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Search Results: 1 - 10 of 435358 matches for " Mário Luiz Ribeiro; "
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Unilateral blindness as a complication of nasal septoplasty: case report
Monteiro, Mário Luiz Ribeiro;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000200020
Abstract: blindness as a complication of nasal septoplasty is a devastating occurrence with only a few cases reported in the literature. in most of these cases, visual loss was attributed to retinal embolism following intra-arterial injection of substances into the nasal turbinate. this paper documents one case of complete unilateral blindness from direct optic nerve trauma following an apparently uneventful septorhinoplasty. ophthalmologists and otolaryngologists should therefore be aware of the possible occurrence of such complication.
Anterior ischemic optic neuropathy: a comparison of the optic disc area of patients with the arteritic and non-arteritic forms of the disease and that of normal controls
Monteiro, Mário Luiz Ribeiro;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000600005
Abstract: purpose: to evaluate the optic disc area of patients with non-arteritic anterior ischemic optic neuropathy (na-aion) and arteritic anterior ischemic optic neuropathy (a-aion) and compare the results between each other and with those from controls in order to verify the existence and the magnitude of anatomical factors predisposing to the development of anterior ischemic optic neuropathy. methods: this is a case-controlled study of the optic disc area of 24 consecutive patients affected with na-aion, 13 patients with a-aion and 24 consecutive healthy normals, sex- and age-matched with the patients with the na-aion group. measurements of optic disc area were performed for each studied group using disc photographs projected, measured and corrected for the refractive error and the keratometric readings, according to littmann's method in each studied group. the results were compared using variance analysis. results: the mean areas and standard deviations of the optic discs from patients with na-aion, a-aion and normals were respectively 1.99 ± 0.35 mm2, 2.29 ± 0.39 mm2 and 2.49 ± 0.53 mm2. the statistical analysis revealed that the mean areas of the optic disc of patients with na-aion were significantly different from those of normal controls. no statistical difference was found between a-aion and normal controls. conclusion: na-aion occurs predominantly in small discs while the arteritic form of the disease shows no such preference. factors related to optic disc structure play a role in the pathophysiology of na-aion. the occurrence of aion in large optic optic discs should raise the suspicion of temporal arteritis. on the other hand, small optic disc areas do not rule out that vasculitis.
Descompress?o da bainha do nervo óptico para tratamento do papiledema no pseudotumor cerebral
Monteiro, Mário Luiz Ribeiro;
Arquivos Brasileiros de Oftalmologia , 2002, DOI: 10.1590/S0004-27492002000400002
Abstract: purpose: to evaluate the efficacy of optic nerve sheath decompression (onsd) performed in eyes with papilledema and visual loss in patients with pseudotumor cerebri. methods: seventeen patients (24 eyes) submitted to optic nerve sheath decompression from january 1991 until january 1999 were analyzed. all of them had the diagnosis of pseudotumor cerebri and were operated on due to reduction of visual acuity (va) and/or visual fields (vf). two patients did not tolerate clinical treatment with diuretics and corticosteroids and the others did not present a satisfactory response to these treatments. four patients had been previously submitted to lumboperitoneal shunt. results: surgery was unilateral in 10 patients and bilateral in 7. four patients were submitted to bilateral simultaneous surgery because of the severity of visual loss. visual acuity and/or visual fields improved in 14 eyes, remained unchanged in 9 and became worse in one of 24 operated eyes. the patient that worsened already had rapidly progressive severe visual loss with a remaining paracentral island of vision and visual acuity of counting finger in the preoperative period. papilledema resolved in every operated eye, followed by optic atrophy in many of them. patients who did not improve vision were those who already had severe visual loss at the time of surgery. moderate intraoperative hemorrhage occurred in two surgeries. conclusions: optic nerve sheath decompression can be useful to protect visual function in patients with papilledema from pseudotumor cerebri who do not respond properly to clinical treatment. it can also be helpful as an adjunctive treatment in patients with lumboperitoneal shunt surgery.
Multiple brown tumors of the orbital walls: case report
Monteiro, Mário Luiz Ribeiro;
Arquivos Brasileiros de Oftalmologia , 2009, DOI: 10.1590/S0004-27492009000100025
Abstract: we report the case of a 40-year-old woman with chronic renal failure and secondary hyperparathyroidism that presented with slowly progressive proptosis of the right eye and mass sensation in the temporal and frontal orbital margins. computerized tomography scan revealed two separate hyperdense and well-circumscribed lesions in the right orbital walls. a biopsy followed by histopathologic study revealed a dense lesion, with fibrous proliferation associated with osseous metaplasia and osteoclastic activity in the tumor, compatible with the diagnosis of brown tumor. the patient was submitted to surgical removal of the parathyroid glands that resulted in marked improvement in her condition and regression of the orbital tumors. although the occurrence of more than one separate bone lesion in the orbit usually suggests metastasis, our case shows that brown tumors should also be included in the differential diagnosis of such lesions, particularly in patients with hyperparathyroidism.
