1
|
Parolini B, Rosales Padrón JF, Lopes E, Matello V, Crincoli E. Evaluation of macular atrophy in patients treated with macular buckle for myopic traction maculopathy (MTM): mid and long-term follow-up. Retina 2024:00006982-990000000-00618. [PMID: 38452307 DOI: 10.1097/iae.0000000000004094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To evaluate the incidence, rate and pattern of progression of myopic maculopathy in eyes operated with macular buckle (MB) for myopic traction maculopathy (MTM) vs a control group without surgery to find out if the progression varies due to the macular buckle's indentation, and to evaluate possible MB-related pigmentary changes or atrophy. METHODS Eyes operated with macular buckle with two good quality fundus images: one preoperative or early postoperative image and the second image of at least 12 months apart, the control group was comprised by the contralateral eyes. Demographics, axial length, follow-up, stage of MTM and myopic maculopathy were reported. Groups and subgroups (mid and long-term follow-up) progression results were reported and compared. RESULTS We included 116 eyes of 66 patients. Progression was found in 29 eyes (41.4%) and 23 eyes (50%) in the macular buckle group and control group, respectively. The progression rate was 73 per 1000 eye-years and 88.9 per 1000 eye-years in the macular buckle group and the control group, respectively. Axial length was found a predictor of progression (OR,2.59; p=0.02). CONCLUSION Progression of myopic maculopathy was similar in both groups, even mildly grater in the control group. We did not find any MB-related pigmentary changes or atrophy.
Collapse
Affiliation(s)
- Barbara Parolini
- . Department of Ophthalmology, Eyecare Clinic, Brescia, Italy (Institution where the study was performed)
| | - Jaime Francisco Rosales Padrón
- . Department of Ophthalmology, Eyecare Clinic, Brescia, Italy (Institution where the study was performed)
- . Department of Retina, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Edgar Lopes
- . Department of Ophthalmology, Eyecare Clinic, Brescia, Italy (Institution where the study was performed)
- . Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Veronika Matello
- . Department of Ophthalmology, Eyecare Clinic, Brescia, Italy (Institution where the study was performed)
| | - Emanuele Crincoli
- . Department of Ophthalmology, Eyecare Clinic, Brescia, Italy (Institution where the study was performed)
- . Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| |
Collapse
|
2
|
Ripa M, Motta L, Matello V, Frisina R, Parolini B. Long-Term results of macular buckle for MTM stage 3-4 With maculoschisis and macular detachment without and With lamellar macular hole. Eur J Ophthalmol 2024:11206721241234958. [PMID: 38419477 DOI: 10.1177/11206721241234958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE To report the long-term anatomical and functional results of macular buckle for Myopic Traction Maculopathy (MTM) in stages 3a, 3b, 4a, and 4b according to the MTM Staging System (MSS). METHODS Retrospective observational cohort study involving 55 consecutive patients with MTM in stages 3a, 3b, 4a, and 4b who underwent macular buckle (MB). Postoperative outcomes, including optical coherence tomography (OCT) scans to evaluate the MTM stage and its progression, were evaluated 1-month postoperatively (i.e., "intermediate follow-up") and at last follow-up ranging between 6 and 156 months postoperatively (i.e., "final follow-up"). RESULTS Fifty-five eyes affected by MTM who underwent MB were enrolled. The mean preoperative and postoperative axial length was 31.13 ± 2.14 and 29.73 ± 2.16 mm, respectively (p < 0.01), with a mean axial shift of 1.32 ± 0.77 mm. The mean sample best corrected visual acuity (BCVA) at baseline, intermediate, and final follow-ups was 0.87 ± 0.36, 0.73 ± 0.31, 0.41 ± 0.32 logMar, respectively (p < 0.01). Foveal and retinal anatomical improvements were achieved in 50 (91%) and 53 (96.4%) eyes at intermediate follow-up, respectively. In the final follow-up, 54 (98.2%) and 55 (100%) eyes showed foveal and retinal anatomical improvements, respectively. CONCLUSIONS MB as a single procedure, when applied to MTM in stages 3a, 3b, 4a, and 4b, leads to significant anatomical and functional improvement. The MTM Staging System allows us to evaluate the best surgical technique and the surgical timing tailored to the different stages to increase the surgery's success and lower the complications of each technique.
Collapse
Affiliation(s)
- Matteo Ripa
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| | | | - Rino Frisina
- Ophthalmology Unit of Surgery, Department of Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | |
Collapse
|
3
|
Sharma A, Wu L, Bloom S, Stanga P, Sosa Lockward J, Tadayoni R, Mateo C, Parolini B, Mirajkar A, Mehrotra N, Nagpal M, Rezaei KA. RWC Update: Improving Surgical Outcomes With Intraoperative Fluorescein Angiography; Myopic Macular Holes - When to Operate?; Harada's Disease. Ophthalmic Surg Lasers Imaging Retina 2024; 55:5-8. [PMID: 38189795 DOI: 10.3928/23258160-20231215-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
|
4
|
Sharma A, Wu L, Bloom S, Stanga P, Tyagi M, Ramamurthy S, Zacharias LC, Nagpal M, Bakri S, Tagare S, Maindargi N, Matello V, Parolini B, Rezaei KA. RWC Update: Fibrin Glue-Assisted Hemostasis for Persistent Intraoperative Optic Nerve Bleeding; Managing Submacular Hemorrhage; Valsalva Retinopathy Drained with YAG Laser; The EmPuzzled Eye. Ophthalmic Surg Lasers Imaging Retina 2023; 54:677-681. [PMID: 38113359 DOI: 10.3928/23258160-20231101-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
|
5
|
Ramamurthy SR, Dave VP, Chou HD, Ozdek S, Parolini B, Dhawahir-Scala F, Wu WC, Ribot FMD, Chang A, Ruamviboonsuk P, Pathengay A, Pappuru RR. Retinotomies and retinectomies: A review of indications, techniques, results, and complications. Surv Ophthalmol 2023; 68:1038-1049. [PMID: 37406778 DOI: 10.1016/j.survophthal.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
Retinotomy refers to "cutting" or "incising" the retina, whereas retinectomy denotes "excising" the retina. Retinotomies and retinectomies aid in tackling traction and retinal shortening that persist following membrane dissection and scleral buckling. We performed a literature search using Google Scholar and PubMed, followed by a review of the references procured. All relevant literature was studied in detail and summarized. We discuss the indications of retinotomies and retinectomies for relaxing retinal stiffness, accessing the subretinal space for choroidal neovascular membrane, hemorrhage and abscess clearance, drainage retinotomies to allow retinal flattening, radial retinotomies to release circumferential traction, harvesting free retinal grafts, and prophylactic chorioretinectomies in trauma.
Collapse
Affiliation(s)
- Srishti Raksheeth Ramamurthy
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India; Standard Chartered-LVPEI Academy for Eye Care Education, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
| | - Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sengul Ozdek
- Department of Ophthalmology, Gazi University School of Medicine, Ankara, Turkey
| | | | | | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Andrew Chang
- Sydney Retina Clinic & Sydney Eye Hospital, Sydney, NSW, Australia; The University of Sydney, Camperdown, NSW, Australia
| | - Paisan Ruamviboonsuk
- College of Medicine, Rangsit University, Lak Hok, Thailand; Center of Excellence for Vitreous and Retinal Disease, Rajavithi Hospital, Bangkok, Thailand
| | - Avinash Pathengay
- GMR Varalakshmi Campus, Retina and Uveitis Service, Anant Bajaj Retina Institute, Visakhapatnam, Andhra Pradesh, India
| | - Rajeev Reddy Pappuru
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| |
Collapse
|
6
|
Tozzi L, Gius I, Greggio A, Meduri A, De Salvo G, Parolini B, Frisina R. Case Report: Spontaneous Closure of Idiopathic Full-thickness Macular Hole and Early Development of Lamellar Hole. Optom Vis Sci 2023; 100:804-809. [PMID: 37678581 DOI: 10.1097/opx.0000000000002070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
SIGNIFICANCE Spontaneous closure of an idiopathic full-thickness macular hole (FTMH) is a rare event. The underlying mechanisms are unclear because of the difficulty in detecting subtle structural changes even with serial imaging. Previous reports are largely optical coherence tomography (OCT) based, but multimodal imaging could highlight new information. PURPOSE This study aimed to report the spontaneous closure of an idiopathic FTMH (iFTMH) and its recurrence and late closure documented by serial OCT integrated with multimodal imaging modalities and microperimetry (MP). CASE REPORT A healthy 46-year-old man was referred to the Department of Ophthalmology of the University of Padova for an iFTMH in the right eye with preserved visual acuity. The patient was scheduled for monthly controls up to 12 months by an integrated assessment of OCT, angiography-OCT, short-wavelength fundus autofluorescence, and MP. Two months later, tracked OCT scans showed a closure of the hole with a residual lamellar macular hole. Sequential examinations revealed a discontinuation of photoreceptors (ellipsoid zone) and a recurrence of iFTMH, and 7 months later, iFTMH reclosed without any relevant changes up to 12 months. Foveal avascular zone area increased from the baseline reaching its maximum value when iFTMH recurred. Two hyper-fundus autofluorescence points were detected in the foveal area, one progressively decreased and one reached the most intense signal when iFTMH recurred. Retinal sensitivity decreased mostly in one hyper-fundus autofluorescence point when the ellipsoid zone line discontinued and reached the lowest value when iFTMH recurred, and increased mostly in the other points when iFTMH reclosed. CONCLUSIONS Spontaneous iFTMH closure, as well as its recurrence and reclosure, is a rare event. By monitoring with multiple imaging modalities, MP and their overlaying elaboration can add new biomarkers with diagnostic and prognostic value.
Collapse
Affiliation(s)
| | - Irene Gius
- Department of Ophthalmology of University of Padova, Padova, Italy
| | - Angelo Greggio
- Department of Ophthalmology of University of Padova, Padova, Italy
| | - Alessandro Meduri
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
| | - Gabriella De Salvo
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Rino Frisina
- Department of Ophthalmology of Guglielmo da Saliceto Hospital of Piacenza, Piacenza, Italy
| |
Collapse
|
7
|
Parolini B, Ripa M, Frisina R, Matello V, Motta L. The Role of the Intraoperative Optical Coherence Tomography for Vitreoretinal Surgery in a Real-Life Setting. Life (Basel) 2023; 13:1813. [PMID: 37763217 PMCID: PMC10533019 DOI: 10.3390/life13091813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND To descriptively report the advantages and the feasibility of microscope-integrated intraoperative optical coherence tomography (i-OCT) in managing different vitreoretinal diseases in a real-life setting. METHODS We conducted an observational retrospective study involving 265 eyes that underwent elective retinal surgery and intraoperative OCT between 1 September 2018 and 1 October 2022 at Eyecare Clinic (Brescia, Italy). RESULTS 52 epiretinal membranes, 30 retinal detachments, 60 high myopic eyes, 30 choroidal transplants, 40 macular holes, and 32 vitreo-proliferative retinopathies underwent vitreoretinal surgery and intraoperative OCT scans. The i-OCT was a useful diagnostic exam for all cases and significantly influenced our surgical management. CONCLUSIONS i-OCT is a helpful surgical tool in ophthalmic surgery as it provides real-time feedback of tissue anatomy to surgeons, thereby guiding decision-making. Moreover, it provides additional information on the microarchitectural changes after instrument-tissue interactions, further guiding procedures when necessary and possibly reducing unessential surgical maneuvers.
Collapse
Affiliation(s)
- Barbara Parolini
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy (V.M.)
| | - Matteo Ripa
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| | - Rino Frisina
- Ophthalmology Unit of Surgery, Department of Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
| | - Veronika Matello
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy (V.M.)
