Objective: To assess the number of cases and the profile of hospitalizations from varicella after the introduction of the measles, mumps, rubella and varicella combination vaccine in the public health system. Methods: Retrospective study in an infectious diseases pediatric hospital of reference in Southeast Brazil. The cases with a clinical diagnosis of varicella, from January 2011 to June 2016, were assessed from pediatricians’ medical records. The hospitalizations were classified into a pre-vaccine group and post-vaccine group, based on the date the vaccine was introduced (September 2013). Both groups were compared by age, sex, time of hospitalization, reason for hospitalization, hospital complications, duration of intensive care, and clinical outcome. Results: A total of 830 hospitalizations were recorded; 543 in the pre-vaccine period and 287 in the post-vaccine period, a reduction of 47.1% (p<0.001). In both periods, a similar profile in the hospitalizations was noticed: majority male; aged between one to five years old; most complications due to secondary causes (mainly skin infections); main outcome was clinical improvement and discharge from the hospital. In the pre-vaccine period, six deaths were recorded and two were recorded in the post-vaccine period. Conclusions: The profile of the hospitalizations was expected to stay the same since this study did not compare vaccinated with unvaccinated children, but hospitalizations before and after the vaccine was introduced. In accordance with the medical literature, we found a significant fall in the number of hospitalizations from varicella.

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Mucous membrane pemphigoid is a rare, systemic autoimmune disease characterized by the production of antigens against adapted antigens on the skin and mucous membranes. This pathology generates a chronic recurrent inflammatory process and aberrant scarring, the diagnosis difficult in the early stages of the disease. Among other characteristics, it can manifest as a chronic and recurrent conjunctivitis, the difficulty and delays the beginning of treatment. The earlier the diagnosis and the beginning of the intervention, the better the patient's visual prognosis. The present work aims to report a case of mucous membrane pemphigoid, describing its main signs and symptoms and its different forms of presentation, facilitating its early diagnosis and correct correction. The ophthalmologist plays a fundamental role in the evolution of the disease, as he is often one of the first doctors to be sought out by these patients.

Hypertensive choroidopathy is a rare vascular complication, eventually associated with pre-eclampsia, which can lead to visual loss if the underlying disease is not properly managed. This study aims to describe a rare case of a patient with heterozygosity for the prothrombin gene, who had preeclampsia and placental abruption during pregnancy, in addition to intrapartum hemorrhage, and evolved with hypertensive choroidopathy with complete remission.

Introduction: Acute retinal necrosis is a rare form of infectious necrotizing retinitis that affects individuals regardless of sex or age. It is characterized by an acute panuveitis, with associated retinal periarteritis, progressing to a diffuse necrotizing retinitis and, eventually, to retinal detachment. This study aims to report a case of acute retinal necrosis, with unilateral involvement and presumed etiology by herpesvirus. Case description: A 67-year-old man, complaining of eye pain and low visual acuity in his right eye, with 15 days of evolution. He had reduced visual acuity, anterior and posterior uveitis, with lesions suggestive of acute retinal necrosis. The patient was tested for HIV, tuberculosis, syphilis, toxoplasmosis and herpesvirus. He presented positive IgM and IgG for cytomegalovirus and positive IgG for herpes simplex virus, only. Despite the positive IgM for CMV, the treatment with Acyclovir was sustained due to the strong etiological suspicion of herpes simplex. The patient evolved with good response to treatment, progressing with clinical and visual improvement. Discussion: Acute retinal necrosis cases due to infection are frequently related to herpes simplex and varicella zoster viruses, but other viruses of the same family should be investigated. The diagnosis is clinical, in most cases, but etiological confirmation can be performed. The analysis of clinical and epidemiological factors, associated with the according classification of the onset uveitis and the observation of ophthalmological findings is a solid based thread for the etiological definition and for better management of the case. Complementary exams must be carefully requested, and the results must be associated with the clinical presentation before the medical conduct is chosen.