Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study)

Background/aims: The aim of this study was to compare the morphological and visual acuity outcomes associated with a single intravitreal injection of triamcinolone acetonide versus bevacizumab for the treatment of refractory diffuse diabetic macular oedema.Methods: Twenty-eight patients were randomly assigned to receive a single intravitreal injection of either 4 mg/0.1 ml triamcinolone acetonide or 1.5 mg/0.06 ml bevacizumab. Comprehensive ophthalmic evaluation was performed at baseline and at weeks 1, 4, 8 (+/- 1), 12 (+/- 2) and 24 (+/- 2) after treatment. Main outcome measures included central macular thickness measured with optical coherence tomography (OCT) and best corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity.Results: Twenty-six patients (26 eyes) completed all study visits (two patients missed two consecutive study visits). Central macular thickness was significantly reduced in the intravitreal triamcinolone group compared with the bevacizumab group at weeks 4, 8, 12 and 24 (p<0.05). Logarithm of the minimum angle of resolution (LogMAR) best-corrected visual acuity was significantly higher at weeks 8 (0.69; similar to 20/100(+1)) and 12 (0.74; 20/100(-2)) in the intravitreal triamcinolone group compared with the bevacizumab group (weeks 8 (0.83; similar to 20/125(-1)) and 12 (0.86; 20/ 160(+2))) (p<0.05). Significant change from baseline in mean intraocular pressure (mmHg) was seen at week 4 (+2.25) only in the intravitreal triamcinolone group (p<0.0001). No patient had observed cataract progression during the study.Conclusions: One single intravitreal injection of triamcinolone may offer certain advantages over bevacizumab in the short-term management of refractory diabetic macular oedema, specifically with regard to changes in central macular thickness. The actual clinical relevance of our preliminary findings, however, remains to be determined in future larger studies.

Ideais formativos de homem da emissora de Educação Rural de Caicó (Rio Grande do Norte, 1963-1978)

Under the aegis of the third diocese bishop of Caicó, Dom Manuel Tavares de Araújo, the Broadcasting Station of Rural Education of that city was founded, in May 1 s" 1963 with the ideal of being then an educational city, preferentially for youths and adults, rural meu and women of the arca of Seridó in Rio Grande do Norte state. In the year of its 40th birthday (2003), we began the investigation of that radio station choosing as study object its educational and formative programming, in the inc1usion of the first fifteen years of its existence (1963-1978), period that reaches the official inauguration of the Radio Station and the end of the bishopric of its fOllllder as Bishop of Caicó. Elucidating and showing Man's formative ideaIs longed by that Catholic educational broadcasting station, underlying to its radiophonic programming, such as the idealization for it reached, is the objective of this Doctorate work. It was considered pertinent to discover the guidelines that historically have permeated the Social Doçtrine of the Catholic Church addressing its aggiornamento, especially in what concerns to the employment of the modern ways of communication for the distance with the aim of evangelizing and educating. In arder to understand the ideaIs of the investigated educational Radio, we have delimited the research to the thematic Catholic Church, means of social communication and base education. In face of the study object and the aim to be reached it was appealed, methodologically, to the notion of cultural action present in Certeau (1995), and to the understanding of educational formation backgrounded fIam the modern thinkers that discuss it. Such frame references have allowed us to analyze in a wider spectrum tl)e programming broadcasted on the air by the sound wavys of that educ(itional Çatholic Radio, as well as, the very acts of cultural idealizations that has orientated it in its foundations. The thesis here defended is that. the Radio, at procJaiming itself as a broadcasting station of rural education directed preferably to the rural sertanejo countrymen, without neglecting its admitted ends, has surpassed them in its overall range. It was identified an articulate approach of its programmatic modules with the guid,elines emanateq from the Catholic Teaching about the use of the. means of social communication. At conceiving, establishin,g and executing an ec1ectic programmatic and div,ersified grating, the Rural Radio of Caicó has transcended to a strict human-Christian formation to request the development of the human, spiritual and cQrporaldimensions, jointly. With suchprogramming, it addressed to the seridoenses as real meu and women inserted in the "sertanej.o" environment with effective structural and existential problems of alI types, induding the hunger, the thirst, the syndical organization, the cQoperativism, the colIective modero work and the absence of universalizing school education. Its radiophonic transmissions, I}lled by the demands of an enlarged, open, dialogic and responsible communication, wheneIllbracing dedicated modules to religious and catechetical emissions, to the entertainment, to the radiojoumalism, to the country root culture, and to the school education of b se for the modality of the School and of the radiophonic classes, subsumed to ideaIs that longed for the formation of a multifaceted and pluridimensional sertanejo Man; of men and women that, without abjuring the Catholicism, were able to understand, to dialogued and to live together with the general demands of a society in progressive mutation, whose economical, social, cultural and educational demands it IDade themselves to be felt through the sertão potiguar of the Serido region, equal way of the intemationalized world

