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1.
Neuroophthalmology ; 48(5): 348-351, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39145323

RESUMO

Arachnoid cysts (ACs) are cerebrospinal fluid collections between the two layers of the normal arachnoid membrane. Although they are often asymptomatic with a stationary course, eventual complications may occur. Herein, we report the case of a 9-year-old boy who developed bilateral papilloedema secondary to spontaneous rupture of an AC in the left middle cranial fossa. Although the papilloedema worsened during follow-up, his visual field remained bilaterally stable, supporting the expectant management and obviating the potential morbidity associated with neurosurgical intervention. This case report highlights the importance of a multidisciplinary approach to patients with secondary intracranial hypertension, including serial ophthalmological examinations, which provide a useful guide to surgical decision-making.

2.
Rev. cuba. oftalmol ; 36(2)jun. 2023.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1550921

RESUMO

La perimetría tradicional estándar es la base de la introducción de innovaciones no convencionales, que continúan considerándola como punto de referencia para comparar su eficiencia y señalar sus desventajas. Aunque la mayoría de estas contribuciones se centran en el glaucoma, también existen informes significativos sobre resultados satisfactorios en otras enfermedades. El propósito de esta revisión es abordar la tendencia emergente de las pantallas y monitores de última generación que se integran con las computadoras. Estos avances resaltan la accesibilidad mejorada, la introducción de nuevos equipos y la incorporación de nuevos pasos, variables y grupos etarios. La búsqueda de información se concentró en la literatura publicada en línea, especialmente en inglés, de los últimos 5 y 17 años. En total, se identificaron y recuperaron 24 artículos: 17 de los últimos cinco años y 7 de los últimos 17 años. Se registraron 18 tecnologías diferentes que compararon sus resultados con la perimetría estándar. Estas tecnologías se clasificaron, para los propósitos del estudio, en dos categorías: aquellas basadas en computadora (en línea y fuera de línea) y aquellas asistidas por el monitor y acopladas a simulación(AU)


Standardized traditional perimetry is the basis for the introduction of unconventional innovations, which continue to be considered as a benchmark to compare its efficiency and point out its disadvantages. Although most of these contributions focus on glaucoma, there are also significant reports of successful results in other diseases. The purpose of this review is to address the emerging trend of state-of-the-art screens and displays integrated with computers. These advances highlight improved accessibility, the introduction of new equipment, as well as the incorporation of new steps, variables and age groups. The search for information focused on the literature published online, especially in English, between the last 5 to 17 years. A sheer number of 24 articles were identified and retrieved, 17 from the last 5 years and 7 from the last 17 years. Eighteen different technologies were identified, whose results were compared to those of standardized perimetry. These technologies were classified, for the purposes of the study, into two categories: computer-based (online and offline), or display-assisted and simulation-coupled(AU)


Assuntos
Humanos , Glaucoma/diagnóstico , Testes de Campo Visual/métodos , Literatura de Revisão como Assunto
3.
Neuroradiology ; 61(12): 1425-1436, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494681

RESUMO

PURPOSE: This study assessed whether optic radiations (OR) microstructure after temporal lobe epilepsy (TLE) surgery correlated with visual field defects (VFD). METHODS: Patients were subjected to diffusion tensor imaging (DTI) tractography of the OR and Humphrey perimetry after TLE surgery. We used Spearman's test to verify correlations between tractographic parameters and perimetry mean deviation. Tractographic variables were compared between patients with VFD or intact perimetry. Multiple logistic regression was applied between DTI and perimetry values. DTI sensitivity and specificity were assessed with a receiver operating characteristic (ROC) curve to evaluate VFD. RESULTS: Thirty-nine patients had reliable perimetry and OR tractography. There was a significant correlation between (1) fractional anisotropy (FA) and both total (rho = 0.569, p = 0.0002) and quadrant (rho = 0.453, p = 0.0037) mean deviation and (2) radial diffusivity and total mean deviation (rho = - 0.350, p = 0.0286). There was no other significant correlation. Patients with VFD showed a significantly lower FA compared with patients with normal perimetry (p = 0.0055), and a 0.01 reduction in FA was associated with a 44% increase in presenting VFD after surgery (confidence interval, CI = 1.10-1.88; p = 0.0082). Using a FA of 0.457, DTI tractography showed a specificity of 95.2% and a sensitivity of 50% to detect VFD after surgery (area under the curve = 0.7619, CI = 0.6020-0.9218). CONCLUSION: The postoperative OR microstructure correlated with visual loss after epilepsy surgery. DTI postoperative OR tractography may be helpful in evaluating VFD.


