Bakgrund: Diabetes är en av de främsta orsakerna till synnedsättning och blindhet. Dåförekomsten av diabetes ökar utgör de synrelaterade komplikationerna ett växande globalt hälsoproblem. En ökad förståelse för hur personer med diabetesretinopati upplever att synnedsättning påverkar deras dagliga kan vara till stor hjälp i mötet med dessa personer. Syfte:Syftet med studien var att beskriva personers upplevelser av att leva med diabetesretinopati. Metod: Studien genomfördes som en allmän litteraturstudie. Vetenskapliga, empiriska studier med kvalitativ och kvantitativ ansats ligger till grund för studien. Resultat: Studiens resultat redovisas utifrån tre olika teman: känsla av delaktighet, känsla av begränsningar och känsla av otillräcklighet. Diskussion: Sjuksköterskan bör vara professionell i mötet med patienten. Kommunikation, undervisning och en helhetssyn av personens upplevelse av sin livssituation ligger till grund för personens vård och behandling. Det är viktigt med hälsofrämjande insatser för att kunna förebygga komplikationer. / Background: Diabetes is one of the leading causes of vision loss and blindness. Since the prevalence of diabetes is increasing, the sight-related complications are a growing global health problem. A better understanding of how people with diabetic retinopathy are experiencing vision loss that affects their daily may be helpful in meeting with these people. Purpose: The purpose of this study was to describe people's experiences of living with diabetic retinopathy. Method: The study was conducted as a general literature review. Scientific, empirical studies using qualitative and quantitative approach is the basis for the study. Results: The results are reported from three different themes: sense of ownership, sense of limitations and feelings of inadequacy. Discussions: Nurse should be professional in the meeting with the patient. Communication, education and a holistic view of the person's experience of their lives is the basis for the person's care and treatment. It is important with health promotion efforts to prevent complications.

Objectif : L'évaluation de l'acuité visuelle (AV) chez la personne âgée atteinte de troubles cognitifs peut être limitée par le manque de collaboration ou les difficultés de communication du patient. Très peu d'études ont examiné l'AV chez les patients atteints de déficits sévères de la cognition. L’objectif de cette étude était d’évaluer l'AV chez la personne âgée vulnérable ayant des troubles cognitifs à l'aide d'échelles variées afin de vérifier leur capacité à répondre à ces échelles. Méthodes: Trois groupes de 30 sujets chacun ont été recrutés. Le premier groupe était constitué de sujets jeunes (Moy.±ET: 24.9±3.5ans) et le second, de sujets âgés (70.0±4.5ans), ne présentant aucun trouble de la cognition ou de la communication. Le troisième groupe, composé de sujets atteints de démence faible à sévère (85.6±6.9ans), a été recruté au sein des unités de soins de longue durée de l’Institut Universitaire de Gériatrie de Montréal. Le test du Mini-Mental State Examination (MMSE) a été réalisé pour chaque sujet afin de déterminer leur niveau cognitif. L’AV de chaque participant a été mesurée à l’aide de six échelles validées (Snellen, cartes de Teller, ETDRS-lettres,-chiffres,-Patty Pics,-E directionnel) et présentées selon un ordre aléatoire. Des tests non paramétriques ont été utilisés afin de comparer les scores d’AV entre les différentes échelles, après une correction de Bonferroni-Holm pour comparaisons multiples. Résultats: Le score moyen au MMSE chez les sujets atteints de démence était de 9.8±7.5, alors qu’il était de 17.8±3.7 et 5.2±4.6 respectivement, chez les sujets atteints de démence faible à modérée (MMSE supérieur ou égal à 13; n=11) et sévère (MMSE inférieur à 13; n=19). Tous les sujets des groupes 1 et 2 ont répondu à chacune des échelles. Une grande majorité de sujets avec démence ont répondu à toutes les échelles (n=19) alors qu’un seul sujet n’a répondu à aucune échelle d’AV. Au sein du groupe 3, les échelles d’AV fournissant les scores les plus faibles ont été les cartes de Teller (20/65) et les Patty Pics (20/62), quelque soit le niveau cognitif du sujet, alors que les meilleurs scores d’AV ont été obtenus avec les échelles de Snellen (20/35) et les lettres ETDRS (20/36). Une grande proportion de sujets avec démence sévère ont répondu aux cartes de Teller (n=18) mais le score d’AV obtenu était le plus faible (20/73). Au sein des trois groupes, l’échelle de lettres-ETDRS était la seule dont les scores d’AV ne différaient pas de ceux obtenus avec l’échelle de Snellen traditionnelle. Conclusions: L’acuité visuelle peut être mesurée chez la personne âgée atteinte de troubles cognitifs ou de la communication. Nos résultats indiquent que les échelles les plus universelles, utilisant des lettres comme optotypes, peuvent être utilisées avec de bons résultats chez les personnes âgées atteintes de démence sévère. Nos résultats suggèrent de plus que la mesure d’acuité visuelle doit être tentée chez toutes les personnes, peu importe leur niveau cognitif. / Purpose: The evaluation of visual acuity (VA) in cognitively impaired older individuals may be limited by a reduced ability to cooperate or communicate. To date, no study has been performed to guide the clinician as to which VA chart to use in older individuals with moderate to severe dementia. This is important knowing that dementia affects more than 30% of seniors above 85 yrs of age, many of whom will be affected by the most severe stages of the disease. The objective of this research was to assess VA in older institutionalized individuals with moderate to severe dementia, using various acuity charts, and to verify their ability to respond to each of these charts. Methods: Three groups of 30 subjects each were recruited. The first group consisted of young subjects (Avg ± SD: 24.9 ± 3.5 yrs) and the second one, older subjects (70.0 ± 4.5 yrs) with no history of cognitive or communication disorders. The third group (85.6 ± 6.9 yrs) included subjects with mild to severe dementia residing in long-term care units. The Mini Mental-State Examination (MMSE) was performed for each institutionalized subject to verify their cognitive level. The VA of each participant was measured using six validated VA charts (Snellen, Teller cards, ETDRS-letters, -numbers, -Patty Pics, -Tumbling E's) presented in random order. Non parametric tests were used to compare VA scores obtained between the various charts, after Bonferroni-Holm corrections for multiple comparisons Results: The average MMSE scores of subjects with dementia was 9.8 ± 7.5, while it was 17.8 ± 3.7 and 5.2 ± 4.6, for those with mild to moderate (MMSE ≥ 13; n=11) and severe (MMSE < 13; n= 19) dementia. All subjects in groups 1 and 2 responded to each of the charts. A large proportion of subjects with dementia responded to all charts (n= 19) while only one did not respond to any chart. In group 3, VA charts with the lowest scores were the Teller cards (20/65) and Patty Pics (20/62), regardless of the level of dementia, while the best VA scores were obtained with the Snellen (20/35) and ETDRS-letter (20/36) charts. More subjects with severe dementia responded to the Teller cards (n= 18) but the VA obtained was the lowest (20/73). Across all groups, the ETDRS-letter chart was the only one whose scores did not differ from those obtained with the standard Snellen chart. Time to read the letter charts was faster than for the other optotypes. Conclusions: Visual acuity can be measured, and should at least be attempted, in older cognitively impaired individuals having a reduced ability to communicate. Our results indicate that the most universal scales, using letters as optotypes, can be used with good results in people with more severe dementia. Testing requires, however, more time and encouragement in individuals with more severe cognitive deficits in order to obtain and maintain their collaboration.

