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[PMID]: 27772649 [Au] Autor: Raven ML; Burris CK; Potter HD [Ad] Endereço: Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison. [Ti] Título: Scleritis with Devastating Consequences. [So] Source: Ophthalmology;123(11):2337, 2016 11. [Is] ISSN: 1549-4713 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Cegueira/etiologia Esclerite/complicações [Mh] Termos MeSH secundário: Adulto Doenças da Córnea/etiologia Enucleação Ocular Glaucoma/induzido quimicamente Glucocorticoides/efeitos adversos Seres Humanos Masculino Recidiva Esclerite/diagnóstico Esclerite/tratamento farmacológico Doenças da Úvea/etiologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Glucocorticoids) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE

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[PMID]: 28859118 [Au] Autor: Tarmann L; Wackernagel W; Ivastinovic D; Schneider M; Winkler P; Langmann G [Ad] Endereço: Department of Ophthalmology, Medical University Graz, Graz, Austria. [Ti] Título: Tumor parameters predict the risk of side effects after ruthenium-106 plaque brachytherapy of uveal melanomas. [So] Source: PLoS One;12(8):e0183833, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: To report on radiation-related side effects and complications after ruthenium-106 plaque brachytherapy of uveal melanomas. METHODS: Medical records of 143 eyes with uveal melanoma, treated by ruthenium-106 brachytherapy between 1997 and 2012 at a single center, were analyzed. We evaluated the occurrence of radiation-related side effects on the anterior and posterior segment of the eye. The influence of patient, tumor and treatment parameters on outcome was analyzed by multivariate time to event analysis considering competing risks. RESULTS: The median overall follow-up was 37.9 months. After treatment, the estimated risk at 12, 24 and 48 months for developing anterior segment complications was 25.3%, 37.5% and 50.3% for cataract formation and 5.4%, 6.4% and 8.1% for secondary glaucoma, respectively. The estimated risk for the occurrence of posterior segment complications 12, 24 and 48 months after treatment was 3.1%, 6.7% and 18.3% for radiation retinopathy, 18.3%, 27.1% and 42.6% for radiation maculopathy and 16.5%, 21.0% and 32.8% for radiation neuropathy, respectively. The risk of an increase in retinal detachment after treatment was 14.7%, 14.7% and 17.4% at 12, 24 and 48 months, respectively. The risk of vitreous hemorrhage occurring after treatment was 6.2%, 8.1% and 12.7%, and the risk of tumor vasculopathy was 15.4%, 17.4% and 19.0%. Scleral necrosis was observed in one patient. CONCLUSION: Radiation-related side effects and complications are common among patients treated with ruthenium brachytherapy for uveal melanoma. However, the risk for those largely depends on individual tumor parameters. Before treatment, patients should be informed of their specific risks to develop various side effects. Patient information before treatment should cover not only general information about the treatment and possible complications and side effects but should also give details on the specific risks of the patient in her individual situation. This also includes elucidating the patient's individual resources and expectations and her willingness for long-term regular follow-up examinations and secondary adjunct treatments. [Mh] Termos MeSH primário: Braquiterapia/efeitos adversos Melanoma/radioterapia Compostos de Rutênio/efeitos adversos Neoplasias Uveais/radioterapia Acuidade Visual/efeitos da radiação [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Catarata/etiologia Catarata/patologia Olho/patologia Olho/efeitos da radiação Feminino Seres Humanos Masculino Melanoma/complicações Melanoma/patologia Meia-Idade Doenças do Nervo Óptico/etiologia Doenças do Nervo Óptico/patologia Descolamento Retiniano/etiologia Descolamento Retiniano/patologia Neoplasias Uveais/complicações Neoplasias Uveais/patologia Hemorragia Vítrea/etiologia Hemorragia Vítrea/patologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Ruthenium Compounds); 97E960G9RP (ruthenium tetraoxide) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171013 [Lr] Data última revisão: 171013 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170901 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0183833

