MARCELO HATANAKA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Reproducibility of the water drinking test in treated glaucomatous patients(2015) BABIC, Mirko; MORAES, C. Gustavo De; HATANAKA, Marcelo; JU, Guilherme; SUSANNA JR., RemoBackgroundTo evaluate the reproducibility of intraocular pressure peaks and fluctuation elicited during the water drinking test in treated glaucomatous patients with a long follow-up interval. DesignRetrospective cohort study in a tertiary care practice. ParticipantsThirty-four treated primary open-angle glaucoma patients. MethodsAll patients underwent the water drinking test performed in two consecutive visits without any change in the therapeutic regimen. The mean interval between tests was 4.85 (range: 3-6) months. Reproducibility of peak and fluctuation during the water drinking test was assessed using intraclass correlation coefficients. Bland-Altman analysis was used to assess the agreement of intraocular pressure peaks and fluctuation measured between two consecutive tests. Main Outcome MeasuresIntraclass correlation and agreement of intraocular pressure peaks and fluctuation between visits. ResultsThere were no significant differences in baseline intraocular pressure values (meanstandard deviation, 11.73 +/- 2.36 and 11.61 +/- 2.71mmHg; P=0.72) and peaks (14.55 +/- 3.41 and 15.02 +/- 3.66mmHg, respectively; P=0.163) detected during the water drinking test between the first and second visits. There was also no significant difference between the average intraocular pressure fluctuation values (2.82 +/- 1.99 and 3.41 +/- 2.54mmHg, respectively; P=0.135). Intraocular pressure peaks and fluctuation presented intraclass correlation coefficients of 0.85 (P<0.001) and 0.50 (P<0.001), respectively. ConclusionsOur results demonstrate excellent reproducibility of intraocular pressure peaks during the water drinking test. Intraocular pressure fluctuation did not reveal good reproducibility, though. These results emphasize the applicability of this test to assess treatment efficacy in daily practice and interventional studies.
- Applications of the water drinking test in glaucoma management(2017) SUSANNA JR., Remo; CLEMENT, Colin; GOLDBERG, Ivan; HATANAKA, MarceloIntraocular pressure (IOP) peaks and means have been considered important factors for glaucoma onset and progression. However, peak IOP detection depends only on appropriated IOP checks at office visits, whereas the mean IOP requires longitudinal IOP data collection and may be affected by the interval between visits. Also, IOP peak assessment is necessary to verify if the peak pressure of a given patient is in target range, to evaluate glaucoma suspect risk, the efficacy of hypotensive drugs and to detect early loss of IOP control. The water-drinking test has gained significant attention in recent years as an important tool to evaluate IOP peaks and instability. The main objective of this review was to present new findings and to discuss the applicability of the water-drinking test in glaucoma management.
- Reproducibility of intraocular pressure peak and fluctuation of the water-drinking test(2013) HATANAKA, Marcelo; ALENCAR, Luciana M.; MORAES, Carlos G. De; SUSANNA JR., RemoBackground The water-drinking test has been used as a stress test to evaluate the drainage system of the eye. However, in order to be clinically applicable,a test must provide reproducible results with consistent measurements. This study was performed to verify the reproducibility of intraocular pressure peaks and fluctuation detected during the water-drinking test in patients with ocular hypertension and open-angle glaucoma. Design A prospective analysis of patients in a tertiary care unit for glaucoma treatment. Participants Twenty-four ocular hypertension and 64 open-angle glaucoma patients not under treatment. Methods The water-drinking test was performed in 2 consecutive days by the same examiners in patients not under treatment. Reproducibility was assessed using the intraclass correlation coefficient. Main Outcome Measures Peak and fluctuation of intraocular pressure obtained with the water-drinking test were analysed for reproducibility. Results Eighty-eight eyes from 24 ocular hypertension and 64 open-angle glaucoma patients not under treatment were evaluated. Test and retest intraocular pressure peak values were 28.38 +/- 4.64 and 28.38 +/- 4.56mmHg, respectively (P=1.00). Test and retest intraocular pressure fluctuation values were 5.75 +/- 3.9 and 4.99 +/- 2.7mmHg, respectively (P=0.06). Based on intraclass coefficient, reproducibility was excellent for peak intraocular pressure (intraclass correlation coefficient=0.79) and fair for intraocular pressure fluctuation (intraclass correlation coefficient=0.37). Conclusion Intraocular pressure peaks detected during the water-drinking test presented excellent reproducibility, whereas the reproducibility of fluctuation was considered fair.
