Publications by authors named "Oswaldo Moura Brasil"

8 Publications

  • Page 1 of 1

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000492132DOI Listing
February 2019

Regression of Macular Cavernous Hemangioma with Systemic Infliximab.

Ophthalmic Surg Lasers Imaging 2010 Mar 9:1-3. Epub 2010 Mar 9.

Cavernous hemangioma of the retina is an unusual vascular hamartoma that has been reported to occur either sporadically or as a dominantly inherited trait. A case of a large and sporadic macular cavernous hemangioma that was successfully treated with systemic infliximab as a first line of treatment is presented. The patient was referred with decreased vision of the right eye for 6 months. Fundus examination disclosed a reddish elevated lesion in the posterior pole that obscured the macula and encroached on the fovea. It consisted of grapelike aneurysms. The patient underwent treatment with infliximab intravenously. Two weeks after the second infusion of infliximab, visual acuity improved to 20/80 with a marked involution of the tumor in the right eye. Although the data are limited, we think that a new perspective for treatment of retinal vascular tumors may appear in the future considering antibodies to tumor necrosis factor (TNF)-alpha.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3928/15428877-20100215-34DOI Listing
March 2010

Management of traumatic macular holes: case report.

Arq Bras Oftalmol 2008 Jul-Aug;71(4):581-4

Instituto Brasileiro de Oftalmologia, Rio de Janeiro, Brasil.

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0004-27492008000400022DOI Listing
June 2009

Photodynamic therapy for bilateral and simultaneous choroidal neovascularization in stargardt disease.

Retin Cases Brief Rep 2008 ;2(1):9-11

From Instituto Brasileiro de Oftalmologia, Rio de Janeiro, Brazil.

Background: Stargardt disease may lead to chronic destructive changes to the retinal pigment epithelium and secondarily cause a lesion in the Bruch membrane, predisposing to subsequent subretinal choroidal neovascularization (CNV).

Methods: The authors report an angiographically documented, bilateral, and simultaneous case of CNV in Stargardt disease that was successfully treated with photodynamic therapy (PDT).

Results: A 53-year-old man with unequivocal Stargardt disease presented with CNV in both eyes simultaneously. Best-corrected visual acuity was 20/30 in the right eye and 20/40 in the left eye. PDT was performed in both eyes and vision improved to 20/25 in the right eye and 20/30 in the left eye. The lesions recurred 3 months later when vision had decreased to 20/40 in the right eye and 20/60 in the left eye. Retreatment with PDT was performed in both eyes and vision improved to 20/30 in the right eye and 20/50 in the left eye. No further recurrence was observed for 4 months.

Conclusion: Considering the positive short-term outcome in this case as well as the limited data available, PDT may be considered in cases of CNV in Stargardt disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICB.0b013e3180467837DOI Listing
November 2014

Clinical, histologic, and immunohistochemical evaluation of iris metastases from small cell lung carcinoma.

Can J Ophthalmol 2006 Dec;41(6):775-7

Instituto Brasilerio de Oftalmologia, Rio de Janeiro, Brazil.

Case Report: We report the case of a patient with small cell lung carcinoma who developed multiple metastases in the iris. The eye was enucleated after failure of a conservative approach. The specimen underwent histologic and immunohistochemical evaluation that confirmed the diagnosis.

Comments: Metastatic carcinoma is the most common form of intraocular malignancy, and breast is the most prevalent primary location, followed by lung. Small cell lung carcinoma constitutes 23.1% of lung neoplasias. It has a significantly worse prognosis than non-small cell carcinoma due to its propensity for early and widespread dissemination. Uveal metastases involve the choroid more often than the iris and ciliary body, probably because the arterial distribution is more abundant in the posterior than in the anterior uvea. Iris involvement represents only 9% of the metastatic uveal tumours.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3129/i06-077DOI Listing
December 2006

Different presentations of intraretinal fluid collections in optic disc pits: OCT study of 3 cases.

Arq Bras Oftalmol 2006 Sep-Oct;69(5):745-7

Universidade Federal de São Paulo, São Paulo, SP, Brasil.

The congenital optic disc pit is a rare anomaly that can lead to major visual impairment associated with subretinal fluid accumulation. The authors describe the optical coherence tomography study of three cases of untreated congenital optic disc pits with different levels of visual impairment and its different presentations of intraretinal fluid collections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0004-27492006000500024DOI Listing
June 2007

[Comparative analysis of macular hole surgery followed by internal limiting membrane removal with and without indocyanine green staining].

Arq Bras Oftalmol 2006 Mar-Apr;69(2):157-60. Epub 2006 May 8.

Instituto Brasileiro de Oftalmologia, Rio de Janeiro, RJ, Brazil.

Purpose: To describe comparatively the outcomes of macular hole surgery followed by internal limiting membrane removal with and without indocyanine green staining.

Methods: We evaluated 142 consecutive macular hole surgeries with internal limiting membrane removal performed in the period from January 2001 to March 2004. These were divided into two groups, based on the use or not of indocyanine green staining.

Results: Both studied groups were similar concerning the patients' profile and preoperative stage of the macular holes. Mean preoperative visual acuity was 0.12+/-0.15 in the group with indocyanine green staining and 0.18+/-0.18 in the group without internal limiting membrane staining (p=0.02). Mean postoperative visual acuity was 0.27+/-0.27 in the group with internal limiting membrane staining and 0.43+/-0.25 in the group without internal limiting membrane staining (p=0.0002). We observed improvement of visual acuity in 63% of cases in the group in which internal limiting membrane staining was performed and in 80.3% of cases in the group without internal limiting membrane staining. Macular hole closure rates were 76.5% in the group treated with internal limiting membrane staining and 95.1% in the group treated without internal limiting membrane staining.

Conclusions: Macular hole surgeries followed by internal limiting membrane removal without use of staining have better visual and anatomic results when compared to macular hole surgeries followed by internal limiting membrane removal guided by indocyanine green staining. We recommend caution in using indocyanine green staining in macular hole surgeries due to its possible toxic effect.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0004-27492006000200004DOI Listing
October 2006

[Pseudotoxocariasis: a case report].

Arq Bras Oftalmol 2006 Jan-Feb;69(1):119-21. Epub 2006 Feb 10.

Instituto Brasileiro de Oftalmologia, Rio de Janeiro, RJ, Brazil.

The authors describe a case where the initial diagnosis, clinical and laboratorial, was compatible with ocular toxocariasis. Therefore the follow-up added to a histopathologic examination disclosed a different diagnosis, proving the importance of the histopathologic examination, mainly in presumable diagnostics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0004-27492006000100023DOI Listing
October 2006