Artigos e Materiais de Revistas Científicas - LIM/33

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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Brolucizumab after failure of aflibercept with photodynamic therapy in polypoidal choroidal vasculopathy: A case report
(2023) YUAN, P. H.; KHAN, H. M.; SUMITA, F. A. G.; MONTEIRO, M. L. Ribeiro; PRETI, R. C.; NAVAJAS, E. V.
We describe one case of polypoidal choroidal vasculopathy with persistent subretinal fluid despite multiple treatment with intravitreal bevacizumab, ranibizumab and aflibercept, as well as aflibercept associated with photodynamic therapy. The patient reached complete resolution after intravitreal brolucizumab injection, but experienced recurrence of subretinal fluid 12 weeks after discontinuation. Brolucizumab might be an option in treating subretinal fluid after failure of other anti-VEGF agents associated with photodynamic therapy.
Challenges and advantages of being a scientific journal editor in the era of ChatGPT
(2023) LIRA, Rodrigo Pessoa Cavalcanti; ROCHA, Eduardo Melani; KARA-JUNIOR, Newton; COSTA, Dacio Carvalho; PROCIANOY, Fernando; PAULA, Jayter Silva de; GRACITELLI, Carolina P. B.; PRATA, Tiago da Silva; V, Caio Regatieri; NETO, Laurentino Biccas; ALVES, Monica
SciELO 25 years: The Scientific Electronic Library Online celebrates its 25th anniversary
(2024) ROCHA, Eduardo M.; OSAKI, Tammy H.; KARA-JUNIOR, Newton; ALVES, Monica; MORAL, Claudia
Who is the ophthalmologist that developing countries need?
(2021) KARA-JUNIOR, Newton
Retinal arterial macroaneurysms in patients recovered from COVID-19
(2023) SILVA NETO, Epitácio Dias da; RODRIGUES NETO, Taurino dos Santos; CONCI, Lívia da Silva; PRETI, Rony; MONTEIRO, Mário Luiz Ribeiro; ZACHARIAS, Leandro Cabral
ABSTRACT This is a case series about retinal arterial macroaneurysms in three patients recovered from COVID-19. None of them had previous past ocular and systemic history. The first patient was a 47-year-old man, with best-corrected visual acuity of 20/20 in both eyes. He presented a cotton wool spot in the right eye and two peripheral exudative retinal arterial macroaneurysms in the left eye. Laser photocoagulation was performed and best-corrected visual acuity remained stable. The second one was a 62-year-old-woman with acute visual loss in the right eye (best-corrected visual acuity of 20/400). There was vitreous hemorrhage and a peripheral retinal arterial macroaneurysm in the right eye. Laser photocoagulation was performed and best-corrected visual acuity improved to 20/20. The third patient was a 54-year-old woman, with best-corrected visual acuity of 20/20 in the right eye and 20/600 in the left eye. Fundus examination showed multiple layer hemorrhage in the macular region and retinal arterial macroaneurysms in the superior temporal branch. The cases underwent fluorescein angiography, which confirmed the diagnosis of retinal arterial macroaneurysms.
Situation of ophthalmology education in Brazil: versus demand
(2024) KARA-JUNIOR, Newton; SCHERER, Rafael; KOCH, Camila; MELLO, Paulo Augusto de Arruda
Purpose: The number of medical schools in Brazil has increased in recentyears; however, vacancies for specialization in ophthalmology probably have not kept up with the growing demand. This study wants to estimate the increase in medical schools, the demand for ophthalmology specialization, and evaluate learning opportunities in ophthalmology. Methods: This was a retrospective study with research from the Ministry of Education and Brazilian Council of Ophthalmology database from 2002 to 2021. These data were checked through 120 notices published by the institutions in 2021. Results: The number of medical school vacancies increased by 370%, whereas the number of certified ophthalmology vacancies increased by 64%. There was an 11.4% misalignment between the Brazilian Council of Ophthalmology data in the Ministry of Education. Conclusion: The proportion of medical graduates has increased much more than opportunities for ophthalmology specialization. The effect on the search for unaccredited specialization positions is unknown, and policies for monitoring the specialization of ophthalmology vacancies should be established.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHÇET'S UVEITIS
(2023) FERREIRA, Bruno F. A.; HIGASHI, Alex H.; PRADO, Leandro L.; GONCALVES, Celio R.; HADDAD, Maria A. O.; ZACHARIAS, Leandro C.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.
