LUIZ GUILHERME MARCHESI MELLO
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
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conferenceObject OCT analysis of Bruch's opening-minimum rim width, peripapillary retinal nerve fiber layer and cup depth in eyes with compressive chiasmal lesions, glaucoma and normal controls.(2023) MONTEIRO, Mario; ANDRADE, Thais; ARAUJO, Rafael; ROCHA, Arthur do Nascimento; MELLO, Luiz Marchesi- Bruch Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Helps Differentiate Compressive Optic Neuropathy From Glaucoma(2022) ANDRADE, Thais de Souza; ARAUJO, Rafael Barbosa de; ROCHA, Arthur Andrade do Nascimento; MELLO, Luiz Guilherme Marchesi; CUNHA, Leonardo P.; MONTEIRO, Mario L. R.center dot PURPOSE: To compare optical coherence tomography measured Bruch membrane opening minimum rim width (MRW), peripapillary retinal nerve fiber layer (pRNFL) measurements, and MRW:pRNFL ratios in eyes with compressive optic neuropathy (CON) and glaucoma and controls, and evaluate the ability of these parameters to differentiate CON from glaucoma. center dot DESIGN: Prospective, cross-sectional study. center dot METHODS: Setting : Single-center tertiary hospital and outpatient clinic. Patient population : One hundred fifteen eyes of 77 participants, 34 with CON from chiasmal lesions, 21 with glaucoma, and 22 healthy controls. Observation procedures : Optical coherence tomography-measured MRW, pRNFL, and MRW:pRNFL ratios for each optic disc sector and global average. Main outcome measures: MRW, pRNFL, and MRW:pRNFL ratios compared using generalized estimated equations. Area under the receiver operating characteristic curve and positive and negative likelihood ratios were calculated. center dot RESULTS: MRW and pRNFL measurements were significantly reduced in CON and glaucoma compared with controls. In glaucoma, MRW was thinner than in CON in the global, inferotemporal, superonasal, inferonasal, and vertical average measurements, but a significant overlap was observed in many parameters. MRW:pRNFL ratios increased the ability to discriminate between CON and glaucoma, as shown by the high area under the receiver operating characteristic curve, high positive likelihood ratios, and low negative likelihood ratios, especially in the nasal disc sector and the nasal and temporal average. center dot CONCLUSIONS: MRW measurements alone cannot reliably distinguish CON from glaucoma, but the combination of MRW, pRNFL, and MRW:pRNFL ratios significantly improves accuracy. When comparing the 2 conditions, MRW:pRNFL ratios yielded higher area under the receiver operating characteristic curve and positive and negative likelihood ratios, suggesting this parameter may be helpful in clinical practice. (Am J Ophthalmol 2021;234: 156-165.
conferenceObject New insights into structural and functional evaluation of the retina and optic nerve in Parkinson's disease(2023) MELLO, Luiz Marchesi; PARAGUAY, Isabela Bezerra; ANDRADE, Thais; ROCHA, Arthur do Nascimento; BARBOSA, Egberto; OYAMADA, Maria; MONTEIRO, Mario- Electroretinography reveals retinal dysfunction in Parkinson's disease despite normal high-resolution optical coherence tomography findings(2022) MELLO, Luiz Guilherme Marchesi; PARAGUAY, Isabela Bruzzi Bezerra; ANDRADE, Thais de Souza; ROCHA, Arthur Andrade do Nascimento; BARBOSA, Egberto Reis; OYAMADA, Maria Kiyoko; MONTEIRO, Mario Luiz RibeiroIntroduction: Parkinson's disease (PD)-associated inner retinal abnormalities, particularly the retinal ganglion cells (RGC) layer, on optical coherence tomography (OCT) have recently gained importance as a biomarker of non-motor involvement of the disease but functional RGC evaluation using photopic negative response (PhNR) has not yet been determined. This study aims to compare structural and functional findings of the retina and optic nerve in PD with healthy controls (CT) including PhNR and OCT. Methods: Forty-one eyes of 21 PD patients and 38 eyes of 19 CT underwent ophthalmic examination including visual contrast sensitivity test (CS), OCT, light-adapted full-field electroretinography (ffERG), and PhNR. OCT was used to measure the peripapillary retinal nerve fiber layer, the segmented macular layers, and the choroid. For functional parameters, CS, ffERG (oscillatory potentials, photopic response, 30 Hz-flicker), and PhNR waves were used. Measurements were compared using generalized estimating equation and significance was set at P = 0.05. Results: The PD group presented a significantly lower mono- and binocular CS, oscillatory potentials amplitude, b-wave amplitude on ffERG (152.3[45.4] vs 187.1[32.7]mu V; P = 0.002), and PhNR amplitude (135.0[35.0] vs 156.3[34.1]mu V; P = 0.025). There was no statistically significant difference in OCT measurements between groups. No correlation was found between statistically significant measurements and clinical data. Conclusions: Functional abnormalities on CS, ffERG, and PhNR can be detected in PD even when structural damages are not observed on OCT. PhNR represents a new potential biomarker in PD. Our findings indicate dysfunction of bipolar, amacrine, and retinal ganglion cells in PD, probably with a cellular dysfunction overcoming morphological damage.
