulación puede resultar eficiente, simple, mínimamente invasiva y económica para la maculopatía asociada a la foseta papilar(AU)
Congenital optic disc pits are an infrequent condition typically characterized by unilateral oval grayish-white papillary depressions. A case report is presented of this condition associated to serous detachment treated with photocoagulation. A descriptive study was conducted of a 14-year-old female patient who reported loss of vision in her left eye with a month of evolution. Laser photocoagulation was performed on the temporal juxtapapillary edge of the pit, with evolution checks at 3, 6, 9, 12 and 24 months by optical coherence tomography, best corrected visual acuity and ophthalmoscopy. Progressive macular detachment reduction and visual acuity improvement were observed since the first control. At 9 months optical coherence tomography showed a normal macular architecture and visual acuity improvement to 20/25 (95 VAR) with identical results at 12 and 24 months. Photocoagulation therapy may be efficient, simple, minimally invasive and economical for maculopathy associated to optic disc pits(AU)
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Oftalmoscopía/métodos , Disco Óptico/anomalías , Coagulación con Láser/efectos adversos , Tomografía de Coherencia Óptica/métodosRESUMEN
La foseta papilar es una rara anomalía congénita que forma parte del espectro de las anormalidades congénitas del disco óptico. Se trata de invaginaciones intrapapilares que suelen localizarse en el margen del disco óptico. La mayoría se localiza a nivel temporal; en torno al 20 por ciento son de localización central seguidas por las fosetas superiores, inferiores o nasales. La bilateralidad se estima en un 10-15 por ciento y su incidencia se ha establecido en torno al 0,19 por ciento. Suelen ser asintomáticas, aunque en aproximadamente el 50 por ciento de los casos se produce afectación macular por el paso de fluido procedente desde la foseta papilar hacia las diferentes capas retinianas, lo que afecta secundariamente la agudeza visual y es, por tanto, el motivo de consulta. Hasta el momento se han descrito múltiples alternativas terapéuticas para el tratamiento de los desprendimientos de retina serosos asociados a foseta de papila, pero ninguna de estas alternativas se ha impuesto sobre el resto. El tratamiento de esta enfermedad consiste en cerrar la comunicación entre la foseta y el espacio subretiniano con diversas opciones terapéuticas como: la fotocoagulación láser, la neumoretinopexia, la indentación escleral posterior, la fenestración del nervio óptico, la vitrectomía o alguna combinación de las anteriores. La actual revisión bibliográfica se propone profundizar en el tema, sobre la base de pacientes en consulta con dicha afección retiniana(AU)
Papillary pit is a rare congenital anomaly that is part of the congenital optic disc anomaly spectrum. It deals with intrapapillary invaginations that may be located at the border of the optic disc. Most of them is located at temporal level, around 20 percent are located centrally followed by upper, lower and nasal pits. Bilateral pits are estimated to be 10-15 percent and their incidence has been set at 0.19 percent. They are asymptomatic although 50 percent of cases suffer macular damage due to the passing of fluid from the papillary pit to the different retinal layers, which affecgs in a secondary way the visual acuity and thus it is the reason to go to the ophthalmologist. Multiple therapeutic alternatives for the treatment of papillary pit-associated serous retinal detachments have been described but none of them has predominated over the others. The treatment of this disease consists of closing the communication between the pit and the subretinal space with several therapeutic options such as laser photocoagulation, pneumoretinopexia, posterior scleral indentation, optic nerve fenestration, vitrectomy or any combination of the above-mentioned methods(AU)
Asunto(s)
Humanos , Coloboma/fisiopatología , Bases de Datos Bibliográficas , Disco Óptico/anomalías , Desprendimiento de Retina/terapia , Literatura de Revisión como Asunto , Coagulación con Láser/efectos adversos , Vitrectomía/efectos adversosRESUMEN
