1
|
Marques JH, Baptista PM, Ribeiro B, Menéres P, Beirão JM. Intraocular lens power calculation: angle κ and ocular biomechanics. J Cataract Refract Surg 2024; 50:345-351. [PMID: 37962186 DOI: 10.1097/j.jcrs.0000000000001362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 11/02/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To study the effect of ocular biomechanics on the prediction error of intraocular lens (IOL) power calculation. SETTING Centro Hospitalar Universitário do Porto, Porto, Portugal. DESIGN Prospective longitudinal study. METHODS This study included 67 subjects. Before cataract surgery subjects underwent biometry with IOLMaster 700 and biomechanical analysis with Corvis Scheimpflug technology. The targeted spherical equivalent was calculated with SRK-T and Barrett Universal II. Associations between prediction error (PE), absolute prediction error (AE), and biometric and biomechanical parameters were performed with stepwise multivariate linear correlation analysis. RESULTS Using the SRKT formula, there was association between PE and Corvis Biomechanical Index (CBI, B = -0.531, P = .011) and between AE and the horizontal offset between the center of the pupil and the visual axis (angle κ, B = -0.274, P = .007). Considering the Barret Universal II formula, PE was independently associated with anterior chamber depth ( B = -0.279, P = .021) and CBI ( B = -0.520, P = .013) and AE was associated with angle κ ( B = -0.370, P = .007). CONCLUSIONS A large angle κ may reduce the predictability of IOL power calculation. Ocular biomechanics likely influence the refractive outcomes after IOL implantation. This study showed that eyes with softer corneal biomechanics had more myopic PE. This may relate to anteriorization of the effective lens position. Dynamic measurements may be the way to progress into future formulas.
Collapse
Affiliation(s)
- João Heitor Marques
- From the Serviço de Oftalmologia, Centro Hospitalar Universitário do Porto, Porto, Portugal (Marques, Baptista, Ribeiro, Menéres, Beirão); Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal (Baptista, Menéres, Beirão)
| | | | | | | | | |
Collapse
|
2
|
Ferreira A, Vieira RJ, Furtado MJ, Lume M, Andrade JP, Menéres P. Detection of subclinical microvascular changes in systemic lupus erythematous using optical coherence tomography angiography: A systematic review and meta-analysis. Surv Ophthalmol 2023; 68:1115-1128. [PMID: 37544614 DOI: 10.1016/j.survophthal.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic, systemic, autoimmune connective tissue disease that affects several vascular territories. We sought to assess the role of optical coherence tomography angiography in detecting subclinical microvascular alterations in SLE patients. PubMed, Scopus, and Web of Science databases were systematically searched until January 21, 2023. Studies using optical coherence tomography angiography as a primary diagnostic method to evaluate the macular microvasculature of SLE patients versus healthy controls were included. Primary outcomes were macular vessel density and foveal zone parameters. A meta-analysis was performed using a random-effects model. Of 301 screened abstracts, 15 were found eligible, enrolling 1,246 eyes from 1,013 patients. SLE patients presented a reduction of macular vessel density at both plexuses in all zones (whole scan, fovea, parafovea, and perifovea), and of foveal density compared with healthy controls. No differences were found at foveal avascular zone parameters. SLE patients presented a reduction of macular vessel density without signs or symptoms of SLE ocular involvement. Optical coherence tomography angiography application for the assessment of subclinical microvascular changes needs to be elucidated with longitudinal studies.
Collapse
Affiliation(s)
- André Ferreira
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Department of Biomedicine - Unit of Anatomy, Faculty of Medicine of University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal.
| | - Rafael José Vieira
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Maria João Furtado
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ICBAS - Instituto de Ciência Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - José P Andrade
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine of University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ICBAS - Instituto de Ciência Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
3
|
Castro C, Marques JH, Marta A, Baptista PM, José D, Sousa P, Menéres P, Barbosa I. Comparison of Light-Based Devices in the Treatment of Meibomian Gland Dysfunction. Cureus 2023; 15:e41386. [PMID: 37546127 PMCID: PMC10401307 DOI: 10.7759/cureus.41386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
PURPOSE To compare different light-based devices, namely, intense pulsed light (IPL) and IPL with low-level light therapy (LLLT), in the treatment of meibomian gland dysfunction (MGD). METHODS This was a prospective, observational study that included patients with MGD. Group 1 included 58 eyes treated with IPL (eye-light®, Espansione Marketing S.p.A., Bologna, Italy), followed by LLLT (my-mask®, Espansione Marketing S.p.A., Bologna, Italy); Group 2 included 60 eyes treated with IPL (E>Eye®, E-Swin, Houdan, France); and Group 3 included 58 eyes treated with IPL (Thermaeye Plus®, OptiMed, Sydney, Australia). The presence of symptoms (Ocular Surface Disease Index (OSDI)) and ocular surface changes were evaluated at baseline, three weeks, and six months after treatment. RESULTS At week three, there was an improvement in the OSDI in all groups (p<0.001), without differences among them (p=0.339). The lipid layer thickness (LLT) increased in Groups 1 and 2 (p<0.001), with a similar variation (p=0.144). Patients with superior OSDI and lower LLT at baseline had the greatest improvement in the respective parameters (p<0.001). The basal tear flow increased in Group 1 (p=0.012). Corneal staining (CS) significantly decreased in Groups 2 (p<0.001) and 3 (p<0.001). At six months, compared to three weeks, there was further improvement in the OSDI (p<0.001) and the LLT (p=0.007), in Group 1, and an increase in the presence of CS in Group 3 (p=0.011). CONCLUSION IPL treatment led to a sustained decrease in patients' symptoms, even after six months. Different IPL devices seem to have different beneficial effects. Adding LLLT to IPL appears to have an additional long-term beneficial effect as well as positive effects on the lacrimal gland.
