Polypoidal choroidal vasculopathy in pachychoroid: combined treatment with photodynamic therapy and aflibercept

Abstract Introduction To evaluate the effects of combined therapy using intravitreal Aflibercept (IVA) and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy related to pachychoroid disease (PPCV).Methods Patients with PPCV were treated with PDT combined with 3 IVA injections on a monthly basis, followed by pro re nata criteria. The 12-month follow-up consisted of multiple revaluations of visual acuity and SSOCT parameters of clinical activity.Results Nineteen eyes were included in the study; mean age was 65.5 years. Visual acuity improved after 12 months (0.35 ± 0.25 to 0.2 ± 0.20 logMAR, p = 0.005). Percentage of eyes with intraretinal and subretinal fluid reduced from baseli…

INVERSE RELATIONSHIP BETWEEN CHOROIDAL THICKNESS AND SUBCLINICAL RENAL DAMAGE IN ESSENTIAL HYPERTENSION

The introduction in last years of advanced techniques of optical coherence tomography (OCT) has greatly increased our understanding of the choroid, that is the most important vascular layer of the eye. Our study was aimed to assess choroidal thickness by using Swept-Source OCT (SS-OCT) in essential hypertensive patients (EHs) with and without subclinical renal damage (SRD). We enrolled 100 EHs of which 65 without kidney damage and 35 with SRD. In all the participants SS-OCT and a routine biochemical workup were performed. Glomerular filtration rate (GFR) was estimated by the CKD-EPI equation (eGFR). SRD was defined, by the presence of microalbuminuria or eGFR between 30 and 60 mL/min/1.73 m…

THE CLINICAL ACTIVITY SCORE IN MANAGEMENT OF GRAVES’ OPHTHALMOPATHY: CORRELATION WITH ORBITAL MR IMAGING.

Our aime was to investigate the correlation between GO ocular parameters obtained by MRI with contrast administration and the well-know clinical indicators of GO and to examine the relationship between the clinical course of hyperthyroidism and GO severity

maculopatia associata a tilted disk

sj-pdf-5-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-pdf-5-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Multifocal choroiditis: Indocyanine green angiographic features

The aim of this study is to retrospectively evaluate the indocyanine green (ICG) angiographic features in 13 patients affected by multifocal choroiditis. We identified two clinical and angiographic patterns. The ‘active’ pattern showed hypofluorescence up to the late phases and more extensive choroidal involvement than presumed by ophthalmoscopy and fluorescein angiography. In the ‘inactive’ pattern, ICG angiography showed hypofluorescence during all the phases: no increase in lesion number was observed between early and late phases. Choroidal neovascularization was present in 10 patients, and it was bilateral in 2 of these: it occurred only in the inactive stage. The appearance of choroida…

Back pain after photodynamic therapy with verteporfin.

Purpose To report the incidence of back pain after photodynamic therapy, which suggests methods for prevention that are related to its pathogenesis. Design Retrospective case series. Methods We retrospectively observed 548 patients who had undergone photodynamic therapy with verteporfin. Results Of 548 patients at the first treatment, 14 patients (2.6%) experienced pain during the infusion. Eleven patients were being treated for age-related macular degeneration; their mean age was 81 years, which significantly differed from the mean age of the overall age-related macular degeneration group ( P = .003). The pain was mild in eight patients, moderate in four patients, and severe in two patient…

Intraoperative dexamethasone intravitreal implant in diabetic macular edema patients undergoing phacoemulsification: The CataDex study

Purpose To assess the impact of preoperative intravitreal dexamethasone implant (DexI) on functional and anatomic outcomes in patients with diabetic macular edema (DME) who underwent phacoemulsification cataract surgery. Methods Prospective and non-comparative study conducted on consecutive DME patients undergoing cataract surgery. DexI was administered 15 days before surgery and in a pro re nata regime after surgery. Main outcome measures were mean change in central retinal thickness (CRT), central subfield thickness (CST), total macular volume (TMV), and central subfield volume (CSV) from baseline to month-12. Secondary outcome was mean change in best corrected visual acuity (BCVA). Resul…

Lacrimal glands herniation in patients with Graves’ Ophthalmopathy: an effective MRI-derived marker of disease activity

Aims and objectives Methods and materials Results Conclusion Personal information References

Preoperative, Intraoperative and Postoperative Corticosteroid Use as an Adjunctive Treatment for Rhegmatogenous Retinal Detachment

The treatment for rhegmatogenous retinal detachment (RRD) is surgery, including pars plana vitrectomy (PPV) and scleral buckling (SB). Despite surgical advances, degeneration of the photoreceptors and post-operative complications, such as proliferative vitreoretinopathy (PVR), often occurs as the result of inflammation, preventing complete visual recovery or causing RRD recurrence. There is increasing evidence that in the presence of RRD, the activation of inflammatory processes occurs and the surgery itself induces an inflammatory response. This comprehensive review focuses on the use of different formulations of corticosteroids (CCS), as an adjunctive treatment to surgery, either PPV or S…

