Pedro Hélio Estevam Ribeiro Júnior

To report the surgical outcomes of patients with primary congenital glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy. This retrospective, noncomparative, interventional study included consecutive patients with primary congenital glaucoma with uncontrolled intraocular pressure undergoing gonioscopy-assisted transluminal trabeculotomy between January 2017 and January 2020. The included participants were followed up for at least 24 months, and only one surgeon performed all the procedures. The number of glaucoma medications, pre- and postoperative intraocular pressure, treatment extension (in quadrants), surgical complications, and any associated events or interventions were documented. This study included 13 eyes from 10 patients (mean age, 4.5 ± 3.2 years; range, 3 months to 10 years). After a 24-month follow-up, the mean intraocular pressure significantly decreased from 26.1 ± 3.7 to 11.8 ± 2.5 mmHg (p<0.001). The mean number of glaucoma medications was reduced from 3.3 ± 0.5 to 0.85 ± 1.0 (p<0.001). At the end of the follow-up interval, all eyes (13 out of 13) had an intraocular pressure between 7 and 15 mmHg. In 11 of 13 eyes (84.6%), gonioscopy-assisted transluminal trabeculotomy was performed in all quadrants (360º). The most frequent postoperative complication was transitory (self-limited) hyphema (7 out of 13 eyes [53.8%]). No sight-threatening adverse events occurred during the entire follow-up period. The 2-year follow-up results indicated gonioscopy-assisted transluminal trabeculotomy as an efficient and safe option for primary congenital glaucoma treatment with minimal postoperative complications.

BACKGROUND Telemedicine applied to ophthalmology has been developed since 1960s, however, it only had a greater evolution and a wide-scale implementation in 2020 with the coronavirus pandemic (COVID-19). Since then, dozens of software and applications have been developed to evaluate different aspects of visual function. OBJECTIVE This study aimed to evaluate the application of tests carried out through telemedicine to evaluate visual acuity, color vision, and visual field in patients of all Brazilian regions METHODS An observational, cross-sectional, and retrospective study was carried out. A convenience sample was made up of patients evaluated by the Eyecare Health clinic via telemedicine between the months of October 2023 and January 2024. All these patients evaluated via telemedicine were employees of a multinational evaluated in an occupational context (admission, periodic and dismissal consultations). The inclusion criteria was age over 18 years old and the exclusion criteria were incomplete or unavailable medical records. All patients performed three online tests: Best Corrected Visual Acuity (Eyecare Visual Acuity Test ®), color test evaluation (Eyecare Color Vision Test®) and remote confrontation perimetry. Data analysis was performed on DATAtab Online Statistics Calculator (2023, Austria). Data were described as measures of frequency, absolute numbers, percentages, mean, and standard deviation (when applicable). RESULTS 2197 patients from all Brazilian regions were evaluated. 91.81% were male and the mean age was 37 years. 17.10% had never undergone an ophthalmological evaluation. The mean visual acuity evaluated by Eyecare Visual Acuity Test ® was 0.2logMar for both eyes (± 0.16). Eyecare Color Vision Test® detected a prevalence of 2.28% of color vision deficiency. Confrontation perimetry showed 3.23% of visual field defects. CONCLUSIONS Tele-ophthalmology has proven to be an important ally in the widespread access to eye health, especially in countries or regions with unequal access to health services. In our study we assessed remotely 2197 patients and performed visual acuity test, color vision test, and remote confrontation visual field. We found a mean visual acuity of 0.2logMar for both eyes, 2.28% prevalence of color vision blindness and 3.23% of visual field defects. These findings reaffirm and highlight the importance of tele-ophthalmology in the detection and screening of ophthalmological diseases.