RESUMEN
PURPOSE: To determine the clinical outcomes in patients after type 1 Boston keratoprosthesis surgery and the significance of ultrasound biomicroscopy imaging for postoperative follow-up. METHODS: This retrospective analysis included 20 eyes of 19 patients who underwent corneal transplantation with type 1 Boston keratoprosthesis between April 2014 and December 2021. Data on patient demographics, preoperative diagnosis, visual acuity, and postoperative clinical findings were analyzed. RESULTS: Type 1 Boston keratoprosthesis implantation resulted in intermediate- and long-term positive outcomes. However, blindness and other serious complications such as glaucoma, retroprosthetic membrane formation, endophthalmitis, or retinal detachment also occurred. The use of ultrasound biomicroscopy imaging allowed for better evaluation of the back of the titanium plate, anterior segment structures, and the relationship of the prosthesis with surrounding tissues, which provided valuable postoperative information. CONCLUSION: Regular lifetime monitoring and treatment are necessary in patients who undergo Boston type 1 keratoprosthesis implantation for high-risk corneal transplantation. ultrasound biomicroscopy imaging can be a valuable imaging technique for the evaluation of patients with Boston type 1 keratoprosthesis, providing important information on anterior segment anatomy and potential complications. Further studies and consensus on postoperative follow-up protocols are required to optimize the management of patients with Boston type 1 keratoprosthesis.
Asunto(s)
Enfermedades de la Córnea , Microscopía Acústica , Prótesis e Implantes , Agudeza Visual , Humanos , Microscopía Acústica/métodos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Enfermedades de la Córnea/cirugía , Enfermedades de la Córnea/diagnóstico por imagen , Resultado del Tratamiento , Anciano , Complicaciones Posoperatorias/diagnóstico por imagen , Trasplante de Córnea/métodos , Periodo Posoperatorio , Implantación de Prótesis/métodos , Córnea/diagnóstico por imagen , Córnea/cirugía , Adulto Joven , Órganos Artificiales , AdolescenteRESUMEN
PURPOSE: Peters-plus syndrome is a rare, autosomal recessive congenital disorder of glycosylation caused by mutations in the gene B3GLCT. A detailed description of the ocular findings is currently lacking in the scientific literature. We report a case series of Peters-plus syndrome with deep ocular phenotyping using anterior segment optical coherence tomography and ultrasound biomicroscopy. Where available, we describe the histology of host corneal buttons. METHODS: A retrospective chart review of patients with Peters-plus syndrome was conducted under the care of the senior author between January 2000 and June 2019. Demographic and clinical data including ocular and systemic features, ophthalmic imaging, and molecular diagnostic reports were collected. RESULTS: Four cases of Peters-plus syndrome were identified. Three patients were male and 1 was female. Five of the 8 eyes had an avascular paracentral ring opacity with relative central clearing. The paracentral opacity is due to iridocorneal adhesion and the relative central clearing associated with posterior stromal thinning. One eye had persistent fetal vasculature and microphthalmia, which has not previously been reported. One eye from each of 2 patients had a significantly different phenotype with a large vascularized central corneal opacity. CONCLUSIONS: The most common ocular phenotype seen in Peters-plus syndrome is an avascular paracentral ring opacity with relative central clearing. A different phenotype with a large vascularized corneal opacity may also be observed.
Asunto(s)
Segmento Anterior del Ojo/anomalías , Labio Leporino/genética , Córnea/anomalías , ADN/genética , Galactosiltransferasas/genética , Glucosiltransferasas/genética , Trastornos del Crecimiento/genética , Deformidades Congénitas de las Extremidades/genética , Microscopía Acústica/métodos , Tomografía de Coherencia Óptica/métodos , Segmento Anterior del Ojo/diagnóstico por imagen , Labio Leporino/diagnóstico , Análisis Mutacional de ADN , Femenino , Galactosiltransferasas/metabolismo , Glucosiltransferasas/metabolismo , Trastornos del Crecimiento/diagnóstico , Humanos , Lactante , Recién Nacido , Deformidades Congénitas de las Extremidades/diagnóstico , Masculino , Fenotipo , Estudios RetrospectivosRESUMEN
We report a case of a 49-year-old female who presented to the emergency department with blurred vision and vomiting, hours after taking two tablets of 250 mg of acetazolamide. The anterior chamber was bilaterally flat, with normal intraocular pressure in both eyes. An ultrasound biomicroscopic (UBM) examination showed bilateral ciliary effusion and complete appositional angle closure in all quadrants. Acetazolamide-induced bilateral angle closure was diagnosed. Steroid and cycloplegic therapy were initiated, and acetazolamide was discontinued. The following day, the anterior chamber had regained its volume without substantial change in the effusion size. Three weeks later, complete resolution of the ciliary effusion was verified by means of a third UBM scan.