La foseta papilar es una rara anomalía congénita que forma parte del espectro de las anormalidades congénitas del disco óptico. Se trata de invaginaciones intrapapilares que suelen localizarse en el margen del disco óptico. La mayoría se localiza a nivel temporal; en torno al 20 por ciento son de localización central seguidas por las fosetas superiores, inferiores o nasales. La bilateralidad se estima en un 10-15 por ciento y su incidencia se ha establecido en torno al 0,19 por ciento. Suelen ser asintomáticas, aunque en aproximadamente el 50 por ciento de los casos se produce afectación macular por el paso de fluido procedente desde la foseta papilar hacia las diferentes capas retinianas, lo que afecta secundariamente la agudeza visual y es, por tanto, el motivo de consulta. Hasta el momento se han descrito múltiples alternativas terapéuticas para el tratamiento de los desprendimientos de retina serosos asociados a foseta de papila, pero ninguna de estas alternativas se ha impuesto sobre el resto. El tratamiento de esta enfermedad consiste en cerrar la comunicación entre la foseta y el espacio subretiniano con diversas opciones terapéuticas como: la fotocoagulación láser, la neumoretinopexia, la indentación escleral posterior, la fenestración del nervio óptico, la vitrectomía o alguna combinación de las anteriores. La actual revisión bibliográfica se propone profundizar en el tema, sobre la base de pacientes en consulta con dicha afección retiniana(AU)
Papillary pit is a rare congenital anomaly that is part of the congenital optic disc anomaly spectrum. It deals with intrapapillary invaginations that may be located at the border of the optic disc. Most of them is located at temporal level, around 20 percent are located centrally followed by upper, lower and nasal pits. Bilateral pits are estimated to be 10-15 percent and their incidence has been set at 0.19 percent. They are asymptomatic although 50 percent of cases suffer macular damage due to the passing of fluid from the papillary pit to the different retinal layers, which affecgs in a secondary way the visual acuity and thus it is the reason to go to the ophthalmologist. Multiple therapeutic alternatives for the treatment of papillary pit-associated serous retinal detachments have been described but none of them has predominated over the others. The treatment of this disease consists of closing the communication between the pit and the subretinal space with several therapeutic options such as laser photocoagulation, pneumoretinopexia, posterior scleral indentation, optic nerve fenestration, vitrectomy or any combination of the above-mentioned methods(AU)
Asunto(s)
Humanos , Coloboma/fisiopatología , Bases de Datos Bibliográficas , Disco Óptico/anomalías , Desprendimiento de Retina/terapia , Literatura de Revisión como Asunto , Coagulación con Láser/efectos adversos , Vitrectomía/efectos adversosRESUMEN
PURPOSE:: To evaluate the central corneal thickness (CCT), corneal volume (CV), and anterior and posterior corneal surfaces using the Scheimpflug imaging system in patients diagnosed with tilted disc syndrome (TDS). METHODS:: The study group (Group 1) and the control group (Group 2) comprised 35 eyes of 35 age-, sex-, and refraction-matched cases. All cases underwent a full ophthalmic examination that included cycloplegic refraction, axial ocular length measurement, and Scheimpflug imaging. RESULTS:: The mean age was 34.68 ± 15.48 years in Group 1 and 34.11 ± 12.01 years in Group 2 (p=0.864). The gender distribution was 18 males and 17 females in Group 1 and 16 males and 19 females in Group 2 (p=0.618). All subjects were Caucasian. The spherical equivalent was 3.62 ± 1.75 D in Group 1 and 3.69 ± 1.51 D in Group 2 (p=0.850). There was no significant difference in age, sex, race, or spherical equivalent between groups. There was no significant difference in mean keratometric value and CV3 (the CV in the central 3 mm) between groups (p=0.232 and 0.172, respectively). There were statistically significant differences in CCT, CV5, and CV7 (CV in the central 5 and 7 mm3, respectively) and total CV between groups (p=0.008, 0.003, 0.023, and 0.019, respectively). The values of all parameters were lower in the study group than in the control group. There was also a statistically significant difference in the anterior elevation parameters of the cornea between groups (p<0.05). The mean values of Group 1 were higher than those of Group 2. There were statistically significant differences in the two parameters referring to the posterior elevation of the cornea between the two groups (p<0.05). CONCLUSION:: The results of this study showed that eyes with TDS have thinner CCT, lower CV, and different anterior corneal curvature than normal eyes.
