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- Application of different Scheimpflug-based lens densitometry methods in phacodynamics predictionPublication . Faria-Correia, F; Lopes, BT; Ramos, IC; Monteiro, T; Franqueira, N; Ambrósio, RPURPOSE: To evaluate the correlations between preoperative Scheimpflug-based lens densitometry metrics and phacodynamics. METHODS: The Lens Opacities Classification System III (LOCS III) was used to grade nuclear opalescence (NO), along with different methods of lens densitometry evaluation (absolute scale from 0% to 100%): three-dimensional (3D), linear, and region of interest (ROI) modes. Cumulative dissipated energy (CDE) and total ultrasound (US) time were recorded and correlated with the different methods of cataract grading. Significant correlations were evaluated using Pearson or Spearman correlation coefficients according to data normality. RESULTS: A positive correlation was detected between the NO score and the average density and the maximum density derived from the 3D mode (r=0.624, P<0.001; r=0.619, P<0.001, respectively) and the ROI mode (r=0.600, P<0.001; r=0.642, P<0.001, respectively). Regarding the linear mode, only the average density parameter presented a significant relationship with the NO score (r=0.569, P<0.001). The 3D-derived average density and maximum density were positively correlated with CDE (rho =0.682, P<0.001; rho =0.683, P<0.001, respectively) and total US time (rho =0.631 and rho =0.668, respectively). There was a linear relationship between the average density and maximum density of the ROI mode and CDE (rho =0.686, P<0.001; rho =0.598, P<0.001, respectively) and total US time (rho =0.642 and rho =0.644, respectively). The average density was the only parameter derived from the linear mode that showed a significant correlation with CDE (rho =0.522, P<0.001) and total US time (rho =0.450, P<0.001). CONCLUSION: Specific Scheimpflug-derived densitometric parameters of the nucleus correlated with phacoemulsification parameters. The use of the appropriate densitometry approach can predict more efficiently the phacodynamics.
- Automatic localization of the optic disc by combining vascular and intensity informationPublication . Mendonça, AM; Sousa, A; Mendonça, L; Campilho, AThis paper describes a new methodology for automatic location of the optic disc in retinal images, based on the combination of information taken from the blood vessel network with intensity data. The distribution of vessel orientations around an image point is quantified using the new concept of entropy of vascular directions. The robustness of the method for OD localization is improved by constraining the search for maximal values of entropy to image areas with high intensities. The method was able to obtain a valid location for the optic disc in 1357 out of the 1361 images of the four datasets.
- Characterization of all Surgical Specimens Provided by a Portuguese Department of Ophthalmology over a 13 Year PeriodPublication . Ferreira Mendes, J; Ferreira, AM; Freitas, CINTRODUCTION: We intend to evaluate clinically, topographically and morphologically all surgical specimens sent by the Department of Ophthalmology of Hospital de Braga to the Department of Pathology of the same hospital. MATERIAL AND METHODS: Two hundred and fifty eight surgically obtained specimens, from the Department of Ophthalmology of Hospital de Braga, analyzed in the Department of Pathology, from January 2002 to June 2015, were characterized. Data was arranged according to year, age, sex, topography and morphological diagnosis according to the SNOMED® coding system. RESULTS: Mean age at time of diagnosis was 54.6 years old; 52.3% were male subjects. The number of specimens was relatively stable until the year 2010, with a significant increase between 2011 and 2013. Most specimens sent corresponded to eyelid (54.7%), followed by conjunctiva (26.7%); the most common pathological diagnosis was malignant epithelial lesions (22.48%), followed by melanocytic tumours (22.09%) and benign epithelial lesions (17.05%). DISCUSSION: The results are distinct from previous publications presumably because of differences between the populations submitted to analysis. CONCLUSION: This is the first indexed publication characterizing surgical specimens from a Department of Ophthalmology in Portugal; moreover, it also includes an extensive review of global epidemiological data about ophthalmic surgical specimens.
- Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 familiesPublication . Sá, MJ; Storey, H; Flinter, F; Nagel, M; Sampaio, S; Castro, R; Araújo, JA; Gaspar, MA; Soares, C; Oliveira, A; Henriques, AC; Costa, AG; Abreu, CP; Ponce, P; Alves, R; Pinho, L; Silva, SE; Moura, CP; Mendonça, L; Carvalho, FPathogenic mutations in genes COL4A3/COL4A4 are responsible for autosomal Alport syndrome (AS) and thin basement membrane nephropathy (TBMN). We used Sanger sequencing to analyze all exons and splice site regions of COL4A3/COL4A4, in 40 unrelated Portuguese probands with clinical suspicion of AS/TBMN. To assess genotype-phenotype correlations, we compared clinically relevant phenotypes/outcomes between homozygous/compound heterozygous and apparently heterozygous patients. Seventeen novel and four reportedly pathogenic COL4A3/COL4A4 mutations were identified in 62.5% (25/40) of the probands. Regardless of the mutated gene, all patients with ARAS manifested chronic renal failure (CRF) and hearing loss, whereas a minority of the apparently heterozygous patients had CRF or extrarenal symptoms. CRF was diagnosed at a significantly younger age in patients with ARAS. In our families, the occurrence of COL4A3/COL4A4 mutations was higher, while the prevalence of XLAS was lower than expected. Overall, a pathogenic COL4A3/COL4A4/COL4A5 mutation was identified in >50% of patients with fewer than three of the standard diagnostic criteria of AS. With such a population background, simultaneous next-generation sequencing of all three genes may be recommended as the most expedite approach to diagnose collagen IV-related glomerular basement membrane nephropathies.
