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Nov-Dez - Sociedade Brasileira de Oftalmologia

Nov-Dez - Sociedade Brasileira de Oftalmologia

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Estudo do comportamento da PIO <strong>de</strong> 24 horas e frequência <strong>de</strong> glaucoma em pacientes com síndrome...343glaucoma was alteration of the visual field (VF) compatiblewith glaucoma and one or more of the following alterations:cup-disc ratio ≥ 0.7, hemorrhage, wedge-shaped <strong>de</strong>fect,bayonet-shaped vessels, Hoyt’s sign, asymmetry > than 0.2between cup/disc ratio of the eyes. The angle should beopened without alterations. Results: 9 (82%) of 11 patientsshowed glaucoma or were suspected to have glaucoma,9% of which exhibited normal tension glaucoma and 73%were suspected to have glaucoma for presenting alterationsin the optic nerve or ocular hypertension. The mean for theIOP values of the 11 patients was observed to be the highestat 6 o’clock, when they were lying down. Variations of IOP≥ 5 mmHg occurred in 7 (64%) of the patients, andvariations of up to 14 mmHg and IOP peaks of up to 32mmHg were observed. Conclusion: OSAS may be animportant risk factor for the <strong>de</strong>velopment of glaucoma,particularly that of normal tension glaucoma. Patients withOSAS must be referred to an ophthalmologist and thoseprofessionals must be attentive to the association of sleepdisor<strong>de</strong>rs in patients with open-angle glaucoma.Keywords: Sleep apnea, obstructive; Intraocularpressure; Glaucoma, open-angle; Diagnostic techniques,ophthalmologicalREFERÊNCIAS1. Wilson MR, Martone JF. Epi<strong>de</strong>miology of chronic open-angleglaucoma. In: Ritch R, Bruce Shields M, Krupin T. The Glaucomas.2nd ed. St Louis: Mosby; 1998. p. 753-68.2. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet.2004; 363(9422):1711-20.3. Me<strong>de</strong>iros FA, Weinreb RN. Medical backgroun<strong>de</strong>rs: glaucoma.Drugs Today (Barc). 2002; 38(8):563-70.4. Mojon DS, Hess CW, Goldblum D, Fleischhauer J, Koerner F,Bassetti C, et al. High prevalence of glaucoma in patientswith sleep apnea syndrome. Ophthalmology. 1999;106(5):1009-12.5. Bezerra ML. A prevalência do glaucoma nos pacientes comsíndrome da apnéia/hipopnéia do sono do Instituto do Sonoda Universida<strong>de</strong> Estácio <strong>de</strong> Sá. In: IX Congresso Brasileiro<strong>de</strong> Sono; 2003 <strong>Nov</strong> 5-8; Vitória. Anais. Vitória: <strong>Socieda<strong>de</strong></strong><strong>Brasileira</strong> <strong>de</strong> Sono; 2003. p. 45.6. Sergi M, Salerno DE, Rizzi M, Blini M, Andreoli A, MessenioD, et al. Prevalence of normal tension glaucoma in obstructivesleep apnea syndrome patients. J Glaucoma. 2007;16(1):42-6.7. Mojon DS, Hess CW, Goldblum D, Boehnke M, Koerner F,Gugger M, et al. Normal-tension glaucoma is associated withsleep apnea syndrome. Ophthalmologica. 2002; 216(3):180-4.8. Mojon DS, Hess CW, Goldblum D, Bohnke M, Korner F, MathisJ. Primary open-angle glaucoma is associated with sleep apneasyndrome. Ophthalmologica. 2000; 214(2):115-8.9. Marcus DM, Costari<strong>de</strong>s AP, Gokhale P, Papastergiou G, Miller JJ,Johnson MH, Chaudhary BA. Sleep disor<strong>de</strong>rs: a risk factor fornormal – tension glaucoma. J Glaucoma. 2001; 10(3):177-83.10. Girkin CA, McGwin G Jr, McNeal SF, Owsley C. Is there anassociation between pre-existing sleep apnoea and the <strong>de</strong>velopmentof glaucoma? Br J Ophthalmol. 2006; 90(6): 679-81.11. Geyer O, Cohen N, Segev E, Rath EZ, Melamud L, Peled R,et al. The prevalence of glaucoma in patients with sleep apneasyndrome: same as in the general population. Am JOphthalmol. 