Orientador: Cláudia Valéria Seullner Brandão / Banca: Claudia Helena Pellizzon / Banca: Karina Preising Aptekmann / Resumo: A ceratoconjuntivite seca (CCS) é uma afecção de caráter inflamatório, comum em cães. O uso do ômega 3 e 6 no tratamento de humanos e coelhos com CCS tem sido pesquisado devido ao potencial efeito imunomodulador desses ácidos graxos, porém não há relatos do seu uso em cães com essa afecção. Objetivou-se avaliar o efeito dos óleos de linho e peixe, produtos ricos em ômega 3 e 6, administrados por via oral, na produção lacrimal e inflamação ocular de cães com CCS. Foram utilizados 45 cães, sendo 15 sem CCS, constituindo o grupo controle (GC), e 30 com CCS. Estes foram divididos de forma randomizada e cega em dois grupos: grupo tratado com óleo de linho (GL) e grupo tratado com óleo de peixe (GP); cada animal recebeu, por via oral, uma cápsula a cada 24 horas durante 60 dias, de acordo com o seu grupo. Exame clínico, teste lacrimal de Schirmer 1, teste de ruptura do filme lacrimal e teste de fluoresceína foram realizados antes do início do tratamento (M0) e aos 15 (M15), 30 (M30), 45 (M45) e 60 (M60) dias de tratamento. A citologia de impressão de superfície ocular foi realizada no M0, M30 e M60, enquanto a biópsia conjuntival para histopatologia foi obtida antes do tratamento e no momento final de avaliação. Houve diminuição significativa da hiperemia conjuntival nos cães de ambos os grupos tratados aos 60 dias. Na análise histopatológica, detectou-se diminuição da espessura epitelial no GL e GP, diminuição da queratinização no GL e diminuição do infiltrado de células inflamatórias no GP ao final do tratamento. Não houve diferença significativa nas demais avaliações. Conclui-se que os óleos de linho e peixe não aumentam a produção lacrimal até 60 dias do tratamento, porém melhoram a qualidade da superfície ocular. O óleo de peixe reduz o quadro inflamatório. Desta forma, o tratamento com óleo de linho ou peixe pode ser indicado como terapia adjuvante para cães com CCS / Abstract: The keratoconjunctivitis sicca (KCS) is inflammatory and a common disease in dogs. The use of omega 6 and 3 for treatment in humans and rabbits has been researched because of the potential immunomodulatory effect of these fatty acids, but there are no reports of its use in dogs with this condition. The aim of this study was to investigate the effect of linseed oil and fish oil, products rich in omega 3 and 6, administered orally on tear production and ocular inflammation in dogs with KCS. For this study we used 45 dogs: 15 without KCS, constituting the control group (CG) and 30 with KCS. A randomized, double-blind clinical study was performed in assigned to treatment orally with oil fish (FO) or linseed oil (LO), both once daily for 60 days. More 15 dogs with no KCS were evaluated for a control group (CG). Clinical examination of the eye, Schirmer tear tests I, tear film breakup time, fluorescein test were performed prior to treatment (M0) and at days 15 (M15), 30(M30), 45(M45) and 60(M60) after initiation of treatment. The impression cytology on ocular surface was performed at M0, M30 and M60. The conjunctival histopathological analysis was only performed prior to treatment and at day 60 after treatment. That was a significant decrease in conjunctival hyperemia in dogs of both treatments at day 60. The histopathological analysis revealed a decrease in the epithelial thickness both in FO and LO, a decrease on the degree of keratinization in LO and a decrease inflammatory cell infiltration in FO. There were no significant differences in the others evaluations in both groups. The analyzed results demonstrate that although both treatments administered orally do not increase tear production within 60 days of treatment, it improve the ocular surface. Thus, fish oil reduces eye inflammation. Therefore, treatment with linseed oil or fish may be indicated as adjunctive therapy for dogs with KCS / Mestre

Thesis (MPH.) -- University of Limpopo, 2021 / Dry eye disease (DED) is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolality of the tear film and inflammation of the ocular surface. DED is one of the most frequently established diagnoses in ophthalmology and represents a growing public health concern, with consequences that remain widely underestimated. There is variability of clinical manifestations and diagnostic criteria which leads to poor correlation between clinical signs and symptoms, therefore resulting in difficulties to assess prevalence of DED despite an improved understanding of pathogenic factors of acquired DED. However, its prevalence has been reported to range from 74% to 33% worldwide and the current study aimed to investigate the prevalence of DED and its determinants amongst people consulting at Focus Optometrists in Kwa-Mhlanga Township in Mpumalanga Province. Methodology: The current study was quantitative in nature and it followed a cross-sectional descriptive design to address the research question. The study population were people consulting at Focus Optometrists in Kwa-Mhlanga Township in Mpumalanga Province in which two standardized optometry diagnostic tests (Schimer test and the tear film break up time) were used for data collection coupled with a comprehensive case history which was taken for all participants. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). Frequency tables were used to make comparisons between groups for continuous and categorical variables using student t-test, and chi-square test. P-value less than 0.05 at 95% confidence level were regarded as significant. Results: A total of 236 participants were recruited and the mean age of the participants was 39.7 in which majority of participants were females and there was a statistical significance difference in age groups of both males and females at p-value=0.011. Majority of the participants have reported to have experience of sensitivity to light vi and foreign body sensation sometimes. The poor vision and blurred vision have been reported by majority of participants sometimes and the prevalence of dry eye disease was found to be 80.9% and the risk of the dry eye disease in the current study was found significantly increasing with old age. Those who were older (35 years above) were 4.2 times more likely to develop dry eye disease at p-value <0.001 as compared to young participants. Female gender was found not to be protective of developing dry eye disease in the current and participants who were single, having secondary and education qualifications were more likely to develop dry eye disease. Participants with ocular conditions, systemic disease, surgery and those with high blood pressure were more likely to develop dry disease Conclusion: The prevalence of dry eye disease in the current study was found to be very high and therefore, patients coming to the clinic from the age of 40 with underlying systemic diseases should be screened for dry eyes. Dry eye disease can be a major contributor of refractive error in the visual systems and or can also be a sign or a symptom of hormonal or related ocular or systemic disease. More eye care awareness should be done at primary eye care level to detect the cause or to eliminate future associated symptoms.

A imunodeficiência comum variável (ICV) é uma imunodeficiência predominantemente humoral, com prejuízo na produção de imunoglobulinas. A maioria dos pacientes apresenta infecções recorrentes. No entanto, os pacientes com ICV podem apresentar comorbidades não infecciosas, dentre elas, alterações oftalmológicas. Manifestações oftalmológicas são muito pouco conhecidas em pacientes com ICV, porém alguns relatos de casos já foram descritos na literatura. Este trabalho teve como objetivos realizar avaliação oftalmológica completa dos pacientes com ICV dos ambulatórios de Imunologia do Hospital das Clínicas, procurando correlacionar as manifestações oftalmológicas encontradas com processos infecciosos e inflamatórios. Foram avaliados 16 pacientes, com idades entre 10 e 50 anos, dos quais seis apresentaram alterações oftalmológicas (três pacientes com síndrome do olho seco, um paciente com estrabismo, um paciente com pterígio e um paciente com retinopatia hipertensiva e espessamento da parede arteriolar). Entretanto, pterígio e estrabismo foram considerados alterações casuais, não sendo associados à ICV. Dois pacientes com olho seco fizeram avaliação da lágrima, com a finalidade de diagnóstico precoce de possível síndrome de Sjögren, mas a avaliação foi normal. Desta forma, são necessários mais estudos e com maior número de pacientes com finalidade de estabelecer marcadores laboratoriais preditivos para lesões oftalmológicas / The common variable immunodeficiency (CVID) is a predominantly humoral immunodeficiency, with impairment in the production of immunoglobulins. Most patients have recurrent infections. However, patients with CVID may have noninfectious comorbidities, including ophthalmological changes. Ophthalmologic manifestations are very little known in patients with CVID, but some case reports have already been described in the literature. The aim of this study was to perform a complete ophthalmologic evaluation of patients with CVID who are seeing in the Immunology Ambulatory of the Hospital das Clínicas, seeking to correlate the ophthalmological manifestations found with infectious and inflammatory processes. Sixteen patients were evaluated, between the ages of 10 and 50 years, six of which presented alterations (three patients with dry eye syndrome, one patient with strabismus, one patient with pterygium and one patient with hypertensive retinopathy and arteriolar wall thickening). However, pterygium and strabismus were considered casual alterations and were not associated with CVID. Two patients with dry eye made a tear evaluation, in view of the early diagnosis of Sjögren\'s Syndrome, but it was normal. Thus, additional studies with a larger patient sample are necessary to establish predictive laboratory markers for ophthalmological injuries

