Dimensão fractal como método de avaliação de diferentes protocolos no tratamento da ceratoconjuntivite seca em cães

Abstract

keratoconjunctivitis sicca (KCS) is a chronic ophthalmopathy, of immune-mediated origin, commonly diagnosed in dogs and humans. Conventional treatment consists of the use of immunosuppressive eye drops and lubricants, and as an adjunct to oral supplementation of omegas and antioxidants. Recent research points to the use of mesenchymal stem cells (MSC) in several chronic and degenerative diseases, thus being a new alternative for the treatment of KCS due to its capacity for tissue regeneration and immunoregulatory actions. The fractal dimension (FD) calculation has been used in several areas of medicine as an additional, mathematical and quantitative method in the evaluation of complex and irregular structures. The objective of the study was evaluate and to compare different treatment protocols in CCS, using the DF method. In article 1, 210 slides of dogs' palpebral conjunctiva biopsies were evaluated, divided into 7 groups: normal group (healthy eyes), T0 (tacrolimus before treatment), T6 (tacrolimus after treatment), TO0 (tacrolimus associated with oral omega 3 before treatment), TO6 (tacrolimus associated with oral omega 3 after treatment), TOA0 (tacrolimus associated with omega 3 + antioxidants before treatment) and TOA6 (tacrolimus associated with oral omega 3 + antioxidants after treatment). In article 2, 84 histopathological slides divided into 3 groups were evaluated: normal control group (n = 28), group CTM0 at the time of diagnosis CCS (n = 28) and CTM6 after 6 months of treatment with CTM (n = 28). In article 1, the normal group had a higher fractal dimension value than the other groups (1.84 ± 0.04) and the T0 group had a lower value (1.66 ± 0.07). A statistically significant difference was found between all groups (p <0.05), except in the TO6 group (1.81 ± 0.06), which presented values closer to the normality group. In article 2, there was a statistical difference (p <0.05) when the CTM0 group (1.71 ± 0.15) was compared with the normal groups (1.78 ± 0.03). The CTM6 group (post treatment) presented DF values like the normal group and without statistical difference (p = 0.2). We conclude that the DF calculation mathematically evaluated that treatment with topical tacrolimus associated with oral omega 3 supplementation showed values closer to normality, and treatment with MSC presented values similar to the normality group, which may suggest that these treatment protocols managed to restore better connective tissue. In this way, the fractal dimension method showed good applicability and was an important tool for the analysis of biopsy samples quantitatively and may be an additional evaluation of histopathological slides in the study of ocular pathologies.