RONY CARLOS PRETI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina

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Assunto: macular edema ×

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  • article 3 Citação(ões) na Scopus
    Diagnostic ability of confocal near-infrared reflectance fundus imaging to detect retrograde microcystic maculopathy from chiasm compression. A comparative study with OCT findings
    (2021) MONTEIRO, Mario L. R.; SOUSA, Rafael M.; ARAUJO, Rafael B.; FERRAZ, Daniel; SADIQ, Mohammad A.; ZACHARIAS, Leandro C.; PRETI, Rony C.; CUNHA, Leonardo P.; NGUYEN, Quan D.
    Purpose To evaluate the ability of confocal near-infrared reflectance (NIR) to diagnose retrograde microcystic maculopathy (RMM) in eyes with temporal visual field (VF) loss and optic atrophy from chiasmal compression. To compare NIR findings with optical coherence tomography (OCT) findings in the same group of patients. Methods Thirty-four eyes (26 patients) with temporal VF loss from chiasmal compression and 41 healthy eyes (22 controls) underwent NIR fundus photography, and macular OCT scanning. VF loss was estimated and retinal layers thickness were measured on OCT. Two examiners blinded to the diagnosis randomly examined NIR images for the presence of hyporeflective abnormality (HA) and OCT scans for the presence of microcystic macular abnormalities (MMA). The total average and hemi-macular HA area and number of microcysts were determined. The groups were compared and the level of agreement was estimated. Results The OCT-measured macular retinal nerve fiber and ganglion cell layers were thinner and the inner nuclear layer was thicker in patients compared to controls. HA and MMA were detected in 22 and 12 patient eyes, respectively, and in 0 controls (p<0.001, both comparisons). HA was significantly more frequent than MMA in patients with optic atrophy, and agreement between HA and MMA (both total and hemi-macular) was fair (kappa range: 0.24-0.29). The mean HA area was significantly greater in the nasal than temporal hemi-macula. A re-analysis of the 14 eyes with discrepant findings allowed to confirm RMM in 20 eyes (20/34) indicating that OCT detected RMM in 12 and missed it in 8 eyes. On the other hand, NIR correctly detected 18 out of 20 eyes, overcalled 4 and missed 2. Conclusions RMM is a frequent finding in eyes with severe VF loss from long-standing chiasmal compression. NIR photography appears to be more sensitive than OCT for detecting RMM and may be useful as screening method for its presence.
  • article 8 Citação(ões) na Scopus
    The Effect of Glycemia on Choroidal Thickness in Different Stages of Diabetic Retinopathy
    (2020) ABALEM, Maria Fernanda; VELOSO, Helen Nazareth Santos; GARCIA, Rafael; CHEN, Xing Dong; CARRICONDO, Pedro C.; ZACHARIAS, Leandro Cabral; PRETI, Rony C.
    Objective:The purpose of this study was to evaluate the influence of renal and glycemic parameters on choroidal thickness (CT) in patients with diabetes with and without diabetic retinopathy (DR).Methods:This cross-sectional study included patients with and without diabetes. Patients underwent comprehensive ocular examination. CT was obtained using spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode. Clinical parameters were body mass index, mean arterial pressure, glycated hemoglobin, fasting plasma glucose, estimated glomerular filtration rate, and capillary plasma glucose (CPG) a few minutes before EDI-SD-OCT.Results:The study included 275 participants: 42 with diabetes and no DR, 43 with mild nonproliferative diabetic retinopathy (NPDR), 46 with moderate NPDR, 39 with severe NPDR, 24 with proliferative diabetic retinopathy (PDR), 40 with previous panretinal photocoagulation (PRP) treatment for DR, and 41 without diabetes. The diabetic patients had thinner subfoveal CT than the nondiabetic participants (280.5 +/- 83.4 vs. 327.1 +/- 48.8 mu m,p< 0.001). After multivariable adjustment, CT was significantly correlated with age, DR stage, and CPG. In patients with mild and moderate NPDR, a higher level of CPG was associated with thicker CT. This relationship was not found in patients with PDR.Conclusion:CPG had the strongest correlation with CT in patients with NPDR (mild, moderate, and severe), but not in PDR and PRP PDR patients. Our study suggests that the glucose level at the time of the test should be aggregated to other systemic and ocular parameters, such as age and axial length, when studying the choroid using SD-OCT.
  • article 4 Citação(ões) na Scopus
    EFFECT OF LASER PHOTOCOAGULATION ON MACULAR EDEMA ASSOCIATED WITH MACULAR HOLES
    (2021) FRANCONE, A.; ESSILFIE, J.; SARRAF, D.; PRETI, R. C.; MONTEIRO, M. L. R.; HUBSCHMAN, J.-P.
