WALTER YUKIHIKO TAKAHASHI
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
63 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 63
- Structural and Functional Assessment of Macula in Patients with High-Risk Proliferative Diabetic Retinopathy Submitted to Panretinal Photocoagulation and Associated Intravitreal Bevacizumab Injections: A Comparative, Randomised, Controlled Trial(2013) PRETI, Rony Carlos; RAMIREZ, Lisa Marie Vasquez; MONTEIRO, Mario Luiz Ribeiro; PELAYES, David E.; TAKAHASHI, Walter YukihikoPurpose: To compare the efficacy of therapy with panretinal photocoagulation (PRP) and intravitreal bevacizumab (IVB) injections versus PRP alone in patients with high-risk proliferative diabetic retinopathy (HR-PDR) with a 6-month follow-up. Methods: Forty-two patients with HR-PDR were prospectively studied in a randomised, masked, controlled trial. Both eyes of each patient were randomised either to the study group (SG) receiving PRP plus IVB injections or the control group (CG) receiving PRP alone. Mean change in visual acuity (VA), optical coherence tomography-measured fovea! thickness (FT) and macular volume (MV) were compared. Results: Intergroup comparisons showed no significant difference in VA while FT exhibited a significant (p < 0.05) difference at 1 month of follow-up and MV was significantly reduced at the 1- and 3-month follow-up. Compared to baseline, VA was significantly worse at all follow-ups in the CG and was stable in the SG. FT increased significantly in the CG from baseline to the 1- and 6-month follow-ups and in the SG, no significant difference was observed. MV was significantly increased in the CG during all follow-up periods. Conclusion: In HR-PDR, using IVB injections as adjuvant treatment to PRP reduces the VA deterioration and results in decreased FT and MV measurements compared to PRP alone.
- Unusual macular thickness in Alport syndrome: case report(2012) IGAMI, Thais Z.; LAVEZZO, Marcelo M.; FERRAZ, Daniel A.; TAKAHASHI, Walter Y.; NAKASHIMA, YoshitakaThis case report describes the presence of bilateral macular atrophy in a patient with Alport syndrome and compares this finding with literature. At fundoscopy, there was a discrete circumscribed macular thinning showing intense retinal pigment epithelium color and the presence of whitish circular retinal lesions (""dots"" and ""flecks"") at nasal mid periphery of both eyes. Optical coherence tomography showed bilateral partial atrophy of the neurosensory retina in the macula, with a greater extent in the temporal region. This case describes a rare ophthalmological finding in Alport syndrome and important to be recognized for a precise diagnosis as well as for determining visual prognosis.
bookPart Perda visual crônica(2021) AVAKIAN, Amaryllis; RAIZA, Ana Carolina Pasquini; TAKAHASHI, Walter Yukihiko; SUSANNA JUNIOR, RemoconferenceObject Prenatal exposure to marijuana causes morphological retinal changes in mice(2020) ZANTUT, Paulo; VERAS, Mariana; TAKAHASHI, Walter; BENEVENUTO, Sarah; SAFATLE, Angelica; PECORA, Ricardo; SALDIVA, Paulo; DAMICO, Francisco Max- Short-term effects of intravitreal bevacizumab in contrast sensitivity of patients with diabetic macular edema and optimizing glycemic control(2019) MOTTA, Augusto A. L.; BONANOMI, Maria Teresa B. C.; FERRAZ, Daniel A.; PRETI, Rony C.; SOPHIE, Raafay; ABALEM, Maria F.; QUEIROZ, Marcia S.; PIMENTEL, Sergio L. G.; TAKAHASHI, Walter Y.; DAMICO, Francisco M.Aims: To analyze contrast sensitivity of intravitreal bevacizumab injections with optimizing glycemic control versus optimizing glycemic control (in combination with sham injections) in eyes with Diabetic Macular Edema (DME). Design: Prospective, interventional, masked, randomized controlled trial. Methods: Forty-one eyes of 34 patients with type 2 diabetes mellitus and DME with glycated hemoglobin (HbA1c) < 11% received either intravitreal bevacizumab injection (Group 1) or sham injection (Group 2) at 0 and 6 weeks along with optimizing glycemic control. Mean change in best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT)-measured by central macular thickness (CMT) were compared and correlated at baseline, 2, 6 and 12 weeks. Results: The study showed a mean CS improved in group 1 from 1.14 +/- 0.36 logCS to 1.32 +/- 0.24 logCS and also in group 2 from 1.11 +/- 0.29 logCS to 1.18 +/- 0.29 logCS at 12 weeks (P = 0.12). CS and CMT promptly decreased in group 1 compared to group 2 at 2 weeks (Delta CS = 0.15 +/- 0.25 vs. 0.03 +/- 0.15 logCS; P = 0.04; Delta CMT = 116 +/- 115 vs. 17 +/- 71 mu m; P = 0.01). There was a mean reduction of approximately 0.5% in HbA1c levels in both groups at 12 weeks (P = 0.002). Conclusion: The use of bevacizumab in combination with optimizing glycemic control results in earlier improvement of contrast sensitivity in type 2 diabetes patients with DME. However, the optimizing glycemic control itself has shown also to be effective at 12 weeks.