Asunto(s)
Acetazolamida/efectos adversos , Cámara Anterior/efectos de los fármacos , Cámara Anterior/diagnóstico por imagen , Inhibidores de Anhidrasa Carbónica/efectos adversos , Microscopía Acústica/métodos , Miopía/inducido químicamente , Miopía/diagnóstico por imagen , Femenino , Humanos , Presión Intraocular , Persona de Mediana Edad , Midriáticos/uso terapéutico , Miopía/tratamiento farmacológico , Esteroides/uso terapéutico , Resultado del TratamientoRESUMEN
ABSTRACT We report a case of a 49-year-old female who presented to the emergency department with blurred vision and vomiting, hours after taking two tablets of 250 mg of acetazolamide. The anterior chamber was bilaterally flat, with normal intraocular pressure in both eyes. An ultrasound biomicroscopic (UBM) examination showed bilateral ciliary effusion and complete appositional angle closure in all quadrants. Acetazolamide-induced bilateral angle closure was diagnosed. Steroid and cycloplegic therapy were initiated, and acetazolamide was discontinued. The following day, the anterior chamber had regained its volume without substantial change in the effusion size. Three weeks later, complete resolution of the ciliary effusion was verified by means of a third UBM scan.
RESUMO Relatamos um caso de uma mulher de 49 anos que se apresentou ao departamento de emergência informando visão borrada e vômitos, horas após ter tomado dois comprimidos de 250 mg de acetazolamida. A câmara anterior era bilateralmente plana com pressão intraocular normal em ambos os olhos. Um exame de biomicroscopia ultrassônica (UBM) mostrou efusão ciliar bilateral e fechamento completo do ângulo aposicional em todos os quadrantes. O bloqueio angular bilateral induzido por acetazolamida foi diagnosticado. O tratamento com esteróides e cicloplégicos foi iniciado e a acetazolamida foi descontinuada. No dia seguinte, a câmara anterior recuperou seu volume sem alterações substanciais no tamanho da efusão. Três semanas depois, a resolução completa da efusão ciliar foi verificada por meio de uma terceira biomicroscopia ultrassônica.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Inhibidores de Anhidrasa Carbónica/efectos adversos , Microscopía Acústica/métodos , Cámara Anterior/efectos de los fármacos , Cámara Anterior/diagnóstico por imagen , Acetazolamida/efectos adversos , Miopía/inducido químicamente , Esteroides/uso terapéutico , Resultado del Tratamiento , Presión Intraocular , Midriáticos/uso terapéutico , Miopía/tratamiento farmacológico , Miopía/diagnóstico por imagenRESUMEN
RATIONALE: Conjunctival lymphoproliferative lesions constitute a significant diagnostic challenge and it is essential to exclude neoplastic lesions. Histopathological and immunohistochemical tests are very useful in establishing the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate treatment of conjunctival RLH. We report a case treated with topical corticosteroid. PATIENT CONCERNS: A 40 year-old female presented with a 7-month history of a slow growth tumor in the superior conjunctiva of the right eye. Slit-lamp examination demonstrated salmon colored lesion in the upper conjunctiva, with little conjunctival injection, but no significant neovascularization. There was no eyelid involvement. DIAGNOSES: Ultrasound biomicroscopy showed lesion depth (1.53âmm) and larger diameter (10.73âmm). Pathological examination revealed a chronic inflammatory process with conjunctival folicular hyperplasia. The immunohistochemistry examination showed predominance of CD20, CD23, and CD 3 e CD 5. INTERVENTION: We started topic prednisolone 1% 6 times daily. OUTCOMES: Six months after starting treatment, the lesion completely resolved, without any side-effects or recurrence during three-year follow-up period. LESSONS: Conjunctival RLH can be managed in various ways, depending on patient symptonm, comorbities, and disease distribution. Surgical resection with cryotherapy, radiotherapy, systemic corticosteroids, subconjunctival triamcinolone, and rituximab are some options. There is no strong evidence in the literature of conjunctival RLH successfully treated with topical eye drops corticosteroid. In this report, we obtained completely resolution of conjunctival RLH with topical corticosteroid. CONCLUSION: Topical eye drops corticosteroids are an alternative treatment for selected cases of conjuncitval RLH with no orbital or eyelid involvement.
Asunto(s)
Conjuntiva/patología , Neoplasias de la Conjuntiva/diagnóstico , Prednisolona/administración & dosificación , Seudolinfoma , Administración Tópica , Adulto , Diagnóstico Diferencial , Femenino , Glucocorticoides/administración & dosificación , Humanos , Inmunohistoquímica , Microscopía Acústica/métodos , Soluciones Oftálmicas , Seudolinfoma/diagnóstico , Seudolinfoma/tratamiento farmacológico , Seudolinfoma/fisiopatología , Resultado del TratamientoRESUMEN
The development of high-frequency endoscopic ultrasound for the investigation of models of esophageal disease may offer insights for future translation to human imaging. With respect to small animal models of esophageal diseases, ultrasound imaging instrumentation must employ frequencies scaled up to maintain the compromise between image resolution and inspected region. In this sense, a 40-MHz endoluminal ultrasound biomicroscopy (eUBM) system and an endoscope were tested as diagnostic methods of imaging rat esophageal lesions in the acute and chronic phases caused by sodium hydroxide. Although endoscopy allowed grading of the esophagus in accordance with a classification specific to the epithelial alterations and including hyperemia, edema, exudates, fibrin and superficial and deep ulcerations, the eUBM images yielded the detection of superficial and deep ulcerations, as well as wall alterations caused by edema and inflammatory infiltrate in the submucosa. Additionally, eUBM enabled wall thickness measurements, which were statistically significantly increased (p < 0.05) in the acute phase.
