Public health strategy vs. golden standard for ocular cancer care in Brazil

Neto, Rubens Belfort

doi:10.5935/0004-2749.20200021

Cited by 4 publications

(4 citation statements)

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“…Therefore, our sample represents approximately 25% of the nationwide Brazilian patient cohort. Social networks were an essential tool in recruiting these patients spread across the country, and other reports have already demonstrated the critical role of this tool in the public health strategy (16) . A 61-year-old woman with XPE and ocular surface squamous neoplasia (OSSN) staining with toluidine blue (A).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum

Marcos,

Freitas,

Hazarbassanov

et al. 2024

ABO

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To assess Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum and correlate with ocular surface changes. Methods: This cross-sectional study evaluated patients with xeroderma pigmentosum. All patients underwent a comprehensive and standardized interview. The best-corrected visual acuity of each eye was determined. Detailed ophthalmic examination was conducted, including biomicroscopy examination of the ocular surface, Schirmer test type I, and meibography, and fundus examination was also performed when possible. Meibomian gland dysfunction was assessed by non-contact meibography using Oculus Keratograph ® 5M (OCULUS Inc., Arlington, WA, USA). Saliva samples were collected using the Oragene DNA Self-collection kit (DNA Genotek Inc., Ottawa, Canada), and DNA was extracted as recommended by the manufacturer. Factors associated with abnormal meiboscores were assessed using generalized estimating equation models. Results: A total of 42 participants were enrolled, and 27 patients underwent meibography. The meiboscore was abnormal in the upper eyelid in 8 (29.6%) patients and in the lower eyelid in 17 (62.9%). The likelihood of having abnormal meiboscores in the lower eyelid was 16.3 times greater than that in the upper eyelid. In the final multivariate model, age (p=0.001), mutation profile (p=0.006), and presence of ocular surface malignant tumor (OSMT) (p=0.014) remained significant for abnormal meiboscores. For a 1-year increase in age, the likelihood of abnormal meiboscores increased by 12%. Eyes with OSMT were 58.8 times more likely to have abnormal meiboscores than eyes without ocular surface malignant tumor. Conclusion: In the final model, age, xeroderma pigmentosum profile, previous cancer, and clinical alterations on the eyelid correlated with a meiboscore of ≥2. Meibomian gland dysfunction was common in patients with xeroderma pigmentosum, mainly in the lower eyelid. The severity of Meibomian gland dysfunction increases with age and is associated with severe eyelid changes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum

Marcos,

Freitas,

Hazarbassanov

et al. 2024

ABO

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“…The ocular oncology division at UNIFESP is one of the main centers specialized in ocular oncology treatment in Brazil through the national health insurance system SUS [ 24 ]. About 30% of patients referred to our service with an initial diagnostic hypothesis of choroidal melanoma were confirmed as not having the disease which reflects the challenges faced by general ophthalmologists due to the rarity of melanoma.…”

Section: Discussionmentioning

confidence: 99%

Choroidal melanoma tumor profile and treatment pattern for newly diagnosed patients at a reference public hospital in Sao Paulo, Brazil

et al. 2022

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Background Choroid, ciliary body, and iris melanomas are often grouped as uveal melanoma, the most common intraocular primary malignancy. The purpose of the current study was to analyze the tumor profile of newly diagnosed cases of choroidal melanoma at a reference center in Sao Paulo, Brazil, and to investigate the frequency of eyes treated by enucleation that could have been treated with brachytherapy if available in the service. Methods Medical records of patients referred to our service with initial diagnostic hypothesis of choroidal melanoma from July 2014 to June 2020 were analysed on demographics, diagnosis confirmation, tumor measurement by ultrasonography and established treatment. Data were evaluated on clinical and demographic characteristics as age, sex, affected eye, ultrasound parameters, and treatment management of patients with clinically diagnosed choroidal melanoma. Among the patients submitted to enucleation, we investigated how many could have been selected to receive brachytherapy. Results From the 102 patients referred with the choroidal melanoma diagnosis hypothesis, 70 (68.62%) were confirmed. Mean measurements from the tumors in millimetres were: 9.19 ± 3.69 at height and 12.97 ± 3.09 by 13.30 ± 3.30 at basal. A total of 48 cases (68.57%) were enucleated, 8 (11.43%) were treated by brachytherapy in a different service, and 14 patients (20.00%) returned for enucleation at their original referral center. Out of the 48 patients enucleated, 26 (54.17%) could have been selected to brachytherapy treatment. Conclusions The results indicate a late diagnosis of choroidal melanoma cases referred to our service. Most enucleated cases could have been treated with brachytherapy if it was broadly available at the national public health insurance. Further public health political efforts should focus on early diagnosis and better quality of life post-treatment for oncologic patients.

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“…Our flagship service is called 'Oncophone', 3 in which we provide free consultation exclusive to ophthalmologists and other medical professionals. Typically, the doctor sends clinical information, supporting clinical pictures and ancillary investigations of patients suspected of ocular cancer through the messaging service WhatsApp ® .…”

Section: Using Social Media In Ocular Oncologymentioning

confidence: 99%