Contribuição ao estudo das distrofias corneanas

Contribution to the study of corneal dystrophies

RESUMO

Foram analisados os prontuários e as córneas provenientes de 49 pacientes submetidos à ceratoplastia penetrante, com diagnóstico de distrofia, durante o período de 1982 a 1988.

Destes casos, 16 pacientes (32,7%) eram do sexo masculino e 33 (67,3%) do sexo feminino. A idade média dos pacientes foi de 32 anos, variando de 7 a 76 anos. Entre as mulheres, a faixa etária compreendida entre 21 e 30 anos foi a que apresentou o maior número de casos que evoluíram para transplante, entretanto nos homens a faixa etária entre 31 e 40 anos foi a que apresentou o maior número de casos.

Em ordem decrescente as distrofias mais freqüentes foram: Granular, Macular, Lattice, Fuchs, Reis-Bücklers e Polimorfa Posterior.

Palavras-chave:
córnea; distrofia; Reis-Bücklers; granular; lattice; macular; polimorfa posterior; Fuchs

SUMMARY

Forty-nine patients who underwent penetrating keratoplasty, had their medical history charts and corneas analized during the period from 1982 to 1988 and were diagnosed with dystrophy.

Of these case, 16 patients (32,7%) were male and 33 (67,3%) female. The average age of the patients was 32, varying from 7 to 76 years old. Among the women, the age group between 21 and 30 years was the one which has show the largest number of cases that have lead to transplant, however among the men, the age group between 31 to 40 years, was the one which has shown the largest number of cases.

In deceasing order the most common dystrophies were: Granular, Macular, Lattice, Fuchs, Reis-Bücklers and Posterior Polymorphous Dystrophy.

Texto completo disponível apenas em PDF.

• Parte da Tese de Cunha, M.C. para obtenção do grau de Mestre em Oftalmologia, pela Escola Paulista de Medicina. Trabalho financiado em parte pelo CAPES.

