1
|
Abstract
PURPOSE To evaluate the incidence of neovascularization (NV) secondary to central serous chorioretinopathy (CSC)-a condition belonging to the spectrum of pachychoroid disorders by means of optical coherence tomography angiography. METHODS One hundred and seventy five eyes with CSC were evaluated in this retrospective observational study. The eyes with acute or chronic CSC with no NV were included in Group 1, and those with NV were evaluated in Group 2. Only eyes that had undergone structural optical coherence tomography and optical coherence tomography angiography were included. Age, best-corrected visual acuity, and subfoveal choroidal thickness were evaluated in all eyes. In Group 2, the type and morphology of NV and the occurrence of exudation were considered. RESULTS Of a total of 175 eyes with CSC, 86 had the acute form and 89 the chronic. Approximately 140 belonged to Group 1 (80%) and 35 to Group 2 (20%). Approximately 39.2% of all patient with chronic CSC developed NV. Mean age in Groups 1 and 2 was 53.3 years (±10.9) and 66.6 years (±10.2), respectively. Mean best-corrected visual acuity in Groups 1 and 2 was 45.7 (±11.7) and 30.9 (±17.9) early treatment diabetic retinopathy study letters, respectively. Mean CCT in Group 1 and 2 was 417.5 µm (±123) and 344.2 µm (±165.9), respectively. In Group 2, all patients had Type 1 NV (100%); 29 eyes (83%) had filamentous feature, and 6 eyes (17%) had irregular shape. Silent nonexudative NV was observed in 7 eyes (20%), all belonging to Group 2. CONCLUSION The use of optical coherence tomography angiography in everyday clinical practice allows for the accurate analysis of the chorioretinal vascular setting, with the identification of new vessels that could remain misdiagnosed.
Collapse
Affiliation(s)
- M Cristina Savastano
- UOC Oftalmologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro, Rome, Italy
| | | | | |
Collapse
|
2
|
Savastano MC, Rispoli M, Lumbroso B, Di Antonio L, Mastropasqua L, Virgili G, Savastano A, Bacherini D, Rizzo S. Fluorescein angiography versus optical coherence tomography angiography: FA vs OCTA Italian Study. Eur J Ophthalmol 2020; 31:514-520. [PMID: 32228026 DOI: 10.1177/1120672120909769] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess the current role of fluorescein angiography after the introduction of optical coherence tomography angiography in real-life clinical practice. METHODS This was a multicentric retrospective observational study to evaluate the number of fluorescein angiography and optical coherence tomography angiography procedures performed by different devices from January 2013 to December 2018. The centers involved were Centro Italiano Macula (Rome), and ophthalmology departments of University "G. D'Annunzio" Chieti-Pescara (Chieti) and "Azienda Ospedaliero Universitaria Careggi" (Florence). RESULTS Out of 19,898 total fluorescein angiography procedures performed in the observation period, 3444 (17.3%) were in 2013, 3972 (19.9%) were in 2014, 3601 (18.1%) were in 2015, 3407 (17.2%) were in 2016, 3285 (16.5%) were in 2017, and 2189 (11%) were in 2018. Out of 7949 optical coherence tomography angiography procedures performed in the observation period, none were performed in 2013, 550 (6.9%) were in 2014, 908 (11.5%) were in 2015, 2098 (26.4%) were in 2016, 2090 (26.3%) were in 2017, and 2303 (28.9%) were in 2018. CONCLUSION Fluorescein angiography procedures were performed less often after the introduction of optical coherence tomography angiography technology. The ease, speed, and safety of the optical coherence tomography angiography procedure in everyday clinical practice have facilitated more optical coherence tomography angiography application compared to fluorescein angiography in recent years. In the future, we will probably evaluate the different pathologies that still need an evaluation by fluorescein angiography.
