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
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Author Response, ""The Water-drinking Test and Glaucoma Progression: Considerations Regarding the Test Usefulness as an Independent Risk Assessment Tool""(2018) MORAES, Carlos G. De; SUSANNA JR., Remo; SAKATA, Lisandro M.; HATANAKA, Marcelo
- Comparison of the hypotensor effect between latanoprost versus selective laser trabeculoplasty obtained with the water drinking test(2021) GERMANO, Renato Antunes Schiave; HATANAKA, Marcelo; GARCIA, Arthur Sonego; GERMANO, Flavio Augusto Schiave; GERMANO, Caroline Schiave; CID, Felipe Biscegli; GERMANO, Jorge EstefanoPurpose: Glaucoma is the main cause of irreversible blindness worldwide. Peak intraocular pressure is one of the main risk factors for glaucoma progression, and intraocular pressure reduction remains the only therapeutic strategy for all types of glaucoma. The main purpose of our study was to compare the baseline and peak intraocular pressure reduction obtained with the water drinking test between the two eyes of the same patients using 0.005% latanoprost in one eye and selective laser trabeculoplasty application in the contralateral eye. Methods: This was a prospective, interventional, longitudinal, and randomized clinical trial, in which 30 consecutive glaucomatous patients, medically controlled using latanoprost monotherapy, were recruited from a single ophthalmological center. The patients' eyes were randomized, and one eye was selected for SLT treatment and topical 0.005% latanoprost was introduced in the contralateral eye. The baseline intraocular pressure and peak intraocular pressure were evaluated 1 month (water drinking test 2) and 6 months (water drinking test 3) after treatment. Results: There was no significant difference between the mean pre-washout intraocular pressure in the randomized eyes for selective laser trabeculoplasty and latanoprost (13.6 +/- 2.1 and 13.3 +/- 1.8 mmHg, respectively; p=0.182). Regarding baseline intraocular pressure, there was no significant difference in the water drinking test 2 (p=0.689) and water drinking test 3 (p=0.06) between the groups. There was no significant difference in the intraocular pressure peak between the SLT and latanoprost groups at water drinking test 2 (p=0.771) or water drinking test 3 (p=0.774). Conclusions: The intraocular pressure reduction efficacy is similar between latanoprost and selective laser trabeculoplasty. Glaucomatous patients who are medically controlled with latanoprost and switch treatment to selective laser trabeculoplasty maintain control of intraocular pressure.
- 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.
- 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.
- The influence of topical anesthetic and fluorescein on non-contact tonometry measurements using ultra-high-speed dynamic Scheimpflug(2023) MACEDO, Marcelo; HATANAKA, Marcelo; BARBOZA, Wilma Lelis; MINGIONE, Gabriella Marranghello; AMBROSIO, Renato; JR, Remo SusannaThis study aimed to investigate the effects of topical anesthetic and fluorescein drops on intraocular pressure (IOP), central corneal thickness (CCT) and biomechanical properties as measured by Corvis ST (CST-Oculus; Wezlar, Germany) in healthy eyes. A cross-sectional observational study was conducted on 46 healthy patients. The CST measurements were obtained before and immediately after the instillation of topical anesthetic and fluorescein drops. Pre-post instillation data were statistically analyzed. IOP measurements were compared to Goldmann's Applanation Tonometry (GAT), which was also performed after drops instillation. Biomechanical parameters analyzed included applanation 1 velocity, applanation 2 velocity, applanation 1 time, applanation 2 time, whole eye movement, deflection amplitude, and stiffness parameter at first applanation. A statistically significant difference in IOP, both for non-corrected IOP (IOPnct) and biomechanically corrected IOP (bIOP), was observed before and after the instillation of eyedrops. Despite this statistical significance, the observed difference lacked clinical relevance. The IOPnct demonstrated a significant difference pre and post-anesthetic and fluorescein instillation compared to GAT (14.99 +/- 2.27 mmHg pre-instillation and 14.62 +/- 2.50 mmHg post-instillation, versus 13.98 +/- 2.04 mmHg, with p-values of 0.0014 and 0.0490, respectively). Comparable findings were noted when justaposing bIOP to GAT (14.53 +/- 2.10 mmHg pre-instillation and 13.15 +/- 2.25 mmHg post-instillation, against 13.98 +/- 2.04 mmHg, with p-values of 0.0391 and 0.0022, respectively). Additionally, CCT measurements revealed a statistically significant elevation following the administration of topical anesthetic and fluorescein drops (from 544.64 +/- 39.85 mu m to 586.74 +/- 41.71 mu m, p < 0.01. None of the analyzed biomechanical parameters showed statistically significant differences after drops instillation. While the administration of topical anesthetic and fluorescein drops induced a statistically significant alteration in both IOPnct and bIOP readings, these changes were not clinically consequential. Furthermore, a notable statistical rise was observed in CCT measurements post-drops instillation, as determined by CST. Yet, corneal biomechanical parameters remained unaffected.
- Effect of panretinal photocoagulation on the peripapillary retinal nerve fiber layer in diabetic retinopathy patients(2019) ZACHARIAS, Leandro Cabral; AZEVEDO, Breno M. S.; ARAUJO, Rafael B. de; CIONGOLI, Marina R.; HATANAKA, Marcelo; PRETI, Rony C.; MONTEIRO, Mario Luiz RibeiroOBJECTIVES: To determine the effect of panretinal photocoagulation (PRP) on the peripapillary retinal nerve fiber layer (RNFL) in nonglaucomatous patients with proliferative diabetic retinopathy (PDR). METHODS: This is a prospective, single center, observational study. Thirty-eight eyes of 26 diabetic patients underwent PRP for proliferative diabetic retinopathy. Peripapillary RNFL thickness was measured using scanning laser polarimetry (SLP) with variable corneal compensation (GDx VCC; by Carl Zeiss Meditec, Dublin, CA) and spectral-domain optical coherence tomography (OCT) (Heidelberg Spectralis, Carlsbad, USA) at baseline and 12 months after PRP was performed. RESULTS: Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 years (range 26 to 74 years) were recruited. No significant difference was found among all RNFL thickness parameters tested by GDx VCC software (p=0.952, 0.464 and 0.541 for temporal-superior-nasal-inferior-temporal (TSNIT) average, superior average, inferior average, respectively). The nerve fiber indicator (NFI) had a nonsignificant increase (p=0.354). The OCT results showed that the average RNFL thickness (360 degrees measurement) decreased nonsignificantly from 97.2 mm to 96.0 mm at 1 year post-PRP (p=0.469). There was no significant difference when separately analyzing all the peripapillary sectors (nasal superior, temporal superior, temporal, temporal inferior, nasal inferior and nasal thickness). CONCLUSION: Our results suggest that PRP, as performed in our study, does not cause significant changes in peripapillary RNFL in diabetic PDR patients after one year of follow-up.