Collapse
Affiliation(s)
- Catarina Castro
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | | | - Ana Marta
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | | | - Diana José
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Paulo Sousa
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Pedro Menéres
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Irene Barbosa
- Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| |
Collapse
|
4
|
Ferreira A, Vieira R, Maia S, Miranda V, Parreira R, Menéres P. Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis. Eur J Ophthalmol 2023; 33:92-103. [PMID: 35522228 DOI: 10.1177/11206721221099777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Amblyopia is a leading cause of preventable and treatable vision loss in the pediatric population. Instrument-based screening of amblyopia-risk factors is being widely adopted but the audit of its results is still lacking. We sought to review the existing evidence regarding the outcomes of photoscreening applied to children under the age of three years. METHODS A three-database search (Pubmed, ISI Web of Science, and Scopus) was performed from inception to March 2021. A meta-analysis of proportions was conducted to summarize the referral rate, untestable rate and positive predictive value (PPV). RESULTS Thirteen studies were selected among 705 original abstracts. The quantitative analysis included twelve studies enrolling 64,041 children. Of these, 13% (95%CI: 7-19%) were referred for further confirmation of the screening result. Astigmatism was the most common diagnosis both after screening and after ophthalmologic assessment of referred children. The pooled untestable rate and PPV were 8% (95%CI: 3-15%) and 56% (95%CI: 40-71%), respectively. CONCLUSION There is no global consensus on the optimal age, frequency or what magnitude of refractive error must be considered an amblyopia-risk factor. Optimization of referral criteria is therefore warranted.
Collapse
Affiliation(s)
- André Ferreira
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Rita Vieira
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sofia Maia
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Vasco Miranda
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Ricardo Parreira
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Service of Ophthalmology, 112085Centro Hospitalar Universitário do Porto, Porto, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| |
Collapse
|
5
|
Leite J, Castro C, Abreu AC, Pessoa B, Furtado MJ, Lume M, Menéres P. Posterior capsular rupture during cataract surgery in eyes treated previously with intravitreal injections. Ophthalmologica 2022; 246:9-13. [DOI: 10.1159/000528657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
Introduction:
Intravitreal injections are currently the most common intraocular surgical procedure worldwide.
Some studies have reported a higher risk of intraoperative complications, namely posterior capsular rupture (PCR), during cataract surgery.
The aim of this retrospective and observational study, conducted at Department of Ophthalmology, Centro Hospitalar Universitário do Porto, was to assess the risk of posterior capsular rupture (PCR) during cataract surgery in eyes previously treated with intravitreal injections (IVI) with antivascular endothelial growth factor (anti-VEGF) and/or corticosteroids.
Methods:
Eyes undergoing cataract surgery between June 2019 and May 2021. Combined surgeries, such as glaucoma surgery and pars plana vitrectomy (PPV) were excluded. The occurrence of PCR during cataract surgery in treated and previously untreated eyes with IVI was analyzed.
Results:
A total of 5813 cataract surgeries were analyzed; 4.1% of the cases had previously undergone IVI. The PCR rate in cataract surgery was 1.8%: 6.7% in eyes previously treated with IVI and 1.6% without previous IVI (OR=4.5, 95% CI: 2.6-7.7, p<0.001).
The combined therapy (anti-VEGF with corticosteroids) presents a higher risk compared to the two therapies alone as monotherapy (OR=11.6, 95% CI: 4.7-28.5, p<0.001), as well as treated eyes treated with ≥10 IVI (OR=2.1, 95% CI: 0.8-6.1, p=0.144) and a time interval between the last IVI and cataract surgery was ≤6 months (OR=1.9, 95% CI: 0.6-6.1, p=0.296).
Discussion/Conclusion:
These results demonstrate that eyes that require IV treatment prior to cataract surgery are at increased risk of CPA during cataract surgery, and careful assessment of the characteristics of the cataract and posterior capsule is critical.
Collapse
|
6
|
Oliveira I, Ferreira A, Vieira R, Malheiro L, Caiado F, Maia S, Miranda V, Parreira R, Menéres P. The Impact of Early Photoscreening on Medium-term Visual Acuity: A Population-Based Study. J Pediatr Ophthalmol Strabismus 2022; 60:178-183. [PMID: 35611825 DOI: 10.3928/01913913-20220428-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the outcomes of an early ophthalmological intervention in children included in the pilot project of the "Rastreio de Saúde Visual Infantil" (RSVI) visual screening program in Portugal. METHODS This was a retrospective analysis of the medical records of all children included in the RSVI from April 1, 2016 to December 31, 2016, and who were referred to an ophthalmology appointment. Data of refractive errors, anisometropia, amblyopia, instituted treatments, and visual acuity at the end of the ophthalmological intervention were collected. RESULTS Two hundred sixty-seven (18.2%) 2-year-old children from the Centro Hospitalar Universitário do Porto reference area had a positive screening result and were subsequently referred to an ophthalmology appointment. Glasses were prescribed to 31.1% of the patients who attended. Presumed amblyopia was diagnosed in 2.5% and occlusion was prescribed. At the end of a median follow-up of 3 years, of those who wore glasses without occlusion, 94.3% had a visual acuity of 20/25 or better in both eyes with an asymmetry of two lines or less between eyes. Of the 4 children who wore glasses with occlusion, 3 of them had a visual acuity of 20/25 or better in both eyes with an asymmetry of two lines or less between eyes. CONCLUSIONS This study demonstrates the effectiveness of an early intervention in the prevention and treatment of amblyopia, because after a median follow-up of 3 years after treatment none of the referred children met criteria for amblyopia and 94.3% of the referred children who had an intervention had a normal visual acuity. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].
