{"id":346,"date":"2015-01-23T13:25:37","date_gmt":"2015-01-23T15:25:37","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=346"},"modified":"2019-06-24T13:41:03","modified_gmt":"2019-06-24T16:41:03","slug":"avaliacao-da-progressao-atraves-10-2-vs-24-2","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/avaliacao-da-progressao-atraves-10-2-vs-24-2\/","title":{"rendered":"AVALIA\u00c7\u00c3O DA PROGRESS\u00c3O ATRAV\u00c9S 10-2 vs. 24-2 \u2013 \u201cSUA ATEN\u00c7\u00c3O ESPECIAL PARA\u201d"},"content":{"rendered":"
\n
\"\"Editor Associado e Comentarios por Roberto Murad Vessani sobre:<\/strong>
\nRef.: Parafoveal scotoma progression in glaucoma: humphrey 10-2 versus 24-2 visual field analysis<\/strong>.
\nPark SC, Kung Y, Su D, Simonson JL, Furlanetto RL, Liebmann JM, Ritch R
\nOphthalmology. 2013 Aug;120(8):1546-50<\/strong>.
\n<\/span><\/div>\n<\/div>\n

Estudos mostram que defeitos por glaucoma na campimetria automatizada s\u00e3o detectados mais frequentemente e de maneira mais detalhada quando se utiliza um teste com pontos mais pr\u00f3ximos.<\/p>\n

Dessa forma \u00e9 poss\u00edvel que o teste de campo visual 10-2 possa ter performance melhor do que o 24-2 na detec\u00e7\u00e3o de mudan\u00e7as de defeitos campim\u00e9tricos por glaucoma localizados dentro dos 10 graus centrais.<\/span><\/p>\n

Park e colaboradores compararam a habilidade dos testes 10-2 e 24-2 da perimetria automatizada Humphrey para detectar progress\u00e3o em indiv\u00edduos com glaucoma e escotoma parafoveal inicial (localizado somente dentro dos 10 graus centrais).<\/p>\n

Nesse estudo restrospectivo, foi utilizada an\u00e1lise de regress\u00e3o linear para calcular a taxa de progress\u00e3o em cada ponto do mapa de limiares de sensibilidade para os testes 10-2 e 24-2 .<\/p>\n

“Apesar dos achados desse estudo \u00e9 preciso considerar que o teste 24-2 continua sendo importante no monitoramento do glaucoma mesmo em pacientes com defeitos localizados somente nos 10 graus centrais. Nesse mesmo estudo um n\u00famero importante de indiv\u00edduos mostrou progress\u00e3o em outros setores.”<\/span>Avaliando 50 olhos com mais de 5 campos visuais, os autores observaram que o teste 10-2 apresentou maior capacidade para detectar olhos que apresentaram progress\u00e3o glaucomatosa do que o teste 24-2 (24 olhos vs. 11 olhos, respectivamente).<\/span> Essa diferen\u00e7a foi mais significativa (5 vezes maior) quando apenas os 10 graus centrais foram considerados nos dois tipos de exames.<\/p>\n

A literatura sugere que a forma mais comum de progress\u00e3o no campo visual \u00e9 o aprofundamento de um escotoma pr\u00e9-existente seguido pela sua expans\u00e3o. Dessa forma a taxa de progress\u00e3o no campo visual ser\u00e1 provavelmente maior na \u00e1rea central em pacientes com escotoma parafoveal inicial.<\/span><\/p>\n

Apesar dos achados desse estudo \u00e9 preciso considerar que o teste 24-2 continua sendo importante no monitoramento do glaucoma mesmo em pacientes com defeitos localizados somente nos 10 graus centrais. Nesse mesmo estudo um n\u00famero importante de indiv\u00edduos mostrou progress\u00e3o em outros setores.<\/p>\n

“Futuros exames que combinem as vantagens dos testes 24-2 e 10-2 poderiam trazer benef\u00edcios no cuidado do paciente, reduzindo tempo, esfor\u00e7o e custos.”<\/span>Sendo assim, o planejamento desses dois exames 24-2 e 10-2 em pacientes com escotoma pr\u00f3ximo \u00e0 area central pode ser um desafio.<\/p>\n