REFERÊNCIAS BIBLIOGRÁFICAS

• ¹
  AKIA, S.; BROWN, S.L - The ultrastructure of Reis-Bücklers' dystrophy. Am. J. Ophthalmol., 72: 549-54, 1971.
• ²
  ARENTSEN, J.J.; MORGAN.B.; GREEN, W.R. - Changing indications for keratoplasty. Am. J. Ophthalmol. 81: 313-8, 1976.
• ³
  BABEL, J.; LEVENBERGER, P - Reis-Bücklers' corneal dystrophy. Ultrastructural study of 2 cases. Arch. Ophthal., 33: 49-62, 1973.
• ⁴
  CROSS, H.E.; MAUMENNE, A.E.; CANTOLINO, S.J. - Inheritance of Fuchs' endothelial dystrophy. Arch. Ophthalmol., 85: 268-75, 1971.
• ⁵
  DONNENFELD, E.; COHEN, E.; INGRAHAN, H.; POLESKI, S.; GOLDSMITH, E.; LAIBSON, P. - Corneal thinning in Macular corneal dystrophy. Am. J. Ophthalmol., 101: 112-3, 1986.
• ⁶
  FUCHS, E. - Dystrophia epithelialis corneae. Graefes Arch. Klin. Exp. Ophthalmol., 76: 478-82, 1910.
• ⁷
  HALL, P. - Reis-Bücklers' dystrophy. Arch. Ophthalmol., 91: 170-73, 1974.
• ⁸
  HENRIQUEZ, A.; KENYON, K.; DOHLMAN, C.; BORUCHOFF, A.; FROSTOT, S.; MEYER, R.; HANNINEN, L. - Morphologic characteristics of Posterior Polymorphous dystrophy. A study of nine corneas and review of the literature. Survey of Ophthalmol., 29 (suppl. 2): 141-7, 1984.
• ⁹
  HIDA, T.; TSUBOTA. K.; KIGASAWA, K.; MURATA, H.; OGATA, T.; AKIJA, J. - Clinical features of a newly recognized type of Lattice corneal dystrophy. Am. J. Ophthalmol., 104: 241-8, 1987.
• ¹⁰
  HOGAN, M.J.; WOOD, L - Reis-Bückler's corneal dystrophy. Trans. Ophthalmol. Soc. U.K. 91:41-57, 1971.
• ¹¹
  JONES, S.T.; STOUFFER, L.K. Reis-Bückler's corneal dystrophy: a clinicopathological study. Trans. Am. Acad. Ophthalmol. Otolaryngol., 74: 417-26, 1970.
• ¹²
  JONES, S.T.; ZIMMERMAN, L.E. - Histopathologic differentiation of Granular, Macular and Lattice dystrophies of the cornea. Am. J. Ophthalmol., 51: 394-410, 1961.
• ¹³
  JOHNSON, B.L.; BROWN, S.I.; ZAIDMAN, G.W. - A light and electron microscopic study of recurrent Granular dystrophy of the cornea. Am J. Ophthalmol., 92: 49-58, 1981.
• ¹⁴
  KRACHMER, J. - Posterior Polymorphous corneal dystrophy: A disease characterized by epithelial-like endothelial cells wich influence management and prognosis. Tr. Am. Ophth. Soc., 83: 413-75, 1985.
• ¹⁵
  KRACHMER, J.H.; PURCELL. J.J.; YOUNG. C.W., BUCHER, K.D. - A study of 64 families with corneal endothelial dystrophy. Arch. Ophthalmol., 96: 2036-60, 1978.
• ¹⁶
  LANG, G.K.; GOTTFRIED., O.; NAUMANN, G. - The frequency of corneal dystrophies requiring keratoplasty in Europe and the USA. Cornea, 6 (suppl. 3): 209-211, 1987.
• ¹⁷
  MEISLER, D.M.; FINE, M. - Recurrence of the clinical signs of Lattice corneal dystrophy in corneal transplants. Am. J. Ophthalmol., 97: 210-4, 1984.
• ¹⁸
  MORGAN, G. - Macular dystrophy of the cornea. Br. J. Ophthalmol., 50: 57-67, 1966.
• ¹⁹
  OLSEN, T., EHLERS, N.; FAVINI, E.; - Long term results of corneal grafting in Fuchs's endothelial dystrophy. Acta Ophthalmologica. 62. 445-52, 1984.
• ²⁰
  PANJWANI, N.; RODRIGUES, M.; ALROY, J.; ALBERT, D.; BAUM, J. - Alterations in stromal glycoconjugates in Macular corneal dystrophy. Inv. Ophthalmol. Vis. Sci., 27: 1211-16, 1986.
• ²¹
  PANJWANI, N.; RODRIGUES, M.; FRE, K.; KRACHMER, J.; ALBERT, D.; BAUM, J. - Lectin receptors of amyloid in corneas with Lattice dystrophy. Arch. Ophlhalmol., 105: 688-91, 1987.
• ²²
  POLACK, F.M. - Contributions of eletron microscopy to the study of corneal pathology. Surv. Ophthalmol., 20: 375-414, 1976.
• ²³
  ROBIN, J.B.; GINDI, J.J; KOH, K.; SCHNZLIN, D.J.; RAO, N.A.; YORK, K.K.; SMITH, R.E. - An update of the indications for penetrating keratoplasty - 1979 through 1983. Arch. Ophthalmol., 104: 87-9, 1986.
• ²⁴
  SCHWARTZ, M.F.; TAYLOR, H.R. - Surgical management of Reis-Bückler's corneal dystrophy. Cornea, 4: 100-7, 1985.
• ²⁵
  SMITH, R.E.; McDONALD, H.R.; NESBURN, A.B.; MINCKLER, D.S. - Penetrating keratoplasty changing indications, 1947 to 1978. Arch. Ophthalmol., 98: 1226-9, 1980.
• ²⁶
  SMOLIN, G - Dystrophies and degenerations. In: SMOLIN, G.; THOFT, R. - The Cornea. Boston, Little, Brown and Company, 1987. p. 427-55.
• ²⁷
  WITSCHEL, H.; SUNDMACHER, R. - Bilateral recurrence of Granular corneal dystrophy in the grafts. A clinico-pathological study. Graefe's Arch. Klin. Exp. Ophthalmol., 209: 179-88, 1979.
• ²⁸
  WOOD, T.O.; FELMING, J.C.; DOTSON, R.S.; COTTEN, M.S. - Treatment of Reis-Bücklers's corneal dystrophy by removal of subephithelial fibrous tissue. Am. J. Ophthalmol., 85:360-2, 1978.
• ²⁹
  YANG, C.; SANDARRAJ, N.; KLINTWORTH, C. - Immunohistochemical evidence of heterogeneity in Macular corneal dystrophy. Am. J. Ophthalmol., 106: 65-71, 1988.

Datas de Publicação

• Publicação nesta coleção
  Sep-Oct 1992