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- ItemAcesso aberto (Open Access)Age norms for monocular grating acuity measured by sweep-VEP in the first three years of age(Conselho Brasileiro de Oftalmologia, 2008-08-01) Salomão, Solange Rios [UNIFESP]; Ejzenbaum, Fábio [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Sacai, Paula Yuri [UNIFESP]; Pereira, Josenilson Martins [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To determine age norms for grating visual acuity and interocular acuity differences measured by the sweep-visually evoked potentials (VEP) technique in the first three years of life. METHODS: Monocular grating visual acuity was measured using the sweep-VEP in 67 healthy normal infants and children in the first 36 months of life. RESULTS: Sweep-VEP grating acuity ranged from 0.80 logMAR (20/125 Snellen equivalent) in the first month of life to 0.06 logMAR (20/20 Snellen equivalent) at 36 months of age. Lower normal limits (95th percentile limit) ranged from 0.95 logMAR (20/180) to 0.12 logMAR (20/25) with a progression of approximately 3 octaves in the first 36 months of age. The largest acceptable interocular acuity difference for clinical purposes was 0.10 logMAR. CONCLUSIONS: Age norms for grating acuity along with interocular acuity differences were determined using the sweep-VEP technique. These norms should be incorporated in clinical practice for precise diagnosis of visual status in infants and preverbal children.
- ItemAcesso aberto (Open Access)Análise do custo-benefício da avaliação ocular de pacientes portadores de rosácea(Conselho Brasileiro de Oftalmologia, 2005-02-01) Lima, Keila Barbosa de Oliveira [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]; Santos, Namir Clementino [UNIFESP]; Barros, Jeison de Nadai [UNIFESP]; Antonio, Denise [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To observe the main ocular manifestations of patients with rosacea and to evaluate the cost-benefit of supplementary diagnostic examinations. METHODS: Twenty patients with acne rosacea from the Dermatology Service of the São Paulo Federal University (UNIFESP) were interviewed through a questionnaire, submitted to ophthalmologic examination and tested with Schirmer I, fluorescein and rose Bengal staining, impression cytology and conjunctival scrub. The costs of these examinations were abstracted from the Public Health System's values (SUS), Brazilian Medical Association values (AMB) and values charged by a private service. RESULTS: Twenty patients were enrollet initially in the study, but only 16 completed it. Eleven patients were female (55%), 19 were white (95%) and the average age was 56 years. All patients had at least one complaint related to rosacea. The most common symptoms were itching (40%), tearing (35%), foreign body sensation (30%). The most common signs were telangiectasis of lid margins (70%), hyperemia of lid margins (70%), meibomitis (65%) and blepharitis (50%). Most subsidiary examination showed normal results. There was difference of costs between the different paying sources. CONCLUSIONS: The main ocular manifestations in rosacea were related with meibomian gland disease. Considering the subsidiary examination costs and their results, the ophthalmologic check-up presents the best cost-benefit for the patient with rosacea.
- ItemAcesso aberto (Open Access)Aspectos socioeconômicos que influenciam no comparecimento ao exame oftalmológico de escolares com alterações visuais(Conselho Brasileiro de Oftalmologia, 2004-10-01) Abud, Alfredo Borghetto [UNIFESP]; Ottaiano, José Augusto Alves; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Marília Setor de Lentes de Contato da Disciplina de Oftalmologia; Universidade de Marília Faculdade de Medicina de MaríliaPURPOSE: To identify socioeconomic aspects influencing the attendance of schoolchildren, who showed visual impairment, at ophthalmologic examination. METHODS: 237 schoolchildren were referred to examinations. A survey questionnaire was applied to the parents or those responsible who accompanied the schoolchildren during the ophthalmologic appointment, of the National Campaign for Visual Rehabilitation Eye to Eye 2002 in Lins (SP) city. The following parameters were analyzed: educational level of the parents or those responsible, family income level, possession of a vehicle, the distance between their homes and the place of the examination and the association with a private medical health plan. The same questionnaire was applied afterwards, by means of a personal house visit, to the parents or those responsible for the absent schoolchildren. RESULTS: 163 schoolchildren (68.8%) attended the ophthalmologic examination and answered the questionnaire; 74 students were absent (31.2%) and 72 of them answered the questionnaire later. Educational level, family income level, possession of a vehicle and the distance between their homes and the place of the examination did not show significant difference between the students. There was a significant difference (p = 0,017) between the schoolchildren who have a private medical health plan and attended the examination (27.6%) and the absentees (44.4%). CONCLUSIONS: The fact that the student was protected by a private medical health plan was associated with the fact that he/she did not attend the examination.
- ItemAcesso aberto (Open Access)Cirurgia da catarata infantil unilateral(Conselho Brasileiro de Oftalmologia, 2008-04-01) Brandão, Adriana Maria Drummond [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow), and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.