Purpose: To evaluate the parafoveal macular microvasculature and the macular function in patients with retinal vasculitis associated with Beh & ccedil;et's uveitis.Methods: In 14 patients with inactive Beh & ccedil;et's uveitis and 26 control individuals (13 with nonocular Beh & ccedil;et's syndrome and 13 healthy subjects), we analyzed the retinal nerve fiber layer, ganglion cell layer, full retinal thickness, foveal avascular zone area and sectorial parafoveal vascular density in the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus using SPECTRALIS optical coherence tomography (OCT) 2 and OCT angiography. Macular sensitivity was analyzed using an MP-3 microperimeter.Results: Eighteen eyes (78%) had a best-corrected visual acuity >= 20/25. Significant differences were found in Beh & ccedil;et's uveitis in comparison with the controls on the OCT and OCT angiography: 14.8%, 22.4%, and 14.9% ganglion cell layer thinning in the global, nasal, and inferior sectors, respectively; 6%, 13.2%, and 7.5% full retinal thickness thinning in the superior, nasal, and inferior sectors; and 16.8%, 14.9%, 23.6%, 15.8%, and 12.6% mean deep capillary plexus density reduction in the global, superior, nasal, inferior, and temporal sectors. Microperimetry data demonstrated significant mean reductions of 21% and 23.6% in central and average macular sensitivities and 28.8%, 40.4%, 27.7%, and 24.2% in the superior, nasal, inferior, and temporal sectors, respectively. Outer plexiform layer elevations were observed in Beh & ccedil;et's uveitis (69.6%).Conclusion: Beh & ccedil;et's uveitis presented structural and functional macular damage despite good best-corrected visual acuity, mainly affecting the nasal sector and the deep capillary plexus. On OCT and OCT angiography, quantitative and qualitative changes can be valuable biomarkers of ocular involvement in Beh & ccedil;et's syndrome.
Transforming growth factor beta-3 localization in the corneal response to epithelial-stromal injury and effects on corneal fibroblast transition to myofibroblasts
(2023) SHIJU, Thomas Michael; SAMPAIO, Lycia Pedral; MARTINEZ, Valeria Villabona; HILGERT, Guilherme S. L.; WILSON, Steven E.
The purpose of this study was to evaluate the localization of TGF beta-3 in situ in unwounded rabbit corneas and corneas that had epithelial-stromal injuries produced by photorefractive keratectomy (PRK) in rabbits and to evaluate the in vitro effects of TGF beta-3 compared to TGF beta-1 on alpha-smooth muscle actin (alpha-SMA) protein expression and myofibroblast development in corneal fibroblasts. Forty-eight New Zealand white rabbits underwent either -3 diopter (D) or -9D PRK and were studied from one to eight weeks (four corneas in each group at each time point) after surgery with immunohistochemistry for TGF beta-3, laminin alpha-5, and alpha-smooth muscle actin (alpha-SMA). Rabbit corneal fibroblasts were treated with activated TGF beta-1 and/or TGF beta-3 at different concentrations and duration of exposure and studied with immunocytochemistry for myofibroblast development and the expression of alpha-SMA using Jess automated Western blotting. TGF beta-3 was detected at high levels in the stroma of unwounded corneas and corneas at one to eight weeks after -3D or -9D PRK, as well as in the epithelium and epithelial basement membrane (EBM). No difference was noted between corneas that healed with and without myofibroblast-mediated fibrosis, although TGF beta-3 was commonly associated with myofibroblasts. TGF beta-3 effects on corneal fibroblasts in vitro were similar to TGF beta-1 in stimulating transition to alpha-SMA-positive myofibroblasts and promoting alpha-SMA protein expression. The corneal stromal localization pattern of TGF beta-3 protein in unwounded corneas and corneas after epithelial-stromal injury was found to be higher and different from TGF beta-1 and TGF beta-2 reported in previous studies. TGF beta-3 had similar effects to TGF beta-1 in driving myofibroblast development and alpha-SMA expression in corneal fibroblasts cultured in medium with 1% fetal bovine serum.
Topical Losartan Decreases Myofibroblast Generation But Not Corneal Opacity After Surface Blast-Simulating Irregular PTK in Rabbits
(2023) SAMPAIO, Lycia Pedral; VILLABONA-MARTINEZ, Valeria; SHIJU, Thomas Michael; SANTHIAGO, Marcony R.; WILSON, Steven E.