Assuntos
Imagem de Tensor de Difusão , Epilepsia do Lobo Temporal/cirurgia , Transtornos da Visão/etiologia , Campos Visuais , Vias Visuais/ultraestrutura , Adulto , Anisotropia , Feminino , Humanos , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade
4.
Doc Ophthalmol ; 139(3): 235-245, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31338649

RESUMO

BACKGROUND: Sellar region tumor growth represents an important cause of visual loss due to mechanical compression of the optic nerve apparatus. Many investigations have used non-invasive tools to evaluate the visual field consequences of this damage, and good associations have been reported between psychophysical and electrophysiological perimetries. Few reports have considered the tumor size as a predictor of visual field loss. AIMS: In the present study, we evaluated the association between the visual perimetry measured by Humphrey visual field analyzer and multifocal visual evoked cortical potential (mfVECP) and the tumor size. METHODS: Our sample was composed of 14 patients diagnosed with sellar tumors by magnetic resonance imaging. We accounted the number of sectors with negative visual responses for both methods. A simple logistic regression analysis was used to evaluate the association between the tumor dimensions and the visual field features RESULTS: Three patients had preserved visual fields, three patients showed hemianopic defects, and eight patients had generalized visual field losses at both evaluations. We observed that the three maximum diameters of the tumor and total tumor volume had different predictive abilities regarding the extent of visual field loss when using psychophysical and mfVECP data. The maximum craniocaudal diameter of the tumor was the better predictor of the psychophysical measurements, whereas for the mfVECP results, all tumor dimensions and volumes had similar values that predict visual field losses. CONCLUSION: Tumor size as a predictor of visual loss has potential to assist in the clinical intervention and to prevent the irreversible visual impairment caused by tumors of the sellar region.


Assuntos
Adenoma/patologia , Potenciais Evocados Visuais/fisiologia , Neoplasias Hipofisárias/patologia , Retina/fisiopatologia , Transtornos da Visão/fisiopatologia , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Adenoma/diagnóstico por imagem , Adulto , Idoso , Eletrorretinografia , Feminino , Humanos , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico por imagem , Psicofísica , Adulto Jovem
5.
Ophthalmol Ther ; 8(2): 305-311, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30868416

RESUMO

INTRODUCTION: White-on-white standard automated perimetry (AP) uses a white round stimulus with 0.43° diameter and 4.0 mm2 area (Goldmann size III). Patients with low vision have difficulty seeing such a small stimulus and are often tested with perimetry using the size V stimulus with 1.72° diameter and 64 mm2 area. We undertook an observational case-control study to compare the performance of patients on AP using two differently sized stimuli. METHODS: Patients with glaucoma and visual acuity worse than 20/100 underwent AP using the standard size III stimulus Swedish Interactive Threshold Algorithm (SITA) standard test and size V stimulus full threshold test. All patients were familiar with the procedure, having done the test at least twice previously. Another group of glaucoma patients with visual acuity better than 20/40 served as controls. The main outcome measures included test time, mean retinal sensitivity (MRS), foveal sensitivity (FS), fixation loss (FL), false positive (FP), false negative (FN), and the patient's subjective preference. RESULTS: Fifty patients were included in the study. Most preferred the size V stimulus target size test. For glaucoma patients, test time was shorter with size III; MRS and FS were higher with size V; FL, FP, and FN did not differ between the tests. CONCLUSION: AP with stimulus size V may be a good alternative to standard size III in selected visually debilitated patients who report difficulty undergoing a standard SITA 24-2 test.

6.
J Optom ; 12(3): 180-185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30377085

RESUMO

PURPOSE: To compare the retinal sensitivity and evaluate its contribution to the foveal sensitivity in patients with and without diabetes who maintain normal visual acuity. METHODS: Observational, descriptive, cross-sectional and prospective study in 20 subjects without diabetes (group 1) and 23 with type 2 diabetes mellitus (group 2) that had no ocular abnormalities. Retinal sensitivity was measured with the macular threshold test by the Humphrey's computerized perimeter. The mean sensitivity in each of the 16 points and the foveal sensitivity were compared between groups using the Mann-Whitney's U test; the correlation between retinal sensitivity and foveal sensitivity was analyzed by the Spearman's test and the contribution of each point to the foveal sensitivity was identified by multiple regression. RESULTS: Sixty eyes were evaluated, 30 in group 1 and 30 in group 2; the mean foveal sensitivity was 34.77±0.5dB in group 1 and 32.87±0.6 in group 2. The highest sensitivity of the temporal visual field had an inferior paracentral location (point 3) in both groups. In the linear regression analysis, points which contributed to the foveal sensitivity were 1 in group 1 and points 7 and 15 in group 2. CONCLUSIONS: Subjects without diabetes have a significantly higher sensitivity in the temporal retina compared with those with diabetes; points with highest mean retinal sensitivity do not correspond to the central four. The reduced sensitivity in point 1 decreases the mean foveal sensitivity in subjects with diabetes, because this variable correlates with lower perimetry points.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Fóvea Central/fisiologia , Macula Lutea/fisiopatologia , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Regressão
7.
Nosso clínico ; 21(124): 12-18, July.-Aug.2018. graf, tab, ilus
Artigo em Português | VETINDEX | ID: biblio-1486059

RESUMO

A hidroterapia é uma das principais técnicas para auxiliar no tratamento das afecções osteomusculares em cães. Dentre as afecções ortopédicas, a displasia coxofemoral é a enfermidade articular de maior incidência em cães. O presente estudo teve como objetivo a análise dos efeitos da esteira aquática no ganho de massa muscular em membros pélvicos em um animal acometido por displasia coxofemoral. Para avaliação do ganho de massa muscular, foram utilizadas a escalas de claudicação, avaliação por perimetria e avaliação do movimento em flexão e extensão dos membros pélvicos pela goniometria. Após 4 semanas de tratamento, constatou-se melhora no padrão do passo, ganho de 3 cm em média em cada coxa do animal, de 15 graus na amplitude de movimento da coxofemoral direita, e de 5 graus na articulação esquerda.


