RESUMO
Cerebral malaria (CM) is a significant cause of mortality and morbidity in sub-Saharan Africa, particularly among young children. Malarial retinopathy is the most specific clinical finding in CM, and fundus examination could help clinicians distinguish CM from other causes of encephalopathy in resource-poor areas. To assess clinician knowledge, practice patterns, and barriers to the use of funduscopy in the diagnosis of CM, we designed a descriptive multinational survey of clinicians in malaria endemic areas. Results of this survey showed that 19% of respondents were not aware of the utility of eye examinations for malarial retinopathy, and almost half (49%) never or almost never examine the eyes in cases of suspected CM. Educating clinicians about malarial retinopathy could be important in improving diagnostic specificity for CM.
Assuntos
Malária Cerebral/diagnóstico , Oftalmoscópios/estatística & dados numéricos , Padrões de Prática Médica/tendências , Ásia , Consenso , Humanos , Internacionalidade , Malária Cerebral/fisiopatologia , Oftalmoscópios/tendências , Inquéritos e QuestionáriosAssuntos
Doença de Alzheimer/diagnóstico , Microscopia Confocal/tendências , Oftalmoscópios/tendências , Doenças do Nervo Óptico/diagnóstico , Nervo Óptico/patologia , Nervo Óptico/fisiopatologia , Doença de Alzheimer/complicações , Doença de Alzheimer/fisiopatologia , Biomarcadores/análise , Humanos , Microscopia Confocal/métodos , Degeneração Neural/diagnóstico , Degeneração Neural/etiologia , Degeneração Neural/fisiopatologia , Doenças do Nervo Óptico/etiologia , Doenças do Nervo Óptico/fisiopatologia , Valor Preditivo dos Testes , Degeneração Retiniana/diagnóstico , Degeneração Retiniana/etiologia , Degeneração Retiniana/fisiopatologia , Células Ganglionares da Retina/patologiaRESUMO
In 1851 Helmholtz introduced the ophthalmoscope. The instrument allowed the observation of light reflected at the fundus. The development of this device was one of the major advancements in ophthalmology. Yet ophthalmoscopy allows only qualitative observation of the eye. Since 1950 attempts were made to address the challenging, quantitative assessment of the amount of light reflected by the fundus. At first, only comparative measurements were possible, applied in the study of macular and visual pigments. With improvements in light detecting techniques, and with the advent of microprocessors, the measurement of spectral and spatial distribution of the reflectance became feasible. This led to the development of models that explained the observed wavelength dependence and the directional behavior of light reflected from the fovea. The models allowed a quantitative assessment of many parameters on absorption and reflection by structures in the human eye. This paper provides a review of both the experimental and theoretical progress, and summarizes the results of fundamental and clinical research using fundus reflectometry.
Assuntos
Técnicas de Diagnóstico Oftalmológico , Oftalmologia/instrumentação , Oftalmoscópios , Técnicas de Diagnóstico Oftalmológico/história , Olho/anatomia & histologia , Oftalmopatias/diagnóstico , Oftalmopatias/fisiopatologia , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Modelos Biológicos , Fenômenos Fisiológicos Oculares , Oftalmologia/métodos , Oftalmoscópios/história , Oftalmoscópios/tendências , Espectrofotometria/métodosRESUMO
Con la llegada del nuevo milenio el oftalmoscopio directo habrá cumplido 150 años de su creación. A pesar de ser una herramienta importante para el exámen de pacientes de cualquier edad, sigue siendo subutilizado por médicos generales y especialistas. Nuestro objetivo es dar a pediatras y médicos no oftalmólogos argumentos y claves para incluir rutinariamente la oftalmoscopia directa en el exámen inicial de sus pacientes