Camila Vieira Ventura

RESUMO Objetivo: Avaliar a resposta terapêutica do brolucizumabe em olhos de pacientes com degeneração macular neovascular crônica refratários a outros tratamentos antiangiogênicos. Métodos: Estudo prospectivo observacional que incluiu pacientes com degeneração macular neovascular crônica que não responderam a, pelo menos, três doses de ranibizumabe e/ou aflibercepte, sem episódios prévios de uveíte ou vasculite. Os participantes receberam entre uma e três injeções intravítreas de brolucizumabe. A acuidade visual foi avaliada antes e 4 semanas após cada injeção, bem como a distribuição [...] RESUMO Objetivo: Avaliar a resposta terapêutica do brolucizumabe em olhos de pacientes com degeneração macular neovascular crônica refratários a outros tratamentos antiangiogênicos. Métodos: Estudo prospectivo observacional que incluiu pacientes com degeneração macular neovascular crônica que não responderam a, pelo menos, três doses de ranibizumabe e/ou aflibercepte, sem episódios prévios de uveíte ou vasculite. Os participantes receberam entre uma e três injeções intravítreas de brolucizumabe. A acuidade visual foi avaliada antes e 4 semanas após cada injeção, bem como a distribuição

RESUMO Objetivo: Comparar o conhecimento, as percepções e as competências em Prática Baseada em Evidências entre residentes de primeiro e terceiro ano de Oftalmologia no Brasil. Métodos: Responderam a um questionário de 13 itens e ao instrumento ACE, que avalia cinco domínios da PBE (Perguntar, Buscar, Avaliar, Aplicar e Analisar), 31 residentes (16 do primeiro ano e 15 do terceiro). Resultados: O desempenho geral foi intermediário, sem diferença significativa nas pontuações totais do ACE (46,7 versus 53,3; p = 0,509). [...] RESUMO Objetivo: Comparar o conhecimento, as percepções e as competências em Prática Baseada em Evidências entre residentes de primeiro e terceiro ano de Oftalmologia no Brasil. Métodos: Responderam a um questionário de 13 itens e ao instrumento ACE, que avalia cinco domínios da PBE (Perguntar, Buscar, Avaliar, Aplicar e Analisar), 31 residentes (16 do primeiro ano e 15 do terceiro). Resultados: O desempenho geral foi intermediário, sem diferença significativa nas pontuações totais do ACE (46,7 versus 53,3; p = 0,509).

Objective: To assess the knowledge and perceptions of artificial intelligence (AI) among ophthalmologists and ophthalmology residents in Brazil and its applicability in clinical practice. Subjects and Methods: This observational, cross-sectional, descriptive, and analytical study used a 19-item structured questionnaire covering sociodemographic data, professional profile, AI knowledge, clinical applications, perceived benefits, and ethical concerns. The online survey was distributed nationwide using convenience and snowball sampling. Data were analyzed using appropriate statistical tests with a significance level of 0.05 (Jamovi v. 2.3.28). Ethical approval was granted by the Fundação Altino Ventura Institutional Review Board (approval no. 6.631.825). Results: A total of 165 participants completed the survey, including 120 ophthalmologists (73%) and 45 residents (27%), with a mean age of 38.8 ± 11 years. Moderate AI knowledge was reported by 48% of respondents, good knowledge by 27%, and limited knowledge by 22%. AI was considered relevant to ophthalmology by 58% of participants, and 88% expressed moderate trust in AI-generated data. Ethical concerns were reported by 84%. The most frequent AI applications were differential diagnosis (93%), report preparation (81%), therapeutic guidance (59%), and reduction of diagnostic errors (58%). Most participants (73%) viewed AI as a complementary tool to clinical practice, whereas 22% anticipated partial and 1% full professional replacement. Conclusion: Brazilian ophthalmologists recognize AI as a relevant and promising adjunct in clinical practice, particularly for diagnostic support. Although knowledge levels are predominantly moderate, AI is largely perceived as complementary rather than substitutive, with ongoing ethical and reliability concerns emphasizing the need for education, regulation, and continuous evaluation.