Televisão em solo educativo: educando o olhar

This work supplies a reflection concerning the presence of the daily television in the children s lives. It points with respect to the necessity of the incorporation of the nature of the medias and information in the educative proposals in way to promote the approach of the two areas in the junction of its respective epistemologies. It considers the development of a visual acuity for the student staff, pointing out the paper of the educator as a promoter of this taken over on a contract basis. Therefore, we present a research of field, carried through in some public and private primary schools in Natal and other cities that are part of the Grande Natal , trying to show with what perspective the teachers use the languages in this stage of education, prioritizing the television elements. As elements of the collection of the information, we made use of half-structuralized interviews, beyond comments directed for the moments where the teachers used the television with educative intention. As results, we noticed that some considerable part of the involved educators still don t get to conceive the television as integrating part of the roll of the languages, using this resource in a limited way, restricting to the contact with sets of documentaries and essentially educative productions, besides the use of objectives directed toward the entertainment, forgetting the opened TV, present in the daily lives of the children since the tender age

Qualidade do serviço de informação digital :um estudo exploratório em web sites de Programas de Pós-Graduação

This dissertation of Mestrado investigated the performance and quality of web sites. The target of the research is the proposal of an integrated model of evaluation of services of digital information in web educational sites. The universe of the research was constituted by eighteen Brazilian Universities that offer after-graduation courses, in the levels of mestrado and doutorado in the area of Engineering of Production. The adopted methodology was a descriptive and exploratory research, using the technique of systematic comment and focus group, for the collection of the data, using itself changeable independent dependents and, through the application of two instruments of research. The analysis protocol was the instrument adopted for evaluation and attainment of qualitative results. E the analysis grating was applied for evaluation and attainment of the quantitative results. The qualitative results had identified to the lack of standardization of web sites, under the attributes of content, hierarchy of information, design of the colors and letters. It of accessibility for carriers of auditory and visual special necessities was observed inexistence, as well as the lack of convergence of medias and assistivas technologies. The language of the sites also was evaluated and all present Portuguese only language. The general result demonstrated in grafico and tables with classification of the Universities, predominating the Good note As for the quantitative results, analysis method ed was estatistico, in order to get the descriptive and inferencial result between the dependent and independent variaveis. How much a category of analysis of the services of the evaluated sites, was found it props up and the index generality weighed. These results had served of base for ranking of existence or inexistence the Universities, how much of the information of services in its web sites. In analysis inferencial the result of the test of correlation or association of the independent variaveis (level, concept of the CAPES and period of existence of the program) with the caracteristicas, called was gotten categories of services. For this analysis the estatisticos methods had been used: coefficient of Spearman and the Test of Fisher. But the category you discipline of the Program of Mestrado presented significance with variavel independent and concept of the CAPES. Main conclusion of this study it was ausencia of satandardization o how much to the subjective aspects, design, hierarchy of information navigability and content precision and the accessibility inexistence and convergence. How much to the quantitative aspects, the information services offered by web sites of the evaluated Universities, still they do not present a satisfactory and including quality. Absence of strategies, adoption of tools web, techniques of institucional marketing and services that become them more interactive, navigable is perceived and with aggregate value

Abordagem da ergonomia para a análise da acessibilidade de uma instituição de longa permanência para idosos da cidade de Natal-RN

This dissertation presents and discusses the results of an applied research on the accessibility of residents in a Long Term Care Institution (LTCIs) in the city of Natal- RN. The main objective of this research is to suggest projectual improvements that maximize the accessibility in a LTCIs of Natal-RN, considering the aspects of mobility, safety, comfort and independence of elderly residents. Moreover, one should consider the specific characteristics of the user population, capabilities and limitations of the biological process of aging, which causes damage to the neurological system, musculoskeletal and cardiovascular and progressively affects on visual acuity, balance and locomotion of elderly people. This research has a qualitative approach and divided into four phases: exploratory, bibliographical and documentary research, mapping of the LTCIs of Natal-RN, case study. The phase of the mapping presented an overview of accessibility on LTCIs of Natal-RN. The institution of the case study was defined based on the overall assessment of accessibility and ergonomics criteria, preceded by an application of an Ergonomic Work Analysis to understand the accessibility of the elderly people. Interactional and observational methods were used to collect field data. To this end, an intense process of social construction was conducted, involving the elderly residents, caregivers, health professionals and general servants and LTCIs´ managers. It was found that the NBR 9050 is not comprehensive to solve the diversity of accessibility problems found in LTCIs. All LTCIs investigated were in disconformity to the NBR 9050. In the case study, it was found that the inappropriate design hinders the daily activities of the elderly people and is a source of risk of accidents. The environment, facilities and lack of assistive technologies hinder the autonomy of the elderly people, and this LTCI requires ergonomic intervention to improve the accessibility, autonomy and security of the elderly people

