{"id":4437,"date":"2016-11-25T16:48:22","date_gmt":"2016-11-25T18:48:22","guid":{"rendered":"https:\/\/sbglaucoma2.websiteseguro.com\/medico\/?p=4437"},"modified":"2019-06-11T12:26:21","modified_gmt":"2019-06-11T15:26:21","slug":"the-impact-of-visual-field-clusters-on-the-performance-based","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/the-impact-of-visual-field-clusters-on-the-performance-based\/","title":{"rendered":"The impact of visual field clusters on the performance-based"},"content":{"rendered":"

The impact of visual field clusters on the performance-based measures and vision-related quality of life in patients with glaucoma.<\/h3>\n
\n
\"\"Tulio Frades Reis<\/strong>
Fellow em Glaucoma HC FMRP\/USP.Doutorando em Ci\u00eancias Medicas pela FMRP\/USP\t<\/p>\n<\/div>\n
Marcelo Jord\u00e3o L da Silva<\/strong>
Mestre em Medicina pelo IASMPE. Doutor em Ci\u00eancias Medicas pela UNICAMP. Doutor em Ci\u00eancias Medicas pela FMRP\/USP. MBA em Gest\u00e3o da Sa\u00fade pela INEPAD\/USP. Preceptor Depto. Glaucoma HC FMRP\/USP
\n<\/span>\n<\/div>\n<\/div>\n

Ref.: The impact of visual field clusters on the performance-based measures and vision-related quality of life in patients with glaucoma.<\/strong>.
\nYi Sun, Clarissa Lin, Michael Waisbourd, Feyzahan Ekici, Elif Erdem, Sheryl S. Wizov, Lisa A. Hark, And George L. Spaeth
\nAmerican Journal Of Ophthalmology March 2016 <\/p>\n

 <\/p>\n

A perda visual pelo glaucoma \u00e9 conhecida por reduzir a qualidade de vida dos acometidos. Os estudos que comparam estes dois dados o fazem quantificando a severidade da perda por meio do Mean Deviation (MD). No entanto, valores semelhantes de MD est\u00e3o relacionados a efeitos diversos na vida dos glaucomatosos. Visando sanar esta defici\u00eancia, outros estudos associaram perdas no hemicampo inferior com piores resultados em avalia\u00e7\u00f5es subjetivas de qualidade de vida.<\/p>\n

Este estudo observacional e prospectivo avaliou quanto a perda em setores pr\u00e9-determinados do campo visual afetaria objetivamente o desempenho em Atividades da Vida Di\u00e1ria e, tamb\u00e9m, aspectos subjetivos da qualidade de vida. Foram utilizados os resultados iniciais de uma coorte de 4 anos do Wills Eye Hospital, somando 322 olhos de 161 pacientes portadores de glaucoma prim\u00e1rio de \u00e2ngulo aberto ou de glaucoma cr\u00f4nico de \u00e2ngulo fechado. Todos os participantes tinham diagn\u00f3stico de glaucoma h\u00e1 pelo menos 2 anos e em est\u00e1gio moderado em pelo menos um olho, segundo o Disk Damage Likelihood Scale (classifica\u00e7\u00e3o que usa o aspecto do nervo para graduar o dano glaucomatoso). <\/p>\n

Foram feitas duas campimetrias com estrat\u00e9gia SITA STANDARD 24:2. Cada exame foi dividido em 5 setores: nasal, temporal, central, paracentral e perif\u00e9rico (figura). A pontua\u00e7\u00e3o de cada setor foi obtida pela m\u00e9dia dos seus pontos no gr\u00e1fico Total Deviation e, como foram realizados dois exames, o resultado final foi a m\u00e9dia de ambos.<\/p>\n

A avalia\u00e7\u00e3o objetiva da qualidade de vida foi feita por meio do Compressed Assessment of Ability Related to Vision (CAARV). Ele \u00e9 dividido em quatro itens: detec\u00e7\u00e3o de movimento na tela de computador, reconhecimento de express\u00f5es faciais, leitura de sinais de tr\u00e2nsito e encontrar objetos em uma sala. Cada item \u00e9 pontuado de 0 a 7. O resultado do CAARV \u00e9 a m\u00e9dia dos quatro. A avalia\u00e7\u00e3o subjetiva, por sua vez, foi realizada com o NEI VFQ-25 e o Modified Glaucoma Symptom Scale. <\/p>\n

