ABSTRACT Purpose: To evaluate the profile of emergency eye-related visits at a reference eye hospital in Sao Paulo during the first months of the quarantine due to the coronavirus disease (COVID-19) pandemic and to compare it with that in the same period of the previous year. Methods: Data were obtained from the emergency department of Ophthal Hospital Especializado, Sao Paulo, Brazil. All the cases registered between March 23 and May 19, 2020, were included in the study as Group 2020. The cases registered between March 23 and May 19, 2019, were included in the study as Group 2019. Frequency tables were used for the descriptive analyses. The chi-square and Fisher exact tests were applied to compare categorical variables between the groups. Results: We observe a decrease of 46.15% in the number of cases during the COVID-19 pandemic in 2020 compared with the same period in 2019. We observed a significant increase in the incidence rates of the following pathologies in 2020 compared with 2019: eyelid disorders (12.3%), corneal disorders (97.1%), retinal pathologies (173.1%), refraction (62.9%), glaucoma (acute and chronic; 43.9%), scleral alterations (68.8%), trauma (39.3%), herpes (54.7%), and cataracts (549.9%). On the other hand, the incidence rates of the following disorders decreased: conjunctivitis (-33.4%), disorders of lacrimal system (-81.0%), iridocyclitis (-39.9%), and postoperative visits (-80.1%). Conclusion: During the early phase of the COVID-19 pandemic, we observed a drastic decrease in the number of patients who visited the emergency eye service. The main reasons for visiting were also changed, with higher frequencies of high-severity cases such as retina disturbances, cornea disturbances, glaucoma, and trauma and lower frequencies of transmittable conditions such as conjunctivitis.

RESUMO Objetivos: Avaliar o perfil das consultas de emergência oftalmológicas durante os primeiros meses de quarentena por pandemia de covid-19 em um hospital oftalmológico de referência em São Paulo e compará-lo com o mesmo período do ano anterior. Métodos: Os dados foram extraídos do serviço de emergência do Hospital Ophthal Especializado, São Paulo, Brasil. Todos os casos registrados entre 23 de março e 19 de maio de 2020 foram incluídos no estudo como Grupo 2020. Os casos registrados entre 23 de março e 19 de maio de 2019 foram incluídos no estudo como Grupo de 2019. Tabelas de frequência foram utilizadas para análises descritivas. Os testes Qui-quadrado e Exato de Fisher foram aplicados para comparar variáveis categóricas entre os grupos. Resultados: Observamos uma diminuição de 46,15% no número de casos durante a pandemia Covid-19 em 2020 quando comparado ao mesmo período sem pandemia em 2019. Foi observado um aumento significativo nos achados de pálpebra (+12,3%), córnea (+97,1%), retina (+173,1%), refração (+62,9%), glaucoma (+43,9%), esclera (+68,8%), trauma (+39,3%), herpes (+54,7%) e catarata (+549,9%) em 2020 quando comparado para 2019. Por outro lado, houve redução nos casos de conjuntivite (-33,4%), transtornos do aparelho lacrimal (-81,0%), iridociclite (-39,9%) e consultas pós-operatórias (-80,1%). Conclusão: durante a fase inicial da pandemia Covid-19, foi observada uma redução drástica no número de pacientes que procuram o serviço de emergência ocular. Houve também uma mudança nos principais motivos para visitas com frequências mais altas de casos de alta gravidade como distúrbios da retina, distúrbios da córnea, glaucoma e trauma, e frequências mais baixas de condições transmissíveis como conjuntivite.

ABSTRACT This is a case report involving a 56-year-old male patient with a history of pars plana vitrectomy due to a rhegmatogenous retinal detachment in the right eye that resulted in the implantation of a drainage device after the patient developed secondary glaucoma. Two years after the device’s implantation, the patient was referred to our care as his visual acuity had decreased to 20/200 (1.00 LogMAR). At the fundus evaluation, a choroidal amelanotic elevation was observed at the upper temporal equator, and a potential diagnosis was made of amelanotic choroidal melanoma. The ultrasound exam visualized the patient’s implanted superotemporal justabulbar drainage device, which revealed a transscleral communication from the plate fibrocapsular’s draining space to the suprachoroidal space (fistula). The ultrasound also revealed a focal pocket of choroidal detachment in the patient’s superotemporal region, simulating an amelanotic choroidal melanoma. A new pars plana vitrectomy was performed to remove the internal limiting membrane without repercussions at the fistula site. The patient’s recovery progressed well, and he regained a visual acuity of 20/70 (0.55 LogMAR). To the best of our knowledge, this is the first case report of this condition.

