, abaixo assinado, nº mecanográfico 050801116, estudante do 6º ano do Mestrado Integrado em Medicina, na Faculdade de Medicina da Universidade do Porto, declaro ter actuado com absoluta integridade na elaboração deste projecto de opção.Neste sentido, confirmo que NÃO incorri em plágio (acto pelo qual um indivíduo, mesmo por omissão, assume a autoria de um determinado trabalho intelectual, ou partes dele). Mais declaro que todas as frases que retirei de trabalhos anteriores pertencentes a outros autores, foram referenciadas, ou redigidas com novas palavras, tendo colocado, neste caso, a citação da fonte bibliográfica. I also wish to thank my parents for everything they taught me, for their guidance and for their unconditional love and support. ABSTRACT AimsTo perform a systematic review of screening for pre-eclampsia (PE) with the combination of uterine artery Doppler (UAD), maternal history, mean arterial pressure and/or maternal serum markers. MethodsWe identified eligible studies through a search of Medline, and, for each included study,we assessed the risk of bias and extracted relevant data. We reported the performance of screening tests according to the target population (low or high-risk), the trimester of screening (first and/or second) and the subset of PE screened for (early and late). ResultsSeveral tests provided moderate or convincing prediction of early PE, but screening for late PE was poor. Although UAD is more accurate in the second-trimester, we found encouraging results for first-trimester screening when it was combined with other markers.Performance of screening was consistently lower in populations with risk factors for PE in the maternal history. ConclusionsWe present encouraging results for the prediction of early PE, even in the first-trimester of pregnancy. The different performance of tests in screening for early versus late PE, and of low versus high-risk populations, supports the concept that PE is a heterogeneous disease.

We conclude that a short cervix is predictive of preterm delivery and can identify women that may benefit from preventive and therapeutic measures, however, a negative result is not always reassuring.

Purpose To evaluate the predictive factors of long-term visual outcomes in neovascular age-related macular degeneration (nAMD) treated with antivascular endothelial growth factor (anti-VEGF) agents. Methods Unicentric retrospective review of patients with nAMD treated with anti-VEGF agents. Visual outcomes, 12 and 60 months after diagnosis, were evaluated. In an attempt to identify predictive factors of visual outcomes, multiple variables (demographic and epidemiological characteristics, angiographic and tomographic features) were analyzed, at baseline and during follow-up. Results One hundred and seventeen patients were included. In multivariate analysis, baseline best-corrected visual acuity was associated with all visual endpoints at 12 and 60 months. Additionally, age, gender, number of injections, and development of subretinal fibrosis during follow-up were also significant predictors of visual outcomes at 60 months. Conclusions Several factors can be useful in clinical practice as predictors of visual outcomes in response to anti-VEGF treatment of nAMD.

PurposeTo evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD) with anti-VEGF agents.Materials and methodsWe retrospectively analyzed all patients with nAMD who initiated anti-VEGF treatment before October 2009. We collected data regarding visual and anatomical outcomes.ResultsA total of 278 patients met the selection criteria. The mean number of intravitreal injections was 5.7 in the first year and 3.7 in the fifth year. A positive mean visual acuity variation of +3.7 Early Treatment Diabetic Retinopathy Study letters occurred in the first year, but no significant differences relative to baseline were observed thereafter. The majority of patients (71%) maintained stable visual acuity throughout follow-up. At 5 years, mean central macular thickness remained substantially inferior to baseline (−96.6 μm), and 56% of patients maintained dry retinas.ConclusionAnti-VEGF therapy leads to long-term visual stabilization in the great majority of patients.