Applicability of portable retinal cameras and telemedicine as facilitating tools in screening diabetic retinopathy in the COVID-19 pandemic scenario

Abstract

To evaluate the clinical course and management of infectious interface keratitis after Descemet membrane endothelial keratoplasty. Methods: A total of 352 cases that had undergone Descemet membrane endothelial keratoplasty were retrospectively reviewed. Patients with infectious interface keratitis during follow-up were analyzed. The microbiological analyses, time to infection onset, clinical findings, follow-up duration, treatment, and post-treatment corrected distance visual acuity were recorded. Results: IIK was detected in eight eyes of eight cases. Three fungal and three bacterial pathogens were identified in all cases. All patients received medical treatment according to culture sensitivity. Antifungal treatment was initiated in two cases with no growth on culture, with a preliminary diagnosis of fungal interface keratitis. Intrastromal antifungal injections were performed in all patients with fungal infections. The median time to infection onset was 164 days (range: 2-282 days). The postoperative infectious interface keratitis developed in the early period in two cases. The mean follow-up duration was 13.4 ± 6.2 months (range: 6-26 months). Re-Descemet membrane endothelial keratoplasty was performed in two patients (25%) and therapeutic penetrating keratoplasty in four patients (50%) who did not recover with medical treatment. The final corrected distance visual acuity was 20/40 or better in five patients (62.5%). Conclusions: The diagnosis and treatment of infectious interface keratitis following Descemet membrane endothelial keratoplasty are challenging. Early surgical intervention should be preferred in the absence of response to medical treatment. Better graft survival and visual acuity can be achieved with therapeutic penetrating keratoplasty and re-Descemet membrane endothelial keratoplasty in patients with infectious interface keratitis.

Progression of Diabetic Retinopathy in Patients After Covid-19

“…Currently, diabetic retinopathy (DR) represents one of the most common retinal diseases that can lead to vision loss in workingage individuals. Patients with diabetes mellitus (DM) are particularly vulnerable to coronavirus infection since there are multiple publications indicating a more severe course of the disease in such patients and its association with obesity as one of the most significant comorbidity factors [10,11,12,13].…”

Ensaio clínico utilizando dexametasona associada ao bevacizumabe para tratamento de edema macular diabético persistente. DexaBe

“…proporções continentais e que auxiliarão sobremaneira, num futuro próximo, a detecção precoce da RD e a diminuição do tempo até o tratamento, minimizando a barreira da falta de especialista nas áreas mais remotas deste Brasil, assim como em outros países menos desenvolvidos (Cyrino et al, 2022;Malerbi et al, 2022a).…”