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| |
Collapse
|
8
|
Sharma A, Holz FG, Regillo CD, Freund KB, Sarraf D, Khanani AM, Baumal C, Holekamp N, Tadayoni R, Kumar N, Parachuri N, Kuppermann BD, Bandello F, Querques G, Loewenstein A, Özdek Ş, Rezai K, Laurent K, Bilgic A, Lanzetta P, Zur D, Yannuzzi N, Corradetti G, Kaiser P, Hilely A, Boyer D, Rachitskaya A, Chakravarthy U, Wintergerst M, Sarao V, Parolini B, Mruthyunjaya P, Nguyen QD, Do D, Keane PA, Hassan T, Sridhar J, Eichenbaum D, Grewal D, Splitzer M. Biosimilars for retinal diseases: United States-Europe awareness survey (Bio-USER - survey). Expert Opin Biol Ther 2023; 23:851-859. [PMID: 36726203 DOI: 10.1080/14712598.2023.2176218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/31/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE To assess the awareness of biosimilar intravitreal anti-VEGF agents among retina specialists practicing in the United States (US) and Europe. METHODS A 16-question online survey was created in English and distributed between Dec 01, 2021 and Jan 31, 2022. A total of 112 respondents (retinal physicians) from the US and Europe participated. RESULTS The majority of the physicians (56.3%) were familiar with anti-VEGF biosimilars. A significant number of physicians needed more information (18.75%) and real world data (25%) before switching to a biosimilar. About one half of the physicians were concerned about biosimilar safety (50%), efficacy (58.9 %), immunogenicity (50%), and their efficacy with extrapolated indications (67.8 %). Retinal physicians from the US were less inclined to shift from off-label bevacizumab to biosimilar ranibizumab or on-label bevacizumab (if approved) compared to physicians from Europe (p=0.0001). Furthermore, physicians from the US were more concerned about biosimilar safety (p=0.0371) and efficacy compared to Europe (p= 0.0078). CONCLUSIONS The Bio-USER survey revealed that while the majority of retinal physicians need additional information regarding the safety, efficacy and immunogenicity when making clinical decisions regarding their use. Retinal physicians from US are more comfortable in continuing to use off-label bevacizumab compared to physicians from Europe.
Collapse
Affiliation(s)
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Carl D Regillo
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, USA
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA
| | - David Sarraf
- Stein Eye Institute, UCLA, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Arshad M Khanani
- Sierra Eye Associates, Reno, NV, USA and The University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Caroline Baumal
- Tufts University School of Medicine, New England Eye Center, Boston, Massachusetts
| | | | - Ramin Tadayoni
- Université Paris Cité, AP-HP, Lariboisière, St Louis and Fondation Adolphe de Rothschild hospitals, Paris, France
| | | | | | - Baruch D Kuppermann
- Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Mete M, Parolini B, Maggio E, Airaghi G, De Santis N, Guerriero M, Pertile G. Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience. Ophthalmologica 2023; 246:209-218. [PMID: 37245503 DOI: 10.1159/000531141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION This is a multicentric study on the use of heavy silicon oil (HSO) as an intraocular tamponade for inferior retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR). METHODS 139 eyes treated for RD with PVR were included in the study. 10 (7.2%) were affected by primary RD with inferior PVR, while 129 (92.8%) were affected by recurrent RD with inferior PVR. 102 eyes (73.9%) had received a silicon oil (SO) tamponade in a previous intervention prior to receiving HSO. Mean follow-up was 36.5 (standard deviation = 32.3) months. RESULTS The median interval between HSO injection and removal was 4 months (interquartile range: 3). At the time of HSO removal, the retina was attached in 120 eyes (87.6%), whereas in 17 eyes (12.4%), it had re-detached while the HSO was in situ. 32 eyes (23.2%) showed recurrent RD. A subsequent RD relapse was observed in 14.2% of cases with no RD at the time of HSO removal, and in 88.2% if an RD was present at the time of HSO removal. Advancing age showed a positive association with retinal attachment at the end of follow-up, while the risk of RD relapse at the end of the follow-up showed a significant negative association with HSO tamponade duration and with the use of SO rather than air or gas as post-HSO tamponade materials. Mean best corrected visual acuity was 1.1 logarithm of minimum angle of resolution at all follow-up time points. 56 cases (40.3%) needed treatment for elevated intraocular pressure (IOP), with which no clinically relevant variables were associated during follow-up. CONCLUSION HSO represents a safe and effective tamponade in cases of inferior RD with PVR. The presence of RD at the time of HSO removal is a negative prognostic factor for the development of a subsequent RD relapse. According to our findings, in cases of RD at the time of HSO removal, a short-term tamponade should definitely be avoided, in favor of SO. Special attention must be paid to the risk of IOP elevation, and patients should be closely monitored.
Collapse
Affiliation(s)
- Maurizio Mete
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Emilia Maggio
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giulia Airaghi
- Department of Ophthalmology, ASST Valle Olona, Varese, Italy
| | - Nicoletta De Santis
- Clinic Research Unit, URC, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Massimo Guerriero
- Clinic Research Unit, URC, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Grazia Pertile
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| |
Collapse
|
10
|
Frisina R, De Salvo G, Tozzi L, Gius I, Sahyoun JY, Parolini B, Meduri A. Effects of physiological fluctuations on the estimation of vascular flow in eyes with idiopathic macular pucker. Eye (Lond) 2023; 37:1470-1478. [PMID: 35794376 PMCID: PMC10169772 DOI: 10.1038/s41433-022-02158-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/10/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To evaluate the macular vascular flow in eyes with idiopathic macular pucker (EyeiMP), pre and post pars plana vitrectomy with epiretinal and limiting membranes peeling, and to compare it with the vascular flow in the healthy fellow eyes (Eyefellow), taken as physiological reference value. METHODS 40 eyes of 40 patients were recruited. Best-corrected visual acuity (BCVA) was evaluated. Spectral domain optical coherence tomography (SD-OCT) and OCT-angiography parameters were central foveal thickness (CFT), choroidal thickness (CT), foveal avascular zone (FAZ) area, vessel area density (VAD), vessel length fraction (VLF), vessel density index (VDI) of superficial capillary plexus (SCP) and deep vascular complex (DVC), choriocapillaris (CC) flow. Absolute and relative difference calculation was applied to evaluate macular vascular flow in EyeiMP adjusted for physiological changes detected in Eyefellow. FOLLOW-UP 6 months. RESULTS BCVA improved (p = 0.003) in all cases following surgery. CFT reduced postoperatively (p = 0.0138). FAZ area was smaller in EyeiMP than Eyefellow (p = 0.0071) preoperatively and postoperatively it shrank further (p = 0.0027). After surgery, inverse correlation between FAZ area and BCVA was detected (r-0.683). VAD of SCP was pre- and post-operatively higher in EyeiMP than Eyefellow (baseline p = 0.0344, 6th month p = 0.0466). Relative difference of VDI of SCP (p = 0.0096) and CC flow (p = 0.0013) at 6 months reduced. DVC flow changed significantly only in Eyefellow. CT increased post-operatively in both EyeiMP (p = 0.0345) and Eyefellow (p = 0.00423), but relative difference did not change. CONCLUSIONS Vascular flow indices monitoring demonstrated significant changes in both eyes: EyeiMP and Eyefellow. Relative difference of vascular flow provided objective estimate of changes due to iMP surgery taking into account physiological changes in Eyefellow.
Collapse
Affiliation(s)
- Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Gabriella De Salvo
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Luigi Tozzi
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Irene Gius
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Jean-Yves Sahyoun
- Department of Ophthalmology, Universite' de Montreal, Montreal, QC, Canada
| | | | - Alessandro Meduri
- Biomedical, Dental and Morphological and Functional Images Sciences, Department, University of Messina, Messina, Italy
| |
Collapse
|
11
|
Gius I, Tozzi L, De Biasi CS, Pizzolon T, Parolini B, Frisina R. Artificial iris: state of the art. J Cataract Refract Surg 2023; 49:430-437. [PMID: 36719472 DOI: 10.1097/j.jcrs.0000000000001147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Surgical correction of traumatic aniridia aims to improve the quality of vision, compartmentalize the anterior and posterior chamber, and re-establish a satisfying cosmetic appearance. Various types of prosthetic iris devices (PIDs) are available, which differ in technical difficulty of implant and design: artificial iris (AI)-intraocular lens prosthesis, endocapsular capsular tension ring-based PID, and customized AI. The choice depends on the preexisting clinical condition after severe ocular trauma and on patient functional and cosmetic expectations. This systematic review of the literature compared anatomical and functional outcomes of various types of PIDs. Of 185 articles found in the literature, 70 fulfilled the eligibility criteria. 5 subgroups of PIDs were Ophtec, artificial iris from Ophtec BV, Morcher GmbH, HumanOptics AG, and other prosthesis. Both glare and aesthetic outcome improved postoperatively; in comparison with other PIDs, intraocular pressure rise was higher in the Morcher group (40%), whereas prosthesis dislocation was higher in the Ophtec group (39%).
Collapse
Affiliation(s)
- Irene Gius
- From the Department of Ophthalmology, University of Padova, Padova, Italy (Gius); Department of Ophthalmology, Pordenone Hospital, Pordenone, Italy (Tozzi, De Biasi); Department of Ophthalmology, "Ca Foncello" Hospital, Treviso, Italy (Pizzolon); Ophthalmology, Eye Care Clinic, Brescia, Italy (Parolini); Ophthalmology-Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy (Frisina)
| | | | | | | | | | | |
Collapse
|
12
|
Parolini B, Arevalo JF, Hassan T, Kaiser P, Rezaei KA, Singh R, Sakamoto T, Rocha J, Frisina R. International Validation of Myopic Traction Maculopathy Staging System. Ophthalmic Surg Lasers Imaging Retina 2023; 54:153-157. [PMID: 36944066 DOI: 10.3928/23258160-20230217-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to evaluate the interobserver agreement of the myopic traction maculopathy (MTM) staging system (MSS). PATIENTS AND METHODS Each observer was asked to look at the MSS Table and then identify, in each optical coherence tomography scan, one among four stages of MTM in the retina, one among three stages in the fovea, and, as secondary findings, the presence or absence of an outer lamellar macular hole and the presence or absence of epiretinal abnormalities. The interobserver agreement value was calculated using the Gwet's AC1 unweighted and AC2 weighted statistics. The outcomes were interpreted as poor (<0.00), slight (0.00 to 0.20), fair (0.21 to 0.40), moderate (0.41 to 0.60), substantial (0.61 to 0.80), or almost perfect (0.81 to 1.00) agreement. RESULTS The agreement, among 65 participants, was 0.62 (AC1) and 0.77 (AC2) for the retina stage; 0.63 (AC1) and 0.81 (AC2) for the fovea stage; 0.56 (AC1) for the outer lamellar macular hole; and 0.26 (AC1) for epiretinal abnormalities. CONCLUSION The MSS is highly reproducible and helps ophthalmologists to share information on MTM in a more accurate and reliable way. [Ophthalmic Surg Lasers Imaging Retina 2023;54(3):153-157.].
Collapse
|
13
|
Sharma A, Wu L, Bloom S, Stanga P, RaviChandran N, Ting DSW, Parolini B, Matello V, Rezaei KA. RWC Update: Artificial Intelligence and Smart Eyewearables for Healthy Longevity; Choroidal Hemangioma Widefield Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina 2023; 54:74-77. [PMID: 36780639 DOI: 10.3928/23258160-20221219-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
14
|
Besozzi G, Montericcio A, Costa MC, Nitti G, Parolini B, Giancipoli E, Greggio A, Tozzi L, Gius I, Frisina R. Microscope-assisted pneumatic retinopexy for the management of primary rhegmatogenous retinal detachment. Eur J Ophthalmol 2022; 33:11206721221142636. [PMID: 36437613 DOI: 10.1177/11206721221142636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE Outcomes of pneumatic retinopexy (PnR) using surgical microscope, wide-angle viewing system, and chandelier endoilluminator (microscope-assisted pneumatic retinopexy) for primary rhegmatogenous retinal detachment (RRD). METHODS Retrospective study. 43 consecutive eyes with RRD undergoing microscope-assisted PnR surgery (MAPR) were analysed. Inclusion criteria comprehend phakic eyes with single retinal break or a group of breaks in detached retina in the same quadrant above 8- and 4-o'clock meridians. Follow-up was at least 6 months. RESULTS Of the 43 eyes, a total of 25 (58%) presented preoperatively a single retinal break, 15 (35%) had two retinal breaks in the same quadrant and 3 (7%) presented three or more retinal breaks in the same quadrant. Other retinal breaks not observed preoperatively were discovered intraoperatively in 12 eyes (28%). In 9 (21%) the missed retinal breaks were in the same quadrant as the main diagnosed break(s), while 3 (7%) had missed retinal breaks in a different one. These 3 eyes as no longer adhering to the PnR indication criteria switched intraoperatively to other surgical procedures and were excluded in the reattachment rate results. The total primary reattachment rate with MAPR was achieved in 37 eyes (92.5%). No significant BCVA changes were observed postoperatively. CONCLUSION MAPR is an effective and safe surgical option, it allows to work with both hands free and provides an adequate visualization of the retina during the procedure minimizing the risk of missed retinal breaks potentially leading to surgical failure.