Collapse
|
7
|
Pessoa B, Heitor J, Coelho C, Leander M, Menéres P, Figueira J, Meireles A, Beirão M. Systemic and vitreous biomarkers - new insights in diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2022; 260:2449-2460. [PMID: 35325286 DOI: 10.1007/s00417-022-05624-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 03/05/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Diabetic retinopathy (DR) is a microvascular inflammatory and neurodegenerative disease. The purpose of this study was to analyze the relationship between DR severity and the levels of potential biomarkers in the serum and/or vitreous. METHODS A prospective, consecutive, controlled, observational study was performed between June 2018 and January 2020. Blood and vitreous samples were collected on the day of vitrectomy in patients without diabetes and in patients with diabetes with epiretinal membrane, macular edema, and indication for vitrectomy. RESULTS Transthyretin (TTR) was the only blood biomarker with levels statistically higher in patients with diabetes (p = 0.037). However, no correlation with DR severity was observed. Erythropoietin (EPO) was the only blood biomarker whose levels were associated with DR severity (p = 0.036). In vitreous samples, levels of EPO (p = 0.011), interleukin (IL)-6 (p < 0.001), IL-8 (p < 0.001), IL-17 (p = 0.022), monokine induced by interferon-γ (MIG) (p < 0.001), and interferon gamma-induced protein 10 (IP-10) (p = 0.005) were significantly higher in patients with diabetes. Additionally, in vitreous, IL-6, IL-8, MIG, and IPL-10 levels were also higher in more severe DR cases (p < 0.05). CONCLUSIONS Among the studied biomarkers, vitreous IL-6, IL-8, MIG, and IP-10 were the ones whose levels had the strongest coherent relationship with DR severity prediction and, thus, have the best potential post-vitrectomy prognostic value.
Collapse
Affiliation(s)
- Bernardete Pessoa
- Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar-Edifício Neoclássico, 4099-001, Porto, Portugal.
- Unit for Multidisciplinary Investigations in Biomedicine (UMIB/ICBAS/UP), Porto, Portugal.
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
| | - João Heitor
- Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar-Edifício Neoclássico, 4099-001, Porto, Portugal
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade Do Porto, Porto, Portugal
| | - Constança Coelho
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Magdalena Leander
- Unit for Multidisciplinary Investigations in Biomedicine (UMIB/ICBAS/UP), Porto, Portugal
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| | - Pedro Menéres
- Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar-Edifício Neoclássico, 4099-001, Porto, Portugal
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade Do Porto, Porto, Portugal
| | - João Figueira
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
- Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Association for Innovation and Biomedical Research On Light and Image, Coimbra, Portugal
| | - Angelina Meireles
- Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar-Edifício Neoclássico, 4099-001, Porto, Portugal
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade Do Porto, Porto, Portugal
| | - Melo Beirão
- Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar-Edifício Neoclássico, 4099-001, Porto, Portugal
- Unit for Multidisciplinary Investigations in Biomedicine (UMIB/ICBAS/UP), Porto, Portugal
- Laboratory of Cytometry, Unit for Diagnosis in Hematology, Clinical Hematology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| |
Collapse
|
8
|
Silva N, Castro C, Caiado F, Maia S, Miranda V, Parreira R, Menéres P. Evaluation of Functional Vision and Eye-Related Quality of Life in Children with Strabismus. Clin Ophthalmol 2022; 16:803-813. [PMID: 35321043 PMCID: PMC8934867 DOI: 10.2147/opth.s354835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Nisa Silva
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Correspondence: Nisa Silva, Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, Porto, 4099-001, Portugal, Tel +35 1918367661, Fax +35 1222077500, Email
| | - Catarina Castro
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Filipa Caiado
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sofia Maia
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Vasco Miranda
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Ricardo Parreira
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| |
Collapse
|
9
|
Ferreira A, Marta A, Baptista PM, Caiado F, Abreu AC, Maia S, Miranda V, Pinto MC, Parreira R, Menéres P. Refractive Surgery for Older Children and Adults with Accommodative Esotropia: A Systematic Review. Ophthalmic Res 2022; 65:361-376. [PMID: 35226900 DOI: 10.1159/000523816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/20/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Accommodative esotropia (AET) is characterized by an esodeviation of the eyes due to uncorrected hyperopia, deficient fusional divergence, or high accommodative convergence. Decreasing hyperopia would reduce accommodative convergence and strabismus. We sought to review the existing evidence regarding the outcomes of refractive surgery in patients with AET. METHODS A four-database search (Pubmed, ISI Web of Science, Cochrane, and Scopus) was performed from inception to March 2021 using the following MeSH terms: ("Refractive Surgical Procedures" OR "Keratomileusis, Laser In Situ" OR "Photorefractive Keratectomy" OR "Lens Implantation, Intraocular") AND ("Esotropia" OR "Accommodative Esotropia" OR "Refractive Esotropia" OR "Accommodative Strabismus"). No meta-analysis was performed due to studies' heterogeneity. RESULTS Twenty-eight studies including 22 case series enrolling 378 patients and 6 case reports enrolling 8 patients were selected among 185 original abstracts. In the case series, a total of 378 patients (726 eyes) were recruited with an age range of 8-52 years. All studies reported mean follow-up periods of at least 12 months. Photorefractive keratectomy was performed in 7 studies, laser-assisted in situ keratomileusis in 9 studies, laser-assisted sub-epithelial keratectomy was reported in 1 study, and 3 studies implanted intraocular lenses, including iris-fixated and collamer. Considering the adult patients with a preoperative corrected