RESUMO
Endocrine disruptors are a group of compounds that occur in increasing amounts in the environment. These compounds change the hormone homeostasis of the target organs regulated by those hormones, mostly by binding to their receptors and affecting their signaling pathways. Among the hormones altered by endocrine disruptors are sex hormones, thyroid hormones, and insulin. Studies have documented abnormalities in the reproductive and metabolic systems of various animal species exposed to endocrine disruptors. Endocrine disruptors can play a significant role in ocular diseases once hormone deficiency or excess are involved in the mechanism of that disease. Cataracts, dry eye disease and retinal diseases, such as macular hole and diabetic retinopathy, are some of the frequent problems where hormones have been implicated. We found that some compounds function as endocrine disruptors in the metabolism of body organs and systems. The increasing frequency of dry eye and other ocular diseases indicates the need to better investigate the potential relationships beyond the isolated associations mentioned by patients and documented as rare case reports. The evidence from case-control studies and experimental assays can provide the information necessary to confirm the endocrine effects of these chemicals in the pathophysiology of dry eye disease. We hypothesize that endocrine disruptors may contribute to the increase of ocular diseases, such as dry eye disease, in recent years.
Assuntos
Síndromes do Olho Seco/etiologia , Disruptores Endócrinos/efeitos adversos , Poluentes Ambientais , Oftalmopatias/etiologia , Animais , Retinopatia Diabética , Sistema Endócrino , Feminino , Homeostase , Hormônios , Humanos , Inflamação , Aparelho Lacrimal/fisiopatologia , Masculino , Reprodução , Perfurações Retinianas , Transdução de Sinais , Hormônios TireóideosRESUMO
PURPOSE: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. METHODS: A total of 278 patients ≥65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. RESULTS: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 ± 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). CONCLUSIONS: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.
Assuntos
Obstrução dos Ductos Lacrimais/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Blefarite/complicações , Blefarite/epidemiologia , Constrição Patológica , Estudos Transversais , Feminino , Humanos , Aparelho Lacrimal/patologia , Aparelho Lacrimal/fisiopatologia , Obstrução dos Ductos Lacrimais/etiologia , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Turquia/epidemiologiaRESUMO
ABSTRACT Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients ≥65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 ± 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.
RESUMO Objetivo: Estimar a prevalência de estenose externa do ponto lacrimal (EEPL) na população idosa e investigar os fatores associados. Métodos: Foram avaliados 278 pacientes ≥65 anos com estenose externa do ponto lacrimal de janeiro a julho de 2016. Todos os fatores sistêmicos, oculares, demográficos e de estilo de vida associados foram investigados. Foram utilizadas análises de regressão logística múltipla para avaliar os fatores relacionados a estenose externa do ponto lacrimal, valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A prevalência de estenose externa do ponto lacrimal foi de 63,3%, com idade média de 70,67 ± 7,85 (65-92 anos). O fator ocular mais relacionado com estenose externa do ponto lacrimal foi blefarite crônica. (IC de 95%, 0,08-0,96, p=0,043), história de tabagismo (IC 95%, 0,13-0,84, p=0,021), ectrópio (IC 95%, 0,004-0,26, p=0,001), queixa de lacrimejamento (95% IC, 1,11-3,52, p=0,02) e atividade ocupacional ao ar livre (IC 95%, 3,42-9,97, p<0,05). Conclusão: A estenose externa do ponto lacrimal é um distúrbio mais comum em pacientes idosos do que na população em geral. Atividade ocupacional ao ar livre, medicação antiglaucomatosa, ectrópio e tabagismo foram significativamente associados com estenose externa do ponto lacrimal. A decisão sobre tratamento cirúrgico deve ser dada após a avaliação completas dos fatores associados em cada paciente.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Obstrução dos Ductos Lacrimais/epidemiologia , Turquia/epidemiologia , Blefarite/complicações , Blefarite/epidemiologia , Fumar/efeitos adversos , Modelos Logísticos , Prevalência , Estudos Transversais , Fatores de Risco , Fatores Etários , Constrição Patológica , Aparelho Lacrimal/fisiopatologia , Aparelho Lacrimal/patologia , Obstrução dos Ductos Lacrimais/etiologiaRESUMO