Asunto(s)
Córnea/patología , Disco Óptico/anomalías , Disco Óptico/patología , Enfermedades del Nervio Óptico/patología , Adolescente , Adulto , Estudios de Casos y Controles , Córnea/diagnóstico por imagen , Córnea/fisiopatología , Paquimetría Corneal/métodos , Topografía de la Córnea/métodos , Estudios Transversales , Femenino , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Disco Óptico/fisiopatología , Enfermedades del Nervio Óptico/fisiopatología , Tamaño de los Órganos , Valores de Referencia , Estadísticas no Paramétricas , Síndrome , Agudeza Visual , Adulto JovenRESUMEN
A 42-year-old woman was admitted to our clinic with a complaint of glare in both eyes. Biomicroscopic examination of both the eyes revealed iris and lens colobomas in the inferior quadrant. Fundus examination of the right eye revealed an oval and gray inferotemporal optic pit and two choroid colobomas in the inferior quadrant. In the left eye, two choroid colobomas were detected that were inferior to the optic nerve head. Furthermore, a 21-year-old man presented to our clinic for a routine ophthalmologic examination. Bilateral biomicroscopic examination was normal. Fundus examination of the left eye revealed an oval and gray inferotemporal optic pit and a choroid coloboma that was inferior to the optic nerve head. Here we describe optic pits co-occurring with iris, lens, and choroidal colobomas. On the basis of these cases, a defect in the closure of the embryonic fissure is the most plausible etiology of the optic pit.
Asunto(s)
Coroides/anomalías , Coloboma/patología , Iris/anomalías , Cristalino/anomalías , Disco Óptico/anomalías , Adulto , Coroides/diagnóstico por imagen , Coroides/patología , Coloboma/diagnóstico por imagen , Femenino , Angiografía con Fluoresceína/métodos , Fondo de Ojo , Humanos , Iris/diagnóstico por imagen , Iris/patología , Cristalino/diagnóstico por imagen , Cristalino/patología , Masculino , Disco Óptico/diagnóstico por imagen , Disco Óptico/patología , Tomografía de Coherencia Óptica/métodos , Agudeza Visual , Adulto JovenRESUMEN
ABSTRACT A 42-year-old woman was admitted to our clinic with a complaint of glare in both eyes. Biomicroscopic examination of both the eyes revealed iris and lens colobomas in the inferior quadrant. Fundus examination of the right eye revealed an oval and gray inferotemporal optic pit and two choroid colobomas in the inferior quadrant. In the left eye, two choroid colobomas were detected that were inferior to the optic nerve head. Furthermore, a 21-year-old man presented to our clinic for a routine ophthalmologic examination. Bilateral biomicroscopic examination was normal. Fundus examination of the left eye revealed an oval and gray inferotemporal optic pit and a choroid coloboma that was inferior to the optic nerve head. Here we describe optic pits co-occurring with iris, lens, and choroidal colobomas. On the basis of these cases, a defect in the closure of the embryonic fissure is the most plausible etiology of the optic pit.
RESUMO Uma mulher de 42 anos de idade foi internada em nossa clínica com queixa de ofuscamento em ambos os olhos. O exame biomicroscópico revelou coloboma de íris e cristalino no quadrante inferior em ambos os olhos. O exame de fundo do olho direito revelou um fosseta óptica oval e acinzentada na região inferotemporal e dois colobomas coroide no quadrante inferior. No olho esquerdo, dois colobomas de coroide foram detectados inferiormente à da cabeça do nervo óptico. Outro homem de 21 anos apresentou-se em nossa clínica para um exame oftalmológico de rotina. O exame biomicroscópico foi normal, bilateralmente. O exame de fundo do olho esquerdo revelou uma fosseta oval e acinzentada de nervo óptico óptico inferotemporal e um coloboma coroide inferior à cabeça do nervo óptico. Nestes relatos nós descrevemos fossetas ópticas ocorrendo simultaneamente com colobomas de íris, cristalino, e coroide. Com base nestes casos, o defeito no fechamento da fissura embrionária é uma provável etiologia da fosseta óptica.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Disco Óptico/anomalías , Coloboma/patología , Iris/anomalías , Coroides/anomalías , Cristalino/anomalías , Disco Óptico/patología , Disco Óptico/diagnóstico por imagen , Angiografía con Fluoresceína/métodos , Agudeza Visual , Coloboma/diagnóstico por imagen , Iris/patología , Iris/diagnóstico por imagen , Coroides/patología , Coroides/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Fondo de Ojo , Cristalino/patología , Cristalino/diagnóstico por imagenRESUMEN
