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Abstract(s)
Este estudo teve como objetivo verificar a importância do OCT-Angiografia (OCTA) na avaliação de alterações microvasculares peripapilares em doentes com hipertensão ocular e também averiguar se o OCTA poderia ser um potencial biomarcador de lesões precoces do glaucoma.
Tratou-se de um estudo observacional transversal, no qual foram incluídos um grupo de doentes com hipertensão ocular (n=35 olhos) e um grupo controlo ajustado à idade (n=29 olhos). Todos os participantes realizaram uma avaliação oftalmológica completa, avaliação do campo visual e OCT estrutural do disco ótico. Com o intuito de estudar a densidade vascular peripapilar, foram avaliados dois parâmetros, o índice de
fluxo (IF) e densidade de perfusão vascular (DPP), através do OCTA.
Relativamente à DPP, o valor médio obtido foi significativamente menor no grupo com hipertensão ocular, comparando com o grupo controlo (p=0.0235). No que diz respeito ao IF, o valor médio obtido foi menor no grupo com hipertensão ocular, em comparação com o grupo controlo, não sendo esta diferença significativa, mas estando no limite de significância (p=0.0627). Foram encontradas diferenças estatisticamente significativas para os quadrantes inferior (p=0.0200), nasal (p=0.0204) e temporal (p=0.0239).
Procurou-se ainda averiguar a capacidade diagnóstica do OCTA em detetar alterações vasculares precoces, através da análise da curva ROC. Verificou-se que o IF (quadrante inferior) foi o parâmetro com maior capacidade diagnóstica (AUC = 0.670, p=0.015) e maior valor de sensibilidade para 80% de especificidade (54%).
Concluindo, é possível afirmar que este estudo veio reforçar a ideia de que as alterações da densidade vascular podem realmente preceder o declínio estrutural e funcional e, portanto, podem ser úteis no diagnóstico e monitorização numa fase mais precoce do glaucoma.
This study aimed to verify the importance of OCT-Angiography (OCTA) in the evaluation of peripapillary microvascular alterations in patients with ocular hypertension and also verify if OCTA could be a potential biomarker of early glaucoma lesions. This was an observational transversal study, in which a group of patients with ocular hypertension (n=35 eyes) and an age-adjusted control group (n=29 eyes) were included. All participants underwent a complete ophthalmologic evaluation, visual field assessment and structural OCT of the optic disc. With the aim of studying the peripapillary vascular density, two parameters were evaluated, the flow index (FI) and vascular perfusion density (VPD), using OCTA. Regarding VPD, the average value obtained was significantly lower in the group with ocular hypertension, compared with the control group (p=0.0235). Concerning FI, the average value obtained was lower in the group with ocular hypertension, compared to the control group, this difference was not significant, but was at the limit of significance (p=0.0627). Statistically significant differences were found for the inferior (0.0200), nasal (p=0.0204) and temporal (p=0.0239) quadrants. We also sought to ascertain the diagnostic accuracy of OCTA in detecting early vascular alterations, through the analysis of the ROC curve. It was found that the FI (lower quadrant) was the parameter with the greatest diagnostic accuracy (AUC = 0.670, p=0.015) and the highest sensitivity value for 80% specificity (54%). In conclusion, it is possible to state that this study has reinforced the idea that changes in vascular density can actually precede structural and functional decline and, therefore, can be useful in diagnosing and monitoring an earlier phase of glaucoma.
This study aimed to verify the importance of OCT-Angiography (OCTA) in the evaluation of peripapillary microvascular alterations in patients with ocular hypertension and also verify if OCTA could be a potential biomarker of early glaucoma lesions. This was an observational transversal study, in which a group of patients with ocular hypertension (n=35 eyes) and an age-adjusted control group (n=29 eyes) were included. All participants underwent a complete ophthalmologic evaluation, visual field assessment and structural OCT of the optic disc. With the aim of studying the peripapillary vascular density, two parameters were evaluated, the flow index (FI) and vascular perfusion density (VPD), using OCTA. Regarding VPD, the average value obtained was significantly lower in the group with ocular hypertension, compared with the control group (p=0.0235). Concerning FI, the average value obtained was lower in the group with ocular hypertension, compared to the control group, this difference was not significant, but was at the limit of significance (p=0.0627). Statistically significant differences were found for the inferior (0.0200), nasal (p=0.0204) and temporal (p=0.0239) quadrants. We also sought to ascertain the diagnostic accuracy of OCTA in detecting early vascular alterations, through the analysis of the ROC curve. It was found that the FI (lower quadrant) was the parameter with the greatest diagnostic accuracy (AUC = 0.670, p=0.015) and the highest sensitivity value for 80% specificity (54%). In conclusion, it is possible to state that this study has reinforced the idea that changes in vascular density can actually precede structural and functional decline and, therefore, can be useful in diagnosing and monitoring an earlier phase of glaucoma.
Description
Trabalho realizado para a obtenção do Título de Especialista na área de Tecnologias de Diagnóstico e Terapêutica – Ortóptica
Keywords
OCT-Angiografia OCTA Hipertensão ocular Glaucoma