University of São Paulo: Preventable diseases are important causes of intractable visual impairment

Global studies indicate that the number of people with low functional vision, characterized by intractable visual impairment, is increasing. With the objective of tracing the profile of patients with the condition, researchers from the Faculty of Medicine of Ribeirão Preto (FMRP) at USP evaluated the medical records of people treated at the Rehabilitation Center (CER) of the Hospital das Clínicas da FMRP (HCFMRP) between 2009 and 2017.

“As there are few epidemiological studies that tell us the causes of low functional vision or irreversible blindness, especially in children, articles like this one help us to have an overview of the main diseases in our region. In this way, we can plan health education, diagnosis, treatment and rehabilitation actions”, explains Manuela Molina Ferreira, an ophthalmologist with a master’s degree from the FMRP and first author of the study Causes of functional low vision in a Brazilian rehabilitation service .

The results of the study in Ribeirão Preto showed that, among children, the three main causes of low functional vision are: cerebral palsy (neurological alteration that affects motor and cognitive development) in 27.9% of cases, ocular toxoplasmosis (disease caused by by a protozoan) in 8.2%, and retinopathy of prematurity (problem in retinal vascularization) in 7.8%. “In the last two situations, it is possible to adopt preventive measures that can reduce the index. For example, guidance on water and food consumption for cases of toxoplasmosis and education campaigns aimed at pregnant women about retinopathy of prematurity, in addition to adequate prenatal care,” he says.

Among middle-aged and elderly adults, diabetic retinopathy, which is caused by damage to the blood vessels of the retina and is associated with poor blood glucose control, is present in 18% of cases and age-related macular degeneration, which it is a progressive lesion of the macula, in 25.3%. “Retinopathy is an important cause and the data tell us that many diabetics are not properly controlling their blood glucose”, explains João Marcello Furtado, professor at FMRP and coordinator of the study.

Furtado says that age-related macular degeneration is the main cause in the elderly. “The disease has an expensive and non-curative treatment. Therefore, with the increase in life expectancy that is expected to occur in the coming decades, the impact of age-related macular degeneration is expected to be even greater in the near future,” he says.

The importance of the result lies in increasing knowledge about diseases that are related to low functional vision. “If we manage to avoid blindness, we improve people’s quality of life and increase the chance of these individuals reaching a higher level of study and productivity at work. This generates a direct benefit for those who suffer the health action, but also for their surroundings and society in general”, concludes Professor Furtado.

The search
The researchers retrieved and evaluated data from the physical and digital medical records of people treated at the HCFMRP’s Visual Rehabilitation outpatient clinic (CER) between 2009 and 2017. prescribed optical aids.

For the studies, 1,393 patients were included, who were separated into three age groups: from 0 to 14 years old, from 15 to 49 years old and 50 years old or older. The elderly represented the largest number, with 38.8% of patients, followed by children with 36.7%.

The study Causes of functional low vision in a Brazilian rehabilitation service was published in the journal Scientific Reports, by the Nature group, in February and was authored by Manuela Ferreira, Furtado and physician Rosalia Antunes Foschini, from the HCFMRP.

Rehab center
Created in December 2007, the HCFMRP CER is a reference in high-complexity rehabilitation for Ribeirão Preto and the region. The services are aimed at the areas of Physical, Visual, Hearing, Intellectual, Ostomy and Multiple Disabilities Rehabilitation, in addition to dispensing orthoses, prostheses, mobility aids and optical aids.

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