Browsing by Author "Lino, Pedro"
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- Alterações morfométricas na retina, coroide e nervo ótico após infeção por SARS-CoV-2Publication . Lino, Pedro; Camacho, Pedro; Mendonça, Paula; Silva, Carina; Cunha, João Paulo; Barroqueiro, Olga; Condado, P.; Nicho, I.; Carmo, R.; Castelhano, M.; Carvalho, F.; Almeida, J. C.; Prieto, I.; Poças, Ilda MariaO novo coronavírus responsável pela síndrome respiratória aguda grave (SARS-CoV- 2) surgiu associado à pandemia por COVID-19. A enzima conversora da angiotensina 2 (ACE-2), com aparente importância na COVID-19, pela interação com as proteínas na superfície do vírus, tem expressão em vários tecidos oculares e várias alterações como conjuntivite, uveíte, vasculite e neurite foram descritas inicialmente em modelos animais. Em estudos mais recentes, embora na maioria em doentes COVID-19 moderados/grave, tem sido descrito o comprometimento da superfície ocular anterior e do polo posterior reforçando a ideia de neurotropismo (pela facilidade de envolvimento do sistema nervoso central) que classicamente é descrito em outros coronavirus. Algumas alterações do polo posterior incluem o compromisso vascular/ isquémico tornando relevante também a observação da coroide. A SARS-CoV-2 tem sido associada à diminuição das camadas internas da retina e à presença de lesões hiperrefletivas, micro-hemorragias e manchas algodonosas. No entanto, o envolvimento da retina e a coróide em doentes previamente infetados com COVID-19 ainda não é totalmente compreendido. De forma a clarificar o envolvimento dos fatores de neuro-degeneração e vasculares, descritos em indivíduos recuperados de COVID-19 moderada/grave, é fundamental perceber que alterações existem ao nível da retina interna e da coroide, em indivíduos recuperados de COVID-19 ligeira. Questão de investigação: Existem alterações morfométricas da retina, coroide e nervo ótivo em indivíduos recuperados de COVID-19 ligeira?
- ExotropiasPublication . Lino, PedroEstrabismo - Síndroma oculomotora com duas componentes motora e sensorial. Na componente motora um dos olhos encontra se desviado, estando numa posição anómala face ao outro, dito dominante. Na componente sensorial existe alterações da visão binocular de modo a que as imagens não se formam em pontos retinianos correspondentes o que leva ao desenvolvimento de fenómenos sensoriais subsequentes e/ou compensatórios. Exotropia - Desvio temporal dos eixos visuais. Exotropia intermitente X(T): representa a forma mais comum de exodesvios. Prevalência estimada 60 em crianças com desenvolvimento normal. Exotropia constante: desvio divergente permanente dos eixos visuais XT congénita, XT secundária (sensorial), XT secundária a uma X(T) descompensada.
- Ocular repercussions in COVID-19 patients: structural changes of the retina and choroidPublication . Poças, Ilda Maria; Lino, Pedro; Silva, Carina; Mendonça, Paula; Cunha, João Paulo; Barroqueiro, Olga; Carvalho, Francisca; Nicho, Inês; Castelhano, Mariana; Condado, Patrícia; Carmo, Rita; Almeida, Júlio; Prieto, Isabel; Camacho, PedroBackground: Neurotropic capabilities of SARS-COVs allow viruses to reach the central nervous system by hematogenous neuronal dissemination. The human retina, as an extension of the Central Nervous System, may have some neurodegenerative and/or vascular modifications related to COVID-19. Objectives: To evaluate choroidal and inner neural layers in participants previously recovered from COVID-19 compared to the control group using optical coherence tomography. Methods: With a cross-sectional approach, the sample (n = 96), consisting of patients who have recovered from COVID-19 (n = 56) and healthy participants control group (n = 40) were ophthalmologically characterized. The neurodegenerative and vascular histological assessment was performed using SD-OCT and the mean thickness was measured in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The retinal nerve fiber layer, Ganglion cell layer, and subfoveal choroidal thickness were obtained through semi-automatic measurement. Results: A total of 40 controls (27 women [67.5%]) and 56 COVID-19 participants (34 women [60.8%]) were included in this first report. There were retinal thickness significant differences in nearly all inner ETDRS subfields: nasal 3 mm (p = .025), I3 (p = .049), and temporal 3 mm (p = .009). Also, a decrease in neural layers was found in the nasal 3 mm (p = .049) and temporal 3 mm (p = .029) during ganglion cell layer assessment. The peripapillary retinal nerve fiber layer thickness was thinner in the COVID-19 group in superior temporal (p = .019), nasal (p = .002), inferior temporal (p = .046), and global (p = .014). Concerning the subfoveal choroidal measurement, an increase was observed in the COVID-19 group (p = .002). Conclusion: Participants who had recovered from COVID-19 showed a non-glaucomatous neuropathy trend pattern. We found differences closer to the classic description of the “bow-tie” observed in other neurological as compressive neuropathies at the chiasma location. OCT assessment also showed an increase in choroidal thickness as a result of vascular changes.
