{"id":342,"date":"2015-01-23T13:18:00","date_gmt":"2015-01-23T15:18:00","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=342"},"modified":"2019-06-24T13:31:28","modified_gmt":"2019-06-24T16:31:28","slug":"utilidade-da-avaliacao-macular-pelo-oct-em-pacientes-alto-miopes","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/utilidade-da-avaliacao-macular-pelo-oct-em-pacientes-alto-miopes\/","title":{"rendered":"UTILIDADE DA AVALIA\u00c7\u00c3O MACULAR PELO OCT EM PACI\u00caNTES ALTO M\u00cdOPES \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d"},"content":{"rendered":"<div class=\"row-fluid\">\n<div class=\"span12\"><span class=\"tituloDoutorEsq\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-715 size-full\" src=\"https:\/\/sbglaucoma.org.br\/medico\/wp-content\/uploads\/2015\/01\/Roberto-Murad-Vessani.jpg\" alt=\"\" width=\"100\" height=\"120\" \/><strong>Editor Associado e Comentarios por Roberto Murad Vessani sobre<\/strong>:<br \/>\nRef.: <strong>Macular imaging in highly myopic eyes with and without glaucoma<\/strong>.<br \/>\nNakano N, Hangai M, Noma H, Nukada M, Mori S, Morooka S, Takayama K, Kimura Y, Ikeda HO, Akagi T, Yoshimura N.<br \/>\n<strong>Am J Ophthalmol. 2013 Sep;156(3):511-23<\/strong><br \/>\n<\/span><\/div>\n<\/div>\n<p>A miopia afeta cerca de 1.6 bilh\u00e3o de pessoas no mundo. Estudos epidemiol\u00f3gicos apontam a miopia como fator de risco para o desenvolvimento de glaucoma.<\/p>\n<p><span class=\"destaqueBgAzul\">Avaliar discos \u00f3pticos mi\u00f3picos \u00e9 uma tarefa que pode ser dif\u00edcil devido a maior frequ\u00eancia de altera\u00e7\u00f5es como inclina\u00e7\u00e3o, ciclotors\u00e3o, palidez, escava\u00e7\u00e3o rasa e (ou) ampla e \u00e1rea de atrofia peripapilar extensa.<\/span><\/p>\n<p><span class=\"destaqueBgAzul\">A avalia\u00e7\u00e3o da camada de fibras nervosas pela tomografia de coer\u00eancia \u00f3ptica (OCT) \u00e9 uma ferrramenta complementar interessante na avalia\u00e7\u00e3o do glaucoma, mas infelizmente sua utilidade parece ser bastante reduzida em discos \u00f3pticos mi\u00f3picos pelas caracter\u00edsticas mencionadas.<\/span><\/p>\n<p><span class=\"destaqueBgAzul\">Entretanto, a m\u00e1cula pode apresentar menores distors\u00f5es pelo alongamento do globo ocular do que o disco \u00f3ptico e as estruturas peripapilares. Dessa forma, a avalia\u00e7\u00e3o macular pelo OCT seria interessante em olhos com alta miopia e glaucoma.<\/span><\/p>\n<p>Nakano e colaboradores examinaram a utilidade da avalia\u00e7\u00e3o qualitativa da camada de c\u00e9lulas ganglionares e camada de fibras nervosas da \u00e1rea macular pelo OCT Spectralis na investiga\u00e7\u00e3o de glaucoma em olhos com miopia elevada.<\/p>\n<p>Nesse estudo, as imagens obtidas pelo OCT demonstraram que as estruturas maculares s\u00e3o sim\u00e9tricas e n\u00e3o distorcidas em olhos com alta miopia sem glaucoma, apesar da importante distor\u00e7\u00e3o do disco \u00f3ptico e da atrofia peripapilar.<\/p>\n<p>As estereofotografias e as imagens obtidas com o OCT foram avaliadas por 2 especialistas em glaucoma do Departamento de Oftalmologia da Faculdade de Medicina da Universidade de Kyoto no Jap\u00e3o.<\/p>\n<p>De maneira interessante, a concord\u00e2ncia entre examinadores na avalia\u00e7\u00e3o subjetiva das imagens da m\u00e1cula obtidas com o OCT foi melhor do que na avalia\u00e7\u00e3o subjetiva das estereofotografias do disco \u00f3ptico para separar olhos com alta miopia e glaucoma de olhos com alta miopia sem glaucoma. O mesmo foi observado comparando esses exames na classifica\u00e7\u00e3o de indiv\u00edduos normais, glaucoma inicial e glaucoma severo por cada examinador.<\/p>\n<p><span class=\"destaqueBgAzul\">Os autores conclu\u00edram que a avalia\u00e7\u00e3o da apar\u00eancia da m\u00e1cula pelo OCT Spectralis demonstrou maior confiabilidade e melhor acur\u00e1cia do que as estereofotografias do disco \u00f3ptico na identifica\u00e7\u00e3o de glaucoma em olhos com alta miopia.