Asunto(s)
Endoscopía/métodos , Esofagitis/diagnóstico , Esófago/diagnóstico por imagen , Microscopía Acústica/métodos , Animales , Modelos Animales de Enfermedad , Esofagitis/diagnóstico por imagen , Esofagitis/patología , Masculino , Ratas , Ratas WistarRESUMEN
PURPOSE: To track the regeneration process of lateral gastrocnemius due to a muscle laceration in rats, and to treatment with plateletrich plasma (PRP). METHODS: Ultrasound (40 MHz) images were used for measuring pennation angle (PA), muscle thickness (MT) and mean pixel intensity, along with claudication scores, of treated (PRPG) and non-treated (NTG) groups of rats. RESULTS: NTG showed a PA increase for the non-injured leg (p<0.05) and a tendency of MT to increase, whereas for PRPG there were no differences. There was a progressive reduction of the claudication score for the PRPG group throughout the entire period, with an immediate difference after seven days (p<0.05), whereas the NTG had a significant reduction only at day 28 (p<0.05). CONCLUSION: It was observed a compensatory hypertrophic response due to the overload condition imposed to healthy leg for NTG that did not occur in PRPG, suggesting an accelerated repair process of the injured leg due to treatment, anticipating its use.
Asunto(s)
Laceraciones/terapia , Músculo Esquelético/fisiología , Músculo Esquelético/fisiopatología , Plasma Rico en Plaquetas , Regeneración/fisiología , Animales , Femenino , Estudios de Seguimiento , Claudicación Intermitente/terapia , Microscopía Intravital/métodos , Laceraciones/diagnóstico por imagen , Microscopía Acústica/métodos , Modelos Animales , Músculo Esquelético/diagnóstico por imagen , Distribución Aleatoria , Ratas WistarRESUMEN
PURPOSE: To track the regeneration process of lateral gastrocnemius due to a muscle laceration in rats, and to treatment with plateletrich plasma (PRP). METHODS: Ultrasound (40 MHz) images were used for measuring pennation angle (PA), muscle thickness (MT) and mean pixel intensity, along with claudication scores, of treated (PRPG) and non-treated (NTG) groups of rats. RESULTS: NTG showed a PA increase for the non-injured leg (p<0.05) and a tendency of MT to increase, whereas for PRPG there were no differences. There was a progressive reduction of the claudication score for the PRPG group throughout the entire period, with an immediate difference after seven days (p<0.05), whereas the NTG had a significant reduction only at day 28 (p<0.05). CONCLUSION: It was observed a compensatory hypertrophic response due to the overload condition imposed to healthy leg for NTG that did not occur in PRPG, suggesting an accelerated repair process of the injured leg due to treatment, anticipating its use.
Asunto(s)
Animales , Femenino , Regeneración/fisiología , Músculo Esquelético/fisiología , Músculo Esquelético/fisiopatología , Laceraciones/terapia , Plasma Rico en Plaquetas , Distribución Aleatoria , Estudios de Seguimiento , Ratas Wistar , Músculo Esquelético/diagnóstico por imagen , Laceraciones/diagnóstico por imagen , Modelos Animales , Microscopía Acústica/métodos , Microscopía Intravital/métodos , Claudicación Intermitente/terapiaRESUMEN
PURPOSE: Implement a laceration protocol of the rat lateral gastrocnemius (LG) and following-up its repair with ultrasound biomicroscopy (UBM), contractility tests and histology. METHODS: Sixty-three male Wistar rats were distributed into two groups. One, with sub-groups GI, GII and GIII (n=12), each containing right LG lacerated (n=6), control and sham (n=3) animals. LG muscles in GI, GII and GIII were inspected by UBM (40 MHz) immediately after, 14 and 28 days post-surgery and thereafter excised with four (GI), 14 (GII) and 28 (GIII) days post-surgery for histology. Animals in second group were distributed into right LG lacerated and control sub-groups. LG muscles in lacerated sub-group were submitted to contractility tests at four (n=8), 14 (n=8) and 28 (n=8) days post-surgery, while in the control sub-group (n=5) were submitted to contractility tests along the course of the experiments. RESULTS: Descriptive findings agreed between the lesion model, muscle repair, UBM images and histology. Contractility results for right LG were different (p<0.05) between control and injured muscle with four and 14 days post-surgery, at tetanic stimulating frequencies (50 and 70 Hz). CONCLUSION: A laceration protocol of the lateral gastrocnemius was implemented and ultrasound biomicroscopy, contractility and histology findings agreed regarding the following-up of injured muscle repair.
