Publications by authors named "Laurentino Biccas Neto"

9 Publications

  • Page 1 of 1

Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review.

Case Rep Ophthalmol Med 2020 30;2020:6490535. Epub 2020 Jan 30.

Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.

Colorectal cancer may yield metastasis to the choroid. Its management may be challenging, since there is no consensus about treatment. We describe a case of a 70-year-old male with colon cancer who complained of worsening visual acuity of his better-seeing eye to 20/40 secondary to a nonpigmented choroidal mass of medium reflectivity under the inferior temporal arcade and neurosensory foveal detachment. Besides systemic chemotherapy, local treatment with verteporfin photodynamic therapy (vPDT) was performed. After one month, visual acuity improved to 20/25 and subretinal fluid faded. In conclusion, vPDT may be a useful adjuvant treatment modality for choroidal metastasis secondary to colorectal cancer.
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http://dx.doi.org/10.1155/2020/6490535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016402PMC
January 2020

Effectiveness and Safety of Intravitreal Dexamethasone Implant (Ozurdex) in Patients with Diabetic Macular Edema: A Real-World Experience.

Ophthalmologica 2019 8;241(1):9-16. Epub 2018 Nov 8.

Retina Private Office, Buenos Aires, Argentina.

Introduction: There are few real-life studies on the intravitreal 0.7-mg dexamethasone implant for the treatment of diabetic macular edema (DME) conducted in Latin America. We aimed to assess the effectiveness and safety of this implant in clinical practice.

Methods: Twenty-seven centers from Brazil and one from Argentina provided information on patients with DME treated with Ozurdex. The efficacy outcome variables were best-corrected visual acuity (BCVA) in Snellen and central retinal thickness (CRT). Safety was assessed by the elevation in intraocular pressure (IOP), occurrence of cataracts, and adverse events.

Results: A total of 329 eyes (both treated cases and naïve eyes) from 282 patients underwent treatment. The time since diagnosis of DME ranged from 1 to 156 months. The median BCVA was 0.7 logMAR/50 letters at baseline and 0.3 logMAR/70 letters after treatment (both p < 0.001). Median CRT values decreased from 425 µm at baseline to 270 µm after treatment (p < 0.001). Increases in IOP of at least 10 mm Hg were observed in 7.4% of eyes, and 4% of eyes had cataract evolution. No cases of endophthalmitis were reported.

Conclusion: These real-life results suggest that the intravitreal dexamethasone implant is effective and safe for eyes with DME.
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http://dx.doi.org/10.1159/000492132DOI Listing
February 2019

Acute visual loss and optic disc edema followed by optic atrophy in two cases with deeply buried optic disc drusen: a mimicker of atypical optic neuritis.

BMC Ophthalmol 2018 Oct 26;18(1):278. Epub 2018 Oct 26.

Ocular Oftalmologia, Vitória, Brazil.

Background: Sudden visual loss and optic disc edema caused by optic neuritis (ON) is usually followed by significant visual recovery. However, little or no recovery occurs when the loss is caused by atypical ON, especially in patients with neuromyelitis optica (NMO). Optic disc drusen (ODD) is a cause of pseudo optic disc edema and may be a predisposing factor for non-arteritic anterior ischemic optic neuropathy (NAION), thereby mimicking atypical ON. In such cases, if globular concretions are seen protruding from the disc substance, ODD may be suspected. The purpose of this paper is to describe two patients with acute visual loss followed by optic disc atrophy initially labeled as atypical ON. Though not suspected on clinical examination, optical coherence tomography (OCT) revealed deeply buried ODD as a predisposing factor for NAION.