<\/span><\/p>\n<p>Os crit\u00e9rios desse estudo foram rigorosos e um importante n\u00famero de pacientes foram exclu\u00eddos. <span class=\"destaqueBgAzul\">Todos os pacientes com glaucoma apresentavam defeito de campo visual e exame de imagem no OCT com qualidade adequada. Sendo assim, seus resultados n\u00e3o podem ser generalizados para todos os olhos com alta miopia, mas geram boas expectativas sobre a utiliza\u00e7\u00e3o de recursos de imagem na \u00e1rea macular na dif\u00edcil tarefa de investigar glaucoma nesses olhos.<\/span><\/p>\n<div class=\"envolveConteudo\">\n<div class=\"accordion-noticias\">\n<h3 style=\"background-color: #dadada;\"><img decoding=\"async\" src=\"https:\/\/sbglaucoma.org.br\/medico\/wp-content\/uploads\/2015\/03\/seg.png\" \/>Resumo deste artigo<\/h3>\n<div>\n<div class=\"accordion-resumo\">\n<div class=\"box-isolado\">\n<p><em>Am J Ophthalmol<\/em>. 2013 Sep;156(3):511-23.e6. doi: 10.1016\/j.ajo.2013.04.028. Epub 2013 Jun 15.<br \/>\n<strong>Macular imaging in highly myopic eyes with and without glaucoma.<\/strong><br \/>\nNakano N, Hangai M, Noma H, Nukada M, Mori S, Morooka S, Takayama K, Kimura Y, Ikeda HO, Akagi T, Yoshimura N.<br \/>\n<strong>Author information<\/strong><\/p>\n<p><strong>Abstract<\/strong><\/p>\n<p><strong>PURPOSE<\/strong>:<br \/>\nTo determine how evaluations of macular structures on spectral-domain optical coherence tomography compare with those of the optic disc and circumpapillary retinal nerve fiber layer (RNFL) in discriminating between highly myopic eyes with and without glaucoma.<\/p>\n<p><strong>DESIGN<\/strong>:<br \/>\nRetrospective, comparative study.<\/p>\n<p><strong>METHODS<\/strong>:<br \/>\nThe appearances of ganglion cell layer and RNFL on Spectralis macular scans (Heidelberg Engineering) and optic disc on photographs were evaluated by 2 observers. The receiver operating characteristic regression was conducted for macular ganglion cell complex and circumpapillary RNFL measurements on RTVue-100 (Optovue).<\/p>\n<p><strong>RESULTS<\/strong>:<br \/>\nNinety highly myopic eyes (-6.0 to -15.0 diopters; mean deviation [MD], -5.6 \u00b1 5.1 dB) and 91 non-highly myopic eyes (1.0 to -5.5 diopters; MD, -4.9 \u00b1 5.7 dB) were enrolled. In highly myopic eyes ( Copyright \u00a9 2013 Elsevier Inc. All rights reserved.<br \/>\nPMID: 23777978 [PubMed &#8211; indexed for MEDLINE]<\/p>\n<p><strong>CONCLUSIONS<\/strong>:<br \/>\nIn high myopes, observers&#8217; assessments of the spectral-domain optical coherence tomography macular scans may agree better and be more accurate than observers&#8217; optic disc assessments. Glaucoma diagnostic performance of the macular ganglion cell complex may be less affected by axial length compared with that of circumpapillary RNFL.<br \/>\nCopyright \u00a9 2013 Elsevier Inc. All rights reserved.<br \/>\nPMID: 23777978 [PubMed &#8211; indexed for MEDLINE]<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Editor Associado e Comentarios por Roberto Murad Vessani sobre: Ref.: Macular imaging in highly myopic eyes with and without glaucoma. Nakano N, Hangai M, Noma H, Nukada M, Mori S, Morooka S, Takayama K, Kimura Y, Ikeda HO, Akagi T, Yoshimura N. Am J Ophthalmol. 2013 Sep;156(3):511-23 A miopia afeta cerca de 1.6 bilh\u00e3o de [&hellip;]<\/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-342","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>UTILIDADE DA AVALIA\u00c7\u00c3O MACULAR PELO OCT EM PACI\u00caNTES ALTO M\u00cdOPES \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\/utilidade-da-avaliacao-macular-pelo-oct-em-pacientes-alto-miopes\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"UTILIDADE DA AVALIA\u00c7\u00c3O MACULAR PELO OCT EM PACI\u00caNTES ALTO M\u00cdOPES \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Editor Associado e Comentarios por Roberto Murad Vessani sobre: Ref.: Macular imaging in highly myopic eyes with and without glaucoma. Nakano N, Hangai M, Noma H, Nukada M, Mori S, Morooka S, Takayama K, Kimura Y, Ikeda HO, Akagi T, Yoshimura N. 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