Browsing by Author "Papoila, Ana Luísa"
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- Corneal subbasal nerve plexus evaluation by in vivo confocal microscopy in multiple sclerosis: a potential new biomarkerPublication . Fernandes, Diogo; Luís, Maria; Cardigos, Joana; Xavier, Catarina; Alves, Marta; Papoila, Ana Luísa; Cunha, João Paulo; Ferreira, Joana CorreiaPurpose/Aim: Our study aims to evaluate corneal subbasal nerve plexus morphology by in vivo corneal confocal microscopy (CCM) in Multiple Sclerosis (MS) patients and to explore its potential ability to distinguish between MS patients and healthy subjects. Materials and methods: Cross-sectional study, including 60 MS patients and 22 healthy subjects. Expanded Disability Status Scale (EDSS) was used to assess neurological disability. All participants underwent full ophthalmology evaluation, CCM and optical coherence tomography (OCT). Corneal nerve fibre density (CNFD), branch density (CNBD), fibre length (CNFL) and fibre tortuosity (CNFT) were analysed. Generalized additive regression models were used to analyse the data. Results: Compared to controls, MS patients had lower CNFD, CNBD and CNFL (p < .001) and higher CNFT (p = .002). The area under the ROC curve to distinguish MS patients from healthy controls with CNFD and CNBD was 0.84 (95%CI: 0.75 to 0.93; 95%CI: 0.75 to 0.92, respectively). A nonlinear association between EDSS and CNFD was found, with an initial density increase followed by a significant decrease until more severe disability status. EDSS was associated with CNFL and CNBD, with values being significantly lower for patients with an EDSS > 2.5 (-2.06 mm/mm2; 95%CI: -3.84 to -0.28; p = .027 and -8.70 branches/mm2; 95%CI: -14.69 to -2.71; p = .006, respectively). Optic neuritis (ON) history did not influence CCM parameters. Conclusions: Our results confirm CCM parameters' potential to differentiate MS patients from healthy subjects, not being influenced by a previous ON history. A significant relationship between the patient's disability and corneal nerve morphology was also found.
- Retinal structural changes in preterm children without retinopathy of prematurityPublication . Maleita, Diogo; Serras-Pereira, Rita; Passos, Inês; Elisa-Luís, Maria; Alves, Marta; Papoila, Ana Luísa; Brito, Cristina; Cunha, João Paulo; Ferreira, Joana TavaresPurpose: The aim of this study was to compare all retinal layers' thickness in full-term and preterm children without retinopathy of prematurity (ROP). Methods: Cross-sectional study including two groups of patients: group 1 children with a history of preterm gestation without ROP (gestational age < 37 weeks) and group 2 healthy children with a history of full-term gestation. All subjects underwent an ophthalmic examination including spectral domain-optical coherence tomography. After automatic retinal segmentation, each retinal layer thickness (eight separate layers and overall thickness) was calculated in all nine Early Treatment Diabetic Retinopathy Study areas. Demographic, systemic, gestational, and birth data were collected. Generalized additive regression models were used to analyze the data. Results: Fifty-one children (51 eyes) were recruited, 19 full-term and 32 preterm children, mean age at an ophthalmic examination of 10.58 (4.21) and 14.13 (3.16), respectively. In multivariable analysis, the preterm group's retinal thickness was significantly decreased in total retina nasal outer sector, ganglion cell layer (GCL), and inner plexiform layer (IPL), specifically GCL temporal outer (p = 0.010), GCL superior outer (p = 0.009), IPL temporal outer (p = 0.022), and IPL superior outer (p = 0.004), when compared with the full-term group. From the variables compared only with a birth head circumference that influenced the models, a non-linear association was identified and consequently modeled with splines through a generalized additive model. Conclusion: This study suggests that preterm children without ROP have structural retinal alterations, mostly in GCL and IPL in outer areas of the macula. Therefore, it is crucial to question gestational history since these retinal changes may be found later in life leading to a useless investigation.