- Indocyanine green angiography findings in patients with long-standing Vogt-Koyanagi-Harada disease: a cross-sectional study(2012) SILVA, Felipe T. da; HIRATA, Carlos E.; SAKATA, Viviane M.; OLIVALVES, Edilberto; PRETI, Rony; PIMENTEL, Sergio L. G.; GOMES, Andre; TAKAHASHI, Walter Y.; COSTA, Rogerio A.; YAMAMOTO, Joyce H.Background: To investigate indocyanine green angiography (ICGA) findings in patients with long-standing Vogt-Koyanagi-Harada (VKH) disease and their correlation with disease activity on clinical examination as well as with systemic corticosteroid therapy. Methods: Twenty-eight patients (51 eyes) with long-standing (>= 6 months from disease onset) VKH disease whose treatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All patients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography and ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working Group. Fisher exact test and logistic regression models were used for statistical analysis. Results: Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes). Angiographic findings suggestive of (choroidal and/or retinal) disease activity were not observed on FA. Clinically active disease based on clinical evaluation was observed in 41.2% (21 of 51 eyes). In these 21 eyes, disease-related choroidal inflammation on ICGA was observed in 76.2% (16 of 21 eyes); in the remaining eyes (without clinical active disease) disease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes). In respect to systemic corticosteroid therapy, 10 patients (18 of 51 eyes) were under treatment with prednisone. In these 10 (18 of 51 eyes) patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes); in the remaining patients (33 of 51 eyes) disease-related choroidal inflammation on ICGA was observed in 66.7% (22 of 33 eyes). Conclusion: ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable proportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on clinical examination or current use of systemic corticosteroid. Therefore, the current study reinforces the crucial role of ICGA to assist the management and treatment of patients with long-standing VKH disease.
- Autoimmune retinopathy: A Review(2018) CANAMARY, A. M. Jr.; TAKAHASHI, W. Y.; SALLUM, J. M. F.Autoimmune retinopathy (AIR) is a rare and still poorly understood immune-mediated disease that may cause inflammation from circulating autoantibodies against the retina. It may be related to history of autoimmune disease in the patient or in a family member or the presence of neoplastic disease in the individual. The disease may be subdivided into paraneoplastic and non-paraneoplastic AIR. When related to melanoma, it is referred to as MAR, and when related to other cancers, it is called CAR. The exact prevalence of AIR is unknown. It mainly affects older adults. Patients present with bilateral and asymmetric scotomas, photopsias, visual field defects, with rapidly progressive visual loss in late onset. In the initial stage, fundus examination is unremarkable, and in late stages, there is limited retinal epitheliopathy and vascular attenuation, with or without optic disc pallor, associated or not with intraocular inflammation and with no evidence of degenerative retinal disease. A clinical investigation with detailed anamnesis and laboratory tests should be performed to search for an associated neoplasm. Ophthalmologic and complementary examinations such as full-field electroretinogram, optical coherence tomography, visual field and fundus autofluorescence, help the diagnosis. Blood tests to search for autoantibodies should be requested. Management consists of prolonged immunosuppression, which may be combined with antioxidant vitamins. In general, the prognosis is uncertain, so the disease still needs to be better understood. More studies should be performed to improve diagnostic measures and define specific management that could preserve or even restore vision. © The Author(s) 2018.
