ALLAN CHRISTIAN PIERONI GONCALVES

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina

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Autor: GONCALVES, Allan Christian Pieroni ×

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Agora exibindo 1 - 8 de 8
  • 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 Ribeiro
    Primary 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.
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  • article 3 Citação(ões) na Scopus
    Bilateral periorbital necrotizing fasciitis: case report
    (2018) LEONARDO, Fabio Henrique Luiz; ANABUKI, Mariana; GONCALVES, Allan Christian Pieroni
    Necrotizing fasciitis is a severe infection of the subcutaneous tissue characterized by necrosis of the superficial fascia and overlying skin and is usually associated with previous trauma and comorbidities. Periorbital necrotizing fasciitis is rare and commonly causes visual loss and soft tissue defects. A better prognosis relies critically on early diagnosis, prompt medical treatment, and timely surgical intervention. We describe a rare case of periorbital necrotizing fasciitis in the absence of an inciting event. A 55-year-old female patient presented with acute painful swelling and redness of the right upper eyelid that spread to both eyelids bilaterally within 24 h. We swiftly started the patient on intravenous antibiotic therapy, and we surgically debrided the necrotic tissue the following day. We performed two further procedures to improve eyelid closure and appearance. Despite the severe presentation, timely antibiotic therapy and proper surgical interventions led to a successful outcome in this case.
  • article 6 Citação(ões) na Scopus
    Y Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study
    (2021) LEITE, Cristiane de Almeida; PEREIRA, Thais de Sousa; CHIANG, Jeane; MORITZ, Rodrigo Bernal; GONCALVES, Allan Christian Pieroni; MONTEIRO, Mario Luiz Ribeiro
    OBJECTIVES: To compare the surgical outcomes of inferomedial wall orbital decompression (IM-OD) and balanced medial plus lateral wall orbital decompression (ML-OD) in patients with inactive Graves' orbitopathy (GO) with regard to exophthalmos reduction and ocular motility abnormalities. METHODS: Forty-two patients with inactive GO eligible for OD were randomly assigned to either the IM-OD or ML-OD groups. Pre and postoperative evaluations included Hertel exophthalmometry, sensory, and motor extraocular motility assessment, standardized photographs in the nine gaze positions, and computed tomography (CT) of the orbits. ClinicalTrials.gov: NCT03278964. RESULTS: Exophthalmometry reduction was statistically significant in both groups (p<0.001), but was greater in the ML-OD group (p=0.010). New-onset esotropia occurred in 11.1% and 23.5% of patients who underwent IM-OD and ML-OD, respectively, with no statistically significant difference in the frequency of pre and postoperative strabismus in either group. The mean increase in preoperative esotropia was 24 +/- 6.9 and 12 +/- 8.8 prism diopters in patients who underwent IM-OD and ML-OD, respectively. In the IM-OD group, abduction and elevation worsened at the first (p<0.05) and third (p<0.05) postoperative visits but were restored at 6 months. The versions did not change postoperatively with ML-OD. The preoperative CT-measured medial rectus muscle area predicted new-onset strabismus (p=0.023). Significant postoperative medial rectus muscle enlargement occurred in both groups (p<0.001). Restriction in elevation and abduction was significantly associated with enlarged inferior (p=0.007) and medial rectus muscle areas (p=0.002). CONCLUSIONS: IM-OD is as safe as ML-OD with regard to new-onset strabismus, and represents a good alternative for patients who do not require significant exophthalmos reduction. ML-OD offers greater exophthalmos reduction and smoother postoperative recovery. Patients with preoperative enlarged medial rectus muscle on CT are at risk for new-onset esotropia, and preoperative esotropia is likely to increase after OD.
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    A RANDOMIZED COMPARATIVE STUDY OF SURGICAL CORRECTION OF GRAVES UPPER EYELID RETRACTION THROUGH CONJUNCTIVAL OR BLEPHAROTOMY APPROACH
    (2014) GONCALVES, Allan Christian Pieroni; NOGUEIRA, Thiago Machado; GONCALVES, Ana Carolina A.; SILVA, Luzia D.; MONTEIRO, Mario L. R.
  • article 11 Citação(ões) na Scopus
    Bilateral extraocular muscles enlargement from Kimura's disease of the orbit
    (2016) GONCALVES, Allan Christian Pieroni; MORITZ, Rodrigo B.; ALDRED, Vera L.; MONTEIRO, Mario Luiz Ribeiro
    Kimura's disease (KD) is a rare chronic inflammatory disease of unclear etiology, characterized by subcutaneous nodules, mainly in the head and neck region, frequently associated with regional lymphadenopathy. Orbital involvement is infrequent and when it occurs, usually affects the eyelid or the lacrimal gland. We report a case of a 44-year-old man that presented with bilateral slowly progressive proptosis that was initially misdiagnosed as Graves' Ophthalmopathy. 15 months of worsening proptosis and the development of facial and temporal swelling led to further investigation. Computed tomography and magnetic resonance imaging showed enlargement of all recti muscles and diffuse orbital infiltration. An orbital biopsy was performed and was consistent with the diagnosis of KD. Long term oral corticosteroid showed marked improvement of proptosis and facial swelling. This case serves to emphasize that KD should be included in the differential diagnosis of inflammatory diseases of the orbit, even when characterized by predominant involvement of the extraocular muscles.
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    Comparison Between Pre- and Postoperative Quantitative Analysis of Graves Upper Eyelid Retraction Using Margin Reflex Distance and a Digital Eyelid Image Processing Method
    (2014) NOGUEIRA, Thiago Machado; GONCALVES, Allan Christian Pieroni; GONCALVES, Ana Carolina A.; SILVA, Luzia D.; MONTEIRO, Mario L. R.
  • article 2 Citação(ões) na Scopus
    Chronic unilateral tearing as a sign of lacrimal sac squamous cell carcinoma
    (2021) MATOS, Aline Mota Freitas; BREGA, Danielle Ribeiro; CUNHA, Leonardo Provetti; GOLLNER, Angela Maria; GONCALVES, Allan Christian Pieroni
    Tearing is a very common symptom in ophthalmic practice; however, this issue is commonly overlooked. The authors describe the case of a patient with chronic unilateral epiphora that had been neglected for 8 y; lacrimal system workup was performed for this patient only because of dacryocystitis evolvement. Following the diagnosis of nasolacrimal duct blockage, dacryocystorhinostomy was indicated. Intraoperative abnormal mucosa was subjected to biopsy, and a diagnosis of squamous cell carcinoma in the lacrimal sac was established. Extended tumor excision was performed for the patient and adjuvant radiotherapy was administered, without any recurrence till the 2-year follow-up. The present report highlights the relevance of a detailed evaluation for determining the underlying causes of tearing, especially in chronic unilateral presentation. The consideration of potential malignancy in such cases could prevent delayed diagnosis of uncommon but potentially life-threatening malignancies of the lacrimal drainage system.