Rubens Siqueira - Academia.edu (original) (raw)

Papers by Rubens Siqueira

Purpose: To examine differences between fluorescein angiography (FA) and indocyanine green angiog... more Purpose: To examine differences between fluorescein angiography (FA) and indocyanine green angiography (ICG) findings in patients with chronic central serous chorioretinopathy (CSC), comparing these with optical coherence tomography (OCT) findings. Methods: Ten consecutive patients with chronic CSC (19 eyes; 7 men; mean age, 50.7 ± 8.4 years) underwent multimodal evaluation that included FA, ICG, and OCT (Spectralis HRA-OCT, Heidelberg Engineering, Heidelberg, Germany). Changes such as hyperfluorescence (caused by increased transmission of the normal choroidal fluorescence, staining, or "pooling") and hypofluorescence (caused by a blockage or vascular filling defect) were evaluated in the early (4 min), middle (4-8 min) and late (>8 min) angiography phases and compared to OCT findings. Results: Bilateral disease was present in nine of the 10 patients. Areas of discontinuation or attenuation of the hyporeflective layer of the retinal pigment epithelium (RPE) on OCT were ...

Additional file 2. Complications following autologous hematopoietic stem cell transplantation.

Additional file 1. Sociodemographic and clinical characteristics.

Abstract: Clinical laboratories are strong, integral partners in personalized health care. Labora... more Abstract: Clinical laboratories are strong, integral partners in personalized health care. Laboratory databases hold a vast amount of data on human phenotypes, genotypes, biomarkers, progression of disease, and response to therapy. These structured and unstructured free text data are critical for patient care and a resource for personalized medicine and translational research. Laboratory data are integrated into many electronic medical records that provide “summary reports ” and “trending ” to visualize longitudinal patient data. Recent advances in ophthalmology such as gene therapy, cell therapy using stem cells, and also retinal prosthesis explore the potential of translational research marking a new era in research into the diagnosis and treatment of eye diseases.

Stem Cells International

To assess the therapeutic potential and the safety of intravitreous use of a bone marrow mononucl... more To assess the therapeutic potential and the safety of intravitreous use of a bone marrow mononuclear fraction (BMMF) containing CD34+ cells in patients with Stargardt type macular dystrophy. The study was conducted on 10 patients with Stargardt dystrophy with worse eye visual acuity ≤ 20 / 125 . A bone marrow aspirate was obtained from all patients, and after processing in the cell therapy center (CTC), 0.1 ml of the intravitreous BMMF suspension was injected into the eye with worse visual acuity. A sham injection was performed in the contralateral eye. The patients were evaluated at baseline and one, three, and six months after the injection. All of them were submitted to measurement of best corrected visual acuity (BCVA), microperimetry, multifocal electroretinography (mfERG) and full field electroretinography (ffERG), autofluorescence (AF), and optical coherence tomography (OCT). Fluorescein angiography was also performed before and six months after the injection. All patient...

Stem cell research & therapy, Jan 13, 2018

Bone marrow-derived mesenchymal stromal cell (MSC) therapy is a promising treatment for several d... more Bone marrow-derived mesenchymal stromal cell (MSC) therapy is a promising treatment for several degenerative ocular diseases; however, no reproducible method of monitoring these cells into the eye has been established. The aim of this study was to describe successful bioluminescence imaging (BLI) to detect viable luciferase-expressing MSC in the eye. Human donor MSC in culture were transduced with 50 μl luciferase lentiviral vector (three viral particles/cell) prior to intraocular injection. Twenty-one right eyes of 21 rabbits were evaluated through BLI after receiving 1 × 10 luciferase-expressing MSC intravitreally. Contralateral eyes were injected with vehicle (phosphate-buffered saline (PBS)) and were used as controls. At seven different time points (1 h to 60 days), D-luciferin (40 mg/ml, 300 μl PBS) was injected in subsets of six enucleated eyes for evaluation of radiance decay through BLI analysis. CD90 and CD73 immunofluorescence was studied in selected eyes. Eyes injected wi...