Collapse
Affiliation(s)
- Gianluca Besozzi
- Department of Ophthalmology, 34408Vito Fazzi Hospital, Lecce, Italy
| | | | | | - Giuseppe Nitti
- Department of Ophthalmology, 34408Vito Fazzi Hospital, Lecce, Italy
| | | | | | - Angelo Greggio
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Luigi Tozzi
- Department of Ophthalmology, Belluno Hospital, Belluno, Italy
| | - Irene Gius
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy
| |
Collapse
|
15
|
Sharma A, Wu L, Bloom S, Stanga P, Parolini B, Matello V, Rezaei KA. RWC Update: Biosimilar Biologics—Need for Real World Data; Autologous Choroidal Transplantation for Wet AMD. Ophthalmic Surg Lasers Imaging Retina 2022; 53:602-605. [PMID: 36378612 DOI: 10.3928/23258160-20220930-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
16
|
Ripa M, Motta L, Florit T, Sahyoun JY, Matello V, Parolini B. The Role of Widefield and Ultra Widefield Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Diseases. Diagnostics (Basel) 2022; 12:diagnostics12092247. [PMID: 36140648 PMCID: PMC9497586 DOI: 10.3390/diagnostics12092247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study reports on the advantages of wide-field (WF)- and ultra-widefield (UWF)- optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in managing different vitreoretinal diseases in a real-life setting using the new WF—Swept Source (SS)—OCT Xephilio S1 (Canon, Tokyo, Japan). Methods: We conducted an observational retrospective case series study involving 1472 eyes that underwent retinal scans with Canon Xephilio® OCT-S1 between 1 March 2021 and 1 December 2021 at Eyecare Clinic (Brescia, Italy). All patients underwent routine ophthalmologic examinations along with WF and UWF color fundus retinography with Clarus 500™ (Carl Zeiss Meditec, Inc., Dublin, CA, USA) and Xephilio® OCT-S1. WF SS-OCT, UWF-OCT, WF-OCTA, and UWF-OCTA were taken by using Xephilio® OCT-S1. Results: We analyzed 122 peripheral retinal lesions, 144 retinal detachment, 329 high myopic eyes, 37 pediatric cases, 60 vascular retinopathies, 15 choroidal lesions, and 90 eyes as follow-up post vitreoretinal surgery. The OCT-S1 was the only reliable and diagnostic exam for peripheral lesions, pediatric and high myopic cases, and significantly influenced the management in 10% of cases and the postoperative follow-up. Conclusions: WF and UWF OCT and OCTA imaging may help in the management of several vitreoretinal diseases, becoming an indispensable tool for the high-quality management of patients.
Collapse
Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Ophthalmology Unit, Catholic University “Sacro Cuore”, 00168 Rome, Italy
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
- Correspondence:
| | - Teresa Florit
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
| | - Jean-Yves Sahyoun
- Department of Ophthalmology, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Department of Ophthalmology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, QC H2X 3E4, Canada
| | - Veronika Matello
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
| | - Barbara Parolini
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
| |
Collapse
|
17
|
Parolini B, Penzani R, Pascotto P. Application of Soft Directional Prismatic Contact Lenses to Correct Diplopia. J Pediatr Ophthalmol Strabismus 2022:1-5. [PMID: 36102266 DOI: 10.3928/01913913-20220727-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To verify whether diplopia due to a small-angle strabismus within 8 prism diopters (PD) could be corrected by applying soft directional prismatic contact lenses, obtaining higher comfort and quality of vision for the patients. METHODS A prospective study was undertaken by enrolling consecutive patients affected by vertical and/or horizontal diplopia and small-angle strabismus within 8 PD. The patients were tested for best corrected visual acuity, refraction, cover test for near and for distance, ocular motility test, prismatic fit test, corneal topography, tear film evaluation, binocular vision test, head position evaluation, retinography, and optical coherence tomography of the posterior and anterior segment. Custom soft contact lenses, made in Benz G5X material, were designed and developed for this study. All patients were first corrected with prismatic glasses according to their degree of strabismus and ametropia. Then they were asked to wear custom-made directional prismatic contact lenses with appropriate simultaneous correction of strabismus and ametropia. The patients were then asked to answer whether the comfort and quality of vision was higher with directional prismatic contact lenses or prismatic glasses. RESULTS Eight patients were enrolled with different causes of diplopia caused by a strabismus of 8 PD or less. The soft directional prismatic contact lenses could resolve diplopia in 100% of patients. All patients reported greater comfort and quality of vision with directional prismatic contact lenses. CONCLUSIONS The study demonstrated that diplopia resulting from an angle of strabismus within 8 PD can be corrected through the use of soft directional prismatic contact lenses, obtaining greater quality of vision free of aberrations. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].
Collapse
|
18
|
Nicolò M, Ciucci F, Nardi M, Parolini B, Russo A, Scupola A, Torregrossa S, Vadalà M. PERSEUS-IT 24-month analysis: a prospective observational study to assess the effectiveness of intravitreal aflibercept in routine clinical practice in Italy in patients with neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2022; 260:3185-3195. [PMID: 35511286 PMCID: PMC9477902 DOI: 10.1007/s00417-022-05679-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose PERSEUS-IT (NCT02289924) was a prospective, observational, 2-year study evaluating the effectiveness and treatment patterns of intravitreal aflibercept (IVT-AFL) in patients with neovascular age-related macular degeneration (nAMD) in routine clinical practice in Italy. Methods Treatment-naïve patients with nAMD receiving IVT-AFL per routine clinical practice were enrolled. The primary endpoint was mean change in visual acuity (VA; decimals) from baseline to month (M) 12 and M24. Outcomes were evaluated for the overall study population and independently for the 2 treatment cohorts: regular (3 initial monthly doses, ≥ 7 injections by M12, and ≥ 4 injections between M12 and M24) and irregular (any other pattern). Results Of 813 patients enrolled, 709 were included in the full analysis set (FAS); VA assessments were available for 342 patients at M12 (FAS1Y, 140 regular and 202 irregular) and 233 patients at M24 (FAS2Y, 37 regular and 196 irregular). In the overall FAS, the mean ± SD change in VA from baseline to M12 and M24 was + 0.09 ± 0.24 and + 0.02 ± 0.25 decimals, and there was a statistically significant difference between the regular and irregular cohorts in both FAS1Y (p = 0.0034) and FAS2Y (p = 0.0222). Ocular treatment-emergent adverse events were reported in 4.1% (n = 33/810 [safety set]) of patients. Conclusion In PERSEUS-IT, clinically relevant functional and anatomic improvements were observed within the first 12 months of IVT-AFL treatment in routine clinical practice in Italy in patients with treatment-naïve nAMD. These gains were generally maintained across the 2-year study. The safety profile of IVT-AFL was consistent with prior studies. Trial registration number ClinicalTrials.gov Identifier: NCT02289924. Date of registration November 13, 2014. ![]() Supplementary Information The online version contains supplementary material available at 10.1007/s00417-022-05679-6.
Collapse
Affiliation(s)
- Massimo Nicolò
- Clinica Oculistica - DiNOGMI, University of Genoa, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
| | | | | | | | | | - Andrea Scupola
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Maria Vadalà
- BIND Department, University of Palermo, Palermo, Italy
| | | |
Collapse
|
19
|
Sharma A, Parachuri N, Kumar N, Romano MR, Parolini B, Ozdek S, Tawfik MA, Marashi A, Kuppermann BD, Nguyen QD. MYTHS AND TRUTHS OF THE ASSOCIATION OF RETINAL VASCULAR OCCLUSION WITH COVID-19. Retina 2022; 42:413-416. [PMID: 34907124 PMCID: PMC10919546 DOI: 10.1097/iae.0000000000003371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To critically review data published in the recent past to scrutinize a causal relationship between retinal vascular occlusion and COVID-19. METHOD A comprehensive literature search was performed on Pubmed with the key words retinal vascular occlusion, retinal vein occlusion, retinal artery occlusion, and COVID-19. RESULTS A total of 17 case reports were published during this period, and 10 were on retinal vein occlusion and 7 on retinal artery occlusion. Most of the published reports lacked convincing evidences in one or the other aspects, such as insufficient laboratory workup or presence of multiple confounding risk factors. CONCLUSION In this index article, strength of the data is insufficient to establish a definitive cause-and-effect relationship of retinal vascular occlusive disorders with COVID-19. Hence, clinicians can continue to manage these cases according to the standard guidelines until there are more robust evidences to support this association to alter the diagnostic and treatment modalities.
Collapse
Affiliation(s)
- Ashish Sharma
- Lotus Eye Hospital and Institute, Coimbatore, Tamil Nadu, India
| | | | - Nilesh Kumar
- Lotus Eye Hospital and Institute, Coimbatore, Tamil Nadu, India
| | | | | | - Sengul Ozdek
- Ophthalmology, Gazi University, School of Medicine, Ankara, Turkey
| | | | - Ameen Marashi
- Memorial Institute of Ophthalmology Research, Cairo, Giza, Egypt
| | - Baruch D Kuppermann
- Gavin Herbert Eye Institute, University of California, Irvine, Irvine, California; and
| | | |
Collapse
|
20
|
Iros M, Parolini B, Ozdek S, Gini G, Nawrocka ZA, Ellabban AA, Faramawi MF, Adelman R, Sallam AB, Meireles A, Lee CS, Ducournau D, Tsouris D, Kozina E, Patelli F, Viola F, Ascaso F, Becquet F, Tosi GM, Besozzi G, Oh H, Othman IS, Fiser I, Le Rouic J, Perone J, Amar J, Nawrocki J, Nascimento J, Arrevola L, Nagpal M, Mehrotra N, Demir M, Chelazzi P, Miesbauer P, Turkcuoglu P, Koch P, Uy R, Weinfurter SB, Bopp S, Park S, Schönherr U, Alsanova V, Bonfiglio V, Szijárt Z. Management of optic disc pit maculopathy: the European VitreoRetinal society optic pit study. Acta Ophthalmol 2021; 100:e1264-e1271. [PMID: 34877796 DOI: 10.1111/aos.15076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/26/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate a variety of techniques, and their anatomical and functional results, for the treatment of optic disc pit maculopathy (ODP-M). A secondary aim was to report on results of secondary procedures in cases of initial failure or recurrence. METHODS Multicentre retrospective study of 95 eyes with ODP-M, treated by 25 surgeons from 12 countries. Primary outcomes were anatomical resolution of subretinal fluid (SRF), intraretinal fluid (IRF) and visual acuity (VA) at 12 months. RESULTS Higher rates of SRF and IRF resorption were achieved in eyes treated with pars plana vitrectomy (PPV) compared to external laser with or without tamponade: 64/72 (88.9%) versus 8/14 (57.1%) for SRF (p = 0.003), and 50/59 (84.7%) versus 3/10 (30%) for IRF (p = 0.002). The addition of juxtapapillary laser or internal limiting membrane (ILM) peel during PPV did not improve SRF or IRF resolution. Pars plana vitrectomy (PPV) with tamponade and PPV with tamponade plus endolaser were associated with significant visual gain. In the former group, VA improved from a mean of logMAR 0.91 (20/162), to a mean of logMAR 0.52 (20/66) at 12 months; in the latter group, VA improved from a mean of logMAR 0.82 (20/132) to a mean of logMAR 0.47 (20/59) at 12 months. Retreatments were performed in 14 eyes (15.7%), only enhancing anatomical outcomes. CONCLUSION Vitrectomy with tamponade had better final outcomes than external laser treatment with or without gas tamponade. Laser endophotocoagulation and ILM peel provided no additional benefit. A secondary treatment resulted in anatomical but not functional improvement.
