ABSTRACT
Introdução: A inteligência artificial (IA) está revolucionando a área da saúde. Na oftalmologia, esta tecnologia pode possibilitar diagnósticos mais rápidos e precisos, impedindo a progressão das alterações na visão. Médicos e algoritimosalgoritmos podem ser mais eficientes quando trabalham juntos. Desenvolver um software de IA com alta especificidade e sensibilidade para apoio no diagnóstico de algumas patologias oftalmológicas. Métodos: O software de deep learning foi construído através de redes neurais valendo de duas bases computacionais MobileNet e Inception. Para o treinamento do banco de dados foram utilizadas 2.520 imagens de glaucoma, retinopatia diabética, toxoplasmose ocular, papiledema, descolamento de retina e retina normal. Para a validação foi utilizado 428 imagens patológicas e normais para os cálculos de sensibilidade e de especificidade. Todas as imagens foram cedidas da Sociedade Americana de Especialistas da Retina. Resultados: Os resultados de sensibilidade e especificidade foram no MobileNet de 91% (IC 95%, 89-92%) e 98,5% (IC 95%, 98-99%); no Inception, de 91,4% (IC 95%, 89-93,5%) de 98,4% (IC 95%, 98-98,8%), respectivamente. Não houve diferença significativa entre os dois métodos utilizados. Conclusão: O software apresentou resultados promissores na distinção das condições oftalmológicas pesquisadas. (AU)
Introduction: Artificial intelligence (AI) is revolutionizing health care. In ophthalmology, this technology can enable faster and more accurate diagnoses, preventing the progression of vision Physicians and algorithms are most effective when working together. To develop an AI software with high specificity and sensitivity to support the diagnosis of some ophthalmic diseases. Methods: A deep learning software was built through neural networks using two computational bases, MobileNet and Inception. For training the database, 2520 images of glaucoma, diabetic retinopathy, ocular toxoplasmosis, papilledema, retinal detachment, and normal retina were used. For validation, 428 pathological and normal images were used for calculations of sensitivity and specificity. All images were obtained from the American Society of Retina Specialists. Results: The results of sensitivity and specificity were 91% (95% confidence interval [CI], 89-92%) and 98.5% (95% CI, 98-99%) on MobileNet, and 91.4% (95% CI, 89-93.5%) and 98.4% (95% CI, 98-98.8%) on Inception, respectively. There was no significant difference between the two methods. Conclusion: The software showed promising results in distinguishing the main ophthalmic conditions surveyed. (AU)
Subject(s)
Retinal Detachment/diagnosis , Papilledema/diagnosis , Toxoplasmosis, Ocular/diagnosis , Glaucoma , Diabetic Retinopathy/diagnosis , Software , Artificial Intelligence , Sensitivity and Specificity , Deep LearningABSTRACT
Optic disc drusen (ODD) is the accumulations of calcified hyaline-like material within the substance of the optic nerve head. Optic disc drusen, especially if it is bilateral, may mimic the clinical presentation of papilledema. Usually retinal nerve fiber layer (RNFL) thinning can be present in ODD. In this report we present uncommon RNFL changes in a patient with bilateral ODD. A 17-year-old male was referred by another center with a diagnosis of optic disc edema. The patients visual acuity, the slit-lamp examination and the intraocular pressures were normal in both eyes. On fundus examination, there were irregularly elevated discs bilaterally and the optic nerves appear with hazy disk margins. He did not have visual field defects in automated perimetry. Bilateral ODD were identified and confirmed by B-scan ultrasonography and optical coherence tomography (OCT) demonstrated 4 clock hours of RNFL thickening. Optic disc drusen may be misdiagnosed as papilledema. Thus, clinical suspicion of ODD is important in order to diagnose papilledema and prevents unnecessary interventions. Although most of eyes with ODD have normal or thinner RNFL thickness, some of these eyes can have thicker RNFL thickness.
