RESUMO
OBJECTIVE: This study evaluates the epidemiological characteristics, ophthalmological manifestations, and different therapeutic options available for patients with multiple sclerosis (MS) in China, Spain, and Cuba. METHODS: A self-designed questionnaire was used to conduct a comparable descriptive cross-sectional study on patients with MS. The survey included patients' demographic data, ocular manifestations related to MS, and treatment methodology followed in the three countries. The online survey was designed using the Wenjuanxing survey platform, and a survey link was circulated through WhatsApp, WeChat, and emails. Quantitative data were expressed as mean and standard deviation, the Kruskal-Wallis test was used for non-parametric variables. Qualitative data were expressed as numerical and percentage. The chi-square test (χ2) was used to compare the group's response categories. The statistical difference was considered significant when p < 0.05. RESULTS: The female-to-male ratio in all the three countries was 2-3:1, and relapsing-remitting MS (RRMS) was the most frequent in all three countries. Vision loss was slow and progressive in half of the patients from the three countries, with no significant differences (p = 0.524). A higher percentage of steroid treatment was observed in Chinese patients in comparison with the patients from other two countries (p < 0.001), and a similar trend was seen in the use of traditional medicines. Almost one-third of patients who did not receive any treatment recovered spontaneously in all the three countries (p = 0.097). CONCLUSIONS: MS occurs more frequently in the relapsing-remitting clinical form and there is a clear female predominance. The first ocular crisis or clinical debut of MS is characterized by slow and progressive visual impairment, increasing and adding to other ocular manifestations during its evolutionary course. Spontaneous recovery of vision after an attack of optic neuritis in the course of MS is possible.
Assuntos
Esclerose Múltipla , Transtornos da Visão , China/epidemiologia , Estudos Transversais , Cuba/epidemiologia , Feminino , Humanos , Internet , Masculino , Esclerose Múltipla/complicações , Espanha/epidemiologia , Inquéritos e Questionários , Transtornos da Visão/epidemiologia , Transtornos da Visão/patologia , Transtornos da Visão/terapiaRESUMO
PURPOSE: To evaluate the spatial association between visual field (VF) sensitivity loss and retinal nerve fiber layer (RNFL) thinning in patients infected by the human immunodeficiency virus. METHODS: Fifty-one eyes of 51 human immunodeficiency virus-infected patients and 22 eyes of 22 control subjects were enrolled. Patients were evaluated using the Fast RNFL scan strategy on Stratus OCT and the 24-2 full-threshold program on the Humphrey Matrix frequency doubling technology (FDT) perimeter. Associations between RNFL thickness and VF sensitivity were evaluated globally, in 12 clock-hour optical coherence tomography sectors and in 21 VF zones; linear and quadratic regression models were used in the statistical analysis. RESULTS: The linear and quadratic regression associations between the FDT Matrix pattern standard deviation and the average RNFL thickness in human immunodeficiency virus-infected patients were r2 = 0.185 and r2 = 0.218 (P < 0.05), respectively. The correlation between the FDT Matrix mean deviation and the average RNFL thickness was not significant (P > 0.05). Stronger associations were found when regional RNFL thinning was compared with locally measured FDT Matrix pattern deviation, especially between nasal RNFL measurements and temporal VF zones, and between superior RNFL measurements and inferior VF zones. CONCLUSION: Retinal nerve fiber layer thinning was related to VF sensitivity loss in human immunodeficiency virus-infected patients and regional associations between optical coherence tomography and FDT Matrix sectors were stronger than the associations between global measurements.