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developing the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. It s important to point out that, in spite of the loads being normally connected to the transformer s secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developping the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. Its important to point out that, in spite of the loads being normally connected to the transformers secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity

Pré-fabricados lingüísticos: estrutura e funcionamento de sintagmas verbais idiomatizados - por uma abordagem cognitivo-funcional em sala de aula

This work aims at under the cognitive-functional perspective describing, inside the vast domain of the linguistic prefabs, the structure and the functioning of the Idiomatic Verb Phrases (SVIs), produced by speakers of the Portuguese from Brazil, located in Natal (RN). From the functionalist presupposition that the language is used essentially to assist to communicative demands, it is observed that its morphologic-syntactic structure is conditioned to the inherent pragmatic vicissitudes to the verbal interaction of subjects, socially heterogeneous and historically established. It is focalized, in the composition of SVIs, the relationships VT + OD (transitive verb + direct object), characterizing the syntactic-semantic nature of the verb and of the respective verbal complement. Those verb combinations + complement can be interpreted as lexical structures, reflexes of the idiomaticity inherent to conventional constructions already systematized in the users' of the language cultural repertoire. It is sought, still, to glimpse the cognitive and discursive motivations pertinent to that linguistic phenomenon. In the investigative process, are analyzed exclusive data of speech collected in Corpus Discurso & Gramática a lingua falada e escrita na cidade do Natal, organized by Furtado da Cunha (1998). The adopted methodological procedures configure as methods of empiric analysis and use of the intuition, being emphasized the qualitative approach (explanatory) of the data with quantitative support of statistical indicators. It shows, finally, a grating of didactic suggestions on SVIs, for Portuguese's classes, as subsidies to the educational practice in the Medium Teaching and in the course of Letters.

The influence of visual inter-hemispheric connections on spiking, assembly and LFP activities, and their phase relationship during figure-ground stimulation

Desde os descobrimentos pioneiros de Hubel e Wiesel acumulou-se uma vasta literatura descrevendo as respostas neuronais do córtex visual primário (V1) a diferentes estímulos visuais. Estes estímulos consistem principalmente em barras em movimento, pontos ou grades, que são úteis para explorar as respostas dentro do campo receptivo clássico (CRF do inglês classical receptive field) a características básicas dos estímulos visuais como a orientação, direção de movimento, contraste, entre outras. Entretanto, nas últimas duas décadas, tornou-se cada vez mais evidente que a atividade de neurônios em V1 pode ser modulada por estímulos fora do CRF. Desta forma, áreas visuais primárias poderiam estar envolvidas em funções visuais mais complexas como, por exemplo, a separação de um objeto ou figura do seu fundo (segregação figura-fundo) e assume-se que as conexões intrínsecas de longo alcance em V1, assim como as conexões de áreas visuais superiores, estão ativamente envolvidas neste processo. Sua possível função foi inferida a partir da análise das variações das respostas induzidas por um estímulo localizado fora do CRF de neurônios individuais. Mesmo sendo muito provável que estas conexões tenham também um impacto tanto na atividade conjunta de neurônios envolvidos no processamento da figura quanto no potencial de campo, estas questões permanecem pouco estudadas. Visando examinar a modulação do contexto visual nessas atividades, coletamos potenciais de ação e potenciais de campo em paralelo de até 48 eletrodos implantados na área visual primária de gatos anestesiados. Estimulamos com grades compostas e cenas naturais, focando-nos na atividade de neurônios cujo CRF estava situado na figura. Da mesma forma, visando examinar a influência das conexões laterais, o sinal proveniente da área visual isotópica e contralateral foi removido através da desativação reversível por resfriamento. Fizemos isso devido a: i) as conexões laterais intrínsecas não podem ser facilmente manipuladas sem afetar diretamente os sinais que estão sendo medidos, ii) as conexões inter-hemisféricas compartilham as principais características anatômicas com a rede lateral intrínseca e podem ser vistas como uma continuação funcional das mesmas entre os dois hemisférios e iii) o resfriamento desativa as conexões de forma causal e reversível, silenciando temporariamente seu sinal, permitindo conclusões diretas a respeito da sua contribuição. Nossos resultados demonstram que o mecanismo de segmentação figurafundo se reflete nas taxas de disparo de neurônios individuais, assim como na potência do potencial de campo e na relação entre sua fase e os padrões de disparo produzidos pela população. Além disso, as conexões laterais inter-hemisféricas modulam estas variáveis dependendo da estimulação feita fora do CRF. Observamos também uma influência deste circuito lateral na coerência entre potenciais de campo entre eletrodos distantes. Em conclusão, nossos resultados dão suporte à ideia de um mecanismo complexo de segmentação figura-fundo atuando desde as áreas visuais primárias em diferentes escalas de frequência. Esse mecanismo parece envolver grupos de neurônios ativos sincronicamente e dependentes da fase do potencial de campo. Nossos resultados também são compatíveis com a hipótese que conexões laterais de longo alcance também fazem parte deste mecanismo