Acta tropica, Jan 31, 2018

Ocular toxoplasmosis, caused by Toxoplasma gondii, is the most common cause of inflammation in th... more Ocular toxoplasmosis, caused by Toxoplasma gondii, is the most common cause of inflammation in the back of the eye. Analysis of the infecting strain may provide information regarding disease behavior and recurrence. Here, we describe clinical and epidemiological data for toxoplasmic retinochoroiditis in two Brazilian women infected by T. gondii strain toxoDB#65, living in an urban region of São Paulo State, Brazil.

Acta tropica, Jan 6, 2017

CC chemokine receptor type 5 (CCR5) is a chemokine receptor that influences the immune response t... more CC chemokine receptor type 5 (CCR5) is a chemokine receptor that influences the immune response to infectious and parasitic diseases. This study aimed to determine whether the CCR5Δ32 and CCR5 59029 A/G polymorphisms are associated with the development of ocular toxoplasmosis in humans. Patients with positive serology for Toxoplasma gondii were analyzed and grouped as 'with ocular toxoplasmosis' (G1: n=160) or 'without ocular toxoplasmosis' (G2: n=160). A control group (G3) consisted of 160 individuals with negative serology. The characterization of the CCR5Δ32 and CCR5 59029 A/G polymorphisms was by PCR and by PCR-RFLP, respectively. The difference between the groups with respect to the mean age (G1: mean age: 47.3, SD±19.3, median: 46 [range: 18-95]; G2: mean age: 61.3, SD±13.7, median: 61 [range: 21-87]; G3: mean age: 38.8, SD±17.9, median: 34 [range: 18-80]) was statistically significant (G1 vs.G2: p-value <0.0001; t=7.21; DF=318; G1 vs.G3: p-value <0.0001;...

Arquivos brasileiros de oftalmologia

Herein, we report two cases of vision loss after successful cataract surgery, associated with dru... more Herein, we report two cases of vision loss after successful cataract surgery, associated with drusenoid retinal pigment epithelial detachment without features of choroidal neovascularization on optical coherence tomography along with angiographic examinations suggestive of choroidal neovascularization in which anatomical and functional improvements were achieved with intravitreal injections of anti-vascular endothelial growth factor.

BMC Ophthalmology

Background: The aim of this study is to report a case of cystoid macular oedema (CME) associated ... more Background: The aim of this study is to report a case of cystoid macular oedema (CME) associated with Rosai-Dorfman Disease (RDD). Case presentation: A 52-year-old male initially presented with a two-month history of a congested left eye. At presentation, visual acuity was 20/20 in the right eye and 20/80 in the left eye. Biomicroscopy showed conjunctival hyperaemia in the left eye with a slight elevation, suggesting a subconjunctival mass. Retinal fluorescein angiography and optical coherence tomography (OCT) revealed the presence of CME in the left eye. A clinical examination revealed nodular lesions in the ears and a lump in the subcutaneous tissue of the left arm. A biopsy of the subcutaneous lesion showed histological and immunohistochemical characteristics of RDD. The patient was treated with intravitreal triamcinolone (0.1 mL/4 mg). One month after treatment, there was complete regression of the oedema with a significant improvement in visual acuity to 20/20. Conclusions: This is the first reported case of RDD associated with cystoid macular oedema. Macular oedema responded to intravitreal treatment with triamcinolone.