Assuntos
Infecções por HIV/complicações , Fibras Nervosas/patologia , Doenças Retinianas/virologia , Neurônios Retinianos/patologia , Transtornos da Visão/virologia , Campos Visuais/fisiologia , Adulto , Estudos de Casos e Controles , Feminino , Infecções por HIV/patologia , Infecções por HIV/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/patologia , Doenças Retinianas/fisiopatologia , Tomografia de Coerência Óptica , Transtornos da Visão/patologia , Transtornos da Visão/fisiopatologiaRESUMO
É um trabalho que trata do Censo Visual realizado em escolares da rede pública, relacionando com a dislexia e distúrbios de aprendizagem e comportamento, baseado em pesquisa efetuada no CEAE (Centro de Atendimento ao Educando) da Secretaria de Educação e Cultura do Estado do Rio Grande do Sul e em revisão bibliográfica. Relaciona-se com a educação e a psicologia. Analisa a importância do Censo Visual nas escolas para a prevenção dos distúrbios de aprendizagem e na prevenção da cegueira
This work deals with the Visual Census conducted among public school students. Focused on dyslexia and learning disorders and behavior, the article is based on the research performed in the CEAE (Student Support Center) of the Department of Education and Culture of Rio Grande do Sul and on a literature review. It is related to education and psychology and emphasizes the importance of the Visual Census in schools for the prevention of learning disabilities and blindness
Assuntos
Transtornos da Visão/diagnóstico , Transtornos da Visão/patologia , Transtornos da Visão/prevenção & controleRESUMO
A 12-year-old girl with a 3-month history of epistaxis and Castleman's disease presented with blurred vision in both eyes for 2 weeks. Indirect ophthalmoscopy revealed a blurred optic disc margin, venous engorgement and tortuosity, intraretinal hemorrhages and cotton wool spots, and serous detachment of the neurosensory retina in the posterior pole of each eye. Fluorescein angiography and laboratory tests revealed abnormalities consistent with the clinical examination. Six months following institution of immunosuppressive treatment, cryoglobulin levels decreased and visual acuity and funduscopic abnormalities were markedly improved. However, a few microaneurysms, retinal hemorrhages, and venous engorgement and tortuosity persisted. One month after the cessation of immunosuppressive treatment, symptoms related to the hyperviscosity syndrome recurred and the patient was treated with one session of plasmapheresis. One month after the plasmapheresis, the patient's symptoms resolved, laboratory values were normal, visual acuity was 20/15 in both eyes, and the funduscopic examination of each eye was unremarkable.
Assuntos
Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/terapia , Terapia de Imunossupressão , Plasmaferese , Transtornos da Visão/etiologia , Aneurisma/diagnóstico por imagem , Hiperplasia do Linfonodo Gigante/diagnóstico , Hiperplasia do Linfonodo Gigante/fisiopatologia , Criança , Epistaxe/etiologia , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Oftalmoscopia/métodos , Radiografia , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/patologia , Veia Retiniana/diagnóstico por imagem , Veia Retiniana/patologia , Timoma/complicações , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico , Transtornos da Visão/patologiaRESUMO
We studied the relationships between magnetic resonance imaging (MRI) findings and neuropsychological sequelae in children after severe traumatic brain injury. Twenty-three children ages 7-13 years underwent MRI assessment of brain lesion topography and volume and neuropsychological evaluations, more than 1 year after sustaining severe traumatic brain injury. Most children had lesions to the corpus callosum and frontal lobes. Total lesion volume and extent of cerebral atrophy did not impact on the neuropsychological evaluation. Additional relationships were observed: left frontal lesions with lower semantic verbal fluency, right occipital lesions with lower visual recognition task scores, dyscalculia with cerebellar lesions, and cerebellar damage with lower cognitive performances and lower visual recognition memory. This study demonstrates the significance of the cerebellum's role in neuropsychological outcomes after traumatic brain injury and the importance of the lesion depth classification in predicting functional results.
Assuntos
Lesões Encefálicas/patologia , Lesões Encefálicas/psicologia , Doenças Cerebelares/patologia , Doenças Cerebelares/psicologia , Cerebelo/lesões , Cerebelo/patologia , Adolescente , Fatores Etários , Lesões Encefálicas/fisiopatologia , Doenças Cerebelares/etiologia , Cerebelo/fisiopatologia , Criança , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/patologia , Transtornos Cognitivos/fisiopatologia , Corpo Caloso/lesões , Corpo Caloso/patologia , Corpo Caloso/fisiopatologia , Avaliação da Deficiência , Feminino , Lobo Frontal/lesões , Lobo Frontal/patologia , Lobo Frontal/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos da Memória/etiologia , Transtornos da Memória/patologia , Transtornos da Memória/fisiopatologia , Testes Neuropsicológicos , Lobo Occipital/lesões , Lobo Occipital/patologia , Lobo Occipital/fisiopatologia , Reconhecimento Visual de Modelos/fisiologia , Prognóstico , Distúrbios da Fala/etiologia , Distúrbios da Fala/patologia , Distúrbios da Fala/fisiopatologia , Transtornos da Visão/etiologia , Transtornos da Visão/patologia , Transtornos da Visão/fisiopatologiaRESUMO
INTRODUCTION: In 1996, Hinchey et al described a clinico-radiological picture they called posterior reversible leukoencephalopathy syndrome (PRLS), which is characterized by visual disorders, seizures, altered mental states and changes in the subcortical white matter of the temporoparietooccipital lobes that are shown up in the neuroimages. These clinical manifestations are associated with arterial hypertension. Later, other triggering elements, such as cytostatic drugs, were described without being linked to hypertension. Other authors have suggested the name of posterior reversible encephalopathy, since magnetic resonance imaging (MRI) reveals a high percentage of cortical compromise. CASE REPORTS: We present three cases of posterior reversible encephalopathy with different origins. Two of the cases involved females, one of whom was a 19-year-old hypertensive with lupus nephropathy and the other was a 33-year-old with eclampsia. The third case was an 11-year-old male child with post streptococcal glomerulonephritis and hypertension. The most relevant signs and symptoms included seizures, visual disorders, arterial hypertension and sensory deterioration. MR played a decisive role in diagnosis and it revealed an alteration of the signal in the supra and infratentorial white matter of the cortex and the subcortex, which was predominant in the posterior areas of the encephalon. The three cases presented a significant radiological and clinical improvement in a short time. CONCLUSION: Failure of the self regulation of cerebral vascular circulation, with development of oedema, is the most widely accepted hypothesis to explain the pathophysiological mechanism at work in this entity.