- OPTICAL COHERENCE TOMOGRAPHY ANALYSIS OF OUTER RETINAL TUBULATIONS Sequential Evolution and Pathophysiological Insights(2018) PRETI, Rony C.; GOVETTO, Andrea; AQUETA FILHO, Richard Geraldo; ZACHARIAS, Leandro Cabral; PIMENTEL, Sergio Gianotti; TAKAHASHI, Walter Y.; MONTEIRO, Mario L. R.; HUBSCHMAN, Jean Pierre; SARRAF, DavidPurpose: To describe the sequential evolution of outer retinal tubulations (ORTs) in patients diagnosed with choroidal neovascularization and/or retinal pigment epithelium atrophy. Methods: Retrospective evaluation of spectral domain optical coherence tomography of a consecutive cohort of patients with various retinal conditions. Results: We reviewed the clinical findings of 238 eyes of 119 consecutive patients (54 men and 65 women) with a mean age of 76.2 +/- 14.2 years (range: 57-90) and a mean follow-up of 3 +/- 1.6 years (range 1-7). Over the follow-up period, ORTs were diagnosed in 67 of 238 eyes (28.1%), 9 of which were imaged with sequential, eye-tracked spectral domain optical coherence tomography dating from the beginning of ORT formation. The presence of geographic atrophy and subretinal hyperreflective material at baseline were found to be risk factors for ORT development (P < 0.001 and P < 0.001, respectively). Outer retinal tubulations were divided into forming versus formed morphologies. The latter was comprised open and closed ORTs of which the open subtype was the most common. The formation of ORTs was significantly associated with microcystic macular lesions in the inner nuclear layer and the downward displacement of the outer plexiform layer, referred to as the outer plexiform layer subsidence sign (P < 0.001). Conclusion: Outer retinal tubulation is a frequent optical coherence tomography finding in eyes with choroidal neovascularization and geographic atrophy. Open ORTs with progressive scrolled edges and shortened diameter were significantly associated with microcystic macular lesions in the inner nuclear layer and the outer plexiform layer subsidence sign.
conferenceObject Enhanced Depth Image Optical Coherence Tomography (EDI-OCT) choroidal evaluation in patients with diabetes and correlation with retinal and kidney disease(2016) ABALEM, Maria Fernanda; PRETI, Rony Carlos; GARCIA, Rafael; SANTOS, Helen Nazareth Veloso; CARRICONDO, Pedro C.; PIMENTEL, Sergio Luis Gianotti; TAKAHASHI, Walter Y.; MONTEIRO, Mario L. R.- The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy(2017) PRETI, Rony C.; MUTTI, Anibal; FERRAZ, Daniel A.; ZACHARIAS, Leandro C.; NAKASHIMA, Yoshitaka; TAKAHASHI, Walter Y.; MONTEIRO, Mario L. R.OBJECTIVES: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. METHODS: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials. gov: NCT01389505. RESULTS: Nineteen patients (38 eyes) with a mean +/- standard deviation age of 53.4 +/- 9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68 +/- 67.66 mm and 345.79 +/- 83.66 mm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. CONCLUSIONS: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.