MARIO LUIZ RIBEIRO MONTEIRO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina - Líder
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article 5 Citação(ões) na Scopus Primary localized amyloidosis presenting as diffuse amorphous calcified mass in both orbits: case report(2011) GONCALVES, Allan Christian Pieroni; MORITZ, Rodrigo Bernal da Costa; MONTEIRO, Mario Luiz RibeiroPrimary localized amyloidosis is rare in the orbit. We report the case of a 63-year-old woman that presented with bilateral proptosis and ophthalmoplegia. A computed tomography scan revealed an infiltrative amorphous and markedly calcified mass in both orbits while a magnetic resonance scan showed a heterogeneous hypointense signal on T2-weighted images. A biopsy was performed through an anterior orbitotomy. Microscopy revealed extracellular amorphous and eosinophilic hyaline material which stained pink with Congo red and displayed green birefringence on polarized microscopy, leading to a diagnosis of amyloidosis. The results of the systemic workup were completely normal. A two-year follow-up period without any treatment disclosed no worsening of the condition. While calcification of nonvascular orbital lesions has often been regarded as suggestive of malignant disease, our case is a reminder that it can also be a characteristic presenting sign of orbital amyloidosis.- Relationship between automated choroidal thickness measurements and retinal sensitivity using microperimetry in patients with myopia and different stages of myopic maculopathy(2024) SILVA, Fillipe de Biaggi Borges da; SILVA, Luis Claudio Pimentel; CUNHA, Leonardo Provetti; ZACHARIAS, Leandro Cabral; NAVAJAS, Eduardo V.; MONTEIRO, Mario L. R.; PRETI, Rony C.Purpose To assess the relationship between macular choroidal thickness (CT) measurements and retinal sensitivity (RS) in eyes with myopia and different stages of myopic maculopathy. Methods A masked, cross-sectional, and consecutive study involving patients with emmetropia/myopia (control group) and high myopia (HM) eyes. Automated choroidal thickness (CT) and manual outer retinal layer (ORL) thickness were acquired using swept-source optical coherence tomography, while retinal sensitivity (RS) assessed by microperimetry (MP3) in all regions of the macular Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Comparisons were made between groups, and correlations were performed among these measurements, demographic and ocular parameters and myopic maculopathy classification. Results A total of 37 (74 eyes) patients were included in the study. The mean age was 39 +/- 13 years, and 28 patients (76%) were female. HM eyes exhibited inferior best-corrected visual acuity and a more advanced myopic maculopathy classification compared to the control group. The mean macular CT were 255 and 179 mu m in the control and HM eyes (P < 0.001), respectively. In the HM eyes, superior ETDRS region presented the greatest values. Mean RS in control and HM groups was 28 and 24 dB (P = 0.001), respectively. Inner temporal followed by superior, were the regions of higher RS. Mean ORL thickness was 83 and 79 mu m (P < 0.001), in the control and HM groups, respectively. The inner temporal ETDRS region presented the thickest measure. CT correlated significantly with RS (r = 0.41, P < 0.001) and ORL thickness, (r = 0.58, P < 0.001), which also correlated with RS (r = 0.40, P < 0.001). Spherical equivalent, axial length and myopic maculopathy stage were the parameters that most correlated with CT, RS and ORL thickness. For every 100 mu m increase in thickening of CT there was an average increase of 3.4 mu m in ORL thickness and 2.7 dB in RS. Myopic maculopathy classification demonstrated influence only with CT. Conclusion Myopia degree is related to ORL and choroidal thinning and deterioration of retinal sensitivity in some ETDRS regions of the macula. Choroidal thinning is associated to with a decline of retinal sensitivity, thinning of ORL, and worsening of myopic maculopathy classification, so new treatments are necessary to prevent myopia progression.
