Navegando por Palavras-chave "Ophthalmoscopy"
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- ItemAcesso aberto (Open Access)Análise de regressão logística na combinação de métodos propedêuticos no diagnóstico do glaucoma(Conselho Brasileiro de Oftalmologia, 2013-12-01) Fasolo, Leonardo Reichmann [UNIFESP]; Melo Júnior, Luiz Alberto Soares [UNIFESP]; Barbosa, Aline Silva [UNIFESP]; Fernandes, Rodrigo Antônio Brant [UNIFESP]; Prata Junior, João Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Triângulo MineiroPURPOSES: 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.
- ItemAcesso aberto (Open Access)Desenvolvimento e resultados preliminares de um sistema cromático de iluminação para oftalmoscópios indiretos(Conselho Brasileiro de Oftalmologia, 2009-04-01) Oliveira, Thiago Bellini; Trevelin, Luis Carlos; Moreira, Fernando Manoel Araújo; Bagnato, Vanderlei Salvador; Schor, Paulo [UNIFESP]; Carvalho, Luis Alberto Vieira De [UNIFESP]; Universidade Federal de São Carlos Programa de Pós-graduação em Biotecnologia; Computing Lab da UniKent; UFSCAR Departamento de Biotecnologia; University of Maryland Center for Superconductivity Research; Massachusetts Institute of Technology; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)PURPOSE: Chromatic contrast is a technique used in some areas of medicine to provide better visualization of biological tissues. Based on principles of color composition, a new illumination system was constructed using colored emitting diodes to reproduce the spectral range of visible light. This technique was devised to be used in indirect ophthalmoscopes to improve the visualization of the posterior segment of the eye. METHODS: The original illumination system of a general purpose indirect ophthalmoscope was substituted by a system of color-emitting diodes. RESULTS: Using an electronic interface it was possible to control the intensity of the color lights and therefore generate different wavelengths in the visible spectrum of the light. Preliminary tests undertaken in a mechanical model of the human eye generated very clear and homogenous colors. However in vivo examinations with patients were performed in our laboratory at the IFSC-USP and UNIFESP, and obtained the preliminary results show the possibilities of the chromatic contrast technique, and may represent in the future a differential in the analyses of the posterior segment of the eye. CONCLUSION: The use of color-emitting diodes to reproduce the spectral range of the visible light in indirect ophthalmoscopes seems to be a promising technological advance in the fundoscopy of the eye. This is an innovation that can yield better quality examinations with indirect ophthalmoscopes.
- ItemAcesso aberto (Open Access)Factors affecting the variability of the Heidelberg Retina Tomograph III measurements in newly diagnosed glaucoma patients(Conselho Brasileiro de Oftalmologia, 2010-08-01) Prata, Tiago dos Santos [UNIFESP]; Meira-Freitas, Daniel [UNIFESP]; Lima, Verônica Castro [UNIFESP]; Guedes, Lia Manis [UNIFESP]; Magalhães, Fernanda Pedreira [UNIFESP]; Paranhos Junior, Augusto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To determine factors associated with the test-retest variability of optic nerve head (ONH) topography measurements with confocal scanning laser ophthalmoscopy (CSLO) in newly diagnosed glaucomatous patients. METHODS: Consecutive patients with newly diagnosed primary open-angle glaucoma were prospectively enrolled. Patients presenting with any ocular disease other than glaucoma were excluded. All patients underwent CSLO using the Heidelberg Retina Tomograph III (HRT-III) in one randomly selected eye (three consecutive scans; performed by the same examiner). For each Heidelberg Retina Tomograph III parameter, repeatability was assessed using within subject standard deviation (Sw) and coefficient of variation (CVw), repeatability coefficient (RC) and intraclass correlation coefficient (ICC). Scatter plots and regression lines were constructed to identify which factors influenced test-retest measurement variability. RESULTS: A total of 32 patients were included (mean age, 65.4 ± 13.8 years). Most patients were female (65%) and white (50%). Among all Heidelberg Retina Tomograph III parameters evaluated, rim area and mean cup depth had the best measurement repeatability. Vertical cup-to-disc ratio (CDR, as determined by optic disc stereophotograph examination) was significantly associated (R²=0.21, p<0.01) with test-retest measurement variability. Eyes with larger CDR showed less variable measurements. Other factors, including age, disc area, central corneal thickness and intraocular pressure were not significant (p>0.14). CONCLUSION: Heidelberg Retina Tomograph III showed good test-retest repeatability for all ONH topographic measurements, mainly for rim area and mean cup depth. Test-retest repeatability seemed to improve with increasing CDR. These findings suggest that HRT-III topographic measurements should be cautiously interpreted when evaluating longitudinally glaucoma patients with early structural damage (small CDR).
- ItemAcesso aberto (Open Access)Importância da perimetria de dupla freqüência na detecção do glaucoma: rastreamento em funcionários de hospital público numa área urbana de São Paulo(Conselho Brasileiro de Oftalmologia, 2005-02-01) Almeida, Geraldo Vicente de; Mandia Júnior, Carmo; Paolera, Maurício Della; Kasahara, Niro; Umbelino, Cristiano Caixeta; Almeida, Paula Boturão de; Eliezer, Ricardo Nunes; Pinheiro, Renato Klingelfus; Seixas, Francisco Soares [UNIFESP]; Flank, Mauricio; Villaça Filho, Eduardo; Cohen, Ralph; Santa Casa de São Paulo Departamento de Oftalmologia; Santa Casa de Misericórdia de São Paulo Departamento de Oftalmologia Setor de Glaucoma; Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Faculdade de Ciências Médicas Departamento de OftalmologiaPURPOSE: To study the prevalence of glaucoma in employees of a public hospital in São Paulo and to analyze the role of frequency doubling perimetry along with non-contact tonometry and direct ophthalmoscopy, in the screening for glaucoma. METHODS: 612 employees of the Central Hospital of the Santa Casa de São Paulo were evaluated from October 15 to 20, 2000; 438 were women and 174 men, with mean age of 45.05±7.7 years (range, 35 to 81 years); 437 were white, 104 mulatto, 43 black and 28 Asian. All examinations were done by 10 eye specialists with experience in glaucoma. All employees had both eyes examined, by means of frequency doubling perimetry (FDT), ophthalmoscopy (FO), and non-contact tonometry (TNC). RESULTS: 159 (25.98%) subjects presented with at least one abnormal testing; 5 (3.14%) had high IOP (TNC+); 13 (8.17%) presented suspicious disk (FO+); 110 (69.18%) presented abnormal FDT (FDP+); 8 (5.03%) TNC+ and FO+; 10 (6.28%) had TNC+ and FDT+; 9 (5.66%) presented FO+ and FDT+; 4 (2.51%) had TNC+, FO+ and FDT+; 12 (1.96%) individuals were diagnosed with glaucoma, four of whom (0.65%), with normal pressure glaucoma. CONCLUSIONS: Frequency doubling perimetry was found to be an important step in the screening for glaucoma in the study. Of the 12 individuals that had the diagnosis of glaucoma, 5 (41.6%) would not have been diagnosed if they had not undergone frequency doubling perimetry.