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1.
Medicine (Baltimore) ; 99(26): e20895, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590799

RESUMO

INTRODUCTION: In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia. PATIENT CONCERNS: This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity. DIAGNOSES: Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye. INTERVENTIONS: In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed. OUTCOMES: After surgery, the patient's visual acuity improved in both eyes. CONCLUSION: The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.


Assuntos
Anormalidades do Olho/cirurgia , Vitrectomia/métodos , Anormalidades do Olho/complicações , Feminino , Humanos , Japão , Pessoa de Meia-Idade , Miopia/etiologia , Miopia/fisiopatologia , Microscopia com Lâmpada de Fenda/métodos , Tomografia de Coerência Óptica/métodos
2.
Medicine (Baltimore) ; 99(23): e20410, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501987

RESUMO

BACKGROUND: Myopia is a common visual disorder which has become a public health problem worldwide. Myopia and high myopia are substantial risk factors for severe visual impairment and other serious eye diseases. Acupuncture used to prevent and control myopia is a common practice in China, but it is controversial in other countries. This study aims to evaluate the efficacy and safety of acupuncture in delaying the progression of myopia in children and adolescents through systematic evaluation. METHODS AND ANALYSIS: The following electronic databases will be searched from inception to November 2019 regardless of publication status and language: Medline, EMBASE, Web of Science, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Chinese Scientific Journal Database (VIP), Wanfang Database, Chinese Biomedical Literature Database (CBLD), Chinese Science and Technology Periodical Database (CSTPD). RCT registration websites, including http://www.ClinicalTrials.gov and http://www.chictr.org.cn, will also be searched. Review Manager V.5.3 will be used to analysis the statistic. Two reviewers (ZY and XW) will independently select studies, extract and code the data, assess risk of bias of the included studies, evaluate the quality of evidence for outcomes. RESULTS: This study will provide a rational synthesis of current evidences for acupuncture to delay the progression for myopia in children and adolescents. CONCLUSION: The conclusion of this study will provide evidence for evaluating the efficacy and safety of acupuncture to delay the progression for myopia in children and adolescents.


Assuntos
Terapia por Acupuntura/normas , Miopia/terapia , Segurança do Paciente/normas , Terapia por Acupuntura/métodos , Terapia por Acupuntura/estatística & dados numéricos , Protocolos Clínicos , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
4.
BMC Med Genet ; 21(1): 93, 2020 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375772

RESUMO

BACKGROUND: Pathogenic SLC6A1 variants have been reported in patients with myoclonic-atonic epilepsy (MAE). NOTCH1, encoding a member of the Notch family of proteins, is known to be associated with aortic valve disease. The PRIMPOL variant has only been identified in Chinese patients with high myopia. Exome sequencing analysis now allows the simultaneous detection of multiple genetic etiologies for patients with complicated clinical features. However, the presence of three Mendelian disorders in one patient supported by their respective pathogenic variants and clinical phenotypes is very rare. CASE PRESENTATION: Here, we report a 4-year-old Chinese boy who presented with MAE, delayed language, borderline intellectual disability (ID), mildly impaired social skills and attention deficit hyperactivity disorder (ADHD). He also had mild aortic valve stenosis and high myopia. Using whole-exome sequencing (WES), we identified three variants: (1) SLC6A1, NM_003042.4: c.881-883del (p.Phe294del), (2) NOTCH1, NM_017617.5:c.1100-2A > G and (3) PRIMPOL, NM_152683.4:c.265 T > G (p.Tyr89Asp). Parental Sanger sequencing confirmed that SLC6A1 and NOTCH1 variants were de novo, whereas the PRIMPOL variant was inherited from the father who also had high myopia. Furthermore, the PRIMPOL variant was absent from the genomes of the paternal grandparents, and thus was also a de novo event in the family. All three variants are classified as pathogenic. CONCLUSION: The SLC6A1 variant could explain the features of MAE, delayed language, borderline ID, impaired social skills and ADHD in this patient, whereas the features of aortic valve stenosis and high myopia of the patient may be explained by variants in NOTCH1 and PRIMPOL, respectively. This case demonstrated the utility of exome sequencing in uncovering the multiple pathogenic variants in a patient with complicated phenotypes due to the blending of three Mendelian disorders.