A associa\u00e7\u00e3o entre campo e avalia\u00e7\u00e3o de qualidade de vida foi feita pelo coeficiente de correla\u00e7\u00e3o de Spearman. No melhor olho, a regi\u00e3o central teve rela\u00e7\u00e3o com o CAARV e com o NEI VFQ-25, sendo a rela\u00e7\u00e3o com o CAARV mais forte, com coeficiente de 0,39 (p<0,001), e a outra, com 0,34 (p=0,002). No pior olho, o campo temporal apresentou correla\u00e7\u00e3o com CAARV, resultando no coeficiente de 0,4 (p<0,001). Ao comparar a correla\u00e7\u00e3o do hemicampo superior e inferior com o CAARV, houve rela\u00e7\u00e3o significativa com os dois hemicampos do melhor olho e com a regi\u00e3o inferior do pior olho, sendo a rela\u00e7\u00e3o mais forte com o campo inferior do melhor olho com Spearman de 0,35 (p<0,001).\n\n
\nA novidade no presente trabalho \u00e9 a an\u00e1lise da perda de qualidade de vida por meio de avalia\u00e7\u00e3o objetiva e a setoriza\u00e7\u00e3o do campo visual, concluindo que a redu\u00e7\u00e3o do hemicampo inferior prejudica atividades rotineiras como: reconhecimento facial, leitura de sinais de tr\u00e2nsito, detec\u00e7\u00e3o de movimento e procura de objetos.
\n<\/span>
\nA novidade no presente trabalho \u00e9 a an\u00e1lise da perda de qualidade de vida por meio de avalia\u00e7\u00e3o objetiva e a setoriza\u00e7\u00e3o do campo visual, concluindo que a redu\u00e7\u00e3o do hemicampo inferior prejudica atividades rotineiras como: reconhecimento facial, leitura de sinais de tr\u00e2nsito, detec\u00e7\u00e3o de movimento e procura de objetos.<\/p>\n

O Modified Glaucoma Symptom Scale n\u00e3o apresentou rela\u00e7\u00e3o com os setores dos campos visuais. Isto j\u00e1 era esperado, tendo em vista que esta escala foca mais em queixas de superf\u00edcie ocular.<\/p>\n

H\u00e1 tamb\u00e9m limita\u00e7\u00f5es, pois foram avaliados apenas pacientes com glaucoma moderado. Por isso, os resultados n\u00e3o podem ser aplicados em outros est\u00e1gios da doen\u00e7a. <\/strong><\/p>\n

Al\u00e9m disso, a classifica\u00e7\u00e3o utilizada foi apenas estrutural, sem considerar a fun\u00e7\u00e3o visual para estadiar os doentes. Tamb\u00e9m pode ter ocorrido um vi\u00e9s de confus\u00e3o ao analisar os dados, pois quando as perimetrias s\u00e3o avaliadas por setor, n\u00e3o se considera que a perda em outra regi\u00e3o possa afetar tamb\u00e9m as atividades de vida di\u00e1ria e qualidade de vida. Por fim, para uma an\u00e1lise menos te\u00f3rica, deveria ter sido avaliada a situa\u00e7\u00e3o de binocularidade, que \u00e9 o comum na maioria dos pacientes.<\/p>\n

Extrai-se do estudo que talvez seja prudente uma maior agressividade no tratamento de pacientes com risco de progress\u00e3o central no melhor olho e no hemicampo inferior em qualquer olho, j\u00e1 que estas altera\u00e7\u00f5es est\u00e3o relacionadas \u00e0 piora da qualidade de vida. <\/strong><\/p>\n

<\/center><\/p>\n","protected":false},"excerpt":{"rendered":"

The impact of visual field clusters on the performance-based measures and vision-related quality of life in patients with glaucoma. Tulio Frades Reis Fellow em Glaucoma HC FMRP\/USP.Doutorando em Ci\u00eancias Medicas pela FMRP\/USP Marcelo Jord\u00e3o L da SilvaMestre em Medicina pelo IASMPE. Doutor em Ci\u00eancias Medicas pela UNICAMP. Doutor em Ci\u00eancias Medicas pela FMRP\/USP. MBA em […]<\/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-4437","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nThe impact of visual field clusters on the performance-based - 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\/the-impact-of-visual-field-clusters-on-the-performance-based\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The impact of visual field clusters on the performance-based - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"The impact of visual field clusters on the performance-based measures and vision-related quality of life in patients with glaucoma. 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