Navegando por Palavras-chave "Oftalmopatia de Graves"
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- ItemAcesso aberto (Open Access)Colchicine in the treatment of the inflammatory phase of Graves' ophthalmopathy: a prospective and randomized trial with prednisone(Conselho Brasileiro de Oftalmologia, 2006-12-01) Stamato, Francisco José da Cunha [UNIFESP]; Maciel, Rui Monteiro de Barros [UNIFESP]; Manso, Paulo Gois [UNIFESP]; Wolosker, Ângela Maria Borri [UNIFESP]; Paiva, Elias Rodrigues de [UNIFESP]; Lopes, Antonio Carlos [UNIFESP]; Furlanetto, Reinaldo Perrone [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To investigate if colchicine is valuable in the treatment of Graves' ophthalmopathy (GO), we compared its effect with prednisone in 22 patients during the inflammatory phase of GO. METHODS: All patients, similar in age, sex and smoking habits, were euthyroid for at least 3 months and randomly divided into two groups, one treated with colchicine (1.5 mg/day) and the other treated with prednisone (0.75 mg/kg/day). They were monitored with ophthalmologic assessment (clinical activity score-CAS) and magnetic resonance imaging, using a signal intensity ratio (SIR) of the recti muscles in comparison to the cerebral substantia alba. RESULTS: Amelioration of CAS was seen in 68% of the orbits in both groups. SIR also had a significant reduction after treatment: the initial median of 1.14 in G1 and 1.27 in G2, evolved, after treatment, to 1.07 in G1 and 0.69 in G2. The variation between both groups after treatment was not significant (p=0.22). None of the patients treated with colchicine had side effects; on the other hand, side effects in G2 were weight gain, edema, gastric complaints, hirsutism, weakness, depression, and alterations in blood pressure. CONCLUSION: Colchicine had a beneficial effect on the inflammatory phase of GO without the side effects of prednisone.
- ItemSomente MetadadadosOftalmopatia de Graves: achados tomográficos e suas correlações clínicas(Universidade Federal de São Paulo (UNIFESP), 2006) Abreu, Elvira Barbosa [UNIFESP]; Burnier Júnior, Miguel Noel Nascente [UNIFESP]Resumo : Introdução: Werner, em1974, concluiu que achados radiológicos são os mais confiáveis no diagnóstico da oftalmopatia de Graves. Desde então, inúmeros padrões têm sido descritos, inclusive o envolvimento dos tendões dos músculos extra-oculares. Bem Simon, em 2004, correlacionou este achado à diplopia, hipótese que pretendemos avaliar no presente estudo. Objetivo: O propósito é, então, estudar os diferentes padrões tomográficos em busca de estabelecer suas correlações clínicas. Pacientes, material e método: 20 pacientes, entre 20 e 80 anos de idade, de ambos os sexos, previamente classificados em formas benigna (não infiltrativa), intermediária e infiltrativa foram avaliados pela tomografia das órbitas. Todos os pacientes já estavam eutireoideanos há pelo menos um ano. Os padrões tomográficos foram estudados e divididos em três grupos: pacientes com envolvimento muscular posterior (congestão apical), pacientes com envolvimento dos tendões dos músculos extra-oculares e pacientes com envolvimento do tecido conectivo/adiposo orbitário. Resultados: Foram encontradas relações estatistica mente significativas entre espessamento muscular posterior (congestão apical) e a forma infiltrativa (p<0.01) e entre envolvimento dos tendões e a forma intermediária (p<0.012). Conclusão: A tomografia orbitária é útil para determinar a forma clínica do paciente, possibilitando uma escolha terapêutica correta.
- ItemAcesso aberto (Open Access)Protein expression of VEGF, IGF-1 and FGF in retroocular connective tissues and clinical correlation in Graves' ophthalmopathy(Conselho Brasileiro de Oftalmologia, 2008-08-01) Matos, Kimble [UNIFESP]; Manso, Paulo Gois [UNIFESP]; Marback, Eduardo [UNIFESP]; Furlanetto, Reinaldo [UNIFESP]; Alberti, Gustave Nosé; Nosé, Vania [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia; Tufts University Medical Center; Brigham and Women's Hospital Department of PathologyPURPOSE: To investigate the immunohistochemical expression (IGF-1, EGFr, EGF, c-erbB-2/HER-2/neu, PDGF-A, PDGF-B, FGF and VEGF) in patients with Graves' ophthalmopathy. METHODS: Twenty-four samples (Graves' ophthalmopathy patients) underwent lateral rectus muscle and surrounding fibrous and adipose tissue biopsy. The control group was obtained by strabismus surgery. Correlation between clinical- ophthalmologic, endocrinological, ultrasonographic findings, and immunohistochemical expression was performed. RESULTS: IGF-1: There were 7 positive cases (29.2%). There was a direct relation with higher CAS (clinical activity score) in all of them and if only CAS equal or higher than 5 was considered, this was 54.5%. FGF: There was expression in 5 cases (20.8%) with a direct relation in all those with higher CAS (>5) (45.4%). VEGF: There were two positive cases (8.3%) for VEGF in endothelial cells, in these cases the patients also presented CAS higher than 5. There was no expressions of all growth factors in the control group. CONCLUSIONS: All patients, except one, with positive expression of FGF, IGF-1 and VEGF showed CAS greater than 5, suggesting in this way an important role of these growth factors in the pathogenesis and severity of Graves' ophthalmopathy. However, statistical analysis revealed only significant association between IGF-1 and male sex (P=0.034). Low ultrasound reflectivity and endocrine status may not correlate directly with disease activity or with immunoexpression of growth factors and c-erbB-2/HER-2/neu.
- ItemAcesso aberto (Open Access)Radioterapia para pacientes portadores de oftalmopatia de Graves: avaliação clínica e radiológica(Universidade Federal de São Paulo (UNIFESP), 2009-09-30) Cardoso, Cejana Casimiro de Deus [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate the clinical and radiological response of patients with Graves’ ophthalmopathy underwent to orbital radiotherapy concomitant or not with corticotherapy. Methods and materials: Eighteen patients (36 orbits) were underwent to orbital radiotherapy with a total dose of 10 Gy, fractioned in 1 Gy once a week over 10 weeks; nine of these patients made concomitant use of corticoids. The patients were evaluated clinically by means of a verbal questionnaire and by the evaluation of the clinical activity score (CAS), and radiologically, by magnetic resonance (MR) imaging parameters, before treatment and six months following it. Results: After treatment, total improvement of ocular pain, palpebral edema, visual acuity and ocular motility was observed. The patients presented a significant decrease in the symptoms such as tearing, diplopia, conjunctival hyperemia and ocular grittiness. There was a significant reduction of the inflammatory activity in the left eye, and all patients were classified as quiescent in the right eye. The MR indicated a marked decrease in ocular muscle thickness and in signal intensity bilaterally. The comparative analysis between groups I (radiotherapy exclusively) and II (radiotherapy combined with corticotherapy) showed no statistical difference regarding the clinical and radiological parameters evaluated. Conclusion: Whether associated or not with corticotherapy, radiotherapy delivered in low dose and in a protracted scheme suggest to be effective and safe, as verified by the clinical and radiological improvements, and is an efficient therapeutic option for patients with Graves’ ophthalmopathy.
- ItemSomente MetadadadosUtilizacao da ressonancia magnetica na analise das medidas das estruturas orbitarias na oftalmopatia de Graves(Universidade Federal de São Paulo (UNIFESP), 2008) Goldenberg, Fabiana Chaves [UNIFESP]