esodeviation ≤10 prism diopters (PD) (n = 129), all but 5 (3.9%) presented orthophoria or ≤10PD after refractive surgery. All children but 4 (4.5%) ended up with an esodeviation ≤10PD after surgery with those exceptions being in the range of 11-15PD. Six case reports were included in this review, comprising a total of 8 patients (16 eyes) with an age range of 7-34 years and a follow-up range of 4-48 months. Six case reports were included in this review, comprising a total of 8 patients (16 eyes) with an age range of 7-34 years and a follow-up range of 4-48 months. CONCLUSION Evidence produced so far points out that refractive surgery may be an alternative for spectacle correction for adults with AET ≤10PD. There is not enough evidence to recommend its use for patients under 18 years of age. The safety and predictability of these procedures for this purpose remains unclear as the selection criteria used for these patients are much different than the usual indications and there are no studies with long-term follow-up.
Collapse
Affiliation(s)
- André Ferreira
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Ana Marta
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | - Filipa Caiado
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Carolina Abreu
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sofia Maia
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Vasco Miranda
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Maria Céu Pinto
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ricardo Parreira
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| |
Collapse
|
10
|
Pessoa B, Castro C, Ferreira A, Leite J, Heitor J, Menéres P, Figueira J, Meireles A, Beirão JM. Changes in ganglion cell layer thickness after treatment with the 0.2 µg/day fluocinolone acetonide implant in vitrectomized and nonvitrectomized eyes with diabetic macular edema. Ophthalmic Res 2022; 65:310-320. [PMID: 35086095 DOI: 10.1159/000520411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To compare changes in ganglion cell layer (GCL) between vitrectomized and nonvitrectomized eyes with diabetic macular edema (DME) over a 2-year period following treatment with 0.2 µg/day fluocinolone acetonide (FAc) implant. METHODS Eighteen vitrectomized (group 1) and 8 nonvitrectomized (group 2) eyes were included in this cohort study. Changes in central macula GCL thickness were measured using the Spectralis spectral domain optical coherence tomography (SD-OCT) at baseline and 6, 12 and 24 months of follow-up. Other parameters analyzed included best-corrected visual acuity (BCVA), central foveal thickness (CFT) and intraocular pressure (IOP). RESULTS Treatment with the FAc implant led to small reductions in mean global GCL thickness versus baseline and contrasts with the control group that was stable or slightly increased versus baseline. FAc therapy also led to improvements in mean BCVA and CFT that were observed at Month 6 and maintained to Month 24. For vitrectomised and non-vitrectomised eyes, no differences were observed between mean global GCL, BCVA and CFT values during follow-up. Linear correlations revealed that in all groups mean BCVA at Month 24 positively correlated with mean GCL thickness at baseline and at Month 24. IOP remained stable throughout the 24 months. CONCLUSION There was no evident retinal neurodegeneration in the 2-year period following treatment with FAc in both groups. GCL thickness may be a useful biomarker for assessing safety and effectiveness in patients with DME.
Collapse
Affiliation(s)
- Bernardete Pessoa
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Catarina Castro
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - André Ferreira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Leite
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Heitor
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - João Figueira
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Angelina Meireles
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - João Melo Beirão
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
11
|
Silva N, Ferreira A, Baptista PM, Figueiredo A, Reis R, Sampaio I, Beirão J, Vinciguerra R, Menéres P, Menéres MJ. Corneal Biomechanics for Ocular Hypertension, Primary Open-Angle Glaucoma, and Amyloidotic Glaucoma: A Comparative Study by Corvis ST. Clin Ophthalmol 2022; 16:71-83. [PMID: 35035215 PMCID: PMC8754459 DOI: 10.2147/opth.s350029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To evaluate biomechanical parameters of the cornea provided by Corvis ST in patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma and to compare with healthy controls. METHODS This was a cross-sectional study of patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma that underwent Corvis ST imaging. Primary outcome was the comparison of corneal biomechanical parameters between study groups after adjusting for age, gender, Goldmann intraocular pressure (GAT-IOP), and prostaglandin analogues medication. Secondary outcome was the comparison of different IOP measurements in each group. RESULTS One hundred and eighty-three eyes from 115 patients were included: 61 with primary open-angle glaucoma, 32 with amyloidotic glaucoma, 37 with ocular hypertension and 53 were healthy controls. Amyloidotic glaucoma group had smaller radius (p=0.025), lower deflection amplitude at highest concavity (p=0.019), and higher integrated radius (p=0.014) than controls. Ocular hypertension group had higher stiffness parameter at first applanation (p=0.043) than those with primary open-angle glaucoma, and higher stress-strain index (p=0.049) than those with amyloidotic glaucoma. Biomechanically corrected intraocular pressure was significantly lower than Goldmann intraocular pressure in group with primary open-angle glaucoma (p=0.005) and control group (p=0.013), and Goldmann intraocular pressure adjusted for pachymetry in group with primary open-angle glaucoma (p=0.01). CONCLUSION Eyes with amyloidotic glaucoma have more deformable corneas, while eyes with ocular hypertension have less deformable corneas. These findings may be linked to the susceptibility to glaucomatous damage and progression. There were significant differences between Goldmann applanation tonometry and biomechanically corrected intraocular ocular pressure provided by Corvis ST.