Case Presentations: Case 1: A 48-year-old woman had bilateral sequential visual loss associated with optic disc edema. Despite treatment, vision did not improve and severe disc pallor ensued. Atypical ON was suspected. Eventually, she was started on immunosuppressant therapy based on a tentative diagnosis of NMO-spectrum disorder. On examination 5 years later, only severe optic disc pallor was observed, but OCT radial B-scans showed ovoid hyporeflective areas in the retrolaminar region of both eyes, compatible with ODD; this led to a diagnosis of NAION and deeply buried ODD. Case 2. A 35-year-old woman with suspicion of ON in the left eye and a history of previous atypical ON in the right eye was referred for neuro-ophthalmic examination which revealed diffuse optic disc pallor and a dense arcuate visual field defect in the right eye. OCT B-scans passing through the disc showed large ovoid areas of reduced reflectivity in the retrolaminar region of the optic disc in the right eye. These findings helped confirm the diagnosis of NAION in one eye, with deeply buried ODD as predisposing factor.

Conclusions: Deeply buried ODD may be associated with NAION causing irreversible visual loss and optic disc pallor, a condition easily mistaken for atypical ON. Awareness of such occurrence is important to avoid unnecessary testing and minimize the risk of mismanagement.
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http://dx.doi.org/10.1186/s12886-018-0949-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203970PMC
October 2018

Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome.

Arq Neuropsiquiatr 2013 Feb 8;71(2):74-7. Epub 2013 Jan 8.

Neuroscience Post-graduation Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Objective: To evaluate the quality of life (QoL) and potential QoL determinants in patients with clinically isolated syndrome (CIS).

Methods: Eighteen CIS patients and eighteen controls were submitted to QoL evaluation with Functional Assessment of Multiple Sclerosis QoL instrument (FAMS). Cognition was evaluated with specific battery tests; Anxiety and depression with Beck Anxiety (BAI) and Depression (BDI) Inventories and Neurological disability with Guy's Neurological Disability Scale (GNDS).

Results: There was a significant difference in QoL between CIS patients and controls. CIS patients had worse performance in Paced Auditory Serial Addition 2 seconds (p=0.009) and fluency tests (p=0.0038). There was a significant difference in BAI (p=0.003), but no significant difference in BDI between patients and controls. There were significant correlations between QoL measure and verbal fluency and Stroop's test.

Conclusions: Cognition, but not anxiety, depression and disability, was associated with reduced quality of life.
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http://dx.doi.org/10.1590/s0004-282x2013005000004DOI Listing
February 2013

Cognitive impairment in patients with clinically isolated syndrome.

Dement Neuropsychol 2012 Oct-Dec;6(4):266-269

Professor, Department of Pathology and Internal Medicine, Santa Casa School of Health Sciences, Vitória ES, Brazil and Neuroscience Postgraduate Program, Federal University of Minas Gerais, Belo Horizonte MG, Brazil.

Cognitive abnormalities have been extensively studied in Multiple Sclerosis (MS). However, little is known about the cognitive involvement in patients with Clinically Isolated Syndrome (CIS).

Objective: This study aimed to investigate cognitive impairment in patients with CIS compared with healthy subjects.

Methods: 18 CIS patients and 18 controls were subjected to the Wechsler memory scale, Rey Auditory Verbal Learning, Rey Complex Figure, Paced Auditory Serial Addition, Digit Span, verbal fluency, Stroop color card test, D2, and Digit Symbol tests.

Results: CIS patients had significantly worse performance on the Paced Auditory Serial Addition Test (PASAT) 2 seconds (P=0.009) and on verbal fluency tests (P=0.0038) than controls.

Conclusion: CIS patients had worse cognitive performance than controls on neuropsychological tests evaluating executive functioning.
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http://dx.doi.org/10.1590/S1980-57642012DN06040011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5619339PMC
December 2017

[Toxic maculopathy caused by antimalarial drugs: detection using spectral domain OCT: case reports].

Arq Bras Oftalmol 2009 Sep-Oct;72(5):710-4

Escola de Medicina, Santa Casa de Misericórdia de Vitória, Vitória, ES, Brasil.

