Objective: To evaluate indications, results and strategy of retinal exams requested at Primary Care Units. Methods: A retrospective study that analyzed the indications and results of retinal exams, in the modalities clinical dilated fundus exams and color fundus photographs. In the following situations, patients were considered eligible for color fundus photographs if visual acuity was normal and ocular symptoms were absent: diabetes mellitus and/or hypertension, in use of drugs with potential retinal toxicity, diagnosis or suspicion of glaucoma, stable and asymptomatic retinopathies, except myopia greater than-3.00 diopters. Results: A total of 1,729 patients were evaluated (66% female, age 63.5±15.5 years), and 1,190 underwent clinical dilated fundus exam and 539 underwent color fundus photographs. Diabetes was present in 32.2%. The main indications were diabetes (23.7%) and glaucoma evaluation (23.5%). In 3.4% of patients there was no apparent indication. The main results were a large cup/disc ratio (30.7%) and diabetic retinopathy (13.2%). Exam was normal in 9.6%, detected peripheral changes in 7% and could not be performed in 1%. Considering patients eligible for fundus photographs (22.4%), more than half underwent clinical dilated fundus exams. Conclusion: Regarding exam modality, there were no important differences in the distribution of indications or diagnosis. Color fundus photograph is compatible with telemedicine and more cost-effective, and could be considered the strategy of choice in some scenarios. Since there are no clear guidelines for retinal exams indications or the modality of choice, this study may contribute to such standardization, in order to optimize public health resources.

Objective To describe retinal diseases found in patients who were waiting for treatment at a tertiary care hospital in Rio Branco, Acre, Brazil. Methods Patients underwent slit lamp biomicroscopy, dilated fundus exam and ocular ultrasound. Patients were classified according to phakic status and retinal disease of the most severely affected eye.Results A total of 138 patients were examined. The mean age was 51.3 years. Diabetes was present in 35.3% and hypertension in 45.4% of these patients. Cataract was found in 23.2% of patients, in at least one eye. Retinal examination was possible in 129 patients. The main retinal diseases identified were rhegmatogenous retinal detachment (n=23; 17.8%) and diabetic retinopathy (n=32; 24.8%). Out of 40 patients evaluated due to diabetes, 13 (32.5%) had absent or mild forms of diabetic retinopathy and did not need further treatment, only observation.Conclusion Diabetic retinopathy was the main retinal disease in this population. It is an avoidable cause of blindness and can be remotely evaluated, in its initial stages, by telemedicine strategies. In remote Brazilian areas, telemedicine may be an important tool for retinal diseases diagnosis and follow-up.

Objective To evaluate retinal changes in patients who underwent solid organ or bone marrow transplantation.Methods A retrospective analysis of medical records of patients evaluated from February 2009 to December 2016. All patients included underwent funduscopy. Clinical and demographic data regarding transplantation and ophthalmological changes were collected.Results A total of 126 patients were analyzed; of these, 108 underwent transplantation and 18 were in the waiting list. Transplantation modalities were heart, lung, kidney, liver, pancreas, combined pancreas and kidney and bone marrow transplantation. The main pre-transplantation comorbidities were diabetes and arterial hypertension. Of the 108 transplanted patients, 82 (76%) had retinal changes. All patients who underwent pancreas or combined pancreas and kidney transplantation had diabetic retinopathy. The main retinal changes found were diabetic retinopathy, hypertensive retinopathy, retinal vascular occlusions, chorioretinal infections and central serous chorioretinopathy.Conclusion Retinal changes were either related to preexisting conditions, mainly diabetic retinopathy, or developed postoperatively as a complication of the surgical procedure, or as an infection related to the immunosuppressive status, or due to drug toxicity. These patients may present with complex ophthalmological changes and should be carefully evaluated prior to surgery and further followed by an ophthalmologist skilled in the management of diabetic retinopathy and posterior pole infections.

O presente artigo focalizado sobre o romance Se o passado não tivesse asas, do escritor angolano Pepetela visa esclarecer a presença do cronotopo, conforme a compreensão e definição do pensador russo Mikhail Bakhtin, no texto pepeteliano, como forma de garantir técnica e fortalecer a mensagem e os objetivos estéticos da obra. O romance se passa em duas épocas, em 1995 e 2012, e tem como protagonista a menina Himba que muda seu nome para Sofia, como seu amigo Kassule muda o nome para Diego, com o fim de escaparem da guerra e do passado de órfãos de guerra. Ao longo do texto, comparamos os cronotopos elencados por Bakhtin e os exemplificamos na obra de Pepetela.

Estação das chuvas (2010) narra a estória de Lídia do Carmo Ferreira e do narrador-jornalista. Engloba um período da história de Angola, a partir da Independência, abrangendo acontecimentos anteriores e posteriores. Há uma perspectiva crítica, via “metaficção historiográfica”, no universo pós-moderno, em que a história oficial é permanentemente questionada. Há o estreitamento dos limites entre a história e a ficção, como no episódio da televisão da cadeia de São Paulo. O autor estabelece a construção de uma poética do encontro, através do convívio e da comunicação consensual entre os personagens, representantes de vários matizes políticos, ideológicos e étnicos, com o fim de oferecer a possibilidade de uma Angola diferente daquela que foi determinada pela conduta do MPLA e de Agostinho Neto.