Collapse
Affiliation(s)
| | | | | | - Luca Di Antonio
- Department of Ophthalmology, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Leonardo Mastropasqua
- Department of Ophthalmology, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Gianni Virgili
- Department of Ophthalmology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alfonso Savastano
- Department of Ophthalmology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Daniela Bacherini
- Department of Ophthalmology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Stanislao Rizzo
- Department of Ophthalmology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| |
Collapse
|
3
|
Savastano MC, Rispoli M, Lumbroso B. Choroidal juxtapapillary neovascularization regression in multiple evanescent white dot syndrome by optical coherence tomography angiography: a case report. J Med Case Rep 2019; 13:274. [PMID: 31470898 PMCID: PMC6717392 DOI: 10.1186/s13256-019-2211-8] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple evanescent white dot syndrome most often resolves spontaneously without complications; however, choroidal neovascularization can sometimes occur. CASE PRESENTATION Here, we describe a case of a 22-year-old white Caucasian man with blurred vision in his left eye who exhibited juxtapapillary choroidal neovascularization on optical coherence tomography angiography. Although multiple evanescent white dot syndrome is often self-limiting, to reduce the possibility of an inflammatory reaction, we preferred to administer prednisolone orally. After 3 months, significant regression of juxtapapillary neovascularization was observed by B-scan and optical coherence tomography angiography. Symptoms resolved in 3 months. A steady situation was observed at 4 years of follow-up. CONCLUSION This case report highlights the helpful use of optical coherence tomography angiography in daily clinical practice, even in inflammatory diseases, such as atypical juxtapapillary neovascularization in multiple evanescent white dot syndrome. Choroidal neovascularization associated with multiple evanescent white dot syndrome by means of optical coherence tomography angiography showed neovascular activity regression, thus avoiding invasive therapy.
Collapse
Affiliation(s)
| | - Marco Rispoli
- Centro Italiano Macula, Via Angelo Brofferio, 7, 00196, Rome, Italy
| | - Bruno Lumbroso
- Centro Italiano Macula, Via Angelo Brofferio, 7, 00196, Rome, Italy
| |
Collapse
|
4
|
Podoleanu A, Izatt J, Lumbroso B, Pircher M, Rosen R, Weitz R. Progress in Multimodal En Face Imaging: feature introduction. Biomed Opt Express 2019; 10:2135-2140. [PMID: 31086718 PMCID: PMC6484991 DOI: 10.1364/boe.10.002135] [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] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Indexed: 06/09/2023]
Abstract
This feature issue contains papers that report on the most recent advances in the field of en face optical coherence tomography (OCT) and of combinations of modalities facilitated by the en face view. Hardware configurations for delivery of en face OCT images are described as well as specific signal and image processing techniques tailored to deliver relevant clinical diagnoses. The value of the en face perspective for enabling multimodality is illustrated by several combination modalities.
Collapse
|
5
|
Rispoli M, Savastano MC, Lumbroso B. Quantitative Vascular Density Changes in Choriocapillaris Around CNV After Anti-VEGF Treatment: Dark Halo. Ophthalmic Surg Lasers Imaging Retina 2018; 49:918-924. [DOI: 10.3928/23258160-20181203-02] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/15/2018] [Indexed: 02/04/2023]
|
6
|
Savastano MC, Dansingani KK, Rispoli M, Virgili G, Savastano A, Freund KB, Lumbroso B. CLASSIFICATION OF HALLER VESSEL ARRANGEMENTS IN ACUTE AND CHRONIC CENTRAL SEROUS CHORIORETINOPATHY IMAGED WITH EN FACE OPTICAL COHERENCE TOMOGRAPHY. Retina 2018; 38:1211-1215. [PMID: 28489695 DOI: 10.1097/iae.0000000000001678] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the prevailing patterns of Haller vessel arrangements at the posterior pole between healthy eyes and those with central serous chorioretinopathy (CSC) using en face optical coherence tomography. METHODS Eyes of normal subjects and patients with acute or chronic CSC underwent optical coherence tomography imaging (RTVue 100; Optovue Inc, Fremont, CA). En face sections at the level of the Haller layer were classified by two masked graders into five mutually exclusive morphologic categories (temporal herringbone, branched from below, laterally diagonal, double arcuate, and reticular). The relative prevalence of each Haller vessel arrangement pattern was determined for each phenotype. RESULTS Numbers of eyes examined were as follows: 154 eyes of 77 normal subjects; 41 eyes of 31 patients with acute CSC; and 39 eyes of 33 patients with chronic CSC. The mean age of participants was 44.4 ± 14.6 years for healthy subjects (M:F = 37:40), 48.5 ± 8.2 years (M:F = 24:7) for acute CSC, and 65.3 ± 13.1 years (M:F = 28:5) for chronic CSC. The relative prevalence of each Haller vessel arrangement pattern differed by phenotype. The temporal herringbone pattern was most prevalent in healthy eyes (49.2%), whereas a reticular pattern was most prevalent in eyes with acute and/or chronic CSC (combined, 48.8%). CONCLUSION A significant difference was observed in the prevalence of respective Haller vessel arrangement patterns between eyes of normal subjects and those of patients with either acute or chronic CSC. Although further study is needed to determine the mechanistic factors underlying these differences, and the hemodynamic implications, our data suggest that en face optical coherence tomography may find a formal role in choroidal disease classification.
