{"id":338,"date":"2015-01-23T13:14:55","date_gmt":"2015-01-23T15:14:55","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=338"},"modified":"2019-06-24T13:25:35","modified_gmt":"2019-06-24T16:25:35","slug":"progressao-glaucoma-concordancia-entre-analise-de-evento-e-tendencia","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/progressao-glaucoma-concordancia-entre-analise-de-evento-e-tendencia\/","title":{"rendered":"PROGRESS\u00c3O GLAUCOMA: CONCORD\u00c2NCIA ENTRE AN\u00c1LISE DE EVENTO E TEND\u00caNCIA \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d"},"content":{"rendered":"
\n
\"\"Comentarios de Marcelo Hatanaka sobre<\/strong>:
\nRef.: Agreement between event-based and trend-based glaucoma progression analyses<\/strong>.
\nRao HL, Kumbar T, Kumar AU, Babu JG, Senthil S, Garudadri CS.
\nEye (Lond). 2013 Jul;27(7):803-8<\/strong>.
\n<\/span><\/div>\n
\"\"Editor Associado<\/strong>
\nLuciana Alencar<\/strong>
\n<\/span><\/div>\n<\/div>\n

“Sob uma perspectiva pr\u00e1tica, podemos inferir que a progress\u00e3o detectada por um m\u00e9todo n\u00e3o necessariamente ser\u00e1 identificada por outro.”<\/span>O acompanhamento do paciente portador de glaucoma pressup\u00f5e a realiza\u00e7\u00e3o de campos visuais seriados para a pesquisa de novos defeitos ou de progress\u00e3o de defeitos preexistentes. O programa Guided Progression Analysis do camp\u00edmetro computadorizado Humphrey (Carl Zeiss Meditec, Inc. Dublin, CA, Estados Unidos) gera um impresso que cont\u00e9m duas formas de an\u00e1lise de progress\u00e3o: baseada em eventos (GPA, do ingl\u00eas Glaucoma Progression Analysis) e baseada em tend\u00eancia (taxa de progress\u00e3o do VFI). Enquanto o primeiro avalia os limiares de sensibilidade para cada ponto testado e apresenta um mapa de probabilidades para que seja determinada a presen\u00e7a e localiza\u00e7\u00e3o da progress\u00e3o, o \u00faltimo resume cada campo visual testado em um \u00fanico valor (VFI) e calcula a velocidade da progress\u00e3o deste par\u00e2metro quando exames suficientes s\u00e3o realizados para permitir uma an\u00e1lise de regress\u00e3o linear.<\/span><\/p>\n

“Assim, enquanto a realiza\u00e7\u00e3o de campos visuais permanece como uma das melhores formas de seguimento do paciente com glaucoma, recomenda-se uma avalia\u00e7\u00e3o global do impresso do camp\u00edmetro automatizado para a melhor conclus\u00e3o diagn\u00f3stica, evitando-se a aten\u00e7\u00e3o exclusiva a um \u00fanico par\u00e2metro em detrimento de outros. A correla\u00e7\u00e3o com dados cl\u00ednicos \u00e9 essencial.”<\/span>Este estudo teve como objetivo avaliar se existe concord\u00e2ncia entre as duas formas de avalia\u00e7\u00e3o de progress\u00e3o. Para tanto, 238 olhos de 175 pacientes, selecionados de uma amostra de 335 pacientes, foram estudados. Este grupo, acompanhado entre 1989 e 2008, com no m\u00ednimo cinco campos visuais, teve a taxa de progress\u00e3o baseada no VFI, comparada \u00e0 classifica\u00e7\u00e3o do GPA. Al\u00e9m disso, a capacidade de discernimento entre campos est\u00e1veis e com progress\u00e3o pelos dois m\u00e9todos foi comparada. A taxa de concord\u00e2ncia variou de 75% (k=0,48) a 82% (k=0,50), dependendo do crit\u00e9rio utilizado. A acur\u00e1cia diagnostica da an\u00e1lise por tend\u00eancia para detec\u00e7\u00e3o de progress\u00e3o teve sensibilidade de 56,8% e especificidade de em torno de 90%, utilizando-se a an\u00e1lise por eventos como padr\u00e3o.<\/p>\n

O estudo demonstrou concord\u00e2ncia moderada entre os m\u00e9todos de an\u00e1lise de progress\u00e3o.<\/span> Sob uma perspectiva pr\u00e1tica, podemos inferir que a progress\u00e3o detectada por um m\u00e9todo n\u00e3o necessariamente ser\u00e1 identificada por outro.<\/p>\n