ABSTRACT Purpose: To evaluate the central corneal thickness (CCT), corneal volume (CV), and anterior and posterior corneal surfaces using the Scheimpflug imaging system in patients diagnosed with tilted disc syndrome (TDS). Methods: The study group (Group 1) and the control group (Group 2) comprised 35 eyes of 35 age-, sex-, and refraction-matched cases. All cases underwent a full ophthalmic examination that included cycloplegic refraction, axial ocular length measurement, and Scheimpflug imaging. Results: The mean age was 34.68 ± 15.48 years in Group 1 and 34.11 ± 12.01 years in Group 2 (p=0.864). The gender distribution was 18 males and 17 females in Group 1 and 16 males and 19 females in Group 2 (p=0.618). All subjects were Caucasian. The spherical equivalent was 3.62 ± 1.75 D in Group 1 and 3.69 ± 1.51 D in Group 2 (p=0.850). There was no significant difference in age, sex, race, or spherical equivalent between groups. There was no significant difference in mean keratometric value and CV3 (the CV in the central 3 mm) between groups (p=0.232 and 0.172, respectively). There were statistically significant differences in CCT, CV5, and CV7 (CV in the central 5 and 7 mm3, respectively) and total CV between groups (p=0.008, 0.003, 0.023, and 0.019, respectively). The values of all parameters were lower in the study group than in the control group. There was also a statistically significant difference in the anterior elevation parameters of the cornea between groups (p<0.05). The mean values of Group 1 were higher than those of Group 2. There were statistically significant differences in the two parameters referring to the posterior elevation of the cornea between the two groups (p<0.05). Conclusion: The results of this study showed that eyes with TDS have thinner CCT, lower CV, and different anterior corneal curvature than normal eyes.
RESUMO Objetivo: Avaliar a espessura central da córnea (CCT), o volume de córnea (CV), e a superfície corneana anterior e posterior utilizando sistema de imagem Scheimpflug em pacientes com diagnóstico de síndrome do disco inclinado (TDS). Métodos: O grupo de estudo (grupo 1) e o grupo controle (grupo 2) consistiu de 35 olhos de 35 pacientes pareados por idade, sexo e refração em cada grupo. Todos os casos foram submetidos a um exame oftalmológico completo incluindo refração sob cicloplegia, medida do comprimento axial ocular e avaliação por Scheimpflug. Resultados: A idade média foi de 34,68 ± 15,48 anos no grupo 1 e 34.11 ± 12,01 anos no grupo 2 (p=0,864). A distribuição por sexo foi de 18 homens e 17 mulheres do grupo 1 e 16 homens e 19 mulheres no grupo 2 (p=0,618). Todos os indivíduos eram caucasianos. O equivalente esférico foi 3,62 ± 1,75 D no Grupo 1 e 3,69 ± 1,51 D no Grupo 2 (p=0,850). Não houve diferença significativa entre os dois grupos para idade, sexo, raça e equivalente esférico. Não houve diferença significativa entre os dois grupos para o valor médio ceratométrico e CV3 (o volume da córnea na central 3 mm) (p=0,232, p=0,172, respectivamente). Houve diferença estatisticamente significativa entre os dois grupos para CCT, CV5, CV7 (volume de córnea na região central 5 e 7 mm, respectivamente) e CV total (p=0,008, p=0,003, p=0,023 e p=0,019, respectivamente). Os valores do grupo de estudo foram menores do que o grupo controle para todos os parâmetros. Houve também diferença estatisticamente significativa entre os dois grupos nos parâmetros elevação anterior da córnea (p<0,05). Os valores médios do grupo 1 foram maiores do que o grupo 2. Não houve diferença entre os dois grupos para os dois parâmetros referentes à elevação posterior da córnea (p<0,05). Conclusões: Nosso estudo mostrou que os olhos com TDS apresentam CCT mais fina, menor volume da córnea e alterações na curvatura corneana anterior quando comparados aos olhos normais.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Disco Óptico/anomalías , Disco Óptico/patología , Enfermedades del Nervio Óptico/fisiopatología , Córnea/patología , Disco Óptico/fisiopatología , Tamaño de los Órganos , Valores de Referencia , Síndrome , Agudeza Visual , Estudios de Casos y Controles , Estudios Transversales , Estadísticas no Paramétricas , Córnea/fisiopatología , Córnea/diagnóstico por imagen , Topografía de la Córnea/métodos , Paquimetría Corneal/métodos , Presión IntraocularRESUMEN
Purpose: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). Methods: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. Results: SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). Conclusion: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups. .