Collapse
Affiliation(s)
- Mariano Iros
- Instituto de Microcirugía Ocular Córdoba Córdoba Argentina
| | | | - Sengul Ozdek
- Department of Ophthalmology Faculty of Medicine Gazi University Ankara Turkey
| | - Giampaolo Gini
- Western Sussex NHS Trust and Nuffield Haywards Heath Hospital Sussex UK
| | | | - Abdallah A Ellabban
- Hull University Teaching Hospitals Hull UK
- Department of Ophthalmology Suez Canal University Ismailia Egypt
| | - Mohammed F. Faramawi
- Departments of Bioinformatics and Epidemiology University of Arkansas for Medical Sciences Little Rock AR USA
| | - Ron Adelman
- Department of Ophthalmology Yale University New Haven CT USA
| | - Ahmed B. Sallam
- Jones Eye Institute University of Arkansas for Medical Sciences Little Rock AR USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Mundo L, Tosi GM, Lazzi S, Pertile G, Parolini B, Neri G, Posarelli M, De Benedetto E, Bacci T, Silvestri E, Siciliano MC, Barbera S, Orlandini M, Greenwood J, Moss SE, Galvagni F. LRG1 Expression Is Elevated in the Eyes of Patients with Neovascular Age-Related Macular Degeneration. Int J Mol Sci 2021; 22:8879. [PMID: 34445590 PMCID: PMC8396268 DOI: 10.3390/ijms22168879] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/14/2022] Open
Abstract
Leucine-rich a-2-glycoprotein 1 (LRG1) is a candidate therapeutic target for treating the neovascular form of age-related macular degeneration (nvAMD). In this study we examined the expression of LRG1 in eyes of nvAMD patients. Choroidal neovascular membranes (CNVMs) from patients who underwent submacular surgery for retinal pigment epithelium-choroid graft transplantation were collected from 5 nvAMD patients without any prior intravitreal anti-VEGF injection, and from six patients who received intravitreal anti-VEGF injections before surgery. As controls free of nvAMD, retina sections were obtained from the eyes resected from a patient with lacrimal sac tumor and from a patient with neuroblastoma. CNVMs were immunostained for CD34, LRG1, and α-smooth muscle actin (α-SMA). Aqueous humor samples were collected from 58 untreated-naïve nvAMD patients prior to the intravitreal injection of anti-VEGF and 51 age-matched cataract control patients, and LRG1 concentration was measured by ELISA. The level of LRG1 immunostaining is frequently high in both the endothelial cells of the blood vessels, and myofibroblasts in the surrounding tissue of CNVMs of treatment-naïve nvAMD patients. Furthermore, the average concentration of LRG1 was significantly higher in the aqueous humor of nvAMD patients than in controls. These observations provide a strong experimental basis and scientific rationale for the progression of a therapeutic anti-LRG1 monoclonal antibody into clinical trials with patients with nvAMD.
Collapse
Affiliation(s)
- Lucia Mundo
- Section of Pathology, Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy; (L.M.); (S.L.); (M.C.S.)
- Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Gian Marco Tosi
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (G.M.T.); (G.N.); (M.P.); (E.D.B.); (T.B.)
| | - Stefano Lazzi
- Section of Pathology, Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy; (L.M.); (S.L.); (M.C.S.)
| | - Grazia Pertile
- IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Italy;
| | | | - Giovanni Neri
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (G.M.T.); (G.N.); (M.P.); (E.D.B.); (T.B.)
| | - Matteo Posarelli
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (G.M.T.); (G.N.); (M.P.); (E.D.B.); (T.B.)
| | - Elena De Benedetto
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (G.M.T.); (G.N.); (M.P.); (E.D.B.); (T.B.)
| | - Tommaso Bacci
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (G.M.T.); (G.N.); (M.P.); (E.D.B.); (T.B.)
| | - Ennio Silvestri
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A. Moro, 2, 53100 Siena, Italy; (E.S.); (S.B.); (M.O.)
| | - Maria Chiara Siciliano
- Section of Pathology, Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy; (L.M.); (S.L.); (M.C.S.)
| | - Stefano Barbera
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A. Moro, 2, 53100 Siena, Italy; (E.S.); (S.B.); (M.O.)
| | - Maurizio Orlandini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A. Moro, 2, 53100 Siena, Italy; (E.S.); (S.B.); (M.O.)
| | - John Greenwood
- UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK;
| | - Stephen E. Moss
- UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK;
| | - Federico Galvagni
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via A. Moro, 2, 53100 Siena, Italy; (E.S.); (S.B.); (M.O.)
| |
Collapse
|
22
|
Frisina R, Besozzi G, Finzi A, Pinackatt SJ, Palmieri M, Parolini B. Inter-observer and intra-observer reliability of the myopic traction maculopathy staging system. Eur J Ophthalmol 2021; 32:1577-1583. [PMID: 34096365 DOI: 10.1177/11206721211023319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The aim of this study is to evaluate the inter-observer and intra-observer agreement of the myopic traction maculopathy (MTM) staging system (MSS). METHODS The agreement test for MSS was based on the evaluation of 104 optical coherence tomography (OCT) scans from 104 myopic eyes. According to the MSS, six observers were asked to identify, in each image, one among four retinal patterns and one among three foveal patterns of MTM, the presence of an outer lamellar macular hole (OLMH) and an epiretinal membrane (ERM). Each observer repeated the agreement test after a 60 days interval. RESULTS Inter-observer reliability: the agreement of the test for the retina pattern was substantial (0.724), for the fovea pattern was 0.821, for the OLMH was 0.656, and for the ERM was 0.463. When all the criteria are included in the validation test the agreement was 0.657. Regarding the weighted statistics (Gwet's AC2, 95% CI), the validation test was statistically significant both when the variables were considered one by one, with an excellent agreement, respectively for the retina pattern (0.955) and the fovea pattern (0.963) and when all the variables were included in the tests (0.930). Intra-observer repeatability: all observers rerun the test after 2 months with a statistically significant percentage of confirmation of the previous test. CONCLUSION The MSS offers in one Table information on diagnosis, natural history, function, prognosis, and management of MTM. The MSS is user-friendly and highly reproducible.
Collapse
Affiliation(s)
- Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Veneto, Italy
| | - Gianluca Besozzi
- Department of Ophthalmology, Vito Fazzi Hospital, Lecce, Puglia, Italy
| | | | | | | | | |
Collapse
|
23
|
Palmieri M, Frisina R, Finzi A, Besozzi G, Parolini B. The Role of the Outer Lamellar Macular Hole in the Surgical Management of Myopic Traction Maculopathy. Ophthalmologica 2021; 244:229-236. [PMID: 33540420 DOI: 10.1159/000514993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/22/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the anatomical and functional surgical outcomes of eyes affected by myopic traction maculopathy (MTM) with and without an outer lamellar macular hole (O-LMH). METHODS Forty-eight eyes affected by MTM were included: a study group of 24 eyes with an O-LMH and a control group of 24 eyes without an O-LMH. All patients underwent spectral-domain optical coherence tomography (SD-OCT) and were staged according to the MTM staging system. The surgical techniques applied were pars plana vitrectomy (PPV), macular buckle (MB), or combined surgery. The follow-up visit was 12 months after the latest intervention. RESULTS Best-corrected visual acuity (BCVA) improved significantly in both groups after surgery (p < 0.05). A successful surgical result was obtained in both groups at the final follow-up. In the study group, 3 eyes underwent PPV, 14 eyes underwent MB, and 7 underwent a combined surgery. Six patients developed an iatrogenic full-thickness macular hole (FTMH). In the control group, 5 eyes underwent PPV, 16 underwent MB, and 3 had combined surgery. Four patients developed a FTMH. In both groups, all the eyes with an iatrogenic FTMH received PPV as first surgery (alone or combined). A topographical correspondence between the interruption of the ellipsoid zone (EZ) and the backscattering phenomenon was found on OCT. CONCLUSION The O-LMH is an OCT sign that may occur in eyes affected by MTM. Its presence is correlated with a higher risk of developing an iatrogenic FTMH after PPV (alone or combined) probably due to the thinner residual retinal tissue. Postoperative BCVA is not limited in eyes with an O-LMH and this may be explained by the restoration of the EZ after surgery.
Collapse
Affiliation(s)
| | - Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Alessandro Finzi
- Department of Ophthalmology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | | | | |
Collapse
|
24
|
Parolini B, Palmieri M, Finzi A, Besozzi G, Frisina R. Myopic Traction Maculopathy: A New Perspective on Classification and Management. Asia Pac J Ophthalmol (Phila) 2021; 10:49-59. [PMID: 33481391 DOI: 10.1097/apo.0000000000000347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
ABSTRACT Myopic traction maculopathy (MTM) is a complex disease affecting approximately 30% of eyes with pathologic myopia. A review of the history of treatment of MTM with success rates and limitations of different surgical techniques are reported.The pathogenesis, the definition and the management were clarified in a recent study(cit). The MTM Staging System (MSS) table summarizes all the stages of MTM offering insights on the pathogenesis and natural evolution of the disease.Guidelines of management of MTM were therefore proposed, but customized for each stage.Initial stages 1a and 2a, which define maculoschisis in the inner or inner-outer or only outer layers of the retina, should be observed. Stages 3a and 4a, defining macular detachment with and without associated schisis, should be treated with a macular buckle (MB).Stage 1b, which is a lamellar macular hole in a myopic eye, should be treated with pars plana vitrectomy (PPV) only in symptomatic cases. Stages 2b, 3b, and 4b should be treated with a MB and PPV should be added in a second step only if the presence of a lamellar macular hole requires intervention to improve visual function.Stage 1c, which is a full thickness macular hole in a myopic eye, should be treated with PPV. Stages 2c, 3c and 4c should be treated with a combination of simultaneous MB + PPV to treat both the retinal pattern of schisis or detachment and the full thickness macular hole.
Collapse
Affiliation(s)
| | | | - Alessandro Finzi
- Policlinico St. Orsola-Malpighi, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Rino Frisina
- Department of Ophthalmology, University of Padova, Italy
| |
Collapse
|
25
|
Parolini B, Palmieri M, Finzi A, Frisina R. Proposal for the management of myopic traction maculopathy based on the new MTM staging system. Eur J Ophthalmol 2020; 31:3265-3276. [PMID: 33345597 DOI: 10.1177/1120672120980943] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To propose the Myopic Traction Maculopathy (MTM) management Table, based on the MTM Staging System (MSS). METHODS A retrospective review of 157 eyes affected by MTM, operated with pars plana vitrectomy (PPV), or macular buckle (MB) or combined surgery (MB + PPV). Each case was classified according to the MSS. Anatomical results were evaluated with OCT at an intermediate follow-up (3-6 months) and at a final follow-up (2-8 years), considering changes both in the foveal and in the retinal pattern. The number and type of operations needed were noted. The surgical complications were reported. RESULTS Primary surgery was MB for 83 eyes (52%), PPV for 36 (23%) and MB + PPV for 38 (24%). At intermediate follow-up, the retinal pattern was restored in 55.41% and foveal in 42.68%.Further surgery was indicated as PPV in 25.48%, MB in 14.65%. At the final follow-up, the retinal pattern was restored in 96.16% and the foveal pattern in 87.90%.BCVA improved at the final follow-up (p < 0.05). The complications of MB were not sight-threatening. The complications of PPV were FTMH in 67% cases in stages 2, 3, and 4. Cataract developed in 60% of phakic eyes. The complications of combined MB+PPV were cataract (56%) and PVR (5%). CONCLUSIONS Both PPV and MB may be used to treat MTM. PPV addresses the changes in the foveal pattern while MB addresses the changes in the retinal pattern. The MTM management table offers a proposal for the choice of type and timing of treatment customized per each stage of MTM.
Collapse
Affiliation(s)
| | | | - Alessandro Finzi
- Department of Ophthalmology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy
| |
Collapse
|
26
|
Frisina R, Gius I, Palmieri M, Finzi A, Tozzi L, Parolini B. Myopic Traction Maculopathy: Diagnostic and Management Strategies. Clin Ophthalmol 2020; 14:3699-3708. [PMID: 33173268 PMCID: PMC7646438 DOI: 10.2147/opth.s237483] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022] Open
Abstract
Pathologic myopia (PM) is an ocular disorder characterized by a spherical equivalent (SE) of more than - 6.0 diopters (D) or by an axial length (AL) of more than 26.5 millimeters (mm). PM is associated with myopic maculopathy (MM). The ATN classification describes all the aspects of MM which regroups atrophic, tractional and neovascular consequences to the sclera, choroid and retina of highly myopic eyes. The advent of OCT allowed to define the ultrastructural characteristics of the tractional changes in MM, described by the term myopic traction maculopathy (MTM). They include foveoschisis/maculoschisis/retinoschisis (FS/MS/RS), retinal/foveal detachment (RD/FD), lamellar macular holes (LMH) and full-thickness macular holes (FTMH) with or without RD (MHRD). The MTM staging system (MSS) describes all foveal and retinal changes related to MTM and their natural history interpreting them as different stages of a single progressive disorder. The management of MTM can be just observation for the earliest cases with good vision or surgery for the severe stages with vision loss. There are two possible surgical approaches: ab externo, that acts on the alteration of the scleral shape and includes posterior scleral reinforcement and macular buckle. Ab interno, that targets the alteration of the foveal profile and consists in pars plana vitrectomy with removal of all the epiretinal tractions, maneuvers on the internal limiting membrane, and the use of intravitreal tamponade and laser. As they target two different sides of the same pathology, the two techniques have to be selected on the base of the MTM stage, single or combined.