Choroidal thickness is associated with renal hemodynamics in essential hypertension

The choroid is the most vascularized structure of the eye and plays a central role in the development of the retinal vascular changes that occur in arterial hypertension. Changes of choroidal thickness (ChT) assessed by optical coherence tomography (OCT) technology could reflect the vascular complications of hypertension. Also, intrarenal hemodynamic damage, associated with endothelial dysfunction, demonstrated to be a good indicator of systemic morphofunctional arterial impairment. The aim of this study is to assess the relationship between ChT and renal hemodynamics in subjects with essential hypertension. Routine laboratory tests, clinical history, and physical examination, including blo…

Next-generation sequencing confirms the implication ofSLC24A1in autosomal-recessive congenital stationary night blindness

Congenital stationary night blindness (CSNB) is a clinically and genetically heterogeneous retinal disorder which represents rod photoreceptor dysfunction or signal transmission defect from photoreceptors to adjacent bipolar cells. Patients displaying photoreceptor dysfunction show a Riggs-electroretinogram (ERG) while patients with a signal transmission defect show a Schubert–Bornschein ERG. The latter group is subdivided into complete or incomplete (ic) CSNB. Only few CSNB cases with Riggs-ERG and only one family with a disease-causing variant in SLC24A1 have been reported. Whole-exome sequencing (WES) in a previously diagnosed icCSNB patient identified a homozygous nonsense variant in SL…

sj-docx-2-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-2-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Retrobulbar anesthesia complicated by combined central retinal vein and artery occlusion and massive vitreoretinal fibrosis.

Retrobulbar anaesthesia is routine procedure in ocular surgery. Complication are infrequent but often severe, involving both retina and the optic nerve. we report a case of combined central retinal vein and artery occlusion, secondary to retrobulbar anaesthesia, which evolved into retinal ischemia and Vitreoretinal fibrosis. This is the first time to our knowledge that such a dramatic evolution of post traumatic retinal occlusion has been reported.

sj-docx-3-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-3-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Early OCTA Changes of Type 3 Macular Neovascularization Following Brolucizumab Intravitreal Injections

Background and Objectives: Brolucizumab is a novel anti-vascular endothelial growth factor (VEGF), whose efficacy has been shown in the Hawk and Harrier phase 3 clinical studies. The goal of the present case series is to report initial results of brolucizumab intravitreal injections (IVI) on type 3 neovascularization in neovascular age-related macular degeneration (nAMD), evaluated by optical coherence tomography angiography (OCTA). Materials and Methods: This is a bicentric retrospective case series. Patients with newly diagnosed type 3 MNV treated with brolucizumab IVI and at least 6 months follow-up were enrolled. OCTA en face images and B-scans were analyzed for lesions at baseline, 1 m…

Effectiveness of anti-vascular endothelial growth factors in neovascular age-related macular degeneration and variables associated with visual acuity outcomes: Results from the EAGLE study

Objective To assess the overall effectiveness of anti-vascular endothelial growth factor (VEGF) therapy in treatment-naïve patients with neovascular age-related macular degeneration (nAMD) in a clinical practice setting. Study design EAGLE was a retrospective, 2-year, cohort observational, multicenter study conducted in Italy that analyzed secondary data of treatment-naïve patients with nAMD. The primary endpoint evaluated the mean annualized number of anti-VEGF injections at Years 1 and 2. The main secondary endpoints analyzed the mean change in visual acuity (VA) from baseline and variables associated with visual outcomes at Years 1 and 2. Results Of the 752 patients enrolled, 745 (99.07…

A Real-World Study of Dexamethasone Implant in Treatment-Naïve Patients with Diabetic Macular Edema: Efficacy and Correlation Between Inflammatory Biomarkers and Treatment Outcome.

Purpose There has been an increasing clinical interest in specific retinal parameters as non-invasive biomarkers of retinal inflammation in diabetic macular edema (DME) that have been shown to have prognostic value, such as hyperreflective retinal fields (HRFs) and subfoveal neuroretinal detachment (SND). Methods We conducted a prospective, non-comparative study of treatment-naive patients with DME to evaluate the efficacy of a Pro Re Nata (PRN) regimen of intravitreal dexamethasone implant 0.7 mg (DexI, Ozurdex™). After administration, patients underwent subsequent injections according to PRN criteria in case of edema relapse, but not earlier than 4 months after the previous treatment. Pat…

One year study of efficacy and safety of infliximab in the treatment of patients with ocular and neurological Behçet's disease refractory to standard immunosuppressive drugs

Abstract The aim of the study was to assess the long-term efficacy and safety of Infliximab therapy in the treatment of patients with Behçet’s disease refractory to standard immunosuppressive agents. Twenty-one patients that did not respond to corticosteroids and to at least one immunosuppressant (cyclosporin, methotrexate, azathioprine, cyclophosphamide) for the presence of ocular and/or CNS involvement were enrolled. Eighteen patients completed the study up to 54 weeks. Stable doses of prednisone (<10 mg/day) were permitted, immunosuppressants were discontinued at least 4 weeks prior baseline visit. The patients received three infusions of 5 mg/kg Infliximab (at weeks 0, 2 and 6) and then…

