CARLOS EDUARDO HIRATA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
46 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 46
conferenceObject Comparative analysis of different treatment schedules in the course of Vogt-Koyanagi-Harada disease (VKHD)(2019) YAMAMOTO, Joyce H.; LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; RODRIGUEZ, Ever Ernesto Caso; KANENOBU, Cintia; ABDALLAH, Smairah Frutuoso; MORITA, Celso; OYAMADA, Maria Kiyoko; HIRATA, Carlos EduardoconferenceObject Vogt-Koyanagi-Harada disease (VKHD) after systemic treatment discontinuation(2021) SOUTO, Fernanda Maria Silveira; MISSAKA, Ruy Felippe Brito Goncalves; LAVEZZO, Marcelo Mendes; NOBREGA, Priscilla Figueiredo Campos; SAKATA, Viviane Mayumi; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.conferenceObject Subclinical signs persistence in Vogt-Koyanagi-Harada disease (VKHD) patients treated with early high-dose corticosteroids and immunosuppressive therapy(2018) TAKIUTI, J. H. Yamamoto; LAVEZZO, M. M.; SAKATA, V. M.; KANENOBU, C.; MORITA, C.; OYAMADA, M. K.; HIRATA, C. E.conferenceObject Association between visual function and quality of life in patients with Vogt-Koyanagi-Harada disease(2018) TAKIUTI, J. H. Yamamoto; MISSAKA, R. F.; SOUTO, F. M.; MARCHIORI, B. M.; CAETANO, V. M.; TAKIUTI, J. T.; LAVEZZO, M. M.; OYAMADA, M. K.; HIRATA, C. E.conferenceObject Retinal vasculitis (RV) in pediatric population: case series(2020) GIAMPIETRO, Barbara; SOUTO, Fernanda Maria Silveira; TAKIUTI, Julia Tieme; CAMPOS, Lucia Maria Arruda; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.- Vogt-Koyanagi-Harada disease: review of a rare autoimmune disease targeting antigens of melanocytes(2016) LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; MORITA, Celso; RODRIGUEZ, Ever Ernesto Caso; ABDALLAH, Smairah Frutuoso; SILVA, Felipe T. G. da; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce HisaeVogt-Koyanagi-Harada disease (VKHD) is a rare granulomatous inflammatory disease that affects pigmented structures, such as eye, inner ear, meninges, skin and hair. This disease is mainly a Th1 lymphocyte mediated aggression to melanocytes after a viral trigger in the presence of HLA-DRB1*0405 allele. The absence of ocular trauma or previous intraocular surgery sets VKHD appart from sympathetic ophthalmia, its main differential diagnosis. The disease has an acute onset of bilateral blurred vision with hyperemia preceded by flu-like symptoms. The acute uveitic stage is characterized by a diffuse choroiditis with serous retinal detachment and optic disc hyperemia and edema. Fluorescein angiography in this phase demonstrates multiple early hyperfluorescent points. After the acute uveitic stage, ocular and integumentary system pigmentary changes may appear. Ocular findings may be accompanied by lymphocytic meningitis, hearing impairment and/or tinnitus in a variable proportion of patients. Prompt diagnosis followed by early, aggressive and long-term treatment with high-dose corticosteroids is most often ensued by good visual outcomes. However, some patients may experience chronic uveal inflammation with functional eye deterioration. The current review discusses the general features of VKHD, including epidemiology, classification into categories, differential diagnosis and current therapeutic approaches.
- Indocyanine green angiography findings in patients with long-standing Vogt-Koyanagi-Harada disease: a cross-sectional study(2012) SILVA, Felipe T. da; HIRATA, Carlos E.; SAKATA, Viviane M.; OLIVALVES, Edilberto; PRETI, Rony; PIMENTEL, Sergio L. G.; GOMES, Andre; TAKAHASHI, Walter Y.; COSTA, Rogerio A.; YAMAMOTO, Joyce H.Background: To investigate indocyanine green angiography (ICGA) findings in patients with long-standing Vogt-Koyanagi-Harada (VKH) disease and their correlation with disease activity on clinical examination as well as with systemic corticosteroid therapy. Methods: Twenty-eight patients (51 eyes) with long-standing (>= 6 months from disease onset) VKH disease whose treatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All patients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography and ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working Group. Fisher exact test and logistic regression models were used for statistical analysis. Results: Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes). Angiographic findings suggestive of (choroidal and/or retinal) disease activity were not observed on FA. Clinically active disease based on clinical evaluation was observed in 41.2% (21 of 51 eyes). In these 21 eyes, disease-related choroidal inflammation on ICGA was observed in 76.2% (16 of 21 eyes); in the remaining eyes (without clinical active disease) disease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes). In respect to systemic corticosteroid therapy, 10 patients (18 of 51 eyes) were under treatment with prednisone. In these 10 (18 of 51 eyes) patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes); in the remaining patients (33 of 51 eyes) disease-related choroidal inflammation on ICGA was observed in 66.7% (22 of 33 eyes). Conclusion: ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable proportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on clinical examination or current use of systemic corticosteroid. Therefore, the current study reinforces the crucial role of ICGA to assist the management and treatment of patients with long-standing VKH disease.
conferenceObject Correlation between visual function and clinical/subclinical disease activity parameters in Vogt-Koyanagi-Harada disease (VKHD).(2017) LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; RODRIGUEZ, Ever Ernesto Caso; ABDALLAH, Smairah Frutuoso; MORITA, Celso; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.- Outcomes of Intravitreal Bevacizumab in Choroidal Neovascularization in Vogt-Koyanagi-Harada Disease-A Prospective Study(2021) SAKATA, Viviane M.; MORITA, Celso; LAVEZZO, Marcelo M.; RODRIGUEZ, Ever E. C.; ABDALLAH, Smairah F.; PIMENTEL, Sergio L. G.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.Purpose: To assess the effectiveness of intravitreal (IV) bevacizumab and the need for systemic immunosuppressive therapy (IMT) in choroidal neovascularization (CNV) in Vogt-Koyanagi-Harada disease (VKHD). Methods: CNV treatment consisted of three monthly IV bevacizumab injections as a loading dose; if intra/subretinal fluid (IRF) persisted, further injections were proceeded besides increment in systemic IMT. Outcome analyses at 3, 6, and 12 months were visual acuity, central foveal thickness, macular volume, IRF, and addition of IMT. Results: Seven eyes of six patients were included. Five patients (five eyes) completed a 12-month follow-up and received 12 IV bevacizumab injections. At the 12-month follow-up, visual acuity improved in four out of five eyes (p = .0568); all eyes had decreased macular volume (p = .0431) but they still had persistent IRF; and all cases needed IMT introduction/increment. Conclusion: Intravitreal bevacizumab in association with systemic IMT was effective for CNV in VKHD. Active CNV may indicate disease of inadequate clinical control.
conferenceObject Changes in quality of life (QoL) in a 24-month interval in patients with non-acute Vogt-Koyanagi-Harada disease (VKHD)(2022) SOUTO, Fernanda Maria Silveira; MISSAKA, Ruy Felippe; LAVEZZO, Marcelo Mendes; NOBREGA, Priscilla Figueiredo; SAKATA, Viviane Mayumi; MAGALHAES, Breno Marchiori; CAETANO, Victor Marcos Couto; TAKIUTI, Julia Thiemi; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.