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 MarchesibookPart Doenças do Nervo Óptico(2016) MONTEIRO, Mário Luiz Ribeiro; CUNHA, Leonardo Provetti; KREUZ, André Carvalho; OYAMADA, Maria Kiyoko- Structural and Functional Assessment of Macula in Patients with High-Risk Proliferative Diabetic Retinopathy Submitted to Panretinal Photocoagulation and Associated Intravitreal Bevacizumab Injections: A Comparative, Randomised, Controlled Trial(2013) PRETI, Rony Carlos; RAMIREZ, Lisa Marie Vasquez; MONTEIRO, Mario Luiz Ribeiro; PELAYES, David E.; TAKAHASHI, Walter YukihikoPurpose: To compare the efficacy of therapy with panretinal photocoagulation (PRP) and intravitreal bevacizumab (IVB) injections versus PRP alone in patients with high-risk proliferative diabetic retinopathy (HR-PDR) with a 6-month follow-up. Methods: Forty-two patients with HR-PDR were prospectively studied in a randomised, masked, controlled trial. Both eyes of each patient were randomised either to the study group (SG) receiving PRP plus IVB injections or the control group (CG) receiving PRP alone. Mean change in visual acuity (VA), optical coherence tomography-measured fovea! thickness (FT) and macular volume (MV) were compared. Results: Intergroup comparisons showed no significant difference in VA while FT exhibited a significant (p < 0.05) difference at 1 month of follow-up and MV was significantly reduced at the 1- and 3-month follow-up. Compared to baseline, VA was significantly worse at all follow-ups in the CG and was stable in the SG. FT increased significantly in the CG from baseline to the 1- and 6-month follow-ups and in the SG, no significant difference was observed. MV was significantly increased in the CG during all follow-up periods. Conclusion: In HR-PDR, using IVB injections as adjuvant treatment to PRP reduces the VA deterioration and results in decreased FT and MV measurements compared to PRP alone.
- Recurrent and Reversible, Bitemporal Field Defect from Presumed Chiasmitis in a Patient with Systemic Lupus Erythematosus(2021) ALMEIDA, Glauco Batista; MORO, Nilson; MONTEIRO, Mario Luiz RibeiroSystemic lupus erythematosus (SLE) is a chronic, recurrent and remitting autoimmune disease affecting mostly women and presenting between late adolescence and the fourth decade of life. Ocular manifestations may occur in one-third of patients with SLE, with keratoconjunctivitis sicca as the most common and optic nerve and retina abnormalities as the most severe. Neuro-ophthalmological manifestations occur in approximately 1% of patients with SLE, usually in the form of optic neuropathy. The purpose of this paper is to describe a patient who developed recurrent optic chiasmitis as an uncommon sign of disease activity in SLE.
- Evaluation of Ocular Versions in Graves' Orbitopathy: Correlation between the Qualitative Clinical Method and the Quantitative Photographic Method(2020) LEITE, Cristiane de Almeida; PEREIRA, Thais de Sousa; CHIANG, Jeane; GONCALVES, Allan C. Pieroni; MONTEIRO, Mario L. R.Purpose. To assess the agreement between the qualitative clinical method and the quantitative photographic method of evaluating normal and abnormal ocular versions in patients with inactive Graves' orbitopathy (GO).Methods. Forty-two patients with inactive GO had their ocular versions evaluated clinically according to three categories: normal, moderate alterations (-1 or -2 hypofunction), and severe alterations (-3 or -4 hypofunction). The subjects were photographed in the 9 positions of gaze, and the extent (mm) of eye movement in each position was estimated using Photoshop(R)and ImageJ and converted into degrees with a well-established method. The agreement between the two methods (qualitative vs. quantitative) for classifying ocular versions as normal or abnormal was assessed.Results. The mean quantitative measurements of versions were significantly different for each clinical category (normal, moderate alterations, and severe alterations) in the following five positions: abduction, adduction, elevation in abduction, elevation, and elevation in adduction (p<0.001). No such pattern was observed for the three infraversion positions (depression in abduction,p=0.573; depression,p=0.468; depression in adduction,p=0.268).Conclusion. The agreement was strong between the quantitative photographic method and the qualitative clinical method of classifying ocular versions, especially in lateral and supraversions, which are typically affected in GO. Digital photography is recommended for the assessment of ocular versions due to its practicality, suitability for telemedicine applications, and ease of monitoring during follow-up. This trial is registered with.
- 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.
article 9 Citação(ões) na Scopus Pattern-reversal electroretinograms for the diagnosis and management of disorders of the anterior visual pathway(2011) HOKAZONO, Kenzo; OYAMADA, Maria Kiyoko; MONTEIRO, Mario Luiz RibeiroThe pattern electroretinogram is an electrophysiological test that assesses the function of inner retinal layers, particularly the ganglion cells layer of retina, using a reversing checkerboard or grating pattern that produces no change in average luminance over time. The normal pattern electroretinogram is composed of a proeminent positive component (P50) and a large later negative component (N95). Since structural damage that compromises the retinal ganglion cell layer can lead to pattern electroretinogram changes, particularly in the N95 amplitude, the test can be useful in the treatment of a number of anterior visual pathway diseases. In this article, we review the methods for recording pattern electroretinogram and its usefulness in the diagnosis and management of diseases including inflammatory, hereditary, ischemic and compressive lesions of the anterior visual pathway.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