Purpose: To evaluate the efficacy of topical losartan after blast injury-simulating irregular phototherapeutic keratectomy (PTK) in rabbits.Methods: Twelve NZW rabbits underwent 100 pulse 6.5 mm diameter PTK over a metal screen to generate severe surface irregularity and inhibit epithelial basement membrane regeneration. Corneas were treated with 0.8 mg/mL losartan in balanced salt solution (BSS) or BSS 50 mu L six times per day for six weeks after PTK. All corneas had slit lamp photography, with and without 1% fluorescein at two, four, and six weeks after PTK, and were analyzed using immunohistochemistry for the myofibroblast marker alpha-smooth muscle actin (alpha-SMA), keratocyte marker keratocan, mesenchymal cell marker vimentin, transforming growth factor (TGF)-beta 1, and collagen type IV.Results: Topical 0.8 mg/mL losartan six times a day significantly decreased anterior stromal alpha-SMA intensity units compared to BSS at six weeks after anterior stromal irregularity-inducing screened PTK (P = 0.009). Central corneal opacity, however, was not significantly different between the two groups. Keratocan, vimentin, TGF-beta 1, or collagen type IV levels in the anterior stroma were not significantly different between the two groups.Conclusions: Topical losartan effectively decreased myofibroblast generation after surface blast simulation irregular PTK. However, these results suggest initial maskingsmoothing PTK, along with adjuvant topical losartan therapy, may be needed to decrease corneal stromal opacity after traumatic injuries that produce severe surface irregularity.Translational Relevance: Topical losartan decreased scar-producing stromal myofibroblasts after irregular PTK over a metal screen but early smoothing of irregularity would also likely be needed to significantly decrease corneal opacity.
The influence of topical anesthetic and fluorescein on non-contact tonometry measurements using ultra-high-speed dynamic Scheimpflug
(2023) MACEDO, Marcelo; HATANAKA, Marcelo; BARBOZA, Wilma Lelis; MINGIONE, Gabriella Marranghello; AMBROSIO, Renato; JR, Remo Susanna
This study aimed to investigate the effects of topical anesthetic and fluorescein drops on intraocular pressure (IOP), central corneal thickness (CCT) and biomechanical properties as measured by Corvis ST (CST-Oculus; Wezlar, Germany) in healthy eyes. A cross-sectional observational study was conducted on 46 healthy patients. The CST measurements were obtained before and immediately after the instillation of topical anesthetic and fluorescein drops. Pre-post instillation data were statistically analyzed. IOP measurements were compared to Goldmann's Applanation Tonometry (GAT), which was also performed after drops instillation. Biomechanical parameters analyzed included applanation 1 velocity, applanation 2 velocity, applanation 1 time, applanation 2 time, whole eye movement, deflection amplitude, and stiffness parameter at first applanation. A statistically significant difference in IOP, both for non-corrected IOP (IOPnct) and biomechanically corrected IOP (bIOP), was observed before and after the instillation of eyedrops. Despite this statistical significance, the observed difference lacked clinical relevance. The IOPnct demonstrated a significant difference pre and post-anesthetic and fluorescein instillation compared to GAT (14.99 +/- 2.27 mmHg pre-instillation and 14.62 +/- 2.50 mmHg post-instillation, versus 13.98 +/- 2.04 mmHg, with p-values of 0.0014 and 0.0490, respectively). Comparable findings were noted when justaposing bIOP to GAT (14.53 +/- 2.10 mmHg pre-instillation and 13.15 +/- 2.25 mmHg post-instillation, against 13.98 +/- 2.04 mmHg, with p-values of 0.0391 and 0.0022, respectively). Additionally, CCT measurements revealed a statistically significant elevation following the administration of topical anesthetic and fluorescein drops (from 544.64 +/- 39.85 mu m to 586.74 +/- 41.71 mu m, p < 0.01. None of the analyzed biomechanical parameters showed statistically significant differences after drops instillation. While the administration of topical anesthetic and fluorescein drops induced a statistically significant alteration in both IOPnct and bIOP readings, these changes were not clinically consequential. Furthermore, a notable statistical rise was observed in CCT measurements post-drops instillation, as determined by CST. Yet, corneal biomechanical parameters remained unaffected.