RESUMO Relato de caso de paciente 56 anos, sexo masculino, com histórico de vitrectomia via pars plana por descolamento de retina em olho direito e posterior implante de dispositivo de drenagem por glaucoma secundário. Dois anos após o procedimento foi encaminhado ao serviço por baixa de acuidade visual (AV) de 20/200 (1.00 LogMAR). À fundoscopia, observou-se uma elevação amelanótica temporal no equador com hipótese diagnóstica de melanoma de coroide amelanótico. O exame de ultrassom mostrou implante de dispositivo de drenagem justabulbar temporal superior com comunicação transescleral para espaço subcoroidal (fístula), sugerindo bolsão focal de descolamento de coroide em equador temporal superior simulando melanoma de coroide amelanótico. O paciente foi abordado cirurgicamente devido membrana epirretiniana com nova vitrectomia via pars plana para peeling de membrana limitante interna, sem repercussões no local da fístula, evoluindo bem com acuidade visual de 20/70 (0.55 LogMAR). Ao nosso conhecimento, este é o primeiro caso relatado nessa condição.

RESUMO Relato de caso de paciente 56 anos, sexo masculino, com histórico de vitrectomia via pars plana por descolamento de retina em olho direito e posterior implante de dispositivo de drenagem por glaucoma secundário. Dois anos após o procedimento foi encaminhado ao serviço por baixa de acuidade visual (AV) de 20/200 (1.00 LogMAR). À fundoscopia, observou-se uma elevação amelanótica temporal no equador com hipótese diagnóstica de melanoma de coroide amelanótico. O exame de ultrassom mostrou implante de dispositivo de drenagem justabulbar temporal superior com comunicação transescleral para espaço subcoroidal (fístula), sugerindo bolsão focal de descolamento de coroide em equador temporal superior simulando melanoma de coroide amelanótico. O paciente foi abordado cirurgicamente devido membrana epirretiniana com nova vitrectomia via pars plana para peeling de membrana limitante interna, sem repercussões no local da fístula, evoluindo bem com acuidade visual de 20/70 (0.55 LogMAR). Ao nosso conhecimento, este é o primeiro caso relatado nessa condição.

ABSTRACT This is a case report involving a 56-year-old male patient with a history of pars plana vitrectomy due to a rhegmatogenous retinal detachment in the right eye that resulted in the implantation of a drainage device after the patient developed secondary glaucoma. Two years after the device’s implantation, the patient was referred to our care as his visual acuity had decreased to 20/200 (1.00 LogMAR). At the fundus evaluation, a choroidal amelanotic elevation was observed at the upper temporal equator, and a potential diagnosis was made of amelanotic choroidal melanoma. The ultrasound exam visualized the patient’s implanted superotemporal justabulbar drainage device, which revealed a transscleral communication from the plate fibrocapsular’s draining space to the suprachoroidal space (fistula). The ultrasound also revealed a focal pocket of choroidal detachment in the patient’s superotemporal region, simulating an amelanotic choroidal melanoma. A new pars plana vitrectomy was performed to remove the internal limiting membrane without repercussions at the fistula site. The patient’s recovery progressed well, and he regained a visual acuity of 20/70 (0.55 LogMAR). To the best of our knowledge, this is the first case report of this condition.

Abstract Aim: The present study aimed to analyze the effects of N-acetylcysteine supplementation associated with concurrent training on the bone mineral density of spontaneously hypertensive elderly rats. Methods: For the present study, 28 male spontaneously hypertensive rats, six months old, were distributed in the following groups: control (C, n=7); control + N-acetylcysteine (CNAC, n=7); concurrent training (T, n=7); and concurrent training+N-acetylcysteine (TNAC, n=7). The concurrent training was composed of aerobic training on a treadmill and resistance training in the same training session, three times a week. Animals of the NAC groups received a dose equivalent to 120 mg/kg/day orally for eight weeks. The animals in the trained groups underwent training for eight weeks. The animals were evaluated at the beginning and end of the experiment. After euthanasia, the tibias and femurs were submitted to bone densitometry analysis in an X-ray dual emission device. Results: Lower weight variation was observed in the trained animals and a reduction in pressure values in all groups, but without a statistical difference (p> 0.05). The animals in the T and TNAC groups presented a better performance in the physical tests (p <0.05). In relation to bone, the NAC groups demonstrated a decrease in femoral bone density when compared to groups C and T. Finally, all experimental groups demonstrated an increase in tibial bone density, but with no statistical difference (p>0.05). Conclusion: The animals in group T demonstrated better performance in the physical tests. In addition, the NAC caused a reduction in the bone mineral density of the femur.