Navegando por Palavras-chave "Low vision"
Agora exibindo 1 - 8 de 8
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Avaliação da função visual em pacientes com distrofia de cones(Conselho Brasileiro de Oftalmologia, 2003-06-01) Sato, Marta [UNIFESP]; Sacai, Paula Yuri [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Salomão, Solange Rios [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To evaluate visual function by full-field electroretinography (ERG) and visual acuity in patients with cone dystrophy. METHODS: 23 (7 male and 16 female) patients with suspicion of cone dystrophy were evaluated at the Clinical Electrophysiology of Vision Laboratory of the Universidade Federal de São Paulo (UNIFESP). Inclusion criteria were: clinical history, visual acuity measured by ETDRS or Snellen charts and retinal function assessed by full-field electroretinography. The peak-to-peak amplitude and b-wave implicit time values were compared with previously published age norms. RESULTS: Visual acuity measurement in the best eye ranged from 0.07 to 3.00 logMAR (HM to 20/25) with mean VA of 0.85±0.64 logMAR (20/140). Mean peak-to-peak amplitude for scotopic rod-response was 144.29±80.05 µV (normal for age) and mean of implicit time was 92.85±9.02 ms (normal for age). Mean peak-to-peak amplitude for single-flash cone response was 5.06±8.59 µV (reduced for age) and mean implicit time was 43.4±14.4ms (reduced for age) for detectable responses; for 30 Hz-flicker mean amplitude was 5.00±9.00 µV (reduced for age) and the mean of implicit time was 34.9±10.9 ms (reduced for age). CONCLUSION: Mean visual acuity was 0.85 logMAR (20/140) in this group of patients with cone dystrophy. Photophobia was the main complaint, followed by decreased vision and defective colour vision. Ten of 23 (10/23) patients had their final diagnosis only after full-field electroretinography recording, since the fundus examination was normal.
- ItemAcesso aberto (Open Access)Avaliação da qualidade de vida relacionada à visão em crianças com catarata congênita bilateral(Conselho Brasileiro de Oftalmologia, 2009-08-01) Lopes, Marcia Caires Bestilleiro [UNIFESP]; Salomão, Solange Rios [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To assess vision-related quality of life in children with bilateral congenital cataracts, using the recently developed Children's Visual Function Questionnaire (CVFQ). METHODS: CVFQ has two presentations, one for children under 3 years of age and the other for older children, and is divided in six subscales - general health; general vision; competence; personality; family impact and treatment. From those, a composite score can also be calculated. The CVFQ was applied in the hospital setting to parents or other caretakers by personal interview. The subscale scores were compared for control group (n=32 - normal vision) versus congenital cataract group (n=16 no visual impairment, n=10 - mild visual impairment and n=11 - severe visual impairment). For analysis, t-tests and analysis of variance (ANOVA) were performed. RESULTS: All quality of life subscales presented low scores for children with bilateral congenital cataracts. Congenital bilateral cataract scores were lower than those of the control group for all subscales. Competence subscale in the experimental group was significantly lower in the comparison with visual impairment severity (F=5.1, p=0.01; Tukey test p<0.01) as well as the composite score (F=5.4, p=0.01; Tukey test p=0.01/0.05). CONCLUSIONS: Bilateral congenital cataracts influence vision-related quality of life of children as confirmed by low scores in all subscales assessed by the CVFQ with emphasis on the competence subscale. This instrument should be incorporated in the clinical assessment of children with bilateral cataracts as a measure of the impact of visual impairment in their quality of life.