Functional vision refers to the use of vision to perform day-day tasks and is assessed by the ability to perform these tasks. Assessment of functional vision is an integral component of the management of children with visual impairment. The results of the assessment help in designing appropriate educational and rehabilitation intervention strategies. The L V Prasad-Functional Vision Questionnaire (LVP-FVQ) is a reliable and valid tool for assessing self-reported functional vision performance (FVP) in children. Self-reports are obviously the child's perception of his or her ability to perform certain tasks but they may not reflect actual performance. Various studies of FVP in adults have used actual performance measures of everyday tasks, but very few studies, even in adults with visual impairment, have compared self-reports and performance measures and none have included identical tasks on the 2 methods of assessment. To date, no study has assessed FVP using performance measures of daily tasks in the paediatric population. Therefore, the aims of the current study were: (1) To develop performance measures of FVP and compare them with self-reports of FVP from the LVP-FVQ in a prospective cohort of Indian school-going children with visual impairment. (2) To investigate the effect of a psychological attribute, self-concept, on self-reports, performance measures and the relationships between the 2 measures. (3) To investigate the relationship between clinical measures of vision and FVP. Performance measures of FVP for children with visual impairment were developed for 17 day to day tasks for comparison with self-reports of the same tasks for the LVP-FVQ. The LVP-FVQ was verbally administered by the researcher to 178 Indian school-going children aged between 8 and 17 years with visual impairment. Similarly, the performance of each of the tasks by these children was measured by the researcher. The performance measures for most of these tasks were recorded on continuous scales and later categorized to match the ordinal ratings from the LVP-FVQ. The self-report and performance measure ratings for the 17 tasks were then converted into the same metric using a Rasch model allowing an accurate picture of whether and how these two measures of FVP compared with each other. Rasch analysis was used to estimate the person ability and item difficulty for FVP from the 2 methods of assessment. Self-reports showed stronger correlations with performance measures of FVP than were hypothesized. Similar to some studies in adults, binocular high-contrast visual acuity was found to be the single most significant predictor of a child's functional vision performance. Contrary to expectations, self-concept did not have a significant effect on the relationship between the 2 measures. A few reasons for the stronger than expected relationship between the 2 methods of assessment of FVP in children with visual impairment are suggested. Firstly, the use of identical tasks for self-reports and performance measures of FVP is likely to improve the relationship. Secondly, the LVP-FVQ was developed using focus groups of children with visual impairment, their parents, low vision specialists and rehabilitation professionals leading to good content validity. Since children were included in the development of the LVP-FVQ, the tasks were representative of a child's typical daily life. Thus, the performance measures were also suited to the day-day tasks of school-going children but were not tapping any social and psychological issues relating to visual impairment. Thirdly, the use of Rasch analysis which addresses many of the issues of unequal measurement and defines a hierarchy of items for self-reports and performance measures could have led to higher correlations in the present study. Finally, the high reliability and validity of self-reports and performance measures of FVP in the present study may have contributed to the higher than expected correlations. None of the demographic variables or self-concept affected the relationship between self-reports and performance measures of FVP, but self-concept had a weak significant association with self-reports. This result is unique to this study and warrants further investigation. Binocular high-contrast visual acuity alone, the most common visual function measured in ophthalmic clinics, explained between one-third and two-thirds of the variance in functional vision performance. This confirms the expected trend that with worse visual impairment, FVP is lower. The addition of the variable, self-concept, resulted in a very small increase in the variability explained for self-reported FVP. Similarly, the addition of other clinical measures of vision such as binocular low contrast visual acuity and colour vision resulted in a small increase in the variability explained for performance measures of FVP. The correlation between binocular high-contrast visual acuity and performance measures of FVP was statistically significantly higher than that between binocular high-contrast visual acuity and self-reports of FVP. There are a few possible reasons for this higher correlation. Firstly, performance measures are considered to be a more "objective" form of assessment, while self-reports are a child's perception of his or her ability and therefore lack a context, which may result in either over-estimation or under-estimation of actual ability. Furthermore, performance measures include dimensions such as the time taken to perform a task or other criteria specific to a task, while self-reports do not use such qualifiers. Secondly, the higher correlation may be the result of the visual complexity of some of the tasks. While self-concepts of children with visual impairment played a small but significant role in the self-reported FVP, studies in adults with visual impairment have suggested that other psychological factors such as mood, anxiety, motivation etc. are associated with an individual's perception of visual performance. Future studies are required to explore the possible role of these and other factors in FVP in Indian school-going children with visual impairment. This thesis makes a significant contribution to the field of paediatric low vision rehabilitation by providing performance measures of FVP and relating them to self-reports in children with visual impairment and their relationship with common measures of visual function. With self-reports, the child is reporting his or her perception of ability to complete a task, where performance measures examine the child's ability to complete a task by observing his or her performance. Thus, although the two methods are comparable, it is because of the different yields from each of these measures that they are not considered interchangeable. A combination of the 2 measures where practical would perhaps provide a richer depiction of the FVP of children with visual impairment. As developing countries such as India have limited resources allocated for eye care services where less than seven percent of the gross national product is spent on health care, self-reports can be utilized together with clinical measures of vision (mainly visual acuity) to assess the FVP in children with visual impairment in a community setting. However, both methods of assessment of FVP together with clinical measures of vision are essential if a comprehensive assessment of FVP is to be carried out in children with visual impairment. Information from these assessments can help clinicians better understand the functioning of children with visual impairment and incorporate them in the management of low vision in school-going children with visual impairment in India.

