MARIA FERNANDA ABALEM DE SA CARRICONDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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
- Construct Validity of Inherited Retinal Disease-Specific Patient-Reported Outcome Measures(2023) JAYASUNDERA, K. Thiran; ABUZAITOUN, Rebhi O.; POPOVA, Lilia; ABALEM, Maria Fernanda; ANDREWS, Chris A.; LACY, Gabrielle D.; FRESCO, David M.; MUSCH, David C.PURPOSE: To evaluate aspects of construct validity of the Michigan Retinal Degeneration Questionnaire (MRDQ) and the Michigan Vision-related Anxiety Ques-tionnaire (MVAQ). center dot METHODS: Subjects with a clinical diagnosis of an inherited retinal disease (IRD) were recruited prospec-tively and 3 tests were used to assess construct valid-ity: the ability to distinguish different IRD phenotypes; test a priori hypothesis of an association between vision-related anxiety and vision-related disabilities; and corre-late MRDQ and MVAQ with the National Eye Insti-tute Visual Functioning Questionnaire 25 (NEI VFQ-25) and the Impact of Vision Impairment (IVI). One-way analysis of variance (ANOVA) was used to com-pare different phenotypes for mean domain scores for MRDQ/MVAQ. Pearson correlations were performed be-tween; Cone-Function Anxiety and Central Vision con-trolling for better eye visual acuity, Rod-Function Anxi-ety and Scotopic Function controlling for visual field area (III4e and IV4e), and scores of MRDQ/MVAQ, NEI VFQ-25, and IVI. center dot RESULTS: The study sample consisted of 146 pa-tients evenly divided between males and females, and mean age was 50 years. The 1-way ANOVA test was significant for distinguishing IRD phenotypes in 6 do-mains of MRDQ/MVAQ. Cone-Function Anxiety corre-lated with Central Vision controlling for visual acuity, Rod-Function Anxiety correlated with Scotopic Func-tion controlling for visual field area, and all domains in MRDQ/MVAQ had significant correlations with NEI VFQ-25 and IVI composite scores. center dot CONCLUSION: MRDQ and MVAQ domenstrate aspects of construct-validity set forth by the US Food and Drug Administration. The study futher supports the use of both patient-reported outcome measures in IRD clinical trials and natural history studies. (Am J Ophthalmol 2023;248: 116-126. (c) 2022 Elsevier Inc. All rights re-served.)
- RETINAL DEPOSITS OF TRIAMCINOLONE-MOXIFLOXACIN AFTER DROPLESS CATARACT SURGERY(2023) FREIRE, F. S.; LANG, R.; ABALEM, M. F.; JOHNSON, M. W.To report a case of epiretinal crystalline deposits observed on fundus examination and optical coherence tomography 2 years after transzonular intravitreal injection of triamcinolone-moxifloxacin (TriMoxi) during ""dropless"" cataract surgery.Methods:Observational case report with literature review of toxic effects of intravitreal triamcinolone and differential diagnosis of retinal crystalline deposits.Results:A 37-year-old asymptomatic pseudophakic man presented with refractile crystalline retinal deposits that had prompted an extensive systemic embolic workup. The systemic evaluation for emboli was negative. OCT imaging revealed that the crystalline deposits were confined to the anterior surface of the internal limiting membrane. Further historical inquiry determined that transzonular intravitreal triamcinolone-moxifloxacin injection had been performed at the time of cataract surgery 2 years earlier.Conclusion:Transzonular triamcinolone acetonide delivered during cataract surgery can deposit on the retinal surface for long periods. These epiretinal crystalline deposits are benign and generally do not interfere with visual acuity. Nevertheless, clinicians should be aware of this differential diagnosis because clinical misdiagnosis can lead to unwarranted evaluation and treatment.
- Positive feedback loop between vision-related anxiety and self-reported visual difficulty(2023) POPOVA, Lilia T.; ABUZAITOUN, Rebhi O.; FRESCO, David M.; ABALEM, Maria Fernanda; ANDREWS, Chris A.; MUSCH, David C.; EHRLICH, Joshua R.; JAYASUNDERA, K. ThiranBackgroundPatients with Inherited Retinal Diseases typically experience progressive, irreversible vision loss resulting in low vision and blindness. As a result, these patients are at high risk for vision-related disability and psychological distress, including depression and anxiety. Historically, the relationship between self-reported visual difficulty (encompassing metrics of vision-related disability and quality of life, among others) and vision-related anxiety has been regarded as an association and not a causal relationship. As a result, there are limited interventions available that address vision-related anxiety and the psychological and behavioral components of self-reported visual difficulty.Materials and MethodsWe applied the Bradford Hill criteria to evaluate the case for a bidirectional causal relationship between vision-related anxiety and self-reported visual difficulty.ResultsThere is sufficient evidence to satisfy all nine of the Bradford Hill criteria of causality (strength of association, consistency, biological gradient, temporality, experimental evidence, analogy, specificity, plausibility, and coherence) for the relationship between vision-related anxiety and self-reported visual difficulty.ConclusionsThe evidence suggests that there is a direct positive feedback loop-a bidirectional causal relationship-between vision-related anxiety and self-reported visual difficulty. More longitudinal research on the relationship between objectively-measured vision impairment, self-reported visual difficulty, and vision-related psychological distress is needed. Additionally, more investigation of potential interventions for vision-related anxiety and visual difficulty is needed.