Asunto(s)
Modelos Animales de Enfermedad , Laceraciones/fisiopatología , Músculo Esquelético/lesiones , Regeneración/fisiología , Animales , Laceraciones/diagnóstico por imagen , Laceraciones/patología , Masculino , Microscopía Acústica/métodos , Células Musculares/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/fisiopatología , Ratas Wistar , Reproducibilidad de los Resultados , Factores de TiempoRESUMEN
PURPOSE: Implement a laceration protocol of the rat lateral gastrocnemius (LG) and following-up its repair with ultrasound biomicroscopy (UBM), contractility tests and histology. METHODS: Sixty-three male Wistar rats were distributed into two groups. One, with sub-groups GI, GII and GIII (n=12), each containing right LG lacerated (n=6), control and sham (n=3) animals. LG muscles in GI, GII and GIII were inspected by UBM (40 MHz) immediately after, 14 and 28 days post-surgery and thereafter excised with four (GI), 14 (GII) and 28 (GIII) days post-surgery for histology. Animals in second group were distributed into right LG lacerated and control sub-groups. LG muscles in lacerated sub-group were submitted to contractility tests at four (n=8), 14 (n=8) and 28 (n=8) days post-surgery, while in the control sub-group (n=5) were submitted to contractility tests along the course of the experiments. RESULTS: Descriptive findings agreed between the lesion model, muscle repair, UBM images and histology. Contractility results for right LG were different (p<0.05) between control and injured muscle with four and 14 days post-surgery, at tetanic stimulating frequencies (50 and 70 Hz). CONCLUSION: A laceration protocol of the lateral gastrocnemius was implemented and ultrasound biomicroscopy, contractility and histology findings agreed regarding the following-up of injured muscle repair. .
Asunto(s)
Animales , Masculino , Modelos Animales de Enfermedad , Laceraciones/fisiopatología , Músculo Esquelético/lesiones , Regeneración/fisiología , Laceraciones/patología , Laceraciones , Microscopía Acústica/métodos , Células Musculares/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/fisiopatología , Músculo Esquelético , Ratas Wistar , Reproducibilidad de los Resultados , Factores de TiempoRESUMEN
We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.
Apresentamos um caso com encavalamento corneano devido à sutura inadequada de uma laceração da córnea de espessura total. Houve uma diferença 2,5 mm entre as medidas do branco ao branco horizontais e verticais na córnea. No entanto, o exame da lâmpada de fenda não conseguiu demonstrar a arquitetura exata da laceração. A biomicroscopia ultrassônica definiu as bordas da ferida completamente e confirmou a presença de encavalamento da córnea. Seis semanas após a melhora da sutura, a aparência oval anormal da córnea havia desaparecido, e a correta aposição das bordas da córnea foi identificada na biomicroscopia ultrassônica. A biomicroscopia ultrassônica pode ser usada no planejamento cirúrgico pré-operatório de casos com lacerações corneanas complicadas. Ela pode ser utilizada para ajustar e melhorar a arquitetura da ferida em olhos com lesão penetrante.
Asunto(s)
Adulto , Humanos , Masculino , Lesiones de la Cornea/cirugía , Laceraciones/cirugía , Complicaciones Posoperatorias/cirugía , Técnicas de Sutura/efectos adversos , Lesiones de la Cornea , Lesiones Oculares Penetrantes/complicaciones , Lesiones Oculares Penetrantes/cirugía , Laceraciones , Microscopía Acústica/métodos , Complicaciones Posoperatorias , Resultado del TratamientoRESUMEN
Purpose: To describe quantitative and qualitative features of eyes with advanced bullous keratopathy assessed using ultrasound biomicroscopy, before and after anterior stromal puncture (ASP) or amniotic membrane transplantation (AMT) procedures to relieve chronic pain. Methods: The present descriptive comparative study included 40 eyes of 40 patients with chronic intermittent pain due to bullous keratopathy who were randomly assigned to one of the two treatments (AMT or ASP). Ultrasound biomicroscopy (Humphrey, UBM 840, 50 MHz transducer, immersion technique) was used, and a questionnaire about pain intensity was completed preoperatively and postoperatively at days 90 and 180, respectively. Exclusion criteria were age<18 years, presence of concurrent infection, ocular hypertension, and absence of pain. Results: In a 180-day follow-up, the AMT group exhibited mean central corneal thickness (CCT), 899.4 µm preoperatively and 1122.5 µm postoperatively (p<0.001); mean epithelial thickness (ET), 156.4 µm preoperatively and 247.8 µm postoperatively (p<0.001); and mean stromal thickness (ST), 742.9 µm preoperatively and 826.3 µm postoperatively (p=0.005). The ASP group exhibited mean CCT, 756.7 µm preoperatively and 914.8 µm postoperatively (p<0.001); mean ET, 102.1 µm preoperatively and 245.2 µm postoperatively (p<0.001); and mean ST, 654.6 µm preoperatively and 681.5 µm postoperatively (p<0.999). Correlations between CCT and pain intensity in the AMT group (p=0.209 pre- and postoperatively) and the ASP group (p=0.157 preoperatively and p=0.426 at the 180-day follow-up) were not statistically significant. Epithelial and stromal edema, Descemet’s membrane folds, epithelial bullae, and the presence of interface fluid were frequently observed qualitative features. Conclusion: CCT increased over time in both groups. The magnitude of CCT did not correlate with pain intensity in the sample studied. The presence of interface ...