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[PMID]: 28774289 [Au] Autor: Chang R; Du Y; Peng Z; Lu Y; Zhu X [Ad] Endereço: Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. [Ti] Título: Acute uveal effusion during phacoemulsification with preoperative central serous chorioretinopathy: a case report. [So] Source: BMC Ophthalmol;17(1):137, 2017 Aug 03. [Is] ISSN: 1471-2415 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: We report a case of acute uveal effusion during phacoemulsification in an eye with preoperative chronic central serous chorioretinopathy (CSC). CASE PRESENTATION: A 55-year-old man with a history of chronic CSC for >18 months presented with bilateral opaque lenses. A preoperative ophthalmic examination showed suspected lenticonus and risky anatomical features, including a thick ciliary body, and anterior rotation of the ciliary process and iris root in both eyes. Optical coherence tomography (OCT) detected CSC in the left eye, but the results of fundus photography and B-scan ultrasonography were unremarkable. The anterior chamber flattened during phacoemulsification. Anterior vitrectomy was quickly performed for suspected infusion misdirection syndrome, and was followed by uneventful surgery. On postoperative day 1, fundus photography, type B ultrasound, and OCT revealed uveal exudation in the macula of the left eye. On postoperative day 50, the patient's visual acuity recovered to 20/32, and fundus photography, ultrasonography, and OCT revealed complete resolution of the uveal effusion. CONCLUSIONS: This case suggests an association between preoperative CSC and uveal effusion during surgery, because choroidal hyperperfusion and hyperpermeability were present in the patient's CSC-affected eyes. [Mh] Termos MeSH primário: Catarata/complicações Coriorretinopatia Serosa Central/cirurgia Edema/etiologia Complicações Intraoperatórias Facoemulsificação/efeitos adversos Doenças da Úvea/etiologia [Mh] Termos MeSH secundário: Catarata/diagnóstico Coriorretinopatia Serosa Central/complicações Coriorretinopatia Serosa Central/diagnóstico Doença Crônica Edema/diagnóstico Angiofluoresceinografia Fundo de Olho Seres Humanos Masculino Meia-Idade Tomografia de Coerência Óptica/métodos Úvea/patologia Doenças da Úvea/diagnóstico [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170805 [St] Status: MEDLINE [do] DOI: 10.1186/s12886-017-0530-3

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[PMID]: 28763558 [Au] Autor: Matet A; Daruich A; Zografos L [Ad] Endereço: Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland. [Ti] Título: Radiation Maculopathy After Proton Beam Therapy for Uveal Melanoma: Optical Coherence Tomography Angiography Alterations Influencing Visual Acuity. [So] Source: Invest Ophthalmol Vis Sci;58(10):3851-3861, 2017 Aug 01. [Is] ISSN: 1552-5783 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Purpose: To analyze microvascular and structural changes in radiation maculopathy and their influence on visual acuity (VA), using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: This was a retrospective analysis of consecutive patients with radiation maculopathy, 12 months or more after proton-beam irradiation for uveal melanoma, imaged with fluorescein angiography, OCT, and OCTA. Clinical parameters potentially affecting VA were recorded, including OCTA-derived metrics: foveal avascular zone (FAZ) area, vascular density, and local fractal dimension of the superficial (SCP) and deep capillary plexuses (DCP). Nonirradiated fellow eyes served as controls. Results: Ninety-three patients were included. FAZ was larger, while SCP/DCP capillary density and local fractal dimension were lower in the 35 irradiated than in the 35 fellow eyes (P < 0.0001). Microvascular alterations graded on fluorescein angiography (minimally damaged/disrupted/disorganized) were correlated to FAZ area and SCP/DCP density on OCTA (P < 0.01). By univariate analysis, worse VA was associated to macular detachment at presentation (P = 0.024), total macular irradiation (P = 0.0008), higher central macular thickness (CMT) (P = 0.019), higher absolute CMT variation (P < 0.0001), cystoid edema (P = 0.030), ellipsoid zone disruption (P = 0.002), larger FAZ (P < 0.0001), lower SCP (P = 0.001) and DCP capillary density (P < 0.0001), and lower SCP (P = 0.009) and DCP local fractal dimension (P < 0.0001). Two multivariate models with either capillary density or fractal dimension as covariate showed that younger age (P = 0.014/0.017), ellipsoid zone disruption (P = 0.034/0.019), larger FAZ (P = 0.0006/0.002), and lower DCP density (P = 0.008) or DCP fractal dimension (P = 0.012), respectively, were associated with worse VA. Conclusions: VA of eyes with radiation maculopathy is influenced by structural and microvascular factors identified with OCTA, including FAZ area and DCP integrity. [Mh] Termos MeSH primário: Macula Lutea/patologia Melanoma/radioterapia Terapia com Prótons/efeitos adversos Lesões por Radiação/etiologia Doenças Retinianas/etiologia Neoplasias Uveais/radioterapia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Feminino Angiofluoresceinografia Fóvea Central/patologia Seres Humanos Masculino Meia-Idade Lesões por Radiação/patologia Lesões por Radiação/fisiopatologia Doenças Retinianas/patologia Doenças Retinianas/fisiopatologia Vasos Retinianos/patologia Estudos Retrospectivos Tomografia de Coerência Óptica Acuidade Visual/fisiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170803 [Lr] Data última revisão: 170803 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170802 [St] Status: MEDLINE [do] DOI: 10.1167/iovs.17-22324

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[PMID]: 28636126 [Au] Autor: Klemp K; Kiilgaard JF; Heegaard S; Nørgaard T; Andersen MK; Prause JU [Ad] Endereço: Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. [Ti] Título: Bilateral diffuse uveal melanocytic proliferation: Case report and literature review. [So] Source: Acta Ophthalmol;95(5):439-445, 2017 Aug. [Is] ISSN: 1755-3768 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic intraocular disease that causes progressive visual loss in patients driven by an IgG factor associated with an underlying malignancy. Characteristic ocular findings include exudative retinal detachment, rapid cataract formation and uveal melanocytic tumours. The awareness and documentation of BDUMP has increased during the past decade, and the increasing amount of data collected demonstrates the effect of treatment with plasmapheresis and the value of diagnostic tools in BDUMP such as genetic and immunologic investigations. The literature of BDUMP has not been reviewed since 2003, and there is a growing need for an updated review on diagnosis and management of BDUMP. We review the literature and report a case of BDUMP with a white ciliary body tumour, iris rubeosis, increased iris pigmentation and cataract. [Mh] Termos MeSH primário: Corpo Ciliar/patologia Melanócitos/patologia Síndromes Paraneoplásicas/patologia Tomografia de Coerência Óptica/métodos Doenças da Úvea/patologia [Mh] Termos MeSH secundário: Idoso Proliferação Celular Seres Humanos Masculino [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171004 [Lr] Data última revisão: 171004 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170622 [St] Status: MEDLINE [do] DOI: 10.1111/aos.13481

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[PMID]: 28586956 [Au] Autor: Yazici G; Kiratli H; Ozyigit G; Sari SY; Cengiz M; Tarlan B; Mocan BO; Zorlu F [Ad] Endereço: Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. [Ti] Título: Stereotactic Radiosurgery and Fractionated Stereotactic Radiation Therapy for the Treatment of Uveal Melanoma. [So] Source: Int J Radiat Oncol Biol Phys;98(1):152-158, 2017 May 01. [Is] ISSN: 1879-355X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiation therapy (SRS/FSRT) for uveal melanoma. METHODS AND MATERIALS: We retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered with CyberKnife. RESULTS: According to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received <45 Gy, and 111 received ≥45 Gy. Median follow-up time was 24 months. Complete and partial response was observed in 8 and 104 eyes, respectively. The rate of 5-year overall survival was 98%, disease-free survival 57%, local recurrence-free survival 73%, distant metastasis-free survival 69%, and enucleation-free survival 73%. There was a significant correlation between tumor size and disease-free survival, SRS/FSRT dose and enucleation-free survival; and both were prognostic for local recurrence-free survival. Enucleation was performed in 41 eyes owing to progression in 26 and complications in 11. CONCLUSIONS: The radiation therapy dose is of great importance for local control and eye retention; the best treatment outcome was achieved using ≥45 Gy in 3 fractions. [Mh] Termos MeSH primário: Melanoma/radioterapia Radiocirurgia/métodos Neoplasias Uveais/radioterapia [Mh] Termos MeSH secundário: Intervalo Livre de Doença Fracionamento de Dose Enucleação Ocular/estatística & dados numéricos Feminino Seres Humanos Masculino Melanoma/mortalidade Melanoma/patologia Melanoma/cirurgia Meia-Idade Recidiva Local de Neoplasia Radiocirurgia/efeitos adversos Planejamento da Radioterapia Assistida por Computador Doenças Retinianas/etiologia Estudos Retrospectivos Carga Tumoral Neoplasias Uveais/mortalidade Neoplasias Uveais/patologia Neoplasias Uveais/cirurgia Acuidade Visual [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170721 [Lr] Data última revisão: 170721 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170608 [St] Status: MEDLINE

