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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- 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.
- Reproducibility of the Mean, Fluctuation, and IOP Peak in the Diurnal Tension Curve(2013) HATANAKA, Marcelo; BABIC, Mirko; SUSANNA JR., RemoPurpose: To verify the reproducibility of the mean, peak, and fluctuation of intraocular pressure (IOP) observed during modified diurnal tension curves (mDTC) performed on ocular hypertensive and primary open-angle glaucoma patients.Methods: Prospective analysis of 88 eyes from 88 ocular hypertensive and primary open-angle glaucoma patients subjected to 2 consecutive mDTCs (IOP measurements obtained at 8:00 am, 11:00 am, 2:00 pm, and 4:00 pm) on 2 consecutive days. Mean IOP was calculated as the average of all IOP measurements obtained during each mDTC. Peak and minimum IOP levels were considered as the highest and lowest IOP level during each mDTC, respectively. IOP fluctuation was calculated using 2 different approaches: the difference between IOP peak and minimum IOP detected during each mDTC and as the SD of all mDTC measurements. Reproducibility was assessed using the intraclass correlation coefficient (ICC).Results: IOP fluctuation between 2 days in the modified diurnal curve, calculated as the difference between peak IOP and minimum IOP and as the SD of all mDTC measurements, was less reproducible than the mean IOP and peak IOP (ICC values 0.60, 0.62, 0.91, and 0.85, respectively; all ICC values, P<0.001).Conclusions: Mean IOP and peak IOP observed during the mDTC had good reproducibility, whereas the reproducibility of IOP fluctuation was only fair.
- 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.