El síndrome de disfunción de la película lagrimal mejor conocido como ojo seco, por su variación clínico patológica conlleva a un subregistro en los pacientes, por lo que es necesario la valoración en nuestra consulta, para determinar varios aspectos en torno a la patología y su prevalencia en los pacientes del servicio de reumatología del Hospital Universitario de Caracas. Métodos: fue de tipo observacional descriptivo de corte transversal, evaluando pacientes con patologías reumatológicas que acudieron a la consulta en el servicio de oftalmología, la muestra fue de 59 pacientes con antecedentes reumatológicos, que no presentaron síntomas específicos de ojo seco del servicio de reumatología del Hospital Universitario de Caracas, durante el período junio 2013 diciembre 2013.Se empleó la técnica de encuesta mediante un instrumento de recolección de datos tipo cuestionario que permitió identificar signos, síntomas y se logró medir cuantitativa y cualitativamente la secreción lagrimal y el grado de daño epitelial. Resultados: Se observó una prevalencia de 41,9 % del Síndrome Sjögren siendo más común en el sexo femenino y 44,8 % cursaban con SDPL, siendo más frecuente en el Síndrome de Sjögren. Asimismo 64,3 % de los pacientes con SDPL leve se encontraban sin tratamiento. Por su parte, 71,4 % de los pacientes con SDPL pertenecen al Síndrome de Sjögren. Conclusiones: El síndrome de disfunción de la película lagrimal es una entidad muy frecuente que debe tenerse presente siempre en patologías reumatológicas, y su control es esencial para la calidad visual del paciente(AU)
Syndrome of dysfunction of tear film as all too dry eye, for is relation pathologic clinic that begin to sub register in the patients, for that reason in necessary have a register in consult, for determine some aspects in relation with the illness and prevalence of tear film dysfunction in the patients of the rheumatology service University hospital of Caracas. Methods: The investigation was observation type, descriptive court traversal, evaluating patients on rheumatology pathologic that go to our ophthalmologist service. The total patients was 59 with antecedent rheumatologic, without specific symptoms of dry eye of the rheumatology service University Hospital of Caracas between June to December 2013. Using an assessment through an instrument of recollection information for tis way identify tool signs, symptoms were identified and managed quantitatively and qualitatively measure tear secretion and the degree of epithelial damage Results: The prevalence of 41.9 % of Sjögren 's syndrome is more common in females and 44.8 % were enrolled with SDPL, being more common in Sjögren's syndrome was observed. Also 64.3 % of patients with mild SDPL were untreated. Meanwhile, 71.4 % of patients with SDPL belong to Sjögren's syndrome. Conclusions: The syndrome of the tear film dysfunction is a very common condition that must be always present in rheumatologic diseases, and their control is essential for the patient's visual quality(AU)
Assuntos
Humanos , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/fisiopatologia , Aparelho Lacrimal/fisiopatologia , Reumatologia , Síndrome de SjogrenRESUMO
ABSTRACT We present two patients with dacryoliths and patent lacrimal drainage with intermittent tearing and without infection. Dacryoliths can be present in the lacrimal sac or lacrimal duct without acute or chronic inflammation. In these cases, we believe dacryolith formation was a causative factor of intermittent epiphora even with a patent drainage system, and we propose that dacryoliths and even fungal colonization formation may be the first event before dacryocystitis and should be considered as a cause of epiphora.
RESUMO Apresentamos dois pacientes com dacriolitíase e drenagem lacrimal patente com lacrimejamento intermitente, sem infecção. Os dacriolitos podem estar presentes no saco lacrimal ou duto lacrimal, sem inflamação aguda ou crônica. Neste caso nós acreditamos que a dacriolitíase foi um fator causador da epífora intermitente mesmo com sistema de drenagem patente e propomos que dacriolitíase e até mesmo a colonização fúngica pode ser o primeiro evento antes dacriocistite, e deve ser adicionada como uma das causas de epífora.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Cálculos/complicações , Aparelho Lacrimal/microbiologia , Doenças do Aparelho Lacrimal/complicações , Lágrimas/metabolismo , Infecções Oculares Fúngicas/complicações , Dacriocistite/complicações , Dacriocistite/microbiologia , Aparelho Lacrimal/fisiopatologiaRESUMO
We present two patients with dacryoliths and patent lacrimal drainage with intermittent tearing and without infection. Dacryoliths can be present in the lacrimal sac or lacrimal duct without acute or chronic inflammation. In these cases, we believe dacryolith formation was a causative factor of intermittent epiphora even with a patent drainage system, and we propose that dacryoliths and even fungal colonization formation may be the first event before dacryocystitis and should be considered as a cause of epiphora.