- ItemAcesso aberto (Open Access)Avaliação de Sistema de Leitura Portátil (SLP) para baixa visão desenvolvido no Brasil(Sociedade Brasileira de Oftalmologia, 2009-10-01) Santos, Vagner Rogério dos [UNIFESP]; Lima, Eliana Cunha; Berezovsky, Adriana [UNIFESP]; Schor, Paulo [UNIFESP]; Uras, Ricardo [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Dorina Nowill para Cegos Setor de Reabilitação VisualPURPOSE: The proposal of this study is to test and to validate as the effectiveness and efficiency in a series of cases the prototype of a national equipment of magnification to reading. METHODS: A recently developed of equipment of magnification (patent pending Brazilian Institutte of Industrial Property # 020050145260) was tested in a group of 30 patients (age range 9 to 80 years, 17 males). A portable apparatus was developed with a system of capture of images coupled with a 5,6 inch monitor, providing an increase of 15 X. The effectiveness of the visual acuity and the reading efficiency were analyzed after the use of the proposed prototype. RESULTS: Six patients (20%) presented AV 8M, 12 patients (40%) presented AV 6,0M, 7 patients (23.3%) presented AV 5M, 5 patients (16.7%) presented 4M. The average of visual acuity before the utilization of SPR measured by LHNV-1 logMAR chart was 5,75M. After the use of LHNV-1 logMAR chart, 100% (one hundred percent) of the patients reached the efficacy of AV J1. CONCLUSION: The prototype of SPR is an alternative resource in the social inclusion process of low vision patients with different levels of visual residue. It demonstrates psychological incentive, allows comfort, mobility and independence to those who need a more extended lecture and more distance of work.
- ItemAcesso aberto (Open Access)Design centrado no humano aplicado à saúde: desenvolvimento e avaliação de objeto para auxiliar a autoadministração de medicamentos por idosos com baixa visão e cegueira(Universidade Federal de São Paulo (UNIFESP), 2016-08-30) Harada, Fernanda Jordani Barbosa [UNIFESP]; Schor, Paulo [UNIFESP]; http://lattes.cnpq.br/3542867700396961; http://lattes.cnpq.br/5169887016433605; Universidade Federal de São Paulo (UNIFESP)Objective: Create and develop one solution for improving medicine selfadministering in elderly with low vision and blindness due to diabetic retinopathy (DR) and age related macular degeneration (ARMD). Then, evaluate the efficacy of this solution. Methods: The study is transdisciplinary, qualitative, human centered, using ethnography techniques and design operational methodology. Initially, patients were evaluated by chats in the Retina and Macule outward patient care at the Ophthalmology Department from São Paulo Federal University in order to identify and understand their demands on medicine self-administering, and define requirements for creating a solution. Sequentially the operational design methodology was used in workshops with potentially future users to create and develop the solution. Finally, the prototype developed was used by 10 patients for 1 month. Their usage was evaluated by two interviews with open and narrative questions. The analysis of the ranscribed interviews contemplated 3 aspects: the subject content, which was divided in categories and had their respective frequency accounted; the use, regarding the prototype usage; and the discourse, which focused in its nuances and subjective impressions on the prototype usage. These analyses were mutually complimentary on the usage evaluation by each patient. Results: The prototype is composed by a chord that contains five flexible silicon rings with different colors and textures each. The content analysis contemplated eight categories: autonomy, prototype impression, affection, relation to previous status, organization, pattern of prototype identification on usage, the standard for distributed medicines by Unified Health System (SUS) and self-esteem. We inferred no adherence to the prototype by one patient due to his laconic and neutral answers. Nine patients had a positive impression, supported by their frequent affective words for descripting the prototype and referred autonomy on medicine self-administering. Words indicating improvement and organization were also frequent in the same 9 patients, allied to a discourse suggesting usage facility. Notwithstanding, distinction by blisters and pills characteristics persisted despite the lack of standardization for medicines distributed by SUS. In usage analysis, seven patients easily used the prototype from the very beginning, two just after the second meeting, and one, in spite of inadequate use, reported interest in using it in the third meeting. Patients combined in different grades the characteristics of the prototype with those ones from blisters and pills. Eight patients organized the prototype and changed the medicine blisters independently, and six added silicon rings to the prototype for medicines of occasional use. All manifested interest in the prototype use at the end of the study. In the discourse analysis, nine patients suggested the prototype to be a valid solution for medicine self-administering. Finally, despite the essentially similar usage of the prototype, the nine patients that incorporated it in their routine personalized, in part, their relationship with the prototype, which may have facilitated its acceptance and usage. Conclusion: This research created and developed one project solution for improving medicine self-administering in low vision and blind elderly due to DR and ARMD. Besides that, evaluated the efficacy of the developed prototype. This composite work suggest that the human centered methodology and approach support universal solutions for low vision and blind elderly. The prototype was used and well received by these patients, which led to independence on their medicine use. Future studies in other populations may broaden its applicability, keeping the simple and intuitive concept in order to improve independency and quality of life.
