OCULAR CHANGES IN PATIENTS ON LONG TREATMENT WITH HYDROXYCHLOROQUINE

Introduction: To study the ocular changes in patients on long term treatment with Hydroxychloroquine (HCQ); and detect means for early detection of toxicity.Methods: We conducted a cross-sectional observational study at a tertiary care hospital, in which 100 patients, male and female, aged 35 years or more, taking HCQ for 5 years or more were included. Patients with any known ocular or systemic diseases were not included. Indication, dosage, duration and cumulative dose of HCQ intake were recorded. History of ocular symptoms, visual acuity, colour vision, complete ophthalmic examination, visual field using Amsler grid and 10-2 Humphrey’s automated fields (HVF), Spectral Domain Optical Coherence Tomography (SD-OCT), colour fundus photography, fundus fluorescein angiography (FFA) and fundus autofluorescence (FAF) were recorded. The data was analyzed using descriptive and inferential analysis.Result: 15% of the study population showed signs of HCQ related ocular toxicity. 17%, 21% and 10% patients had abnormal SD-OCT, HVF and FAF findings respectively.Conclusion: HCQ related ocular toxicity has been found in patients in the absence of symptoms. Objective tests like HVF, SD- OCT and FAF were more useful in early detection of toxicity than subjective tests such as Amsler grid, colour vision and FFA.

Congenital Cataracts and Microphakia with Retinal Dysplasia and Optic Nerve Hypoplasia in a Calf

Case Description. A two-month-old, female, Aberdeen-Angus calf was presented for congenital cataracts and blindness in both eyes (OU). The dam had a reported history of visual defects (not specified) and had produced other affected calves (per owner history). Ophthalmic examination revealed mature bilateral cataracts, attenuation of the iridic granules, persistent pupillary membranes, and dyscoric pupils. Additionally, the calf had a poor body condition, prognathism, dome-shaped head, excessive nasal drainage, limb contracture, and fever. Histopathology of both eyes revealed lenticular degeneration (congenital cataracts), retinal dysplasia, and optic nerve hypoplasia. BVDV IHC detected antigen within only the left eye (OS), consisting of intrahistiocytic and endothelial immunoreactivity within the ciliary body, iris, and choroid. No BVDV immunoreactivity could be detected in the right eye (OD). This case highlights the unique ocular changes present in in utero BVDV infection of cattle with a different immunohistochemical staining profile than previously described.

Pseudoexfoliation Syndrome Association with Aging and Ocular Changes in Cornea, Lens, Retina

Purpose: To examine the 10-year incidence of the pseudoexfoliation syndrome (PEX), possible risk factors of PEX, and its association with aging and ocular changes in cornea, lens, retina within a population-based follow-up study.Methods: The baseline examination was conducted in 2006 on a random sample of 1,033 adult participants from Kaunas city (Lithuania) population. Out of them 631 participants returned to the follow-up study in 2016. Ophthalmological examination included keratometry, central corneal pachymetry, after diagnostic mydriasis lens opacification was evaluated by LOCS III International classification, PEX was diagnosed by the presence of typical grayish-white exfoliation material on the anterior capsule surface of the lens.Results: During the 10 years follow-up, the prevalence of the PEX increased from 9.8% to 34.2%. Nuclear cataract was diagnosed the most both in the PEX-group and those without, however, there was no statistically significantly increased risk of developing cataract in those with PEX when compared to those without PEX (OR 1.2; p=0.61). Central corneal thickness (CCT) was thinner in PEX group (529±34μm) and in the eldest group (525±36μm) (p<0.001). Compared to baseline, corneal curvature (CC) became steeper both in the PEX and the no-PEX groups during the follow-up (p=0.013), but the difference didn’t reach significance between groups. The biggest part of corneal astigmatism was with-the-rule in no-PEX and PEX groups (37 vs 148; p>0.05). The age, sex and PEX had no influence to age related macular degeneration distribution.Conclusion: The prevalence of the PEX increased significantly with age. CCT was thinner in PEX group and in elder people. CC was flatter in PEX group.

A Narrative Review of the Complex Relationship between Pregnancy and Eye Changes

Pregnancy is a condition often characterized by changes that occur in different parts of the body. Generally, the eyes suffer several changes during pregnancy that are usually transient but may become permanent at times. This may occur due to the release of placental hormones and those of maternal endocrine glands and fetal adrenal glands. Due to hormonal influences, physiological ocular changes during pregnancy have been shown in Caucasian women, so corneal sensitivity, refractive status, intraocular pressure, and visual acuity may change during pregnancy. Within this review, all studies that referred to physiological aspects and to changes of ocular pathology of pregnancy, the effect of the pregnancy on pre-existing (diabetic retinopathy, neuro-ophthalmic disorders) eye disorders, postpartum ocular changes, the intraocular pressure and the effect of hypotensive ophthalmic medicine during pregnancy, the connection between pregnancy and the neuro-ophthalmic pathology, as well as the role of anesthesia were analyzed.

