{"id":2861,"date":"2015-09-01T17:55:34","date_gmt":"2015-09-01T20:55:34","guid":{"rendered":"https:\/\/sbglaucoma2.websiteseguro.com\/medico\/?p=2861"},"modified":"2019-06-13T17:02:18","modified_gmt":"2019-06-13T20:02:18","slug":"qualidade-de-vida-vs-cirurgia-em-glaucoma","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/qualidade-de-vida-vs-cirurgia-em-glaucoma\/","title":{"rendered":"Qualidade de Vida vs. Progress\u00e3o do Glaucoma: Estudo Prospectivo"},"content":{"rendered":"
\n
\"Ricardo-Paletta-Guedes\"<\/a>Editor Associado e Comentarios por Ricardo Guedes sobre:
\nRef.: Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients.
\n<\/strong> Medeiros FA, Gracitelli CP, Boer ER, Weinreb RN, Zangwill LM, Rosen PN.
\nOphthalmology. 2015 Feb;122(2):293-301.<\/strong><\/div>\n<\/div>\n

 <\/p>\n

Os autores avaliaram a rela\u00e7\u00e3o entre a taxa de progress\u00e3o do dano campim\u00e9trico no glaucoma e a mudan\u00e7a na qualidade de vida.<\/p>\n

Este estudo foi um estudo observacional de coorte prospectivo que faz parte do DIGS (Diagnostic Innovations Glaucoma Study) na Universidade de San Diego na Calif\u00f3rnia, onde 322 olhos de 161 pacientes foram acompanhados por um tempo m\u00e9dio de 3,5 anos. Todos os pacientes foram submetidos a exame oftalmol\u00f3gico completo.<\/p>\n

Para a an\u00e1lise da qualidade de vida, os autores fizeram uma adapta\u00e7\u00e3o do escore obtido no question\u00e1rio NEI-VFQ-25 atrav\u00e9s de uma an\u00e1lise de Rasch, uma metodologia estat\u00edstica para calibrar o instrumento de pesquisa e obter um valor em uma escala linear de 0 a 100.<\/p>\n


\nUm dos pontos fortes do estudo foi avaliar a relacao entre estas duas vari\u00e1veis de maneira prospectiva, visto que a percep\u00e7\u00e3o da qualidade de vida varia entre indiv\u00edduos (como a percep\u00e7\u00e3o da dor varia entre diferentes pessoas). Assim, pacientes com maior ou menor percep\u00e7\u00e3o\/sensibilidade, foram comparados com eles mesmos prospectivamente em rela\u00e7\u00e3o a piora da qualidade de vida.
\n<\/span><\/p>\n

A an\u00e1lise do campo visual (CV) considerou exames de perimetria automatizada (Humphrey) acrom\u00e1tica realizada a cada 6 meses. Dados do campo visual binocular foram obtidos atrav\u00e9s da combina\u00e7\u00e3o dados dos exames de cada olho segundo uma metodologia especifica.<\/p>\n

Um dos pontos fortes do estudo foi avaliar a relacao entre estas duas vari\u00e1veis de maneira prospectiva, visto que a percep\u00e7\u00e3o da qualidade de vida varia entre indiv\u00edduos (como a percep\u00e7\u00e3o da dor varia entre diferentes pessoas). Assim, pacientes com maior ou menor percep\u00e7\u00e3o\/sensibilidade, foram comparados com eles mesmos prospectivamente em rela\u00e7\u00e3o a piora da qualidade de vida.<\/p>\n

Os autores evidenciaram que existe uma rela\u00e7\u00e3o entre a mudan\u00e7a nos escores de qualidade de vida ao longo do tempo com: 1. com a severidade do comprometimento campimetrico no in\u00edcio do acompanhamento; 2. com a magnitude da piora do CV; 3. com a velocidade da taxa de progress\u00e3o do glaucoma.<\/p>\n

A maior chance de piora da qualidade de vida em pacientes com defeitos campimetricos mais severos no baseline representa um resultado esperado, visto que estes pacientes ja apresentam defeitos que tendem a comprometer a qualidade de vida de maneira mais acentuada do que defeitos menos severos. Seguindo o mesmo raciocinio, a magnitude da piora do CV tamb\u00e9m tende a piorar mais a qualidade de vida. E, de maneira interessante, a velocidade de piora apresentou correla\u00e7\u00e3o significativa com a qualidade de vida, pois os pacientes provavelmente tiveram mais dificuldade para se adaptar com a deteriora\u00e7\u00e3o da fun\u00e7\u00e3o visual que ocorreram de maneira mais r\u00e1pida.<\/p>\n


\nOs autores evidenciaram que existe uma rela\u00e7\u00e3o entre a mudan\u00e7a nos escores de qualidade de vida ao longo do tempo com: 1. com a severidade do comprometimento campimetrico no in\u00edcio do acompanhamento; 2. com a magnitude da piora do CV; 3. com a velocidade da taxa de progress\u00e3o do glaucoma.
\n<\/span><\/p>\n