Assuntos
Epilepsias Mioclônicas/genética , Epilepsia Generalizada/genética , Predisposição Genética para Doença , Miopia/genética , Estenose da Valva Aórtica/genética , Estenose da Valva Aórtica/patologia , Pré-Escolar , DNA Primase/genética , DNA Polimerase Dirigida por DNA/genética , Epilepsias Mioclônicas/patologia , Epilepsia Generalizada/patologia , Proteínas da Membrana Plasmática de Transporte de GABA/genética , Testes Genéticos , Humanos , Deficiência Intelectual/genética , Deficiência Intelectual/patologia , Masculino , Enzimas Multifuncionais/genética , Mutação/genética , Miopia/patologia , Receptor Notch1/genética , Sequenciamento Completo do Exoma
7.
PLoS One ; 15(4): e0231011, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32282799

RESUMO

PURPOSE: There is a strong association between severe hyperhomocysteinemia and myopia. Thus we studied the hypothesis that even moderately increased levels of homocysteine (Hcy) might be a potentially treatable risk factor for myopia. METHODS: The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74 at recruitment. The baseline examination was conducted from 2007-2012. Refraction was measured using autorefraction (HARK 599, Carl Zeiss AG, Jena, Germany). Hcy was measured by an immunoassay. We included only phakic participants without a history of corneal surgery or corneal laser treatment. We used linear regression models to evaluate the potential association between Hcy and refraction at baseline, and between Hcy and change in refraction between baseline and 5-year-follow-up examination. We used generalized estimating equation models to account for the correlation between fellow eyes. RESULTS: We included 13,749 participants, categorized as having no myopia (spherical equivalent > -0.75 D, 65.2%), low myopia (-0.75 D--2.75 D, 21.5%), moderate myopia (-3.00 D- 5.75 D, 9.8%) and high myopia (≤ -6 D, 3.5%). Median Hcy levels were similar in all groups (µmol/l). We observed no association of Hcy with refraction or 5-year change in refraction in the models adjusted for age, sex and socioeconomic status. CONCLUSION: We found no evidence for an association of Hcy levels and refractive error.


Assuntos
Homocisteína/sangue , Erros de Refração/sangue , Adulto , Idoso , Feminino , Alemanha , Humanos , Hiper-Homocisteinemia/sangue , Hiper-Homocisteinemia/complicações , Masculino , Pessoa de Meia-Idade , Miopia/sangue , Miopia/etiologia , Estudos Prospectivos , Fatores de Risco
8.
Medicine (Baltimore) ; 99(17): e19531, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332602

RESUMO

To observe the effectiveness and complications of inverted internal limiting membrane insertion through 25-G minimally invasive vitrectomy assisted with autologous blood adhesion fixation and combined with gas tamponade type-II macular hole retinal detachment in pathologic myopia.This was a retrospective study. The best-corrected visual acuity, intraocular pressure, macular hole closure, retinal reattachment, and systemic and ocular adverse events were observed.Twenty-three eyes were operated. Best-corrected visual acuity before surgery and at 3 and 6 months were 2.25 ±â€Š0.47, 1.85 ±â€Š0.32, and 1.32 ±â€Š0.36 LogMAR (P < .001). On days 2 to 5, all the retinas reattached, and the macular holes closed. On days 5 to 9, 5 eyes showed increased intraocular pressure. At 2 and 4 months, 2 eyes showed retinal detachment recurrence. No serious systemic or ocular adverse events were observed.This surgical technique showed clinical benefits and no significant complications. Clinical trials are necessary to confirm efficacy and safety.


Assuntos
Miopia/epidemiologia , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/epidemiologia , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Fatores Etários , Idoso , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Fatores Sexuais , Tomografia de Coerência Óptica , Acuidade Visual
9.
Mol Genet Genomics ; 295(4): 843-853, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32227305

RESUMO

Genome-wide association studies (GWAS) have revealed that the genetic contribution to certain complex diseases is well-described by Fisher's infinitesimal model in which a vast number of polymorphisms each confer a small effect. Under Fisher's model, variants have additive effects both across loci and within loci. However, the latter assumption is at odds with the common observation of dominant or recessive rare alleles responsible for monogenic disorders. Here, we searched for evidence of non-additive (dominant or recessive) effects for GWAS variants known to confer susceptibility to the highly heritable quantitative trait, refractive error. Of 146 GWAS variants examined in a discovery sample of 228,423 individuals whose refractive error phenotype was inferred from their age-of-onset of spectacle wear, only 8 had even nominal evidence (p < 0.05) of non-additive effects. In a replication sample of 73,577 individuals who underwent direct assessment of refractive error, 1 of these 8 variants had robust independent evidence of non-additive effects (rs7829127 within ZMAT4, p = 4.76E-05) while a further 2 had suggestive evidence (rs35337422 in RD3L, p = 7.21E-03 and rs12193446 in LAMA2, p = 2.57E-02). Accounting for non-additive effects had minimal impact on the accuracy of a polygenic risk score for refractive error (R2 = 6.04% vs. 6.01%). Our findings demonstrate that very few GWAS variants for refractive error show evidence of a departure from an additive mode of action and that accounting for non-additive risk variants offers little scope to improve the accuracy of polygenic risk scores for myopia.