Alport Syndrome

Alport syndrome (AS) is a type IV collagen hereditary disease characterized by the association of progressive Hematuric nephritis, hearing loss, and, frequently, ocular changes. Mutations in the COL4A5 collagen gene are responsible for the more common X-linked dominant form of the disease.

Alterações oculares em unidade de terapia intensiva: scoping review

Mapear as evidências científicas sobre alterações oculares em pacientesinternados em terapia intensiva. Trata-se de uma revisão de escopo, com adoção da estratégia PPC nas bases de dados PUBMED, WEB OF SCIENCE e a biblioteca virtual SCIELO. Adotou-se como elegiveis, estudos primarios, empiricos, quantitativos e qualitativos, publicados em três idiomas. Foram encontrados 204 artigos e após análise, selecionou-se 08 artigos para compor o estudo. A lagoftalmia apresenta-se como principal alteração ocular e fator determinante para o desenvolvimento de danos oftálmicos. Evidencia-se que o ambiente, a terapêutica instituída e as próprias comorbidades do paciente possuem associação com as alterações oculares. As doenças oculares são passíveis de prevenção. O diagnóstico precoce de alterações oculares e a rastreabilidade dos fatores de risco para doenças oculares são medidas necessária para evitar ocorrência de dano ocular aos pacientes internados em terapia intensiva.Descritores: Síndrome do Olho Seco, Doenças da Córnea, Unidade de Terapia Intensiva. Eye changes in an intensive care unit: scoping reviewAbstract: To map the scientific evidence on ocular changes in patients in intensive care. Method: this is a scope review, with the adoption of the PPC strategy in the PUBMED, WEB OF SCIENCE databases and the SCIELO virtual library. Primary, empirical, quantitative and qualitative studies, published in three languages, were adopted as eligible. 204 articles were found and after analysis, 08 articles were selected to compose the study. Lagophthalmia is the main ocular alteration and a determining factor for the development of ophthalmic damage. It is evident that the environment, the instituted therapy and the patient's own comorbidities are associated with ocular changes. Eye diseases are preventable. The early diagnosis of eye changes and the traceability of risk factors for eye diseases are necessary measures to prevent the occurrence of eye damage to patients admitted to intensive care.Descriptors: Dry Eye Syndrome, Corneal Diseases, Intensive Care Unit. Cambios oculares en una unidad de cuidados intensivos: revisión del alcanceResumen: Mapear la evidencia científica sobre cambios oculares en pacientes en cuidados intensivos. Método: se trata de una revisión de alcance, con la adopción de la estrategia PPC en las bases de datos PUBMED, WEB OF SCIENCE y la biblioteca virtual SCIELO. Los estudios primarios, empíricos, cuantitativos y cualitativos, publicados en tres idiomas, se aprobaron como elegibles. Se encontraron 204 artículos y luego del análisis se seleccionaron 08 artículos para componer el estudio. La lagoftalmia es la principal alteración ocular y un factor determinante para el desarrollo de daño oftálmico. Es evidente que el entorno, la terapia instituida y las propias comorbilidades del paciente se asocian a cambios oculares. Las enfermedades oculares se pueden prevenir. El diagnóstico precoz de los cambios oculares y la trazabilidad de los factores de riesgo de enfermedades oculares son medidas necesarias para prevenir la aparición de daños oculares en los pacientes ingresados en cuidados intensivos.Descriptores: Síndrome del Ojo Seco, Enfermedades Corneales, Unidade de Cuidados Intensivos.

POSTERIOR REVERSBLE ENCEPHALOPATHY SYNDROME IN ECLAMPSIA: A RARE PHENOMENON

preeclampsia can affect multiple organ systems due to hypertension and systemic endothelial dysfunction, one of the more delicate maternal systems impacted is the brain It is not always the acute risk of preeclampsia and eclampsia on the brain that impacts maternal outcome. Cortical blindness is generally reversible, and permanent blindness from retinal vascular changes is rare [8].Other than effective treatment of preeclampsia/eclampsia and termination of pregnancy, no specic therapy is indicated in pre- eclamptic women who experience ocular changes. A Similar case with Eclampsia and blindness is presented here.

Unilateral acute posterior multifocal placoid pigment epitheliopathy in a convalescent COVID-19 patient

Background To report a case of unilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in a Hispanic convalescent COVID-19 female patient. Case presentation A 35-year-old Hispanic female with exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was evaluated due to unilateral visual loss. Ophthalmic examination and diagnostic tests were consistent with APMPPE. Discussion Ocular changes can be observed in patients with COVID-19. A complete ophthalmic evaluation must be performed in patients with low vision after SARS-CoV-2 infection.