Profile of patients with essential blepharospasm and hemifacial spasm in the two largest ophthalmology reference centers in Brazil
(2024) FOWLER, Flavio A.; YABUMOTO, Cristina; OSAKI, Midori H.; GAMEIRO, Gustavo R.; BRABO, Janaina L.; MATAYOSHI, Suzana; MARINHO, Regina C. R. S.; OSAKI, Tammy H.
Purpose: Information is scarce regarding the comprehensive profile of patients with essential blepharospasm and hemifacial spasm in Brazil. The present study aimed to assess the clinical features of patients with these conditions, followed up in two reference centers in Brazil. Methods: The study included patients with essential blepharospasm and hemifacial spasm, followed up at the Departments of Ophthal- mology at Universidade Federal de Sao Paulo and Universidade de Sao Paulo. Apart from demographic and clinical features, past stressful events related to the first symptoms (triggering event), aggravating factors, sensory tricks, and other amelio- rating factors for the eyelid spasms were assessed.Results: A total of 102 patients were included in this study. Most patients were female (67.7%). Essential blepharospasm was the most frequent movement disorder [51/102 patients (50%)], followed by hemifacial spasm (45%) and Meige's syndrome (5%). In 63.5% of the patients, the onset of the disorder was associated with a past stressful event. Ameliorating factors were reported by 76.5% of patients; 47% of patients reported sensory tricks. In addition, 87% of the patients reported the presence of an aggravating factor for the spasms; stress (51%) was the most frequent. Conclusion: Our study provides infor- mation regarding the clinical features of patients treated in the two largest ophthalmology reference centers in Brazil.
Immunoglobulin A Antibodies Against Myelin Oligodendrocyte Glycoprotein in a Subgroup of Patients With Central Nervous System Demyelination
(2023) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; KULSVEHAGEN, Laila; LIPPS, Patrick; CAGOL, Alessandro; CERDA-FUERTES, Nuria; NEZIRAJ, Tradite; FLAMMER, Julia; LERNER, Jasmine; LECOURT, Anne-Catherine; SIEBENBORN, Nina De Oliveira S.; CORTESE, Rosa; SCHAEDELIN, Sabine; SCHOEPS, Vinicius Andreoli; MATOS, Aline de Moura Brasil; MENDES, Natalia Trombini; PEREIRA, Clarissa dos Reis; MONTEIRO, Mario Luiz Ribeiro; APOSTOLOS-PEREIRA, Samira Luisa dos; SCHINDLER, Patrick; CHIEN, Claudia; SCHWAKE, Carolin; SCHNEIDER, Ruth; PAKEERATHAN, Thivya; AKTAS, Orhan; FISCHER, Urs; MEHLING, Matthias; DERFUSS, Tobias; KAPPOS, Ludwig; AYZENBERG, Ilya; RINGELSTEIN, Marius; PAUL, Friedemann; CALLEGARO, Dagoberto; KUHLE, Jens; PAPADOPOULOU, Athina; GRANZIERA, Cristina; PROBSTEL, Anne-Katrin
IMPORTANCE Differential diagnosis of patients with seronegative demyelinating central nervous system (CNS) disease is challenging. In this regard, evidence suggests that immunoglobulin (Ig) A plays a role in the pathogenesis of different autoimmune diseases. Yet little is known about the presence and clinical relevance of IgA antibodies against myelin oligodendrocyte glycoprotein (MOG) in CNS demyelination. OBJECTIVE To investigate the frequency of MOG-IgA and associated clinical features in patients with demyelinating CNS disease and healthy controls. DESIGN, SETTING, AND PARTICIPANTS This longitudinal study comprised 1 discovery and 1 confirmation cohort derived from 5 centers. Participants included patients with suspected or confirmed demyelinating diseases and healthy controls. MOG-IgA, MOG-IgG, and MOG-IgM were measured in serum samples and cerebrospinal fluid (CSF) of patients, who were assessed from September 2012 to April 2022. MAIN OUTCOMES AND MEASURES Frequency and clinical features of patients who were seropositive for MOG-IgA and double-seronegative for aquaporin 4 (AQP4) IgG and MOG-IgG. RESULTS After the exclusion of 5 participants with coexisting AQP4-IgG and MOG-IgA, MOG-IgG, and/or MOG-IgM, 1339 patients and 110 healthy controls were included; the median follow-up time was 39 months (range, 0-227 months). Of included patients with isolated