Hydrotherapy is one of the main techniques to assist in the treatment of orthopedic, neurological and endocrinological conditions. Among the orthopedic conditions, the hip dysplasia is the one with the highest incidence in the hip joint in dogs. The present study aimed to analyze the effects of the aquatic treadmill on the muscule mass gain in pelvic limbs. For this evaluation, claudication scales, perimetry muscle mass evaluation menses assessment of the movement in flexion and extension of the pelvic limbs by goniometry were used. There was improvement in the pattern of the step, gain of 3 cm in average in each thigh of the animal, 15 degrees in the range of movement of the right hip, and 5 degrees in the left.


La hidroterapiaesuna de las principales técnicas para auxiliar el tratamiento de las afecciones osteomusculares en perros. Entre las afecciones ortopédicas, la displasia de cadera es la enfermedad articular de mayor incidencia en los perros. El presente estudio tuvo como objetivo el análisis de los efectos de la cinta caminadora acuática en el aumento de masa muscular en miembros pélvicos de un animal acometido por displasia de cadera. Para la evaluación del aumento de la masa muscular, se utilizaron la escala de claudicación, evaluación por perimetría y evaluación del movimiento en flexión y extensión de los miembros pélvicos por la goniometría. Después de 4 semanas de tratamiento, se constató una mejora en el patrón del paso, con el aumento pro medio de 3 cm en cada muslo del animal, de 15 grados en el rango de movimiento de la cadera derecha, y de 5 grados en la izquierda.


Assuntos
Animais , Cães , Displasia Pélvica Canina/terapia , Hidroterapia/métodos , Hidroterapia/veterinária , Medicina Esportiva , Medicina Física e Reabilitação
8.
Nosso Clín. ; 21(124): 12-18, July.-Aug.2018. graf, tab, ilus
Artigo em Português | VETINDEX | ID: vti-736415

RESUMO

A hidroterapia é uma das principais técnicas para auxiliar no tratamento das afecções osteomusculares em cães. Dentre as afecções ortopédicas, a displasia coxofemoral é a enfermidade articular de maior incidência em cães. O presente estudo teve como objetivo a análise dos efeitos da esteira aquática no ganho de massa muscular em membros pélvicos em um animal acometido por displasia coxofemoral. Para avaliação do ganho de massa muscular, foram utilizadas a escalas de claudicação, avaliação por perimetria e avaliação do movimento em flexão e extensão dos membros pélvicos pela goniometria. Após 4 semanas de tratamento, constatou-se melhora no padrão do passo, ganho de 3 cm em média em cada coxa do animal, de 15 graus na amplitude de movimento da coxofemoral direita, e de 5 graus na articulação esquerda.(AU)


Hydrotherapy is one of the main techniques to assist in the treatment of orthopedic, neurological and endocrinological conditions. Among the orthopedic conditions, the hip dysplasia is the one with the highest incidence in the hip joint in dogs. The present study aimed to analyze the effects of the aquatic treadmill on the muscule mass gain in pelvic limbs. For this evaluation, claudication scales, perimetry muscle mass evaluation menses assessment of the movement in flexion and extension of the pelvic limbs by goniometry were used. There was improvement in the pattern of the step, gain of 3 cm in average in each thigh of the animal, 15 degrees in the range of movement of the right hip, and 5 degrees in the left.(AU)


La hidroterapiaesuna de las principales técnicas para auxiliar el tratamiento de las afecciones osteomusculares en perros. Entre las afecciones ortopédicas, la displasia de cadera es la enfermedad articular de mayor incidencia en los perros. El presente estudio tuvo como objetivo el análisis de los efectos de la cinta caminadora acuática en el aumento de masa muscular en miembros pélvicos de un animal acometido por displasia de cadera. Para la evaluación del aumento de la masa muscular, se utilizaron la escala de claudicación, evaluación por perimetría y evaluación del movimiento en flexión y extensión de los miembros pélvicos por la goniometría. Después de 4 semanas de tratamiento, se constató una mejora en el patrón del paso, con el aumento pro medio de 3 cm en cada muslo del animal, de 15 grados en el rango de movimiento de la cadera derecha, y de 5 grados en la izquierda.(AU)


Assuntos
Animais , Cães , Hidroterapia/veterinária , Displasia Pélvica Canina/terapia , Hidroterapia/métodos , Medicina Física e Reabilitação , Medicina Esportiva
9.
Saudi J Ophthalmol ; 31(4): 229-233, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29234224