Retinal and choroidal vasculature changes associated with chronic kidney disease

Retinal and choroidal microvascular changes can be related to renal impairment in hypertension and chronic kidney disease (CKD). The study examines the association between retinochoroidal parameters and renal impairment in hypertensive, non-diabetic patients. This is a cross-sectional study on Caucasian patients with systemic arterial hypertension with different levels of renal function. All subjects were studied by blood chemistry, urine examination, microalbuminuria and blood pressure. Complete eye examination was completed with swept source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) scans of macular region. Patients were divided in groups: L…

The lacrimal gland herniation role in the Graves’ orbitopathy

To evaluate the LG involvement, through the measurement of the LG herniation by of magnetic resonance imaging (MRI), in patients with different GO activity

THINKING ABOUT OPHTHALMOLOGY IN THE ERA OF THE COVID-19 PANDEMIC

There is no part of the health care system that has remained unscathed by the COVID-19 pandemic in terms of its organizational, scientific or medical models. The surgical specialities were called upon to analyse the concepts of urgency and deferrable, reconsider the procedures and the times for those, and to evaluate new and specific strategies for the remote and safe management of patients. The aim of this paper is to evaluate new and different approaches in the field of ophthalmology triggered by the COVID-19 emergency. We analysed literature and on line documents; key words for the research were: SARS-CoV-2, COVID-19, ophthalmology, ophthalmologist, eye, guidelines, and their combination…

Mutation spectrum and clinical investigation of achromatopsia patients with mutations in the GNAT2 gene

Achromatopsia (ACHM) is a hereditary cone photoreceptor disorder characterized by the inability to discriminate colors, nystagmus, photophobia, and low-visual acuity. Six genes have been associated with this rare autosomal recessively inherited disease, including the GNAT2 gene encoding the catalytic α-subunit of the G-protein transducin which is expressed in the cone photoreceptor outer segment. Out of a cohort of 1,116 independent families diagnosed with a primary clinical diagnosis of ACHM, we identified 23 patients with ACHM from 19 independent families with likely causative mutations in GNAT2, representing 1.7% of our large ACHM cohort. In total 22 different potentially disease-causing…

N-retinylidene-N-retinylethanolamine adduct induces expression of chronic inflammation cytokines in retinal pigment epithelium cells

Blindness due to photoreceptor degeneration is observed in both genetic and acquired eye disorders. Long blue light exposure can contribute to increase levels of oxidative compounds within the retinal pigment epithelium (RPE), enhancing risk of retinal damage. In retina, reactive oxygen species contribute to the activation of inflammatory cascade. If chronic, this inflammatory response can result in photoreceptor death. Therefore, we investigated the effects of the endogenous adduct N-retinylidene-N-retinylethanolamine (A2E) on RPE cells, in order to identify the most dysregulated cytokines and their related inflammatory pathways. RPE cells were exposed to A2E and blue light for 3h and 6h. …

PHOTODYNAMIC THERAPY WITH VERTEPORFIN FOR CHOROIDAL NEOVASCULARIZATION ASSOCIATED WITH RETINAL PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION

Abstract PURPOSE: To assess the effectiveness of photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV) associated with retinal pigment epithelium detachment (PED) in age-related macular degeneration. METHODS: Thirty eyes of 26 patients with CNV and PED were treated with PDT. The eyes were divided in two groups based on CNV location in relation to PED; group 1 included 13 eyes with CNV within PED, and group 2 included 17 eyes with CNV at the edge of PED. The median follow-up was 16 months. RESULTS: Patients received a mean +/- SD of 2.83 +/- 1.26 treatments (range, 1-6 treatments). In the whole cohort, the mean preoperative visual acuity changed from 20/144 (0.86…

Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Background: The purpose of this study was to evaluate the association between a novel psychometric 12-item questionnaire (U-qest) and other validated questionnaires to assess quality of life and work impairment in patients with non-infectious uveitis. Methods: Data were collected at baseline and 3 months postbaseline using U-qest and two other validated questionnaires: The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and the 12-Item Short-Form Health Survey (SF-12). Results: A total of 136 patients (52.2% female) aged 47.9 ± 14.8 years (mean ± SD) were enrolled in 14 uveitis referral centres. U-qest correlated moderately with VFQ-25 and SF-12 at baseline and at 3 mo…

Relationship of choroidal thickness with pulsatile hemodynamics in essential hypertensive patients