MOG-IgA, 11 of 18 were female (61%), and the median age was 31.5 years (range, 3-76 years). Among patients double-seronegative for AQP4-IgG and MOG-IgG (1126/1339; 84%), isolated MOG-IgA was identified in 3 of 50 patients (6%) with neuromyelitis optica spectrum disorder, 5 of 228 patients (2%) with other CNS demyelinating diseases, and 10 of 848 patients (1%) with multiple sclerosis but in none of the healthy controls (0/110). The most common disease manifestation in patients seropositive for isolated MOG-IgA was myelitis (11/17 [65%]), followed by more frequent brainstem syndrome (7/16 [44%] vs 14/75 [19%], respectively; P =.048), and infrequent manifestation of optic neuritis (4/15 [27%] vs 46/73 [63%], respectively; P =.02) vs patients with MOG-IgG. Among patients fulfilling 2017 McDonald criteria for multiple sclerosis, MOG-IgA was associated with less frequent CSF-specific oligoclonal bands (4/9 [44%] vs 325/351 [93%], respectively; P <.001) vs patients with multiple sclerosis who were MOG-IgG/IgA seronegative. Further, most patients with isolated MOG-IgA presented clinical attacks after recent infection or vaccination (7/11 [64%]). CONCLUSION AND RELEVANCE In this study, MOG-specific IgA was identified in a subgroup of patients who were double-seronegative for AQP4-/MOG-IgG, suggesting that MOG-IgA may be a novel diagnostic biomarker for patients with CNS demyelination.
Role of Corneal Epithelial Measurements in Differentiating Eyes with Stable Keratoconus from Eyes that Are Progressing
(2023) SANTHIAGO, Marcony R.; STIVAL, Larissa R.; ARAUJO, Daniella C.; KARA-JUNIOR, Newton; TOLEDO, Marcia C.
Purpose: To evaluate measures of corneal epithelium in eyes that showed documented signs of keratoconus (KC) progression and compare with stable eyes and healthy controls. Also, to determine the correlation of these epithelial parameters with maximum keratometry (K max) and pachymetry. Design: Prospective, observational, comparative study. Participants: One-hundred and fifty eyes from 150 patients. The study included 50 eyes from patients with documented KC progression, 50 eyes with stable KC, and 50 clinically normal eyes to serve as controls. Methods: A spectral-domain (SD)-OCT imaging was obtained in all eyes, and mean values were compared between the groups. The correlation of epithelial parameters with K max and thinnest pachymetry was also investigated. Main Outcome Measures: For the purposes of this study, the epithelial measures maximum, minimum, superior, and inferior values as well as the difference between the minimum and maximum (min-max) and epithelial standard deviation were considered, obtained from SD-OCT and compared between groups. Measurements of the thinnest point and min-max in pachymetry were also recorded. Results: The only epithelial parameter that presented a statistically significant difference between stable and progressive KC was epithelium min-max. Although stable KC presented epithelium min-max mean values of -18.2 +/- 6.6, progressive KC eyes presented mean values of -23.4 +/- 10.3 (P < 0.0001). Epithelial maximum (P = 0.16), minimum (P = 0.25), superior (P = 0.28), inferior (P = 0.23), and standard deviation (P = 0.25) values were not significantly different between stable and progressive eyes. Difference min-max pachymetry points in stable (-108.3 +/- 33.5) and progressive KC (-115.2 +/- 56.0) were not significantly different (P = 0.723). There was no significant correlation between epithelium min-max with corneal thinning (P = 0.39) or K max (P = 0.09) regardless of disease progression. Conclusions: Epithelial measures are useful to identify KC eyes that are progressing; the parameters that measure the difference between min-max epithelium points were significantly different between stable and progressive groups, unlike this difference in pachymetry. Finally, this epithelial parameter seems to be inde-pendent of corneal thinning and K max. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (c) 2022 by the American Academy of Ophthalmology.