RESUMO

PURPOSE: To present the clinical characteristics of a group of patients with the diagnosis of chiasmal syndrome who attended a large ophthalmological institute. METHODS: Retrospective, observational clinical study with the review of medical records of patients with a diagnosis of chiasmal syndrome. The following variables were assessed: demographic characteristics, chief complaint upon presentation, best-corrected visual acuity (BCVA), presence or absence of diplopia, pupillary responses, optic nerve head morphology, etiology, and results from the ancillary tests including Ishihara test, Goldmann visual field (GVF) perimetry and neuroimaging. RESULTS: A total of 104 met the inclusion criteria, with a median age of 52 years (range 4-86 years). Fifty-four patients (51.9%) were referred to our institution with a diagnosis of a causative etiology for chiasmal syndrome, while in 50 (48.1%) the diagnosis was performed at our center. The most common presenting symptom was low visual acuity in 57 patients (54.8%), and the most common GVF defect was bitemporal hemianopsia in 39 patients (78 eyes, 39.8%). Pupillary abnormalities were present in 58 patients (55.7%), the optic nerve revealed pallor at any degree in 67 patients (64.4%) and the Ishihara test was affected in 65 patients (62.5%). The most common diagnosis was pituitary macroadenoma. CONCLUSION: The ophthalmologist participates in the diagnosis and rehabilitation of patients with chiasmal syndrome. Low visual acuity is the most common symptom at presentation, and bitemporal hemianopia the most frequent GVF defect. Examination of the optic nerve head and pupillary responses, and ancillary tests including Ishihara test and neuroimaging are relevant for diagnosis.

10.
Front Neurol ; 8: 619, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29255441

RESUMO

PURPOSE: The aims of this study are to compare optical coherence tomography (OCT)-measured macular retinal layers in eyes with permanent temporal hemianopia from chiasmal compression and control eyes; to compare regular and slow-flash multifocal electroretinography (mfERG) in patients and controls; and to assess the correlation between OCT, mfERG, and central visual field (SAP) data. METHODS: Forty-three eyes of 30 patients with permanent temporal hemianopia due to pituitary tumors who were previously submitted to chiasm decompression and 37 healthy eyes of 19 controls were submitted to macular spectral domain OCT, mfERG, and 10-2 SAP testing. After segmentation, the thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer, and photoreceptor layer (PRL) was measured. Amplitudes and oscillatory potentials (OPs) were measured on regular and slow-flash mfERG, respectively, and expressed as the mean values per quadrant and hemifield. RESULTS: RNFL, GCL, and IPL thickness measurements were significantly reduced in all quadrants, whereas INL, OPL, and PRL thicknesses were significantly increased in the nasal quadrants in patients compared to those in controls. Significant correlations between OCT and 10-2 SAP measurements were positive for the RNFL, GCL, and IPL and negative for the INL, OPL, and PRL. OPs and mfERG N1 amplitudes were significantly reduced in the nasal hemiretina of patients. Significant correlations were found between OP and mfERG amplitudes for inner and outer nasal hemiretina OCT measurements, respectively. CONCLUSION: Patients with permanent temporal hemianopia from previously treated chiasmal compression demonstrated significant thinning of the RNFL, GCL, IPL, and thickening of the INL, OPL, and PRL associated with reduced OP and mfERG N1 amplitudes, suggesting that axonal injury to the inner retina leads to secondary damage to the outer retina in this condition.

11.
J Ophthalmic Vis Res ; 12(1): 53-57, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28299007

RESUMO

PURPOSE: To evaluate the correlation between visual field index (VFI) and both structural and functional measures of the optic disc in primary open angle glaucoma patients and suspects. METHODS: In this retrospective study, 162 glaucoma patients and suspects underwent standard automated perimetry (SAP), retinography, and retinal nerve fiber layer (RNFL) measurement. The optic disc was stratified according to the vertical cup/disc ratio (C/D) and sorted by the disc damage likelihood scale (DDLS). RNFL was measured with the optical coherence tomography. The VFI perimetry was correlated with the mean deviation (MD) and pattern standard deviation (PSD) obtained by SAP, and structural parameters by Pearson's correlation coefficients. RESULTS: VFI displayed strong correlation with MD (R = 0.959) and PSD (R = -0.744). The linear correlations between VFI and structural measures including C/D (R = -0.179, P = 0.012), DDLS (R = -0.214, P = 0.006), and RNFL (R = 0.416, P < 0.001) were weak but statistically significant. CONCLUSION: VFI showed a strong correlation with MD and PSD but demonstrated a weak correlation with structural measures. It can possibly be used as a marker for functional impairment severity in patients with glaucoma.

