Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo

Detalhes bibliográficos
Autor(a) principal: Rossetto, Julia Dutra [UNIFESP]
Data de Publicação: 2017
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060940
http://repositorio.unifesp.br/handle/11600/50513
Resumo: Purpose: To assess the accuracy of anterior segment optical coherence tomography (AS-OCT) in measuring the distance of extraocular muscle (EOM) insertion to the limbus to improve preoperative assessment of adult patients undergoing strabismus surgery. Methods: A reliability analysis at an institutional practice performed in adult patients scheduled for strabismus surgery on rectus muscles. The distance between the EOM insertion and the limbus was measured preoperatively with AS-OCT. The value was compared to intraoperative measurement obtained with calipers. Additional measurements included the limbus-anterior chamber angle distance with AS-OCT and the axial length with IOLMaster. The main outcome measure was the greement between preoperative AS-OCT and intraoperative measurements. A difference of ≤ 1 millimeter (mm) was "clinically acceptable". Results: 144 muscles were analyzed from 74 patients. 31 of 33 reoperated muscles were successfully imaged. AS-OCT measurements were within 1 mm of intraoperative measurements in 77% of all the muscles. The accuracy was higher for muscles with no prior surgery (83%), as compared to re-operated muscles (58%). Although the accuracy decreased when comparing reoperations to primary surgeries for the medial (79 to 63%; p=0.09; 95%CI, -1.38 to 0.11) and the lateral rectus (81 to 49%; p=0.11; 95%CI, -2.06 to 0.22), the difference was not significant. No correlation between limbus-anterior chamber angle distance and axial length was established. Conclusions: AS-OCT is valuable in identifying EOM insertions in primary strabismus surgeries, but the accuracy decreases in re-operations. The intraoperative measure performed before the detachment of the muscle's tendon and the use of limbus as a reference point in the OCT proved to be suitable for performing the measurements.
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spelling Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismoAccuracy of optical coherence tomography measurements of rectus muscles insertions in adults undergoing strabismus surgeryOptical coherence tomographyStrabismusOculomotor musclesLimbus of corneaTomografia de coerência ópticaEstrabismoMúsculos oculomotoresLimbo da córneaPurpose: To assess the accuracy of anterior segment optical coherence tomography (AS-OCT) in measuring the distance of extraocular muscle (EOM) insertion to the limbus to improve preoperative assessment of adult patients undergoing strabismus surgery. Methods: A reliability analysis at an institutional practice performed in adult patients scheduled for strabismus surgery on rectus muscles. The distance between the EOM insertion and the limbus was measured preoperatively with AS-OCT. The value was compared to intraoperative measurement obtained with calipers. Additional measurements included the limbus-anterior chamber angle distance with AS-OCT and the axial length with IOLMaster. The main outcome measure was the greement between preoperative AS-OCT and intraoperative measurements. A difference of ≤ 1 millimeter (mm) was "clinically acceptable". Results: 144 muscles were analyzed from 74 patients. 31 of 33 reoperated muscles were successfully imaged. AS-OCT measurements were within 1 mm of intraoperative measurements in 77% of all the muscles. The accuracy was higher for muscles with no prior surgery (83%), as compared to re-operated muscles (58%). Although the accuracy decreased when comparing reoperations to primary surgeries for the medial (79 to 63%; p=0.09; 95%CI, -1.38 to 0.11) and the lateral rectus (81 to 49%; p=0.11; 95%CI, -2.06 to 0.22), the difference was not significant. No correlation between limbus-anterior chamber angle distance and axial length was established. Conclusions: AS-OCT is valuable in identifying EOM insertions in primary strabismus surgeries, but the accuracy decreases in re-operations. The intraoperative measure performed before the detachment of the muscle's tendon and the use of limbus as a reference point in the OCT proved to be suitable for performing the measurements.Objetivo: Avaliar a precisão da tomografia de coerência óptica de segmento anterior (AS-OCT) ao medir a distância entre a inserção dos músculos extraoculares e o limbo, visando melhorar a avaliação pré-operatória de pacientes adultos a serem submetidos a cirurgia primária ou repetida de estrabismo. Métodos: Estudo prospectivo, mascarado, realizado em pacientes adultos (> 18 anos) agendados para cirurgia de estrabismo e intervenção nos músculos retos horizontais e/ou verticais. A distância entre a inserção da musculatura e o limbo (em milímetros) foi medida no pré- operatório com AS-OCT (OCT Visante) e seu valor foi comparado à medida peroperatória obtida com compasso cirúrgico. Uma diferença ≤ 1 milímetro foi considerada "clinicamente aceitável". Medições adicionais foram obtidas, incluindo a distância a partir do limbo ao ângulo da câmara anterior com AS-OCT e o comprimento axial do olho com biometria óptica (IOLMaster). Resultados: Foram analisados 74 pacientes e um total de 144 músculos, incluindo 31 músculos já submetidos previamente a cirurgia (reoperação). As medições com AS-OCT diferiram em menos de 1 mm das medidas peroperatórias em 77,1% dos músculos. A precisão foi maior para os músculos sem cirurgia anterior (83,2%), quando