Development of cataracts is a relatively frequent ocular disease of the dog and cataract extraction via phacoemulsification (PE) is commonly performed by veterinary ophthalmologists. Postoperative ocular hypertension (POH) describes the elevation of pressures within the eye during the acute postoperative period and can result in vision loss and poor surgical outcome. Relatively little is known about risk factors or efficacy of prophylactic treatment for POH, and current clinical practice with regard to pressure monitoring and medication administration are highly variable. The literature on POH prophylaxis in humans indicates that improved efficacy may be achieved with a multi-dose approach and that dorzolamide hydrochloride/timolol maleate (DHTM) may be more efficacious than other pressure lowering medications. The canine literature on POH prophylaxis is limited and DHTM has not yet been evaluated despite common use in the clinical setting. Our objectives, therefore, were to investigate risk factors for POH and to test the hypothesis that perioperative topical ophthalmic dorzolamide hydrochloride 2%/timolol maleate 0.5% (DHTM) reduces the prevalence and/or severity of postoperative ocular hypertension (POH) in dogs undergoing cataract extraction by phacoemulsification (PE). We employed a randomized double-masked placebo-controlled study and enrolled 103 dogs (180 eyes) presenting for unilateral or bilateral PE. Select historical, signalment, ophthalmic examination, and surgical data was collected. Dogs were treated with DHTM or Blink Contacts (BC) placebo at 14- and 2-h preoperatively and at conclusion of surgical closure. Intraocular pressures were assessed by rebound tonometry at 2, 4, 6, and 8 hours after surgery and at 8 am the following morning. POH was defined as IOP>25 mmHg and intervention consisted of latanoprost 0.005% if IOP rose to 26 mmHg - 45 mmHg or surgeon treatment of choice if >45 mmHg. Our investigation of risk factors yielded a statistically significant association only with surgeon and surgical time, which were also associated with one another. DHTM significantly reduced the prevalence of POH in comparison with BC (26% versus 49% of eyes, OR=0.36; 34% versus 62% of dogs, OR=0.32). There was also a trend toward reduction of POH severity in DHTM-treated eyes (POH value 37.17±10.47 mmHg with BC, 32.67±6.39 mmHg with DHTM). DHTM-treated eyes that developed POH were significantly more likely to respond favorably (1 hour post-treatment IOP <25 mmHg) to treatment with latanoprost than those in the BC group (76% versus 51%, OR=3.87). We conclude that multi-dose perioperative administration of DHTM may be recommended in dogs undergoing PE to reduce the risk of POH and improve responsiveness of POH to treatment with latanoprost. / Master of Science

A remoção cirúrgica da catarata é uma intervenção cada vez mais praticada na medicina veterinária e, com ela, diversos estudos têm sido realizados com o intuito de reduzir as possíveis complicações de seu pós-operatório, tal como a opacidade da cápsula posterior, alteração ocasionada principalmente pela diferenciação e migração das células do epitélio lenticular para a cápsula posterior da lente. O objetivo deste estudo foi analisar a morfologia da cápsula anterior e seu epitélio pela coloração de rotina com hematoxilina-eosina; a composição molecular da cápsula pelas técnicas histoquímicas de PAS (avaliação de proteoglicanos) e picrosirius red (avaliação de colágeno IV); além da expressão de morte celular nas células epiteliais pelas técnicas de imunofluorescência com Beclina 1 (autofagia) e Caspase 3 (apoptose), em cães idosos com catarata diabética e não diabética do tipo hipermadura, submetidos ao uso ou não de azul de tripano a 0,1 % durante a cirurgia de remoção da catarata por facoemulsificação. Para o estudo, foram estudadas as células epiteliais e cápsula anterior da lente de 27 cães, sendo 21 fêmeas e 6 machos, de 8 a 12 anos de idade (média = 9,6 anos), de diversas raças, que foram primeiramente divididos em 2 grupos: GC (catarata hipermadura) e GCD (catarata diabética) e, depois, subdivididos em outros 4 grupos: os que utilizaram o corante: GAND (catarata hipermadura com azul de tripano) e GAD (catarata diabética com azul de tripano); e os que não foram submetidos ao uso do corante: GND (catarata hipermadura sem azul de tripano) e GD (catarata diabética sem azul de tripano). Os resultados das análises realizadas observaram que ambas as amostras, tanto as provenientes das cataratas hipermaduras, quanto as diabéticas, sofrem alterações em igual intensidade apesar do diferente processo de formação, ou seja, observou-se que houve positividade na expressão de morte celular do epitélio por apoptose e autofagia em igual intensidade e independente da utilização de azul de tripano a 0,1 % em todos os grupos; que a composição molecular da cápsula quanto à quantidade de proteoglicanos e colágeno IV também é semelhante e que, apesar da cápsula apresentar-se mais espessada do que o normal, ainda preserva sua relação anatômica com o epitélio. Conclui-se, portanto, que as lesões ocasionadas pela formação da catarata diabética e hipermadura no epitélio e em sua membrana basal (cápsula) são semelhantes apesar da diferente fisiopatologia de formação, mas que o epitélio e a cápsula ainda preservam sua relação anatômica e morfologia. Com os resultados, também se pode sugerir que cães que apresentem cataratas destes tipos, devam apresentar menor risco de ocorrência de opacidade na cápsula posterior no pós cirúrgico da catarata / Nowadays, surgical removal of cataracts in dogs is being considered a common intervention. Along with that, many studies have been realized aiming to reduce its post operatory complications, such as the posterior lens capsule opacity, which occurs due to epithelium cells differentiation and migration to the posterior pole. The objective of this study was to evaluate, by morphometry (hematoxilin-eosin), histochemistry (PAS and picrosirius red) and immunofluorescence (Caspase 3 and Beclin 1) analysis: the morphological alterations of the lens anterior capsule and its epithelium; the molecular components of the extracellular matrix; and the expression of lens epithelium cellular death (by autophagy and apoptosis), in elderly diabetic and non diabetic dogs with cataracts, after phacoemulsification surgery utilizing or not 0,1 % trypan blue. Twenty seven dogs, including 21 female and 6 male dogs, with ages varying from 8 to 12 years old (mean = 9.6 yo), of different breeds were studied. Animals were first divided into 2 groups: GC (hypermature cataracts) and GCD (diabetic cataracts); then, subdivided in 4 different groups: GAND (non diabetic dogs with trypan blue), GAD (diabetic dogs with trypan blue), GND (non diabetic dogs without trypan blue) and finally, GD (diabetic dogs without trypan blue). Results showed that both types of studied samples (diabetic and hypermature ones), are equally altered besides its different pathophysiology, since no statistical significant differences were observed in both capsule and epithelium thickness, type IV collagen and proteoglycans concentration and also, in the epithelium cells autophagy and apoptosis, observed by Caspase 3 and Beclin 1 expression in every studied group. In addition, 0,1 % trypan blue was not capable to demonstrate its toxicity rate, as cells were already under the referred death processes. In conclusion, our findings suggests that, besides the differences in both, hypermature and diabetic cataracts, pathophysiologies of formation, serious and similar alterations are observed with the same intensity in the anterior lens capsule and its epithelium in dogs, what must probably reduce posterior lens capsule opacity post phacoemulsification surgery

