{"id":322,"date":"2015-01-23T12:49:04","date_gmt":"2015-01-23T14:49:04","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=322"},"modified":"2019-06-24T16:05:02","modified_gmt":"2019-06-24T19:05:02","slug":"prevalencia-e-severidade-dos-casos-de-glaucoma-emgt","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/prevalencia-e-severidade-dos-casos-de-glaucoma-emgt\/","title":{"rendered":"PREVAL\u00caNCIA E SEVERIDADE DOS CASOS DE GLAUCOMA EMGT"},"content":{"rendered":"
\n
E\"\"ditor Associado e Comentarios por Roberto Murad Vessani sobre:<\/strong>
\nRef.: Prevalence and severity of undetected manifest glaucoma: results from the early manifest glaucoma trial screening<\/strong>.
\nHeijl A, Bengtsson B, Oskarsdottir SE.
\nOphthalmology. 2013 Aug;120(8):1541-5.<\/strong>
\n<\/span><\/div>\n<\/div>\n

“Um ter\u00e7o dos indiv\u00edduos tinha glaucoma avan\u00e7ado em pelo menos um dos olhos. A cegueira unilateral estava presente em todas as faixas et\u00e1rias. Sob o ponto de vista de sa\u00fade p\u00fablica esses achados chamam aten\u00e7\u00e3o, considerando que os pacientes nao tinham diagn\u00f3stico pr\u00e9vio de glaucoma, e pelo menos uma triagem anterior com oftalmologista havia sido realizada de 1992 a 1997.”Estudos populacionais demonstraram que em pa\u00edses desenvolvidos aproximadamente metade dos indiv\u00edduos com glaucoma n\u00e3o sabem que s\u00e3o portadores dessa doen\u00e7a. Identificar maiores detalhes desse grande problema atrav\u00e9s de novas investiga\u00e7\u00f5es \u00e9 sem d\u00favida fundamental para abordagens adequadas em sa\u00fade p\u00fablica.<\/p>\n

Nessa publica\u00e7\u00e3o baseada nos dados “Early Manifest Glaucoma Trial Screening “(EMGT), Heijl e colaboradores avaliaram a preval\u00eancia e a gravidade do glaucoma em 32918 indiv\u00edduos (55-79 anos) sem diagn\u00f3stico pr\u00e9vio, e analizaram os dados conforme as diferentes faixas et\u00e1rias. Vale lembrar que o n\u00famero de indiv\u00edduos avaliados nesse tipo de estudo n\u00e3o tem precedentes. Por outro lado, a popula\u00e7\u00e3o estudada foi principalmente caucasiana, o que n\u00e3o permite extender suas conclus\u00f5es para popula\u00e7\u00f5es compostas por outras etnias como afro-descendentes e asi\u00e1ticos.<\/p>\n

A preval\u00eancia total de glaucoma n\u00e3o detectado na popula\u00e7\u00e3o rastreada foi de 1,23%. Em concord\u00e2ncia com outros estudos, os autores observaram que a preval\u00eancia de glaucoma n\u00e3o detectado aumentava com a idade, chegando a ser 5 vezes maior na faixa et\u00e1ria mais avan\u00e7ada (0.55% de 55-59 anos vs. 2.73% de 75-79 anos).<\/p>\n

“Um ter\u00e7o dos indiv\u00edduos tinha glaucoma avan\u00e7ado em pelo menos um dos olhos. A cegueira unilateral estava presente em todas as faixas et\u00e1rias. Sob o ponto de vista de sa\u00fade p\u00fablica esses achados chamam aten\u00e7\u00e3o, considerando que os pacientes nao tinham diagn\u00f3stico pr\u00e9vio de glaucoma, e pelo menos uma triagem anterior com oftalmologista havia sido realizada de 1992 a 1997.”<\/span><\/p>\n

A diferen\u00e7a na severidade do dano glaucomatoso entre os pacientes detectados nesse rastreamento e os diagnosticados clinicamente na mesma cidade \u00e9 ampla (-8.0dB vs. -16.2dB, respectivamente). Baseado nesse achado, os autores sugerem que um periodo de tempo consider\u00e1vel poderia ter passado antes que o paciente rastreado tivesse sido diagnosticado clinicamente numa consulta habitual, ou seja, dentro do sistema usual de atendimento, o diagnostico do glaucoma tende a ocorrer em fases consideravelmente mais avan\u00e7adas, mesmo num pais de primeiro mundo.“ou seja, dentro do sistema usual de atendimento, o diagnostico do glaucoma tende a ocorrer em fases consideravelmente mais avan\u00e7adas, mesmo num pais de primeiro mundo.”<\/span><\/p>\n