Proposal of a new slit-lamp shield for ophthalmic examination and assessment of its effectiveness using computational simulations
(2023) FERRAZ, Daniel Araujo; GUAN, Zeyu; COSTA, Edinilson A.; MARTINS, Eduardo; KEANE, Pearse A.; TING, Daniel Shu Wei; JR, Rubens Belfort; SCHERER, Rafael; KOH, Victor; MUCCIOLI, Cristina
Purpose: This study aimed to use computational models for simulating the movement of respiratory droplets when assessing the efficacy of standard slit-lamp shield versus a new shield designed for increased clinician comfort as well as adequate protection. Methods: Simulations were performed using the commercial software Star-CCM+. Respiratory droplets were assumed to be 100% water in volume fraction with particle diameter distribution represented by a geometric mean of 74.4 (& PLUSMN;1.5 standard deviation) & mu;m over a 4-min duration. The total mass of respiratory droplets expelled from patients' mouths and droplet accumulation on the manikin were measured under the following three conditions: with no slit-lamp shield, using the standard slit-lamp shield, and using our new proposed shield. Results: The total accumulated water droplet mass (kilogram) and percentage of expelled mass accumulated on the shield under the three aforementioned conditions were as follows: 5.84e-10 kg (28% of the total weight of particle emitted that settled on the manikin), 9.14e-13 kg (0.045%), and 3.19e-13 (0.015%), respectively. The standard shield could shield off 99.83% of the particles that would otherwise be deposited on the manikin, which is comparable to 99.95% for the proposed design. Conclusion: Slit-lamp shields are effective infection control tools against respiratory droplets. The proposed shield showed comparable effectiveness compared with conventional slit-lamp shields, but with potentially enhanced ergonomics for ophthalmologists during slit-lamp examinations.
Real-world application of the 2022 diagnostic criteria for first-ever episode of optic neuritis
(2023) TERRIM, Sara; SILVA, Guilherme Diogo; FALCAO, Fernando Cavalcanti de Sa e Benevides; PEREIRA, Clarissa dos Reis; BENASSI, Thais de Souza Andrade; FORTINI, Ida; GONCALVES, Marcia Rubia Rodrigues; CASTRO, Luiz Henrique Martins; COMERLATTI, Luiz Roberto; RIMKUS, Carolina de Medeiros; ADONI, Tarso; PEREIRA, Samira Luisa Apostolos; MONTEIRO, Mario Luiz; CALLEGARO, Dagoberto
Optic neuritis (ON) admits diverse differential diagnoses. Petzold proposed diagnostic criteria for ON in 2022, although real-world application of these criteria is missing. We conducted a retrospective review of patients with ON. We classified patients into definite or possible ON, and into groups A (typical neuritis), B (painless), or C (binocular) and estimated the frequency of etiologies for each group. We included 77 patients, with 62% definite and 38% possible ON. CRION and NMOSD-AQP4 negative-ON were less commonly seen in definite ON. Application of the 2022 criteria revealed a lower-than-expected frequency of definite ON, particularly for seronegative non-MS causes.
Uso da estereofotogrametria para mensuração do volume da anatomia externa da face: revisão sistemática
(2018) MIRANDA, RICARDO EUSTACHIO DE; MATAYOSHI, SUZANA; BRABO, JANAINA LUCILA; MIYOSHI, LETÍCIA HARUMI
ABSTRACT Introduction: Photographic documentation is important in several medical specialties, such as plastic surgery. Two-dimensional photography has limitations in capturing structure depth and volume, requiring other instruments to evaluate these changes. Several technologies have been developed for three-dimensional analysis of objects, of which stereophotogrammetry uses computerized analysis of two or more simultaneous photographs of the object to produce a three-dimensional geometric model. The advantages of stereophotogrammetry include lower cost, portability, absence of radiation, and speed of image capture. The aim of the present study was to perform a bibliographic review evaluating the use and accuracy of stereophotogrammetry for measuring the volume of facial structures. Methods: Using a combination of MeSH keywords and free terms, a search was performed in the Cochrane Library and MEDLINE databases. The search included all articles published on or before May 2018. Results: 2,213 studies were initially retrieved using this search strategy. Of these, 27 studies were selected based on the eligibility criteria, of which 21 were non-randomized case studies and 6 were randomized clinical trials. The methodological quality of the studies varied between 50 and 67%, on a grading scale from 0 to 100%. Conclusions: Stereophotogrammetry is a promising technology that is increasingly being used to check for facial volume variations with high accuracy and reproducibility. More studies with higher methodological quality are needed for evaluating the accuracy and use of stereophotogrammetry for facial volume evaluations.