- Paralisia parcial do III par craniano no contexto de aneurisma intracraniano: relato de casoPublication . Poças, Ilda Maria; Lino, PedroAs queixas de diplopia podem surgir de uma série de doenças que variam de benignas a potencialmente fatais, sendo muitas vezes o primeiro sinal de causas graves, como o caso de aneurismas. A abordagem diagnóstica inicial para diplopia consiste na anamnese e exame neurológico e oftalmológico detalhados, com foco especial na motilidade e alinhamento ocular; assim como no exame imagiológico dirigido. A Paralisia parcial do III par craniano afeta um ou mais músculos enervados por este par. Uma vez que este par craniano é responsável pela inervação da musculatura intrínseca do olho, a mesma também pode estar afetada de acordo com a localização da lesão. Objetivo do estudo: Descrever o caso de uma paralisia parcial do III Par direito, envolvendo a musculatura extrínseca do olho direito, no contexto de um aneurisma cerebral.
- Success of strabismus surgery in intermittent exotropiaPublication . Lino, Pedro; Aguiar, Pedro Vargues de; Cunha, João PauloIntroduction: Intermittent exotropia (IXT) is the most common form of childhood divergent strabismus. Surgery remains the primary approach to control ocular deviation and preserve binocular function. Although previous studies report a success rate of approximately 75%, factors influencing surgical outcomes remain insufficiently explored. This study evaluates the effectiveness of strabismus surgery in children with IXT and identifies predictors of postoperative alignment stability. Methods: This retrospective study included 258 children with basic-type IXT or divergence excess who underwent bilateral lateral rectus recession. Clinical records and surgical data were analyzed to determine the overall success rate and identify associated predictive factors. Results: The sample included 166 females (64.3%) and 92 males (35.7%), with a mean age of 11.19 ± 3.73 years. Surgical success was achieved in 238 patients (92.2%). Success rates were similar across sexes (92.8% in females vs. 91.3% in males). No significant associations were found between surgical success and sex, age, preoperative occlusion therapy, binocular function, or IXT subtype. However, patients with moderate preoperative deviations had higher success rates. A statistically significant difference was observed in the preoperative deviation angle between successful (31 ± 7.08∆) and unsuccessful (42 ± 7.27∆) cases. A lower AC/A ratio was also associated with better outcomes, although it was not the main predictor. Discussion: The high success rate (92.2%) suggests a limited impact of demographic or preoperative variables. The preoperative deviation angle emerged as the strongest predictor of success, with smaller angles correlating with more favorable surgical outcomes. These findings underscore the importance of accurate preoperative assessment in surgical planning for IXT.
- Surgical management of intermittent exotropia (IXT) in children: a literature reviewPublication . Lino, Pedro; Aguiar, Pedro; Cunha, Maria JoãoIntroduction: Surgical treatment of intermittent exotropia (IXT) in children presents variable outcomes due to diverse surgical techniques, success definitions, and follow-up durations. There is a need to clarify factors influencing prognosis to guide clinical decisions. Methods: This review synthesizes published studies assessing surgical outcomes in pediatric IXT, focusing on success rates, criteria used, surgical approaches, and predictive factors influencing long-term results. Results: Short- and medium-term motor success rates are generally high; however, outcomes tend to decline over time, mainly due to postoperative exodrift, resulting in recurrence and reoperation. Unilateral recess-resect procedures showed better long-term results in some cohorts, while modified techniques like slanted lateral rectus recession yielded promising results in specific IXT subtypes. Preoperative sensory function and deviation control were significant predictors of success. Conclusion: Surgical outcomes in pediatric IXT vary widely, highlighting the importance of standardized success criteria, including sensory and motor measures. Extended follow-up and patient-specific surgical planning are essential for optimizing results. Future prospective research with uniform methodologies is necessary to improve treatment strategies.