12.
Transl Vis Sci Technol ; 5(6): 15, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27980878

RESUMO

PURPOSE: We evaluate driving risk under simulated fog conditions in glaucoma and healthy subjects. METHODS: This cross-sectional study included 41 glaucoma patients and 25 age-matched healthy subjects who underwent driving simulation. Tests consisted of curve negotiation without and with fog preview at 30 m of distance and two controlled speeds (slow and fast). Inverse time-to-line crossing (invTLC) was used as metric to quantify risk; higher invTLC values indicating higher risk, as less time is available to avoid drifting out of the road. Piecewise regression models were used to investigate the relationship between differences in invTLC in fog and nonfog conditions and visual field loss. RESULTS: Glaucoma patients had greater increase in driving risk under fog compared to controls, as indicated by invTLC differences (0.490 ± 0.578 s-1 and 0.208 ± 0.106 s-1, respectively; P = 0.002). Mean deviation (MD) of the better eye was significantly associated with driving risk under fog, with a breakpoint of -9 dB identified by piecewise regression. For values below the breakpoint, each 1 dB lower MD of better eye was associated with 0.117 s-1 higher invTLC under fast speed (adjusted R2 = 57.9%; P < 0.001). CONCLUSIONS: Glaucoma patients have a steeper increase in driving risk under fog conditions when compared to healthy subjects, especially when the severity of visual field damage falls below -9 dB of MD in the better eye. TRANSLATIONAL RELEVANCE: By investigating the relationship between driving risk and disease severity breakpoint, this study may provide guidance to clinicians in recognizing glaucoma patients who may be unfit to drive in complex situations such as fog.

13.
Clinics ; Clinics;70(1): 14-17, 1/2015. tab
Artigo em Inglês | LILACS | ID: lil-735864

RESUMO

OBJECTIVES: Psoriasis is a hyperproliferative chronic inflammatory skin disease of unknown etiology and ocular structures and visual pathways can also be affected during the course of this disease. Subclinical optic neuritis has previously been observed in psoriatic patients in visual evoked potential studies. This trial was designed to evaluate retinal sensitivity in patients with psoriasis vulgaris. METHODS: A total of 40 eyes of 40 patients with chronic plaque-type psoriasis and 40 eyes of 40 age- and sex-matched control subjects were included in this study. The diagnosis of psoriasis was confirmed by skin biopsy. The severity was determined using the Psoriasis Area and Severity Index and the duration of the disease was recorded. After a full ophthalmological examination, including tests for color vision and pupil reactions, the visual field of each subject was assessed using both standard achromatic perimetry and short wavelength automated perimetry. RESULTS: The mean Psoriasis Area and Severity Index was 22.05±6.40′. There were no significant differences in the visual field parameters of subjects versus controls using either method. There were correlations between disease severity and the mean deviations in standard achromatic perimetry and short wavelength automated perimetry and between disease severity and the corrected pattern standard deviation and pattern standard deviation of short wavelength automated perimetry (r = -0.363, r = -0.399, r = 0.515 and r = 0.369, respectively). CONCLUSIONS: Retinal sensitivity appears to be affected by the severity of psoriasis vulgaris. .


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Psoríase/fisiopatologia , Retina/fisiopatologia , Doenças Retinianas/fisiopatologia , Análise de Variância , Estudos de Casos e Controles , Citocinas/fisiologia , Psoríase/patologia , Retina/patologia , Doenças Retinianas/patologia , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Testes de Campo Visual , Campos Visuais/fisiologia
14.
Int Ophthalmol ; 35(1): 81-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25425106

RESUMO

The purpose of the study was to correlate the Fourier-domain OCT ganglion cell complex (GCC) parameters with automated perimetry (AP) functional measures of the optic nerve. This retrospective study included patients who had previously undergone examination with the RTVue-100 OCT and AP, SITA strategy. The parameters of GCC (average, superior, inferior, S-I [superior inferior difference], S-I SD [standard deviation of S-I], GLV [global loss volume] and FLV [focal loss volume]) were correlated with the mean deviation (MD) and pattern standard deviation (PSD) values of AP using linear and logarithmic regression analysis. All correlations between GCC and automated perimetry parameters were strong (r > 0.60), except that for SI and MD (r = -0.05); SI and PSD (r = 0.09); SI-DS and MD (r = -0.06); and SI-SD and PSD (r = 0.08). In summary, GCC derived structural measures showed good correlation with functional parameters from AP.


Assuntos
Glaucoma/diagnóstico , Pressão Intraocular , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Feminino , Seguimentos , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Tonometria Ocular , Testes de Campo Visual , Campos Visuais
15.
Clin Ophthalmol ; 8: 1323-30, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25075173

