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.
- Clinical relevance of protruded retinal layers in minimum rim width measurement of the optic nerve head(2019) TORRES, Lucas A.; JARRAR, Faisal; SHARPE, Glen P.; HUTCHISON, Donna M.; FERRACIOLI-ODA, Eduardo; HATANAKA, Marcelo; NICOLELA, Marcelo T.; VIANNA, Jayme R.; CHAUHAN, Balwantray C.Background/aims Optical coherence tomography (OCT) imaging of the optic nerve head minimum rim width (MRW) has recently been shown to sometimes contain components besides extended retinal nerve fibre layer (RNFL). This study was conducted to determine whether excluding these components, termed protruded retinal layers (PRLs), from MRW increases diagnostic accuracy for detecting glaucoma. Methods In this cross-sectional study, we included 123 patients with glaucoma and 123 normal age-similar controls with OCT imaging of the optic nerve head (24 radial scans) and RNFL (circle scan). When present, PRLs were manually segmented, and adjusted MRW measurements were computed. We compared diagnostic accuracy of adjusted versus unadjusted MRW measurement. We also determined whether adjusted MRW correlates better with RNFL thickness compared with unadjusted MRW. Results The median (IQR) visual field mean deviation of patients and controls was -4.4 (-10.3 to -2.1) dB and 0.0 (-0.6 to 0.8) dB, respectively. In the 5904 individual B-scans, PRLs were identified less frequently in patients (448, 7.6%) compared with controls (728, 12.3%; p<0.01) and were present most frequently in the temporal sector of both groups. Areas under the receiver operating characteristic curves and sensitivity values at 95% specificity indicated that PRL adjustment did not improve diagnostic accuracy of MRW, globally or temporally. Furthermore, adjusting MRW for PRL did not improve its correlation with RNFL thickness in either group. Conclusion While layers besides the RNFL are sometimes included in OCT measurements of MRW, subtracting these layers does not impact clinical utility.
- Predictive Value of the Water Drinking Test and the Risk of Glaucomatous Visual Field Progression(2017) MORAES, Carlos G. De; SUSANNA JR., Remo; SAKATA, Lisandro M.; HATANAKA, MarceloPurpose: The purpose of this is to test the hypothesis the intraocular pressure (IOP) peaks during a stress test [the water drinking test (WDT)] can estimate the risk of future visual field progression in treated primary open- angle glaucoma (POAG) patients. Patients and Methods: Design: Prospective, longitudinal study. Setting: Clinical practice. Study population: Treated POAG patients whose IOP was <= 18mmHg and who had no IOPlowering interventions between the date of the WDT and the last eligible visual field. Intervention: At baseline examination, patients underwent the WDT and were then followed at regular intervals with office-based IOP measurements and visual field testing. Main outcome measure: Cox-proportional hazards survival analysis testing the predictive value of IOP peaks during the WDT versus IOP measurements during office hours on visual field progression. Results: A total of 144 eyes of 96 patients with baseline visual field damage ranging from mild to severe followed for a mean of 28 months were analyzed. In the multivariable analysis adjusting for potential confounders, higher IOP peaks during the WDT were predictive of future visual field progression (hazard ratio=1.11; 95% confidence interval, 1.02 to 1.21; P= 0.013). The average and peak IOP during office hours over the same follow-up period were not significantly associated with progression (P= 0.651 and 0.569, respectively). Conclusions: IOP peaks detected with the WDT were predictive of future visual field progression in a treated POAG population. This stress test could be a useful tool for risk assessment in daily practice.
- 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.
- 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.
- 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.
- The role of pattern-reversal electroretinography in the diagnosis of glaucoma(2014) KREUZ, Andre Carvalho; OYAMADA, Maria Kiyoko; HATANAKA, Marcelo; MONTEIRO, Mario Luiz RibeiroPattern electroretinography is used to assess the function of the inner retinal layers, particularly the retinal ganglion cell layer, using a reversing checkerboard or grating pattern that maintains a constant overall mean luminance over time. A normal transient response comprises a positive component of the wave (P50) followed by a longer negative component of the wave (N95). Glaucomatous optic neuropathy causes progressive loss of retinal ganglion cells, potentially detectable as abnormalities on examination, particularly in the N95 component. Therefore, pattern electroretinography may be useful in the diagnosis and evaluation of glaucoma. The present article is an updated review of published data regarding the use of pattern electroretinography for the detection of glaucoma-induced retinal changes.