Purpose: To evaluate the efficacy of oral riboflavin and sunlight exposure in stabilizing keratoconus progression. Methods: In this prospective interventional study with a retrospective historical control group, patients with progressive keratoconus received 60 mg/day of oral riboflavin and 30 min/day of sunlight exposure for three months. A historical control group included patients with similar characteristics who were awaiting cross-linking or keratoplasty. Ophthalmological exams and corneal topography were conducted at baseline, 6 months, and 12 months post-treatment. A sub-analysis was performed for patients with corneal stromal thickness (CST) ≥ 400 µm and < 400 µm. Results: Fifty patients [91 eyes; 31 (62%) males] with a mean age of 18.7 ± 4.4 years (range, 11–31) and a mean maximum keratometry (Kmax) of 57.9 ± 8.3 D comprised the treatment group. Kmax flattened (−1.22 ± 4.78 D; P = 0.003) in treated eyes; however, it steepened (+0.32 ± 11.96 D; P = 0.455) in controls at 6 months. Keratoconus progression occurred in 27.5% of treated eyes versus 49.5% in controls (P = 0.002). Eyes with CST ≥ 400 µm had a 3.85-fold higher risk of progression in the control group than in treated eyes (95% CI: 1.6–9.3; P = 0.001). Conclusion: After one year, 72.5% of treated eyes remained stable following the use of oral riboflavin and sunlight exposure, with a significantly lower risk of progression in eyes with normal CST.

To assess musculoskeletal symptoms, identify the most affected body areas, and investigate factors associated with the development of musculoskeletal disorders among ophthalmologists in Brazil. A survey was conducted using an online questionnaire and snowball sampling. Statistical analyses were performed using Jamovi version 2.3.28, and graphs were generated using RStudio version 2023.06.2 + 561. A total of 233 participants (42 ophthalmology residents and 191 ophthalmologists) were included, with a mean age of 40.4 years (standard deviation 11.3; range 25-73 years). Musculoskeletal symptoms were reported by 83% of participants. The cervical region (57.1%), upper back (54.5%), and lumbar region (53.6%) were the most frequently reported sites of pain. A high body mass index was identified in 54.9% of the sample, and 50.2% of participants reported using painkillers in the previous year for musculoskeletal symptoms. The mean duration of professional activity in ophthalmology was 13.5 years, and the mean weekly workload was 39 hours. A significant association was observed between weekly workload and the presence of musculoskeletal disorders (p=0.045). This study demonstrated a high prevalence of musculoskeletal disorders among ophthalmologists in Brazil, particularly involving the cervical, lumbar, and upper back regions, consistent with findings reported in international studies. Important contributing factors include long working hours, a high patient volume, and repetitive or awkward postures during examinations and procedures. Preventive strategies and improvements in working conditions are needed to protect the health and well-being of ophthalmologists.

Vision impairment is considered a global health concern, as around 246 million people worldwide have low vision.() In remote areas, the lack of access to an ophthalmologist and the absence of diagnostic technology from urban centers have a negative impact on the screening and monitoring of various eye diseases.(,) In this sense, our team conducted an eye care taskforce in November 2024, in the archipelago of Fernando de Noronha, located approximately 350 kilometers off the Brazilian coast, in the State [...] Vision impairment is considered a global health concern, as around 246 million people worldwide have low vision.() In remote areas, the lack of access to an ophthalmologist and the absence of diagnostic technology from urban centers have a negative impact on the screening and monitoring of various eye diseases.(,) In this sense, our team conducted an eye care taskforce in November 2024, in the archipelago of Fernando de Noronha, located approximately 350 kilometers off the Brazilian coast, in the State