Assuntos
Estudo de Associação Genômica Ampla , Miopia/genética , Característica Quantitativa Herdável , Erros de Refração/genética , Adulto , Idoso , Bancos de Espécimes Biológicos , Feminino , Genes Dominantes/genética , Predisposição Genética para Doença , Variação Genética/genética , Humanos , Laminina/genética , Masculino , Pessoa de Meia-Idade , Herança Multifatorial/genética , Miopia/patologia , Polimorfismo de Nucleotídeo Único/genética , Erros de Refração/patologia
10.
PLoS One ; 15(4): e0227240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298265

RESUMO

This study examined and compared outcomes of deep learning (DL) in identifying swept-source optical coherence tomography (OCT) images without myopic macular lesions [i.e., no high myopia (nHM) vs. high myopia (HM)], and OCT images with myopic macular lesions [e.g., myopic choroidal neovascularization (mCNV) and retinoschisis (RS)]. A total of 910 SS-OCT images were included in the study as follows and analyzed by k-fold cross-validation (k = 5) using DL's renowned model, Visual Geometry Group-16: nHM, 146 images; HM, 531 images; mCNV, 122 images; and RS, 111 images (n = 910). The binary classification of OCT images with or without myopic macular lesions; the binary classification of HM images and images with myopic macular lesions (i.e., mCNV and RS images); and the ternary classification of HM, mCNV, and RS images were examined. Additionally, sensitivity, specificity, and the area under the curve (AUC) for the binary classifications as well as the correct answer rate for ternary classification were examined. The classification results of OCT images with or without myopic macular lesions were as follows: AUC, 0.970; sensitivity, 90.6%; specificity, 94.2%. The classification results of HM images and images with myopic macular lesions were as follows: AUC, 1.000; sensitivity, 100.0%; specificity, 100.0%. The correct answer rate in the ternary classification of HM images, mCNV images, and RS images were as follows: HM images, 96.5%; mCNV images, 77.9%; and RS, 67.6% with mean, 88.9%.Using noninvasive, easy-to-obtain swept-source OCT images, the DL model was able to classify OCT images without myopic macular lesions and OCT images with myopic macular lesions such as mCNV and RS with high accuracy. The study results suggest the possibility of conducting highly accurate screening of ocular diseases using artificial intelligence, which may improve the prevention of blindness and reduce workloads for ophthalmologists.


Assuntos
Neovascularização de Coroide/diagnóstico , Aprendizado Profundo , Interpretação de Imagem Assistida por Computador/métodos , Miopia/diagnóstico , Retinosquise/diagnóstico , Adulto , Idoso , Cegueira/prevenção & controle , Corioide/diagnóstico por imagem , Neovascularização de Coroide/complicações , Conjuntos de Dados como Assunto , Diagnóstico Diferencial , Feminino , Humanos , Macula Lutea/diagnóstico por imagem , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Miopia/etiologia , Curva ROC , Retinosquise/complicações , Índice de Gravidade de Doença , Tomografia de Coerência Óptica
11.
Nat Genet ; 52(4): 401-407, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32231278

RESUMO

Refractive errors, in particular myopia, are a leading cause of morbidity and disability worldwide. Genetic investigation can improve understanding of the molecular mechanisms that underlie abnormal eye development and impaired vision. We conducted a meta-analysis of genome-wide association studies (GWAS) that involved 542,934 European participants and identified 336 novel genetic loci associated with refractive error. Collectively, all associated genetic variants explain 18.4% of heritability and improve the accuracy of myopia prediction (area under the curve (AUC) = 0.75). Our results suggest that refractive error is genetically heterogeneous, driven by genes that participate in the development of every anatomical component of the eye. In addition, our analyses suggest that genetic factors controlling circadian rhythm and pigmentation are also involved in the development of myopia and refractive error. These results may enable the prediction of refractive error and the development of personalized myopia prevention strategies in the future.