Parasite immunology, Jan 24, 2017

This study evaluated levels for mRNA expression of 7 cytokines in ocular toxoplasmosis. Periphera... more This study evaluated levels for mRNA expression of 7 cytokines in ocular toxoplasmosis. Peripheral blood mononuclear cells (PBMC) of ocular toxoplasmosis patients (OT Group, n= 23) and chronic toxoplasmosis individuals (CHR Group, n= 9) were isolated and stimulated in vitro with T. gondii antigen. Negative controls (NC) were constituted of 7 PBMC samples from individuals seronegative for toxoplasmosis. mRNA expression for cytokines was determined by qPCR. Results showed a significant increase of mRNA levels from antigen stimulated PBMCs derived from OT Group for expressing IL-6 (at p<0.005 and p < 0.0005 for CHR and NC groups, respectively), IL-10 (at p<0.0005 and p < 0.005 for CHR and NC groups, respectively) and TGF-β (at p < 0.005) for NC group. mRNA levels for TNF-α and IL-12 were also up-regulated in OT patients compared to CHR and NC individuals, although without statistical significance. Additionally, mRNA levels for IL-27 and IFN-γ in PBMC of OT patients were ...

Clinical ophthalmology (Auckland, N.Z.), 2017

To evaluate the therapeutic potential and safety of intravitreal injections of bone marrow mononu... more To evaluate the therapeutic potential and safety of intravitreal injections of bone marrow mononuclear fraction (BMMF) containing CD34(+) cells in patients with atrophic age-related macular degeneration (AMD). Ten patients with atrophic AMD and best-corrected visual acuity (BCVA) in the worse-seeing eye of ≤20/100 were enrolled in this study. The bone marrow from all patients was aspirated and processed for mononuclear cell separation. A 0.1 mL suspension of BMMF CD34(+) cells was injected into the vitreous cavity of the worse-seeing eye. Patients were evaluated at Baseline and 1,3,6,9 and 12 months after injection. Ophthalmic evaluation included BCVA measurement, microperimetry, infrared imaging, fundus autofluorescence and SD-optical coherence tomography at all study visits. Fluorescein angiography was performed at Baseline and at 6 and 12 months after intravitreal therapy. All patients completed the 6-month follow-up, and six completed the 12-month follow-up. Prior to the injecti...

Arquivos brasileiros de oftalmologia

We report retinal functional and structural changes of a 40-year-old man diagnosed with occult ma... more We report retinal functional and structural changes of a 40-year-old man diagnosed with occult macular dystrophy. Comprehensive ophthalmological evaluation was performed, followed by spectral-domain optical coherence tomography (SD-OC - Heidelberg) and image acquisition using an adaptive optics (AO) camera (RTX1, Imagine Eyes) for photoreceptor density analysis. Functional tests included full-field ERG (ERG) and multifocal electroretinography (mfERG) (Diagnosys, LLC) and microperimetry with scanning laser ophthalmoscope (SLO) fixation controlled (MAIA, CenterVUE). OCT revealed a line of discontinuity corresponding to cone outer-segment photoreceptors associated with a loss of cone density, highlighted by a dark blue spot on the AO co ne-density map on the fovea in both eyes. Loss of central sensitivity was revealed using microperimetry; ERG was within the normal range, although the mfERG showed a reduced central response amplitude.

Scientific Reports, 2016

The objective of this study was to investigate the influence of the genes encoding the KIR recept... more The objective of this study was to investigate the influence of the genes encoding the KIR receptors and their HLA ligands in the susceptibility of ocular toxoplasmosis. A total of 297 patients serologicallydiagnosed with toxoplasmosis were selected and stratified according to the presence (n = 148) or absence (n = 149) of ocular scars/lesions due to toxoplasmosis. The group of patients with scars/ lesions was further subdivided into two groups according to the type of ocular manifestation observed: primary (n = 120) or recurrent (n = 28). Genotyping was performed by PCR-SSOP. Statistical analyses were conducted using the Chi-square test, and odds ratio with a 95% confidence interval was also calculated to evaluate the risk association. The activating KIR3DS1 gene was associated with increased susceptibility for ocular toxoplasmosis. The activating KIR together with their HLA ligands (KIR3DS1-Bw4-80Ile and KIR2DS1 + /C2 ++ KIR3DS1 + /Bw4-80Ile +) were associated with increased susceptibility for ocular toxoplasmosis and its clinical manifestations. KIR-HLA inhibitory pairs-KIR2DL3/2DL3-C1/ C1 and KIR2DL3/2DL3-C1-were associated with decreased susceptibility for ocular toxoplasmosis and its clinical forms, while the KIR3DS1 − /KIR3DL1 + /Bw4-80Ile + combination was associated as a protective factor against the development of ocular toxoplasmosis and, in particular, against recurrent manifestations. Our data demonstrate that activating and inhibitory KIR genes may influence the development of ocular toxoplasmosis.