Collapse
Affiliation(s)
- Nisa Silva
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - André Ferreira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, 4200-319, Portugal
| | - Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Ana Figueiredo
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Rita Reis
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Isabel Sampaio
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - João Beirão
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| | - Riccardo Vinciguerra
- Ophthalmology Department, Humanitas San Pio X Hospital, Milan, Italy
- The School of Engineering, University of Liverpool, Liverpool, UK
| | - Pedro Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| | - Maria João Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| |
Collapse
|
12
|
José-Vieira R, Ferreira A, Menéres P, Sousa-Pinto B, Figueira L. Efficacy and safety of intravitreal and periocular injection of corticosteroids in non-infectious uveitis: a systematic review. Surv Ophthalmol 2021; 67:991-1013. [PMID: 34896190 DOI: 10.1016/j.survophthal.2021.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
Uveitis is among the leading causes of visual loss in the working age population. In non-infectious uveitis, corticosteroids are the first line therapy. We sought to review systematically the evidence regarding the regional corticosteroid delivery modalities in the treatment of non-infectious uveitis. A five-database search (Pubmed, ISI Web of Science, Cochrane, ClinicalTrials.gov, and Scopus) was performed from inception to February, 2021. Nineteen studies with a total of 1935 eyes of 1753 patients were selected from 8922 abstracts retrieved by the initial search. The most frequently compared regimens were intravitreal triamcinolone acetonide injection and orbital floor triamcinolone acetonide injection (2 studies), intravitreal triamcinolone acetonide injection and posterior sub-Tenon triamcinolone acetonide injection (2 studies), and posterior sub-Tenon triamcinolone acetonide injection with the intravitreal dexamethasone implant (2 studies). Our results show that the intravitreal injection of corticosteroids is more effective, but is associated with more adverse events, than periocular injection. Some evidence supports the use of subconjunctival triamcinolone acetonide over intravitreal/periocular triamcinolone acetonide. Moreover, the overall results of 0.59 mg dosage of the intravitreal fluocinolone acetonide implant were superior to those from the 2.1 mg dose. The evidence, however, is not robust and further studies with standardized outcomes are warranted.
Collapse
Affiliation(s)
- Rafael José-Vieira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, Porto, Portugal; RISE-Health Research Network, Porto, Portuga.
| | - André Ferreira
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Department of Ophthalmology, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, Porto, Portugal; RISE-Health Research Network, Porto, Portuga
| | - Luís Figueira
- Department of Ophthalmology, University Hospital Center of S. João, Porto, Portugal; Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; MedInUP-Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
| |
Collapse
|
13
|
Marques JP, Marta A, Geada S, Carvalho AL, Menéres P, Murta J, Saraiva J, Silva R. Clinical/Demographic Functional Testing and Multimodal Imaging Differences between Genetically Solved and Unsolved Retinitis Pigmentosa. Ophthalmologica 2021; 245:134-143. [PMID: 34695833 DOI: 10.1159/000520305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to compare clinical/demographic functional testing and multimodal imaging features between genetically solved and genetically unsolved nonsyndromic retinitis pigmentosa (nsRP) patients. METHODS A cross-sectional study was conducted at an inherited retinal dystrophies reference center. Consecutive patients with nsRP and available genetic testing results performed between 2018 and 2020 were included. Genetic testing was clinically oriented, and variants were classified according to the American College of Medical Genetics and Genomics. Only class IV or V variants were considered disease-causing. Clinical/demographic, functional, and imaging features were compared between genetically unsolved (G1) and genetically solved (G2) patients. RESULTS A total of 175 patients (146 families) were included: 68 patients (59 families) in G1 and 107 patients (87 families) in G2. First symptoms <25 years, consanguinity, evidence for a particular inheritance pattern, and the absence of indicators for phenocopies were significantly more prevalent in G2. No significant differences were observed on best-corrected visual acuity. The visual field index and mean central retinal layer thickness were significantly higher in G1. The frequency of atypical features on multimodal imaging did not differ between groups. CONCLUSION Individual clinical/demographic functional testing and multimodal imaging features should be considered when counseling patients about the probability of identifying disease-causing variants.