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[PMID]: 28412300 [Au] Autor: Paschalis EI; Zhou C; Lei F; Scott N; Kapoulea V; Robert MC; Vavvas D; Dana R; Chodosh J; Dohlman CH [Ad] Endereço: Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophtha [Ti] Título: Mechanisms of Retinal Damage after Ocular Alkali Burns. [So] Source: Am J Pathol;187(6):1327-1342, 2017 Jun. [Is] ISSN: 1525-2191 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Alkali burns to the eye constitute a leading cause of worldwide blindness. In recent case series, corneal transplantation revealed unexpected damage to the retina and optic nerve in chemically burned eyes. We investigated the physical, biochemical, and immunological components of retinal injury after alkali burn and explored a novel neuroprotective regimen suitable for prompt administration in emergency departments. Thus, in vivo pH, oxygen, and oxidation reduction measurements were performed in the anterior and posterior segment of mouse and rabbit eyes using implantable microsensors. Tissue inflammation was assessed by immunohistochemistry and flow cytometry. The experiments confirmed that the retinal damage is not mediated by direct effect of the alkali, which is effectively buffered by the anterior segment. Rather, pH, oxygen, and oxidation reduction changes were restricted to the cornea and the anterior chamber, where they caused profound uveal inflammation and release of proinflammatory cytokines. The latter rapidly diffuse to the posterior segment, triggering retinal damage. Tumor necrosis factor-α was identified as a key proinflammatory mediator of retinal ganglion cell death. Blockade, by either monoclonal antibody or tumor necrosis factor receptor gene knockout, reduced inflammation and retinal ganglion cell loss. Intraocular pressure elevation was not observed in experimental alkali burns. These findings illuminate the mechanism by which alkali burns cause retinal damage and may have importance in designing therapies for retinal protection. [Mh] Termos MeSH primário: Queimaduras Químicas/metabolismo Queimaduras Oculares/metabolismo Retina/lesões [Mh] Termos MeSH secundário: Álcalis Animais Apoptose/efeitos dos fármacos Apoptose/fisiologia Queimaduras Químicas/tratamento farmacológico Queimaduras Químicas/etiologia Queimaduras Químicas/patologia Córnea/imunologia Lesões da Córnea/tratamento farmacológico Lesões da Córnea/etiologia Lesões da Córnea/metabolismo Lesões da Córnea/patologia Modelos Animais de Doenças Avaliação Pré-Clínica de Medicamentos/métodos Queimaduras Oculares/tratamento farmacológico Queimaduras Oculares/etiologia Queimaduras Oculares/patologia Concentração de Íons de Hidrogênio Infliximab/farmacologia Infliximab/uso terapêutico Camundongos Endogâmicos C57BL Camundongos Knockout Fármacos Neuroprotetores/farmacologia Fármacos Neuroprotetores/uso terapêutico Oxirredução Coelhos Receptores Tipo I de Fatores de Necrose Tumoral/deficiência Receptores Tipo I de Fatores de Necrose Tumoral/genética Receptores Tipo II do Fator de Necrose Tumoral/deficiência Receptores Tipo II do Fator de Necrose Tumoral/genética Retina/imunologia Retina/metabolismo Retina/patologia Células Ganglionares da Retina/efeitos dos fármacos Células Ganglionares da Retina/patologia Hidróxido de Sódio Fator de Necrose Tumoral alfa/antagonistas & inibidores Fator de Necrose Tumoral alfa/metabolismo Úvea/metabolismo Uveíte Anterior/induzido quimicamente Uveíte Anterior/metabolismo Uveíte Anterior/patologia Uveíte Anterior/prevenção & controle [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Alkalies); 0 (Neuroprotective Agents); 0 (Receptors, Tumor Necrosis Factor, Type I); 0 (Receptors, Tumor Necrosis Factor, Type II); 0 (Tnfrsf1a protein, mouse); 0 (Tumor Necrosis Factor-alpha); 55X04QC32I (Sodium Hydroxide); B72HH48FLU (Infliximab) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170808 [Lr] Data última revisão: 170808 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170417 [St] Status: MEDLINE