Made available in DSpace on 2015-07-22T20:50:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24 / Objetivos: verificar o comportamento de resolução temporal, de localização sonora e de identificação de sons verbais degradados em indivíduos portadores de perda auditiva unilateral e investigar possíveis associações com a presença ou não de queixas de dificuldades escolares, comunicação e de linguagem. Método. Participaram deste estudo 26 indivíduos, sendo 13 portadores de perda auditiva unilateral, que constituiu o GP e foi subdividido em GPAD (perda auditiva unilateral na orelha direita) e GPAE (perda na orelha esquerda) e 13 ouvintes normais, dos sexos masculino e feminino, com idade entre 8 a 15 anos. Foi realizada anamnese com os pais que responderam um questionário desenvolvido pelas autoras que visa caracterizar o desempenho auditivo, comunicativo e de linguagem, através de dados referentes à idade de suspeita e diagnóstico da perda, fatores de risco auditivos, desenvolvimento de fala e linguagem bem como desempenho escolar. Ainda, foram submetidos à avaliação do Processamento Auditivo por meio dos testes fala com ruído, memória seqüencial verbal e não verbal, localização sonora em cinco direções e teste de detecção de gap randomizado (RGDT). Os dados foram analisados estatisticamente com testes não paramétricos, em um nível de significância de 0.05. Resultados. Não houve diferenças significantes entre o Grupo com Perda Auditiva (GP) e Grupo sem perda auditiva (GSP) na análise do comportamento de resolução temporal medido pelo limiar de acuidade temporal por meio do Teste RGDT. Houve diferenças significantes entre Grupo com Perda Auditiva (GP) e Grupo sem Perda (GSP) na análise de sons degradados por meio do Teste Fala com Ruído. Houve diferenças significantes entre Grupo com Perda Auditiva (GP) e Grupo sem Perda (GSP) na análise do comportamento de localização sonora por meio do Teste de Localização Sonora em cinco direções. O grupo com Perda Auditiva (GP) apresentou maiores índices de dificuldades em seu desempenho auditivo, comunicativo e de linguagem do que as crianças do Grupo Sem Perda Auditiva. Dentro do Grupo com Perda Auditiva (GP) os maiores índices de repetência escolar, freqüência de programa de apoio escolar, problemas comportamentais, atraso de fala e linguagem ocorreram no Grupo com Perda Auditiva à Direita (GPAD). Conclusão: Resolução temporal não distinguiu indivíduos com e sem perda auditiva. Indivíduos com perda auditiva unilateral desempenharam-se pior em tarefas de localização sonora, fechamento e comunicação do que os sem perda auditiva. Grupo com Perda Auditiva Unilateral à direita (GPAD) teve pior desempenho comunicativo, mais atraso de fala ou linguagem e mais problemas comportamentais do que o grupo com perda auditiva à esquerda. / The goal of this research is to verify the temporal resolution , sound localization and identification of degraded verbal sounds in individuals with unilateral hearing loss and investigate possible associations with learning or language disorders. Method: Twenty-six 8 to 15 year-old girls and boys participated in this study .Thirteen had normal hearing ( GSP ).Thirteen had a unilateral hearing loss ( GP ) and were divided into 2 groups: GPAD, with right hearing loss, and GPAE, with left hearing loss . An anamnesis was performed with parents who provided information about child’s auditory, communicative and linguistic behavior as well as performance at school. They informed what the risk factors were, the age of the child when they suspected there might be a hearing loss and the age when the diagnosis was established .The individuals underwent auditory processing assessment with speech in noise tests, sound localization and a gap detection test (RGDT).The data were analyzed with non- parametric tests and a 0.05 significance level. Results. There was no significant difference between the group with hearing loss (GP) and the group without hearing loss (GSP) as to temporal resolution. There was significant difference between the group with hearing loss (GP) and the group without loss (GSP) in degraded sound analysis through speech in noise test. There was significant difference between the group with hearing loss (GP) and the group without loss (GSP) in sound localization in five directions. The group with hearing loss (GP) presented more auditory, communicative and linguistic difficulties than the group without hearing loss. Within the group with hearing loss (GP), the children with right hearing loss ( GPAD ) had a history of speech and language delay, failed at school, attended school remedial programmes , and had behavioural problems more often than GPAE, the children with left hearing loss . Conclusion: Temporal resolution did not distinguish individuals without hearing loss and those with unilateral hearing loss. Individuals with unilateral hearing loss did less well in sound localization and closure tasks and did not communicate as proficiently as those without hearing loss. The Individuals with right hearing loss (GPAD) had often had speech and language delay, academic difficulty, and behavioural problems. / TEDE / BV UNIFESP: Teses e dissertações

O estudo teve como objetivos verificar em dois grupos de pacientes com visão monocular (grupo 1) e com visão binocular (grupo 2), a serem submetidos à cirurgia de catarata no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, opiniões, expectativas e reações emocionais em relação ao problema ocular, à qualidade da visão e à cirurgia de catarata; influência da característica de apresentar visão mono ou binocular nas reações emocionais relacionadas à cirurgia de catarata. Foi realizado estudo transversal e comparativo, de forma consecutiva, por meio de questionário estruturado, aplicado por entrevista a pacientes, elaborado a partir de estudo exploratório e medidas acuidade visual e causa da perda visual. A amostra foi constituída por 96 indivíduos do grupo 1 (50,0% homens; 50,0% mulheres, com idade entre 41 e 91 anos, média 69,3 anos ± 10,4 anos) e 110, do grupo 2 (40,9% homens; 59,1% mulheres, com idade entre 40 e 89 anos, média 68,2 anos ± 10,2 anos). A maioria dos indivíduos de ambos os grupos apresentava baixa escolaridade. Não houve diferença estatisticamente significante entre os grupos em relação ao sexo (p = 0,191), à idade (p = 0,702) e à escolaridade (p = 0,245). Não exerciam atividade laboral 95,8% dos indivíduos do grupo 1 e 83,6%, do grupo 2 (p = 0,005) e 30,4% do grupo 1 mencionaram não ter possibilidade de trabalhar por causa da deficiência visual. Observou-se acuidade visual do olho a ser operado menor que 0,05 em 40,6% (grupo 1) e 33,6% (grupo 2), entre 0,25 e 0,05. Quase a totalidade dos indivíduos de ambos os grupos afirmou ter dificuldade para realização das atividades de vida diária e qualificou como insuficiente a respectiva acuidade visual; 71,9% dos entrevistados do grupo 1 e 71,6%, do grupo 2 mencionaram saber a causa da visão fraca; desses, 87,1% do grupo 1 e 83,3% do grupo 2 referiram a catarata