RESUMO
Diabetic retinopathy (DR) is the major microvascular complication of diabetes and causes vitreous traction and intraretinal hemorrhages leading to retinal detachment and total blindness. The evolution of diabetes is related to exacerbating inflammation caused by hyperglycemia and activation of inflammatory cells. Neutrophils are cells able to release structures of extracellular DNA and proteolytic enzymes called extracellular traps (NETs), which are associated with the persistence of inflammation in chronic pathologies. The purpose of the study was to determine the usefulness of neutrophil traps as indicators of DR progression in patients with type 2 diabetes (T2DM). We performed a case-control study of seventy-four cases classified into five groups (non-proliferative DR, mild, moderate, severe, and proliferative) and fifteen healthy controls. We found correlations between NETs and a diagnostic time of T2DM (r = 0.42; p < 0.0001), fasting glucose (r = 0.29; p < 0.01), glycated hemoglobin (HbA1c) (r = 0.31; p < 0.01), estimated glomerular filtration rate (eGFR) (r = -0.29; p < 0.01), and plasma osmolarity (r = 0.25; p < 0.01). These results suggest that due to NETs being associated with clinical indicators, such as HbA1c and eGFR, and that NETs are also associated with DR, clinical indicators might be explained in part through an NET-mediated inflammation process.
RESUMO
BACKGROUND: Simulation in medicine is an indispensable tool to improve doctors' responses to different situations, enhancing their performance. However, simulation in ophthalmology is a very recent trend, mainly because of the high complexity of developing newer teaching tools, with the need for highly realistic models, mostly in surgical ophthalmic simulation. DISCUSSION: The whole development of simulation in ophthalmology, from the very first attempts that used basic models, to the newer virtual reality models, allows for a comprehensive, faster, and more efficient development of skills necessary in basic and advance procedures in ophthalmology, creating a better learning environment, improving costs, and developing a very promising panorama, in which simulation can be incorporated in teaching programs all around the globe. CONCLUSIONS: Simulation in ophthalmology allows for better results in the formation of ophthalmologists, and it is becoming a new tool to achieve better results in medical and surgical procedures, thus improving outcomes and quality of care.
Assuntos
Simulação por Computador , Procedimentos Cirúrgicos Oftalmológicos/educação , Oftalmologia/educação , Educação de Pós-Graduação em Medicina/métodos , HumanosRESUMO
The purpose of this paper was to report the case of a 23-year-old patient suffering from bilateral acute visual loss who received the diagnosis of hypertensive retinopathy. After systemic evaluation, he was diagnosed with bilateral renal disease and chronic renal failure, requiring a kidney transplantation to manage the systemic illness, followed by gradual improvement of his visual acuity.
RESUMO
The purpose of this paper is to report the case of a 62-year-old male diagnosed with a retinal macrocyst secondary to a long-standing retinal detachment in his right eye. At fundoscopy examination, an oval, elevated retinal lesion in the superior nasal quadrant was noted. Ultrasonography was performed, with a B-mode echography showing an oval, anechoic image and a standardized A-mode echography with a reflectivity spike higher than 98%, which was compatible with a retinal macrocyst. The patient refused surgical treatment for the retinal detachment and was followed for 14 months with stable visual acuity and no clinical or echographic changes.