JOYCE HISAE YAMAMOTO
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
31 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 31
conferenceObject Comparative analysis of different treatment schedules in the course of Vogt-Koyanagi-Harada disease (VKHD)(2019) YAMAMOTO, Joyce H.; LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; RODRIGUEZ, Ever Ernesto Caso; KANENOBU, Cintia; ABDALLAH, Smairah Frutuoso; MORITA, Celso; OYAMADA, Maria Kiyoko; HIRATA, Carlos EduardoconferenceObject Vogt-Koyanagi-Harada disease (VKHD) after systemic treatment discontinuation(2021) SOUTO, Fernanda Maria Silveira; MISSAKA, Ruy Felippe Brito Goncalves; LAVEZZO, Marcelo Mendes; NOBREGA, Priscilla Figueiredo Campos; SAKATA, Viviane Mayumi; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.conferenceObject Retinal vasculitis (RV) in pediatric population: case series(2020) GIAMPIETRO, Barbara; SOUTO, Fernanda Maria Silveira; TAKIUTI, Julia Tieme; CAMPOS, Lucia Maria Arruda; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.- Vogt-Koyanagi-Harada disease: review of a rare autoimmune disease targeting antigens of melanocytes(2016) LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; MORITA, Celso; RODRIGUEZ, Ever Ernesto Caso; ABDALLAH, Smairah Frutuoso; SILVA, Felipe T. G. da; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce HisaeVogt-Koyanagi-Harada disease (VKHD) is a rare granulomatous inflammatory disease that affects pigmented structures, such as eye, inner ear, meninges, skin and hair. This disease is mainly a Th1 lymphocyte mediated aggression to melanocytes after a viral trigger in the presence of HLA-DRB1*0405 allele. The absence of ocular trauma or previous intraocular surgery sets VKHD appart from sympathetic ophthalmia, its main differential diagnosis. The disease has an acute onset of bilateral blurred vision with hyperemia preceded by flu-like symptoms. The acute uveitic stage is characterized by a diffuse choroiditis with serous retinal detachment and optic disc hyperemia and edema. Fluorescein angiography in this phase demonstrates multiple early hyperfluorescent points. After the acute uveitic stage, ocular and integumentary system pigmentary changes may appear. Ocular findings may be accompanied by lymphocytic meningitis, hearing impairment and/or tinnitus in a variable proportion of patients. Prompt diagnosis followed by early, aggressive and long-term treatment with high-dose corticosteroids is most often ensued by good visual outcomes. However, some patients may experience chronic uveal inflammation with functional eye deterioration. The current review discusses the general features of VKHD, including epidemiology, classification into categories, differential diagnosis and current therapeutic approaches.
conferenceObject Correlation between visual function and clinical/subclinical disease activity parameters in Vogt-Koyanagi-Harada disease (VKHD).(2017) LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; RODRIGUEZ, Ever Ernesto Caso; ABDALLAH, Smairah Frutuoso; MORITA, Celso; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.conferenceObject Changes in quality of life (QoL) in a 24-month interval in patients with non-acute Vogt-Koyanagi-Harada disease (VKHD)(2022) SOUTO, Fernanda Maria Silveira; MISSAKA, Ruy Felippe; LAVEZZO, Marcelo Mendes; NOBREGA, Priscilla Figueiredo; SAKATA, Viviane Mayumi; MAGALHAES, Breno Marchiori; CAETANO, Victor Marcos Couto; TAKIUTI, Julia Thiemi; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.- Diagnosis and classification of Vogt-Koyanagi-Harada disease(2014) SAKATA, Viviane Mayumi; SILVA, Felipe Theodoro da; HIRATA, Carlos Eduardo; CARVALHO, Jozelio Freire de; YAMAMOTO, Joyce HisaeVogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune disorder that affects pigmented tissues of the body, with its most dire manifestations affecting the eyes. This review focuses on the diagnostic criteria of VKH disease, including some information on history, epidemiology, appropriate clinical and classification criteria, etiopathogenesis, treatment and outcomes. Expert review of most relevant literature from the disease's first description to 2013 and correlation with the experience in the care of VKH disease patients at a tertiary Uveitis Service in Brazil gathered over the past 40 years. The clinical manifestations and ancillary assessment of VKH disease have been summarized in the Revised Diagnostic Criteria proposed in 2001 in a manner that allows systematic diagnosis of both acute and chronic patients. It includes the early acute uveitic manifestations (bilateral diffuse choroiditis with bullous serous retinal detachment and optic disk hyperemia), the late ocular manifestations (diffuse fundus depigmentation, nummular depigmented scars, retinal pigment epithelium clumping and/or migration, recurrent or chronic anterior uveitis), besides the extraocular manifestations (neurological/auditory and integumentary). There are two exclusion criteria, i.e. absence of previous ocular penetrating trauma or surgery and any other ocular disease that could be confounded with VKH disease. HLA-DRB1*0405 plays an important role in pathogenesis, rendering carriers more susceptible to disease. The primary ocular pathological feature is a diffuse thickening of the uveal tract in the acute phase. Later on, there may be a compromise of choriocapillaris, retinal pigment epithelium and outer retina, mostly due to an ""upstream"" effect, with clinical correlates as fundus derangements. Functional tests (electroretinogram and visual field testing) as well as imaging modalities (retinography, fluorescein/indocyanine green angiography, optical coherence tomography and ultrasound) play an important role in diagnosis, severity grading as well as disease monitorization. Though high-dose systemic corticosteroids remain gold-standard therapy, refractory cases may need other agents (cyclosporine A, anti-metabolites and biological agents). In spite of good visual outcomes in the majority of patients, knowledge about disease progression even after the acute phase and its impact on visual function warrant further investigation.