Objetivo: Descrever as características quantitativas e qualitativas da biomicroscopia ultrassônica (UBM) em olhos com ceratopatia bolhosa avançada, antes e após os procedimentos de punção estromal anterior (ASP) ou transplante de membrana amniótica (AMT) para alívio de dor crônica. Métodos: Estudo comparativo descritivo incluindo 40 olhos de 40 pacientes com dor crônica intermitente devido a ceratopatia bolhosa, randomizados em duas modalidades de tratamento (AMT e ASP). Biomicroscopia ultrassônica (Humphrey, UBM 840, transdutor de 50 MHz, técnica de imersão) foi utilizada, e um questionário de avaliação da intensidade da dor foi aplicado no pré-operatório, e após 90 e 180 dias de pós-operatório. Critérios de exclusão foram: idade abaixo de 18 anos, presença de infecção, hipertensão ocular, e ausência de dor. Resultados: No seguimento de 180 dias, o grupo Transplante de membrana amniótica apresentou: média da espessura corneana central (CCT): 899,4 µm (pré), 1.122,5 µm (pós-operatório) (p<0,001); média da espessura epitelial (ET): 156,4 µm (pré), 247,8 µm (pós-operatório) (p<0,001); média da espessura estromal (ST): 742,9 µm (pré), 826,3 µm (pós-operatório) (p=0,005), e, grupo ASP apresentou: CCT média: 756.7 µm (pré), 914,8µm (pós-operatório) (p<0,001); ET média: 102,1 µm (pré), 245,2 µm (pós-operatório) (p<0,001); ST média: 654,6 µm (pré), 681.5 µm (pós-operatório) (p<0,999). A correlação entre intensidade da dor e espessura corneana central no grupo AMT (p=0,209 pré e pós-operatórios) e no grupo ASP (p=0,157 pré-operatório e p=0,426 aos 180 dias de seguimento) não foi significativa. Edema epitelial e estromal, dobras na membrana de Descemet, bolhas epiteliais, e presença de fluido na interface foram características qualitativas frequentemente observadas. Conclusão: A espessura corneana central aumentou ao longo do tempo em ambos os grupos. A magnitude da espessura corneana central não interfere na intensidade da dor ...
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Enfermedades de la Córnea/cirugía , Enfermedades de la Córnea , Amnios/trasplante , Vesícula/cirugía , Paquimetría Corneal , Sustancia Propia/patología , Sustancia Propia/cirugía , Sustancia Propia , Endotelio Corneal/patología , Endotelio Corneal/cirugía , Endotelio Corneal , Dolor Ocular/cirugía , Microscopía Acústica/métodos , Dimensión del Dolor , Periodo Posoperatorio , Periodo Preoperatorio , Punciones , Manejo del Dolor/métodos , Cuidados Paliativos/métodos , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
This study used ultrasound biomicroscopy (UBM) to quantify the pennation angle (PA) and muscle thickness (MT) of rat skeletal muscle and evaluated the reliability and reproducibility of the method by statistical analysis, determining the coefficient of variation (CV), intraclass correlation coefficient (ICC) and typical error of measurement. A UBM system with a center frequency of 40 MHz was used to acquire images of the right lateral gastrocnemius of ten male Wistar rats on two different days and with two ankle positions (90° or 150°). Two independent measurements of the PA and MT were randomly performed in each of three picture frames. The analysis resulted in CVs of 10.47% and 4.81% for the PA and the MT, respectively, for the ankle at 90° and 9.24% and 5.98% for the ankle at 150°. Additionally, the ICC values ranged from 0.75 to 0.92 for the PA and 0.57 to 0.99 for the MT. Statistically significant differences between the ankle positions were observed for the PA (pâ=â0.00013). The reliability of the PA and MT measurements for the rat right lateral gastrocnemius, determined from the ultrasound biomicroscopy images, was high (>0.90) for the methodology proposed. This finding indicates the potential of ultrasound biomicroscopy for quantitative muscle characterization and the longitudinal examination of tissue adaptation to different conditions of use, disease and rehabilitation.
