Departamento de Otorrinolaringologia e Oftalmologia - FM/MOF
URI Permanente desta comunidade
O Departamento de Otorrinolaringologia e Oftalmologia da Faculdade de Medicina da Universidade de São Paulo vincula-se à disciplina de mesmo nome que está presente na grade da Faculdade de Medicina da USP desde a sua fundação (1912). Contribui para a formação técnica, científica e profissional dos alunos da FMUSP e de profissionais oriundos desta e outras faculdades do país e do exterior, nos seus cursos de graduação em Medicina, residência médica, programa de complementação especializada (fellowship), programa de capacitação profissional para médicos estrangeiros, programa de prática profissionalizante, programa de pesquisador e cursos de pós graduação stricto-sensu (Mestrado e Doutorado). Contribui igualmente com a formação técnica, científica e profissional de alunos do curso de graduação em fonoaudiologia, fisioterapia e terapia ocupacional, bem como em cursos de especialização a profissionais já formados destas áreas (Fonoaudiologia, Fisioterapia e Psicologia).
A área de oftalmologia tem como subespecialidades: catarata, córnea, ecografia, estrabismo, glaucoma, glaucoma congênito, neuroftalmologia, plástica ocular, retina, uveíte e visão subnormal.
Site: http://www.otorrinousp.org.br/
http://www.oftalmologiausp.com.br/
A área de oftalmologia tem como subespecialidades: catarata, córnea, ecografia, estrabismo, glaucoma, glaucoma congênito, neuroftalmologia, plástica ocular, retina, uveíte e visão subnormal.
Site: http://www.otorrinousp.org.br/
http://www.oftalmologiausp.com.br/
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Coleções desta Comunidade
- Departamento de Otorrinolaringologia e Oftalmologia - FM/MOF
- Departamento de Otorrinolaringologia e Oftalmologia - FM/MOF
- Departamento de Otorrinolaringologia e Oftalmologia - FM/MOF
Submissões Recentes
Manifestações oftalmológicas na doença inflamatória intestinal
(2015) ALVES, Milton Ruiz; ROIZENBLATT, Jaime; ROIZENBLATT, Marina
Otite média crônica
(2021) RAPOPORT, Priscila Bogar; MARONE, Silvio Antonio Monteiro
Patologia infecciosa do anel linfático de Waldeyer
(2021) MARONE, Silvio Antonio Monteiro; ALMEIDA, Edigar Rezende de; SILVEIRA, José Alexandre Médicis da
Relationship between automated choroidal thickness measurements and retinal sensitivity using microperimetry in patients with myopia and different stages of myopic maculopathy
(2024) SILVA, Fillipe de Biaggi Borges da; SILVA, Luis Claudio Pimentel; CUNHA, Leonardo Provetti; ZACHARIAS, Leandro Cabral; NAVAJAS, Eduardo V.; MONTEIRO, Mario L. R.; PRETI, Rony C.
Purpose To assess the relationship between macular choroidal thickness (CT) measurements and retinal sensitivity (RS) in eyes with myopia and different stages of myopic maculopathy. Methods A masked, cross-sectional, and consecutive study involving patients with emmetropia/myopia (control group) and high myopia (HM) eyes. Automated choroidal thickness (CT) and manual outer retinal layer (ORL) thickness were acquired using swept-source optical coherence tomography, while retinal sensitivity (RS) assessed by microperimetry (MP3) in all regions of the macular Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Comparisons were made between groups, and correlations were performed among these measurements, demographic and ocular parameters and myopic maculopathy classification. Results A total of 37 (74 eyes) patients were included in the study. The mean age was 39 +/- 13 years, and 28 patients (76%) were female. HM eyes exhibited inferior best-corrected visual acuity and a more advanced myopic maculopathy classification compared to the control group. The mean macular CT were 255 and 179 mu m in the control and HM eyes (P < 0.001), respectively. In the HM eyes, superior ETDRS region presented the greatest values. Mean RS in control and HM groups was 28 and 24 dB (P = 0.001), respectively. Inner temporal followed by superior, were the regions of higher RS. Mean ORL thickness was 83 and 79 mu m (P < 0.001), in the control and HM groups, respectively. The inner temporal ETDRS region presented the thickest measure. CT correlated significantly with RS (r = 0.41, P < 0.001) and ORL thickness, (r = 0.58, P < 0.001), which also correlated with RS (r = 0.40, P < 0.001). Spherical equivalent, axial length and myopic maculopathy stage were the parameters that most correlated with CT, RS and ORL thickness. For every 100 mu m increase in thickening of CT there was an average increase of 3.4 mu m in ORL thickness and 2.7 dB in RS. Myopic maculopathy classification demonstrated influence only with CT. Conclusion Myopia degree is related to ORL and choroidal thinning and deterioration of retinal sensitivity in some ETDRS regions of the macula. Choroidal thinning is associated to with a decline of retinal sensitivity, thinning of ORL, and worsening of myopic maculopathy classification, so new treatments are necessary to prevent myopia progression.