Gene, 2016

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apol... more This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

JAMA Ophthalmology, 2016

horoidal nevi are relatively common among white individuals. 1 Malignant transformation occurs in... more horoidal nevi are relatively common among white individuals. 1 Malignant transformation occurs in only 1 of 8845 individuals annually. 2 Current knowledge suggests these benign intraocular tumors threaten vision only if located under the fovea. 3 Clinical evaluation of choroidal nevi has included baseline ophthalmic examination, ultrasonography, fundus photography, occasional optical coherence tomography (OCT), and follow-up every 6 to 12 months. 3 The following 2 noninvasive tools have been incorporated for such evaluation: enhanced-depth spectral domain OCT (EDI SD-OCT) and fundus autofluorescence. 4 Current fundus autofluorescence techniques provide limited information on choroidal tumors owing to faint or barely detectable autofluorescence. 5 Conversely, a known factor associated with activity in melanocytic choroidal tumors, subretinal fluid, 3 is detected by EDI SD-OCT, although it is occasionally overlooked clinically and ultrasonographically. 6 This study takes an alternative approach with noninvasive en face imaging acquired by an adaptive optics (AO) system to analyze the retina overlying the choroidal nevi. Thus, we report novel findings on photoreceptor density and arrangement overlying choroidal nevi and consider their effect on retinal function. Methods This study adheres to the Declaration of Helsinki 7 and was approved by the ethics and research committee of the

Retinal cases & brief reports, Jan 14, 2016

To evaluate the safety and feasibility of a 25-gauge biodegradable implant containing 350 μg of d... more To evaluate the safety and feasibility of a 25-gauge biodegradable implant containing 350 μg of dexamethasone (DDS-25) for the treatment of decreased vision due to macular edema associated with central or branch retinal vein occlusion. Prospective, nonrandomized, open-label, Phase I clinical trial, including 10 patients with decreased vision (best-corrected early treatment diabetic retinopathy study visual acuity of 20/40 or worse) due to macular edema associated with central retinal vein occlusion (n = 4) or branch retinal vein occlusion (n = 6) for more than 4 months. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, spectral domain optical coherence tomography (Spectralis Heidelberg Engineering) for determination of central subfield thickness, full-field electroretinography (ISCEV standard ERG), and fluorescein angiography, was performed at baseline, and 1, 4, 12, and 24 weeks after intravitreal DDS-25 insertion. Mean best-corrected visual acuity was 0....

International Medical Case Reports Journal, 2016

Purpose: To report a case of a patient with ischemic retinopathy associated with Crohn's disease.... more Purpose: To report a case of a patient with ischemic retinopathy associated with Crohn's disease. Case report: This report presents a case of a 28-year-old female patient with Crohn's disease and sudden decrease of visual acuity in the right eye. Fluorescein angiography, optical coherence tomography, and multifocal electroretinography confirmed the clinical features of ischemic retinopathy. After systemic corticosteroid treatment, the patient developed epiretinal membrane without significant improvement in visual acuity. Discussion: The patient presented with ischemic retinopathy associated with Crohn's disease with deficiency of central visual acuity. Periodic examination by a retina specialist is recommended for patients being treated for Crohn's disease.