A imunodeficiência comum variável (ICV) é uma imunodeficiência predominantemente humoral, com prejuízo na produção de imunoglobulinas. A maioria dos pacientes apresenta infecções recorrentes. No entanto, os pacientes com ICV podem apresentar comorbidades não infecciosas, dentre elas, alterações oftalmológicas. Manifestações oftalmológicas são muito pouco conhecidas em pacientes com ICV, porém alguns relatos de casos já foram descritos na literatura. Este trabalho teve como objetivos realizar avaliação oftalmológica completa dos pacientes com ICV dos ambulatórios de Imunologia do Hospital das Clínicas, procurando correlacionar as manifestações oftalmológicas encontradas com processos infecciosos e inflamatórios. Foram avaliados 16 pacientes, com idades entre 10 e 50 anos, dos quais seis apresentaram alterações oftalmológicas (três pacientes com síndrome do olho seco, um paciente com estrabismo, um paciente com pterígio e um paciente com retinopatia hipertensiva e espessamento da parede arteriolar). Entretanto, pterígio e estrabismo foram considerados alterações casuais, não sendo associados à ICV. Dois pacientes com olho seco fizeram avaliação da lágrima, com a finalidade de diagnóstico precoce de possível síndrome de Sjögren, mas a avaliação foi normal. Desta forma, são necessários mais estudos e com maior número de pacientes com finalidade de estabelecer marcadores laboratoriais preditivos para lesões oftalmológicas / The common variable immunodeficiency (CVID) is a predominantly humoral immunodeficiency, with impairment in the production of immunoglobulins. Most patients have recurrent infections. However, patients with CVID may have noninfectious comorbidities, including ophthalmological changes. Ophthalmologic manifestations are very little known in patients with CVID, but some case reports have already been described in the literature. The aim of this study was to perform a complete ophthalmologic evaluation of patients with CVID who are seeing in the Immunology Ambulatory of the Hospital das Clínicas, seeking to correlate the ophthalmological manifestations found with infectious and inflammatory processes. Sixteen patients were evaluated, between the ages of 10 and 50 years, six of which presented alterations (three patients with dry eye syndrome, one patient with strabismus, one patient with pterygium and one patient with hypertensive retinopathy and arteriolar wall thickening). However, pterygium and strabismus were considered casual alterations and were not associated with CVID. Two patients with dry eye made a tear evaluation, in view of the early diagnosis of Sjögren\'s Syndrome, but it was normal. Thus, additional studies with a larger patient sample are necessary to establish predictive laboratory markers for ophthalmological injuries

Portadores de diabetes parecem ter mais queixas de olho seco do que o resto da população. Acredita-se que isto possa estar associado a uma forma de neuropatia diabética expressa por uma redução na sensibilidade corneana desses pacientes. Nossos principais objetivos neste estudo foram avaliar a influência da diabetes melito tipo 2 na sensibilidade corneana central e verificar se há uma associação entre a sensibilidade corneana central e a síndrome do olho seco em indivíduos com a doença. Assim, 62 portadores de diabetes tipo 2 foram submetidos a um exame oftalmológico de rotina, a uma ceratoestesiometria e a testes específicos para avaliar olho seco e polineuropatia distal simétrica. Num outro grupo, 20 voluntários saudáveis tiveram seus olhos avaliados da mesma forma, exceto pela não realização dos testes específicos para disfunção lacrimal. Entre os indivíduos diabéticos avaliados, foram observados 53.2% com hipoestesia corneana, 54.2% com retinopatia diabética, 45.9% com polineuropatia distal simétrica e 51.6% com a síndrome do olho seco. Entre os principais achados, observamos associações significativas envolvendo: diabetes tipo 2 e hipoestesia corneana central, síndrome do olho seco e hipoestesia corneana central, produção lacrimal reflexa (avaliada pelo teste de Schirmer II) e sensibilidade corneana central e retinopatia diabética proliferativa e sensibilidade corneana central. Uma possível associação foi encontrada envolvendo síndrome do olho seco retinopatia