As drusas do disco óptico (DDO) são depósitos de material hialino calcificado dentro da substância da cabeça do nervo óptico. Drusas do disco óptico, especialmente se for bilateral, podem apresentar o quadro clínico de edema de papila. Usualmente o espessamento da camada de fibras nervosas da retina (RCFN) podem estar presentes em DDO. Neste relato apresentamos o caso de um homem com 17 anos de idade que foi encaminhado por um outro centro, com o diagnóstico de edema do disco óptico. A acuidade visual do paciente, o exame de lâmpada de fenda e a pressão intraocular foram normais em ambos os olhos. No exame de fundo de olho havia discos elevados de forma irregular bilateralmente e os nervos ópticos com margens de disco nebulosas. Ele não tinha defeitos do campo visual em perimetria computadorizada. Drusas do disco óptico (DDO) bilateral foram identificados e confirmados pela ultrassonografia Bscan e tomografia de coerência óptica (TCO) que demonstraram 4 horas de relógio de RCFN com espessamento. As drusas do disco óptico podem ser diagnosticadas como papiledema. Assim, a suspeita clínica de DDO é importante a fim de evitar intervenções desnecessárias. Embora a maioria dos olhos com DDO têm espessura normal ou thinner RCFN, alguns desses olhos podem ter camada mais grossa na RCFN.
Subject(s)
Humans , Male , Adolescent , Optic Disk Drusen/diagnosis , Nerve Fibers/pathology , Papilledema/diagnosis , Retina/pathologyABSTRACT
No abstract available.
Subject(s)
Adult , Female , Humans , Angiogenesis Inhibitors/administration & dosage , Bevacizumab/administration & dosage , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Intravitreal Injections , Optic Disk/pathology , POEMS Syndrome/complications , Papilledema/diagnosisABSTRACT
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Angiogenesis Inhibitors/administration & dosage , Bevacizumab/administration & dosage , Follow-Up Studies , Intravitreal Injections , Optic Disk/pathology , POEMS Syndrome/complications , Papilledema/diagnosis , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitorsABSTRACT
Isoladamente, o edema de papila não costuma causar sintomatologia, porém, ao ser encontrado, pode auxiliar no diagnóstico de algumas condições clínicas. Neste capítulo serão descritas as principais causas do seu achado, além da técnica da realização do exame fundoscópico.
Lonely, papilledema doesn't causes symptoms, but, when we find it, it may help us doing diagnosis of some diseases. In this chapter we will find the leading causes of the origin of this disorder and the correct execution of fundoscopic exam.
Subject(s)
Papilledema , Ophthalmoscopes , Optic Nerve Diseases , Papilledema/diagnosisABSTRACT
Papillitis and complicating acute toxoplasma retinochoroiditis, are unusual and atypical features of toxoplasmosis. This report presents a female with unusual acute papillitis. This patient had an active toxoplasmic chorioretinitis lesion that appeared to involve the optic nerve head and a major blood vessel as well as central nervous systems [CNS]. Papillitis may be secondary to juxtapapillary retinitis [Jensen choroiditis]. Very rarely, the optic nerve head may be the primary site of involvement. This case report illustrates a rare presentation of acute papillitis in a young immunocompetent female
Subject(s)
Humans , Female , Adult , Toxoplasmosis, Ocular/diagnosis , Toxoplasmosis, Ocular/pathology , Papilledema/etiology , Papilledema/diagnosis , Chorioretinitis/diagnosis , Optic Nerve Diseases/parasitologyABSTRACT
A 45-year-old male patient presented with gradual onset of headache, vomiting and blurring of vision of 28 days duration. Ophthalmological examination revealed normal anterior segment and pupillary reflex. No abnormality was detected in the vitreous. Optic disc showed features of advanced papilledema with normal macula and retinal periphery in both eyes. Visual acuity was 20/200 in the right eye and counting fingers close range in the left eye. Non-contrast computed tomography of brain was normal and magnetic resonance imaging showed sagittal sinus thrombosis without any evidence of venous infarction or intracranial mass. Routine hematological investigations revealed increased hemoglobin level, packed cell volume and leucocytosis. Further investigation revealed increased Vitamin B12 and decreased serum erythropoietin. A diagnosis of polycythemia vera was made from the above findings. This case is being presented for the rarity of association of polycythemia vera with bilateral advanced papilledema due to sagittal sinus thrombosis.
Subject(s)
Acetazolamide/therapeutic use , Drug Therapy, Combination , Functional Laterality , Headache/diagnosis , Hematocrit , Hemoglobins/analysis , Heparin/therapeutic use , Humans , Hydroxyurea/therapeutic use , Magnetic Resonance Imaging , Male , Middle Aged , Papilledema/diagnosis , Platelet Count , Polycythemia Vera/diagnosis , Vision Disorders/diagnosis , Vomiting/diagnosisABSTRACT
A case of cryptococcal meningitis in an AIDS patient who presented with optic disc edema, bilateral retinal and peripapillary haemorrhages is reported.
