Biomedical subjects

Antonio A V Cruz

Publications and source records attributed to Antonio A V Cruz.

12 recordsLinked to original sources

PubMed2006

Palpebral dimensions in Brazilian children: assessment based on digital images.

PURPOSE: To determine palpebral dimensions and development in Brazilian children using digital images. METHODS: An observational study was performed measuring eyelid angles, palpebral fissure area and interpupillary distance in 220 children aged from 4 to 72 months. Digital images were obtained with a Sony Lithium movie camera (Sony DCR-TRV110, Brazil) in frontal view from awake children in primary ocular position; the object of observation was located at pupil height. The images were saved to tape, transferred to a Macintosh G4 (Apple Computer Inc., USA) computer and processed using NIH 1.58 software (NTIS, 5285 Port Royal Rd., Springfield, VA 22161, USA). Data were submitted to statistical analysis. RESULTS: All parameters studied increased with age. The outer palpebral angle was greater than the inner, and palpebral fissure and angles showed greater changes between 4 and 5 months old and at around 24 to 36 months. CONCLUSION: There are significant variations in palpebral dimensions in children under 72 months old, especially around 24 to 36 months.

Brazil↗

PubMed2005

Intraconal grease-gun injury: a therapeutic dilemma.

The case of a 31-year-old man with an accidental grease-gun injury to his left orbital region is presented. CT and MRI showed a well-delineated intraconal cyst in the superior aspect of the left orbit surrounded by a significant inflammatory response. The patient was followed for 11 months. Diplopia was not reported at any time, and visual acuity, visual fields, and all other examinations remained normal. Uneventful surgical removal was performed at the patient's request. Histopathologic examination demonstrated a typical picture of lipogranulomatous inflammation. In a review of the accessible literature, only four cases of intraorbital grease-gun injuries were detected; all of them submitted to early surgical removal. We conclude, however, that an intraconal oil/grease cyst can be carefully monitored and--in the absence of symptoms--must not necessarily be removed.

Accidents, Occupational↗

PubMed2005

Refractive status of indigenous people in the northwestern Amazon region of Brazil.

PURPOSE: The purpose of this study was to investigate the refractive status of the illiterate indigenous people of the upper Rio Negro region of the Amazon rain forest in northwestern Brazil. METHODS: From an overall sample of 486 people, 259 indigenous people and 78 Brazilians between 12 and 59 years of age with no compromising optical opacities were refracted with cycloplegic retinoscopy. Subjects were categorized as indigenous if they had at least three generations of indigenous ancestry with no folklore suggesting other ancestors. RESULTS: Myopia was rare among the indigenous population. Only 2.7% of eyes showed myopia of -1.00 D or more and 1.6% (four people) had bilateral myopia of -1.00 D or more. Half of this small group were the only educated indigenous people examined. The prevalence of astigmatism and anisometropia equal to or >1.00 D was 15.5% and 8.2%, respectively. Most of the astigmatism in the indigenous people had an against-the-rule axis. Age was not associated with the refractive errors of the indigenous people. Brazilians from the small city in which the study was performed had higher rates of myopia (6.4% of eyes and 5.1% of subjects bilaterally). Older preeducation adults also had a very low prevalence of myopia (3.2% of eyes and 2.0% of subjects), whereas the younger, slightly educated Brazilians had a higher prevalence of myopia (11.3% of eyes and 9.7% of subjects). CONCLUSION: The low prevalence of myopia in the illiterate indigenous people is consistent with other studies and suggests that myopia is related to literacy. The generational change among the local mixed race Brazilians further supports this conclusion. The relatively high rates of astigmatism and anisometropia in the indigenous people were unusual for a predominantly emmetropic sample.

Adolescent↗

PubMed2004

Eyelid involvement in paracoccidioidomycosis.