A diabetes mellitus (DM) causa alterações em todas as camadas da córnea. Córneas de pacientes diabéticos têm controle de sua hidratação prejudicado e são mais propensas à descompensação após injúria. A uveíte faco-induzida (UFI) ocorre em grandes proporções associada à catarata hipermatura em cães. A UFI também acarreta danos ao endotélio da córnea e pode levar ao edema estromal, usualmente transitório. Cães diabéticos são particularmente predispostos ao desenvolvimento de catarata e UFI associada. Os efeitos da DM e UFI podem potencialmente vir a se somar em córneas de cães com catarata diabética. A pressão intra-ocular (PIO) e paquimetria podem ser ferramentas úteis na determinação dessas alterações. O objetivo deste estudo foi determinar a relação entre pressão intra-ocular e paquimetria nos diferentes estágios de desenvolvimento das cataratas diabéticas e não diabéticas em cães da raça Poodle. Cento e vinte e dois cães adultos da raça Poodle, 134 fêmeas e 99 machos, com idades de 2 a 16 anos, foram admitidos no Serviço de Oftalmologia do Hospital Veterinário da Universidade de São Paulo e incluídos no trabalho. Afecções oculares concomitantes, ou doenças sistêmicas com manifestação ocular, foram consideradas fatores de exclusão. Após exame clínico oftalmológico, coletou-se dados referentes ao tempo de leucocoria e tempo de desenvolvimento da DM. Os cães tiveram a PIO mensurada por meio do TonoPen-XL® e a paquimetria mensurada com o uso do PachPen®. Para isso realizou-se anestesia tópica (colírio de Proximetacaína a 0,5% - Anestalcon®, Alcon). As comparações estatísticas entre as variáveis foram realizadas utilizando os testes de Spearman, Mc-Nemar e Mann-Whitney quando apropriados. As distribuições das variáveis entre os grupos foram avaliadas pelo test de Kruskal-Wallis, e quando significantes, o teste de Dunn foi utilizado para descriminar as diferenças encontradas. O nível de significância foi estabelecido em p<0,05. Dos 122 cães, 233 olhos foram incluídos e classificados em grupo controle (n=39), catarata incipiente (n=20), imatura (n=29), matura (n=20), hipermatura (n=80), catarata diabética imatura (n=9), diabética matura (n=11) e diabética hipermatura (n=25). As distribuições das variáveis (sexo, idade, peso, presença de uveíte, tempo de leucocoria, PIO e paquimetria) foram estatisticamente diferentes entre os diversos grupos. Fêmeas apresentaram-se mais acometidas por catarata diabética. A idade média dos animais variou de 7,03 a 10,73 anos entre os grupos, e os animais diabéticos foram estatisticamente mais velhos. A PIO foi estatisticamente menor e os sinais clínicos de UFI mais prevalentes nos grupos de cataratas hipermaturas, tanto diabéticas, quanto não diabéticas. A PIO correlacionou-se negativamente com a idade e a paquimetria. Houve correlação positiva da paquimetria com a idade e o peso; e correlação negativa com o tempo de leucocoria e a PIO. Olhos acometidos por UFI tiveram PIO estatisticamente menor e paquimetria maior, com diferença de 2 mmHg e 60 µm, respectivamente. Nos cães acometidos por catarata diabética, a paquimetria encontrou-se particularmente aumentada, e a UFI particularmente presente. Esse aumento possivelmente reflete a somatória dos efeitos da DM e UFI sobre a córnea. A hipermaturidade foi correlacionada à presença da UFI. A PIO e paquimetria mostraram-se instrumentos valiosos na determinação da UFI, principalmente se forem negativamente correlacionadas entre si. / Diabetes mellitus (DM) causes different alterations in all corneal layers, such as deficient control of hydration, what makes them prone to decompensate after injury. Lens induced uveitis (LIU) occurs mainly in dogs presenting hypermature cataracts, what causes irreversible damages to the corneal endothelium and may lead to stromal edema, usually transient. DM dogs are particularly predisposed to cataract with LIU associated. Intraocular pressure (IOP) and pachymetry measurements may be useful procedures capable to detect such alterations. The aim of this study was to determinate the relationship between intraocular pressure and pachymetry on diabetic and nondiabetic Poodles, presenting different stages of cataracts. One hundred twenty-two Poodles, 134 females and 99 males, with ages varying from 2 to 16 years, were admitted at the Ophthalmology Service, of the Veterinary Hospital, of the University of São Paulo. After complete identification of the animals, anamnese (time of DM and cataract formation) and ophthalmological exam, dogs were included in the study. Dogs affected by other systemic diseases inducing ocular manifestation or other primary ocular alteration were excluded. LIU was diagnosed by observation of congestion of the episcleral vases and