- ItemAcesso aberto (Open Access)Reabilitação visual em pacientes com ceratocone submetidos a transplante de córnea(Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Prazeres, Tatiana Moura Bastos [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]; Hirai, Flávio Eduardo [UNIFESP]; http://lattes.cnpq.br/6575096591259140; http://lattes.cnpq.br/2367491641205774; http://lattes.cnpq.br/1162471488621838; Universidade Federal de São Paulo (UNIFESP)Objetivos: 1) Avaliar a efetividade do implante de anel intracorneano na reabilitação visual de pacientes com ceratocone submetidos a transplante de córnea; 2) Avaliar resultados visuais de pacientes com ceratocone submetidos a transplante lamelar anterior, utilizando córneas doadas com a presença da membrana de Descemet e endotélio; 3) Comparar os resultados visuais em pacientes com ceratocone submetidos a transplante de córnea lamelar anterior, utilizando córneas doadas com e sem a presença da membrana de Descemet e endotélio; e 4) Descrever qualitativamente as características do exame de microscopia confocal em pacientes com ceratocone submetidos a transplante lamelar anterior, utilizando córneas doadas com e sem a presença da membrana de Descemet e endotélio. Métodos: o primeiro estudo analisou retrospectivamente 14 olhos com alto astigmatismo após transplante penetrante e que foram submetidos a implante de anel intracorneano. Foram avaliados acuidade visual com e sem correção, astigmatismo e curvatura corneana máxima. No segundo estudo, foram revisados 90 prontuários e avaliados os resultados visuais em pacientes com ceratocone submetidos a transplante lamelar anterior sem retirada da membrana de Descemet e endotélio do tecido doado. O terceiro estudo, prospectivo, comparou acuidade visual corrigida e sensibilidade ao contraste com uso de lente de contato rígida em pacientes com ceratocone submetidos a transplante lamelar anterior com e sem a presença da membrana de Descemet e endotélio. O último trabalho foi uma análise descritiva do exame confocal de 11 pacientes com ceratocone submetidos a transplante lamelar anterior com e sem a presença da membrana de Descemet e endotélio no tecido doado. Resultado: A acuidade visual corrigida em pacientes transplantados que apresentavam elevado astigmatismo melhorou após o implante de anel intraestromal comparada com acuidade visual no pré-operatório. A acuidade visual corrigida desses pacientes com 3 meses foi similar à de 6 meses assim como a acuidade visual não corrigida. Astigmatismo e curvatura máxima foram maiores no pré-operatório do que no pós-operatório. No grupo de pacientes analisados retrospectivamente submetidos a transplante lamelar anterior preservando a membrana de Descemet e endotélio do tecido doado, houve melhora significativa no pós-operatório da acuidade visual com e sem correção em relação ao pré-operatório. Em pacientes com ceratocone submetidos a transplante lamelar anterior por meio da técnica de big-bubble não houve diferença estatisticamente significante entre os grupos com e sem membrana de Descemet em relação à acuidade visual corrigida e à sensibilidade ao contraste com uso de lente de contato rígida, assim como em relação à contagem endotelial. Na análise da microscopia confocal um aumento da refletividade da matriz acelular e ceratócitos ativados foi observado nos 2 grupos; entretanto esses achados foram mais evidentes no grupo sem membrana de Descemet. Conclusão: O implante de anel intraestromal usando laser de femtosegundo para correção de astigmatismo residual após transplante penetrante de córnea é seguro e apresenta resultados visuais satisfatórios. Em pacientes com ceratocone submetidos a transplante lamelar anterior através da técnica de big-bubble não houve diferença nos resultados visuais em relação à preparação do botão doado com ou sem a membrana de Descemet e endotélio.
