O Diabetes Mellitus Gestacional (DMG) é definido pelo aumento nos níveis da glicemia, detectado pela primeira vez durante a gestação, que cursa com complicações maternas e fetais. O presente estudo, objetivou avaliar a prevalência do DMG em um ambulatório especializado e os possíveis fatores de risco associados. Trata-se de um estudo quantitativo, de caráter descritivo-observacional realizado de maneira retrospectiva no Ambulatório de Alto Risco da Ginecologia e Obstetrícia do Centro de Atendimento Especializado (CAE), na cidade de Cascavel-PR. A população analisada foi constituída por todas as gestantes com idade superior a 18 anos, portadoras de DMG atendidas e diagnosticadas entre Janeiro e Dezembro de 2018. Foram selecionados 148 prontuários e destes 14 foram excluídos devido a equívoco de diagnóstico ou DM franco. A prevalência de DMG foi de 18,35%, sendo que 37,71% das gestantes se encontravam na faixa etária de 25 a 30 anos, 59,7% autodenominaram-se de raça branca; 50,76% eram obesas; 76,11% eram multíparas; 44,77% foram diagnosticadas no terceiro trimestre da gestação, 4,47% possuíam diagnóstico de DMG em gestações anteriores, 97,01% apresentavam pelo menos 1 fator de risco para DMG e 83,58% apresentavam 2 ou mais fatores de risco. Sendo assim, é importante atentar-se às pacientes com qualquer fator de risco, a fim de diagnosticar e tratar precocemente a doença, evitando complicações.

Com o levantamento de dados de 769 gestantes acompanhadas no ambulatório de ginecologia e obstetrícia de alto risco do Centro de Atendimento Especializado (CAE) de Cascavel durante o ano de 2018, foram selecionadas 149 pacientes com o diagnóstico de diabetes gestacional. Diante disso, foram revisados 100 prontuários dentro de critérios específicos para quantificar as complicações durante o acompanhamento da gestação dessas pacientes, confrontando com números encontrados em literatura. Além disso, foi proposto formas de abordagem diante de cada uma das complicações encontradas nessas gestantes estudadas. Foi possível estabelecer a frequência das complicações e de forma sucinta sugerir modos de intervenção e tratamento durante a complicações e também conduta após desfechos desfavoráveis da evolução dessas pacientes.

Fonte de auxílio à pesquisa:trabalho não financiado.Conflitos de interesse: os autores declaram que não há conflitos de interesses.

Aims: To describe a solar retinopathy. Presentation of Case: ALPN, 29 years old, male, with cognitive deficit that started after a car accident that occurred at the age of 6 years, attends the ophthalmology clinic of the University Hospital Antônio Pedro, Rio de Janeiro, Brazil with complaints of decreased visual acuity and metamorphopsia in both eyes (AO) started approximately 8 months ago. Family members reported that after the accident, the patient had the habit of spending mornings and afternoons looking at the sun. Discussion: Solar retinopathy is caused by the photochemical and thermal effects of ultraviolet radiation on retinal cells, especially in the outer retina and retinal pigment epithelium (RPE). Symptoms can start a few hours after direct observation of the sun, and in most cases a bilateral involvement, although asymmetrically with variable visual acuity. Conclusions: A Solar retinopathy has a multifactorial origin, as it is related to the exposure time and the susceptibility of each individual. The use of hats and sunglasses with protection against ultraviolet rays and anti-reflection are effective preventive measures to be adopted if there is a need for exposure and observation of sunlight.