Rev Bras Oftalmol, May 1, 1996

Rev Bras Oftalmol, Apr 1, 1999

Purpose: To examine differences between fluorescein angiography (FA) and indocyanine green angiog... more Purpose: To examine differences between fluorescein angiography (FA) and indocyanine green angiography (ICG) findings in patients with chronic central serous chorioretinopathy (CSC), comparing these with optical coherence tomography (OCT) findings. Methods: Ten consecutive patients with chronic CSC (19 eyes; 7 men; mean age, 50.7 ± 8.4 years) underwent multimodal evaluation that included FA, ICG, and OCT (Spectralis HRA-OCT, Heidelberg Engineering, Heidelberg, Germany). Changes such as hyperfluorescence (caused by increased transmission of the normal choroidal fluorescence, staining, or "pooling") and hypofluorescence (caused by a blockage or vascular filling defect) were evaluated in the early (4 min), middle (4-8 min) and late (>8 min) angiography phases and compared to OCT findings. Results: Bilateral disease was present in nine of the 10 patients. Areas of discontinuation or attenuation of the hyporeflective layer of the retinal pigment epithelium (RPE) on OCT were ...

Additional file 2. Complications following autologous hematopoietic stem cell transplantation.

Additional file 1. Sociodemographic and clinical characteristics.

Abstract: Clinical laboratories are strong, integral partners in personalized health care. Labora... more Abstract: Clinical laboratories are strong, integral partners in personalized health care. Laboratory databases hold a vast amount of data on human phenotypes, genotypes, biomarkers, progression of disease, and response to therapy. These structured and unstructured free text data are critical for patient care and a resource for personalized medicine and translational research. Laboratory data are integrated into many electronic medical records that provide “summary reports ” and “trending ” to visualize longitudinal patient data. Recent advances in ophthalmology such as gene therapy, cell therapy using stem cells, and also retinal prosthesis explore the potential of translational research marking a new era in research into the diagnosis and treatment of eye diseases.

Stem Cells International

To assess the therapeutic potential and the safety of intravitreous use of a bone marrow mononucl... more To assess the therapeutic potential and the safety of intravitreous use of a bone marrow mononuclear fraction (BMMF) containing CD34+ cells in patients with Stargardt type macular dystrophy. The study was conducted on 10 patients with Stargardt dystrophy with worse eye visual acuity ≤ 20 / 125 . A bone marrow aspirate was obtained from all patients, and after processing in the cell therapy center (CTC), 0.1 ml of the intravitreous BMMF suspension was injected into the eye with worse visual acuity. A sham injection was performed in the contralateral eye. The patients were evaluated at baseline and one, three, and six months after the injection. All of them were submitted to measurement of best corrected visual acuity (BCVA), microperimetry, multifocal electroretinography (mfERG) and full field electroretinography (ffERG), autofluorescence (AF), and optical coherence tomography (OCT). Fluorescein angiography was also performed before and six months after the injection. All patient...

Stem cell research & therapy, Jan 13, 2018

Bone marrow-derived mesenchymal stromal cell (MSC) therapy is a promising treatment for several d... more Bone marrow-derived mesenchymal stromal cell (MSC) therapy is a promising treatment for several degenerative ocular diseases; however, no reproducible method of monitoring these cells into the eye has been established. The aim of this study was to describe successful bioluminescence imaging (BLI) to detect viable luciferase-expressing MSC in the eye. Human donor MSC in culture were transduced with 50 μl luciferase lentiviral vector (three viral particles/cell) prior to intraocular injection. Twenty-one right eyes of 21 rabbits were evaluated through BLI after receiving 1 × 10 luciferase-expressing MSC intravitreally. Contralateral eyes were injected with vehicle (phosphate-buffered saline (PBS)) and were used as controls. At seven different time points (1 h to 60 days), D-luciferin (40 mg/ml, 300 μl PBS) was injected in subsets of six enucleated eyes for evaluation of radiance decay through BLI analysis. CD90 and CD73 immunofluorescence was studied in selected eyes. Eyes injected wi...