como causa da baixa acuidade visual. No que se refere ao medo, 40,6% dos indivíduos do grupo 1 e 22,7%, do grupo 2, relataram ter medo do procedimento cirúrgico (p = 0,009). As causas de medo mais referidas foram: possibilidade de perder a visão; piorar a visão; sofrer alguma complicação na cirurgia; morrer durante a cirurgia. Os sentimentos mais preponderantes entre os grupos foram: satisfação por saber que a catarata pode ser operada e melhorar a visão, alívio por saber que vai ser operado, dúvida quanto a ter bom resultado, nervosismo. Referiram esperar que mudanças ocorressem na vida após a cirurgia 90,6% (grupo 1) e 84,6% (grupo 2). Quanto às atividades que esperavam realizar após a cirurgia mencionaram: realizar serviços de casa; ler; sair sozinho. Concluiu-se que: os indivíduos de ambos os grupos tiveram acesso à cirurgia de catarata com acuidade visual menor do que a idealmente indicada; os pacientes com visão monocular apresentaram acuidade visual significativamente menor em relação aos com visão binocular; a maioria dos entrevistados de ambos os grupos referiu dificuldades para realizar atividades cotidianas como conseqüência da baixa visão; os indivíduos com visão monocular referiram mais dúvida em relação aos resultados cirúrgicos do que os com visão binocular; muitos indivíduos de ambos os grupos desconheciam a causa da dificuldade visual ou a atribuíram a outra causa que não a catarata; indivíduos de ambos os grupos apontaram expectativas positivas em relação à reabilitação após a cirurgia. / The purpose of the study was to verify in two groups of patients with monocular vision (group 1) and with binocular vision (group 2) to be submitted to cataract surgery in Hospital das Clínicas, São Paulo University Medical School, opinions, expectances and emotional reactions related to the ocular problem, to the quality of vision and to cataract surgery, the influence of monocular or binocular vision in the emotional reactions related to cataract surgery. A transversal comparative and consecutive study was performed using a structured questionnaire applied by interview of patients. The questionnaire was elaborated from a previous exploratory study, the visual acuity and cause of the visual loss were evaluated. The sample was constituted by 96 persons of group 1 (50% males; 50% females, ages ranging from 41 to 91 years old; average 69,3 years ± 10,4 years) and 110 persons of group 2 (40,9% males; 59,1% females, ages ranging from 40 to 89 years old; average 68,2 years ± 10,2 years). The majority of persons of both groups presented low educational level. There was no statistically significant difference between the groups in relation to gender (p = 0,191), age (p = 0,702) and educational level (p = 0,245). No work activity was mentioned in 95,8% of the persons of group 1 and 83,6% of group 2 (p = 0,005) and 30,4% of group 1 informed the impossibility to work due the visual deficiency. It was observed that the visual acuity of the eye to be operated was less than 0,05 in 40,6% (group 1) and in 33,6% (group 2), presented visual acuity ranging from 0,05 to 0,25. Almost the totality of the persons of both groups informed difficulties to perform activities of daily life and qualified as insufficient their visual acuities; 71,9% of the patients of group 1 and 71,6% of group 2 informed to know the reason of low vision; among these, 87,1% of group 1 and 83,3% of group 2 mentioned cataract as the reason of low visual acuity. Concerning fear, 40,6% of patients of group 1 and 22,7% of group 2 informed about fear of the surgical procedure (p = 0,009). The causes of fear more frequently reported were: possibility of loss of vision; worsening of vision; complications during the surgical procedure and to die during the surgery. The more preponderant feelings in both groups were: satisfaction knowing that a cataract can be operated with improvement of vision, relief knowing that will be submitted to surgery, doubt about a good result, nervousness. Changes in the life after surgery were mentioned by 90,6% (group 1) and by 84,6% (group 2) of the persons. Housework activities, reading and moving around without help were the mentioned activities expected to be performed after surgery. It was concluded that the patients of both groups were submitted to cataract surgery with visual acuities less than the visual acuity ideally indicated; the patients with monocular vision showed visual acuities significantly less in relation to the patients with binocular vision; the majority of the patients of both groups mentioned difficulties to perform daily activities as a consequence of low vision; patients with monocular vision mentioned doubts in relation to the surgical results as compared with the patients with binocular vision; many patients of both groups did not know the cause of the visual difficulty or explained the visual difficulty by other cause than the cataract; patients of both groups were positively expectant in relation to the visual rehabilitation after the surgery.

Objetivo: Analisar a influência da espessura corneana central na acuidade visual (AV) corrigida após transplante de córnea endotelial lamelar profundo (TCELP). Métodos: Foram estudados de forma prospectiva 155 olhos de 127 pacientes portadores de ceratopatia bolhosa ou distrofia endotelial de Fuchs no sexto mês de pós-operatório do TCELP, entre março de 2000 e março de 2005. Foram excluídos pacientes com outras alterações oculares que justificassem baixa AV. Todos os pacientes foram submetidos à avaliação oftálmica, quando foram determinadas AV corrigida, por meio de exame refratométrico, e espessura corneana central, através da paquimetria ultra-sônica. As técnicas usada foram previamente descritas. Os olhos foram agrupados de acordo com as medidas de AV: grupo I (20/20 - 20/30), grupo II (20/40 - 20/50), grupo III (20/60 - 20/80), grupo IV (20/100 - 20/400). Para correlação com paquimetria e análise estatística, as medidas de AV foram convertidas da tabela de Snellen para a tabela logarítmica (logMAR). Foram criadas variáveis categóricas para expressar status de faixa de normalidade de espessura corneana (entre 495 e 651 ?m), usando como pontos de corte valores encontrados na literatura. Resultados: A média, o desvio padrão e a variação da paquimetria foi: grupo I (n=38) 571 ±80 um, 408 a 784 um; grupo II (n=79) 598 ±80 um, 437 a 816 um; grupo III (n=30) 605 ±99 um, 454 a 945 um e grupo IV (n=8) 607 ±120 ?m, 410 a 781 ?m. Analisando o resultado da AV e a porcentagem de casos com espessura corneana acima de 651 um, foi observada associação linear significativa (P=0,037; ?2 de tendência linear) entre o aumento da paquimetria e a piora da AV. Analisando a associação entre os grupos de AV e a porcentagem de casos com espessura corneana abaixo da faixa de normalidade (<495 um), não foi encontrada significância estatística (P=0,92; x2 de Pearson). Quando analisado o resultado visual do grupo I em relação ao resultado dos grupos II+III+IV em conjunto, observou-se que somente 13% dos