Collapse
Affiliation(s)
- Rino Frisina
- Department of Ophthalmology of University of Padova, Padova, Italy
| | - Irene Gius
- Department of Ophthalmology of University of Padova, Padova, Italy
| | | | | | - Luigi Tozzi
- Department of Ophthalmology of University of Padova, Padova, Italy
| | | |
Collapse
|
27
|
Romano MR, Parolini B, Allegrini D, Michalewska Z, Adelman R, Bonovas S, Bopp S, Tekin K, Fiser I, Boon CJF, Dijk ECH, Donvito G, Güngel H, Özdoğan Erkul S, Ünsal E, Osmanbaşoğlu Ö, Dinçer N, Erçalık NY, Yenerel NM, Amar J, Ennemoser A, Besozzi G, Sallam AAB, Ellabban AA, Chang W, Eandi CM, Demir M, Lee J, Pak K, Arrevola L, Sloka A, Morawski K, Kulig ‐ Stochmal A, Romanowska ‐ Dixon B, Striebe N, Feltgen N, Hoerauf H, Inan UU, Tanev I, Dyrda A, Schüler A, Lucke K, Brix A, Pape S, Kusserow‐Napp C, Loo PA, Kanra AY, Ardagil Akçakaya A, Arı Yaylalı S, Bae SH, Kim HK, Kim SJ, Han JR, Nam WH, Odrobina D, Lavaque E, Bertelli E, Coser S, Ziemssen F, Forlini M, Benatti C, Cavallini GM, Stefanickova J, Berrod J, Saksonov S, Lytvinchuk L, Moussa M, Stefaniotou M, Christodoulou E, Zayed MA, Oz O, Tassinari P, Koch P, Declercq C, Johnston R, Rusnak S, Penas S, Ozdek S, Ucgul Y, Cisiecki S, Dziegielewski K, Klimczak D, Michalewska Z, Michalewski J, Nawrocka Z, Nawrocki J, Ornafel K, Pikulski Z, Maciej M, Acar N, Elshafei MM, Hamon F, Soyeur R, Badat I, Brousseau B, Hermouet E, Peiretti E, Lee J, Ferreira N, Yoon H, Alkhars WI, Dudani A, Minu R, Telang O, MorePatil VG, Furtado MJ, Jo Y, Piccolino FC, Finzi A. An international collaborative evaluation of central serous chorioretinopathy: different therapeutic approaches and review of literature. The European Vitreoretinal Society central serous chorioretinopathy study. Acta Ophthalmol 2020; 98:e549-e558. [PMID: 31808315 DOI: 10.1111/aos.14319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 11/02/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To study and compare the efficacy of different therapeutic options for the treatment of central serous chorioretinopathy (CSCR). METHODS This is a nonrandomized, international multicentre study on 1719 patients (1861 eyes) diagnosed with CSCR, from 63 centres (24 countries). Reported data included different methods of treatment and both results of diagnostic examinations [fluorescein angiography and/or optical coherent tomography (OCT)] and best-corrected visual acuity (BCVA) before and after therapy. The duration of observation had a mean of 11 months but was extended in a minority of cases up to 7 years. The aim of this study is to evaluate the efficacy of the different therapeutic options of CSCR in terms of both visual (BCVA) and anatomic (OCT) improvement. RESULTS One thousand seven hundred nineteen patients (1861 eyes) diagnosed with CSCR were included. Treatments performed were nonsteroidal anti-inflammatory eye drops, laser photocoagulation, micropulse diode laser photocoagulation, photodynamic therapy (PDT; Standard PDT, Reduced-dose PDT, Reduced-fluence PDT), intravitreal (IVT) antivascular endothelial growth factor injection (VEGF), observation and other treatments. The list of the OTHERS included both combinations of the main proposed treatments or a variety of other treatments such as eplerenone, spironolactone, acetazolamide, beta-blockers, anti-anxiety drugs, aspirin, folic acid, methotrexate, statins, vitis vinifera extract medication and pars plana vitrectomy. The majority of the patients were men with a prevalence of 77%. The odds ratio (OR) showed a partial or complete resolution of fluid on OCT with any treatment as compared with observation. In univariate analysis, the anatomical result (improvement in subretinal fluid using OCT at 1 month) was favoured by age <60 years (p < 0.005), no previous observation (p < 0.0002), duration less than 3 months (p < 0.0001), absence of CSCR in the fellow eye (p = 0.04), leakage outside of the arcade (p = 0.05) and fluid height >500 μm (p = 0.03). The OR for obtaining partial or complete resolution showed that anti-VEGF and eyedrops were not statistically significant; whereas PDT (8.5), thermal laser (11.3) and micropulse laser (8.9) lead to better anatomical results with less variability. In univariate analysis, the functional result at 1 month was favoured by first episode (p = 0.04), height of subretinal fluid >500 μm (p < 0.0001) and short duration of observation (p = 0.02). Finally, there was no statistically significant difference among the treatments at 12 months. CONCLUSION Spontaneous resolution has been described in a high percentage of patients. Laser (micropulse and thermal) and PDT seem to lead to significant early anatomical improvement; however, there is little change beyond the first month of treatment. The real visual benefit needs further clarification.
Collapse
Affiliation(s)
- Mario R Romano
- Department of Ophthalmology, Gavazzeni - Castelli Hospital, Humanitas University, Rozzano, Italy
| | - Barbara Parolini
- Department of Ophthalmology, Istituto Clinico S. Anna, Brescia, Italy
| | - Davide Allegrini
- Department of Ophthalmology, Gavazzeni - Castelli Hospital, Humanitas University, Rozzano, Italy
| | | | - Ron Adelman
- Department of Ophthalmology, Yale University, New Haven, Connecticut, USA
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Silvia Bopp
- Department of Ophthalmology & Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Tosi GM, Neri G, Barbera S, Mundo L, Parolini B, Lazzi S, Lugano R, Poletto E, Leoncini L, Pertile G, Mongiat M, Dimberg A, Galvagni F, Orlandini M. The Binding of CD93 to Multimerin-2 Promotes Choroidal Neovascularization. Invest Ophthalmol Vis Sci 2020; 61:30. [PMID: 32697305 PMCID: PMC7425738 DOI: 10.1167/iovs.61.8.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/20/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose The purpose of this study was to investigate the involvement of CD93 and Multimerin-2 in three choroidal neovascularization (CNV) models and to evaluate their contribution in the neovascular progression of age-related macular degeneration (AMD). Methods Choroidal neovascular membranes collected during surgery from AMD patients were analyzed by microscopy methods. Laser-induced CNV mouse models and choroid sprouting assays (CSAs) were carried out using the CD93 knockout mouse model. An original ex vivo CSA of vascular angiogenesis, employing choroid tissues isolated from human donors, was developed. Results In contrast to healthy choroid endothelium, hyperproliferative choroidal endothelial cells (ECs) of AMD patients expressed high levels of CD93, and Multimerin-2 was abundantly deposited along the choroidal neovasculature. CD93 knockout mice showed a significant reduced neovascularization after laser photocoagulation, and their choroidal ECs displayed a decreased ability to produce sprouts in ex vivo angiogenesis assays. Moreover, the presence of an antibody able to hamper the CD93/Multimerin-2 interaction reduced vascular sprouting in the human CSA. Conclusions Our results demonstrate that CD93 and its interaction with Multimerin-2 play an important role in pathological vascularization of the choroid, disclosing new possibilities for therapeutic intervention to neovascular AMD.
Collapse
Affiliation(s)
- Gian Marco Tosi
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giovanni Neri
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Stefano Barbera
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Lucia Mundo
- Department of Medical Biotechnology, Section of Pathology, University of Siena, Siena, Italy
| | | | - Stefano Lazzi
- Department of Medical Biotechnology, Section of Pathology, University of Siena, Siena, Italy
| | - Roberta Lugano
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Evelina Poletto
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Lorenzo Leoncini
- Department of Medical Biotechnology, Section of Pathology, University of Siena, Siena, Italy
| | - Grazia Pertile
- IRCCS Sacro Cuore Don Calabria Hospital, Negrar (VR), Italy
| | - Maurizio Mongiat
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Anna Dimberg
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Federico Galvagni
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Maurizio Orlandini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| |
Collapse
|
29
|
Parolini B, Palmieri M, Finzi A, Besozzi G, Lucente A, Nava U, Pinackatt S, Adelman R, Frisina R. The new Myopic Traction Maculopathy Staging System. Eur J Ophthalmol 2020; 31:1299-1312. [PMID: 32506945 DOI: 10.1177/1120672120930590] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe a comprehensive OCT-based classification of myopic traction maculopathy (MTM). METHODS Two hundred eighty-one eyes with MTM (visited from 2006 to 2018), were retrospectively reviewed for age, best-corrected-visual-acuity (BCVA), axial length (AL), optical coherence tomography (OCT), and wide-field color fundus-photographs. The study was divided in two Phases. Phase 1: MTM types were categorized with OCT and correlated with age and BCVA. The type of staphyloma was described. Phase 2: the evolution of MTM was studied evaluating at least three OCT exams of each eye taken at different timings (interval between each exam: 1-10 years). RESULTS Phase 1: We identified, four MTM retinal stages (1. Inner/Outer Maculoschisis; 2. Predominantly outer Maculoschisis; 3. Maculoschisis-Macular Detachment; 4. Macular Detachment) and three foveal stages (a. Normal fovea; b. Inner Lamellar-Macular-Hole; c. Full-Thickness-Macular-Hole). Outer-Lamellar-Macular-Holes and epiretinal abnormalities were associated findings. Stages 1 to 2 were younger than stages 3 to 4 (p < 0.05). BCVA in stages 1, 2 was similar, and higher than stages 3, 4 (p < 0.02). About 14% of eyes had no staphyloma, 73% of eyes had staphyloma type 1 or 2. MTM stages were not correlated with AL. Phase 2: The retina could change in time from stage 1 to 4, or the fovea could change from stage a to c. Mean evolution time from stage 1 to 2, stage 2 to 3, and 3 to 4 were 20, 12, 3 months, respectively. BCVA decreased over time as stages increased (p = 0.47). CONCLUSION The MSS Table displays a new classification, the natural evolution, and practical insights for the management of MTM.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Sajish Pinackatt
- Department of Ophthalmology, Istituto Clinico S. Anna, Brescia, Lombardia, Italy
| | - Ron Adelman
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, USA
| | - Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy
| |
Collapse
|
30
|
Frisina R, Forlini M, Date P, Meduri A, Pinackatt JS, Sborgia L, Besozzi G, Parolini B. Microscope-Assisted ab externo Surgery for the Treatment of Primary Rhegmatogenous Retinal Detachment - New Tech Meets Old Art. Ophthalmic Res 2019; 63:34-40. [PMID: 31352453 DOI: 10.1159/000501213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
AIM To report the outcomes of ab externo surgery using a surgical microscope, wide-angle viewing system, and chandelier endoilluminator (microscope-assisted ab externo surgery) for rhegmatogenous retinal detachment (RRD). METHODS This was a retrospective study. Consecutive charts of patients with RRD who underwent microscope-assisted ab externo surgery were analyzed. The following demographic parameters were analyzed: age (years), gender (male/female), and eye (right/left). Clinical parameters were axial length (AL) measured in millimeters (mm), preoperative best-corrected visual acuity (BCVA) measured in logarithm of minimum angle of resolution (logMAR), intraocular pressure (IOP), and lens status (phakic/pseudophakic). The parameters of RRD were number and type of retinal breaks, location of retinal breaks, extent of retinal detachment (RD) (number of detached quadrants), and macular detachment (MD), as well as retinal breaks not detected preoperatively. Use of cryopexy, circumferential or segmental scleral buckle, drainage of subretinal fluid, injection of air or gas, and duration of surgery were recorded. The postoperative parameters analyzed were BCVA, IOP and recurrence of RD and postoperative complications. Follow-up was established at 3 months. RESULTS A total of 213 eyes (97 right, 116 left) of 205 patients (114 males, 91 females) affected by primary RRD were included. Fifty-two eyes (24.4%) were affected by high myopia (AL >26.5 mm), and 160 patients (75.1%) were affected by RRD caused by a single retinal break and involving only one quadrant. The superior quadrant was the most frequently involved (49.3%). Forty-two eyes (19.7%) were affected by MD. In 13 eyes (11.3%), retinal breaks were not detected preoperatively. The duration of surgery was 75.5 ± 42 min. No significant BCVA changes were observed in the whole group, whereas a significant improvement of BCVA from the baseline (2.83 ± 0.87 logMAR) to each time point of follow-up was observed in the subgroup of patients affected by MD. Six eyes (2.8%) developed a recurrent RD, secondary to proliferative vitreoretinopathy (3 eyes) and secondary to a new retinal break (3 eyes). Two eyes developed a persistent vitreous hemorrhage, and one eye developed a macular hole after 1 week. PPV was performed for both. CONCLUSION Microscope-assisted ab externo surgery is effective and safe, it reduces discomfort, it allows the surgeon to work with both hands free, and provides an adequate visualization of each step being performed.