Antimalarial drugs, such as chloroquine, are useful in the management of rheumatic diseases, but may cause a potentially blinding condition known as toxic maculopathy. This report describes the findings on standard and on high-resolution spectral domain ocular coherence tomography performed in a CirrusTM HD-OCTdevice in two patients with chloroquine maculopathy. In one case, a very similar aspect of retinal pigment epithelium (RPE) plaque atrophy occured in both angiographic and HD-OCT images obtained by 'en-face' (coronal) segmentation. In another patient with clinical signs of maculopathy and no angiographic abnormalities, signs of RPE atrophy could also be observed in HD-OCT scans, raising the possibility that this technique may allow the early detection of the disease.
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http://dx.doi.org/10.1590/s0004-27492009000500023DOI Listing
May 2010

[Intracranial tumors in patients referred for optical coherence tomography examination as glaucoma suspects: case report].

Arq Bras Oftalmol 2009 Sep-Oct;72(5):701-5

Universidade Federal de Minas Gerais, Rua Fortunato Ramos, 411 - Vitória (ES) CEP 29055-290.

Optical coherence tomography (OCT) has proved to be a very valuable tool in the assessment of patients with glaucoma. In this report, intracranial tumors were discovered in two glaucoma suspects referred for diagnostic confirmation by OCT - a clivus chordoma and a craniopharyngeoma. Optical coherence tomography findings - marked asymmetrical diffuse attenuation of the peripapillary nerve fiber layer in nasal and temporal sectors - raised concerns about lesions in chiasmatic region and permitted the timely diagnosis of these intraocular tumors.
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http://dx.doi.org/10.1590/s0004-27492009000500021DOI Listing
May 2010

Familial exudative vitreoretinopathy (FEVR) associated with infantile osteoporosis: case report.

Arq Bras Oftalmol 2009 Mar-Apr;72(2):257-60

Escola Superior de Ciências, Santa Casa de Misericórdia de Vitória, ES, Brazil.

Familial exudative vitreoretinopathy (FEVR) is an inherited blinding condition characterized by abnormal development of the retinal vasculature. The authors describe a rare case of the disease associated with severe infantile osteoporosis in a young female patient. The patient was submitted to multiple vitreoretinal procedures in both eyes due to tractional macular detachments. The case was complicated by diffuse uveitis of difficult control in one eye, which stimulated proliferative vitreoretinopathy and retinal redetachment. The inflammatory potential of drugs used in the control of the osteoporosis, in contrast with the inherent inflammatory activity the disease, are discussed.
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http://dx.doi.org/10.1590/s0004-27492009000200026DOI Listing
November 2009

[Intraocular involvement in Erdheim-Chester disease--first report in the literature: case report].

Arq Bras Oftalmol 2007 Sep-Oct;70(5):862-7

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Erdheim-Chester disease (ECD) is a granulomatous and infiltrative disorder of unknown etiology with proliferation of cholesterol-containing histiocytes and peculiar bone involvement. It is very similar to Langerhans cell histiocytosis (LCH) on histology but with a different immunohistochemical profile. This is the first report of intraocular involvement in this disease. MPSG, a 46 y.o. woman, presented with proptosis of the OD. She referred ulcerated lesions on the hard palate, symmetrical and bilateral osteosclerosis of the fibulae and tibiae and a nodule in the right breast (biopsy: xantomatous histiocytic infiltrate CD68+, S-100 and CD1a negative on immunohistochemistry compatible with ECD). MRI studies demonstrated an extraconal tumor in the juxta-bulbar temporal portion of the right orbit close to the lacrimal gland and hyperintense on T1. Vision was 20/20 OU, with numerous drusen in the posterior pole, similar to basal laminar drusen. Two regions of orange subretinal infiltrates that showed progressive staining on the angiogram were seen in the peripapillary region and also close to the fovea in the OD. Choroidal neovascular membranes were seen 2 years later in OU leading to severe visual loss in the OS and to a slight visual field loss in the OD, which retained 20/20 vision. This pioneer report depicts in vivo characteristics of histiocytic granulomas in ECD. Caution should be taken with patients with ECD as potentially blinding intraocular complications may arise.
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http://dx.doi.org/10.1590/s0004-27492007000500025DOI Listing
May 2008