OFT - Artigos publicados em revistas não indexadas
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- 10 anos de experiência no tratamento de retinoblastomaPublication . Santos, C; Coutinho, I; Azevedo, AR; Constantino, C; Sousa, AB; Pereira, F; Laranjeira, J; Cabral, J; Teixeira, SObjectivo: Descrever a experiência do Serviço de Oftalmologia do Hospital Prof. Doutor Fernando Fonseca no diagnóstico e tratamento de retinoblastoma entre Janeiro de 2004 e Dezembro de 2014. Métodos: Revisão retrospectiva dos processos clínicos e exames complementares de diagnóstico. Resultados: Foram tratados dezasseis doentes no período em estudo, sendo cinco casos bilaterais . O diagnóstico foi estabelecido em média aos 27 meses de idade e a forma de apresentação mais frequente foi leucocória. Dois casos apresentavam história familiar . O tempo médio de seguimento foi de 51,6 meses. Um dos doentes desenvolveu um pineoblastoma, tendo acabado por falecer do complicações relacionadas com a quimioterapia sistémica. De entre as 16 crianças, 11 realizaram quimioterapia sistémica. Nove olhos foram submetidos a enucleação, dois deles após falência da terapêutica conservadora. Os restantes doze olhos foram sujeitos a tratamento conservador, cinco dos quais exclusivamente em Portugal, recorrendo a quimioterapia sistémica, crioterapia e fotocoagulação com LASER. Oito doentes (nove olhos) foram encaminhados para o Hôpital Ophthalmique Jules Gonin na Suiça, para complementar a terapêutica realizada. Conclusões: O tratamento do retinoblastoma tem evoluído nos últimos anos. As novas opções para tratamento local, mais eficazes e seguras, têm tornado possível cada vez mais preservar a vida, o órgão e a função. No entanto, para o sucesso terapêutico é fundamental o diagnóstico precoce.
- Alterações da refracção e motilidade na população de prematuros do HFF rastreada para ROPPublication . Rodrigues, J; Vaz, F; Santos, MJ; Ribeiro, F; Teixeira, SA criança prematura apresenta maior risco de morbilidade ofltalmológica e de alterações do desenvolvimento neurológico, nomeadamente de estrabismo, erros refractivos (miopia), diminuição da acuidade visual, defeitos da visão cromática e dos campos visuais. Os autores realizaram uma análise retrospectiva sobre a distribuição de casos de estrabismo, nistagmo e erros refractivos (miopia eq. esférico >= -0.25 D; alta miopia eq. esférico >= -5.00 D; astigmatismo >= 1.00D) na população de prematuros rastreada para ROP e nascidos no HFF entre Outubro de 1997 e Outubro de 2001. Foram considerados como critérios de inclusão: idade gestacional <= 32 semanas ou muito baixo peso ao nascer <= 1500g; 12 meses de idade corrigida até 31 de Outubro de 2002; e seguimento clínico após os 6 meses de idade. São apresentados os resultados e as conclusões da análise de 191 processos clínicos consultados
- Amaurose súbita e doença falciforme: a propósito de um casoPublication . Oliveira, J; Nunes, P; Ferreira, T; Correia, P; Dias, A; Teixeira, S; Silva, F; Bernardo, MOs autores apresentam o caso clínico de uma criança com doença falciforme, internada por choque séptico com meningite e pneumonia a Streptococcus pneumoniae. No decurso do internamento surgiu amaurose súbita à esquerda e herpes mucocutâ- neo labial. O exame oftalmológico foi sugestivo de oclusão arterial no olho esquerdo e de necrose retiniana viral à direita, pelo que foi instituída terapêutica antiviral e anticoagulante. A evolução clínica e imagiológica foi compatível com necrose retiniana aguda. Verificou-se ligeira melhoria da acuidade visual à direita (6/10) mas persistiu um défice grave da acuidade visual à esquerda (< 1/10). A necrose retiniana aguda é um evento raro em idade pediátrica, cujo diagnóstico diferencial inclui outras causas de amaurose súbita.