Collapse
Affiliation(s)
- Rino Frisina
- Department of Ophthalmology, University of Padova, Padova, Italy,
| | | | | | | | | | - Luigi Sborgia
- Institute of Ophthalmology, University of Bari, Bari, Italy
| | | | | |
Collapse
|
31
|
Grewal DS, Charles S, Parolini B, Kadonosono K, Mahmoud TH. Autologous Retinal Transplant for Refractory Macular Holes: Multicenter International Collaborative Study Group. Ophthalmology 2019; 126:1399-1408. [PMID: 30711606 DOI: 10.1016/j.ophtha.2019.01.027] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/16/2019] [Accepted: 01/26/2019] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To report the structural and functional outcomes of autologous neurosensory retinal transplant for closure of refractory large macular holes (MHs). DESIGN Multicenter, retrospective, consecutive case series. PARTICIPANTS A total of 41 eyes of 41 patients with a full-thickness MH refractory to prior vitrectomy with internal limiting membrane (ILM) peel and tamponade. METHODS All patients underwent pars plana vitrectomy, autologous neurosensory retinal transplant with gas, silicone oil tamponade, or short-term perfluoro-n-octane heavy-liquid tamponade. All patients had at least 6 months' follow-up. MAIN OUTCOME MEASURES Anatomic closure of MH, change in ellipsoid zone (EZ) and external limiting membrane (ELM) defect on OCT, visual acuity (VA) recovery, and surgical complications were analyzed. RESULTS Mean number of prior surgeries was 1.5±0.94 (range, 1-3), and patients were followed for a mean of 11.1±7.7 months (range, 6-36 months). Complete anatomic closure of MH by OCT was achieved in 36 of 41 eyes (87.8%). Mean corrected VA (logarithm of the minimum angle of resolution [logMAR]) improved (P = 0.03) from 1.11±0.66 (range, 0.48-3) to 1.03±0.51 (range, 0.1-2) at the last postoperative visit. The VA improved (≥0.3 logMAR units) in 15 eyes (36.6%), was stable in 17 eyes (41.5%), and worsened in 9 eyes (21.9%). Among eyes with anatomic closure, VA improved in 52.3% and worsened in 13.8%, whereas in those without closure, VA worsened in 40% and improved in none. Mean preoperative largest basal diameter was 1468.1±656.4 μm (range, 621-2600 μm), and mean inner-opening diameter was 825±422.5 μm (range, 336-1649 μm). Mean preoperative EZ defect was 1777.3±513.8 μm (range, 963-2808 μm), which decreased to 1370±556.9 μm (range, 288-2000 μm) at final follow-up (P = 0.007). Mean preoperative ELM was 1681.5±429 μm (range, 1172-2606 μm), which decreased to 1408.5±571.2 μm (range, 200-2000 μm) at final follow-up (P = 0.017). Major postoperative complications were retinal detachment (n = 1) and vitreous hemorrhage (n = 1). There were no cases of proliferative vitreoretinopathy, endophthalmitis, suprachoroidal hemorrhage, or choroidal neovascularization. CONCLUSIONS The autologous retinal transplant technique offers a high degree of anatomic success and proved safe in this initial experience for closure of refractory MHs.
Collapse
Affiliation(s)
- Dilraj S Grewal
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | | | - Barbara Parolini
- Department of Ophthalmology, Sant'Anna Institute, Brescia, Italy
| | - Kazuaki Kadonosono
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Tamer H Mahmoud
- Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Associated Retinal Consultants, Royal Oak, Michigan.
| |
Collapse
|
32
|
Parolini B, Cardillo D, Baldi A, Di Salvatore A, Finzi A, Pinackatt SJ, Frisina R, Besozzi G. Partial thickness sclerectomy to treat exudative retinal detachment secondary a submacular choroidal hemangioma in a Sturge-Weber syndrome. Int Ophthalmol 2018; 39:491-495. [PMID: 30564966 DOI: 10.1007/s10792-018-1056-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To demonstrate the safety and efficacy of partial thickness sclerectomies to treat exudative retinal detachment secondary to choroidal hemangioma, non-suitable with photodynamic therapy in a 5-year-old child with Sturge-Weber syndrome. METHODS A 5 year-old child presented exudative retinal detachment secondary to choroidal subfoveal diffuse hemangioma. The child was non-compliant to undergo a photodynamic therapy. A partial thickness sclerectomy was made in each quadrant under general anesthesia. RESULTS The retina was re-attached with improvement in vision from 20/400 to 20/80. Two years after primary surgery, the retinal detachment relapsed. Drainage of the subretinal fluid was obtained by the revision of the sclerectomies. After obtaining retinal reattachment, photodynamic therapy was applied to treat the hemangioma. No complications were reported after treatment. CONCLUSION Sclerectomies may be considered an efficient and safe surgical option for the management of exudative retinal detachment secondary to choroidal hemangioma in patients non-suitable for photodynamic therapy, waiting for photodynamic therapy to be practicable directly on the hemangioma.
Collapse
Affiliation(s)
- Barbara Parolini
- S. Anna Clinical Institute, Via del Franzone, 31, 25127, Brescia, Italy
| | - Daniele Cardillo
- S. Anna Clinical Institute, Via del Franzone, 31, 25127, Brescia, Italy
| | - Andrea Baldi
- S. Anna Clinical Institute, Via del Franzone, 31, 25127, Brescia, Italy
| | | | - Alessandro Finzi
- S. Anna Clinical Institute, Via del Franzone, 31, 25127, Brescia, Italy
| | | | - Rino Frisina
- Ophthalmology Unit, Department of Neurosciences DNS, University Hospital-Medical School, Padua, Italy
| | - Gianluca Besozzi
- S. Anna Clinical Institute, Via del Franzone, 31, 25127, Brescia, Italy.
| |
Collapse
|
33
|
Besozzi G, Di Salvatore A, Cardillo D, Finzi A, Pinackatt JS, Baldi A, Monfardini A, Forioli V, Frisina R, Parolini B. Intracameral cefuroxime in combined pars plana vitrectomy and phacoemulsification: a study of safety. Clin Ophthalmol 2018; 12:1567-1570. [PMID: 30214140 PMCID: PMC6118255 DOI: 10.2147/opth.s170751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Postoperative endophthalmitis is a severe complication after intraocular surgery. The aim of this pilot study was to investigate the safety of intracameral cefuroxime in combined vitrectomy and phacoemulsification for cataract and various vitreoretinal disease. Methods The charts of 152 patients who underwent combined phacoemulsification, intraocular lens implant and pars plana vitrectomy were reviewed. The final tamponade was chosen among fluid, air, gas or silicone oil, based on the requirement of each single case. Patients were operated on by four different surgeons. At the end of surgery, 1 mg/0.1 mL of intracameral cefuroxime (Aprokam) was administered. Results The mean follow-up was 6.26±7.78 months (range 1–12). No retinal complication, such as retinal infarction or hemorrhages were observed. No acute macular serous detachment and no new intraretinal cysts were noted, in those patients who received optical coherence tomography within the fifth day after surgery. No endophthalmitis was recorded. Conclusion Intracameral cefuroxime, at the end of combined phacoemulsification and pars plana vitrectomy, is safe as it has no toxicity on the retina and maybe could be considered effective in endophthalmitis prevention. Due to the relatively small number of patients, further studies are advisable. Summary statement The standard dose of intracameral cefuroxime at the end of combined phacoemulsification and pars plana vitrectomy has no toxic effects on the retina. This paper/The abstract of this paper was presented at the European Vitreo Retinal Society Conference 2017 as a conference talk with interim findings. The poster’s abstract was not published.
Collapse
Affiliation(s)
| | | | - Daniele Cardillo
- Department of Ophthalmology, Sant'Anna Clinical Institute, Brescia, Italy
| | - Alessandro Finzi
- Department of Ophthalmology, Sant'Anna Clinical Institute, Brescia, Italy
| | | | - Andrea Baldi
- Department of Ophthalmology, Sant'Anna Clinical Institute, Brescia, Italy
| | | | - Valeria Forioli
- Department of Ophthalmology, Sant'Anna Clinical Institute, Brescia, Italy
| | - Rino Frisina
- Department of Ophthalmology, Padova University Hospital, Padova, Italy
| | - Barbara Parolini
- Department of Ophthalmology, Sant'Anna Clinical Institute, Brescia, Italy
| |
Collapse
|
34
|
Tosi GM, Neri G, Caldi E, Fusco F, Bacci T, Tarantello A, Nuti E, Marigliani D, Baiocchi S, Traversi C, Barbarino M, Eandi CM, Parolini B, Mundo L, Santucci A, Orlandini M, Galvagni F. Publisher Correction: TGF-β concentrations and activity are down-regulated in the aqueous humor of patients with neovascular age-related macular degeneration. Sci Rep 2018; 8:10141. [PMID: 29955097 PMCID: PMC6023889 DOI: 10.1038/s41598-018-28203-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Gian Marco Tosi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Giovanni Neri
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Elena Caldi
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy
| | - Fiorella Fusco
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Tommaso Bacci
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Antonio Tarantello
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Elisabetta Nuti
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Davide Marigliani
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Stefano Baiocchi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Claudio Traversi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Marcella Barbarino
- University of Siena, Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Chiara M Eandi
- University of Turin, Department of Surgical Science, Turin, 10124, Italy
| | | | - Lucia Mundo
- University of Siena, Department of Medical Biotechnology, Siena, 53100, Italy
| | - Annalisa Santucci
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy
| | - Maurizio Orlandini
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.
| | - Federico Galvagni
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.
| |
Collapse
|
35
|
Romano MR, Ilardi G, Ferrara M, Cennamo G, Parolini B, Mariotti C, Staibano S, Cennamo G. Macular peeling-induced retinal damage: clinical and histopathological evaluation after using different dyes. Graefes Arch Clin Exp Ophthalmol 2018; 256:1573-1580. [DOI: 10.1007/s00417-018-4029-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/22/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022] Open
|
36
|
Tosi GM, Neri G, Caldi E, Fusco F, Bacci T, Tarantello A, Nuti E, Marigliani D, Baiocchi S, Traversi C, Barbarino M, Eandi CM, Parolini B, Mundo L, Santucci A, Orlandini M, Galvagni F. TGF-β concentrations and activity are down-regulated in the aqueous humor of patients with neovascular age-related macular degeneration. Sci Rep 2018; 8:8053. [PMID: 29795291 PMCID: PMC5966430 DOI: 10.1038/s41598-018-26442-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/11/2018] [Indexed: 01/21/2023] Open
Abstract
Controversy still exists regarding the role of the TGF-β in neovascular age-related macular degeneration (nAMD), a major cause of severe visual loss in the elderly in developed countries. Here, we measured the concentrations of active TGF-β1, TGF-β2, and TGF-β3 by ELISA in the aqueous humor of 20 patients affected by nAMD, who received 3 consecutive monthly intravitreal injections of anti-VEGF-A antibody. Samples were collected at baseline (before the first injection), month 1 (before the second injection), and month 2 (before the third injection). The same samples were used in a luciferase-based reporter assay to test the TGF-β pathway activation. Active TGF-β1 concentrations in the aqueous humor were below the minimum detectable dose. Active TGF-β2 concentrations were significantly lower at baseline and at month 1, compared to controls. No significant differences in active TGF-β3 concentration were found among the sample groups. Moreover, TGF-β pathway activation was significantly lower at baseline compared to controls. Our data corroborate an anti-angiogenic role for TGF-β2 in nAMD. This should be considered from the perspective of a therapy using TGF-β inhibitors.
