MARINA RAVAGNANI CIONGOLI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 7 de 7
  • conferenceObject
    Effect of panretinal photocoagulation on confocal laser scanning ophthalmoscopy and stereo photographic parameters of the optic disc topography in diabetic retinopathy patients
    (2018) AZEVEDO, Breno; ARAUJO, Rafael Barbosa de; CIONGOLI, Marina; CUNHA, Leonardo Provetti; PRETI, Rony Carlos; HATANAKA, Marcelo; ZACHARIAS, Leandro C.; MONTEIRO, Mario L. R.
  • article 5 Citação(ões) na Scopus
    Small-Gauge Endoscopy-Guided Pneumatic Anterior Hyaloid Detachment: A New Surgical Technique for Combined Pars Plana Vitrectomy and Pars Plana Glaucoma Drainage Implant
    (2018) DIRANI, Ali; CIONGOLI, Marina Ravagnani; LESK, Mark R.; REZENDE, Flavio
    BACKGROUND AND OBJECTIVE: Pars plana glaucoma drainage Implant (GDI) occlusion is mainly related to entrapment of residual anterior vitreous gel in the implant. The aim ofthe present report is to describe a new surgical technique to induce pneumatic anterior hyaloid detachment In eyes with GDI. PATIENTS AND METHODS: This is a description of the surgical technique used to induce pneumatic anterior hyaloid detachment. RESULTS: The technique was used In two cases. The first patient had secondary Ahmed valve (New World Medical, Rancho Cucamonga, CA) obstruction secondary to anterior vitreous entrapment; the second patient had neovascular glaucoma secondary to proliferative diabetic retinopathy and underwent pars plana GDI implantation. CONCLUSION: Endoscopy-assisted anterior hyaloid detachment allows for complete removal of anterior hyaloid and decreases the risk of secondary implant obstruction.
  • article 5 Citação(ões) na Scopus
    Hemorrhagic complications associated with suprachoroidal buckling
    (2020) ANTAKI, F.; DIRANI, A.; CIONGOLI, M.R.; STEEL, D.H.W.; REZENDE, F.
    Background: Multiple surgical techniques exist for the repair of rhegmatogenous retinal detachments (RRD). Suprachoroidal buckling (SCB), consisting of injecting viscoelastic material in the suprachoroidal space to allow chorioretinal apposition, has been recently described in the repair of RRD. The aim of this study is to report the complications of SCB and to propose measures to decrease their incidence during the learning curve. Methods: A total of 26 eyes of 26 patients who underwent a SCB procedure for the management of RRD secondary to a single or multiple retinal breaks were enrolled. Patients were operated between January 2014 and March 2017 at two academic institutions. Patient and retinal detachment characteristics were obtained from the charts. Surgical videos were reviewed for every case and intraoperative complications were recorded. Complications observed postoperatively were obtained from the charts. Results: Sixteen eyes (62%) underwent SCB alone, 5 eyes (19%) underwent additional gas tamponade and 5 eyes (19%) had combined pars plana vitrectomy. The most common complication was hemorrhage (6 cases, 23%). There were no cases of ischemic choroidal changes or hyperpigmentation at the edge of the dome. All six complications occurred in phakic patients who had inferior RRD with retinal breaks in the inferior quadrants. Isolated subretinal hemorrhage occurred in 4 patients and isolated suprachoroidal hemorrhage in 1 patient, and those did not affect final visual outcome. Extensive combined subretinal and suprachoroidal hemorrhage occurred in one case, and was complicated by phthisis bulbi. Re-detachment occurred in 4/6 (67%) of patients, and 5/6 (83%) of patients required a secondary procedure. Three out of 6 patients (50%) had at least 2 lines of visual acuity improvement. Conclusion: SCB performed for RRD can be associated with hemorrhagic complications. The hemorrhages are usually self-limited but may occasionally result in severe visual compromise when involving the suprachoroidal space. Specific surgical measures need to be undertaken in order to decrease the likelihood of complications and further studies are needed to assess the safety and efficacy of this technique. © 2020 The Author(s).
  • article 0 Citação(ões) na Scopus
    Effect of panretinal photocoagulation on the peripapillary retinal nerve fiber layer in diabetic retinopathy patients
    (2019) ZACHARIAS, Leandro Cabral; AZEVEDO, Breno M. S.; ARAUJO, Rafael B. de; CIONGOLI, Marina R.; HATANAKA, Marcelo; PRETI, Rony C.; MONTEIRO, Mario Luiz Ribeiro
    OBJECTIVES: To determine the effect of panretinal photocoagulation (PRP) on the peripapillary retinal nerve fiber layer (RNFL) in nonglaucomatous patients with proliferative diabetic retinopathy (PDR). METHODS: This is a prospective, single center, observational study. Thirty-eight eyes of 26 diabetic patients underwent PRP for proliferative diabetic retinopathy. Peripapillary RNFL thickness was measured using scanning laser polarimetry (SLP) with variable corneal compensation (GDx VCC; by Carl Zeiss Meditec, Dublin, CA) and spectral-domain optical coherence tomography (OCT) (Heidelberg Spectralis, Carlsbad, USA) at baseline and 12 months after PRP was performed. RESULTS: Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 years (range 26 to 74 years) were recruited. No significant difference was found among all RNFL thickness parameters tested by GDx VCC software (p=0.952, 0.464 and 0.541 for temporal-superior-nasal-inferior-temporal (TSNIT) average, superior average, inferior average, respectively). The nerve fiber indicator (NFI) had a nonsignificant increase (p=0.354). The OCT results showed that the average RNFL thickness (360 degrees measurement) decreased nonsignificantly from 97.2 mm to 96.0 mm at 1 year post-PRP (p=0.469). There was no significant difference when separately analyzing all the peripapillary sectors (nasal superior, temporal superior, temporal, temporal inferior, nasal inferior and nasal thickness). CONCLUSION: Our results suggest that PRP, as performed in our study, does not cause significant changes in peripapillary RNFL in diabetic PDR patients after one year of follow-up.
