Avulsão traumática de músculos extraoculares: relatos de casos

We described the clinical, surgical details and results (motor and sensory) of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.Foram descritos os quadros clínicos, detalhes cirúrgicos e resultados (motores e sensoriais) da reinserção de músculos traumaticamente avulsionados, em três pacientes sem estória prévia de estrabismo ou diplopia, atendidos no Departamento de Oftalmologia da Universidade Estadual de Campinas. A porção muscular deslizada foi reinserida na linha da inserção original e sob o coto remanescente, o qual foi acomodado e suturado sobre o músculo reinserido. Para os três casos houve recuperação da visão binocular única e da estereopsia.12412

Traumatic Avulsion Of Extraocular Muscles: Case Reports.

We described the clinical, surgical details and results (motor and sensory) of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.76124-

Distrofia miotônica tipo 1: frequência dos achados oftalmológicos

The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1) patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP). Method Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P) and ophthalmic protocol. Results We evaluated 42 patients aged 17 to 64 years (mean 40.7 ± 12.5), 22 of which were men. IOP (n = 41) was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48%) and ptosis in 23 (54.76%). These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment.O objetivo do estudo foi avaliar a frequência das anormalidades oftalmológicas em uma coorte de pacientes com distrofia miotônica tipo 1 (DM1) correlacionando-as à função motora. Revisamos a fisiopatogenia da catarata e baixa pressão intraocular (PIO). Método Os pacientes foram incluídos após diagnóstico clínico-laboratorial de DM1. Aqueles que assinaram o termo de participação foram avaliados pela escala medida da função motora, versão em português (MFM-P) e protocolo oftalmológico. Resultados Avaliamos 42 pacientes de 17 a 64 anos (média 40,7 ± 12,5), 22 do sexo masculino. Encontramos catarata ou positividade de cirurgia em 38 (90,48%) e blefaroptose em 23 (54,76%) e esses sinais foram correlacionados significativamente à maior gravidade da disfunção motora. Baixa PIO também foi comum e não correlacionada à gravidade motora. Alterações da motilidade ocular e de estereopsia ocorreram. Conclusão Catarata e ptose palpebral são frequentes na DM1 e associadas à gravidade motora. Baixa PIO é comum e parece ser independente da evolução motora.74318318

Myotonic Dystrophy Type 1: Frequency Of Ophthalmologic Findings

The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1) patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP). Method: Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P) and ophthalmic protocol. Results: We evaluated 42 patients aged 17 to 64 years (mean 40.7 +/- 12.5), 22 of which were men. IOP (n = 41) was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48%) and ptosis in 23 (54.76%). These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion: Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment.74318318

Identification and frequency of ophthalmologic findings in myotonic dystrophy type 1 (DM1)

Orientadores: Keila Miriam Monteiro de Carvalho, Anamarli NucciDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Objetivo: identificar a frequência das anormalidades oftalmológicas dos pacientes com distrofia miotônica tipo 1 (DM1), e avaliar se há correspondência entre a gravidade motora e a presença/ausência de catarata e entre outras alterações oftalmológicas e a gravidade motora. Métodos: foi realizado estudo descritivo em pacientes com DM1, os quais foram incluídos após diagnóstico clínico e laboratorial e após terem assinado o termo de consentimento livre e esclarecido. Eles foram avaliados pela escala Medida da Função Motora, versão em Português (MFM-P) e por protocolo oftalmológico incluindo: acuidade visual, refração, teste de visão de cores de Ishihara, avaliação do reflexo pupilar, tonometria de aplanação (tonômetro de Goldmann), biomicroscopia, fundoscopia, exame de motilidade ocular, teste de estereopsia (Titmus), avaliação de nistagmo e de diplopia. Em pacientes em que não foi possível realizar todos os exames, por algum motivo, foram considerados os demais exames para a análise dos resultados. Foi aplicada a Análise de Correlação de Spearman para verificar o grau de relacionamento entre as variáveis de interesse escalares. Para verificar possíveis diferenças entre as variáveis categóricas foi aplicado o Teste de Mann-Whitney. Resultados: A casuística de 42 pacientes incluiu 20 pacientes do sexo masculino (47,62%) e 22 do sexo feminino (52,38%). A idade variou de 17 a 64 anos com média de 40,74 (DP±12,48). Em relação à presença de catarata, dos 42 pacientes avaliados, 38 (90,48%) apresentaram algum grau de opacidade do cristalino ou já tinham sido submetidos à cirurgia de catarata em pelo menos um dos olhos, e 4 (9,52%) apresentaram cristalino transparente em ambos os olhos. A pressão intraocular (PIO) foi aferida em 41 pacientes, sendo que, no olho direito variou de 6 a 13 mmHg, média de 8,7 mmHg (DP±2). No olho esquerdo, variou de 6 a 13 mmHg, com média de 8,7 mmHg (DP ±1,99). Vinte e três pacientes (54,76%) apresentaram ptose palpebral. Em relação à acuidade visual corrigida (n=42), no olho direito, ela variou de 1,3 a 0 e, no olho esquerdo, variou de 1 a 0. Cinco dos 42 pacientes (11,90%) apresentaram alguma alteração na retina. Também foram observadas alterações na motilidade ocular e na estereopsia. Piores valores de MFM-P foram correlacionados com a presença de catarata (p=0,019) e ptose (p=0,031); não houve correlação entre os valores da PIO e MFM-P. Conclusão: A catarata foi a alteração mais frequente, seguida de ptose palpebral. A PIO encontrava-se em valores abaixo da média da população. A presença de catarata e ptose foi correlacionada à pior expressão do MFM-P, e não houve correlação da PIO e MFM-PAbstract: Purpose: to identify the frequency of ophthalmologic findings in patients with myotonic dystrophy type 1 (DM1), and to correlate them with motor function. Methods: This was a descriptive study in patients with DM1, who were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by MFM-P scale and ophthalmic protocol, which included: visual acuity, refraction, Ishihara color vision test, pupillary reflex, tonometry (Goldmann tonometer), biomicroscopy, fundoscopy, ocular motility, stereopsis test (Titmus), evaluation of nystagmus and diplopia. It was applied Spearman correlation analysis to check the degree of relationship between the variables of interest. To verify possible differences between each categorical variable we applied the Mann -Whitney test. Results: Forty-two patients were enrolled in this study: 20 men (47.62%) and 22 women (52.38%), aged 17 to 64 years with a mean of 40.74 (SD±12.48). Cataract or prior phacoemulsification in at least one eye was detected in 38 patients (90.48%), and 4 (9.52%) presented transparent lens in both eyes. Intraocular pressure (IOP) (n=41) in the right eye ranged from 6 to 13 mmHg, mean 8.7 mmHg (SD ± 2); in the left eye ranged 6-13 mmHg, mean 8.7 mmHg (SD ± 1.99). Twenty-three patients (54.76%) had ptosis. Visual acuity in the right eye ranged from 1.3 to 0 and, in the left eye, 1 to 0. Five of the 42 patients (11.90%) showed abnormalities in the retina. Abnormalities in ocular motility and stereopsis were also observed. Worst MFM-P score was correlated with cataract (p = 0.019) and ptosis (p = 0.031). There was no correlation between IOP versus MFM-P. Conclusions: Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairmentMestradoOftalmologiaMestra em Ciências Médica

Myotonic dystrophy type 1: frequency of ophthalmologic findings

ABSTRACT The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1) patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP). Method Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P) and ophthalmic protocol. Results We evaluated 42 patients aged 17 to 64 years (mean 40.7 ± 12.5), 22 of which were men. IOP (n = 41) was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48%) and ptosis in 23 (54.76%). These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment