maculopatia associata a tilted disk

The effects of prostaglandin F2α in the human eye

The ocular effects of 200 micrograms of topically applied prostaglandin F2 alpha were studied in 18 nonglaucomatous volunteers. A fall in intraocular pressure was seen in the prostaglandin-treated eyes when compared with the placebo-treated control eyes. The maximum intraocular pressure reduction was observed at the 7th h and hypotensive ocular effect persisted for 24 h. Prostaglandins did not produce any change in pupillary diameter or signs of intraocular inflammation visible by anterior segment biomicroscopy or iris fluorescein angiography. The drug caused side effects: conjunctival hyperemia was constant and many patients complained of ocular smarting and headache. It could be useful in…

Casteldaccia eye study: prevalence of cataract in the adult and elderly population of a Mediterranean town.

Prevalence of cataract was studied in a population based survey performed in adults aged 40 years or more living in Casteldaccia, a small Sicilian town. Lens opacities of moderate or severe grade (type II or worse, according to the Lens Opacity Classification System II) were found at the following rates: nuclear opalescence in 18.5%, cortical cataract in 12.9%, posterior subcapsular cataract in 10.8%. All these types of cataract were much more frequent in the elderly population and were about 1.5 times more common in women than in men. Late cataract was found in about 1/3 of subjects aged 60 to 69 years, in 2/3 of subjects aged 70 or more, but rarely under 60 years of age. However, early ca…

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.

OPTICAL COHERENCE TOMOGRAPHIC FINDINGS IN BIETTI’S CRYSTALLINE TAPETORETINAL DYSTROPHY

Purpose: To report the optical coherence tomography (OCT) findings of Bietti crystalline tapetoretinal dystrophy. Design: Observational case report. Methods: A subject with Bietti crystalline tapetoretinal dystrophy was evaluated with ophthalmoscopy, fluorescein angiography, and OCT (Stratus). Results: OCT showed thinning and hyporeflectivity of the outer nuclear layer in the macula due to photoreceptor degeneration. The retinal areas showing atrophy of the retinal pigment epithelium displayed greater penetration of the optical beam into the choroid and visualization of residual choroidal vessels. The hyperreflective band normally seen under the neurosensory retina was extremely wide when a…

Vascular modifications within a choroidal osteoma

We report a case of choroidal osteoma followed-up for 7 years. During this lapse of time the choroidal osteoma showed slight enlargement, development of subretinal hemorrhage and modifications of intratumoral vascularization. Some large intratumoral vessels visible at first examination disappeared at follow-up, while other vessels not observed before developed. The changes in the vascularization of the choroidal osteoma denote profound dynamics in the processes of osseous rearrangement of the tumor.

Idiopathic intracranial hypertension: orbital MRI

The case is reported of a patient with idiopathic intracranial hypertension examined with magnetic resonance imaging. Marked enhancement of the optic nerve heads was found, which might be related to blood-retinal barrier breakdown related to a sudden rise in intracranial cerebrospinal fluid pressure.

Main posterior watershed zone of the choroid

The main posterior watershed zone of the choroid is located between the nasal edge of the optic disc and the fovea and represents the area situated between the territories supplied by the temporal and nasal posterior ciliary arteries. In the fluorescein angiographies of 800 normal subjects a watershed zone was not observed in 33.1% due to technical reasons and in 22.3% due to the simultaneous filling of the peripapillar and macular choriocapillaris. In the remaining 44.6% the watershed zone was well outlined: it was straddling the optic disc in about half of these cases and involved the temporal half of the optic disc and the close choroid in the other half. Very rarely the watershed zone i…

Optociliary veins and central retinal vein occlusion.

In a follow up of 94 patients with central retinal vein occlusion (CRVO) whose onset had taken place less than 1 year earlier, optociliary veins (OCVs) were found in 7.4% at first examination. Among the 79 eyes in which the fundus of the eye was very visible after a follow up of more than 1 year OCVs were found in 30.4%, showing a late development of OCVs in many cases of CRVO. No difference was found in the occurrence of OCVs between non-ischaemic and ischaemic forms of CRVO. The visual acuity of the eyes with CRVO that developed OCVs was not significantly different from the visual acuity of the eyes without OCVs. Thus, the presence of OCVs in CRVO does not seem to be associated with bette…

Peripapillary Staphyloma and Asymmetric Morning Glory Anomaly

We report a patient with concomitant occurrence of peripapillary staphyloma and morning glory anomaly. The morning glory anomaly presented with an optic nerve head with oblique entrance, located on one side of the peripapillary staphyloma, giving an unusually asymmetric and previously undescribed appearance to the abnormality. The optical coherence tomography provided useful information about the shape and deepness of the peripapillary staphyloma and disclosed a retinal detachment not appreciated ophthalmoscopically.