resistence to midriasis after induction with Mydriacyl®. IOP was measured by TonoPen-XL® and pachymetry by PachPen® after instillation of anesthetic eyedrop (Proximetacaine 0,5% - Anestalcon, Alcon). Statistical comparison between factors were made using Spearman, Mc-Nemar and Mann-Whitney tests when appropriated. The distributions of the factors among the groups were compared by Krusskal-Walliss test, and when significant, Dunns test was used to describe the differences found. The level of significance was set at p<0,05. Two hundred thirty-three eyes of 122 Poodles were evaluated. Eyes were classified in different groups: healthy dogs without cataracts (n=39); dogs presenting incipient cataract (n=20); with immature cataracts (n=29); mature cataracts (n=20); or hypermature cataracts (n=80); DM dogs presenting immature cataract (n=9); DM with mature cataracts (n=11); and DM with hypermature cataracts (n=25). Distribution of factors, such as age, sex, weight, time of DM and cataract, presence of LIU, IOP and pachymetry were statistically different between groups. Female Poodles were more affected by diabetic cataract and diabetic dogs were older than the other ones. IOP was statistically lower and LIU alterations more prevalent in the hypermature cataract groups (diabetic and no diabetics). IOP was negatively correlated to age and pachymetry measures. Pachymetry was positively correlated to age and weight. Negative correlation was observed between pachymetry and time of cataracts formation. LIU eyes presented lower IOP and higher pachymetry. The difference found at pachymetry and IOP measurements in LIU and non LIU eyes were 60 µm and 2 mmHg respectively. In diabetic dogs, pachymetry was particularly higher and LIU particularly present. The higher corneal thickness may possible be related to the sum of alterations caused by DM and LIU to those corneas. Hypermaturity was directly related to LIU. We concluded that pachymetry and IOP measurements are important procedures to the LIU diagnosis, mainly when negatively correlated.

PURPOSE. To determine the influence of cataractous and refractive blur on postural stability and limb-load asymmetry (LLA) and to establish how postural stability changes with the spatial frequency and contrast of the visual stimulus. METHODS. Thirteen elderly subjects (mean age, 70.76 ± 4.14 [SD] years) with no history of falls and normal vision were recruited. Postural stability was determined as the root mean square [RMS] of the center of pressure (COP) signal in the anterior¿posterior (A-P) and medial¿lateral directions and LLA was determined as the ratio of the average body weight placed on the more-loaded limb to the less-loaded limb, recorded during a 30-second period. Data were collected under normal standing conditions and with somatosensory system input disrupted. Measurements were repeated with four visual targets with high (8 cyc/deg) or low (2 cyc/deg) spatial frequency and high (Weber contrast, 95%) or low (Weber contrast, 25%) contrast. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with cataract simulation. The data were analyzed in a population-averaged linear model. RESULTS. The cataract simulation caused significant increases in postural instability equivalent to that caused by 8-D blur conditions, and its effect was greater when the input from the somatosensory system was disrupted. High spatial frequency targets increased postural instability. Refractive blur, cataract simulation, or eye closure had no effect on LLA. CONCLUSIONS. Findings indicate that cataractous and refractive blur increase postural instability, and show why the elderly, many of whom have poor vision along with musculoskeletal and central nervous system degeneration, are at greater risk of falling. Findings also highlight that changes in contrast sensitivity rather than resolution changes are responsible for increasing postural instability. Providing low spatial frequency information in certain environments may be useful in maintaining postural stability. Correcting visual impairment caused by uncorrected refractive error and cataracts could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.