Acta tropica, Jan 31, 2018

Ocular toxoplasmosis, caused by Toxoplasma gondii, is the most common cause of inflammation in th... more Ocular toxoplasmosis, caused by Toxoplasma gondii, is the most common cause of inflammation in the back of the eye. Analysis of the infecting strain may provide information regarding disease behavior and recurrence. Here, we describe clinical and epidemiological data for toxoplasmic retinochoroiditis in two Brazilian women infected by T. gondii strain toxoDB#65, living in an urban region of São Paulo State, Brazil.

Acta tropica, Jan 6, 2017

CC chemokine receptor type 5 (CCR5) is a chemokine receptor that influences the immune response t... more CC chemokine receptor type 5 (CCR5) is a chemokine receptor that influences the immune response to infectious and parasitic diseases. This study aimed to determine whether the CCR5Δ32 and CCR5 59029 A/G polymorphisms are associated with the development of ocular toxoplasmosis in humans. Patients with positive serology for Toxoplasma gondii were analyzed and grouped as 'with ocular toxoplasmosis' (G1: n=160) or 'without ocular toxoplasmosis' (G2: n=160). A control group (G3) consisted of 160 individuals with negative serology. The characterization of the CCR5Δ32 and CCR5 59029 A/G polymorphisms was by PCR and by PCR-RFLP, respectively. The difference between the groups with respect to the mean age (G1: mean age: 47.3, SD±19.3, median: 46 [range: 18-95]; G2: mean age: 61.3, SD±13.7, median: 61 [range: 21-87]; G3: mean age: 38.8, SD±17.9, median: 34 [range: 18-80]) was statistically significant (G1 vs.G2: p-value <0.0001; t=7.21; DF=318; G1 vs.G3: p-value <0.0001;...

Arquivos brasileiros de oftalmologia

Herein, we report two cases of vision loss after successful cataract surgery, associated with dru... more Herein, we report two cases of vision loss after successful cataract surgery, associated with drusenoid retinal pigment epithelial detachment without features of choroidal neovascularization on optical coherence tomography along with angiographic examinations suggestive of choroidal neovascularization in which anatomical and functional improvements were achieved with intravitreal injections of anti-vascular endothelial growth factor.

BMC Ophthalmology

Background: The aim of this study is to report a case of cystoid macular oedema (CME) associated ... more Background: The aim of this study is to report a case of cystoid macular oedema (CME) associated with Rosai-Dorfman Disease (RDD). Case presentation: A 52-year-old male initially presented with a two-month history of a congested left eye. At presentation, visual acuity was 20/20 in the right eye and 20/80 in the left eye. Biomicroscopy showed conjunctival hyperaemia in the left eye with a slight elevation, suggesting a subconjunctival mass. Retinal fluorescein angiography and optical coherence tomography (OCT) revealed the presence of CME in the left eye. A clinical examination revealed nodular lesions in the ears and a lump in the subcutaneous tissue of the left arm. A biopsy of the subcutaneous lesion showed histological and immunohistochemical characteristics of RDD. The patient was treated with intravitreal triamcinolone (0.1 mL/4 mg). One month after treatment, there was complete regression of the oedema with a significant improvement in visual acuity to 20/20. Conclusions: This is the first reported case of RDD associated with cystoid macular oedema. Macular oedema responded to intravitreal treatment with triamcinolone.