Procedimentos cirúrgicos e não cirúrgicos para elevação das sobrancelhas: revisão sistemática e fluxograma de abordagem
(2019) MIRANDA, RICARDO EUSTACHIO DE; MATAYOSHI, SUZANA
ABSTRACT Introduction: To review the medical literature regarding the surgical and non-surgical treatments of eyebrow ptosis and to present a decision flowchart for eyebrow lift. Methods: A systematic review of the literature available was held in PUBMED following inclusion and exclusion criteria. A flowchart was elaborated to systematize the approach to eyebrow ptosis based on the experience of the authors. Results: Several articles were included describing a variety of surgical and non-surgical correction techniques for eyebrow ptosis. The most common surgical approaches were internal eyebrow elevation, direct elevation, temporal elevation, and coronal/pretrichial/endoscopic rhytidoplasty. The non-surgical approaches found were botulinum toxin injections, fillers, and fixation threads. Conclusion: There are several surgical and non-surgical procedures described in the literature for lifting of the eyebrow, demonstrating that there is no ideal method for all patients. The use of a flowchart can help carry out a systematic and personalized approach according to the characteristics of each patient.
Optical coherence tomography angiography in a case of multiple retinal arterial macroaneurysms
(2020) LIMA, L. H.; CUNHA, L. P.
Retinitis pigmentosa and nanophthalmos in a patient with attenuated Hunter's syndrome
(2023) MARTINS, Thiago Goncalves dos Santos; COSTA, Ana Luiza Fontes de Azevedo; PIMENTEL, Sergio Luis Gianotti; OYAMADA, Maria Kiyoko; FINZI, Simone
PurposeTo describe a case of retinitis pigmentosa and nanophthalmos in a patient with attenuated Hunter's syndrome.MethodsFundus photography, total field electroretinogram, ultrasound, computerized visual field examination, biochemical examination and genetic testing were obtained.ResultsThe fundus exam showed diffuse arteriolar attenuation, optic disc with regular contours, and pigment agglomerates like ""bone spicules"" in the middle periphery. Ultrasound examination revealed scleral thickening and short axial diameter in both eyes. The total field electroretinogram exam showed a subnormal result with greater impairment of the scotopic phase of the exam. Computerized visual field examination demonstrated a diffuse reduction in retinal sensitivity in the periphery. Biochemical examination showed increased urine glycosaminoglycan excretion and iduronate-2-sulphatase activity (IDS) deficiency in leukocytes, confirming the type II mucopolysaccharidosis. Molecular analysis revealed a novel missense mutation (p.A77D) in the IDS gene.ConclusionThe case report is about a patient presented an attenuated form of the syndrome, with no cognitive impairment. Ophthalmologic follow-up is still an important part of multidisciplinary treatment for Hunter's syndrome.
Losartan Inhibition of Myofibroblast Generation and Late Haze (Scarring Fibrosis) After PRK in Rabbits
(2022) SAMPAIO, Lycia Pedral; HILGERT, Guilherme S. L.; SHIJU, Thomas Michael; SANTHIAGO, Marcony R.; WILSON, Steven E.
PURPOSE: To study the effect of topical losartan compared to vehicle on the generation of myofibroblasts and development of late haze scarring fibrosis after photorefractive keratectomy (PRK) in rabbits. METHODS: Twelve rabbits had-9.00 diopter (D) PRK in one eye followed by 50 mu L of topical 0.2 mg/mL losartan or 50 mu L of vehicle six times per day for 1 month. Standardized slit lamp photographs were obtained prior to death. Duplex immunohistochemistry was performed on cryofixed corneas for myofibroblast marker alpha-smooth muscle actin (a-SMA) and keratocyte marker keratocan or collagen type IV and transforming growth factor (TGF)-I31. ImageJ software (National Institutes of Health) was used for quantitation. RESULTS: Topical losartan compared to vehicle significantly decreased corneal opacity (P = .04) and anterior stromal myofibroblast generation (P = .01) at 1 month after PRK. Topical losartan compared to vehicle also decreased anterior stromal non-basement membrane collagen type IV at 1 month after PRK (P = .004). CONCLUSIONS: Topical angiotensin converting enzyme II receptor inhibitor losartan, a known inhibitor of TGF-I3 signaling, decreased late haze scarring fibrosis and myofibroblast generation after-9.00 D PRK in rabbits compared to vehicle. It also decreases TGF-I3-modulated, corneal fibroblast-produced, non-basement membrane stromal collagen type IV-likely also through inhibition of TGF-I3 signaling.[J Refract Surg. 2022;38(12):820-829.]

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