diabética proliferativa. Os autores discutem os resultados obtidos e os mecanismos envolvidos. / Diabetes bearers seem to have more complaints of dry eye than the rest of the population. It`s believed that this fact might be associated to a kind of diabetes neuropathy wich is represented by a reduction in corneal sensibility of these patients. Our main target in this study was to evaluate the influence of type 2 diabetes mellitus in central corneal sensibility and to determine if there is an association among central corneal sensibility and the dry eye syndrome in individuals suffering of this disease. Therefore, 62 type 2 diabetic patients were submitted to an ophthalmological routine examination, to corneal esthesiometry and to specific tests to evaluate dry eye and peripheral polineurophaty. In other group, 20 healthy volunteers had their eyes evaluated in the same way, except for the non accomplishment of the specific tests for dry eye. Among the examined diabetic individuals, 53.2% had corneal hypoesthesia, 54.2% presented diabetic retinopathy, 45.9% presented periferal polineuropathy and 51.6% presented the dry eye syndrome. Among the main findings, we observed associations between: type 2 diabetes and central corneal hypoesthesia, dry eye syndrome and central corneal hypoesthesia, reflex tear production (evaluated by Schirmer 2 test) and central corneal esthesiometry and also between proliferative diabetic retinopathy and central corneal sensibility. A possible association was found involving dry eye syndrome and proliferative diabetic retinophaty. The authors discuss the results obtained and the involved mechanisms.

Portadores de diabetes parecem ter mais queixas de olho seco do que o resto da população. Acredita-se que isto possa estar associado a uma forma de neuropatia diabética expressa por uma redução na sensibilidade corneana desses pacientes. Nossos principais objetivos neste estudo foram avaliar a influência da diabetes melito tipo 2 na sensibilidade corneana central e verificar se há uma associação entre a sensibilidade corneana central e a síndrome do olho seco em indivíduos com a doença. Assim, 62 portadores de diabetes tipo 2 foram submetidos a um exame oftalmológico de rotina, a uma ceratoestesiometria e a testes específicos para avaliar olho seco e polineuropatia distal simétrica. Num outro grupo, 20 voluntários saudáveis tiveram seus olhos avaliados da mesma forma, exceto pela não realização dos testes específicos para disfunção lacrimal. Entre os indivíduos diabéticos avaliados, foram observados 53.2% com hipoestesia corneana, 54.2% com retinopatia diabética, 45.9% com polineuropatia distal simétrica e 51.6% com a síndrome do olho seco. Entre os principais achados, observamos associações significativas envolvendo: diabetes tipo 2 e hipoestesia corneana central, síndrome do olho seco e hipoestesia corneana central, produção lacrimal reflexa (avaliada pelo teste de Schirmer II) e sensibilidade corneana central e retinopatia diabética proliferativa e sensibilidade corneana central. Uma possível associação foi encontrada envolvendo síndrome do olho seco retinopatia diabética proliferativa. Os autores discutem os resultados obtidos e os mecanismos envolvidos. / Diabetes bearers seem to have more complaints of dry eye than the rest of the population. It`s believed that this fact might be associated to a kind of diabetes neuropathy wich is represented by a reduction in corneal sensibility of these patients. Our main target in this study was to evaluate the influence of type 2 diabetes mellitus in central corneal sensibility and to determine if there is an association among central corneal sensibility and the dry eye syndrome in individuals suffering of this disease. Therefore, 62 type 2 diabetic patients were submitted to an ophthalmological routine examination, to corneal esthesiometry and to specific tests to evaluate dry eye and peripheral polineurophaty. In other group, 20 healthy volunteers had their eyes evaluated in the same way, except for the non accomplishment of the specific tests for dry eye. Among the examined diabetic individuals, 53.2% had corneal hypoesthesia, 54.2% presented diabetic retinopathy, 45.9% presented periferal polineuropathy and 51.6% presented the dry eye syndrome. Among the main findings, we observed associations between: type 2 diabetes and central corneal hypoesthesia, dry eye syndrome and central corneal hypoesthesia, reflex tear production (evaluated by Schirmer 2 test) and central corneal esthesiometry and also between proliferative diabetic retinopathy and central corneal sensibility. A possible association was found involving dry eye syndrome and proliferative diabetic retinophaty. The authors discuss the results obtained and the involved mechanisms.