casos do grupo I e 30% dos casos dos demais grupos apresentaram espessura corneana maior do que 651 ?m. Essa correlação demonstrou significância estatística limítrofe (P=0,066; x2 de Pearson com correção de Yates). Conclusão: Observou-se associação linear significativa entre piora da AV corrigida e aumento da espessura corneana central. Quando analisados somente casos com paquimetria abaixo da faixa de normalidade, não foi observada associação significativa entre piora da AV corrigida e espessura corneana central / Purpose: To analyze the influence of central corneal thickness in the corrected visual acuity (VA) after deep lamellar endothelial corneal keratoplasty (DLEK). Methods: Retrospective study of 155 eyes of 127 patients 6 months post-op DLEK between March 2000 and March 2005. These patients had been previously diagnosed with either bullous keratopathy or Fuch\'s endothelial dystrophy. Patients with other ophthalmic conditions that could cause loss of vision were excluded. All patients underwent ophthalmic evaluation to determine corrected VA by means of refraction and central corneal thickness by means of ultrasonic pachymetry. Eyes were grouped according to visual acuity into 4 groups: I (20/20 - 20/30), II (20/40 - 20/50), III (20/60 - 20/80), IV (20/100 - 20/400). For statistical analysis and corelation with pachymetry, VA measurements were converted to logMAR. Categorical variables were created to express normal range corneal thickness status (from 495 to 651 um) using values published on the literature. Results: Mean and standart deviation pachymetry values were: group I (n=38) 571 ±80 ?m, ranging from 408 to 784 um; group II (n=79) 598 ±80 um, ranging from 437 to 816 ?m; group III (n=30) 605 ±99 um, ranging from 454 to 945 um and group IV (n=8) 607 ±120 um, ranging from 410 to 781 ?m. Analyzing the VA results and the percentage of cases with corneal thickness above 651 um, a significant linear correlation between higher pachymetry and worse VA was observed (P=0.037; linear trend). Analyzing the association between the different groups and the percentage of cases with corneal thickness bellow 495 um, there was no statistical significance (P=0.92; Pearson\'s x2). When analyzing the visual results of group I compared to groups II+III+IV together, it was observed that only 13% of group I cases and 30% of cases from the other groups presented corneal thickness greater then 651 um. This correlation showed borderline statistical significance (P=0.066; Pearson\'s x2 with Yates\' correction). Conclusions: A significant linear correlation between increased corneal thickness and worse VA was observed. When analyzing only cases bellow normal pachymetry, there was no correlation between corneal thickness and worse VA

Submitted by GABRIEL PEREIRA BRAGA null (gabrielbraga@yahoo.com) on 2016-12-02T09:58:55Z No. of bitstreams: 1 Tese Revisão FINAL.pdf: 8445004 bytes, checksum: 2e04918d8a1ac628b07d606003577ce5 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-12-05T20:00:36Z (GMT) No. of bitstreams: 1 braga_gp_dr_bot.pdf: 8445004 bytes, checksum: 2e04918d8a1ac628b07d606003577ce5 (MD5) / Made available in DSpace on 2016-12-05T20:00:36Z (GMT). No. of bitstreams: 1 braga_gp_dr_bot.pdf: 8445004 bytes, checksum: 2e04918d8a1ac628b07d606003577ce5 (MD5) Previous issue date: 2016-03-01 / Introdução: As doenças cerebrovasculares são causas maiores de morbimortalidade no Brasil e no mundo, sendo associadas a enormes custos biopsicossociais. As alterações eletrocardiográficas e cardíacas na fase aguda do acidente vascular cerebral são relacionadas com elevada mortalidade após estes eventos e grande debate existe sobre a gênese destas alterações nesta fase ictal. O eletrocardiograma é método diagnóstico não invasivo capaz de fornecer informações sobre fisiologia e processos patológicos do coração, incluindo eventual influência negativa exercida pelo sistema nervoso autônomo. Objetivo: O presente estudo objetiva avaliar se alterações eletrocardiográficas e enzimáticas na fase aguda do AVC são preditoras de desfecho desfavorável definido por pontuação na escala modificada de Rankin entre 3-6 em 90 dias do evento cerebrovascular. Métodos: Foi realizado estudo prospectivo, com pacientes atendidos no PS de Neurologia do HC-FMB, no período de março de 2012 a março de 2013, com até 24 horas de evolução de AVC, e excluídos aqueles com eventos cardíacos recentes. Foram coletados dados demográficos, história clínica, traçados de eletrocardiograma e dosagens de biomarcadores de necrose miocárdica obtidos na admissão. Associação entre tipo AVC e variáveis categóricas e numéricas foi analisada pelos testes de Fisher e Kruskal-Wallis seguido do teste de Dunn para comparações múltiplas, respectivamente. Associação entre alguma complicação geral ou cardíaca com chance de mau prognóstico neurológico e óbito foi analisada por regressão logística simples. Regressão logística corrigida para sexo, idade, controle da pressão arterial e complicações cardíacas foi utilizada na determinação da associação entre alterações eletrocardiográficas e mau prognóstico neurológico. Resultados: Foram analisados 112 pacientes, com idade de 69 (26 - 93) anos e maioria do sexo masculino. Pacientes com AVC hemorrágico apresentaram quadro clínico mais grave na entrada com NIHSS 20 (0 – 42). Não houve diferença em relação aos fatores de risco. Dos eletrocardiogramas avaliados, 71(63,3%) possuíam alguma anormalidade. As principais alterações foram fibrilação atrial, alterações de repolarização e achados sugestivos de isquemia miocárdica. Não houve diferença dos subtipos de AVC em relação aos níveis de marcadores de necrose miocárdica. Foi observado que 61(54,4%) apresentavam níveis de CKMB e 15(13,3%) níveis de troponina I acima do valor de referência. Análise multivariada evidenciou relação da fibrilação atrial (5,29 OR p=0,006 IC95% 1,6-17,5), frequência cardíaca (1,032 OR p=0,008 IC95% 1,008 – 1,056) e presença de alguma anormalidade no segmento ST (4,736 OR p=0,008 IC95% 1,496-14,988) com complicações cardíacas durante a internação. Aumentos no intervalo PR (1,037 OR p=0,002 IC95% 1,013-1,060), presença de anormalidades do segmento ST (3,457 OR p=0,038 IC95% 1,074 – 11,127) e anormalidade de onda T (7,244 OR p=0,001 IC95% 2,290 – 22,913) se relacionaram com maior grau de incapacidade em 90 dias. Elevações da troponina I (2,954 OR, p=0,039, IC95% 1,056 – 8,260), anormalidade do segmento ST (4,257 OR, p=0,028, IC95% 1,170 – 15,498), anormalidade de onda T (5,599 OR, p=0,014, IC95% 1,410 – 22,230), somatório de onda Q (1,3 OR, p=0,038, IC95% 1,014-1,667) se relacionaram com maior chance de óbito. A alteração do segmento ST que mais se relacionou com este desfecho foram as alterações do nivelamento de ST (OR 14,625 IC95% 2,120-100,909 p 0,006). Conclusões: Alterações eletrocardiográficas na fase aguda de doenças cerebrovasculares são frequentes e relacionadas a maior chance de mortalidade e maior grau de incapacidade em 90 dias. / Introduction: Cerebrovascular diseases are major causes