ALEX HARUO HIGASHI
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
8 resultados
Resultados de Busca
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- Ocular retinal findings in asymptomatic patients with antiphospholipid syndrome secondary to systemic lupus erythematosus(2023) NETO, Epitacio D. S.; NETO, Taurino S. R.; SIGNORELLI, Flavio; BALBI, Gustavo G. M.; HIGASHI, Alex H.; MONTEIRO, Mario Luiz R.; BONFA, Eloisa; ANDRADE, Danieli C. O.; ZACHARIAS, Leandro C.The objective is to perform a multimodal ophthalmological evaluation, including optical coherence angiography ( OCTA), asymptomatic APS secondary to SLE (APS/SLE), and compare to SLE patients and control group (CG). We performed a complete structural/functional ophthalmological evaluation using OCTA/microperimetry exam in all participants. One hundred fifty eyes/75 asymptomatic subjects [APS/SLE (n = 25), SLE (n = 25), and CG (n = 25)] were included. Ophthalmologic abnormalities occurred in 9 (36%) APS/SLE, 11 (44%) SLE, and none of CG (p < 0.001). The most common retinal finding was Drusen-like deposits (DLDs) exclusively in APS/SLE and SLE (16% vs. 24%, p = 0.75) whereas severe changes occurred solely in APS/SLE [2 paracentral acute middle maculopathy (PAMM) and 1 homonymous quadrantanopsia]. A trend of higher frequency of antiphospholipid antibody (aPL) triple positivity (100% vs. 16%, p = 0.05) and higher mean values of adjusted Global Antiphospholipid Syndrome Score ( aGAPSS) (14 +/- 0 vs. 9.69 +/- 3.44, p = 0.09) was observed in APS/SLE with PAMM vs. those without this complication. We identified that ophthalmologic retinal abnormalities occurred in more than 1/4 of asymptomatic APS/SLE and SLE. DLDs are the most frequent with similar frequencies in both conditions whereas PAMM occurred exclusively in APS/SLE patients. The possible association of the latter condition with aPL triple positivity and high aGAPSS suggests these two conditions may underlie the retinal maculopathy. Our findings in asymptomatic patients reinforce the need for early surveillance in these patients.
- Efficacy and Patients' Satisfaction with the ORCAM MyEye Device Among Visually Impaired People: A Multicenter Study(2023) AMORE, Filippo; SILVESTRI, Valeria; GUIDOBALDI, Margherita; SULFARO, Marco; PISCOPO, Paola; TURCO, Simona; ROSSI, Francesca De; RELLINI, Emanuela; FORTINI, Stefania; RIZZO, Stanislao; PERNA, Fabiana; MASTROPASQUA, Leonardo; BOSCH, Vanessa; OEST-SHIRAI, Luz Ruriko; HADDAD, Maria Aparecida Onuki; HIGASHI, Alez Haruo; SATO, Rodrigo Hideharo; PYATOVA, Yulia; DAIBERT-NIDO, Monica; MARKOWITZ, Samuel N. N.To evaluate usability of and satisfaction with OrCam MyEye, a finger-size wearable assistive technology device for visually impaired during real-world tasks. This prospective multicenter study was conducted on visually impaired people recruited from 5 vision rehabilitation centers. Patients performed real-world tasks such as near and distance reading, money handling, colour identification and face recognition in 2 different scenarios: without using any low vision aid and with OrCam. System Usability Scale (SUS), Patient's Global Impression of Change (PGIC), the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and the Psychosocial Impact of Assistive Devices Scale (PIADS) were administered after the use of the OrCam device. Among the 100 participants, use of OrCam MyEye device improved many daily-living tasks (F = 1.67, P < .05), and in particular reading and face recognition. Multivariate logistic regression showed that age and visual field defect explained 89% of the variation in efficacy of the device. Nearly half (45%) of the participants indicated a positive rating with the SUS. The PGIC rates showed a minimal improvement with a mean score of 4.2 (SD:1.8). The most highlighted parameter with the QUEST 2.0 test was ""ease of use"" in 58% (48 subjects). The PIADS indicator showed that the device positively impacted on the daily-living tasks of users (r(2) = 0.72, P < .05). Regression modelling demonstrated a good relation between the questionnaires scores and demographic, disease and visual factors (P < .05). OrCam MyEye allowed visually impaired people to read, handle money and face recognition independently. This device may offer to these subjects to be independent.
- Ocular findings in asymptomatic patients with primary antiphospholipid syndrome(2022) NETO, Taurino S. R.; NETO, Epitacio D. S.; BALBI, Gustavo G. M.; SIGNORELLI, Flavio; HIGASHI, Alex H.; MONTEIRO, Mario Luiz R.; BONFA, Eloisa; ZACHARIAS, Leandro C.; ANDRADE, Danieli C. O.BackgroundPrimary antiphospholipid syndrome (PAPS) is characterized by the presence of antiphospholipid antibodies (aPL), repetitive fetal loss, and arterial/venous thrombosis and no association with other autoimmune rheumatic disease. Ocular involvement can also occur including retinal vascular thrombosis and neuro-ophthalmological manifestations, such as optic neuropathy and amaurosis fugax. Early detection of ocular changes is crucial to minimize functional loss.PurposeTo perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with PAPS without ocular complaints and compare with healthy individuals.MethodsWe performed a complete structural and functional ophthalmological evaluation using OCTA and microperimetry exam in patients with PAPS, followed at a tertiary Rheumatology outpatient clinic.ResultsWe included 104 eyes of 52 subjects [PAPS without ocular complaints (N = 26) and healthy individuals (N = 26)]. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. PAPS manifestations were venous (65.4%), arterial thrombosis (34.6%), and obstetrical (34.6%) and all of them had lupus anticoagulant. Ophthalmologic findings were more frequent in PAPS compared to healthy individuals (19.2% vs. 0%, p = 0.05). The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (PPE) (1 patient, 1 eye). Hypertension and hyperlipidemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together (p = 0.03).ConclusionsWe provide novel evidence that approximately 20% of our asymptomatic PAPS patients without ocular symptoms have ophthalmologic findings that require early identification and careful surveillance focusing on minimizing systemic and vascular risk factors.
conferenceObject ASSESSMENT OF PARAFOVEAL RETINAL VASCULATURE IN BEHCET'S SYNDROME USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY(2021) FERREIRA, Bruno Fortaleza de Aquino; HIGASHI, Alex Haruo; PRADO, Leandro Lara do; GONCALVES, Celio Roberto; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce Hisae- Normative data for macular perimetry using the MP-3 microperimeter in healthy individuals(2024) NETO, Taurino dos Santos Rodrigues; NETO, Epitacio Dias da Silva; HIGASHI, Alex Haruo; MEGNIS, Bianca Partezani; HADDAD, Maria Aparecida Onuki; MONTEIRO, Mario Luiz Ribeiro; ZACHARIAS, Leandro CabralPurpose: Microperimetry has been used for several years as a form of visual function testing in patients with retinal diseases. Normal microperimetry values obtained with microperimeter MP-3 have not yet been fully published, and baseline values for topographic macular sensitivity and correlations with age and sex are needed to establish degrees of impairment. This study aimed to determine values for light sensitivity thresholds and fixation stability using the MP-3 in healthy individuals. Methods: Thirty-seven healthy volunteers (age, 28-68 years), underwent full-threshold microperimetry using a 4-2 (fast) staircase strategy with the standard Goldmann III stimulus size and 68 test points positioned identically to those in the Humphrey Field Analyzer 10-2 test grid. The fixation stability was simultaneously recorded during the microperimetry test. The relationship between global sensitivity and age was calculated using linear regression analysis. Results: Microperimetry was performed on 37 participants (74 eyes). The global mean sensitivity was 29.01 +/- 1.44 (range, 26-31) dB. The mean central sensitivity at 2 degrees measured by the MP-3 was 28.5 +/- 1.77 dB in the right eye (OD) and 28.75 +/- 1.98 dB in the left eye (OS). The total median fixation stability values within 2 degrees and 4 degrees were 80% and 96%, respectively. The linear regression analysis also revealed an age-related global sensitivity decline per year of -0.051 dB +/- 0.018 (OD) and -0.078 dB +/- 0.021 (OS). Conclusions: Microperimetry performed with the MP-3 allows for an automatic, accurate, and topography-specific examination of retinal sensitivity thresholds. The results of this study provide a normal and age-matched database of MP-3 microperimetry.
- OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHÇET'S UVEITIS(2023) FERREIRA, Bruno F. A.; HIGASHI, Alex H.; PRADO, Leandro L.; GONCALVES, Celio R.; HADDAD, Maria A. O.; ZACHARIAS, Leandro C.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.Purpose: To evaluate the parafoveal macular microvasculature and the macular function in patients with retinal vasculitis associated with Beh & ccedil;et's uveitis.Methods: In 14 patients with inactive Beh & ccedil;et's uveitis and 26 control individuals (13 with nonocular Beh & ccedil;et's syndrome and 13 healthy subjects), we analyzed the retinal nerve fiber layer, ganglion cell layer, full retinal thickness, foveal avascular zone area and sectorial parafoveal vascular density in the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus using SPECTRALIS optical coherence tomography (OCT) 2 and OCT angiography. Macular sensitivity was analyzed using an MP-3 microperimeter.Results: Eighteen eyes (78%) had a best-corrected visual acuity >= 20/25. Significant differences were found in Beh & ccedil;et's uveitis in comparison with the controls on the OCT and OCT angiography: 14.8%, 22.4%, and 14.9% ganglion cell layer thinning in the global, nasal, and inferior sectors, respectively; 6%, 13.2%, and 7.5% full retinal thickness thinning in the superior, nasal, and inferior sectors; and 16.8%, 14.9%, 23.6%, 15.8%, and 12.6% mean deep capillary plexus density reduction in the global, superior, nasal, inferior, and temporal sectors. Microperimetry data demonstrated significant mean reductions of 21% and 23.6% in central and average macular sensitivities and 28.8%, 40.4%, 27.7%, and 24.2% in the superior, nasal, inferior, and temporal sectors, respectively. Outer plexiform layer elevations were observed in Beh & ccedil;et's uveitis (69.6%).Conclusion: Beh & ccedil;et's uveitis presented structural and functional macular damage despite good best-corrected visual acuity, mainly affecting the nasal sector and the deep capillary plexus. On OCT and OCT angiography, quantitative and qualitative changes can be valuable biomarkers of ocular involvement in Beh & ccedil;et's syndrome.
conferenceObject Multimodal Evaluation of patients with Primary Antiphospholipid Syndrome Using Optical Coherence Angiotomography and Microperimetry(2020) ZACHARIAS, Leandro C.; RODRIGUES NETO, Taurino dos Santos; SILVA NETO, Epitacio Dias da; HIGASHI, Alex Haruo; BALBI, Gustavo; BONFA, Eloisa Silva Dutra Oliveira; MONTEIRO, Mario L. R.; ANDRADE, Danieli Castro OliveiraconferenceObject PARAFOVEAL OCT-ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHCET'S RETINAL VASCULITIS(2022) FERREIRA, Bruno Fortaleza De Aquino; HIGASHI, Alex Haruo; PRADO, Leandro Lara Do; GONCALVES, Celio Roberto; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.