EDITORIA EDITORIAL

In this issue of ABO

Neste fascículo do ABO

Wallace Chamon

Physician, Department of Ophthalmology, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil and Visiting Professor, Department of Ophthalmology & Visual Sciences, College of Medicine, University of Illinois at Chicago (UIC) - Chicago (IL), EUA

This issue of ABO brings interesting articles in epidemiology, basic research, new technologies and randomized clinical trials.

Kara-Júnior and his colleagues⁽¹⁾ presented the results of a questionnaire administered to more than 600 patients treated in a campaign to perform cataract surgery in São Paulo. The study showed a sad reality for patients excluded from the comprehensive eye care. Almost half of all patients interviewed were unable to gain access to cataract surgery before the campaign, because they have abandoned the free public service as a result of the long waiting lists or for failing to schedule their surgeries (19%), or did not have the resources to afford the costs associated with surgeries performed by health insurance or private care (29%). The costs reported by patients who had not sought public service ranged from R$ 1,000 to over R$ 4,000.00. Authors rightly emphasized in their conclusions "the need to continue to carry out community campaigns to meet people who would not have access to surgery by conventional means." I also believe it is important to consider that, despite the campaigns being indispensable at the present time the Brazilian public health, we must keep in mind that, ideally, access to health care should be possible for the whole population without the need to create specific campaigns.

Patients with anophthalmic cavities were evaluated in two articles^(2,3). Narikawa and colleagues⁽²⁾ retrospectively analyzed the epidemiological profile of 107 patients with anophthalmic cavity in a reference service in the state of São Paulo, detecting trauma as the most frequent etiology, especially in men. In another study conducted in the Federal District, Goulart and colleagues⁽³⁾ assessed the psychosocial aspects involved in the rehabilitation of patients with anophthalmic cavity. In their study, which evaluated 44.4% of patients with anophthalmic cavity since 2004, the trauma was also nominated as the most frequent cause. In this sample, one third of patients said that the eye loss negatively influenced their daily routine.

Several epidemiological, clinical and basic research articles focused on retinal aspects. In another epidemiological study, evaluating patients with sickle cell disease, Freitas and colleagues⁽⁴⁾ demonstrated that routine eye examination may, in specific cases, establish clinical suspicion of systemic diseases. Gil and colleagues⁽⁵⁾ conducted a randomized double-blind clinical trial to compare, through morphological and functional assessment, the treatment of diffuse diabetic macular edema with intravitreal triamcinolone and with laser phototherapy. Twenty-one eyes of 14 patients were randomly assigned to each group. Although intravitreal injection have led to the decrease in retinal thickness measured by OCT, the study showed no functional differences between the initial examination after three months of treatment in either group. In a study of basic research, evaluating a promising anti-inflammatory drug for intravitreal use, Rassi et al.⁽⁶⁾ demonstrated that infliximab can be used repeatedly for two or three times, with minimal retinal toxicity in rabbits. In another study comparing the action of the ranibizumab and bevacizumab "in vitro", Souto et al.⁽⁷⁾ showed greater effect than the first in cultured endothelial cells from human umbilical cord vein.

Bottós and colleagues⁽⁸⁾ addressed, through novel basic research, a very important subject related to the promotion of corneal collagen crosslinking (CXL): the influence of the corneal epithelium in maintaining the effectiveness of CXL. In this novel approach the authors found that the maintenance of epithelium does not interfere in the transmission of ultraviolet light to the corneal stroma, but interferes with the absorption of riboflavin for the same. This study opens up space for future research in the transepithelial use of drugs that promote crosslinking and are able to cross the epithelial barrier.