RESUMO

INTRODUCTION: The gold standard in functional glaucoma evaluation is standard automated perimetry (SAP). However, SAP depends on the reliability of the patients' responses and other external factors; therefore, other technologies have been developed for earlier detection of visual field changes in glaucoma patients. The frequency-doubling perimetry (FDT) is believed to detect glaucoma earlier than SAP. The multifocal visual evoked potential (mfVEP) is an objective test for functional evaluation. OBJECTIVE: To evaluate the sensitivity and specificity of FDT and mfVEP tests in normal, suspect, and glaucomatous eyes and compare the monocular and interocular mfVEP. METHODS: Ninety-five eyes from 95 individuals (23 controls, 33 glaucoma suspects, 39 glaucomatous) were enrolled. All participants underwent a full ophthalmic examination, followed by SAP, FDT, and mfVEP tests. RESULTS: The area under the curve for mean deviation and pattern standard deviation were 0.756 and 0.761, respectively, for FDT, 0.564 and 0.512 for signal and alpha for interocular mfVEP, and 0.568 and 0.538 for signal and alpha for monocular mfVEP. This difference between monocular and interocular mfVEP was not significant. CONCLUSION: The FDT Matrix was superior to mfVEP in glaucoma detection. The difference between monocular and interocular mfVEP in the diagnosis of glaucoma was not significant.

16.
Rev. chil. neuro-psiquiatr ; Rev. chil. neuro-psiquiatr;52(2): 73-80, jun. 2014. tab
Artigo em Espanhol | LILACS | ID: lil-715176

RESUMO

Introduction: Different methods of assessing visual field by confrontation (VFC) with the Goldmann Perimetry (GP) are compared. Method: 52 consecutive patients evaluated in Neuropthalmology Department that met inclusion criteria. Seven tests of VFC and GP are performed on each patient. Sensitivity, specificity and degree of association of each test confrontation regarding Goldmann Perimetry is evaluated. Results: The tests were the most sensitive tests comparing fingers (58%) and compared red (55%) Color object. Greater specificity tests were counting fingers (95%), finger movement in a fixed position of the hand in different quadrants (95%), finger movement from the periphery to the center of the quadrants (93%) and test moving red pin of 5 mm (93%). The two most sensitive tests had low specificity. Conclusions: The VFC is performed routinely in all neuroopthalmology patients. Tests are of limited use for screening visual pathway pathology because of its low sensitivity but the detected alterations are sufficiently specific. The most useful tests were dynamic (moving from the periphery to the center finger or a red pin). To confirm the diagnosis and monitoring is needed as objective evidence of Goldmann Perimetry.


Introducción: Se comparan distintos métodos de evaluación de campo visual por confrontación (CVC) con la Campimetría de Goldmann (CG) en pacientes derivados al Servicio de Neuroftalmología del Instituto de Neurocirugía. Método: En cincuenta y dos pacientes consecutivos que cumplen criterios de inclusión, se realizan siete pruebas de CVC y CG en cada paciente. Se evalúa sensibilidad, especificidad y grado de asociación de cada prueba de confrontación en relación a Campimetría de Goldmann. Resultados: Las pruebas de mayor sensibilidad fueron las pruebas de comparación de dedos (58%) y comparación objeto color rojo (55%). Las pruebas de mayor especificidad fueron conteo de dedos (95%), movimiento del dedo en posición fija de la mano en diferentes cuadrantes (95%), movimiento de dedo desde la periferia al centro de los cuadrantes (93%) y la prueba de movimiento de pin rojo de 5 mm (93%). Las dos pruebas de mayor sensibilidad presentaron baja especificidad. Conclusiones: Los CVC se realizan de manera rutinaria en todos los pacientes neuroftalmológicos. Son pruebas de utilidad limitada para el tamizaje de patologías de vía visual por su baja sensibilidad pero las alteraciones detectadas son suficientemente específicas. Las de mayor utilidad fueron las pruebas dinámicas (mover de la periferia al centro el dedo o un pin rojo). Para confirmar el diagnóstico y hacer el seguimiento es necesario realizar pruebas objetivas como la Campimetría de Goldmann.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Patologia , Campos Visuais , Testes de Campo Visual , Epidemiologia Descritiva
17.
Invest Ophthalmol Vis Sci ; 55(5): 3074-80, 2014 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-24722699

RESUMO

PURPOSE: We examined the structure-function relationship between two perimetric tests, the frequency doubling technology (FDT) matrix and standard automated perimetry (SAP), and two optical coherence tomography (OCT) devices (time-domain and spectral-domain). METHODS: This cross-sectional study included 97 eyes from 29 healthy individuals, and 68 individuals with early, moderate, or advanced primary open-angle glaucoma. The correlations between overall and sectorial parameters of retinal nerve fiber layer thickness (RNFL) measured with Stratus and Spectralis OCT, and the visual field sensitivity obtained with FDT matrix and SAP were assessed. The relationship also was evaluated using a previously described linear model. RESULTS: The correlation coefficients for the threshold sensitivity measured with SAP and Stratus OCT ranged from 0.44 to 0.79, and those for Spectralis OCT ranged from 0.30 to 0.75. Regarding FDT matrix, the correlation ranged from 0.40 to 0.79 with Stratus OCT and from 0.39 to 0.79 with Spectralis OCT. Stronger correlations were found in the overall measurements and the arcuate sectors for both visual fields and OCT devices. A linear relationship was observed between FDT matrix sensitivity and the OCT devices. The previously described linear model fit the data from SAP and the OCT devices well, particularly in the inferotemporal sector. CONCLUSIONS: The FDT matrix and SAP visual sensitivities were related strongly to the RNFL thickness measured with the Stratus and Spectralis OCT devices, particularly in the overall and arcuate sectors.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Fibras Nervosas/patologia , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Limiar Sensorial/fisiologia
18.
Arq. bras. oftalmol ; Arq. bras. oftalmol;76(6): 341-344, nov.-dez. 2013. tab
Artigo em Português | LILACS | ID: lil-701283

