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ABSTRACT: To report the clinical picture of the rare association of nanophthalmos and pigmentary retinal dystrophy and its cataract surgery outcome.
We report a case of a 60-year-old female who presented with bilateral slowly progressive visual loss.
The patient presented with bilateral light perception visual acuity, exotropia, brunescent cataract hindering fundus examination and hypodontia. Ultrasonography revealed bilateral nanophthalmos. A visual-evoked potential was also performed preoperatively. Cataract surgery with +40D IOL implantation was uneventful. Postoperative fundus examination revealed pigmentary retinal dystrophy, confirmed by electrophysiologic tests. Glycosaminoglycan urinary excretion was normal.
Congenital bilateral nanophthalmos may rarely be associated with pigmentary retinal dystrophy. We suggest thorough preoperative evaluation in nanophthalmic eyes for the exclusion of significant features concerning visual prognosis.
Albrecht von Graæes Archiv für Ophthalmologie 10/2006; 244(9):1203-5. · 2.17 Impact Factor
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ABSTRACT: To evaluate the efficacy of postoperative beta irradiation and to analyze treatment sequelae in patients with primary and recurrent pterygium.
From June 1986 to June 1998, 94 patients corresponding to 100 eyes received postoperative beta irradiation. Two groups of patients were treated: 37 eyes with primary pterygium (Group I) and 63 eyes with recurrent pterygium (Group II). Terson technique surgery was used in the majority of patients. Time between surgery and beta irradiation ranged from 2 to 48 h. Radiation doses and fractionation consisted of 30 Gy/3 fractions/5 days in 17 cases, 60 Gy/6 fractions/6 weeks in 80 cases, and 20 Gy/1 fraction in 3 patients.
Fourteen of the 100 cases (14%) treated with surgery and adjuvant irradiation recurred. The overall crude local recurrence rates were 5.4% for Group I and 19% for Group II patients. The 5-year probability of local tumor control was 83.5% for the whole group of patients, 94% for Group I, and 76.9% for Group II (p = 0.04). The early sequelae related to surgery or irradiation were self limited and disappeared by 6 months after the end of the treatment: ocular irritation (14 cases), scleral atrophy (5 cases), and neovascularization (7 cases). A greater incidence of sequelae was observed in Group II patients, but the difference between the groups was not statistically significant (p = 0.15). No significant correlation between treatment sequelae and treatment dose was noted: 29% sequelae with 30 Gy vs. 18.7% sequelae with 60 Gy (p = 0.32). No late complications have been observed.
Adjuvant beta irradiation provides effective therapy for primary pterygium, is somewhate less effective in patients with recurrent pterygium, and is associated with a moderate rate of early and transient sequelae.
International Journal of Radiation OncologyBiologyPhysics 11/2000; 48(3):865-9. · 4.11 Impact Factor
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ABSTRACT: To evaluate basal serum prolactin levels in patients with HLA-B27-associated uveitis.
Prospective, nonrandomized comparative trial. Thirty-three patients with HLAB27- associated uveitis and 30 age- and sex-matched healthy control subjects were included. Age, systemic disease, treatment, and uveitis activity were recorded for comparative analysis between groups. Fourteen out of 23 patients with arthritic disease had ankylosing spondylitis. Basal serum prolactin levels were determined by electrochemiluminescence immunoassay on a Modular Analytics E170 analyzer.
Prolactinemia was significantly higher (mean=15.84 ng/mL) in patients vs controls (mean=11.50 ng/mL) (p=0.026). Subgroup analysis revealed prolactinemia in arthritic disease patients (mean=17.21 ng/mL) significantly higher than controls (mean=11.50 ng/mL) (p=0.009) and in ankylosing spondylitis (mean=17.65 ng/mL) vs controls (mean=11.50 ng/mL) (p=0.006). No correlation was found between prolactinemia and systemic treatment. Prolactinemia did not correlate with disease activity. Autoimmunity features also correlated with higher prolactinemia (mean=17.26 ng/mL) vs controls (mean=11.50 ng/mL) (p=0.015).
These results suggest the role of serum prolactin levels in HLA-B27-associated uveitis pathogenesis and its subgroups. There was no correlation with disease activity.