- ItemAcesso aberto (Open Access)Contribuição diagnóstica da avaliação eletrofisiológica visual em pacientes atendidos em hospital universitário(Conselho Brasileiro de Oftalmologia, 2003-01-01) Sacai, Paula Yuri [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Fantini, Sérgio Costa; Salomão, Solange Rios [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To determine the frequency of diagnostic categories obtained in a clinical vision electrophysiology laboratory at a university hospital. METHODS: Patients who underwent visual electrodiagnostic testing from October 1998 to October 2000 (N=570) were cross-sectionally studied. Electroretinogram (ERG) was performed in 385 (68%) patients and pattern and/or flash visually evoked potentials were performed in 185 (32%) patients. RESULTS: After electroretinogram assessment, the most frequently identified diagnostic categories were (in this order): retinitis pigmentosa, Stargardt's disease, cone dystrophy, cone-rod degeneration, retinotoxic effects due to several agents (chloroquine, tamoxifen, methanol, etc) and ocular trauma, besides unclear visual loss. In 23% of the cases, it was impossible to obtain a final diagnosis on the first examination. The largest group referred to electroretinogram testing was for documentation or exclusion of tapetoretinal degenerations (42%). In this group, 110 cases of RP were identified: 91 isolated and 19 syndromic cases. Visually evoked potential testing helped to identify the following diagnostic categories: diseases affecting only the optic nerve (optic nerve atrophy, optic neuritis, optic disk edema, etc); neurological conditions affecting the visual pathway (multiple sclerosis, cerebral palsy, blunt head trauma, tumors, etc): pediatric eye and/or neurological conditions (congenital cataract, cortical visual impairment, congenital glaucoma, etc) and opaque media (leucoma, ocular trauma, etc). CONCLUSIONS: Frequent and meaningful indications for visual electrophysiologic recording and diagnostic decisions arise from this relatively large group of studied patients. A number of diagnoses can hardly, if not all, be established without visual electrophysiologic testing. These include early stages of retinitis pigmentosa, progressive cone dystrophy, toxic retinopathy without fundus changes, optic nerve or retinal dysfunction in opaque media, optic nerve involvement in multiple sclerosis and pediatric eye disease with or without neurological damage.
- ItemAcesso aberto (Open Access)Correlação entre sinais e sintomas de olho seco em pacientes portadores da síndrome de Sjögren(Conselho Brasileiro de Oftalmologia, 2008-08-01) Barboza, Marcello Novoa Colombo; Barboza, Guilherme Novoa Colombo; Melo, Gustavo Mendonça de; Sato, Elcio Hideo [UNIFESP]; Dantas, Maria Cristina Nishiwaki; Dantas, Paulo Elias Correa; Felberg, Sérgio; Santa Casa de Misericórdia de São Paulo; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Misericórdia de São Paulo Departamento de OftalmologiaPURPOSE: To study the correlation between the signals and symptoms of dry eye in Sjögren's syndrome patients. METHODS: We formed the case group with 17 Sjögren's syndrome patients and the control group with 25 normal patients. For evaluation of the symptoms the Ocular Surface Disease Index (OSDI) questionnaire was applied to both groups and, after that, all the individuals were submitted to the ocular tests: Schirmer I and II, coloration of the ocular surface with rose bengal, pachymetry and esthesiometry. Spearman's correlation test was used to analyze the correlations between signals and symptoms and Student's t test for independent samples was used for comparison of the averages of the values found by the Ocular Surface Disease Index (OSDI) questionnaire and the ocular tests between the patients of the groups. RESULTS: This study had evidenced a weak correlation between Ocular Surface Disease Index (OSDI) symptoms and ocular tests, which it indicates that not all the patients who presented exuberant symptoms, showed proportionally modified tests. The cornea sensitivity of the case group was reduced when compared with that of the control group. All the studied parameters in the case group presented significant differences (p<0.05) when compared with the control group. CONCLUSION: There was a weak correlation between Sjögren's syndrome patients' ocular symptoms and signals that indicate the severity of the illness. The variation of cornea sensitivity found in the Sjögren's syndrome patient group may be one of the responsible factors for this weak correlation. All the studied parameters were significantly modified in the Sjögren's syndrome patients group when compared with those found in the control group.
- ItemAcesso aberto (Open Access)Medida da visão e testes psicofísicos(Conselho Brasileiro de Oftalmologia, 2008-02-01) Kronbauer, Airton Leite [UNIFESP]; Schor, Paulo [UNIFESP]; Carvalho, Luis Alberto Vieira De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); University of RochesterVision measurement is the basis for the study and standardization of visual sciences. Measurement of visual acuity has great value for research and for clinical practice. This paper (1) reviews the fundamental concepts to understand visual sense and the measuring units; (2) presents the fundamental limits to visual performance and the principles of aberration measurement of the eye; and (3) discusses methods for measuring and classifying vision with new technologies.