Assuntos
Predisposição Genética para Doença/genética , Miopia/genética , Erros de Refração/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Estudo de Associação Genômica Ampla/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética
14.
15.
PLoS One ; 15(3): e0229867, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134980

RESUMO

PURPOSE: To estimate the central 10-degree visual field of glaucoma patients using en-face images obtained by optical coherence tomography (OCT), and to examine its usefulness. PATIENTS AND METHODS: Thirty-eight eyes of 38 patients with primary open angle glaucoma were examined. En-face images were obtained by swept-source OCT (SS-OCT). Nerve fiber bundles (NFBs) on en-face images at points corresponding to Humphrey Field Analyzer (HFA) 10-2 locations were identified with retinal ganglion cell displacement. Estimated visual fields were created based on the presence/absence of NFBs and compared to actual HFA10-2 data. κ coefficients were calculated between probability plots of visual fields and NFBs in en-face images. RESULTS: Actual HFA10-2 data and estimated visual fields based on en-face images were well matched: when the test points of <5%, <2%, and <1% of the probability plot in total deviation (TD) and pattern deviation (PD) of HFA were defined as points with visual field defects, the κ coefficients were 0.58, 0.64, and 0.66 in TD, respectively, and 0.68, 0.69, and 0.67 in PD. In eyes with spherical equivalent ≥ -6 diopters, κ coefficients for <5%, <2%, and <1% were 0.58, 0.62, and 0.63 in TD and 0.66, 0.67, and 0.65 in PD, whereas for the myopic group with spherical equivalent < -6 diopters, the values were 0.58, 0.69, and 0.71 in TD and 0.72, 0.71, and 0.71 in PD, respectively. There was no statistically significant difference in κ coefficients between highly myopic eyes and eyes that were not highly myopic. CONCLUSIONS: NFB defects in en-face images were correlated with HFA10-2 data. Using en-face images obtained by OCT, the central 10-degree visual field was estimated, and a high degree of concordance with actual HFA10-2 data was obtained. This method may be useful for detecting functional abnormalities based on structural abnormalities.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos , Campos Visuais , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico por imagem , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Adulto Jovem
16.
PLoS One ; 15(3): e0230119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163466

RESUMO

OBJECTIVE: To elucidate the relationship between lipid layer thickness (LLT), incomplete blinking rate and tear film stability in patients with different myopia degrees after small-incision lenticule extraction (SMILE) and to determine whether there is a difference in the prevalence of dry eye disease (DED) after SMILE among patients with different myopia degrees. METHODS: Fifty patients (100 eyes) were enrolled in this study; they were divided into 3 groups according to the degree of spherical refraction: a low-myopia group (LMG; spherical refraction ≤-3.00 D, 20 eyes), a moderate-myopia group (MMG; -3.00 D < spherical refraction <-6.00 D, 40 eyes), and a high-myopia group (HMG; spherical refraction ≧-6.00 D, 40 eyes). Testing indicators included the ocular surface disease index (OSDI), fluorescein tear film breakup time (FBUT), corneal fluorescence staining (CFS), the Schirmer test (SI), lipid layer thickness (LLT), blink rate (BR) per 20 seconds, incomplete blinking rate, noninvasive keratograph assessment of first and average tear film breakup time (NIKBUTf, NIKBUTav), and tear meniscus height (TMH). Each indicator was evaluated preoperatively and postoperatively at 1 w, 1 mo and 3 mo. RESULTS: The mean age was 29.12±5.95 years. There were no significant differences among the three groups (p>0.05), except preoperative age (p = 0.006). There were significant differences in the FBUT among the three groups at postoperative 1 w and 1 mo (p<0.05). There were significant differences in the incomplete blinking rate and FBUT between the LMG and the HMG at postoperative 1 mo (p<0.05). The number of first tear film breakup points located beyond the 6 mm diameter of the cornea was higher in the HMG than in the other groups. The prevalence of DED in the LMG, the MMG, the HMG was 15%, 8% and 23%, respectively, at 1 w postoperative and 30%, 45% and 53%, respectively, at postoperative 1 mo. The change in LLT was significantly correlated with the changes in FBUT (r = 0.408, p<0.001) and incomplete blinking rate (r = -0.266, p = 0.007). The change in OSDI was negatively correlated with the change in SI (r = -0.502, p = 0.000). CONCLUSIONS: The changes in LLT and incomplete blinking rate decreased the stability of the tear film. The changes in LLT, FBUT and incomplete blinking rate differed postoperatively with different myopia degrees. The prevalence of DED was higher in the HMG than in the other two groups.