Collapse
Affiliation(s)
- João Pedro Marques
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Ana Marta
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal.,Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Sara Geada
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Ana Luísa Carvalho
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Department of Medical Genetics, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,University Clinic of Medical Genetics, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal.,Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Joaquim Murta
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Jorge Saraiva
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Department of Medical Genetics, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| | - Rufino Silva
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
| |
Collapse
|
14
|
Vieira R, Baptista P, Castro C, Leite J, Menéres MJ, Menéres P. Return of phacoemulsification after emergency status related to COVID-19: experience of a tertiary referral center. J Cataract Refract Surg 2021; 47:691-694. [PMID: 33229967 DOI: 10.1097/j.jcrs.0000000000000526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To present a protocol of priority criteria for phacoemulsification after the backlog due to severe acute respiratory syndrome coronavirus (SARS-CoV)-2 pandemic status. SETTING Ophthalmology department of Centro Hospitalar e Universitário do Porto (CHUP), Oporto, Portugal. DESIGN Cross-sectional, nonrandomized, retrospective study. METHODOLOGY Data of all patients waiting for cataract surgery were analyzed at the beginning of May 2020, after 2 months without performing elective surgery. The waiting time since surgical inscription was considered an independent and overriding factor. In addition, higher priority was given to patients with white or brunescent cataracts and patients with low visual acuity: corrected distance visual acuity (CDVA) of 20/200 or less in binocular patients or CDVA of 20/63 or less in monocular patients. Criteria of medium priority included patients who remained with anisometropia and patients with glaucoma or low to moderate risk for chronic angle closure. Data of scheduled surgeries in the following months were then analyzed. RESULTS A total of 717 patients were waiting for phacoemulsification. One hundred ninety-one patients (26.64%) were on the waiting list more than 4.5 months; the medium waiting time was 3.51 ± 1.57 months. According to both priority criteria and waiting time, 348 (48.6%) were categorized as priority cases. A total of 158 patients (22.0%) met the highest priority; 61 patients (8.5%) met the medium priority criteria. In 129 patients (18.0%), priority was considered based solely on higher waiting time. This algorithm allowed surgeons to operate on all priority cases within the first 3 months. CONCLUSIONS The presented protocol showed to be effective, providing a timely surgical opportunity for priority cases.
Collapse
Affiliation(s)
- Rita Vieira
- From the Ophthalmology Department of Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal (Vieira, Baptista, Castro, Leite, M.J. Menéres, P. Menéres); ICBAS (Instituto de Ciências Biomédicas Abel Salazar), Porto, Portugal (M.J. Menéres, P. Menéres)
| | | | | | | | | | | |
Collapse
|
15
|
Marta A, Coelho J, Vieira R, Figueiredo A, Reis R, Sampaio I, Menéres MJ, Menéres P. Biometric Predictability in Combined Cataract Surgery and Ahmed Glaucoma Valve Implantation Depending on Tube Position. Clin Ophthalmol 2021; 15:2037-2045. [PMID: 34017168 PMCID: PMC8131069 DOI: 10.2147/opth.s315940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the predictability of biometric results in patients undergoing cataract surgery combined with Ahmed glaucoma valve (AGV) implantation according to tube position. Methods A retrospective cohort study was performed in patients who underwent phacoemulsification surgery combined with AGV implantation with the tube in posterior (group PC) and anterior (group AC) chamber, between November 2012 and April 2020. The main outcome was the mean biometric prediction error, according to tube position, using different formulas. Results The study included 49 eyes of 36 patients, 23 eyes in group PC and 26 eyes in group AC. Gender (p=0.774), age (p=0.822), type of glaucoma (p=0.168), preoperative correct distance visual acuity (p=0.139), axial length (p=0.765), anterior chamber depth (p=0.351), keratometry (p=0.577) and intraocular lens power (p=0.608) were similar between groups. Only preoperative intraocular pressure was higher in group PC (p=0.005). The mean prediction errors using Haigis, SRK/T, Hoffer Q, Holladay 1, Barrett Universal II, Kane and Hill RBF formulas were all positive in group PC (hyperopic) and all negative (myopic) in group AC. In group PC, there was no significant difference in prediction error between these formulas (p>0.05). In group AC, the formula with the worst prediction error was Haigis (p=0.001), and the best was Barrett Universal II (p=0.043). Conclusion The biometric predictability and expected final refraction in phacoemulsification surgery combined with AGV implantation are modified by the position of the tube.
Collapse
Affiliation(s)
- Ana Marta
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Oporto, Portugal
| | - João Coelho
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal
| | - Rita Vieira
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal
| | - Ana Figueiredo
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal
| | - Rita Reis
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal
| | - Isabel Sampaio
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal
| | - Maria João Menéres
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Oporto, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Oporto, Portugal
| |
Collapse
|
16
|
Baptista PM, Marta AA, Marques JH, Abreu AC, Monteiro S, Menéres P, Pinto MDC. The Role of Corneal Biomechanics in the Assessment of Ectasia Susceptibility Before Laser Vision Correction. Clin Ophthalmol 2021; 15:745-758. [PMID: 33642854 PMCID: PMC7903962 DOI: 10.2147/opth.s296744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/20/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose To describe the tomographic and corneal biomechanical status of a sample of eyes excluded from LVC and to present the differences in biomechanical behavior in relation to cutoffs of clinical- and tomography-based screening methods used in clinical practice. Patients and Methods Observational cross-sectional study including 61 eyes from 32 consecutive patients who were excluded from LVC in our department. Clinical and demographic data were collected from the patients’ clinical records. Tomographic data was assessed with a Scheimpflug camera (Pentacam, OCULUS®). Ablation depth (µm) and residual stromal bed (µm) were calculated by the WaveLight® EX500 laser system software (Alcon, EUA). The corneal biomechanical assessment was made through ultra-high speed Scheimpflug imaging during noncontact tonometry (Corvis ST, OCULUS®). Several ectasia risk scores were analyzed. Results Mean age was 31.0±6 years old and mean manifest spherical equivalent was −2.01 ± 2.3D. Belin–Ambrósio deviation index was the tomographic parameter with higher proportion of eyes within the ectasia high risk interval. In the biomechanical assessment, more than 95% of eyes met the criteria for ectasia susceptibility in four of the first generation and in two of the second generation parameters. In a cutoff based comparative analysis, eyes with Kmax ≥45.5 D, eyes with VCOMA <0 and eyes with ARTmax ≤350 presented significantly softer corneal biomechanical behavior. Conclusion The majority of eyes excluded from LVC in the present study met the criteria for ectasia susceptibility in several biomechanical parameters, validating the clinical and tomographic based screening prior to LVC in our center. Differences found in the biomechanical assessment regarding cutoffs used in clinical practice highlight its differential role in characterizing risk profile of these patients. Tomography should not be overlooked and the integration of all data, including treatment-related parameters, can be the future of risk ectasia screening prior LVC.