Assuntos
Cálculos/complicações , Doenças do Aparelho Lacrimal/complicações , Aparelho Lacrimal , Adulto , Dacriocistite/complicações , Dacriocistite/microbiologia , Infecções Oculares Fúngicas/complicações , Feminino , Humanos , Aparelho Lacrimal/microbiologia , Aparelho Lacrimal/fisiopatologia , Masculino , Pessoa de Meia-Idade , Lágrimas/metabolismoRESUMO
El presente estudio tuvo por objetivo evaluar la calidad lagrimal en el perro sin pelo del Perú mediante el uso de la prueba de tiempo de Ruptura de la película lagrimal precorneal (TRPLP). Material y métodos: El estudio se realizó en la ciudad de Lima entre los meses de Julio a Diciembre del año 2008. Se evaluaron 125 canes de diferentes edades, tamaños y de ambos sexos. Resultados: En los resultados de la prueba de TRPLP se observó un alto porcentaje de perros con mala calidad lagrimal: 94,4% (118/125) en el ojo derecho y el 92% (115/125) en el ojo izquierdo. No se encontró asociación entre el sexo, estrato etáreo y lado del ojo evaluado para la prueba de (TRPLP). Conclusión: Se concluye que existe un porcentaje elevado de perros sin pelo del Perú con una mala Calidad lagrimal...
The purpose of this study was to evaluate the tear quality of Peruvian hairless dog through the use of the tear film break up time (TFBUT). Material and methods: The study took place in Lima Between July 2008 and December 2008. Results: A total of 125 animals of different of poor quality: 94.4% (118/125) in the rigth eye and 92%(115/125) in the left eye and without significant difference due to sex, age and eye side evaluated. Conclusion: It is concluded that a high percentage of peruvian hairless dog a poor tear film quality...
Assuntos
Animais , Cães , Aparelho Lacrimal/fisiopatologia , Doenças do Cão , Ruptura/veterináriaRESUMO
PURPOSE OF REVIEW: Dry eye syndrome (DES) prevalence is large and its relationship with hormonal diseases is becoming clearer, although more complex. This review provides insight to this association as well as clarifying what remains unanswered about how to interpret and treat findings common to both DES and hormonal diseases. RECENT FINDINGS: Several sex hormone-related diseases are associated with DES. Hormone replacement therapy to correct such conditions has conflicting outcomes based on epidemiologic studies and clinical trials. Thyroid-associated diseases are frequently involved in DES and must be investigated in cases where the cause of the ocular disease is undetermined. Diabetes mellitus is one of the major causes of DES, whereas correcting the metabolic imbalance minimizes its ocular symptomology. Gene therapy to treat DES-related hormonal diseases is a promising option based on animal studies. SUMMARY: Diagnosis and management of hormonal diseases can minimize the ocular surface damage and severity of DES. Clinical care of DES includes patient evaluation of hormonal status. Future research requires clarification of the underlying disease mechanisms and identifying novel strategies to reprogram the endocrine system rather than chronic medication usage.