of morbidity and mortality in Brazil and worldwide, being associated with huge biopsychosocial costs. Electrocardiographic and cardiac abnormalities in the acute phase of stroke are associated with high morbidity and mortality after these events and great debate exists about the genesis of these changes on ictal phase. The electrocardiogram is a noninvasive diagnostic method able to provide information about anatomy, physiology and pathological processes of the heart, including possible negative influence of the Autonomic Nervous System. Objective: This study aims to assess whether electrocardiographic and enzymatic alterations in the acute phase of stroke are predictors of unfavorable outcome defined by scores on the modified Rankin scale of 3- 6 within 90 days of the cerebrovascular event. Methods: A prospective study was conducted with patients treated at the HC-FMB Neurology ED, from March 2012 to March 2013, up to 24 hours of onset of stroke, and excluded those with recent cardiac events. Demographic data, medical history, electrocardiogram tracings and measurements of myocardial necrosis biomarkers obtained on admission were recorded. Association between stroke type and categorical and numerical variables was analyzed by Fisher and Kruskal-Wallis tests followed by Dunn’s test for multiple comparisons, respectively. Association between any general or cardiac complication and poor neurological outcome and mortality was analyzed by simple logistic regression. Multiple logistic regression adjusted for sex, age, blood pressure control and cardiac complications was used to determine the association between electrocardiographic abnormalities and poor neurological outcome. Results: 112 patients were analyzed, with a median age of 69 years-old (26 - 93) and mostly male. Hemorrhagic stroke patients had the most severe clinical picture at the entrance with NIHSS of 20 (0 - 42). There was no difference regarding to cardiovascular risk factors. Electrocardiographic abnormalities were found in 71(63.3%) patients. The main changes were rhythm disturbances (atrial fibrillation), repolarization changes and findings suggestive of myocardial ischemia. There was no difference in stroke subtype compared to the levels of myocardial necrosis markers. 61(54.4%) had CK-MB and 15(13.3%) troponin levels above the reference value. Multivariate analysis showed that atrial fibrillation (OR 5.29 p = 0.006 95% CI 1.6 to 17.5), heart rate (OR 1.032 p = 0.008 95% CI 1.008 to 1.056) and the presence of an abnormality in the ST segment (4,736 OR p = 0.008 95% CI 1.496 to 14.988) correlated with cardiac complications during hospitalization. Increases in PR interval (p = 0.002 95% CI 1.013 to 1.060 1,037OR), presence of ST-segment abnormalities (p = 0.038 OR 3.457 95% CI 1.074 to 11.127) and T wave abnormalities (p = 0.001 OR 7.244 95% CI 2.290 - 22.913) were related to a higher degree of disability in 90 days. Elevations of troponin (2,954 OR, p = 0.039, 95% CI 1.056 to 8.260), ST segment abnormality (4,257 OR, p = 0.028, 95% CI 1.170 to 15.498), wave abnormality t (5,599 OR, p = 0.014, 95 % 1.410 to 22.230), wave sum Q (OR 1.3, p = 0.038, 95% CI 1.014 to 1.667) were related to a higher likelihood of death. Abnormality of ST segment most associated with this outcome was the changes of ST leveling (OR 95% CI 2.120 to 100.909 14.625 p 0.006). Conclusions: We conclude that the electrocardiographic changes in acute cerebrovascular diseases are frequent and related to a higher chance of mortality and a greater degree of disability in 90 days.

O presente trabalho tem por objetivo analisar o efeito do metilmercúrio na retina de peixe tropical Hoplias malabaricus (Traíra) através de baixas doses agudas. As intoxicações foram realizadas, por meio de injeção intraperitoneal, nas doses de 0,01, 0,05, 0,1 e 1,0 g/g, com um período de quinze dias de depuração do MeHg. Após o término do período de depuração, os olhos foram enucleados e as retinas isoladas foram fixadas em PFA 4% por 3 horas. As retinas foram conservadas, até o momento do uso (ou por no mínimo 9 horas), em tampão PB 0,1M a 4ºC. Após os procedimentos imunohistoquímicos para marcação de células bipolares do tipo ON com estratificação na sublâmina b da CPI, as retinas foram aplanadas para confecção de montagens planas para a análise quantitativa de células bipolares ON imunorreativas a proteína cinase C _. A análise quantitativa das células da camada de células ganglionares (CCG) também foi realizada. Células da CCG foram coradas pela técnica de Nissl, as retinas foram aplanadas em lâminas gelatinizadas e submetidas a uma bateria de desidratação (com diferentes concentrações alcoólicas) e coloração, utilizando cresil violeta como corante. Estas análises foram realizadas em 3 ou 4 retinas para cada dose testada. Análises idênticas foram realizadas nas retinas controle. Todas as retinas foram dividas nos quadrantes dorsal, ventral, nasal, temporal e em centro e periferia. Campos foram fotografados por toda a retina com intervalos de 1 mm, com auxilio do programa Axio Vision por meio de uma câmera digital e um microscópio acoplados a um computador. Os campos amostrados foram contados com o auxilio do programa NIH Scion Imagem 2.0. A densidade média de células foi estimada para cada retina e os grupos intoxicados foram comparados com o grupo controle (Teste T-student). A partir dos dados de densidade celular, mapas de isodensidade foram confeccionados, além de permitir estimar o poder de resolução teórico da acuidade visual de cada um dos animais experimentais utilizados para análise de células da CCG a partir da densidade máxima de células. Evidenciamos que as baixas doses agudas testadas não causam diminuição na densidade célular de células bipolares ON e células da CCG, comparado ao grupo controle. Não houve reduções significativas na densidade de células para ambos os tipos celulares analizados em nenhuma das regiões retinianas nas doses de MeHg testadas. Assim, a intoxicação de MeHg por baixas doses agudas não alterou o poder de resolução teorio da acuiade visual dos animais testados / This study aims to examine the effects of low acute doses of methylmercury (MeHg) on the retina of the tropical fish Hoplias malabaricus (Thraira). Four levels of MeHg intoxication were induced by intraperitoneal injection of doses of either 0.01, 0.05, 0.1 or 1.0 g MeHg/g of body weight, followed by a fifteen day period of depuration of MeHg. After the depuration period, the eyes were harvested, and the retinas were isolated and fixed in 4% paraformaldehyde for 3 hours. The retinas were then stored (for at least for 9 hours) in 0.1 M sodium phosphate PB buffer at 4°C until the time of analysis. ON bipolar cells in sublamina b of the inner plexiform layer immunoreactive to protein Kinase C_ were immunohistochemically labeled, and the retinas were flattened to make whole mounts for quantitative analysis of ON bipolar cell densities. Quantitative analysis of cells in the retinal ganglion cell layer (GCL) was also performed. GCL