Controversy exists about the association of choroidal thickness (CTh) with blood pressure (BP) values. There is some evidence suggesting that central hemodynamics changes are associated with microvascular disease. Our study was aimed to assess the relationships between CTh and clinic and 24-h BP and between CTh and estimated 24-h aortic pulse pressure (aPP), 24-h aortic systolic BP (aSBP), and 24-h aortic augmentation index (aAIx) in a group of hypertensive patients. We enrolled 158 hypertensive subjects (mean age 48 ± 13 years) all of which underwent evaluation of the choroidal district by Swept-Source optical coherence tomography (SS-OCT) and 24-h BP monitoring, in order to measure periph…

sj-docx-1-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-1-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Optic neuropathy caused by type A botulinic toxin

Purpose To report the development of an optical neuropathy after injection of type A botulinic toxin in a subject with blepharospasm. Methods Optical neuropathy was evaluated through a complete ophthalmologic examination consisting of bio-microscopy, tonometry and study of visual sharpness, colour test, visual field, OCT, fluorangiography and determination of VEPs. Results Intravenous therapy was begun with Metilprednisolone (20 mg/Kg/day) and Vitamin B6 associated with oral Citicoline, and there was a clear improvement down to normalization of the symptoms. After 6 months the Humphrey computerized visual field with central 30-2 program threshold test emphasised in ODx an upper half-field a…

sj-pdf-4-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-pdf-4-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Association between early-stage chronic kidney disease and reduced choroidal thickness in essential hypertensive patients.

The introduction in the past few years of advanced optical coherence tomography (OCT) techniques has greatly increased our understanding of the choroid, which is the most important vascular layer of the eye. Our study aimed to assess choroidal thickness by using swept-source OCT (SS-OCT) in essential hypertensive patients (EHs) with and without early-stage chronic kidney disease (CKD). We enrolled 100 EHs, of whom 65 were without kidney damage, and 35 had stage 1-3 CKD. In all of the participants, SS-OCT and a routine biochemical workup were performed. Glomerular filtration rate (GFR) was estimated by the CKD Epidemiology Collaboration equation (eGFR). CKD was defined in agreement with the …

Muscle Histopathological Abnormalities in a Patient With a CCT5 Mutation Predicted to Affect the Apical Domain of the Chaperonin Subunit.

Recognition of diseases associated with mutations of the chaperone system genes, e.g., chaperonopathies, is on the rise. Hereditary and clinical aspects are established, but the impact of the mutation on the chaperone molecule and the mechanisms underpinning the tissue abnormalities are not. Here, histological features of skeletal muscle from a patient with a severe, early onset, distal motor neuropathy, carrying a mutation on the CCT5 subunit (MUT) were examined in comparison with normal muscle (CTR). The MUT muscle was considerably modified; atrophy of fibers and disruption of the tissue architecture were prominent, with many fibers in apoptosis. CCT5 was diversely present in the sarcolem…

Retinal vascular imaging in cardiovascular medicine: New tools for an old examination

The old concept that the eye is the only window through which the body microcirculation can be observed in life easily, safely and repeatedly is part of the cultural baggage of every physician. When Hermann von Helmholtz invented the direct ophthalmoscope in 1850, he opened the door to a non-invasive visualization of human microcirculation in vivo at the retina. Only a few years later, the Scottish ophthalmologist Marcus Gunn documented the close association between retinal changes, and renal and cardiovascular diseases (CVD) in hypertensive patient. In 1939, Keith, Wagener, and Barker showed that the severity of retinal microvascular abnormalities was predictive of mortality in patients wi…

Rapida induzione di remissione di un caso di malattia di Vogt-Koyonagi-Harada recidivante dopo terapia con infliximab

A randomized trial of intravitreal bevacizumab vs. ranibizumab for myopic CNV.

AIMS: The aim was to compare the efficacy of intravitreal therapy with bevacizumab and ranibizumab for choroidal neovascularization (CNV) in pathologic myopia (PM). METHODS: This was a prospective multicenter randomized nonblinded trial. RESULTS: In seven centers, 78 eyes were randomized 1:1 to treatment with bevacizumab (group B, 40 eyes) or ranibizumab (group R, 38 eyes) given with an "on demand" regimen (PRN). The mean follow-up was 19 months (SD 2, range 12-24). The mean BCVA at baseline was 0.60 logMAR (20/80 Snellen equivalent, Seq) and 50 letter score (ls). Mean final BCVA was 0.51 LogMAR (20/63 Seq) and 57 ls (p = 0.0009 and p = 0.0002, respectively). In group B, mean basal BCVA was…

How Have Intravitreal Anti-VEGF and Dexamethasone Implant Been Used in Italy? A Multiregional, Population-Based Study in the Years 2010–2016

Purpose. To describe intravitreal anti-VEGF drug and dexamethasone use in four Italian regions. Methods. Four regional claims databases were used to measure drug prevalence, compare dosing intervals to those recommended in the summary of product characteristics (SPC), and identify switchers. Bilateral treatment and diabetic macular edema (DME) coding algorithms were validated, linking claims with a sample of prospectively collected ophthalmological data. Results. Overall, 41,836 patients received ≥1 study drug in 2010–2016 (4.8 per 10,000 persons). In 2016, anti-VEGF drug use ranged from 0.8 (Basilicata) to 5.7 (Lombardy) per 10,000 persons while intravitreal dexamethasone use ranged from 0…

