OBJECTIVES: Uncorrected refractive errors are the leading cause of visual impairment in children. In this cross-sectional retrospective study, we analyzed a social visual screening program for school children in São Paulo, Brazil, evaluated its impact on the prevention and treatment of children’s visual disabilities, and assessed its epidemiological outcomes to outline suggestions for its improvement. METHODS: First-grade children from public schools were submitted to prior visual screening by their teachers. Selected children were forwarded to the hospital’s campaigns for a second screening by ophthalmologists and treatment if needed. Data were analyzed for age, sex, visual acuity, biomicroscopy, refractive errors, ocular movement disorders, amblyopia, number of donated spectacles, and number of children forwarded to specialized care. RESULTS: A total of 1080 children were included with mean age of 6.24±0.45 years. Children with normal ophthalmological exam, 591 (54.7%; 95% confidence interval [CI]: 51.7%-57.7%) were dismissed and considered false-positives. Myopia, hyperopia, and astigmatism components were found in 164 (15.2%; CI: 13.1%-17.4%), 190 (17.6%; CI: 15.3%-20.0%), and 330 (30.5%; CI: 27.8%-33.4%) children, respectively. Amblyopia was diagnosed in 54 (5%; CI: 3.5%-6.4%) children, and 117 (10.8%; CI: 9.8%-12.8%) presented ocular movement disorders. A total of 420 glasses were donated. CONCLUSION: Epidemiological findings for amblyopia and refractive errors are consistent with those of similar studies. The expressive number of diagnoses performed and number of glasses donated to underprivileged children depict the importance of such projects. New guidelines to improve their cost-effectiveness, such as professional training and community sensitization, are imperative.

OBJETIVO: Avaliar alterações na camada de fibras nervosas da retina na retinopatia diabética tratada por panfotocoagulação com laser de argônio. MÉTODOS: Estudo prospectivo de portadores de retinopatia diabética submetidos a panfotocoagulação retiniana. Inicialmente, foram realizados exame oftalmológico completo e tomografia de coerência óptica. Todos pacientes foram submetidos a panfotocoagulação em um dos olhos. A camada de fibras nervosas foi avaliada por meio da tomografia de coerência óptica na 1ª semana, no primeiro, terceiro e sexto meses do tratamento. RESULTADOS: A amostra foi composta por 27 pacientes (27 olhos) portadores de diabetes mellitus tipo 2. A idade variou entre 41 e 64 anos (média de 53,7 ± 6,2 anos), sendo 10 (37%) pacientes do sexo masculino e 17 (63%) do feminino. Quanto ao tipo de retinopatia, 22,2% apresentavam RD proliferativa e 77,8%, RD não proliferativa muito grave. Houve aumento significante nas medidas da espessura da camada de fibras nervosas, permanecendo nos setores temporal, 3 e 4 horas após seis meses de seguimento. Não foi observada qualquer redução na espessura em todos parâmetros analisados. CONCLUSÃO: Não foi evidenciada, a curto e médio prazo, redução na espessura da camada de fibras nervosas em portadores de retinopatia diabética tratada por panfotocoagulação que possa ser identificável por meio da tomografia de coerência óptica. Por outro lado, alguns setores mostraram aumento na espessura durante o seguimento.

PURPOSE: To evaluate the alterations in the retinal nerve fiber layer in diabetic retinopathy treated by argon laser panphotocoagulation. METHODS: Prospective study of patients with diabetic retinopathy submitted to retinal panphotocoagulation. Initially, complete ophthalmologic examination and optical coherence tomography were performed. All patients were submitted to panphotocoagulation with argon laser in one of the eyes. The retinal fiber layer was evaluated by means of optical coherence tomography in the first week, in the first, third and sixth months after treatment. RESULTS: The sample was composed of 27 patients (27 eyes) with type 2 diabetes mellitus. The age varied from 41 to 64 years (mean of 53.7 ± 6.2 years), with 10 (37%) males and 17 (63%) females. Regarding the retinopathy, 22.2% presented proliferative DR and 77.8% very severe non proliferative DR. There was a significant increase in the fiber layer thickness measurements, remaining in the temporal sectors, 3 and 4 hours, after 6 months of follow-up. Reduction of thickness was not observed in any of the analyzed parameters. CONCLUSIONS: Reduction of the fiber layer thickness, identifiable by means of optical coherence tomography, in short and average term, was not observed in patients with diabetic retinopathy treated with panphotocoagulation. On the other hand, some sectors showed thickness increase during the follow-up.

Objetivo: Verificar os efeitos na topografia do disco óptico após a ingestão de glicerina, uma droga que pode atuar significativamente tanto na pressão intra-ocular (Po) como na pressão do líquido cérebro-raquidiano (PLCR). Métodos: Foram estudados 14 pacientes glaucomatosos recentemente diagnosticados com pressão intra-ocular acima de 25 mmHg, sem uso prévio de terapia hipotensora. Foram analisados parâmetros topográficos com o "Heildelberg Retina Tomograph" antes e após a ingestão de glicerina. Resultados: A administração de glicerina produziu uma redução significante da pressão intra-ocular de 28,2% (95% IC de 20,7 a 32,1%). Não foram observadas alterações estatisticamente significantes após ingestão de glicerina nos seguintes parâmetros topográficos: área da escavação, volume da escavação, área da rima, volume da rima, medida da forma da escavação, profundidade média da escavação e profundidade máxima da escavação. Conclusões: Nenhuma mudança significante foi observada nos parâmetros topográficos com o "Heildelberg Retina Tomograph" após a ingestão de glicerina.

Purpose: To verify the effects on optic disc topography of newly diagnosed glaucoma subjects after ingestion of glycerol, a drug that causes major changes in both the intra-ocular pressure (IOP) and cerebrospinal fluid pressure (CSFP). Methods: We studied 14 patients presenting with intra-ocular pressure over 25 mmHg, without previous use of hypotensive therapy. Results: Glycerol produced a significant intra-ocular pressure average reduction of 28.2% (95% CI of 20.7 to 32.1%). Despite the obtained intraocular pressure reduction, no significant change was observed in any evaluated topographic parameter (cup area and volume, rim area and volume, maximal and mean cup depth). Conclusions: Overall, no significant change in the topographic parameters, using the "Heildelberg Retina Tomograph", was observed after ingestion of glycerol.