Collapse
Affiliation(s)
- Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
| | - Ana Ambrósio Marta
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Heitor Marques
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Carolina Abreu
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sílvia Monteiro
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
| | - Maria do Céu Pinto
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| |
Collapse
|
17
|
Pessoa B, Melo-Beirão J, Meireles A, Menéres P. Challenging Clinical Cases - A Walk Through Supplemental Therapy with Intravitreal Ranibizumab Therapy Following Treatment of Diabetic Macular Edema with the 0.19 mg Fluocinolone Acetonide Implant (ILUVIEN ®). Int Med Case Rep J 2020; 13:437-448. [PMID: 32982484 PMCID: PMC7501957 DOI: 10.2147/imcrj.s262587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/24/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose There are limited published data regarding the use of supplemental intravitreal therapies in patients with diabetic macular edema (DME) following treatment with the 0.19 mg fluocinolone acetonide (FAc; ILUVIEN®) intravitreal implant. The aim of this report was to analyze five challenging eyes that required supplemental therapies after treatment with the FAc implant. Methods This is a retrospective case series conducted at the Centro Hospitalar Universitário do Porto in Porto, Portugal, between 2015 and 2019. It aimed to assess the patient background, treatment history and patient outcomes in challenging clinical cases in which intravitreal injections (IVI) of ranibizumab had been given pro re nata following treatment with the FAc implant (with a minimum follow-up of 33 months). Parameters measured included best-corrected visual acuity in early treatment diabetic retinopathy scale, central macular thickness and intraocular pressure. Patients Five eyes (three patients) diagnosed with persistent or recurrent DME and suitable for treatment with the FAc implant according to its licensed indication in Europe. Results In the first 2 patients, one bilateral, DME was refractory to IVI of short-acting corticosteroids and anti-VEGF. Following FAc therapy, there was a favorable evolution and a clear regression of diabetic retinopathy (DR) severity. Supplemental treatments were adopted, but a reduced number of treatments were needed beyond three years in these cases. The third case had bilateral DME. One eye had been vitrectomized and FAc therapy led to resolution of DME within 6 months. In the contralateral eye, the control of DME was dependent on anti-VEGF supplemental treatments until a pars plana vitrectomy was performed. Conclusion The multifactorial nature of DME means there is a need for an individualized treatment approach to the management of DME. It also explains why some patients need a combined or a more aggressive approach to therapy in order to achieve successful outcomes for the patient.
Collapse
Affiliation(s)
- Bernardete Pessoa
- Ophtalmology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - João Melo-Beirão
- Ophtalmology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Angelina Meireles
- Ophtalmology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Pedro Menéres
- Ophtalmology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
18
|
Falcão I, Neiva L, Almeida A, Maia S, Miranda V, Parreira R, Menéres P. Application of the WINROP model in Retinopathy of Prematurity (ROP) screening in a
Portuguese cohort of premature infants. Revista Brasileira de Oftalmologia 2019. [DOI: 10.5935/0034-7280.20190007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
19
|
Abreu AC, Malheiro L, Coelho J, Neves MM, Gomes M, Oliveira L, Menéres P. Implantation of intracorneal ring segments in pediatric patients: long-term follow-up. Int Med Case Rep J 2018; 11:23-27. [PMID: 29445305 PMCID: PMC5808705 DOI: 10.2147/imcrj.s151383] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the long-term outcomes of intracorneal ring segments (ICRS) implantation for keratoconus management in pediatric patients. Methods Retrospective case series review of the long-term (>5 years) outcomes of Intacs® ICRS implantation for keratoconus in pediatric patients (age <18 years old at the time of surgery) between January 2008 and December 2011 at Ophthalmology Department of Hospital de Santo António. Demographic data, follow-up time, preoperative and postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) in decimal scale, and corneal topography were evaluated. Statistical analysis was done using SPSS for windows (version 24). Significance was set at p<0.0125. Results Fourteen eyes of 14 patients, with a mean age of 15.36 years (range 10-18 years), were included in this study. All patients had been diagnosed with keratoconus with reported progression in the 6 months prior to surgery. Follow-up time was 6.36±0.97 years. UCVA and BCVA improved after ICRS implantation (p<0.0125). Keratometry (K) minimum (Kmin) and K maximum (Kmax) decreased after surgery (p<0.0125). During follow-up, UCVA, BCVA, Kmin, and Kmax values ranged, showing a tendency to worsen at the end of follow-up. However, statistically significant differences were not observed. Conclusion ICRS implantation showed good visual and topographic results in pediatric patients. Long-term follow-up suggests that, despite ICRS implantation, there is still progression of keratoconus. To the best of our knowledge, there are no reports regarding the long-term efficacy of ICRS implantation in pediatric patients.