Oropouche fever is caused by the Oropouche virus (OROV; Bunyaviridae, Orthobunyavirus), one of the most frequent arboviruses that infect humans in the Brazilian Amazon. This year, an OROV outbreak was identified in Brazil, and its vertical transmission was reported, which was associated with fetal death and microcephaly. We describe the clinical manifestations identified in three cases of congenital OROV infection with confirmed serology (OROV-IgM) in the mother-newborn binomial. One of the newborns died, and post-mortem molecular analysis using real-time RT-qPCR identified the OROV genome in several tissues. All three newborns were born in the Amazon region in Brazil, and the mothers reported fever, rash, headache, myalgia, and/or retro-orbital pain during pregnancy. The newborns presented with severe microcephaly secondary to brain damage and arthrogryposis, suggestive of an embryo/fetal disruptive process at birth. Brain and spinal images identified overlapping sutures, cerebral atrophy, brain cysts, thinning of the spinal cord, corpus callosum, and posterior fossa abnormalities. Fundoscopic findings included macular chorioretinal scars, focal pigment mottling, and vascular attenuation. The clinical presentation of vertical OROV infection resembled congenital Zika syndrome to some extent but presents some distinctive features on brain imaging and in several aspects of its neurological presentation. A recognizable syndrome with severe brain damage, neurological alterations, arthrogryposis, and fundoscopic abnormalities can be associated with in utero OROV infection.

Oropouche fever is caused by the Oropouche virus (OROV; Bunyaviridae, Orthobunyavirus), one of the most frequent arboviruses that infect humans in the Brazilian Amazon. This year, an OROV outbreak was identified in Brazil, and its vertical transmission was reported, which was associated with fetal death and microcephaly. We describe the clinical manifestations identified in three cases of congenital OROV infection with confirmed serology (OROV-IgM) in the mother-newborn binomial. One of the newborns died, and post-mortem molecular analysis using real-time RT-qPCR identified the OROV genome in several tissues. All three newborns were born in the Amazon region in Brazil, and the mothers reported fever, rash, headache, myalgia, and/or retroorbital pain during pregnancy. The newborns presented with severe microcephaly secondary to brain damage and arthrogryposis, suggestive of an embryo/fetal disruptive process at birth. Brain and spinal images identified overlapping sutures, cerebral atrophy, brain cysts, thinning of the spinal cord, corpus callosum, and posterior fossa abnormalities. Fundoscopic findings included macular chorioretinal scars, focal pigment mottling, and vascular attenuation. The clinical presentation of vertical OROV infection resembled congenital Zika syndrome to some extent but presents some distinctive features on brain imaging and in several aspects of its neurological presentation. A recognizable syndrome with severe brain damage, neurological alterations, arthrogryposis, and fundoscopic abnormalities can be associated with in-utero OROV infection.

To report the ophthalmological signs, symptoms, and clinical management observed during an unprecedented outbreak of chemical ocular injuries related to cosmetic hair ointments in Brazil. This descriptive, cross-sectional study reviewed medical records of patients treated at the emergency center of Fundação Altino Ventura for chemical ocular trauma associated with cosmetic hair ointment use between February 2022 and February 2023. Records with incomplete medical information were excluded. The study included 168 patients (95.2% [n=160] female), with a mean age of 30.8 ± 9.7 years. The most frequently reported symptoms at presentation were pain (167/168, 99.4%) and photophobia (92/168, 54.8%). Severe pain was reported by 137 patients (80%). Keratitis was present in 280 of 336 eyes (83.3%), conjunctival hyperemia in 256 eyes (76.4%), and corneal abrasions in 174 eyes (51.8%). A decrease in visual acuity (worse than 20/25) was documented in 18.5% (31/168) of cases. Lubricants, antibiotics, and re-epithelialization ointments were prescribed to 64.8% (109/168) of the patients. Topical corticosteroids and oral vitamin C were administered to 34% (57/168) and 1.2% (2/168) of patients, respectively. Followup visits were required in 19% (33/168) of cases. The outbreak of chemical ocular injuries linked to cosmetic ointments used for braiding and hair modeling in Brazil was marked by intense ocular pain, conjunctival hyperemia, keratitis, and corneal abrasions. Most patients were treated with lubricants, antibiotics, and re-epithelialization ointments, although approximately one-fifth required followup care, and one-third received additional treatment with either topical corticosteroids and/or oral vitamin C.