- Atypical 'benign behaviour' of eyelid sebaceous carcinomaPublication . Alves, S; Silva, F; Ferreira, M; Cabral, JEyelid sebaceous carcinoma is a rare tumour with slow growth and it is one of the most aggressive malignancies of the eyelid. Death rate can reach 6%. The diagnosis is often delayed because it is confused with other periocular lesions. The authors describe a case with atypical presentation, regarding rapid growth rate and exophytic aspect. Female, 78 years, presenting lower eyelid tumour with 4 months of evolution. Ophthalmological examination showed a tarsal exophytic tumour (22 mm), non-adherent to bulbar conjunctiva. She was medicated topically for 3 months, with the diagnosis of chalazio. Total excision was performed for histological diagnosis. After diagnosis of sebaceous carcinoma with specific immunohistochemical markers, and without free tumour surgical limits, a second surgery was performed with a pentagon entire thickness excision. Being a rare tumour but with a considerable morbidity and mortality; early diagnosis and treatment is essential for a good prognosis and preservation of visual function.
- Blink mystery image: Conjunctival papillomaPublication . Santos, C; Pina, S; Oliveira, R
- Bowman's layer dystrophy with irido-fundal coloboma in the same patient: a case reportPublication . Mota, M; Pedrosa, C; Silva, D; Pires, G; Pêgo, P; Vendrell, C; Prieto, IIntroduction: The corneal dystrophies are rare corneal diseases, defined as bilateral, symmetric and inherited conditions. Ocular coloboma is a congenital defect caused by embryogenesis imperfection, during the sixth week of development. Purpose: The authors report the first clinical case in literature of the association of cornea dystrophy and irido-fundal coloboma. Case report: The authors describe the case of a 34-year-old woman, with decrease visual acuity (VA) in the right and left eyes (RLE). She has had an ocular illness since young, with corneal erosions. Her family members also have alterations in the cornea, her father has held a bilateral corneal transplant. Ophthalmic examination showed a best-corrected visual acuity (BCVA) of 20/40 in the RE and 20/100 in the LE. Biomicroscopy showed an inferior iris coloboma in the LE. A deposition of reticular/granular substance in the Bowman’s layer was observed in both eyes, sparing the limbal portion, compatible with a corneal dystrophy. Fundus examination showed a coloboma in the LE that involves the inferior retina and the optic nerve, no changes in the RE fundus was observed. She started treatment with ocular lubrificant preservative-free eyedrops. The patient has remained stable within 1-year follow-up. Conclusions: This is the first case report of the association of cornea dystrophy and irido-fundal coloboma. The greater decrease in VA in the LE appears to be due to the combination of these two entities in this eye. Despite the Bowman’s layer dystrophy has an autosomal dominant pattern, coloboma seems to have been an acquired change.
- A challenged case of Vogt-Koyanagi-Harada syndrome: when dermatological manifestations came first.Publication . Coutinho, I; Pedrosa, C; Santos, C; Pina, S; Lisboa, M; Bernardo, M; Prieto, INTRODUCTION: Vogt-Koyanagi-Harada syndrome (VKHS) is an inflammatory systemic autoimmune disease principally affecting pigmented tissues in the ocular, auditory, integumentary and central nervous systems. Patients are generally women in the fourth decade of life. The prognosis is correlated mainly with the time between diagnosis and the start of treatment and number of recurrent episodes of inflammation. Most complications are mainly ocular. The purpose of this paper is to describe a clinical case of VKHS. MATERIAL AND METHODS: A child with a challenging clinical presentation in which the dermatological symptoms occurred before ocular manifestations. DISCUSSION AND CONCLUSION: VKHS is rare in children and can be a diagnostic challenge. It seemed interesting to share this case as an opportunity to expand our knowledge of the clinical spectrum of diseases and reflect about current diagnostic criteria.
- Changes in choroidal thickness following trabeculectomy and its correlation with the decline in intraocular pressurePublication . Silva, D; Lopes, AS; Henriques, S; Lisboa, M; Pinto, S; Vaz, F; Prieto, IPURPOSE: Evaluate whether there are significant changes in choroidal thickness following trabeculectomy, and how they relate do the decline in intraocular pressure. METHODS: This was a prospective evaluation of 28 eyes who underwent Moorfields modified trabeculectomy. The choroidal thickness was measured via OCT with enhanced depth imaging, before surgery and 1 day, 1 week and 1 month after surgery. Measurements were taken at the fovea, 1000 µm temporal to the fovea and 1000 µm nasal to the fovea. The relationship between choroidal thickness and intraocular pressure was statistically evaluated. RESULTS: The mean intraocular pressure before surgery was 25.07 ± 4.64 mmHg; 8.57 ± 3.62 mmHg after 1 day; 10.36 ± 4.39 mmHg after 1 week and 13.71 ± 5.13 mmHg after 1 month. Mean choroidal thickness increased after trabeculectomy with maximal values at 1 week. The largest increase was found at the fovea, with an average before surgery of 253.54 ± 62.01 µm; 286.75 ± 64.20 µm at 1 day, 286.36 ± 63.14 µm at 1 week and 271.00 ± 60.31 µm at 1 month. Increase in choroidal thickness was significant 1 day and 1 week after surgery in the foveal (p = 0.012, p = 0.007) and temporal (p = 0.040, p = 0.000) locations and 1 week postoperatively on the nasal location (p = 0.016). None of them were significant at 1 month after surgery. Preoperative IOP and choroidal thickness were correlated at all macular locations (ρ = 0.449-0.525, p = 0.004-0.016) yet no correlation was found between increase in choroidal thickness and decline in intraocular pressure in the postoperative period. CONCLUSION: Choroidal thickness appears to increase temporarily after trabeculectomy and these changes were not correlated with the decline in intraocular pressure. Further research is required to fully understand this phenomenon.