Collapse
Affiliation(s)
| | - Kunal K Dansingani
- Truhlsen Eye Institute, University of Omaha Medical Center, Omaha, Nebraska.,Moorfields Eye Hospital, London, United Kingdom
| | - Marco Rispoli
- Centro Italiano Macula, Rome, Italy.,Nuovo Regina Margherita Hospital, Rome, Italy
| | - Gianni Virgili
- Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy
| | - Alfonso Savastano
- Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York.,The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York.,Department of Ophthalmology, New York University School of Medicine, New York, New York
| | | |
Collapse
|
7
|
Azar G, Wolff B, Mauget-Faÿsse M, Rispoli M, Savastano MC, Lumbroso B. Pachychoroid neovasculopathy: aspect on optical coherence tomography angiography. Acta Ophthalmol 2017; 95:421-427. [PMID: 27597633 DOI: 10.1111/aos.13221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 01/25/2016] [Accepted: 07/10/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe and interpret the features of pachychoroid neovasculopathy (PNV) using optical coherence tomography angiography (OCTA) technique. METHODS This is an observational case series of patients who presented with PNV. Best-corrected visual acuity (BCVA), anterior segment examination, dilated funduscopic examination, infrared and autofluorescence fundus images and spectral-domain optical coherence tomography (SD-OCT; B-scan, 'en-face' and OCTA) were carried out for all patients. Choroid thickness was measured using enhanced depth imaging (EDI) mode. Colour fundus photographs, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were not performed systematically. Optical coherence tomography angiography (OCTA) features of PNV are described and interpreted. RESULTS Five eyes of five patients with a mean age of 62.2 years (range, 53-73 years) presenting with PNV were analysed. They all presented pachychoroid pigment epitheliopathy (PPE) with choroidal thickening and dilated choroidal vessels as seen with EDI-OCT. Fluorescein angiography (FFA) was performed in three patients showing multiple areas of retinal pigment epithelium atrophy and fundus lesions suggestive of chronic central serous chorioretinopathy. Indocyanine green angiography (ICGA) in one patient confirmed the presence of large choroidal veins and choroidal hyperpermeability seen beneath the area of the neovascular tissue. Two eyes had the appearance of polypoidal structures within the neovascular tissue, with the characteristic aspect of the polypoidal lesions on B-scan and 'en-face'. Optical coherence tomography angiography (OCTA) showed the appearance of tangled filamentous vascular network in all eyes. CONCLUSION Optical coherence tomography angiography (OCTA) is a safe, highly sensitive and specific examination for the detection of type 1 neovascularization associated with PPE. Features are characteristic of tangled filamentous vessels overlying a focal area of thickened choroid.