Objetivo: Avaliar camada de fibras nervosas da retina (RNFL) e a espessura da coroide peripapilar em olhos com disco óptico inclinado a fim de identificar as características da RNFL e os padrões de coroide peripapilar verificados pela tomografia de coerência óptica (OCT). Métodos: Vinte e nove olhos de 29 pacientes com discos ópticos inclinadas foram estudados prospectivamente com OCT de domínio espectral (SD) e comparados com controles pareados por sexo e idade. As imagens da RNFL foi obtidas por meio de varreduras circulares com um diâmetro de 3,4 mm em torno do disco óptico usando OCT. Para as medições de espessura da coroide peripapilar, o protocolo padrão para avaliação da RNFL foi realizado. Resultados: O OCT SD indicou diminuição das espessuras significativas da RNFL superotemporal (p<0,001), superonasal (p=0,001), e global (p=0,005) no grupo disco inclinado em relação aos do grupo controle. A coroide peripapilar foi significativamente mais espessa no local da borda elevada dos olhos com disco inclinado (p<0,001). Conclusões: Este estudo demonstrou que a caracterização clínica das principais morfologias disco inclinado pode ser útil na diferenciação entre um disco inclinado de outras alterações morfológicas de disco. Seria importante a comparação entre grupos com glaucoma e com discos inclinados, estudos futuros. .
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Coroides/patología , Fibras Nerviosas/patología , Disco Óptico/anomalías , Disco Óptico/patología , Retina/patología , Estudios de Casos y Controles , Estudios Prospectivos , Valores de Referencia , Tomografía de Coherencia Óptica , Agudeza Visual , Pruebas del Campo VisualRESUMEN
PURPOSE: To evaluate the optic disc and retinal nerve fiber layer (RNFL) thickness in megalopapilla cases by confocal scanning laser ophthalmoscopy and Stratus optical coherence tomography (OCT). To assess the importance of these measurements in diagnosing megalopapilla. METHODS: This study included 59 eyes (30 patients) diagnosed as megalopapilla. All subjects underwent a complete ophthalmic examination that included intraocular pressure and central corneal thickness measurements and standard automated perimetry using the Swedish Interactive Threshold Algorithm and the 24-2 program (Humphrey Field Analyzer; Carl Zeiss Meditec Inc., Dublin, CA). Confocal scanning laser ophthalmoscopy examinations were performed with the Heidelberg retina tomograph (HRTII; Heidelberg Engineering, Germany). Thickness of the RNFL around the optic disc was measured with Stratus OCT, version 4.0.1 (Stratus OCT; Carl Zeiss Meditec). A descriptive analysis was made using SPSS (version 12.0; SPSS Inc., Chicago, IL) statistical software. RESULTS: The mean global optic disc area for all eyes with megalopapilla was 3.28±0.53 mm and was not statistically different among races (P≥0.159) or sex (P≥0.108). The average RNFL thickness was 102.5±12.68 µm. Pattern standard deviation was 3.8±2.4 and mean deviation was -1.22±2.65. Central corneal thickness mean value was 543±35.9 µm. Intraocular pressure (average from 3 measurements) ranged from 10.0 to 20.6 mm Hg (14.4±2.7). CONCLUSIONS: In megalopapilla, the optic disc is abnormally large. The RNFL thickness is normal. These findings are essential for distinguishing megalopapilla from the optic glaucomatous neuropathy.
Asunto(s)
Anomalías del Ojo/diagnóstico , Fibras Nerviosas/patología , Disco Óptico/anomalías , Células Ganglionares de la Retina/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Oftalmoscopía/métodos , Tomografía de Coherencia Óptica/métodos , Tonometría Ocular , Pruebas del Campo Visual , Campos VisualesRESUMEN
PURPOSE: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). METHODS: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standard protocol for RNFL assessment was performed. RESULTS: SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). CONCLUSION: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups.
