Interior 2_2006.qxd - Oftalmologia.ro

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OFTALMOLOGIA 2 - 2006 ABSTRACT PURPOSE To analyze the IOP diurnal fluctuations in patients presenting pseudoexfoliative syndrome (PEX) compared to those without PEX. METHOD A clinical observational prospective study, one year, on 2 groups of patients: group A (13 patients) - with pseudoexfoliative syndrome (PEX) and group B, control, (11 patients) - without PEX. The groups were homogeneous about the age and sex distribution. At each visit 4 IOP measurements were taken using Goldmann aplanotonometry. RESULTS In PEX patients the IOP had greater values during the study period compared to the control group. By comparing the two groups have been observed significant differences about the maximum IOP, the mean IOP and the diurnal fluctuations, also about the incidence of the complications. CONCLUSIONS The IOP diurnal fluctuations in PEX patients are significantly greater than the physiological ones and therefore influence the therapeutic attitude and the prognostic. The significant fluctuations in the IOP diurnal curve are an important predictive factor for the eyes that will develop secondary glaucoma. The pseudoexfoliative syndrome is an independent risk factor for glaucoma in patients with intraocular hypertension. KEY WORDS: • pseudoexfoliative syndrome, • IOP fluctuations, • secondary glaucoma. 122 SCOP Analiza fluctuatiilor diurne ale PIO la pacientii cu sindrom pseudoexfoliativ in comparatie cu pacientii care nu prezinta aceasta patologie. MATERIAL SI METODA Studiu clinic prospectiv, observational, timp de 1 an (01.03.2005-28.02.2006) pe doua loturi de pacienti: - lotul A: 13 pacienti (26 de ochi) cu sindrom pseudoexfoliativ, 3 cu PEX ''bilateral'' si 10 cu PEX aparent clinic ''unilateral''. - lotul B: 11 pacienti (22 de ochi) fara sindrom psedoexfoliativ. Loturile au fost omogene in ceea ce priveste repartitia pe grupe de varsta si sex si nu au prezentat patologie oculara asociata (vicii importante de refractie, patologie corneeana, inflamatii intraoculare, etc.) care sa fi influentat rezultatele studiului. ( tabel 1)
La fiecare vizita stabilita s-a determinat PIO prin aplanotonometrie Goldmann la orele 9, 12, 15 si 18. La toti pacientii s-a efectuat pahimetrie ultrasonica, masurandu-se grosimea corneeana centrala si ajustand unde a fost cazul valorile obtinute la aplanatie. Modificarile functionale au fost obiectivate prin analiza computerizata a campului vizual (programul central Sita Standard 30-2), fiind efectuate 3 detreminari: la intrarea in studiu (T0), la 6L si la 12L. Modificarile morfologice la nivelul capului nervului optic s-au urmarit prin biomicroscopia FO. Prelucrarea statistica a fost realizata prin testul t Student si analiza regresiva Cox. REZULTATE La includerea in studiu cele 2 loturi au fost distribuite dupa PIO in 3 subgrupe: sub 18 mmHg, intre 19 si 22 mmHg si peste 22 mmHg. In lotul A majoritatea ochilor analizati a avut o PIO initiala situata la limita normala statistic si peste aceasta (61,53 % PIO 19-22mmHg si 6 ochi-23% - sindrom de hipertensiune intraoculara), in timp ce in lotul martor 60% au avut PIO initiala sub 18 mmHg si numai 2 ochi, respectiv 8% sindrom de hipertensiune intraoculara. (tabel 2) OFTALMOLOGIA 2 - 2006 O alta caracteristica importanta remarcata la includerea in studiu a fost asimetria presionala intre cei doi ochi la subiectii analizati, astfel: in lotul A, 9 pacienti au prezentat diferente de 3-5 mmHg si 3 pacienti peste 5 mmHg, in timp ce in lotul martor, in majoritatea cazurilor (8 pacienti) a fost inregistrata o asimetrie presionala in limitele fiziologice (2 mmHg), si doar 3 pacienti au avut asimetrie peste 2 mmHg. (tabel 3) Urmarind in dinamica evolutia PIO pe durata studiului s-au observat urmatoarele: - in cadrul lotului martor a existat o constanta a dinamicii si a distributiei PIO in cadrul subgrupelor (22mmHg) - la pacientii cu sindrom pseudoexfoliativ se observa, (grafic 1), pe langa faptul ca pe toata perioada de urmarire majoritatea ochilor au avut o PIO la limita normala (19-22mmHg) ca a crescut numarul ochilor cu hipertensiune intraoculara de la 6 la 9 (cu 50%). 123
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REFERATE GENERALE Bogdana Virgolici
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OFTALMOLOGIA 2 - 2006 FACTORII DE R
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cataract` ]i neag` cre]terea riscul
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exemplu, statinele) nu s-au g`sit
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OFTALMOLOGIA 2 - 2006 27. Dinning W
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ABSTRACT A national and internation
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Tabel 1 - Clasificarea obiectivelor
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Figura II. Articole publicate cu pr
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BIBLIOGRAFIA OFTALMOLOGIA 2 - 2006
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viduale sau [n grup a CG. Este un p
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mecanice existente care scad ]i act
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OFTALMOLOGIA 2 - 2006 TRATAMENTUL P
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junctivale poate duce la accelerare
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OFTALMOLOGIA 2 - 2006 DRUSEN AL PAP
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Figura 3 - Ecografie ochiul stâng
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Figura 7 - Câmpul vizual computeri
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OFTALMOLOGIA 2 - 2006 coroidiene pr
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BIBLIOGRAFIE OFTALMOLOGIA 2 - 2006
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FIZIOPATOLOGIE Materialul cristalin
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OFTALMOLOGIA 2 - 2006 rologic` era
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INTRODUCTION The lens represents a
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tein" 2006 article. The presence of
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OFTALMOLOGIA 2 - 2006 LD Principle
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ABSTRACT OFTALMOLOGIA 2 - 2006 PURP
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REFERINTE OFTALMOLOGIA 2 - 2006 1.
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OFTALMOLOGIA 2 - 2006 PURPOSE To ev
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Evolu\ia acuit`\ii vizuale medii la
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ABSTRACT OFTALMOLOGIA 2 - 2006 PURP
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