Acoustic and psychoacoustic analysis of the noise produced by the police force firearms

Police officers are exposed to impact noise coming from firearms, which may cause irreversible injuries to the hearing system.Aim: To evaluate the noise exposure in shooting stands during gunfire exercises, to analyze the acoustic impact of the noise produced by the firearms and to associate it with tonal audiometry results.Study design: Cross-sectional.Materials and methods: To measure noise intensity we used a digital sound level meter, and the acoustic analysis was carried out by means of the oscillations and cochlear response curves provided by the Praat software. 30 police officers were selected (27 males and 3 females).Results: The peak level measured was 113.1 dB(C) from a .40 pistol and 116.8 dB(C) for a .38 revolver. The values obtained for oscillation and Praat was 17.9 +/- 0.3 Barks, corresponding to the rate of 4,120 and 4,580 Hz. Audiometry indicated greater hearing loss at 4,000Hz in 86.7% of the cases.Conclusion: With the acoustic analysis it was possible to show cause and effect between the main areas of energy excitation of the cochlea (Praat cochlear response curve) and the frequencies of low hearing acuity.

Oligodendroglioma cístico e positividade das reações para cisticercose relato de caso

São poucos os estudos sobre gliomas «low-grade». Os oligodendrogliomas representam de 1,3 a 10% dos tumores intracerebrais. A neurocisticercose é uma das mais graves parasitoses do SNC, com evidente polimorfismo clínico e laboratorial. O objetivo deste estudo é relatar o caso de um doente com cefaléia, perda progressiva da visão, alteração do comportamento e, provas imunológicas positivas para cisticercose no líquido cístico e cefalorra-queano. Após tentativas para tratamento da neurocisticercose, sem muito sucesso, foi submetido a craniotomia frontal para exérese de tumor cístico, que revelou tratar-se de oligodendroglioma. Discutem-se aspectos relacionados aos possíveis mecanismos para associação de neurocisticercose e oligodendroglioma.

Erros de refração como causas de baixa visual em crianças da rede de escolas públicas da regional de Botucatu - SP

OBJETIVO: Estudar a ocorrência dos erros refracionais em escolares de nosso meio. MÉTODOS: Estudo transversal avaliando crianças da pré-escola e do ensino básico, quanto ao sexo, tipo de erro refracional, acuidade visual e tratamento realizado. RESULTADOS: Quatro mil seiscentos e vinte e três crianças foram submetidas a exame de acuidade visual, das quais 8,1% apresentaram necessidade de exame oftalmológico completo. Houve 63,2% de portadores de astigmatismo hipermetrópico, 15,7% de astigmatismo miópico, 12,5% de astigmatismo misto, 4,9% de hipermetropia e 3,7% de miopia. Foi indicada a prescrição de lentes corretoras para 48,7% da amostra estudada. A frequência de erros refracionais na população foi de 3,9%. CONCLUSÃO: O astigmatismo hipermetrópico foi o erro de refracional mais frequente, havendo necessidade de tratamento em cerca de 50% das crianças triadas com frequência de 3,9% de erro refracional passível de correção na população de estudo.

