Modelos para avaliar a correlação estrutura-função entre as tomografias de coerência óptica de domínio de tempo e espectral e as perimetrias automatizada padrão e de frequência duplicada em glaucoma
Arquivos
Data
2013
Tipo
Tese de doutorado
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Título de Volume
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Objetivo: Investigar a correlacao entre as medidas estruturais e funcionais em pacientes portadores de glaucoma primario de angulo aberto em diferentes estagios e em individuos saudaveis com a utilizacao de: Tomografias de Coerencia Optica de Dominio de Tempo (TDOCT) e Dominio Espectral (SD-OCT), Perimetria Automatizada Padrao (SAP) e Perimetria de Frequencia Duplicada (FDT) Matrix. Metodos: A espessura da camada de fibras nervosas retinianas (CFNR) foi avaliada com a OCT Stratus (protocolo Fast RNFL Scan), Cirrus (protocolo Optic Disc Cube 200x200) e Spectralis (protocolo RNFL). A avaliacao funcional foi por meio das perimetrias Humphrey 24-2 e FDT Matrix 24-2. Os limiares de sensibilidade do campo visual e da espessura da CFNR foram divididos em quatro setores. Para determinar a correlacao estrutura-funcao, foram adotados os modelos de Hood et al. (2007) e de Harwerth et al.(2010) modificado por Wheat et al.(2012). Resultados: Foram incluidos 79 olhos de 79 individuos, sendo 20 individuos saudaveis e 19 pacientes com glaucoma leve, 10 moderados e 30 avancados. Os coeficientes de correlacao para o modelo de Hood et al. (2007) das medidas da CFNR entre as OCTs Stratus, Cirrus e Spectralis e as perimetrias SAP e FDT Matrix variaram de 0,23 a 0,75. As estimativas da quantidade de celulas ganglionares determinadas a partir do modelo de Harwerth et al.(2010) modificado por Wheat et al.(2012) para os campos visuais e para as OCTs variaram de 0,73 a 0,94. Os dois modelos apresentaram correlacoes melhores entre o setor inferior nas OCTs e o setor superior nas perimetrias seguida pelo setor superior nas OCTs e o setor correspondente nas perimetrias, assim como entre as medidas globais. Conclusao: As correlacoes estrutura-funcao foram similares entre a FDT Matrix e as OCTs de Dominio Espectral e entre a SAP e a OCT de Dominio de Tempo. As correlacoes mais fortes entre os testes estruturais e funcionais foram encontradas para os setores inferior e superior e para as medidas globais. O fator que mais influenciou essas correlacoes foi a metodologia aplicada, com correlacoes mais fortes com o modelo de Harwerth et al.(2010) modificado por Wheat et al.(2012) em relacao ao modelo de Hood et al.(2007)
Purpose: To investigate the correlation between structure-function measurements in glaucoma using time- and spectral-domain optical coherence tomography (OCT), standard automated perimetry (SAP), and matrix frequency-doubling technology perimetry (FDT) with two different models. Methods: An observational cross-sectional study was conducted including a total of 79 eyes of 20 healthy individuals and 19 early, 10 moderate and 30 advanced primary open-angle glaucoma patients. Peripapillary retinal nerve fiber layer (RNFL) thickness was assessed with the Stratus OCT Fast RNFL Scan, Cirrus OCT Optic Disc Cube 200x200 and Spectralis OCT RNFL protocol. Functional damage was assessed with a 24-2 Humphrey SAP and 24-2 Matrix FDT. Visual field threshold and OCT RNFL data were divided into four sectors. Two different published structure-function models were applied (simple linear and nonlinear neural models). Results: Correlation coefficients for the simple linear model of RNFL measurements between Stratus, Cirrus and Spectralis OCTs and SAP and Matrix FDT ranged from 0.23 to 0.75. The retinal ganglion cell quantities determined from the neural model for visual fields and for the OCTs showed correlation coefficients ranging from 0.73 to 0.94. Both models showed better correlations between the inferior sector on OCTs and superior sectors on both perimeters followed by superior sector on OCTs and the corresponding sector on perimeters as well as between overall estimates. Conclusions: Structure-function correlations were found to be similar between FDT Matrix and spectral-domain OCTs and for SAP and time-domain OCT. The best correlations between structural and functional tests were found for the inferior and superior sectors and for the overall estimates.
Purpose: To investigate the correlation between structure-function measurements in glaucoma using time- and spectral-domain optical coherence tomography (OCT), standard automated perimetry (SAP), and matrix frequency-doubling technology perimetry (FDT) with two different models. Methods: An observational cross-sectional study was conducted including a total of 79 eyes of 20 healthy individuals and 19 early, 10 moderate and 30 advanced primary open-angle glaucoma patients. Peripapillary retinal nerve fiber layer (RNFL) thickness was assessed with the Stratus OCT Fast RNFL Scan, Cirrus OCT Optic Disc Cube 200x200 and Spectralis OCT RNFL protocol. Functional damage was assessed with a 24-2 Humphrey SAP and 24-2 Matrix FDT. Visual field threshold and OCT RNFL data were divided into four sectors. Two different published structure-function models were applied (simple linear and nonlinear neural models). Results: Correlation coefficients for the simple linear model of RNFL measurements between Stratus, Cirrus and Spectralis OCTs and SAP and Matrix FDT ranged from 0.23 to 0.75. The retinal ganglion cell quantities determined from the neural model for visual fields and for the OCTs showed correlation coefficients ranging from 0.73 to 0.94. Both models showed better correlations between the inferior sector on OCTs and superior sectors on both perimeters followed by superior sector on OCTs and the corresponding sector on perimeters as well as between overall estimates. Conclusions: Structure-function correlations were found to be similar between FDT Matrix and spectral-domain OCTs and for SAP and time-domain OCT. The best correlations between structural and functional tests were found for the inferior and superior sectors and for the overall estimates.
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Citação
PINTO, Luciano Moreira. Modelos para avaliar a correlação estrutura-função entre as tomografias de coerência óptica de domínio de tempo e espectral e as perimetrias automatizada padrão e de frequência duplicada em glaucoma. 2013. 99 f. Tese (Doutorado em Ciências) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.