MARCONY RODRIGUES DE SANTHIAGO
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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- Role of Corneal Epithelial Measurements in Differentiating Eyes with Stable Keratoconus from Eyes that Are Progressing(2023) SANTHIAGO, Marcony R.; STIVAL, Larissa R.; ARAUJO, Daniella C.; KARA-JUNIOR, Newton; TOLEDO, Marcia C.Purpose: To evaluate measures of corneal epithelium in eyes that showed documented signs of keratoconus (KC) progression and compare with stable eyes and healthy controls. Also, to determine the correlation of these epithelial parameters with maximum keratometry (K max) and pachymetry. Design: Prospective, observational, comparative study. Participants: One-hundred and fifty eyes from 150 patients. The study included 50 eyes from patients with documented KC progression, 50 eyes with stable KC, and 50 clinically normal eyes to serve as controls. Methods: A spectral-domain (SD)-OCT imaging was obtained in all eyes, and mean values were compared between the groups. The correlation of epithelial parameters with K max and thinnest pachymetry was also investigated. Main Outcome Measures: For the purposes of this study, the epithelial measures maximum, minimum, superior, and inferior values as well as the difference between the minimum and maximum (min-max) and epithelial standard deviation were considered, obtained from SD-OCT and compared between groups. Measurements of the thinnest point and min-max in pachymetry were also recorded. Results: The only epithelial parameter that presented a statistically significant difference between stable and progressive KC was epithelium min-max. Although stable KC presented epithelium min-max mean values of -18.2 +/- 6.6, progressive KC eyes presented mean values of -23.4 +/- 10.3 (P < 0.0001). Epithelial maximum (P = 0.16), minimum (P = 0.25), superior (P = 0.28), inferior (P = 0.23), and standard deviation (P = 0.25) values were not significantly different between stable and progressive eyes. Difference min-max pachymetry points in stable (-108.3 +/- 33.5) and progressive KC (-115.2 +/- 56.0) were not significantly different (P = 0.723). There was no significant correlation between epithelium min-max with corneal thinning (P = 0.39) or K max (P = 0.09) regardless of disease progression. Conclusions: Epithelial measures are useful to identify KC eyes that are progressing; the parameters that measure the difference between min-max epithelium points were significantly different between stable and progressive groups, unlike this difference in pachymetry. Finally, this epithelial parameter seems to be inde-pendent of corneal thinning and K max. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (c) 2022 by the American Academy of Ophthalmology.
- Analysis of ocular cyclotorsion in lying position after peribulbar block and topical anesthesia(2014) KARA-JUNIOR, Newton; MOURAD, Paula C.; MORAES, Renata L. B.; MORAES, Renata L. B.; PIVA, Caroline; SANTHIAGO, Marcony RodriguesPurpose: Evaluate the magnitude of cyclotorsion during cataract surgery in patients with indication for intraocular toric lenses comparing the results after peribulbar and after topical anesthesia. Methods: This prospective study comprised 112 eyes that underwent cataract surgery with implantation of toric intraocular lens by topical anesthesia or peribulbar block. We estimated how many degrees of cyclotorsion occurred after topical anesthesia and peribulbar block with the patient in supine position. A tag was performed in the position of 180 degrees of the right eye and zero degrees of the left eye, with the patient seated. Afterwards, it was requested a change to the supine position and then a new dial in 180 and zero degrees respectively from right and left eye were made. Results: The current study demonstrated that patients submitted to cataract surgery with implantation of toriclens under local anesthesia showed approximately 6.89 degrees of incyclotorsion (82 eyes) and 6.93 degrees of excyclotorsion (38 eyes) and a mean of cyclotorsion of 6.91 degrees. Patients undergoing peribulbar block showed 5.68 degrees of incyclotorsion (73 eyes) and 4.81 degrees of excyclotorsion (47 eyes) and a mean of cyclotorsion of 4.92 degrees. Conclusion: Through the study we can see that the movement of incyclotorsion in patients undergoing peribulbar anesthesia was lower when compared to topical anesthesia. This is relevant since the greater the incyclotorsion, the lower the predictability of the surgery and the lower the chance of obtaining excellent results in the final refractometric.