Avalia??o da camada de fibras nervosas da retina nas afec??es neuroftalmológicas da via óptica anterior
Monteiro, Mário Luiz Ribeiro;
Revista Brasileira de Oftalmologia , 2012, DOI: 10.1590/S0034-72802012000200010
Abstract: retinal nerve fiber evaluation is important in the diagnosis and management of several diseases of the anterior visual pathway. in this report we review the clinical findings and the current techonologies avalilable to analyse the retinal nerve fiber layer. we furthermore review the main findings in several disease of the anterior visual pathways including inflammatory, ischemic, toxics, hereditary, compressive and traumatic optic neuropathies as well as lesion of the optic chiasm, optic tract and lateral geniculate body.
Descompress o da bainha do nervo óptico para tratamento do papiledema no pseudotumor cerebral
Monteiro Mário Luiz Ribeiro
Arquivos Brasileiros de Oftalmologia , 2002,
Abstract: Objetivos: Avaliar a eficácia da descompress o da bainha do nervo óptico (DBNO) realizada em olhos com papiledema e perda visual, de pacientes com pseudotumor cerebral. Métodos: Foram estudados 17 pacientes (24 olhos) submetidos à descompress o da bainha do nervo óptico entre janeiro de 1991 e janeiro de 1999. Todos tinham diagnóstico de pseudotumor cerebral e foram operados por apresentar perda da acuidade (AV) e/ou do campo visual (CV). Duas pacientes n o toleraram o tratamento clínico com diuréticos e corticóides e, nos demais, a medica o n o surtiu efeito satisfatório. Quatro pacientes já haviam sido submetidas à deriva o lombo-peritoneal. Resultados: A cirurgia foi unilateral em dez pacientes e bilateral em sete. Quatro tiveram cirurgia bilateral e simultanea devido à gravidade da perda visual. A acuidade visual e/ou o campos visuais melhorou em 14, permaneceu inalterada em 9 e piorou em apenas 1 dos 24 olhos operados. A paciente que apresentou piora já tinha perda visual acentuada e rapidamente progressiva, com apenas uma ilha paracentral de vis o e conta dedos no pré-operatório. Houve resolu o do edema em todos os olhos operados, seguido de atrofia óptica em muitos deles. Os pacientes que n o melhoraram a fun o visual foram aqueles operados já com perda acentuada da fun o visual. Hemorragia moderada trans-operatória ocorreu em duas cirurgias. Conclus es: A descompress o da bainha do nervo óptico pode ser útil para proteger a fun o visual de pacientes com papiledema por pseudotumor cerebral que n o respondem adequadamente ao tratamento clínico, além de poder servir como tratamento complementar para pacientes já submetidos à deriva o lombo-peritoneal.
Perimetria computadorizada e manual em pacientes com defeitos perimétricos temporais avan?ados causados por tumores supra-selares
Pereira, Andrea;Monteiro, Mário Luiz Ribeiro;
Arquivos Brasileiros de Oftalmologia , 2005, DOI: 10.1590/S0004-27492005000500003
Abstract: purpose: to study, on goldmann perimetry, a group of patients with complete temporal hemianopia on humphrey perimetry (24-2 full threshold test) and to evaluate the percentage of eyes in which computerized perimetry failed to identify a temporal visual field remnants. methods: nineteen patients with visual field defect by chiasmal compression were prospectively studied with manual and automated perimetry. twenty-five eyes with complete temporal hemianopia on humphrey field analyzer, 24-2 threshold test were selected and studied with goldmann perimeter, in order to evaluate the presence of a temporal visual field remnants. according to the result of goldmann perimetry the eyes were divided into two groups: group 1, with complete temporal hemianopia; group 2, with residual temporal visual field remnants in the periphery. the mean number of mean deviation in the 2 groups was calculated and compared using student's t test. results: automated perimetry failed to identify a temporal residual visual field in 17 of 25 eyes studied (68%). mean values of the mean deviation in groups 1 and 2 were respectively -15.43 and -15.93. statistical analysis did not indicate a significant difference between them. conclusions: computerized automated humphrey perimetry using 24-2 threshold test fails to identify temporal visual field remnants in a great percentage of patients with severe chiasmal compression. analysis of the mean deviation is not helpful in identifying such cases. patients evaluated on automated perimetry and presenting with a complete temporal hemianopia should be checked for temporal visual field remnants.
