{"id":327,"date":"2015-01-23T12:55:18","date_gmt":"2015-01-23T14:55:18","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=327"},"modified":"2019-06-24T16:10:02","modified_gmt":"2019-06-24T19:10:02","slug":"avaliacao-do-snc-no-glaucoma-avancado-atraves-da-ressonancia-magnetica-3t","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/avaliacao-do-snc-no-glaucoma-avancado-atraves-da-ressonancia-magnetica-3t\/","title":{"rendered":"AVALIA\u00c7\u00c3O DO SNC NO GLAUCOMA AVAN\u00c7ADO ATRAV\u00c9S DA RESSON\u00c2NCIA MAGN\u00c9TICA 3T"},"content":{"rendered":"
\n
\"\"Comentarios de Ralph Cohen sobre<\/strong>:
\nRef: Structural brain abnormalities in patients with primary open-angle glaucoma: a study with 3T MR imaging<\/strong>.
\nChen WW, Wang N, Cai S, Fang Z, Yu M, Wu Q, Tang L, Guo B, Feng Y, Jonas JB, Chen X,Liu X, Gong Q.
\nInvest Ophthalmol Vis Sci 2013<\/strong>
\n<\/span><\/div>\n
\"\"Editor Associado<\/strong>
\nNiro Kasahara<\/strong>
\n<\/span><\/div>\n<\/div>\n

Neste estudo, os autores se prop\u00f5em a avaliar altera\u00e7\u00f5es estruturais do sistema nervoso central (SNC) em pacientes portadores de glaucoma prim\u00e1rio de \u00e2ngulo aberto (GPAA). Quinze portadores de GPAA, bilateral, em est\u00e1dio avan\u00e7ado, foram comparados com 15 indiv\u00edduos normais (controles)<\/span> quanto \u00e0 espessura da camada de fibras nervosas da retina utilizando tomografia de coer\u00eancia \u00f3ptica. A avalia\u00e7\u00e3o do SNC consistiu de morfometria do nervo \u00f3ptico, quiasma \u00f3ptico e mensura\u00e7\u00e3o do volume de subst\u00e2ncia cinzenta de diferentes s\u00edtios cerebrais com obten\u00e7\u00e3o de imagem por tecnologia sofisticada de resson\u00e2ncia magn\u00e9tica (ressonancia magnetica de 3 tesla). O trabalho \u00e9 muito bem escrito e sugere que a tecnologia empregada para o m\u00e9todo de avalia\u00e7\u00e3o seja adequada.<\/p>\n

Quanto aos resultados, as tabelas comparativas s\u00e3o muito claras. Interessante \u00e9 a observa\u00e7\u00e3o da multiplicidade de \u00e1reas atingidas, nao restritas ao cortex visual. A diferen\u00e7a de valores de volume de subst\u00e2ncia cinzenta entre os glaucomatosos e os indiv\u00edduos do grupo controle \u00e9 significante<\/span> (P < 0,001). As figuras que demonstram as altera\u00e7\u00f5es estruturais cerebrais s\u00e3o visualmente convincentes.<\/p>\n

Uma d\u00favida que surge refere-se \u00e0 discuss\u00e3o quanto \u00e0 possibilidade de rela\u00e7\u00e3o direta entre o n\u00edvel de eleva\u00e7\u00e3o da PIO e o grau de les\u00e3o estrutural cerebral, apesar de todos os indiv\u00edduos do grupo de estudo terem altera\u00e7\u00f5es perim\u00e9tricas que os classificam no grupo do glaucoma avan\u00e7ado.
\nA PIO dos pacientes glaucomatosos variou de 25 a 35 mmHg o que sugere forte componente mec\u00e2nico de patogenia da neuropatia glaucomatosa, nesses indiv\u00edduos. Seria interessante conhecer as altera\u00e7\u00f5es estruturais do SNC em indiv\u00edduos glaucomatosos com n\u00edveis de PIO estatisticamente dentro da normalidade.<\/span><\/p>\n

\n
\n

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

Invest Ophthalmol Vis Sci<\/em>. 2013 Jan 17;54(1):545-54. doi: 10.1167\/iovs.12-9893.
\nStructural brain abnormalities in patients with primary open-angle glaucoma: a study with 3T MR imaging<\/strong>.
\nChen WW, Wang N, Cai S, Fang Z, Yu M, Wu Q, Tang L, Guo B, Feng Y, Jonas JB, Chen X, Liu X, Gong Q.
\nAuthor information<\/strong><\/p>\n

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

PURPOSE<\/strong>:
\nWe examined changes of the central nervous system in patients with advanced primary open-angle glaucoma (POAG).<\/p>\n

METHODS<\/strong>:
\nThe clinical observational study included 15 patients with bilateral advanced POAG and 15 healthy normal control subjects, matched for age and sex with the study group. Retinal nerve fiber layer (RNFL) thickness was measured by optical coherence tomography (OCT). Using a 3-dimensional magnetization-prepared rapid gradient-echo sequence (3D-MP-RAGE) of magnetic resonance imaging (MRI) and optimized voxel-based morphometry (VBM), we measured the cross-sectional area of the optic nerve and optic chiasm, and the gray matter volume of the brain.<\/p>\n

RESULTS<\/strong>:
\nPatients in the POAG group compared to the subjects in the control group showed a significant (P < 0.001) decrease in the bilateral gray-matter volume in the lingual gyrus, calcarine gyrus, postcentral gyrus, superior frontal gyrus, inferior frontal gyrus, and rolandic operculum, as well as in the right cuneus, right inferior occipital gyrus, left paracentral lobule, and right supramarginal gyrus. Patients in the study group showed a significant increase in the bilateral gray matter volume in the middle temporal gyrus, inferior parietal gyrus, and angular gyrus, and in the left gray matter volume in the superior parietal gyrus, precuneus, and middle occipital gyrus. In addition, the cross-sectional area of the optic nerve and optic chiasm, and RNFL thickness were significantly decreased in the POAG group.<\/p>\n

CONCLUSIONS<\/strong>:
\nIn patients with POAG, three-dimensional MRI revealed widespread abnormalities in the central nervous system beyond the visual cortex.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Comentarios de Ralph Cohen sobre: Ref: Structural brain abnormalities in patients with primary open-angle glaucoma: a study with 3T MR imaging. Chen WW, Wang N, Cai S, Fang Z, Yu M, Wu Q, Tang L, Guo B, Feng Y, Jonas JB, Chen X,Liu X, Gong Q. Invest Ophthalmol Vis Sci 2013 Editor Associado Niro Kasahara […]<\/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-327","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nAVALIA\u00c7\u00c3O DO SNC NO GLAUCOMA AVAN\u00c7ADO ATRAV\u00c9S DA RESSON\u00c2NCIA MAGN\u00c9TICA 3T - 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\/avaliacao-do-snc-no-glaucoma-avancado-atraves-da-ressonancia-magnetica-3t\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"AVALIA\u00c7\u00c3O DO SNC NO GLAUCOMA AVAN\u00c7ADO ATRAV\u00c9S DA RESSON\u00c2NCIA MAGN\u00c9TICA 3T - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Comentarios de Ralph Cohen sobre: Ref: Structural brain abnormalities in patients with primary open-angle glaucoma: a study with 3T MR imaging. 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