European journal of ophthalmology 18(6):929-33. · 0.96 Impact Factor
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ABSTRACT: In Portugal, the prevalence of human immunodeficiency virus type 2 (HIV-2) seropositivity is higher than in other European countries or North America. Recent literature data points out a possible difference on the pathogenic potential and on the natural history of HIV-1 and HIV-2, suggesting a lower virulence of HIV-2. Facing these hypothesis and the increasing number of HIV-2 cases, we analysed two infected groups HIV-1 and HIV-2, trying to correlate the ophthalmologic lesions present in both populations and searching for a difference in the clinical presentation of the ocular disorder. We studied prospectively 214 patients with HIV infection at several stages, 83% HIV-1 and 17% HIV-2. Ocular manifestations were present in both populations with a significant prevalence in HIV-1 (48%), compared to HIV-2 (19%) (p < 0.005). The ophthalmologic pathology found, particularly noninfectious retinopathy, infectious retinitis and neuro-ophthalmic disorders, were considered important for the disease's diagnosis and prognosis. All these ophthalmic findings were present in the HIV-1 population. In the HIV-2 group the most frequent lesion was noninfectious retinopathy. Within each group, HIV-1 and HIV-2, the comparison of the survival between AIDS patients with and without ocular lesions, revealed a significant shorter survival time in those with ocular pathology (p < 0.001 and p < 0.05). There seems to exist a certain analogy in clinical expression in both groups, although it is possible to admit a lower severity in ocular involvement in patients infected by HIV-2.
European journal of ophthalmology 3(1):13-20. · 0.96 Impact Factor
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ABSTRACT: To evaluate serum prolactin levels in Behçet disease (BD) and correlate with phenotypic expression of the disease.
This was a prospective, nonrandomized comparative trial. Twenty-two patients fulfilling BD Research Committee criteria and 21 healthy control subjects were included. Patients were classified in complete-type or incomplete-type BD subgroups according to clinical characteristics such as recurrent oral ulcers, genital ulcers, skin lesions, and ocular disease. Age, sex, HLA phenotyping, and therapy were recorded for comparative analysis between groups. Serum prolactin levels were determined by electrochemiluminescence immunoassay on a Modular Analytics E170 analyzer.
Prolactinemia was significantly higher (mean=19.34 ng/mL) in BD patients vs controls (mean=9.83 ng/mL) (p=0.009). This value was also statistically higher in complete-type BD sub-group vs controls (p=0.02). Younger patients (<30 y) required corticosteroids plus immunosuppressives more often (75%), suggesting an association between age and disease severity, al-though not statistically significant.
Results suggest the role of prolactin in BD pathogenesis and its association with disease expression, especially in complete-type BD.
European journal of ophthalmology 17(3):404-7. · 0.96 Impact Factor
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ABSTRACT: Purpose: To evaluate the efficacy of postoperative beta irradiation and to analyze treatment sequelae in patients with primary and recurrent pterygium.Methods and Materials: From June 1986 to June 1998, 94 patients corresponding to 100 eyes received postoperative beta irradiation. Two groups of patients were treated: 37 eyes with primary pterygium (Group I) and 63 eyes with recurrent pterygium (Group II). Terson technique surgery was used in the majority of patients. Time between surgery and beta irradiation ranged from 2 to 48 h. Radiation doses and fractionation consisted of 30 Gy/3 fractions/5 days in 17 cases, 60 Gy/6 fractions/6 weeks in 80 cases, and 20 Gy/1 fraction in 3 patients.Results: Fourteen of the 100 cases (14%) treated with surgery and adjuvant irradiation recurred. The overall crude local recurrence rates were 5.4% for Group I and 19% for Group II patients. The 5-year probability of local tumor control was 83.5% for the whole group of patients, 94% for Group I, and 76.9% for Group II (p = 0.04). The early sequelae related to surgery or irradiation were self limited and disappeared by 6 months after the end of the treatment: ocular irritation (14 cases), scleral atrophy (5 cases), and neovascularization (7 cases). A greater incidence of sequelae was observed in Group II patients, but the difference between the groups was not statistically significant (p = 0.15). No significant correlation between treatment sequelae and treatment dose was noted: 29% sequelae with 30 Gy vs. 18.7% sequelae with 60 Gy (p = 0.32). No late complications have been observed.Conclusion: Adjuvant beta irradiation provides effective therapy for primary pterygium, is somewhate less effective in patients with recurrent pterygium, and is associated with a moderate rate of early and transient sequelae.
International Journal of Radiation Oncology*Biology*Physics.