Collapse
Affiliation(s)
- Gian Marco Tosi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Giovanni Neri
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Elena Caldi
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy
| | - Fiorella Fusco
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Tommaso Bacci
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Antonio Tarantello
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Elisabetta Nuti
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Davide Marigliani
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Stefano Baiocchi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Claudio Traversi
- University of Siena, Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Marcella Barbarino
- University of Siena, Department of Medicine, Surgery and Neuroscience, Siena, 53100, Italy
| | - Chiara M Eandi
- University of Turin, Department of Surgical Science, Turin, 10124, Italy
| | | | - Lucia Mundo
- University of Siena, Department of Medical Biotechnology, Siena, 53100, Italy
| | - Annalisa Santucci
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy
| | - Maurizio Orlandini
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.
| | - Federico Galvagni
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.
| |
Collapse
|
37
|
dell’Omo R, Virgili G, Bottoni F, Parolini B, De Turris S, Di Salvatore A, dell’Omo E, Costagliola C. Lamellar macular holes in the eyes with pathological myopia. Graefes Arch Clin Exp Ophthalmol 2018; 256:1281-1290. [DOI: 10.1007/s00417-018-3995-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
|
38
|
Vizzarri F, Palazzo M, Bartollino S, Casamassima D, Parolini B, Troiano P, Caruso C, Costagliola C. Effects of an antioxidant protective topical formulation on eye exposed to ultraviolet-irradiation: a study in rabbit animal model. Physiol Res 2018. [PMID: 29527920 DOI: 10.33549/physiolres.933759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ultraviolet-radiation exerts a well-known role in the development of various ocular diseases and may contribute to the progress of age-related macular degeneration. Therefore, the use of compounds able to protect the eyes from UV-induced cellular damage is challenging. The aim of this study has been to test the protective effects of an antioxidant topical formulation against UV-induced damage in rabbit eyes. Twelve male rabbits were used. Animals were divided into 4 groups of 3 animals each. Control group (CG) did not receive any irradiation and/or eye drop. The other three experimental groups were treated as follows: the first group received only UVR irradiation for 30 min, without eye drop supplementation (Irradiation group, IG), the second (G30) and the third (G60) groups received UV irradiation for 30' and 60', respectively, and eye drop supplementation (riboflavin, d-alpha-tocopheryl polyethylene glycol, proline, glycine, lysine and leucine solution) every 15 min for three hours. In the IG group a significant increase of oxidized glutathione (GSSG) and hydrogen peroxide (H(2)O(2)) was recorded in the aqueous humor, whereas ascorbic acid levels were significantly lower when compared to control eyes. In the groups exposed to UVR rays for 30 min, and treated with the topical antioxidant formulation, the GSSG, H(2)O(2) and ascorbic acid levels were similar to those recorded in controls, whereas in the G60 group the three markers significantly differ from control group. In the lens, a significant decrease of alpha tocopherol and total antioxidant capacity (TAC) was recorded in IG-animals as compared to control group, whereas malondialdehyde (MDA) levels were significantly higher in UV-induced eye than in control eyes. In the G30 groups the alpha tocopherol, MDA and TAC levels do not significantly differ from those recorded in controls, whereas in the G60 group these three markers significantly differ from control group. Present findings demonstrate that topical treatment with the antioxidant formulation used herein protects ocular structures from oxidative stress induced by UV exposure in in vivo animal model.
Collapse
Affiliation(s)
- F Vizzarri
- Department of Agricultural, Environmental and Food Sciences, University of Molise, Campobasso, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Maggio E, Polito A, Guerriero M, Prigione G, Parolini B, Pertile G. Reply. Ophthalmology 2018; 125:e6-e8. [DOI: 10.1016/j.ophtha.2017.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022] Open
|
40
|
Maggio E, Polito A, Guerriero M, Prigione G, Parolini B, Pertile G. Vitreomacular Adhesion and the Risk of Neovascular Age-Related Macular Degeneration. Ophthalmology 2017; 124:657-666. [PMID: 28214102 DOI: 10.1016/j.ophtha.2017.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/23/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To assess the prevalence of vitreomacular adhesion (VMA) in consecutive naïve eyes diagnosed with exudative age-related macular degeneration (AMD) in comparison with eyes with nonexudative AMD and age-matched controls, and to evaluate prospectively the incidence of vitreomacular interface changes over time and their influence on choroidal neovascularization (CNV) development. DESIGN Retrospective cross-sectional analysis and longitudinal cohort study conducted at Sacrocuore Hospital, Negrar, Verona, Italy. PARTICIPANTS A total of 1067 eyes examined at Sacrocuore Hospital between August 2008 and June 2015 met the inclusion criteria and were evaluated in this study. METHODS Eyes were classified into 3 groups: 403 eyes of 364 patients (mean [standard deviation; SD] age 77.8 [8.0] years) affected by exudative AMD; 350 eyes of 298 subjects (mean [SD] age 78.1 [8.2] years) with nonexudative AMD; and 314 eyes of 214 subjects (mean [SD] age 74.2 [8.2] years) with no signs of AMD enrolled as the control group. The vitreomacular interface status was evaluated by spectral-domain optical coherence tomography (OCT) and was graded according to the OCT-based International Classification System developed by the International Vitreomacular Traction Study Group by 2 independent masked observers. RESULTS VMA was present in 101 (25.1%) eyes with exudative AMD, 84 (24.0%) eyes with nonexudative AMD, and 84 (26.8%) eyes with no signs of AMD (no statistical difference was found; P = 0.3384). Spontaneous release of VMA (RVMA) was found in 15 (15.3%) eyes with exudative AMD, 21 (28.0%) eyes with nonexudative AMD, and 10 (24.4%) eyes with no signs of AMD over a mean follow-up of 25.5, 25.9, and 24.1 months, respectively. The incidence of RVMA in exudative AMD eyes was significantly lower compared with nonexudative (P = 0.0207) and lower, but not statistically significant, with respect to eyes with no signs of AMD (P = 0.1013). In eyes with nonexudative AMD, de novo development of CNV occurred in 91 eyes (30.6%). There was no significant difference regarding the rate of CNV development in the presence or absence of VMA (P = 0.0966). CONCLUSIONS The present study found no significant difference in the prevalence of VMA in eyes affected by AMD compared with age-matched controls and no difference in the rate of de novo CNV development in eyes with or without VMA. Conversely, a lower incidence of RVMA over time was found in eyes affected by exudative AMD. The results of this study suggest that VMA might be a consequence rather than a causative factor in the development of CNV.
Collapse
Affiliation(s)
| | | | | | | | - Barbara Parolini
- Department of Ophthalmology, Sant'Anna Institute, Brescia, Italy
| | | |
Collapse
|
41
|
Tosi GM, Caldi E, Parolini B, Toti P, Neri G, Nardi F, Traversi C, Cevenini G, Marigliani D, Nuti E, Bacci T, Galvagni F, Orlandini M. CD93 as a Potential Target in Neovascular Age-Related Macular Degeneration. J Cell Physiol 2016; 232:1767-1773. [DOI: 10.1002/jcp.25689] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/11/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Gian Marco Tosi
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Elena Caldi
- Department of Biotechnology, Chemistry and Pharmacy; University of Siena; Siena Italy
| | | | - Paolo Toti
- Department of Medical Biotechnologies; University of Siena; Siena Italy
| | - Giovanni Neri
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Federica Nardi
- Department of Biotechnology, Chemistry and Pharmacy; University of Siena; Siena Italy
| | - Claudio Traversi
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Gabriele Cevenini
- Department of Medical Biotechnologies; University of Siena; Siena Italy
| | - Davide Marigliani
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Elisabetta Nuti
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Tommaso Bacci
- Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience; University of Siena; Siena Italy
| | - Federico Galvagni
- Department of Biotechnology, Chemistry and Pharmacy; University of Siena; Siena Italy
| | - Maurizio Orlandini
- Department of Biotechnology, Chemistry and Pharmacy; University of Siena; Siena Italy
| |
Collapse
|
42
|
Zampedri E, Romanelli F, Semeraro F, Parolini B, Frisina R. Spectral-domain optical coherence tomography findings in idiopathic lamellar macular hole. Graefes Arch Clin Exp Ophthalmol 2016; 255:699-707. [DOI: 10.1007/s00417-016-3545-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/16/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022] Open
|
43
|
Beltramello A, Carbognin G, Caudana R, Biasi D, Parolini B, Cerini R, Bambara L. La mielopatia in corso di artrite reumatoide a localizzazione cervicale. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099500800103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In corso di artrite reumatoide l'interessamento del rachide cervicale riguarda circa il 60–70% dei pazienti affetti dalla patologia. Le strutture colpite dalla flogosi reumatoide sono le articolazioni cartilaginee e sinoviali, le cosiddette articolazioni di Luschka, l'inserzione di tendini e legamenti e i tessuti molli della regione cervicale. Il coinvolgimento del tratto cervicale può essere asintomatico o rendersi responsabile di importante dolore, limitazione funzionale e di varie manifestazioni neurologiche, quali parestesie, paresi, ipotrofia muscolare, fino alla quadriplegia e morte, soprattutto in caso di malattia particolarmente aggressiva e perdurante da molto tempo. In questo lavoro si è cercato di individuare i caratteri clinico-radiologici più significativamente associati a sintomatologia neurologica in corso di artrite reumatoide. Particolare attenzione è stata prestata per definire i caratteri morfologici ed il valore degli indici lineari indicatori di compressione midollare per lussazione atlo-assiale. Dei 27 pazienti (24 donne e 3 uomini, età media di 61 anni) appartenenti alla casistica in esame, solo 3 (11,1%) presentavano esclusivo interessamento del tratto sub-assiale; 19 (70,3%) presentavano esclusivo interessamento radiologico della cerniera atlo-assiale, mentre in 5 (18,6%) era rilevabile coinvolgimento radiologico sia del tratto sub-assiale che della cerniera. In base alla nostra esperienza, più della metà di questi pazienti sviluppa lussazione atlo-assiale; di questi, a loro volta, circa la metà presenta interessamento neurologico: è a questo gruppo, in cui più frequentemente ricorre la lussazione anteriore pura (nel 57% dei casi, contro il 37,5% di quelli privi di interessamento neurologico), cui deve essere prestata particolare attenzione in quanto suscettibile di trattamento chirurgico decompressivo (odontoidectomia) che può eliminare la causa di compressione midollare altrimenti destinata a «fissarsi» in maniera irreversibile con conseguenti gravissimi disturbi neurologici. Questo gruppo di pazienti, in base alla nostra casistica, comprende una relativa maggior rappresentazione del sesso maschile, ed una durata media di malattia significativamente inferiore, con conseguente più breve periodo di accertata positività al FR; anche l'età media è significativamente inferiore, situandosi attorno ai 58 anni contro i 64,9 dei pazienti senza interessamento neurologico. In questi pazienti il valore critico di 9 mm di distanza atlo-dentale è stato raggiunto e superato in più della metà dei casi, contro solo il 12,5% dei pazienti senza interessamento neurologico. Parimenti, più frequente è risultata la presenza di cospicuo panno infiammatorio; l'iper-intensità midollare, spia di mielopatia, è stata osservata solo in questi pazienti, nell'86% dei quali l'angolo bulbo-midollare era ristretto per impronta compressiva esercitata dal dente dell'epistrofeo. La RM si è dimostrata eccellente strumento diagnostico per la valutazione del coinvolgimento del rachide cervicale in corso di artrite reumatoide: è l'unica indagine, infatti, che consente contemporaneamente la visualizzazione diretta del panno infiammatorio, del coinvolgimento del legamento trasverso e dei segni della mielopatia da compressione midollare.
Collapse
Affiliation(s)
| | | | | | - D. Biasi
- Cattedra di Reumatologia; Università degli Studi, Verona
| | - B. Parolini
- Clinica Oculistica; Università degli Studi, Verona
| | | | - L.M. Bambara
- Cattedra di Reumatologia; Università degli Studi, Verona
| |
Collapse
|
44
|
Frisina R, Baldi A, Cesana BM, Semeraro F, Parolini B. Morphological and clinical characteristics of myopic posterior staphyloma in Caucasians. Graefes Arch Clin Exp Ophthalmol 2016; 254:2119-2129. [PMID: 27106626 DOI: 10.1007/s00417-016-3359-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 04/04/2016] [Accepted: 04/14/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE We aimed to study the morphological characteristics of myopic posterior staphyloma in Caucasians and to evaluate the correlation between posterior staphyloma, myopic macular lesions and visual acuity. METHODS Ninety eyes of 67 consecutive patients affected by high myopia associated with posterior staphyloma were recruited between January 2012 and December 2013. Posterior staphyloma was classified according to Curtin's criteria. Every patient underwent fundoscopic examination and best corrected visual acuity measurement (BCVA). A and B-scan ultrasound (US), high-resolution, three-dimensional magnetic resonance image (MRI), optical coherence tomography (OCT), fundus autofluorescence (FAF), red free (RF) and color fundus photography studies were performed. RESULTS The mean age was 64.4 ± 9.48 years (range: 41-82). The mean BCVA was 0.7 ± 0.5 logMAR (range: 0-2). The mean axial length was 29.92 ± 2.39 millimeters (range: 24.25-36.53). The authors found four types of posterior staphyloma according to Curtin's classification: I, II, IV and IX. Significant prevalence of posterior staphyloma in female sex was observed (p = 0.0235). Significant correlation between the depth and the diameters of posterior staphyloma was demonstrated (p < 0.0001). Significant association between posterior staphyloma type and tomographic foveal patterns (p = 0.0230) was highlighted. Posterior staphyloma type I was more frequently associated with peripapillary atrophy and less with macular atrophy compared to type II and IX (p = 0.0169). The prevalence of macular atrophy was more than double in posterior staphyloma type II (33.3 %) in comparison to posterior staphyloma type I (12.5 %). CONCLUSIONS This study confirms that the type I and II are the most common types of posterior staphyloma, as already highlighted in the literature. A significant association between the type of posterior staphyloma and the MRI ocular shape pattern, the OCT patterns of macular profile and the location of chorioretinal atrophy was highlighted. The correlation between the depth and the width of posterior staphyloma has demonstrated that the deeper the staphyloma, the wider it was. The deepest area of the posterior staphyloma was characterized by a greater thinning of the sclera and by a higher prevalence of chorioretinal atrophy compared to the other parts of the eye. More studies are necessary to support our findings and to add more information on the natural evolution of posterior staphyloma and on its associated complications.