- Topical Losartan Decreases Myofibroblast Generation But Not Corneal Opacity After Surface Blast-Simulating Irregular PTK in Rabbits(2023) SAMPAIO, Lycia Pedral; VILLABONA-MARTINEZ, Valeria; SHIJU, Thomas Michael; SANTHIAGO, Marcony R.; WILSON, Steven E.Purpose: To evaluate the efficacy of topical losartan after blast injury-simulating irregular phototherapeutic keratectomy (PTK) in rabbits.Methods: Twelve NZW rabbits underwent 100 pulse 6.5 mm diameter PTK over a metal screen to generate severe surface irregularity and inhibit epithelial basement membrane regeneration. Corneas were treated with 0.8 mg/mL losartan in balanced salt solution (BSS) or BSS 50 mu L six times per day for six weeks after PTK. All corneas had slit lamp photography, with and without 1% fluorescein at two, four, and six weeks after PTK, and were analyzed using immunohistochemistry for the myofibroblast marker alpha-smooth muscle actin (alpha-SMA), keratocyte marker keratocan, mesenchymal cell marker vimentin, transforming growth factor (TGF)-beta 1, and collagen type IV.Results: Topical 0.8 mg/mL losartan six times a day significantly decreased anterior stromal alpha-SMA intensity units compared to BSS at six weeks after anterior stromal irregularity-inducing screened PTK (P = 0.009). Central corneal opacity, however, was not significantly different between the two groups. Keratocan, vimentin, TGF-beta 1, or collagen type IV levels in the anterior stroma were not significantly different between the two groups.Conclusions: Topical losartan effectively decreased myofibroblast generation after surface blast simulation irregular PTK. However, these results suggest initial maskingsmoothing PTK, along with adjuvant topical losartan therapy, may be needed to decrease corneal stromal opacity after traumatic injuries that produce severe surface irregularity.Translational Relevance: Topical losartan decreased scar-producing stromal myofibroblasts after irregular PTK over a metal screen but early smoothing of irregularity would also likely be needed to significantly decrease corneal opacity.
- Losartan Inhibition of Myofibroblast Generation and Late Haze (Scarring Fibrosis) After PRK in Rabbits(2022) SAMPAIO, Lycia Pedral; HILGERT, Guilherme S. L.; SHIJU, Thomas Michael; SANTHIAGO, Marcony R.; WILSON, Steven E.PURPOSE: To study the effect of topical losartan compared to vehicle on the generation of myofibroblasts and development of late haze scarring fibrosis after photorefractive keratectomy (PRK) in rabbits. METHODS: Twelve rabbits had-9.00 diopter (D) PRK in one eye followed by 50 mu L of topical 0.2 mg/mL losartan or 50 mu L of vehicle six times per day for 1 month. Standardized slit lamp photographs were obtained prior to death. Duplex immunohistochemistry was performed on cryofixed corneas for myofibroblast marker alpha-smooth muscle actin (a-SMA) and keratocyte marker keratocan or collagen type IV and transforming growth factor (TGF)-I31. ImageJ software (National Institutes of Health) was used for quantitation. RESULTS: Topical losartan compared to vehicle significantly decreased corneal opacity (P = .04) and anterior stromal myofibroblast generation (P = .01) at 1 month after PRK. Topical losartan compared to vehicle also decreased anterior stromal non-basement membrane collagen type IV at 1 month after PRK (P = .004). CONCLUSIONS: Topical angiotensin converting enzyme II receptor inhibitor losartan, a known inhibitor of TGF-I3 signaling, decreased late haze scarring fibrosis and myofibroblast generation after-9.00 D PRK in rabbits compared to vehicle. It also decreases TGF-I3-modulated, corneal fibroblast-produced, non-basement membrane stromal collagen type IV-likely also through inhibition of TGF-I3 signaling.[J Refract Surg. 2022;38(12):820-829.]
conferenceObject Cell biology of spontaneous persistent epithelial defects after photorefractive keratectomy in rabbits(2023) WILSON, Steven; SAMPAIO, Lycia; VILLABONA-MARTINEZ, Valeria; MICHAEL, Shiju; HILGERT, Guilherme; SANTHIAGO, Marcony- Mudando um paradigma: PTA é mais importante que o leito residual como fator de risco para ectasia pós-LASIK(2015) SANTHIAGO, Marcony R.
- Corneal stromal localization of TGF beta isoforms in spontaneous persistent epithelial defects after PRK in rabbits(2024) VILLABONA-MARTINEZ, Valeria; DUTRA, Barbara A. L.; SAMPAIO, Lycia P.; SANTHIAGO, Marcony R.; WILSON, Steven E.The purpose of this study was to evaluate transforming growth factor beta (TGFI3) isoform localization in rabbit corneas with spontaneous persistent epithelial defects (PEDs) after photorefractive keratectomy (PRK). Four cryofixed corneas from a previously reported series of PEDs in rabbits that had PRK were evaluated with triplex immunohistochemistry (IHC) for TGFI33, myofibroblast marker alpha-smooth muscle actin (alpha-SMA) and mesenchymal marker vimentin. One cornea had sufficient remaining tissue for triplex IHC for TGFI31, TGFI32, or TGFI33 (each with alpha-SMA and vimentin) using isoform-specific antibodies. All three TGFI3 isoforms were detected in the subepithelial stroma at and surrounding the PED. Some of each TGFI3 isoform co-localized with alpha-SMA of myofibroblasts, which could be TGFI3 isoform autocrine production by myofibroblasts or TGFI3-1, -2, and -3 binding to these myofibroblasts.
