BRUNO FORTALEZA DE AQUINO FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject ASSESSMENT OF PARAFOVEAL RETINAL VASCULATURE IN BEHCET'S SYNDROME USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY(2021) FERREIRA, Bruno Fortaleza de Aquino; HIGASHI, Alex Haruo; PRADO, Leandro Lara do; GONCALVES, Celio Roberto; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce Hisae- Frosted branch angiitis and cerebral venous sinus thrombosis as an initial onset of neuro-Behçet’s disease: a case report and review of the literature(2017) FERREIRA, B. F. D. A.; RODRIGUEZ, E. E. C.; PRADO, L. L. D.; GONCALVES, C. R.; HIRATA, C. E.; YAMAMOTO, J. H.Background: Frosted branch angiitis is a rare, severe condition. It can be either a primary or a secondary condition and is characterized by rapid deterioration of vision and fulminant retinal vasculitis that manifests as diffuse sheathing of retinal vessels, macular edema, papillitis, vitritis and anterior uveitis. We aimed to describe a case of frosted branch angiitis and cerebral venous sinus thrombosis as an initial neuro-Behçet’s disease onset. Diagnosis of Behçet’s disease was based on the current 2014 International Criteria for Behçet’s Disease and the International consensus recommendation criteria for neuro-Behçet’s disease. In addition, a literature review using search parameters of “frosted branch angiitis”, “Behçet” and “neuro-Behçet” in the PubMed database is presented. Case presentation: A 28-year-old Brazilian pardo woman presented to our hospital with abrupt bilateral vision loss associated with recurrent aphthous oral ulcers 6 months before visual symptom onset. A fundus examination showed bilateral widespread retinal vasculitis with venous and arterial white sheathing, optic disc swelling, macular edema, and retinal hemorrhages, leading to the diagnosis of frosted branch angiitis. An extensive systemic workup for retinal vasculitis was uneventful, except for brain magnetic resonance imaging demonstrating cerebral venous sinus thrombosis and lymphocytic aseptic meningitis. A diagnosis of neuro-Behçet’s disease was made, and treatment was started with methylprednisolone therapy 1 g/day for 5 consecutive days, followed by oral mycophenolate mofetil and infliximab 5 mg/kg infusion. The patient’s response was rapid, with improvement of visual acuity to hand movement and counting fingers by day 7 and final visual acuity of counting fingers and 20/130. Conclusions: Frosted branch angiitis may be associated with infectious, noninfectious, or idiopathic causes. An extensive workup should be done to exclude systemic vasculitis such as Behçet’s disease. Treatment with systemic steroids must be promptly initiated in association with specific treatment aimed at inflammation control and blindness risk reduction. © 2017 The Author(s).
- OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHÇET'S UVEITIS(2023) FERREIRA, Bruno F. A.; HIGASHI, Alex H.; PRADO, Leandro L.; GONCALVES, Celio R.; HADDAD, Maria A. O.; ZACHARIAS, Leandro C.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.Purpose: To evaluate the parafoveal macular microvasculature and the macular function in patients with retinal vasculitis associated with Beh & ccedil;et's uveitis.Methods: In 14 patients with inactive Beh & ccedil;et's uveitis and 26 control individuals (13 with nonocular Beh & ccedil;et's syndrome and 13 healthy subjects), we analyzed the retinal nerve fiber layer, ganglion cell layer, full retinal thickness, foveal avascular zone area and sectorial parafoveal vascular density in the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus using SPECTRALIS optical coherence tomography (OCT) 2 and OCT angiography. Macular sensitivity was analyzed using an MP-3 microperimeter.Results: Eighteen eyes (78%) had a best-corrected visual acuity >= 20/25. Significant differences were found in Beh & ccedil;et's uveitis in comparison with the controls on the OCT and OCT angiography: 14.8%, 22.4%, and 14.9% ganglion cell layer thinning in the global, nasal, and inferior sectors, respectively; 6%, 13.2%, and 7.5% full retinal thickness thinning in the superior, nasal, and inferior sectors; and 16.8%, 14.9%, 23.6%, 15.8%, and 12.6% mean deep capillary plexus density reduction in the global, superior, nasal, inferior, and temporal sectors. Microperimetry data demonstrated significant mean reductions of 21% and 23.6% in central and average macular sensitivities and 28.8%, 40.4%, 27.7%, and 24.2% in the superior, nasal, inferior, and temporal sectors, respectively. Outer plexiform layer elevations were observed in Beh & ccedil;et's uveitis (69.6%).Conclusion: Beh & ccedil;et's uveitis presented structural and functional macular damage despite good best-corrected visual acuity, mainly affecting the nasal sector and the deep capillary plexus. On OCT and OCT angiography, quantitative and qualitative changes can be valuable biomarkers of ocular involvement in Beh & ccedil;et's syndrome.
conferenceObject PARAFOVEAL OCT-ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHCET'S RETINAL VASCULITIS(2022) FERREIRA, Bruno Fortaleza De Aquino; HIGASHI, Alex Haruo; PRADO, Leandro Lara Do; GONCALVES, Celio Roberto; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.