cells were Nissl stained, and the retinas were flattened on gelatinized slides and subjected to another battery of dehydration (with different alcohol concentrations) and staining using cresyl violet. These analyses were carried out in 3 or 4 retinas for each dose tested. Identical analyses were performed on the control retinas. All retinas were divided into regions: dorsal, ventral, nasal, temporal, center and periphery. Sample retinal fields were photographed throughout the retina at intervals of 1 mm, with a digital camera attached to a microscope using Axio Vision software coupled to a computer. ON bipolar and GCL cells within the fields were counted with the help of the NIH Scion Image 2.0 software. The average density (mm2) of both types of cells was estimated for each retina and the data from each of the four MeHgintoxicated groups were compared with the control group values (Student t-test). From the density data we derived isodensity maps, permitting us to estimate the theoretical resolving power (maximum visual acuity) of each of the experimental animals used from the maximum density of cells in the ganglion cell layer. We showed that low acute doses of MeHg/g do not decrease cell densities of either ON bipolar cells or cells in the GCL, compared to controls. There were no significant decreases in cell density (counts) for either cell type in any of the retinal regions, for any of the MeHg doses tested. Thus, acute low-dose MeHg intoxication did not degrade the estimates of the animals theoretical resolving power

A prematuridade ao nascimento é um fator de risco para a visão, podendo causar retinopatia, uma condição em que há descolamento da retina. Retinopatia da prematuridade ocorre em uma parcela relativamente pequena dos recém nascidos prematuros e não sabemos se os demais, cujo desenvolvimento visual é aparentemente normal, seguem de fato o mesmo curso que o observado em bebes nascidos após uma gestação completa, ou se também sofrem algum prejuízo devido ao nascimento prematuro. Alternativamente, estes bebês poderiam ter um desenvolvimento visual acelerado pela sua exposição mais longa ao mundo visual. Para saber se a condição de prematuridade acelera, retarda, ou não altera o desenvolvimento da visão, o presente trabalho comparou o desenvolvimento das funções de acuidade visual e de sensibilidade ao contraste espacial de luminância em bebês nascidos prematuros e a termo. O estudo utilizou o método dos Potenciais Visuais Corticais Provocados de Varredura para examinar essas funções. Possíveis correlações entre os limiares visuais obtidos durante o primeiro ano de vida e idade gestacional, índices de Apgar, e valores de peso ao nascimento, foram examinadas. Os participantes foram 57 bebês de ambos os sexos encaminhados pelo Hospital Universitário da Universidade de São Paulo, dos quais 31 prematuros e 26 nascidos a termo. As avaliações foram realizadas principalmente em 3 fases do desenvolvimento visual: 4, 6 e 12 meses de vida. Os bebês prematuros tiveram suas idades corrigidas com relação à idade gestacional para a comparação com os grupos de termos. Um grupo de 14 sujeitos adultos também foi avaliado com os mesmos estímulos visuais. As avaliações das funções de acuidade visual e sensibilidade ao contraste foram realizadas através do método de potenciais visuais corticais provocados de varredura. Eletrodos posicionados no escalpo da região occipital dos pacientes captaram as respostas eletrofisiológicas provocadas por estímulos gerados em um monitor de alta resolução por um sistema computadorizado (sistema NuDiva). Estes estímulos consistiam de grades quadradas com valor de contraste fixo (80%) para avaliação da acuidade visual, e grades senoidais de 4 freqüências espaciais: 0,2 , 0,8 , 2,0 e 4,0 ciclos por grau para a avaliação da sensibilidade ao contraste. Prematuros e termos não apresentaram diferenças estatísticas significantes nas funções visuais avaliadas em nenhuma fase do desenvolvimento. O pico de sensibilidade ao contraste ocorreu entre .8 e 2.0 cpg de 4 meses de idade. No sexto mês o pico deslocou-se para 2.0 cpg, e entre os meses 9 e 12 passou para freqüências espaciais mais altas, por volta de 4.0 cpg coincidindo com o pico encontrado para os adultos. Nossos dados sugerem que nem a experiência visual, maior nos prematuros em relação aos termos, nem o tempo de gestação, maior nos termos em relação aos prematuros, afetam o desenvolvimento da visão espacial em humanos. / Prematurity at birth is a risk factor for vision, since it may lead to retinopathy - a condition in which there is retinal detachment. Retinopathy of prematurity occurs in a relatively small percentage of premature infants and it is not known if the remainder, whose visual development is apparently normal, follow the same course as in term babies after a complete gestational period, or if they also suffer some loss from having been born before complete development. Alternatively, these babies might have an accelerated visual development due to their longer exposure to the visual world, compared to term babies. To examine if prematurity accelerates, slows down, or does not affect visual development, the present study compared the development of visual acuity and contrast sensitivity in premature and term babies. The study used the methodology of the sweep visual evoked potentials to examine these functions. Possible correlations between visual thresholds obtained during the first year of life and gestational age, apgar index and birth weight, were examined. Participants were 57 infants of both genders, recruited by the University Hospital of São Paulo University, of which 31 were prematurely born and 26 were term infants. Evaluations were performed at three visual developmental epochs: 4, 6 e 12 months of age. The age of preterm infants was corrected by their gestational ages in order to allow comparison with the term infants. Another group with 14 adult subjects was tested with the same visual stimulus. Visual acuity and contrast sensitivity tests were performed with the sweep visual evoked potential method. Electrodes placed over the infant\'s scalp at the occipital role recorded electrophysiological responses evoked to visual stimuli generated by a high resolution monitor of a computerized system. The stimuli were square wave gratings with 80% of contrast to evaluate visual acuity, and sine wave gratings of 4 spatial frequencies: 0,2 , 0,8 , 2,0 e 4,0 cycles per degree to evaluate contrast sensitivity. Preterm and term infants did not show statistical differences in the evaluated visual functions in any developmental phase. The contrast sensitivity peak occurred between 0.8 and 2.0 cpd at 4 months of age. At the sixth month the peak moved to 2.0 cpd and it was displaced to a higher spatial frequency (4.0 cpd) at 12 months, where it coincides with the adult SCS peak. Our data suggest that neither visual experience, longer in the preterm, nor gestational age, longer in the term infants, seems to affect spatial vision functions in humans.

