Elastografia acoustic radiation force impulse (ARFI) em lentes de cães com catarata
Carregando...
Data
2019-02-28
Autores
Abreu, Thais Guimarães Morato
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os objetivos deste estudo foram avaliar a acurácia da elastografia Acoustic Radiation Force Impulse na diferenciação entre lentes normais e com catarata, além de correlacionar o grau de rigidez da lente intraocular com os parâmetros avaliados durante a facoemulsificação (tempo de ultrassom, controle de vácuo e quantitativo de solução salina balanceada). No total, 145 olhos de 98 cães foram avaliados e divididos em grupos de lentes normais e de acordo com o estágio da catarata.. A velocidade de cisalhamento (VC) (m/s) do núcleo foi estatisticamente diferente entre lentes normais e lentes com catarata, bem como entre os estágios da catarata (P <0,001). As lentes saudáveis e as cataratas incipientes tinham um núcleo mais rígido do que as intumescentes, as imaturas e as hipermaturas. A catarata madura apresentou maior rigidez nuclear (P <0,001). Na região cortical, a VC foi maior (P <0,01) nas cataratas intumescentes e incipientes. VC inferiores a 2,67 m/s indicam que a lente apresenta catarata com sensibilidade de 72% e especificidade de 94%. Valores inferiores a 2,23 m/s sugerem catarata madura, com sensibilidade de 71% e especificidade de 76%. VC superiores a 2,66 m/s estão associadas às cataratas normal ou incipiente, apresentando sensibilidade de 94% e especificidade de 84%. O método qualitativo permitiu a diferenciação entre lentes saudáveis e cataratosas e a classificação de seus estágios evolutivos da catarata. Dentre os pacientes avaliados, 42 olhos, de 26 cães, foram submetidos à facoemulsificação. Houve correlação entre o grau de rigidez da lente nas regiões cortical e nuclear (p=00165; r=0,37) e entre o quantitativo de solução salina balanceada utilizada e o tempo cirúrgico (p<0,01; r=0,73). O grau de rigidez da lente não apresentou correlação com os parâmetros cirúrgicos da facoemulsificação. O tempo cirúrgico (p=0,130), o quantitativo de solução salina balanceada (p=0,174), e o vácuo aplicado (p=0,167) foram estatisticamente similares independente do estágio evolutivo. Embora a técnica tenha se mostrado exequível para a avaliação da lente, a sensibilidade e a especificidade não são suficientes para considerar o método como ferramenta de diagnóstico da afecção.
The goals of this study were to evaluate the accuracy of the acoustic radiation force impulse in the differentiation between normal and cataract lenses and correlate the degree of lens rigidity to the parameters evaluated during phacoemulsification. In total, 145 eyes of 98 dogs were assessed and divided into groups according to the cataract stage. The shear velocity of the nucleus was statistically different between the normal lenses and lenses with cataracts, and between the stages of cataract (P<0.001). Healthy lenses and incipient cataracts had a more rigid nucleus than those affected by intumescent, immature and hypermature cataracts. Mature cataracts presented greater nuclear rigidity when compared to the others (P<0.001). On cortical region, shear velocity was significantly higher (P<0.01) in intumescent and incipient cataracts than in the other stages. SWV less than 2.67 m/s indicates cataract with a sensitivity of 72% and specificity of 94%. Values lower than 2.23 m/s suggest mature cataract, with sensitivity of 71% and specificity of 76%. Shear velocity greater than 2.66 m/s are associated with normal or incipient cataract, presenting sensitivity of 94% and specificity of 84%. The qualitative method allowed differentiation between healthy and affected lenses and the classification of the evolutionary stages of the cataract. Forty-two eyes of 26 dogs were submitted to phacoemulsification, after finding significant visual deficiency and normality of retinal parameters to the electroretigraphy examination. There was a correlation between the degree of stiffness of the lens in the cortical and nuclear regions (p = 00165; r = 0.37) and between the BSS quantitative and surgical time (p <0.01; r = 0.73). The degree of stiffness of the lens did not correlate with surgical parameters of phacoemulsification (time, vacuum and quantitative BSS). The surgical time (p = 0.130), the quantitative BSS (p = 0.174) as well as the applied vacuum (p = 0.167) were similar regardless of the evolutionary stage of the cataract. Although the elastographic method proved feasible for evaluating the lens of dogs, its sensitivity and specificity were not sufficient to consider the method applicable to the diagnosis of this condition in the present study.
The goals of this study were to evaluate the accuracy of the acoustic radiation force impulse in the differentiation between normal and cataract lenses and correlate the degree of lens rigidity to the parameters evaluated during phacoemulsification. In total, 145 eyes of 98 dogs were assessed and divided into groups according to the cataract stage. The shear velocity of the nucleus was statistically different between the normal lenses and lenses with cataracts, and between the stages of cataract (P<0.001). Healthy lenses and incipient cataracts had a more rigid nucleus than those affected by intumescent, immature and hypermature cataracts. Mature cataracts presented greater nuclear rigidity when compared to the others (P<0.001). On cortical region, shear velocity was significantly higher (P<0.01) in intumescent and incipient cataracts than in the other stages. SWV less than 2.67 m/s indicates cataract with a sensitivity of 72% and specificity of 94%. Values lower than 2.23 m/s suggest mature cataract, with sensitivity of 71% and specificity of 76%. Shear velocity greater than 2.66 m/s are associated with normal or incipient cataract, presenting sensitivity of 94% and specificity of 84%. The qualitative method allowed differentiation between healthy and affected lenses and the classification of the evolutionary stages of the cataract. Forty-two eyes of 26 dogs were submitted to phacoemulsification, after finding significant visual deficiency and normality of retinal parameters to the electroretigraphy examination. There was a correlation between the degree of stiffness of the lens in the cortical and nuclear regions (p = 00165; r = 0.37) and between the BSS quantitative and surgical time (p <0.01; r = 0.73). The degree of stiffness of the lens did not correlate with surgical parameters of phacoemulsification (time, vacuum and quantitative BSS). The surgical time (p = 0.130), the quantitative BSS (p = 0.174) as well as the applied vacuum (p = 0.167) were similar regardless of the evolutionary stage of the cataract. Although the elastographic method proved feasible for evaluating the lens of dogs, its sensitivity and specificity were not sufficient to consider the method applicable to the diagnosis of this condition in the present study.
Descrição
Palavras-chave
Cegueira, Cães, Lente, Oftalmologia, Rigidez, Ultrassonografia