Asunto(s)
Microscopía Acústica/métodos , Músculo Esquelético , Animales , Masculino , Microscopía Acústica/instrumentación , Ratas , Ratas WistarRESUMEN
PURPOSE: To describe quantitative and qualitative features of eyes with advanced bullous keratopathy assessed using ultrasound biomicroscopy, before and after anterior stromal puncture (ASP) or amniotic membrane transplantation (AMT) procedures to relieve chronic pain. METHODS: The present descriptive comparative study included 40 eyes of 40 patients with chronic intermittent pain due to bullous keratopathy who were randomly assigned to one of the two treatments (AMT or ASP). Ultrasound biomicroscopy (Humphrey, UBM 840, 50 MHz transducer, immersion technique) was used, and a questionnaire about pain intensity was completed preoperatively and postoperatively at days 90 and 180, respectively. Exclusion criteria were age<18 years, presence of concurrent infection, ocular hypertension, and absence of pain. RESULTS: In a 180-day follow-up, the AMT group exhibited mean central corneal thickness (CCT), 899.4 µm preoperatively and 1122.5 µm postoperatively (p<0.001); mean epithelial thickness (ET), 156.4 µm preoperatively and 247.8 µm postoperatively (p<0.001); and mean stromal thickness (ST), 742.9 µm preoperatively and 826.3 µm postoperatively (p=0.005). The ASP group exhibited mean CCT, 756.7 µm preoperatively and 914.8 µm postoperatively (p<0.001); mean ET, 102.1 µm preoperatively and 245.2 µm postoperatively (p<0.001); and mean ST, 654.6 µm preoperatively and 681.5 µm postoperatively (p<0.999). Correlations between CCT and pain intensity in the AMT group (p=0.209 pre- and postoperatively) and the ASP group (p=0.157 preoperatively and p=0.426 at the 180-day follow-up) were not statistically significant. Epithelial and stromal edema, Descemet's membrane folds, epithelial bullae, and the presence of interface fluid were frequently observed qualitative features. CONCLUSION: CCT increased over time in both groups. The magnitude of CCT did not correlate with pain intensity in the sample studied. The presence of interface fluid was a qualitative feature specifically found in some patients who underwent AMT.
Asunto(s)
Enfermedades de la Córnea/diagnóstico por imagen , Enfermedades de la Córnea/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Amnios/trasplante , Vesícula/cirugía , Paquimetría Corneal , Sustancia Propia/diagnóstico por imagen , Sustancia Propia/patología , Sustancia Propia/cirugía , Endotelio Corneal/diagnóstico por imagen , Endotelio Corneal/patología , Endotelio Corneal/cirugía , Dolor Ocular/cirugía , Femenino , Humanos , Masculino , Microscopía Acústica/métodos , Persona de Mediana Edad , Manejo del Dolor/métodos , Dimensión del Dolor , Cuidados Paliativos/métodos , Periodo Posoperatorio , Periodo Preoperatorio , Punciones , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.
Asunto(s)
Lesiones de la Cornea/cirugía , Laceraciones/cirugía , Complicaciones Posoperatorias/cirugía , Técnicas de Sutura/efectos adversos , Adulto , Lesiones de la Cornea/diagnóstico por imagen , Lesiones Oculares Penetrantes/complicaciones , Lesiones Oculares Penetrantes/cirugía , Humanos , Laceraciones/diagnóstico por imagen , Masculino , Microscopía Acústica/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Resultado del TratamientoRESUMEN
Estabelecer padrão evolutivo de um caso de esclerite nodular à ultrassonografia de alta frequência durante o tratamento. Mulher, 27 anos, com manifestação inicial de uveíte intermediária, edema macular bilateral após tratamento clínico com corticosteroide tópico e via oral. Após quatro meses, observou-se a formação de um nódulo escleral no olho direito quando foi submetido à ultrassonografia de alta frequência (Paradigm, transdutor de 50 MHz, técnica de imersão). A lesão do olho direito foi caracterizada à ultrassonografia de alta frequência como uma lesão nodular da parede anterior temporal inferior associada à redução localizada da espessura da escleral. Após a injeção intravítrea de triancinolona para tratamento do edema macular, observou-se a regressão clínica do nódulo escleral no olho direito, mantendo reduzida a espessura escleral. A ultrassonografia de alta frequência auxiliou no diagnóstico da esclerite nodular durante as fases de tratamento e na identificação da sua sequela característica, o afinamento escleral.
To stablish evolutionary pattern of a case of nodular scleritis with high frequency ultrasound during treatment. Twenty-seven year old female, initial manifestation of intermediate uveitis, bilateral macular edema after clinical treatment with topical and oral steroids. After four months, we observed the formation of a scleral nodule in the right eye when patient underwent high frequency ultrasound (Paradigm, 50 MHz transducer, immersion technique). The lesion in right eye was characterized at high frequency ultrasound as a nodular lesion located at the anterior inferior temporal wall associated with localized reduction of scleral thickness. After intravitreal injection of triamcinolone for treatment of macular edema, clinical regression of the scleral nodule was observed in right eye, maintaining reduced scleral thickness. High frequency ultrasound assisted in the diagnosis of nodular scleritis during the phases of treatment and in the identify its characteristic sequel feature, the scleral thinning.