Assuntos
Síndromes do Olho Seco/fisiopatologia , Doenças do Sistema Endócrino/fisiopatologia , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/terapia , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/terapia , Terapia de Reposição Hormonal , Humanos , Aparelho Lacrimal/fisiopatologia , Soluções Oftálmicas/uso terapêuticoRESUMO
BACKGROUND: One of the adverse effects of radioactive iodine (¹³¹I) treatment in patients with thyroid cancer is damage to the salivary and lacrimal glands. In almost all studies evaluating salivary and lacrimal gland dysfunction, the patients received ¹³¹I after levothyroxine (L-T4) withdrawal. Since the biokinetics of ¹³¹I after recombinant human thyrotropin (rhTSH) is not the same as in hypothyroidism, studies need to evaluate ¹³¹I-induced salivary and lacrimal toxicity after preparation with rhTSH. This prospective study investigated the occurrence of salivary and lacrimal damage after ablation with ¹³¹I using this preparation. METHODS: One hundred forty-eight patients who had a total thyroidectomy were included in the study. The subjects were evaluated after thyroidectomy during L-T4 use to exclude those who already showed symptoms or had a history of ocular or oral disease. Symptoms were investigated 12 and 18 months after ablation. In patients who had persistent symptoms, specific tests were performed to confirm glandular dysfunction and to rule out other causes. RESULTS: Twelve months after ablation, symptoms of salivary or lacrimal dysfunction were observed in 10 (6.7%) patients, including oral symptoms in 8 (5.4%) and ocular symptoms in 6 (4%). Eighteen months after ¹³¹I, symptoms persisted in eight (5.4%) patients, including oral symptoms in seven (4.7%) and ocular symptoms in five (3.4%). In all of the patients, glandular dysfunction was confirmed by specific tests and other causes were ruled out. No symptoms were seen in the patients who received a low ¹³¹I dose (30 mCi). In the patients who received high ¹³¹I doses (100 or 150 mCi), symptoms were noted 12 months after ¹³¹I in 10 patients (9.2%), and 18 months after ¹³¹I in 8 patients (7.4%). CONCLUSIONS: Apparently, the rates of salivary and lacrimal damage were lower than those reported in prospective studies that used similar ¹³¹I activities, but these studies were performed in patients who were hypothyroid at the time of ¹³¹I ablation. Further studies are needed to compare radiotoxicity between patients prepared for ¹³¹I ablation with rhTSH and those prepared for ¹³¹I ablation with L-T4 withdrawal.
Assuntos
Radioisótopos do Iodo/efeitos adversos , Doenças do Aparelho Lacrimal/prevenção & controle , Tolerância a Radiação/efeitos dos fármacos , Compostos Radiofarmacêuticos/efeitos adversos , Doenças das Glândulas Salivares/prevenção & controle , Neoplasias da Glândula Tireoide/radioterapia , Tireotropina/uso terapêutico , Adulto , Brasil/epidemiologia , Terapia Combinada/efeitos adversos , Relação Dose-Resposta à Radiação , Feminino , Terapia de Reposição Hormonal , Humanos , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/etiologia , Radioisótopos do Iodo/administração & dosagem , Radioisótopos do Iodo/uso terapêutico , Aparelho Lacrimal/efeitos dos fármacos , Aparelho Lacrimal/metabolismo , Aparelho Lacrimal/fisiopatologia , Aparelho Lacrimal/efeitos da radiação , Doenças do Aparelho Lacrimal/epidemiologia , Doenças do Aparelho Lacrimal/etiologia , Doenças do Aparelho Lacrimal/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Doenças das Glândulas Salivares/epidemiologia , Doenças das Glândulas Salivares/etiologia , Doenças das Glândulas Salivares/fisiopatologia , Glândulas Salivares/efeitos dos fármacos , Glândulas Salivares/metabolismo , Glândulas Salivares/fisiopatologia , Glândulas Salivares/efeitos da radiação , Neoplasias da Glândula Tireoide/fisiopatologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Tiroxina/uso terapêuticoRESUMO
PURPOSE: To evaluate the outcomes of the tests used for dry eye diagnosis in patients with hepatitis C virus, and to verify if there is any relationship between the duration of illness and intensity of ocular surface changes. METHODS: 25 patients with hepatitis C virus without treatment, and 29 patients with negative serologic tests for hepatitis C virus were selected. Biomicroscopy, tear film crystallization test, tear film break-up time, evaluation of the corneal staining with 1% fluorescein sodium, Schirmer I test, ocular surface staining with 1% rose bengal and esthesiometry were performed in both groups. RESULTS: In the Schirmer I test, the group of patients with hepatitis C displayed lower values in both eyes (OR p=0.0162; OS p=0.0265). For the tear film break-up time, there was a lower score in the group with hepatitis C, but it was statistically significant only in the left eye (p=0.0007). Regarding the ocular surface damage, the rose bengal staining test showed a higher average in the hepatitis group in both eyes (right p=0.0008; left p=0.0034). There was a difference in the average esthesiometry between the groups, being the average lower in infected patients (OR p=0.0006; OS p=0.0015). There was no linear association between time of hepatitis C infection and intensity observed in dry eye tests. CONCLUSIONS: Hepatitis C virus infection causes dry eye. Further researches are necessary to establish the physiopathology and the relationship with Sjögren syndrome.