Aims: To describe the importance of optical coherence tomography and autofluorescence in the documentation of papillary colobomatous fossette. Presentation of Case: F.D.O. A 14-year-old male student is referred for evaluation of the fundus of the eye due to an alteration in the optic disc noticed by another professional who did not feel safe in the follow-up. The patient was completely asymptomatic at the time of the consultation and did not claim previous visual complaints. She denied systemic and ocular comorbidities and did not use any systemic and topical medication. Discussion: The congenital optic disc pit is a rare and typically unilateral congenital anomaly, consisting of a retinal herniation that extends into the subarachnoid space through a lamina cribrosa defect. 8,13,15,16 Although this condition, in most cases, does not present complications and remains asymptomatic, it can sometimes worsen with a significant decrease in visual acuity. This more serious condition can be characterized by important macular alterations, such as serous retinal detachment, cystic degenerations and degenerative pigmentary alterations. 14,16,17,18 The patient in the present report did not have any visual complaints and did not present severe structural and functional retinal damage, which highlights the importance of early diagnosis. Conclusions: The colobomatous papilla pit is characterized by the presence of isolated cavities in the optic disc head secondary to a developmental disorder of the primitive epithelial papilla. Its incidence is 1:10,000 people without sexual or racial predilection. It presents, in most cases, asymptomatic, unilateral in 85-95% of cases and rarely with more than one pit per disc.

Parinaud's oculoglandular syndrome (PCOS) is a rare eye disease caused by different etiological agents, including bacteria, viruses and fungi. PCOS is a special form of granulomatous conjunctivitis and is often associated with cat scratch disease, herpes simplex infection, sporotrichosis, blastomycosis, and coccidioidomycosis. Sporotrichosis is a subcutaneous mycosis caused by the fungus Sporothrix schenckii with global distribution and, in general, patients are treated on an outpatient basis. Since 1998, there has been an increase in cases in the State of Rio de Janeiro, Brazil, especially due to zoonotic transmission involving cats. PCOS is characterized by granulomatous conjunctivitis accompanied by adjacent pre-auricular lymphadenopathy and systemic symptoms such as sweating, feeling sick, and fever. Complementary tests including culture confirm the diagnosis of sporotrichosis. Its classic clinical presentation should always be remembered by specialists so that the correct diagnosis and treatment with antifungal agents is carried out early, so that the condition can be resolved without sequelae for the patients.

Aims: To describe a Stargardt disease, (STGD1) is an autosomal recessive inherited disease often associated with mutations in ABCA4 and characterized by the accumulation of autofluorescent lipofuscin deposits in the retinal pigment epithelium (RPE). Presentation of Case:  J.A.D.L, male, 52 years old, foreman, born in Rio de Janeiro, attends the ophthalmologic consultation complaining of progressive low visual acuity, noticed at around 31 years of age. Discussion: Stargardt disease is the most common hereditary macular dystrophy, representing 7% of retinal dystrophies. The first and only clinical manifestation is the decrease in central vision, which predominantly starts between six and fifteen years of age. Methodology: Case report. Results: Therefore, the referral of young patients with visual complaints without initial abnormalities of the fundus of the eye for ophthalmological evaluation is essential, since the diagnosis of patients at an early stage of the disease is increasingly important with the advent of new therapeutic possibilities. Conclusion: Although many factors contribute to the phenotype of patients with STGD1, the expression and residual activity of ABCA4 mutants play an important role in determining disease severity. Retinal thickness and disease duration influence the visual prognosis of patients. Patients with Stargardt's disease have a smaller macular thickness when compared to normal individuals, and this reduction is related to the duration of the pathology. Therefore, OCT is fundamental for the follow-up of these patients, contributing to a better prognostic assessment of the disease.

Aims: To describe Congenital Ocular Melanocytosis. Presentation of Case: LPC, 7 years old, male, brown, with no previous comorbidities, was taken to the ophthalmology outpatient clinic of the Hospital Universitário Antônio Pedro, Brazil by parents who alleged the presence of bluish-looking lesions in the sclera of the child's right eye since birth. Discussion: Congenital Ocular Melanocytosis is a rare pathology characterized by an increase in the number, size and pigmentation of melanocytes. Its pathophysiological picture is unknown, but it is believed to be due to an alteration in the migration of melanocytes from the neural crest to the epidermis during the embryonic process. This condition can be complicated by glaucoma and uveal melanoma. Gonioscopy is essential in these cases to assess whether there is pigmentation of the trabeculae, so that the propaedeutics of investigation of glaucoma becomes essential in these patients, since 10% of cases can complicate this condition. Conclusions: Congenital Ocular Melanocytosis early in life and the importance of monitoring these patients should be emphasized. Comprehensive tests are important for early detection and treatment, in order to improve the prognosis and avoid more severe consequences than what can happen from melanocytosis.