De maneira interessante n\u00e3o houve diferen\u00e7a na severidade da doen\u00e7a (baseada na extens\u00e3o de perda de campo visual) entre as faixas et\u00e1rias acima de 60 anos. Considerando esse resultado e o poder da amostra os autores sugerem que a severidade da doen\u00e7a no momento do diagnostico n\u00e3o parece aumentar substancialmente com a idade (ao menos em pacientes previamente sem a doen\u00e7a). Apesar disso, a propor\u00e7\u00e3o de pacientes com doen\u00e7a bilateral foi diferente entre as faixas et\u00e1rias, variando de 28% a 48%, a partir dos 60 anos at\u00e9 os indiv\u00edduos mais idosos.<\/p>\n

Em conclus\u00e3o, o conhecimento da preval\u00eancia e severidade do glaucoma por faixa et\u00e1ria desse estudo acrescenta informa\u00e7\u00f5es que podem ser \u00fateis nas decis\u00f5es de servi\u00e7os de sa\u00fade p\u00fablica e privada.<\/p>\n

\n
\n

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

Ophthalmology<\/em>. 2013 Aug;120(8):1541-5. doi: 10.1016\/j.ophtha.2013.01.043. Epub 2013 Apr 28.
\nPrevalence and severity of undetected manifest glaucoma: results from the early manifest glaucoma trial screening<\/strong>.
\nHeijl A, Bengtsson B, Oskarsdottir SE.
\nAuthor information<\/strong><\/p>\n

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

PURPOSE<\/strong>:
\nTo estimate the prevalence and severity of undetected glaucoma in the population.
\nDESIGN<\/strong>:
\nCross-sectional study.
\nPARTICIPANTS<\/strong>:
\nA total of 32\u2009918 subjects aged 55 to 79 years from Malm\u00f6, Sweden, who were screened between 1992 and 1997. All subjects in the screened age groups living in the catchment area, and for whom there were no recent records at the Malm\u00f6 University Hospital Ophthalmology department, were invited. The main purpose of the screening was to recruit subjects for the Early Manifest Glaucoma Trial.
\nMETHODS<\/strong>:
\nWe registered the age, sex, and amount of visual field loss in subjects with previously undiagnosed glaucoma identified at the screening. The disease was categorized into 5 stages based on perimetric mean deviation values.
\nMAIN OUTCOME MEASURES:
\nPrevalence of undetected glaucoma at various disease stages in different age groups expressed as percentages.
\nRESULTS<\/strong>:
\nAmong the screened subjects, who were 77.5% of all invited subjects, a total of 406 subjects (1.23%) were identified with previously undetected glaucoma. Prevalence increased with age, from 0.55% at 55 to 59 years to 2.73% at 75 to 79 years. Unilateral disease accounted for 66% of all cases. Extent of visual field loss was similar in all age groups from 60 years and more. Most eyes had early (35%) or moderate (31%) glaucomatous visual field defects, but 134 subjects (33%) had advanced visual field loss in at least 1 eye. No subject was blind in both eyes, but 3.4% of the newly diagnosed patients were unilaterally blind because of glaucoma.
\nCONCLUSIONS<\/strong>:
\nPrevalence of undetected glaucoma increased with age, whereas disease severity did not increase in subjects older than 60 years of age. One third of subjects with previously undetected glaucoma had advanced or later-stage disease in at least 1 eye. Unilaterally blind subjects were present in all age groups.
\nFINANCIAL DISCLOSURE(S)<\/strong>:
\nProprietary or commercial disclosure may be found after the references.<\/p>\n

Copyright \u00a9 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
\nPMID: 23631945 [PubMed – indexed for MEDLINE] PMCID: PMC3874585 [Available on 2014\/8\/1]<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Editor Associado e Comentarios por Roberto Murad Vessani sobre: Ref.: Prevalence and severity of undetected manifest glaucoma: results from the early manifest glaucoma trial screening. Heijl A, Bengtsson B, Oskarsdottir SE. Ophthalmology. 2013 Aug;120(8):1541-5. “Um ter\u00e7o dos indiv\u00edduos tinha glaucoma avan\u00e7ado em pelo menos um dos olhos. A cegueira unilateral estava presente em todas as […]<\/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-322","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nPREVAL\u00caNCIA E SEVERIDADE DOS CASOS DE GLAUCOMA EMGT - 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\/prevalencia-e-severidade-dos-casos-de-glaucoma-emgt\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PREVAL\u00caNCIA E SEVERIDADE DOS CASOS DE GLAUCOMA EMGT - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Editor Associado e Comentarios por Roberto Murad Vessani sobre: Ref.: Prevalence and severity of undetected manifest glaucoma: results from the early manifest glaucoma trial screening. 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