comparadas com os músculos reoperados (58,1%). Não foi demonstrada relação entre o comprimento axial do olho e a distância entre o limbo e o ângulo da câmara anterior (p > 0,05) para todos os músculos retos). Conclusão: A tomografia de coerência óptica foi considerada um método acurado para a avaliação da distância entre o limbo e a inserção dos músculos retos em toda a amostra constituída de olhos submetidos a cirurgia primária e/ou reoperação e isoladamente para aqueles submetidos apenas a cirurgia primária. O mesmo método não apresentou a mesma acurácia para o grupo com cirurgia prévia de estrabismo. A medida peroperatória antes da desinserção do tendão e o uso do limbo como ponto de referência na tomografia de coerência óptica mostraram-se adequados para a realização das medidas.Dados abertos - Sucupira - Teses e dissertações (2017)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP)Allemann, Norma [UNIFESP]Mattos Júnior, Rubens Belfort [UNIFESP]http://lattes.cnpq.br/4270399167335564http://lattes.cnpq.br/0956596522261307http://lattes.cnpq.br/8314526091344602Universidade Federal de São Paulo (UNIFESP)Rossetto, Julia Dutra [UNIFESP]2019-06-19T14:58:01Z2019-06-19T14:58:01Z2017-03-29info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion106 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060940http://repositorio.unifesp.br/handle/11600/50513porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-10T13:50:21Zoai:repositorio.unifesp.br/:11600/50513Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-10T13:50:21Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
Accuracy of optical coherence tomography measurements of rectus muscles insertions in adults undergoing strabismus surgery
title Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
spellingShingle Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
Rossetto, Julia Dutra [UNIFESP]
Optical coherence tomography
Strabismus
Oculomotor muscles
Limbus of cornea
Tomografia de coerência óptica
Estrabismo
Músculos oculomotores
Limbo da córnea
title_short Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
title_full Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
title_fullStr Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
title_full_unstemmed Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
title_sort Acurácia da medida da inserção dos músculos retos com tomografia de coerência óptica em adultos submetidos a cirurgias de estrabismo
author Rossetto, Julia Dutra [UNIFESP]
author_facet Rossetto, Julia Dutra [UNIFESP]
author_role author
dc.contributor.none.fl_str_mv Allemann, Norma [UNIFESP]
Mattos Júnior, Rubens Belfort [UNIFESP]
http://lattes.cnpq.br/4270399167335564
http://lattes.cnpq.br/0956596522261307
http://lattes.cnpq.br/8314526091344602
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Rossetto, Julia Dutra [UNIFESP]
dc.subject.por.fl_str_mv Optical coherence tomography
Strabismus
Oculomotor muscles
Limbus of cornea
Tomografia de coerência óptica
Estrabismo
Músculos oculomotores
Limbo da córnea
topic Optical coherence tomography
Strabismus
Oculomotor muscles
Limbus of cornea
Tomografia de coerência óptica
Estrabismo
Músculos oculomotores
Limbo da córnea
description Purpose: To assess the accuracy of anterior segment optical coherence tomography (AS-OCT) in measuring the distance of extraocular muscle (EOM) insertion to the limbus to improve preoperative assessment of adult patients undergoing strabismus surgery. Methods: A reliability analysis at an institutional practice performed in adult patients scheduled for strabismus surgery on rectus muscles. The distance between the EOM insertion and the limbus was measured preoperatively with AS-OCT. The value was compared to intraoperative measurement obtained with calipers. Additional measurements included the limbus-anterior chamber angle distance with AS-OCT and the axial length with IOLMaster. The main outcome measure was the greement between preoperative AS-OCT and intraoperative measurements. A difference of ≤ 1 millimeter (mm) was "clinically acceptable". Results: 144 muscles were analyzed from 74 patients. 31 of 33 reoperated muscles were successfully imaged. AS-OCT measurements were within 1 mm of intraoperative measurements in 77% of all the muscles. The accuracy was higher for muscles with no prior surgery (83%), as compared to re-operated muscles (58%). Although the accuracy decreased when comparing reoperations to primary surgeries for the medial (79 to 63%; p=0.09; 95%CI, -1.38 to 0.11) and the lateral rectus (81 to 49%; p=0.11; 95%CI, -2.06 to 0.22), the difference was not significant. No correlation between limbus-anterior chamber angle distance and axial length was established. Conclusions: AS-OCT is valuable in identifying EOM insertions in primary strabismus surgeries, but the accuracy decreases in re-operations. The intraoperative measure performed before the detachment of the muscle's tendon and the use of limbus as a reference point in the OCT proved to be suitable for performing the measurements.
publishDate 2017
dc.date.none.fl_str_mv 2017-03-29
2019-06-19T14:58:01Z
2019-06-19T14:58:01Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060940
http://repositorio.unifesp.br/handle/11600/50513
url https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060940
http://repositorio.unifesp.br/handle/11600/50513
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 106 f.
application/pdf
dc.coverage.none.fl_str_mv São Paulo
dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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