EDUARDO CUNHA DE SOUZA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
- Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever(2014) SUZUKI, Ana Claudia De Franco; ARAUJO, Rafael Barbosa de; SOUZA, Eduardo Cunha de; MONTEIRO, Mario Luiz RibeiroHemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.
- Characterisation of macular neovascularisation subtypes in age-related macular degeneration to optimise treatment outcomes(2023) MATHIS, Thibaud; HOLZ, Frank G.; SIVAPRASAD, Sobha; YOON, Young Hee; ETER, Nicole; CHEN, Lee-Jen; KOH, Adrian; SOUZA, Eduardo Cunha de; STAURENGHI, GiovanniThe aim of this review is to identify the common characteristics and prognoses of different subtypes of neovascular age-related macular degeneration (nAMD). We also propose recommendations on how to tailor treatments to the subtype of neovessels to optimise patient outcomes. The authors, selected members of the Vision Academy, met to discuss treatment outcomes in nAMD according to macular neovascularisation (MNV) subtypes, using evidence from a literature search conducted on the PubMed database (cut-off date: March 2019). This review article summarises the recommendations of the Vision Academy on how the characterisation of MNV subtypes can optimise treatment outcomes in nAMD. The identification of MNV subtypes has been facilitated by the advent of multimodal imaging. Findings from fluorescein angiography, indocyanine green angiography and spectral-domain optical coherence tomography collectively help refine and standardise the determination of the MNV subtype. To date, three subtypes have been described in the literature and have specific characteristics, as identified by imaging. Type 1 MNV is associated with better long-term outcomes but usually requires more intense anti-vascular endothelial growth factor dosing. Type 2 MNV typically responds quickly to treatment but is more prone to the development of fibrotic scars, which may be associated with poorer outcomes. Type 3 MNV tends to be highly sensitive to anti-vascular endothelial growth factor treatment but may be associated with a higher incidence of outer retinal atrophy, compared with other subtypes. Accurately assessing the MNV subtype provides information on prognosis and helps to optimise the management of patients with nAMD.
- AN ASYMPTOMATIC CHILD WITH A JUXTAPAPILLARY LESION: DIAGNOSTIC CONUNDRUM(2021) MOREIRA-NETO, C. A.; MOREIRA, C. A. Jr.; NOBREGA, M. J.; LIMA, L. H.; BALARATNASINGAM, C.; PULIDO, J. S.; SOUZA, E. C.
- Congenital Retinal Macrovessel and the Association of Retinal Venous Malformations With Venous Malformations of the Brain(2018) PICHI, Francesco; FREUND, K. Bailey; CIARDELLA, Antonio; MORARA, Mariachiara; ABBOUD, Emad B.; GHAZI, Nicola; DACKIW, Christine; CHOUDHRY, Netan; SOUZA, Eduardo Cunha; CUNHA, Leonardo Provetti; AREVALO, J. Fernando; LIU, T. Y. Alvin; WENICK, Adam; HE, Lingmin; VILLARREAL JR., Guadalupe; NERI, Piergiorgio; SARRAF, DavidIMPORTANCE Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. OBJECTIVE To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associations. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional multicenter study, medical records were retrospectively reviewed from 7 different retina clinics worldwide over a 10-year period (2007-2017). Patients with CRM, defined as an abnormal, large, macular vessel with a vascular distribution above and below the horizontal raphe, were identified. Data were analyzed from December 2016 to August 2017. MAIN OUTCOMES AND MEASURES Clinical information and multimodal retinal imaging findings were collected and studied. Pertinent systemic information, including brain magnetic resonance imaging findings, was also noted if available. RESULTS Of the 49 included patients, 32 (65%) were female, and the mean (SD) age at onset was 44.0 (20.9) years. A total of 49 eyes from 49 patients were studied. Macrovessel was unilateral in all patients. Color fundus photography illustrated a large aberrant dilated and tortuous retinal vein in all patients. Early-phase frames of fluorescein angiography further confirmed the venous nature of the macrovessel in 40 of 40 eyes. Optical coherence tomography angiography, available in 17 eyes (35%), displayed microvascular capillary abnormalities around the CRM, which were more evident in the deep capillary plexus. Of the 49 patients with CRM, 39 (80%) did not illustrate any evidence of ophthalmic complications. Ten patients (20%) presented with retinal complications, typically an incidental association with CRM. Twelve patients (24%) were noted to have venous malformations of the brain with associated magnetic resonance imaging. Of these, location of the venous anomaly in the brain was ipsilateral to the CRM in 10 patients (83%) and contralateral in 2 patients (17%), mainly located in the frontal lobe in 9 patients (75%). CONCLUSIONS AND RELEVANCE Our study has identified an association between macrovessels in the retina and venous anomalies of the brain (24% compared with 0.2% to 6.0% in the normal population). Thus, we recommend new guidelines for the systemic workup of patients with CRM to include brain magnetic resonance imaging with contrast. These lesions may be more accurately referred to as retinal venous malformations, which may raise awareness regarding potential cerebral associations.
- Diagnostic and Therapeutic Challenges(2017) SOUZA, Eduardo Cunha; DOLZ-MARCO, Rosa; SUZUKI, Ana Claudia de Franco; MORITA, Celso; SARRAF, David; FREUND, K. Bailey; COHEN, Salomon Y.