Intravitreal dexamethasone implant one month before versus concomitant with cataract surgery in patients with diabetic macular oedema: the dexcat study

Purpose: To report clinical outcomes of two different timings of intravitreal dexamethasone (DEX) implant administration for prevention of diabetic macular oedema (DME) worsening following cataract surgery. Methods: This multicentre, retrospective study included patients with DME who received an intravitreal DEX implant 1 month before cataract surgery, ‘precataract DEX’ group, or at the time of cataract surgery, ‘concomitant treatments’ group. Inclusion criteria were a follow-up ≥3 months and ophthalmological examination with optical coherence tomography (OCT) imaging at baseline (cataract surgery) and throughout follow-up. Anatomical improvement was considered to be a decrease in OCT centr…

sj-docx-3-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-3-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

sj-pdf-5-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-pdf-5-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

sj-docx-1-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-1-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Angioid streak-related choroidal neovascularization treated by intravitreal ranibizumab.

PURPOSE The purpose of this study was to report the visual outcome of intravitreal therapy with ranibizumab of choroidal neovascularization secondary to angioid streaks after 1-year follow-up. METHODS Nine patients (age, 58 +/- 4 years; range, 53-65 years) were treated with off-label intravitreal injections of 0.3 mg ranibizumab. Primary outcomes were best-corrected visual acuity changes (Early Treatment Diabetic Retinopathy Study logarithm of the minimum angle of resolution and letters) and optical coherence tomography macular thickness changes. RESULTS Mean follow-up was 14 months (+/-2; range, 12-18 months). Mean visual acuity was 0.52 logarithm of the minimum angle of resolution and 30 …

Lacrimal gland herniation in Graves ophthalmopathy: a simple and useful MRI biomarker of disease activity

Lacrimal gland (LG) involvement in patients with Graves ophthalmopathy (GO) has been considered as a potential cause of the associated GO symptoms and different studies demonstrated the LG involvement in patients with GO than healthy controls. The aim of this study was to evaluate LG involvement, through measurement of its herniation, using a magnetic resonance imaging (MRI) index, in patients with different GO activities. Thirty-two consecutive Caucasian patients affected by GO were enrolled and grouped in group A (16 with inactive GO, CAS < 3) and B (16 with active GO, CAS ≥ 3) according to their GO activity. All patients underwent clinical-endocrinological assessment, a complete ocular e…

Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization in pathologic myopia: a long-term follow-up study.

Purpose To assess the effect of verteporfin photodynamic therapy (PDT) in juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia (PM). Design Prospective, open-label, consecutive, interventional case series. Methods We prospectively followed a series of 48 consecutive patients (49 eyes) with pathologic myopia (≥ 6 diopters) who received verteporfin PDT for juxtafoveal CNV. This population was divided into two groups based on age (group A ≤ 55 years old, group B >55 years old), in three subgroups based on CNV lesion size, and in three categories based on refractive error at baseline. Results The median follow-up was 32 months (range, 12 to 56 months). Visual acuity (VA…

Mutation Analysis Identifies GUCY2D as the Major Gene Responsible for Autosomal Dominant Progressive Cone Degeneration

PURPOSE. Heterozygous mutations in the GUCY2D gene, which encodes the membrane-bound retinal guanylyl cyclase-1 protein (RetGC-1), have been shown to cause autosomal dominant inherited cone degeneration and cone–rod degeneration (adCD, adCRD). The present study was a comprehensive screening of the GUCY2D gene in 27 adCD and adCRD unrelated families of these rare disorders. METHODS. Mutation analysis was performed by direct sequencing as well as PCR and subsequent restriction length polymorphism analysis (PCR/RFLP). Haplotype analysis was performed in selected patients by using microsatellite markers. RESULTS. GUCY2D gene mutations were identified in 11 (40%) of 27 patients, and all mutation…

Efficacy and Safety of Subthreshold Micropulse Yellow Laser for Persistent Diabetic Macular Edema After Vitrectomy: A Pilot Study

Aim: To examine the effect of subthreshold micropulse yellow laser (SMYL) on best-corrected visual acuity (BCVA), central macular thickness (CMT), and optical coherence tomography angiography (OCT-A) changes in eyes with persistent diabetic macular edema (DME) after pars plana vitrectomy (PPV) for tractional DME (TDME).Patients and Methods: In a comparative study, 95 eyes of 95 consecutive patients with persistent DME were prospectively enrolled. The SMYL group (54 eyes) was treated with SMYL 6 months after PPV, while the control group (41 eyes) was followed up without treatment. BCVA and CMT by OCT were analyzed at baseline and 3 and 6 months. Additionally, parameters such as the vessel de…

Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long-Term Swept-Source OCT Analysis