Se por um lado a performance do paciente \u00e9 pior quando os dois exames s\u00e3o realizados no mesmo dia, um intervalo de tempo grande para realizar os dois testes poderia atrasar a detec\u00e7\u00e3o de progress\u00e3o. Futuros exames que combinem as vantagens dos testes 24-2 e 10-2 poderiam trazer benef\u00edcios no cuidado do paciente, reduzindo tempo, esfor\u00e7o e custos.<\/p>\n

Veja coment\u00e1rios do International Glaucoma Review sobre este artigo:
\nhttp:\/\/www.e-igr.com\/ES\/index.php?issue=152&ComID=1255<\/a><\/p>\n

\n
\n

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

Ophthalmology<\/em>. 2013 Aug;120(8):1546-50. doi: 10.1016\/j.ophtha.2013.01.045. Epub 2013 May 19.
\nParafoveal scotoma progression in glaucoma: humphrey 10-2 versus 24-2 visual field analysis<\/strong>.
\nPark SC, Kung Y, Su D, Simonson JL, Furlanetto RL, Liebmann JM, Ritch R.
\nAuthor information<\/strong><\/p>\n

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

OBJECTIVE<\/strong>:
\nTo compare the performance of 10-2 versus 24-2 visual fields (VFs) in detecting progression of initial parafoveal scotoma (IPFS) in glaucomatous eyes.<\/p>\n

DESIGN<\/strong>:
\nRetrospective, observational study.<\/p>\n

PARTICIPANTS<\/strong>:
\nGlaucoma patients with the following criteria: (1) an IPFS (\u2265 3 adjacent points with P<\/p>\n

METHODS<\/strong>:
\nBased on threshold map sensitivities, VF progression, defined as having 1 or more significantly progressing point(s) with a slope of sensitivity of less than -1.0 dB\/year at P<0.01, was evaluated using pointwise linear regression. MAIN OUTCOME MEASURES: The number of progressing eyes in 10-2 and 24-2 VF analyses. RESULTS: Fifty eyes (50 patients) were included (mean age \u00b1 standard deviation, 62 \u00b1 9 years). Mean follow-up period (5.7 vs. 5.6 years) and number of VFs (7.6 vs. 7.8) were similar between 10-2 and 24-2 analyses (all P>0.3). Significantly more progressing eyes were detected in 10-2 than in 24-2 analyses (24 vs. 11 eyes; P = 0.007). This difference became greater within the central 10\u00b0 (24 vs. 4 eyes; P<0.001). Four of the 11 progressing eyes in 24-2 analysis were missed in 10-2 analysis, whereas 17 of the 24 progressing eyes in 10-2 analysis were missed in 24-2 analysis. The 4 progressing eyes missed in 10-2 analysis had progressing point(s) only outside the central 10\u00b0 in 24-2 analysis. The other 3 eyes with progressing point(s) only outside the central 10\u00b0 in 24-2 analysis were detected as progressing in 10-2 analysis. Similar results were obtained when more stringent criteria (at least 2 significantly progressing points within the same hemifield) were used for VF progression.<\/p>\n

CONCLUSIONS<\/strong>:
\nThe 10-2 VF detects more progressing eyes than the 24-2 VF in glaucoma patients with IPFS, suggesting that closer surveillance of the central VF using testing algorithms with closely spaced grids is warranted in eyes with parafoveal scotomas.<\/p>\n

FINANCIAL 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: 23697959 [PubMed – indexed for MEDLINE]<\/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.: Parafoveal scotoma progression in glaucoma: humphrey 10-2 versus 24-2 visual field analysis. Park SC, Kung Y, Su D, Simonson JL, Furlanetto RL, Liebmann JM, Ritch R Ophthalmology. 2013 Aug;120(8):1546-50. Estudos mostram que defeitos por glaucoma na campimetria automatizada s\u00e3o detectados mais frequentemente e de maneira […]<\/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-346","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nAVALIA\u00c7\u00c3O DA PROGRESS\u00c3O ATRAV\u00c9S 10-2 vs. 24-2 \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\/avaliacao-da-progressao-atraves-10-2-vs-24-2\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"AVALIA\u00c7\u00c3O DA PROGRESS\u00c3O ATRAV\u00c9S 10-2 vs. 24-2 \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.: Parafoveal scotoma progression in glaucoma: humphrey 10-2 versus 24-2 visual field analysis. 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