Chemosensory Dysfunction 3-Months After COVID-19, Medications and Factors Associated with Complete Recovery
(2023) FORNAZIERI, Marco Aurelio; SILVA, Jose Lucas Barbosa da; GAMEIRO, Juliana Gutschow; SCUSSIATO, Henrique Ochoa; RAMOS, Rafael Antonio Matias Ribeiro; CUNHA, Bruno Machado; FIGUEIREDO, Alan Felipe; TAKAHASHI, Eduardo Hideki; MARIN, Gabrielli Algazal; CAETANO, Igor Ruan de Araujo; MELI, Tainara Kawane; HIGUCHI, Diego Issamu; SANTOS, Rafael Rodrigues Pinheiro dos; RAMPAZZO, Ana Carla Mondek; PINNA, Fabio de Rezende; VOEGELS, Richard Louis; DOTY, Richard L.
Objectives: To examine the longitudinal prevalence and recovery of olfactory, gustatory, and oral chemesthetic deficits in a sizable cohort of SARS-CoV-2 infected persons using quantitative testing. To determine whether demographic and clinical factors, mainly the medications used after the COVID-19 diagnosis, influence the test measures. Methods: Prospective cohort in a hospital with primary, secondary, tertiary, and quaternary care. Patients with confirmed COVID-19 were tested during the acute infection phase (within 15 days of initial symptom, n = 187) and one (n = 113) and 3 months later (n = 73). The University of Pennsylvania Smell Identification Test, the Global Gustatory Test, and a novel test for chemesthesis were administered at all visits. Results: During the acute phase, 93% were anosmic or microsmic and 29.4% were hypogeusic. No one was ageusic. A deficit in oral chemesthesis was present in 13.4%. By 3 months, taste and chemesthesis had largely recovered, however, some degree of olfactory dysfunction remained in 54.8%. Remarkably, patients who had been treated with anticoagulants tended to have more olfactory improvement. Recovery was greater in men than in women, but was unrelated to disease severity, smoking behavior, or the use of various medications prior to, or during, COVID-19 infection. Conclusions: When using quantitative testing, olfactory disturbances were found in nearly all SARS-CoV-2 infected patients during the acute infection phase. Taste or chemesthetic deficits were low. Olfactory impairment persisted to some degree in over half of the patients at the 3-month follow-up evaluation, being more common in women and less common in those who had been treated earlier with anticoagulants.
Surgical management of retinal detachment and macular holes secondary to ocular toxoplasmosis: a systematic review and meta-analysis
(2024) AMARAL, Dillan Cunha; LANE, Mark; AGUIAR, Eduardo Henrique Cassins; MARQUES, Guilherme Nunes; CAVASSANI, Luiza Visentin; RODRIGUES, Marcio Penha Mortera; ALVES, Milton Ruiz; MANSO, Jose Eduardo Ferreira; MONTEIRO, Mario Luiz Ribeiro; LOUZADA, Ricardo Noguera
BackgroundToxoplasma gondii causes ocular toxoplasmosis (OT), involving inflammation, scarring, and retinal complications. The OT complications were retinal detachment (RD), and retinal breakage (RB). Surgical interventions like scleral buckling (SB) and vitrectomy are common. Limited understanding exists of the safety and efficacy of surgical management of RD/RB secondary to OT. Another complication is toxoplasmosis-related macular holes (tMH), with sparse evidence on surgical outcomes. This meta-analysis aims to clarify clinical characteristics, and surgical results, and enhance understanding of RD, RB, and MH secondary to OT.MethodsPubMed, Cochrane, Embase and Web of Science database were queried for retrospective studies, case series and case reports that provided information on RD, RB and MH associated with OT and reported the outcomes of: (1) Retinal reattachment of RD/RB and tMH closure; (2) Best-corrected visual acuity (BCVA) improvement; and (3) Complications. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Statistical analysis was performed using the software R (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria).ResultsFourteen final studies, comprising a total of 96 patients were analyzed, 81 with RD or RB and 15 with tMH. Overall, surgical management was associated with several advantages: a high rate of retinal reattachment of RD/RB of 97% (95% Confidence Interval [CI] 92-100%; I2 = 0%), retinal reattachment of just RD of 96% (95% CI 89-100%; I2 = 30%) and tMH closure 97% (95% CI 87-100; I2 = 12%). There were significant differences in BCVA after surgeries in studies of RD/RB (MD 0.60; 95% CI 0.35-0.65; I2 = 20%) and MH (MD 0.67; 95% CI 0.50-0.84; I2 = 0%). The overall complication rate associated with surgical procedures in RD/RB secondary to OT was confirmed to be 25%.ConclusionsThe systematic review and meta-analysis showed that the treatment approaches currently in use are effective, with a remarkable rate of retinal reattachment of RD/RB, tMH closure, and substantial improvements in visual acuity. More randomized, long-term studies on disease and surgical factors can provide valuable insights into their impact on anatomical and visual outcomes.