Portadores de diabetes parecem ter mais queixas de olho seco do que o resto da população. Acredita-se que isto possa estar associado a uma forma de neuropatia diabética expressa por uma redução na sensibilidade corneana desses pacientes. Nossos principais objetivos neste estudo foram avaliar a influência da diabetes melito tipo 2 na sensibilidade corneana central e verificar se há uma associação entre a sensibilidade corneana central e a síndrome do olho seco em indivíduos com a doença. Assim, 62 portadores de diabetes tipo 2 foram submetidos a um exame oftalmológico de rotina, a uma ceratoestesiometria e a testes específicos para avaliar olho seco e polineuropatia distal simétrica. Num outro grupo, 20 voluntários saudáveis tiveram seus olhos avaliados da mesma forma, exceto pela não realização dos testes específicos para disfunção lacrimal. Entre os indivíduos diabéticos avaliados, foram observados 53.2% com hipoestesia corneana, 54.2% com retinopatia diabética, 45.9% com polineuropatia distal simétrica e 51.6% com a síndrome do olho seco. Entre os principais achados, observamos associações significativas envolvendo: diabetes tipo 2 e hipoestesia corneana central, síndrome do olho seco e hipoestesia corneana central, produção lacrimal reflexa (avaliada pelo teste de Schirmer II) e sensibilidade corneana central e retinopatia diabética proliferativa e sensibilidade corneana central. Uma possível associação foi encontrada envolvendo síndrome do olho seco retinopatia diabética proliferativa. Os autores discutem os resultados obtidos e os mecanismos envolvidos. / Diabetes bearers seem to have more complaints of dry eye than the rest of the population. It`s believed that this fact might be associated to a kind of diabetes neuropathy wich is represented by a reduction in corneal sensibility of these patients. Our main target in this study was to evaluate the influence of type 2 diabetes mellitus in central corneal sensibility and to determine if there is an association among central corneal sensibility and the dry eye syndrome in individuals suffering of this disease. Therefore, 62 type 2 diabetic patients were submitted to an ophthalmological routine examination, to corneal esthesiometry and to specific tests to evaluate dry eye and peripheral polineurophaty. In other group, 20 healthy volunteers had their eyes evaluated in the same way, except for the non accomplishment of the specific tests for dry eye. Among the examined diabetic individuals, 53.2% had corneal hypoesthesia, 54.2% presented diabetic retinopathy, 45.9% presented periferal polineuropathy and 51.6% presented the dry eye syndrome. Among the main findings, we observed associations between: type 2 diabetes and central corneal hypoesthesia, dry eye syndrome and central corneal hypoesthesia, reflex tear production (evaluated by Schirmer 2 test) and central corneal esthesiometry and also between proliferative diabetic retinopathy and central corneal sensibility. A possible association was found involving dry eye syndrome and proliferative diabetic retinophaty. The authors discuss the results obtained and the involved mechanisms.