Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2006. / Härtill 4 uppsatser.

Thesis (Ph. D.)--Case Western Reserve University, 2005. / [School of Medicine] Department of Pharmacology. Includes bibliographical references. Available online via OhioLINK's ETD Center.

Thesis (M.S.)--Worcester Polytechnic Institute. / Keywords: Diabetes; imaging; phosphorescence; retina. Includes bibliographical references (p. 69-70).

Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 190-220.

Thesis (Ph.D.)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 95 pages. Includes Vita. Includes bibliographical references.

Introdução: A retinopatia da prematuridade (ROP) é uma das principais causas de cegueira e morbidade visual na infância. É uma doença ocular vasoproliferativa secundária à vascularização inadequada da retina dos recém-nascidos (RNs) prematuros (PMTs), cuja etiologia é multifatorial e não está completamente elucidada. Dentre os fatores implicados na sua patogênese estão a exposição da retina em desenvolvimento a níveis anormais de oxigênio e a deficiência do fator de crescimento insulínico-1 (insulin-like growth factor-1, IGF-1). O leite materno (LM) contém IGF-1 e pode ter um efeito protetor contra o desenvolvimento da ROP. Objetivos: Avaliar o possível efeito protetor do LM contra a ROP, através da comparação da quantidade de LM recebida entre os pacientes que desenvolveram ROP e aqueles livres da doença. Tentar determinar a quantidade mínima necessária e o momento em que o RN precisa receber o LM para que esse efeito seja significativo. Pacientes e métodos: Estudo de coorte observacional incluindo RNs com peso de nascimento (PN) inferior a 1500 gramas e / ou com idade gestacional (IG) inferior a 32 semanas, nascidos no período de janeiro de 2011 a outubro de 2014 e internados nas primeiras 24 horas de vida na UTI Neonatal do Hospital da Criança Conceição (HCC) em Porto Alegre. Resultados: A prevalência da ROP em qualquer grau foi de 31% (100 casos em 323 pacientes) e a de ROP grave foi de 9% (29 casos em 323 pacientes). A mediana da quantidade de LM recebida pelos pacientes foi de 10,2mL/kg/dia entre os pacientes sem ROP (amplitude interquartil 1,5-25,5) e de 4,9 mL/kg/dia entre os pacientes com ROP (0,3-15,4). A quantidade de LM recebida nas primeiras seis semanas de vida foi inversamente associada à incidência de ROP em qualquer grau e de ROP grave nas análises univariadas, mas a significância estatística não se manteve após análise multivariada para controle de fatores confundidores na maioria dos períodos avaliados, exceto na sexta semana de vida. Conclusão: Pequenas quantidades de LM não são suficientes para prevenção de ROP em PMTs de risco para a doença. / Introduction: Retinopathy of prematurity (ROP) is one of the major causes of blindness and visual morbidity in childhood. It is a vasoproliferative eye disease secondary to inad-equate vascularization of the retina in premature neonates. Its etiology is multifactorial and it is not completely elucidated. The exposure of the developing retina to abnormal oxygen levels and the deficiency of insulin-like growth factor-1 (IGF-1) are among the factors involved in its pathogenesis. Breast milk (BM) contains IGF-1 and may have a protective effect against the development of ROP. Objectives: To evaluate the possible protective effect of BM against ROP by comparing the amount of breast milk received among patients who developed ROP and those who were disease-free. To attempt to determine both the required minimum amount and the time in which a neonate needs to receive BM for this effect to be significant. Patients and methods: Observational cohort study of newborns with a birth weight be-low 1500 grams and/or gestational age less than 32 weeks, born from January 2011 to October 2014 and hospitalized within their first 24 hours of life in the Neonatal Intensive Care Unit (NICU) at the Hospital da Criança Conceição (HCC), in Porto Alegre- RS- Brazil. Results: The prevalence of ROP at any degree was of 31% (100 cases in 323 patients) and of severe ROP was of 9% (29 cases in 323 patients). The median amount of BM received by patients was 10.2 mL/kg/day among patients without ROP (interquartile range 1.5-25.5) and 4.9 mL/kg/day among patients with ROP (0.3-15.4). The amount of breast milk received in the first six weeks of life was inversely associated with the inci-dence of ROP in any degree and of severe ROP in the univariate analyses. The statistical significance was not maintained after a multivariate analysis to control for confounding factors in the majority of the periods evaluated, except in the sixth week of life. Conclusion: Small amounts of BM are not enough to prevent ROP in premature new-borns at risk of the disease.