A remoção cirúrgica da catarata é uma intervenção cada vez mais praticada na medicina veterinária e, com ela, diversos estudos têm sido realizados com o intuito de reduzir as possíveis complicações de seu pós-operatório, tal como a opacidade da cápsula posterior, alteração ocasionada principalmente pela diferenciação e migração das células do epitélio lenticular para a cápsula posterior da lente. O objetivo deste estudo foi analisar a morfologia da cápsula anterior e seu epitélio pela coloração de rotina com hematoxilina-eosina; a composição molecular da cápsula pelas técnicas histoquímicas de PAS (avaliação de proteoglicanos) e picrosirius red (avaliação de colágeno IV); além da expressão de morte celular nas células epiteliais pelas técnicas de imunofluorescência com Beclina 1 (autofagia) e Caspase 3 (apoptose), em cães idosos com catarata diabética e não diabética do tipo hipermadura, submetidos ao uso ou não de azul de tripano a 0,1 % durante a cirurgia de remoção da catarata por facoemulsificação. Para o estudo, foram estudadas as células epiteliais e cápsula anterior da lente de 27 cães, sendo 21 fêmeas e 6 machos, de 8 a 12 anos de idade (média = 9,6 anos), de diversas raças, que foram primeiramente divididos em 2 grupos: GC (catarata hipermadura) e GCD (catarata diabética) e, depois, subdivididos em outros 4 grupos: os que utilizaram o corante: GAND (catarata hipermadura com azul de tripano) e GAD (catarata diabética com azul de tripano); e os que não foram submetidos ao uso do corante: GND (catarata hipermadura sem azul de tripano) e GD (catarata diabética sem azul de tripano). Os resultados das análises realizadas observaram que ambas as amostras, tanto as provenientes das cataratas hipermaduras, quanto as diabéticas, sofrem alterações em igual intensidade apesar do diferente processo de formação, ou seja, observou-se que houve positividade na expressão de morte celular do epitélio por apoptose e autofagia em igual intensidade e independente da utilização de azul de tripano a 0,1 % em todos os grupos; que a composição molecular da cápsula quanto à quantidade de proteoglicanos e colágeno IV também é semelhante e que, apesar da cápsula apresentar-se mais espessada do que o normal, ainda preserva sua relação anatômica com o epitélio. Conclui-se, portanto, que as lesões ocasionadas pela formação da catarata diabética e hipermadura no epitélio e em sua membrana basal (cápsula) são semelhantes apesar da diferente fisiopatologia de formação, mas que o epitélio e a cápsula ainda preservam sua relação anatômica e morfologia. Com os resultados, também se pode sugerir que cães que apresentem cataratas destes tipos, devam apresentar menor risco de ocorrência de opacidade na cápsula posterior no pós cirúrgico da catarata / Nowadays, surgical removal of cataracts in dogs is being considered a common intervention. Along with that, many studies have been realized aiming to reduce its post operatory complications, such as the posterior lens capsule opacity, which occurs due to epithelium cells differentiation and migration to the posterior pole. The objective of this study was to evaluate, by morphometry (hematoxilin-eosin), histochemistry (PAS and picrosirius red) and immunofluorescence (Caspase 3 and Beclin 1) analysis: the morphological alterations of the lens anterior capsule and its epithelium; the molecular components of the extracellular matrix; and the expression of lens epithelium cellular death (by autophagy and apoptosis), in elderly diabetic and non diabetic dogs with cataracts, after phacoemulsification surgery utilizing or not 0,1 % trypan blue. Twenty seven dogs, including 21 female and 6 male dogs, with ages varying from 8 to 12 years old (mean = 9.6 yo), of different breeds were studied. Animals were first divided into 2 groups: GC (hypermature cataracts) and GCD (diabetic cataracts); then, subdivided in 4 different groups: GAND (non diabetic dogs with trypan blue), GAD (diabetic dogs with trypan blue), GND (non diabetic dogs without trypan blue) and finally, GD (diabetic dogs without trypan blue). Results showed that both types of studied samples (diabetic and hypermature ones), are equally altered besides its different pathophysiology, since no statistical significant differences were observed in both capsule and epithelium