Publications (13) View all
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Article: Oculometric parameters of hyperopia in children with esotropic amblyopia.
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ABSTRACT: To study the oculometric parameters of hyperopia in children with esotropic amblyopia, comparing amblyopic eyes with fellow eyes. Thirty-seven patients (5-8 years old) with bilateral hyperopia and esotropic amblyopia underwent a comprehensive ophthalmic examination, including cycloplegic refraction, keratometry and A-scan ultrasonography. Anterior chamber depth, lens thickness, vitreous chamber depth and total axial length were recorded. The refractive power of the crystalline lens was calculated using Bennett's equations. Paired Student's t-tests were used to compare ocular biometric measurements between amblyopic eyes and their fellow eyes. The associations of biometric parameters with refractive errors were assessed using Pearson correlation coefficients and linear regression. Multivariable models including axial length, corneal power and lens power were also constructed. Amblyopic eyes were found to have significantly more hyperopic refraction, less corneal power, greater lens power, shorter vitreous chamber depth and shorter axial length, despite similar anterior chamber depth and lens thickness. The strongest correlation with refractive error was observed for the axial length/corneal radius ratio (r(36) = -0.92, p < 0.001 for amblyopic and r(36) = -0.87, p < 0.001 for fellow eyes). Axial length accounted for 39.2% (R(2)) of the refractive error variance in amblyopic eyes and 35.5% in fellow eyes. Adding corneal power to the model increased R(2) to 85.7% and 79.6%, respectively. A statistically significant correlation was found between axial length and corneal power, indicating decreasing corneal power with increasing axial length, and they were similar for amblyopic eyes (r(36) = -0.53, p < 0.001) and fellow eyes (r(36) = -0.57, p < 0.001). A statistically significant correlation was also found between axial length and lens power, indicating decreasing lens power with increasing axial length (r(36) = -0.72, p < 0.001 for amblyopic eyes and r(36) = -0.69, p < 0.001 for fellow eyes). We observed that the correlation among the major oculometric parameters and their individual contribution to hyperopia in esotropic children were similar in amblyopic and non-amblyopic eyes. This finding suggests that the counterbalancing effect of greater corneal and lens power associated with shorter axial length is similar in both eyes of patients with esotropic amblyopia.Ophthalmic and Physiological Optics 07/2011; 31(4):389-97. · 1.58 Impact Factor -
Article: E-learning program for medical students in dermatology.
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ABSTRACT: Dermatological disorders are common in medical practice. In medical school, however, the time devoted to teaching dermatology is usually very limited. Therefore, online educational systems have increasingly been used in medical education settings to enhance exposure to dermatology. The present study was designed to develop a e-learning program for medical students in dermatology and evaluate the impact of this program on learning. This prospective study included second year medical students at the University of Technology and Science, Salvador, Brazil. All students attended discussion seminars and practical activities, and half of the students had adjunct online seminars (blended learning). Tests were given to all students before and after the courses, and test scores were evaluated. Students who participated in online discussions associated with face-to-face activities (blended learning) had significantly higher posttest scores (9.0 ± 0.8) than those who only participated in classes (7.75±1.8, p <0.01). The results indicate that an associated online course might improve the learning of medical students in dermatology.Clinics (São Paulo, Brazil) 01/2011; 66(4):619-22. · 1.59 Impact Factor -
Article: Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study.
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ABSTRACT: To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. A nonrandomized retrospective case-series study analyzed data from 22 patients with Behçet's disease uveitis, from a single Uveitis Service, São Paulo, Brazil (period 1978-2007), under systemic chlorambucil and/or cyclosporine A, for at least 6 months with a minimum one-year follow-up. Drug efficacy was measured by reduction in relapse rate and reduction of prednisone dose. Patients (10M/12F) mean age was 29 (range 10-43) years-old at the onset of uveitis. The median duration of followup was 11 (range 1-29) years-old. Chlorambucil (2-6 mg/day) was used in 13 patients and cyclosporine A (3-5 mg/kg/day) in 9 patients at initiation. Drugs were switched because of no effectiveness or side-effects. Chlorambucil was effective in 78.5% (11/14) and induced disease remission in 43% (6/14) of patients, whereas cyclosporine A was effective in 57% (8/14) of patients. Chlorambucil and cyclosporine A were discontinued due to side effects in 21% (leucopenia) and in 57% of patients (nephrotoxicity, 36% and gastrointestinal complications, 21%), respectively. No case of late malignancy was observed. 36% (16/44) of eyes had final visual acuity < or =0.1, among which 69% (11/16) had already this visual acuity at the first visit. This study reiterates previous data that chlorambucil can induce long-term remission of Behçet's disease uveitis, whereas cyclosporine is effective but side effects limit its use. Chlorambucil therapy may still be a reasonable option in patients with intractable, sight-threatening Behçet's disease uveitis.Arquivos brasileiros de oftalmologia 02/2010; 73(1):40-6. -
Article: Evaluation of machine learning classifiers in keratoconus detection from orbscan II examinations.
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ABSTRACT: To evaluate the performance of support vector machine, multi-layer perceptron and radial basis function neural network as auxiliary tools to identify keratoconus from Orbscan II maps. A total of 318 maps were selected and classified into four categories: normal (n = 172), astigmatism (n = 89), keratoconus (n = 46) and photorefractive keratectomy (n = 11). For each map, 11 attributes were obtained or calculated from data provided by the Orbscan II. Ten-fold cross-validation was used to train and test the classifiers. Besides accuracy, sensitivity and specificity, receiver operating characteristic (ROC) curves for each classifier were generated, and the areas under the curves were calculated. The three selected classifiers provided a good performance, and there were no differences between their performances. The area under the ROC curve of the support vector machine, multi-layer perceptron and radial basis function neural network were significantly larger than those for all individual Orbscan II attributes evaluated (p < 0.05). Overall, the results suggest that using a support vector machine, multi-layer perceptron classifiers and radial basis function neural network, these classifiers, trained on Orbscan II data, could represent useful techniques for keratoconus detection.Clinics (São Paulo, Brazil) 01/2010; 65(12):1223-8. · 1.59 Impact Factor -
Article: [Teledermatology: diagnostic correlation in a primary care service].
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ABSTRACT: Telemedicine can be defined as the use of telecommunication technologies for the transmission of health data. It has been described in different medical specialties, especially those in which interpretation of images represents a fundamental key in formulating diagnosis. To evaluate the role of teledermatology in primary care system. A prospective analysis included 60 patients seen in a primary care unit. All patients were seen by a dermatologist as regular outpatient dermatology consultation. A medical student obtained digital images and a brief clinical history of all patients. Using a Telemedicine system these data were reviewed by two dermatologists for distance diagnosis. Agreement between the diagnoses was assessed. Good agreement, ranging from 86.6% to 91.6%, was achieved between direct observation and teleconsultation. Good agreement was also achieved between two telemedicine diagnosis (Kappa = 0.62). Teledermatology is a form of care with great potential for use in dermatology, and could represent a useful tool in cases of low complexity from primary health units.Anais brasileiros de dermatologia 10/2009; 84(5):489-93.