O objetivo mais importante do tratamento do glaucoma \u00e9 a preserva\u00e7\u00e3o da qualidade de vida dos pacientes.<\/strong> Este estudo traz informa\u00e7\u00f5es muito importantes para o dia-a-dia do m\u00e9dico que cuida do glaucoma, pois permite de certa forma prever quais pacientes que sofrer\u00e3o com uma piora da qualidade de vida.<\/p>\n

Com esta informa\u00e7\u00e3o os m\u00e9dicos podem intervir de maneira mais adequada para evitar tal perda na qualidade de vida, seja atrav\u00e9s de um tratamento mais eficaz, a fim de diminuir a taxa de progress\u00e3o, seja atrav\u00e9s de um cuidado mais global do paciente (rela\u00e7\u00e3o m\u00e9dico-paciente), a fim de dar um suporte m\u00e9dico-psicol\u00f3gico a estes pacientes fragilizados pela sua patologia.<\/strong><\/p>\n

\n
\n

\"\"Resumo deste artigo<\/h3>\n
\n
\n
\n

Ophthalmology. 2015 Feb;122(2):293-301. doi: 10.1016\/j.ophtha.2014.08.014. Epub 2014 Oct 16.
\nLongitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients.
\nMedeiros FA1, Gracitelli CP2, Boer ER3, Weinreb RN3, Zangwill LM3, Rosen PN3.
\nAuthor information<\/p>\n

Abstract<\/strong><\/p>\n

PURPOSE:<\/strong>
\nTo evaluate the association between longitudinal changes in quality of life (QoL) and rates of progressive visual field loss in glaucoma.<\/p>\n

DESIGN:<\/strong>
\nProspective observational cohort study.<\/p>\n

PARTICIPANTS:<\/strong>
\nWe recruited 322 eyes of 161 patients with glaucomatous visual field loss from the Diagnostic Innovations Glaucoma Study followed for an average of 3.5\u00b10.7 years.<\/p>\n

METHODS:<\/strong><\/p>\n

All subjects had National Eye Institute Visual Function Questionnaire (NEI VFQ)-25 performed annually and standard automated perimetry (SAP) at 6-month intervals. Subjects were included if they had a minimum of 2 NEI VFQ-25 and \u22655 SAP during follow-up. Evaluation of rates of visual field change was performed using the mean sensitivity (MS) of the integrated binocular visual field (BVF). Rasch analysis was performed to obtain final scores of disability as measured by the NEI VFQ-25. A joint longitudinal multivariate mixed model was used to investigate the association between change in NEI VFQ-25 Rasch-calibrated scores and change in BVF sensitivity. Potentially confounding socioeconomic and clinical variables also were analyzed.<\/p>\n

MAIN OUTCOME MEASURES:<\/strong>
\nThe relationship between change in NEI VFQ-25 Rasch-calibrated scores and change in binocular SAP MS.<\/p>\n

RESULTS:<\/strong>
\nThere was a significant correlation between change in the NEI VFQ-25 Rasch scores during follow-up and change in binocular SAP sensitivity. Each 1-dB change in binocular SAP MS per year was associated with a change of 2.9 units per year in the NEI VFQ-25 Rasch scores during the follow-up period (R(2) = 26%; P<0.001). Eyes with more severe disease at baseline were also more likely to have a decrease in NEI VFQ-25 scores during follow-up (P<0.001). For subjects with the same amount of change in SAP sensitivity, those with shorter follow-up times had larger changes in NEI VFQ-25 scores (P = 0.005). A multivariable model containing baseline and rate of change in binocular MS had an adjusted R(2) of 50% in predicting change in NEI VFQ-25 scores.<\/p>\n

CONCLUSIONS:<\/strong>
\nBaseline severity, magnitude, and rates of change in BVF sensitivity were associated with longitudinal changes in QoL of glaucoma patients. Assessment of longitudinal visual field changes may help to identify patients at greater risk for developing disability from the disease.
\nCopyright \u00a9 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Editor Associado e Comentarios por Ricardo Guedes sobre: Ref.: Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients. Medeiros FA, Gracitelli CP, Boer ER, Weinreb RN, Zangwill LM, Rosen PN. Ophthalmology. 2015 Feb;122(2):293-301.   Os autores avaliaram a rela\u00e7\u00e3o entre a taxa de progress\u00e3o do dano campim\u00e9trico no […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_joinchat":[],"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2861","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nQualidade de Vida vs. Progress\u00e3o do Glaucoma: Estudo Prospectivo - SBG - Sociedade Brasileira de Glaucoma<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.sbglaucoma.org.br\/medico\/qualidade-de-vida-vs-cirurgia-em-glaucoma\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Qualidade de Vida vs. Progress\u00e3o do Glaucoma: Estudo Prospectivo - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Editor Associado e Comentarios por Ricardo Guedes sobre: Ref.: Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients. 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