Asunto(s)
Coroides/patología , Fibras Nerviosas/patología , Disco Óptico/anomalías , Disco Óptico/patología , Retina/patología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Valores de Referencia , Tomografía de Coherencia Óptica , Agudeza Visual , Pruebas del Campo Visual , Adulto JovenRESUMEN
PURPOSE: To evaluate 5 patients with serous macular detachment due to optic disc pit that were submitted to pars plana vitrectomy and were followed for at least 7 years. METHODS: Patients were submitted to pars plana vitrectomy, posterior hyaloid removal, autologous serum injection and gas-fluid exchange, without laser photocoagulation, and were evaluated pre and post-operatively with visual acuity and Amsler grid testing, retinography, and recently, with autofluorescence imaging and high resolution OCT. RESULTS: All 5 eyes improved visual acuity significantly following the surgical procedure maintaining good vision throughout the follow-up period. Mean pre-operative visual acuity was 20/400 and final visual acuity was 20/27 with a mean follow-up time of 13.6 years. No recurrences of serous detachments were observed. OCT examinations demonstrated an attached retina up to the margin of the pit. CONCLUSION: Serous macular detachments due to optic disc pits were adequately treated with pars plana vitrectomy and gas fluid exchange, without the need for laser photocoagulation, maintaining excellent visual results for a long period of time.
Asunto(s)
Mácula Lútea/cirugía , Disco Óptico/anomalías , Enfermedades del Nervio Óptico/complicaciones , Desprendimiento de Retina/cirugía , Vitrectomía/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Desprendimiento de Retina/etiología , Factores de Tiempo , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Agudeza Visual , Adulto JovenRESUMEN
OBJETIVO: Avaliar 5 olhos com descolamento seroso da mácula devido à fosseta de disco óptico que foram submetidos à vitrectomia via pars plana e seguidos por pelo menos 7 anos. MÉTODOS: Os pacientes foram submetidos à vitrectomia via pars plana, remoção da membrana hialoide posterior, injeção de soro autólogo e troca fluido-gasosa, sem aplicação de fotocoagulação a laser, e foram testados quanto à acuidade visual, tela de Amsler, retinografia e, recentemente, retinografia com autofluorescência e OCT de alta resolução. RESULTADOS: Todos os 5 olhos operados tiveram significativa melhora da visão após o procedimento cirúrgico, mantendo boa visão durante todo período de acompanhamento. A acuidade visual pré-operatoria média foi de 20/400 enquanto a acuidade visual final foi de 20/27 com um tempo médio de seguimento de 13,6 anos. Não foram observadas recorrências do descolamento seroso da mácula e os exames de OCT mostraram a retina perfeitamente aplicada até a margem da fosseta de disco óptico. CONCLUSÃO: Descolamentos serosos da mácula causados por fosseta de disco óptico são adequadamente tratados com vitrectomia via pars plana e troca fluido-gasosa, sem a necessidade de fotocoagulação da retina, mantendo excelente acuidade visual por vários anos após o procedimento, sem o aparecimento de recorrências.
PURPOSE: To evaluate 5 patients with serous macular detachment due to optic disc pit that were submitted to pars plana vitrectomy and were followed for at least 7 years. METHODS: Patients were submitted to pars plana vitrectomy, posterior hyaloid removal, autologous serum injection and gas-fluid exchange, without laser photocoagulation, and were evaluated pre and post-operatively with visual acuity and Amsler grid testing, retinography, and recently, with autofluorescence imaging and high resolution OCT. RESULTS: All 5 eyes improved visual acuity significantly following the surgical procedure maintaining good vision throughout the follow-up period. Mean pre-operative visual acuity was 20/400 and final visual acuity was 20/27 with a mean follow-up time of 13.6 years. No recurrences of serous detachments were observed. OCT examinations demonstrated an attached retina up to the margin of the pit. CONCLUSION: Serous macular detachments due to optic disc pits were adequately treated with pars plana vitrectomy and gas fluid exchange, without the need for laser photocoagulation, maintaining excellent visual results for a long period of time.