OBJECTIVE: Bevacizumab has been widely used as a vascular endothelial growth factor antagonist in the treatment of retinal vasoproliferative disorders in adults and, more recently, in infants with retinopathy of prematurity. Recently, it has been proposed that vascular endothelial growth factor acts as a protective factor for neurons and glial cells, particularly in developing nervous tissue. The purpose of this study was to investigate the effects of bevacizumab on the developing retinas of juvenile rabbits. METHODS: Juvenile rabbits received bevacizumab intravitreously in one eye; the other eye acted as an untreated control. Slit-lamp and fundoscopic examinations were performed both prior to and seven days after treatment. At the same time, retina samples were analyzed using immunohistochemistry to detect autophagy and apoptosis as well as proliferation and glial reactivity. Morphometric analyses were performed, and the data were analyzed using the Mann-Whitney U test. RESULTS: No clinical abnormalities were observed in either treated or untreated eyes. However, immunohistochemical analyses revealed a reduction in the occurrence of programmed cell death and increases in both proliferation and reactivity in the bevacizumab-treated group compared with the untreated group. CONCLUSIONS: Bevacizumab appears to alter programmed cell death patterns and promote gliosis in the developing retinas of rabbits; therefore, it should be used with caution in developing eyes

OBJETIVO: Determinar a prevalência, frequência e distribuição dos estágios evolutivos da retinopatia da prematuridade (ROP) realizado num hospital de nível terciário no Rio de Janeiro. Identificar fatores de risco sistêmicos associados ao seu aparecimento e progressão, descrever o tratamento instituído e evolução dos pacientes. MÉTODOS: Estudo observacional de coorte, entre março de 2005 e fevereiro de 2007. Foram examinados 152 recém-natos(RN) prematuros com 32 semanas ou menos de idade gestacional(IG), e ou 1500gramas ou menos de peso ao nascimento(PN). Uma revisão simultânea dos prontuários foi realizada procurando correlação dos fatores de risco para o desenvolvimento da ROP com a clínica encontrada. Foram feitas análises estatísticas descritiva, intervalo de confiança e multivariados (Anova / pós-teste:Tukey). RESULTADOS: Dos 302 olhos examinados, 72,19% estavam normais e 27,81% desenvolveram ROP. O estágio 2 com 29 (9,60%) de olhos acometidos foi o mais prevalente. O tratamento foi indicado em 6,57% dos RN triados, com regressão em 90% dos casos. Houve diferença estatística significativa entre a média dos principais fatores de risco pesquisados de acordo com apresentação clínica da ROP. CONCLUSÃO: O perfil epidemiológico dos RN prematuros no nosso hospital foi definido ao longo desses 2 anos. O APGAR de 1 minuto deve ser levado em consideração nos RN que desenvolveram a ROP e o seu acompanhamento feito com cautela. Os dados referentes aos RN prematuros nesse tipo de estudo são sempre dinâmicos e variáveis, exigindo pesquisas periódicas para se estabelecer estratégias, melhorando o desempenho e resultados nos programas de prevenção a cegueira.

ABSTRACT PURPOSE: To resolve the prevalence, frequency and the evolutive stages distribution of retinopathy of prematurity (ROP) at a tertiary level hospital in Rio de Janeiro (RJ). To identify some of the systemic risk factors associate with their appearing and progression, and describe the treatment and evolution of these patients. METHODS: Cohort observational study did between march 2005 and february 2007. It were included 152 preterm infants with 32 weeks or less of gestacional age(GA), and or 1500grams or less of birth weight(BW). A simultaneous data review were did, search for correlation the risk factors of ROP development to the found clinic. It were done descriptive statistic analyze, confidence interval and Anova with Tukey pos-test. RESULTS: 302 examined eyes, 71,19% were normal and 27,81% developed ROP. The stage 2 with 29 (9,60%) of the affected eyes were the most prevalent. The treatment was indicated in 6,57% of the preterm infants, with more than 90% of regression. It had a significative statistic difference between the mean of searched main risk factors from accord the clinic presentation of ROP. CONCLUSION: The epidemiological profile of the preterm infants in our hospital was definite by this 2 years. The 1 minute APGAR must be leaved in consideration at the preterm infants who developed ROP, and their follow up maide with precaution. The datas referees to the preterm infants in this kind of study are always dynamics and variables, requiring periodics researches to strategies established, improving the performance and results at blindness prevention programs.

Este trabalho descreve o caso de uma paciente de 56 anos que se apresentou com cefaléia, edema unilateral de papila e constrição do campo visual nasal. Os exames laboratoriais e de neuroimagem, o acompanhamento clínico e resposta ao tratamento permitiram o diagnóstico de hipertensão intracraniana idiopática. Chamamos a atenção que o papiledema unilateral pode ser uma forma de apresentação incomum da síndrome e discutimos o seu diagnóstico diferencial e tratamento.

We describe a 56-year-old female patient that presented with headache, unilateral optic disc edema and nasal visual field constriction. Laboratory and imaging investigation, clinical findings and response to treatment lead to the diagnosis of idiopathic intracranial hyperthension. We emphasize that unilateral papiledema can be an unusual clinical presentation of the syndrome and discuss its differential diagnosis and treatment.

OBJETIVO: Estabelecer a prevalência das ametropias e oftalmopatias, no ano de 2001, em população pré-escolar e escolar de favelas do Alto da Boa Vista, Rio de Janeiro, Brasil. MÉTODOS: Estudo observacional do tipo transversal, durante campanha de saúde ocular na rede pública de ensino. Crianças com acuidade visual inferior a 0,8 ou com anormalidades foram triadas por voluntários treinados para serem avaliadas por oftalmologistas no Instituto Benjamin Constant. RESULTADOS: Foram avaliadas 1800 crianças no total. Destas, 306 (17,00 % do total) foram encaminhadas ao IBC. Houve 183 (10,17% do total e 59,80% das triadas) que receberam alta por apresentarem visão melhor que 0,8. A prevalência dos erros refrativos foi de 3,50% (ametropias positivas , 1,78%; ametropias negativas, 1,06% e astigmatismos mistos, 0,67%). A prevalência das oftalmopatias foi de 4,83%. (ambliopia teve prevalência de 2,00%, manifestações do estrabismo, 1,72% e outras causas 1,11%.) CONCLUSÃO: Demonstrou-se a prevalência dos principais distúrbios oftalmológicos infantis nas favelas do Alto da Boa Vista e ressaltou-se a necessidade de campanhas para bom êxito no desenvolvimento da acuidade visual das crianças.

PURPOSE: To estabilish the prevalence of the ametropias and eye diseases, in the year 2001, within a preschool and school population in Alto da Boa Vista favelas (slum), in the city of Rio de Janeiro, Brazil. METHODS: Transversal observational study during an ocular health campaign in public education schools. The children that have shown visual acuity fewer than 0.8 or abnormally were referred by trained volunteers to avaliation by ophthalmologists from the Benjamin Constant Institute. RESULTS: From the 1800 children who were examined, 306 (17.00%) were referred to the ophthalmologic examination. There were 183 children (10.17% from total and 59.80% from referred) that were dismissed for presenting visual acuity better than 0.8. The refractive errors prevalence was 3.50% (hyperopia and astigmatism hyperopic were 1.78%, myopia and astigmatism myopic 1.06%, mixed astigmatism 0.67%).The eyes diseases prevalence was 3.50% (amblyopia was 2.00%, manifest strabismus was 1.72% and others causes was 1.11%). CONCLUSION: It was shown the prevalence of the main ophthalmologic children disorders. It also points out the need of ocular health campaigns thus achieve remarkably the development of the children visual acuity.