Assuntos
Piscadela/fisiologia , Córnea/cirurgia , Lipídeos/química , Miopia/patologia , Lágrimas/fisiologia , Adulto , Córnea/fisiologia , Síndromes do Olho Seco/complicações , Síndromes do Olho Seco/epidemiologia , Síndromes do Olho Seco/patologia , Feminino , Humanos , Lasers de Excimer , Masculino , Microcirurgia/métodos , Miopia/complicações , Período Pós-Operatório , Prevalência , Índice de Gravidade de Doença
17.
Invest Ophthalmol Vis Sci ; 61(3): 37, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32196099

RESUMO

Purpose: To investigate the relationship between sleep duration and bedtime with myopia progression and axial elongation during a 4-year follow-up in primary school children. Methods: This study included 1887 children (aged 7.09 ± 0.41 years) who had cycloplegic refractions data at baseline and a fourth visit and 2209 children (aged 7.10 ± 0.41 years) for axial length. All children underwent comprehensive ophthalmologic examinations, including cycloplegic refraction and ocular biometry, and standardized questionnaires, including average night-time sleep duration (h/d) and bedtime (time to bed). Myopia was defined as spherical equivalent < -0.5 diopters. Results: At the last follow-up, the mean myopia progression and axial elongation for all children were -1.89 ± 1.28 diopters and 1.22 ± 0.57 mm. After stratifying the sleep duration into tertile groups, myopia progression and axial elongation were slower in children with highest sleep duration tertile (P = 0.04 and P =0.014) in girls but not in boys, compared with the middle sleep duration tertile. However, after adjusting for potential confounders, no significant association was found for sleep duration with myopia progression and axial elongation for the children (P = 0.255 and P = 0.068), and the association with axial elongation was only of borderline significance in girls (P = 0.045). The bedtime was not associated with myopia progression and axial elongation in the regression analyses (P = 0.538; P = 0.801). Conclusions: These results show that there was no significant association between sleep duration and bedtime with myopia progression and axial elongation among children. The findings in girls might be related to the earlier onset of puberty.


Assuntos
Grupo com Ancestrais do Continente Asiático/etnologia , Miopia/diagnóstico , Sono/fisiologia , Comprimento Axial do Olho/patologia , Criança , Pré-Escolar , China/epidemiologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Miopia/etnologia , Miopia/fisiopatologia , Refração Ocular/fisiologia , Fatores de Risco , Inquéritos e Questionários
19.
20.
Invest Ophthalmol Vis Sci ; 61(3): 19, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32176269

RESUMO

Purpose: The purpose of this study was to analyze the clinical features of dome-shaped macula (DSM) in highly myopic eyes and its morphological relationship with myopic retinoschisis (MRS). Methods: In this cross-sectional study, 409 eyes of 409 patients with high myopia who had spectral-domain optical coherence tomography (OCT) examinations were included. The associations of DSM with the distribution of MRS and ocular biometry were evaluated. Results: Of 409 eyes, DSM was detected in 64 eyes (15.6%). The eyes with DSM were more myopic (-18.8 ± 3.9 vs. -13.4 ± 5.9; P < 0.001) and had longer axial length (31.7 ± 2.4 vs. 29.5 ± 2.5; P < 0.001) compared with those without DSM. A higher rate of extrafoveal retinoschisis (35.9% vs. 9.6%; P < 0.001) and a lower rate of foveoschisis (10.9% vs. 26.1%; P = 0.01) were detected in the eyes with DSM compared with those without DSM. In the eyes with DSM, MRS was detected in 30 eyes (46.9%). MRS predominantly affected the extrafoveal area (76.7%), especially the base of the dome (82.6%). The extrafoveal retinoschisis was most frequently distributed in the superior quadrant (52.2%). None of the eyes with DSM displayed fovea-only retinoschisis. The ratio of the height and width of the macular bulge was higher in eyes with MRS than those without MRS (0.05 vs. 0.04; P = 0.001). Conclusions: A DSM is found in highly myopic eyes with a longer axial length. MRS in eyes with DSM is more likely to affect the extrafoveal area, especially the base of the dome. A steeper macular bulge is associated with the occurrence of MRS.


Assuntos
Macula Lutea/patologia , Miopia/complicações , Retinosquise/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biometria/métodos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Macula Lutea/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico por imagem , Miopia/patologia , Retinosquise/diagnóstico por imagem , Retinosquise/patologia , Tomografia de Coerência Óptica/métodos , Adulto Jovem
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