Background and Objectives: To compare the long-term toxicity of infracyanine green (IFCG) to brilliant blue G (BBG) in inverted internal limiting membrane flap surgery (I-ILMFS) for large, full-thickness macular holes (FTMHs). Materials and Methods: Prospective randomized study including 39 eyes with &ge

SUBCLINICAL RENAL DAMAGE IS ASSOCIATED WITH A REDUCED CHOROIDAL THICKNESS IN PATIENTS WITH PRIMARY HYPERTENSION

Objective: The retina is considered the easiest accessible window to study the state of the systemic microcirculation, even if the choroid is the most important vascular layer of the eye. Our understanding of the choroid has been greatly increased in last years since the introduction of advanced techniques of optical coherence tomography (OCT). Our study was aimed to assess choroidal thickness by using Swept-Source OCT (SS-OCT) in essential hypertensive patients (EHs) with and without subclinical renal damage (SRD). Design and method: We enrolled 100 EHs of which 65 without kidney damage and 35 with SRD. In all the participants SS-OCT and a routine biochemical work-up were performed. Glomer…

Is Ranibizumab effective in stopping the loss of vision for Choroidal Neovascularization in Pathologic Myopia? A Long Term Follow-up Study

Aim To assess the efficacy and safety of ranibizumab in the treatment of choroidal neovascularisation (CNV) caused by pathologic myopia (PM). Design Prospective, multicentre, interventional case series. Methods 40 eyes of 39 consecutive patients with PM and CNV were treated with ‘on demand’ intravitreal injection of ranibizumab 0.5 mg. Final best corrected visual acuity (BCVA) and its change from baseline were the main outcome measures. Changes in optical coherence tomography (OCT) central retinal thickness (CRT) were a secondary outcome. Results Mean age was 53±13 years and mean refractive error –13.5±6.5 D. Median follow-up was 13.3±2 (range 12–18) months. Fifteen eyes (37.5%) had previou…

A Novel CCT5 Missense Variant Associated with Early Onset Motor Neuropathy

Diseases associated with acquired or genetic defects in members of the chaperoning system (CS) are increasingly found and have been collectively termed chaperonopathies. Illustrative instances of genetic chaperonopathies involve the genes for chaperonins of Groups I (e.g., Heat shock protein 60, Hsp60) and II (e.g., Chaperonin Containing T-Complex polypeptide 1, CCT). Examples of the former are hypomyelinating leukodystrophy 4 (HLD4 or MitCHAP60) and hereditary spastic paraplegia (SPG13). A distal sensory mutilating neuropathy has been linked to a mutation [p.(His147Arg)] in subunit 5 of the CCT5 gene. Here, we describe a new possibly pathogenic variant [p.(Leu224Val)] of the same subunit b…

GLI INDICATORI DI WOLFF PER LA VALUTAZIONE DEL RISCHIO CLINICO

Real-life patient journey in neovascular age-related macular degeneration: a narrative medicine analysis in the Italian setting

Objectives To investigate the real-life experience of patients affected by neovascular age-related macular degeneration (nAMD), in the healthcare pathway for the management of the disease, using a "patient journey" and narrative method approach. Methods The patient journey of subjects affected by nAMD was designed using a process-mapping methodology involving a team from 11 Italian centres. Subsequently, narratives were collected from nAMD patients and family members. The interviews were analyzed using the narrative medicine methodology. Results Eleven specialized retina centres across Italy were involved and 205 narratives collected. In 29% of cases, patients underestimated their symptoms …

Deep sclerectomy versus punch trabeculectomy with or without phacoemulsification: a randomized clinical trial.

Purpose: To compare the efficacy of non-penetrating deep sclerectomy without implant with Crozafon-De Laage punch trabeculectomy, and to evaluate the effect of simultaneous temporal approach phacoemulsification on both techniques. Patients and Methods: Setting: Department of Ophthalmology of the University of Palermo. Design: Prospective randomized clinical trial. Patients and intervention procedures: Sixty-five patients (65 eyes) with primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PEXG): 32 eyes underwent non-penetrating deep sclerectomy (NPDS), 17 as single procedure and 15 combined with phacoemulsification (phaco- NPDS), and 33 eyes underwent punch trabeculectomy (PT),…

Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization secondary to pathologic myopia: long-term study.

Purpose: To assess the safety and effectiveness of photodynamic therapy (PDT) with verteporfin for subfoveal choroidal neovascularization (CNV) secondary to pathologic myopia (PM). Methods: Sixty-two patients (62 eyes) with PM underwent PDT according to the guidelines of the Verteporfin in Photodynamic Therapy Study. Clinical evaluations performed at all study visits included measurement of best-corrected Snellen visual acuity, slit-lamp biomicroscopy, and fundus fluorescein angiography. Patients were followed up at 1 month and 3 months after treatment and thereafter at 3-month intervals. Results: The final visual acuity of the study patients, after a median follow-up of 31 months, improved…

Uveal effusion syndrome complicated by anterior ischemic optic neuropathy

We report on a case of idiopathic uveal effusion syndrome complicated by AION. To our knowledge such an association hasn't been previously described. We suggest that scleral thickening caused obstruction of vortex veins followed by uveal effusion and compression of posterior ciliary arteries within their intrascleral tract, leading to AION. Nevertheless it can't be excluded that AION was the result of mechanical compression on ciliary vessels of optic disc by choroidal detachment. © 1996, Kluwer Academic Publishers. All rights reserved.

