LUIZ GUILHERME MARCHESI MELLO
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
conferenceObject OCT analysis of Bruch's opening-minimum rim width, peripapillary retinal nerve fiber layer and cup depth in eyes with compressive chiasmal lesions, glaucoma and normal controls.(2023) MONTEIRO, Mario; ANDRADE, Thais; ARAUJO, Rafael; ROCHA, Arthur do Nascimento; MELLO, Luiz Marchesi- Bruch Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Helps Differentiate Compressive Optic Neuropathy From Glaucoma(2022) ANDRADE, Thais de Souza; ARAUJO, Rafael Barbosa de; ROCHA, Arthur Andrade do Nascimento; MELLO, Luiz Guilherme Marchesi; CUNHA, Leonardo P.; MONTEIRO, Mario L. R.center dot PURPOSE: To compare optical coherence tomography measured Bruch membrane opening minimum rim width (MRW), peripapillary retinal nerve fiber layer (pRNFL) measurements, and MRW:pRNFL ratios in eyes with compressive optic neuropathy (CON) and glaucoma and controls, and evaluate the ability of these parameters to differentiate CON from glaucoma. center dot DESIGN: Prospective, cross-sectional study. center dot METHODS: Setting : Single-center tertiary hospital and outpatient clinic. Patient population : One hundred fifteen eyes of 77 participants, 34 with CON from chiasmal lesions, 21 with glaucoma, and 22 healthy controls. Observation procedures : Optical coherence tomography-measured MRW, pRNFL, and MRW:pRNFL ratios for each optic disc sector and global average. Main outcome measures: MRW, pRNFL, and MRW:pRNFL ratios compared using generalized estimated equations. Area under the receiver operating characteristic curve and positive and negative likelihood ratios were calculated. center dot RESULTS: MRW and pRNFL measurements were significantly reduced in CON and glaucoma compared with controls. In glaucoma, MRW was thinner than in CON in the global, inferotemporal, superonasal, inferonasal, and vertical average measurements, but a significant overlap was observed in many parameters. MRW:pRNFL ratios increased the ability to discriminate between CON and glaucoma, as shown by the high area under the receiver operating characteristic curve, high positive likelihood ratios, and low negative likelihood ratios, especially in the nasal disc sector and the nasal and temporal average. center dot CONCLUSIONS: MRW measurements alone cannot reliably distinguish CON from glaucoma, but the combination of MRW, pRNFL, and MRW:pRNFL ratios significantly improves accuracy. When comparing the 2 conditions, MRW:pRNFL ratios yielded higher area under the receiver operating characteristic curve and positive and negative likelihood ratios, suggesting this parameter may be helpful in clinical practice. (Am J Ophthalmol 2021;234: 156-165.
conferenceObject New insights into structural and functional evaluation of the retina and optic nerve in Parkinson's disease(2023) MELLO, Luiz Marchesi; PARAGUAY, Isabela Bezerra; ANDRADE, Thais; ROCHA, Arthur do Nascimento; BARBOSA, Egberto; OYAMADA, Maria; MONTEIRO, Mario- Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension(2021) MATOS, Aline Mota Freitas; CUNHA, Leonardo Provetti; SUZUKI, Ana Claudia F.; MELLO, Luiz Guilherme Marchesi; PRETI, Rony C.; ZACHARIAS, Leandro C.; MONTEIRO, Mario L. R.We have reported here the case of a 54-year-old woman with intracranial hypertension that presented with the unique features of unilateral papilledema and peripapillary polypoidal choroidal vasculopathy. Our investigations lead to the diagnosis of idiopathic intracranial hypertension and an incidental small right frontal meningioma. The patient was accordingly treated with oral acetazolamide, followed by three consecutive monthly intravitreal injections of bevacizumab, which resulted in the inactivation of the polypoidal choroidal vasculopathy, marked reduction of lipid exudation, and complete absorption of the subretinal fluid. This case serves as the first documentation of polypoidal choroidal vasculopathy associated with papilledema. It also demonstrates that choroidal vascular abnormalities may occur even when optic disk edema is unilateral, which is an uncommon manifestation of increased intracranial pressure. Prompt recognition of such findings and its appropriate management are essential for adequate treatment and prevention of irreversible visual loss.