- Comparison of Intraocular Pressure Changes During the Water Drinking Test Between Different Fluid Volumes in Patients With Primary Open-angle Glaucoma(2018) SUSANNA, Carolina N.; SUSANNA JR., Remo; HATANAKA, Marcelo; SUSANNA, Bianca N.; SUSANNA, Fernanda N.; MORAES, Carlos G. DePurpose: The main objective of this study was to compare the intraocular pressure (IOP) response during the water drinking test (WDT) performed with 800 mL, 1000 mL, and 10 mL/kg of body weight and to test its relationship with body mass index (BMI). Methods: In this prospective, observer-masked, observational study, patients treated with primary open-angle glaucoma were evaluated. In group I, 29 consecutive patients with body weight <= 60 kg underwent an 800 mL fluid challenge followed by a second WDT session with 10 mL/kg of body weight no longer than 4 months apart. Group II included 30 consecutive patients with body weight > 60 kg who underwent a 1000 mL fluid challenge followed by an 800 L test no longer than 4 months apart. IOP was measured before (baseline) and after water ingestion every 15 minutes for 45 minutes. Results: In group I, there was no significant difference in baseline or peak IOP between 800 mL and 10 mL/kg of body weight tests (P = 0.12 and 0.56, respectively). However, 10 mL/kg tended to lead to consistently lower IOP values and a biased response in eyes with higher IOP. In group II, there was also no significant difference in baseline or peak IOP between 800 and 1000mL tests (P = 0.26 and 0.72, respectively). No biased response was observed in this group. There was no significant association between IOP peak and BMI with 800mL (P = 0.18), 10 mL/kg (P = 0.29), or 1000mL (P = 0.34). Conclusions: There was overall good agreement between WDT results with different fluid volumes. The response to the volume loads tested in this study was not influenced by the BMI.
- Choroidal thickness variation in highly myopic eyes during the water drinking test(2016) GERMANO, Renato Antunes Schiave; HATANAKA, Marcelo; SUSANNA JUNIOR, RemoPurpose: To evaluate variations in choroidal thickness (CT) during the water drinking test (WDT) in emmetropic eyes (EE) and highly myopic eyes (ME) using spectral-domain optical coherence tomography (SD-OCT). Methods: Clinical trial performed at a tertiary care hospital comprising 30 randomly selected eyes. The WDT and SD-OCT macular scans were performed 10 and 45 min after water ingestion in 15 myopic and 15 EE of 15 healthy patients in each group. Primary study outcomes were average macular CT measured by SD-OCT and intraocular pressure (IOP) during the WDT. Results: The mean spherical equivalent refraction was 0.15 +/- 0.24 D in emmetropic and -7.1 +/- 1.75 D in ME (p < 0.001). No statistical differences between EE and ME were observed during the WDT response. EE had higher CT compared with ME at the fovea (361.4 +/- 55.4 vs 257.9 +/- 95.3; p < 0.001), 3 mm nasal to the fovea (158.0 +/- 71.8 vs 122.5 +/- 54.5; p = 0.047), and 3 mm temporally to the fovea (310.6 +/- 52.4 vs 247.6 +/- 90.1; p = 0.05). Regarding CT variation, significant differences in foveal CT at 10 min after water ingestion were observed in both EE and ME, with no statistically significant difference observed between groups. A moderate correlation between IOP peak during the WDT and CT was demonstrated in ME (r = 0.52; p = 0.04). Conclusions: No statistically significant differences in CT variation during the WDT were observed between EE and ME, indicating similar behavior of the choroidal bed during the WDT in both groups. Further, CT was thinner in highly ME, with CT variation unable to explain elevations in IOP observed during the WDT.