thickness, type IV collagen and proteoglycans concentration and also, in the epithelium cells autophagy and apoptosis, observed by Caspase 3 and Beclin 1 expression in every studied group. In addition, 0,1 % trypan blue was not capable to demonstrate its toxicity rate, as cells were already under the referred death processes. In conclusion, our findings suggests that, besides the differences in both, hypermature and diabetic cataracts, pathophysiologies of formation, serious and similar alterations are observed with the same intensity in the anterior lens capsule and its epithelium in dogs, what must probably reduce posterior lens capsule opacity post phacoemulsification surgery

A diabetes mellitus (DM) causa alterações em todas as camadas da córnea. Córneas de pacientes diabéticos têm controle de sua hidratação prejudicado e são mais propensas à descompensação após injúria. A uveíte faco-induzida (UFI) ocorre em grandes proporções associada à catarata hipermatura em cães. A UFI também acarreta danos ao endotélio da córnea e pode levar ao edema estromal, usualmente transitório. Cães diabéticos são particularmente predispostos ao desenvolvimento de catarata e UFI associada. Os efeitos da DM e UFI podem potencialmente vir a se somar em córneas de cães com catarata diabética. A pressão intra-ocular (PIO) e paquimetria podem ser ferramentas úteis na determinação dessas alterações. O objetivo deste estudo foi determinar a relação entre pressão intra-ocular e paquimetria nos diferentes estágios de desenvolvimento das cataratas diabéticas e não diabéticas em cães da raça Poodle. Cento e vinte e dois cães adultos da raça Poodle, 134 fêmeas e 99 machos, com idades de 2 a 16 anos, foram admitidos no Serviço de Oftalmologia do Hospital Veterinário da Universidade de São Paulo e incluídos no trabalho. Afecções oculares concomitantes, ou doenças sistêmicas com manifestação ocular, foram consideradas fatores de exclusão. Após exame clínico oftalmológico, coletou-se dados referentes ao tempo de leucocoria e tempo de desenvolvimento da DM. Os cães tiveram a PIO mensurada por meio do TonoPen-XL® e a paquimetria mensurada com o uso do PachPen®. Para isso realizou-se anestesia tópica (colírio de Proximetacaína a 0,5% - Anestalcon®, Alcon). As comparações estatísticas entre as variáveis foram realizadas utilizando os testes de Spearman, Mc-Nemar e Mann-Whitney quando apropriados. As distribuições das variáveis entre os grupos foram avaliadas pelo test de Kruskal-Wallis, e quando significantes, o teste de Dunn foi utilizado para descriminar as diferenças encontradas. O nível de significância foi estabelecido em p<0,05. Dos 122 cães, 233 olhos foram incluídos e classificados em grupo controle (n=39), catarata incipiente (n=20), imatura (n=29), matura (n=20), hipermatura (n=80), catarata diabética imatura (n=9), diabética matura (n=11) e diabética hipermatura (n=25). As distribuições das variáveis (sexo, idade, peso, presença de uveíte, tempo de leucocoria, PIO e paquimetria) foram estatisticamente diferentes entre os diversos grupos. Fêmeas apresentaram-se mais acometidas por catarata diabética. A idade média dos animais variou de 7,03 a 10,73 anos entre os grupos, e os animais diabéticos foram estatisticamente mais velhos. A PIO foi estatisticamente menor e os sinais clínicos de UFI mais prevalentes nos grupos de cataratas hipermaturas, tanto diabéticas, quanto não diabéticas. A PIO correlacionou-se negativamente com a idade e a paquimetria. Houve correlação positiva da paquimetria com a idade e o peso; e correlação negativa com o tempo de leucocoria e a PIO. Olhos acometidos por UFI tiveram PIO estatisticamente menor e paquimetria maior, com diferença de 2 mmHg e 60 µm, respectivamente. Nos cães acometidos por catarata diabética, a paquimetria encontrou-se particularmente aumentada, e a UFI particularmente presente. Esse aumento possivelmente reflete a somatória dos efeitos da DM e UFI sobre a córnea. A hipermaturidade foi correlacionada à presença da UFI. A PIO e paquimetria mostraram-se instrumentos valiosos na determinação da UFI, principalmente se forem negativamente correlacionadas entre si. / Diabetes mellitus (DM) causes different alterations in all corneal layers, such as deficient control of hydration, what makes them prone to decompensate after