Collapse
Affiliation(s)
- Georges Azar
- Eye & Ear Hospital International; Beirut Lebanon
- Faculty of Medicine; Holy Spirit University of Kaslik (USEK); Kaslik Lebanon
- Faculty of Medicine; Saint Joseph University (USJ); Beirut Lebanon
| | - Benjamin Wolff
- Rothschild Ophthalmological Foundation; Paris Cedex France
| | | | | | | | | |
Collapse
|
8
|
Lumbroso B. OCT-A in neovascular age related macular degeneration. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Toto L, Di Antonio L, Mastropasqua R, Mattei PA, Carpineto P, Borrelli E, Rispoli M, Lumbroso B, Mastropasqua L. Multimodal Imaging of Macular Telangiectasia Type 2: Focus on Vascular Changes Using Optical Coherence Tomography Angiography. ACTA ACUST UNITED AC 2016; 57:OCT268-76. [DOI: 10.1167/iovs.15-18872] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Lisa Toto
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| | - Luca Di Antonio
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| | | | - Peter A. Mattei
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| | - Paolo Carpineto
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| | - Enrico Borrelli
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| | | | | | - Leonardo Mastropasqua
- Department of Medicine and Science of Aging Ophthalmology Clinic, University “G. d'Annunzio” Chieti-Pescara, Chieti, Italy
| |
Collapse
|
10
|
Lumbroso B, Rispoli M, Savastano MC, Jia Y, Tan O, Huang D. Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Early Response after Treatment. Dev Ophthalmol 2016; 56:77-85. [PMID: 27022967 DOI: 10.1159/000442782] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS Study the choroidal neovascularization (CNV) morphological evolution after treatment using optical coherence tomography angiography (OCTA). METHOD We used Optovue XR Avanti, with split-spectrum amplitude-decorrelation angiography algorithm. RESULTS OCT Angiography allows to recognize better the CNV type. In our series all our cases seem to follow a 45 to 60 days cycle, after intra vitreal injection. After each injection a pruning of smaller vessels is seen immediately (after 24 hours) that increases for 6 to 12 days when it reaches a maximum. It is followed by a reopening or new sprouting of the vessels 20 to 50 days later. The later cycles seem longer. Our results on early CNV evolution seem to confirm previous observations of CNV abnormalization and arterialization. Pruning the small peripheral branches seems to strengthen the trunk. In OCTA, closing terminal vessels (anti-VEGF effects) seems to cause an increased flow in trunk after the CNV reactivation.
Collapse
|
11
|
Huang D, Jia Y, Gao SS, Lumbroso B, Rispoli M. Optical Coherence Tomography Angiography Using the Optovue Device. Developments in Ophthalmology 2016; 56:6-12. [DOI: 10.1159/000442770] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
12
|
Savastano MC, Rispoli M, Savastano A, Lumbroso B. En Face Optical Coherence Tomography for Visualization of the Choroid. Ophthalmic Surg Lasers Imaging Retina 2015; 46:561-5. [PMID: 26057759 DOI: 10.3928/23258160-20150521-07] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/11/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To assess posterior pole choroid patterns in healthy eyes using en face optical coherence tomography (OCT). PATIENTS AND METHODS This observational study included 154 healthy eyes of 77 patients who underwent en face OCT. The mean age of the patients was 31.2 years (standard deviation: 13 years); 40 patients were women, and 37 patients were men. En face imaging of the choroidal vasculature was assessed using an OCT Optovue RTVue (Optovue, Fremont, CA). To generate an appropriate choroid image, the best detectable vessels in Haller's layer below the retinal pigment epithelium surface parallel plane were selected. RESULTS Images of diverse choroidal vessel patterns at the posterior pole were observed and recorded with en face OCT. Five different patterns of Haller's layer with different occurrences were assessed. Pattern 1 (temporal herringbone) represented 49.2%, pattern 2 (branched from below) and pattern 3 (laterally diagonal) represented 14.2%, pattern 4 (doubled arcuate) was observed in 11.9%, and pattern 5 (reticular feature) was observed in 10.5% of the reference plane. CONCLUSION In vivo assessment of human choroid microvasculature in healthy eyes using en face OCT demonstrated five different patterns. The choroid vasculature pattern may play a role in the origin and development of neuroretinal pathologies, with potential importance in chorioretinal diseases and circulatory abnormalities.