Electrofunctional features of the tilted disc syndrome.

The ERG, EOG and VEPs of 15 patients with tilted disc syndrome were studied. The ERG showed abnormal amplitudes in about 1/4 of the eyes and the EOG values were pathological in 3 patients. It is probable that the abnormality of the inferior-nasal portion of the retina and retinal pigment epithelium seen in the tilted disc syndrome causes the changes in the ERG and EOG. Pattern VEPs latency was delayed in most patients. This finding is probably due to the poor focusing of the light in the retina.

Tilted discs and central retinal vein occlusion.

Choroidal filling pattern during a hypotensive crisis

Observation d'une jeune femme de 18 ans atteinte de dystrophie progressive des cones et bâtonnets et ayant presente une crise d'hypotension arterielle au cours d'une angiographie fluoresceinique

Changes in colour discrimination during the menstrual cycle.

A group of normal women of reproductive age were recruited to investigate colour discrimination during the various phases of the menstrual cycle. Colour vision was tested with the Farnsworth-Munsell 100-hue arrangement test, and the test was administered at 3 time points: the beginning of the cycle, ovulation, and the end of the cycle. We found that colour discrimination was better at ovulation than at the other 2 time points. It is possible that psychological as well as hormonal factors could contribute to improved colour vision performance at ovulation.

Gd-DTPA in blood-ocular barrier damage: a new diagnostic tool for future application in MRI?

The blood-brain barrier is not the only neuroepithelial blood filter in the body: the eye too is supported by a highly specialised microvascular filter, the so-called blood-ocular barrier (BOB). The BOB is actually divided into a blood-aqueous (BAB) and a blood-retinal (BRB) barrier, filtering the aqueous fluid and biological supplies, respectively, to the retina. The authors’ purpose was to study the possibility of imaging BAB or BRB damage by contrast-enhanced MRI: they examined 21 patients with a 0.5 T system and surface coil. Despite the normal findings in the damaged eyes immediately after a Gd-DTPA bolus, delayed contrast-enhanced MRI was able to show focal or diffuse barrier damage.

Psychophysical and electrofunctional contrast sensitivity in cataractous patients treated with bendazac-lysine salt

The clinical progression of the cataract may be influenced by drugs which reduce the denaturation of lens proteins. One of the most promising drugs is the bendazac-lysine salt. The drug was used in a double-blind study of a group of patients with initial cortical cataract in order to evaluate the changes in visual acuity and contrast sensitivity by means of a psychophysical and an electrophysiological method. After 6 months of treatment with bendazac the mean values of visual acuity showed a statistically significant increase in respect to baseline values, as well as an improvement of the threshold of contrast for most spatial frequencies. In the eyes treated with placebo there was no stati…

HER2 status in advanced gastric carcinoma: A retrospective multicentric analysis from Sicily.

According to the ToGA trial, HER2 has been shown to be predictive for the success of treatment with trastuzumab in advanced gastric cancer (AGC). A number of studies have analyzed HER-2/neu overexpression in gastric carcinoma and identified the rate of HER2 positivity to be markedly varied. To date, the prevalence of HER2 overexpression in Sicilian people with AGC is unknown. Therefore, in the present study, a retrospective immunohistochemical analysis of HER2 was performed in a cohort of 304 AGC samples that were obtained from the archives of 10 Sicilian anatomopathological diagnostic units in order to verify the positive rate of HER2-positive cases. Furthermore, the characteristics of his…

Serous Detachment of the Retina: A Complication of Branch Retinal Vein Stenosis

The author reports a case of serous detachment of the retina, which has developed in an eye with veno-venous collaterals, secondary to stenosis of a branch of the central retinal vein near the optic disc. This complication has not previously been described in this retinal vascular obstructive disease.