Orientadores: Abimael Aranha Netto, André Moreno Morcillo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T16:08:29Z (GMT). No. of bitstreams: 1 Martini_Giovana_M.pdf: 6946196 bytes, checksum: 0958a806379064012236749e08f7a700 (MD5) Previous issue date: 2012 / Resumo: Objetivos: Determinar o desenvolvimento da acuidade visual de grades binocular e monocular, mensuradas com o Lea Gratings, prover uma base idade-dependente por esta técnica em uma coorte de crianças saudáveis e comparar os resultados obtidos por este teste com os obtidos com os Cartões de Acuidade de Teller. Método: Tratou-se de estudo prospectivo e longitudinal, descritivo e analítico, da acuidade visual de resolução de grades de um grupo de lactentes, nos três primeiros meses de vida e no período entre 12 e 24 meses. Considerou-se, como critérios de inclusão, lactentes que foram nascidos a termo e adequados para a idade gestacional, com um mês de idade cronológica e residentes na região metropolitana de Campinas, que apresentaram o Reflexo Vermelho presente ao nascimento. A acuidade visual de resolução de grades foi mensurada por meio do teste Lea Gratings, mês a mês, e, a partir dos 12 meses, também por meio dos Cartões de Acuidade de Teller, quando foram descartadas alterações oftalmológicas nos participantes do estudo. A amostra foi constituída de 133 lactentes e a análise dos resultados foi realizada utilizando-se o Statistical Package for Social Sciences for Personal Computer (SPSS 16.0). Os valores de acuidade (CPD) foram apresentados em distribuição de frequência e para determinação da média e do desvio padrão, os dados foram transformados em escala de uma oitava. Para comparação da acuidade visual entre as idades foi utilizada a análise de variância para medidas repetidas e o de Wilcoxon para comparação das medidas entre os olhos para amostras relacionadas. A correlação entre os resultados obtidos pelos dois testes foi avaliada pelo Coeficiente de Correlação de Spearman. Resultados: Os valores de acuidade visual binocular foram crescentes, sendo obtida no primeiro mês a média de 0,55 cpd (±0,70), de 1,35 cpd (±0,69) no segundo mês e de 3,11 cpd (±0,54) no terceiro mês. A partir dos 12 meses, as médias dos valores de acuidade visual binocular e monocular - foram, respectivamente, de 14,41 cpd (±0,25) e de 12,03 cpd (±0,39) nas crianças com idade entre 12 e 14 meses, de 14,10 cpd (±0,27) e de 10,79 cpd (±0,42) em crianças com idade entre 15 e 18 meses e de 15,50 cpd (±0,13) e de 13,42 cpd (±0,26) em crianças com idade entre 19 e 24 meses. Os resultados da análise de variância demonstraram diferenças significativas nos valores de acuidade visual entre todas as idades. Os coeficientes de Correlação de Spearman entre os testes Lea Gratings e Cartões de Acuidade de Teller foram de 0,53505 e de 0,65175 para, respectivamente, as medidas binocular e monocular. Conclusão: O teste foi capaz de avaliar a evolução da acuidade visual no primeiro trimestre de vida e no período entre 12 a 24 meses, e permitiu o fornecimento de uma base idade-dependente por esta técnica em uma coorte de lactentes saudáveis até o período de 12 meses. A comparação entre os dois testes de acuidade visual de grades demonstrou correlação positiva / Abstract: Purpose: This study aims to determine the development of the binocular and monocular grating acuity with Lea Gratings, to established age-related norms for this method in a health children cohort and comparing the results obtained by this test with those obtained with the Teller Acuity Cards. Methods: This was a prospective and longitudinal study, descriptive and analytic, of infant grating visual acuity in the first three months of life and between the ages 12 and 24 months. The sample was composed of infants that met the following criteria: full-term infants appropriate for gestational age, with a chronological age of one month, residents in the Campinas metropolitan region, born with positive red reflex and whose parents consented to participate in this study. The grating acuity of each infant was measured three times at regular intervals, using Lea Gratings, and after 12 months, also with the Teller Acuity Cards, when a complete ophthalmologic examination was conducted to reject any visual alteration. The final sample was composed of 133 infants and the results were analyzed with the Package for Social Sciences for the Personal Computer (SPSS 16.0). The grating acuity results were stated in frequency tables and converted into a one-octave scale for statistical calculation. Repeated measure analysis of variance was applied to compare the grating acuity results among ages. The Wilcoxon test was used to compare the measures between the eyes in related samples and the Spearman Correlation was applied to evaluate the results obtained with the two tests. Results: The binocular grating acuity measures were crescent. In the first month, the mean acuity was 0.55 cpd (±0.70); in the second month, the mean acuity was 1.35 cpd (±0.69) and in the third month it was 3.11 (±0.54). After 12 months, the means of binocular and monocular acuity were, respectively, 14.41 cpd (±0.25) and 12.03 cpd (±0.39) in children between ages 12 and 14 months; 14.10 cpd (±0.27) and 10.79 cpd (±0.42) in children between ages 15 and 18 months; 15.50 cpd (±0.13) and 13.42 cpd (±0.26) in children between ages 19 and 24 months. Analysis of variance to repeated measures indicated differences between the measures of grating acuity in all ages. The coefficient of Spearman Correlation between the tests Lea Gratings and Teller Acuity Cards was respectively 0.53505 and 0.65175 for binocular and monocular measures. Conclusions: This test was capable to assess the evolution of grating acuity in the first three months of life and between 12 and 24 months, and established age-related norms for this method in a health children cohort until 12 months age. The comparison between the two tests of grating acuity demonstrated positive correlation / Mestrado / Saude da Criança e do Adolescente / Mestra em Saúde da Criança e do Adolescente