Two studies used ocular ultrasound associated to Doppler technology to assess blood flow in the ophthalmic artery⁽⁹⁾ as well as in central retinal artery and short posterior ciliary arteries⁽¹⁰⁾. Almeida-Freitas et al.⁽⁹⁾ evaluated the flow of the ophthalmic artery in 18 patients with chronic heart failure and 21 controls, demonstrating differences between groups in diastolic velocity and arterial resistance index. Ramos and colleagues⁽¹⁰⁾ used the same technology to study the central retinal artery and short posterior ciliary arteries in 36 patients with glaucoma and 20 controls. In this study, Doppler data were associated with visual perimetry results showing that, together, these data have 90% sensitivity in glaucoma diagnosis.

Torricelli and colleagues⁽¹¹⁾ wrote an interesting review article on a problem that increasingly affects the world's urban population: environmental pollution. The manuscript addresses the pertinent literature and concludes that, although there are many studies on the effects of pollution on the respiratory system, the literature is scarce in relation to ocular alterations related to environmental pollution.

REFERENCES

1. Kara-Júnior N, Dellapi Jr. R, Espindola RF. Dificuldades de acesso ao tratamento de pacientes com indicação de cirurgia de catarata nos sistemas de saúde público e privado. Arq Bras Oftalmol. 2011;74(5):323-5.         

2. Narikawa S, Natsuaki KL, Fruet J, Padovani CR, Schellini SA. Perfil dos portadores de cavidade anoftálmica - estudo na Faculdade de Medicina de Botucatu - UNESP. Arq Bras Oftalmol. 2011;74(5):357-60.         

3. Goulart DR, Queiroz E, Fernandes AUR, Oliveira LM. Aspectos psicossociais envolvidos na reabilitação de pacientes com cavidade anoftálmica: implicações do uso de prótese ocular. Arq Bras Oftalmol. 2011;74(5):330-4.         

4. Freitas LGA, Isaac DLC, Tannure WT, Lima EVS, Abud MB, Tavares RS, Freitas CA, Ávila MP. Alterações retinianas apresentadas em pacientes portadores de hemoglobinopatia falciforme atendidos em um serviço universitário de oftalmologia. Arq Bras Oftalmol. 2011;74(5):335-7.         

5. Gil AL, Azevedo MJ, Tomasetto GG, Muniz CHG, Lavinsky J. Treatment of diffuse diabetic maculopathy with intravitreal triamcinolone and laser photocoagulation: randomized clinical trial with morphological and functional evaluation. Arq Bras Oftalmol. 2011; 74(5):343-7.         

6. Rassi AR, Rigueiro MP, Isaac DLC, Dourado L, Abud MB, Freitas EC, Carneiro LB, Ávila MP. Estudo de toxicidade retiniana após injeções intravítreas seriadas de infliximabe em olhos de coelhos. Arq Bras Oftalmol. 2011;74(5):352-6.         

7. Souto AC, Maricato JT, Denapoli PMA, Sallum JMF, Han SW. Comparação do efeito antiangiogênico do ranibizumab e do bevacizumab in vitro. Arq Bras Oftalmol. 2011; 74(5):338-42         

8. Bottós KM, Schor P, Dreyfuss JL, Nader HB, Chamon W. Effect of corneal epithelium on ultraviolet-A and riboflavin absorption. Arq Bras Oftalmol. 2011;74(5):348-51.         

9. Almeida-Freitas DB, Meira-Freitas D, Melo Jr. LAS, Paranhos JR. A, Iared W, Ajzen S. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure. Arq Bras Oftalmol. 2011;74(5):326-9.         

10. Ramos MHMC, Bergés O, Prata Jr. JA, Allemann N. Análise discriminante dos pacientes portadores de glaucoma primário de ângulo aberto através do exame de Doppler colorido e do campo visual. Arq Bras Oftalmol. 2011;74(5):361-4.         

11. Torricelli AAM, Novaes P, Matsuda M, Alves MR, Monteiro MLR. Ocular surface adverse effects of ambient levels of air pollution. Arq Bras Oftalmol. 2011;74(5):377-82.         

Submitted for publication: November 25, 2011
Accepted for publication: November 25, 2011
Funding: No specific financial support was available for this study.
Disclosure of potential conflicts of interest: W.Chamon, None.