Assim, enquanto a realiza\u00e7\u00e3o de campos visuais permanece como uma das melhores formas de seguimento do paciente com glaucoma, recomenda-se uma avalia\u00e7\u00e3o global do impresso do camp\u00edmetro automatizado para a melhor conclus\u00e3o diagn\u00f3stica, evitando-se a aten\u00e7\u00e3o exclusiva a um \u00fanico par\u00e2metro em detrimento de outros. A correla\u00e7\u00e3o com dados cl\u00ednicos \u00e9 essencial. A leitura deste artigo na \u00edntegra \u00e9 recomendada, uma vez que apresenta uma discuss\u00e3o proveitosa sobre a an\u00e1lise de progress\u00e3o em glaucoma.<\/p>\n

\n
\n

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

Eye (Lond)<\/em>. 2013 Jul;27(7):803-8. doi: 10.1038\/eye.2013.77. Epub 2013 Apr 19.
\nAgreement between event-based and trend-based glaucoma progression analyses<\/strong>.
\nRao HL, Kumbar T, Kumar AU, Babu JG, Senthil S, Garudadri CS.
\nAuthor information<\/strong><\/p>\n

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

PURPOSE<\/strong>:
\nTo evaluate the agreement between event- and trend-based analyses to determine visual field (VF) progression in glaucoma.<\/p>\n

METHODS<\/strong>:
\nVFs of 175 glaucoma eyes with \u22655 VFs were analyzed by proprietary software of VF analyzer to determine progression. Agreement (\u03ba) between trend-based analysis of VF index (VFI) and event-based analysis (glaucoma progression analysis, GPA) was evaluated. For eyes progressing by event- and trend-based methods, time to progression by two methods was calculated.<\/p>\n

RESULTS<\/strong>:
\nMedian number of VFs per eye was 7 and follow-up 7.5 years. GPA classified 101 eyes (57.7%) as stable, 30 eyes (17.1%) as possible and 44 eyes (25.2%) as likely progression. Trend-based analysis classified 122 eyes (69.7%) as stable (slope >-1% per year or any slope magnitude with P>0.05), 53 eyes (30.3%) as progressing with slope <-1% per year, P\u22640.05 (sensitive criteria), and 37 eyes (21.1%) as progressing with slope <-1% per year, P\u22640.01 (specific criteria). \u03ba between sensitive criteria of GPA (possible combined with likely progression) and trend-based analysis was 0.48, and between specific criteria of GPA (possible clubbed with no progression) and trend-based analysis was 0.50. In eyes progressing by sensitive criteria of both methods (42 eyes), median time to progression by GPA (4.9 years) was similar (P=0.30) to trend-based method (5.0 years). This was also similar in eyes progressing by specific criteria of both methods (25 eyes; 5.6 years versus 5.9 years, P=0.23).<\/p>\n

CONCLUSION<\/strong>:
\nAgreement between event- and trend-based progression analysis was moderate. GPA seemed to detect progression earlier than trend-based analysis, but this wasn’t statistically significant.
\nPMID: 23598668 [PubMed – in process] PMCID: PMC3709397 [Available on 2014\/7\/1]<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Comentarios de Marcelo Hatanaka sobre: Ref.: Agreement between event-based and trend-based glaucoma progression analyses. Rao HL, Kumbar T, Kumar AU, Babu JG, Senthil S, Garudadri CS. Eye (Lond). 2013 Jul;27(7):803-8. Editor Associado Luciana Alencar “Sob uma perspectiva pr\u00e1tica, podemos inferir que a progress\u00e3o detectada por um m\u00e9todo n\u00e3o necessariamente ser\u00e1 identificada por outro.”O acompanhamento do […]<\/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-338","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nPROGRESS\u00c3O GLAUCOMA: CONCORD\u00c2NCIA ENTRE AN\u00c1LISE DE EVENTO E TEND\u00caNCIA \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d - 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\/progressao-glaucoma-concordancia-entre-analise-de-evento-e-tendencia\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PROGRESS\u00c3O GLAUCOMA: CONCORD\u00c2NCIA ENTRE AN\u00c1LISE DE EVENTO E TEND\u00caNCIA \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Comentarios de Marcelo Hatanaka sobre: Ref.: Agreement between event-based and trend-based glaucoma progression analyses. Rao HL, Kumbar T, Kumar AU, Babu JG, Senthil S, Garudadri CS. Eye (Lond). 2013 Jul;27(7):803-8. 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