    PURPOSE: To report the outcomes of laser therapy to barricade eccentric full-thickness macular hole with associated cystoid macular edema. METHODS: We report two patients who developed an eccentric full-thickness macular hole with persistent cystoid macular edema after pars plan vitrectomy with and without internal limiting membrane peel for epiretinal membrane and the results of argon laser therapy. RESULTS: Barricade argon laser therapy was applied concentric to the full-thickness macular hole. Associated cystoid macular edema was noted to resolve within 1 to 3 months of therapy in both cases. CONCLUSION: Barricade laser therapy surrounding a macular hole can lead to resolution of associated cystoid macular edema. Pathogenic mechanisms to explain this favorable outcome are discussed. Copyright © 2019 The Author(s).
  • article 0 Citação(ões) na Scopus
    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 Ribeiro
    OBJECTIVES: 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.
  • article 39 Citação(ões) na Scopus
    A RANDOMIZED CONTROLLED TRIAL OF PANRETINAL PHOTOCOAGULATION WITH AND WITHOUT INTRAVITREAL RANIBIZUMAB IN TREATMENT-NAIVE EYES WITH NON-HIGH-RISK PROLIFERATIVE DIABETIC RETINOPATHY
    (2015) FERRAZ, Daniel A.; VASQUEZ, Lisa M.; PRETI, Rony C.; MOTTA, Augusto; SOPHIE, Raafay; BITTENCOURT, Millena G.; SEPAH, Yasir J.; MONTEIRO, Mario L. R.; Quan Dong Nguyen; TAKAHASHI, Walter Yukihiko
    Purpose: To compare the efficacy of panretinal photocoagulation (PRP) and intravitreal ranibizumab injection with PRP alone in patients with treatment-naive bilateral non-high-risk proliferative diabetic retinopathy. Methods: Sixty eyes of 30 patients were randomized either to the study group (SG) receiving PRP plus 2 ranibizumab injections or to the control group (CG) receiving PRP alone. Mean change in best-corrected visual acuity and in optical coherence tomography were compared at baseline and 1, 3, and 6 months. Results: Best-corrected visual acuity was significantly better at 6 months in the SG; however, there was decrease in best-corrected visual acuity in the CG. Central macula thickness decreased significantly at 6 months in SG when compared with baseline (-47.6 mm, P < 0.001) and did not reveal significant difference in the CG. In eyes with diabetic macular edema, best-corrected visual acuity increased by 3.6 letters (P = 0.06) in the SG and decreased by 4.4 letters in the CG (P = 0.003). Central macula thickness decreased by 69.3 mm (P = 0.001) in the SG and decreased by 45.5 mm (P = 0.11) in the CG. Conclusion: Intravitreal ranibizumab in combination with PRP can be an effective treatment in eyes with non-high-risk proliferative diabetic retinopathy and diabetic macular edema.
  • article 31 Citação(ões) na Scopus
    Contrast sensitivity evaluation in high risk proliferative diabetic retinopathy treated with panretinal photocoagulation associated or not with intravitreal bevacizumab injections: a randomised clinical trial
    (2013) PRETI, Rony Carlos; RAMIREZ, Lisa Mariel Vasquez; MONTEIRO, Mario Luiz Ribeiro; CARRA, Mario Kehdi; PELAYES, David E.; TAKAHASHI, Walter Yukihiko
    Purpose To compare the effect on contrast sensitivity (CS) measurements of panretinal photocoagulation (PRP) associated with intravitreal bevacizumab (IVB) injections versus PRP alone in high risk proliferative diabetic retinopathy (HR-PDR). Design Prospective, randomised, masked, controlled trial. Participants 42 patients with HR-PDR with visual acuity >= 20/200. Methods Eyes were randomised to one of two groups: one underwent PRP and IVB injections (study group) and the other PRP alone (control group). PRP was performed three times during the study and IVB injection was administered twice. Main outcome measures Mean change in CS threshold scores between and within groups, from baseline to 6 months. Results Seven patients presented with vitreous haemorrhage and were removed from the study. Mean results for CS threshold (at 1.5, 3, 6, 12 and 18 cycles per degree (cpd) frequencies) for patients with and without diabetic macular oedema showed no significant differences (p>0.05 for all comparisons) between the two groups. In 35 eyes in the control group, compared with baseline values, there was significant worsening (p<0.05) of CS at 1.5, 12 and 18 cpd after 1 month, at 12 cpd after 3 months, and at 6 and 12 cpd after 6 months. In the study group, there was significant improvement in CS at 3 cpd, 3 months after treatment. Conclusions In eyes with HR-PDR, PRP treatment is associated with deterioration of CS while adjuvant use of bevacizumab prevents such deterioration. CS evaluation seems to support the adjuvant use of bevacizumab when using PRP for the treatment of HR-PDR.