RESUMO

OBJETIVOS: Estudar a habilidade diagnóstica do tomógrafo retiniano de Heidelberg (HRT II), GDx analisador de fibras nervosas (GDx), perimetria azul-amarelo (SWAP), tecnologia de frequência duplicada (FDT) isoladamente e em conjunto no diagnóstico do glaucoma. MÉTODOS: Sessenta glaucomatosos e 60 pacientes normais foram submetidos a exames de HRT II, GDx, SWAP e FDT. HRT foi considerado alterado quando pelo menos uma região do anel neurorretiniano esteve fora dos limites da normalidade, conforme a análise de regressão de Moorfields. GDx alterado foi definido quando pelo menos um índice foi considerado pelo programa do equipamento como fora dos limites normais, excluindo-se o índice simetria, ou ainda quando no gráfico "the deviation from normal graph" apareceu um quadrante com significância abaixo de 5%. O FDT foi considerado anormal quando pelo menos uma região testada apresentou-se com defeito severo ou com a presença de dois defeitos moderados contíguos. Para o SWAP foram adotados os critérios de anormalidade propostos por Anderson. Análise de regressão logística foi realizada. RESULTADOS: Quando foram estudadas as tecnologias isoladamente, a análise de regressão logística apresentou melhores índices de razão das chances para glaucoma com exames positivos para o HRT (22,49), seguido pelo SWAP (21,71). FDT (3,97) e GDx (2,73). Quando se associaram exames positivos de diferentes tecnologias, as razões das chances aumentaram. Nos casos com exames de HRT, FDT e SWAP fora dos limites normais, a razão das chances foi de 252,6 e com HRT, SWAP e GDx alterados, 173,1. Quando associamos exames positivos de diferentes tecnologias, a razão das chances dos pacientes serem glaucomatosos aumentou consideravelmente, chegando a 689,7 com todos os exames fora dos limites normais, o que ocorreu em 26 pacientes deste estudo. CONCLUSÕES: A análise de regressão logística confirmou que a presença de exames alterados de HRT ou SWAP apresentam as maiores razões das chances de glaucoma. A associação de exames alterados aumentou a razão das chances, principalmente, quando o HRT e o SWAP estavam fora dos limites normais.


PURPOSES: In this research was studied the diagnostic ability of the Heidelberg Retinal Tomograph (HRT II), GDx nerve fiber analyzer (GDx), Short-wavelenght Automated Perimetry (SWAP) and Frequency-doubling technology (FDT), all of them together and also separately in the diagnosis of glaucoma. METHODS: Sixty glaucomatous patients and 60 normal ones were submitted to examination with the technology of HRT II, GDx, FDT and SWAP. In the interpretation of HRT, based on the Moorfields regression analysis, were considered abnormal when at least one area of the neuroretinal ring was outside the bounds of normality. GDx was defined as altered, when it was observed that at least one index was considered by equipment program as outside of normal limits, excluding the index symmetry, or when "the deviation from normal graph" appeared a quadrant with significance below 5%. The FDT was considered abnormal when at least one region tested presented with severe defects, or two contiguous moderate defects in at least two reliable tests. For SWAP was adopted the abnormality criteria proposed by Anderson. Logistic regression analysis was performed. RESULTS: When the technologies were studied separately, the Logistic regression analysis showed better odds ratio rates to test positive for glaucoma with HRT (22.49), followed by EAP (21.71), FDT (3.97) and GDx (2.73). When positive tests were associated with different technologies, the odds ratios increased. In cases with HRT, FDT and PAA tests, outside normal bounds, the odds ratio was 252.6. Concerning the HRT, GDx and PAA the result have changed to 173.1. When we associate positive tests from different technologies, the odds ratio of glaucomatous patients have increased considerably, reaching 689.7 with all the tests outside normal bounds, which have happened with 26 patients of this study. CONCLUSIONS: The Logistic Regression analysis confirmed that the abnormal tests of HRT and PAA have shown to be the highest reasons for glaucoma occurrence. The association of abnormal tests increased the odds ratio, especially when the HRT and PAA were out of normal bounds.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glaucoma/diagnóstico , Oftalmoscopia/métodos , Polarimetria de Varredura a Laser/métodos , Testes de Campo Visual/métodos , Estudos de Casos e Controles , Pressão Intraocular/fisiologia , Modelos Logísticos , Disco Óptico/patologia , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Acuidade Visual/fisiologia
19.
Rev. bras. oftalmol ; 70(1): 32-36, jan.-fev. 2011. ilus
Artigo em Português | LILACS | ID: lil-581591