Endoscopic Study of Ethmoidal Canals in Cadavers, Including a Histological Analysis of Their Contents
(2024) FELIPPU, Alexandre Wady Debes; MORSCH, Thiago Picolli; FELIPPU, Andre Wady Debes; CASCIO, Filippo; OLIVEIRA, Claudia Regina Gomes Cardim Mendes de; FELIPPU, Alexandre; VOEGELS, Richard Louis
Introduction The advent of the endoscope has enabled the use of the endonasal approach for a variety of diseases. Studying the ethmoidal canals is important for surgeries of the paranasal sinuses and the anterior base of the skull.Objective To investigate the ethmoidal canals and evaluate their structure, the presence of vessels and nerves, their location, and to perform an anatomopathological study of their contents.Methods We evaluated 20 cadavers (20 left and 20 right nasal cavities) through endoscopic dissection of the anterior base of the skull and exposure of the medial periorbita and dura mater; then, the ethmoidal canals were located and measured in relation to the anterior wall of the sphenoid sinus and between the ethmoidal canals, followed by removal of their content for histological analysis.Results Vessels were present in 75% of the left anterior ethmoidal canals, 70% of the left posterior ethmoidal canals, 75% of the left middle ethmoidal canals, 85% of the right anterior ethmoid canals, and 64.5% of the right posterior ethmoid canals; 50% of the right middle ethmoidal canals contained one vessel.Conclusion The ethmoidal canal does not necessarily contain an ethmoidal artery. Studies with a larger sample should be performed to quantify the correct proportion of arteries and ethmoidal canals.
Correlation between retinal sensitivity assessed by microperimetry and structural abnormalities on optical coherence tomography after successful epiretinal membrane surgery
(2024) MATOS, Aline Mota Freitas; DEFINA, Raphael Lucas Sampaio; COSTA-CUNHA, Luciana Virginia Ferreira; ZACHARIAS, Leandro Cabral; PRETI, Rony Carlos; MONTEIRO, Mario Luiz Ribeiro; CUNHA, Leonardo Provetti
BackgroundTo verify the correlation between retinal sensitivity (RS) assessed by the microperimetry (MP) and optical coherence tomography (OCT) parameters measured in eyes submitted to pars-plana vitrectomy (PPV) for idiopathic epiretinal membrane (ERM) treatment.Methods43 patients underwent PPV. Best-corrected visual acuity (BCVA) and OCT imaging were acquired preoperatively and 6 months after surgery. The RS values were recorded 6 months after the surgery. Total macular thickness (TMT) measurements and OCT-evaluated structural findings were also analyzed. The MP examination tested 44 points, with direct topographic correspondence with the OCT-ETDRS map. Correlations between BCVA, RS, and OCT parameters were assessed.ResultsTMT measurements in patients were significantly thicker preoperatively and reduced after surgery. All patients demonstrated BCVA improvements after surgery. The RS parameters after surgery were significantly lower in patients. For OCT structural analyses, patients with lower RS at the fovea correlated with the preexisting disorganization of retinal inner layers (DRIL). In addition, lower RS values were associated with DRIL, outer retinal changes (ORC), and intraretinal microcysts after surgery.ConclusionsThe RS values after surgery were significantly lower when compared to controls. The DRIL presence before and after surgery, and microcysts and ORC after surgery were related to worse visual outcomes.