- Evaluation of the Efficacy and Safety of the New Susanna Glaucoma Drainage Device in Refractory Glaucomas: Short-term Results(2017) BITELI, Luis G.; PRATA, Tiago S.; GRACITELLI, Carolina P. B.; KANADANI, Fabio N.; BOAS, Flavia Villas; HATANAKA, Marcelo; PARANHOS JUNIOR, AugustoPurpose:To assess the efficacy and safety of the new Susanna glaucoma drainage device (SGDD) in patients with neovascular and refractory glaucomas.Materials and Methods:In this prospective study, patients with neovascular glaucoma or refractory glaucomas (defined as eyes with previous trabeculectomy failure) were enrolled. All eyes had to have intraocular pressure (IOP) above 21 mm Hg despite maximum tolerated topical medication, or recent documentation of anatomic and/or functional progression. Patients underwent glaucoma surgery with the new SGDD in a standardized manner. Postoperative visits were performed at days 1 and 7; months 1, 3, and 6; and every 6 months thereafter. Preoperative and postoperative IOP, number of antiglaucoma medications, surgical complications, and any subsequent related events were recorded. Success criteria were: (I) IOP6 and 21 mm Hg; (II) IOP6 and 18 mm Hg. Each criterion was classified as complete (without medication) or qualified (with medication).Results:A total of 58 patients with a mean age of 64.311.5 years were included [19 with neovascular glaucoma (group 1) and 39 with failure of first trabeculectomy (group 2)]. Overall, mean follow-up was 7.1 +/- 3.8 months, and mean IOP was reduced from 31.5 +/- 1.6 (range, 18 to 68) mm Hg to 12.6 +/- 0.7 (range, 2 to 28) mm Hg at the last follow-up visit (P<0.01). The mean number of antiglaucoma medications used was reduced from 3.4 +/- 0.9 to 1.4 +/- 1.5 (P<0.01). At 6 months postoperatively, qualified success rates for groups 1 and 2 were 73% and 86%, respectively (considering the stricter criterion). Main complications were 2 cases of conjunctival erosion and 2 cases of late hypotony.Conclusions:Our initial findings suggest that the new SGDD is an effective alternative for managing neovascular and refractory glaucomas, with minor postoperative complications in the short-term.
- Macular and Multifocal PERG and FD-OCT in Preperimetric and Hemifield Loss Glaucoma(2018) KREUZ, Andre C.; MORAES, Carlos G. de; HATANAKA, Marcelo; OYAMADA, Maria K.; MONTEIRO, Mario L. R.Purpose: To evaluate the ability of macular and multifocal (mf) pattern electroretinogram (PERG) to differentiate preperimetric glaucoma (PG) and glaucoma with hemifield loss (GHL) from controls, to compare the discrimination ability of PERG and fourier-domain optical coherence tomography (FD-OCT), and to assess the relationship between measurements. Patients and Methods: Standard automated perimetry, steady-state and transient PERG and mfPERG measurements were obtained from PG (n=14, 24 eyes), GHL (n=5, 7 eyes), and controls (n=19, 22 eyes). Circumpapillary retinal nerve fiber layer (cpRNFL), fullthickness macula, and segmented macular layer thicknesses on FDOCT were investigated. Measurements were compared using mixed effects linear models. The relationships between measurements and the diagnostic performance of each technology were assessed. Results: Compared with controls, average P50 peak time transient PERG responses were reduced in PG and GHL, whereas average latency and amplitude steady-state and mfPERG responses were abnormal only in GHL. cpRNFL and macular thickness measurements in PG and GHL differed significantly from controls. A significant relationship was found between PERG and most FDOCT or SAP parameters. Partial least squares discriminant analysis revealed that OCT parameters, along with mfPERG and transient PERG parameters had similar ability to discriminate PG and GHL from healthy controls. Conclusions: PERG and OCT parameters may be abnormal, with significant correlations between measurements, in PG eyes. Both technologies may be useful for detection of early glaucoma.