- Effects of duration and number of symptoms on vision-related anxiety in patients with Inherited Retinal Diseases(2023) POPOVA, Lilia T. T.; ABUZAITOUN, Rebhi O. O.; ABALEM, Maria Fernanda; ANDREWS, Chris A. A.; MONDUL, Alison M. M.; LACY, Gabrielle D. D.; MUSCH, David C. C.; JAYASUNDERA, K. ThiranBackground: Patients with Inherited Retinal Diseases (IRDs) are at increased risk for vision-related anxiety due to progressive and irreversible vision loss, yet little is known about risk factors for anxiety in these patients. Materials and Methods: This was a single-center, retrospective cross-sectional study at a large academic center. 128 adults with an IRD and without other significant eye conditions were recruited between December 2016 and March 2020. Participants were asked about the duration and number of symptoms they had in the following vision domains: reading, contrast vision, color vision, glare/light sensitivity, night vision, and peripheral vision. The outcomes of interest were the two domains of the Michigan Vision-Related Anxiety Questionnaire (MVAQ), rod- and cone-function related anxiety. We conducted an adjusted analysis to isolate the independent effect of duration and number of symptoms on vision-related anxiety. Results: Of 126 participants had complete data, 62 (49%) were female and 64 (51%) were male, with an average age of 49 years (range: 18-87). Patients with duration of symptoms for greater than 25 years had an adjusted anxiety theta that was one-half standard deviations lower than patients with symptoms for less time. Patients with higher number of symptoms had higher anxiety theta after adjusting for confounding variables (p < 0.0001). Conclusions: The number of symptoms but not the duration of symptoms, is an independent risk factor for vision-related anxiety. Patients with more symptoms are at higher risk for vision-related anxiety. Having symptoms for longer than 25 years may reduce this anxiety.
- Self-reported visual function and psychosocial impact of visual loss in EYS-associated retinal degeneration in a Portuguese population(2023) MARQUES, Joao Pedro; SOARES, Ricardo Machado; SIMAO, Silvia; ABUZAITOUN, Rebhi; ANDREWS, Chris; ALVES, C. Henrique; AMBROSIO, Antonio Francisco; MURTA, Joaquim; SILVA, Rufino; ABALEM, Maria Fernanda; JAYASUNDERA, K. ThiranPurpose: To evaluate self-reported visual function and the psychosocial impact of visual loss EYSassociated retinal degeneration (EYS-RD) using two patient-reported outcome (PRO) measures: Michigan Retinal Degeneration Questionnaire (MRDQ) and Michigan Vision-related Anxiety Questionnaire (MVAQ).Methods: Cross-sectional, single-center study conducted at a tertiary care hospital in Portugal. Patients with biallelic EYS variants were invited to participate. Clinical data including demographics, ETDRS best corrected visual acuity (BCVA) in the better-seeing eye and genetic testing results were collected. Interviews were carried out during clinic visits or by phone between November 2021 and February 2022. A blind grader used horizontal and vertical spectral domain optical coherence tomography (SD-OCT) scans to manually measure ellipsoid zone (EZ) width in the nasal, temporal, superior and inferior macular quadrants to calculate the EZ area.Results: Forty-nine patients (53.1% males; mean age 53 +/- 14 years) were included. A positive correlation (p < .05) was found between age and most MRDQ domain scores (central vision, color vision, contrast sensitivity, scotopic function, photopic peripheral vision and mesopic peripheral vision). A negative correlation was found between both BCVA and EZ area across all MRDQ domains. In MVAQ, SD-OCT EZ area negatively correlated with both rod function and cone function-related anxiety. Neither age, BCVA or gender correlated with MVAQ domains.Conclusions: This study provides strong evidence supporting a correlation between PRO measures and both functional and structural clinician-reported outcomes. The use of MRDQ and MVAQ adds a new dimension to our understanding of EYS-RD and establishes both PRO measures as important disease outcome measures.
- The validation of inherited retinal disease-specific patient-reported outcome measures in adolescent patients(2023) SELVAN, Kavin; ABUZAITOUN, Rebhi; ABALEM, Maria Fernanda; VINCENT, Ajoy; ANDREWS, Chris A. A.; LACY, Gabrielle D. D.; FARJO, Rafid; KAO, Karissa; KAO, Krystal; DAGNELIE, Gislin; MUSCH, David C. C.; JAYASUNDERA, K. Thiran; HEON, ElisePurpose: To determine the validity of the validate the adult patient-reported outcome measure tools, the Michigan Retinal Degeneration Questionnaire (MRDQ) and Michigan Vision-Related Anxiety Questionnaire (MVAQ), in adolescent patients with inherited retinal diseases (IRDs).Methods: Ninety-one adolescent patients diagnosed with IRDs were recruited at the Hospital for Sick Children (University of Toronto) and the Kellogg Eye Center (University of Michigan). The patients were administered the MRDQ, MVAQ, and Patient Health Questionnaire-4 (PHQ-4). Test-retest variability was assessed in eighteen patients within 14 days of the initial administration. Adolescent responses were analyzed for validity and reliability. As a further validation step, comparisons were made to adult data from the original MRDQ and MVAQ studies to ensure consistency in response ranges.Results: The existing MRDQ and MVAQ content and format could accurately detect the impact of IRD on activities of daily living in adolescents with IRDs. No floor/ceiling effects were identified, test-retest reliability was established (r = 0.73-0.86), and no items were excluded after differential item functioning analysis. Domain and trait associations with visual acuity and IRD phenotypes were similar between adolescents and adults.Conclusions: The MRDQ and MVAQ are psychometrically validated questionnaires for which we have shown validity for use in adolescent patients with IRDs.