João Pinheiro Costa, doctorate degree in Medicine

The Hospital da Luz ophthalmologist researched on keratoconus, a disease deforming the cornea and causing loss of vision.

João Pinheiro Costa, Hospital da Luz ophthalmologist, concluded his doctorate degree in Medicine, last January 19, at the Faculty of Medicine of Porto University (FMUP). In his thesis - entitled "The choroid in keratoconus: a marker of inflammation and progression of the disease" -, João Pinheiro Costa analyses the morphology of the choroid in patients with keratoconus, resorting to OCT (optical coherence tomography) and correlates the increase in choroidal thickness found with known pathophysiological mechanisms of the disease, such as atopy, the habit of rubbing the eyes, the inflammatory profile and progression of the disease.

The keratoconus:

• Is a disease affecting essentially teenagers and young adults;
• Causes a decrease in visual acuity, with great impact on the quality of life of patients. Often, these patients require treatment of the ocular surface, the use of hard contact lenses and surgical procedures (corneal cross-linking, ring segments implantation or cornea transplant).

"The keratoconus is defined as a progressive, bilateral and asymmetrical ectasia. Although typically considered as a non-inflammatory condition, recent evidence indicates an inflammatory role in the pathophysiology of the disease. The finding of the possibility of alterations in the posterior segment in patients with keratoconus, namely an increase in thickness of this vascular layer, raised doubts and inspired this project of research", explained the physician.

The research work, which counted with the participation of 114 patients with keratoconus and 65 controls adjusted by age, was conducted in the Ophthalmology Service of Centro Hospitalar Universitário de São João and in the labs of the Biomedicine Department of FMUP.

Among the main conclusions of the thesis, which earned the unanimous approval of the jury, we highlight the following:

• The patients with keratoconus present a significant increase in the macular choroidal thickness, compared to controls adjusted by age.
• Patients with keratoconus present increased pro-inflammatory seric cellular indexes, this being an additional evidence of a systemic inflammation role in the pathophysiology of the disease.
• The increase in choroidal thickness is positively correlated with the seric inflammatory markers described.
• The habit of rubbing the eyes and atopy are also correlated with the increase in choroidal thickness.
• The choroid profile cannot be used as a progression marker capable of differentiating the patients in need of cross-linking at a particular moment.

"These studies contribute to a better understanding of the pathophysiology of the disease and open new lines of investigation on alterations not yet described", explained João Pinheiro Costa.

The advisors of this thesis were Fernando Falcão Reis, Dulce Madeira and Ângela Carneiro (all teaching at FMUP).

In the photo, the new doctor with doctorate jury: Fernando Falcão Reis, João Pinheiro Cost, José Estevão da Costa (FMUP), Maria João Quadrado (Faculty of Medicine, Coimbra University), José Ruiz Moreno (Universidad Castilla-La Mancha, Madrid), José Paulo Andrade (FMUP) and João Lima Bernardes (FMUP).

• Facebook
• Show more
  • LinkedIn
  • E-mail
  • Copy page link
  • Print page