- Comparison of macular thickness and volume in amblyopic children using time domain optical coherence tomographyPublication . Silva, F; Alves, S; Pina, S; Azevedo, A; Pêgo, P; Santos, MJ; João, RPurpose: Cortical and lateral geniculate changes are well documented in amblyopia but retinal involvement is controversial. Our aim was to compare macular volume and thickness between the sound and the amblyopic eye, in children with unilateral amblyopia due to anisometropia or strabismus, using optical coherence tomography. Materials and Methods: Amblyopic children up to the age of 18 were examined with Stratus OCT3, assessing macular volume and thickness. Statistical analysis was done using the Wilcoxon signed rank test and a level of significance of 5% was chosen. Results: 19 amblyopic patients were studied, 15 with strabismus and 4 with anisometropia. The foveal minimum thickness was significantly greater in the amblyopic eye; by contrast, significantly reduced thickness was found in the inner nasal, inner inferior and outer inferior macular areas of the amblyopic eye. Macular volume and retinal thickness in the other macular areas were reduced in amblyopic eyes but this was not significant. Conclusions: There seems to be a difference in macular thickness between both eyes in patients with unilateral amblyopia due to strabismus or anisometropia, at least in some areas. Our results are according to some studies performed so far, although others contradict these results, reflecting the different experimental settings used.
- Comprimentos Axiais Extremos e Cálculo de Lentes Intraoculares com o IoImaster - Análise de 78 OlhosPublication . Silva, D; Ramalho, M; Pedrosa, C; Coutinho, I; Mota, M; Lopes, A; Pêgo, P; Pinto, S; Vendrell, C; Prieto, IObjetivo: Avaliar a magnitude do erro das fórmulas usadas no cálculo de lentes intraoculares (SRKII, HofferQ, Holladayl, SRK-T) para comprimentos axiais extremos (<22mm e >26mm) e comparar o desempenho relativo destas fórmulas nos dois subgrupos. Métodos: Avaliaram-se retrospectivamente 78 olhos de 65 doentes, com biometria realizada no IolMaster*. Destes, 48 têm comprimento axial inferior a 22mm e 30 têm comprimento axial su- perior a 26mm. A refração prevista calculada pelas diferentes fórmulas foi comparada com a re- fração um mês após a cirurgia. Testou-se a correlação entre comprimento axial e erro verificado. Resultados: A refração final média foi 0,18+0,65D para comprimentos axiais inferiores a 22mm e -1,48+1,03D nos superiores a 26mm. O erro absoluto médio (diferença entre o cálculo de lente e refração final) para comprimentos axiais inferiores a 22mm foi menor na fórmula HofferQ, diferindo com significado estatístico da Holladayl (p=0,016), mas não da SRK-T (p=0,350). Para comprimentos axiais superiores a 26mm, o erro absoluto médio foi menor na fórmula SRK-T. Diferiu com significado estatístico da Holladayl (p=0,032), mas não da HofferQ (p=0,156). Houve correlação entre erro absoluto médio e comprimento axial em com- primentos axiais superiores a 26mm, para as fórmulas SRK-T (R=0,438, p=0,016), HofferQ (R=0,447, p=0,013) e Holladayl (R=0,386, p=0,035). Conclusão: A HofferQ tem o melhor desempenho nos comprimentos axiais menores que 22mm e a SRK-T nos superiores a 26mm. A comprimentos axiais sucessivamente mais extremos corresponde um aumento estatisticamente significativo do erro absoluto médio nos comprimentos axiais superiores a 26mm, mas não nos inferiores a 22mm.