INVERSE RELATIONSHIPS BETWEEN CHOROIDAL THICKNESS AND RENAL RESISTANCE INDEX IN HYPERTENSIVE PATIENTS

Introduction: Alterations of the renal microcirculation have been documented in animal models of hypertensive renal damage. Traditionally, the retina has been considered the easiest accessible window to study the systemic microcirculation, even though the choroid is the most important vascular layer of the eye. The introduction in the past few years of advanced optical coherence tomography (OCT) techniques has greatly increased our understanding of the choroid. Although the renal resistive index (RRI) was initially considered to reflect intrarenal vascular pathological processes, this index is actually regarded as the result of complex interaction between renal and systemic vascular wall pr…

Optical coherence tomography angiography evaluation of peripapillary microvascular changes after rhegmatogenous retinal detachment repair

PURPOSE To evaluate the radial peripapillary capillary plexus (RPCP) vessel density (VD) and the retinal nerve fiber layer (RNFL) thickness in eyes successfully treated with pars plana vitrectomy for primary rhegmatogenous retinal detachment. METHODS In this cross-sectional multicenter clinical study, eyes with a minimum 12-month follow-up were reexamined. The RPCP VD and RNFL thickness in the rhegmatogenous retinal detachment subfields of the affected eye (study group) were compared with the corresponding areas of the healthy fellow eyes (control group). RESULTS Fifty-three eyes were included in the study. A significantly lower RPCP VD and RNFL thickness were observed in those subfields af…

Indicatori di Wolff per la valutazione del rischio clinico: Fase preliminare presso il Presidio Ospedaliero "Sant'Antonio Abate" di Trapani.

sj-docx-2-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-docx-2-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Mutations in the Cone Photoreceptor G-Protein α-Subunit Gene GNAT2 in Patients with Achromatopsia

Achromatopsia is an autosomal recessively inherited visual disorder that is present from birth and that features the absence of color discrimination. We here report the identification of five independent families with achromatopsia that segregate protein-truncation mutations in the GNAT2 gene, located on chromosome 1p13. GNAT2 encodes the cone photoreceptor-specific alpha-subunit of transducin, a G-protein of the phototransduction cascade, which couples to the visual pigment(s). Our results demonstrate that GNAT2 is the third gene implicated in achromatopsia.

Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies.

Hypertension is a major cardiovascular risk factor that is responsible for a heavy burden of morbidity and mortality worldwide. A critical aspect of cardiovascular risk estimation in hypertensive patients depends on the assessment of hypertension-mediated organ damage (HMOD), namely the generalized structural and functional changes in major organs induced by persistently elevated blood pressure values. The vasculature of the eye shares several common structural, functional, and embryological features with that of the heart, brain, and kidney. Since retinal microcirculation offers the unique advantage of being directly accessible to non-invasive and relatively simple investigation tools, the…

sj-pdf-4-ejo-10.1177_11206721211034649 – Supplemental material for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires

Supplemental material, sj-pdf-4-ejo-10.1177_11206721211034649 for Non-infectious uveitis burden on quality of life and work impairment assessed through different psychometric questionnaires by Luca Cimino, Piergiorgio Neri, Elisabetta Miserocchi, Maria Pia Paroli, Lorenzo Vannozzi, Leonardo Mastropasqua, Caterina Gagliano, Maria Vadalà, Michele Figus, Francesca Romana Florio, Barbara Iaccheri, Paolo Mora, Maurizio Fossarello, Paola Balestrieri, Giuliana Gualberti, Francesca Marando and Massimo Accorinti in European Journal of Ophthalmology

Risonanza magnetica DWI nei pazienti affetti da Orbitopatia di Graves.

Postoperative endophthalmitis incidence after intravitreal therapy: a comparison of two different preoperative antibiotic prophylaxis.

Prevention of postoperative endophthalmitis (POE) is a goal of every ophthalmic procedure and also in intravitreal therapy (IVT). This comparative retrospective study targets whether systemic and topical preoperative antibiotic prophylaxis (PAP) regimen does prevent POE after IVT in a higher rate compared with topical PAP alone. Out of 6111 IVT performed over a period of 103.5 months, in the study group A patients were treated with systemic and topical PAP (2881 IVT), and in the study group B patients were treated only with topical PAP (3230 IVT). Intravitreal drugs were anti-VEGF, triamcinolone and dexamethasone implants. The incidence of POE in group A (1/2881 or 0.035 % per injection) wa…

Assessment of intravitreal anti-VEGF drugs and dexamethasone for retinal diseases in real world setting: A multi-centre prospective study from Southern Italy