Asunto(s)
Adulto , Femenino , Humanos , Microscopía Acústica/métodos , Escleritis , Progresión de la Enfermedad , Glucocorticoides/uso terapéutico , Inyecciones Intravítreas , Edema Macular/tratamiento farmacológico , Edema Macular , Escleritis/tratamiento farmacológico , Resultado del Tratamiento , Triamcinolona/uso terapéutico , Uveítis Intermedia/tratamiento farmacológico , Uveítis IntermediaRESUMEN
PURPOSE: To investigate the correlation between the measurements of the cup/retrobulbar optic nerve diameter (C/OND) proportion obtained by high-resolution 20-MHz B-mode ultrasound (US) and those of the cup/disc ratio (C/D) obtained by fundus biomicroscopy (BIO) and optical coherence tomography (OCT). METHODS: Thirty eyes of 15 glaucomatous patients with any C/D proportion were studied. All patients underwent examination of the vertical C/D by BIO with a 78D lens and time-domain OCT analysis, as well as the vertical C/OND proportion using 20-MHz US measurements. All data were analyzed by correlation and agreement tests. RESULTS: The Spearman test showed a strong correlation between C/D results obtained by BIO and the measurements of C/OND (US) (r=0.788, p<0.0001), and with C/D obtained by OCT (r=0.8529, p<0.0001). However, comparison of C/D results obtained with OCT to those obtained by with C/OND (US) showed only a moderate correlation (r=0.6727, p<0.0001). Bland-Altman analysis did not show good agreement between C/D (BIO) and C/OND (US). CONCLUSIONS: The results demonstrate that B-mode ultrasound examination with a 20 MHz probe can be a good additional method for the evaluation of the C/D ratio in glaucomatous patients, and may be considered as an alternative gross tool in glaucomatous patients with optic media opacities.
Asunto(s)
Glaucoma/diagnóstico por imagen , Microscopía Acústica/métodos , Nervio Óptico/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Opacidad de la Córnea , Estudios Transversales , Femenino , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Disco Óptico/diagnóstico por imagen , Estadísticas no Paramétricas , Tomografía/métodosRESUMEN
PURPOSE: To determine the prevalence of signs and symptoms of ocular surface disease (OSD) in patients using topical intraocular pressure-lowering therapy. METHODS: In this cross-sectional study, 40 patients were consecutively recruited from the glaucoma clinic of a public hospital located in Rio de Janeiro, Brazil. Eligible patients were 18 years of age or older, with primary open-angle glaucoma or ocular hypertension and on the same topical ocular therapy for at least 6 months. The following data were considered: sex, age, medication history and number of years on topical intraocular pressure-lowering therapy. All patients underwent an evaluation of the ocular surface which included: an interview using the Ocular Surface Disease Index® (OSDI®) questionnaire, break-up time, biomicroscopy, fluorescein corneal staining and rose Bengal ocular surface staining. RESULTS: The mean OSDI® score was 24.6 ± 20.7. Most patients (67.5%) had an abnormal score on the OSDI® questionnaire. In 25% of patients, the score was consistent with mild symptoms, 12.5% with moderate symptoms and 30% with severe symptoms. Blepharitis and punctate keratitis were diagnosed in 42.5% and 20% of patients respectively. Tear film instability was observed in 75% of patients and ocular surface staining with rose Bengal in 35%. A positive statistically significant correlation (r=0.4; p=0.01) was found between OSDI® scores and the duration of topical intraocular pressure-lowering therapy. CONCLUSION: Patients with primary open-angle glaucoma or ocular hypertension on topical intraocular pressure-lowering therapy have high prevalence of OSD. Longer duration since diagnosis is significantly correlated with worsening of OSD symptoms.
Asunto(s)
Antihipertensivos/uso terapéutico , Presión Intraocular/efectos de los fármacos , Hipertensión Ocular/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Tiofenos/uso terapéutico , Timolol/uso terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Blefaritis/diagnóstico , Córnea/efectos de los fármacos , Estudios Transversales , Femenino , Fluoresceína , Glaucoma de Ángulo Abierto/prevención & control , Humanos , Queratitis/diagnóstico , Enfermedades del Aparato Lagrimal/diagnóstico , Masculino , Microscopía Acústica/métodos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: To investigate the correlation between the measurements of the cup/retrobulbar optic nerve diameter (C/OND) proportion obtained by high-resolution 20-MHz B-mode ultrasound (US) and those of the cup/disc ratio (C/D) obtained by fundus biomicroscopy (BIO) and optical coherence tomography (OCT). METHODS: Thirty eyes of 15 glaucomatous patients with any C/D proportion were studied. All patients underwent examination of the vertical C/D by BIO with a 78D lens and time-domain OCT analysis, as well as the vertical C/OND proportion using 20-MHz US measurements. All data were analyzed by correlation and agreement tests. RESULTS: The Spearman test showed a strong correlation between C/D results obtained by BIO and the measurements of C/OND (US) (r=0.788, p<0.0001), and with C/D obtained by OCT (r=0.8529, p<0.0001). However, comparison of C/D results obtained with OCT to those obtained by with C/OND (US) showed only a moderate correlation (r=0.6727, p<0.0001). Bland-Altman analysis did not show good agreement between C/D (BIO) and C/OND (US). CONCLUSIONS: The results demonstrate that B-mode ultrasound examination with a 20 MHz probe can be a good additional method for the evaluation of the C/D ratio in glaucomatous patients, and may be considered as an alternative gross tool in glaucomatous patients with optic media opacities.