Collapse
Affiliation(s)
- Ana Carolina Abreu
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Luisa Malheiro
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - João Coelho
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Miguel Mesquita Neves
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Miguel Gomes
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal.,Ophthalmology Department, Instituto de Ciências Biomédicas Abel Salazar (ICBAS) - Universidade do Porto, Porto, Portugal
| | - Luis Oliveira
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal.,Ophthalmology Department, Instituto de Ciências Biomédicas Abel Salazar (ICBAS) - Universidade do Porto, Porto, Portugal
| | - Pedro Menéres
- Ophthalmology Department of Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal.,Ophthalmology Department, Instituto de Ciências Biomédicas Abel Salazar (ICBAS) - Universidade do Porto, Porto, Portugal
| |
Collapse
|
20
|
Carneiro I, Dias D, Casal I, Maia S, Miranda V, Parreira R, Menéres P. Preverbal visual photo screening Project implementation in Portugal. Revista Brasileira de Oftalmologia 2018. [DOI: 10.5935/0034-7280.20180029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
21
|
Marcos-Figueiredo P, Marcos-Figueiredo A, Menéres P, Braga J. Ocular Changes During Pregnancy. Rev Bras Ginecol Obstet 2018; 40:32-42. [PMID: 28783856 PMCID: PMC10416176 DOI: 10.1055/s-0037-1605366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022] Open
Abstract
Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of the mode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.
Collapse
Affiliation(s)
| | | | - Pedro Menéres
- Centro Hospitalar do Porto (CHP), Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
| | - Jorge Braga
- Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
- Centro Materno-Infantil do Norte (CMIN), CHP, Porto, Portugal
| |
Collapse
|
22
|
Abreu AC, Lages V, Batista P, Ribeiro A, Menéres P, Pessoa B. First 5 years of Implementation of Diabetic Screening Program in Centro Hospitalar do Porto. Revista Brasileira de Oftalmologia 2017. [DOI: 10.5935/0034-7280.20170061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
23
|
Vale C, Menezes C, Firmino-Machado J, Rodrigues P, Lume M, Tenedório P, Menéres P, Brochado MDC. Astigmatism management in cataract surgery with Precizon(®) toric intraocular lens: a prospective study. Clin Ophthalmol 2016; 10:151-9. [PMID: 26855559 PMCID: PMC4727514 DOI: 10.2147/opth.s91298] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon® toric intraocular lens (IOL) for the correction of corneal astigmatism in cataract surgery. Setting Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal. Design This was a prospective clinical study. Patients and methods A total of 40 eyes of 27 patients with corneal astigmatism greater than 1.0 diopter (D) underwent cataract surgery with implantation of Precizon® toric IOL. IOL power calculation was performed using optical coherence biometry (IOLMaster®). Outcomes of uncorrected (UDVA) and best-spectacle corrected distance visual acuities (BCDVA), refraction, and IOL rotation were analyzed at the 1st week, 1st, 3rd, and 6th month’s evaluations. Results The median postoperative UDVA was better than preoperative best-spectacle corrected distance visual acuity (0.02 [0.06] logMAR vs 0.19 [0.20] logMAR, P<0.001). At 6 months, postoperative UDVA was 0.1 logMAR or better in 95% of the eyes. At last follow-up, the mean spherical equivalent was reduced from −3.35±3.10 D to −0.02±0.30 D (P<0.001) with 97.5% of the eyes within ±0.50 D of emmetropia. The mean preoperative keratometric cylinder was 2.34±0.95 D and the mean postoperative refractive cylinder was 0.24±0.27 D (P<0.001). The mean IOL rotation was 2.43°±1.55°. None of the IOLs required realignment. Conclusion Precizon® toric IOL revealed very good rotational stability and performance regarding predictability, efficacy, and safety in the correction of preexisting regular corneal astigmatism associated with cataract surgery.
Collapse
Affiliation(s)
- Carolina Vale
- Department of Ophthalmology, Hospital Geral de Santo António - Centro Hospitalar do Porto, EPE, Porto, Portugal
| | - Carlos Menezes
- Department of Ophthalmology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | | | - Pedro Rodrigues
- Department of Ophthalmology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Hospital Geral de Santo António - Centro Hospitalar do Porto, EPE, Porto, Portugal
| | - Paula Tenedório
- Department of Ophthalmology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Hospital Geral de Santo António - Centro Hospitalar do Porto, EPE, Porto, Portugal
| | - Maria do Céu Brochado
- Department of Ophthalmology, Hospital Geral de Santo António - Centro Hospitalar do Porto, EPE, Porto, Portugal
| |
Collapse
|
24
|
Miranda V, Zilhão C, Menéres P, Guedes M. PReS-FINAL-2112: Mapping the treatment effect of infliximab on a case of refractory anterior uveitis related to juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2013. [PMCID: PMC4044215 DOI: 10.1186/1546-0096-11-s2-p124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|