PURPOSE: To describe a series of patients with eyelid lesions caused by paracoccidioidomycosis and to estimate the prevalence of eyelid involvement in this disease METHODS: The medical records of 439 patients with paracoccidioidomycosis admitted to our hospital from 1992 to 2002 were reviewed. Age, sex, and clinical forms of the disease were recorded. All patients with eyelid involvement had a skin biopsy positive for paracoccidioidomycosis and were examined by an ophthalmologist with oculoplastic training. RESULTS: Of 439 patients with acute, subacute, or chronic paracoccidioidomycosis, 11 (2.5%) had eyelid involvement. Active lesions ranged from erythematous patches of madarosis to frank destructive ulcers indistinguishable from malignancies. Healed lesions were characterized by a high degree of fibrosis. Cicatricial changes induced eyelid malpositions (entropion or ectropion) and fusion of eyelid tissues to the globe. Madarosis was a constant finding in the inactive lesions. CONCLUSIONS: The prevalence of eyelid involvement in paracoccidioidomycosis is low. Isolated active lesions are usually diagnosed as malignant tumors. Cicatricial changes are characterized by a high degree of fibrosis. If not treated, the mycosis can destroy the eyelid.

Acute Disease↗

PubMed2004

Orbital involvement in juvenile nasopharyngeal angiofibroma: prevalence and treatment.

PURPOSE: To assess the prevalence of orbital invasion by juvenile nasoangiofibroma and to discuss its surgical treatment. METHODS: A retrospective review of the medical records and tomographic scans of a case series of 19 patients with juvenile nasoangiofibroma was performed. All scans were reviewed by a radiologist and an orbital surgeon. The presence of the tumor was assessed in the pterygopalatine fossa, nasal cavity, nasopharynx, paranasal sinuses, inferior orbital fissure, orbit, and middle cranial fossa. RESULTS: The most common structures invaded were pterygopalatine fossa (100%), nasal cavity (94.7%), sphenoid sinus (84.2%), and nasopharynx (73.7%). The orbit was invaded in 6 (31.6%) patients. In 5 of these patients, the tumor extended in the orbit through the inferior orbital fissure. Four patients with orbital invasion were successfully operated with the Le Fort I approach. CONCLUSIONS: Orbital involvement is relatively common in the setting of juvenile nasoangiofibroma extension. The main route of orbital invasion is the inferior orbital fissure. The Le Fort I osteotomy is an adequate approach for managing juvenile nasoangiofibroma when it invades the orbit.

Adolescent↗

PubMed2003

Sclerosing inflammation in the orbit and in the pterygopalatine and infratemporal fossae.

PURPOSE: To describe two cases with sclerosing inflammation in the orbit and in the pterygopalatine and infratemporal fossae and to review the literature of head and neck idiopathic inflammation. METHODS: Interventional case series. Two clinical case reports of sclerosing inflammation in the orbits and in the pterygopalatine and infratemporal fossae are presented. A review of the literature and discussion was performed. RESULTS: Both patients had histologic findings typical of chronic orbital sclerosing inflammation, including mature lymphocytes associated with dense collagen deposition and occasional lymphoid follicles. Bone erosion was present in one patient. CONCLUSIONS: The clinical findings of this case series concur with the literature that idiopathic inflammation can be found simultaneously in the orbit and in the infratemporal and pterygopalatine fossae. These cases of idiopathic inflammation are often clinically indistinguishable from malignant neoplasms.

Adult↗

PubMed2003

Quantitative comparison between upper eyelid retraction induced voluntarily and by Graves orbitopathy.

PURPOSE: To compare 2-dimensional palpebral fissure measurements of normal subjects with voluntary upper eyelid retraction and patients with Graves upper eyelid retraction. METHODS: Three groups of monocular palpebral fissure images were measured. Group 1 consisted of 32 images of healthy subjects with the upper eyelid in a normal position of rest. Group 2 included the same subjects with voluntary upper eyelid retraction. Group 3 included 45 images of patients with Graves upper eyelid retraction. Fissure images were acquired with a digital camera and transferred to a Macintosh computer. For all images, three variables were quantified with NIH Image software: the midpupil-to-upper eyelid margin distance and the nasal and temporal upper areas of the palpebral fissure. RESULTS: Voluntary upper eyelid retraction significantly increases the absolute difference between the temporal and nasal areas of normal subjects. The disproportion between the lateral and medial areas of the palpebral fissure was greater for the patients with Graves than for the control group with voluntary eyelid retraction, even though there was no difference between the midpupil-to-upper eyelid margin distance of these two groups. Overall, there was a positive correlation between the midpupil-to-upper eyelid margin distance and absolute difference between the temporal and nasal areas (r = 0.75, P < 0.0001). CONCLUSIONS: In normal subjects, voluntary upper eyelid retraction increases the disproportion between the lateral and medial aspects of the fissure. However, even for the same amount of eyelid elevation, the mean disproportion of the control group with voluntary eyelid retraction is smaller than the disproportion displayed by patients with Graves. These findings suggest that an enhanced lateral retraction is a normal finding associated with levator muscle contraction.

