Browsing by Author "Meireles, A."
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- Atypical Cogan’s SyndromePublication . Queirós, J.; Maia, S.; Seca, M.; Friande, A.; Araújo, M.; Meireles, A.Background. Cogan's syndrome is a rare clinical entity whose etiopathology is still unknown, and the treatment strategies are not clearly defined. Case. A 23-year-old male presented with symptoms of headache, peripheral facial palsy, persistent right hearing loss and bilateral papillitis. Workup excluded all infectious, granulomatous, neoplastic, and immune causes. The diagnosis of atypical Cogan's syndrome was established, and the patient was treated with systemic corticosteroids and later on with cyclophosphamide and methotrexate. There were improvement of visual symptoms and stabilisation of left hearing. Conclusion. Cogan's syndrome is a very rare disease with no specific biological tests for the diagnosis. The diagnostic exams are mostly important to exclude other etiologies. The atypical ocular and audiovestibular manifestations make the diagnosis difficult, delaying the institution of appropriate therapy which may result in profound bilateral deafness.
- Conjunctival lymphangioma: a case report and brief review of the literaturePublication . Seca, M.; Borges, P.; Gomes, M.; Meireles, A.Background. Lymphangioma is a rare venolymphatic lesion, characterized by dilation of lymphatic vessels. It may occur as an isolated lesion or, more often, represent the surface component of a deep orbital lymphangioma. Case. We report a case of a conjunctival lymphangioma on a 58-year-old male that had simultaneously an upper respiratory tract infection. Excision and biopsy confirmed the nature of the lesion, and there has been no relapse to date. Conclusion. Conjunctival lymphangioma is a rare condition in which the diagnose, must be kept in mind in patients with a red eye resistance to topical therapy and in association with an upper respiratory tract infection. Finally, it is also necessary to be aware of possible recurrence of the lesion.
- ENCERRAMENTO PERCUTÂNEO DE COMUNICAÇÃO INTERAURICULAR E FORAMEN OVALE PATENTE EM ADULTOS – A EXPERIÊNCIA DE UM CENTROPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Guedes, R.; Oliveira, F.; Cabral, S.; Pereira, L.; Braga, P.; Cyrne-Carvalho, H.; Torres, S.
- HOME MONITORING SYSTEM EM DOENTES COM POLINEUROPATIA AMILOIDÓTICA FAMILIARPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Roque, C.; Reis, H.; Lagarto, V.; Cyrne-Carvalho, H.; Torres, S.
- Management of pediatric traumatic macular holes - case reportPublication . Azevedo, S.; Ferreira, N.; Meireles, A.PURPOSE: To report and describe the clinical course of four pediatric traumatic macular hole (TMH) cases and respective management. CASE REPORT: Four pediatric patients with macular hole following blunt ocular trauma underwent early pars plana vitrectomy, with consecutive hole closure. Initial visual acuity was <20/400 or worse in all patients. After surgery, all patients had visual acuity improvement, with final visual acuity being <20/50 in 2 of the patients by the end of the follow-up. Macular hole closure was achieved in all patients with a single procedure, and anatomical success was confirmed by optical coherence tomography until the end of the follow-up. CONCLUSIONS: Although spontaneous closure of TMH is not uncommon, especially in pediatric patients, early pars plana vitrectomy seems to be a safe and effective choice in pediatric TMH management. The risk/benefit ratio of surgery seems to be better than observation.
- Photodynamic therapy for diffuse choroidal hemangioma in sturge-weber syndromePublication . Monteiro, S.; Casal, I.; Santos, M.; Meireles, A.Purpose. To report the treatment outcome of photodynamic therapy with verteporfin (PDT) for exudative retinal detachment (RD) associated with diffuse choroidal hemangioma in Sturge-Weber syndrome (SWS). Methods. An interventional case report of a 10-year-old girl with SWS who developed an exudative RD (visual acuity hand motions) that was treated with PDT. She was treated with a first session of multispot PDT. Posteriorly, a choroidotomy for drainage of subretinal fluid was created, combined with an intravitreal injection of gas (SF6) and cryoapplication. Finally, a second session of PDT was applied. Results. Subretinal fluid resolved over a period of one year and visual acuity increased to 20/125. Conclusions. PDT is an effective therapeutic option for exudative RD associated with diffuse choroidal hemangioma.
- PROGNÓSTICO A CURTO E LONGO PRAZO E FOLLOW-UP ANGIOGRÁFICO APÓS INTERVENÇÃO CORONÁRIA PERCUTÂNEA COM STENTS REVESTIDOS COM RAPAMICINA EM OCLUSÕES CORONÁRIAS CRÓNICAS: ESTUDO PROSPECTIVO DE UM CENTROPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Luz, A.; Dias, H.; Correia, A.; Pinto, R.; Silveira, J.; Sousa, P.; Cyrne-Carvalho, H.; Torres, S.
- Purtscher-Like RetinopathyPublication . Massa, R.; Vale, C.; Macedo, M.; Furtado, M.; Gomes, M.; Lume, M.; Meireles, A.Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis. Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma). The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA) of 20/32 in the right eye (RE) and of 20/40 in the left eye (LE); biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo- and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT) revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots. Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.
- Purtscher-like retinopathyPublication . Massa, R.; Vale, C.; Macedo, M.; Furtado, M.; Gomes, M.; Lume, Mi.; Meireles, A.Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis. Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma). The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA) of 20/32 in the right eye (RE) and of 20/40 in the left eye (LE); biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo- and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT) revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots. Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.
- A Retrospective Analysis of the Real-Life Utilization of Ranibizumab in Patients with Wet Age-Related Macular Degeneration from PortugalPublication . Silva, R.; Goncalves, C.; Meireles, A.; Teixeira, C.; Rosa, P.; Monteiro-Grillo, M.; Canelas, J.; Carneiro, A.; Flores, R.INTRODUCTION: Anti-vascular endothelial growth factor therapy has revolutionized the treatment of wet age-related macular degeneration; however, it is important to monitor actual use of ranibizumab and related treatment outcomes in routine practice. MATERIAL AND METHODS: This was a retrospective, observational study to monitor the 2-year outcomes following ranibizumab treatment for wet age-related macular degeneration in Portugal. Patients treated between January 2009 and December 2009 were retrospectively evaluated. All decisions were made by the treating physician in accordance with their usual routine clinical practice. The primary assessment was mean change in visual acuity score using Early Treatment Diabetic Retinopathy Study or Snellen equivalent. RESULTS: A total of 128 patients with wet age-related macular degeneration were analyzed (mean age 79.4 years; mean visual acuity score 54.2 letters). Mean change in visual acuity score from baseline was -1.6 letters (n = 82) at year one and -5.1 letters (n = 72) at year two. The mean number of ranibizumab injections was 3.8 (year one) and 1.6 (year two). On average, patients attended 8.6 and 5.0 visits and optical coherence tomography was used in 75.0% of patients in year one and in 56.3% of patients in year two, respectively. DISCUSSION: Despite a relatively high number of visits, including monitoring visits and use of optical coherence tomography - guided therapy, few injections were administered and visual acuity was not improved. CONCLUSION: These findings indicate that as-needed treatment resulted in under-dosing in a real-life setting in Portugal. Such limitations may also be related to increasing numbers of patients, resulting in clinic saturation