- Angioid streaks and optic disc drusen in cherubism: a case report(2020) MELLO, Luiz Guilherme Marchesi; SARAIVA, Fabio Petersen; MONTEIRO, Mario Luiz RibeiroA 65-year-old female patient was referred to our hospital for evaluation for cataract surgery. Her past medical history included corrective jaw surgeries for facial deformities that developed during infancy and persisted through early adulthood. A complete ophthalmological examination revealed bilateral angioid streaks, drusen in both optic disc areas, and a subretinal neovascular membrane in the left macula. Genetic analysis revealed a mutation in the SH3BP2 gene compatible with the diagnosis of cherubism. Clinical and laboratory evaluation revealed no additional systemic disorders. Cherubism is a rare disease characterized by the development of painless fibro-osseous lesions in the jaws and the maxilla in early childhood. Ophthalmologic findings in this disease are primarily related to orbital bone involvement. This is the first report of AS and optic disc drusen in a patient diagnosed with cherubism. Our findings suggest that angioid streaks and optic disk drusen should be included in the differential diagnosis of ophthalmic disorders identified in patients with this genetic abnormality.
conferenceObject OCT findings in Patients with Parkinson's Disease with or Without Pramipexole Treatment(2020) MONTEIRO, Mario L. R.; MELLO, Luiz Guilherme Marchesi; BISSOLI, Leandro Bortolon; MAIA, Raphael De Paula Doyle; SARAIVA, Fabio Petersen- Simultaneous Unilateral Abducens Nerve Palsy and Contralateral Anterior Ischaemic Optic Neuropathy as the Presenting Signs of Giant Cell Arteritis(2023) ARIELLO, Leonardo E.; ANDRADE, Thais de Souza; MELLO, Luiz Guilherme Marchesi; OYAMADA, Maria Kiyoko; CUNHA, Leonardo Provetti; MONTEIRO, Mario L. R.Ischaemic optic neuropathy is the most common, feared, and recognised ocular manifestation of giant cell arteritis (GCA), while extraocular muscle palsy rarely occurs in the disease. Overlooking the diagnosis of GCA in aged patients with acquired diplopia and strabismus is not only sight- but also life-threatening. Here, we present, for the first time, a case of unilateral abducens nerve palsy and contralateral anterior ischaemic optic neuropathy as the presenting signs of GCA in a 98-year-old woman. Prompt diagnosis and treatment prevented further visual loss and systemic complications and allowed for rapid resolution of the abducens nerve palsy. We also aim to discuss the possible pathophysiological mechanisms of diplopia in GCA and to emphasise that acquired cranial nerve palsy must raise suspicion of this severe disease in elderly patients, particularly in association with ischaemic optic neuropathy.
- Visual Hallucinations as a Major Manifestation of Posterior Reversible Encephalopathy Syndrome: Case Report and Literature Review(2023) ANDRADE, Thais de Souza; MELLO, Luiz Guilherme Marchesi; HOKAZONO, Kenzo; MONTEIRO, Mario Luiz RibeiroWe evaluated a 48-year-old woman who had visual hallucinations (VHs) as a major presenting sign of posterior reversible encephalopathy syndrome (PRES). Despite her mild loss of vision, she described various hallucinations after awakening from a comatose state days after a motorcycle collision. VHs are usually accompanied by more severe loss of vision, yet our case and literature review indicate that sudden onset of formed VHs should suggest a possible diagnosis of PRES in patients who have large fluctuations in blood pressure, renal failure, or autoimmune dysfunction, as well as in patients taking cytotoxic agents.
- Retinal Layers and Choroid Measurements in Parkinson's Disease with or Without Pramipexole Treatment(2020) MELLO, Luiz Guilherme Marchesi; BISSOLI, Leandro Bortolon; SARAIVA, Fabio Petersen; MAIA, Raphael de Paula Doyle; MONTEIRO, Mario Luiz Ribeiro
- Metastatic and aggressive renal cell carcinoma mimicking a unilateral choroidal tuberculoma(2023) CAETANO, Lais Mesquita; FROSSARD, Jessica Cararo; SARAIVA, Fabio P.; MELLO, Luiz Guilherme Marchesi; CABRAL, ThiagoOcular metastases from systemic tumors are uncommon. The choroid is the most frequent target, with a preference for elderly individuals. Lung cancer is the predominant primary tumor that metastasizes to the eyes in males, although other ocular conditions such as uveitis and retinal lesions can mimic secondary tumor implants in ocular tissues. On fundoscopy, choroidal metastasis resembles other infectious processes, espe- cially choroidal tuberculoma. Therefore, patients presenting with choroidal masses should undergo detailed clinical examinations, especially if the mass is the first manifestation of a systemic and severe disease. In this report, we describe a young man with a metastatic choroidal tumor secondary to papillary renal cell carcinoma mimicking a unilateral choroidal tuberculoma.