injury. Lens induced uveitis (LIU) occurs mainly in dogs presenting hypermature cataracts, what causes irreversible damages to the corneal endothelium and may lead to stromal edema, usually transient. DM dogs are particularly predisposed to cataract with LIU associated. Intraocular pressure (IOP) and pachymetry measurements may be useful procedures capable to detect such alterations. The aim of this study was to determinate the relationship between intraocular pressure and pachymetry on diabetic and nondiabetic Poodles, presenting different stages of cataracts. One hundred twenty-two Poodles, 134 females and 99 males, with ages varying from 2 to 16 years, were admitted at the Ophthalmology Service, of the Veterinary Hospital, of the University of São Paulo. After complete identification of the animals, anamnese (time of DM and cataract formation) and ophthalmological exam, dogs were included in the study. Dogs affected by other systemic diseases inducing ocular manifestation or other primary ocular alteration were excluded. LIU was diagnosed by observation of congestion of the episcleral vases and resistence to midriasis after induction with Mydriacyl®. IOP was measured by TonoPen-XL® and pachymetry by PachPen® after instillation of anesthetic eyedrop (Proximetacaine 0,5% - Anestalcon, Alcon). Statistical comparison between factors were made using Spearman, Mc-Nemar and Mann-Whitney tests when appropriated. The distributions of the factors among the groups were compared by Krusskal-Walliss test, and when significant, Dunns test was used to describe the differences found. The level of significance was set at p<0,05. Two hundred thirty-three eyes of 122 Poodles were evaluated. Eyes were classified in different groups: healthy dogs without cataracts (n=39); dogs presenting incipient cataract (n=20); with immature cataracts (n=29); mature cataracts (n=20); or hypermature cataracts (n=80); DM dogs presenting immature cataract (n=9); DM with mature cataracts (n=11); and DM with hypermature cataracts (n=25). Distribution of factors, such as age, sex, weight, time of DM and cataract, presence of LIU, IOP and pachymetry were statistically different between groups. Female Poodles were more affected by diabetic cataract and diabetic dogs were older than the other ones. IOP was statistically lower and LIU alterations more prevalent in the hypermature cataract groups (diabetic and no diabetics). IOP was negatively correlated to age and pachymetry measures. Pachymetry was positively correlated to age and weight. Negative correlation was observed between pachymetry and time of cataracts formation. LIU eyes presented lower IOP and higher pachymetry. The difference found at pachymetry and IOP measurements in LIU and non LIU eyes were 60 µm and 2 mmHg respectively. In diabetic dogs, pachymetry was particularly higher and LIU particularly present. The higher corneal thickness may possible be related to the sum of alterations caused by DM and LIU to those corneas. Hypermaturity was directly related to LIU. We concluded that pachymetry and IOP measurements are important procedures to the LIU diagnosis, mainly when negatively correlated.

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women aged 40 to 55 years of age from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Surveys. Variables of interest included vision-related issues, cataract surgeries, bone density data, blood lead levels, and markers of lead mobilization. The results of the logistic regression analysis in the absence of confounders (OR = 1.50, 95% CI [1.08, 2.09]) indicated that endogenous lead is a possible causative factor for the low-level vision problems women experience during their perimenopausal years. Chi-square analysis of mobilized lead was also associated with cataract surgeries, p < .05. This appears to be the first report of a possible association between lead and cataracts in women and highlights the need for women to be studied in the context of their biology when their clinical results differ from those of men. These results should engender positive social change initiatives to minimize women's perimenopausal exposure to endogenous lead. Recommendations for further research include a case control study, which includes plasma lead levels, and a longitudinal study.