Describe drug utilisation and clinical outcomes of intravitreal anti-VEGF drug and dexamethasone use in the real-world setting in Southern Italy using data from multi-centre study of retinal disease. Clinical data of retinal disease patients treated with anti-VEGF drugs and dexamethasone implant in 6 out-patient ophthalmology centres from Southern Italy were collected by means of an electronic case report form. Patients receiving at least one intravitreal injection/implant of the study drugs were followed for up to two years and described in terms of demographics and clinical characteristics. Drug utilisation patterns were described. A sign-rank test was used to compare clinical data on vi…

The Renal Dangers of an Increased Cardio-Ankle Vascular Index

Although a number of longitudinal investigations assessed the ability of aortic PWV to predict the development of kidney disfunction or progression of renal disease, little is known about the association of CAVI with the risk of renal function deterioration. In the current issue of the American Journal of Hypertension is published a paper of Itano S et al, that add a new piece of evidence in this scenario. The authors analyzed data from the national health check-up system in Japan, including 24.297 participants with normal baseline kidney function. They found that those with CAVI measurements ≥8.1 had a higher risk for CKD events compared to their counterparts with CAVI measurements &lt;8.1…

The Narrative Medicine Approach in the Treatment of Diabetic Macular Edema: An Italian Experience.

The study retraces the healthcare pathway of patients affected by diabetic macular edema (DME) through the direct voice of patients and caregivers by using a &ldquo;patient journey&rdquo; and narrative method approach. The mapping of the patient&rsquo;s journey was developed by a multidisciplinary board of health professionals and involved four Italian retina centers. DME patients on intravitreal injection therapy and caregivers were interviewed according to the narrative medicine approach. Narratives were analyzed through a quali-quantitative tool, as set by the narrative medicine method. The study involved four specialized retina centers in Italy and collected a total of 106 narratives, 8…

The ocular manifestations in IBD screening (OMIS) questionnaire: pilot study on detection of ocular involvement in inflammatory bowel diseases.

Purpose: To assess the usefulness of a dedicated questionnaire for patients with inflammatory bowel diseases (IBD) treated with biological drugs for the detection of ocular extraintestinal manifestations (EIMs). IBD can cause extraintestinal symptoms including ocular complaints which are frequently ignored and may be associated with significant morbidity, including blindness. Methods: We developed a questionnaire, named Ocular Manifestations in IBD Screening (OMIS) questionnaire, after agreement between gastroenterologists and ophthalmologists. The questionnaire was administered by a non-ophthalmologist physician to 96 IBD patients treated with biological drugs. Results: 35 patients (36.5%)…

Transient reduction of the ocular perfusion pressure and the oscillatory potentials of the ERG

Abstract Purpose. To evaluate the changes of the Oscillatory Potentials (OPs) of Electroretinogram (ERG) caused by short-term hypertension in human subjects, and their relationship with ocular perfusion pressure (OPP). Methods. Suction cup technique in 12 normal volunteers with OPs simultaneously recording. Results. Scotopic and photopic OPs were altered during OPP drop. Scotopic OPs showed more sensitiveness, with higher reduction (from 21% to 47%), when compared to the basal value, than in photopic recordings (from 14% to 34%). In both conditions, the relationship between OPP and OPs presented a steady amplitude before the trough after the +30 step, and rapid recovery after OPP normalisat…

Bilateral Ultrathin Descemet’s Stripping Automated Endothelial Keratoplasty vs. Bilateral Penetrating Keratoplasty in Fuchs’ Dystrophy: Corneal Higher-Order Aberrations, Contrast Sensitivity and Quality of Life

Background and Objectives: The objective of this paper is to compare the visual outcomes and quality of life (QoL) after bilateral ultrathin Descemet’s stripping automated endothelial keratoplasty (UT-DSAEK) with bilateral penetrating keratoplasty (PK) for Fuchs’ endothelial dystrophy (FED). Materials and Methods: Retrospective comparative cohort study, including 11 patients with FED who underwent bilateral PK and 13 patients with FED who underwent bilateral UT-DSAEK. All patients were already pseudophakic or had undergone a combined cataract procedure. The main outcomes were corrected distance visual acuity (CDVA) corneal higher-order aberrations (HOAs), contrast sensitivity (CS) and quali…

OCT-Angiography evaluation of peripapillary microvascular changes after rhegmatogenous retinal detachment repair

Purpose: To evaluate the radial peripapillary capillary plexus (RPCP) vessel density (VD) and the retinal nerve fiber layer (RNFL) thickness in eyes successfully treated with pars plana vitrectomy for primary rhegmatogenous retinal detachment. Methods: In this cross-sectional multicenter clinical study, eyes with a minimum 12-month follow-up were reexamined. The RPCP VD and RNFL thickness in the rhegmatogenous retinal detachment subfields of the affected eye (study group) were compared with the corresponding areas of the healthy fellow eyes (control group). Results: Fifty-three eyes were included in the study. A significantly lower RPCP VD and RNFL thickness were observed in those subfields…