Propedêutica complementar em ectasia corneana
Data
2022-12-13
Autores
Carvalho, Marcella Quaresma Salomão Hoyer 
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Ceratocone é uma doença ectásica que cursa com afinamento progressivo e subsequente protrusão da estrutura corneana. Essas mudanças na estrutura e na arquitetura corneanas induzem astigmatismo irregular e, geralmente, miopia, acarretando baixa da acuidade visual. Para um experiente examinador, a identificação de formas mais avançadas de ceratocone ocorre até mesmo na biomicroscopia com lâmpada de fenda, pela observação de sinais característicos da doença. Entretanto, ceratocone tem uma grande variação de severidade e apresentações, de modo que a identificação de formas menos evidentes, chamadas frustras, pode representar um desafio. A identificação precoce de formas frustras é fundamental em candidatos à cirurgia refrativa, uma vez que esses pacientes comumente obtêm resultados insatisfatórios e podem apresentar ectasia corneana progressiva depois de submetidos à cirurgia de correção visual a laser. A necessidade de identificar essas formas mais precoces está, da mesma forma, relacionada ao surgimento de novas modalidades terapêuticas para tratamento do ceratocone, as quais também se beneficiam de uma abordagem em fases mais iniciais da doença. Esta pesquisa descreve as principais tecnologias envolvidas no diagnóstico de ceratocone, destacando a contribuição da propedêutica multimodal, especialmente na identificação de formas menos avançadas da doença.
Keratoconus is an ectatic disease characterized by progressive thinning and subsequent protrusion of the corneal structure. These structural and architectural changes induce irregular astigmatism and often myopia, leading to low visual acuity. For an experienced examiner, the identification of more advanced forms of keratoconus is accomplished even in slitlamp biomicroscopy, when observing characteristic signs of the disease. Nevertheless, keratoconus has a wide range of severity and presentation, so the identification of milder forms, also called form fruste keratoconus, might be challenging. Early identification of forme fruste keratoconus is critical among refractive surgery candidates, as these patients commonly obtain unsatisfactory results and may experience progressive iatrogenic ectasia after laser vision correction. The need to identify mild forms is also associated to the development of new therapeutic modalities for keratoconus, which benefit from an earlier intervention as well. This research describes the main technologies involved in keratoconus diagnosis, highlighting the role of multimodal propaedeutics, especially in the identification of miler forms of the disease.
Keratoconus is an ectatic disease characterized by progressive thinning and subsequent protrusion of the corneal structure. These structural and architectural changes induce irregular astigmatism and often myopia, leading to low visual acuity. For an experienced examiner, the identification of more advanced forms of keratoconus is accomplished even in slitlamp biomicroscopy, when observing characteristic signs of the disease. Nevertheless, keratoconus has a wide range of severity and presentation, so the identification of milder forms, also called form fruste keratoconus, might be challenging. Early identification of forme fruste keratoconus is critical among refractive surgery candidates, as these patients commonly obtain unsatisfactory results and may experience progressive iatrogenic ectasia after laser vision correction. The need to identify mild forms is also associated to the development of new therapeutic modalities for keratoconus, which benefit from an earlier intervention as well. This research describes the main technologies involved in keratoconus diagnosis, highlighting the role of multimodal propaedeutics, especially in the identification of miler forms of the disease.