Collapse
|
13
|
Lumbroso B. OCT angiography in CNV quantitative follow up. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
14
|
Matet A, Savastano MC, Rispoli M, Bergin C, Moulin A, Crisanti P, Behar-Cohen F, Lumbroso B. En face optical coherence tomography of foveal microstructure in full-thickness macular hole: a model to study perifoveal Müller cells. Am J Ophthalmol 2015; 159:1142-1151.e3. [PMID: 25728860 DOI: 10.1016/j.ajo.2015.02.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/19/2015] [Accepted: 02/20/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE To characterize perifoveal intraretinal cavities observed around full-thickness macular holes (MH) using en face optical coherence tomography and to establish correlations with histology of human and primate maculae. DESIGN Retrospective nonconsecutive observational case series. METHODS Macular en face scans of 8 patients with MH were analyzed to quantify the areas of hyporeflective spaces, and were compared with macular flat mounts and sections from 1 normal human donor eye and 2 normal primate eyes (Macaca fascicularis). Immunohistochemistry was used to study the distribution of glutamine synthetase, expressed by Müller cells, and zonula occludens-1, a tight-junction protein. RESULTS The mean area of hyporeflective spaces was lower in the inner nuclear layer (INL) than in the complex formed by the outer plexiform (OPL) and the Henle fiber layers (HFL): 5.0 × 10(-3) mm(2) vs 15.9 × 10(-3) mm(2), respectively (P < .0001, Kruskal-Wallis test). In the OPL and HFL, cavities were elongated with a stellate pattern, whereas in the INL they were rounded and formed vertical cylinders. Immunohistochemistry confirmed that Müller cells followed a radial distribution around the fovea in the frontal plane and a "Z-shaped" course in the axial plane, running obliquely in the OPL and HFL and vertically in the inner layers. In addition, zonula occludens-1 co-localized with Müller cells within the complex of OPL and HFL, indicating junctions in between Müller cells and cone axons. CONCLUSION The dual profile of cavities around MHs correlates with Müller cell morphology and is consistent with the hypothesis of intra- or extracellular fluid accumulation along these cells.
Collapse
|
15
|
Savastano MC, Rispoli M, Di Antonio L, Mastropasqua L, Lumbroso B. Observed positive correlation between Epstein-Barr virus infection and focal choroidal excavation. Int Ophthalmol 2013; 34:927-32. [PMID: 24193503 DOI: 10.1007/s10792-013-9874-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 10/20/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate a possible correlation between focal choroidal excavation and Epstein-Barr virus (EBV) infection. METHOD Three eyes of three patients underwent a comprehensive ophthalmologic examination including visual field testing, color fundus photography, optical coherence tomography (OCT), fluorescein angiography and indocyanine green angiography. In addition, hematological and viral infectivity were also evaluated. PATIENTS Two females and one male with a mean age of 53.6 ± 5.6 years were studied. RESULTS In all patients, both the anterior and posterior segment evaluations were unremarkable except for the presence of a spot with focal retinal pigment epithelium (RPE) alteration. In patients 1 and 2, OCT disclosed a normal neuroretinal structure above the lesion and a focal 'punch-out' choroidal lesion with total absence of the RPE coupled with a localized hyporeflectivity in the subretinal space. In two of the three patients, OCT showed normal outer retinal layers, including the photoreceptor layer and the external limiting membrane with a hyporeflective space under the inner segment/outer segment (IS/OS) junction. In one patient, the retinal structure appeared to descend down into the choroidal excavation with an absence of the IS/OS junction and RPE. Moreover, the outer retinal layers appeared to be deformed. In all three patients, the choriocapillaris and choroid showed significant defects as if 'punched out' and the scleral boundary was more evident. In all three patients, an active EBV infection was confirmed by hematological investigation. CONCLUSIONS In all our patients with focal choroid anomalies, such as choroidal excavation observed by OCT, a systemic infection by the EBV was detected. A larger number of similar cases are necessary to corroborate these preliminary observations.