Parasite immunology, Jan 24, 2017

This study evaluated levels for mRNA expression of 7 cytokines in ocular toxoplasmosis. Periphera... more This study evaluated levels for mRNA expression of 7 cytokines in ocular toxoplasmosis. Peripheral blood mononuclear cells (PBMC) of ocular toxoplasmosis patients (OT Group, n= 23) and chronic toxoplasmosis individuals (CHR Group, n= 9) were isolated and stimulated in vitro with T. gondii antigen. Negative controls (NC) were constituted of 7 PBMC samples from individuals seronegative for toxoplasmosis. mRNA expression for cytokines was determined by qPCR. Results showed a significant increase of mRNA levels from antigen stimulated PBMCs derived from OT Group for expressing IL-6 (at p<0.005 and p < 0.0005 for CHR and NC groups, respectively), IL-10 (at p<0.0005 and p < 0.005 for CHR and NC groups, respectively) and TGF-β (at p < 0.005) for NC group. mRNA levels for TNF-α and IL-12 were also up-regulated in OT patients compared to CHR and NC individuals, although without statistical significance. Additionally, mRNA levels for IL-27 and IFN-γ in PBMC of OT patients were ...

Clinical ophthalmology (Auckland, N.Z.), 2017

To evaluate the therapeutic potential and safety of intravitreal injections of bone marrow mononu... more To evaluate the therapeutic potential and safety of intravitreal injections of bone marrow mononuclear fraction (BMMF) containing CD34(+) cells in patients with atrophic age-related macular degeneration (AMD). Ten patients with atrophic AMD and best-corrected visual acuity (BCVA) in the worse-seeing eye of ≤20/100 were enrolled in this study. The bone marrow from all patients was aspirated and processed for mononuclear cell separation. A 0.1 mL suspension of BMMF CD34(+) cells was injected into the vitreous cavity of the worse-seeing eye. Patients were evaluated at Baseline and 1,3,6,9 and 12 months after injection. Ophthalmic evaluation included BCVA measurement, microperimetry, infrared imaging, fundus autofluorescence and SD-optical coherence tomography at all study visits. Fluorescein angiography was performed at Baseline and at 6 and 12 months after intravitreal therapy. All patients completed the 6-month follow-up, and six completed the 12-month follow-up. Prior to the injecti...

Arquivos brasileiros de oftalmologia

We report retinal functional and structural changes of a 40-year-old man diagnosed with occult ma... more We report retinal functional and structural changes of a 40-year-old man diagnosed with occult macular dystrophy. Comprehensive ophthalmological evaluation was performed, followed by spectral-domain optical coherence tomography (SD-OC - Heidelberg) and image acquisition using an adaptive optics (AO) camera (RTX1, Imagine Eyes) for photoreceptor density analysis. Functional tests included full-field ERG (ERG) and multifocal electroretinography (mfERG) (Diagnosys, LLC) and microperimetry with scanning laser ophthalmoscope (SLO) fixation controlled (MAIA, CenterVUE). OCT revealed a line of discontinuity corresponding to cone outer-segment photoreceptors associated with a loss of cone density, highlighted by a dark blue spot on the AO co ne-density map on the fovea in both eyes. Loss of central sensitivity was revealed using microperimetry; ERG was within the normal range, although the mfERG showed a reduced central response amplitude.

Scientific Reports, 2016

The objective of this study was to investigate the influence of the genes encoding the KIR recept... more The objective of this study was to investigate the influence of the genes encoding the KIR receptors and their HLA ligands in the susceptibility of ocular toxoplasmosis. A total of 297 patients serologicallydiagnosed with toxoplasmosis were selected and stratified according to the presence (n = 148) or absence (n = 149) of ocular scars/lesions due to toxoplasmosis. The group of patients with scars/ lesions was further subdivided into two groups according to the type of ocular manifestation observed: primary (n = 120) or recurrent (n = 28). Genotyping was performed by PCR-SSOP. Statistical analyses were conducted using the Chi-square test, and odds ratio with a 95% confidence interval was also calculated to evaluate the risk association. The activating KIR3DS1 gene was associated with increased susceptibility for ocular toxoplasmosis. The activating KIR together with their HLA ligands (KIR3DS1-Bw4-80Ile and KIR2DS1 + /C2 ++ KIR3DS1 + /Bw4-80Ile +) were associated with increased susceptibility for ocular toxoplasmosis and its clinical manifestations. KIR-HLA inhibitory pairs-KIR2DL3/2DL3-C1/ C1 and KIR2DL3/2DL3-C1-were associated with decreased susceptibility for ocular toxoplasmosis and its clinical forms, while the KIR3DS1 − /KIR3DL1 + /Bw4-80Ile + combination was associated as a protective factor against the development of ocular toxoplasmosis and, in particular, against recurrent manifestations. Our data demonstrate that activating and inhibitory KIR genes may influence the development of ocular toxoplasmosis.

