Avaliação da evolução na avaliação do disco óptico durante o programa de residência médica de oftalmologia

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Data
2014-07-30
Autores
Rossetto, Julia Dutra [UNIFESP]
Orientadores
Campos, Mauro Silveira de Queiroz [UNIFESP]
Tipo
Dissertação de mestrado profissional
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Purpose: To assess clinical agreement among ophthalmology residents with a glaucoma expert in detecting glaucomatous optic nerve head (ONH) changes using stereoscopic photographs. Methods: Ophthalmology residents just after completing the first year of the Residency Program (First Year Group) and just after completing the third year (Third Year Group) analyzed 20 high-quality simultaneous stereophotos. All stereophotos were reviewed by a glaucoma expert. Agreement was assessed by calculation of the kappa statistic (k) and the limits of agreement. Results: Twenty eyes were analyzed. The agreement between the two groups and the expert ranged from moderate to good. The agreement between the Third Year Group and the expert was better than between the First Year Group with the expert, specially in the 'nasal cupping', 'barring circumlinear vessel?, 'notching' and 'RNFL defect' criteria. The agreement between First Year Group and the expert in the presence of glaucomatous optic neuropathy (GON) criteria was 64% (k=0.19) and 63% (k=0.20) between the Third Year Group and the expert. The mean difference (95% limits of agreement) between the First Year Group and the expert in vertical cup-to-disc ratio (C:D ratio) was -0.04 (-0.41 to 0.32) and between the Third Year Group and the expert was -0.04 (-0.35 to 0.26); and in the horizontal C:D ratio it was -0.06 (-0.48 to 0.35) for the First Year Group and -0.05 (-0.39 to 0.29) for the Third Year Group. Conclusion: Both groups had moderate to good agreement with the expert, and an improvement during the residency program was shown. The agreement between the Third Year Group and the expert was better than between the First Year Group with the expert, specially in the 'nasal cupping', 'barring circumlinear vessel?, 'notching' and 'RNFL defect' criteria.
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ROSSETTO, Julia Dutra. Avaliação da evolução na avaliação do disco óptico durante o programa de residência médica de oftalmologia. 2014. 12 f. Dissertação (Mestrado Profissional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.