- Dual Scheimpflug imaging as a screening method for occludable angles-a comparison with gonioscopy(2019) BESSA, Natalia Maes; SOUZA, Rebeca de Azevedo; SANTHIAGO, Marcony R.; JR, Haroldo Vieira Moraes; GOMES, Beatriz FiuzaAIM: To evaluate dual Scheimpflug analyzer (Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles (ACA). METHODS: In 40 eyes of 40 patients with different ACA range, the ACA, anterior chamber volume (ACV) and anterior chamber depth (ACD) were analyzed using the dual Scheimpflug analyzer (Galilei G6 system). Correspondence between these parameters and Shaffer's classification based on gonioscopy were studied. Receiving operator characteristic (ROC) curves and partition analysis were used to determine the efficacy of the Galilei system in screening for narrow angles. Agreement (Kappa statistics), sensitivity, and specificity for each eye, according to Galilei measures, were also assessed. RESULTS: Shaffer's grade (from 0 to 4) were significantly associated with each of the measurements (P<0.001). In screening eyes with narrow angles with the Galilei, the area under the ROC curve was largest (0.90) when ACD was used as the reference, and partition analysis demonstrated that those eyes were most adequately partitioned with an ACD of 2.86 mm with 100% sensitivity and 80% specificity. CONCLUSION: The Galilei is a secure, repeatable and noncontact screening method for narrow angles. However it does not provide sufficient information about the ACA anatomy to be considered a substitute for gonioscopy.
- Management of Pain after Photorefractive Keratectomy A Report by the American Academy of Ophthalmology(2023) STEIGLEMAN, Walter Allan; ROSE-NUSSBAUMER, Jennifer; AL-MOHTASEB, Zaina; SANTHIAGO, Marcony R.; LIN, Charlies C.; PANTANELLI, Seth M.; KIM, Stephen J.; SCHALLHORN, Julie M.Objective: To evaluate current best practices for postoperative photorefractive keratectomy (PRK) pain control.Methods: Literature searches in the PubMed database were last conducted in October 2021 and were restricted to publications in English. This search identified 219 citations, of which 84 were reviewed in full text for their relevance to the scope of this assessment. Fifty-one articles met the criteria for inclusion; 16 studies were rated level I, 33 studies were rated level II, and 2 studies were rated level III.Results: Systemic opioid and nonsteroidal anti-inflammatory drugs (NSAIDs); topical NSAIDs; postoperative cold patches; bandage soft contact lenses (BCLs), notably senofilcon A contact lenses; and topical anesthetics were demonstrated to offer significantly better pain control than comparison treatments. Some other commonly reported pain mitigation interventions such as systemic gabapentinoids, chilled intraoperative balanced salt solution (BSS) irrigation, cycloplegia, and specific surface ablation technique strategies offered limited improvement in pain control over control treatments.Conclusions: Systemic NSAIDs and opioid medications, topical NSAIDs, cold patches, BCLs, and topical an-esthetics have been shown to provide improved pain control over alternative strategies and allow PRK-associated pain to be more tolerable for patients. Ophthalmology 2023;130:87-98 2022 by the American Academy of Ophthalmology
- Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery(2019) ONG, Hon Shing; FAROOK, Mohamed; TAN, Benjamin Boon Chuan; WILLIAMS, Geraint P.; SANTHIAGO, Marcony R.; MEHTA, Jodhbir S.Purpose: A percentage tissue altered (PTA) score of >= 40% has been advocated as an independent indicator of post-operative ectasia risk following laser in-situ keratomileusis (LASIK). This study was performed to test the hypothesis that refractive procedures, such as laser-assisted subepithelial keratectomy (LASEK) or small incision lenticule extraction (SMILE), may alter the range of PTA, within which refractive corneal surgery can be safely performed. Setting: Refractive department, tertiary ophthalmic hospital. Design: Retrospective observational study. Methods: Review of case notes was performed for patients who presented for refractive surgeries, other than LASIK. To determine the risk of corneal ectasia for each patient prior to refractive surgery, we estimated what each patient's PTA would have been if they had undergone LASIK. The Randleman Ectasia Risk Score System (ERSS) was also calculated. Results: 114 eyes (66 patients) were included. 94 eyes underwent SMILE. 20 eyes underwent LASEK. A significant proportion of eyes had PTA >= 40% - SMILE eyes: up to 31.9%, LASEK eyes: up to 60.0% (at presumed LASIK flap of 120 mu m). The maximum calculated PTA was up to 47.9% in the SMILE group and up to 51.5% in the LASEK group. Using ERSS, 12.8-16% of SMILE eyes and 15.0-80.0% of LASEK eyes would have been considered to have moderate-to-high ectasia risk. No post-surgical ectasia was observed at 3 years. Conclusion: SMILE and LASEK alter the range of PTA, within which corneal refractive surgery may be performed with a lower risk of developing post-operative corneal ectasia; a safe PTA threshold needs to be determined for these procedures before recommendations for clinical practice can be made.