Adult↗

PubMed2002

Orbital invasion with prolactinoma: a clinical review of four patients.

PURPOSE: To present four patients with invasive prolactin-secreting pituitary adenomas extending in the orbit. METHODS: Retrospective, noncomparative case series. RESULTS: In all cases, the tumor was a large, invasive prolactin-secreting adenoma. In three cases, significant permanent vision loss occurred and severe disfigurement resulted; two of these patients died of tumor-related complications. In one case, the tumor responded well to medical treatment, and the orbital symptoms improved significantly. CONCLUSION: Although it is rare for a pituitary adenoma to invade the orbit, devastating consequences to the integrity of the globe and ocular adnexa may result. Therefore, early recognition and proper treatment of orbital pituitary tumors are of utmost importance to minimize ocular and orbital damage.

Adult↗

PubMed2002

Cicatricial upper eyelid retraction in encephalocraniocutaneous lipomatosis: a report of two cases and review of literature.

PURPOSE: To describe two patients with encephalocraniocutaneous lipomatosis (ECCL) and to review the literature on this disorder. METHODS: Brain and orbit CT scans were performed on two patients with ECCL. Both patients were examined by the same ophthalmologist and neurologist during at least a 2-year follow-up period. RESULTS: Unilateral skull hamartomas, intracranial abnormalities, epibulbar choristomas, and ocular adnexal changes including a specific form of cicatricial upper eyelid retraction were present in both patients. CONCLUSIONS: ECCL is a special form of oculocerebrocutaneous disease that has significant adnexal findings that are essential for the diagnosis of this rare disorder.

Brain↗

PubMed2002

Bilateral infraorbital nerve involvement in idiopathic orbital myositis.

We describe a case of bilateral infraorbital nerve involvement in idiopathic orbital myositis. Computed tomographic scanning of the orbits showed enlargement of extraocular muscles consistent with orbital myositis and enlargement of the ipsilateral infraorbital nerve. With disease progression, infiltration of the contralateral infraorbital nerve also developed. Biopsies of the inferior oblique muscle and infraorbital nerve showed the same inflammatory infiltrate: a mixed population of lymphocytes (B and T) with B cells expressing kappa and lambda light chains. Although orbital myositis may be associated with several conditions, to the best of our knowledge, this is the first time a case of idiopathic orbital myositis with bilateral infraorbital nerve involvement has been described.

Aged↗

PubMedDate not supplied

Nodular fasciitis presenting as a large mass in the upper eyelid.

A 3-year-old boy was examined for a large nodular fasciitis in the upper eyelid. The lesion was confined to the preseptal plane of the upper eyelid, provoking mechanical ptosis. Excision by an eyelid crease approach was sufficient to restore normal eyelid position.

Blepharoptosis↗

PubMedDate not supplied

Aggravation of eyelid and conjunctival malignancies following photodynamic therapy in DeSanctis-Cacchione syndrome.

A 5-year-old girl with DeSanctis-Cacchione syndrome (a severe variant of xeroderma pigmentosum) was referred for evaluation of multiple eyelid and bulbar conjunctival squamous cell carcinomas. Examination evidenced multiple vegetating lesions on the eyelid, bulbar conjunctiva, and cornea of both eyes. As the lesions were considered not to be manageable by surgical excision and would have required exenteration, photodynamic therapy was performed on the patient's left eye. Three months after photodynamic therapy, the patient presented with a dramatic increase in the extension of the tumors. Since xeroderma pigmentosum is a DNA repair disorder, the radiation involved in photodynamic therapy probably played an iatrogenic role in the evolution of the case. We believe that photodynamic therapy may be harmful to patients with DNA repair disorders.

Carcinoma, Squamous Cell↗