Navegando por Palavras-chave "Keratoconjunctivitis"
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- ItemAcesso aberto (Open Access)Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso(Conselho Brasileiro de Oftalmologia, 2008-12-01) Diniz, Camila Melo Gadelha Pereira [UNIFESP]; Vieira, Luiz Antonio [UNIFESP]; Rigueiro, Moacyr Pezati [UNIFESP]; Vasconcelos, Mônica [UNIFESP]; Freitas, Denise de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)To describe a case of bilateral cicatrizing keratoconjunctivitis in a patient with lichen planus and review the literature. Conjunctiva cicatrization with symblepharon formation, dry eye, corneal infiltration and neovascularization and thinning were the most observed prominent signs. Diagnosis was based on clinical findings and biopsy, after exclusion of typical causes of cicatricial keratoconjuntivitis.
- ItemAcesso aberto (Open Access)Galectina-3 : seu papel na alergia ocular e potencial uso como biomarcador(Universidade Federal de São Paulo (UNIFESP), 2017-03-31) Andrade, Frans Eberth Costa [UNIFESP]; Gil, Cristiane Damas [UNIFESP]; http://lattes.cnpq.br/6047408996026135 ; http://lattes.cnpq.br/5356033561755196; Universidade Federal de São Paulo (UNIFESP)A galectina-3 (Gal-3) é uma proteína ligante de beta-galactosídeos que atua na regulação da resposta inflamatória. No entanto, seu mecanismo de ação na alergia não está bem estabelecido. Objetivo: Avaliar a Gal-3 como possível biomarcador na ceratoconjuntivite alérgica em pacientes. Além disso, avaliar o papel dessa proteína na inflamação alérgica ocular utilizando modelo de conjuntivite alérgica (CA) induzida por ovalbumina (OVA) em camundongos selvagens (WT) e nocautes para Gal-3 (Gal-3-/-). Métodos: Células epiteliais da conjuntiva bulbar de pacientes controles e com CA severa, tratados ou não, foram coletadas por citologia de impressão para realização de imunocitoquímica. Para a realização do modelo experimental, nos dias 0 e 7, camundongos BALB/c machos WT e Gal-3-/- receberam injeção subcutânea de OVA (5 μg), e nos dias 14, 15 e 16, foram desafiados com 250 μg de OVA por instilação no saco conjuntival. Parte dos animais WT sensibilizados com OVA foram pré-tratados nos dias 14 a 16 com tacrolimus a 0,03% ou com dexametasona (1 mg/kg). Os animais controles receberam apenas salina. Resultados: O aumento da expressão de Gal-3 detectada no epitélio conjuntival de pacientes com ceratoconjuntivite alérgica foi modulado negativamente pelos tratamentos farmacológicos acompanhados de corticosteroide. Esses achados foram corroborados no modelo animal de CA que mostrou altos níveis de Gal-3 nas conjuntivas palpebrais, efeito revertido pela ação de dexametasona e tacrolimus. Após 24 horas do último desafio com OVA, os níveis de IgE total e anti-OVA aumentaram significantemente no sangue dos animais WT e Gal-3-/- sensibilizados por OVA em comparação aos controles, confirmando a eficácia do modelo de CA. A falta endógena de Gal-3 exacerbou a resposta inflamatória local, aumentando o influxo de eosinófilos e ativação de mastócitos. Além disso, os animais Gal-3-/- sensibilizados e desafiados pela OVA apresentaram aumento da expressão da protease 6 de mastócitos nos olhos e dos níveis de eotaxina, IL-4, IL-13 e IFN-γ no fluido lacrimal, em comparação aos animais WT com CA. Conclusão: A ausência de Gal-3 associada com o aumento da resposta inflamatória alérgica evidencia a participação dessa lectina na patogênese da alergia ocular e como relevante alvo terapêutico.
- ItemAcesso aberto (Open Access)Microbiota conjuntival em pacientes com alergia ocular(Conselho Brasileiro de Oftalmologia, 2005-12-01) Libório, Alexandre Mattoso; Nishiwaki-Dantas, Maria Cristina [UNIFESP]; Mimica, Lycia Mara Jenne; Dantas, Paulo Elias Correa; Hofling-Lima, Ana Luisa [UNIFESP]; Santa Casa de São Paulo Faculdade de Ciências Médicas Departamento de Oftalmologia; Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Faculdade de Ciências Médicas Laboratório de Microbiologia; Santa Casa de São Paulo Faculdade de Ciências Médicas setor de Córnea e Doenças ExternasPURPOSE: To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. METHODS: One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication) were in group A and 70 patients from the general outpatient clinic were in group B (control group). Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar). RESULTS: In group A, 30 cultures (47.7%) were positive and 6 (8.6%) in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. CONCLUSION: Bacterial microbiota was more frequently found in patients with ocular allergy.
- ItemAcesso aberto (Open Access)Ocular allergy latin american consensus(Conselho Brasileiro de Oftalmologia, 2011-12-01) Santos, Myrna Serapião dos [UNIFESP]; Alves, Milton Ruiz; Freitas, Denise de [UNIFESP]; Sousa, Luciene Barbosa de; Wainsztein, Ricardo; Kandelman, Sérgio; Lozano, Mauricio; Beltrán, Francisco; Lozada, Oscar Baça; Santacruz, Concepción; Guzzo, Giovanni; Zaccarelli Filho, Carlos Alberto [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Hospital de Olhos de Sorocaba Departamento de Oftalmologia; Universidad de Buenos Aires Instituto de La Visión; Clínica Skopus; Universidad del Rosario Fundación Oftalmologica Nacional Departamento de Oftalmologia Pediatrica y Estrabismo; Hospital Dr. Luis Sánchez Bulnes e Clínica Lomas Altas Servicio de Córnea y Cirugía Refractiva; Fundación Hospital Nuestra Señora Servicio de Córnea; Fundación Conde de Valenciana I.A.P. Instituto de Oftalmología Servicio de Córnea; Intrials Clinical Research Clinical Operations Manager; Intrials Clinical Research BDM & Clinical Research AssociatePURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: Ocular allergy was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.
- ItemAcesso aberto (Open Access)Uso de ganciclovir 0,15% gel para tratamento de ceratoconjuntivite adenoviral(Conselho Brasileiro de Oftalmologia, 2011-12-01) Yabiku, Simone Tiemi [UNIFESP]; Yabiku, Mariann Midori [UNIFESP]; Bottós, Kátia Mantovani [UNIFESP]; Araújo, Aline Lutz [UNIFESP]; Freitas, Denise de [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To evaluate the efficacy and the toxicity of 0.15% ganciclovir gel in the treatment of adenoviral conjunctivitis and in preventing ocular complications after adenoviral conjunctivitis, such as corneal infiltrates and pseudomembranes. METHODS: Double blind, interventional and randomized clinical trial. Thirty-three patients with clinical diagnosis of adenoviral conjunctivitis with onset of symptoms for five or less days were randomized in two groups: Group 1 (treatment) with 19 patients used ganciclovir gel and Group 2 (control) with 14 patients used artificial tears without preservative. Patients answered a questionnaire of signs and symptoms and were submitted to an ophthalmologic exam. On the 6th and 10th days of treatment they answered the same questions and were re-examined by the same ophthalmologist. Signs and symptoms were compared. T Student, Mann-Whitney e Wilcoxon tests were used to statistical analysis. RESULTS: Trend of better response in the treatment group in relation of patients' perception, besides faster improvement of this group compared to the control group (p=0.26). There were lower transmission to the fellow eye (p=0.86) and to people living together (p=0.16) in the treatment group. No statistical difference related to signs and symptoms of conjunctivitis were found comparing both groups. We observed statistical difference in pain, itch and photophobia only in the treatment group, comparing each group alone. No toxicity and more tolerance of the ganciclovir were observed. There was no statistical difference in the ocular complications after conjunctivitis between both groups. CONCLUSIONS: This study showed trend of better and faster response of the signs and symptoms of the patients treated with ganciclovir compared with the control group, but with no statistical significant. These results need to be confirmed by additional studies, with more patients and longer follow-up. Clinical Trails.gov: NCT01349452