Gene, 2016

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apol... more This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

JAMA Ophthalmology, 2016

horoidal nevi are relatively common among white individuals. 1 Malignant transformation occurs in... more horoidal nevi are relatively common among white individuals. 1 Malignant transformation occurs in only 1 of 8845 individuals annually. 2 Current knowledge suggests these benign intraocular tumors threaten vision only if located under the fovea. 3 Clinical evaluation of choroidal nevi has included baseline ophthalmic examination, ultrasonography, fundus photography, occasional optical coherence tomography (OCT), and follow-up every 6 to 12 months. 3 The following 2 noninvasive tools have been incorporated for such evaluation: enhanced-depth spectral domain OCT (EDI SD-OCT) and fundus autofluorescence. 4 Current fundus autofluorescence techniques provide limited information on choroidal tumors owing to faint or barely detectable autofluorescence. 5 Conversely, a known factor associated with activity in melanocytic choroidal tumors, subretinal fluid, 3 is detected by EDI SD-OCT, although it is occasionally overlooked clinically and ultrasonographically. 6 This study takes an alternative approach with noninvasive en face imaging acquired by an adaptive optics (AO) system to analyze the retina overlying the choroidal nevi. Thus, we report novel findings on photoreceptor density and arrangement overlying choroidal nevi and consider their effect on retinal function. Methods This study adheres to the Declaration of Helsinki 7 and was approved by the ethics and research committee of the

Retinal cases & brief reports, Jan 14, 2016

To evaluate the safety and feasibility of a 25-gauge biodegradable implant containing 350 μg of d... more To evaluate the safety and feasibility of a 25-gauge biodegradable implant containing 350 μg of dexamethasone (DDS-25) for the treatment of decreased vision due to macular edema associated with central or branch retinal vein occlusion. Prospective, nonrandomized, open-label, Phase I clinical trial, including 10 patients with decreased vision (best-corrected early treatment diabetic retinopathy study visual acuity of 20/40 or worse) due to macular edema associated with central retinal vein occlusion (n = 4) or branch retinal vein occlusion (n = 6) for more than 4 months. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, spectral domain optical coherence tomography (Spectralis Heidelberg Engineering) for determination of central subfield thickness, full-field electroretinography (ISCEV standard ERG), and fluorescein angiography, was performed at baseline, and 1, 4, 12, and 24 weeks after intravitreal DDS-25 insertion. Mean best-corrected visual acuity was 0....

International Medical Case Reports Journal, 2016

Purpose: To report a case of a patient with ischemic retinopathy associated with Crohn's disease.... more Purpose: To report a case of a patient with ischemic retinopathy associated with Crohn's disease. Case report: This report presents a case of a 28-year-old female patient with Crohn's disease and sudden decrease of visual acuity in the right eye. Fluorescein angiography, optical coherence tomography, and multifocal electroretinography confirmed the clinical features of ischemic retinopathy. After systemic corticosteroid treatment, the patient developed epiretinal membrane without significant improvement in visual acuity. Discussion: The patient presented with ischemic retinopathy associated with Crohn's disease with deficiency of central visual acuity. Periodic examination by a retina specialist is recommended for patients being treated for Crohn's disease.

Rev Bras Oftalmol, May 1, 1996

Rev Bras Oftalmol, Apr 1, 1999