Fausto Carvalheira

Bio: Fausto Carvalheira is an academic researcher. The author has contributed to research in topics: Cataract surgery & Endophthalmitis. The author has an hindex of 3, co-authored 5 publications receiving 44 citations.

Postcataract surgery endophthalmitis after introduction of the ESCRS protocol: a 5-year study.

Abstract: PurposeTo present the results of a retrospective comparative unicentric institutional study of the incidence of postcataract surgery endophthalmitis before and after the introduction of the Europea...

Refractory coats' disease of adult onset.

Abstract: Purpose: We present the case of an 18-year-old Caucasian male with a unilateral macular star and retinal vascular anomalies compatible with adult onset Coats’ disease Methods: Diagnosis was based on fundoscopic, fluorescein angiography and optical coherence tomography findings Results: The patient presented to our emergency department with complaints of low vision in his left eye (LE) detected 10 days before The best-corrected visual acuity in the LE was 20/50 Fundoscopy of the LE evidenced a complete macular star Optical coherence tomography showed increased retinal thickness, infiltration of the retinal wall, and detachment of the neuroepithelium Angiography revealed no appreciable diffusion in the macula Above the superior temporal (ST) arcade, anomalies in the retinal vasculature were found, with interruption of the peripheral vessels and vessels which were ‘sausage’-like After 1 month, the LE vision evolved to hand movements Laser photocoagulation was performed in the ST quadrant Intravitreal injection of bevacizumab 125 mg/005 ml and photodynamic therapy were performed without any significant changes, progression of ST serous detachment of the neuroepithelium, and finally progression to macular fibrosis Discussion: Coats’ disease is usually diagnosed in childhood, but rare cases may occur in adults Those cases usually have a more indolent course which was not observed in our patient When there is macular involvement, prognosis is more guarded, despite treatment

Right Homonymous Hemianopia: A Clinical Case Report of Schizencephaly

Abstract: Purpose: To report a case of a 56-year-old male with right homonymous hemianopia. Methods: Retrospective descriptive study o

Ankyloblepharon filiforme adnatum: case report and literature review

Abstract: Ankyloblepharon filiforme adnatum (AFA) is a rare condition defined by a partial or complete fusion of eyelids, which can lead to privation amblyopia. A female new born was referred for ophthalmological examination at her fourth day of life due to the presence of bilateral tissue adhesions between upper and lower eyelid. The obstetric history was unremarkable, except for an advanced maternal age. The baby underwent surgical excision of the bands at the level of each eyelid margin, without complications. Neonatal examination of the new born was normal, without systemic alterations or another eye abnormality. Ankyloblepharon filiform adnatum can be associated with systemic syndromes and the treatment should be performed as soon as the diagnosis is done.

Coriorretinite Multifocal Periférica: Desafio Diagnóstico

Abstract: Objectivo : Apresentar o desafio do diagnostico e da decisao terapeutica num caso de coriorreti - nite multifocal periferica (CMP) num olho unico de um doente jovem, com historia de trauma- tismo e cirurgia ocular no olho adelfo. Metodos : Estudo descritivo de um caso clinico com base na recolha de informacao do processo clinico, observacao do doente e analise de exames complementares de diagnostico. Resultados : Doente do sexo masculino, de raca caucasiana, com 18 anos, que recorreu ao Ser - vico de Urgencia por miodesopsias do olho direito, com uma semana de evolucao. Apresentava uma acuidade visual de 10/10, precipitados queraticos granulomatosos e multiplos focos perife- ricos de coriorretinite, com vitrite e edema da papila. O olho esquerdo apresentava amaurose e desorganizacao estrutural, consequentes a traumatismo ocular ocorrido 6 anos antes. O estudo sistemico revelou apenas uma elevacao dos niveis sericos da enzima conversora da angiotensina. As hipoteses diagnosticas colocadas foram a sarcoidose ocular e a oftalmia simpatica. Com a utilizacao da terapeutica combinada (corticosteroides e ciclosporina A) obteve-se uma remissao completa da inflamacao ocular. Apos 6 meses, foi iniciada a suspensao gradual dos corticosteroides verificando-se uma recaida da inflamacao intraocular. Foi tentada a suspensao da ciclosporina A, nao se tendo registado recaidas, mesmo apos a sua suspensao. Discussao : A evolucao favoravel a terapeutica combinada e o reaparecimento da uveite anterior quando se tentou a suspensao dos corticosteroides mas nao da ciclosporina A sao dados a favor do diagnostico de sarcoidose. Deste modo, nao existindo criterios de diagnosticos de uma pro- vavel sarcoidose, conclui-se que a resposta a terapeutica pode constituir, por si mesmo, um dado importante no diagnostico de provavel sarcoidose ocular.

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey.

Abstract: A 2014 online survey of the American Society of Cataract and Refractive Surgery members indicated increasing use of intracameral antibiotic injection prophylaxis compared with a comparable survey from 2007 Forty-seven percent of respondents already used or planned to adopt this measure One half of all surgeons not using intracameral prophylaxis expressed concern about the risks of noncommercially prepared antibiotic preparations Overall, the large majority (75%) said they believe it is important to have a commercially available antibiotic approved for intracameral injection Assuming reasonable cost, the survey indicates that commercial availability of Aprokam (cefuroxime) would increase the overall percentage of surgeons using intracameral antibiotic injection prophylaxis to nearly 84% Although the majority used topical perioperative antibiotic prophylaxis, and gatifloxacin and moxifloxacin were still the most popular agents, there was a trend toward declining use of fourth-generation fluoroquinolones (60%, down from 81% in 2007) and greater use of topical ofloxacin and ciprofloxacin (21%, up from 9% in 2007)

Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis

Abstract: Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.

Update on the prevention and treatment of

Abstract: Endophthalmitis remains a rare but serious cause of visual loss. Over time, changes have been noted in endophthalmitis in terms of predominant causes, infecting organisms and antibiotic susceptibilities. There is controversy regarding the use of intracameral prophylactic antimicrobials during cataract surgery. Alternatively, there appears to be increasing evidence against using routine topical antibiotics for intravitreal injections. There are also increasing reports of multidrug-resistant organisms causing endophthalmitis, but the combination of vancomycin and ceftazidime appears effective for the vast majority of cases. Future trends may involve increasing utilization of polymerase chain reaction for diagnosis, and possibly office-based pars plana vitrectomy for treatment of endophthalmitis.