Prepapillary venous loops and choroidal veins tortuosity

Morphological and biomolecular characteristics of subcentimetric invasive breast carcinomas in Sicily: A multicentre retrospective study in relation to trastuzumab treatment

Little information from clinical trials is available regarding the efficacy of trastuzumab treatment in subcentimetric breast carcinomas (BCs). The aim of this study was to verify the existence of correlations between HER2 and hormone receptor status, Ki67 values, grade, histotype and node involvement in a cohort of pT1a,b BCs from an area not widely covered by screening campaigns. A total of 410 pT1a,b BC formalin-fixed paraffin-embedded samples collected from eight Sicilian Anatomo-Pathological Units (APUs) were classified according to the WHO classification and tumour grading was established. Estrogen and progesterone receptor status, Ki67 labelling index and HER2 status were available. …

A case-control study on risk factors for nuclear, cortical and posterior subcapsular cataract: The Casteldaccia Eye Study

. Purpose: To investigate risk factors for nuclear, cortical and posterior subcapsular age-related cataract. Methods: A case-control study was carried out on subjects aged 40 years and older, living in Casteldaccia, Sicily. Twenty-seven potential risk factors were investigated. Nuclear, cortical and posterior subcapsular opacities of the lens were classified according to the Lens Opacities Classification System II. Subjects with advanced lens opacities represented the cases, while an identical number of subjects without or with early cataract, matched for sex and age, were recruited as controls from within the same population. Results: Univariate analysis showed that myopia and iris atrophy…

Optical coherence tomography of chorioretinal and choroidal folds

. Purpose:  To report the optical coherence tomography (OCT) findings in cases of chorioretinal and choroidal folds. Methods:  Eight subjects with folds of the fundus of the eye were examined with fundus photography, fluorescein angiography, B-scan ultrasonography and Stratus OCT. Results:  Two types patterns were found on OCT. Five cases showed undulating retinal as well as retinal pigment epithelial lines of normal thickness; these were defined as chorioretinal folds. The posterior vitreous surface often adhered to the crests of the folds only. Three cases exhibited a wavy appearance of the retinal pigment epithelium and a flat retinal surface; these were classified as choroidal folds. Co…

Prevalence and causes of blindness and low vision in the Casteldaccia Eye Study.

In a population-based survey performed on the middle-aged and elderly population of Casteldaccia, Sicily, we found that the prevalence of blindness was 0.47% and the prevalence of low vision 1.22%. Unilateral blindness affected 2.81% of the population and unilateral low vision 4.12%. Visual impairment was much more frequently seen in subjects aged 70 years or more than in younger persons. The main cause of visual impairment was cataract, followed by amblyopia, which was responsible for many cases of unilateral low vision.

Prevalence of glaucoma and distribution of intraocular pressure in a population. The Casteldaccia Eye Study.

IOP was measured in 1062 middle-aged and elderly subjects of a small Sicilian town, enrolled in a population based survey. The mean IOP was 15.1 +/- 3.7 mmHg without interocular or sex differences. A small but significant age-dependent increase of IOP was found. Circadian and seasonal influences were recorded: IOP was higher in the morning and in winter. The prevalence of chronic open-angle glaucoma was 1.2%, but it grew to 3.6 if only subjects aged 70 years or more were considered. IOP of 24 mmHg or more was found in 2.7%, while 4.3% of subjects showed IOP of 21 mmHg or more. This survey shows that mean IOP of the Mediterranean population studied is similar to the IOP found in other epidem…

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.

Su di un caso di Schwannoma primitivo intraorbitario

Gli Schwannomi costituiscono il 6,8% dei tumori intracranici ed originano solitamente dai nervi sensitivi, con particolare predilezione per il V e VIII nervo cranico. Uno schwannoma a partenza da un nervo oculomotore costituisce invece una evenienza piuttosto rara, e solo 17 casi di s. del III n.c. sono stati documentati in letteratura. Sono da considerare ancora più rari gli schwannomi ad esclusiva localizzazione intraorbitaria (1–5, 7% dei tumori orbitari). Solitamente tipico dell'uomo adulto, con l'eccezione dei soggetti affetti da Neurofibromatosi di tipo 2, lo schwannoma orbitario esordisce solitamente come un processo espansivo a lento accrescimento, determinante diplopia, esoftalmo …

Optic pit syndrome

In a study of 15 eyes with optic pits fluorescein angiography revealed that only pits associated with serous detachment of the macular retina showed fluorescence in the late venous phase, while the pits uncomplicated by detachment remained hypofluorescent throughout the test. This finding strongly supports the hypothesis that the subretinal fluid producing the macular detachment originates from leakage of vessels located in the floor of the pit. In addition a high incidence of anomalies was found to be associated with optic pits. Therefore the author suggests to call the association between optic pit and large optic disc, parapapillary chorioretinal changes, cilioretinal vessels, situs inve…

