{"id":335,"date":"2015-01-23T13:08:12","date_gmt":"2015-01-23T15:08:12","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=335"},"modified":"2019-06-24T13:20:15","modified_gmt":"2019-06-24T16:20:15","slug":"assimetria-da-pio-entre-os-olhos-vs-diagnostico-do-glaucoma","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/assimetria-da-pio-entre-os-olhos-vs-diagnostico-do-glaucoma\/","title":{"rendered":"ASSIMETRIA DA PIO ENTRE OS OLHOS VS. DIAGN\u00d3STICO DO GLAUCOMA"},"content":{"rendered":"
\n
\"\"Comentarios de Mauricio Della Paolera sobre<\/strong>:
\nRef.: The value of intraocular pressure asymmetry in diagnosing glaucoma<\/strong>.
\nWilliams AL, Gatla S, Leiby BE, Fahmy I, Biswas A, de Barros DM, Ramakrishnan R, Bhardwaj S, Wright C, Dubey S, Lynch JF, Bayer A, Khandelwal R, Ichhpujani P, Gheith M, Siam G, Feldman RM, Henderer JD, Spaeth GL.
\nJ Glaucoma 2013<\/strong>
\n<\/span><\/div>\n
\"\"Editor Associado<\/strong>
\nNiro Kasahara<\/strong>
\n<\/span><\/div>\n<\/div>\n

Neste estudo multic\u00eantrico retrospectivo foram analisados 326 pacientes com glaucoma prim\u00e1rio de angulo aberto (GPAA) e 326 pacientes sem a doen\u00e7a (grupo controle) com o objetivo de avaliar o montante da assimetria da press\u00e3o intraocular (PIO) em coorte de indiv\u00edduos de v\u00e1rias etnias e delinear o risco de glaucoma em fun\u00e7\u00e3o da diferen\u00e7a de medida entre os olhos.
\nOs autores observam que a assimetria da PIO \u00e9 fator de risco significante para ter glaucoma (odds ratio, 2,14; IC 95%, 1,86 \u2013 2,47; P < 0,001). A aus\u00eancia de assimetria entre os olhos est\u00e1 associada com probabilidade menor que 1% de ter glaucoma. Para diferen\u00e7a de 3 mmHg entre os dois olhos, o risco de desenvolver glaucoma \u00e9 de 6% e aumenta para at\u00e9 57% se a diferen\u00e7a for maior que 6 mmHg.<\/span><\/p>\n

Como os autores explicam no artigo, a assimetria da PIO entre olhos de pacientes com glaucoma j\u00e1 era reconhecida em outros estudos, por\u00e9m s\u00f3 agora foi estratificada a partir de qual n\u00edvel de PIO \u00e9 mais importante, e qual diferen\u00e7a ela \u00e9 mais significante. Neste artigo a assimetria de PIO acima de 6 mmHg passa a ser um fator de risco. No estudo foram inclu\u00eddos pacientes com glaucoma com PIO desde 9 a 57 mmHg no olho direito, e de 9 a 60 mmHg no olho esquerdo (esses pacientes poderiam ou nao estar sob tratamento para o glaucoma). Acredito que a inclus\u00e3o de pacientes com PIO muito baixa possa ter provocado um aumento na assimetria entre os olhos normais e glaucomatosos, embora tamb\u00e9m haja a inclus\u00e3o de pacientes considerados normais com press\u00f5es elevadas. Os autores n\u00e3o citam o c\u00e1lculo do poder da amostra, j\u00e1 que trabalhamos com diferen\u00e7as pequenas seria importante colocar no estudo. O ton\u00f4metro de Goldmann ainda n\u00e3o \u00e9 t\u00e3o sens\u00edvel para demonstrar diferen\u00e7as de 1 ou 2 mmHg , assim, diferen\u00e7as maiores s\u00e3o mais f\u00e1ceis de mensurar. Al\u00e9m disso, o estudo \u00e9 retrospectivo e a coleta de dados secund\u00e1rios sem padroniza\u00e7\u00e3o espec\u00edfica limita a integridade dos resultados.<\/p>\n

Este artigo mostra a import\u00e2ncia da assimetria da PIO no diagn\u00f3stico do GPAA, por\u00e9m ainda precisamos saber das suas implica\u00e7\u00f5es.<\/span><\/p>\n

\n
\n

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

J Glaucoma<\/em>. 2013 Mar;22(3):215-8. doi: 10.1097\/IJG.0b013e318237bfb8.
\nThe value of intraocular pressure asymmetry in diagnosing glaucoma.
\nWilliams AL, Gatla S, Leiby BE, Fahmy I, Biswas A, de Barros DM, Ramakrishnan R, Bhardwaj S, Wright C, Dubey S, Lynch JF, Bayer A, Khandelwal R, Ichhpujani P, Gheith M, Siam G, Feldman RM, Henderer JD, Spaeth GL
\nAuthor information<\/strong><\/p>\n

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

PURPOSE<\/strong>:
\nTo investigate the amount of intraocular pressure (IOP) asymmetry in a large group of ethnically diverse patients with and without glaucoma, and to delineate the risk for glaucoma which increasing amounts of IOP asymmetry confer upon the patient.<\/p>\n

PATIENTS AND METHODS<\/strong>:
\nCollaborative retrospective study of 326 glaucoma patients and 326 controls. Former Wills Eye Institute fellows collected single pre-treatment measurements of IOP on patients diagnosed as having definite glaucoma based on characteristic optic nerve damage and confirmatory visual field damage. Patients with a normal eye examination who had normal-appearing optic discs and no apparent glaucoma, or who had a normal eye examination in association with refractive error or cataract, were used as controls.<\/p>\n

RESULTS<\/strong>:
\nIntraocular pressure asymmetry is a significant risk factor for having glaucoma (odds ratio, 2.14; 95% confidence interval, 1.86-2.47; P<0.001). Absence of IOP asymmetry between the fellow eyes is associated with a 1% probability of having glaucoma. A difference of 3 mm Hg is associated with a 6% probability of having glaucoma, and a difference of >6 mm Hg with a 57% probability of having glaucoma. The association between IOP asymmetry and glaucoma status is significant for subjects with both elevated IOP (P=0.014) and statistically normal IOP (maximum IOP \u2264 21 mm Hg; P<0.001).<\/p>\n

CONCLUSIONS<\/strong>:
\nInter-eye asymmetry of IOP is a common finding in patients with glaucoma. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Comentarios de Mauricio Della Paolera sobre: Ref.: The value of intraocular pressure asymmetry in diagnosing glaucoma. Williams AL, Gatla S, Leiby BE, Fahmy I, Biswas A, de Barros DM, Ramakrishnan R, Bhardwaj S, Wright C, Dubey S, Lynch JF, Bayer A, Khandelwal R, Ichhpujani P, Gheith M, Siam G, Feldman RM, Henderer JD, Spaeth GL. […]<\/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-335","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nASSIMETRIA DA PIO ENTRE OS OLHOS VS. 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