Detalhes bibliográficos
| Ano de defesa: |
2018 |
| Autor(a) principal: |
Franco, Cláudia Gomide Vilela de Sousa
 |
| Orientador(a): |
Silva, Leopoldo Magacho dos Santos
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| Banca de defesa: |
Silva, Leopoldo Magacho dos Santos,
Paula, Alcio Coutinho de,
Isaac, David Leonardo Cruvinel,
Pereira, Luciano de Sousa |
| Tipo de documento: |
Dissertação
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| Tipo de acesso: |
Acesso aberto |
| Idioma: |
por |
| Instituição de defesa: |
Universidade Federal de Goiás
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| Programa de Pós-Graduação: |
Programa de Pós-graduação em Ciências da Saúde (FM)
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| Departamento: |
Faculdade de Medicina - FM (RG)
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| País: |
Brasil
|
| Palavras-chave em Português: |
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| Palavras-chave em Inglês: |
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| Área do conhecimento CNPq: |
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| Link de acesso: |
http://repositorio.bc.ufg.br/tede/handle/tede/9178
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Resumo: |
The aim of this study was to assess and compare the influence of Visual Field (VF) and/or Optical Coherence Tomography (OCT) when analyzed in association with Color Retinography (CR) to differentiate glaucomatous patients from those with increased physiological cupping, by non-glaucoma specialists. Eighty patients were selected, half with glaucoma and half with physiological cupping. The patients were randomized into 4 groups according to the exam performed on their right eye, which would be shown through Power Point slides to 20 non-specialist ophthalmologists: GI (CR), GII (CR + VF), GIII (CR + OCT), GIV (CR + VF + OCT). The ophthalmologists completed a questionnaire in which they checked whether or not the patient was glaucomatous, without direct examination of the patient. Inter-rater agreement determined by Kappa test was good for GII (k: 0.63; 95% CI,0.53-0.72), moderate for GIII (k:0.58; 95% CI,0.48-0.68) and for GIV (k: 0.41; 95% CI,0.31-0.51) and low for GI (k:0.30; 95% CI,0.20-0.39), the difference among groups being statistically significant (p<0.001). Statistically significant difference was found regarding correct diagnoses among groups, GIII being higher (15.8 ± 1.82) in comparison with GI (12.95 ± 1.46), (p<0.001); and higher for GII (16.25 ± 2.02) when compared to GI and GIV (14.10 ± 2.24), for both p<0.001. We found higher values for GII and GIII (p<0.001) regarding correct diagnoses of slides with glaucomatous patients single-handedly. Sensitivity and Specificity for each group were respectively: GI (59% and 70.5%); GII (86.5% and 76%); GIII (86.5% and 71.5%); GIV (68.5% and 72.5%). Accuracy was higher for GII 81.3% (95% CI,77.1-84.8), followed by GIII 79% (95% CI,74.7-82.7), GIV 70,5% (95% CI,65.9-74.8) and lower for GI 64.8% (95% CI, 60.0-69.3). We concluded that isolated assessment of CR by non-glaucoma specialists failed to properly differentiate glaucomatous patients from those with increased physiological cupping. We detected a significant increase in diagnostic accuracy and inter-rater agreement when either VF or OCT is employed. Increase for Sensitivity and Specificity was not detected for both. |