Assuntos
Encefalopatia Hipertensiva/patologia , Encefalopatia Hipertensiva/fisiopatologia , Convulsões/fisiopatologia , Transtornos da Visão/fisiopatologia , Adulto , Córtex Cerebral/patologia , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Síndrome , Transtornos da Visão/patologiaRESUMO
BACKGROUND: It has been traditionally accepted that ophthalmologic alterations in cases of primary empty sella syndrome are caused by the herniation of the visual system in the pituitary fossa, but this cannot be stated categorically. METHODS: Two female patients with primary empty sella syndrome and visual field defects were included in this series. The peculiarity of these cases was that in neither of them was there an evident herniation of the visual system. In the absence of other causes that could explain the visual defects, the patients were operated on through a transsphenoidal approach. RESULTS: Both patients showed immediate improvement of their visual deficits without recurrence. Postoperative imaging studies have shown continuance of an adequate elevation of the sellar contents during the 5-year follow-up period. CONCLUSIONS: Visual field defects in cases of primary empty sella syndrome may occur even without radiological evidence of herniation of the visual system. The fact that the two patients described in this paper improved after surgery supports other reports that in this syndrome traction on the infundibular stalk may cause some microscopic anatomic alteration in the visual system or in its vascular supply that is not evident on imaging studies.
Assuntos
Síndrome da Sela Vazia/complicações , Síndrome da Sela Vazia/patologia , Transtornos da Visão/etiologia , Transtornos da Visão/patologia , Adulto , Síndrome da Sela Vazia/cirurgia , Feminino , Hérnia/etiologia , Hérnia/patologia , Herniorrafia , Humanos , Imageamento por Ressonância Magnética , Transtornos da Visão/cirurgiaRESUMO
Esta é a segunda parte de urna revisäo da literatura do sistema visual sensorial. O autor seleciona artigos publicados na literatura entre os anos de 1997 e 1999 relacionados aneurorretinites; neuropatia óptica compressiva, tumores do nervo óptico, pseudotumor cerebral, neuropatias ópticas hereditárias, hipoplasia do nervo óptico, drusas do disco óptico, neuropatia óptica tóxica, neuropatia óptica traumática, outras neuropatias ópticas e doenças retinianas, doenças do quiasma óptico e do trato óptico, assim como alteraçöes geniculares e retrogeniculares, incluindo os distúrbios visuais corticais. Os artigos säo apresentados e comentados quanto às suas conclusöes, alcance e relaçöes com o conhecimento previamente estabelecido.
Assuntos
Humanos , Corpos Geniculados , Quiasma Óptico , Doenças do Nervo Óptico , Traumatismos do Nervo Óptico , Neoplasias do Nervo Óptico , Pseudotumor Cerebral , Retinite , Neurônios Aferentes/patologia , Neurite Óptica , Transtornos da Visão/patologiaRESUMO
PURPOSE: To report clinical and laboratory findings of bilateral corneal involvement in a patient with epidermolysis bullosa acquisita. METHODS: A 25-year-old man with a history of progressive and painless loss of vision in both eyes presented to our service with bilateral corneal involvement: peripheral corneal perforation in one eye and advanced corneal thinning in the other eye. There was concomitant dermatologic bullous disease. Clinical and laboratory exams were analyzed. RESULTS: The patient was diagnosed as having epidermolysis bullosa acquisita. Therapeutic corneal patch graft and conjunctival resection with cryotherapy were done, with satisfactory results. CONCLUSION: Bilateral corneal involvement in epidermolysis bullosa acquisita is described. To the best of our knowledge, this is the first description of such a case. Surgical management of the ocular findings associated with systemic therapy with colchicine seems to be a good therapeutic option in the management of this defying disease.