Collapse
Affiliation(s)
- Rino Frisina
- Multizonal Unit of Ophthalmology of Autonomous Province of Trento, corso Verona 4, 38068 Rovereto, Trento, TN, Italy.
| | - Andrea Baldi
- Department of Ophthalmology, University of Brescia, Brescia, Italy
| | - Bruno Mario Cesana
- Biostatistical and Biomathematics Unit, DMMT, University of Brescia, Brescia, Italy
| | | | - Barbara Parolini
- Department of Ophthalmology, Sant'Anna Institute, Brescia, Italy
| |
Collapse
|
45
|
Parolini B, Alkabes M, Baldi A, Pinackatt S. VISUAL RECOVERY AFTER AUTOLOGOUS RETINAL PIGMENT EPITHELIUM AND CHOROIDAL PATCH IN A PATIENT WITH CHOROIDAL NEOVASCULARIZATION SECONDARY TO ANGIOID STREAKS: LONG-TERM RESULTS. Retin Cases Brief Rep 2016; 10:368-372. [PMID: 26679062 DOI: 10.1097/icb.0000000000000265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To describe a successfully treated case of autologous retinal pigment epithelium and choroidal patch in a patient with choroidal neovascularization secondary to angioid streaks. METHODS A 53-year-old man with angioid streaks and a subfoveal choroidal neovascularization underwent autologous retinal pigment epithelium and choroid transplantation. Lensectomy, pars plana vitrectomy, 200° peripheral temporal retinotomy, isolation of the patch, endolaser, and silicone oil tamponade 1,000 cts were performed. Preoperative and postoperative ophthalmic examinations included best-corrected visual acuity, fluorescein angiography, indocyanine green angiography, autofluorescence, and optical coherence tomography. RESULTS Two months after surgery, best-corrected visual acuity (Snellen equivalent) improved from 20/200 to 20/100. At 6 months, best-corrected visual acuity further increased to 20/40 and the reading ability, which was absent preoperatively, improved to J2. Visual results were maintained after 2.5 years and no recurrence of choroidal neovascularization was observed. CONCLUSION Transplantation of a full-thickness patch of retinal pigment epithelium and choroid under the fovea may be considered to prevent retinal atrophy with significant visual improvement in the case of a low active choroidal neovascularization secondary to angioid streaks. Moreover, preoperative optical coherence tomography might guide in highlighting those patients in whom the outer retinal layers are still visible as the best candidate for surgery.
Collapse
Affiliation(s)
- Barbara Parolini
- *Department of Ophthalmology, S. Anna Hospital, Brescia, Italy; and †IRCCS Multimedica, San Giuseppe Hospital, University Eye Clinic, Milan, Italy
| | | | | | | |
Collapse
|
46
|
Morescalchi F, Costagliola C, Duse S, Gambicorti E, Parolini B, Arcidiacono B, Romano MR, Semeraro F. Heavy silicone oil and intraocular inflammation. Biomed Res Int 2014; 2014:574825. [PMID: 25114909 PMCID: PMC4119646 DOI: 10.1155/2014/574825] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022]
Abstract
In the past two decades, many advances have been made in vitrectomy instrumentation, surgical techniques, and the use of different tamponade agents. These agents serve close retinal breaks, confine eventual retinal redetachment, and prevent proliferative vitreoretinopathy (PVR). Long-acting gases and silicone oil are effective internal tamponade agents; however, because their specific gravity is lower than that of the vitreous fluid, they may provide adequate support for the superior retina but lack efficacy for the inferior retina, especially when the fill is subtotal. Thus, a specific role may exist for an internal tamponade agent with a higher specific gravity, such as heavy silicone oils (HSOs), Densiron 68, Oxane HD, HWS 45-300, HWS 46-3000, and HeavySil. Some clinical evidence seems to presume that heavy tamponades are more prone to intraocular inflammation than standard silicone if they remain in the eye for several months. In this review, we discuss the fundamental clinical and biochemical/molecular mechanisms involved in the inflammatory response after the use of heavy tamponade: toxicity due to impurities or instability of the agent, direct toxicity and immunogenicity, oil emulsification, and mechanical injury due to gravity. The physical and chemical properties of various HSOs and their efficacy and safety profiles are also described.
Collapse
Affiliation(s)
- Francesco Morescalchi
- Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Ciro Costagliola
- Department of Health Science, Ophthalmology Clinic, University of Molise, Via De Sanctis 1, 86100 Campobasso, Italy
| | - Sarah Duse
- Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Elena Gambicorti
- Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Barbara Parolini
- Dipartimento di Oftalmologia, Istituto Clinico Sant'Anna, Via del Franzone 31, 25126 Brescia, Italy
| | - Barbara Arcidiacono
- Dipartimento di Oftalmologia, Istituto Clinico Sant'Anna, Via del Franzone 31, 25126 Brescia, Italy
| | - Mario R. Romano
- Department of Neurological Sciences, Reproductive Sciences and Dentistry, Federico II University, Via Pansini 5, 80121 Naples, Italy
| | - Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| |
Collapse
|
47
|
Semeraro F, Arcidiacono B, Nascimbeni G, Angi M, Parolini B, Costagliola C. Anti-TNF therapy for juvenile idiopathic arthritis-related uveitis. Drug Des Devel Ther 2014; 8:341-8. [PMID: 24711694 PMCID: PMC3969254 DOI: 10.2147/dddt.s54207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Juvenile idiopathic arthritis-related uveitis is the most common type of uveitis in childhood and one of the main causes of visual impairment in children. The introduction of biological treatment has widened the range of therapeutic options for children with uveitis refractory to standard nonbiologic immunosuppressants. Data from clinical trials suggest that both adalimumab and infliximab have demonstrated effectiveness and safety in open-label studies, although no large, randomized, controlled trials have been reported so far. The role of etanercept in treating juvenile idiopathic arthritis-related uveitis is not yet well defined. In our experience, anti-tumor necrosis factor therapy has been shown to be more effective than steroids and/or methotrexate in treating uveitis. Up to now, tumor necrosis factor blocking compounds have been reserved for the treatment of the most severe cases of refractory uveitis, and larger prospective clinical trials are required in order to better assess the safety of these new compounds.
Collapse
Affiliation(s)
- Francesco Semeraro
- Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia, Brescia, Italy
| | | | - Giuseppe Nascimbeni
- Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia, Brescia, Italy
| | - Martina Angi
- Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia, Brescia, Italy
| | | | - Ciro Costagliola
- Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy
| |
Collapse
|
48
|
Parolini B, Schumann RG, Cereda MG, Haritoglou C, Pertile G. Lamellar macular hole: a clinicopathologic correlation of surgically excised epiretinal membranes. Invest Ophthalmol Vis Sci 2011; 52:9074-83. [PMID: 22025575 DOI: 10.1167/iovs.11-8227] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To correlate clinical and optical coherence tomographic (OCT) features with morphologic and immunohistochemical findings of epiretinal membranes (ERMs) in lamellar macular holes (LMHs). METHODS Nineteen specimens were removed from 19 eyes during vitrectomy for lamellar macular hole with ERM and internal limiting membrane peeling, and were processed for transmission electron microscopy and immunohistochemistry by cross-sectional and flat-mount preparation techniques. By using OCT criteria and intraoperative observations, ERM specimens were divided into two groups: 13 "dense" and 6 "tractional" membranes. Patients' records were reviewed. RESULTS "Dense" ERMs were seen with abundant clusters of fibrous long-spacing collagen embedded in compactly folded native vitreous collagen strands. Posterior hyaloids were attached to the retina in the majority of cases. Both groups of ERMs showed positive immunoreactivity for glial fibrillic acidic protein and hyalocyte markers. Anti-α-smooth muscle actin labeling was most positive in "tractional" ERMs. Surgery resulted in significant improvement (74%) of visual acuity, with a mean gain of 2 Snellen lines in both groups. All other patients (26%) preserved vision. Three patients (16%) developed a full-thickness macular defect requiring additional surgery. CONCLUSIONS Morphologic components differ in epiretinal cell proliferations of LMHs. In association with degradation of vitreous collagen, glial cells and hyalocytes seem to play an important role in LMH development. Since functional benefit after surgery was limited and progression to a full-thickness macular defect was a notable complication, we recommend caution in proceeding with surgical intervention. Further investigations are needed to elucidate whether "dense" and "tractional" LMHs represent different disease entities or different stages of one disorder.
Collapse
Affiliation(s)
- Barbara Parolini
- Department of Ophthalmology, Ospedale Sacrocuore Don Calabria, Negrar, Verona, Italy
| | | | | | | | | |
Collapse
|
49
|
Mete M, Parolini B, Maggio E, Pertile G. 1000 cSt silicone oil vs heavy silicone oil as intraocular tamponade in retinal detachment associated to myopic macular hole. Graefes Arch Clin Exp Ophthalmol 2010; 249:821-6. [PMID: 21080197 DOI: 10.1007/s00417-010-1557-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 10/16/2010] [Accepted: 10/21/2010] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Several surgical techniques have been described for the treatment of retinal detachment (RD) associated to myopic macular hole (MMH). In this retrospective study, the anatomical and functional outcomes of pars plana vitrectomy (PPV) with long-term tamponade, using either 1000 cSt silicone oil (SO) or heavy silicone oil (HSO), are compared. METHODS Forty-two eyes affected by RD associated with MMH were included. The surgical technique involved standard 3-port 20-gauge PPV with long-term tamponade. The patients were divided into two groups, according to the intraocular tamponade: SO in group 1 (n = 17), and HSO in group 2 (n = 25). Internal limiting membrane (ILM) removal was performed in 15 cases of group 1 and 20 cases of group 2. Tamponade removal was performed 2 to 5 months after primary surgery. The patients were assessed 1 week and 1 month after primary surgery, and then 1 week and 1 month after tamponade removal or after further surgery if macular redetachment had occurred. The patients were also visited every 2 months for at least 1 year after final tamponade removal. Follow-up was considered closed at 1 year after final tamponade removal. RESULTS Preoperative best-corrected visual acuity (BCVA), expressed as LogMar, was 2.8 ± 0.77 for group 1 and 2.1 ± 0.94 for group 2. At the last visit, the BCVA was 1.41 ± 0.96 and 1.48 ± 0.77 for groups 1 and 2 respectively. Retinal reattachment was achieved with one operation in 13 eyes of group 1 (76.5%) and 18 of group 2 (81.8%) (P = 0.69). The average number of surgery needed to achieve retinal attachment by patients of group 1 and 2 was respectively 1.36 ± 0.63 and 1.46 ± 0.59 (P = 0.77). Five patients of group 1 and four of group 2 developed a chronic glaucoma (P = 0.238). CONCLUSIONS PPV with ILM peeling and long-term tamponade was demonstrated to be a good surgical option to treat RD due to MMH; SO and HSO seemed to be equally effective, although the success rates remained far from an ideal 100%.
Collapse
Affiliation(s)
- Maurizio Mete
- Department of Ophthalmology, Ospedale Sacro Cuore - Don Calabria, Via don A. Sempreboni 5, 37024, Negrar, VR, Italy.
| | | | | | | |
Collapse
|
50
|
Parolini B, Romanelli F, Prigione G, Pertile G. Response to Letter: Tips and pitfalls in the 23-gauge vitrectomy surgery. One size fits (almost) all. Comment on the article "Incidence of endophthalmitis in a large series of 23-gauge and 20-gauge transconjunctival pars plana vitrectomy" by Grosso et al. Graefes Arch Clin Exp Ophthalmol 2009. [DOI: 10.1007/s00417-009-1142-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|