- RETINAL HEMORRHAGES IN A PATIENT WITH ACUTE ATAXIA(2021) PEREIRA, F. B.; OLIVEIRA, H. Soares Dutra; LIMA, V. C.; LIMA, L. H.; BALARATNASINGAM, C.; PULIDO, J. S.; SOUZA, E. Cunha de
- A Brazilian case of exudative perifoveal vascular anomalous complex responsive to aflibercept intravitreal injections(2024) SOUZA, Eduardo Cunha de; TOMBOLINI, Beatrice; SACCONI, Riccardo; BANDELLO, Francesco; QUERQUES, GiuseppePurpose To report a case of exudative perifoveal exudative vascular anomalous complex (ePVAC) in a Brazilian healthy patient that underwent a complete resolution after aflibercept intravitreal injections.Case description A 41-year-old healthy Brazilian man complained of acute central vision loss in his right eye (RE). Fundus examination showed a perifoveal hemorrhagic aneurysmal lesion, accompanied by several hard exudates in RE. On fluorescein angiography, these abnormalities showed a progressive hyperfluorescence with surrounding leakage. Optical coherence tomography (OCT) revealed a deep, perifoveal hyporeflective cystic space with a hyperreflective wall and hyperreflective material inside of fibrin-like aspect. Around this aneurism, intraretinal hyporeflective spaces suggestive of exudation were detected. Nor pathological flow signal, or telangiectatic dilations were evidenced on OCT-angiography. Therefore, a diagnosis of exudative ePVAC in RE was hypothesized. After an initial observation, the patient underwent three monthly aflibercept intravitreal injections (0.05 ml/2 mg), with a significative anatomical and functional improvement after two weeks from first dose. On last follow-up at five months from baseline, patient experienced no evidence of new exudation and a stable visual acuity.Discussion Placental growth factor (PlGF) may impact on pericytes' dropout, and thus on ePVAC development. In contrast to the other anti-VEGF drugs, aflibercept is the only molecule contrasting PlGF. Therefore, aflibercept would act on ePVAC not as an anti-VEGF drug, but rather as an anti-PlGF one.Conclusion This report encouraged the use of aflibercept as a therapeutic option for ePVAC. Further studies are required to confirm our result and the impact of PlGF on ePVAC pathogenesis.
- BACILLARY LAYER DETACHMENT: MULTIMODAL IMAGING AND HISTOLOGIC EVIDENCE OF A NOVEL OPTICAL COHERENCE TOMOGRAPHY TERMINOLOGY Literature Review and Proposed Theory(2021) RAMTOHUL, Prithvi; ENGELBERT, Michael; MALCLES, Ariane; GIGON, Edward; MISEROCCHI, Elisabetta; MODORATI, Giulio; SOUZA, Eduardo Cunha De; BESIRLI, Cagri G.; CURCIO, Christine A.; FREUND, K. BaileyPurpose: To clarify the histologic basis of bacillary layer detachment (BALAD) through a review of the current literature and an analysis of retinal imaging. Methods: The literature for previous reports of BALAD were reviewed. An analysis of retinal images was performed to support anatomical conclusions. Results: A total of 164 unique patients with BALAD on optical coherence tomography (OCT) were identified from the published literature. Twenty-two underlying etiologies, all associated with subretinal exudation, were identified. Forty-one different OCT terminologies were found. The defining OCT feature of BALAD was a split at the level of the photoreceptor inner segment myoid creating a distinctive intraretinal cavity. Resolution of BALAD was followed by a rapid restoration of the ellipsoid zone. Histology of age-related macular degeneration eyes suggests that individual photoreceptors can shed inner segments. Furthermore, detachment of the entire layer of inner segments is a common postmortem artifact. It is proposed that BALAD occurs when outwardly directed forces promoting attachment of photoreceptor outer segments to the retinal pigment epithelium exceed the tensile strength of the photoreceptor inner segment myoid. Conclusion: This review serves to strengthen the OCT nomenclature ""bacillary layer detachment,"" based on specific reflectance information obtained by OCT and previously published histologic observations.
article 11 Citação(ões) na Scopus PERIPAPILLARY SEROUS DETACHMENT IN MULTIPLE EVANESCENT WHITE DOT SYNDROME(2015) CHAO, Daniel L.; MARSIGLIA, Marcela; AHMAD, Baseer; SRIDHAR, Jayanth; SHAH, Gaurav K.; SOUZA, Eduardo Cunha De; YANNUZZI, Lawrence A.; ALBINI, Thomas A.Background: To report the presence of transient peripapillary serous detachments in multiple evanescent white dot syndrome. Methods: Retrospective case series. Results: Four eyes of four patients diagnosed with multiple evanescent white dot syndrome presented with peripapillary serous detachments. Diagnosis was based on clinical presentation, fundus findings, and angiographic findings. All 4 were female with age ranges between 24 and 40 years and presented with photopsias, an enlarged scotoma contiguous with the blind spot, and chorioretinal white dots in the posterior pole with characteristic angiographic features. All of the serous detachments resolved or were greatly reduced concomitantly with the resolution of the patient's other clinical symptoms and fundus findings. Conclusion: The authors report peripapillary serous detachments as a previously unreported manifestation of multiple evanescent white dot syndrome. These seem to be self limited with concurrent resolution with the rest of the patient's symptoms.conferenceObject The Association of Venous Malformations of Retina and Brain(2018) CORRADETTI, Giulia; PICHI, Francesco; FREUND, K. Bailey; CIARDELLA, Antonio; ABBOUD, Emad; GHAZI, Nicola; DACKIW, Christine; CHOUDHRY, Netan; CUNHA-SOUZA, Eduardo; CUNHA, Leonardo Provetti; AREVALO, J. Fernando; LIU, Tin Yan Alvin; WENICK, Adam; VILLARREAL JR., Guadalupe; HE, Lingmin; SARRAF, David
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