conferenceObject Minimum rim width and peripapillary retinal nerve fiber layer in neuromyelitis optica spectrum disorders, glaucoma and healthy controls(2023) ANDRADE, Thais; PEREIRA, Clarissa; ROCHA, Arthur do Nascimento; MELLO, Luiz Marchesi; PRETI, Rony; CUNHA, Leonardo; MONTEIRO, Mario- Discrimination ability of central visual field testing using stimulus size I, II, and III and relationship between VF findings and macular ganglion cell thickness in chiasmal compression(2024) ROCHA, Arthur Andrade do Nascimento; BENASSI, Thais de Souza Andrade; MELLO, Luiz Guilherme Marchesi; PRETI, Rony Carlos; ZACHARIAS, Leandro C.; CUNHA, Leonardo P.; MONTEIRO, Mario L. R.Purpose To compare the relationship between macular ganglion cell layer (mGCL) thickness and 10-2 visual field (VF) sensitivity using different stimulus sizes in patients with temporal hemianopia from chiasmal compression.Methods A cross-sectional study was conducted involving 30 eyes from 25 patients with temporal VF loss on 24-2 SITA standard automated perimetry due to previous chiasmal compression and 30 healthy eyes (23 controls). Optical coherence tomography (OCT) of the macular area and 10-2 VF testing using Goldmann stimulus size I (GI), II (GII), and III (GIII) were performed in the Octopus 900 perimeter. For the sake of analysis, mGCL thickness and VF data were segregated into four quadrants (two temporal and two nasal) and two halves (temporal and nasal) centered on the fovea, in order to evaluate separately both the severely affected nasal hemi-retina corresponding to the temporal VF sectors and the subclinically affected temporal hemi-retina corresponding to the nasal VF sectors. Data from patients and controls were compared using generalized estimated equations. The discrimination ability of GI, GII, and GIII was evaluated, as was the correlation between mGCL and 10-2 VF sensitivity using GI, GII, and GIII.Results All mGCL parameters in the nasal and temporal halves of the retina were significantly reduced in patients compared to controls. 10-2 VF test sensitivity using GI, GII, and GIII was significantly lower in patients than in controls (p <= 0.008) for all parameters, except the three nasal divisions when using GI (p = 0.41, 0.07 and 0.18) Significant correlations were found between temporal VF sectors (all stimulus sizes) and the corresponding nasal mGCL measurements, with similar discrimination ability. Significant correlations were also observed between all three nasal VF divisions and the corresponding temporal mGCL thickness when using stimulus sizes I and II, but not stimulus size III.Conclusions On 10-2 VF testing, GII outperformed GI and GIII with regard to discrimination ability and structure-function correlation with mGCL thickness in the subclinically affected nasal part of the VF in patients with chiasmal compression. Our findings suggest that the use of GII can enhance the diagnostic power of 10-2 VF testing in early cases of chiasmal compression, although further studies are necessary to support this conclusion.