properly cited.Purpose. To evaluate the e cacy and safety of hyperbaric oxygen therapy (HBOT) in patients with acute retinal artery occlusion (RAO). Secondarily, to analyse the epidemiology and the clinical approach. Methods. Retrospective study of 13 patients submitted to HBOT between 2013 and 2018. e analysed parameters consisted of: systemic history, time between symptoms onset and treatment, initial approach, number of HBOT sessions, complications of HBOT and best corrected visual acuity-BCVA (of the total sample, central RAO-CRAO-group, and branch RAO-BRAO group). Results. Arterial hypertension was the most prevalent systemic risk factor (53.8%). Initial therapies were 100% normobaric oxygen administration, topical and oral hypotensive medication, eye massage and aspirin. CRAO was observed in 69.2% and BRAO in 30.8% of the cases, with clinically signi cant visual improvement (a decrease in logMAR of 0.3) in 55.5% and 75%, respectively. Time between symptoms onset and treatment had a median of 9 hours. e median number of HBOT sessions was 7, without complications. Conclusions. HBOT provide BCVA improvement in patients with RAO, when it is performed in an early time a er the symptom onset. It seems to be an e ective and safe therapeutic option for a pathology that still remains without approved treatment.
Purpose. This study aimed to evaluate the long-term effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) injections in the treatment of choroidal neovascularization (CNV) associated with angioid streaks. Methods. Multicenter retrospective cohort study, including eyes with CNV secondary to angioid streaks treated with anti-VEGF injections, were performed. Best-corrected visual acuity (BCVA) in ETDRS letters; qualitative and quantitative (foveal thickness) OCT parameters; anti-VEGF type; and number of injections were collected at baseline and at 3, 6, 12, 24, 36, 48, 60, and 72 months. Results. Thirty-nine eyes from 29 patients, 17 (58.6%) females, were included. The mean follow-up time was 69.4 ± 34.5 months. BCVA was 59.3 ± 23.3 letters at baseline and 63.7 ± 21.9 letters at 48 months. At 3 months, BCVA improved 6.9 ± 11.7 letters ( P = 0.003 ). Then, BCVA remained stable. The mean foveal thickness decreased from 343.3 ± 120.2 μm at baseline to 268.3 ± 65.4 at 48 months ( P = 0.021 ). The mean number of injections was 4.6 ± 2.1 at 12 months, decreasing to 1.7 ± 2.4 injections between 36 and 48 months ( P = 0.093 ). Conclusion. This real-world study suggests that the functional and morphologic response to anti-VEGF therapy for CNV related to angioid streaks is generally satisfactory and maintained in the long term.
019 AbstractPurpose: The purpose of this report is to present a case of optic neuropathy as a manifestation of secondary syphilis in an HIV-negative patient. Methods:We describe a case of gradual loss of visual acuity in the left eye (LE) in a 53-year-old healthy woman. Results:The patient presented with visual acuity of 20/20 in the right eye and hand movements in the LE. Fundoscopy revealed swollen optic disc in the LE. Fluorescein angiography showed leakage of dye from the optic disc. Optical coherence tomography (OCT) confirmed the oedema in the left optic disc. Serologic testing was positive for venereal disease research laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS), and negative for HIV antibodies. Conclusions:Ophthalmologic findings, including disc oedema, may be the presenting features of syphilis, therefore ophthalmologists have the opportunity to play a key role in the diagnosis and management of this disease, important for a good visual outcome.pressure was 12mmhg in both eyes. Fundoscopy showed a swollen optic disc in the LE, with no abnormalities detected in the RE. A left relative afferent pupillary defect was present ( Figure 1 and Figure 2).Fluorescein angiography showed leakage of dye from the optic disc. Optical coherence tomography (OCT) confirmed the oedema in the left optic disc.Serologic testing was positive for VDRL (1:128) and FTA-ABS, and negative for HIV antibodies. No abnormalities were detected during magnetic resonance imaging of the cranium and orbits.
Purpose: Behçet uveitis is a cause of retinal vasculitis, with fluorescein angiography being the gold-standard diagnostic exam. Optical coherence tomography with angiography (OCT-A) is a non-invasive exam that analyzes macular retinal circulation with high resolution, and therefore, could be a useful diagnostic exam in these patients.Material and methods: Analysis of 14 eyes of 8 patients with Behçet uveitis from our institution that were examined by OCT A (AngioPlex®, Zeiss). Macular morphology, area, perimeter and circularity of the foveal avascular zone, as well as central internal and global macular vascular density were evaluated. We compared our results with healthy controls.Results: Mean visual acuity in the patient’s subgroup was 0,84±0,25 and 3 eyes had previous diagnosis of retinal vasculitis with fluorescein angiography. Morphologically we found attenuation of the superficial and deep capillary plexus in 8 eyes, and in 1 of these eyes atrophy of the internal retinal layers was also found in a localized territory. In the foveal avascular area, no statistically significant changes were observed in its area and perimeter (p=0.804 and p=0.380 respectively), although we did find significant changes in its circularity (p=0.027). Vascular density was significantly altered in the internal (p=0.023) and global (p=0.028) macular parameters.Conclusion: We found changes in the macular microcirculation in patients with Behçet uveitis, even in the absence of angiographic changes. Future studies with more patients are necessary to understand the clinical significance of these changes.
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