Subject(s)
AIDS-Related Opportunistic Infections/complications , Adult , Cerebrospinal Fluid/microbiology , Cryptococcus neoformans/isolation & purification , Diagnosis, Differential , Female , HIV Antibodies/analysis , HIV-1/immunology , Humans , Meningitis, Cryptococcal/complications , Optic Disk/pathology , Papilledema/diagnosis , Retinal Hemorrhage/diagnosisSubject(s)
Humans , Male , Female , Ophthalmology , Pediatrics , Meningitis/diagnosis , Hypertension/diagnosis , /diagnosis , Papilledema/diagnosis , NeoplasmsABSTRACT
La etiopatogenia de la papilopatía diabética es incierta. La neuropatía óptica isquémica anterior (NOIA) determina alteración visual irreversible; puede presentarse en jóvenes en forma recurrente y entre sus causas se reconoce a la diabetes mellitus. Se presenta un paciente diabético con diagnóstico de papilopatía bilateral, con cuadrantopsia inferonasal de ambos ojos, persistente por más de 12 meses, y en directa relación con no perfusión angiográfica en cuadrantes superotemporales de ambas papilas. Y otro caso de paciente que inicia su enfermedad con papilopatía tipo NOIA, y que su estudio determina diabetes mellitus. Se concluye que en algunos casos de papilopatía diabética puede existir relación directa con NOIA
Subject(s)
Humans , Male , Middle Aged , Diabetes Mellitus/complications , Optic Neuropathy, Ischemic/complications , Papilledema/etiology , Optic Neuropathy, Ischemic/drug therapy , Optic Disk , Papilledema/complications , Papilledema/diagnosis , Prednisone/therapeutic useABSTRACT
Se presentan dos casos clínicos con el padecimiento descrito por Hayreh, conocido como "Vasculitis del Disco Optico". Se describe su evolución y el uso de esteroides en uno de ellos y se hace mención de la importancia del conocimiento de este cuadro clínico al establecer el diagnóstico diferencial en los pacientes que cursan con edema de la papila, en especial con pseudotumor cerebri
Subject(s)
Humans , Female , Adult , Vasculitis/diagnosis , Papilledema/diagnosis , Optic Disk/pathologyABSTRACT
Se presentan cinco pacientes con meningitis criptocócica y SIDA que presentaron manifestaciones oftalmológicas; cuatro presentaron papiledema, dos de los cuales evolucionaron, uno atrofia papilar y otro a coriorretinitis. La recaída de la enfermedad fue muy frecuente. Estas manifestaciones oftalmológicas son similares a las previamente reportadas en la literatura
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/diagnosis , Meningitis, Cryptococcal/diagnosis , Chorioretinitis/diagnosis , Cryptococcus neoformans/pathogenicity , Meningitis, Cryptococcal/etiology , Meningitis, Cryptococcal/drug therapy , Papilledema/diagnosisABSTRACT
La descompresión quirúrgica de la vaina del nervio óptico ha sido utilizada en diversas patologías, pero su principal indicación en la actualidad la constituye el pseudotumor cerebri. Se revisan las historias e información disponibles de todos los pacientes a quienes se les ha practicado DVNO (Descompresión de la Vaina del Nervio Optico) en nuestro país. El total fue de 12 pacientes (18 n) entre noviembre de 1987 y agosto de 1994, con edades entre los 6 y 47 años. Se encontró mejoría visual en nueve ojos (60 por ciento), se mantiene sin cambios en cuatro ojos (60 por ciento) y empeoró en dos (13,33 por ciento). Hubo mejoría en la agudeza visual en los ojos contralaterales no sometidos a cirugía de tres pacientes
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Papilledema/surgery , Papilledema/complications , Papilledema/diagnosis , Decompression, Surgical/methods , Optic Nerve/surgery , Optic Nerve/pathology , OphthalmologyABSTRACT
Os autores têm por finalidade revisar a literatura sobre Papiledema, com o objetivo de ressaltar e atualizar os aspectos mais importantes relacionados a etiologia, diagnóstico, tratamento e prognóstico