2003; 136(6):1093-6.12. Sleep-related breathing disor<strong>de</strong>rs in adults: recommendationsfor syndrome <strong>de</strong>finition and measurement techniques in clinicalresearch. The Report of an American Aca<strong>de</strong>my of SleepMedicine Task Force. Sleep. 1999; 22(5):667-89.13. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. Theoccurrence of sleep- disor<strong>de</strong>red breathing among middleagedadults. N Engl J Med. 1993; 328(17):1230-5.14. Stradling JR, Crosby JH. Relation between systemic hypertensionand sleep hypoxaemia or snoring: analysis in 748 mendrawn from general practice. Br Med J. 1990; 300(6717):75-8.15. Strobel RJ, Rosen RC. Obesity and weight loss in obstructivesleep apnea: a critical review. Sleep. 1996; 19(2):104-15.16. Hayreh SS, Zimmerman MB, Podhajsky P, Alward WL. Nocturnalarterial hypotension and its role in optic nerve headand ocular ischemic disor<strong>de</strong>rs. Am J Opthalmol. 1994;117(5):603-24.17. Hayreh SS. The 1994 Von Sallman Lecture. The optic nerve headcirculation in health and disease. Exp Eye Res. 1995; 61(3):259-72.18. Hayreh SS Acute ischemic disor<strong>de</strong>rs of the optic nerve. Pathogenesis,clinical manifestations, and management. OphthalmolClin North Am. 1996; 9:407-42.19. Luscher TF. The endothelium and cardiovascular disease – acomplex relation. N Engl J Med. 1994; 330(15):1081-3.20. Rodrigues LD, Silva MR, Schellini SA, Jorge EN. Picos <strong>de</strong>pressão intra-ocular: comparação entre curva tensional diária,minicurva e medida da pressão intra-ocular às 6h. Arq BrasOftalmol. 2004; 67(1):127-31.21. Liu JH, Kripke DF, Twa MD, Hoffman RE, Mansberger SL,Rex KM, et al. Twenty-four-hour pattern of intraocular pressurein the aging population. Invest Ophthalmol Vis Sci. 1999;40(12):2912-7.22. Tsukahara S, Sasaki T. Postural change of IOP in normal personsand in patients with primary wi<strong>de</strong> open-angle glaucoma andlow-tension glaucoma. Br J Ophthalmol. 1984; 68(6):389-92.23. Yamabayashi S, Aguilar RN, Hosoda M, Tsukahara S. Posturalchange of intraocular and blood pressures in ocular hypertensionand low tension glaucoma. Br J Ophthalmol. 1991;75(11):652-5.24. James CB, Smith SE. Pulsatile ocular blood flow in patients withlow tension glaucoma. Br J Ophthalmol. 1991; 75(8):466-70.25. Goldblum D, Mathis J, Böhnke M, Basset C, Hess CW, Gugger M,et al. [Nocturnal measurements of intraocular pressure in patientswith normal-tension glaucoma and sleep apnea syndrome].Klin Monatsbl Augenheilkd. 2000; 216(5):246-9. German.26. Kremmer S, Nie<strong>de</strong>rdraing N, Ayertey HD, Steuhl KP, Selbach JM.Obstructive sleep apnea syndrome, normal tension glaucoma,and nCPAP therapy - a short note. Sleep. 2003; 26(2):161-2.27. Davanger M, Ringvold A, Blika S. The probability of havingglaucoma at different IOP levels. Acta Ophthamol (Copenh).1991; 69(5):565-8.28. Asrani S, Zeimer R, Wilensky J, Gieser D, Vitale S, Lin<strong>de</strong>nmuthK. Large diurnal fluctuations in intraocular pressure are anin<strong>de</strong>pen<strong>de</strong>nt risk factor in patients with glaucoma. J Glaucoma.2000; 9(2):134-42.29. Gordon MO, Beiser JA, Brandt JD, Heuer DK, HigginbothamEJ, Johnson CA, et al. The Ocular Hypertension TreatmentStudy: baseline factors that predict the onset of primary openangleglaucoma. Arch Ophthalmol. 2002; 120(6):714-20.En<strong>de</strong>reço para correspondência:Faculda<strong>de</strong> <strong>de</strong> Medicina <strong>de</strong> Botucatu – UNESPDepartamento <strong>de</strong> <strong>Oftalmologia</strong>, Otorrinolaringologiae Cirurgia <strong>de</strong> Cabeça e PescoçoDistrito <strong>de</strong> Rubião Júnior s/nºCEP 18618-970 - Botucatu - SPTel/fax: (14) 3811-6256 / 3811-6081E-mail: rosabet@fmb.unesp.brRev Bras Oftalmol. 2009; 68 (6): 338-43

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