Condição ocular entre trabalhadores de uma indústria metalúrgica brasileira

OBJETIVO: Avaliar a condição ocular em população de trabalhadores de uma indústria metalúrgica paulista. MÉTODOS: Amostra de 2516 funcionários de uma fábrica na cidade de São Paulo foi submetida a uma avaliação oftalmológica como exame ocupacional periódico. Foi aplicado um questionário e realizado o exame de acuidade visual (Snellen) e teste de Ishihara. Os funcionários com acuidade visual menor que 0,7 ou com diferenças maior que duas linhas ou que apresentassem alguma queixa ocular, passaram por avaliação complementar (biomicroscopia, refração, tonometria e fundo de olho). Prescreveu-se óculos conforme indicação. RESULTADOS: Houve predomínio do sexo masculino (62,5%) e faixa etária de 20 a 29 anos (41%). A maioria não apresentava antecedentes oculares (97,6%) ou sistêmicos (96,6%).A acuidade visual estava acima de 0,7 em 95,5% dos olhos e 84% não utilizavam correção. O diagnóstico final foi exame normal em 55% dos casos, presbiopia em 13.6%, astigmatismo miópico em 10% e hipermetrópico em 7,7% dos indivíduos. Baixa visão foi encontrada em 2,4%, cegueira unilateral em 0,4%, não havendo casos de cegueira ou de deficiência visual entre os trabalhadores. As principais causas de baixa visão foram erros refrativos e ambliopia. CONCLUSÃO: A maioria dos funcionários da indústria pesquisada apresentava exame oftalmológico normal e nenhum deles apresentava cegueira bilateral.

Condição ocular dos indivíduos facectomizados na região centro-oeste do estado de São Paulo: estudo populacional

OBJETIVO: Avaliar as causas de baixa visão e cegueira em indivíduos facectomizados, de amostra da população de cidades da região centrooeste do estado de São Paulo. Métodos: Estudo transversal, observacional, feito em cinco cidades da região centro-oeste do estado de São Paulo, em amostra domiciliar e baseada nos dados do último Censo Demográfico (IBGE, 1995), com escolha sistemática dos domicílios. Foi considerada para o presente estudo uma subamostra de indivíduos facectomizados, dos quais foram obtidos dados de identificação e exame oftalmológico completo. Os dados foram avaliados por estatísticas descritivas, análise de freqüência de ocorrência e proporção de concordância, com intervalo de confiança de 95%. RESULTADOS: Dos indivíduos amostrados, 2,37% haviam sido submetidos à facectomia. Dos 201 olhos operados, 26,9% apresentavam acuidade visual compatível com cegueira ou deficiência visual. Com a melhor correção óptica, a acuidade visual permaneceu <0,3 em 19,0%. O exame refracional proporcionou melhora da acuidade visual para 27,9% dos indivíduos facectomizados. As causas de baixa visão foram os erros refrativos não corrigidos, opacidade de cápsula posterior (19,4%), ceratopatia bolhosa (8,3%) coriorretinite cicatricial (8,3%), afacia (8,3%), degeneração macular relacionada a idade (5,5%), leucoma (5,5%), glaucoma (5,5%), atrofia de papila (5,5,%), descolamento de retina (2,8%), atrofia de epitelio pigmentado da retina (2,8%) e alta miopia (2,8%). CONCLUSÃO: Apesar da catarata ser causa de cegueira que pode ser evitável, mesmo após a correção cirúrgica porcentagem expressiva de indivíduos permanece com baixa visão, em geral, em decorrência de fatores relacionados ao seguimento pós-operatório negligenciado.

Comparação entre acuidade visual e photoscreening como métodos de triagem visual para crianças em idade escolar

OBJETIVO: Avaliar a sensibilidade do aparelho photoscreener na detecção de alterações oculares em crianças informantes, comparando os dados à acuidade visual obtida pela tabela E de Snellen. MÉTODOS: Foram avaliadas 500 crianças de idades entre 5 e 12 anos, de escola do município de Botucatu, estado de São Paulo. As crianças foram submetidas ao teste de acuidade visual pela tabela E de Snellen e foram fotografadas utilizando-se o aparelho photoscreenerTM system model MTI-PS100, seguindo-se a análise das fotos obtidas. RESULTADOS: Houve concordância negativa (criança com boa acuidade visual e teste negativo com o photoscreener) em 81,0%; concordância positiva (acuidade visual alterada e teste positivo) em 7,6% e não houve concordância de resultados em 11,0% dos casos. CONCLUSÃO: A avaliação comparativa entre o método da acuidade visual pela tabela E de Snellen e o photocreener para detecção de problemas visuais mostrou alta concordância. Os autores sugerem entretanto, a triagem usando tabelas de acuidade visual quando se trata de crianças informantes, devido aos custos com o aparelho.