Prevalence and risk factors of diabetic retinopathy in adult and elderly subjects. The Casteldaccia Eye Study

PURPOSE: To investigate the prevalence and risk factors of diabetic retinopathy in subjects aged 40 years or older living in Casteldaccia, Sicily. METHODS: A population-based survey was performed on 1,588 subjects randomly enrolled among people aged 40 years or older. A total of 1,068 persons could be examined and in 1,019 the fundus of the eye was adequately observed (64.2% of the enrolled population). Diabetic retinopathy was diagnosed by ophthalmoscopy and fundus photographs; fluorescein angiography was performed in 91% of retinopathic subjects. In addition, a case-control study was carried out in order to demonstrate the association of diabetic retinopathy with a number of variables. RE…

Risk factors of ocular hypertension and glaucoma. The Casteldaccia Eye Study.

A case-control study was planned as a part of the Casteldaccia Eye Study in order to investigate about risk factors of ocular hypertension and glaucoma. Cases were 44 subjects with glaucoma or intraocular pressure of 24 mm Hg or more. Controls were 220 subjects with intraocular pressure of 20 mm Hg or less and no signs of glaucoma. A number of environmental, behavioral, systemic and ocular variables were studied. Among the others we investigated the following: sunlight exposure, smoking, alcohol intake, pregnancies, systemic hypertension, diabetes, use of corticosteroids, refractive status, anterior chamber depth, lens nuclear sclerosis, iris color and texture. After univariate analysis the…

Orbital varices: a tricky diagnosis in MRI

Orbital varix (OV) is a rare condition causing intermittent positional exophthalmos. Because of low venous pressure, OVs tend to collapse, being frequently undetectable in routine CT or MRI examinations. We describe one case of giant intraorbital varix studied with CT and MRI techniques.

Optical coherence tomography in congenital hypertrophy of the retinal pigment epithelium.

Delayed filling of retinal and ciliary circulation after central retinal artery occlusion

The filling times of the retinal and choroidal circulation were evaluated in 17 patients with central retinal artery occlusion by means of fluorescein angiography. A correlation between the filling times of the two circulations was found. However, two filling patterns were seen: first, both fillings delayed; second, both fillings normal. It is probable that in the former case an obstructive disease of the carotid arteries exists, while in the latter case an important pathology of the carotid arteries is lacking, favouring a rapid restoration of the retinal circulation. This hypothesis seems to be confirmed by the results of the Doppler velocimetry of the carotid arteries.

The molecular profiling of solid tumors by liquid biopsy: a position paper of the AIOM–SIAPEC-IAP–SIBioC–SIC–SIF Italian Scientific Societies

The term liquid biopsy (LB) refers to the use of various biological fluids as a surrogate for neoplastic tissue to achieve information for diagnostic, prognostic and predictive purposes. In the current clinical practice, LB is used for the identification of driver mutations in circulating tumor DNA derived from both tumor tissue and circulating neoplastic cells. As suggested by a growing body of evidence, however, there are several clinical settings where biological samples other than tissue could be used in the routine practice to identify potentially predictive biomarkers of either response or resistance to targeted treatments. New applications are emerging as useful clinical tools, and o…

Central retinal vein occlusion in young people.

In a study performed on 20 subjects with central retinal vein occlusion (CRVO) aged 40 years or less we found the ischemic form in 20%. Disc edema was a common finding at the onset, while macular edema was less frequently seen. Systemic or ocular disorders that could be related with the development of the CRVO were often found; a patient was affected with myasthenia gravis and another with Sturge-Weber syndrome: these two diseases were not previously reported in association with CRVO. In only two of the 11 patients followed-up the visual acuity improved. The visual prognosis in CRVO of young people is often poor; the more frequent cause of the reduced visual acuity is chronic cystoid macula…

Subretinal neovascularization in anterior ischemic optic neuropathy.

A 66-year-old man with typical anterior ischemic optic neuropathy in one eye suffered from edema of the optic disc without functional changes in the fellow eye. However, 7 months later, a reduction in visual acuity, a change in the visual field and a worsening of the contrast-sensitivity curve demonstrated the development of typical anterior ischemic optic neuropathy in this eye as well. After another 6-month period, in addition to these changes, an extensive subretinal neovascular membrane developed in the papillomacular area, which further reduced the patient's visual acuity and required treatment with laser photocoagulation. To our knowledge, this is the first case report of the occurren…