RESUMO

OBJETIVO: Avaliar a importância da perimetria manual cinética (PMC) de Goldmann em pacientes com glaucoma e defeito de campo visual avançado à perimetria computadorizada automática estática (PAE) com perímetro Humphrey (PH). MÉTODOS: Realizou-se exame de PMC com perímetro de Goldmann (PG) em pacientes com glaucoma primário de ângulo aberto avançado que apresentavam defeito avançado ao exame de PAE com PH. Realizou-se ainda uma análise qualitativa da extensão do campo visual à perimetria de Goldmann destes pacientes. RESULTADOS: Os resultados encontram-se ilustrados de forma qualitativa. CONCLUSÃO: A PMC com PG mostrou-se útil para complementar a avaliação da real condição campimétrica de pacientes com glaucoma primário de ângulo aberto avançado.


PURPOSE: To evaluate the importance of Goldmann manual kinetic perimetry (MKP) in glaucomatous patients with advanced visual field loss in automated static perimetry (ASP) with Humphrey perimeter (HP). METHODS: The MKP with Goldmann perimeter (GP) was performed in patients with advanced primary open angle glaucoma with advanced visual field defect in the ASP with HP. A qualitative analysis was realized on the visual field extension in the Goldmann perimetry of these patients. RESULTS: The results are illustrated in a qualitative way. CONCLUSION: The MKP with GP was useful to complement the evaluation of the real campimetric condition of advanced primary open angle glaucomatous patients.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Glaucoma de Ângulo Aberto , Cinética , Nervo Óptico , Testes de Campo Visual/métodos , Campos Visuais , Estudos Transversais
20.
Arq. bras. oftalmol ; Arq. bras. oftalmol;73(5): 409-413, Sept.-Oct. 2010. ilus, graf, tab
Artigo em Inglês | LILACS | ID: lil-570500

RESUMO

PURPOSE: To correlate visual field sensitivity (VFS) loss on standard automated perimetry (SAP) and quadrantic macular thickness on optical coherence tomography (OCT) in patients with permanent temporal hemianopia from chiasmal compression. METHODS: Forty eyes from 40 patients with chiasmal compression and 40 healthy eyes were submitted to standard automated perimetry and Stratus-OCT scanning. Raw data of the fast macular thickness scanning protocol were exported and macular thickness measurements were recorded and averaged for each quadrant and half of the central area. The correlation between visual field sensitivity loss and optical coherence tomography measurements was tested with Pearson's correlation coefficients and with linear regression analysis. RESULTS: A significant association was found between each macular thickness parameter and the corresponding central VF mean sensitivity. The strongest association was observed between superonasal macular thickness and the inferotemporal mean defect measured both in decibel (R=0.47; p=0.001) and in 1/Lambert (R=0.59; p<0.0001) units. CONCLUSION: Stratus-OCT-measured macular thickness was topographically related with visual field sensitivity loss in patients with temporal hemianopia from chiasmal compression. Such measurements could prove clinically useful in the diagnosis and follow-up of patients with chiasmal compression. ClinicalTrial.gov identifier number: NCT0039122.


OBJETIVO: Avaliar a correlação entre o defeito de campo visual ao exame de perimetria computadorizada e a espessura macular quadrântica ao exame de tomografia de coerência óptica (OCT) em pacientes com hemianopsia temporal permanente causada por compressão quiasmática. MÉTODOS: Quarenta olhos de 40 pacientes com compressão quiasmática e 40 olhos de 40 indivíduos controles foram submetidos aos exames de perimetria computadorizada e tomografia de coerência óptica. Dados não processados foram exportados e as medidas de espessura macular foram calculadas para cada quadrante e metade da área macular central. A correlação entre o defeito campimétrico e as medidas de espessura macular foi avaliada por coeficiente de correlação de Pearson e por análise de regressão linear. RESULTADOS: Associação significante foi encontrada entre os parâmetros de espessura macular e seus respectivos defeitos campimétricos. A correlação mais forte foi encontrada entre o parâmetro espessura macular nasal superior e o defeito campimétrico médio temporal inferior medido em decibel (R=0,47; p=0,001) e em 1/Lambert (R=0,59; p<0,0001). CONCLUSÃO: Medidas de espessura macular avaliada através da tomografia de coerência óptica foi topograficamente relacionada ao defeito campimétrico em pacientes com hemianopsia temporal por compressão quiasmática. Estas medidas podem provar a importância clínica no diagnóstico e seguimento dos pacientes com compressão quiasmática. ClinicalTrial.gov identifier number: NCT0039122.


Assuntos
Adulto , Feminino , Humanos , Masculino , Hemianopsia/fisiopatologia , Macula Lutea/patologia , Síndromes de Compressão Nervosa/complicações , Quiasma Óptico/patologia , Campos Visuais/fisiologia , Métodos Epidemiológicos , Hemianopsia/etiologia , Hemianopsia/patologia , Tomografia de Coerência Óptica
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