- ItemAcesso aberto (Open Access)A tecnologia assistiva na inclusão de alunos com deficiência visual e baixa visão no ensino fundamental(Universidade Federal de São Paulo (UNIFESP), 2016-10-31) Garcia, Gínez [UNIFESP]; Ferretti, Eliana Chaves [UNIFESP]; http://lattes.cnpq.br/6560097254021874; http://lattes.cnpq.br/3608880141633414; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to understand the use of Assistive technology in pedagogical practices of teachers in the elementary school which works with students with visual impairment and low vision in the municipality of Itapevi, São Paulo. The research is characterized as qualitative, transversal and exploratory approach. Teachers were asked to answer a self-administered questionnaire with questions regarding the use of assistive technology for the activities developed in their settings. The results indicated that the assistive technology equipments, provided by the government, most used for students with visual and low vision disabilities were the screen reader computer programs (DOSVOX and NVDA) and among those made by hand by teachers was the Braille alphabet. The selection criteria used by teachers to choose the assistive technology are based on the students' needs to promote functionality, autonomy and facilitate the learning process. The practicality of use and the degree of visual acuity were also determining factors in the selection of each technology. Teachers reported difficulty as the lack of sophisticated features and training for appropriate use of equipment.
- ItemAcesso aberto (Open Access)Validade da topografia de córnea na cirurgia refrativa com excimer laser(Conselho Brasileiro de Oftalmologia, 2003-12-01) Silva Filho, Orlando da [UNIFESP]; Schor, Paulo [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Abreu, Mariza Toledo de [UNIFESP]; Beer, Sandra Maria Canelas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Mogi das Cruzes Departamento de Oftalmologia Setor de Córnea e Doenças externasPURPOSE: To evaluate the refractive results and safety of PRK (photorefractive keratectomy) based on the preoperative corneal topography. METHODS: 44 operated eyes, using the photorefractive keratectomy process, and which presented preoperative topographical abnormalities. The control group consisted of 44 eyes with preoperative normal corneal topography. Eighty-eight eyes were submitted to the photorefractive keratectomy process using the Summit Apex plus Excimer Laser. Corneal topographies were accessed by the EyeSys Analysis system; the topographic abnormalities which were considered are the following: apex displacement above 1.5D (AD), asphericity above 0.25D/mm (AS), obliquity above 15 degrees (OB), inferior-superior asymmetry equal to or more than 1.5D (IS), curvature above 47D (CU) and two combined features (CB). Main measured outcome: loss of one or more lines were safety defined for the prognosis. RESULTS: All patients were followed up during 6 months. A significant loss of BCVA occurred in PRK-AD (p<0.001) and PRK-CO (p<0.05). CONCLUSION: These data suggest that patients, who wish to be submitted to the refractive surgery must undergo preoperative corneal topography analysis and if any topographic abnormality is found in these patients, this can indicate the loss of lines of corrected vision after surgery.
- ItemAcesso aberto (Open Access)Visual impairment from uveitis in a reference hospital of Southeast Brazil: a retrospective review over a twenty years period(Conselho Brasileiro de Oftalmologia, 2013-12-01) Silva, Luci Meire Pereira da [UNIFESP]; Muccioli, Cristina [UNIFESP]; Oliveira, Filipe de [UNIFESP]; Arantes, Tiago Eugênio [UNIFESP]; Gonzaga, Lucas Renó [UNIFESP]; Nakanami, Célia Regina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. METHODS: In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. RESULTS: The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9%) followed by uveitis (862 patients, 15.7%). Uveitis was posterior in 792 patients (91.9% of uveitis) and toxoplasmosis was the most common diagnosis (765 patients, 88.7%). CONCLUSIONS: In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.