Collapse
Affiliation(s)
- Maria Cristina Savastano
- Department of Ophthalmology, Catholic University "Sacro Cuore - A. Gemelli", Largo A. Gemelli, 8, 00168, Rome, Italy,
| | | | | | | | | |
Collapse
|
16
|
Piermarocchi S, Sartore M, Bandello F, Lanzetta P, Brancato R, Garattini L, Lumbroso B, Rispoli M, Pece A, Isola V, Pulazzini A, Menchini U, Virgili G, Tedeschi M, Varano M. Quality of vision: A consensus building initiative for a new ophthalmologic concept. Eur J Ophthalmol 2007; 16:851-60. [PMID: 17191192 DOI: 10.1177/112067210601600611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/16/2022]
Abstract
PURPOSE Many studies have addressed the quantification of visual acuity, and the conventional method of measuring it has so far demonstrated serious limitations. Vision testing requires new methods that can more precisely express the quality of vision as perceived by the patient. METHODS This study employed the Delphi method of consensus building. Concepts associated with quality of vision (QoV) were identified by a board of experts and proposed to participating specialists in two subsequent questionnaires. Upon receipt of the completed questionnaires, the replies were classified to determine the building blocks of a consensus. RESULTS By analyzing the replies to the two questionnaires, the authors determined the key elements of QoV on which a consensus was found among the respondents. CONCLUSIONS A consensus was reached on the opinion that the quantification of visual acuity by traditional means is inadequate for investigating QoV. Although visual acuity is still a basic element for testing, the experts believe that contrast sensitivity, reading speed, and microperimetry are additional parameters necessary for quantifying QoV. The use of a psychometric questionnaire on visual function could allow a better interpretation of visual impairment.
Collapse
Affiliation(s)
- S Piermarocchi
- Department of Neurosciences, Section of Ophthalmology, University of Padova, Padova, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Lumbroso B, Sciuto V, Pascarella A, Lasram L. [Retinotomy with the Yag-laser in cases of retinal folds with vitreo-retinal traction in proliferative diabetic retinopathy]. Ophtalmologie 1988; 2:307-10. [PMID: 3247196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
18
|
Lumbroso B, Stirpe M. [Yag-laser treatment of 2 cases of retinal detachment with sub-retinal stringing. Cure without surgery]. Ophtalmologie 1987; 1:385-7. [PMID: 3153900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
19
|
Lumbroso B, Cantarella S, Pedone G, Costantini M. [Yag-laser surgery of glaucoma. Advantages and drawbacks]. Bull Soc Ophtalmol Fr 1984; 84:1353-5. [PMID: 6544656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
|
20
|
Irvine WJ, Di Mario U, Guy K, Iavicoli M, Pozzilli P, Lumbroso B, Andreani D. Immune complexes and diabetic microangiopathy. J Clin Lab Immunol 1978; 1:187-91. [PMID: 756468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Soluble immune complexes (AgAb) as detected and quantitated by the solid phase Clq assay (Clq-SP) were found to be increased in (a) long-duration diabetics with proliferative retinopathy and (b) short duration diabetics with early onset of retinopathy irrespective of whether they were treated with insulin or oral hypoglycaemic agents (OHA), in comparison to a normal population. No such increases were observed in diabetics of comparable duration without retinopathy. The trend for long-term diabetics to show an increased prevalence of AgAb according to the severity of retinopathy was statistically significant. Detection and quantitation of AgAb by the Raji cell assay (RAJI) gave comparable results although the differences were less pronounced and fell short of statistical significance. AgAb as detected by either method in insulin-treated diabetics could not be correlated with insulin antibodies. These findings suggest that AgAb, not necessarily comprised of insulin and anti-insulin antibodies, may contribute to the pathogenesis of diabetic microangiopathy.
Collapse
|
21
|
|
22
|
Lumbroso B, Melchionda C, Barcaroli I. [Variations in age of onset and the average age of patients operated on for cataract. Importance of economic, social, and geographic factors]. Ann Ocul (Paris) 1971; 204:1089-108. [PMID: 5127320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|