Perimetria computadorizada na detec??o de defeitos campimétricos discretos (ao perímetro de Goldmann) causados por tumores hipofisários
Monteiro, Mário Luiz Ribeiro;Pereira, Andrea;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000700013
Abstract: purpose: to analyze the findings observed using the humphrey field analyzer in patients with subtle visual field defects caused by chiasmal compression and study the best strategy for their detection. methods: twelve patients with chiasmal compression were prospectively studied by manual and automated perimetry. seventeen eyes with subtle defects on goldmann perimetry were studied with the humphrey field analizer, 24-2 threshold test. analyzed items included: the gray scale drawing, the mean deviation, the number of missing points in the temporal as well as on the nasal hemi-field observed both on the total as well as on the pattern deviation. a mean deviation index was calculated using 12 points in the superior temporal quadrant and 12 points in the superior nasal quadrant. findings from the nasal field were compared with those of the temporal field using student's t test. results: analysis of the gray scale pattern failed to identify the field defect in six eyes. calculated superior temporal and nasal temporal mean deviation were respectivelly -9.65 ± 6.48 e -3.98 ± 2.30. statistical analysis showed a significant difference between the two values. the mean number of missing points in the temporal hemifield observed on the total deviation was 11.64 ± 7.35 and in the nasal 8.11 ± 5.07. there was no significant difference between these data. on pattern deviation, the mean number of missing points in the temporal hemi-field was 5.82 ± 5.42 and in the nasal 2.41 ± 2.64. statistical analysis showed significant differences between them. conclusions: a simple analysis of the gray scale of visual fields fails to identify early defect from chiasmal compression in a significant number of patients. the observation of missing points on total deviation also seems to be insufficient to identify such field defects. the comparison between the mean deviation calculated in the nasal and temporal quadrants and the observation of a higher number of missing points in the temporal field
Retinal nerve fiber layer loss documented by optical coherence tomography in patients with optic tract lesions
Monteiro, Mário Luiz Ribeiro;Hokazone, Kenzo;
Revista Brasileira de Oftalmologia , 2009, DOI: 10.1590/S0034-72802009000100009
Abstract: purpose: to report abnormalities of retinal nerve fiber layer (rnfl) thickness using stratus - optical coherence tomography (oct) in two patients with optic tract lesions. methods: two patients with long standing homonymous hemianopia from optic tract lesions were submitted to a complete neuro-ophthalmic evaluation and to stratus -optical coherence tomography examination. results: both patients revealed diffuse loss of the rnfl at stratus - oct in both eyes. in the eyes with the temporal hemianopia, rfnl loss was diffuse but predominantly in the nasal and temporal areas of the optic disc, the classic pattern of band atrophy of the optic nerve. in the eyes with nasal hemianopia rnfl loss could be documented in the superior and inferior quadrants of the optic disc. rnfl loss correlated well with visual field loss and the expected pattern of rnfl loss in optic tract lesions. conclusion: stratus-optical coherence tomography can provide useful information in the diagnosis of optic tract lesions by identifying the characteristic pattern of rnfl loss that occurs in both eyes in this condition.
Perimetria computadorizada na detec o de defeitos campimétricos discretos (ao perímetro de Goldmann) causados por tumores hipofisários
Monteiro Mário Luiz Ribeiro,Pereira Andrea
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract: OBJETIVO: Analisar os achados ao perímetro de Humphrey em pacientes com defeitos campimétricos discretos por compress o quiasmática e verificar a melhor estratégia na detec o destas altera es. MéTODOS: Doze pacientes com defeitos campimétricos por compress o quiasmática foram estudados, prospectivamente, por meio das perimetrias manual e computadorizada. Dezessete olhos com defeitos discretos, selecionados pelo Goldmann, foram estudados pela perimetria computadorizada, com o programa 24-2 do Humphrey Field Analizer. Foram analisados o gráfico em escalas de cinza, o "mean deviation" fornecido pelo aparelho, e o número de falhas encontradas ao "total deviation" e ao "pattern deviation" nos hemicampos nasal e temporal. Além disso, foi calculado um desvio médio para 12 pontos situados nos quadrantes nasal superior e temporal superior. Os achados do setor nasal do campo visual foram comparados com aqueles do setor temporal pelo teste t de Student. RESULTADOS: A análise do gráfico na escala de cinzas n o identificou o defeito campimétrico em seis olhos. Os valores médios do "mean deviation" temporal superior e nasal superior foram respectivamente -9,65 ± 6,48 e -3,98 ± 2,30. O estudo estatístico mostrou diferen a significativa entre os dois valores. A média do número de pontos de falhas observadas ao "total deviation" no hemicampo temporal foi 11,64 ± 7,35 e no nasal de 8,11 ± 5,07. N o houve diferen a significativa entre eles. Ao "pattern deviation", a média de pontos de falhas no hemicampo temporal foi de 5,82 ± 5,42 e no nasal foi de 2,41 ± 2,64. O estudo estatístico revelou diferen a significativa entre estes valores. CONCLUS ES: A simples análise do gráfico em tons de cinza deixa de identificar defeitos quiasmáticos discretos em número considerável de pacientes. Da mesma forma a observa o dos pontos de falhas ao "total deviation" parece n o ser suficiente para identificar defeitos quiasmáticos iniciais. A compara o dos desvios médios calculados para os quadrantes temporal e nasal superior e a observa o de um maior número de falhas ao "pattern deviation" no campo temporal comparado ao nasal parecem ser critérios úteis para identificar tais defeitos.
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