  • article 0 Citação(ões) na Scopus
    Inverted internal limiting membrane flap for the management of optic disc pit maculopathy
    (2020) ZACHARIAS, Leandro Cabral; NASCIMENTO, Micael Valtoni Dantas do; GHOSN, Nagilton Bou; CIONGOLI, Marina Ravagnani; PRETI, Rony Carlos; MONTEIRO, Mario Luiz Ribeiro
    Optic disc pit is a rare congenital anomaly that can cause serous macular detachment. It has no universally accepted single treatment. Recently, several investigators have performed new procedures to directly seal the pit. Herein, we report a case showing a promising method for optic pit maculopathy surgical treatment. We created an inverted internal limiting membrane flap and fold it over the pit to promote barrier in order to stop further fluid accumulation. Gradual absorption of subretinal fluid was observed over 12 months of follow-up. Optical coherence tomography can demonstrate internal limiting membrane folded over the pit and progressive subretinal fluid resolution. This technique resulted in a satisfactory anatomic outcome with good functional improvement in the best-corrected visual acuity.
  • article 1 Citação(ões) na Scopus
    Socket Reconstruction With Bleomycin, Gentamicin, and Gelatin Sponges Following Eyelid-Sparing Orbital Exenteration for a Colobomatous Macrocyst in an Infant
    (2018) MICHELSON, Sarah J.; CIONGOLI, Marina R.; ELNER, Victor M.; KAHANA, Alon
    Microphthalmia is defined by a globe axial length greater than or equal to 2 standard deviations below the age-adjusted mean and can occur as part of a broader syndrome. The presence of a colobomatous cyst with microphthalmia signifies failure of the embryonic neuroectodermal fissure to close appropriately during development of the globe, creating a protuberant globular appendage that inhibits normal growth and development of the eye itself. Cystic reaccumulation of fluid is common after aspiration or surgical removal. Here, the authors describe a case of a young boy with a colobomatous cyst who underwent eyelid-sparing orbital exenteration followed by reconstruction with absorbable gelatin sponge (Gelfoam, Pfizer, Inc.) and the chemotherapeutic agent bleomycin to promote scarring, achieving the equivalent of a biointegrated implant and facilitating satisfactory placement of an ocular prosthesis. A 2-year follow-up MRI revealed adequate volume in the posterior orbit.
  • article 0 Citação(ões) na Scopus
    The effect of panretinal photocoagulation on confocal laser scanning ophthalmoscopy and stereo photographic parameters of optic disk topography in patients with diabetic retinopathy
    (2019) AZEVEDO, Breno Marques da Silva; ARAUJO, Rafael Barbosa de; CIONGOLI, Marina R.; HATANAKA, Marcelo; PRETI, Rony Carlos; MONTEIRO, Mario Luiz Ribeiro; ZACHARIAS, Leandro Cabral
    Purpose: To determine the effect of panretinal photocoagulation on optic disk topographic parameters in non-glaucomatous patients with proliferative diabetic retinopathy. Methods: This was a prospective, single-center, observational study. Thirty-eight eyes of 26 patients with diabetes underwent panretinal photocoagulation for proliferative diabetic retinopathy. Stereoscopic disk photographs and optic nerve head parameters were evaluated using the Zeiss fundus camera and the confocal scanning laser ophthalmoscope (Heidelberg Retinal Tomograph), respectively, at baseline and 12 months after the completion of panretinal photocoagulation. Results: Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 (range 26-74) years were recruited. No significant difference was found between the stereo photography determined mean horizontal and vertical cup-to-disk ratio before and after panretinal photocoagulation treatment (p=0.461 and 0.839, respectively). The global values of the optic nerve head parameters analyzed with the HRT3 showed no significant change from baseline to 12 months, including the disk area, cup area, rim area, cup volume, rim volume, cup-to-disk area ratio, linear cup-to-disk ratio, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean retinal nerve fiber layer thickness, and cross-sectional area. Conclusion: Our results suggest that panretinal photocoagulation does not cause morphological optic disk changes in patients with diabetic proliferative retinopathy after 1 year of follow-up.