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Abstract

RESUMOObjetivo:Relatar e comparar as abordagens cirúrgicas e os resultados visuais e anatômicos no tratamento de lentes intraoculares (IOL) deslocadas.Métodos:Foram avaliados os registros médicos de 28 olhos de 28 pacientes. Idade, sexo, melhor acuidade visual corrigida pré e pós-operatória, abordagens cirúrgicas e complicações foram registrados.Resultados:Melhor acuidade visual corrigida pré e pós-operatória variou de conta dedos a 20/32 e de conta dedos a 20/25, respectivamente. Os deslocamentos tardios foram os mais frequentemente encontrados. A cirurgia mais frequente foi o reposicionamento da IOL em 15 dos 28 pacientes, em seguida, o troca da IOL em 11 pacientes, e a remoção da IOL em dois pacientes. Apenas um caso de necessitou de reintervenção devido à captura da IOL.Conclusões:A acuidade visual melhorou em ambas as abordagens, reposicionamento e troca de IOL. Não houve superioridade de um método sobre o outro. Na presente série de casos retrospectiva, o tratamento do deslocamento de IOL com reposição ou troca do implante primário gerou resultados cirúrgicos e visuais comparáveis.

Keywords: Implante de lente intraocular/métodos; Lentes intraoculares; Acuidade visual/fisiologia

Abstract

PURPOSE: To investigate choroidal structural and vascular changes in patients with mild autonomous cortisol secretion using enhanced depth imaging optical coherence tomography and optical coherence tomography angiography.
METHODS: This cross-sectional study included 60 eyes of 30 patients with mild autonomous cortisol secretion and 60 eyes of 30 subjects with nonfunctional adenoma (controls) between February 2023 and January 2024. Subfoveal choroidal thickness, pachychoroid spectrum disease and choroidal vascularity index were evaluated using spectral-domain optical coherence tomography. Group comparisons were performed, and correlations between subfoveal choroidal thickness and clinical features were analyzed.
RESULTS: Pachyvessels were more common in patients with mild autonomous cortisol secretion than in controls (71.4% vs. 42.9%, p=0.002). The frequency of pachychoroidal spectrum disease was significantly higher in the mild autonomous cortisol secretion Group (68.3% vs. 31.7%; p<0.001). Median subfoveal choroidal thickness was 355 μm (range, 150–535) in the mild autonomous cortisol secretion Group and 297 μm (range, 162–597) in controls (p=0.014). Choroidal vascularity index was comparable between groups (p=0.072). Subfoveal choroidal thickness correlated significantly with axial length, spherical equivalent, post-1-mg dexamethasone suppression test cortisol level, and disease duration.
CONCLUSION: Patients with mild autonomous cortisol secretion exhibited greater subfoveal choroidal thickness and a higher frequency of pachychoroidal spectrum disease compared with controls, whereas stromal and vascular structural alterations were proportionally similar between groups.

Keywords: Adrenal gland neoplasms; Central serous chorioretinopathy; Choroid; Cushing syndrome; Hydrocortisone; Optical coherence tomography