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[PMID]: 28165428 [Au] Autor: Chen HY; Chou HC; Chang SJ; Liao EC; Tsai YT; Wei YS; Li JM; Lin LH; Lin MW; Chen YJ; Chen YS; Lin CC; Wang YS; Ko ML; Chan HL [Ad] Endereço: Institute of Bioinformatics and Structural Biology & Department of Medical Sciences, National Tsing Hua University, Hsinchu 300, Taiwan. dful690@yahoo.com.tw. [Ti] Título: Proteomic Analysis of Various Rat Ocular Tissues after Ischemia-Reperfusion Injury and Possible Relevance to Acute Glaucoma. [So] Source: Int J Mol Sci;18(2), 2017 Feb 05. [Is] ISSN: 1422-0067 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: Glaucoma is a group of eye diseases that can cause vision loss and optical nerve damage. To investigate the protein expression alterations in various intraocular tissues (i.e., the cornea, conjunctiva, uvea, retina, and sclera) during ischemia-reperfusion (IR) injury, this study performed a proteomic analysis to qualitatively investigate such alterations resulting from acute glaucoma. The IR injury model combined with the proteomic analysis approach of two-dimensional difference gel electrophoresis (2D-DIGE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used to monitor the protein expression alterations in two groups of specimens (an IR injury group and a control group). The analysis results revealed 221 unique differentially expressed proteins of a total of 1481 proteins in the cornea between the two groups. In addition, 97 of 1206 conjunctival proteins, 90 of 1354 uveal proteins, 61 of 1180 scleral proteins, and 37 of 1204 retinal proteins were differentially expressed. These findings imply that different ocular tissues have different tolerances against IR injury. To sum up, this study utilized the acute glaucoma model combined with 2D-DIGE and MALDI-TOF MS to investigate the IR injury affected protein expression on various ocular tissues, and based on the ratio of protein expression alterations, the alterations in the ocular tissues were in the following order: the cornea, conjunctiva, uvea, sclera, and retina. [Mh] Termos MeSH primário: Glaucoma/etiologia Glaucoma/metabolismo Proteoma Proteômica Traumatismo por Reperfusão/complicações Traumatismo por Reperfusão/metabolismo [Mh] Termos MeSH secundário: Doença Aguda Animais Túnica Conjuntiva/metabolismo Córnea/metabolismo Modelos Animais de Doenças Proteômica/métodos Ratos Reprodutibilidade dos Testes Retina/metabolismo Esclera/metabolismo Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz Eletroforese em Gel Diferencial Bidimensional [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Proteome) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170420 [Lr] Data última revisão: 170420 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170207 [St] Status: MEDLINE

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[PMID]: 28057647 [Au] Autor: Gupta P; Thakku SG; Sabanayagam C; Tan G; Agrawal R; Cheung CMG; Lamoureux EL; Wong TY; Cheng CY [Ad] Endereço: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore. [Ti] Título: Characterisation of choroidal morphological and vascular features in diabetes and diabetic retinopathy. [So] Source: Br J Ophthalmol;101(8):1038-1044, 2017 08. [Is] ISSN: 1468-2079 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIM: We aimed to characterise specific morphological and vascular features of the choroid in Indian adults with diabetes and diabetic retinopathy (DR). METHODS: Consecutive participants from the Singapore Indian Eye Study's 6-year follow-up examination underwent choroidal imaging using spectral domain optical coherence tomography (OCT) with enhanced depth imaging. Raw OCT images were loaded on a custom-written application on MATLAB that enabled delineation for detailed morphological and vascular analyses. Multiple linear regression analyses were performed to assess differences in choroidal characteristics by diabetes DR. RESULTS: Of the 462 recruited participants, 273 had no diabetes (mean age was 60.1±6.8 years), 100 had diabetes but no DR (61.8±7.4 years) and 89 had DR (62.4±6.0 years). In multiple regression analysis, after accounting for relevant confounders, compared with those without diabetes, participants with diabetes had significantly thinner mean choroidal thickness (CT; mean difference (MD)=-25.19 µm, p=0.001), smaller choroidal volume (MD=-0.23 mm , p=0.003), more inflection points (MD=1.78, p<0.001) and lesser choroidal vascular area within the foveal (MD=-0.024 mm , p=0.001) and macular (MD=-0.095 mm , p<0.001) regions. Among the diabetic group, subjects with DR had significantly thicker mean CT (MD=25.91 µm, p=0.001), greater choroidal