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Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-03-04T14:04:41Z No. of bitstreams: 2 Dissertação - Tainara Sardeiro de Santana - 2015.pdf: 1062874 bytes, checksum: 058833ae40af483b9ce8962092d2e4bf (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-04T14:49:42Z (GMT) No. of bitstreams: 2 Dissertação - Tainara Sardeiro de Santana - 2015.pdf: 1062874 bytes, checksum: 058833ae40af483b9ce8962092d2e4bf (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-03-04T14:49:42Z (GMT). No. of bitstreams: 2 Dissertação - Tainara Sardeiro de Santana - 2015.pdf: 1062874 bytes, checksum: 058833ae40af483b9ce8962092d2e4bf (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-08-11 / Population aging is a global trend and brings as a consequence the increasing prevalence of chronic diseases of the elderly such as cataract.The purpose of this study was to evaluate the visual improvement on the 15th day after cataract surgery and the impact on the quality of life of older people. A prospective study was conducted with a quantitative, descriptive and correlational approach, developed with 156 patients with indication for cataract surgery. The surgeries were performed after an agreement between the Department of Health of Amapá and the Reference Center for Ophthalmology/Federal University of Goiás, in September and October 2013. Visual Functioning Questionnaire (VQF-25) was used to evaluate quality of life and Snellen chart was used to measure visual acuity. The visual acuity average in logMAR after 15 days from surgery improved from 1.23 (20/340 Snellen) to 0.57 (20/74 on the Snellen chart) and was statistically significant (p = 0.000). When comparing the average quality of life before and after cataract surgery, the overview subdomain showed the greatest difference between the averages before and after surgery (of 29.65 to 89.87). Correlation analysis showed that the better the visual acuity after surgery, the higher the satisfaction with distance activity, the better eye pain, mental health, addiction and overall satisfaction. The cataract surgery was associated with a positive impact on visual acuity and quality of life of older people. The assistancial campaign was useful to treat patients with cataracts and improved the accessibility to eye care in public health. / O processo de envelhecimento populacional é uma tendência mundial e traz, como conseqüência, o aumento da prevalência das doenças crônicas no idoso, entre as quais se destaca a catarata. O objetivo do presente estudo foi avaliar a melhora visual no 15º dia do pós-operatório de cirurgia de facectomia e o impacto dessa na qualidade de vida dos idosos. Realizou-se um estudo prospectivo, com abordagem quantitativa, descritiva-correlacional, desenvolvido com 156 pacientes com indicação de cirurgia de catarata realizada por um convênio entre a Secretaria Estadual de Saúde do Amapá e o Centro de Referência em Oftalmologia da Universidade Federal de Goiás entre setembro e outubro de 2013. Foram utilizados o questionário de avaliação da qualidade de vida Visual Functioning Questionnaire (VQF-25) e a tabela de Snellen para medir a acuidade visual. A acuidade visual média, em logMAR, após 15 dias da cirurgia melhorou de 1,23 (20/340 na tabela de Snellen) para 0,57 (20/74 na tabela de Snellen) e foi estatisticamente significativa (p=0,000). Na comparação das médias de qualidade de vida antes e após a facectomia, o subdomínio visão geral apresentou a maior diferença entre as médias (de 29,65 para 89,87). A análise de correlação apontou que quanto melhor a acuidade visual do paciente após a cirurgia, maior foi a satisfação em relação à atividade para longe, melhora da dor ocular, saúde mental, dependência e satisfação geral. A facectomia associou-se a um impacto positivo sobre a acuidade visual e a qualidade de vida dos idosos. A campanha assistencial mostrou-se útil para atender pacientes com catarata e diminuir a inacessibilidade ao tratamento oftalmológico na saúde pública.