- Comparative study of induced changes in effective lens position and refraction after Nd:YAG laser capsulotomy according to intraocular lens designPublication . Monteiro, T; Soares, AF; Leite, RD; Franqueira, N; Faria-Correia, F; Vaz, FPURPOSE: To evaluate and compare the changes in refraction and effective intraocular lens (IOL) position between a plate-haptic IOL and a c-loop single-piece IOL after neodymium-doped yttrium aluminium garnet (YAG) laser posterior capsulotomy. METHODS: In a prospective study, anterior chamber depth and subjective refraction were measured in 110 pseudophakic eyes from 110 patients, before and 1 month after YAG laser capsulotomy. Patients were divided into 2 groups according to the IOL design: group 1 (plate-haptic acrylic hydrophilic AT LISA tri 839MP®) and group 2 (c-loop acrylic hydrophobic single-piece AcrySof® SA60AT). Lens position was obtained through optical coherence biometry (Biograph WaveLight OB820®). RESULTS: YAG laser capsulotomy was performed 37.8±9.8 months after surgery in group 1 and 40.6±8.6 months in group 2 (p=0.125). Significant changes were found in the lens effective position after treatment in the 2 groups. The YAG posterior capsulotomy led to a change of anterior chamber depth in group 1 from 4.03±0.32 mm to 3.86±0.34 mm (p=0.02) and in group 2 from 4.03±0.37 mm to 4.14±0.45 mm (p=0.025). After YAG laser posterior capsulotomy, no significant changes were observed in mean spherical equivalent, sphere or cylinder for both groups (p>0.05). CONCLUSION: YAG laser posterior capsulotomy can induce a significant change in the IOL position according to the IOL type; however, the refractive change after treatment is clinically insignificant.
- Comprometimento Visual com Dano Macular Mínimo numa Lesão Causada por Laser de FemtosegundoPublication . Ferreira-Mendes, J; Freitas, C; Gentil, RThe authors describe the case of a 26-year-old female patient with a history of bilateral central scotomas which has lasted 24 hours, which appeared after an injury caused by a plasma laser for the production of nanoparticles. The ophthalmologic assessment including observing the ocular fundis in mydriasis, fluorescein angiography and optical coherence tomography (OCT). In a first assessment, the visual acuity of the right eye was 20/20 and the left eye was 20/25. Foveal pigmentary alterations were observed in the macula of both eyes. Bilaterally, the OCT revealed a central interruption of the photoreceptor layer; the fluorescein angiography was normal. In subsequent assessments, the visual acuity was always 20/20 bilaterally. The abnormal findings observed in the OCT disappeared in less than five months, despite continued subjective complaints of scotomas in the left eye.
- Continuous Transitional Focus (CTF): A New Concept in Ophthalmic SurgeryPublication . Mesa, RR; Monteiro, TPresbyopia is a condition that affects many as the lens ages, and is a secondary effect of cataract surgery. Multifocal lenses for the treatment of presbyopia have been undergoing cycles of development and improvement over the past two decades. The latest advancements have yielded lenses with a continuous range of optical powers, otherwise known as continuous transitional focus (CTF) lenses. Modern CTF lenses provide a more natural experience for patients while minimizing unwanted optical side effects.
- Corneal biomechanics: Where are we?Publication . Luz, A; Faria-Correia, F; Salomão, MQ; Lopes, BT; Ambrósio, R
- Doença de Graves associada à artrite idiopática juvenilPublication . Marques, VM; Dias de Carvalho, SC; Antunes, AM; Pinho-Marques, OA; Fernandes-Silva, MH; Costa-Vieira, MJThe authors report the case of a 10-year-old girl with Graves' disease (GD), treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.
- Effect of superior blepharoplasty on tear film: objective evaluation with the Keratograph 5M - a pilot studyPublication . Soares, AM; Faria-Correia, F; Franqueira, N; Ribeiro, SPURPOSE: To evaluate the effect of superior blepharoplasty on the tear film using the corneal topographer Keratograph 5M. METHODS: A prospective study was performed of 27 eyes of 14 patients with superior dermatochalasis who underwent superior blepharoplasty between May and June 2016. Conservative upper eyelid blepharoplasty was performed by an en bloc resection of anterior lamellar tissue that included skin, subcutaneous tissue, and the orbicularis oculi muscle. All the eyes were imaged using the noninvasive tear breakup time tools of the Keratograph 5M. The following parameters were recorded in each patient before and 6 weeks after surgery: first noninvasive Keratograph 5M tear breakup time (the time at which the first breakup of tears occurs) and average noninvasive Keratograph 5M tear breakup time (the average time of all breakup incidents). The exclusion criteria were ophthalmological pathology, previous eyelid surgery, use of eye drops, systemic pathology, and medication that interferes with lacrimal tears. RESULTS: The mean age of the patients was 65.1 years (range, 51-84); 86% were female. Student's t-test was used to compare the values of first and average noninvasive Keratograph 5M tear breakup times before and after surgery. The values for first noninvasive Keratograph 5M tear breakup time evaluated before and after surgery were not significantly different (9.04 and 8.71, respectively; p=0.926). The values for average noninvasive Keratograph 5M tear breakup time evaluated before and after surgery were also not significantly different (13.01 seconds and 13.14 seconds, respectively; p=0.835). CONCLUSIONS: The results of this pilot study suggest that upper blepharoplasty does not affect tear breakup time according to the objective evaluation of breakup time with the Keratograph 5M.