conferenceObject Retinal vasculitis (RV) in acute and non-acute Vogt-Koyanagi-Harada disease (VKHD): a cross-sectional study with multimodal analysis(2020) MISSAKA, Ruy F. B. G.; SOUTO, Fernanda Maria Silveira; LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; NOBREGA, Priscilla Figueiredo Campos da; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce H.- Associations between functional and structural measurements in non-acute Vogt-Koyanagi-Harada disease(2021) SOUTO, Fernanda Maria Silveira; MISSAKA, Ruy Felippe Brito Goncalves; LAVEZZO, Marcelo Mendes; SAKATA, Viviane Mayumi; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce HisaePurpose To evaluate associations between functional and structural measurements in patients with non-acute VKHD. Methods In this cross-sectional study, 16 non-acute VKHD patients (32 eyes; 14 female) were evaluated with multifocal electroretinogram (mfERG), standardized automated perimetry (SAP) and optical coherence tomography (OCT)examinations. All included patients had a minimum 12 months of follow-up from acute onset and were participants of an ongoing prospective study since acute phase with systematic clinical imaging evaluations and electroretinogram examinations within a predefined treatment. Age- and gender-matched controls were included. Main outcomes were functional and structural abnormalities and their correlation; secondary outcome was correlation of these findings with clinical characteristics, including fundus abnormalities. Results SAP and mfERG parameters were significantly worse in patients than in controls. Fourteen eyes (43.7%) had disrupted ellipsoid zone (EZ); visual acuity (VA) was similar between eyes with intact or disrupted EZ. Eyes with intact and disrupted EZ differed significantly concerning N1 and P1 amplitudes and N1 peak time values on mfERG and mean sensitivity (MS), central sensitivity (CS), foveal threshold, visual field index, mean deviation (MD) and pattern standard deviation values on SAP. The area under the curve on receiver operating curves for P1 amplitude was 0.81 (cut-off value = 34.7 nV/deg(2)) and for MD value was 0.84 (cut-off value = -5.2 dB). Central retinal thickness (CRT) significantly correlated with N1 and P1 amplitudes and P1 peak time values on mfERG (r = 0.354, r = 0.442 and r = -0.405, respectively) and MD, MS, CS and fovea threshold (log values) on SAP (r = 0.372, r = 0.406, r = 0.431 and r = 0.414, respectively). Statistically significant associations were found with the presence of peripapillary atrophy and recurrent anterior uveitis with a worse MD value (p = 0.004 and p < 0.001, respectively). Conclusion In non-acute VKHD, disrupted EZ and reduced CRT were correlated with impaired mfERG and SAP parameters, even in patients with good VA.
- Full-field electroretinogram behavior in Vogt-Koyanagi-Harada disease: a 24-month longitudinal study in patients from acute onset evaluated with multimodal analysis(2019) SAKATA, Viviane Mayumi; LAVEZZO, Marcelo Mendes; SILVA, Felipe T. da; RODRIGUEZ, Ever Ernesto Caso; MORITA, Celso; ABDALLAH, Smairah Frutuoso; OYAMADA, Maria Kiyoko; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce HisaePurpose To prospectively evaluate the dynamic changes of the full-field electroretinogram (ff-ERG) and its association with inflammatory signs in patients with Vogt-Koyanagi-Harada disease (VKHD) followed up after acute onset. Methods Twelve acute VKHD patients, who were followed up for at least 24 months, were enrolled at a tertiary center from June 2011 to January 2017. Treatment consisted of intravenous methylprednisolone followed by 1 mg/kg/day of oral prednisone with a slow tapering associated with late non-steroidal immunosuppressive therapy in previously defined cases. Inflammation was systematically evaluated with clinical and posterior segment imaging (PSI) exams (fluorescein angiography, FA, indocyanine green angiography, ICGA, enhanced depth imaging optical coherence tomography, EDI-OCT). A ff-ERG was performed upon enrollment as well as at predefined intervals. Scotopic ff-ERG parameters changes between the 12th and 24th months defined the ERG-stable or ERG-worsening groups. ""Flare"" was defined as an appearance or worsening of inflammatory signs (after the initial 6 months following disease onset) under the predefined treatment protocol. Results ff-ERG parameters initially improved in all eyes; in the evaluation between the 12th and 24th months, ff-ERG results were stable in 17 eyes (71 %) and worsened in 7 eyes (29 %). Subnormal ff-ERG results were observed in 15 eyes (62 %) at the 24th month. On the other hand, the flare was observed in 8 eyes (33 %) as cells in the anterior chamber and in 24 eyes (100 %) as any PSI inflammatory sign. The ERG-worsening group presented thicker subfoveal choroid at the first month (p = 0.001) and fluctuations in choroidal thickness more often during follow-up when compared to the ERG-stable group (p = 0.02). Conclusions Scotopic ff-ERG parameters worsened between the 12th and 24th months in a quarter of the patients. Subclinical inflammation detected as an increase in CT seems to be related to worsening in visual function measured with ffERG.