volume (MD=0.24 mm , p=0.009), lesser inflection points (MD=-0.478, p=0.045) and greater choroidal vascular area at foveal (MD=0.016 mm , p=0.019) and macular (MD=0.057 mm , p=0.016) regions, compared with those without DR. CONCLUSIONS: Choroidal morphology and vasculature were altered in Indian adults with diabetes and DR. These findings may provide insights into choroidal changes in diabetes and DR. [Mh] Termos MeSH primário: Corioide/patologia Retinopatia Diabética/patologia Doenças da Úvea/patologia [Mh] Termos MeSH secundário: Corioide/irrigação sanguínea Corioide/diagnóstico por imagem Estudos Transversais Retinopatia Diabética/diagnóstico por imagem Feminino Seguimentos Fóvea Central/patologia Seres Humanos Masculino Meia-Idade Tamanho do Órgão Tomografia de Coerência Óptica Doenças da Úvea/diagnóstico por imagem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170815 [Lr] Data última revisão: 170815 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170107 [St] Status: MEDLINE [do] DOI: 10.1136/bjophthalmol-2016-309366

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[PMID]: 27856029 [Au] Autor: Skalet AH; Li Y; Lu CD; Jia Y; Lee B; Husvogt L; Maier A; Fujimoto JG; Thomas CR; Huang D [Ad] Endereço: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon. [Ti] Título: Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors. [So] Source: Ophthalmology;124(2):197-204, 2017 Feb. [Is] ISSN: 1549-4713 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in malignant iris melanomas and benign iris lesions. DESIGN: Cross-sectional observational clinical study. PARTICIPANTS: Patients with iris lesions and healthy volunteers. METHODS: Eyes were imaged using OCTA systems operating at 1050- and 840-nm wavelengths. Three-dimensional OCTA scans were acquired. Iris melanoma patients treated with radiation therapy were imaged again after I-125 plaque brachytherapy at 6 and 18 months. MAIN OUTCOME MEASURES: OCT and OCTA images, qualitative evaluation of iris and tumor vasculature, and quantitative vessel density. RESULTS: One eye each of 8 normal volunteers and 9 patients with iris melanomas or benign iris lesions, including freckles, nevi, and an iris pigment epithelial (IPE) cyst, were imaged. The normal iris has radially oriented vessels within the stroma on OCTA. Penetration of flow signal in normal iris depended on iris color, with best penetration seen in light to moderately pigmented irides. Iris melanomas demonstrated tortuous and disorganized intratumoral vasculature. In 2 eyes with nevi there was no increased vascularity; in another, fine vascular loops were noted near an area of ectropion uveae. Iris freckles and the IPE cyst did not have intrinsic vascularity. The vessel density was significantly higher within iris melanomas (34.5%±9.8%, P < 0.05) than in benign iris nevi (8.0%±1.4%) or normal irides (8.0%±1.2%). Tumor regression after radiation therapy for melanomas was associated with decreased vessel density. OCTA at 1050 nm provided better visualization of tumor vasculature and penetration through thicker tumors than at 840 nm. But in very thick tumors and highly pigmented lesions even 1050-nm OCTA could not visualize their full thickness. Interpretable OCTA images were obtained in 82% of participants in whom imaging was attempted. CONCLUSIONS: This is the first demonstration of OCTA in iris tumors. OCTA may provide a dye-free, no-injection, cost-effective method for monitoring a variety of tumors, including iris melanocytic lesions, for growth and vascularity. This could be helpful in evaluating tumors for malignant transformation and response to treatment. Penetration of the OCT beam remains a limitation for highly pigmented tumors, as does the inability to image the entire iris in a single field. [Mh] Termos MeSH primário: Neoplasias da Íris/patologia Iris/diagnóstico por imagem Melanoma/patologia Neoplasias Uveais/patologia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Braquiterapia Estudos de Casos e Controles Estudos Transversais Feminino Angiofluoresceinografia Seres Humanos Iris/irrigação sanguínea Iris/patologia Neoplasias da Íris/radioterapia Masculino Melanócitos/patologia Melanoma/radioterapia Meia-Idade Nevo Pigmentado/patologia Projetos Piloto Tomografia de Coerência Óptica Neoplasias Uveais/radioterapia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170718 [Lr] Data última revisão: 170718 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161119 [St] Status: MEDLINE

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