Optical coherence tomography detection of retinal neural loss in patients with tuberous sclerosis
(2024) DIAS, Paula Basso; LINHARES, Anna Carolina Badotti; URZEDO, Ana Barbara Dias Lopes; PRETI, Rony Carlos; ZACHARIAS, Leandro Cabral; CUNHA, Leonardo Provetti; MONTEIRO, Mario Luiz Ribeiro; HOKAZONO, Kenzo
PurposeTuberous Sclerosis (TS) is a rare, multisystem genetic disease caused by mutations in the TSC1 and TSC2 genes, leading to abnormalities in cell differentiation and proliferation. This study aimed to evaluate the neural integrity of individuals with TS by using Optical Coherence Tomography (OCT) to examine the peripapillary retinal nerve fiber layer (RNFL) thickness and the macular thickness in patients with TS and to compare with healthy controls.MethodsPeripapillary and macular OCT scans (Optopol Revo NX SD OCT) were performed on 41 eyes from 22 TS patients, divided into two groups based on the presence of retinal hamartomas, and compared to 20 eyes from a control group. The average peripapillary RNFL thickness was measured for each quadrant. The macular total thickness and ganglion cell layer (GCL) + inner plexiform layer (IPL) thickness were measured based on the Early Treatment Diabetic Retinopathy Study (ETDRS) map. All measurements were then compared between the groups and controls.ResultsThe TS group showed significantly reduced RNFL thickness and macular thickness when compared to the control group. Specifically, patients with retinal hamartomas exhibited an even more pronounced thinning of both RNFL and macular thickness.ConclusionsThese findings suggest that TS patients undergo significant changes in retinal neurodevelopment and experience axonal loss. This finding may have significant prognostic utility regarding central nervous system degeneration in TS, particularly among patients with retinal hamartomas. OCT may serve as a valuable tool for assessing axonal structural abnormalities in TS patients.Trial Registration Number: Not applicable.ConclusionsThese findings suggest that TS patients undergo significant changes in retinal neurodevelopment and experience axonal loss. This finding may have significant prognostic utility regarding central nervous system degeneration in TS, particularly among patients with retinal hamartomas. OCT may serve as a valuable tool for assessing axonal structural abnormalities in TS patients.Trial Registration Number: Not applicable.
Retinoblastoma treatment in a Brazilian population. Presentation and long-term results
(2024) BONANOMI, Maria Teresa Brizzi Chizzotti; ALMEIDA, Maria Tereza A. de; HOLLAENDER, Marianna A.; BONANOMI, Roberta Chizzotti; MONTEIRO, Mario Luiz Ribeiro
IntroductionRetinoblastoma is a malignant tumor with a high cure potential when proper therapy is used. The purpose of this paper is to report the clinical features and outcomes of patients with retinoblastoma who were treated with a combination of local and systemic chemotherapy-based protocols.MethodWe retrospectively studied patients treated with systemic chemotherapy plus local treatment between 2003 and 2015 with a follow-up >= 2 years. We correlated clinical and pathological characteristics with decimal visual acuity (VA) and death.ResultsAmong 119 patients, 60% had unilateral disease (UNI), and 52% were male. The median presentation age was 19.5 months, 10% had a positive family history, and the most frequent sign was leukocoria (68.8%). Advanced disease was more frequent in eyes with UNI (98.4%) than in eyes with bilateral retinoblastoma (BIL: 55.3%). Enucleation was performed in 97% of UNI eyes and in 55.8% of BIL eyes. The overall globe salvage was 26.6%, 44.25% of BIL eyes. Bilateral enucleation was required in 5%. High-risk pathologic features occurred in 50% and 37% of eyes enucleated without and with neoadjuvant chemotherapy, respectively. High-risk features were related to the presence of goniosynechiae in the pathologic specimen and were more frequent in children younger than 10 months or older than 40 months. Extraocular disease was present in 5% of patients, and the death rate related to metastasis of the tumor was 8%. The final VA was >= 0.7 in 72.8% and >= 0.1 in 91% of BIL patients.ConclusionsTreatment of retinoblastoma with conservative systemic-based chemotherapy was associated with an excellent survival rate (92%). Albeit the low overall globe salvage rate, in BIL patients, approximately half the eyes were conserved, and a satisfactory functional visual result was achieved The evaluated protocol is an important treatment option, especially in developing countries. We report the clinical features and outcomes of patients with retinoblastoma treated with systemic chemotherapy and local consolidation with a follow-up period of greater than 2 years in Brazil. We discuss the high-risk features of this neoplasm and emphasize the high success rate obtained, including 92% survival and reading visual acuity in 72.8% of bilateral disease.image