OBJETIVOS: Verificar a correlação entre os achados da relação escavação/diâmetro do nervo óptico retrobulbar (E/DNO) obtidos pelo exame de ultrassom (US) modo B de alta resolução com sonda de 20 MHz e a relação escavação/disco (E/D) obtidos pela biomicroscopia de fundo de olho (BIO) e pela tomografia de coerência óptica (OCT). MÉTODOS: Foram analisados 30 olhos de 15 pacientes com diagnóstico de glaucoma com qualquer proporção da relação E/D. Todos os pacientes foram submetidos ao exame de BIO, com lente 78D, e de OCT, com tecnologia de domínio temporal, para a análise da relação E/D vertical e exame de US modo B, com sonda de 20 MHz, para determinação da proporção E/DNO vertical. Todos os resultados foram analisados por métodos de correlação e concordância. RESULTADOS: Observou-se forte correlação entre as medidas E/D obtidas pela BIO, e as medidas E/DNO (US) (r=0,788; p<0,0001), e com as medidas E/D obtidas pelo OCT (r=0,8529; p<0,0001). Porém, a análise entre as medidas E/DNO (US) e E/D (OCT) mostrou apenas níveis moderados de correlação (r=0,6727, p<0,0001). O teste de Bland-Altman não mostrou bons níveis de concordância entre E/D (BIO) e E/DNO (US). CONCLUSÕES: Os resultados demonstraram que o exame de US modo B com sonda de 20 MHz pode ser um bom método adicional para avaliar a relação E/D de pacientes com glaucoma, a ser considerado como uma ferramenta alternativa na avaliação de pacientes glaucomatosos com opacidades dos meios ópticos.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Glaucoma , Microscopía Acústica/métodos , Nervio Óptico , Opacidad de la Córnea , Estudios Transversales , Fondo de Ojo , Disco Óptico , Estadísticas no Paramétricas , Tomografía/métodosRESUMEN
OBJETIVO: determinar a prevalência de sinais e sintomas de doença da superfície ocular (OSD) em pacientes em uso crônico de hipotensores oculares tópicos. MÉTODOS: Neste estudo transversal, foram recrutados 40 pacientes consecutivos, provenientes do ambulatório de glaucoma de um hospital público localizado no Rio de Janeiro, Brasil. Os mesmos deveriam apresentar: idade maior ou igual a 18 anos, diagnóstico de hipertensão ocular ou glaucoma primário de ângulo aberto e deveriam estar em uso da mesma terapia hipotensora ocular há pelo menos seis meses. Foram considerados: sexo, idade, medicação utilizada e duração do tratamento. Todos os pacientes foram submetidos à avaliação da superfície ocular que incluiu: entrevista por meio do questionário Ocular Surface Disease Index® (OSDI®), tempo de rotura do filme lacrimal, biomicroscopia, avaliação da superfície ocular com fluoresceína e com rosa Bengala. RESULTADOS: A média de pontuação do OSDI® foi 24,6 ± 20,7. A maioria dos pacientes (67,5%) apresentou uma pontuação anormal no questionário do OSDI®. Em 25% dos pacientes, a pontuação foi compatível com sintomas leves, em 12,5% com sintomas moderados e em 30% com sintomas graves. Blefarite e ceratite ponteada foram diagnosticadas em 42,5% e 20% dos pacientes respectivamente. Instabilidade do filme lacrimal foi observada em 75% dos pacientes, enquanto que alteração da superfície ocular foi evidenciada pelo teste de rosa bengala em 35% dos pacientes. Foi encontrada correlação positiva (r=0,4) estatisticamente significativa (p=0,01) entre a pontuação do OSDI® e o tempo de duração do tratamento com hipotensores oculares tópicos. CONCLUSÃO: Pacientes em uso crônico de hipotensores oculares tópicos apresentam alta prevalência de sinais e sintomas de OSD. Existe correlação significativa entre a duração do tratamento e a gravidade dos sintomas de OSD.
PURPOSE: To determine the prevalence of signs and symptoms of ocular surface disease (OSD) in patients using topical intraocular pressure-lowering therapy. METHODS: In this cross-sectional study, 40 patients were consecutively recruited from the glaucoma clinic of a public hospital located in Rio de Janeiro, Brazil. Eligible patients were 18 years of age or older, with primary open-angle glaucoma or ocular hypertension and on the same topical ocular therapy for at least 6 months. The following data were considered: sex, age, medication history and number of years on topical intraocular pressure-lowering therapy. All patients underwent an evaluation of the ocular surface which included: an interview using the Ocular Surface Disease Index® (OSDI®) questionnaire, break-up time, biomicroscopy, fluorescein corneal staining and rose Bengal ocular surface staining. RESULTS: The mean OSDI® score was 24.6 ± 20.7. Most patients (67.5%) had an abnormal score on the OSDI® questionnaire. In 25% of patients, the score was consistent with mild symptoms, 12.5% with moderate symptoms and 30% with severe symptoms. Blepharitis and punctate keratitis were diagnosed in 42.5% and 20% of patients respectively. Tear film instability was observed in 75% of patients and ocular surface staining with rose Bengal in 35%. A positive statistically significant correlation (r=0.4; p=0.01) was found between OSDI® scores and the duration of topical intraocular pressure-lowering therapy. CONCLUSION: Patients with primary open-angle glaucoma or ocular hypertension on topical intraocular pressure-lowering therapy have high prevalence of OSD. Longer duration since diagnosis is significantly correlated with worsening of OSD symptoms.