PURPOSE: This study examined the surgical outcomes after pars plana vitrectomy in patients with proliferative diabetic retinopathy at various stages of posterior vitreous detachment. The investigation assessed the changes in visual acuity and the frequency of complications associated with each stage of detachment. METHODS: This retrospective, single-site, single-surgeon study reviewed 328 medical records of patients at Beth Israel Deaconess Medical Center (Boston, MA) requiring pars plana vitrectomy (PPV) for complications of proliferative diabetic retinopathy between 2000 and 2017. The 328 patients were separated into 4 groups based on their vitreous status (Stages 0 and 1, Stage 2, Stage 3, and Stage 4). Preoperative characteristics were collected, including best-corrected visual acuity (BCVA) and diabetes duration. Complications, visual acuity, and reoperation data were collected postoperatively. RESULTS: Sixty-one percent of the patients in the combined group (Stages 0 and 1), 56% in Stage 2, 67% in Stage 3, and 77% in Stage 4 did not require a revision PPV. Thirteen percent of the patients in the combined group, 13% in Stage 2, 5% in Stage 3, and 0% in Stage 4 required a revision PPV for retinal detachment. This represented a statistically significant difference between the groups (p = 0.0254). The combined group had a postoperative change in BCVA of 0.31 compared with 0.29 for Stage 2, 0.67 for Stage 3, and 0.90 for Stage 4. These BCVA changes represented a statistically significant difference (p = 0.0001) between the groups. CONCLUSIONS: This study shows that having a preoperative posterior vitreous detachment leads to improved visual acuity postoperatively and decreased chance of developing a postoperative retinal detachment. The study also indicates that increased vitreoretinal traction results in less change in visual acuity and an increase in complications. Further research is needed to validate these findings.

abstract: Diabetic retinopathy (DR) is a common cause of blindness occurring due to prolonged presence of diabetes. The risk of developing DR or having the disease progress is increasing over time. Despite advances in diabetes care over the years, DR remains a vision-threatening complication and one of the leading causes of blindness among American adults. Recent studies have shown that diagnosis based on digital retinal imaging has potential benefits over traditional face-to-face evaluation. Yet there is a dearth of computer-based systems that can match the level of performance achieved by ophthalmologists. This thesis takes a fresh perspective in developing a computer-based system aimed at improving diagnosis of DR images. These images are categorized into three classes according to their severity level. The proposed approach explores effective methods to classify new images and retrieve clinically-relevant images from a database with prior diagnosis information associated with them. Retrieval provides a novel way to utilize the vast knowledge in the archives of previously-diagnosed DR images and thereby improve a clinician's performance while classification can safely reduce the burden on DR screening programs and possibly achieve higher detection accuracy than human experts. To solve the three-class retrieval and classification problem, the approach uses a multi-class multiple-instance medical image retrieval framework that makes use of spectrally tuned color correlogram and steerable Gaussian filter response features. The results show better retrieval and classification performances than prior-art methods and are also observed to be of clinical and visual relevance. / Dissertation/Thesis / M.S. Electrical Engineering 2012

O comprometimento macular na retinopatia diabética pode ocorrer devido a isquemia macular, hemorragias maculares intra-retinianas e pré-retinianas, descolamento macular tracional, neovascularização e mais freqüentemente o edema macular. Cerca de 10% da população total de pacientes com diabete melito (DM) e 25% daqueles com mais de 20 anos de evolução da doença apresentam edema macular, constituindo a principal causa de perda visual neste grupo de pacientes(1-3). Em pacientes com DM tipo 1, o edema macular é visto raramente antes dos primeiros nove anos após o diagnóstico de DM(4), ao contrário de pacientes diabéticos tipo 2 cujo início da maculopatia é mais precoce. A detecção e o tratamento precoce do edema macular podem resultar na melhora ou na estabilização da visão. Novas teorias sobre a fisiopatologia do edema macular surgiram nos últimos anos e novas terapias como a triancinolona sub-tenoneana ou intravítrea, os anti-VEGFs e implantes intravítreos de liberação lenta de dexametasona foram testadas a partir destes conhecimentos. Este manuscrito propõe a revisão destes conceitos e em especial, dos novos aspectos terapêuticos. / The macular commitment on diabetic retinopathy can occur due to macular ischaemia, intraretinal or preretinal haemorrhages, tractional detachment, neovascularization and more frequently, macular edema. About 10% of the diabetic population and 25% of those with more than 20 years of illness, present macular edema, constituting the main cause of visual loss in this group of patients (1-3). In diabetic type 1 patients, macular edema is rarely seen before 9 years after the diagnostic(4). On the other hand, in diabetic type 2 patients, the maculopathy appears earlier. The detection and the precocious treatment of macular edema can result a visual improvement or stabilization. New theories about the fisiopathology of macular edema had appeared in the last years and new therapies such as sub-tenonean or intravitreal triamcinolone, the anti- VEGFs and slow liberation intravitreal implants of dexametazone were tested since this knowledge. This article considers the revision of these concepts and specially, new therapeutic aspects.